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Biomedical subjects

V Hunt

Publications and source records attributed to V Hunt.

At least 19 recordsLinked to original sources

Paediatric nurses' attitudes to massage and aromatherapy massage.

Complementary therapies have continued to increase in popularity in healthcare and it is widely accepted that they can be incorporated into the nursing role. However, this acceptance does not necessarily mean that the introduction of therapies into the nursing arena has been without confusion and without professional and legal implications. Consequently, this small-scale, qualitative study aimed to explore the perceptions and lived experiences of paediatric nurses of two therapies, namely massage and aromatherapy massage. There is a dearth of literature exploring nurses' perceptions to the incorporation of these therapies, especially in the arena of paediatric nursing where massage and aromatherapy massage are common practice. Semi-structured interviews were undertaken with qualified nurses and revealed the themes of 'benefit', 'family centred care', 'nursing care' and 'being held back'. It was found that at some stage during their professional career each nurse had performed massage and/or aromatherapy massage. All nurses were able to recall certain benefits of the therapies for the children that they had observed and many discussed the importance of involving the family as a way of including them in to the care of their child. However, for the nurses in this study, it was evident that the incorporation of complementary therapies into the nursing role was determined by the context in which they practised. Due to the dominance of the medical model, nurses faced pressures and conflicts in the realities of their nursing work, which meant they were often unable to carry out these therapies.

Anecdotes as Topic↗

Assessment at the end of training--a necessity nuisance.

If the public are to be assured that surgeons are safe, then there must be some form of competence assessment on which a licence to practice is based. However, the assessment and the licence needs to be both appropriate to the training received by the surgeon and to the requirements of the post they propose to take up. The 'key-concept' described in this paper attempts to address this problem.

Accreditation↗

Selecting the best from the rest.

The current method for selecting surgeons of the future is neither objective nor relevant to present day needs. An assessment is needed which ranks potential trainees according to aptitude, motivation and diligence, all of which is validated. This task should be a core duty for the Royal Colleges of Surgeons working in close co-operation with surgical specialty associations.

Clinical Competence↗

Training teachers--changing practice?

A three-day course was designed to improve the skills of those who provide clinical training to medical students. This long-term follow up of past participants shows a sustained improvement to their skills, especially in terms of involving students in their own learning, and giving them positive feedback.

Clinical Competence↗

Where there is no family doctor: the development of family practice around the world.

Family physicians are generalists trained at the postgraduate level to address the majority of primary care needs of patients of all ages in communities they serve. Throughout the world there is a need for family physicians to serve as cornerstones of comprehensive health care systems that provide high-quality, cost-effective medical and public health services to the entire population. To meet this need, each country must value and adequately finance essential medical and public health services and must provide family physicians with a thorough education focused on the relevant health care problems of the population being served. The authors present an overview of the status of this training throughout the world, outline challenges to the development of such training, and suggest strategies for successful development accompanied by illustrative case studies from South Korea, Venezuela, and Pakistan.

Education, Medical↗

Clinical evaluation of ankle inversion injuries in family practice offices.

BACKGROUND: The use of radiography in evaluating inversion ankle injuries remains high despite several studies suggesting that x-ray examination should be limited to patients meeting certain clinical criteria. These studies were all done in emergency departments. The present study examined detection of ankle fractures by clinical evaluation alone in private family practice offices. METHODS: Twelve physicians in three family practice offices participated. Check-off forms were developed to record clinical data. The physicians all attended a session to standardize terminology. The physicians then evaluated 94 consecutive patients with inversion ankle injuries. RESULTS: Eight fractures were detected by radiography, five of which had not been suspected on clinical examination (5.9% false-negative rate). Only one fracture required treatment different from that for a sprain. Tenderness on the dorsum of the foot, impaired weight-bearing ability, recentness of injury (less than 12 hours earlier), and presence of additional injuries were significantly associated with a fracture. Unlike several previous studies, swelling was not associated with fractures. If radiography had been limited to patients presenting with inability to bear weight fully or tenderness on the dorsum of the foot, none of the fractures would have been missed, and the use of radiography would have been reduced from 90% to 61%. CONCLUSIONS: The fracture rate in these family practice offices is lower than that reported in most emergency department studies. It is important that family physicians order radiographs judiciously rather than routinely for patients with inversion ankle injuries. The clinical criteria reported here are likely to reduce unnecessary ordering of radiographs and are compatible with recently published, prospectively validated rules for acute ankle injury in an emergency department setting.

Adult↗

3-Hydroxy-3-methylglutaryl-coenzyme a reductase inhibitors. 7. Modification of the hexahydronaphthalene moiety of simvastatin: 5-oxygenated and 5-oxa derivatives.

Modification of the hexahydronaphthalene ring 5-position in simvastatin 2a via oxygenation and oxa replacement afforded two series of derivatives which were evaluated in vitro for inhibition of 3-hydroxy-3-methylglutaryl-coenzyme A reductase and acutely in vivo for oral effectiveness as inhibitors of cholesterogenesis in the rat. Of the compounds selected for further biological evaluation, the 6 beta-methyl-5-oxa 10 and 5 alpha-hydroxy 16 derivatives of 3,4,4a,5-tetrahydro 2a, as well as, the 6 beta-epimer 14 of 16 proved orally active as hypocholesterolemic agents in cholestyramine-primed dogs. Subsequent acute oral metabolism studies in dogs demonstrated that compounds 14 and 16 evoke lower peak plasma drug activity and area-under-the-curve values than does compound 10 and led to the selection of 14 and 16 for toxicological evaluation.

Acetates↗

Learning to live at risk for Huntington's disease.

Huntington's disease (HD) is an autosomal dominant inherited disorder of the central nervous system. Consequently, a child of an affected parent has a 50% risk of developing the disease. This article provides an overview of HD by providing a brief history of the disease and describing progressive symptoms of chorea, dystonia, incoordination and decreased mental acuity. Steps in diagnosis, treatment and prognosis are outlined. Because persons at risk for HD have usually witnessed the deterioration of an HD parent, they are often dominated by fears of developing HD themselves. Life's choices, such as whether or not to have children, then become dilemmas. The importance of maintaining a positive life perspective, while making practical choices about employment, marriage, children and other concerns needs to be addressed.

Adaptation, Psychological↗

Nursing documentation: a format not a form.

Nurses have a difficult time committing themselves to the documentation of patient care. Various forms, assessment sheets, and checklists have been created only to prove ineffectual or to be discarded. Our format allows for the documentation of health status and permits nurses to document in the style with which they are most comfortable. The format is designed to elicit critical information and to reflect the hospital's established nursing practice standards. Subjective and objective evaluations conducted over a three month period demonstrated an appreciation for the format, a marked increase in nursing documentation, and a strong commitment by the nursing staff to reflect nursing practice in nursing documentation. A format not a form-is a method that has proven successful.

Boston↗

Mevinolin: a highly potent competitive inhibitor of hydroxymethylglutaryl-coenzyme A reductase and a cholesterol-lowering agent.

Mevinolin, a fungal metabolite, was isolated from cultures of Aspergillus terreus. The structure and absolute configuration of mevinolini and its open acid form, mevinolinic acid, were determined by a combination of physical techniques. Mevinolin was shown to be 1,2,6,7,8,8a-hexahydro-beta, delta-dihydroxy-2,6-dimethyl-8-(2-methyl-1-oxobutoxy)-1-naphthalene-hepatanoic acid delta-lactone. Mevinolin in the hydroxy-acid form, mevinolinic acid, is a potent competitive inhibitor of 3-hydroxy-3-methylglutaryl-coenzyme A reductase [mevalonate: NADP+ oxidoreductase (CoA-acylating), EC 1.1.1.34]; its Ki of 0.6 nM can be compared to 1.4 nM for the hydroxy acid form of the previously described related inhibitor, ML-236B (compactin, 6-demethylmevinolin). In the rat, orally administered sodium mevinolinate was an active inhibitor of cholesterol synthesis in an acute assay (50% inhibitory dose = 46 microgram/kg). Furthermore, it was shown that mevinolin was an orally active cholesterol-lowering agent in the dog. Treatment of dogs for 3 weeks with mevinolin at 8 mg/kg per day resulted in a 29.3 +/- 2.5% lowering of plasma cholesterol.

Animals↗