PubMed Health⌕ Search

Biomedical subjects

L Wade

Publications and source records attributed to L Wade.

At least 19 recordsLinked to original sources
PubMed1999

Advance directives: the experience of health care professionals across the continuum of care.

This study explored the perceptions of health care providers across the continuum of care as to how effective advance directive arrangements were in assuring compliance with the patients' wishes, as well as their overall satisfaction levels with the process. The health care providers who responded to the survey indicated high levels of overall satisfaction with advance directives, despite low patient completion rates and, most significantly, low confidence levels that surrogate decision making accurately reflected the patient's wishes. A secondary analysis compared the perceptions of health care providers with consumers' reasons for failing to complete advance directives. The need for further education was perceived as a primary need by the health care professionals but not by the consumers. Recommendations for policy initiatives and further research are then presented.

Advance Directives↗
PubMed1998

An orphan nuclear receptor activated by pregnanes defines a novel steroid signaling pathway.

Steroid hormones exert profound effects on differentiation, development, and homeostasis in higher eukaryotes through interactions with nuclear receptors. We describe a novel orphan nuclear receptor, termed the pregnane X receptor (PXR), that is activated by naturally occurring steroids such as pregnenolone and progesterone, and synthetic glucocorticoids and antiglucocorticoids. PXR exists as two isoforms, PXR.1 and PXR.2, that are differentially activated by steroids. Notably, PXR.1 is efficaciously activated by pregnenolone 16alpha-carbonitrile, a glucocorticoid receptor antagonist that induces the expression of the CYP3A family of steroid hydroxylases and modulates sterol and bile acid biosynthesis in vivo. Our results provide evidence for the existence of a novel steroid hormone signaling pathway with potential implications in the regulation of steroid hormone and sterol homeostasis.

Amino Acid Sequence↗
PubMed1998

Effects of monensin on the reproduction, health, and milk production of dairy cows.

A randomized clinical trial including 1109 cows from 12 Australian dairy herds was used to evaluate the effects of monensin on the health (n = > 686 cows), production (n = 915 cows), and reproduction (n = > 908 cows) of dairy cows. Cows were allocated to a treatment group receiving a slow-release intraruminal bolus containing 32 g of sodium monensin that was administered 40 d before and 50 d following the anticipated calving date or to a control group. Treatment did not significantly alter any reproductive outcome; 54.5% of cows treated with monensin and 58.2% of control cows were pregnant at first service, and days to conception were lower for cows treated with monensin. The hazard rate (0.95) was not significant for these cows. The percentage of cows pregnant was 83.8 for control cows, and days to first estrus (hazard rate = 1.04) and first service (hazard rate = 1.04) were not significantly higher for treated cows. Treatment with monensin did not significantly alter the risk of any disease. The incidence of retained fetal membranes, pyometra, lameness, abortion, and infectious diseases was not significantly lower for cows in the treatment group, and the incidence of mastitis was not significantly higher for cows in the treatment group. Monensin significantly increased milk production by 0.75 L/d per cow and tended to increase milk fat and protein yields but had no significant effect on milk fat or milk protein percentages. Changes in the production of milk and milk constituents were consistent throughout lactation.

Animals↗
PubMed1997

Feature extraction and modeling of the variability of performance in terms of biomechanical motion patterns during MMH tasks.

In investigating manual material handling (MMH) jobs, such as lifting, the quantification of the various kinematic and kinetic parameters of the lift is an important step towards functional assessment and evaluation. Experimental data collection generates a large quantity of data for the different kinetic, kinematic, and electromyographic parameters over the various lifting cycles. In order to efficiently manage and interpret the data, it is important to use appropriate tools which would reduce the dimension of the original data set without sacrificing any important features. Furthermore, the generated parameters are often expressed as a function of the lifting cycle resulting in complex waveforms as the unit of analysis. Appropriate statistical analysis of these waveforms or motion profiles should reflect their vectorial constitution as a function of the lifting cycle rather than the usual method of using traditional descriptive statistics based on collapsing the data over the cycle.

Adult↗
PubMed1994

The effect of low-dose bupivacaine on postoperative epidural fentanyl analgesia and thrombelastography.

We performed a prospective, randomized, double-blind study to determine the effect of bupivacaine on postoperative epidural fentanyl analgesia and thrombelastography in 120 patients who underwent extensive gastrointestinal or genitourinary surgery. The patients were randomized into four groups, 30 patients per group: Group I = epidural fentanyl (EF), 10 micrograms/mL in saline; Group II = EF with 0.1% bupivacaine; Group III = EF with 0.15% bupivacaine; and Group IV = EF with 0.2% bupivacaine. Pain relief was evaluated by a visual analog scale (VAS), both at rest and during coughing, and by a visual rating scale (VRS). The VAS, VRS, degree of sedation, and side effects (nausea, vomiting, and pruritus) were evaluated every 2 h from 8:00 AM to 6:00 PM, for 24 h after surgery. Forced vital capacities (FVCs) were determined before surgery and at 24 h after surgery. Blood was withdrawn for thrombelastography (TEG) measurements preoperatively, in the recovery room (PARR), and 24 h postoperatively. The VAS, VRS, sedation scores, changes in postoperative FVCs, and the incidence of side effects were not statistically different among the four groups. The 24-h total volumes of infusion in the four groups (146 +/- 40 mL, 140 +/- 38 mL, 142 +/- 40 mL, 124 +/- 21 mL, respectively) were not statistically different from each other. There were no significant differences in the TEG values [reaction time (R), coagulation time (K), angle (alpha), and maximum amplitude (mA)] among the four groups at anytime nor was there any difference between the baseline, PARR, and 24-h TEG values within any group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Home nebulisers. Comparative study of lung deposition by different models.

Home nebulisers are extensively used in the ambulatory treatment of chronic chest conditions. This study compares the intrapulmonary deposition of aerosol generated by 6 different models of electrical home nebuliser in healthy male volunteers. Deposition was quantified by measurement of the radio-activity over the right lung during nebulisation of 3 ml normal saline containing 2 mCi of technetium-99m pertechnetate. The 3 cheaper nebulisers studied (Simba, New Constellation and Ariette) take considerably longer to nebulise the same volume compared with the 3 more expensive nebulisers (Eolo, Pharmoneb and Pari) (> 20 minutes compared with < 5 minutes). With one exception, in every comparison between two models, intrapulmonary deposition at 3 minutes was significantly greater for the more expensive nebuliser. Mean deposition with the cheapest model was only one-fifteenth of the mean for the most expensive model. Large variations between different individuals on the same model were observed (up to 6-fold). Factors accounting for the inter-individual variation in deposition are considered and the correct method of use of nebulisers is emphasised. Multiple regression of forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) and height versus deposition with very similar nebulisers in 12 volunteers shows that these parameters can account for 69% of the inter-individual variation observed (r = 0.83). The clinical application of the findings is considered.

Adult↗
PubMed1992

Teaching social skills to students with autism to increase peer interactions in an integrated first-grade classroom.

We investigated the use of social skills groups to facilitate increased social interactions for students with autism and their nonhandicapped peers in an integrated first-grade classroom. Social skills groups consisted of training students and peers in initiating, responding, and keeping interactions going; greeting others and conversing on a variety of topics; giving and accepting compliments; taking turns and sharing; asking for help and helping others; and including others in activities. Training occurred during the first 10 min of 20-min play groups, four times per week. Using a multiple baseline across subjects design, results demonstrated increases in the frequency of, time engaged in, and duration of social interactions, as well as the responsivity of students and peers to each other. Results were maintained when students were monitored and given feedback on social performance in play groups and during follow-up.

Autistic Disorder↗
PubMed1988

Vitamin E in the treatment of tardive dyskinesia: the possible involvement of free radical mechanisms.

One of the major problems associated with long-term neuroleptic treatment is persistent tardive dyskinesia (TD), for which there is no satisfactory treatment. We have recently proposed that some cases of TD are associated with neuronal dysfunction resulting from excess free radical production occurring during catecholamine metabolism. We therefore decided to assess the efficacy of a powerful free radical scavenging agent, alpha-tocopherol (vitamin E), on the clinical signs of TD. We treated 15 patients with persistent TD with alpha-tocopherol and matched placebo in a randomized crossover design. Patients demonstrated a significant overall reduction in scores on the Abnormal Involuntary Movements Scale (AIMS) after treatment with alpha-tocopherol, but not after placebo. The mean reduction in the AIMS score with alpha-tocopherol was 43 percent, with seven patients showing a greater than 50 percent reduction in their dyskinesia. There was also a trend for a decrease in scores on the Brief Psychiatric Rating Scale, but no change was observed in scores on the Simpson-Angus Scale for Extrapyramidal Side Effects. Our findings are consistent with the possibility that alpha-tocopherol is beneficial in the treatment of some patients with TD, but further research is necessary to establish the efficacy of this agent.

Antipsychotic Agents↗
PubMed1986

Increased fibrinolytic activity in patients undergoing cardiopulmonary bypass operation.

The influence of cardiopulmonary bypass on fibrinolytic activity was assessed by a sensitive clot lysis assay in eight patients undergoing coronary artery bypass operations. Fibrinolytic activity increased immediately after cardiopulmonary bypass was begun and remained elevated throughout the period of extracorporeal circulation. At the conclusion of the operative procedure, fibrinolytic activity returned to the normal range in all patients, and no subject had postoperative bleeding.

Blood Cell Count↗
PubMed1984

Teacher- versus peer-mediated instruction: an ecobehavioral analysis of achievement outcomes.

In three experiments, we compared the effects of instructional arrangements that varied in: teacher versus peer mediators, methods used, levels of student academic responding generated, and content taught and tested. Instructional arrangements (i.e., tasks, structure, teacher position, teacher behavior) and students' levels of academic responding were measured by an observation system which served as an index of the independent variables. Students' accuracy on weekly spelling, arithmetic, and vocabulary tests and pre- and post-standardized achievement tests (Experiments 2 and 3 only) were the dependent variables. Results indicated that the classwide peer tutoring, compared to the teacher's procedure, produced more student academic responding and higher weekly test scores, regardless of treatment order or subject matter content (Experiment 1). The four lowest performing students in each class, in particular, benefited from peer tutoring, often performing as well as the other students. These findings were replicated in Experiments 2 and 3 wherein content taught/tested was also manipulated. Standardized test score gains were higher in those areas in which peer tutoring was used longest. Issues related to the functional analysis of instruction and achievement gain are discussed.

Achievement↗