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Biomedical subjects

G Livingston

Publications and source records attributed to G Livingston.

At least 55 records · Page 3Linked to original sources
PubMed1994

The Gospel Oak Study stage III: the incidence of dementia.

Of an original sample of 705 elderly (aged over 65) community residents 71% were rescreened after two years and four months using Short CARE. Thirty-one (6.7%) subjects were identified as possible new cases of dementia, implying a mean annual inception rate among the survivors of 26 per 1000. These were subjected to full clinical assessment, which yielded 10 cases of Alzheimer's disease (8 per 1000) and 5 multi-infarct dementia (4 per 1000). The remainder of the cases consisted of 6 with a dementia secondary to other causes, 1 case of mixed dementia and there was insufficient information to classify the remaining 3. Six were found not to be suffering from dementia. This yields an overall annual incidence rate for dementia among the survivors of 20 per 1000.

Aged↗
PubMed1993

Does sleep disturbance predict depression in elderly people? A study in inner London.

Insomnia in elderly people has traditionally been regarded as inevitable and trivial. A longitudinal study was undertaken to examine the prevalence of sleep disturbance among elderly people in an inner London community and its association with demographic variables, depression, dementia and disability. Those aged 65 years and over living at home were interviewed using a validated and reliable semi-structured interview schedule. A total of 705 people were interviewed in 1987-88 and 524 were re-interviewed in 1990. Subjective sleep disturbance was found to be common (33% and 43%, respectively). Sleep disturbance was associated with being a woman, being unmarried, living alone, disability, and current and future depression, but not with dementia or older age. The best predictor of future depression in elderly people who were not depressed was current sleep disturbance. In the presence of current sleep disturbance, the traditional predictors of depression--being a woman, having a disability, being unmarried, living alone and being older--did not contribute further. This study has shown that sleep disorder is associated with pathology. Insomnia in elderly people requires assessment and this must be accompanied by the treatment of underlying disorders and monitoring of future health.

Aged↗
PubMed1992

The Gospel Oak Study: the prevalence and incidence of dementia in an inner city area of London.

An inner city population of people over 65 years of age was screened using Short CARE in 1987. Eight percent were identified as having possible cognitive impairment and 4.7% as probable pervasive dementia, from the scores on two scales of this interview. A detailed clinical reassessment of these subjects identified by screening, suggested a rate of clinical dementia at 6.1%, 3.1% meeting the criteria for probable Alzheimer's disease. Two and a half years later, 72% have been rescreened using Short CARE. Fifteen percent of the population had died, 7% moved away and 6% were not available for interview. Thirty-five (5.9%) of the subjects rescreened appeared, from their scores on the two scales, to be new cases of dementia, giving a possible annual incidence rate of 2.6%. The annual incidence rate of probable pervasive dementia was 1.4%. These subjects are now in the process of having a detailed clinical diagnostic assessment. The medical records of those who had died between the two screens are being checked for evidence of dementia, so that more precise incidence rates can be calculated.

Activities of Daily Living↗
PubMed1991

Concordance between two measures of dream bizarreness.

To assess the level of concordance between two published measures of dream bizarreness, 100 randomly selected dreams from 93 college students were scored for primary process using the Auld, Goldenberg, and Weiss scale and for dream distortion using Zepelin's scale. This analysis yielded a strong relationship between these measures, indicating adequate concurrent validity for the content analysis of the construct of dream bizarreness.

Adult↗
PubMed1990

The Gospel Oak Study: prevalence rates of dementia, depression and activity limitation among elderly residents in inner London.

The steps to setting up a population register of elderly residents are described. Based upon this, 87.2% of the elderly residents of an inner-city electoral area were screened for memory disorder, depression and activity limitation using the Short CARE. Contact with medical and social agencies was also recorded; 4.7% were classed as cases by the dementia diagnostic scale, sufferers being older and not living alone. Of the residents 15.9% were classed as depressed, this state being more prevalent in those not currently married. The depressed were, in contrast to the demented residents, likely to be in recent contact with hospital and general practitioner. Thirty-two per cent of the population showed impairment in daily activity, these individuals were usually older, not married and receiving hospital care. Sleep disorder and complaint of many somatic symptoms were associated with a diagnosis of depression. In contrast, most respondents with a subjective complaint of memory disorder, which was common in this population, were neither suffering from depression nor dementia. With this accurate sampling frame and a good response rate, the prevalence rate of clinical depression must be seen as disturbingly high. The prevalence rate of dementia approximated to that of other surveys. This study also indicated that general practitioners' lists may be inaccurate and that non-responders to first approaches for interview, although similar in demographic features to those responding, may contain among them many suffering from dementia.

Activities of Daily Living↗
PubMed1990

The Gospel Oak Study stage II: the diagnosis of dementia in the community.

An attempt was made to assess in detail subjects screened as suffering from dementia among a North London community sample of elderly people. Forty-eight (80%) subjects were interviewed, 7 (12%) were found to have died and 5 (8%) either refused interview or were lost to follow-up. By clinicians' diagnosis of the 48 interviewed, 22 subjects (46%) had probable Alzheimer's disease, one had multi-infarct dementia, five had mixed dementia, five had secondary dementia, 10 had a dementia which could not be further classified and 5 were not demented. No subject had a reversible condition. The prevalence rate for clinical dementia was 6.1%, and for Alzheimer's disease 3.1%. According to AGECAT diagnosis the prevalence of organicity was 5.7%. The AGECAT diagnoses and psychiatrists' diagnoses were significantly associated (P less than 0.003) and AGECAT was more likely to identify as organic those subjects with dementia diagnosed by psychiatrists as Alzheimer's disease, than those not so diagnosed (P less than 0.04). A short psychometric battery, including the MMSE in two versions, was administered and its acceptability to a community sample evaluated. This detailed clinical investigation showed that the Dementia Diagnostic Scale of the Short-CARE was a specific predictor of clinical dementia or death at the time of follow-up, whereas the more inclusive Organic Brain Syndrome scale was a more satisfactory first phase screening instrument.

Aged↗
PubMed1990

The Gospel Oak Project: the use of health and social services by dependent elderly people in the community.

The Gospel Oak Project surveyed a community sample of elderly people. Prevalence rates of depression and dementia were determined. Cases were assessed in detail and subject to long-term follow-up. Demographic information and morbidity data identified details of health service, social service and informal service contact. This paper reports the findings of the first survey of this population completed in 1987. It examines the effect of the increase in the very elderly on the need for health and social services, including contact with general practitioners. Duplication of service contacts are explored and the dependent elderly people not in receipt of services are identified. Finally, the survey investigates the effect of informal care on the level of service contact. Results confirm that contact increases with age, especially multiple service contact, implying a need for an expansion in future services. Although most depressed residents do not usually complain of depression, they have increased contact with health services but are not treated with anti-depressant medication. Few dependent elderly people receive no services; conversely there is no evidence of service duplication. Finally, receipt of informal care affected attendance at a day centre but no other service provision.

Aged↗
PubMed1987

The Present State Examination Change Rating Scale.

The development and use of a new psychiatric symptom change scale based on the Present State Examination (PSE)--the PSE Change Rating Scale--is described. The advantages of the PSE are retained (the extensive glossary, the diagnostic facility and the standardised interview technique) while improving its sensitivity to change and decreasing its administration time. The scale has been designed to prevent feedback of results and 'halo' effects: it has proved highly reliable in use across raters with different backgrounds and experience. The scale has been used to monitor drug effects on clinical state across a variety of diagnoses and examples of its use are given.

Adult↗
PubMed1984

Morbidity in childhood--a longitudinal view.

We examined all the morbidity experienced in a six-year period by a total of 2591 children who were continuously enrolled in a prepaid medical plan. The children had received 19,291 diagnoses, each of which was assigned to one of 14 types of morbidity, and the frequency of each type was determined. Although the typical child had at least one problem in 5 of the 14 types of morbidity in the six-year period, over 20 per cent of children had at least 8 different types of problems during that time. Children with a greater variety of acute problems and more frequent acute problems were also more likely to have nonacute problems during the six-year period. Conversely, children with nonacute problems had more acute problems than other children. Our findings indicate that morbidity, like use of health services, occurred in clusters in this population of children. Therefore, an understanding of the cause and projected outcome of morbidity among children will be incomplete if the focus is only on specific diseases or specific types of illnesses.

Adolescent↗
PubMed1984

Further delineation of the 10p deletion syndrome.

Nine children with a partial deletion of the short arm of the number 10 chromosome have been described in the medical literature. In two new cases of 10p-, the children have several features in common with those previously reported; these features include down-slanting short palpebral fissures, ear anomalies, anteverted nostrils, a short neck, and psychomotor delay. At this stage in the delineation of this condition, the phenotypic expression is variable. However, the craniofacial features of the two children with recently reported 10p- and others display a constellation of individually nonspecific but consistent findings that together form a recognizable gestalt. Pediatric practitioners should consider performing karyotypes in children with developmental disabilities accompanied by multiple structural defects and/or multiple physical variations not part of the family background.

Abnormalities, Multiple↗
PubMed1982

Failure to demonstrate an effect of in vivo diagnostic ultrasound on sister chromatid exchange frequency in amniotic fluid cells.

Antepartum use of diagnostic ultrasound has markedly reduced radiation exposure of the fetus. Previous investigations have documented the safety of ultrasound, but concern persists regarding its long-term effects. As new methods become available to study possible subtle effects of ultrasound, it is important to reevaluate this technique continually because of its universal use in obstetrics and elsewhere. We report results of in vivo studies of effect of diagnostic ultrasound on the sister chromatid exchange (SCE) frequency in amniotic fluid cells. SCE is a cytogenetic phenomenon believed to be a sensitive indicator of environmental perturbations and chromosome stability. In amniotic fluid cells from six pregnancies without ultrasound exposure and in 34 pregnancies that received varying amount of ultrasound immediately before amniocentesis, there was no difference in SCE frequency in exposed verus nonexposed cells. These data, which appear to confirm again the safety of ultrasound, are reassuring to both patients and clinicians.

Amniotic Fluid↗
PubMed1977

Nurse clinician productivity using a relative value scale.

The use of relative value units to measure the productivity of nurse clinicians in four primary care practices is described. Relative value points and equivalent dollar values assigned to services provided by professionals yielded a different assessment of productivity than that provided by a count of patient visits. The physician-nurse clinician teams studied were only 6 percent more productive than the physician-nurse teams when productivity was measured by the number of patient visits processed during an 8-hour period but were 26 percent more productive in terms of the value of services they produced per day.

Efficiency↗
PubMed1976

Contribution of a nurse clinician to office practice productivity: comparison of two solo primary care practices.

A comparison of two solo primary care practices with similar patient populations reveals a significant difference in productivity. A nurse clinician was employed in the more productive practice. She independently managed 1,848 patient visits a year that would otherwise have required the time and attention of a physician. She contributed to the productivity of the physician by performing some tasks he would normally have performed during visits they managed jointly. It was primarily because of the assistance he received from the nurse clinician that the physician in practice II was 12 percent more productive than the physician in practice I. The nurse clinician and physician managed 31 percent more patient visits during a standard day than the physician in practice I, or a difference of 2,856 patient visits a year. This annual difference is based on a work schedule that could be matched in other practices: an eight-hour day and a 240-day work year.

Humans↗
PubMed1974

The effects of prompting question-asking upon on-task behavior and reading comprehension.

This study investigated a teacher-implemented prompting procedure for training students to ask questions. Two special-class (EMR) students who asked no questions were selected as subjects. Baseline data were also collected on reading comprehension and on-task behavior, and these suggested decreasing levels of performance. The results indicated that prompting was effective for initiating question-asking. In addition, increased levels of reading comprehension and on-task behavior were observed.

Achievement↗
PubMed1973

Self-recording and student teacher supervision: variables within a token economy structure.

A token system was used to attempt to increase the accuracy with which special education students answered questions about reading assignments. In the token system, students recorded their own data, received toy money for accurately completing assignments, and were allowed to spend their toy money at the end of the week for educational activities. The accuracy with which students answered questions was higher when the token system was in effect than when it was not. When student teachers were used to manage the token system and when the self-recording feature of the system was removed, only slight changes in the accuracy of the student performance were obtained.

Journal Article↗