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Biomedical subjects

V Hamilton

Publications and source records attributed to V Hamilton.

At least 19 recordsLinked to original sources
PubMed2006

Characterization of chitosan films and effects on fibroblast cell attachment and proliferation.

Chitosan has been researched for implant and wound healing applications. However, there are inconsistencies in reports on the tissue and fibroblast responses to chitosan materials. These inconsistencies may be due to variations in chitosan material characteristics. The aim of this study was to correlate fibroblast responses with known chitosan material characteristics. To achieve this aim, chitosan was characterized for degree of deacetylation (DDA), molecular weight (MW), residual protein and ash contents, and then solution cast into films and characterized for hydrophilicity by water contact angle. The films were seeded with normal human dermal fibroblasts and the number of attached cells was evaluated for after 30 min. Cell proliferation was evaluated over 5 days. This study found no relationship between DDA, contact angle, cell attachment, and or proliferation. General trends were observed for increasing proliferation with increasing residual ash content and decreasing residual protein. These data indicate that chitosan characteristics other than DDA may be important to their biological performance.

Acetylation↗
PubMed2004

The social and economic consequences of childhood asthma across the lifecourse: a systematic review.

BACKGROUND: Asthma prevalence rates are high, and may be increasing in the Western world, particularly among children. The aim of this study was to evaluate the longer-term social and economic consequences of having asthma as a child and to determine whether adverse consequences are more severe for poorer children. METHODS: Results from published and unpublished, quantitative and qualitative studies were synthesized narratively to examine the impact of childhood-onset asthma on school attendance, academic achievement and employment in adulthood. The question of whether the impact differed for different social groups was also examined. FINDINGS: Twenty-nine good quality studies were identified, including in total 12 183 children with asthma or wheeze. Compared with asymptomatic children, those with asthma missed more days of school (additional absence as a result of asthma ranged from 2.1 to 14.8 days). Studies of academic achievement found that children with asthma performed as well as their healthy peers. The existing evidence on labour market performance is sparse, but there is an indication that people with asthma during childhood experience disadvantage in later employment. In an examination of consequences by social position, children with asthma from deprived areas were more likely to miss school than their more affluent peers, and minority ethnic children were also more likely to have poor school attendance. The only qualitative study suggested that children with asthma strove to participate fully in every aspect of their daily lives. INTERPRETATION: Although asthma limits children's daily activities and affects their social activities, this research synthesis found little evidence of major, adverse long-term social and economic consequences in studies reviewed. Further longitudinal research using comparison groups is needed to fill key gaps in the existing evidence base.

Age of Onset↗
PubMed2000

The role of a high-dependency unit in a regional obstetric hospital.

The aim of our study was to review a series of critically ill patients admitted to a high-dependency unit (HDU) in a regional obstetric centre, to assess our HDU utilisation rate and to determine the indications for and rate of transfer to an intensive care unit (ICU) in a tertiary referral centre. A 4-year retrospective review of case notes and HDU/ICU registers was performed. One hundred and twenty-three patients were admitted to the HDU in the 2 years following its inception, representing 1.02% of all deliveries. Obstetric complications accounted for 81.3% of admissions. Seventeen patients were admitted to an ICU during the study period; 12 (0.08%) were transferred before and five (0.04%) after the development of HDU facilities (p = 0.25). The advantages of a HDU within this setting include the concurrent availability of expert obstetric care and critical care management, the avoidance of the hazards of emergency transport and improved continuity of antenatal and postnatal care.

Adult↗
PubMed1998

A medium-term intervention study on the impact of high- and low-fat snacks varying in sweetness and fat content: large shifts in daily fat intake but good compensation for daily energy intake.

Thirty-six normal-weight, habitual snackers (eighteen males, eighteen females) completed a medium-term intervention study designed to examine the tendency of four different types of snacks, varying in nutrient (low- (LF) or high-fat (HF) and sensory properties (sweet (SW) or non-sweet (NSW)), to influence the control of appetite and to adjust daily energy intake. Subjects were exposed to each snack category for a 3-week period and were asked to consume a minimum number of snacks each day so that at least 25% of their daily energy intake would be derived from the test snacks. Energy and macronutrient intakes from the test snacks were calculated every day and also from other eating episodes (using 3 d food diary records) during the third week of snack exposure. Subjects consumed more energy/d from the SW snacks than from the NSW snacks, with most energy being consumed from the HF/SW snacks (3213 kJ) and least energy from the LF/NSW snacks (1628 kJ). This differential snack intake remained stable across the whole snack exposure period. Total daily energy intake did not differ significantly during exposure to any of the four snack types. Furthermore, the encouragement to eat freely from the test snacks did not lead to daily overconsumption of energy when compared with pre-study intakes. Hence, the level of snack consumption was largely compensated for by the energy consumed from the rest of the eating pattern. Although daily energy intake during exposure to the HF snacks was an average of 364 kJ higher (NS) than that during exposure to the LF snacks, the clearest and most significant effect of snack consumption was on daily macronutrient intake. Appreciable consumption of the HF snacks raised the percentage of total daily energy intake consumed as fat from 37 to 41% (P < 0.01). In contrast, the LF snacks reduced daily fat intake to 33.5% (LF/SW, P < 0.05; LF/NSW, NS) of total daily energy. The results, therefore, suggest that, in habitual snackers, generous consumption of LF snacks, when compared with HF snacks, is an effective strategy to reduce fat intake so that it approaches the recommendations of dietary guidelines without increasing total daily energy intake.

Adolescent↗
PubMed1994

The impact of ownership form and regulatory measures on firm behavior: a study of hospices.

This article examines differential responses to the Medicare hospice benefit across ownership types. The analysis reveals little difference in costs or quality of service among government-owned, for-profit, and nonprofit hospices. However, there are significant differences in the numbers of patients served by ownership status. The results are consistent with the hypothesis that nonprofit hospices are patient maximizers, not profit maximizers in disguise who are aiming to circumvent the nondistribution constraint. A comparison of these results with those in the hospital and nursing home industries leads to the conclusion that Medicare regulations and the predominance of Medicare revenues in an industry induce similar outcomes in cost and quality across ownership types.

Costs and Cost Analysis↗
PubMed1993

The Medicare hospice benefit: the effectiveness of price incentives in health care policy.

This article examines the implications of fixed-price reimbursement of providers for access to hospice care by Medicare beneficiaries. Hospices that are offered higher reimbursement rates by Medicare are found to be more likely to become certified to provide care under the Medicare Hospice Benefit program. Each $1.00 increase in the daily routine home care rate raises the probability of certification by 1.7%. In turn, the Hospice Benefit increases access to hospice care by enabling Medicare-certified facilities to serve more patients than they would if they were noncertified. However, care must be taken to set reimbursement rates appropriately. Failure to correctly adjust reimbursement rates for the real costs of certification across different parts of the country leads to disparities in hospice certification and differential access to hospice care for Medicare beneficiaries.

Certification↗
PubMed1993

Truth and reality in psychoanalytic discourse.

In this paper, I examine the influences of two philosophical theories of truth--coherence and correspondence--on the current debate on the search for 'common ground' and on specific aspects of clinical practice. Results from a previous empirical study of analysts' approaches to transference interpretation are described in order to illustrate the way in which a network of clinical concepts is held together by explicit and implicit beliefs concerning the nature of subjectivity, truth and reality. Excerpts from interviews of psychoanalysts of varying orientations practising in different geographical locations indicate the complex interrelationships between concepts of analytic neutrality, extra-transference, the real relationship, countertransference, the death instinct and the therapeutic alliance. These findings suggest that the coherence versus correspondence theories of truth may constrain rather than enhance the investigation of the differences and commonality between varying analytic theories, schools and clinical practices.

Attitude to Death↗