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Biomedical subjects

G Robertson

Publications and source records attributed to G Robertson.

At least 91 records · Page 5Linked to original sources

Mentally abnormal offenders: manner of death.

A 23 year follow up of deaths in a population of mentally disordered patients was carried out, and a typical case history is reported. A quarter (71) of the deaths reported were unnatural, verdicts of suicide or accidental death or open verdicts having been recorded. For men in most age groups the proportion of deaths by suicide was two to three times greater than in the general population in 1982; the rate among those aged 25-29 was five times that in the general population. Differences in the rate of unnatural death among diagnostic categories of mental illness were not significant, but the proportion of unnatural deaths among the mentally handicapped will probably eventually be lower than that among psychotic offenders or those with personality disorders. Violent death occurs at an older age in those with affective disorders. Social isolation and alienation add to the handicap of mental disorder in this group of people, and these sometimes difficult but always vulnerable patients must continue to be offered asylum other than prison.

Adult↗

Detention in Broadmoor. Factors in length of stay.

When the length of stay of restricted patients admitted to Broadmoor under the legal category of psychopathic disorder was examined, the factor found to be of primary importance was the gravity of the admission offence. If the men's offences did not cause personal injury, they had a good chance of early release. Patients convicted of violent or sexual offences, and particularly those who attacked strangers, made up the great majority of the long-term group. For the mentally ill there was no relationship between length of stay and admission offence: instead the data suggested that severity and chronicity of illness were the main relevant factors.

Antisocial Personality Disorder↗

Does violence have cognitive correlates?

The relationship between cognitive function and violence in 76 remanded prisoners, without formal psychiatric illness, was investigated. The violent group tended to be of slightly lower general ability than the non-violent group, but not abnormally so in relation to the general population; no relationship was found between specific patterns of cognitive functioning and violence. The violent group reported significantly higher levels of neurotic symptoms than the non-violent group, and were more socially deviant. To a small extent, general intelligence (reasoning ability), in interaction with many other factors, may be related to a propensity for violent behaviour, but no particular aspect of cortical functioning seems to be related to violence.

Cognition↗

A ten-year follow-up of men discharged from Grendon prison.

A ten-year follow-up on the criminal records of men discharged from Grendon Prison was carried out. These records were compared with those of a matched control group, and no differences were found regarding frequency or severity of post-discharge convictions. The validity of this exercise is questioned, and several case histories presented. An examination of subsequent offending within the Grendon group suggests that for some men, the better motivated and more intelligent, exposure to the Grendon regime may have contributed to a change in their criminal behaviour.

Adult↗

Vectorcardiographic and blood pressure correlates of obstructive pulmonary diseases in a community population.

Vectorcardiography was performed on 2,449 subjects, aged six years and older, in the Tucson (Ariz) Epidemiological Study of Airway Obstructive Diseases (AOD), 95 percent of the white non-Mexican Americans in the stratified cluster population sample. The objectives were to confirm previous relationships and to determine if hypothesized changes in the vectorcardiogram (VCG) could predict AOD. Trained nurse technicians performed the VCGs, which were read and interpreted by a cardiologist. Vectorcardiographic results were broadly interpreted for abnormalities. Also, calculated vector means and angles were compared to standard questionnaire responses for medical history, to maximum expiratory flow-volume variables, and to values for blood pressure; these were all corrected for sex, age, height, weight, and the ponderal index. Values were expressed as percentages of predicted. Over 80 percent of the VCGs were found to be normal. Measured hypertrophy was related to disease; there were significantly more abnormalities in those with histories of heart disease, hypertension, arteriosclerosis, and AOD, when examined by types of ventricular hypertrophy and VCG-identified heart disease or hypertension; findings of AOD and heart disease were also correlated significantly. Of all the ventricular hypertrophy, right ventricular hypertrophy (RVH), type C, was confirmed to be the predominant type associated with decreased pulmonary function in all smoking groups. Systolic blood pressure was related to RVH, type A, and diastolic 4 and 5 blood pressure with RVH, types A and B. The vectors' magnitude and angles were related to abnormality of pulmonary function in those with and without heart disease and AOD.

Adolescent↗

Desensitization to substance P following intrathecal injection. A technique for investigating the role of substance P in nociception.

The intrathecal injection of substance P (SP) (2.5-15 micrograms) has been shown to produce hyperalgesia in the rat tail flick test. Repeated injection of SP (7.5 or 15 micrograms) or pretreatment with two of these doses produces desensitization to this hyperalgesic response. Desensitization is dose-related with respect to degree and duration. This phenomenon is relatively specific because the hyperalgesic response to methysergide, a serotonin receptor antagonist, is unaffected, while that produced by phentolamine, an adrenergic receptor antagonist, is much less affected than that of SP. Pretreatment with a desensitizing regimen of SP potentiates the antinociceptive effect of morphine and baclofen when they are tested immediately after the regimen but if a 30 min delay is permitted, an inhibition of their effects is observed. These results support the notion that the spinal antinociceptive effect of morphine and baclofen is due to an interaction with SP mechanisms in the spinal cord, the nature of which may be more complex than is presently understood. Desensitization produces no change in baseline responsiveness in the tail flick test. This suggests that the hyperalgesic response to SP is due either to an action at a site other than the primary afferent synapse, or if it is at this site either compensatory mechanisms occur or SP is not the primary determinant of tail flick latency but may play a modulatory role.

Animals↗

Antimicrobial cream susceptibility testing.

Utilizing a recently described rapid needle extrusion method for determining the sensitivities of burn wound isolates, we have compiled data on the resistance patterns of over 250 isolates from our burn unit. Major isolate groups were Staphylococcus aureus, Pseudomonas aeruginosa, various Enterobacteriaceae and Enterococci. Excellent correlation was exhibited between the inhibitory zone sizes and the minimal inhibitory concentration for 120 organisms tested. Utilizing the needle extrusion sensitivities to facilitate the selection of the burn creams, a significant reduction in the microbiologic flora of the burn wound was noted. The utilization of this technique in the selection of burn creams deserves controlled trials to assess whether changes in topical therapy might alter clinical outcome.

Administration, Topical↗

Some cognitive correlates of schizophrenic illnesses.

A battery of tests was developed to assess verbal, non-verbal and mixed cognitive functions. Interest was based on pattern of response rather than absolute scores. The subjects were 167 men held in prison on criminal charges or in a maximum security hospital after conviction. The present paper deals exclusively with two subgroups: the 61 schizophrenic men and the 41 men with no psychiatric disorder. The schizophrenic group as a whole presented a very different cognitive pattern from the 'normal' men. First, with the exception of the vocabulary subtest of the WAIS, the schizophrenics were inferior on all tests, whether verbal, non-verbal or mixed function. Secondly, they showed considerably more variation within subtests. The schizophrenic sample was therefore subdivided into four clinical groups. Each showed a distinctive cognitive profile. It is argued that these cognitive differences reflect real differences in the disorder and type of illness being experienced by members of these subgroups.

Cognition Disorders↗

Some cognitive correlates of affective disorders.

Seventy-one men completed a battery of cognitive tests which were designed to reflect verbal analytic and non-verbal holistic functioning. Interest centred around pattern of response. Thirty men were suffering from an affective disorder and forty-one were well. All the men were in prison, the majority awaiting trial. The affective disorder group was subdivided into three categories: men who had a history of manic-depressive illness; a group of unipolar, psychotically depressed men; and men who were regarded as being depressed in reaction to circumstances. All three groups showed specific difficulty in dealing with spatial/holistic tasks, other factors being held constant. They were also found to differ in a number of other respects. The possible significance of these differences is discussed.

Adjustment Disorders↗

The induction of ovulation using pulsatile luteinizing hormone releasing hormone in clinical practice.

Until recently induction of ovulation in patients resistant to clomiphene has required gonadotrophin therapy. This has entailed intensive biochemical monitoring to ascertain the correct dosage and to avoid ovarian hyperstimulation. Described here is a simple, safe effective method of ovulation induction, using pulsed luteinizing hormone releasing hormone and requiring only minimal, readily available monitoring methods.

Adult↗

The validity of the SCL-90 in a sample of British men remanded to prison for psychiatric reports.

The SCL-90 is a self-report inventory of psychopathology, which has not previously been validated in the UK. In the present study, the scale was found to correlate well with other measures of mental state, namely the Present State Examination (PSE) and the Comprehensive Psychopathological Rating Scale (CPRS). The scale was able to distinguish psychotic from non-psychotic patients on its paranoid ideation sub-scale, but not on its psychoticism one, nor any of its seven neurotic sub-scales. It is suggested that in research or population screening studies, this type of questionnaire should be supplemented with information relating to psychiatric history and motivation for treatment.

Humans↗

A community training scheme in cardiopulmonary resuscitation.

Community instruction in basic life support and resuscitation techniques has been offered in Brighton Health District since 1978. Classes are held frequently for the general public and businesses, schools, and other organisations. First aid care for unconscious patients, the treatment of respiratory obstruction or failure, and the recognition and management of cardiac arrest is taught in a single two hour session. Over 20 000 people have been taught, up to 40 at a time in multiple groups of six to eight, by lay instructors usually supervised by ambulancemen trained to "paramedic" standards. Fifty four incidents have been reported to us in which techniques learnt in the classes have been implemented. Five patients recovered after first aid support but subsequently did not seek medical treatment. Of the 34 patients reviewed in hospital, at least 20 survived to be discharged. We believe that intervention may have been life saving in 16 instances. The benefit of cardiopulmonary resuscitation for victims who may have been asystolic is, however, difficult to quantify because the outcome without intervention cannot be predicted accurately. Community training in basic life support should be considered in association with ambulances equipped for resuscitation and hospital intensive care and cardiac care units as an integrated service for the victims of sudden circulatory or respiratory emergencies. The results achieved so far in Brighton and in other more advanced schemes, particularly in the United States of America, may encourage other health authorities to adopt similar programmes.

Adolescent↗