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Biomedical subjects

A Miles

Publications and source records attributed to A Miles.

At least 19 recordsLinked to original sources
PubMed2005

Adverse psychological outcomes in colorectal cancer screening: does health anxiety play a role?

People who are anxious about their health are more likely to misinterpret health information as personally threatening and less likely to be reassured by medical investigations that show they are free from disease. Consequently, health anxious people would be expected to react more adversely to cancer screening, but this possibility has rarely been explored. The moderating role of health anxiety on the psychological impact of participating in colorectal cancer screening was examined among a sub-sample of 3535 participants in a large, community-based trial of colorectal cancer screening in the UK. The screening modality was flexible sigmoidoscopy, which examines the bowel for pre-cancerous polyps. It was predicted that health anxiety would be associated with more worry about cancer before screening, a greater increase in worry if polyps were detected, and less reassurance after a clear result. As expected, health anxious participants were more anxious and more worried about bowel cancer both before and after screening. However, they experienced greater reductions in anxiety and worry about cancer following the examination. They reported lower levels of reassurance following screening, but also expressed more positive reactions to the experience. The positive psychological benefits of attending medical investigations should be examined in future work, because this may go some way towards explaining why health anxious people repeatedly seek medical interventions.

Aged↗
PubMed2005

SunSmart? Skin cancer knowledge and preventive behaviour in a British population representative sample.

The incidence of skin cancer has risen rapidly in the UK over the last 20 years, prompting public health organizations to try and raise awareness of the dangers of sun exposure and the need to practice sun-safe behaviour. This study aimed to assess baseline levels of sun-safe knowledge and behaviour in a British population-representative sample, prior to the launch of Cancer Research UK's 'SunSmart' campaign. A face-to-face survey was conducted through the Office for National Statistics as part of their Omnibus survey. In total, 1848 men and women aged 18 and over were interviewed. Knowledge of what to do to reduce skin cancer risk was modest. Two-thirds mentioned avoiding the sun by seeking shade, 50% mentioned covering up and only 43% said to use high factor sunscreen. Practice of sun-safe behaviours was also poor, with only one-third saying they sought shade, covered up or used high factor sunscreen to protect themselves from the sun. Men and those from lower socioeconomic groups were least informed and least likely to report using sun-protective behaviours. Increases in both knowledge and use of appropriate sun-protective behaviours are needed if skin cancer incidence rates are to decrease.

Adult↗
PubMed2005

Managing constraint: the experience of people with chronic pain.

This study describes the experience of people with chronic pain. Using the method of grounded theory, 29 chronic pain sufferers were interviewed at an outpatient pain clinic. A model depicting the basic social psychological process of maintaining a normal life through constraint was developed. This process revolved around people's perception of the constraints imposed by pain: bodily constraint (constraint on the body and its relationship to the environment); activity constraint (the constraint on what people could do); and identity constraint (the constraint on what people could be). The degree to which pain had challenged what people had previously accepted as 'normal' was illustrated through their evaluation of the impact of pain. The conclusion of this process of evaluation reflected how people coped with the constraints of pain-whether they were assimilated, accommodated, confronted or subverted. In assimilation, the constraints were absorbed and normal life maintained. In accommodation, the constraints were accepted and normal life re-defined. In confrontation, the constraints were rejected and pre-pain identities and activities pursued despite leading to increased pain levels. In subversion, attempts were made to retain pre-pain identities, and although pain levels were minimized, activities were altered to a significant degree. The limitations imposed by pain often form the focus of people's coping efforts, rather than the pain per se. The desire to retain pre-pain 'normal' lifestyles may underlie people's use of coping strategies that exacerbate pain intensity and pain-related disability. Future research needs to explore both the relationship between adjustment to pain and adjustment to the restrictions associated with ageing, and the role of body techniques and identity management in adjustment to pain in order to understand factors which may promote pain acceptance.

Adaptation, Psychological↗
PubMed2005

Survey of paediatric case management practices in Australia for children and young people with acquired brain injury (ABI).

AIM: To investigate the characteristics of paediatric acquired brain injury (ABI) case managers and their organizations in Australia, and to determine the ways in which case managers deliver their service, maintain professional development and evaluate outcomes. METHODS: Postal survey of 57 known paediatric ABI case managers working at 24 separate organizations in Australia. RESULTS: Out of 40 questionnaires returned (70%), the majority of respondents had been providing case management for over 5 years (55%). Co-ordination of services was ranked the most important component of case management, with services most frequently delivered by telephone. Evaluation of case management outcomes was reported by only 52% of the case managers. Whilst the majority of case managers had received some form of training (83%), this varied widely from informal in-house training, to workshops run by insurance companies and government agencies. DISCUSSION: This survey provides information about current case management practices for children with ABI in Australia. Detailing what case managers do is a first step towards developing controlled research designs which are required to demonstrate whether case management is effective in terms of clinical outcomes and cost-benefit.

Adolescent↗
PubMed2005

Gender differences in utilization of colorectal cancer screening.

OBJECTIVES: To assess the demographic and psychological mediators of gender differences in uptake of flexible sigmoidoscopy (FS) screening for colorectal cancer. SETTING: A subsample (n=5462) from a large community trial of FS in the UK. METHODS: Men and women randomized to screening as part of the UK Flexible Sigmoidoscopy Trial were sent a postal questionnaire assessing demographic characteristics and attitudes to screening six months before their screening appointment. Attendance at screening was recorded by the screening centres. RESULTS: More men than women attended screening (73% versus 67%). The higher male attendance was partially explained by their lower levels of socioeconomic deprivation, higher levels of marital status and lower perceived barriers to screening. CONCLUSIONS: Contrary to expectations, men were more likely than women to attend FS screening. This was partially explained by socioeconomic and attitudinal differences to screening, but additional research is needed to understand the key aspects of FS screening that will maximize screening uptake in men and women.

Attitude to Health↗
PubMed2003

Agonist binding to peptide hormone receptors.

A fundamental issue in molecular pharmacology is to define how agonist-receptor interaction differs from that of antagonist-receptor interaction. The V(1a) vasopressin receptor (V(1a)R) is a member of a family of related G-protein-coupled receptors (GPCRs) that are activated by vasopressin, oxytocin (OT) and related peptides. A segment of the N-terminus that was required for agonist binding, but not antagonist binding, was identified by characterizing truncated V(1a)R constructs. Site-directed mutagenesis revealed that a single residue (Arg(46)) was critical for agonist binding and receptor activation. The N-terminus of the related OT receptor (OTR) could recover agonist binding in a chimaeric OTR(N)-V(1a)R construct. Furthermore, Arg(34) of the human OTR, which corresponds to Arg(46) of the rat V(1a)R, provided agonist-specific binding epitopes in the OTR, indicating a conserved function of this locus throughout this GPCR subfamily. Mutation of Arg(46) revealed that high-affinity agonist binding had an absolute requirement for arginine at this position.

Animals↗
PubMed2001

The chromatin remodelling factor Brg-1 interacts with beta-catenin to promote target gene activation.

Wnt-induced formation of nuclear Tcf-beta-catenin complexes promotes transcriptional activation of target genes involved in cell fate decisions. Inappropriate expression of Tcf target genes resulting from mutational activation of this pathway is also implicated in tumorigenesis. The C-terminus of beta-catenin is indispensable for the transactivation function, which probably reflects the presence of binding sites for essential transcriptional coactivators such as p300/CBP. However, the precise mechanism of transactivation remains unclear. Here we demonstrate an interaction between beta-catenin and Brg-1, a component of mammalian SWI/SNF and Rsc chromatin-remodelling complexes. A functional consequence of reintroduction of Brg-1 into Brg-1-deficient cells is enhanced activity of a Tcf-responsive reporter gene. Consistent with this, stable expression of inactive forms of Brg-1 in colon carcinoma cell lines specifically inhibits expression of endogenous Tcf target genes. In addition, we observe genetic interactions between the Brg-1 and beta-catenin homologues in flies. We conclude that beta-catenin recruits Brg-1 to Tcf target gene promoters, facilitating chromatin remodelling as a prerequisite for transcriptional activation.

Amino Acid Substitution↗
PubMed2001

Venous thromboembolism and pregnancy.

Venous thromboembolism remains a major cause of maternal morbidity and mortality. Pregnancy is a thrombogenic state; therefore, clinicians must be familiar with the diagnosis and treatment of acute VTE. It is of paramount importance when caring for pregnant women to understand which patients are at risk for VTE and to use thromboprophylactic heparin accordingly.

Anticoagulants↗
PubMed2001

Mass education for obesity prevention: the penetration of the BBC's 'Fighting Fat, Fighting Fit' campaign.

The study aimed to evaluate the BBC's 'Fighting Fat, Fighting Fit' campaign's success in achieving public awareness of the need for obesity prevention, and putting over its message of healthy eating and increased physical activity. Demographic factors associated with awareness of the campaign were assessed. Data were collected from a national representative British sample as part of the ONS Omnibus survey in March 1999. Questions included weight and height, recognition of the campaign name, recall of the content of the campaign, and participation in the campaign registration scheme. More than half of the respondents had heard of the campaign and 30% recalled the healthy lifestyle messages, although fewer than 1% registered to participate in the scheme. Awareness of the campaign was high in all socio-economic groups, but memory for the healthy lifestyle message was significantly poorer in those with lower levels of education and from ethnic minority groups. Disappointingly, awareness was also no higher in overweight than normal weight respondents. The results strongly support the effectiveness of the campaign in publicizing the issue of increasing prevalence of obesity and the need for lifestyle change, but suggest that different approaches might be needed to maximize participation from groups most in need of lifestyle change.

Adolescent↗
PubMed2001

Using the mass-media to target obesity: an analysis of the characteristics and reported behaviour change of participants in the BBC's 'Fighting Fat, Fighting Fit' campaign.

The study aimed to assess the characteristics and reported behaviour change of participants in the BBC's 'Fighting Fat, Fighting Fit' (FFFF) campaign. A postal questionnaire survey was sent to a random sample of 6000 adults registering with the FFFF campaign at the start of the campaign and 5 months later. Demographic characteristics, weight, eating behaviour and activity patterns were assessed. In total, 3661 respondents completed the baseline questionnaire and 2112 (58%) of these completed a follow-up evaluation questionnaire 5 months later. The majority of evaluation participants were women and classified as 'overweight' or 'obese'. Participants reported significant reductions in weight, and in fat and snack intake, and significant increases in exercise levels, and in fruit, vegetable and starch intake during the 6 months of the campaign. These effects remained significant if non-responders were assumed to have made no change. These results show that mass-media campaigns might make a contribution to weight control at the population level, but particular subgroups such as men and people under 25 may require specifically targeted campaigns. In addition, whilst such campaigns may initially attract obese people, they may be more likely to drop out of the campaign than overweight and normal weight individuals.

Adolescent↗
PubMed2001

Assessing exposure to disinfection by-products in women of reproductive age living in Corpus Christi, Texas, and Cobb county, Georgia: descriptive results and methods.

We conducted a field study in Corpus Christi, Texas, and Cobb County, Georgia, to evaluate exposure measures for disinfection by-products, with special emphasis on trihalomethanes (THMs). Participants were mothers living in either geographic area who had given birth to healthy infants from June 1998 through May 1999. We assessed exposure by sampling blood and water and obtaining information about water use habits and tap water characteristics. Two 10-mL whole blood samples were collected from each participant before and immediately after her shower. Levels of individual THM species (chloroform, bromodichloromethane, dibromochloromethane, and bromoform) were measured in whole blood [parts per trillion (pptr)] and in water samples (parts per billion). In the Corpus Christi water samples, brominated compounds accounted for 71% of the total THM concentration by weight; in Cobb County, chloroform accounted for 88%. Significant differences in blood THM levels were observed between study locations. For example, the median baseline blood level of bromoform was 0.3 pptr and 3.5 pptr for participants in Cobb County and Corpus Christi, respectively (p = 0.0001). Differences were most striking in blood obtained after showering. For bromoform, the median blood levels were 0.5 pptr and 17 pptr for participants in Cobb County and Corpus Christi, respectively (p = 0.0001). These results suggest that blood levels of THM species vary substantially across populations, depending on both water quality characteristics and water use activities. Such variation has important implications for epidemiologic studies of the potential health effects of disinfection by-products.

Activities of Daily Living↗
PubMed2001

The factor structure of the BDI in facial pain and other chronic pain patients: a comparison of two models using confirmatory factor analysis.

OBJECTIVES: 1) To compare two measurement models of the BDI in chronic pain sufferers to see which provides the better fit; 2) to assess whether model fit differs for a facial pain sample compared to a sample of pain sufferers attending a multidisciplinary pain clinic; and 3) to establish which affective and somatic sub-scales of the BDI could be used in chronic pain research. DESIGN: Two groups of chronic pain sufferers, a facial pain group, and a group attending a multidisciplinary pain clinic completed self-report questionnaires on pain (Multidimensional Pain Inventory), depression (BDI), and measures of anxiety and depression-related pain cognitions (the Spielberger State-Trait Anxiety Inventory and the Pain Cognitions Questionnaire). The measurement models of the BDI were tested using LISREL structural equation modelling and their construct validity examined using partial correlation analysis. METHOD: A total of 173 people attending a multidisciplinary pain clinic and 157 patients attending a facial pain clinic completed self-report measures of pain and mood prior to their respective clinical consultations. RESULTS: The model offered by Novy et al. (containing one affective factor 'Negative-attitude suicide' and two somatic factors 'Performance difficulty' and 'Physiological manifestations') fitted both pain groups better than the model offered by Williams and Richardson (containing one affective factor 'Self-reproach', one somatic factor 'Somatic disturbance' and one factor with a mixture of both affective and somatic items 'Sadness about health'). However, when the factors were allowed to correlate in the latter model, both models were broadly equivalent. CONCLUSIONS: The two measurement models adequately fitted data in both pain samples when the factors were allowed to intercorrelate in the Williams and Richardson model. Both the affective scales offered by both models could be used in future research, although the somatic factor offered by the Williams and Richardson model offered much higher levels of internal reliability than either of those offered in the Novy et al. model. The findings are discussed in relation to the issue of depression in chronic pain.

Journal Article↗
PubMed2001

Struvite precipitation potential for nutrient recovery from anaerobically treated wastes.

Geochemical equilibrium speciation modeling was used to determine optimum conditions for precipitation of magnesium ammonium phosphate, or struvite, for the recovery of nutrients from anaerobically digested wastes. Despite a wide range of pH values with the potential to precipitate struvite, the optimum pH was determined to be 9.0. Bench experiments conducted on effluent from an anaerobic sequencing batch reactor (ASBR) treating swine wastes achieved a maximum of 88% ammonia removal at a pH of 9.5 with added magnesium and phosphate to achieve an ammonium: magnesium: phosphate molar ratio of 1:1.25:1. Struvite precipitation was performed on a continuous basis in a pilot-scale ASBR treating swine wastes. Through the addition of supplemental magnesium and phosphate, the ammonia concentration was reduced from 1500 mg/L as nitrogen to less than 10 mg/L. The supenatant from the struvite precipitation clarifier was recycled to the feed of the ASBR without adverse impact, simulating on-farm effluent reuse as flush water.

Agriculture↗