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Biomedical subjects

J Birch

Publications and source records attributed to J Birch.

At least 37 records · Page 2Linked to original sources

Bureaucracy to adhocracy. A possible structure for the Department of Health and Family Services.

At a meeting on Friday, 7 June 1996, the Minister for Health and Family Services, The Hon. Michael Wooldridge MP, asked the authors to prepare a paper on a possible structure for the Department of Health and Family Services. This followed our explanation to him of navigating women's and children's health service issues through the existing departmental structure. We had explained that such navigation included nearly all of the divisions within the department; and then within those divisions there were different branches responsible for different activities. It has been our experience that rarely do the different divisions, branches or sections exchange ideas, views or policies that might affect women and children. The result is a fragmented approach to this important group of the population. We know that this same approach, exists for other key population groups. This paper has been prepared at the request of the Minister, and follows an approach based on population and outcome.

Australia↗

Colour vision requirements of firefighters.

To perform their job safely firefighters must be able to identify colours on industrial gas cylinders, portable fire extinguishers, road traffic signals and several pieces of firefighting equipment. Although good colour vision is necessary we believe that the existing colour vision standard, which bars entry to the fire service to applicants who fail more than two plates of the Ishihara test, is unnecessarily stringent. We have identified and quantified the colour coded information encountered by firefighters. Colours were plotted on the CIE chromaticity diagram (1931) and isochromatic zones, which document the colour confusions of colour deficient observers, superimposed. This novel technique established possible colour confusions in different types of colour deficiency. Analysis of the results showed that red/green dichromats (protanopes and deuteranopes), severe deuteranomalous trichromats who fail the Farnsworth D15 test, and protanomalous trichromats are unsuitable for firefighting work. However, people with slight deuteranomalous trichromatism who pass the D15 test, are not disadvantaged and can be employed safely as firefighters. A new colour vision standard and a new testing procedure is recommended.

Color↗

The SMI nurse.

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Clinical Competence↗

The choroid plexus carcinomas of childhood: histopathology, immunocytochemistry and clinicopathological correlations.

Anaplastic choroid plexus carcinoma is a tumour with a predilection for the posterior fossa of infants and can be difficult to distinguish histologically from medulloblastoma without the aid of immunocytochemistry using a panel of antibodies. Of a series of 17 choroid plexus carcinomas (five of which were classed as moderately differentiated and 12 as anaplastic) 17 expressed antigens to transthyretin, transferrin and cathepsin and 16 expressed carbonic anhydrase II. Eleven expressed at least one epithelial marker (cytokeratin or epithelial membrane antigen). In contrast, none of six medulloblastomas expressed epithelial markers, transrythetin, carbonic anhydrase II or transferrin, though three were positive with antibodies to cathepsin.

Carbonic Anhydrases↗

A suitable study to evaluate colour vision requirements for firefighters?

A recent paper by Rees (Occup. Med. 1994; 44: 253-256) has proposed a study to evaluate the performance of both clinical and trade tests on firefighter recruits. The paper suggests that a new trade test using painted gas cylinders and/or the BOC cylinder identification chart may be appropriate in the selection of firefighter recruits. Evaluation of pass/fail standards on these tests would be achieved by comparing the results with those obtained from the Ishihara test, the City University test and the Holmes-Wright lantern test. In this paper, we argue that the proposed battery of tests does not allow an accurate evaluation of the new trade tests. Indeed,the new trade tests are likely to result in a false sense of obvious fairness' that ultimately be an unsound means of assessing the colour vision requirements of firefighter recruits.

Color Perception Tests↗

Congenital anomalies and genetic syndromes in 173 cases of medulloblastoma.

One hundred seventy-three consecutive cases of medulloblastoma recorded in the Manchester Children's Tumour Registry from 1954 to 1989 were studied. After review of case notes, X-rays, and health surveys the clinical outcome and incidence of congenital anomaly was determined. A previously unreported association with Rubinstein Taybi syndrome was found. Evidence of a genetic syndrome or congenital anomaly was found in 6.4%. These figures provide further evidence of the higher-than-expected incidence of congenital abnormalities.

Adolescent↗

Survey of the accuracy of new pseudoisochromatic plates.

The accuracy of three new pseudoisochromatic tests for detecting red-green colour deficiency was assessed. These were the Ishihara plates, the Ishihara test for 'unlettered persons' and Ohkuma's test cards. We examined 500 subjects; 471 normal trichromats and 29 colour-deficient people. Results obtained for the 1989 edition of the Ishihara plates were compared with the 9th edition and the most efficient plates identified. Although normal trichromats may be expected to make several interpretive misreadings, the Ishihara plates were found to be superior to the 9th edition and to the Ohkuma test (1986) for colour vision screening. The new symbol designs of the Ishihara plates for 'unlettered persons' (1990) were found to be very effective for colour vision screening, and a further study with young children is proposed. The 38 plate 1989 edition of the Ishihara test is recommended for use in clinical practice. The designs included in the concise 24 plate edition and the new abbreviated 14 plate edition are not selected from the point of view of accuracy and more reliable results are obtained if the full test is given or if the practitioner shows only the most efficient designs.

Adolescent↗

Colour vision screening in children: an evaluation of three pseudoisochromatic tests.

We examined 513 children (258 boys and 255 girls), between 3 and 11 years of age, with three pseudoisochromatic tests which involve different visual tasks. These were a selection of numeral designs from the Ishihara test, the Ishihara test for Unlettered Persons and the Velhagen Pfügertrident test. Eighteen children were found to be colour deficient. The symbol designs of the Unlettered Persons test were found to be the quickest and most effective method for examining children under 7 years of age. After 7 years of age the symbol designs of the Unlettered test and the numeral designs of Ishihara test were equally effective. The preferred numeral designs for screening children with the Ishihara plates are listed. Verbal identification always produced the most accurate results. Drawing over the figures or selecting replicas increased the viewing time and assisted children with normal colour vision to see both figures in transformation designs, especially pathway designs. The Velhagen Pfügertrident test was found to be unreliable for colour vision screening and younger children had difficulty performing the figure matching task.

Age Factors↗

New method based on random luminance masking for measuring isochromatic zones using high resolution colour displays.

A new method of measuring normal hue discrimination ellipses and dichromatic zones using a high resolution colour monitor is described. The test involves the detection of chromatic bars on a grey background (x = 0.305, y = 0.323) having a luminance of 34 cd m-2. Elements of the background matrix of square checks are varied randomly in luminance in space and time to provide random luminance masking (RLM) which compensates for differences in the relative luminous efficiency of different observers. The measurement technique provides a rapid and comprehensive colour vision test. Typical results are presented for normal trichromats, protanopes and deuteranopes without RLM and with the RLM set of 25%. The size of the discrimination ellipse in normal observers is the same in both viewing conditions, but the use of the RLM technique reveals the extent of the isochromatic zones in colour deficient observers.

Color Perception Tests↗

Family intervention.

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Combined Modality Therapy↗

Concurrent visual conversion reaction and simulated colour vision defects in a 12-year-old child.

Visual conversion reaction (VCR) is a psychosomatic anomaly which occasionally manifests in children, most commonly in the form of reduced vision and visual field defects. Malingering or conscious simulation for secondary gain would appear to be rare in children but occasionally VCR and simulation coexist. A case history is presented of a 12-year-old child with behavioural and reading difficulties who manifested reduced vision most probably attributable to VCR and severe colour deficiency, which was best explained in terms of simulation or malingering.

Child↗

Serum bioactive lactogenic hormone levels in women with familial breast cancer and their relatives.

Serum levels of bioactive lactogenic hormone (BLH), immunoreactive prolactin and growth hormone (ir-PRL and ir-GH) were measured in a group of familial breast cancer patients and their first degree female relatives and compared to those found in normal healthy women. The ratio of BLH to the sum of ir-PRL and ir-GH was slightly but significantly decreased in the familial breast cancer group (P = 0.018 by the Mann-Whitney U test) although there were no significant differences in the levels of BLH, ir-PRL and ir-GH between the two groups. No differences in the levels of the lactogenic hormones could be detected when the pre-menopausal women were considered separately or when 20 women from the familial group were compared to normal controls matched for age, parity, weight and menopausal status. The levels of BLH were highly correlated with the sum of ir-PRL and ir-GH in both the familial breast cancer group and the controls (P less than 0.001 for both groups by Spearman's rank correlation test). These findings are not indicative of the presence of an additional species of bioactive, but not immunoreactive, lactogen in the sera of women with or at high risk of breast cancer. However, the presence of different, but equipotent, forms of lactogen cannot be excluded in these women.

Adolescent↗