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Biomedical subjects

T Adams

Publications and source records attributed to T Adams.

At least 73 records · Page 4Linked to original sources
PubMed1999

Dentistry and medical dominance.

In this study, I explore the relationship between medicine and dentistry in Ontario between 1868 and 1918. Examination of the rise of dentistry and medical-dental relations reveals that medicine never came to dominate dentistry to the extent it did other health care occupations. The combination of four factors enabled dentistry to avoid outright medical dominance in Ontario. First, dentistry organized and professionalized at approximately the same time as did medicine in Ontario. Second, dentistry's jurisdiction remained somewhat separate from medicine's. Third, unlike other health care occupations, the dental profession never challenged medicine's claims to knowledge or expertise. Fourth, dental and medical leaders shared gender and class backgrounds, identities, and goals that discouraged conflict between them. The importance of these four factors and their implications for future research into inter-professional relations and medical dominance are discussed.

Dentistry↗
PubMed1999

Choice of cuff inflation medium during nitrous oxide anaesthesia.

Air, saline and a mixture of nitrous oxide and oxygen were used to inflate the cuffs of tracheal tubes inserted into three groups of patients, during nitrous oxide anaesthesia. Large increases in intracuff pressure were seen in the air group, but no morbidity resulted. The intracuff pressure decreased in the gas mix group and leaks occurred in some patients. Initial adjustment of cuff pressure was more difficult in the saline group but the pressure remained stable thereafter.

Adult↗
PubMed1999

Postural stability of wheelchair users exposed to sustained, external perturbations.

The postural stability of wheelchair users experiencing external perturbations was examined. Rotation of a tilt platform generated moments in the trunks of subjects seated in a manual wheelchair on the platform. The magnitude and duration of the moments were on the order of those that might be encountered in the sagittal plane during controlled braking maneuvers in a vehicle. Four subjects with tetraplegia, four with paraplegia, and five controls participated in experimental trials on the platform. As input, four different Disturbance profiles with either a 0.2 g (gravitational acceleration) or 0.4 g maximal level were imposed. The majority of the subjects with spinal cord injury lost balance at Disturbance levels below 0.2 g. The results suggest that the rate of change of the applied perturbation may also affect stability. The use of a stability index based on normalized motion of the center of pressure with respect to the seat showed efficacy in characterizing the response.

Adult↗
PubMed1998

The discursive construction of dementia care: implications for mental health nursing.

This paper sets out a new approach to dementia that may be used to underpin mental health nursing practice. The paper begins by examining the development of community care. Various models of service provision to people with dementia are then critically examined. As an alternative to these approaches a new model of dementia is developed which highlights the position of various family members in the provision of dementia care including the person with dementia and also the importance of linguistic devices such as narrative and discourse. Finally the implications of this approach upon the mental health nursing practice are examined together with various suggestions for the development of research.

Caregivers↗
PubMed1998

The concept of serious mental illness: modern myths and grim realities.

Current mental health practice and legislation is influenced significantly by the ill-defined concept of serious mental illness (SMI). Although the concept of SMI originally appeared to include a consideration of a range of forms of mental illness, including dementias, by custom and practice the term has come to mean, often, only people with a psychotic diagnosis. This paper reviews the influence of the term SMI, considering the way older people, younger people and other subgroups within the 'adult' population have been marginalized by the narrow definition of the concept. The paper concludes with a consideration of some of the ethical implications of mental health nurses focusing on an ill-defined 'illness' grouping, and the impact that such a narrow focus might have on the ambition to establish 'health for all by the year 2000'.

Adolescent↗
PubMed1998

Partnership in public health.

In Australia the States, Territories, Federal Government, nongovernmental organizations and the community all contribute to public health development. Efforts are being made to build a partnership between them to improve efficiency and effectiveness.

Australia↗
PubMed1997

A unique myosin isoform transition in cat striated external anal sphincter muscle induced by denervation.

Denervation of limb and trunk muscles leads to characteristic changes in their biochemical properties. However, the effects of denervation of the striated external anal sphincter (EAS) muscle have not been studied, even though denervation is a common etiology for fecal incontinence. The present study reports effects ofdenervation of the cat EAS and compares them with changes in a denervated limb muscle [cat extensor digitorum longus (EDL)]. Nerves supplying the EAS and the EDL were sectioned in anesthetized cats, which were allowed to recover and live for 10, 30, or 60 days. Their muscles were then excised, and myofibrillar proteins were isolated. Myosin heavy chain (MHC) isoform composition was measured by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The EDL and EAS showed progressive increases in MHC type IIA and progressive decreases in MHC type IIB at 10, 30, and 60 days. MHC type I progressively increased in the EDL but showed no change in the EAS. We hypothesize that this distinctive transition is related to the unique embryological origin and function of the EAS.

Anal Canal↗
PubMed1997

Second cancer risk in hairy cell leukemia: analysis of 350 patients.

PURPOSE: The discovery of effective therapy for hairy cell leukemia (HCL) has increased the relevance of long-term outcome. We have therefore examined the incidence of second cancers. PATIENTS AND METHODS: Data on 350 HCL patients was obtained from the M.D. Anderson Cancer Center Cancer Registry's computerized data base and from chart review. Standardized incidence ratios (SIRs) and standardized mortality ratios (SMRs) (observed/expected [O/E]) were calculated with the expected number determined using age, sex, and calendar-year-specific rates from the Connecticut Tumor Registry and from national mortality data, respectively. RESULTS: The median age of the patients was 50 years and the median follow-up duration was 6 years. Twenty-six patients developed a second cancer at least 6 months after the HCL diagnosis (O/E ratio, 1.34; P = .08). There was no excess of malignancy among patients treated with interferon alfa (IFN-alpha; P = .27), 2-chlorodeoxyadenosine (2CDA; P = .37), or deoxycoformycin (DCF; P = .7). However, an excess of myeloma-related neoplasms (O/E, 13.04; P < .001) and lymphomas (O/E, 8.7; P = .03) was observed. Survival from the advent of systemic therapy for HCL was better than before this time (P = .0009). Nevertheless, mortality remained excessive (O/E, 6.17; P < .001), mainly because of HCL-related infections and secondary malignancy. CONCLUSION: Among 350 patients with HCL, there was an increase in the number of second cancers; however, it did not reach statistical significance and was not associated with therapy. The incidence of lymphoid neoplasms was significantly higher than expected. Survival since the advent of effective systemic therapy was excellent, although excess mortality was still observed.

Adult↗
PubMed1997

Accessing primary dental care in three London boroughs.

OBJECTIVE: To investigate and identify factors that may influence individuals' ability to access primary health care services. DESIGN: Cross-sectional study SETTING: Lambeth, Southwark and Lewisham. SUBJECTS: A 0.1 per cent random sample of people aged 18 years and over in the population of 626,621 people in the three boroughs. MAIN OUTCOME MEASURES: Demographic as well as psychosocial profile of the sample, perceptions of their dental health needs, accessed dental care. RESULTS: The results indicated that people believed that their oral health was good. The majority of the sample had attended for dental care within the previous year and were registered with a general dental practitioner. Accessing dental care was related to age, social class, borough of residence, dentate status and dental phobia status. In addition subjects experiencing problems with their teeth gained access to care more readily than others. This was related to social class. Accessing dental care was predicted by dental care being provided by a general dental practitioner, experiencing problems with teeth and not being dentally phobic. CONCLUSIONS: The findings suggest that psychosocial factors together with dental health status can act as determinants when accessing primary dental services. It is considered that family health services authorities should be aware of these influences when developing and monitoring dental health services, in order to make them responsive and sensitive to the needs of the people whom they serve.

Adolescent↗
PubMed1996

Teaching preschool age autistic children to make spontaneous initiations to peers using priming.

Children with autism rarely initiate social interactions with their peers. Currently available interventions have not increased autistic children' spontaneous initiations in natural settings without extensive teacher involvement. A "priming" strategy consisting of a low demand, high reinforcement session prior to the regular school activity was used to increase the spontaneous social initiations of 2 preschool age autistic boys to typically developing peers in a regular preschool classroom. Peers were also trained to independently respond to initiations. Implications for developing practical ways to improve autistic children's social functioning in regular school settings are discussed.

Autistic Disorder↗
PubMed1996

Informal family caregiving to older people with dementia: research priorities for community psychiatric nursing.

The paper reviews the literature relating to the provision of community psychiatric nursing to demented elderly people and their informal family caregivers, and develops priorities for research in that particular area of nursing. Initially, the development of community psychiatric nursing with elderly demented people is examined. Various theoretical models articulating the family's experience of dementia are examined as a basis for identifying various priorities for research in the area. Empirical evidence relating to the efficacy of various interventions is briefly discussed. Various priorities are made regarding the development of research relating to the development of community psychiatric nursing with elderly demented people and their informal caregivers. Finally the paper is placed in the context of the present policy of refocusing psychiatric nursing on to people with serious and enduring mental disorders. It is argued that this policy should include elderly demented people not just younger people with functional mental disorders.

Age Factors↗
PubMed1996

Kitwood's approach to dementia and dementia care: a critical but appreciative review.

This paper critically examines the recent work of Tom Kitwood and his colleagues at the Bradford Dementia Group. After initial details relating to Kitwood's early work and the development of the research group, the paper sets out Kitwood's ideas regarding the nature of dementia and dementia care. Four areas of contribution made by Kitwood are outlined. Problems relating to Kitwood's research methods are then put forward. In conclusion, it is suggested that while Kitwood's work will undoubtedly help enhance the care given to elderly demented people, more work needs to be done to ensure the validity of his methods.

Alzheimer Disease↗
PubMed1996

Medical students' attitudes toward the autopsy.

BACKGROUND: The autopsy is an educational experience that helps students correlate clinical findings with basic science issues. Because of the sensitive nature of the autopsy, students' attitudes should be considered prior to its design and implementation. METHOD: In 1992-1993, all 147 second-year students at the Medical College of Ohio completed a 26-item Likert questionnaire about their attitudes toward the autopsy. After participating in an elective autopsy experience, 26 students completed the same questionnaire plus 18 additional questions about the environment and behavior of the pathologist. Pre- and post-autopsy responses were factor analyzed using principal-components analysis with a varimax rotation. Student's t-tests were used to compare (1) the pre-autopsy factor scores of the elective participants and the rest of the class and (2) the pre- and post-autopsy scores of the participants. RESULTS: Factor analysis of the attitude questions identified seven factors. Comparison of the pre- and post-autopsy scores of the elective participants revealed statistically significant positive increases on four factors; three factors remained positive or neutral. CONCLUSION: It was concluded that the autopsy elective had a positive influence on the student's attitudes. In addition, the pathologist's behavior and the environment in which the autopsy occurred influenced the students. Twenty-two (85%) of the students indicated the autopsy should be mandatory for all students.

Adult↗