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Biomedical subjects

B Hunter

Publications and source records attributed to B Hunter.

At least 19 recordsLinked to original sources
PubMed2001

Emotion work in midwifery: a review of current knowledge.

AIM OF THE PAPER: To review the literature relating to emotional labour in the workplace and identify potential sources of emotion within midwifery work. RATIONALE: There is substantial evidence to indicate that the quality of the relationship between midwife and woman is significant in determining the quality of the childbirth experience for women. Despite this, there is a notable lack of research regarding midwives' experiences of participating in this relationship, and even less regarding the emotional issues involved. METHOD: Literature review of relevant midwifery, nursing and sociological literature. Discussion of the theoretical perspectives provided by sociological and nursing research relating to the management of emotion at work and critical consideration of their application to an analysis of midwifery work. FINDINGS: Although these theoretical perspectives may offer significant insights of relevance to midwifery, there is much more that needs to be uncovered. Midwifery work has the potential for creating high levels of emotion work and current changes in the organization of United Kingdom (UK) maternity care may further increase this. CONCLUSION: It is essential that midwives develop their understanding of emotion at work in order to improve their own working lives, and to meet the needs of childbearing women and their families. More research is needed in this field to develop a body of knowledge to inform midwifery education and practice.

Adaptation, Psychological↗
PubMed2001

Repair of incisional hernias.

Incisional hernias develop in up to 11% of surgical abdominal wounds with a possible recurrence following repair of 44%. We describe our experience with a combined fascial and prosthetic mesh repair. Thirty-five patients (16M:19F) have been treated. The original operation was bowel related in 19 cases, gynaecological in 8, hepatopancreaticobiliary in 3 patients, aortic aneurysm repair in 2 and involved a thoraco-laparotomy in 3. The incisions were midline in 26 cases, transverse in 6, paramedian in 2 and rooftop in one patient. The hernias were considered subjectively to be large in 15, medium in 14 and small in 6 of the patients. A proforma was completed for each patient noting intra-operative and post-operative complications, post-operative hospital stay and analgesic requirements. Post-operative complications included seroma formation in 6 patients, deep vein thrombosis in one and a non-fatal pulmonary embolism in another. One patient developed a wound haematoma and one had a superficial wound infection. Post-operative in-hospital stay ranged from 1 to 27 days with a mean of 6.2 days. Of the 35 patients 33 were available for follow-up. Follow-up was for a median of 20.3 months (range 6.0 to 54.1 months). Two of these (6%) patients reported a persistent lump and one (3%) reported persistent pain but none of the remaining 33 was found to have a recurrence. We advocate this technique because it is applicable to all hernias, most of the mesh is behind the rectus sheath and has 2 points of fixation, it is relatively pain-free allowing early mobilisation, has a modest complication rate and a low recurrence rate.

Aged↗
PubMed2000

Paediatric dentistry.

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Abstracting and Indexing↗
PubMed2000

Interpretation of fine-needle aspirates processed by the ThinPrep technique: cytologic artifacts and diagnostic pitfalls.

The improvement in quality of cytologic preparations with the use of the ThinPrep methodology has been well-documented, but the cytologic artifacts resulting from this technique have not been adequately described. This study describes and illustrates the cytologic artifacts introduced by the ThinPrep technique when used on fine-needle aspirates (FNAs), and evaluates these artifacts as potential diagnostic pitfalls. We reviewed a total of 120 FNAs simultaneously processed by both conventional smears and ThinPrep. FNAs were obtained from the following sites: lymph node (27), breast (23), soft-tissue sites (20), salivary glands (13), gastrointestinal tract (10), lung (9), thyroid gland (13), liver (3), adrenal gland (1), and kidney (1). The ThinPrep smears were consistently devoid of obscuring elements, and the cells were adequately preserved and evenly dispersed. However, we noted some cytomorphologic alterations that should be recognized to avoid erroneous diagnoses. The size of cell clusters was decreased, large branching sheets were fragmented, and there were more single cells, resulting in apparent discohesion. Small cells such as lymphocytes tended to aggregate. All cells were generally smaller and occasionally spindled, the chromatin detail was attenuated, and nucleoli were more prominent. Intranuclear inclusions were difficult to visualize. Background matrix was often altered in both quantity and quality. Extracellular particles, small mononuclear cells, red blood cells, and myoepithelial cells were markedly decreased in number. The pathologist should be cautious in interpreting FNAs prepared using ThinPrep if that is the only methodology employed. Familiarity with artifacts is essential to avoid misinterpretations.

Adenocarcinoma↗
PubMed2000

Consumer demand in the purchase and prescription of sugar-free medicines.

OBJECTIVES: To determine the current level of consumer demand in the purchase and prescription of sugar-free paediatric medicines. DESIGN: Data were collected by administered questionnaire. SETTING: The study was conducted in a Hospital Paediatric Dentistry Unit and a Community Dental Clinic, both within the Bro Taf area of south-east Wales. SAMPLE AND METHODS: The parents of 240 children attending for routine dental care responded to one of two short questionnaires, depending on whether their child had received a liquid oral medicine in the preceding month. RESULTS: Although aware of the benefits of sugar-free medicines, parents did not appear to be attempting to exercise the power of consumer demand to its full potential. They were more likely to ask a pharmacist (or pharmacist's assistant) than their general medical practitioner for a sugar-free medicine. CONCLUSIONS: We must continue to promote sugar-free medicines. While increasing the importance that health professionals attach to such products, future campaigns should also aim to increase consumer demand.

Administration, Oral↗
PubMed2000

Bacteriological and histological profile of turkeys condemned for cyanosis.

Canadian Food Inspection Agency (CFIA) has adopted the term cyanosis to describe a category of condemnation for poultry that is dark but has no other condemnable lesions. Two case-control studies (n = 30 pairs; n = 65 pairs) of 18-wk-old tom turkeys were conducted. A case was defined as a carcass condemned by the veterinary inspector for cyanosis, and a control carcass was one that passed inspection. Microbiological tests were conducted on samples of Pectoralis major and Gastrocnemius lacteralis. A modified Rappaport Vassiliadis medium was used for Salmonella, and a Petrifilm method was used to assess aerobic counts, coliform counts, and Escherichia coli. The Salmonella (qualitative) test was negative for all cases and controls, and there were no significant differences between the aerobic counts, coliform counts, and E. coli counts of case and control carcasses. Two pathologists conducted a blind histopathological study: there were no lesions compatible with those of septicemia-toxemia, as defined by CFIA and the USDA, nor any significant histopathological differences between the skin, P. major, G. lateralis, kidney, liver, spleen, small intestine, pancreas, lung, and heart of cases and controls. The inter-rater agreement between pathologists ranged from good to excellent (Kappa = 0.7 to 1.0). In the absence of important lesions and microbial contamination, carcasses with this color change alone should be suitable for human consumption.

Animals↗
PubMed2000

Crystal structure of the catalytic domain of human bile salt activated lipase.

Bile-salt activated lipase (BAL) is a pancreatic enzyme that digests a variety of lipids in the small intestine. A distinct property of BAL is its dependency on bile salts in hydrolyzing substrates of long acyl chains or bulky alcoholic motifs. A crystal structure of the catalytic domain of human BAL (residues 1-538) with two surface mutations (N186D and A298D), which were introduced in attempting to facilitate crystallization, has been determined at 2.3 A resolution. The crystal form belongs to space group P2(1)2(1)2(1) with one monomer per asymmetric unit, and the protein shows an alpha/beta hydrolase fold. In the absence of bound bile salt molecules, the protein possesses a preformed catalytic triad and a functional oxyanion hole. Several surface loops around the active site are mobile, including two loops potentially involved in substrate binding (residues 115-125 and 270-285).

Amino Acid Sequence↗
PubMed1999

Crystal structure of streptokinase beta-domain.

Streptokinase, a 47 kDa secreted protein of hemolytic strains of streptococci, is a human plasminogen activator and contains three structural domains linked by flexible loops. We describe here the crystal structure of the isolated streptokinase middle (SKbeta) domain determined at 2.4 A resolution. Among the functionally important structural features is a putative binding site for a kringle domain of plasminogen located at the tip of a fully exposed hairpin loop. The distribution of genetically conserved residues of SKbeta is strongly correlated with their functions. The extensive interface of the SKbeta dimer suggests that such dimers may also exist in solution for free SKbeta.

Amino Acid Sequence↗
PubMed1999

Sucking cup caries.

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Child, Preschool↗
PubMed1999

A double-blind placebo-controlled trial of paroxetine in the management of social phobia (social anxiety disorder) in South Africa.

BACKGROUND: Social phobia, also known as social anxiety disorder, is a highly prevalent disorder with significant morbidity. Patients with social phobia frequently develop co-morbid psychiatric disorders such as depression and substance abuse, and the disorder impacts significantly on social and occupational functioning. It has been suggested that the selective serotonin reuptake inhibitors (SSRIs) are useful in the management of this disorder, but few controlled trials have been undertaken in this regard. There are also few data on the pharmacotherapy of social phobia in South Africa. METHODS: A double-blind randomised placebo-controlled multi-site flexible-dose trial of paroxetine was undertaken over 12 weeks among patients with a primary diagnosis of social phobia. Primary response measures were the Global Improvement item on the Clinical Global Impression scale (CGI) and mean change from baseline in the patient-rated Liebowitz Social Anxiety Scale (LSAS) total score. Ninety-three patients participated at 9 South African sites; their data are reported here. RESULTS: There was a significant drug effect on both the CGI Global Improvement score and the LSAS at 12 weeks. In addition, there was no significant difference in overall rate of adverse experiences between those on paroxetine and those on placebo. CONCLUSIONS: Paroxetine is both effective and safe in the acute treatment of social phobia. The findings here are consistent with those of previous controlled studies of the SSRIs as well as with previous work done in the USA on the use of paroxetine in the treatment of this disorder. Early diagnosis and treatment of social phobia should be encouraged. However, further research on long-term pharmacotherapy of social phobia is needed.

Adult↗
PubMed1998

Computer-controlled endoscopic performance assessment system.

We have devised an advanced computer-controlled system (ADEPT) for the objective evaluation of endoscopic task performance. The system's hardware consists of a dual gimbal mechanism that accepts a variety of 5.0-mm standard endoscopic instruments for manipulation in a precisely mapped and enclosed work space. The target object consists of a sprung base plate incorporating various tasks. It is covered by a sprung perforated transparent top plate that has to be moved and held in the correct position by the operator to gain access to the various tasks. Standard video endoscope equipment provides the visual interface between the operator and the target-instrument field. Different target modules can be used, and the level of task difficulty can be adjusted by varying the manipulation, elevation, and azimuth angles. The system's software is designed to (a) prompt the surgeon with the information necessary to perform the task, (b) collect and collate data on performance during execution of specified tasks, and (c) save the data for future analysis. The system was alpha and beta tested to ensure that all functions operated correctly.

Endoscopy↗
PubMed1998

Oral health advice: reported experience of mothers of children aged 5 years and under referred for extraction of teeth under general anaesthesia.

AIMS: To examine the reported receipt of oral health education among mothers of children who required the extraction of teeth under general anaesthesia. DESIGN: Cross-sectional study using questionnaires completed at interview. SAMPLE: 150 mothers of children aged 5 or younger who had been referred for extraction of teeth under general anaesthesia. SETTING: Dental School, University of Wales College of Medicine. RESULTS: 27% of mothers recalled receiving advice from their dentist about dental care during their pregnancy. With regard to their child's oral health, 48% had received dietary advice and 31% oral hygiene advice from the same source. All children lived in areas with suboptimal water fluoride levels; 27% of mothers had been advised by their dentist to give their child fluoride supplements. Few of the mothers recalled receiving advice about oral health from their health visitor.

Adult↗
PubMed1998

HIV vaccine acceptance among heterosexual clients of a sexually transmitted diseases clinic.

We evaluated the willingness of clients at a large urban sexually transmitted diseases (STD) clinic in the southeastern United States to participate in future trials of preventive vaccines for HIV type 1 (HIV-1). A single trained interviewer administered an oral survey instrument to STD clinic clients over a 4-week enrollment period. The participants were 167 randomly selected clients (90 men and 77 women), most of whom were young, African-American heterosexuals. Risk behaviors for HIV-1 infection were highly prevalent. Overall, 67% of clients expressed willingness to consider participation in an HIV-1 vaccine trial. By univariate analysis, prior HIV-1 testing was significantly associated with willingness to participate (P = 0.04). Multivariate analysis revealed that female gender (P = 0.05) and prior HIV-1 testing (P = 0.03) were significant predictors of willingness to participate.

AIDS Vaccines↗
PubMed1998

Correlation of body mass index with thoracic and abdominal panniculus.

Obesity can play a significant role in chronic diseases, sudden unexpected death, and morbid obesity may be important as a cause of death for forensic pathologists. Our study attempted to determine if there is a correlation between panniculus measurements and body mass index (BMI) since BMI has been used in most studies to categorize obesity. Using data obtained from a review of 524 adult autopsies conducted at the University of Michigan from 1990 to 1992 we were able to show a correlation between both thoracic and abdominal panniculus and BMI (r2 = 0.335 and 0.296 respectively) which is statistically significant (p = 10(-47) and 10(-41) respectively). A prospective study confirmed the correlation (r2 = 0.552 for thoracic and 0.436 for abdominal panniculus) when the measurements were taken at the xyphoid process and 3 cm below the umbilicus. Using these data we calculated a panniculus index (PI) which is equal to the thoracic + abdominal panniculus in centimeters divided by the square of the height (in meters). The PI strongly correlated with BMI and was able to predict obesity. Using a BMI cutoff of 39 for morbid obesity, a PI value of 4.07 for females and 3.25 for males predicted morbid obesity with the probability of a false positive less than or equal to 2.5%. Mild and severe obesity could also be determined using the PI. Based on these data we've concluded that a concise mathematical relationship does exist between BMI and panniculus measurements. Therefore panniculus measurements can be used either as a surrogate measurement of morbid obesity or to support BMI calculations.

Abdomen↗
PubMed1997

Development of a novel system for assessing tooth and restoration wear.

OBJECTIVES: This investigation sought to develop a mapping apparatus for use in the assessment of both tooth and restoration wear. METHODS: A computer controlled mapping device, capable of scanning a suitably prepared electroconductive tooth replica by means of an electrical feedback mechanism, was constructed and its accuracy assessed by measuring the thicknesses of four engineers' slip gauges 12 times each. The reproducibility of three potential methods of rendering a die stone replica electroconductive was also investigated. Finally, tooth replicas were surface profiled and compared empirically with the originals using a commercial surface mapping program. RESULTS: The overall mean accuracy of the mean thicknesses of the slip gauges was 4.4 (2.8) microns. Surface deposition of either nickel spray or gold leaf, upon a ready formed replica, did not give a reproducible thickness. Precoating silicone impressions with nickel spray prior to replica production overcame this problem. On an empirical basis the instrument yielded accurate digital terrain models of tooth replicas. CONCLUSIONS: A surface mapping device has been developed which is both accurate and reproducible. A satisfactory electroconductive surface may be produced upon a tooth replica by precoating a silicone impression with nickel spray before casting the replica. The technique should prove invaluable for monitoring both tooth and restoration wear but further work is necessary to examine how such an approach will perform clinically.

Dental Impression Materials↗