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Biomedical subjects

C Mills

Publications and source records attributed to C Mills.

At least 19 recordsLinked to original sources
PubMed2006

Assessing the impact of nutrient enrichment in estuaries: susceptibility to eutrophication.

The main aim of this study was to develop a generic tool for assessing risks and impacts of nutrient enrichment in estuaries. A simple model was developed to predict the magnitude of primary production by phytoplankton in different estuaries from nutrient input (total available nitrogen and/or phosphorus) and to determine likely trophic status. In the model, primary production is strongly influenced by water residence times and relative light regimes. The model indicates that estuaries with low and moderate light levels are the least likely to show a biological response to nutrient inputs. Estuaries with a good light regime are likely to be sensitive to nutrient enrichment, and to show similar responses, mediated only by site-specific geomorphological features. Nixon's scale was used to describe the relative trophic status of estuaries, and to set nutrient and chlorophyll thresholds for assessing trophic status. Estuaries identified as being eutrophic may not show any signs of eutrophication. Additional attributes need to be considered to assess negative impacts. Here, likely detriment to the oxygen regime was considered, but is most applicable to areas of restricted exchange. Factors which limit phytoplankton growth under high nutrient conditions (water residence times and/or light availability) may favour the growth of other primary producers, such as macrophytes, which may have a negative impact on other biological communities. The assessment tool was developed for estuaries in England and Wales, based on a simple 3-category typology determined by geomorphology and relative light levels. Nixon's scale needs to be validated for estuaries in England and Wales, once more data are available on light levels and primary production.

Environmental Monitoring↗
PubMed2006

Allergenicity assessment of apple cultivars: hurdles in quantifying labile fruit allergens.

BACKGROUND: Assessment of allergenicity of foods is important for allergic consumers and regulators. Immunoassays to measure major food allergens are widely applied, often giving variable results. Using the major apple allergen Mal d 1 as a model, we aimed to establish at the molecular level why different immunoassays for assessing allergenicity of apple cultivars produce conflicting outcomes. METHODS: Mal d 1 was measured in 53 cultivars from Italy and 35 from The Netherlands, using four different immunoassays. Purified Mal d 1 standards were molecularly characterized by size-exclusion chromatography (SEC) and mass spectrometry (MS). RESULTS: Three immunoassays using an identical standard gave similar results. Minor differences in sample preparation already resulted in significant loss of allergenicity. The fourth assay, using a different Mal d 1 standard, gave 10- to 100-fold lower outcomes. By SEC, this standard was shown to be almost fully aggregated. This aggregation was accompanied by a decrease of the mass of the Mal d 1 molecule by approximately 1 kDa as analyzed by MS. The deviating immunoassay was shown to selectively recognize this aggregated form of Mal d 1, whereas the other three assays, including the one based on IgE antibody recognition, preferentially bound non-aggregated allergen. CONCLUSIONS: Variable and poorly controllable major allergen modification in both extracts and standards hamper accurate allergenicity assessments of fruits.

Allergens↗
PubMed2005

A framework for measuring costs to society of IgE-mediated food allergy.

Both immunoglobulin E (IgE)-mediated food allergy and food intolerance can lead to many changes in personal behaviour and health care resource use which have important economic consequences. These costs will impact directly, indirectly and intangibly on both individuals and society in general. It is important to measure the cost of illness (COI) of food allergy as a first step in developing and evaluating measures to reduce and control the burden of illness. This paper outlines a framework for assessing COI of food allergy from different viewpoints. It offers a structure for identifying the different cost impacts on allergic and nonallergic consumers, food producers and society as a whole, and for scoping, measurement and valuation of relevant costs. Within this structure, the existing literature is reviewed. This review illustrates the lack of information and clear methodology for assessing costs of food allergy. The paper concludes that there is a need for a more structured research programme to generate data essential for future evaluations of procedures and technologies for the diagnosis, treatment and management of food allergy.

Cost of Illness↗
PubMed2001

Food allergy: a problem on the increase.

It is thought that around 33% of anaphylactic reactions are caused by food, with peanuts causing a quarter of these life-threatening episodes. Given that the severity of symptoms, and in particular the frequency of anaphylactic shock, appears to rise with age, this will produce a public health problem of increasing magnitude in the future.

Age Factors↗
PubMed2000

Competing drug-drug interactions among multidrug antiretroviral regimens used in the treatment of HIV- infected subjects: ACTG 884.

OBJECTIVE: To evaluate the steady state concentrations of saquinavir, ritonavir, nelfinavir, delavirdine, and adefovir in six different three- and four-drug combination regimens. DESIGN: Randomized, partially double-blinded, multicenter study in a population of indinavir-experienced subjects with virologic failure. The first seven subjects enrolled in each of the six treatment arms from 10 participating sites were entered into this pharmacokinetic evaluation. SETTING: Multicenter study of the AIDS Clinical Trials Group (ACTG). PATIENTS: HIV-infected subjects. INTERVENTIONS: A 12-hour pharmacokinetic study was conducted after 2 weeks of drug administration. MAIN OUTCOME MEASURES: Area under the concentration-time curve with statistical comparisons to evaluate the effect of the second protease inhibitor and the effect of the non-protease inhibitors. RESULTS: There was no difference in saquinavir concentrations according to whether the second protease inhibitor was ritonavir or nelfinavir. Saquinavir concentrations in the groups receiving the combination of delavirdine plus adefovir dipivoxil were reduced by approximately 50% compared with those receiving delavirdine. Delavirdine concentrations were reduced by approximately 50%, in the delavirdine plus adefovir dipivoxil arms compared with the delavirdine arms. CONCLUSIONS: Saquinavir concentrations were significantly lower in the arms containing the combination of delavirdine and adefovir dipivoxil compared with the arms containing delavirdine. Delavirdine concentrations were significantly lower when coadministered with adefovir dipivoxil. These drug-drug interactions were not expected, the mechanism(s) is (are) not clear, and additional studies are warranted. This study illustrates the need to understand more fully the pharmacokinetic characteristics of complex combination antiretroviral regimens prior to use in patient management.

Adenine↗
PubMed2000

Randomized study of saquinavir with ritonavir or nelfinavir together with delavirdine, adefovir, or both in human immunodeficiency virus-infected adults with virologic failure on indinavir: AIDS Clinical Trials Group Study 359.

This study compared antiretroviral activity among 6 "salvage" therapy regimens. The study was a prospective, randomized, 2x3 factorial, multicenter study of the AIDS Clinical Trials Group. The study enrolled 277 human immunodeficiency virus (HIV)-infected patients naive to nonnucleoside analogues who had taken indinavir >6 months. The patients had 2000-200,000 HIV RNA copies/mL. Patients received saquinavir with ritonavir or nelfinavir together with delavirdine and/or adefovir and were followed for safety and antiretroviral response between baseline and week 16. At week 16, 30% (77/254) of patients had </=500 HIV RNA copies/mL. Virologic response did not differ significantly between pooled ritonavir and nelfinavir groups (28% vs. 33%; P=.50) or between pooled delavirdine and delavirdine/adefovir groups (40% vs. 33%; P=.42). Pooled delavirdine groups had a greater virologic response rate than did adefovir groups (40% vs. 18%; P=.002). Overall, one-third of patients who experienced virologic failure on an indinavir-containing regimen suppressed virus load levels while they were taking a new salvage regimen.

Adenine↗
PubMed2000

One-year follow-up of opiate injectors treated with oral methadone in a GP-centred programme.

AIMS: To examine changes in drug-related behaviour in opiate-dependent injectors treated with oral methadone, in a shared care scheme where consumption of the daily dose is usually supervised by a community pharmacist. DESIGN: One-year cohort study. SETTING: Recruitment from the main routes into methadone prescribing in Glasgow during 1996: General Practitioner Drug Misuse Clinic Scheme and the Drug Problem Service. PARTICIPANTS: Current opiate injectors entering methadone treatment. FINDINGS: Among the 204 injectors recruited, 148 (73%) were re-interviewed at 6 months and 118 (58%) at both 6 and 12 months. Twenty-nine per cent of the cohort remained continuously on methadone for 12 months. In that group, over the 12-month period, self-reported daily opiate injecting reduced from 78% to 2%; overdose in the previous 6 months from 24% to 2%; mean daily drug spend from 50 Pounds to 4 Pounds; and mean monthly number of acquisitive crimes reduced from 13 to three. Assuming participants lost to follow-up were unchanged, significant improvements in the total cohort were seen in daily opiate injecting (from 80% at recruitment to 43% at 12 months), overdose (from 27% to 15%), mean daily drug spend (from 63 Pounds to 38 Pounds) and mean monthly number of acquisitive crimes (from 18 to 11). Discontinuation of treatment was mainly due to imprisonment (39%) or sanctions by the prescriber (33%). CONCLUSION: Treatment of opiate-dependent drug injectors with methadone in a community-wide general practitioner-centred scheme, with supervised daily consumption, was associated with major beneficial change for a substantial proportion of patients.

Adult↗
PubMed2000

Tinea faciei due to Microsporum canis abscess formation.

Superficial dermatophyte infections are common in children; however, complications are encountered rarely. We describe a child with tinea faciei caused by Microsporum canis, who subsequently developed an abscess. Complete resolution occurred after treatment with oral terbinafine.

Abscess↗
PubMed2000

In search of the wage-labour/service contract: new evidence on the validity of the Goldthorpe class schema.

In this paper we examine new empirical evidence on the coherence and magnitude of the main classes in the Goldthorpe class schema. Particular attention is paid to issues that have recently been a source of academic dispute: the coherence and size of the service class and the distinction between the service class and intermediate classes. Using recently available British data collected by the Office for National Statistics we examine: (i) the extent to which measures of class-relevant job characteristics are empirically discriminated by the categories of the schema; (ii) the structure of a 'contract type' dimension of employment relations conceived of as a categorical latent variable; and (iii) the association between this latent variable and both the Goldthorpe class schema and a related measure socio-economic group (SEG). We find that the data are consistent with the existence of a three category latent 'contract type' variable largely corresponding to the notions of service, intermediate and wage-labour contracts explicit in discussions of the theoretical rationale for the Goldthorpe schema. We further find a substantial degree of fit between the latent 'contract types' and the schema. However, the service class fault line appears to lie within class I and II of the schema rather than between them and the intermediate classes which suggests a revised, smaller service class would better capture the reality of the contemporary British occupational structure.

Adolescent↗
PubMed2000

Patient cost-benefits of realtime teledermatology--a comparison of data from Northern Ireland and New Zealand.

As part of a randomized controlled trial of the costs and benefits of realtime teledermatology in comparison with conventional face-to-face appointments, patients were asked to complete a questionnaire at the end of their consultation. One hundred and nine patients took part in an initial teledermatology consultation and 94 in a face-to-face consultation. The proportion of patients followed up by the dermatologist was almost the same after teledermatology (24%) as after a hospital appointment (26%) and for similar reasons. Two hundred and three questionnaires were completed after the first visit and a further 20 after subsequent visits. Patients seen by teledermatology at their own health centre travelled an average of 12 km, whereas those who attended a conventional clinic travelled an average of 271 km. The telemedicine group spent an average of 51 min attending the appointment compared with 4.3 h for those seen at the hospital. The results of the present study, as in a similar study conducted in Northern Ireland, show that the economic benefits of teledermatology favour the patient rather than the health-care system.

Computer Systems↗
PubMed1999

Evaluation of an evolutionary model of self-preservation and self-destruction.

According to deCatanzaro's mathematical model of self-preservation and self-destruction, staying alive actually may reduce inclusive fitness for an individual who is low in reproductive potential and, at the same time, poses such a burden to close kin that it costs them opportunities for reproduction. Predictions generated from this model were tested using 175 university students as subjects and variables constructed from a 164-item questionnaire. The criterion variables were separate measures of depression, hopelessness, and suicide ideation and behavior. The predictor variables derived from the model were separate measures of reproductive potential of the individual, the individual's perceived benefit or cost to kin, and reproductive potential of the individual's kin. As predicted, there were negative and significant bivariate correlations between each of the model-generated predictor variables and one or more of the criterion variables. Multiple regression analyses showed that benefit to kin was the best predictor of both depression and hopelessness. Discriminant analysis showed that reproductive potential of kin significantly differentiated suicide attempters from nonattempters. Overall, our results support and extend deCatanzaro's model and empirical findings.

Adolescent↗
PubMed1999

Canadian national workshop on measurement of sun-related behaviours [Workshop report].

The idea for the workshop described in this paper emerged from recommendations identified at the 1997 Workshop on Research, Policy and Program Planning on Sun Protective Behaviours. At the 1997 workshop, participants developed a set of recommendations for research initiatives related to sun protection efforts in Canada. One of the primary recommendations was to develop a standard set of definitions and core items to assess sun-related behaviours. In response, the authors of this paper agreed to co-chair the 1998 Canadian National Workshop on Measurement of Sun-Related Behaviours. The purpose of this workshop was to develop consensus on a standard set of measures for program evaluation and for monitoring of sun exposure and protective behaviours in Canada.

Canada↗