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Biomedical subjects

H R Anderson

Publications and source records attributed to H R Anderson.

At least 19 recordsLinked to original sources
PubMed1995

Preterm delivery: effects of socioeconomic factors, psychological stress, smoking, alcohol, and caffeine.

OBJECTIVE: To examine the relation between preterm birth and socioeconomic and psychological factors, smoking, and alcohol, and caffeine consumption. DESIGN: Prospective study of outcome of pregnancy. SETTING: District general hospital in inner London. PARTICIPANTS: 1860 consecutive white women booking for delivery; 1513 women studied after exclusion because of multiple pregnancy and diabetes, refusals, and loss to follow up. MEASUREMENTS: Gestational age was determined from ultrasound and maternal dates; preterm birth was defined as less than 37 completed weeks. Independent variables included smoking, alcohol and caffeine consumption, and a range of indicators of socioeconomic status and psychological stress. MAIN RESULTS: Unifactorial analyses showed that lower social class, less education, single marital status, low income, trouble with "nerves" and depression, help from professional agencies, and little contact with neighbours were all significantly associated with an increased risk of preterm birth. There were no apparent effects of smoking, alcohol, or caffeine on the length of gestation overall, although there was an association between smoking and delivery before 32 weeks. Cluster analysis indicated three subgroups of women delivering preterm: two predominantly of low social status and a third of older women with higher social status who did not smoke. Mean gestational age was highest in the third group. CONCLUSIONS: Adverse social circumstances are associated with preterm birth but smoking is not, apart from an association with very early births. This runs counter to findings for fetal growth (birth weight for gestational age) in this study, where a strong effect of smoking on fetal growth was observed but there was no evidence for any association with psychosocial factors.

Alcohol Drinking↗
PubMed1995

Fasciola hepatica: ultrastructural changes to the tegument of juvenile flukes following incubation in vitro with the deacetylated (amine) metabolite of diamphenethide.

Ultrastructural changes to the tegument of 5-week-old, 3-week-old and freshly-excysted Fasciola hepatica following in vitro incubation with the deacetylated (amine) metabolite of diamphenethide (DAMD, 10 microgramsml-1) were examined by transmission electron microscopy. A similar sequence of tegumental changes occurred in all three age groups of fluke, although, with increasing fluke age, the time before onset increased and the damage became more extensive. The 5-week-old flukes showed an initial stress response after 3 h, typified by blebbing of the apical plasma membrane, formation of microvilli and an accumulation and accelerated release of secretory bodies at the tegumental apex, as well as swelling of the basal infolds. The swelling increased in extent with progressively longer periods of incubation in DAMD, leading to extreme edema and sloughing of the tegument after 9 h. The 3-week-old flukes showed a stress response and swelling of the basal infolds after only 1.5 h, although sloughing of the tegument did not occur until after 9 h. In the freshly-excysted metacercaria, a stress response and some sloughing of the tegument were evident after only 0.5 h. At all stages of development, the ventral tegument was more severely affected than the dorsal. Changes also occurred to the tegumental cells which were indicative of a disruption in the synthesis and release of tegumental secretory bodies: the amount of GER became reduced, the cisternae became swollen and their ribosomal covering decreased, the Golgi complexes disappeared from the cells and the numbers of secretory bodies in the cells also decreased. The heterochromatin content of the nuclei increased and eventually the tegumental cells began to break down. Again, the changes became apparent more rapidly at the earlier stages of development. The ultrastructural changes to the tegument are linked to a possible mode of action for diamphenethide as an inhibitor of protein synthesis. In turn, the results may help to explain the drug's high efficacy against juvenile stages of F. hepatica.

Animals↗
PubMed1995

Effect of ambient levels of smoke and sulphur dioxide on the health of a national sample of 23 year old subjects in 1981.

BACKGROUND: There is concern that, despite the fall in air pollution levels since the 1950s, there may still be adverse effects at current levels. A study was carried out to investigate the association between air pollution and respiratory symptoms in 23 year old subjects in 1981. METHODS: Data on cough, phlegm, and wheeze were available on 11,552 members of the 1958 national birth cohort. Counties in the UK were ranked by annual average level of black smoke and sulphur dioxide (SO2), and then divided into five groups. The subject's county of residence determined their categorisation of pollution exposure. The association between air pollution exposure and respiratory symptoms was examined by logistic regression, adjusting for social class, sex, and smoking. RESULTS: The ranges of the air pollution groups were 2.0-13.0, 13.1-18.7, 19.6-20.8, 21.0-25.8, and 26.1-55.1 micrograms/m3 for black smoke, and 7.0-36.4, 36.7-42.7, 43.0-50.5, 52.0-59.3, and 60.9-87.7 micrograms/m3 for SO2. The overall prevalences of cough, phlegm, wheezing since age 16, and wheezing in the past year were 13.3%, 10.3%, 9.4%, and 4.4%, respectively. Phlegm symptoms increased with increasing smoke levels with evidence of a plateau. Cough and wheeze were not associated with black smoke; no symptom was associated with SO2. In the subgroup with wheeze at ages 16-23 there was no effect of smoke level on phlegm. CONCLUSIONS: Low ambient levels of black smoke were associated with decreased prevalence of phlegm symptoms in young adults in the UK in 1981. The effect was evident below the current EC guideline of 34-51 micrograms/m3 annual black smoke. In 1991 the annual mean smoke level for each county ranged from 3.4 to 26.5 micrograms/m3, spanning all but the last exposure group used here. This is consistent with the existence of adverse and possibly chronic effects at current levels.

Adult↗
PubMed1995

International Study of Asthma and Allergies in Childhood (ISAAC): rationale and methods.

The aetiology of asthma and allergic disease remains poorly understood, despite considerable research. The International Study of Asthma and Allergies in Childhood (ISAAC), was founded to maximize the value of epidemiological research into asthma and allergic disease, by establishing a standardized methodology and facilitating international collaboration. Its specific aims are: 1) to describe the prevalence and severity of asthma, rhinitis and eczema in children living in different centres, and to make comparisons within and between countries; 2) to obtain baseline measures for assessment of future trends in the prevalence and severity of these diseases; and 3) to provide a framework for further aetiological research into genetic, lifestyle, environmental, and medical care factors affecting these diseases. The ISAAC design comprises three phases. Phase 1 uses core questionnaires designed to assess the prevalence and severity of asthma and allergic disease in defined populations. Phase 2 will investigate possible aetiological factors, particularly those suggested by the findings of Phase 1. Phase 3 will be a repetition of Phase 1 to assess trends in prevalence.

Adolescent↗
PubMed1995

Short-term effects of air pollution on health: a European approach using epidemiological time-series data. The APHEA project: background, objectives, design.

Recent studies investigating the adverse health effects of air pollution indicate that effects exist around and below the current national and international air quality guidelines and standards. However, the difficult methodological issues involved, and the diversity of analytical techniques so far applied, hinder direct between-study comparability and the drawing of clear conclusions. The APHEA (Air Pollution on Health: European Approach) project is an attempt to provide quantitative estimates of the short-term health effects of air pollution, using an extensive data base from 10 different European countries, which represent various social, environmental and air pollution situations. Within the framework of the project, the methodology of analysing epidemiological time series data, as well as that of performing meta-analysis, are further developed and standardized. Data have been collected from 15 European cities with a total population exceeding 25 million. The exposure data consist of daily measurements of black smoke, sulphur dioxide, suspended particles, nitrogen dioxide and ozone (each available in several, though not all, cities) from already existing monitoring networks. There is substantial variability in air pollution mixtures and air pollutant levels in participating cities. The mean (24 h) levels of SO2 range 27-327 micrograms.m-3 in the winter season, and those of black smoke range 15-292 micrograms.m-3. The mean (1 h) levels of ozone in the summer season range 32-166 micrograms.m-3. The outcome data are daily counts of total and cause-specific deaths and hospital emergency admissions. Data on potential confounders (mainly meteorological and chronological variables) are also used. There is large diversity in the climatic conditions in the different cities.(ABSTRACT TRUNCATED AT 250 WORDS)

Air Pollutants↗
PubMed1994

Acceptability and perceived effectiveness of a district co-ordinating service for terminal care: implications for quality assurance.

As part of a randomized controlled trial of a new district co-ordinating service for the care of terminally ill cancer patients, the activities of the nurse co-ordinators and the acceptability and perceived effectiveness of the service were assessed. Co-ordinators' activities were self-recorded; professional caregivers completed a postal questionnaire; and family carers were interviewed at home. Thirty-eight per cent of patients allocated to the co-ordinators were not visited at home. Overall, 41% of professionals had heard of the co-ordinating service and 20% had been contacted. A third of relatives, whether allocated or not to the co-ordinating service, felt that terminal care of their patient was not well co-ordinated and that they did not know how to get the help they needed for their dying relative. It may be that the nurse co-ordinators were unwilling or unable to relinquish their skills in order to provide a 'broker' style of co-ordination. Perhaps less skilled co-ordinators would have been more successful. Moreover, the co-ordinating service had no budgetary responsibility. Those concerned with quality assurance in co-ordination of terminal care might consider the skill mix and professional training of the co-ordinators as well as their budgetary responsibilities and authority.

Caregivers↗
PubMed1994

Patient characteristics associated with the labelling of asthma.

Patient characteristics associated with the asthma label were investigated in 262 children, aged 8 years, who reported wheezing illness in the previous 12 months. Children were first identified by a screening questionnaire administered to the parents of all 8 year old schoolchildren in Croydon, south London. Interviews were conducted with those reported to have had a wheezing illness in the previous 12 months to obtain details of the child's illness, medical care, demographic and socioeconomic characteristics. Multivariate analysis showed that the likelihood of being labelled asthmatic was increased in those who had a parental history of hayfever [odds ratio (OR) = 2.24, 95% confidence interval (CI) = 1.22-4.14] or at least two allergic provoking factors (OR = 3.83, 95% CI = 1.44-10.15). No significant associations were found between asthma labelling and children's socioeconomic characteristics or use of general practitioner services. These findings suggest that wheeze is likely to be labelled asthma when the clinical history suggests an allergic aetiology.

Asthma↗
PubMed1994

Stereological estimation of Weibel-Palade bodies in the retinal vasculature of normal and diabetic dogs.

The absolute volume of Weibel-Palade (WP) bodies, the storage organelles of von Willebrand factor (vWF), was estimated by a stereological method in a known volume of central retina from normal and 5-year diabetic dogs. The results showed that the volume of WP bodies present in the endothelium of the retinal vasculature varies with blood vessel type and in diabetes. In both diabetic and normal dogs the endothelium of the retinal veins contained a higher volume of WP bodies than that of the retinal arteries. In dogs which had been diabetic for a duration of 5 years the volume of WP bodies present in the endothelium of retinal veins was significantly greater than in the endothelium of veins from the control animals. However, there was no significant difference in the volume of WP bodies present in the endothelium of retinal arteries or capillaries between the two groups of animals.

Animals↗
PubMed1994

Estimation of the surface area and volume of the retinal capillary basement membrane using the stereologic method of vertical sections.

The modern stereologic method of vertical sections was applied to the retina as a means of generating unbiased estimates of three-dimensional structure. The method is illustrated with real data on the volume and surface area of the capillary basement membrane from the central retina of the rat. Novel methods of estimating the volume of retina sampled and of creating accurate vertical sections are described. The advantages of using stereologic methods to generate quantitative information on the three-dimensional structure of the retina are discussed and compared to those of previous quantitative methods that provide data on two-dimensional structure only.

Animals↗
PubMed1993

The effect of diamphenethide on protein synthesis by the liver fluke, Fasciola hepatica.

The effect of the deacetylated (amine) metabolite of diamphenethide (DAMD, 10 micrograms ml-1) on the uptake and incorporation by adult Fasciola hepatica of radioactively labelled precursors of DNA, RNA and protein synthesis ([3H]thymidine, [3H]uridine and [3H]leucine, respectively) was measured by liquid scintillation counting. Comparison was made between the effects of DAMD and those of specific inhibitors of DNA, RNA and protein synthesis, namely, 5-fluorouracil, cordycepin and cycloheximide, respectively. DAMD caused a significant decrease in the overall uptake and incorporation of [3H]uridine by F. hepatica, decreased the incorporation of [3H]leucine and also caused a significant decrease in the overall protein content of the flukes. The effect of DAMD was similar to that of cycloheximide (1 x 10(-3) M), a potent inhibitor of protein synthesis, which also caused a significant decrease in the incorporation of [3H]leucine by the fluke and a decrease in the overall protein content of the fluke. Cordycepin (100 micrograms ml-1) caused a significant decrease in the protein content of the fluke, but had no effect on the uptake or incorporation of [3H]uridine. 5-Fluorouracil (1 x 10(-4) M) did not affect the uptake or incorporation of [3H]thymidine, nor did it decrease the protein content of the fluke. The results indicate that DAMD inhibits protein synthesis by F. hepatica, possibly by inhibiting RNA synthesis. The results are also consistent with previous morphological investigations involving DAMD.

Animals↗
PubMed1992

Randomised controlled trial of effects of coordinating care for terminally ill cancer patients.

OBJECTIVES: To measure effects on terminally ill cancer patients and their families of coordinating the services available within the NHS and from local authorities and the voluntary sector. DESIGN: Randomised controlled trial. SETTING: Inner London health district. PATIENTS: Cancer patients were routinely notified from 1987 to 1990. 554 patients expected to survive less than one year entered the trial and were randomly allocated to a coordination or a control group. INTERVENTION: All patients received routinely available services. Coordination group patients received the assistance of two nurse coordinators, whose role was to ensure that patients received appropriate and well coordinated services, tailored to their individual needs and circumstances. MAIN OUTCOME MEASURES: Patients and carers were interviewed at home on entry to the trial and at intervals until death. Interviews after bereavement were also conducted. Outcome measures included the presence and severity of physical symptoms, psychiatric morbidity, use of and satisfaction with services, and carers' problems. Results from the baseline interview, the interview closest to death, and the interview after bereavement were analysed. RESULTS: Few differences between groups were significant. Coordination group patients were less likely to suffer from vomiting, were more likely to report effective treatment for it, and less likely to be concerned about having an itchy skin. Their carers were more likely to report that in the last week of life the patient had had a cough and had had effective treatment for constipation, and they were less likely to rate the patient's difficulty swallowing as severe or to report effective treatment for anxiety. Coordination group patients were more likely to have seen a chiropodist and their carers were more likely to contact a specialist nurse in a night time emergency. These carers were less likely to feel angry about the death of the patient. CONCLUSIONS: This coordinating service made little difference to patient or family outcomes, perhaps because the service did not have a budget with which it could obtain services or because the professional skills of the nurse-coordinators may have conflicted with the requirements of the coordinating role.

Anxiety↗
PubMed1992

Asthma and employment in young adults.

BACKGROUND: Little is known about the effect of asthma on employment. The relation between employment history at the age of 23 years and a history of asthma or wheeze was investigated in a controlled prospective study using data collected in the National Child Development Study, a longitudinal survey of all children born in the United Kingdom in one week in March 1958. METHODS: Information about subjects' medical condition was collected at four ages (7, 11, 16, and 23 years) for the original cohort of 17,319 births. At 23 years information about employment and education was obtained for 12,534 subjects (72%), of whom 460 (4%) had current asthma or wheeze, 2758 (22%) had past asthma or wheeze, and 5161 (41%) had never had asthma or wheeze. The remaining subjects could not be classified accurately. RESULTS: The risk of unemployment was higher in subjects with a current history of asthma or wheeze (odds ratio 1.32, 95% confidence interval (CI) 1.09-1.61) or a past history of asthma or wheeze (odds ratio 1.54, 95% CI 1.27-1.85) than in those with no such history, after subjects' sex, region of birth, maximum educational qualification, and father's social class had been controlled for. Current and past asthma or wheezing illness predicted a worse employment history in terms of most of the outcomes examined, including mean percentage of months employed since leaving school, mean number of months in current full time job, mean percentage of months unemployed since leaving school, likelihood of being out of the labour force owing to long term illness, and the proportion attaining social groups 1-3. The differences from those who had never had asthma or a wheezing illness were, however, small and generally non-significant. CONCLUSION: Asthma has only a small adverse effect on employment in young adults.

Adult↗
PubMed1992

Asthma from birth to age 23: incidence and relation to prior and concurrent atopic disease.

BACKGROUND: Few studies present prospective data on the incidence of asthma. Its associations with sex and with prior and concurrent hay fever and eczema were examined in a nationally representative sample followed from birth to 23 years of age (British 1958 birth cohort). METHODS: Reports of asthma or wheezy bronchitis, hay fever and eczema were obtained by interview of parents of children at ages 7, 11, and 16 years, and of cohort members at age 23 years. Linked data from all four interviews were available on 7225 subjects (43% of the original birth cohort). RESULTS: The cumulative incidence of asthma or wheezy bronchitis was 18.2%, 21.8%, 24.5%, and 28.6% by the ages of 7, 11, 16, and 23 years respectively. Over the four incidence periods examined (0 to 7 years, 8 to 11 years, 12 to 16 years, 17 to 23 years) the average annual incidence of new cases was 2.6%, 1.1%, 0.71%, and 0.76% respectively. The male:female incidence ratio rose from 1.23 in the 0 to 7 year period to 1.48 at 12 to 16 years but had reversed to 0.59 at 17 to 23 years. A prior report of hay fever or eczema each increased the subsequent incidence of asthma or wheezy bronchitis by a factor of 1.7 to 2.0 independently of sex. This effect of prior atopic illness, however, was largely explained by the strong independent association of incidence of asthma and wheezy bronchitis with atopic disease at the end of each incidence period (odds ratios 2.0 to 2.5 per atopic condition, p < 0.01). CONCLUSIONS: Gender differences in the incidence of asthma or wheezy bronchitis vary with age and are not explained by atopy. The incidence of asthma or wheezy bronchitis can be predicted from a clinical history of hay fever or eczema but is more strongly associated with the presence of atopic disease at the time of onset.

Adolescent↗
PubMed1992

Marital status: association with social and economic circumstances, psychological state and outcomes of pregnancy.

We examined the association of marital status with economic, social and psychological factors and with the outcomes of pregnancy (defined as onset of labour, type of delivery, live and still births and birthweight). The study population was 1431 white women consecutively booking for antenatal care. Birth registrations were inspected. Of 278 women who were unmarried during pregnancy, 61 per cent were cohabiting, 26 per cent were living with adults other than the father and 13 per cent were living alone. Compared with the married women, unmarried women overall were, on average, younger, less educated, of lower social class, in poorer economic circumstances, more dependent on state support and less satisfied with their living arrangements. Irrespective of age and social class, they were less likely to have planned the pregnancy, more likely to smoke and drink, to book later for antenatal care and to miss more appointments. In general, unmarried women were more likely to have some indication of depression and to experience more serious life events during the pregnancy. Controlling for age and social class, the categories 'married', 'cohabiting' and 'on their own' showed significant trends from best to worst. Those living with adults other than the father showed intermediate results. There were no significant effects of marital status, controlled for age and social class, and associated social, economic and psychological circumstances on outcomes of pregnancy. Forty-one per cent of births to women on their own, 35 per cent to women living with other adults and 11 per cent to women cohabiting during pregnancy were registered by only one parent.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗