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Biomedical subjects

K Burke

Publications and source records attributed to K Burke.

At least 19 recordsLinked to original sources
PubMed2000

Nurses' perceptions of the reliability of an automated medication dispensing system.

Automated medication dispensing systems (AMDS) technology is increasingly being implemented in health care facilities to reduce the risk of medication errors. However, the case study evidence of their effectiveness has so far been mixed. It has been suggested that the attitudes of nursing staff toward AMDS can be an important factor in influencing whether or not the technology will be successfully implemented. Nurses' attitudes toward AMDS were examined at Riverview Health Centre, a long-term care facility where the Meditrol automated dispensing system had been installed the previous year. It was found that nurses were generally distrustful of AMDS and skeptical that it had reduced medication errors. A number of technological, organizational, and social factors has been put forward to explain this distrust. In addition, the efforts of hospital administrators to raise nurses' confidence in the system's reliability were also delineated.

Adult↗
PubMed1998

External beam radiation therapy for choroidal neovascularization.

OBJECTIVE: This study aimed to determine the effect of external beam radiation therapy on choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD). DESIGN: The study design was a nonrandomized clinical trial with an historic control group. PARTICIPANTS: A total of 91 patients were treated with external beam radiation. These patients were compared retrospectively to the 119 patients in a control group. INTERVENTION: Patients with subfoveal CNV who did not meet the criteria for laser treatment defined by published reports from the Macular Photocoagulation Study Group or who did not want laser treatment were considered for radiation therapy in a nonrandomized, prospective clinical trial. Additional entry criteria for this prospective study included visual acuity better than or equal to 20/320 on the Early Treatment Diabetic Retinopathy Study chart and a lesion size less than 12 disc areas. The patients were treated with 5 fractions of 200 cGy 6 MV external beam photons. MAIN OUTCOME MEASURES: The visual acuity measured at baseline was compared to the visual acuity after 1 year of follow-up. RESULTS: The mean baseline visual acuity of the 91 patients entered into the Radiation Study was 20/80. After 1 year, 83 patients (91.2%) completed follow-up, and their mean visual acuity dropped to 20/200. By comparison, the mean baseline visual acuity of the control patients also was 20/80, and after 1 year, the control subjects had a mean visual acuity of 20/125. At 1 year of follow-up, 49.4% of patients treated with radiation and 38.1% of the control subjects lost 3 or more lines of visual acuity (P = 0.16). CONCLUSIONS: This study found that external beam radiation using 1000 cGy in 5 fractions, a dose similar to that used in previous studies, was not effective in the treatment of CNV secondary to AMD. These results suggest that patients should not be treated with this dose of external beam radiation for CNV secondary to AMD.

Aged↗
PubMed1998

Can gerontological nursing survive?

By the year 2041, 11 million individuals 65 and over will reside in Canada. This drastic demographic change, coupled with the increasing acuity and complexity of the health care needs of seniors, creates an immense demand for nurses specialized in gerontology. But can gerontological nursing survive as a specialty and respond to this demand?

Aged↗
PubMed1997

The gift relationship between pharmaceutical companies and physicians: an exploratory survey of physicians.

The purpose of this exploratory study was to survey physicians' attitudes surrounding the 'gift relationship' between pharmaceutical companies and physicians. A survey was mailed to 1000 randomly selected West Virginia physicians, of which 283 (28.3%) responses were received. The most commonly received gifts reported by the study physicians were trinkets (77.4%), followed by books (41.7%) and meals (41%). Principal component analysis and varimax rotation identified seven physician belief constructs. The mean ratings of the constructs indicated that the physicians slightly agreed that pharmaceutical companies give gifts to physicians to influence their prescribing, moderately disagreed that they do so as a form of professional recognition of physicians, and strongly disagreed that their prescribing behaviour could be influenced by the gifts they receive. Physicians slightly disagreed that pharmaceutical companies' sponsoring of CME programmes are only promotional gimmicks. Although the study physicians slightly disagreed that it may be inappropriate for them to accept gifts from pharmaceutical companies, they seemed slightly averse to having 'gift relationships' between pharmaceutical companies and physicians made public. Correlation analysis suggested that physicians who have a large number of patients in their practice, see a larger number of patients per day, or write a large number of prescriptions per day are more likely to be offered gifts by pharmaceutical companies, and they are also more likely to condone the practice of gift giving and receiving.

Attitude of Health Personnel↗
PubMed1997

Optimization and deconvolution of lithium fluoride TLD-100 in diagnostic radiology.

Lithium fluoride (LiF) TLD-100 is one of the most commonly used thermoluminescent (TL) materials for the measurement of entrance surface dose (ESD) in diagnostic radiology. However, the minimum detectable dose (MDD) achieved, as derived from measurements of the random uncertainty present in the background signal, is usually quoted as being 50-100 microGy. A more appropriate definition of MDD for use in the clinical setting is the dose at which measurements exhibit a specified level of random uncertainty. This definition will give rise to a higher value for the MDD. An MDD of 50-100 microGy precludes accurate measurement of ESD in high tube potential (kVp) chest or neonatal radiography. Techniques described in the specialist literature for the reduction of the MDD of LiF were assessed both in the laboratory, and during a patient dose survey of high kVp chest radiography. Optimization of the pre-irradiation annealing and post-irradiation TL read heating cycles in terms of sensitivity and precision resulted in an MDD of 5/80 microGy (derived from background signal variation and 20% random uncertainty at 95% confidence limits, respectively). Deconvolution of the glowcurve was found to result in an MDD of approximately 10 microGy. Clinical measurements were contrasted with calculated values derived from ionization chamber measurements of tube output. The results support the hypothesis that glowcurve deconvolution permits the measurement of ESDs from low dose examinations using basic TL dosimetry equipment available to virtually all medical physics departments.

Fluorides↗
PubMed1997

Encouragement during maximal exercise testing of type A and type B scorers.

The influence of verbal encouragement during assessment of maximal oxygen consumption of subjects scoring as Type A and Type B on the Jenkins Activity Survey, Form T was examined. Fourteen Type A and 12 Type B scorers performed two randomly assigned tests on a motor-driven treadmill with and without verbal encouragement during testing. Treadmill time, oxygen consumption (VO2), heart rate, and respiratory exchange ratio at exhaustion were examined. Verbal encouragement led to significantly greater treadmill time, VO2, and respiratory exchange ratio for Type B scorers when compared with the non-encouragement trial. Treadmill time, VO2, heart rate, and respiratory exchange ratio at exhaustion were not different between treatments for the Type A scorers. Type A scorers ran significantly longer without encouragement than Type B scorers; however, when encouragement was provided, treadmill time for Type A and Type B scorers did not differ significantly. The results suggest that attainment of maximal effort is not dependent on verbal encouragement for Type A scorers, whereas verbal encouragement is necessary to assure attainment of maximal physiologic effort for those individuals scoring as Type B.

Adult↗
PubMed1996

The changing face of carotid endarterectomy.

PURPOSE: The economic milieu and improvements in care have altered the diagnostic and therapeutic algorithm of the patient with carotid stenosis. This study analyzes the efficacy and safety of these changes. METHODS: The records of patients who underwent 320 consecutive carotid endarterectomies performed by three surgeons at our institution from 1990 to 1994 were reviewed retrospectively. Use of diagnostic angiography, use of carotid duplex ultrasound, length of hospital stay, postanesthesia recovery observation, intensive care unit (ICU) observation, complications, and hospital charges were analyzed. RESULTS: The average length of hospital stay decreased from 6.18 days to 2.00 days (p < or = 0.001). The day of discharge decreased from 3.10 days to 1.24 days after surgery (p < or = 0.01). By 1993, 68% were discharged by the first day after surgery, increasing to 73% by 1994. From 1990 to 1992, average postoperative ICU observation time fluctuated between 18 and 25 hours; this time decreased to 12.2 hours by 1994. In 1993, only 12.5% of patients were admitted to the ICU, down from 94.8% in 1990; by 1994, only 7.3% were admitted to the ICU (p < or = 0.001). Postanesthesia recovery observation time decreased from 3.77 hours to 1.63 hours during this time (p < or = 0.04). With regard to preoperative diagnosis, angiography was performed in 93.1% of patients in 1990; by 1994, only 32.8% underwent this procedure (p < or = 0.0001). Average hospital charges decreased significantly (1990, $14,378; 1994, $10,436) with these modifications in patient care (p < or = 0.001). The complication rate reflected no significant changes over the course of the study. There were six incidences of cerebrovascular accident (6/320, 1.9%), including one death. There were four incidences of transient ischemic attack (4/320, 1.3%), with no significant differences noted from year to year. CONCLUSIONS: This study confirms the changing nature of carotid endarterectomy and documents that these changes have not adversely affected the safety of the operation.

Adult↗