The patient always knows best! Conservative management of a large central disc prolapse.
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Adult↗
Biomedical subjects
A Casey
Publications and source records attributed to A Casey.
Retropharyngeal pseudomeningocele.
A 38-year-old male was found to have a retropharyngeal pseudomeningocele along with C1 - C2 dislocation. Absence of any possible history, misleading circumstantial evidence and rarity of the entity made it impossible to diagnose the condition preoperatively. Concurrent medical problems dominated and the patient died. As a result, outcome of the pseudomeningocele could not be evaluated.
Adult↗
Factors determining patient choice of device for GH therapy.
AIM: To assess the factors determining patient choice of GH device, and whether offering free patient choice improves compliance with GH therapy. METHODS: A prospective cross-sectional study performed on patients offered free choice of GH device in a regional growth clinic. In a subgroup having home delivery, GH compliance was assessed using ampoule counts. RESULTS: 125 patients (74 (59%) male), median (range) 9.30 (1.0-18.3) years were commenced on GH from January 2001 to March 2004, and offered free choice of device. 68 (54%) chose a needled device, and 57 (46%) needle-free. There was no statistical difference in age, sex or diagnostic category between the two groups. Light blue devices were more likely to be chosen by males (p=0.056). Questionnaires giving reasons for choosing a device were available in 40, and a further 50 gave reasons for both choosing a specific device and not choosing others. Other than choice of needled/needle-free device, the factor most likely to determine choice was 'ease of use'. Only 6 (4.8%) subsequently changed device, and compliance remained high but unchanged at approximately 90%. CONCLUSIONS: There are no specific features which determine what GH device a patient will choose. For those units offering free patient choice, a wide range of different devices should be made available.
Adolescent↗
Post-awakening cortisol secretion during basic military training.
Salivary free cortisol concentrations in the first 30 min after awakening were assessed in 12 healthy army recruits at the beginning, middle and end of an 11-week intensive physical training course. To ensure strict adherence to protocol saliva collection was supervised and collected on each sampling day immediately on waking and again 15 and 30 min later. Self-rated psychological assessments of state levels of stress, arousal and fatigue were performed in the evening of each sampling day. A within-subjects repeated-measures analysis of participants who completed the course (12 of the original 20) showed a significant main effect of cortisol concentration across all three sampling points after awakening (F((2,22))=54.516, p<0.0001) and a significant main effect of weeks into the training course (F((3,33))=4.390, p=0.010). Further analysis of this effect of measurement-week revealed that at weeks 3 and 6 total cortisol secretion estimated by area under the curve was lower (F((3,33))=4.602, p=0.008) compared to the beginning and end of the course. Surprisingly self-reported stress, arousal and fatigue did not differ significantly across weeks, despite the large dropout rate (40%) and self-evident pressures of the course. We conclude that when controlling for many confounding variables, including participant adherence, post-awakening cortisol levels are sensitive to stressful challenge over a period of weeks.
Adolescent↗
Interfacial friction of thin 3He slabs in the Knudsen limit.
A high precision torsional oscillator has been used to study 3He films of thickness from 100 to 350 nm, in the temperature range 5<T<200 mK. This thickness is much smaller than the viscous penetration depth, and also much smaller than the low temperature inelastic mean-free path of 3He quasiparticles. Such films are observed to decouple from the motion of the oscillator below 60 mK. We interpret the frequency shift and dissipation data in terms of an interfacial friction model.
Journal Article↗
Higher dietary carbohydrate content during intensified running training results in better maintenance of performance and mood state.
The aim of this study was to determine whether consumption of a diet containing 8.5 g carbohydrate (CHO) x kg(-1) x day(-1) (high CHO; HCHO) compared with 5.4 g CHO x kg(-1) x day(-1) (control; Con) during a period of intensified training (IT) would result in better maintenance of physical performance and mood state. In a randomized cross-over design, seven trained runners [maximal O(2) uptake (Vo(2 max)) 64.7 +/- 2.6 ml x kg(-1) x min(-1)] performed two 11-day trials consuming either the Con or the HCHO diet. The last week of both trials consisted of IT. Performance was measured with a preloaded 8-km all-out run on the treadmill and 16-km all-out runs outdoors. Substrate utilization was measured using indirect calorimetry and continuous [U-(13)C]glucose infusion during 30 min of running at 58 and 77% Vo(2 max). Time to complete 8 km was negatively affected by the IT: time significantly increased by 61 +/- 23 and 155 +/- 38 s in the HCHO and Con trials, respectively. The 16-km times were significantly increased (by 8.2 +/- 2.1%) during the Con trial only. The Daily Analysis of Life Demands of Athletes questionnaire showed significant deterioration in mood states in both trials, whereas deterioration in global mood scores, as assessed with the Profile of Mood States, was more pronounced in the Con trial. Scores for fatigue were significantly higher in the Con compared with the HCHO trial. CHO oxidation decreased significantly from 1.7 +/- 0.2 to 1.2 +/- 0.2 g/min over the course of the Con trial, which was completely accounted for by a decrease in muscle glycogen oxidation. These findings indicate that an increase in dietary CHO content from 5.4 to 8.5 g CHO x kg(-1)x day(-1) (41 vs. 65% total energy intake, respectively) allowed better maintenance of physical performance and mood state over the course of training, thereby reducing the symptoms of overreaching.
Adult↗
Cardiological assessment of first-degree relatives in sudden arrhythmic death syndrome.
4.1% of sudden cardiac deaths in the 16-64 age-group are unexplained. In this group, cardiac pathological findings are normal and toxicological tests are negative; termed sudden arrhythmic death syndrome (SADS). We searched for evidence of inherited cardiac disease in cases of SADS. Of 147 first-degree relatives of 32 people who died of SADS, 109 (74%) underwent cardiological assessment. Seven (22%) of the 32 families were diagnosed with inherited cardiac disease: four with long QT syndrome; one with non-structural cardiac electrophysiological disease; one with myotonic dystrophy; and one with hypertrophic cardiomyopathy. Families of people who die of SADS should be offered assessment in centres with experience of inherited cardiac disease.
Adolescent↗
Evidence for a Mott-Hubbard transition in a two-dimensional 3He fluid monolayer.
The heat capacity and magnetization of a fluid 3He monolayer adsorbed on graphite plated with a bilayer of HD have been measured in the temperature range 1-60 mK. Approaching the density at which the monolayer solidifies into a sqrt[7]xsqrt[7] commensurate solid, we observe an apparent divergence of the effective mass and magnetization corresponding to a T=0 Mott-Hubbard transition between a 2D Fermi liquid and a magnetically disordered solid. The observations are consistent with the Brinkman-Rice-Anderson-Vollhardt scenario for a metal-insulator transition. We observe a leading order T2 correction to the linear term in heat capacity.
Journal Article↗
An evaluation of the usefulness of two terminology models for integrating nursing diagnosis concepts into SNOMED Clinical Terms.
OBJECTIVES: We evaluated the usefulness of two models for integrating nursing diagnosis concepts into SNOMED Clinical Terms (CT). METHODS: First, we dissected nursing diagnosis term phrases from two source terminologies (North American Nursing Diagnosis Association Taxonomy 1 (NANDA) and Omaha System) into the semantic categories of the European Committee for Standardization (CEN) categorical structure and ISO reference terminology model (RTM). Second, we critically analyzed the similarities between the semantic links in the CEN and ISO models and the semantic links used to formally define diagnostic concepts in SNOMED CT. RESULTS: Our findings demonstrated that focus, bearer/subject of information, and judgment were present in 100% of the NANDA and Omaha term phrases. The Omaha term phrases contained no additional descriptors beyond those considered mandatory in the CEN and ISO models. The comparison among the semantic links showed that SNOMED CT currently contains all but one of the semantic links needed to model the two source terminologies for integration. In conclusion, our findings support the potential utility of the CEN and ISO models for integrating nursing diagnostic concepts into SNOMED CT.
Classification↗
Effect of eccentric exercise on patients with chronic exertional compartment syndrome.
There are a number of similarities between chronic exertional compartment syndrome (CECS) and the effects of high force eccentric contractions in healthy controls. We hypothesised that CECS patients would be particularly susceptible to pain, fatigue and swelling after eccentric exercise. Ten CECS patients [aged 30.3 (8.0) years, mean (SD)], 7 males) and 14 healthy controls [aged 32.3 (9.0) years, 7 males] performed 40 maximal eccentric contractions of the anterior tibial muscles at an angular velocity of 90(o) s(-1). Maximal voluntary isometric contractions (MVC), force generated by electrical stimulation at 10 Hz and 50 Hz and muscle thickness (measured by real-time ultrasound scanning) were measured before exercise and for 10 min afterwards. Ratings of pain and tenderness were made before exercise, then 24 h and 48 h later. The two groups were comparable for initial isometric strength and muscle size. MVC force immediately after exercise fell to 90 (2.5)% [mean (SEM)] in patients and 86.5 (2.4)% in controls (P<0.0005 for both groups) and had not recovered after 10 min. Preferential loss of force at the low stimulation frequency occurred in both groups to a similar extent (20%, P<0.0005) and continued to decline over 10 min of recovery. There was no significant change in muscle thickness in either group. Only mild pain and tenderness were reported by the controls. The patients showed great individual variation but their mean pain scores were significantly higher during dorsiflexion and palpation (P<0.05) 24 h after exercise. After 48 h the patients reported more pain during dorsiflexion (P=0.005), plantarflexion (P<0.05) and palpation (P<0.05). These results suggest that some, but not all, CECS patients may be more susceptible to the pain associated with eccentric contractions that is thought to be the cause of damage and inflammation of connective tissue.
Adult↗
Hyperactivity and impulsiveness in rats fed diets supplemented with either Aroclor 1248 or PCB-contaminated St. Lawrence river fish.
We examined whether exposure to polychlorinated biphenyls (PCBs) around puberty would produce hyperactivity and impulsiveness in adult Sprague-Dawley rats. Randomly assigned groups consumed food containing environmental concentrations of Aroclor 1248, PCB-contaminated St. Lawrence River carp, or corn oil (control). All received operant training to a final multiple (mult) 120-s, fixed interval (FI), 5-min extinction (EXT) schedule. Pressing rates of both exposed groups for drops of water averaged more than 1.5 times that of controls, especially toward the end of the 120-s interval. This overactivity included bursts with short (< or =0.5 s) interresponse times (IRTs), behavior characteristic of hyperactive boys and genetically hyperactive rats. The exposed groups also overreacted to the decreases in reinforcement density associated with transition to the final schedule. The results were interpreted in terms of the possible alterations in the animals' reinforcement mechanisms and the possible neurotoxic effects of PCB exposure.
Animals↗
Prematurity. Everyday griefs and joys.
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Cerebral Hemorrhage↗
Perspective transformation in RN-to-BSN distance education.
This study examines perspective transformation (or professional resocialization) in RN-to-BSN students obtaining their degree by distance education. A socialization scale was used to compare newly admitted and graduating RN-to-BSN students who had taken their courses onsite, by distance education, or a mixture of the two methods. The scores of entering and graduating RN-to-BSN students also were compared to those of graduates from the generic program to identify if program and experience are factors in scores achieved. Results indicate that all BSN graduates had significantly higher scores than the diploma-prepared nurses entering the RN-to-BSN program. RN-to-BSN graduates who had used distance education had the highest scores, followed by the onsite RN-to-BSN students. Students who had taken a mixture of distance and onsite courses had scores similar to those of generic program graduates. Experience and full-time employment status were significantly associated with higher scores among graduating RN-to-BSN students. Implications for nurse educators working with RN-to-BSN students who use distance education are discussed.
Adult↗
Generic education?
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Education, Nursing, Baccalaureate↗
Role development in children's nursing: dimensions, terminology and practice framework.
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Child, Preschool↗
An evaluation of the utility of the CEN categorical structure for nursing diagnoses as a terminology model for integrating nursing diagnosis concepts into SNOMED.
We evaluated the utility of the CEN Categorical Structure for Nursing Diagnoses as a terminology model for integrating nursing diagnosis concepts into SNOMED. First, we dissected nursing diagnosis term phrases from two source terminologies (North American Nursing Diagnosis Association (NANDA) Taxonomy 1 and Omaha System) into the semantic categories of the CEN categorical structure. Second, we critically analyzed the similarities between the semantic links in the CEN model and the semantic links used to formally define diagnostic concepts in SNOMED RT and SNOMED CT. Our findings demonstrated that focus, bearer, and judgment were present in 100% of the NANDA and Omaha term phrases. The Omaha term phrases contained no additional descriptors beyond those considered mandatory in the CEN model. In contrast, at least 3% of NANDA diagnoses included a term in each semantic category of the categorical structure. The comparison among the semantic links showed that neither SNOMED RT and SNOMED CT currently contain all the semantic links needed to model the two source terminologies for integration. In conclusion, our findings support the potential utility of the CEN categorical structure as a terminology model for dissecting nursing diagnostic concepts for integration into SNOMED RT and SNOMED CT. However, in order to accomplish this task, appropriate semantic links must be added to SNOMED RT and SNOMED CT.
Nursing Diagnosis↗