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Biomedical subjects

P Patterson

Publications and source records attributed to P Patterson.

At least 19 recordsLinked to original sources
PubMed2006

Biomechanical study of prophylactic internal fixation of the radial osteocutaneous donor site using the sheep tibia model.

This study investigated the strengthening effect of different types of plate and position after osteotomy of the sheep tibia, which is a model for the radial osteocutaneous donor site. Fifty matched pairs of adult sheep tibias were tested in torsion and four-point bending. Firstly, the weakening effect of an osteotomy was compared with the intact bone. Then pairs of bones with an osteotomy were compared with and without reinforcement with different types of 3.5mm plate. The plate was placed in either the anterior (over the defect) or posterior (on the intact cortex) position. In torsion the mean strength of the intact bone was 45% greater than after osteotomy (P=0.02). The reinforced bone was on average 61% stronger than the unreinforced bone (P<0.001). In bending the mean strength of the intact bone was 188% greater than after osteotomy (P=0.02). The reinforced bone was on average 184% stronger then the unreinforced bone (P<0.001). The tibia was able to withstand much greater loads in bending. The dynamic compression plate was the strongest reinforcement in both torsion and bending. The position of the plate did not alter the strengthening effect in torsion but the posterior position resisted greater bending loads (P=0.01). This may not be relevant in clinical practice as the radius is likely to fracture first as a result of lower torsional forces.

Analysis of Variance↗
PubMed2006

In vitro study of foot kinematics using a dynamic walking cadaver model.

There is a dearth of information on navicular, cuboid, cuneiform and metatarsal kinematics during walking and our objective was to study the kinematic contributions these bones might make to foot function. A dynamic cadaver model of walking was used to apply forces to cadaver feet and mobilise them in a manner similar to in vivo. Kinematic data were recorded from 13 cadaver feet. Given limitations to the simulation, the data describe what the cadaver feet were capable of in response to the forces applied, rather than exactly how they performed in vivo. The talonavicular joint was more mobile than the calcaneocuboid joint. The range of motion between cuneiforms and navicular was similar to that between talus and navicular. Metatarsals four and five were more mobile relative to the cuboid than metatarsals one, two and three relative to the cuneiforms. This work has confirmed the complexity of rear, mid and forefoot kinematics. The data demonstrate the potential for often-ignored foot joints to contribute significantly to the overall kinematic function of the foot. Previous emphasis on the ankle and sub talar joints as the principal articulating components of the foot has neglected more distal articulations. The results also demonstrate the extent to which the rigid segment assumptions of previous foot kinematics research have over simplified the foot.

Biomechanical Phenomena↗
PubMed2002

Extensive multiple test centre evaluation of the VecTest malaria antigen panel assay.

To determine which species and populations of Anopheles transmit malaria in any given situation, immunological assays for malaria sporozoite antigen can replace traditional microscopical examination of freshly dissected Anopheles. We developed a wicking assay for use with mosquitoes that identifies the presence or absence of specific peptide epitopes of circumsporozoite (CS) protein of Plasmodium falciparum and two strains of Plasmodium vivax (variants 210 and 247). The resulting assay (VecTest Malaria) is a rapid, one-step procedure using a 'dipstick' test strip capable of detecting and distinguishing between P. falciparum and P. vivax infections in mosquitoes. The objective of the present study was to test the efficacy, sensitivity, stability and field-user acceptability of this wicking dipstick assay. In collaboration with 16 test centres world-wide, we evaluated more than 40 000 units of this assay, comparing it to the standard CS ELISA. The 'VecTest Malaria' was found to show 92% sensitivity and 98.1% specificity, with 97.8% accuracy overall. In accelerated storage tests, the dipsticks remained stable for > 15 weeks in dry conditions up to 45 degrees C and in humid conditions up to 37 degrees C. Evidently, this quick and easy dipstick test performs at an acceptable level of reliability and offers practical advantages for field workers needing to make rapid surveys of malaria vectors.

Animals↗
PubMed2001

Clinical outcomes resulting from telemedicine interventions: a systematic review.

BACKGROUND: The use of telemedicine is growing, but its efficacy for achieving comparable or improved clinical outcomes has not been established in many medical specialties. The objective of this systematic review was to evaluate the efficacy of telemedicine interventions for health outcomes in two classes of application: home-based and office/hospital-based. METHODS: Data sources for the study included deports of studies from the MEDLINE, EMBASE, CINAHL, and HealthSTAR databases; searching of bibliographies of review and other articles; and consultation of printed resources as well as investigators in the field. We included studies that were relevant to at least one of the two classes of telemedicine and addressed the assessment of efficacy for clinical outcomes with data of reported results. We excluded studies where the service did not historically require face-to-face encounters (e.g., radiology or pathology diagnosis). All included articles were abstracted and graded for quality and direction of the evidence. RESULTS: A total of 25 articles met inclusion criteria and were assessed. The strongest evidence for the efficacy of telemedicine in clinical outcomes comes from home-based telemedicine in the areas of chronic disease management, hypertension, and AIDS. The value of home glucose monitoring in diabetes mellitus is conflicting. There is also reasonable evidence that telemedicine is comparable to face-to-face care in emergency medicine and is beneficial in surgical and neonatal intensive care units as well as patient transfer in neurosurgery. CONCLUSIONS: Despite the widespread use of telemedicine in virtually all major areas of health care, evidence concerning the benefits of its use exists in only a small number of them. Further randomized controlled trials must be done to determine where its use is most effective.

Humans↗
PubMed2001

Psychometric properties of child- and teacher-reported curl-up scores in children ages 10-12 years.

The purpose of this study was to examine the psychometric properties of child- and teacher-reported curl-up (CU) scores in children ages 10-12 years in both a norm-referenced (NR) and criterion-referenced (CR) framework. Eighty-four children, 36 boys and 48 girls, performed the FITNESSGRAM (Cooper Institute for Aerobics Research, 1992) CU test on 2 days separated by 48-72 hr. Two video cameras were used to record students' CU performances. Two students performed the CU at the same time, with each child's performance recorded by one camera. The test was terminated when the child stopped due to fatigue or after two form errors occurred. Teacher-reported scores were the average of two independent ratings of each video performance, while child-reported scores came from data collected and recorded by the children. Single trial norm-referenced reliability was R = .75 for girls and R = .80 for boys for teacher-reported CU and R = .69 and R = .70 for child-reported CU for girls and boys, respectively. CR reliability was examined using P, proportion of students who consistently passed or failed the test across 2 days, and km, defined as reliability with chance removed. For teacher-reported scores, P = .89 and km = .78 for boys and P = .81 and km = .62 for girls. For child-reported scores, P = .86 and km = .72 for boys, while P = .79 and km = .58 for girls. For teacher-reported data, 39% of boys passed and 50% failed the test on both days, while for girls the percentages were 27% pass and 54% fail. For child-reported data, 64% of boys passed and 22% failed on both days, while 54% of girls passed and 25% failed. NR validity was examined by correlating teacher and child-reported scores. The resultant coefficient was r = .42 (95% CI = .11-.66) for boys and r = .67 (95% CI = .58-.74) for girls. Additionally, child-reported scores were significantly higher than teacher-reported scores. CR validity was examined with a contingency coefficient, and results indicated C = .55 with 44% false master errors for boys and C = .65 with 29% false master errors for girls. The findings of this study suggest that while NR reliability estimates were moderate for teacher-reported scores, single trial estimates suggest that child-reported CU should be viewed with caution. In regard to CR reliability, both teacher-reported and child-reported reliability were moderate. However, there were marked differences between teacher- and child-reported scores, with children reporting higher percentages of students passing and lower percentage of student failing the test when compared with scores reported by teachers. Validity was rather moderate when viewed in either a NR and CR framework. It is suggested that problems with child-reported scores may be due to the need for additional practice or simplification of the testing protocol.

Analysis of Variance↗
PubMed2001

An inquiry-based learning model for an exercise physiology laboratory course.

We developed an inquiry-based learning model to better stimulate undergraduate students' cognitive development of exercise physiology laboratory concepts. The course core is the two independent research projects that students, working in small groups, complete during the last 9 wk of the semester. Student groups develop their own research question and hypothesis, design the experiment, collect and analyze the data, and report their findings to the rest of the class using presentation software. To help with success of the research projects, students are taken through a series of guided-inquiry laboratory activities during the initial 6 wk of the semester to develop laboratory skills and an understanding of the scientific process. Observations of student behaviors reflected a high level of enthusiasm and engagement in laboratory activities. Surveys, journal entries, and interviews indicated that students felt empowered by having ownership in their projects, which may be the key reason for the success of this model.

Curriculum↗
PubMed2000

Preventing the entrenchment of high expressed emotion in first episode psychosis: early developmental attachment pathways.

OBJECTIVE: As part of a strategy to consider the options for preventing the developmental entrenchment of expressed emotion (EE), we examine the early ontogeny of EE in a first-episode sample of individuals with psychosis and its links with the process of adaptation to change. METHODS: The key relatives of 50 first-episode psychosis patients from two locations were interviewed soon after patient referral and again 9 months later using measures of expressed emotion and loss. RESULTS: The developmental pathways of components of expressed emotion, particularly criticism and emotional over-involvement, were independent despite having a similar effect on outcome for patients. Initially, high levels of emotional over-involvement were reduced by follow up, with 37% resolving into high criticism. Overall expressed emotion status changed in 28.2% of key relatives (all parental), predominantly from high to low. High emotional over-involvement and low criticism are associated with significantly high levels of perceived loss in relatives. The metamorphosis of emotional over-involvement to criticism was linked to a reduction in perceived loss. CONCLUSIONS: Expressed emotion is not a stable index in relatives of first-episode psychosis samples. Appraisals of loss by relatives may be driving high emotional over-involvement with implications for family intervention programs. Attachment theory may help to explain some of the processes underlying resistance to change in some of the high-EE behaviours measured by expressed emotion.

Adolescent↗
PubMed2000

An analysis of the yearly changes in sulfur concentrations at various national parks in the United States, 1980-1996.

An apparent increasing trend in the summer concentrations of particulate sulfur at Shenandoah (for the time period 1982-1995) and at Great Smoky Mountains (for the time period 1984-1995) has been pointed out by some researchers. Others have suggested that these increasing trends may be an analytical artifact resulting from the switch from the Stacked Filter Units (SFU) measurement system to the IMPROVE (Interagency Monitoring of Protected Visual Environments) measurement system that occurred during the winter of 1987. To obtain a better understanding of the effect of the protocol change, we investigate the changes in the seasonal averages of sulfur concentrations for successive pairs of years for the period 1980-1996 for about 20 national park sites in the United States. For the period 1980-1987, we use sulfur data from the old (SFU) database and for the period 1988-1996, we use the IMPROVE database. Changes from one year to the next similar to that between 1987 and 1988 occurred during other years and seasons suggesting that chance causes alone could perhaps explain it, the degree to which chance could have caused the changes was measured using the permutation test for matched. At the very least, additional information such as side by side readings using SFU and IMPROVE measurement methods, may be needed to better understand any systematic effect in the sulfur measurements that may be ascribable to the protocol change.

Air Pollution↗
PubMed2000

Trends in the extremes of sulfur concentration distributions.

Understanding the response of air quality parameters such as visibility to the implementation of new air quality regulations, population growth and redistribution, and federal land managing practices is essential to the evaluation of air quality management plans on air quality in federal Class I areas. For instance, the reduction of SO2 emissions from large single point sources should result in the decrease of extreme sulfate concentrations, while population growth in geographic areas outside of urban centers could cause a slow widespread increase of sulfate and organic concentrations. The change in federal land managing practice of increased prescribed fire on a year-round basis in lieu of large naturally occurring wild fires could have the same effect; that is, the frequency of high sulfur days increase and low sulfur days decrease as the result of the management practice. Therefore, it is of interest to examine the trends associated with the proportion of days during which the concentration of some aerosol species is above or below a certain threshold and decide whether this proportion of days is increasing or decreasing or shows a lack of trend. This is a direct indication of whether the quality of the environment is improving or worsening, or neither.

Aerosols↗
PubMed2000

Sampling duration calculations.

Routine air quality monitoring produces filter samples that, when analyzed, yield the total amount of the aerosol present in the volume of air drawn by the pump in the monitoring device during the given sampling period. From this we obtain an average concentration of the aerosol for the given duration. The samples are therefore really aggregate samples. A natural question then is "what is the effect of the duration of aggregation on the accuracy and precision of the estimate of the quantity of interest?" The answer depends on a number of factors, such as the quantity that is being estimated: a mean, or an extreme value, or some other quantity; the nature of the measurement error--additive versus multiplicative; the costs of laboratory analyses, and so on. In this paper, we investigate these issues when the interest is in estimating the mean concentration of a specified aerosol species over a fixed time period. In particular, we propose a method for determining a sampling duration that will yield the "best estimate" of the mean concentration for a given cost whenever appropriate statistical assumptions hold.

Air Pollution↗
PubMed2000

Needs analysis of a cancer education program in south western Sydney.

Before establishing a cancer education program in South Western Sydney (SWS), a study was conducted to investigate the level of interest and presentation format preferred by patients with cancer and their relatives/friends regarding five types of cancer-related information: medical, psychological, and physical care issues as well as support services and available resources. A questionnaire using a Likert scale and open- and close-ended questions was distributed to the local cancer population and their families comprising a total sample size of 141. The results showed a uniformly high level of interest in learning about all five cancer-related topics with a preferred program format that consisted of a mixed media presentation of 1 to 6 weeks duration, consisting of 1- to 2-hour weekly sessions. A cancer education program based on the needs assessment findings was developed and implemented at Liverpool Hospital, which was positively evaluated by participants.

Analysis of Variance↗
PubMed2000

Evaluation of the Waitakere Community Injury Prevention Project.

OBJECTIVE: To evaluate the Waitakere Community Injury Prevention Project (WCIPP). METHODS: Process and outcome evaluations were conducted over a three year period. Process activities included analysis of project documentation, participant observation, key informant interviews, and two post-implementation case studies. A quasiexperimental design was used for the outcome evaluation. Three primary sources of data were collected and analysed: injury statistics; a pre-post telephone survey (n=4,000); and a pre-post organisation survey (n=144). RESULTS: Process evaluation provided a comprehensive account of the operation and activities of the WCIPP. Findings stress the pivotal role of the coordinators and highlight the value of incorporating a multicultural approach. A positive impact on changes to Waitakere City Council safety policies and practices was also evident. Outcome evaluation findings demonstrated significant reductions in rates of Waitakere child injury hospitalisations (p<0.05), while comparison communities showed an increase in child hospitalisation rates. In addition, compared with pre-intervention and comparison data, significantly more Waitakere residents were aware of injury prevention safety messages (p=0.0001) and had acquired appropriate child safety items (p=0.0001). CONCLUSION: The community injury prevention model appears to be an effective strategy for injury prevention. The support provided by the council for the WCIPP has provided a benchmark for the role of local governments in injury prevention.

Adolescent↗