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Biomedical subjects

P Cain

Publications and source records attributed to P Cain.

At least 19 recordsLinked to original sources
PubMed1999

Controversial issues: a case for neutrality?

Controversial issues are defined, in this discussion, as those in relation to which contrary views can be held without those views being contrary to reason. Such issues arise in the range of courses constituting nurse education, especially, but not exclusively, where ethical questions are discussed. The nurse educator may, therefore, have to decide whether or not to say what she thinks, in particular she may have to decide whether or not to assert her own view as correct. Where professional beliefs and values are involved, to assert a view as correct may seem to be required. Might this, though, detract from the aim of developing students' capacity for autonomous reflection? The discussion assesses whether neutrality, in the sense either of not stating one's view or not asserting it as correct, is desirable, by examining arguments both for and against, and highlights ways in which a neutral stance both is, and is not, an option.

Attitude of Health Personnel↗
PubMed1998

Serious hemorrhage complicating diagnostic abdominal paracentesis.

We describe two patients awaiting orthoptic liver transplantation in whom diagnostic paracentesis for the diagnosis of spontaneous bacterial peritonitis led to major hemorrhage. Accordingly, we advise caution in patients such as ours, particularly if the prothrombin time or partial thromboplastin time is more than twice the control value.

Adolescent↗
PubMed1998

The limits of confidentiality.

Two conditions are commonly taken to constitute an obligation of confidentiality: information is entrusted by one person to another; and there is an express understanding that this will not be divulged. This conception of confidentiality, however, does not match much of the practice of health care. Health care practitioners would, for example, hold themselves to be under an obligation of confidentiality in situations where neither of these conditions obtain. The discussion proposes, therefore, two additional grounds for confidentiality. This is in order to clarify, in general terms, the scope of this obligation (i.e. to clarify at what point confidentiality can be said to have been broken). The 'limits of confidentiality', it is argued, are set by the wishes of the client or, where these are not known, by reference to those whose right and need to know relate to the care of the client. Anonymous references to the client outside this limit may not be breaches of confidence; whether they are or not depends, it is suggested, on if such reference is responsible.

Confidentiality↗
PubMed1997

Using clients.

An important part of the student nurse's training involves reflection on practice, as expressed in written assignments and seminar discussions. In this, students make use of material drawn from their work with clients. A key ethical question is, therefore: should clients' permission be sought by students for this use of case material in coursework assignments. This article examines in some detail the arguments both for and against seeking clients' permission and concludes that, in view of the principle of respect for autonomy, there is a moral obligation to gain consent. It is argued, however, that there may be legitimate exceptions to this.

Confidentiality↗
PubMed1996

Recovery of chorda tympani nerve function following injury.

The chorda tympani (CT) nerve carries taste information from the anterior tongue to the brain stem. Injury to the chorda tympani may result in loss or distortion of taste information. This study examined changes occurring in the hamster peripheral taste system during recovery from injury. The hamster chorda tympani nerve was crushed in the middle ear and the animals were allowed to survive from 2 to 16 weeks. At 2 weeks, CT fibers had degenerated distal to the crush site. Up to 16 weeks after crush, there were 67% fewer myelinated fibers in regenerated nerves than in controls. The mean area of the Ca(2+)-ATPase-stained core of the fungiform taste buds was significantly smaller than in controls 2 weeks after injury, but recovered to control values by 4 weeks. Electrophysiological responses to taste stimuli were recorded from the chorda tympani distal to the injury. No responses were seen after 2 weeks; weak and unstable responses were seen after 3 weeks. By 4-8 weeks, relative responses to taste stimuli were similar to control responses, but the variability of the responses to sucrose was significantly greater than that in controls. The frequency of responses to the water rinse following taste stimuli, particularly sucrose, was also greater in the regenerated nerves. The abnormal electrophysiological responses to sucrose may be the result of the differential rate of return of fiber types and/or the transduction mechanisms. In some ways, recovery of the peripheral gustatory system after damage to the chorda tympani nerve recapitulates the later stages of taste bud development.

Animals↗
PubMed1996

Improved pediatric patient flow in a general emergency department by altering triage criteria.

OBJECTIVE: To evaluate the effect of altering pediatric triage criteria on ED triage scoring and patient flow. METHODS: A prospective observational study of a pediatric triage modification was performed. Data for all pediatric patients presenting to an urban general ED during a six-month study period were collected. After the first three months, pediatric triage criteria were altered by elevating the acuity of several historical items and specifically listing abnormal signs and symptoms. Outcome measures included triage score assignment, criteria making the patient emergent, proportion of emergent or urgent triage assignments, and times to examination, disposition, and admission. RESULTS: Altering pediatric triage criteria resulted in a significant (p < 0.05) increase in the number of patients triaged as emergent (2% vs 15%) or urgent (48% vs 55%). In addition, for emergent and urgent patients there was a significant decrease (p < 0.05) in the mean times to ED examination (50 vs 44 min), floor admission (355 vs 245 min), and intensive care unit admission (221 vs 132 min). The triage changes that had a significant impact on these results were a history of color change, decreased activity, and prematurity with complications. CONCLUSIONS: A significant improvement in pediatric patient flow occurred after posting age-specific abnormal signs and symptoms as well as elevating triage acuity for specific historical clues.

Child↗
PubMed1994

DNA typing of grapevines: a universal methodology and database for describing cultivars and evaluating genetic relatedness.

With established ampelographic techniques for grapevine identification it is often difficult to achieve a satisfactory, objective result. We have developed a DNA typing system using sequence-tagged microsatellite site markers as a means of differentiating cultivars of grapevine. A semi-automated analysis procedure was linked to an electronic database and found to be an objective and reliable system for cultivar identification using this simple marker type. The accumulated DNA typing data from over eighty cultivars demonstrated that cultivars that are difficult to differentiate phenotypically using ampelographic techniques can be distinguished by DNA typing. Parentage analysis uncovered errors in parent assignment or cultivar identification in specific cases. The electronic database has a conservative format to take into account the occurrence of null alleles and the possibility of missed alleles. Computer-assisted comparisons of cultivars in the database can be performed and various approaches for estimating the match probability that two unrelated cultivars have the same genotype simply due to chance are discussed. We suggest that further development of the database through international co-operation using standardised sequence-tagged site markers offers the possibility of achieving a universal grapevine identification system.

DNA, Plant↗
PubMed1993

Safety considerations in a surgical robot.

This paper describes the safety features of the ROBODOC Surgical Assistant System, an image-driven robotic system which has been used to perform Total Hip Replacement surgery. These features include a dedicated processor for continuous monitoring of system status, shared data areas (dual-ported RAM), and external sensors (force-torque sensor, redundant positional encoders, and bone motion monitor).

Equipment Safety↗
PubMed1988

Hydrogen peroxide stimulates the synthesis of platelet-activating factor by endothelium and induces endothelial cell-dependent neutrophil adhesion.

Oxidant-induced damage to the intima of pulmonary and systemic vessels is thought to be an important mechanism of injury in a variety of syndromes of vascular damage. Hydrogen peroxide (H2O2) is an active oxygen metabolite that may induce intimal injury by cytolytic attack or by inducing biochemical and functional alterations in the endothelial cells (EC); however, mechanisms involved in noncytolytic perturbation of EC are largely unknown. We found that H2O2 stimulated the synthesis of platelet-activating factor (PAF) by primary cultures of bovine pulmonary artery endothelium (BPAEC) and by human umbilical vein endothelium (HUVEC). In each cell type the incorporation of [3H]acetate into [3H-acetyl]PAF was concentration- and time-dependent and was temporally dissociated from severe plasma membrane disruption and cytolytic cell injury; the newly synthesized PAF remained associated with the EC. H2O2 caused permeabilization of EC to 45Ca2+ and an increase in intracellular Ca2+, suggesting that a transmembrane Ca2+ flux is the signal that initiates PAF synthesis. H2O2 also induced the endothelial cell-dependent adhesion of neutrophils to HUVEC monolayers. This response was rapid, with an onset within minutes and a subsequent time course that paralleled the time course of PAF accumulation, and was dependent on extracellular Ca2+ but not on de novo protein synthesis. These studies demonstrate that H2O2 can induce two rapid activation responses of endothelium, PAF synthesis and EC-dependent neutrophil adhesion, events that may be important in physiologic and pathologic inflammation.

Animals↗
PubMed1978

Effect of halothane on the rate of acid production, lactate production and pyruvate dehydrogenase activity of malignant hyperpyrexia human muscle.

The rates of acid production were compared in thin strips of muscle biopsy samples isolated from malignant hyperpyrexia and control vastus internus human muscle. Halothane doubled the rate of acid production by malignant hyperpyrexia susceptible muscle but had no effect on control samples. This increased rate of release of acid from muscle was not from lactate. In addition, the pyruvate dehydrogenase activity of both control and malignant hyperpyrexia muscle samples was not stimulated by halothane.

Acids↗