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Biomedical subjects

R Wells

Publications and source records attributed to R Wells.

At least 19 recordsLinked to original sources
PubMed2006

Modulation of the soft tissue reactions to percutaneous orthopaedic implants.

To evaluate soft tissue reactions and biofilm formation on percutaneous external fixator screws coated with diamond-like carbon (DLC) and hydroxyapatite (HA) coatings on stainless-steel (SS) pins in an ovine loaded osteotomy model, an Orthofix external fixator was used to stabilize a 3-mm tibial midshaft osteotomy with six tapered pins inserted into the right tibia of 32 skeletally mature Friesland ewes. Animals were divided into four groups; SS, fully coated HA, DLC, and HA-coated threads. At 10 weeks, specimens were harvested and the pins were removed en bloc to examine the interfaces between the surface coatings and the tissues. Fully coated HA pins had a significantly higher percentage of dermal contact with the pin surface than HA-coated threads (p=0.028). The presence of a biofilm was evident on all pin surfaces except DLC-coated pins. Significantly greater numbers of bacteria were present on fully coated HA and plain stainless-steel pins compared with DLC. The surface of DLC-coated pins had a significantly lower number of bacterial colonies compared to SS (p=0.028) and fully coated HA pins (p=0.005). Fully coated HA pins have greater dermal attachment to the pin surface than the other pin coatings investigated. DLC-coated pins have the potential to prevent biofilm formation and bacterial colonization that may reduce infection and consequent pin loosening. An external fixator pin that is partially coated with HA to encourage bone and soft tissue integration and with DLC to reduce biofilm formation is advocated.

Animals↗
PubMed2005

Life satisfaction and distress in family caregivers as related to specific behavioural changes after traumatic brain injury.

PRIMARY OBJECTIVE: To predict long-term outcome of those caring for family members who have sustained a traumatic brain injury (TBI). METHODS AND PROCEDURES: A multivariate approach was used to examine the effectiveness of caregiver coping strategies in the context of TBI-related behavioural change. Self-administered questionnaire packages were collected from 72 adult survivor and family-member pairs who provided information on survivors' altered executive function, behavioural control and emotional sensitivity as well as caregivers' methods of coping, attitudes toward caregiving, indices of distress, mood ratings and quality of life. MAIN OUTCOMES AND RESULTS: Family members generally reported higher levels of satisfaction than dissatisfaction with their caregiving role. The type of neurobehavioural deficit and the approaches taken to cope with stress had specific effects on each dimension of caregiver outcome. CONCLUSIONS: Adequate family support requires finely tuned assessment of factors relevant to successful coping.

Adaptation, Psychological↗
PubMed2004

A multi-method approach to assessing deadlines and workload variation among newspaper workers.

OBJECTIVES: Working under frequent deadlines was previously found to be associated with upper limb work-related musculoskeletal disorders (WMSDs) in newspaper workers. Further investigation was required so that concrete recommendations for change could be offered to the workplace parties (labour and management of a large metropolitan newspaper). STUDY DESIGN: The assessment was based on three methods. A questionnaire was used to clarify time-related aspects of work on deadlines for a larger group of workers. Experience sampling was used to document temporal variation in various aspects of physical and psychological demands over work shifts and deadline cycles. Focus groups were also conducted. RESULTS: Differences were found between the "High" and "Low" deadline groups: Those working with frequent deadlines more frequently were required: to work together with others, to perform tasks on a specific schedule and specific order, to work at a fast paced, to perceive their work as hectic and "hard". Experience sampling showed differential trends in workload across daily, weekly, and no deadline days. The lack of breaks for extended periods of time leading up to a deadline was noticeable. The focus groups were useful in highlighting issues not addressed by the other two methods and to understand the feasibility of various possible interventions. CONCLUSIONS: The integration of results from all methods lead to recommendations for issues upon which to focus prevention related activities where deadlines are present: delays in work flow from others, interruptions from technology related problems, excessive work, insufficient staff/insufficient time, extra/unexpected work, compromising of work quality for speed, and lack of time for breaks.

Cumulative Trauma Disorders↗
PubMed2002

Longitudinal flow of protons from (2-8)A GeV central Au+Au collisions.

Rapidity distributions of protons from central 197Au+197Au collisions measured by the E895 Collaboration in the energy range from (2-8)A GeV at the Brookhaven AGS are presented. Longitudinal flow parameters derived using a thermal model including collective longitudinal expansion are extracted from these distributions. The results show an approximately linear increase in the longitudinal flow velocity, (L), as a function of the logarithm of beam energy.

Journal Article↗
PubMed2001

Characterizing human hand prehensile strength by force and moment wrench.

Characterizing human hand capabilities or demand created by various occupational tasks or activities of daily living has been mainly accomplished by measuring the maximum force exerted on a force dynamometer in a number of standard grips, for example power, key pinch and tip pinch grips. A framework is proposed instead to characterize human hand prehensile strength in generic form by describing external force and moment wrench capability, where a wrench is a vector describing the forces and moments applied at a point. It is further suggested that if tools and activities are characterized by the internal forces and external forces and moments required, a better understanding of the human prehension in occupational settings and during activities of daily living can be obtained. An example of using a pistol grip drill is used to show the utility of the approach.

Biomechanical Phenomena↗
PubMed2001

Model-independent source imaging using two-pion correlations in (2 to 8)a GeV Au+Au collisions.

We report a particle source imaging analysis based on two-pion correlations in high multiplicity Au+Au collisions at beam energies between 2A and 8A GeV. We apply the imaging technique introduced by Brown and Danielewicz, which allows a model-independent extraction of source functions with useful accuracy out to relative pion separations of about 20 fm. The extracted source functions have Gaussian shapes. Values of source functions at zero separation are almost constant across the energy range under study. Imaging results are found to be consistent with conventional source parameters obtained from a multidimensional Hanburg-Brown-Twiss analysis.

Journal Article↗
PubMed2001

Biomechanical analysis of peak and cumulative spinal loads during simulated patient-handling activities: a substudy of a randomized controlled trial to prevent lift and transfer injury of health care workers.

Back injuries are a serious problem for nursing personnel who perform frequent patient-handling activities. Common prevention strategies include body mechanics education, technique training, and ergonomic interventions such as the introduction of assistive equipment. This investigation assessed and compared the effectiveness of two patient-handling approaches to reducing injury risk. One strategy involved using improved patient-handling technique with existing equipment, and the other approach aimed at eliminating manual patient handling through the use of additional mechanical and other assistive equipment. Both intervention arms received training in back care, patient assessment, and use of the equipment available on their particular wards. An analysis of compliance with interventions and the effects of patient-handling methods on both peak and cumulative spinal compression and shear during various tasks was conducted. Results showed greater compliance with interventions that incorporated new assistive patient-handling equipment, as opposed to those consisting of education and technique training alone. In several tasks, subjects who were untrained or non-compliant with interventions experienced significantly higher peak spinal loading. However, patient-handling tasks conducted with the aid of assistive equipment took substantially longer than those performed manually. This, along with variations in techniques, led to increases in cumulative spinal loading with the use of patient-handling equipment on some tasks. Thus, the use of mechanical assistive devices may not always be the best approach to reducing back injuries in all situations. No single intervention can be recommended; instead all patient-handling tasks should be examined separately to determine which methods maximize reductions in both peak and cumulative lumbar forces during a manoeuver.

Adult↗
PubMed2001

How institutional theory speaks to changes in organizational populations.

In this issue, Begun and Luke note striking variation in organizational arrangements across local health care markets and probe how characteristics of those markets affect shifts in organizational populations over time. This article contributes to this FORUM by focusing on how institutional theory's emphasis on the culturally mediated nature of organizational change speaks to the evolution of local market structures over time.

Attitude to Health↗
PubMed2001

Glycine toxicity and unexpected intra-operative death.

A rare complication of the use of glycine irrigation fluid during prostatic surgery in a 69-year-old man is described. Following cystolithopexy and transurethral resection of the prostate for benign prostatomegaly, abdominal distension developed with increasing ventilatory pressures. Despite retroperitoneal fluid evacuation at subsequent urgent laparotomy, cardiac arrest occurred that was not amenable to resuscitation. At autopsy a traumatic defect in the posterior bladder wall filled with calculus debris was confirmed that did not communicate with the peritoneal cavity. Hyponatremia with markedly elevated levels of blood, urine, and body fluid glycine were demonstrated. Death was, therefore, attributed to glycine toxicity following tracking of glycine through a surgical defect in the posterior bladder wall. Careful dissection of surgical sites is required in such cases to demonstrate any additional trauma that may be associated with the fatal episode. Analysis of body fluids for glycine and electrolytes is also necessary to assist in the determination of possible mechanisms of death.

Aged↗
PubMed2000

A critical review of recent US market level health care strategy literature.

In this review, we argue that it would be profitable if the neoclassical economic theories that have dominated recent US market level health care strategy research could be complemented by greater use of sociological frameworks. Sociological theory can address three central questions that neoclassical economic theories have tended to slight: (1) how decision-makers' preferences are determined; (2) who the decision-makers are; and (3) how decision-makers' plans are translated into organizational action. We suggest five sociological frameworks that would enable researchers to address these issues better relative to market level strategy in health care. The frameworks are (1) institutional theory, (2) organizational ecology, (3) social movements, (4) social networks, and (5) internal organizational change. A recent global trend toward privatization of health care provision makes US market level strategy research increasingly applicable to non-US readers.

Decision Making, Organizational↗
PubMed2000

Goal-setting in rehabilitation: report of a workshop to explore professionals' perceptions of goal-setting.

OBJECTIVE: To explore the views of therapists, nurses and doctors working in a variety of rehabilitation settings on the goal-setting process. METHODS: Sixteen rehabilitation staff from three different settings attended a goal-setting workshop in which the difficulties associated with goal-setting were described with their potential solutions. RESULTS: Five difficulties with goal-setting were identified. (1) Formal goal-setting was felt to be an activity unusual for many of the patients although intrinsic to the activity of many professional groups. (2) Goal-setting is often insensitive to people's roles in the community. (3) Goal-setting in the hospital environment does not transfer easily to the community. (4) External factors (e.g. staff turnover) over which staff felt they had little control were important in the success of a goal-setting programme. (5) Goals tend to be formulated and owned by the team, rather than the patient. CONCLUSIONS: Goal-setting is a very satisfactory activity for the team but to be as successful for the patient their needs must be acknowledged. People with mild disability and a short inpatient stay have different needs to those with acute onset severe permanent disability and those with chronic or progressive disability admitted from the community. Comparison of both process and outcome effects of different types of goal-setting is an area for future study.

Activities of Daily Living↗
PubMed1999

p53 gene mutations in neoplastic transformation of C3H 10T1/2 and severe combined immunodeficiency fibroblasts.

The relevance of p53 mutations to the neoplastic malignant transformation of rodent fibroblasts by genotoxic physical and chemical agents is not clear. In the present study, we investigated p53 mutations (in exons 5-8) in non-transformed and neoplastically transformed C3H 10T1/2 and severe combined immunodeficiency (SCID) cells. No p53 mutations were detected in 15 neoplastically transformed (two spontaneous, one 3-methylcholanthrene-induced, seven gamma-ray-induced and five 'hot particle'-induced) and two non-transformed 10T1/2 cells. Wild-type p53 gene was also detected in all non-transformed (immortalized) SCID cell lines analyzed (four lines) whereas all three neoplastically transformed (two spontaneous, one gamma-ray-induced) cell lines displayed missense mutations in the p53 gene. These mutations were all transitions: A > G in codon 123, G > A in codon 152, and C > T in codon 238. We conclude that mutation in the p53 gene appears to be an infrequent event in 10T1/2 cells regardless of the transforming agent, but a frequent event in the neoplastic transformation of immortalized SCID cells. Non-transformed SCID cells are deficient in repair of DNA double-strand breaks, and neoplastically transformed cells are assumed to be deficient as well.

Animals↗
PubMed1999

Serum alpha- and gamma-tocopherols, retinol, retinyl palmitate, and carotenoid concentrations in captive and free-ranging bottlenose dolphins (Tursiops truncatus).

Concentrations of retinol, retinyl palmitate, beta-carotene, alpha-carotene, cryptoxanthin, lutein, lycopene, alpha-tocopherol, and gamma-tocopherol were measured in blood samples collected from 15 captive and 55 free-ranging bottlenose dolphins (Tursiops truncatus). From June 1991 to June 1994, blood samples were collected from captive animals residing at two locations; at Seven Seas (Brookfield Zoo, Brookfield, IL) and Hawk's Cay (Marathon Key, FL). Blood samples were collected from free-ranging animals from June 1991 to June 1996. Retinol levels were not significantly different between captive dolphin groups. However, Seven Seas animals had higher (P < 0.01) serum retinol concentrations compared to free-ranging animals (0.061 vs 0.041 microgram/ml). Retinyl palmitate was not detected in the serum of captive or free-ranging dolphins. Alpha-tocopherol levels were significantly (P < 0.05) higher for Seven Seas dolphins (16.4 micrograms/ml) than for Hawk's Cay (13.0 micrograms/ml) and free-ranging dolphins (12.5 micrograms/ml). Gamma-tocopherol concentrations were similar among captive and free-ranging dolphins. Free-ranging dolphins showed levels of circulating carotenoids (lutein and beta-carotene) while the captive animals did not. Additional carotenoids (lycopene, alpha-carotene and cryptoxanthin) were analyzed but not detected in any samples. Serum vitamin differences between captive and free-ranging dolphins may reflect the natural diet or indicate some potential biological or nutritional status significance.

Animals↗
PubMed1999

How other members of the top management team see the nurse executive.

This study compared how top-level organizational groups within Veterans Affairs Medical Center (VAMC) top management teams perceived nurse executives' participation in strategic decision making. Nurse executives' perceptions of their own involvement in strategic decision making generally agreed with the views of both chiefs of staff and directors. However, the associate director's perceptions of the nurse executive's involvement often differed significantly with those of the nurse. Nurse executives will be better prepared to function effectively within the top management team if they are aware of patterns in how they are perceived by other members.

Attitude of Health Personnel↗
PubMed1997

Upper limb work-related musculoskeletal disorders among newspaper employees: cross-sectional survey results.

At a metropolitan newspaper office in Canada with extensive video display terminal (VDT) use, researchers carried out a survey (n = 1,007, 84% response) to establish baseline prevalence of work-related musculoskeletal disorders (WMSDs) and to identify demographic, postural, task, and psychosocial factors associated with WMSD symptoms. One-fifth of the respondents reported moderate or worse upper limb pain recurring at least monthly or lasting more than a week over the previous year. Logistic regression showed that employees who faced frequent deadlines and high psychological demands (fast work pace and conflicting demands), had low skill discretion and social support, spent more time keyboarding, or who had their screen in a non-optimal position were more likely to report moderate to severe symptoms. Women reported significantly higher levels of symptoms than men.

Adult↗