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Biomedical subjects

G Heath

Publications and source records attributed to G Heath.

At least 19 recordsLinked to original sources
PubMed2004

The detection of psychological problems by General Practitioners--influence of ethnicity and other demographic variables.

BACKGROUND: Common mental illness in Black Africans and Black Caribbeans has been relatively little studied in the UK. Previous studies of the detection of psychological problems by General Practitioners (GPs) in these groups have been inconclusive. AIMS: The aim of this study was to investigate the prevalence, detection and management of psychological problems in General Practice among Black Caribbeans and Black Africans compared to White English attenders and to examine the relative contribution of other sociodemographic factors to these main outcome variables. METHOD: Consecutive attenders aged 16-65 years at 18 General Practitioners in South-East London completed the General Health Questionnaire (GHQ-12) before seeing the GP. The GPs rated the current emotional state of the patients at the end of each consultation. Comparison of the GHQ and GP ratings was used to compute the detection indices. RESULTS: A total of 1211 patients aged 16-65 years were approached to take part in the study. Of the patients, 75 (6%) declined or were not able to complete the GHQ. In all, 994 individuals had both GP and GHQ ratings. There was an overall probable prevalence of 37%, of which 73% were identified as cases by the GPs. Black African patients had lower rates of common mental disorders, were less likely to be detected as psychiatric cases by the GP and less likely to receive active management for their psychological problems than Black Caribbean and White English patients. Rates of prevalence, detection and management were similar between Black Caribbean and White English patients. In the multivariate analysis, ethnicity, employment and age all played a significant independent role in predicting probable prevalence. The patients' reported decision to talk to their GP about psychological problems was the main predictor of detection. Ethnicity did not independently predict detection, but Black African cases were less likely to say that they would talk to their GP about psychological problems. GPs' identification indices mirrored probable prevalence, suggesting that GPs were more sensitive to detecting psychiatric illness in individuals belonging to groups which commonly presented as symptomatic. CONCLUSIONS: The findings suggest that in General Practice the prevalence of common mental disorders, their detection and management in Black Caribbeans are similar to those in White English, but that Black Africans have lower prevalence, are less likely to be detected and are less likely to receive active management. The study of GP consulters presents problems for the interpretation of these results and it may be that Black Africans with psychological problems are less likely than their Caribbean and English counterparts to attend their GP, and less willing to speak to them about these problems when they do. Future similar studies should distinguish Black African and Black Caribbean subjects in their analyses, as categories such as 'Afro-Caribbean' may mask important differences in attitudes and illness behaviour.

Adolescent↗
PubMed2000

An evolution of drug development and clinical pharmacology during the 20th century.

The current state of clinical pharmacology and drug development did not just happen. Clinical pharmacology and the drug development process were born, evolved, and have come to the fore during the past 100 years. The past century has been one of accelerating progress in science and medicine. The progress has not been a straight line but rather more like a sidewinder moving across the desert. Drug development has moved from small experiments with concoctions, extracts, and potions along with the manufacturing and promotion of the purported remedies to processes that exploited unknowing patients to a process that now requires concept generation, discovery, research, planning, and development with many checks and balances for the protection of human subjects. The factors that contributed to this progression from inappropriate use of potions, concoctions, and snake oil to the highly regulated drug development process of today is described in some detail.

Drug Design↗
PubMed1997

In-vivo degradation of polyurethanes: transmission-FTIR microscopic characterization of polyurethanes sectioned by cryomicrotomy.

A combination of cryomicrotomy and transmission Fourier transform infrared (FTIR) microscopy was used to investigate chemical changes in unstrained sheets of Pellethane 2363-80A, Tecoflex EG80A and Biomer caused by biodegradation (18 month subcutaneous ovine implant). Cryomicrotomy was used to obtain thin sections (ca. 2.5 microm) from the surface into the bulk, parallel to the plane of the surface. FTIR microscopy was then used to obtain infrared absorbance spectra in the range 4000-600 cm(-1). Comparisons between the infrared spectra (by spectral subtraction) from implant surface, implant interior and non-implanted controls were used to detect chemical changes. Scanning electron microscopy was used to assess microstructural changes owing to biodegradation. Biodegradation in Biomer was observed as uniform pitting and superficial fissuring (<2.0 microm depth) over the implant surface. Biodegradation in Pellethane 2363-80A and Tecoflex EG 80A was observed as severe localized embrittlement of the surface with fissures infiltrating up to 40 microm into the bulk. The chemical changes associated with biodegradation were observed as localized oxidation of the soft segment and hydrolysis of the urethane bonds joining hard and soft segments. Tecoflex EG80A was also found to be susceptible to localized hydrolysis of the urethane bond within the aliphatic hard segment. Biomer showed evidence of a significant non-specific degradation in the non-implanted wet control (37 degrees C phosphate buffered saline at pH 7.3) samples and in the implant bulk.

Animals↗
PubMed1997

High-resolution digital retroillumination imaging of the posterior lens capsule after cataract surgery.

PURPOSE: To develop a system for high-resolution imaging of the posterior lens capsule after intraocular lens surgery for objective assessment of posterior capsule opacification (PCO). SETTING: Department of Cataract and Refractive Surgery, St. Thomas' Hospital, London, United Kingdom. METHODS: A system was developed that uses coaxial illumination and imaging based on Zeiss components with a digital camera directly linked to a computer for online image verification and image analysis. RESULTS: The system produced high-resolution digital images with even background illumination of sufficient quality to demonstrate progressive lens epithelial cell changes that are amenable to computer image analysis. CONCLUSION: This system produced excellent images for objective documentation and quantitative measurement of PCO.

Cataract↗
PubMed1997

Physical activity and women in the United States: an overview of health benefits, prevalence, and intervention opportunities.

Despite decades of physical activity research and interventions conducted on men, very little is known about the patterns of physical activity among US women. Rates from several national surveys show much lower rates of physical activity for women than for men. Among women, rates may vary by socioeconomic status. Studies relating physical activity and experience with heart disease, cancer, osteoporosis, and mental health are discussed. Interventions in the workplace and the community may increase the level of physical activity among US women. A history of not participating in exercise and lack of time for this activity appear to be important constraints for many women. The Surgeon General's Report on physical activity sanctioned future research on specific groups, such as women. Applied research coupled with community and workplace policies that support women's efforts to be more physically active may decrease the rates of some chronic diseases in this population.

Exercise↗
PubMed1996

Meningitis following a combined spinal-epidural technique in a labouring term parturient.

PURPOSE: To report a case of probable bacterial meningitis in a parturient who received a combined spinal-epidural (CSE) technique for labour analgesia. CLINICAL FEATURES: A 28-yr-old GIPO at 40 wk gestational age presented in labour and requested analgesia. A CSE technique was used to inject a mixture of fentanyl 25 micrograms and bupivacaine 2.5 mg into the subarachnoid space following which a catheter was inserted into the epidural space. Sixteen hours after delivery her body temperature increased to 38.7 degrees C and she complained of a non-positional frontal headache. This was associated with chills, photophobia, and mild nuchal rigidity. Diagnostic lumbar puncture revealed cloudy cerebrospinal fluid (CSF) with increased polymorphonuclear (PMN) white cell count and increased protein and decreased glucose concentrations. Peripheral blood cytology also showed an increased leukocyte count with a shift to the left. Immediate treatment with antibiotics was instituted and the patient rapidly recovered without sequelae. CONCLUSIONS: Meningitis may occur, albeit rarely, with any neuraxial blocks including CSE techniques. Early diagnosis and appropriate antibiotic therapy are important in preventing serious neurological sequelae.

Adult↗
PubMed1996

Natural bites, food consistency and feeding behaviour in man.

Complete feeding sequences (bite to terminal swallow) were recorded in 11 individuals (Class I occlusions) feeding on apple, banana and biscuit (hard cookie) to establish whether jaw movements characteristic of the stage I transport, chewing, stage II transport and swallowing processes found in non-human mammals could be identified in man. All participants took large natural bites (known weight) of each food, but seven were supplied standard 6-g pieces of apple. Jaw movements (three axes) were recorded using a locally calibrated Sirognathograph. Discrete stage I transport movements (bite moved from incisors to postcanines), were found in most records, but least frequently for banana. The number of chewing cycles before the first in-sequence swallow increased in the order: banana, ( = ) apple without peel, apple with peel, biscuit. Chewing cycles showed subtle changes in gape profile but significant variation in mediolateral movement cycle to cycle. Morphologically distinct stage II transport cycles could not be identified. Swallows occurred intermittently during chewing (79% of all sequences, n = 146) with cycle durations in excess of 1 s in contrast to the range for chewing (0.6-0.7 s). Almost all sequences ended with a period, clearance, of highly irregular jaw movements often including swallows. Clearance has not been described in other mammals. Food consistency affected feeding behaviour. The "chew/swallow' ratio (total number of chews/total number of swallows) increased with food hardness. The number of chewing cycles before the first in-sequence swallow also increased. Food type significantly affected sequence duration. The duration of clearance was also affected by bite weight and food hardness. It is concluded that initial food consistency determines the number of chewing cycles before the first swallow and overall sequence duration. The change in the pattern of jaw movement in both the vertical and mediolateral directions cycle to cycle suggests continuous sensory modulation of the motor output to the mandibular musculature.

Adult↗
PubMed1991

Assessing population-based programs to reduce blood cholesterol level and saturated fats.

This article reviews seven community-based programs for prevention of cardiovascular disease and their effects on blood cholesterol levels and saturated fat intake. In two programs, cholesterol levels were reduced more in the intervention area than in the reference area. In two other programs, cholesterol increased less in the intervention area than in the reference area. In one program, cholesterol levels initially fell in the intervention group and increased in the reference group; after the first 4 years, the levels also started to increase in the intervention group. The final two programs reduced cholesterol equally in both groups. Only two programs reported on the intake of saturated fats; in both, intake of saturated fat was reduced more in the intervention area than in the reference populations. In one program area, total intake of fat was reduced more than in the reference area. Published data do not allow us to draw conclusions regarding which components of the programs were most important. These studies show that the average blood cholesterol level can be affected in a general population.

Cardiovascular Diseases↗
PubMed1990

Test characteristics of self-reported hypertension among the Hispanic population: findings from the Hispanic Health and Nutrition Examination Survey.

Data from the Hispanic Health and Nutrition Examination Survey conducted from 1982 to 1984 were analyzed for the sensitivity, specificity, and positive and negative predictive value of self-reported hypertension in 5195 Hispanics of both sexes between the ages of 18 and 74 years. On the basis of a hypertension definition of 140/90 mmHg or of the use of antihypertensive medications, overall sensitivity of self-reported hypertension was 56% for Mexican-Americans, 71% for Cuban-Americans and 72% for Puerto Ricans. Sensitivity was higher among women, among the obese, and among those with access to a regular place for medical care; increased with increasing age; and decreased with education and the time interval since last medical visit. Independent associations for sensitivity were noted for sex, body mass index (BMI), and time interval since last medical visit among Mexican-Americans; and for time interval since last medical visit and for being divorced or separated for Cuban-Americans. Overall positive predictive value reached 49% among Mexican-Americans, 53% among Cuban-Americans, and 39% among Puerto Ricans. Raising the hypertension-threshold to 160/95 mmHg tended to increase the sensitivity but reduced the positive predictive value.

Adolescent↗
PubMed1989

Tactile perceptual asymmetry: the influence of motor activity and imagery instructions.

The purpose of this study was to examine the degree to which changes in muscular activity modify tactile perceptual asymmetries. In two experiments subjects were presented with a series of pairs of random shapes to the fingers of each hand. Their task was to detect the occurrence of a previously learnt target shape. Pressing on to the shape was the only movement allowed and other types of motor activity, particularly tracing movements, were not permitted. Across experimental conditions subjects were required to change the pressure and hence muscular effort used to press upon the shape. A left-hand advantage was found across all experimental conditions and its size did not change when subjects were required to press either firmly or lightly upon the shapes. This result was also found when subjects were required to apply uneven pressure between the hands. One-half of the subjects also performed the experimental conditions following instructions to use imagery. This produced an enhancement of right-hand performance on the task with a loss of the left-hand advantage. The results suggest that observed tactile perceptual asymmetries, while unaffected by changes in muscular effort, are easily overridden by higher-order cognitive and motor processes.

Adult↗
PubMed1984

Effect of prolonged intense endurance training on systolic time intervals in patients with coronary artery disease.

We studied the effect of exercise training (ET) on systolic time intervals (STI) in 13 patients with coronary artery disease (CAD). All patients trained for at least 10 months. They exercised three times/week at 50% to 70% of maximal oxygen uptake (VO2max) for the initial 3 months and at least four times/week for approximately 50 minutes at 70% to 90% of VO2max thereafter. A significant training effect was documented by an increase in VO2max from 26.0 +/- 4.3 to 37.2 +/- 5.8 ml/kg/min (p less than 0.01), a lower heart rate (HR) at rest, and a lower blood pressure and HR during submaximal work. The indices of total electromechanical systole (QS2I) and left ventricular ejection time (LVETI) did not change. However, pre-ejection period index (PEPI) decreased from 137 +/- 9 msec to 129 +/- 9 msec (p less than 0.01). PEP/LVET decreased from 0.373 +/- 0.028 to 0.342 +/- 0.032 (p less than 0.01). Left ventricular end-diastolic dimension and posterior wall thickness, measured echocardiographically, were increased after training. We conclude that exercise training may improve myocardial performance in some patients with CAD.

Adult↗