Search PubMed⌕ Search

Biomedical subjects

F Jones

Publications and source records attributed to F Jones.

At least 37 records · Page 2Linked to original sources
PubMed1996

Marine waters contaminated with domestic sewage: nonenteric illnesses associated with bather exposure in the United Kingdom.

OBJECTIVES: This study identified possible dose-response relationships among bathers exposed to marine waters contaminated with domestic sewage and subsequent risk of nonenteric illness. METHODS: Four intervention follow-up studies were conducted within the United Kingdom. Healthy volunteers (n = 1273) were randomized into bather and nonbather groups. Intensive water-quality monitoring was used to assign five bacteriological indices of water quality to individual bathers. Illnesses studied were acute febrile respiratory illness, and eye, ear, and skin ailments. RESULTS: Fecal streptococci exposure was predictive of acute febrile respiratory illness, while fecal coliform exposure was predictive of ear ailments. Estimated thresholds of effect occurred at bather exposures above 60 fecal streptococci and 100 fecal coliform per 100 ml of water, respectively. Although no relationship was found between eye ailments and indicator organism exposure, compared with nonbathers, bathers were at higher risk for eye ailments. CONCLUSIONS: Nonenteric illness can be transmitted via recreational contact with marine waters contaminated with sewage. These results argue against the use of a single indicator to establish water quality standards.

Adult↗
PubMed1995

Evidence that cytokine-mediated immune interactions induced by Schistosoma mansoni alter disease outcome in mice concurrently infected with Trichuris muris.

In murine models of Schistosoma mansoni infection, egg production is associated with a switch from T helper cell (Th)1- to Th2-type responses to both schistosome-specific and unrelated antigens. Polyparasitism is common in human populations within S. mansoni endemic areas. We have, therefore, examined whether coinfection with S. mansoni could affect the outcome of a second parasitic infection, through Th2 cytokine-dependent modifications to the host immune response. We find that when mice susceptible to infection with the gut nematode Trichuris muris are coinfected with S. mansoni, they acquire the capacity to resolve T. muris infection, thus demonstrating a resistant phenotype. This ability to expel T. muris is associated with the production of Th2-associated cytokines, and corresponding antibody isotypes, in response to S. mansoni egg antigens. The Th2 response shows that there is no compartmentalization between spleen and mesenteric lymph nodes, and that the expulsion of T. muris is not caused by any changes in the host intestine associated with excretion of schistosome eggs. This influence of schistosome infections may be important, not only for the outcome of infections with unrelated pathogens in endemic areas, but also for the efficacy of vaccines in such areas.

Animals↗
PubMed1994

Predicting likelihood of gastroenteritis from sea bathing: results from randomised exposure.

The health effects of bathing in coastal waters is an area of scientific controversy. We conducted the first ever randomised "trial" of an environmental exposure to measure the health effects of this activity. The trial was spread over four summers in four UK resorts and 1216 adults took part. Detailed interviews were used to collect data on potential confounding factors and intensive water quality monitoring was used to provide more precise indices of exposure. 548 people were randomised to bathing, and the exposure included total immersion of the head. Crude rates of gastroenteritis were significantly higher in the exposed group (14.8 per 100) than the unexposed group (9.7 per 100; p = 0.01). Linear trend and multiple logistic regression techniques were used to establish relations between gastroenteritis and microbiological water quality. Of a range of microbiological indicators assayed only faecal streptococci concentration, measured at chest depth, showed a significant dose-response relation with gastroenteritis. Adverse health effects were identified when faecal streptococci concentrations exceeded 32 per 100 mL. This relation was independent of non-water-related predictors of gastroenteritis. We do not suggest that faecal streptococci caused the excess of gastrointestinal symptoms in sea bathers but these microorganisms do seem to be a better indicator of water quality than the traditional coliform counts. Bathing water standards should be revised with these findings in mind.

Adult↗
PubMed1994

Domestic violence in America.

Domestic violence is an underrecognized problem of immense cost. It is a crime; its victims must be identified and protected. The medical and judicial communities share responsibility in addressing this issue and providing support for victims. The role of health care workers in recognizing and preventing domestic violence cannot be overestimated. Direct questioning of patients, especially about the source of any injuries and about safety at home, is the first step in uncovering abuse. Educational programs for health care providers and the general public can change society's view and tolerance of this problem. Physicians must take an active role in changing community attitudes about domestic violence and in instituting programs to reduce its incidence. Medical treatment of the injuries resulting from domestic violence is not sufficient. Abused women need the care of a team of professionals who can address psychological, emotional, and physical injuries. They must also be provided with safe housing and financial and legal assistance in order to escape the abusive relationship. Physicians and legislators must work together to effect change. Domestic violence is a public health menace. We need to break the cycle of abuse that has become an integral part of our society.

Female↗
PubMed1993

Water and non-water-related risk factors for gastroenteritis among bathers exposed to sewage-contaminated marine waters.

All previously published epidemiological studies of the health effects of bathing in marine waters contaminated with domestic sewage contain three major methodological weaknesses in study design: (1) failure to control for the substantial amount of temporal and spatial variation in indicator organism densities shown to occur within just a few hours at marine water bathing locations; (2) failure to relate indicator organism density directly to the individual bather; and (3) failure to rigorously control for non-water-related risk factors on previously reported associations between bathing in marine waters and illness among such bathers. We report the results of two intervention follow-up studies specifically designed to address these methodological weaknesses. We restricted study outcome to bathing-associated gastroenteritis since this is the illness most consistently reported to be associated with bathing in marine waters, and upon which both current US Marine Water Quality Criteria and other standards used worldwide are based. Our results show that faecal streptococci was the only indicator organism to predict the occurrence of gastroenteritis among bathers, and this occurred at only one of the three water quality sampling depths used in our study. The consumption of three different foods known or suspected to act as vectors in the transmission of gastroenteritis, as well as one non-food, non-water-related risk factor for gastroenteritis were found to significantly increase the risk of gastroenteritis among bathers. Multiple logistic regression modelling showed that these non-water-related risk factors confounded the relationship between exposure to marine waters of varying faecal streptococci densities and the occurrence of gastroenteritis among bathers to a moderate degree. Moreover, these analyses showed that the risk of gastroenteritis to the individual bather caused by these non-water-related risk factors, approximated the risk of gastroenteritis among bathers exposed to waters containing relatively high faecal streptococci densities. The implications of these findings with regard to the validity of present marine water quality criteria and on the need for, and design of, future epidemiological studies of bathing water associated illness are discussed.

Adult↗
PubMed1993

Baby friendly care.

In 1991, the United Nations Children's Fund (UNICEF) and the World Health Organization (WHO) launched a global campaign called the Baby-Friendly Hospital Initiative (BFHI). The initiative encourages health professionals to promote, protect and support breastfeeding as the optimal method of infant nutrition and enables families to make an informed choice about infant feeding. Hospitals that serve perinatal families are the focus, because what starts in the hospital carries on into the community. Recognizing the vital role of nurses as patient advocates and health promoters, and their position as the largest group of hospital-based health care workers, WHO and UNICEF are asking nurses to facilitate the implementation of the initiative in their hospitals.

Adult↗
PubMed1992

Health effects of white-water canoeing.

There is little quantitative information on the relation between water quality and disease attack rates after recreational activities in fresh water. We conducted a prospective cohort study to measure the health effects of white-water and slalom canoeing in two channels with different degrees of microbial contamination. Site A, fed by a lowland river, showed high enterovirus concentrations (arithmetic mean 198 pfu per 10 litre and moderate faecal coliform concentrations (geometric mean 285/dl); at site B, from an upland impoundment, all samples were free of enteroviruses and the geometric mean faecal coliform concentration was 22/dl. Between 5 and 7 days after exposure canoeists using site A had significantly higher incidences of gastrointestinal and upper respiratory symptoms than canoeists using site B or non-exposed controls (spectators). Like seawater bathers, fresh-water canoeists can be made ill by sewage contamination. The hazard of fresh water may be best measured by counting of viruses rather than bacteria.

Adult↗
PubMed1992

Disease concordances amongst marital partners: not 'way of life' or mortality data artifact.

Mortality statistics for Great Britain (1979-80, 1982-3) for more than 500 occupations and 20 different causes of death were examined. The paper demonstrates that there is clear concordance of cause of death between men and married women which can be linked to the occupation of the male. Various possible explanations are considered including shared social class and way of life and the suggestion that the associations reported are the result of various forms of statistical bias inherent in Standardized Mortality Ratio statistics. It is proposed that this is consistent with a psychosocial hypothesis, although longitudinal empirical research would be required to establish this.

Adult↗
PubMed1992

An AIDS-related knowledge, attitudes, beliefs, and practices survey among schoolchildren in Barbados.

A knowledge, attitudes, beliefs, and practices (KABP) survey was performed among Barbadian secondary schoolchildren 11-16 years old in January 1990. The survey sought to assess the children's knowledge of AIDS and human immunodeficiency virus (HIV) transmission; their attitudes toward people with HIV/AIDS; their sexual practices; and changes needed in education programs seeking to reduce childhood HIV transmission. A pretested self-administered questionnaire was used. The survey sample was derived by selecting every eleventh student on the rosters of all the secondary schools in Barbados. All of the survey respondents completed the questionnaire on the same day, having been assembled examination-style for that purpose. The results showed high levels of correct knowledge about the principal routes of HIV transmission. However, a considerable proportion of the respondents harbored incorrect beliefs regarding mosquito transmission and dangers to blood donors, and many showed uncertainty or incorrect knowledge regarding possible HIV transmission by biting, spitting, or use of public toilets. About a third of the children (51.4% of the boys and 18.7% of the girls) said they had experienced sexual intercourse, though only 20% reported being sexually active in the year preceding the survey. Three-quarters of the sexually experienced group said they knew how to use condoms, but only a third said there was any time when they had used protection during sexual intercourse. Overall, the results indicate that education efforts prior to the survey had been effective, but that reinforcement of such efforts as well as their extension into the primary schools is warranted. Further research directed at helping these efforts to encourage more meaningful changes in sexual behavior is also needed.

Acquired Immunodeficiency Syndrome↗
PubMed1991

The stressors and strains of health visiting: demands, supports, constraints and psychological health.

An empirical study investigated the work stressors and psychological strains experienced by health visitors in three areas of Hertfordshire and Bedfordshire. A questionnaire, based on Payne's model of occupational stress, probed the perceived demands, supports and constraints of the work and the coping strategies used by the health visitors. The research aimed to establish the extent and nature of strain using validated indicators of general anxiety and depression, to pinpoint specific features of the work which are associated with the strain measures, and to suggest possible changes to working practices. While health visitors found their jobs generally satisfying, a significant number of staff were under strain even though the mean levels of strain were lower than those observed in social workers and hospital-based nursing staff working with people who have a mental handicap, and little different from women who work in industry. Many aspects of the job were perceived to be demanding yet the demanding nature of cases was not related to strain measures. There were, however, interesting statistical relationships between strain scores and demands concerned with colleagues and managers and the amount of support a health visitor perceived.

Adaptation, Psychological↗
PubMed1991

Scales for rating motor impairment in Parkinson's disease: studies of reliability and convergent validity.

Study 1 examined the reliability of the ratings assigned to the performance of five sign-and-symptom items drawn from tests of motor impairment in Parkinson's disease. Patients with Parkinson's disease of varying severity performed gait, rising from chair, and hand function items. Video recordings of these performances were rated by a large sample of experienced and inexperienced neurologists and by psychology undergraduates, using a four point scale. Inter-rater reliability was moderately high, being higher for gait than hand function items. Clinical experience proved to have no systematic effect on ratings or their reliability. The idiosyncrasy of particular performances was a major source of unreliable ratings. Study 2 examined the intercorrelation of several standard rating scales, comprised of sign-and-symptom items as well as activities of daily living. The correlation between scales was high, ranging from 0.70 to 0.83, despite considerable differences in item composition. Inter-item correlations showed that the internal cohesion of the tests was high, especially for the self-care scale. Regression analysis showed that the relationship between the scales could be efficiently captured by a small selection of test items, allowing the construction of a much briefer test.

Activities of Daily Living↗
PubMed1991

Value of fibreoptic oesophago-gastro-duodenoscopy: experience with 4000 procedures at Kilimanjaro Christian Medical Centre, Moshi, Tanzania.

The paper presents the results of a retrospective study and the experiences with 4000 fibreoptic oesophago-gastro-duodenoscopies (EGD), which were performed at Kilimanjaro Christian Medical Centre (KCMC) between 1985 and 1989 in an open access service. Seventy per cent of all patients examined had abnormal findings with duodenal ulcer as the most frequent diagnosis (22%). Pyloric stenosis was seen in 6%, gastric ulcer in 5% and esophageal varices in 4% of all patients. High figures were found for carcinoma of the esophagus (4%) and malignancy of the stomach (5%). Gastritis was diagnosed in 11%. We consider fibreoptic EGD a cost effective and appropriate technology. Because of its high diagnostic yield, we advocate its use in certain centres in developing countries.

Adolescent↗
PubMed1991

Primary care in New York State: report and recommendations of the associated medical schools of New York.

Medical education in New York is unique in the country in its scope and its diversity. It is important, as we go forward, that these strengths be neither eroded nor compromised. The AMS member institutions are making a collective commitment to work together to promote changes that will improve medical education for all students by providing them with enriched experience in primary care. Our major resource is faculty. To whatever degree medical schools can influence career choice, it is essential to this aim that the best possible people are placed in the settings in which primary care is taught. The schools will intensify their efforts to recruit and retain such faculty and, in whatever way is appropriate to each institution, provide them with the stature needed to emphasize the value which the school places on primary care. The schools will also work to provide exposure to primary care early in a student's academic career given anecdotal evidence, at least, that such early experience can influence subsequent specialty choice. Finally, the medical schools will assume greater responsibility for graduate medical education. If, with state support, ambulatory teaching sites are developed, the schools will make every effort to assure that they are staffed with high-quality faculty. Residents and students must see primary care practiced with total commitment to quality. It is hoped that, with state-initiated improvements in the practice environment, the ultimate outcome will be an increase in the number of our graduates selecting primary care disciplines for their practices and locating in areas in need of physicians.2+ Corporation, and the Greater New York Hospital Association. We are ready to work with others toward our common objectives, and we call on all of those who share these concerns to participate with us.

Career Choice↗
PubMed1990

New York's statewide approach to increase the number of minority applicants to medical school.

The Associated Medical Schools of New York (AMS), a consortium of 13 public and private medical schools, has identified the problem of low minority enrollment as its top priority issue. Over the last six years, the consortium has established a multifaceted, statewide effort aimed at increasing the pool of qualified minority applicants. The programs include academic enrichment for precollege and college students, recruitment conferences, and a program to attract minority applicants to residency training in New York. The key to this effort is the work of the AMS Office of Minority Affairs, which provides statewide oversight and coordinates these programs. The consortium approach has proven attractive to both private philanthropy and government funding sources and provides a mechanism for evaluation. The most valid evaluation will occur in about three years, when graduates of the precollege program begin to apply to medical school.

Education, Medical↗
PubMed1990

Persistent nonproductive infection of Epstein-Barr virus-transformed human B lymphocytes by human immunodeficiency virus type 1.

We have studied the interaction of different strains of human immunodeficiency virus type 1 (HIV-1) with an Epstein-Barr virus-transformed human B-lymphocyte line, X50-7. Previously we found that some HIV-1 strains replicated rapidly and were exclusively cytolytic; others induced persistent noncytopathic infection associated with continued shedding of extracellular virus (K. Dahl, K. Martin, and G. Miller, J. Virol. 61:1602-1608, 1987). We now describe a third form of cell-virus relationship in which infection by strain IIIB is maintained in a highly cell-associated state in a small subpopulation (less than 2%) of X50-7 cells. Neither viral subcomponents nor infectious virus was detectable in culture supernatants; however, the carrier lines were fusogenic and HIV-1 could be recovered following prolonged cocultivation with susceptible cells. In these chronic carrier cultures, virions were not seen budding at the cell surface, but a few were found within cytoplasmic vesicles. HIV-1 infection of first- and second-generation cell subclones of the carrier cell line rapidly evolved from a productive to a cell-associated state. There were low levels of HIV DNA, and RNA in the fusogenic secondary clones, but most clones lacked HIV-1 DNA, failed to express HIV-1 RNA, and exhibited no properties associated with HIV-1 infection. The experiments indicate that HIV-1 can be sequestered in human B lymphocytes. The cell cloning experiments introduce the possibility that the HIV-1 provirus may be lost from some lymphocytes.

B-Lymphocytes↗