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At least 775 records · Page 43Linked to original sources
PubMed2002

Extending life: scientific prospects and political obstacles.

Aging can be slowed in laboratory rodents by low-calorie diets, and changes in single genes can extend mouse life span by 40 percent or more. Therefore, despite its surface complexity and effects on multiple cells and intercellular systems, aging in mammals might also be retarded by both genetic and nongenetic means. If human aging could be slowed pharmacologically to the extent now possible in rodents, the effect on healthy life expectancy would exceed that of abolishing cancer, cardiovascular disease, and adult-onset diabetes. Why, then, is research on the biological control of aging and longevity poorly funded and shunned by both most scientists and those setting national research priorities? Economic disincentives, disease-specific lobby groups, scientific careerism, and ineffective nostrums, together with gerontologiphobia, must be overcome before such research can improve public health.

Aged↗
PubMed1992

Obstacles to effective alcohol policy in the workplace: a case study.

Based on a case study of an assembly plant in a large US corporation, this paper reports on cultural and environmental influences on the form and process of workplace alcohol policy. Utilizing both ethnographic and survey methods, research findings indicate that although alcohol policies are in place, management and union leaders are unclear about their source and content, and the general employee population perceives alcohol availability and on-job drinking as poorly controlled. In grounded theory fashion, two conceptual themes are employed for organizing empirical explanations of the weakened policy and under-controlled drinking. These are: (1) the dual alcohol policy dilemma, and (2) the union-management debate over authority to discipline. The ambivalent nature of alcohol policy and organizational mechanisms involved in its implementation become risk factors for developing workplace-related alcohol problems.

Adult↗
PubMed2006

The binary: an obstacle to scholarly nursing discourse?

Recently, a concern has been raised about a particular kind of behaviour that is adversely affecting the quality of nursing theoretical discourse. With the behaviour being attributed to nurses' tendency to think in binary terms, it has been proposed that nurses replace their binary way of thinking with thinking that is inclusive and expansive and is based on an epistemology of contradiction. While agreeing that the behaviour of concern is indeed unscholarly, I disagree that the culprit is the binary. In this commentary, I argue that the culprit is sophistical argumentation involving a binary (real or not) and that, by not making room for legitimate binaries, we run the danger of 'throwing out the baby with the bathwater'. Further, I argue that the proffered solution is illusory. Its epistemological basis prohibits the deliverance of that which is promised.

Attitude of Health Personnel↗
PubMed2006

I thought we could be friends, but ...: systematic miscommunication and defensive distancing as obstacles to cross-group friendship formation.

This study examined the precursors and consequences of systematic miscommunications regarding relationship interest during intergroup interaction. Pairs of previously unacquainted same-sex students (White-White, White-Chinese, or Chinese-Chinese) engaged in a relatively intimate controlled interaction. White participants who had had little prior contact with Chinese persons were more apt to exhibit a signal-amplification bias (i.e., to perceive that their overtures had conveyed more interest than was actually the case) in intergroup as compared with intragroup exchanges. In contrast, White participants with high levels of prior contact with Chinese persons and Chinese participants did not show enhanced signal amplification in intergroup relative to intragroup exchanges. These results support our hypothesis that lack of intergroup contact experience sets the stage for miscommunications regarding friendship interest. White participants' tendency to feel that they had initially communicated more interest in being friends than their Chinese partner mediated a downward shift in their actual friendship interest over time, suggesting that signal amplification triggers defensive distancing and ultimately lowers the likelihood of cross-group friendship formation.

Adult↗
PubMed1995

Clinical problem-solving in geriatric medicine: obstacles to rehabilitation.

This case illustrates how multifactorial medical, neurological and psychiatric conditions can synergistically effect the functional status of elderly individuals. This case also illustrates how iatrogenically induced illness, most commonly in the form of drug therapy, can significantly affect patients' conditions and their progress in rehabilitative therapies. This case also illustrates how the atypical presentation of disease in the elderly, as well as the medical ramifications of rehabilitative therapies, need to be strongly considered during trials at functional rehabilitation. More importantly, however, this case demonstrates how even a community-based geriatrician can be instrumental in recognizing the need of more appropriate evaluations in elderly patients with functional disabilities and how even in the setting of a multidisciplinary team there can still be a consulting relationship, with each person seeing the patient individually and communicating with other members of the team as necessary. Although each team member may have a specific area of expertise, there is still a very important role for the geriatrician to play in making sure that all the different components of the rehabilitation and the medical care proceed in a way that will provide the most favorable outcome for the patient.

Aged↗
PubMed2004

An unusual obstacle in lead extraction.

This case report deals with an unusual complication in the removal of an active fixation implantable cardioverter defibrillator (ICD) lead. We were not able to pass the stylet beyond the point of lead fracture and this was subsequently found to be due to the stylet passing between the electrode and the outer layer of the lead insulation. The lead was removed by rotation extraction of the entire lead.

Adult↗
PubMed2005

Central venous occlusion is not an obstacle to device upgrade with the assistance of laser extraction.

OBJECTIVE: To assess the efficacy and safety of laser-assisted lead extraction for upgrade of existing pacemakers and defibrillators in patients with central venous obstruction. BACKGROUND: Implantable cardiac defibrillators and biventricular pacing have become the accepted therapeutic measures for patients with congestive heart failure. Many patients who are candidates for device therapy, however, already have existing right ventricular leads and the presence of central venous obstruction. Upgrade of existing devices in these patients is a dilemma, which is increasingly encountered by device-implanting physicians. Laser-assisted extraction of existing leads can facilitate access for device upgrade and provide an alternative to lead abandonment and contralateral implant. METHODS: We review our experience with laser-assisted lead extraction in patients, referred for upgrade of existing devices, who were found to have, or known to have, ipsilateral subclavian vein occlusion. RESULTS: Over the past 3 years, 18 patients (13 men, 5 women; mean age 63.9 +/- 16 years) with subclavian vein occlusion underwent successful laser-assisted lead extraction (total 29 leads) and upgrade of existing leads to defibrillators and/or biventricular systems. Mean implant duration prior to extraction was 70.8 +/- 43.5 (11-192) months. Cannulation of the coronary sinus and placement of a transvenous left ventricular lead were achieved in all 13 patients in whom it was attempted. No complications occurred. CONCLUSIONS: Laser-assisted lead extraction is a safe and effective approach, allowing for ipsilateral device upgrade in patients with existing devices and central venous obstruction.

Adult↗
PubMedDate not supplied

Identifying psychosocial obstacles to breastfeeding success.

Breastfeeding is an intimate process that requires psychosocial adjustment as well as technical skill. This article reviews research on the relationships of personality, family and social environments, attitudes, and emotional states to breastfeeding outcomes. Risk factors for breastfeeding difficulties are discussed, alternative feeding plans are outlined, and interventions to address psychosocial needs are described.

Adaptation, Psychological↗
PubMedDate not supplied

Engineering bone: challenges and obstacles.

Repair of large bone defects is still a challenge for the orthopaedic, reconstructive and maxillo-facial surgeon. Availability of pluripotent stem cells from either autologous or allogenic sources and the potential of inducing the osteogenic phenotype is motivating exploration and development of custom-tailored materials known as "bioengineered bone constructs". In such cases, the clinical scenario involves either expansion of stem cells in monolayer and loading them into a porous scaffold prior to surgery or direct cell expansion within the scaffold, and implanting this novel construct back into the donor patient. In this review, we delineate, from an engineering perspective, the progress that has been made to date and the challenges remaining in successfully translating this promising (but not yet definitively established) approach from bench to the bed site.

Animals↗