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Biomedical subjects

C Sheard

Publications and source records attributed to C Sheard.

At least 19 recordsLinked to original sources

Evaluating first-year medical students' attitudes to learning communication skills before and after a communication skills course.

This longitudinal study explores 216 medical students' attitudes towards communication skills learning before (TI) and at the end (72) of their first-year communication skills course. They completed the Communication Skills Attitude Scale and a personal details questionnaire satisfactorily at Ti and T2. Univariate statistics established whether attitudes differed between TI and T2 for the whole sample and for the sample split by demographic and education-related characteristics. Students rated their communication skills slightly but significantly lower at the end of their communication skills course than before the start of the course. Positive attitudes towards communication skills learning became significantly lower by the end of the course compared with the start. Repeated measures ANOVAs indicated that significant two-way interactions existed between attitudes at TI and T2 and the demographic characteristics: gender, language and ethnicity. These findings are discussed in the paper, along with their implications for educational practice and further research.

Adolescent↗

Challenging behaviour and insecure attachment.

BACKGROUND: The present authors investigated a database about people with severe intellectual disability (ID) to explore whether secure/insecure attachment plays a role in challenging behaviour. METHODS: The study took the form of a survey of staff and carers involved with a cohort of 54 school-leavers with severe ID. RESULTS: Thirty-four per cent of students were rated by placement staff as 'over-investing in one or a few relationships which become a source of jealousy'. Students without such problems were significantly less likely to show challenging behaviours, while those with them were significantly more likely to be living outside the family home. CONCLUSIONS: These preliminary results justify more detailed and longitudinal research into the relationship between attachment status and challenging behaviour.

Adult↗

Parental information needs in chronic renal failure and diabetes mellitus.

UNLABELLED: The information needs of parents of children with end stage renal failure (ESRF) or with insulin dependent diabetes mellitus (IDDM) were assessed by questionnaires over a 2-year period. Questionnaires were posted on seven occasions at 4-monthly intervals and were sent to both mothers and fathers. Most information needs were reported to be for detailed test results, for new information about the condition and about the child's future social development. Questions responsible for the three highest scores were concerned with the future: the child's fertility; their social, career and marriage prospects; and the hope for a new improved treatment. For the IDDM mothers, scores were significantly different depending on age of the child (P = 0.02). Change in treatment mode had no significant effect on the information needs of parents of children with ESRF (P = 0.81). Occupation was significantly associated with the mean general information needs scores for parents, with occupations of a lower socioeconomic status associated with higher information needs scores. There were no significant differences between the reported mean general information needs scores of parents of children with ESRF and of parents of children with IDDM (P = 0.69) or between mothers and fathers mean general information needs scores (P = 0.58). CONCLUSION: Multidisciplinary team members need to tailor information to the needs of the individual families and be sensitive to socioeconomic factors and communication issues.

Adaptation, Psychological↗

Bullying and people with severe intellectual disability.

Although bullying has been shown to reduce quality of life in many spheres, anti-bullying strategies have yet to be incorporated into services for adults with severe intellectual disability (ID). The present study employed a survey of staff and parent concerns about 54 previously surveyed students who had left a school for pupils with severe ID. A content analysis of follow-up interviews was performed in 10 cases. Staff identified 19% of the survey sample as bullying others and 11% as being picked on. Neither gender nor communication ability had an impact. There was no significant change in bully or victim status over time, although some people did change. Parents or staff raised bully/victim problems in more than half of the interviews. There is sufficient evidence of bullying behaviour to warrant the adoption of anti-bullying strategies.

Adult↗

Severe intellectual disability and transition to adulthood.

Institutional and psychological aspects of transition were explored with parents and staff involved with five young adults with severe intellectual disability whose challenging behaviour diminished after they made the transition, and five whose challenging behaviour remained high. They were selected from a previously surveyed cohort. Grounded theory analysis of interviews suggested little connection between the perspectives of parents and staff. The impact these differences have on communication about challenging behaviour was explored, and recommendations for service changes are made.

Adult↗

Stimulation of colorectal cancer cell line growth by ET-1 and its inhibition by ET(A) antagonists.

BACKGROUND: The vasoactive peptide endothelin 1 (ET-1) acts via two receptors, endothelin receptors A (ET(A)) and B (ET(B)). ET-1 is overexpressed by human cancers in vivo and in vitro and may be mitogenic for cancer cells. METHOD: To elucidate if ET-1 is a growth regulator the following were investigated in human colorectal cancer cell lines (LIM1215 and HT29): ET-1 production by ELISA; ET receptor expression using radioligand autoradiographic techniques; and responsiveness to ET-1, and to ET(A) and ET(B) antagonism by growth measurements. RESULTS: ET-1 was produced by LIM1215 and HT29 cells (21.3 and 41.7 fmol/ml/10(6) cells (24 hours); 22.6 and 71.7 fmol/ml/10(6) cells (48 hours), respectively). ET(A) and ET(B) receptors were expressed by both cell lines. Addition of ET-1 resulted in a dose dependent increase in cell numbers which was significant at 10(-8)-10(-9) M for LIM1215, with the greatest increase at 10(-8) M (32.7% and 28.4% increase above controls at 48 hours and 72 hours; p<0.05) and at 10(-8)-10(-9) M for HT29, with the greatest increase at 10(-9) M (13.4% and 15.7% increase above controls at 48 hours and 72 hours; p<0.05). ET(A) antagonists BQ123 and BQ610, but not the ET(B) antagonist BQ788, inhibited ET-1 induced proliferation of both LIM1215 and HT29 (p<0.05). CONCLUSION: ET-1 can stimulate the proliferation of colorectal cancer cell lines via the ET(A), but not the ET(B), receptor.

Cell Division↗

A prospective study of the psychological effects of rhinoplasty.

Fifty-three consecutive patients referred for rhinoplasty within the National Health Service by their General Practitioner were evaluated prospectively to determine the psychological impact of this procedure. The patients were independently assessed before surgery, and then 1 week and 4 months after the surgery using the Derogatis Stress Profile, a Self-Esteem Inventory, an Introspectiveness Inventory and a range of questions relating to their expectations of the surgery. Photographs were taken at their initial visit and at 4 months after surgery. These were rated at random order by 28 independent lay people. Pre-operatively, the surgeon also documented his objectives and later assessed how well he had achieved them. Surgical intervention had strong effects in improving self-esteem ratings. These effects became more marked from the first post-operative assessment to those at four months making it likely that this is a real effect of surgery.

Adolescent↗

Pre-frontal structural and functional deficits associated with individual differences in schizotypal personality.

This study tests the hypothesis that pre-frontal deficits underlie schizotypal personality in the normal population. Personality measures assessing features of DSM-IIIR schizotypal personality disorder (SPD) were related to left and right pre-frontal brain area assessed by magnetic resonance imaging (MRI), and neuropsychological measures of pre-frontal functioning (Wisconsin Card Sorting Task, WCST) in a group of non-institutionalized, unmedicated normal subjects. High schizotypal scores were significantly associated with reduced pre-frontal area and more WCST perseveration errors; conversely no relationships were observed between these pre-frontal measures and measures of psychosis-proneness unrelated to SPD traits. Pre-frontal structural findings were not found to be mediated by temporal lobe and posterior cortical structural deficits, height, weight, socio-economic status, education level and sex differences, while pre-frontal functional findings were not mediated by non-prefrontal cognitive ability. These findings of pre-frontal structural and functional deficits associated with schizotypal personality provide some initial converging support for a pre-frontal explanation of individual differences in schizotypal personality in the general population.

Adult↗

An evaluation of structural and functional prefrontal deficits in schizophrenia: MRI and neuropsychological measures.

Magnetic resonance imaging was used to assess prefrontal brain structure in 17 schizophrenic, 18 psychiatric control, and 19 normal control subjects of comparable age, social background, and educational status, while three neuropsychological measures were used to assess prefrontal functioning. Schizophrenic patients had significantly smaller prefrontal areas than both psychiatric control and normal control subjects in all three planes. When posterior brain area and temporal lobe were entered into statistical analysis as covariates, they did not explain the prefrontal deficits. Schizophrenic patients made more perseveration errors on the Wisconsin Card Sorting Task and had fewer correct responses on the Spatial Delayed Response Task than normal control subjects. Schizophrenic patients performed more poorly than psychiatric control subjects on the Block Design Test. No group differences were found on three other nonfrontal tasks. These data lend some support to the role of prefrontal deficits in the development of schizophrenia.

Adult↗

Reliability and agreement of ratings of ataxic dysarthric speech samples with varying intelligibility.

Indices of interjudge reliability and inter- and intrajudge agreement were calculated from the ratings made by 15 experienced speech clinicians on five deviant speech dimensions with respect to 15 speakers with ataxic dysarthria. Speakers were chosen to cover a wide range of speech intelligibility (16-97%) as measured by the sentence intelligibility transcriptions of the Assessment of Intelligibility of Dysarthric Speech (Yorkston & Beukelman, 1981). Intraclass correlation coefficients derived from each judge on two occasions were above .6 for imprecise consonants, excess and equal stress, and harsh voice, but below .6 for distorted vowels and below .5 for irregular articulatory breakdown. The last dimension also had the lowest percent agreement for the interjudge and intrajudge comparisons. Poor speech dimension definition seems to be the most likely source of error on irregular articulatory breakdown. Judges agreed equally well in rating dysarthric speech across the range from low to high intelligibility.

Aged↗

Neuroanatomical correlates of skin conductance orienting in normal humans: a magnetic resonance imaging study.

Although little is known about the neuroanatomical basis of skin conductance orienting in intact normal humans, the limited literature on animals and humans with neurological and clinical disorders implicate prefrontal, temporal/amygdala, and pons brain areas in mediating skin conductance orienting. This study relates area of these structures using magnetic resonance imaging techniques to skin conductance orienting responses in 17 normal humans in order to test hypotheses that larger area of these excitatory structures will be associated with more orienting responses. Left and right hand skin conductance orienting was significantly associated with left and right prefrontal area (r = .44-.60), area of the pons (r = .43-.54), and left but not right temporal/amygdala area (r = .47-.53). No relationships were observed with areas thought to be unrelated to skin conductance activity (cerebellum, nonfrontal cortical area), medial prefrontal cortex, or the third ventricle. This appears to be the first study relating brain structure to skin conductance orienting in intact normal humans. Although preliminary at the present time, these results implicate prefrontal, pons, and temporal/amygdala areas in the mediation of skin conductance orienting in normal humans.

Adult↗

Structural and functional characteristics of the corpus callosum in schizophrenics, psychiatric controls, and normal controls. A magnetic resonance imaging and neuropsychological evaluation.

In 1986 Nasrallah and colleagues found that increased thickness of the corpus callosum may be specific to right-handed female schizophrenics. Male and female right-handed schizophrenics were compared with normal and psychiatric controls of comparable age, sex, education, and social class on measures of callosal thickness from a midsagittal magnetic resonance imaging cut and neuropsychological tests of interhemispheric transfer. The sex difference in anterior and posterior callosal thickness in normal controls was reversed in schizophrenics, with the corpus callosum being thicker in female schizophrenics and thinner in male schizophrenics. Similar findings were also observed in the psychiatric control group. These structural differences were not paralleled by evidence of impaired interhemispheric transfer on neuropsychological tasks. These results support the finding of sex-dependent callosal abnormalities in schizophrenia but indicate that these abnormalities may not be specific to this illness.

Adult↗

Interhemispheric transfer in schizophrenics, depressives, and normals with schizoid tendencies.

Although several studies suggest that schizophrenics suffer from an impairment in the interhemispheric transfer (IHT) of information, methodological weaknesses in these studies preclude clear interpretation of their results. This study addresses these criticisms in order to provide a clearer test of the IHT theory. Schizophrenics, depressives, normal controls, and normals with schizoid tendencies were assessed on five measures of IHT (verbal and nonverbal dichotic listening, intermanual transfer, bimanual block design, finger sequence repetition) and two measures of unilateral hemispheric processing (lateral eye movements, auditory thresholds). Results consistently failed to support an IHT deficit interpretation of schizophrenia. Schizoid normals had a significantly greater right-ear advantage on verbal dichotic listening than both psychiatric groups, a result suggesting enhanced left-hemisphere activation in schizoid normals. It is concluded that the IHT theory requires stronger empirical substantiation than has been obtained to date to warrant further consideration as a central theory of schizophrenia.

Adult↗

Low dose aminophylline accelerates recovery from diazepam premedication for digestive endoscopy.

The value of intravenous aminophylline in accelerating recovery from premedication with diazepam was assessed against placebo in a randomized, double-blind trial. One hundred ten patients undergoing routine diagnostic upper gastrointestinal endoscopy received diazepam intravenously in a dosage sufficient to achieve adequate sedation. On completion of the endoscopy, patients received either aminophylline (1.5 mg/kg) or placebo. Recovery from sedation was assessed on clinical grounds by a nurse, objectively using a serial reaction time test, and by the patient on a visual analogue scale. The number of patients judged to be fully alert at 30 and 60 min after the procedure was significantly greater in the aminophylline group than in the placebo group. Compared with values obtained before sedation, the placebo group had significantly prolonged reaction times 30 min after completion of the endoscopy, whereas patients who received aminophylline did not. However, according to their self-assessments, patients in both groups felt more uncoordinated following sedation. Aminophylline appears to hasten recovery from sedation with diazepam, and its use may permit earlier mobilization of patients after endoscopy.

Adult↗

Blood glucose and insulin levels in normal subjects following a meal with and without added sugar beet pulp.

The fibrous components of sugar beet pulp were investigated to determine whether they would reduce the post-prandial rise in blood glucose and plasma insulin levels when incorporated into a mixed meal. On two separate occasions six healthy volunteers were given either a control meal (providing 86 g carbohydrate) or an identical meal with the addition of 20 g sugar beet pulp (test meal). Blood glucose and plasma insulin levels were measured post-prandially for 3 hours. There was no significant difference between the mean blood glucose of plasma insulin curves at any time after the two meals. Since viscous types of dietary fibers are known to be effective in reducing post-prandial hyperglycaemia and insulinaemia, it would seem that either the physio-chemical nature of the fibre or the procedure employed to extract the sugar renders the particulate fibre inactive.

Adolescent↗