Biomedical subjects

A L Warburton

Publications and source records attributed to A L Warburton.

10 recordsLinked to original sources

PubMed2006

Changes in the levels of knowledge and attitudes of dental hospital staff about domestic violence following attendance at an awareness raising seminar.

OBJECTIVES: To assess changes in dental team knowledge and awareness about domestic violence following attendance at a brief training intervention. MATERIALS AND METHODS: Seventy-five dental hospital staff at the University of Manchester Dental Hospital attended a two-hour session delivered by Manchester's City Wide NHS Domestic Violence Project manager. Participants completed identical questionnaires immediately before and after the session. Paired t-tests were conducted to determine changes in responses to individual questions before and after training. Independent sample t-tests were also conducted to compare mean responses by sex. RESULTS: Statistically significant improvements were seen in 50% of attitude questions and 100% of knowledge questions. After training, there was improved recognition that interpersonal violence was a health issue and that the dental profession should be more involved in identification of abuse. There was also improved comfort asking about abuse and respondents were less afraid of offending the patient and less likely to blame the victims for being abused. Statistically significant sex differences at baseline were also seen for several items: females obtaining more correct answers at baseline than males. CONCLUSIONS: Brief domestic violence training interventions can be effective in improving knowledge and attitudes amongst a dental team but could lead to false confidence in staff and should be followed by in-depth practical training and the development of appropriate processes for dealing with abuse victims.

Adult↗

PubMed2006

Tackling alcohol related violence in city centres: effect of emergency medicine and police intervention.

OBJECTIVES: To identify correlates of alcohol related assault injury in the city centre of a European capital city, with particular reference to emergency department (ED) and police interventions, and number and capacity of licensed premises. METHODS: Assaults resulting in ED treatment were studied using a longitudinal controlled intervention, a three stage design during a three year period of rapid expansion in the night-time economy, when ED initiated targeted police interventions were delivered. A controlled ED intervention targeted at high risk night-clubs was carried out. Main outcome measure was ED treatment after assault in licensed premises and the street. RESULTS: Targeted police intervention was associated with substantial reductions in assaults in licensed premises but unexpected increases in street assault were also observed (34% overall: 105% in the principal entertainment thoroughfare). Combined police/ED intervention was associated with a significantly greater reduction compared with police intervention alone (OR = 0.61, 95% CI 0.40 to 0.91). Street assault correlated significantly with numbers and capacity of premises. Risk of assault was 50% greater in and around licensed premises in the city centre compared with those in the suburbs, although dispersion of violence to more licensed premises was not observed. CONCLUSIONS: Marked decreases in licensed premises assaults resulting from targeted policing were enhanced by the intervention of ED and maxillofacial consultants. Capacity of licensed premises was a major predictor of assaults in the city centre street in which they are clustered. City centre assault injury prevention can be achieved through police/ED interventions targeted at high risk licensed premises, which should also target the streets around which these premises are clustered.

Alcohol Drinking↗

PubMed2004

A national audit of joint mother and baby admissions to UK psychiatric hospitals: an overview of findings.

The Marcé Clinical Audit is an ongoing data collection exercise that gathers socio-demographic and clinical information about mothers and their infants, admitted jointly to specialist units in UK psychiatric hospitals. The maternal and parenting outcomes, in particular of mothers with schizophrenia and mothers who harm themselves and/or their infants, were determined and analysed. The majority of women had a primary diagnosis of either depression (43%) or schizophrenia (21%). Mothers with schizophrenia were three times more likely to experience a poor outcome than non-schizophrenic mothers, were more likely to be separated from their infant at discharge and were perceived, by staff, to be at greater risk of harming their infant. They were, however, shown to be no more likely to cause actual harm to their infant, or themselves, than non-schizophrenic mothers.

Adolescent↗

PubMed2004

Development, utilisation, and importance of accident and emergency department derived assault data in violence management.

OBJECTIVES: To develop formal processes for the collection, disclosure, and effective use of accident and emergency (A&E) department derived assault injury data for city violence reduction. METHODS: Over a four year period, managed by a multi-agency steering group, A&E data collection, collation, and disclosure processes were developed, instituted, and refined. Consultations and negotiations between agencies identified the most effective and ethical methods, appropriate recipients, and the nature of the information of most use. RESULTS: Disclosure of A&E data to city authorities, the police, and local media drew substantial attention and crime prevention resources to the locations of violence. As a result, a police task force responsible for targeting city street crime was funded, which analysed both A&E and police information. Monthly, electronic transfer of raw, anonymous data to the task force crime analyst informed and prompted violence prevention initiatives by several agencies. Police mounted overt and covert interventions targeted at violence hotspot licensed premises and used the data to oppose, on injury grounds, drinks/entertainment licence applications. Transport authorities established new half hourly night time city centre bus services. The local authority mounted an assault awareness campaign in schools and public libraries, and licensing magistrates used the data to measure, for example, the impact of continuous 36 hour drinks licensing on public safety. CONCLUSIONS: The principal finding of this evaluation was that judicious sharing of unique information about locations and times of violence derived from A&E patients was a powerful and effective means of targeting police and other local resource to bring about violence reduction.

Adult↗

PubMed2002

Alcohol-related violence and the role of oral and maxillofacial surgeons in multi-agency prevention.

The maxillofacial region is by far the most frequently selected target in assaults on adults. There is a causal link between alcohol intoxication and injury. Therefore, oral and maxillofacial surgery is, in effect, the lead speciality for those injured in violence and has a responsibility to orchestrate holistic care that takes into account mental health needs. Recent years have also seen a determined effort by oral and maxillofacial surgeons to get involved in wider issues of prevention, exemplified by the national UK BAOMS Facial Injuries Awareness Week. Multi-agency prevention, not just with mental health professionals in the case of individual patients, but also with emergency medicine, public health, local government, the police and the voluntary sector is key to success. Given the potential complexity of collaborations like this, it is important to understand what works in multi-agency prevention. This paper reviews successful interventions: their rationale and how oral and maxillofacial surgeons can contribute to local injury prevention.

Adolescent↗

PubMed2000

Effectiveness of toughened glassware in terms of reducing injury in bars: a randomised controlled trial.

OBJECTIVE: To evaluate the effectiveness, in terms of injury prevention, of toughened pint glassware in bars. DESIGN: Randomised controlled trial. SETTING: A random sample of 57 bars in South Wales, West Midlands, and West of England. SUBJECTS: A total of 1229 bar workers. INTERVENTION: Complete replacement of pint glasses with annealed (control) or toughened (intervention) glassware. MAIN OUTCOME MEASURES: Bar staff injuries recorded monthly: number, site, and severity (lifestyle impact; treatment need) of injuries. RESULTS: Ninety eight bar staff experienced 115 injuries: 43 in the control group, 72 in the intervention group. Adjusting for people at risk gave a relative risk (RR) of 1.48 (confidence interval (CI) 1.02 to 2.15). Similarly, adjusting for hours worked gave RR 1.57 (CI 1.08 to 2.29). Thus, injury rate was 60% higher in the intervention group (p<0.05), with no significant difference in severity. Most were hand injuries requiring first aid. Injuries tended to occur simultaneously in more than one body part in the intervention group, reportedly caused by spontaneous disintegration of toughened glassware. Impact resistance testing showed the energy required to break annealed glass (1.8 +/- 0.2 J) was greater than that for toughened glass (1.4 +/- 0.2 J), though the difference was not significant. CONCLUSIONS: Glass with lower impact resistance caused more injuries. "Toughened" glassware had lower impact resistance. Standards for toughening need to be developed.

Accident Prevention↗

PubMed1997

The hypogastric and thirteenth thoracic ganglia of the rat: effects of age on the neurons and their extracellular environment.

Morphometric analyses of the neurons and microvessels of perfusion-fixed hypogastric (HG) and 13th thoracic (T13) ganglia have been performed in male Wistar rats aged 4, 24 and 30 mo. Estimations of HG volume employing the Cavalieri principle have also been performed and showed that the size of the aged HG is increased by 42%. Routine histological staining of the ganglia with Masson's trichrome indicated that this may be due to the increased amount of interstitial connective tissue which was apparent in the aged animals. The number of neurons per unit area progressively decreased by 38% between ages 4 and 24 mo and by 16% between ages 24 and 30 mo in the HG and by 25% (4 and 24 mo) and 2% (24 and 30 mo) in the T13 ganglion. The total number of neurons in the HG however, estimated by a physical disector analysis, was constant with age. The number of microvessels per unit area, microvessel diameter, neuronal and nuclear areas did not differ significantly between the 3 age groups studied. This observed increase in ganglionic volume and decrease in neuronal packing density may be associated with changes in the extracellular matrix, in particular in glycosaminoglycans whose presence was indicated by metachromasia of the ganglia with toluidine blue. The extracellular matrix was therefore characterised using a panel of monoclonal antibodies against glycosaminoglycans and laminin. Chondroitin-6 sulphate and chondroitin-4 sulphate were present in the interstitial connective tissue, and there was an increase in the expression of both these epitopes at 24 mo, noteably surrounding neuron cell bodies. The expression of chondroitin-4 sulphate/dermatan sulphate was unchanged, thus implying a decreased expression of dermatan sulphate with age. Keratan sulphate and the native chondroitin sulphate epitopes were absent from the ganglia at both ages. Laminin expression was increased in the aged ganglia. It is therefore clear that the constituents of the extracellular matrix are not constant throughout the adult lifespan and that the extracellular matrix may influence neuronal survival in old age. This is the first report characterising age-related changes in the extracellular matrix of autonomic ganglia.

Aging↗

PubMed1995

Decrease in synapsin I staining in the hypogastric ganglion of aged rats.

The rat hypogastric ganglion (HG) contains populations of both sympathetic and parasympathetic postganglionic neurons which supply the lower pelvic viscera. These neuron populations can be identified by tyrosine hydroxylase (TH) and NADPH-diaphorase (NADPH-d) staining, respectively. The effects of age on the distribution of synapsin I, a nerve terminal marker, in relation to these neuron populations has been investigated in young adult and aged rats. Most synapsin staining was axosomatic and was markedly reduced in the aged animals particularly in relation to sympathetic (NADPH-d-negative/TH-positive) neurons. Image analysis of synapsin I staining in relation to individual sympathetic neurons confirmed that there was a reduction with age of about 50% but no change in synapsin I staining in relation to parasympathetic neurons. These results suggest that synaptic transmission and peripheral integration may be affected in old age and that the autonomic control of the pelvic viscera may be compromised as a result, particularly with regard to the sympathetic innervation. Other autonomic ganglia were also studied for comparison but no such age-related differences were observed.

Age Factors↗

PubMed1994

Sympathetic and sensory innervation of the urinary tract in young adult and aged rats: a semi-quantitative histochemical and immunohistochemical study.

The sympathetic innervation of the urinary tract of young adult (4 months) and aged (24+ months) rats has been examined by glyoxylic acid-induced fluorescence for the detection of noradrenaline and by immunofluorescence using antisera against tyrosine hydroxylase (TH) and neuropeptide Y (NPY). Immunostaining for calcitonin gene-related peptide (CGRP), known to be present in pelvic sensory nerves, was also performed. Semi-quantitative estimations of nerve densities were made of noradrenergic and peptidergic fibres innervating the smooth musculature of the ureter, bladder and urethra, and of the urinary tract vasculature. In the aged rats the overall patterns of innervation remained unchanged. However, with the exception of the vesical vasculature, the density of noradrenergic innervation decreased as did the intensity of histofluorescence. A similar pattern of results was observed by TH and NPY immunofluorescence. The results present evidence for a diminution in the sympathetic control of the urinary tract in aged rats. The pattern and density of CGRP-immunoreactive nerves was unchanged in the aged animals suggesting that pelvic visceral sensory innervation is more resistant to the effects of advancing age.

Adrenergic Fibers↗

PubMed1993

Localisation of NADPH-diaphorase and acetylcholinesterase activities and of tyrosine hydroxylase and neuropeptide-Y immunoreactivity in neurons of the hypogastric ganglion of young adult and aged rats.

Neurons in the hypogastric (main pelvic) ganglia of 4- and 24-month-old male rats were investigated by enzyme histochemical methods for NADPH-diaphorase (NADPH-d) and acetylcholinesterase (AChE) activities and by immunofluorescence for tyrosine hydroxylase (TH) and neuropeptide Y (NPY) immunoreactivities. Systematic random sampling of standard sized areas of ganglion parenchyma revealed a content (per unit area) of 40.9 +/- 8.41 NADPH-d-positive neurons and 14.42 +/- 6.7 intensely AChE-positive neurons. In the aged rats the staining intensity was unchanged, but reductions in the numbers of cells stained for NADPH-d and AChE were not significantly different. Similar counts of TH- and NPY-immunoreactive neurons revealed values of 23.2 +/- 1.77 and 19.94 +/- 4.9, respectively, suggesting frequent co-localisation. The numbers of TH- and NPY-immunoreactive neurons were found to have decreased with age by 53% and 60%, respectively. Staining of consecutive sections revealed that those neurons which stained positively for NADPH-d did not show immunoreactivity for TH or NPY, and those neurons that were immunoreactive for TH or NPY did not contain intense NADPH-d staining. Occasional NPY-1R neurons were both TH- and NADPH-d-negative. These results suggest that NADPH-d staining is predominantly confined to the parasympathetic neuron population of the hypogastric ganglion and that it is the sympathetic neuron population alone that decreases in number with age.

Acetylcholinesterase↗