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Biomedical subjects

H Gibb

Publications and source records attributed to H Gibb.

13 recordsLinked to original sources
PubMed2000

Chronic arsenic exposure and risk of infant mortality in two areas of Chile.

Chronic arsenic exposure has been associated with a range of neurologic, vascular, dermatologic, and carcinogenic effects. However, limited research has been directed at the association of arsenic exposure and human reproductive health outcomes. The principal aim of this study was to investigate the trends in infant mortality between two geographic locations in Chile: Antofagasta, which has a well-documented history of arsenic exposure from naturally contaminated water, and Valparaíso, a comparable low-exposure city. The arsenic concentration in Antofagasta's public drinking water supply rose substantially in 1958 with the introduction of a new water source, and remained elevated until 1970. We used a retrospective study design to examine time and location patterns in infant mortality between 1950 and 1996, using univariate statistics, graphical techniques, and Poisson regression analysis. Results of the study document the general declines in late fetal and infant mortality over the study period in both locations. The data also indicate an elevation of the late fetal, neonatal, and postneonatal mortality rates for Antofagasta, relative to Valparaíso, for specific time periods, which generally coincide with the period of highest arsenic concentration in the drinking water of Antofagasta. Poisson regression analysis yielded an elevated and significant association between arsenic exposure and late fetal mortality [rate ratio (RR) = 1.7; 95% confidence interval (CI), 1.5-1.9], neonatal mortality (RR = 1.53; CI, 1.4-1.7), and postneonatal mortality (RR = 1.26; CI, 1.2-1.3) after adjustment for location and calendar time. The findings from this investigation may support a role for arsenic exposure in increasing the risk of late fetal and infant mortality.

Arsenic↗
PubMed1998

Reform in public health: where does it take nursing?

The Australian healthcare system is undergoing changes that are impacting tangibly on professional nursing practice. While the evidence is clear that the changes pose a challenge to maintaining standards amidst resource cuts and restructuring, the processes through which these changes occur and the decisions which drive the reforms remain complex and largely obscure. This paper intends to stimulate further thinking and debate among nurses about the effects of these reforms on the conduct of practice, both in terms of our emerging discipline and our ability to conduct clinical nursing practice. It offers a way of understanding the policy 'reform' process through an application of policy analysis grounded in critical social theory. The discussion sets out to apply these analytical propositions to specific events that constitute examples of change in the nursing workplace, and to focus on the implications for nurses and health service clientele.

Australia↗
PubMed1997

A therapeutic programme for people with dementia.

A programme involving Tai Chi and structured reminiscence was trialed with nine people suffering from moderately advanced dementia. The analysis reported here aimed to examine stories the people told with a view to understanding the purpose of story telling in their lives. Themes derived from the narrative data had a strong evaluative quality, ranging from simple evocative expressions to more cognitive complex insights or treasures. The study indicated a major aim in story telling as being able to generate life values, both for the enrichment of identification of self, and to pass on or leave for today's youth. Findings here further substantiate Luke and Freiden's view that old age has its own cognitive and spiritual goals to achieve. There is strong evidence that people with moderate dementia still aim to participate in that endeavour.

Aged↗
PubMed1996

Is ingested inorganic arsenic a "threshold" carcinogen?

Ingested inorganic arsenic (As) is known to be a human carcinogen. An intriguing question is whether there is a threshold for the carcinogenic effects of As, i.e., is there a level below which it does not induce the development of cancer(s)? This Roundtable will discuss the United States Environmental Protection Agency's As risk assessment using the Taiwan data from different viewpoints. It will also consider the hypothesis that there is a threshold for As and data for or against this hypothesis. For example, some scientists believe that epidemiological data cannot answer this question, while others feel that different study designs and larger sampling will provide adequate data. Reasons for each position are given. This Roundtable discussion demonstrates the controversy surrounding the use of the Taiwan data for risk assessment.

Arsenic Poisoning↗
PubMed1996

The issue of critical paths in Australia: where are they taking us?

This discussion paper sets out some major concerns with the introduction of critical paths into the Australian health care system. It is argued that in their current form as devised in North America, critical paths may not be appropriate to our organisation of health care and may in fact be detrimental to the development of nursing practice. The discussion centres around the socio-political context of the development of managed care in North America, as well as research findings from the implementation of critical paths in an Australian hospital.

Australia↗
PubMed1995

Guidelines for application of meta-analysis in environmental epidemiology. ISLI Risk Science Institute.

The use of meta-analysis in environmental epidemiology can enhance the value of epidemiologic data in debates about environmental health risks. Meta-analysis may be particularly useful to formally examine sources of heterogeneity, to clarify the relationship between environmental exposures and health effects, and to generate information beyond that provided by individual studies or a narrative review. However, meta-analysis may not be useful when the relationship between exposure and disease is obvious, when there are only a few studies of the key health outcomes, or when there is substantial confounding or other biases which cannot be adjusted for in the analysis. Recent increases in the use of meta-analysis in environmental epidemiology have highlighted the need for guidelines for the application of the technique. Guidelines, in the form of desirable and undesirable attributes, are presented in this paper for various components of a meta-analysis including study identification and selection; data extraction and analysis; and interpretation, presentation, and communication of results. Also discussed are the appropriateness of the use of meta-analysis in environmental health studies and when meta-analysis should or should not be used.

Environmental Exposure↗
PubMed1995

Nine steps to better nursing management of incontinence.

This paper describes the development of a new framework for nursing assessment and management of incontinence using action research (Gibb, O'Brien, Bradford and Curtis 1993). The authors worked with nurses and residents in a large extended care setting--clarifying their current understandings of continence issues and looking at ways of improving incontinence management. This process led to the development of a model for assessment and management of incontinence.

Clinical Nursing Research↗
PubMed1994

How to choose: nurses' judgements of the effectiveness of a range of currently marketed continence aids.

Continence is a costly health problem, both in terms of financial burden in continence aids, but also in terms of quality-of-life issues for the person who has continence problems. Manufacturers are often perturbed as to why products specially designed to help continence problems are not popular, or do not appear to be applied as intended. This paper reports on a study involving a quantitative evaluation of a range of continence aids presently being marketed, as applied in a large elderly care centre. The evaluation used nursing judgements on a series of comfort and effectiveness criteria: amount of leakage around the pad, comfort to the client when the pad was either wet or dry, skin integrity and snugness of fit, as well as whether the pad concealed well beneath clothing. Five body pads were evaluated--two disposable and three washable--and three bed under-sheets. Effectiveness of pads was found to vary substantially according to sex of client and voiding type, that is whether the client had heavy or moderate incontinent episodes.

Aged↗
PubMed1991

Models for analyzing data in initiation-promotion studies.

The objective of this paper is to construct a class of models for analyzing data in initiation-promotion (IP) studies. After the application of an initiator in animals IP studies, histochemical and/or histopathologic criteria are used to define the foci that are postulated to be the origin of tumors. Thus, the dynamics of foci growth are of inherent interest in the study of the mechanism of carcinogenesis. In this paper, models to explain these dynamics are developed and can be used to differentiate among proposed mechanisms of tumor formation and promotion. Examples are given to illustrate useful concepts for analyzing data from IP studies.

Animals↗
PubMed1990

Jokes and reassurance are not enough: ways in which nurses relate through conversation with elderly clients.

An ethnographic study was conducted into the style of conversation registered nurses used with elderly residents during activities of morning care. Speech was analysed into basic components of speech act categories (e.g. explanation, instruction, reassurance). Patterns of speech style were seen to vary in relation to the physical procedure being carried out, and to function as an adjunct to the smooth execution of this physical activity. However, they were also seen to have an important psychological function reflecting a particular way of relating. Some morning-care activities--the journey--were associated with a more personally engaging social interaction which appeared to be mutually beneficial to nurse and resident. Other approaches to morning care--the dissection--appeared to constrain the way the nurse interacted, producing a more formal style of relating. Findings were discussed in terms of optimal use of physical activities of nursing care to achieve greatest benefit in relation to the psychological needs of the resident, as addressed through verbal interaction.

Aged↗
PubMed1989

Evaluation of issues relating to the carcinogen risk assessment of chromium.

Important issues in the carcinogenic risk assessment of chromium compounds are whether both trivalent and hexavalent chromium compounds are carcinogenic, the role of solubility in the carcinogenic response, and the carcinogenicity of ingested chromium. Hexavalent chromium compounds are carcinogenic to animals via several routes of exposure, while trivalent chromium compounds, although they demonstrate evidence of genotoxicity, have not been shown in animal studies to be carcinogenic. Workers in chromate production plants, where the risk of lung cancer is elevated, are exposed to both trivalent and hexavalent chromium compounds. A cancer unit risk estimate for Wistar rats exposed to a hexavalent chromium aerosol (sodium dichromate) is less than the risk estimate for workers in chromate production. If this difference is biologically real, a possible explanation may be that trivalent compounds also have a carcinogenic effect. For hexavalent chromium compounds, it is contended that only sparingly soluble hexavalent chromium compounds are carcinogenic. Recent evidence, however, indicates that highly soluble hexavalent chromium compounds are also carcinogenic. Animal ingestion studies have not found trivalent chromium compounds to be carcinogenic by ingestion; hexavalent compounds have not been studied. Research by EPA to address the issue of valence state and solubility with respect to carcinogenicity is currently being conducted.

Animals↗