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Biomedical subjects

R Donovan

Publications and source records attributed to R Donovan.

At least 19 recordsLinked to original sources
PubMed2006

Estimating the reduction of urban PM10 concentrations by trees within an environmental information system for planners.

Trees have been widely quoted as effective scavengers of both gaseous and particulate pollutants from the atmosphere. Recent work on the deposition of urban aerosols onto woodland allows the effect of tree planting strategies on airborne aerosol concentrations to be quantified and considered within the planning process. By identifying the potential planting locations in the local authority area, and applying them within a dispersion and deposition model, the potential magnitude of reduction in the ambient concentration of PM(10), achievable through urban tree planting, has been quantified for two UK cities. As part of the Environmental Information Systems for Planners (EISP), flow diagrams, based on planning decisions, have incorporated output from the model to make decisions on land use planning ranging from development plans and strategic planning, to development control. In this way, for any new developments that contribute to the local PM(10) level, the mitigation by planting trees can be assessed, and in some cases, reductions can be sufficient to meet air quality objectives for PM(10).

Air Pollutants↗
PubMed2003

Recall and response of smokers and recent quitters to the Australian National Tobacco Campaign.

OBJECTIVE: To track national population indices of recall and response among smokers and recent quitters to an ongoing national televised anti-smoking campaign in Australia. METHOD: National cross sectional population telephone surveys of adults. MAIN OUTCOME MEASURES: Unprompted recall of advertising; recognition of advertising; campaign attributed encouragement to quit or stay quit; unprompted awareness of smoking related health effects; new learning about smoking and health; and agreement with campaign related attitudes. RESULTS: Campaign advertising continued to be highly memorable over the period of study, with 88% having confirmed recognition in 2000. Campaign advertising was consistently thought by half of smokers who had seen it to make them more likely to quit (49% in 2000). Specific changes between surveys in unprompted awareness of smoking related health effects, new learning about smoking and health, and agreement with campaign related attitudes were observed in relation to the main messages of the advertisements, which were time sensitive according to the year of launch of the advert. The "artery" advertisement was associated with the largest and most consistent positive change in all of these parameters. The proportion of respondents who disagreed that the dangers of smoking had been exaggerated increased significantly from 59% in May 1997 to 68% in November 2000. CONCLUSION: A national campaign using graphic advertising to emphasise the health risks of smoking can make significant population wide contributions to improving new learning about smoking damage and positively influence attitudes about smoking risks.

Adolescent↗
PubMed1996

Serum lactate is not predicted by anion gap or base excess after trauma resuscitation.

OBJECTIVE: The inability to normalize lactate predicts death after trauma, but lactate may not be immediately available in every center. We postulated that, in a normal acid-base environment, lactate would correlate with the anion gap and the base excess of an arterial blood gas. METHODS: We studied 52 consecutive, invasively monitored patients with trauma admitted directly to the intensive care unit (ICU) from the emergency department or operating room in our level I center to determine whether base excess and anion gap could predict lactate. Lactate, base excess, and anion gap were recorded upon admission to the ICU and 8, 16, 24, 36, and 48 hours after admission. Correlation coefficients (r2) were calculated for the total patients, the 43 survivors, and the nine non-survivors. RESULTS: Serum lactate was significantly higher in nonsurvivors at 16 hours after post ICU admission (4.0 +/- 1.69 vs. 2.84 +/- 1.49, p < 0.05), and this trend persisted; the greatest difference was seen at 48 hours after admission (2.92 +/- 1.47 vs. 1.76 +/- 0.57, p < 0.001). There were no differences in base excess or anion gap between survivors and nonsurvivors. We found no consistent correlation between lactate versus anion gap, lactate versus base excess, or anion gap versus base excess. CONCLUSIONS: There is no correlation between lactate, base excess, and anion gap after initial resuscitation. Neither anion gap nor base excess was capable of predicting lactate; therefore, lactate must be directly measured. The lack of correlation of anion gap with base excess or lactate suggests the presence of unmeasured anions, an impairment in acid-base regulation after injury and resuscitation, or both.

Acid-Base Equilibrium↗
PubMed1993

Improving the lives of home care workers: a partnership of social work and labor.

A school of social work with an occupational program specialization entered into an agreement with one of the largest trade unions in New York City to do a social and health services needs assessment for the union's newest members: home care workers. The vast majority of these home attendants are low-income African American and Latina women who care for frail aged and disabled Medicaid recipients to prevent nursing home placement. Structured interviews with a sample of 400 union members indicated a need for better health care coverage, especially for stress-related illnesses, along with personal social services to assist with housing, debt, child care, and family issues. The union used this independent university data in its subsequent collective bargaining and won expanded benefits for its members based on demonstrated need. The school then established a union-funded member assistance program to institutionalize ongoing support for these members. In the end, action research helped to create both social services and social change; low-income women of color have gained tangible new benefits; and social work's important ties to organized labor have been strengthened.

Female↗
PubMed1992

Amrinone as an inotrope in managing hypermetabolic surgical stress.

Dobutamine is the standard inotrope used as cardiac support for hyperdynamic hypermetabolic patients following acute surgical stress. Amrinone has been utilized in medical patients with heart failure, but its use in hyperdynamic patients to our knowledge has never been reported. We now report the results of a trial of amrinone versus dobutamine in this setting. Over a 3-month period, we compared 28 trials of dobutamine and 27 trials of amrinone in 47 patients. Attempts were made to achieve non-flow-dependent oxygen consumption. Values are expressed as pre/post inotrope. Student's two-tailed t test was used for evaluation. [table: see text] Patients treated initially with dobutamine were slightly younger (mean, 46 vs. 57 years). They required slightly higher doses of dobutamine (mean, 12.9 vs. 12.2 micrograms/kg/min) and a slightly longer treatment period (mean, 11.3 vs. 9.8 hours) to achieve the desired effect. Of the 47 trials with dobutamine, six (13%) failed to achieve non-flow-dependent oxygen consumption. All then responded somewhat to amrinone. The failure rate for amrinone was 10%. No patient developed hypotension when treated with either drug. Amrinone is an effective inotrope useful in the cardiovascular support of hyperdynamic patients following surgical stress. Hypotension is not a problem with adequate intravascular volume loading. It should become part of the standard drug regimen in the surgical ICU.

Adolescent↗
PubMed1990

Vaccine protection of rhesus macaques against simian immunodeficiency virus infection.

Rhesus macaques (Macaca mulatta) immunized with an inactivated whole SIVmac vaccine and muramyl dipeptide (MDP), incomplete Freund's adjuvant (IFA), or aqueous suspension were challenged intravenously with 0.1 TCID50 of cell-free SIVmac. Whereas virus was readily recovered from the peripheral blood lymphocytes of 10 of 10 nonvaccinated controls following this challenge dose, virus was not recovered from the three animals that received the vaccine with MDP nor from one of two animals that received the vaccine with IFA and one of three animals that received the aqueous vaccine. The animals that were protected against challenge were those that had detectable SIV antibody response to the envelop, both the outer glycoprotein (gp120) and the truncated transmembrane glycoprotein (gp31). Protected monkeys tended to have higher titers of syncytial inhibition antibody prior to challenge. An anamnestic response after challenge was observed only in the vaccinated monkeys that became infected. Vaccinated animals that became challenge-infected tended to live longer than infected controls. These results confirm those at two other primate centers and indicate that killed whole SIV vaccines can protect against low challenge doses of SIV and prevent early death in those monkeys that do become infected. The mechanism of this protection remains undetermined. This finding adds optimism to the possibility of an eventual AIDS vaccine.

Acetylmuramyl-Alanyl-Isoglutamine↗
PubMed1989

Polymorphonuclear leucocyte motility in patients with severe burns.

Chemotaxis, chemokinesis and cellular orientation were measured for unstimulated and 10(-7) n-formyl methionyl leucyl phenylalanine (F-met-leu-phe) stimulated polymorphonuclear leucocytes (PMNS) of nine patients with recent 10-80 per cent burns using a computer-assisted image analysis technique. The technique records PMN movement, as viewed with a phase-contrast microscope on videotapes, and then uses computer programs to calculate the speed and direction of up to 50 PMNS over a 5-min period. Orientation was determined visually. Cellular adherence was also measured by attachment methods. PMNS from burn patients were slower (av. speed 16.8 microns/min), responded less well to F-met-leu-phe (av. speed 20.9 microns/min, av. McCutcheon index 0.32), were less often oriented towards the chemoattractant (av. 39 per cent) and were more adherent (av. 50 per cent) than control cells (av. speed 21.8 microns/min; av. speed F-met-leu-phe 32.2 microns/min; McCutcheon index 0.61; oriented 59 per cent adherent; 16 per cent). Thus PMNS from burn patients orient less well, are significantly slower and have less directionality in response to a chemoattractant, and are more adherent suggesting activation.

Adolescent↗
PubMed1989

Obliteration of the middle ear cleft.

All patients who have undergone obliteration of the middle ear cleft at Plymouth are reviewed. All had chronically discharging mastoid cavities and middle ears resistant to medical treatment, and all had at least one major operation to eradicate disease. All had an average hearing loss on the affected side of more than 80 decibels prior to operation. All ears have remained dry since obliteration, with a blind pit in the meatus. There have been no complications apart from a collection of fluid under one muscle flap.

Adolescent↗
PubMed1989

Work stress and job satisfaction: a study of home care workers in New York City.

New York has pioneered the development of publicly-financed home care, establishing a 60,000 member home care workforce that is by far the largest in the nation. This paper describes the Medicaid-funded home care program in New York City and presents findings from a recent survey of the workforce. Data are presented on working conditions in the industry suggesting that structural reform is urgently needed in the employment system for home care workers in New York City. The findings have national implications for the future planning of home care services.

Conflict, Psychological↗
PubMed1987

Cellular telephone transmission of 12-lead electrocardiograms from ambulance to hospital.

Currently, only single-lead, serial telemetry rhythm strips can be transmitted from ambulances. Triage of patients with chest pain and administration of thrombolytic therapy in ambulances is limited by the lack of specific electrocardiographic (ECG) diagnosis. A new technique is described using cellular telephone transmission of simultaneous 12-lead ECGs from ambulance to hospital to overcome this limitation. A portable 12-lead ECG installed in an ambulance was connected via modern link to a cellular telephone and digitized ECG information was transmitted to an ECG device in the hospital emergency room. Paramedics in the field placed adhesive patch electrodes and attached ECG wires. Field ECGs from 23 patients were compared with corresponding transmitted ECGs. There were no differences in heart rate, PR interval, QRS duration, QT interval or R- and T-wave axes. Baseline and transmitted ECGs had identical morphologic characteristics. Differences in R-wave amplitude in 5 transmitted tracings compared with hospital-recorded ECGs resulted in computer diagnosis of left ventricular hypertrophy by voltage, possibly due to differences in patient position. Twelve-lead ECGs can be easily transmitted from a moving ambulance using cellular telephones. This allows diagnosis before hospital arrival, improves prehospital triage of patients and may facilitate prehospital therapy with lidocaine or streptokinase. In addition, the cellular telephone link can convey both verbal and digitized information and thus improve on current telemetry systems.

Ambulances↗
PubMed1984

Effect of 0.64 ppm ozone on rats with chronic pulmonary bacterial infection.

Rats were chronically infected with Pseudomonas aeruginosa by entrapping viable bacteria in agar beads and intratracheally inoculating the beads into the left lung. The infection was allowed to stabilize over a 10-d period and the animals were then placed in environmental chambers and exposed to either filtered air or 0.64 ppm ozone (23 h/d) for 14 or 28 d. Rats exposed to ozone had reduced body weight and increased lung sizes and lung weights when compared with animals breathing filtered air. Rats inoculated with beads containing live P. aeruginosa had increased lung weights when compared with rats inoculated with beads containing heat-killed P. aeruginosa or controls. Quantitation of total viable bacteria in rats exposed to ozone or to filtered air revealed no significant differences in bacterial numbers. Thus, in this model, chronic exposure to ozone produces increases in lung volume and weight but does not enhance a smoldering Pseudomonas infection.

Animals↗