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Biomedical subjects

J A Hall

Publications and source records attributed to J A Hall.

At least 91 records · Page 5Linked to original sources
PubMed1995

Interruptive patterns in medical visits: the effects of role, status and gender.

Fifty physicians (25 female, 25 male) representing six different levels of status (interns, second and third year residents, fellows and junior and senior staff) were videotaped, each with a male and a female patient. The videotapes were coded for interruptive and overlapping speech, for both physician and patient. Specific categories were successful interruptions, partially successful interruptions, unsuccessful interruptions and overlaps. In addition, all instances of interruptive and overlapping speech were coded as a question or a statement. Results showed, overall, that patients engaged in significantly more interruptive and overlapping speech than did physicians. However, when these variables were analyzed separately for questions and statements, patients were found to interrupt more with statements, whereas physicians interrupted more with questions. High and low status physicians did not differ in their use of interruptions. The few gender differences that did emerge did not indicate a clear pattern of male dominance. The results showing patients to interrupt physicians more than the reverse suggest that interrupting may not solely be a behavior of the higher status person. Together the findings of this study challenge the notion that interruptions simply reflect dominance and/or status and are a behavior more often displayed by males than by females.

Adult↗
PubMed1995

Depression research methodologies in the Journal of Personality and Social Psychology: a review and critique.

Personality and social psychological studies of depression and depressive phenomena have become more methodologically sophisticated in recent years. In response to earlier problems in this literature, investigators have formulated sound suggestions for research designs. Studies of depression published in the Journal of Personality and Social Psychology (JPSP) between 1988 and 1993 were reviewed to evaluate how well these recommendations have been followed. Forty-one articles were examined for adherence to 3 suggestions appearing consistently in the literature: (a) multiple assessment periods, (b) multiple assessment methods, and (c) appropriate comparison groups. The studies published in JPSP have not adhered well to these standards. The authors recommend resetting minimum methodological criteria for studies of depression published in the premier journal in personality and social psychology.

Anxiety Disorders↗
PubMed1995

Induction of urinary tract infection by intraurethral inoculation with Escherichia coli: refining the murine model.

Murine models are important for studying the induction and pathophysiology of ascending urinary tract infections (UTI). However, when vesicoureteral reflux occurs during intravesical inoculation of mice with bacterial suspensions, it is difficult to distinguish between naturally ascending infections and those resulting from the inoculation procedure. The current study investigated whether introducing a bacterial suspension into the urethra rather than into the bladder could minimize or eliminate this complication. There were no differences in the intensity or time course of bladder infections induced by intraurethral or intravesical inoculation. In contrast, the prevalence of kidney infections was < 7% in mice given 10 microliters of intraurethral inoculations versus nearly 60% in animals inoculated intravesically with 100 microliters. There were equivalent numbers of bacteria in the kidneys after inoculation by either route. Thus, intraurethral inoculation of female mice with a small volume of bacteria appears to simulate most closely the pathophysiology of ascending UTIs in humans.

Animals↗
PubMed1995

Human sperm morphology evaluation pre- and post-Percoll gradient centrifugation.

Previous experiments have established a relationship between the morphological characteristics of human spermatozoa and their fertilizing potential in vitro. To assess further the efficiency of Percoll gradient centrifugation (PGC) as a method of sperm selection, we have examined morphological characteristics of spermatozoa from 86 teratozoospermic patients attending Nottingham University Research and Treatment Unit in Reproduction (NURTURE). Patients were divided into groups according to percentage normal morphology in the fresh sample: group A (n = 14), < 5% normal morphology; group B (n = 41), 5-14% normal morphology; and group C (n = 31), > 14% normal morphology. Morphology slides were prepared using Diff Quik staining techniques and evaluated by Kruger strict criteria, under oil immersion, at a magnification of x1000; specific defects, viz. head, neck, cytoplasmic droplets, tail, immature cells, were assessed individually. Following PGC, a sperm sample with enhanced morphology was recovered for group B (P < 0.01) and C (P < 0.005); however, for group A (very severe teratozoospermia) PGC did not select a sample with significantly improved morphological quality. Specific sperm defects affected by PGC were head, neck and immature cells. No significant difference was found for tail abnormalities or cytoplasmic fragments.

Cellular Senescence↗
PubMed1995

Regional anesthesia and local anesthetic-induced systemic toxicity: seizure frequency and accompanying cardiovascular changes.

We sought to determine the contemporary frequency of seizures, and the associated cardiovascular changes, resulting from local anesthetic-induced seizures in all patients undergoing brachial plexus, epidural, and caudal regional anesthetics. We investigated the following variables: development and treatment of seizure or cardiac arrest during the regional anesthetic, type of anesthetic (including local anesthetic used), gender, age, ASA physical status class and type of operation (elective or emergent). In addition, each patient who experienced a seizure underwent retrospective review of the acute event to determine the arterial blood pressure and heart rate changes accompanying the seizure, as well as details of the regional block technique. There was a significant difference between the rate of seizure development between epidural, brachia, and caudal anesthetics, with caudal > brachial > epidural. A significant difference was also noted in the rate of seizure development within types of brachial block, with supraclavicular and interscalene > axillary. No adverse cardiovascular, pulmonary or nervous system events were associated with any of the seizures, including the 16 patients who received bupivacaine blocks. The frequency of local anesthetic-induced seizures stratified by block type has a wide range, and cardiovascular collapse after bupivacaine-associated seizure has a low incidence.

Adult↗
PubMed1995

Interpreting and evaluating meta-analysis.

This article offers some guidelines for interpreting and evaluating meta-analytic reviews of research. The fundamental goals of meta-analysis are to combine results across studies to yield an overall estimate of effect and to compare effects between studies in order to understand moderating factors. Suggestions are made for what readers should look for in a meta-analysis, and a discussion is provided of several issues that are not often explicitly addressed: choice of unit of analysis, fixed versus random effects, the meaning of heterogeneity, determination of when contrasts are appropriate, and the choice of measure of central tendency. We recommend that readers adopt a skeptical attitude about the results of meta-analysis, particularly when only complex analyses are reported.

Evaluation Studies as Topic↗
PubMed1995

Gross and histologic evaluation of hepatogastric ligaments in clinically normal dogs and dogs with gastric dilatation-volvulus.

OBJECTIVE--To investigate any potential structural differences in hepatogastric ligaments between clinically normal dogs and dogs with gastric dilatation-volvulus (GDV). DESIGN--Case-control study. ANIMALS--Hepatogastric ligaments were examined in 13 large-breed control dogs and in 13 large-breed dogs referred for surgical treatment of GDV. PROCEDURE--Measurements and biopsies of hepatogastric ligaments were performed at the time of surgery, circumcostal gastropexy, for correction of GDV. Serial sections from each ligament were stained with H&E, Masson's trichrome, and elastin stains to assess morphology, including smooth muscle, collagen, and elastic fiber contents. RESULTS--There were no differences observed by light microscopy in incidence or degree of histopathologic alterations between the 2 groups of dogs. The lengths of hepatogastric ligaments in GDV-affected dogs, however, were significantly longer than those of control dogs (GDV-affected dogs, 7.0 [5.0 to 9.5] cm median [range]; control dogs, 5.0 [3.0 to 7.5] cm median [range]; P = 0.01). CONCLUSIONS--Causality can not be inferred from this study. It is not known whether the ligaments were lengthened as a result of GDV or whether the lengthened ligaments predisposed dogs to GDV. CLINICAL RELEVANCE--This finding may reflect increased laxity of the supporting hepatogastric ligament in the right quadrant of the abdomen. An elongated ligament may permit increased stomach mobility and predispose dogs to partial or complete gastric volvulus.

Animals↗
PubMed1995

Patient gender and communication with physicians: results of a community-based study.

An observational study of 648 routine medical visits with 69 physicians examined patient gender in relation to patient and physician communication, patient preference for the physician's communication style, patient satisfaction, and the physician's awareness of the patient's satisfaction. Data consisted of audiotapes as well as patient and physician questionnaires. Women appeared to be more actively engaged in the talk of medical visits--they sent and received more emotionally charged talk and were judged by independent raters as more anxious and interested both globally and in terms of voice quality than men. Consistent with the more emotional talk, women reported preferring a more "feeling-oriented" physician than male patients did. Mean levels of satisfaction with communication did not differ by gender, and communication predictors of satisfaction were similar for male and female patients, although they were stronger for male patients. Physicians were significantly less aware of some aspects of female patients' satisfaction compared to male patients' satisfaction. In light of the weaker correlations between patients' communication and their satisfaction for women, we suggest that women provided fewer obvious cues to their satisfaction. Training in communication skills may increase open discussion about feelings and emotions and may also produce greater physician sensitivity to patients' satisfaction, particularly with female patients.

Adult↗
PubMed1994

Gender in medical encounters: an analysis of physician and patient communication in a primary care setting.

The relation of physician and patient gender to verbal and nonverbal communication was examined in 100 routine medical visits. Female physicians conducted longer visits, made more positive statements, made more partnership statements, asked more questions, made more back-channel responses, and smiled and nodded more. Patients made more partnership statements and gave more medical information to female physicians. The combinations of female physician-female patient and female physician-male patient received special attention in planned contrasts. These combinations showed distinctive patterns of physician and patient behavior, especially in nonverbal communication. We discuss the relation of the results to gender differences in nonclinical settings, role strains in medical visits, and current trends in medical education.

Adult↗
PubMed1994

Dermatoglyphic asymmetry and sexual orientation in men.

Dermal ridges on the fingertips are formed early in fetal life and remain unchanged throughout the life span. The researchers examined dermatoglyphic characteristics (total ridge count and directional ridge asymmetry) in homosexual and heterosexual men. There was no difference between the 2 groups of men in total ridge count, but more gay men demonstrated leftward asymmetry than did nongay men. Although this effect was not accounted for by differences in hand preference, an association was observed between leftward dermatoglyphic asymmetry and an increased incidence of adextrality in homosexual men, but not in heterosexual men. These findings are consistent with a biological contribution to sexual orientation and indicate that such an influence may occur early in prenatal life.

Adult↗
PubMed1994

Satisfaction, gender, and communication in medical visits.

The authors conducted two studies of routine medical visits, investigating the relation of physician gender, patient gender, and physician age to patient satisfaction, and the correlations between communication behaviors and satisfaction separately for different combinations of patient and physician gender. Study 1 was based on videotaped visits to a hospital-based internal medicine practice (n = 97 visits). Study 2 was based on audiotaped visits to 11 different community and hospital-based practices in the United States and Canada (n = 524 visits). In both studies, patients examined by younger physicians, especially younger female physicians, reported lower ratings of satisfaction. These findings were true for male and female patients; however, in both studies, the lowest satisfaction in absolute terms was among male patients examined by younger female physicians. The effects were not explained by patient and physician background characteristics or by measured communication during the visit. Correlations between verbal and nonverbal communication and satisfaction for different combinations of physician and patient gender suggested that gender-related values and expectations influence patients' reactions to physicians' behavior. There also was evidence that patient satisfaction is reflected in the patient's affective behavior during the visit.

Age Factors↗
PubMed1993

Acidic fibroblast growth factor gene 5' non-coding exon and flanking region from hamster DDT1 cells: identification of the promoter region and transcriptional regulation by testosterone and aFGF protein.

Selected clones of Syrian hamster DDT1-MF2 cells are responsive to testosterone for growth. Heparin binding growth factor 1 (HBGF-1) or acidic fibroblast growth factor (aFGF) can replace testosterone (T) in the stimulation of growth in these cells. This phenomena is correlated with testosterone's ability to elevate aFGF mRNA two- to threefold in DDT1 cells. To better understand the possible mechanisms of regulation of aFGF mRNA by steroids and other growth factors, we isolated the aFGF 5' non-coding exon and its flanking region from a EMBL3 DDT1 genomic library, using a 5' non-coding exon 69 bp DDT1 aFGF cDNA probe. Clones spanning 30 kb of genomic DNA were isolated. After restriction mapping and DNA sequence analysis, the clones were shown to contain all of the 5' non-coding exon included in the cDNA and approximately 10 kb of 5' flanking region. RNase protection and primer extension assays confirmed that the 5' non-coding exon is included in the DDT1 aFGF mRNA and that a major transcription start site is approximately 136 bp upstream of the 5' non-coding splice junction of this exon. The 5' flanking region DNA was inserted into pBLCAT3 reporter gene and transfected into DDT1 cells. Chloramphenicol acetyltransferase (CAT) assays demonstrated that there are promoter elements in the -1645/-392 and -392/+131 regions of the aFGF gene in the context of DDT1 cells. NIH 3T3 cells, on the other hand, show no CAT activity with these aFGF-CAT plasmids. CAT assays also demonstrated that addition of testosterone (T) or aFGF to DDT1 cells increased CAT activity threefold. This activity was mapped to -1645 to -4 bp region of this DDT1 aFGF gene promoter.

3T3 Cells↗
PubMed1993

Mammographic abnormalities and the detection of carcinoma of the breast.

OBJECTIVE: In an attempt to reduce the number of unnecessary breast biopsies, the yield rate of cancer relative to specific types of mammographically detected abnormality was investigated. STUDY DESIGN: Between 1989 and 1991, 169 patients with an abnormality as detected by mammogram but with no palpable mass were reviewed. Abnormalities detected by mammogram were divided into four types. The rate of biopsy-confirmed cancer per type of abnormality was calculated. RESULTS: The incidence of cancer per type of mammographically detected abnormality was as follows: mass 11%, mass with abnormal calcification 21%, abnormal calcification 22%, and asymmetric density 2%. CONCLUSION: Biopsy is recommended for mammographically detected abnormalities of a mass, a mass with abnormal calcification, and abnormal calcification without mass. Consideration should be given to deferring biopsy in favor of a follow-up study for asymmetric densities.

Biopsy↗
PubMed1993

Factors contributing to the formation of experimentally-induced ovarian cysts in prepubertal gilts.

Manipulation of an ovary during the follicular phase in cycling gilts or prepubertal gilts treated with PMSG and hCG results in formation of cysts on manipulated ovaries and corpora lutea (CL) of normal appearance on nonmanipulated ovaries. In contrast, cysts did not form after manipulation in luteal phase gilts. In the present experiment, daily administration of 50 mg progesterone to prepubertal gilts treated with PMSG and hCG established luteal phase concentrations of progesterone but did not lessen the incidence of manipulated-induced cysts. Number of cysts formed was associated with the number of follicles > or = 5 mm at manipulation, which was inversely related to serum concentrations of progesterone. Number of receptors for LH/hCG in follicular tissues did not differ between manipulated and nonmanipulated ovaries but was greater in granulosa (P < .05) and theca (P < .08) from follicles with diameters > or = 7 mm compared to 5 and 6 mm. Contents of estradiol, androstenedione, testosterone, progesterone and prostaglandins E2 and F2 alpha in follicular fluid, granulosa and theca were not different between follicles > or = 5 mm destined to form cysts. Profiles of progesterone and estradiol in peripheral serum and duration of luteal phase concentrations of progesterone were not different for gilts with induced cysts and gilts with CL. In conclusion, manipulation of follicles resulted in a failure to ovulate. Subsequent formation of cysts did not result from or result in a loss of steroidogenic function or the ability to bind LH to follicular receptors. These results demonstrate that the mechanism for ovulation is independent of other follicular processes, since ovulation can be disrupted without altering follicular steriodogenesis or subsequent luteinization.

Animals↗