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Biomedical subjects

J Stirling

Publications and source records attributed to J Stirling.

At least 19 recordsLinked to original sources
PubMed2002

Organophosphate poisoning complicated by a tachyarrhythmia and acute respiratory distress syndrome in a child.

A 9-year-old child presented with documented organophosphate insecticide poisoning. His course was initially complicated by a tachyarrhythmia with QT-interval prolongation that responded promptly to intravenous magnesium. However, following partial recovery, he developed progressive acute respiratory distress syndrome characterized by irreversible fibrosis and obliteration of the lung parenchyma.

Child↗
PubMed2001

Sequence characterization of Ndelle virus genome segments 1, 5, 7, 8, and 10: evidence for reassignment to the genus Orthoreovirus, family Reoviridae.

The full-length nucleotide sequences of genome segments 1, 5, 7, 8 and 10 from Ndelle virus (NDEV) have been characterized. Comparison of the deduced protein amino acid sequences with those of other member viruses of the family Reoviridae demonstrates that NDEV was originally assigned incorrectly to the genus Orbivirus (aa identity values of <20%). In contrast, high levels of amino acid identity were found with members of the species Mammalian orthoreovirus (MRV); for example, amino acid identity in gamma3(Pol) is between 91 and 97%. These findings, together with previous antigenic analyses, provide evidence that NDEV should be reclassified as a new serotype (designated MRV-4) within the Mammalian orthoreovirus species.

Genome, Viral↗
PubMed2000

Compliance and psychological reactance in schizophrenia.

OBJECTIVES: Non-compliance with neuroleptic medication in schizophrenia is a major cause of relapse. A number of sociodemographic variables, and illness, attitudinal and treatment variables, have been demonstrated to be associated with non-compliance. The present study examined a range of these variables and their predictive value in determining past and current compliance. METHODS: Thirty-nine patients suffering from schizophrenia and three patients suffering from schizoaffective disorder completed a series of questionnaires assessing psychological reactance, insight, subjective response to medication, perceived threat to freedom of choice, and degree of current and past compliance. Logistic regression analyses were performed to determine which factors best predicted past and current compliance. RESULTS: Psychological reactance and age were found to be the best predictors of past compliance, with an interaction between reactance and perceived threat to freedom of choice posed by treatment provision also making a significant contribution. Past compliance behaviour and subjective response to medication predicted current compliance most significantly. CONCLUSIONS: Reactance is an important predictor of compliance history especially when patients perceive treatment to be a threat to freedom of choice. Subjective response to neuroleptics is most important in predicting current compliance. Implications for intervention are discussed.

Adult↗
PubMed1998

Vulnerability factors in the anxiety disorders.

Groups of non-clinical individuals scoring high and low on a measure of trait anxiety were compared to a group of people with a history of clinical anxiety on measures of locus of control of behaviour and reported parental rearing practices (group size = 30 in each group). The Parental Bonding Instrument (Parker, Tulping & Brown, 1979) was used to assess parental overprotection and care. A scale relating to parental sensitization was also used in this study. It was hypothesized that the high-trait anxiety group would produce similar results to the anxiety-disorder group on locus of control and parental overprotection, and similar results to the low-trait anxiety group on parental care and parental sensitization. The hypotheses were, in most cases, supported and a relationship between trait anxiety and parental overprotection was suggested. The results also suggested that parental sensitization may be particular to anxiety disorders.

Adolescent↗
PubMed1998

[A prerequisite to the development of community health: the mobilization of professionals and residents in Saint-Herblain].

In 1990-1991, the city of Saint-Herblain (Loire-Atlantique) has been involved in a method of a social development of the area. As part of it, an health project has been made in order to associate the residents. Through a question: "what is health as for you?", residents and professionals have expressed themselves about the neighbourhood sources before identifying the problems and difficulties. This "positive" method has let a dynamics to be carried out and professionals and inhabitants go on participating in it.

Attitude of Health Personnel↗
PubMed1996

Human resource management in general practice: survey of current practice.

BACKGROUND: The organization and management of general practice is changing as a result of government policies designed to expand primary health care services. One aspect of practice management which has been underresearched concerns staffing: the recruitment, retention, management and motivation of practice managers. AIM: A study set out to find out who is routinely involved in making decisions about staffing matters in general practice, to establish the extent to which the human resource management function is formalized and specialized, and to describe the characteristics of the practice managers. METHOD: A postal questionnaire was sent to a stratified random sample of 750 general practices in England and Wales in February 1994 enquiring about the practice (for example, the fundholding status and number of general practitioner partners), how the practice dealt with a range of staffing matters and about the practice manager (for example, employment background and training in human resource management). Practices were classed as small (single-handed and two or three general practitioner partners), medium (four or five partners) or large (six or more partners). RESULTS: Replies were received from 477 practices (64%). Practice managers had limited authority to make decisions alone in the majority of practices although there was a greater likelihood of them taking independent action as the size of practice increased. Formality in handling staffing matters (as measured by the existence and use of written policies and procedures) also increased with practice size. Larger practices were more likely than smaller practices to have additional tiers in their management structure through the creation of posts with the titles assistant practice manager, fund manager and senior receptionist. Most practice managers had been recruited from within general practice but larger practices were more likely than smaller practices to recruit from outwith general practice. Three quarters of practice managers reported having received some type of formal training in staff management. CONCLUSION: This study shows that practice size is a major factor associated with differences in the organization and management of staffing. Any initiatives which increase the scale of primary care functions and services would have to address the issues of communication and coordination that might be associated with such a change.

England↗
PubMed1993

Expressed emotion and schizophrenia: the ontogeny of EE during an 18-month follow-up.

Key relatives of 30 first or early admission psychotic patients (mainly with a diagnosis of schizophrenia) were interviewed (for a second time) 18 months after participating in an initial assessment of expressed emotion (EE). The patients were followed up throughout the interim period, during which time 17 experienced a psychotic relapse. Although there continued to be a negligible association between initial EE rating (established during the index admission) and relapse, a significant association between EE rating at 18 months and psychiatric status of the patient during the follow-up period emerged. Results are discussed in the context of recent interactional theories of the relationship between household EE and psychiatric morbidity.

Adult↗
PubMed1993

Leg lengthening.

The combined experience of the Royal Hospital for Sick Children, Glasgow and the Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry in lengthening 52 lower limb segments with the Orthofix device is reviewed. Forty-eight segments were lengthened by callotasis, 24 in patients with achondroplasia. Attempted lengthening with chondrodiatasis was performed in 4 patients with leg length discrepancy. With callotasis, planned lengthening was achieved in 43/48 (90%) of segments. There was a small number of significant complications. Angulation or buckling of the new bone was the commonest major complication, and was seen in 10% of segments. Pin tract infection was the predominant minor complication. Premature union was noted commonly in the femurs of achondroplastics, but could usually be overcome with manipulation under anaesthesia. We confirm that callotasis achieves its objectives with fewer complications and operations than the commonly used Wagner method which it should supersede. By contrast, we had major complications in all cases with chondrodiatasis and have abandoned this method.

Adolescent↗
PubMed1992

Prevalence of venous disease: a community study in west London.

OBJECTIVE: To find out the prevalence of venous disease in patients aged between 35 and 70 years. DESIGN: Self-administered questionnaire. SETTING: Community study in west London, England. SUBJECTS: A random sample of 2,103 patients aged between 35 and 70 years who were registered with three general practices. RESULTS: 1,338 (64%) subjects filled in the questionnaires. Of these, 323/1,303 (25%) said that they had varicose veins, 81/1,338 (6%) had a deep vein thrombosis or pulmonary embolism, and 52/1,336 (5%) said that they had had phlebitis. In addition, 94/1,326 (7%) had worn support stockings, and 84/1,304 (6%) had been treated with anticoagulants at some time; 31% of responders reported that they had had some form of venous disease. CONCLUSIONS: Increased age and female sex were independent risk factors for varicose veins and phlebitis. Thrombosis and pulmonary embolism were both significantly associated with the presence of diabetes, female sex, and increased age. The facts that a quarter of the sample had varicose veins, and that nearly a third had had venous disease of some kind at some time, suggest that venous disease may place a heavier burden on health resources than had been realised.

Adult↗
PubMed1992

A questionnaire to assess risk factors, quality of life, and use of health resources in patients with venous disease.

OBJECTIVE: To test the accuracy and usefulness of a questionnaire to assess risk factors and symptoms of venous disease, quality of life, and dependence on health and social services. DESIGN: Case-control study. SETTING: Multicentre study in three general practices. SUBJECTS: Patients drawn from a larger investigation of prevalence of venous disease. RESULTS: Patients who had venous disease were taller and heavier and had spent more time standing at work than those who did not. It was strongly associated with both number of pregnancies and number of children. There were weak but not significant associations with the wearing of a corset, constipation, and a family history of venous problems. CONCLUSIONS: The questionnaire was able to pick out recognised risk factors, and is suitable for use in studies of patients with venous disorders. It may also provide information about factors that have not yet been accepted. The case-control study is an appropriate way of assessing not only risk factors, but also signs and symptoms, quality of life, and use of health resources in patients with venous disease.

Case-Control Studies↗
PubMed1991

Expressed emotion and early onset schizophrenia: a one year follow-up.

Key relatives of 33 first or early admission psychotic patients (mainly schizophrenics) were interviewed to determine household levels of expressed emotion (EE). The patients were followed up for 12 months from index admission, during which time 13 (39%) experienced psychotic relapse. There was no association between relapse rate and household EE, but correlations between individual components of EE and pre-morbid measures suggest that level of criticism may be related to less acute onset of index episode, greater elapsed time since first signs of illness, and poor adjustment in the realm of work/study. The results are discussed in the context of continuing uncertainties about the precise nature of the relationship between EE and relapse.

Adult↗
PubMed1989

Autistic children's ability to interpret faces: a research note.

Ten autistic children were compared with 10 non-autistic children matched for chronological age and performance IQ on two tests of finding the odd face out of a set of photographs of faces, two tests of labelling photographs of faces, and a test of labelling photographs of common objects. The autistic children were significantly worse than the non-autistic children at finding the odd person out and the odd facial expression of emotion out, and at labelling facial expressions of emotion. They did no worse than the non-autistic children at labelling upside down faces or at labelling objects. The results, which replicate the findings of Hobson (J. Child Psychol, Psychiat. 27, 321-342, 671-680, 1986; Communication, 20, 12-17, 1986) are consistent with other evidence for a specific perceptual abnormality in at least some children with autism, the nature of which is discussed.

Adolescent↗
PubMed1988

Localization of the pro-sequence within the total deduced primary structure of human beta-hexosaminidase B.

The beta subunit of beta-hexosaminidase (beta-N-acetylhexosaminidase, EC 3.2.1.52) is synthesized in the rough endoplasmic reticulum as a prepropolypeptide. After the loss of the signal peptide and formation of an enzymatically active dimer, the pro-enzyme is either secreted from the cell or transported into the lysosome for processing to its mature form. In order to characterize the early posttranslational events we have purified nearly 1 mg of pro-hexosaminidase B from the NH4Cl containing medium of fibroblasts derived from a patient with the infantile form of Tay-Sachs disease. The partial N-terminal sequence was mapped to a position 42 residues C-terminal to the first in-frame ATG (Met residue) and 79 residues N-terminal to the known mature N-terminus. This position corresponds to that predicted for the cleavage of a 17 amino acid signal peptide generated through the use of the third rather than the first in-frame ATG as the initiation site for protein synthesis.

Amino Acid Sequence↗