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Biomedical subjects

B Daniel

Publications and source records attributed to B Daniel.

At least 19 recordsLinked to original sources
PubMed2006

Operationalizing the concept of resilience in child neglect: case study research.

BACKGROUND: There is a considerable amount of interest in resilience as a concept for child care and protection practice. This paper describes an exploratory project that drew on a set of case studies to explore the extent to which the concept of resilience can be operationalized for use with neglected children in the context of statutory social work. METHOD: The study was carried out within a local authority in Scotland and focused on the value of the concept as an aid to assessment and planning. The study built on a published workbook that provides a structure for the assessment of potential areas of resilience and gives detailed suggestions for intervention in six domains of a child's life. Eight neglected children aged between five and 11 were recruited. Six training days on the concept were held. Questionnaires were used to gather information about the theoretical frameworks already being used. At the end of the study, semi-structured interviews were carried out with the social workers about the value of the concept. Assessment reports completed before and after the training were analysed. RESULTS: Findings indicated that participants were familiar with the concept of resilience and that the training helped enhance their understanding of the concept. Training assisted with the provision of a more structured approach to assessment and planning. Respondents reported that the approach enhanced their knowledge of the child and they were able to identify areas for development in the six domains. CONCLUSION: The study indicated that the concept of resilience can be operationalized for use with neglected children. Further, the case studies raised the issue of the extent to which the need for a secure base underpins other domains. The domain of positive values was also highlighted as an important area for further exploration.

Adaptation, Psychological↗
PubMed2004

Mapping of the prostate in endorectal coil-based MRI/MRSI and CT: a deformable registration and validation study.

The endorectal coil is being increasingly used in magnetic resonance imaging (MRI) and MR spectroscopic imaging (MRSI) to obtain anatomic and metabolic images of the prostate with high signal-to-noise ratio (SNR). In practice, however, the use of endorectal probe inevitably distorts the prostate and other soft tissue organs, making the analysis and the use of the acquired image data in treatment planning difficult. The purpose of this work is to develop a deformable image registration algorithm to map the MRI/MRSI information obtained using an endorectal probe onto CT images and to verify the accuracy of the registration by phantom and patient studies. A mapping procedure involved using a thin plate spline (TPS) transformation was implemented to establish voxel-to-voxel correspondence between a reference image and a floating image with deformation. An elastic phantom with a number of implanted fiducial markers was designed for the validation of the quality of the registration. Radiographic images of the phantom were obtained before and after a series of intentionally introduced distortions. After mapping the distorted phantom to the original one, the displacements of the implanted markers were measured with respect to their ideal positions and the mean error was calculated. In patient studies, CT images of three prostate patients were acquired, followed by 3 Tesla (3 T) MR images with a rigid endorectal coil. Registration quality was estimated by the centroid position displacement and image coincidence index (CI). Phantom and patient studies show that TPS-based registration has achieved significantly higher accuracy than the previously reported method based on a rigid-body transformation and scaling. The technique should be useful to map the MR spectroscopic dataset acquired with ER probe onto the treatment planning CT dataset to guide radiotherapy planning.

Algorithms↗
PubMed2000

Alveolar epithelial barrier. Role in lung fluid balance in clinical lung injury.

Several studies have established that transport of sodium from the air spaces to the lung interstitium is a primary mechanism driving alveolar fluid clearance, although further work is needed to determine the role of chloride in vectorial fluid transport across the alveolar epithelium. Although there are significant differences among species in the basal rates of sodium and fluid transport, the basic mechanism seems to depend on sodium uptake by channels on the apical membrane of alveolar type II cells, followed by extrusion of sodium on the basolateral surface by Na,K-ATPase. This process can be upregulated by several catecholamine-dependent and independent mechanisms. The identification of water channels expressed in lung, together with the high water permeabilities, suggest a potential role for channel-mediated water movement between the air space and capillary compartments, although definitive evidence will depend on the results of transgenic mouse knock-out studies. The application of this new knowledge regarding salt and water transport in alveolar epithelium in relation to pathologic conditions has been successful in clinically relevant experimental studies, as well as in a few clinical studies. The studies of exogenous and endogenous catecholamine regulation of alveolar fluid clearance are a good example of how new insights into the basic mechanisms of alveolar sodium and fluid transport can be translated to clinically relevant experimental studies. Exogenous catecholamines can increase the rate of alveolar fluid clearance in several species, including the human lung, and it is also apparent that release of endogenous catecholamines can upregulate alveolar fluid clearance in animals with septic or hypovolemic shock. It is possible that therapy with beta-adrenergic agonists might be useful to accelerate the resolution of alveolar edema in some patients. In some patients, the extent of injury to the alveolar epithelial barrier may be too severe for beta-adrenergic agonists to enhance the resolution of alveolar edema, although some experimental studies indicate that alveolar fluid clearance can be augmented in the presence of moderately severe lung injury. A longer-term upregulation of alveolar epithelial fluid transport might be achieved by strategies that accelerate the proliferation of alveolar type II cells repopulating the injured epithelium in clinical lung injury. More clinical research is needed to evaluate the strategies that can upregulate alveolar epithelial fluid transport with both short-term therapy (i.e., beta-agonists) and more sustained, longer-term effects of epithelial mitogens such as keratinocyte growth factor. These approaches may be useful in reducing mortality in the acute respiratory distress syndrome.

Animals↗
PubMed2000

The rhetoric vs. the reality in child care and protection: ideology and practice in working with fathers.

Within child care and protection, practitioners can be paralysed by a fundamental gap between the rhetoric and the reality in engaging fathers in their children's care. In an earlier paper we argued that there is a lack of an effective framework to guide practice with fathers in child care and protection work. We examined how health visitors and social workers could begin to assess how fathers could be categorized as either (or both) a risk or an asset to the child. Based on a review of the literature we now explore the limitations of current models of practice and trace the theoretical strands that influence them, drawing from the legal framework, attachment theory and models for anti-oppressive practice. We then highlight messages for practice with fathers for health care professionals involved in child protection. The working context for this paper is Scotland, although we believe that the ideas may be extrapolated to other geographical areas.

Adult↗
PubMed1999

1999 Gary J. Becker Young Investigator Award. MR-guided transjugular portosystemic shunt placement in a swine model.

PURPOSE: To evaluate the performance of portal venous puncture with use of magnetic resonance (MR) guidance, and to place a transjugular intrahepatic portosystemic shunt (TIPS) in a swine model. MATERIALS AND METHODS: A study of 12 swine was performed to evaluate the ability of interventional MR imaging to guide portal vein puncture and TIPS placement. Six swine had catheters placed in the right hepatic vein under C-arm fluoroscopy. A nitinol guide wire was left in the vein and the animals were then moved into an open configuration MR imaging unit. A TIPS needle set was used to puncture the portal vein using MR fluoroscopy. The animals were transferred to the C-arm, and venography confirmed portal vein puncture. A follow-up study was performed in six additional swine to place a TIPS using only MR imaging guidance. MR tracking was used to advance a catheter from the right atrium into the inferior vena cava. Puncture of the portal vein was performed and a nitinol stent was placed, bridging the hepatic parenchyma. MR venogram confirmed placement. RESULTS: Successful portal vein puncture was achieved in all animals. The number of punctures required decreased from 12 in the first animal to a single puncture in the last eight swine. A stent was successfully placed across the hepatic tract in all six swine. CONCLUSIONS: Real-time MR imaging proved to be a feasible method to guide portal vein puncture and TIPS placement in pigs.

Animals↗
PubMed1997

The link between integration and expression of human papillomavirus type 16 genomes and cellular changes in the evolution of cervical intraepithelial neoplastic lesions.

We have matched a PCR assay which detects disruptions in the E2 reading frame of human papillomavirus type 16, with RNA in situ hybridization patterns and shown that in 15 out of 16 cervical intraepithelial neoplastic (CIN) III lesions and in 19 out of 19 tumours, the E2 gene is disrupted with no detectable E2 transcripts. Varying levels of E6-E7 transcripts are detected in CIN III lesions, with stronger signals in tumours. The cytokeratin profile of most tumours: cytokeratin 10-, 14- and 19-positive and 4-, 13- and 18-negative, is also detected in CIN III lesions. The changes in levels of alpha 2, beta 1 and beta 4 integrins, CD44 and E-cadherin occur during the evolution of high-grade CIN lesions. Increases in the levels of expression of CD44 and E6-E7 transcripts, coupled with changes in the cellular localization of the Notch protein, define the transition from CIN III lesions to tumours.

Cadherins↗
PubMed1996

Immunity and morbidity in schistosomiasis japonicum infection.

Schistosomiasis japonica differs significantly from Schistosoma mansoni infection in several epidemiologic, immunologic, and operational characteristics for control. Because of numerous nonhuman hosts, transmission remains high despite aggressive case finding and treatment of human cases. Diagnosis of infection using the Kato-Katz stool technique is less sensitive and specific in this than in other species of human schistosomes, making case finding and treatment a less effective approach to control. Clinically, morbidity induced by S. japonicum appears unrelated to intensity of infection, and is more severe than that of S. mansoni in terms of liver pathology and stunting of child growth and development. Both hepatic enlargement and fibrosis appear to be reversible and preventable with aggressive treatment but several operational characteristics for control of infection due to S. japonicum make the community impact of case-finding and treatment with praziquantel less pronounced than would have been predicted by the analysis of individual cases. In the Philippines, rebound morbidity following reinfection mandates short treatment intervals between screening and treatment to have a significant impact on morbidity, while in China inapparent infection (infection not diagnosed by a single stool examination) appears to be a common cause for persistent hepatic pathology. The authors conclude that for S. japonicum, mass treatment or targeted mass treatment is a more cost-effective approach than case-finding and treatment for control.

Animals↗
PubMed1995

Changes in the physical state and expression of human papillomavirus type 16 in the progression of cervical intraepithelial neoplasia lesions analysed by PCR.

Using a PCR strategy which detects disruptions in the E2 reading frame we have analysed the progression of human papillomavirus type 16 (HPV-16)-positive cervical lesions. From a total of 192 samples analysed, we detected HPV-16 in 74. In samples from the spectrum of inflammatory states and cervical intraepithelial neoplasia (CIN) grade I lesions we detected episomal forms of the virus. In invasive tumours and in samples from CIN III lesions there were no episomes detected, suggesting that lesions with integrated HPV-16 precede the invasive stage. The RT-PCR analysis demonstrated the presence of E6 transcripts at all stages and E2 transcripts in all early lesions. The E2 transcripts were not detected in 26 out of 29 CIN III lesions and tumours in which there was a disruption in the E2 gene. In tumours with E2 gene disruptions, we used single-primer PCR to demonstrate the presence of E2 gene sequences.

DNA Primers↗
PubMed1991

Relative importance of dose, body surface area, sex, and age for 5-fluorouracil clearance.

The pharmacokinetics of 5-fluorouracil (FU) has been investigated in 26 cancer patients; 15 of these patients were pretreated with methotrexate (MTX). FU was given by a constant rate intravenous infusion within 10 min, at doses of 320-960 mg/m2. Total plasma clearance, beta-half-life, and steady-state distribution volume were determined with 43 treatments, based on plasma level measurements up to 90 min after the end of the infusion. Average clearance decreased from 1.3 l/min for 320 to 0.7 l/min for 960 mg FU/m2. Multiple linear regression calculations with dose, body surface area, sex, age, and MTX pretreatment as independent variable and clearance as dependent variable confirmed the dependency of clearance on dose and body surface area but also showed that, with equal FU dose per m2, clearance was higher in males than in females, on the average, by 0.22 l/min. There was also suggestive (although not significant) evidence of a (reducing) influence of age on FU clearance.

Adult↗
PubMed1986

Nosocomial Klebsiella pneumoniae colonization in a neonatal special care unit.

A clinical study is reported of nosocomial Klebsiella pneumoniae colonization and infection in a neonatal special care unit in Barbados. Of the 14 infants who were affected nine were symptomatic and two died (15%) during a 9-day period. This outbreak appeared to have been an indirect result of an acute shortage of nursing personnel coupled with a breakdown in adequate handwashing techniques. We feel that periodic review and continuous reinforcement of infection control policies in areas with patients at high risk of nosocomial infection, such as the neonatal unit, are of paramount importance.

Barbados↗