Search PubMed⌕ Search

Biomedical subjects

J Campbell

Publications and source records attributed to J Campbell.

At least 55 records · Page 3Linked to original sources
PubMed2001

NAC Manchester Asthma and Allergy Study (NACMAAS): risk factors for asthma and allergic disorders in adults.

Asthma and atopic disorders are the most common chronic diseases in the developed countries. Knowledge of the risk factors for these disorders may facilitate the development of preventive strategies aimed at reducing prevalence rates. To investigate the risk factors for asthma and allergic diseases in a large number of adults who are the parents of children in the National Asthma Campaign Manchester Asthma and Allergy Study. All pregnant women and their partners attending "Booking" antenatal clinics were invited to take part in the study. Questionnaire data were collected including the history of asthma and other atopic diseases, pet ownership and smoking habits, and skin prick tests were performed. The prevalence of atopy and the risk factors for asthma and allergic disorders were investigated in all subjects who completed the questionnaire and underwent skin testing. Statistical analysis was carried out using logistic regression. Initially, risk factors were assessed by univariate analysis to see how each potential explanatory variable affected the probability of having allergic disease. Variables were then tested in a forward stepwise multivariate analysis. In 5687 adult subjects there was a very high (48.2%) prevalence of atopy, and 9.7% of subjects had a diagnosis of asthma. In a multivariate regression analysis sensitization to dust mite, cat, dog and mixed grasses were all independently associated with asthma. The odds ratios for current asthma increased with the increasing number of positive skin tests (any two allergens - OR 4.3, 95% CI 3.3-5.5; any three allergens - OR 7.0 95% CI 5.3-9.3; all four allergens - OR 10.4, 95% CI 7.7-14; P < 0.00001). Dog ownership (OR 1.31, 95% CI 1.10-1.57; P = 0.003) and current smoking (OR 1.36, 95% CI 1.15-1.62; P = 0.0004) were significantly and directly associated with "asthma ever". Thirteen per cent of participants reported a history of eczema. In the multivariate analysis the strongest independent associate of eczema was sensitization to dog (OR 1.37, 95% CI 1.14-1.63, P < 0.0001). Apart from dog, the strength of the association between sensitization to common allergens and eczema appeared to be much lower than in the case of asthma. The prevalence of hay fever was high (20.6%), and in the multivariate analysis the association between sensitization to pollen and hay fever was extremely strong (OR 13.6, 95% CI 11.3-16.3; P < 0.0001). The results of the current study emphasize the importance of sensitization to indoor allergens in asthma. However, evidence of a possible direct role of allergen exposure in asthma causation remains unclear.

Adult↗
PubMed2001

Intimate partner violence screening and intervention: data from eleven Pennsylvania and California community hospital emergency departments.

OBJECTIVE: To provide clinical practice recommendations for screening and interventions for intimate partner violence (IPV) in ED settings. SETTING: Eleven mid-sized community-level hospital emergency departments (20,000 to 40,000 admissions annually) in Pennsylvania and California. PARTICIPANTS: All women (4641) aged 18 years or older who came to the emergency department during 309 selected shifts. METHODS: An anonymous survey inquiring about physical, sexual, and emotional IPV was conducted from 1995 through 1997. In addition, medical records were abstracted for every woman (18 years and older) seen in the 11 participating emergency departments during the study period. RESULTS: The vast majority of both abused and nonabused women supported routine screening for IPV; however, fewer than 25% of women said they were asked about IPV by ED staff. ED screening rates for IPV were higher among women who came to the emergency department because of acute trauma from abuse (39%) than for women who reported that they had been abused within the past year (13%). The prevalence of past year and lifetime IPV was significantly higher when the questionnaire was self-administered than when it was administered by a nurse. More than a third of women who had recently been abused and 76% of women who acknowledged experiencing physical or sexual IPV within the past year reported that they did not come to the emergency department for treatment of an injury. Although the majority of women (76% to 90%) agreed with the concept of health care providers reporting IPV to the police, women abused recently were significantly less likely to support this practice. CONCLUSION: The study provides evidence supporting standard protocols for routine screening for IPV among women who come to emergency departments and chart prompts for both screening and interventions. These actions are acceptable to the majority of both abused and nonabused women seen in the emergency department and should be considered in systematic repeated training of health care professionals in emergency departments. This information is important for health care providers who are seeking to improve their identification of and care for abused women.

California↗
PubMed2001

The role of alcohol use in intimate partner femicide.

The purpose of this study was to examine alcohol use by victims and perpetrators as a risk factor for intimate partner violence and femicide. A case control design was used to describe alcohol use among Femicide/Attempted Femicide victims (n = 380), Abused Controls (n = 384) and Non-Abused Controls (n = 376), and their intimate partners. Telephone interviews of proxies (family members or friends) of femicide victims and actual survivors of attempted femicide were conducted in 10 cities. The purpose of the interviews was to gather information about relationship violence and alcohol use by femicide victims, attempted femicide survivors, and their perpetrators. Telephone interviews of controls, recruited from the same cities by random digit dialing, were also conducted. Perpetrator problem drinking was associated with an eight fold increase in partner abuse (e beta = 8.24, p < .0001) and a two fold increased risk of femicide/attempted femicide (e beta = 2.39, p = .001), controlling for demographic differences.

Adolescent↗
PubMed2001

Metaperception in cyberspace.

Knowing how others perceive us is an important aspect of social life. "Impression meta-accuracy" is the extent to which we are correct in our assumptions about the impressions others have formed of us. The goal of this study was to compare meta-accuracy of WWW homepage creators to meta-accuracy of people in face-to-face interactions. Because creators of WWW pages have a high degree of control over the information they make available online, they may believe that they accurately know the nature of the impressions they give to other people. However, perceivers of homepages must form impressions without many of the social and context cues that influence judgments in a face-to-face setting, including body language and speaking qualities, and thus their impressions may not match those assumed by the creators of the pages. Our results showed a general tendency for homepage creators to believe the impression they gave to those who viewed their pages was more positive than was actually the case, and this discrepancy was greater than in face-to-face interactions. The source of online inaccuracy seems to lie in people's belief that others develop the same impression of them in both online and offline contexts. In fact, perceivers are significantly influenced by whether the information they are receiving is based on face-to-face interaction or on cues obtained from a WWW homepage. Our data demonstrate that one of the challenges of social life in cyberspace is managing one's online persona to take into account the limitations of metaperception.

Female↗
PubMed2001

Multisite pooling study using ligase chain reaction in screening for genital Chlamydia trachomatis infections.

BACKGROUND: Ligase chain reaction (LCR), a nucleic acid amplification assay, is a highly specific and sensitive test for detecting Chlamydia trachomatis in cervical and urethral swabs as well as first-void urine specimens. GOAL: To examine the suitability of using the LCR test to detect C trachomatis in pooled cervical specimens. STUDY DESIGN: The performance of LCR in pooled specimens was compared with individual specimen testing at six laboratories using 3,170 cervical swab specimens randomly selected from specimens received for routine testing in the participating laboratories. These samples then were combined consecutively into 634 pools of 5 specimens and 317 pools of 10 specimens. A reduced sample to cutoff ratio of 0.2 or more was used for the pooled specimens. RESULTS: Of the 188 positive specimens (98.9%), 186 were identified when single specimens were analyzed. When pools of 5 or 10 specimens were evaluated, 99.5% and 98.9% of the positive swabs, respectively, were identified correctly. Two positive specimens were detected only through pooling. CONCLUSIONS: Pooling samples for detection of C trachomatis by LCR is sensitive and specific. Depending on the prevalence of infection (positivity), LCR testing may result in cost savings, as compared with individual testing of specimens.

Cervix Uteri↗
PubMed2001

Sociodemographic predictors of success in smoking intervention.

AIM: To examine the role of sociodemographic factors as predictors of sustained smoking cessation for the population who volunteer to participate in intervention programmes. METHOD: Data for the 3575 smokers who participated in the CEASE (collaborative European anti-smoking evaluation) trial, a European multicentred study that used transdermal nicotine patches as an adjunct to smoking cessation in the chest clinic, were analysed. The effects of age, sex, smoking habit, socioeconomic status (housing conditions, education, and employment), disease, smoking habits of relatives, and baseline markers of tobacco use on sustained smoking cessation (self-reported abstinence and expired carbon monoxide < 10 parts per million) were assessed using logistic regression modelling (odds ratio (OR), 95% confidence interval (CI)). RESULTS: 477/3575 smokers were sustained abstainers one year after the intervention (overall success rate 13.3%). In the univariable logistic regression models an effect of active treatment on smoking cessation was observed (OR 1.50, 95% CI 1.15 to 1.96), and additional effects on outcome were found for age (OR 1.02, 95% CI 1.01 to 1.03), sex (men v women: OR 1.38, 95% CI 1.14 to 1.68), housing conditions (OR 1.43, 95% CI 1.25 to 1.65), current respiratory (OR 0.79, 95% CI 0.67 to 0.92) or cardiac disease (OR 0.46, 95% CI 0.28 to 0.75), and markers of tobacco use (cigarettes per day: OR 0.79, 95% CI 0.69 to 0.90; expired carbon monoxide: OR 0.98, 95% CI 0.97 to 0.99). Education and employment did not have a significant effect on the outcome. The effect of the variables associated with success in smoking cessation persisted after adjustment for covariates. CONCLUSION: Age, sex, and housing conditions have a major effect on smoking cessation in European smokers participating in smoking cessation programmes.

Administration, Cutaneous↗
PubMed2001

Inappropriate admissions: thoughts of patients and referring doctors.

Research on inappropriate hospital admissions has tended to neglect the views of the referring doctors and the patients. In this study, the Appropriateness Evaluation Protocol was applied to a random sample of 102 emergency medical admissions. The patients and doctors were then presented with a list of possible alternatives to admission that might have been used at the point of referral. Case notes were available for 88 patients. As judged by these, 28% of admissions were inappropriate, the commonest reason being the potential for treatment or tests to have been performed as outpatient procedures; next commonest was the possibility of lower level care. The response rate to the questionnaires was about two-thirds, for both doctors and patients. Of the general practitioners and casualty doctors who responded, 60% specified alternatives to admission that they would have considered, and the equivalent figure for patients was 70%. For both groups the major preferences were same-day outpatient assessment and admission to a community hospital. Referring doctors and patients, in this survey, favoured alternatives to acute medical care in proportions much higher than that of supposedly inappropriate admission.

Attitude of Health Personnel↗
PubMed2001

Redesigning geriatric healthcare: how cross-functional teams and process improvement provide a competitive advantage.

This study examines the consequences of adding a geriatric subacute unit to the traditional health care mix offered by a nonprofit hospital. Historically, geriatric health care offerings have been limited to either acute care units or long-term care facilities. The study's findings demonstrate that the addition of a subacute unit that is operated by an interdisciplinary team is a competitively rational move for two reasons. First, it provides a continuum of care that integrates services and departments, thereby reducing costs. Second, it provides a supportive environment for patients and their families. As a consequence patients have a higher probability of returning home than patients who are assigned to more traditional modes of care.

Activities of Daily Living↗
PubMed2001

Benefits of a nurse-managed wellness program. A senior center model. Using community-based sites for older adult intervention and self-care activities may promote an ability to maintain an independent lifestyle.

Recent health initiatives have encouraged the promotion of wellness and self-care among the elderly population. This research describes the effectiveness of a nurse-managed wellness program located at a multi-purpose senior center. The wellness clinic was created to provide a broad range of screening services, individual counseling services, health educational programs, and management services for chronic diseases common among older adults. Outcome measures focusing for utilization of health services, healthy behaviors, emotional well-being, and mental and physical health variables gathered from 111 older adults demonstrated significant program success. Respondents who used the wellness clinic more frequently, and in particular, those who consulted regularly with the clinical nurse, were more likely to increase their healthy behavior and subsequent health knowledge. As a result of participation in the wellness programs, respondents reported a greater psychological comfort and a more confident feeling concerning the ability to maintain an independent lifestyle.

Aged↗
PubMed2001

The OMENS trial: opportunistic evaluation of musculo-skeletal physician care among orthopaedic outpatients unlikely to require surgery.

STUDY OBJECTIVE: For orthopaedic outpatients judged as unlikely to require surgery, how does the cost-effectiveness of treatment from a musculo-skeletal medicine physician compare with that of a conventional orthopaedic surgeon-led service? DESIGN: Partially randomised, pragmatic trial comparing management from a single musculo-skeletal medicine physician with orthopaedic surgeon-led management, with the timing and nature of treatments at the discretion of individual clinicians. Main outcomes were: change in patient reported health (SF-36 and EuroQol), and marginal health service costs. SETTING: Outpatient department of an Edinburgh orthopaedic hospital. SUBJECTS: One thousand three hundred and twenty six people; aged over 18, referred to and later attending the outpatient department with a 'non-surgical' musculo-skeletal condition, who provided baseline information. Eight hundred and twenty nine were randomly allocated to management by either the musculo-skeletal medicine physician (medical group) or a conventional orthopaedic surgeon-led service (surgical group); 497 were assigned to the treatment groups according to their general practitioner's preference. RESULTS: There are aspects of the study design concerning statistical power, potential selection bias and generalisability, which mean that any results must be treated with caution. Although there was no statistically significant difference in health gain between the randomly allocated groups (with similar findings in the non-randomised medical and surgical groups), the patient groups were heterogeneous and the confidence intervals did not rule out clinically important differences. The medical group received more outpatient treatment, 20% vs. 10% (difference 95% CI 5% to 15%) with a higher rate of physiotherapy referral, 45% vs. 30% (15%, 9% to 22%). The surgical group received more inpatient surgical care 6% vs. 17% (-11%, -15% to -7%). Mean healthcare costs in the medical group were 179 Pounds per patient compared with 287 Pounds in the surgical group (-108 Pounds, -25 Pounds to -191 Pounds). CONCLUSIONS: Interpretation should take into account the practical difficulties and circumstances of the study. Although no differences in health gain were found between these two management policies for 'non-surgical' orthopaedic outpatients, the trial was less statistically powerful than planned and the confidence intervals included clinically important differences. Differences in treatment emphasis gave estimated costs savings to the Health Service of 108 Pounds per patient treated by the musculo-skeletal medicine service.

Adult↗
PubMed2000

The primate lentiviral receptor Bonzo/STRL33 is coordinately regulated with CCR5 and its expression pattern is conserved between human and mouse.

Chemokines play necessary and important roles in regulating the trafficking of lymphocytes to intra- or interlymphoid tissues as well as to sites of inflammation. The complex migratory patterns of lymphoid lineage cells is governed by subset-specific expression of chemokine receptors and their access to specific ligands. Several chemokine receptors and chemokine receptor-like orphan receptors also serve, in conjunction with CD4, as coreceptors for infection by human and simian immunodeficiency viruses (HIV and SIV). Here we show that the expression pattern of Bonzo/STRL33, an orphan SIV/HIV coreceptor, is highly restricted to the memory subset of T cells and is up-regulated upon stimulation of these cells with IL-2 or IL-15. Both the pattern and the regulation of Bonzo expression closely paralleled that of CC family chemokine receptors CCR5 or CCR6 and inversely correlated with CXCR4 expression. However, in striking contrast to CCR5, Bonzo expression was not down-modulated by PMA or mitogen stimulation of T cells. Targeted replacement of the Bonzo gene with a gene encoding green fluorescent protein in mice revealed that the expression and cytokine regulation of mouse Bonzo are comparable to those of its human counterpart. The similar expression and regulation patterns of Bonzo and the HIV coreceptor CCR5 may have implications for understanding the role of HIV/SIV receptors in viral evolution and pathogenesis.

Animals↗
PubMed2000

Radiotherapy outpatient review: a nurse-led clinic.

The aim of this project was to improve the quality of the delivery of care to patients undergoing outpatient fractionated radiotherapy, in terms of effectiveness and efficiency. This article provides a descriptive account of the activities that took place within a traditional doctor-held radiotherapy review (floor) clinic (71 individual clinic episodes from 71 patients) and compares them with a nurse-led clinic (299 clinic episodes from 141 patients). The outcome measures encompassed the number and type of activities in both clinics, including the number of interventions that occurred, consultation time, waiting time, degree of involvement with other support services, reasons for doctor contact, and perceptions of patients, doctors, nurses and therapy radiographers. Nurse consultations lasted longer than doctor consultations. Waiting times were reduced. Of 299 nurse-led clinic episodes, only 21 contacts were made with the doctor. More interactions and activities occurred during nurse consultations. A greater number of referrals and liaisons with other support services occurred, resulting in the establishment of continuity of care. The results from this small sequential observational study require prospective confirmation, but they suggest that specialist nursing staff, given appropriate medical support, may provide more effective care for patients who are undergoing outpatient radiotherapy.

England↗
PubMed2000

The intersections of HIV and violence: directions for future research and interventions.

The purpose of this paper is to review the available literature on the intersections between HIV and violence and present an agenda for future research to guide policy and programs. This paper aims to answer four questions: (1) How does forced sex affect women's risk for HIV infection? (2) How do violence and threats of violence affect women's ability to negotiate condom use? (3) Is the risk of violence greater for women living with HIV infection than for noninfected women? (4) What are the implications of the existing evidence for the direction of future research and interventions? Together this collection of 29 studies from the US and from sub-Saharan Africa provides evidence for several different links between the epidemics of HIV and violence. However, there are a number of methodological limitations that can be overcome with future studies. First, additional prospective studies are needed to describe the ways which violence victimization may increase women's risk for HIV and how being HIV positive affects violence risk. Future studies need to describe men's perspective on both HIV risk and violence in order to develop effective interventions targeting men and women. The definitions and tools for measurement of concepts such as physical violence, forced sex, HIV risk, and serostatus disclosure need to be harmonized in the future. Finally, combining qualitative and quantitative research methods will help to describe the context and scope of the problem. The service implications of these studies are significant. HIV counseling and testing programs offer a unique opportunity to identify and assist women at risk for violence and to identify women who may be at high risk for HIV as a result of their history of assault. In addition, violence prevention programs, in settings where such programs exist, also offer opportunities to counsel women about their risks for sexually transmitted diseases and HIV.

Adult↗
PubMed2000

The ACHS Care Evaluation Program: a decade of achievement. Australian Council on Healthcare Standards.

In 1989 the Australian Council on Healthcare Standards (ACHS) embarked on a programme to develop acute health care clinical indicators in conjunction with the Australian medical colleges. Through a carefully structured stepwise process this collaboration established a 'World first' in 1993 with the introduction of the first set of indicators into the ACHS Accreditation programme. The programme remains unique in the formal involvement of providers in the development process and in the scope of the clinical areas covered in acute health care. From the year 2000 there will be 18 sets (and over 200 indicators) from which health care organisations (HCOs) can choose to monitor the major services they provide. There remains no compulsion to address a specific number of indicators. The growth of the programme has been considerable with more than half of the nations' acute HCOs reporting their clinical indicator data (twice yearly) and it provides a reflection of the care given for the majority of patient separations in acute care. This reporting process allows HCOs to receive feedback on the aggregate results together with comparative peer group information for each indicator they address. In addition to numerous publications in peer reviewed journals an annual aggregate report, 'the Measurement of Care in Australian Hospitals' is published. It reports both qualitative and quantitative data on all indicator sets for the preceding year. Validity of the indicators is strengthened each year with a review process and reliability and reproducibility of the data can now be demonstrated. The clinical response to the indicators has been overwhelming and there is now documented evidence of numerous actions taken by HCOs to improve both the processes and the outcomes of patient care. The nation wide database can be expected to reflect trends in care over the next few years. The process of indicator refinement, however, will continue and it is likely that a reduction in the total number of indicators will occur with a core group of the more 'robust' indicators remaining. Further directions in indicator development are likely to be in the area of multidisciplinary care and in the assessment of longer-term outcomes. In addition to measures of the quality of care, hopefully, in time, health care providers will also take part in the establishment of measures of the appropriateness of that care.

Accreditation↗
PubMed2000

Dietary plasma protein reduces small intestinal growth and lamina propria cell density in early weaned pigs.

ABSTRACT We quantified the effects of a diet containing animal plasma protein on small intestinal growth and mucosal morphology in early weaned pigs. Ninety-six pigs [14 d old, 4 kg body weight (BW)] were assigned in groups of 32 to three dietary treatments as follows: 1) free access to control diet (C), 2) free access to plasma protein diet (P), and 3) plasma protein, pair-fed to C (PPF). Eight pigs from each group were killed at 2, 4, 8 or 16 d. Over a 16-d period, weight gain in the P group was 43% greater (P < 0.05) than that in C pigs; weight gain was similar in C and PPF groups. Protein intake in the P group was 33% higher (P < 0.05) than that in the PPF group; no significant difference was observed between the C and P groups. Dietary protein conversion efficiencies in both the P and PPF groups were approximately 18% greater (P < 0.05) than those in the C group. Intestinal masses in the three groups did not differ at 2, 4 and 8 d. By 16 d, the jejunal and ileal protein and DNA masses (mg/kg BW) in both the P and PPF groups were lower than those in the C group (P < 0.05). Dietary plasma protein did not affect crypt cell proliferation, crypt depth or villous height in either the jejunum or ileum. However, the intravillous lamina propria cell density in the jejunum was significantly lower (P < 0.05) in P and PPF pigs than in C pigs. Plasma urea concentrations were also 40 and 42% lower (P < 0.05) in the P and PPF groups, respectively, than in the C group. Our results indicate that dietary plasma protein reduces the cellularity of the lamina propria, but not epithelial cell surface of the small intestine. Feeding plasma protein also increased the efficiency of dietary protein utilization, in part, by decreasing amino acid catabolism.

Analysis of Variance↗
PubMed2000

Dietary plasma protein is used more efficiently than extruded soy protein for lean tissue growth in early-weaned pigs.

We compared the effects of supplementing either animal plasma or extruded soy protein in the diet based on the efficiency of dietary protein utilization for lean tissue growth in early-weaned pigs. Twenty-four 14-d-old pigs (4 kg body weight) were pair-fed (per kg body weight) either a control diet containing extruded soy protein (C; n = 12) or a diet with 10% animal plasma (P; n = 12) for 24 d. During the 24 days, protein intake was not different, yet mean daily body weight gains (+23%) and food conversion efficiencies (expressed as the ratio of body weight gain to protein intake) (+19%) were greater (P < 0.05) in the P group than in the C group. Lean body mass measured after 24 d, using both dual-energy X-ray absorptiometry and total body potassium analysis, was significantly (P < 0.05) greater (approximately 16%) in P than in C pigs. The circulating urea concentrations were 40% lower (P < 0.05) in P than in C pigs. Our results demonstrate that supplementing early-weaned pig diets with animal plasma rather than extruded soy protein increased the efficiency of dietary protein use for lean tissue growth and that this response is mediated in part by decreased amino acid catabolism.

Animal Feed↗
PubMed2000

Further evidence for the reliability and validity of the Modified Dental Anxiety Scale.

AIM: To gain further evidence of the psychometric properties of the Modified Dental Anxiety Scale. SETTING: Dental admission clinics. DESIGN: Consecutive sampling, cross-sectional survey. PARTICIPANTS: Patients (n = 800) in four cities (Belfast, Northern Ireland; Helsinki, Finland; Jyväskylä, Finland and Dubai, UAE). METHODS: Questionnaire booklet handed to patients, attending clinics, for completion following an invitation by the researcher to be included in the study. MEASURES: Modified Dental Anxiety Scale (MDAS), together with further questions concerning dental attendance and nervousness about dental procedures. RESULTS: Overall 9.3 per cent of patients indicated high dental anxiety. MDAS showed high levels of internal consistency, and good construct validity. The relationship of dental anxiety with age was similar to previous reports and showed lowered anxiety levels in older patients. CONCLUSION: Data from three countries has supported the psychometric properties of this modified and brief dental anxiety scale.

Adolescent↗