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Biomedical subjects

B Saunders

Publications and source records attributed to B Saunders.

At least 37 records · Page 2Linked to original sources
PubMed1999

Accurate PEG tube placement with magnetic positional imaging.

BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) is a common procedure and accounts for an increasing proportion of an endoscopist's workload. Serious complications can occur from inaccurate abdominal wall puncture. Electronic three-dimensional imaging has been used to aid colonoscopy. We adapted the principles of this technique to PEG insertion in a procedure called magnetic positional imaging. METHODS: Magnetic positional imaging was used to determine the abdominal wall puncture site and angle of insertion that would provide the shortest distance from abdominal wall to the stomach. The pull-through technique was used to perform PEG. RESULTS: PEG insertion with magnetic positional imaging was performed on four patients without complications. The average distance between the internal and external sensors was 5 mm. CONCLUSION: A new technique, magnetic positional imaging, facilitates the pull-through technique for PEG. Additional studies are needed to clarify the potential benefit in endoscopic practice.

Abdominal Muscles↗
PubMed1997

A trial of relapse prevention with severely dependent male problem drinkers.

Over the last two decades, relapse prevention has emerged as a major focus of the treatment of drug problems. Few studies have demonstrated any impact on generally high relapse rates. In this paper the outcome of a controlled trial of a relapse prevention programme with male problem drinkers (n = 60) attending an Alcohol Treatment Unit is reported. Subjects who met the inclusion criteria were allocated to a relapse prevention (n = 20) procedure or a discussion (n = 20) or no-additional treatment (n = 20) control procedure. Subjects were followed-up at 6 and 12 months by the first author. The relapse prevention programme was associated with significantly greater increases in pre- and post-treatment self-efficacy compared to the discussion control group and significantly greater probability of total abstinence than all controls over the first 6-month follow up. In addition, the relapse prevention programme was associated with significantly longer survival time to an initial lapse and relapse than the controls. At 12-month follow-up, treatment effects had been eroded. It was concluded that the relapse prevention programme was an effective treatment in the short term and that longer-term impact may require greater focus on maintenance factors, such as the individual's environment.

Adult↗
PubMed1996

Effect of different infusion regimens on colonic motility and efficacy of colostomy irrigation.

The colonic motility response and short-term clinical effectiveness of colonic irrigation was studied in five patients with an end-colostomy, each of whom was studied on up to six occasions, using volumes of 500 and 1500 ml water infused under gravity and over a period of 2.5 and 5 min with a pump. The median baseline colonic luminal pressure was 14 cmH2O and rose to 42 cmH2O with a 500-ml infusion, and to 74 cmH2O with a 1500-ml infusion. Irrigation induced high-pressure (over 200 cmH2O) propagated waves which caused the efflux of colonic contents. These were more numerous after a 1500- than a 500-ml infusion (median 4.5 versus 2.0 respectively). There was no difference between the two volumes infused in the incidence of colostomy break-through before subsequent irrigation. Colostomy irrigation with 500-1500 ml water appears to produce intracolonic pressure rises that are safe. These volumes can be infused rapidly under gravity alone.

Aged↗
PubMed1996

Influence of growth factors on proliferation and morphogenesis of rabbit ovarian mesothelial cells in vitro.

The ovarian mesothelium (OM) is the source of one of the most frequent and lethal types of common ovarian epithelial tumors, the so-called papillary serous carcinomas. Recent work from our laboratory indicates the existence of postovulatory luteal OM mitogens with variable affinity for heparin. To further investigate the paracrine regulation of this ovarian tissue, rabbit ovarian mesothelial cells (OMC) were cultured in serum-free, fibronectin-rich HL-1 medium with or without one of the following luteal growth factors (0.1, 1, and 10 ng/ml): basic (bFGF) and acidic (aFGF) fibroblastic growth factors, epidermal growth factor (EGF), transforming growth factors alpha (TGF alpha) and beta (TGF beta), tumor necrosis factor alpha, platelet-derived growth factor (PDGF-BB), and vascular endothelial growth factor. After 8 days of culture, OMC growth was stimulated 3-fold by all tested doses of bFGF, EGF, and TGF alpha and 2-2.5-fold by 10 ng/ml of PDGF-BB and aFGF; it was inhibited more than 60% by TGF beta (10 ng/ml). In addition to enhancing the formation of cohesive OMC monolayers, most factors enhanced 3- to 6-fold the aggregation of OMC into papillary processes. The finding of a growth and morphogenetic response to intraluteal growth factors is novel and suggests a role for postovulatory paracrine regulation of OM pathobiology.

Animals↗
PubMed1995

The impact of a brief motivational intervention with opiate users attending a methadone programme.

During the 1980s Motivational Interviewing emerged as one of the memes of the addictions field. This occurred despite the lack of scientific evidence supporting its utility. In this paper findings of a controlled trial of a brief motivational intervention with illicit drug users (n = 122) attending a methadone clinic are reported. Clients who met the study's inclusion criteria were randomly allocated to either a motivational (experimental, n = 57) or educational (control, n = 65) procedure. Over the 6-month follow-up period the motivational subjects demonstrated a greater, immediate, commitment to abstention, reported more positive expected outcomes for abstention, reported fewer opiate-related problems, were initially more contemplative of change, complied with the methadone programme longer and relapsed less quickly than the control group. There was, however, no difference in terms of the severity of reported opiate dependence and the control group fared better on reported self-efficacy. It was concluded that motivational interventions of the type investigated are useful adjuncts to methadone programmes.

Adolescent↗
PubMed1995

Perinatal outcomes in the pregnancies of asthmatic women: a prospective controlled analysis.

Prior studies have found an increased incidence of adverse perinatal outcomes of pregnancies in asthmatic mothers, but these studies have been poorly controlled for asthma therapy and other confounding factors. The purpose of this study was to assess perinatal outcomes in actively managed pregnant asthmatic women as compared with matched nonasthmatic controls. Using an inception cohort design, we studied a volunteer sample of 486 pregnant (< 28 wk) women with documented asthma and 486 pregnant nonasthmatic controls with normal pulmonary function. Cases and controls were matched for age, smoking status, parity, and year of delivery. Asthma was managed with step therapy to prevent acute asthmatic episodes and asthma symptoms that interfered with sleep or normal activity. Chronic hypertension was significantly more common (p = 0.007) in asthmatic subjects (3.7%) than in matched controls (1.0%). However, no significant differences in incidences of preeclampsia, perinatal mortality, preterm births, low-birth-weight infants, intrauterine growth retardation, or congenital malformations were observed in the pregnancies of the asthmatic women as compared with the matched controls. Trends were observed toward relationships between more severe asthma requiring emergency therapy or corticosteroids and increased incidences of preeclampsia and low-birth-weight infants, but these associations were not statistically significant. These data suggest that the overall perinatal prognosis for women with actively managed asthma during pregnancy is comparable to that for the nonasthmatic population.

Adult↗
PubMed1993

Electronic three-dimensional imaging of intestinal endoscopy.

Endoscopists, especially those investigating the colon, need to know where the tip of the instrument is and whether the tube is kinking. A three-dimensional real-time imaging system consisting of sensors, within or taped to the endoscope, to detect weak electric currents in a wire grid below the mattress yields the information needed and should greatly facilitate performance and teaching of endoscopy.

Colonoscopes↗
PubMed1993

Alcohol and young people: minimizing the harm.

In this paper the literature on patterns of use of alcohol by teenagers is reviewed. The model as proposed by Thorley is used to describe the specific nature of alcohol problems experienced by young people. A systemic approach to prevention is explored and recommendations are made about ways to minimise the harm associated with alcohol use by young people.

Journal Article↗
PubMed1993

Women with alcohol problems: do they relapse for reasons different to their male counterparts?

A sample of 44 women and 50 men attending an alcohol treatment facility were assessed on a range of demographic, social and psychological measures in order to determine whether women and men relapse for different reasons. Clients were monitored for a 3 month period after the initial intake interview whereupon follow-up interviews were conducted. The data were analysed by the use of survival analysis techniques. The results indicated that there were different predictors of relapse across the three levels of post treatment alcohol use investigated. Gender differences were present at two of these levels. The implications of these differences are discussed.

Adult↗
PubMed1993

Guarding the guardians: influencing the regulation of alcohol promotions in Australia.

Alcoholic beverage advertising in Australia is allowed provided it conforms with a Code of Conduct approved by the Media Council of Australia (a collective of media proprietors). This system, known as self-regulation, has come under increasing critical scrutiny. It is argued from a systemic perspective that research has been one factor that has led to this increased scrutiny of alcoholic beverage advertising. Important other factors include the advent of the Australian National Campaign against Drug Abuse (which crucially included alcohol on its agenda), some erosion of the alcoholic beverage producers political status, declining per capita consumption, and an increase in media reporting on alcohol and drug issues. By examination of five research reports recently released on alcohol advertising it is argued that, in order to influence policy makers in an area where there is substantial opposition to change, research must be deftly marketed, contain information of political relevance, such as opinion poll material, and be used as a lobbying tool. The role of researchers in this process is considered.

Adolescent↗
PubMed1993

Ophthalmic assessment of physically disabled children attending a rehabilitation centre.

A retrospective analysis was conducted of 397 children, ranging in age from 2 to 19 years, attending the Regency Park Centre for Young Disabled in Adelaide. The disorders represented included cerebral palsy, head injury, spina bifida, severe speech and/or language disorders, muscular dystrophy and a number of less common conditions. The incidence of significant ophthalmic abnormalities in this population was 51%, with the highest incidence being 69 and 62% among children with head injury and cerebral palsy, respectively. Children with severe speech and language disorders had an incidence of 24%. Overall, routine examinations revealed previously unsuspected significant eye abnormalities in 31% of the children. A complete ophthalmic examination should be part of the evaluation of all physically disabled children to ensure early identification and treatment of abnormalities, and to optimize rehabilitation.

Adolescent↗
PubMed1993

What prevents prevention? Lessons from the failure of a university alcohol and drug policy.

This paper describes an investigation of why an attempt at alcohol and drug problem prevention failed. Between 1986 and 1991 a comprehensive policy on alcohol and drug use was developed in a university in Western Australia. Using a key-informant approach, 26 'players' central to the decision to reject the policy were interviewed, and relevant university documents were examined. The failure of the initiative was found to be caused not only by bad policy formulation (for example, the perceived poor tone of the document, concerns about content and general presentation) but also to bad process. Lack of effective consultation, suspicions about the origins of the policy, distrust and dislike of the policy presenters and concerns about the aim of the policy were cited as major impediments. The central tenet of the policy, that in order to reduce alcohol problems everyone must reduce their drinking, was rejected by most of the decision makers. Perceptions that members of the policy working party were taking an anti-alcohol stance engendered criticisms that the policy reflected the work of 'wowsers' and 'health zealots'. The major lessons learned were that policy formulation, presentation and negotiation are skilled tasks. Preventers need a range of abilities with perhaps the foremost being the capacity to listen to criticism, consult genuinely and implement change slowly. The notion that preventers know what is good for other people needs to be avoided. Preventive policy, if it is to be implemented, has to be introduced by invitation not imposition.

Alcoholism↗
PubMed1992

Drug education: an appraisal of a popular preventive.

Drug education is a popular preventive. In this paper, school-based drug education programs as currently conceived and implemented are critically appraised. The evidence indicates that while such education influences knowledge and attitudes, it has little impact on behavior. It is contended that in most drug education programs the value and meaning of being a drug user is misunderstood and the benefits of drug use underestimated. It is argued that existing health promotion models have in the main failed to adopt a systemic approach to drug use and have focused too much attention on individual change at the expense of a broader social understanding of behavior. It is proposed that with regard to illicit drugs, future educational endeavors should take the form of training in "low(er) risk" drug use within a harm-reduction paradigm, and that with regard to alcohol, such strategies need to be augmented by social and legislative changes. It is concluded that if a harm-reduction and systemic approach is adopted, then education will lose some of its popularity, since such an endeavor will be a more challenging, politically difficult, and socially complex enterprise.

Adolescent↗
PubMed1991

Do our guardians need guarding? An examination of the Australian system of self-regulation of alcohol advertising.

In this study the Australian system of self-regulation of alcoholic beverage advertising was examined. Sixteen advertisements, eight print and eight television advertisements, were subjected to public scrutiny. Respondents rated advertisements using a self-completion questionnaire based directly on the Australian Alcoholic Beverage Advertising Code. Responses were collated and where a majority of respondents had endorsed items that constituted a breach of the cose, a complaint, ostensibly from a member of the general public, was made to the Advertising Standards Council. All sixteen advertisements were regarded by the public as containing aspects which breached the code. However, the Advertising Standards Council rejected all but one of the sixteen complaints, often directly contradicting the opinions of our respondents. The social policy implications of these results are considered. It is contended that the system of self-regulation of alcohol advertising does not serve the public interest.

Journal Article↗