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Biomedical subjects

B T Williams

Publications and source records attributed to B T Williams.

At least 73 records · Page 4Linked to original sources
PubMed1989

Alternative test sequences for HIV screening of donated blood.

Human Immunodeficiency Virus (HIV) infection is extremely rare among volunteer blood donors. The highly sensitive Enzyme Linked Immunoassay (ELISA) test and the highly specific Western blot confirmation constitute the test sequence now used to minimize the possibility of transfusion associated HIV infection and to minimize the loss of donors due to false positive test results. The estimated operating characteristics for the test sequence permit the estimation of true infection rates which may be higher or lower than "observed" rates among subcategories of blood donors with progressively lower prevalence rates. The probability that a positive test result indicates true infection also declines with decreasing prevalence. The potential benefits of changing the test sequence so that complete HIV screening is implemented only for donations which are hepatitis-free include a reduction in the costs of Western blot testing and donor counseling, a reduction in the number of donors who use the blood bank inappropriately for personal HIV testing, and a more explicit recognition of the false positive problem when counseling donors.

AIDS Serodiagnosis↗
PubMed1989

Ownership, availability, and use of portable syringe drivers among hospices and home-care services.

We ascertained the ownership, availability and extent of use of portable syringe drivers among 236 hospice in-patient units and home-care services for the terminally ill in the United Kingdom by means of a postal questionnaire (97% response rate). Only 11 hospices and home-care services did not use them. The rest owned a median number of 4 but had only 1 in use. However, the combined hospice with home-care services owned relatively more than either hospices or home-care teams (median number 6 compared to 3.5 and 4 respectively) and used relatively more than the others (estimated median 2 [95% CI: 1-2] compared to 1 [95% CI: 0-1] and 1 [95% CI: 1-2] respectively). The major determinants of ownership and use among units with an in-patient facility were supply factors such as the numbers of trained nurses in palliative care and doctor half-day sessions, whereas for home-care units the number of patients cared for daily was the most important determinant. There does not seem to be any unmet demand for portable syringe drivers among hospices and home-care services.

Home Care Services↗
PubMed1989

Total-body electrical conductivity (TOBEC): relationship to estimates of muscle mass, fat-free weight, and lean body mass.

A comparison of methods for estimating body composition (BC) of 12 subjects was made by using fat-free weight from total-body electrical conductivity (FFWT), muscle mass from 3-methylhistidine excretion (MM3MH) and creatinine excretion (MMCRE), fat-free weight from hydrostatic weighing (FFWBD), and lean body mass from whole-body potassium counting (LBMK). Data were analyzed for day-to-day variability and regression analyses were applied to compare the different methods of measuring BC. Mean values (+/- SEM, kg) for the estimates were 53.9 +/- 3.5 (FFWT), 26.9 +/- 2.9 (MM3MH), 25.3 +/- 2.5 (MMCRE), 53.2 +/- 3.6 (FFWBD), and 52.8 +/- 3.5 (LBMK). Regression analyses revealed that TOBEC estimates of fat-free weight had an adjusted r2 (+/- SEE, kg) of 0.95 +/- 2.2, 0.50 +/- 7.9, 0.95 +/- 1.8, and 0.88 +/- 4.0 for MM3MH, MMCRE, FFWBD, and LBMK, respectively. It was concluded that TOBEC is a potentially reliable method for estimating the muscle mass within the fat-free compartment, as well as fat-free weight and lean body mass.

Adipose Tissue↗
PubMed1988

Patient satisfaction with general practitioner deputising services.

Proposed increases in the average hours of surgery sessions of general practitioners as part of the government programme for improving primary health care may result in more use of deputising services to provide off duty cover. The satisfaction of patients with such a service was studied during one week of October 1987 at nine of the 29 branches of Air Call Medical Services in urban areas in Britain by means of a postal questionnaire. Of a sample of 4626 callers to the service, 3887 (84%) responded. An estimated 32% of the patients expected that a doctor from their own practice would have attended them, 19% expected that they would be admitted to hospital and 8% were admitted. Over 90% of patients were satisfied with the telephonist's handling of the call; 79% of those visited were satisfied with the waiting time; and over 80% were satisfied with various aspects of the doctor's handling of the visit (bedside manner, communication, taking of history, physical examination, and explanation of findings), the lowest figure being for explanation of findings (81%). Satisfaction was generally higher during the daytime; among the elderly, especially men; and among patients who did not anticipate that a doctor from their doctor's practice would call. The results suggest that a high proportion of patients were satisfied with the deputising service they received.

Age Factors↗
PubMed1988

Transendothelial chemotaxis in vitro of human monocytes.

Porcine aortic vascular endothelial cells were grown to confluence on microporous PTFE membranes and incorporated into a two-compartment chemotaxis assembly. Human peripheral blood mononuclear cells (20-25% monocytes) were placed in the upper compartment and zymosan-activated human serum (ZAHS) as chemoattractant in the lower compartment. Over a 3 h period monocytes migrated across the endothelialized membrane and adhered to a collecting filter sited in the lower compartment. Addition of ZAHS to the cell suspension in the upper compartment virtually abolished the migration response whilst only minimal leucocyte migration was supported by the bare unendothelialized PTFE membrane. The extent of transendothelial monocyte chemotaxis was dependent upon the concentration of chemoattractant in the lower compartment and upon the cell density of the suspension containing monocytes. A confluency test of fluid flow across the endothelialized filter showed that monocyte migration could take place without disturbing endothelial barrier function. The culture system is easy to assemble and the method provides experimental versatility.

Animals↗
PubMed1988

A study of the movement of nurses and nursing skills between the NHS and the private sector in England and Wales.

An investigation of 2165 qualified nurses joining eight NHS District Health Authorities (DHAs) and 72 private sector institutions was undertaken in order to measure the skills which move between these sectors and to estimate the likely impact on NHS nursing services of any future growth in the private sector. It was found that 42% (95% confidence interval: 36%, 48%) of the nurses joining private acute hospitals and 28% (95% CI: 21%, 37%) of those joining long-stay private nursing homes came directly from the NHS workforce. Fewer qualified nurses move from the private sector to the NHS. Private acute hospitals appear to attract recruits from a specific section of the NHS workforce: nurses under 30 years of age with specialist skills such as theatre nursing, renal nursing, intensive care and oncology.

Adult↗
PubMed1988

Excretion of 3-methylhistidine and hydroxyproline following acute weight-training exercise.

Changes in urine excretion of 3-methylhistidine (3MH) and hydroxyproline (OHP) were investigated following a single session of weight training that produced delayed onset muscle soreness (DOMS). The subjects (n = 18) maintained meat-free diets for 6 days and collected 24-h urine volume on day 4 (PRE), day 5 (POST1), and day 6 (POST2) for analysis of 3MH, OHP, and creatinine (CRE). At the end of PRE, nine subjects (EX) performed intensive weight-training exercises. The remaining subjects (NE) served as a nonexercised group. All subjects were measured for fat free weight (FFW) and rated DOMS at the end of each urine collection period, i.e., PRE, POST1, and POST2. The results were significant DOMS ratings on POST1 and POST2 compared with PRE2 for EX only. Excretion of 3MH (x +/- SE in mumol/day) by group were, for EX, PRE 271 +/- 18, POST1 243 +/- 16, POST2 259 +/- 23; for NE, PRE 203 +/- 23, POST1 209 +/- 27, POST2 225 +/- 32. Excretion of OHP (x +/- SE in mg/day) were, for EX, PRE 30.0 +/- 5.4, POST1 32.8 +/- 6.4, POST2 29.6 +/- 6.1; for NE, PRE 22.5 +/- 5.2, POST1 21.6 +/- 6.0, POST2 22.7 +/- 6.0. Changes in urine 3MH and OHP were not statistically significant, whether analyzed in absolute terms or relative to CRE and FFW. It was concluded that the acute session of weight training which produced muscle soreness did not effect excretion of 3MH or OHP.

Adult↗
PubMed1988

Variation in demand for accident and emergency departments in England from 1974 to 1985.

Over the period 1974-85 the range of mean annual new attendance rates at Accident and Emergency departments among English health districts was 36-673 per 1000 residents. The socio-economic diversity of these districts explained only one-third of the variation. The rates rose significantly (p less than 0.05) in 89 per cent of districts over the twelve years. Again, socio-economic variation only partly explained differences in district trends. Increases were greater among districts with higher mean rates. In order to plan first-contact care rationally we need a better understanding of the factors underlying these trends.

Emergency Service, Hospital↗
PubMed1987

Effects of subsidising bus travel on the occurrence of road traffic casualties.

Between 1975 and 1 April 1986, public transport by bus in the metropolitan county of South Yorkshire, England, was increasingly subsidised. Trends in road traffic accident casualties between 1974 and 1983 in all the six provincial English metropolitan counties have been compared in order to examine the possible effect of this unique subsidy on the incidence of road traffic accident casualties. During that period the total number of casualties in South Yorkshire did not change significantly compared to the other metropolitan counties. However, the proportion of all casualties in South Yorkshire who were bus occupants did increase relative to other metropolitan counties, indicating either an increase in the amount of bus travel or a decrease in travel by other modes. There was a large increase in bus patronage in South Yorkshire relative to the other metropolitan counties, and the conclusion is that it is the transport policy in South Yorkshire which resulted in an actual increase in distances travelled by bus. Since bus is the safest form of road travel, it is concluded that the public transport subsidy in South Yorkshire has benefited the health of the local population by providing the social amenity of additional travel at the least additional health cost.

Accidents, Traffic↗
PubMed1986

Anaesthetic management and postoperative care of cardiac surgical patients in a general recovery ward.

The postoperative care of 143 cardiac surgical patients has been successfully conducted in a general surgical recovery ward. Admission was limited to overnight stay only and all but two patients were returned to the general ward the following day. There were no deaths. The intra-operative anaesthetic management was considered to have played an important part in the success of this technique.

Adult↗
PubMed1985

Provision of first contact care out of hours in four urban areas in England.

In a typical two week period in 1984 in three urban areas with general practitioner deputising services roughly 40% of first contact patient encounters out of hours were with hospital accident and emergency departments, and only a quarter were with general practitioner deputising services, although 47%, 64%, and 97% of general practitioners in the areas had permission to use such services. Roughly a third only of the encounters were with the practices themselves, and even fewer occurred overnight (11 pm-7 am). In a fourth urban area where 68% of general practitioners formed an out of hours cooperative rota a third of the encounters were with the accident and emergency department and half (more overnight) were with the rota. The presence of a woman principal in a practice and large partnerships of four principals or more were associated with an increased proportion of encounters with the practice itself. Undue prominence may have been given to the role of deputising services in out of hours care. Paradoxically, the use of general practitioner cooperatives may result in even less personal care being given by the patient's own practice.

Data Collection↗