Biomedical subjects
D Whitehead
Publications and source records attributed to D Whitehead.
The relationship between health promotion and complementary therapies.
The underlying philosophies of health promotion and complementary therapies are very closely related and, consequently, share many similarities; yet such similarities that exist between these two disciplines are rarely expressed, acknowledged or explored. It would be almost impossible to practice complementary therapies without incorporating elements of health promotion within them, whether this is done so knowingly, or not, by the practitioner. This account sets out to establish the nature of such a relationship and highlights the common advantages and dilemmas in recognizing such a relationship. It seeks to determine the validity of closer collaboration (between the two disciplines) in order to provide a collective consensus for like-minded nurses to move towards a more holistic and empowering paradigm. It concludes by suggesting that, in order to move the shared aims of health promotion and complementary therapies forward, closer ties need to be established, between the disciplines, and built upon.
Agglomeration inhibition reflected stone-forming activity during long-term potassium citrate therapy in calcium stone formers.
OBJECTIVES: The agglomeration of preformed crystals of calcium oxalate has been hypothesized to be the rate-limiting step in renal stone-forming activity (SFA). The effect of urine on the in vitro inhibition of agglomeration of seed crystals of calcium oxalate monohydrate, designated [tm], has been used to monitor SFA in calcium oxalate stone formers (CaOxSF). The objective of the present study was to determine whether [tm] could be used to help monitor the long-term effectiveness of oral potassium citrate therapy (K-Cit-Rx) in CaOxSF. METHODS: Clinic and radiographic (or ultrasound) reports were evaluated for 80 patients, aged 20 to 72 years, 55 men and 25 women, who were treated with oral K-Cit for recurrent calcium oxalate urolithiasis at the Ochsner Stone Clinic between January 1992 and July 1996. Seventy-five of these patients had at least one 24-hour citrate excretion rate of less than 3.0 mm/day before or after K-Cit-Rx. SFA graded on a scale of -2 to +2 by radiographic criteria was combined with information on stone passage to evaluate clinical stone status, and 24-hour urine collections were evaluated for volume, pH, calcium, citrate, uric acid, oxalate, creatinine, and [tm] on free diet before and after 6 to 53 months of K-Cit-Rx. Historical information on procedures performed for urolithiasis before and on K-Cit-Rx was also reviewed. RESULTS: K-Cit-Rx resulted in increased urine pH (P <0.0001) and decreased calcium (P=0.0475), [tm] (P=0.0045), number of stones passed per year (P=0.0016), and remedial procedures per year (P <0.0001). Patients taking allopurinol in addition to K-Cit required higher doses (P <0.0001) of K-Cit to control their disease, had lower pretreatment urine pH (P=0.0493), and showed greater increase in urine citrate (P=0.0092) than those on K-Cit alone. Those taking high-dose K-Cit were younger (P=0.0363) and showed greater decrease in SFA (P=0.0005) than those taking lower doses. A small group of 10 medication refractory patients, who retained (n=9) or increased (n=1) their stone burden during K-Cit-Rx, was identified. Compared with the medication-responsive group, the refractory patients were older (P=0.0124), and had greatly increased SFA (P <0.0001) and higher (P=0.0347) urine pH before and during (P=0.0173) treatment (data not shown). CONCLUSIONS: The data confirm that [tm] can be used not only to verify previously documented stone formation rate but also to help evaluate the long-term effectiveness of therapy. In this report, changes in [tm] after K-Cit-Rx reflected decreased stone formation rate and decreased remedial procedures.
Differences between descriptive and multivariate estimates of the impact of Chevron Corporation's Health Quest Program on medical expenditures.
This investigation focused on alternative methods for evaluating the impact of Chevron Corporation's Health Quest Fitness Center program on medical expenditures, comparing descriptive and multivariate research designs. Many uncontrolled studies of corporate health management programs base estimates of program effectiveness on descriptive analyses such as Student's tests. Unlike more sophisticated multivariate analyses, descriptive analyses often produce biased estimates of program cost savings. To test alternative research design methods, the investigators compared inpatient and pharmacy expenditures for program participants and non-participants over a 2.5-year period, using descriptive and multivariate regression analyses. Results showed that compared with non-participants, expenditures for participants were significantly lower for subjects who used a Health Quest fitness center at least twice weekly. Previous descriptive studies suggested a much broader impact. The results underscore the need to use multivariate analyses when evaluating the financial impact of corporate health management programs, especially when randomization cannot be used to assign participation status.
cAMP response element-binding protein phosphorylation and DNA binding activity are increased in the anterior pituitary gland following glucocorticoid depletion.
Activation of the hypothalamo-pituitary-adrenal (HPA) axis during stress is associated with increased expression of genes that code for regulatory hormones such as corticotrophin-releasing factor (CRF) and ACTH. The identity of the transcription factors that mediate these changes in gene expression is not known. In the present study we have investigated the expression of the cAMP response-element binding protein (CREB) in mouse pituitary, and its regulation during a pharmacological paradigm that simulates activation of the CRF-ACTH axis. Using Western blots and DNA binding assays we have shown that both CREB protein (43 kDa) and CRE binding exhibit a readily-detectable basal level of activity in the pituitary. Following treatment with the 11 beta-hydroxylase inhibitor metyrapone, CRE binding activity was increased at 1 and 2 h but levels of CREB protein were not found to be consistently elevated. However, using a Ser133 phosphopeptide-specific antibody, that detects the functionally important phosphorylated form of CREB (P-CREB), we have shown that levels of pituitary P-CREB are markedly elevated following metyrapone. The same antibody was also used in DNA binding assays, and in the presence of this antiserum CRE binding activity in samples extracted from metyrapone-treated animals was reduced to levels similar to controls. Parallel experiments have confirmed previous studies showing increases in c-Fos expression and AP-1 DNA binding activity following metyrapone treatment but we have shown that c-Fos-associated binding activity does not appear to contribute to the increase in activity detected using the CRE binding probe. Our evidence of functionally relevant changes in pituitary CREB activity following glucocorticoid depletion must be viewed in the context of numerous other novel pituitary transcription factors that are implicated in HPA regulation, but our use of mice as an experimental model has facilitated the use of novel mouse mutants that can be used to dissect the role of individual factors.
Employers' and purchasers' roles in smoking cessation.
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Physiological responses to water stress and waterlogging in Nothofagus species.
Gas exchange and water relations were investigated in Nothofagus solandri var. cliffortioides (Hook. f.) Poole (mountain beech) and Nothofagus menziesii (Hook. f.) Oerst (silver beech) seedlings in response to water stress and waterlogging. At soil matric potentials (Psi(soil)) above -0.005 MPa, N. solandri had significantly higher photosynthetic rates (A), and stomatal and residual conductances (g(sw) and g(rc)), and lower predawn xylem water potentials (Psi(predawn)) than N. menziesii. The relative tolerance of plants to water stress was defined in terms of critical soil matric potential (Psi(cri)) and lethal xylem water potential (Psi(lethal)). The estimated values of Psi(cri) and Psi(lethal) were -1.2 and -7 MPa, respectively, for N. solandri, and -0.7 and -4 MPa, respectively, for N. menziesii. Photosynthesis was sustained to a xylem water potential (Psi(xylem)) of -7 MPa in N. solandri compared with -4 MPa in N. menziesii. Following rewatering, both A and Psi(xylem) recovered quickly in N. solandri, whereas the two variables recovered more slowly in N. menziesii. During the development of water stress, nonstomatal inhibition significantly affected A in both N. solandri and N. menziesii. Nothofagus menziesii was more susceptible to inhibition of A by waterlogging than N. solandri. However, the tolerance of N. solandri to severe waterlogging was also limited as a result of a failure to form adventitious roots, suggesting a lack of adaptation to these conditions. The differences in tolerance to water stress and waterlogging between the two species are consistent with the distribution patterns of N. solandri and N. menziesii in New Zealand.
Dynamic response of stomata to changing irradiance in loblolly pine (Pinus taeda L.).
Dynamic changes in stomatal conductance and the rate of photosynthesis were measured as periods of shading (decrease in irradiance from 800 to 200 micro mol m(-2) s(-1)) between 5 and 60 min were imposed on needles of Pinus taeda L. trees under laboratory conditions. Shading induced a 39% decrease in stomatal conductance but the rate of change was slow. Average time constants (+/- standard error) were shorter for the decrease in stomatal conductance when shading was imposed for 30 min (14.8 +/- 1.3 min) than for the increase in stomatal conductance when shading was removed (25.5 +/- 3.4 min). The time constants for increasing stomatal conductance when shading was removed were linearly related to the length of the previous dark period. The rate of photosynthesis fell immediately by 58% when shading was imposed and increased more rapidly than the change in stomatal conductance when shading was removed. The increase in photosynthesis during the induction phase after shading was removed was limited by both stomatal and biochemical effects. The long time constants for stomatal response contributed to the poor correlations between stomatal conductance and instantaneous measurements of irradiance from field data. However, the slow response of stomatal conductance to changes in irradiance had little effect on total daily transpiration, carbon gain and water-use efficiency.
Two notes on Greek suicide.
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Pyrolysis mass spectrometry as a method for the classification, identification and selection of actinomycetes.
Pilot experiments were designed to determine the potential of Curie-point pyrolysis mass spectrometry (PyMS) in the classification, identification and typing of industrially significant actinomycetes, and for the detection of target and novel actinomycetes needed for pharmacological screening programmes. The results indicate that the method is of value for the separation of actinomycetes at and below the species level, in the detection and circumscription of novel actinomycetes, and for the detection of identical and duplicated strains. There is also evidence that the pyrolysis system will permit the identification of target actinomycetes directly from selective isolation plates. PyMS is one of the methods that should be used to generate polyphasic taxonomies of actinomycete genera.
Amycolatopsis methanolica sp. nov., a facultatively methylotrophic actinomycete.
The generic position of a gram-positive, facultatively methylotrophic actinomycete known as Nocardia sp. strain 239 was determined by comparing reverse transcriptase sequences of 16S rRNA. The assignment of the organism to the genus Amycolatopsis was strongly supported by chemotaxonomic and morphological data. A comparison with the type strains of validly described Amycolatopsis species showed that the organism formed the nucleus of a new species. The name proposed for this new species is Amycolatopsis methanolica. The organism has been deposited in the National Collection of Industrial Bacteria as NCIB 11946.
A 1,25-dihydroxyvitamin D3 receptor-like protein in mammalian and avian liver nuclei.
The actions of 1,25-dihydroxyvitamin D3 [1,25-(OH)2D3] are thought to be mediated through receptor proteins which have been described in a variety of avian and mammalian tissues, but not in the liver. To determine if a binding protein for 1,25-(OH)2D3 is present in this tissue, rat liver was homogenized in a low ionic strength buffer containing 10 mM Tris (pH 7.4), 2.2 m sucrose, 3 mM calcium chloride, 0.2% Triton X-100, and 0.04% Trasylol (sucrose buffer) and centrifuged over a 10-ml cushion of sucrose buffer at 61,000 x g for 80 min at 4 C. The resultant nuclear pellet was extracted in a 26 mM Tris (pH 7.4) buffer containing 0.3 M potassium chloride, 5 mM dithiothreitol, 1 mM EDTA, and 10 mM sodium molybdate. Saturable 1,25-(OH)2D3 binding was identified in high salt extracts of rat liver nuclei and was eliminated by treatment with trypsin. This liver binding protein cosediments on high salt 5-20% sucrose density gradients with the 1,25-(OH)2D3 receptor protein from intestine and is distinct from the 6.OS tissue binding protein for 25-hydroxyvitamin D3. Perfusion of rat liver with PBS to remove receptor-positive blood cells before isolation of the nuclei did not change 1,25-(OH)2D3 binding. The nuclear protein bound 1,25-(OH)2D3 more avidly than either 24,25-(OH)2 D3 or 25-hydroxyvitamin D3. Saturation analysis of 1,25-(OH)2D3 binding revealed an apparent equilibrium dissociation constant of 20.6 +/- 2.2 pM (mean +/- SEM) at 4 C and a maximum binding capacity of 49.0 +/- 14.6 fmol/extract from 1.0 mg DNA. The 1,25-(OH)2D3-binding binding protein was present in liver nuclei isolated from mice, rabbits, and chicks and in nuclei isolated from cultured rat hepatocytes. The ligand specificity, sedimentation coefficient, limited binding capacity, trypsin sensitivity, and nuclear location of the hepatic 1,25-(OH)2D3-binding protein are similar to those of 1,25-(OH)2D3 receptors described in other tissues and suggest that the liver may be a target organ for [1,25-(OH)2D3] action.
Porcelain: technical ease esthetic superiority and longevity.
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Kissing balloon therapy for Leriche syndrome.
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Comparison of corrected-axis and straight lateral TMJ tomograms.
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The nature of health promotion in acute and community settings.
Since the late 1980s, there has been a consistent call from nursing's advisory and legislative bodies to incorporate the discipline of health promotion into the nursing profession. On reflection, however, evidence indicates that despite these calls there has not been a universal uptake of health promotional activity into the profession. What is evident is that where health promotional activity does take place, it occurs more in the community than in the acute setting. This article sets out to explore the reasons for this. It suggests that certain current and future activities may help to further promote the universal adoption of health promotion within nursing practice.
Is there a place for epidemiology in nursing?
BACKGROUND: Epidemiological research is seen by many to have immense value in helping to determine the health of populations and in helping to plan and determine health service policy. Despite this it seems to be poorly understood and greatly underused by the nursing profession. CONCLUSION: Epidemiological studies can potentially offer considerable benefits to the way nurses incorporate health-related practices into their professional role. Research also offers a valuable opportunity for the nursing profession to become more active in helping to determine health policy issues. This article explores the nature of the dilemmas surrounding nursing and epidemiology and argues that nursing might be better served by a more proactive role in this valuable research discipline.
Applying collaborative practice to health promotion.
BACKGROUND: Since the publication of the Health of the Nation document in 1992, collaborative practice has been at the forefront of health service reform. While other professional groups have readily adopted health promotion and collaboration, the nursing profession has experienced difficulties in changing practice and some have resisted reform. The author examines the issues surrounding nursing's apparent hesitancy in adopting collaborative working practices. CONCLUSION: To promote collaborative practice, nurses need to be aware of the range of teams and agencies involved in health promotion and acknowledge the client as an equal member of the team. However, better education, training and shared learning initiatives are essential to improve collaborative practice.