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Biomedical subjects

Stephen Davies

Publications and source records attributed to Stephen Davies.

10 recordsLinked to original sources

The efficacy of acupuncture in the treatment of temporomandibular joint myofascial pain: a randomised controlled trial.

OBJECTIVES: To compare the effect of real acupuncture and sham acupuncture in the treatment of temporomandibulat joint myofascial pain, in order to establish the true efficacy of acupuncture. METHODS: A double blind randomised controlled trial conducted in the TMD Clinic, at the School of Dentistry, The University of Manchester. Twenty-seven patients were assigned to one of two treatment groups. Group 1 received real acupuncture treatment whilst Group 2 received a sham acupuncture intervention. Both the assessor and the patient were blinded regarding the group allocation. Baseline assessment of the outcome variables was made prior to the first treatment session, and was repeated following the last treatment. RESULTS: The results demonstrated that real acupuncture had a greater influence on clinical outcome measure of TMJ MP than those of sham acupuncture, and the majority of these reached a level of statistical significance. CONCLUSION: Acupuncture had a positive influence on the signs and symptoms of TMJ MP. In addition, this study provides evidence that the Park Sham Device was a credible acupuncture control method for trials involving facial acupoints.

Acupuncture Therapy↗

Health services management education: why and what?

PURPOSE: To examine the importance of appropriate education for health services managers and to identify what might be included in the curriculum for health services management education. DESIGN/METHODOLOGY/APPROACH: The paper approaches these two questions through an exploration of the distinctive characteristics of health services as a context for management, relating these to a less context-specific literature on management education. The case for health services management and a description of the ideal curriculum are both developed from this analysis. The analysis is based on the UK but much of it will be applicable to other national settings. FINDINGS: Health services as a context for management practice are made distinctive by the circumstances of working in close proximity to clinical professionals and dominance of evidence-based practice as a paradigm for the clinical professions. Professionalism is weak as a governing concept for managers and health is often a politicised context for management, especially in publicly owned systems like the UK National Health Service. Management education for health services managers is important for improving systems performance and should offer a broad curriculum that includes the context for practice; research awareness and skills of critical appraisal; a grounding in a range of disciplines and a reflective approach towards general management skills. PRACTICAL IMPLICATIONS: Greater value should be attached to health services management education and a systematic approach taken towards curriculum development. ORIGINALITY/VALUE: The analysis presented leads to the conclusion that health services management requires a broad curriculum reflecting the rich experience that health services management can offer as an occupation. As the power and influence of managers and managerialism in health care continues to grow, so it becomes all the more important that what is required for their education is questioned and value attached to providing opportunities for that education.

Curriculum↗

Reliability of recording static and dynamic occlusal contact marks using transparent acetate sheet.

STATEMENT OF PROBLEM: Inaccuracy in the transfer of information between clinician and technician regarding occlusal contacts can cause problems when fabricating indirect restorations, which can result in frustration for the dentist, technician, and patient. Few studies have considered the reproducibility of recording marked occlusal contacts. PURPOSE: This study aimed to test the reproducibility of a quick and simple means of recording marked occlusal contacts. MATERIAL AND METHODS: The static and dynamic occlusal contacts of 29 subjects, with no missing functional units, were marked using articulating paper. Three clinicians with varying clinical experience (3-10 years after graduation from dental school) were asked to independently record the marked occlusal contacts using a transparent acetate sheet. The results were analyzed for Kappa agreement. RESULTS: For the static occlusion, Kappa values of agreement between pairs of examiners were 0.88, 0.86, and 0.85, respectively, all indicating "almost perfect agreement." For the dynamic occlusion, the range of Kappa agreement between pairs of examiners produced a median of 0.91, 0.88, and 0.85, respectively, indicating almost perfect strength of agreement. CONCLUSIONS: The results suggest that marking occlusal contacts on a transparent acetate sheet provides a simple means of recording static and dynamic occlusal contacts with a high degree of reproducibility.

Acetates↗

An evaluation of PGD in clinical genetic services through 3 years application for prevention of beta-thalassaemia major and sickle cell thalassaemia.

PGD represents an alternative within prenatal diagnosis services, which avoids terminating affected on-going pregnancies. In Greece, prevention programmes for haemoglobinopathies, including the option of prenatal diagnosis, are well established. Following optimization of a single-cell genotyping strategy (designed to be applicable for the majority of beta-thalassaemia major or sickle thalassaemia genotype interactions) along with close collaboration with an IVF unit, we integrated the option of PGD for at-risk couples with a problematic reproductive history. A total of 59 couples requesting PGD were counselled, of whom 41 initiated 63 PGD cycles. Following standard assisted reproduction treatment for oocyte retrieval, 20 cycles were cancelled (too few oocytes and/or poor quality embryos), but in 43 cycles single blastomeres were biopsied from 3 day embryos and genotyped (total 302). Diagnosis was achieved for 236 embryos, and 100 of 125 unaffected embryos were transferred. Sixteen pregnancies were established, although six were lost within the first trimester. Ten pregnancies underwent second trimester prenatal diagnosis, with nine pregnancies (13 babies: six singletons, two twins and one triplet) confirmed unaffected, although one singleton was a PGD misdiagnosis and terminated. The triplet pregnancy was selectively reduced to twins, and nine pregnancies went to term, with 12 healthy babies born. This report highlights advantages, limitations and approaches towards improvement when incorporating PGD within genetic services for a common recessive disease.

Anemia, Sickle Cell↗

Peroxisome proliferator-activated receptor-gamma in thyroid eye disease: contraindication for thiazolidinedione use?

A male type-2 diabetic, treated with the peroxisome proliferator-activated receptor (PPAR) agonist, Pioglitazone, experienced exacerbation of his thyroid eye disease (TED), which had been stable and inactive for more then 2 yr. Expansion of the orbital fat developed, and we have investigated the effects of PPAR gamma agonists, including Pioglitazone and, subsequently, an antagonist on the adipogenesis of preadipocytes from TED orbits and Graves' neck fats. The percentage of differentiating cells, assessed by oil red O staining, morphological changes, and PPAR gamma transcript levels, was determined for preadipocytes in hormone/agonist-induced models of adipogenesis, supplemented or not with PPAR gamma agonists or antagonist. The PPAR gamma agonists resulted in a 2- to 13-fold increase, and a PPAR gamma antagonist produced a 2- to 7-fold reduction in adipogenesis in vitro. Effects were dose dependent and maximal at 1 or 10 micro M. We suggest that care should be exercised when selecting patients for treatment with PPAR gamma agonists and that such agonists may be contraindicated in individuals with a previous history of autoimmune thyroid or eye diseases. Our work also suggests that PPAR gamma antagonists could provide a novel therapy for TED patients in the active stage of disease.

Adipocytes↗

Conformative, re-organized or unorganized?

'Occlusion' is presented within the concept of the articulatory system, and guidance is given on how to avoid unplanned occlusal changes. When and how to examine the occlusion is explained, and this is expanded to cover the needs of restoring a patient to the 're-organized approach'. In addition, the merits of the different types of occlusal records are discussed. In order to avoid a lengthy explanation of the terminology in the text, a glossary is appended; any term that is defined in the glossary is marked by an *.

Centric Relation↗