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Biomedical subjects

K Jones

Publications and source records attributed to K Jones.

At least 145 records · Page 8Linked to original sources
PubMed1999

Prevalence of back, neck and shoulder problems in the inner city: implications for the provision of physiotherapy services in primary healthcare.

BACKGROUND AND PURPOSE: More general practitioners are offering physiotherapy services within primary healthcare; however, this provision may result in increased demand. Resource allocation, based on previous patterns of consultation for musculoskeletal conditions, may be inadequate since the need for treatment in the community may not have been met in the past. Therefore the aim of this study was to determine the prevalence of back, neck and shoulder problems that had restricted normal activity for more than one week during the last year and which health professionals (if any) patients had consulted about their symptoms. METHOD: A postal survey of 2400 adult patients selected at random from four general practices in Newcastle upon Tyne (600 from each practice). RESULTS: A total of 1546 questionnaires were returned, a 64% response rate. Overall, 40% of respondants reported having at least one back, neck and/or shoulder problem. Back problems were most common (30%), followed by those with neck (21%) and shoulder (20%) problems. Approximately one-third of those with problems consulted no one, a further third consulted a general practitioner and only one in six consulted a physiotherapist. CONCLUSIONS: There is a high prevalence of substantial back, neck and shoulder problems in the community and thus a wider provision of physiotherapy services within primary healthcare may be required to manage the considerable levels of potentially unmet need.

Adolescent↗
PubMed1999

Glowing jellyfish, luminescence and a molecule called coelenterazine.

Luminescence has assumed an important role in analytical biochemistry and molecular biology as an extremely sensitive method for determining the concentration of specific ions and molecules. The luminescent system of the jellyfish Aequorea victoria consists of the photoprotein aequorin, which contains the molecule coelenterazine as a prosthetic group and shows considerable potential in this area.

Aequorin↗
PubMed1999

Smoking and deprivation: are there neighbourhood effects?

Debate has centred on whether the character of places plays an independent role in shaping individual smoking behaviour. At the small-area scale, particular attention has focused on whether measures of neighbourhood deprivation predict an individual's smoking status independent of their own personal characteristics. This study applies multilevel modelling techniques to data from the British Health and Lifestyle Survey and ward (local neighbourhood) level deprivation scores based on four variables from the national Census. Results suggest that after taking account of a large range of individual characteristics, both as main effects and interactions, together with complex structures of between-individual variation, measures of neighbourhood deprivation continue to have an independent effect on individual smoking status. In addition, significant between-ward differences in smoking behaviour remain which cannot be explained either by population composition or ward-level deprivation. The study suggests that the character of the local neighbourhood plays a role in shaping smoking behaviour.

Adult↗
PubMed1999

Geographies of health perception in Québec: a multilevel perspective.

Self perceived health is a widely used measure and, in Quebec, it has been shown to vary significantly between geographical areas. In the present study, these geographical variations are examined in a multilevel analysis in order to disentangle compositional (individual characteristics) and contextual (place) effects. The analysis recognizes four levels of variation: individual, household, local and regional. Similar analyses carried out in Britain, have considered only two levels: individual and local. Data come from the 1992-1993 Quebec Health and Social Survey, a general household survey using a stratified two-stage sampling design. Health perception (the response variable) is considered with a set of individual predictor characteristics reflecting gender, lifestyle, socio-economic conditions, marital status and social support. Results show the existence of significant local area variations in health perception after having allowed for individual characteristics and variations at the household level. At the regional level, however, no systematic and significant variations remain although some individual regions are found to have a significant impact on health perception.

Adult↗
PubMed1999

A confidential enquiry into certified asthma deaths in the North of England, 1994-96: influence of co-morbidity and diagnostic inaccuracy.

To understand more fully the nature of events leading to asthmatic death, we conducted a confidential enquiry prospectively throughout 1994-96 among the surviving relatives and respective general practitioners of subjects whose deaths could be attributed to asthma, whether wholly or partly. We also reviewed relevant hospital records and autopsy reports, and we submitted all the gathered information to an enquiry panel for evaluation. The subjects were identified from death certificates issued in five districts of the Northern Health Region of England (population 1 million) on which asthma was recorded as the primary cause of death. The enquiry panel agreed that asthma had been a critical factor in causing death in only 33 of the 79 certified cases for which there were sufficient data. The level of concordance was substantially greater for subjects aged < 65 years (76%) than for those who were older (17%). In 16 of the 33 cases asthma alone appeared to be responsible for death, but in 17 cases a wide variety of additional, co-morbid, disorders appeared to have contributed. They included, during the 24 h preceding death, gastric aspiration, septicaemia, a single dose of a beta-blocker, the abuse of organic solvents or illicit drugs and possibly, an inadvertent exposure to horse allergen. More chronic causes of co-morbidity included ischaemic heart disease, chronic obstructive pulmonary disease (COPD), thoracic cage deformity and alcohol abuse. There were possible errors of judgement in two cases by the supervising physician (6%) and in three cases by the patient (9%). Poor compliance and psychosocial disruption probably exerted an additional adverse influence in nine cases (27%). We conclude: (1) that asthma death certification in subjects aged 65 years or more is very unreliable, (2) that for approximately half of the deaths in which asthma exerted a critical role there were critical co-morbid disorders and (3) that errors of judgement, poor compliance, or psychosocial disruption are likely to have exerted an additional adverse influence in an important minority of cases.

Adolescent↗
PubMed1999

Associations between an asthma morbidity index and ideas of fright and bother in a community population.

There is a need for simple asthma outcome measures for primary care which are not only valid in terms of their relationship with lung function but also in terms of pragmatic psychological constructs. This study assesses the usefulness of adding items on the degree of 'bother' and 'fright' caused by the condition to a previously validated simple asthma morbidity index. A postal questionnaire survey comprising a simple asthma morbidity index and questions on 'fright' and 'bother' was conducted in one general practice in the north-east of England. Responses were obtained from 570 individuals. Of these, 184 (32%) reported low, 133 (23%) medium and 253 (44%) high morbidity. Twenty-nine per cent of respondents had felt frightened by their asthma in the previous 4 weeks. Both the 'fright' and 'bother' items were significantly associated with the morbidity index. The addition of 'bother' and/or 'fright' questions may improve both the content, construct and predictive validity of the morbidity index, but this needs to be established prospectively.

Anxiety↗
PubMed1999

Intermittent shedding of thermophilic campylobacters by sheep at pasture.

The rates at which sheep on different types of pasture shed campylobacters in their faeces were measured over 12 months. Overall, shedding of campylobacters at pasture was between a third and a half of the carriage rate (92%) of the intestines of sheep at slaughter. Shedding was highest during saltmarsh grazing, followed by upland fell and farm grazing. The rate of shedding varied at different times of the year, with the highest rates (100%) coinciding with lambing, weaning, and movement onto new pasture. The lowest rates (0%) occurred when sheep were fed on hay and silage. On the farm, low rates occurred during the whole of gestation, both when the sheep were indoors and outdoors. Campylobacter jejuni was the main species isolated and survived for up to 4 d in sheep faeces. Lambs became colonized by Campylobacter within 1-5 d of being born. Ewes, which were not shedding campylobacters prior to lambing, started to shed after lambing, and ewes which were shedding low numbers of Campylobacter before lambing, increased the numbers of bacteria being shed after lambing.

Animal Feed↗
PubMed1999

The effect of a new sewage treatment plant on faecal indicator numbers, campylobacters and bathing water compliance in Morecambe Bay.

Until recently, sewage from Morecambe was macerated, but otherwise untreated, and discharged at high water via a short outfall pipe into Morecambe Bay adjacent to a recognized bathing water. In March 1997, a new biological sewage treatment plant came on-line and the effluent was discharged via a longer outfall pipe into the Bay south of Heysham. The effect of the new sewage treatment on the quality of the bathing waters was monitored by testing sea water collected from the three EU designated bathing waters on Morecambe Bay: Morecambe North, Morecambe South and Heysham. After sewage treatment came on-line, the numbers of faecal coliforms and faecal streptococci were lower at Morecambe North and Morecambe South but higher at Heysham. Although the changes in numbers were not always statistically significant, they were sufficient to affect compliance with the EU Bathing Water Directive Imperative (mandatory) standards. Compliance improved markedly at Morecambe North and South but declined at Heysham, the closest bathing site to the new outfall. Numbers of thermophilic campylobacters were similar in both years, which is suggestive of their sources being different from those of the indicator bacteria. Campylobacter lari and urease-positive thermophilic campylobacters (UPTC) were the only species of Campylobacter isolated from Morecambe's bathing waters. Very low numbers of Salmonella were found, with Salm, arizonae the only species isolated.

Campylobacter↗
PubMed1999

Distribution and seasonality of microbial indicators and thermophilic campylobacters in two freshwater bathing sites on the River Lune in northwest England.

Two freshwater bathing sites, the Crook O'Lune and the University Boathouse, on the River Lune in the north-west of England, were monitored over a 2 year period for the faecal indicators, faecal coliforms and faecal streptococci, the pathogens, Salmonella and Campylobacter, and compliance with the EU Directive on Bathing Water Quality. Faecal indicator numbers showed no seasonal variation, with numbers in the bathing season similar to those in the non-bathing season. They were consistently above the EU Guideline and Imperative standards so that if the EU Bathing Water Quality Directive (76/160/EEC) were applied, neither site would comply. Faecal indicator numbers in the sediments were an order of magnitude higher than in the overlying water. Campylobacter numbers showed seasonal variation in the water with higher counts in winter than in the summer, although numbers were low. Higher numbers were found in the sediments but there was no seasonal variation. Analysis of various inputs showed that indicators and campylobacters came from a mixture of sources, namely a sewage treatment works, agricultural run-off, streams and mallards. Microbial numbers in the water at the Crook O'Lune, which is closer to the sources of pollution, were twice those at the Boathouse. In the sediments they were six to eight times higher. Faecal coliforms were all identified as Escherichia coli of which 80% were a single biotype. Faecal streptococci were all enterococci of which 55% were E. avium, 38% E. faecalis and 7% E. durans. Salmonella was not isolated from either the water column or the sediments. Campylobacters were mainly Camp. jejuni, followed by Camp. coli, UPTC and Camp. lari.

Animals↗
PubMed1999

Reprogramming of fibroblast nuclei after transfer into bovine oocytes.

Recent landmark achievements in animal cloning have demonstrated that the events of cell differentiation can, in principle, be reversed. This reversal necessarily requires large-scale genetic reprogramming, of which little is known. In the present study we characterized the extent to which blastocyst stage-specific mRNA expression would be conserved in bovine embryos produced by nuclear transfer (NT) using fetal fibroblasts as nuclei donors (FF NT). The mRNA pool of FF NT embryos was compared with that of NT embryos reconstructed from embryonic blastomeres (Emb NT), with embryos produced under in vivo or in vitro conditions, and finally with fibroblast cells. Embryo/cell-specific mRNA pools were contrasted using differential display methodology. Random oligonucleotide primer pair combinations were used to subfractionate mRNA populations and represent individual mRNAs as copy DNA (cDNA) bands ranging in size from 100 to 800 base pairs. Regardless of whether bovine blastocysts developed in vivo or in vitro, or were derived after nuclear transplantation with embryonic blastomeres or fetal fibroblasts, their mRNA profile was highly conserved and distinct from that of fetal fibroblast cells. There was approximately 95% conservation in cDNA banding patterns between FF NT, Emb NT, and in vivo derived blastocysts, when compared with in vitro derived blastocysts. In contrast, the cDNA banding in fibroblasts was only 67% conserved with in vitro derived blastocysts (p < 0.0001), indicating that dramatic changes in gene transcription are induced by nuclear transplantation. After nuclear transplantation, gene expression in fetal fibroblasts is reprogrammed so to mimic that of preimplantation embryo development. Future characterization of these changes will be invaluable for the identification of suitable cell types to serve as nuclear donors for embryo reconstruction and provide information that can be used to improve the efficiency of cloning animals by nuclear transplantation.

Animals↗
PubMed1999

Estimation of the dermal absorption of m-xylene vapor in humans using breath sampling and physiologically based pharmacokinetic analysis.

A physiologically-based pharmacokinetic model, containing a skin compartment, was derived and used to simulate experimentally determined exposure to m-xylene, using human volunteers exposed under controlled conditions. Biological monitoring was conducted by sampling, in exhaled alveolar air and blood, m-xylene and urinary methyl hippuric acid concentrations. The dermal absorption of m-xylene vapor was successfully and conveniently studied using a breath sampling technique, and the contribution to m-xylene body burden from the dermal route of exposure was estimated to be 1.8%. The model was used to investigate the protection afforded by an air-fed, half-face mask. By iteratively changing the dermal exposure concentration, it was possible to predict the ambient concentration that was required to deliver the observed urinary excretion of methylhippuric acid, during and following inhalation exposure to 50 ppm m-xylene vapor. This latter extrapolation demonstrates how physiologically-based pharmacokinetic modeling can be applied in a practical and occupationally relevant way, and permitted a further step not possible with biological monitoring alone. The ability of the model to extrapolate an ambient exposure concentration was dependent upon human metabolism data, thereby demonstrating the mechanistic toxicological basis of model output. The methyl hydroxylation of m-xylene is catalyzed by the hepatic mixed function oxidase enzyme, cytochrome P450 2E1 and is active in the occupationally relevant, (<100 ppm) exposure range of m-xylene. The use of a scaled-up in vitro maximum rate of metabolism (Vmaxc) in the model also demonstrates the increasingly valuable potential utility of biokinetic data determined using alternative, non-animal methods in human chemical-risk assessment.

Administration, Cutaneous↗
PubMed1999

Common peroneal nerve stimulation for neuromuscular monitoring: evaluation in awake volunteers and anesthetized patients.

UNLABELLED: The study was conducted in two parts. First, evoked responses to common peroneal nerve stimulation at four electrode positions were tested in 25 awake volunteers. The initial threshold stimulus current (ITS) (minimal current producing dorsiflexion or eversion of the ankle joint and great toe) and the supramaximal stimulus current (SMS) (the point at which further increases in current did not produce increases in twitch tension) were defined. SMS was not reliably achieved using electrodes at each side of the fibular head. However, an exploratory electrode accurately located the nerve and enabled SMS in all volunteers (SMS/ITS = 3.4). Second, 16 anesthetized, paralyzed patients were studied. The common peroneal and ulnar nerves were stimulated simultaneously. Evoked tension was recorded at the adductor pollicis using a force transducer and at the great toe by a blinded observer. Reversal was given when the train-of-four count at the great toe reached four. Onset times were longer, and median posttetanic counts were greater, at the great toe compared with the adductor pollicis. Time from reversal to train-of-four ratio = 0.7 at the adductor pollicis was 207+/-160 s. We conclude that neuromuscular monitoring at the common peroneal nerve was not equivalent to monitoring at the ulnar nerve. IMPLICATIONS: Accurate neuromuscular monitoring is important for patient safety. We studied the accuracy of monitoring at the common peroneal nerve in volunteers and patients. An exploratory electrode accurately located the common peroneal nerve. Monitoring at the common peroneal nerve was not equivalent to monitoring at the ulnar nerve in patients.

Adult↗
PubMed1999

Preschool boys with oppositional defiant disorder: clinical presentation and diagnostic change.

OBJECTIVE: Little is known about the clinical presentation and course of oppositional defiant disorder (ODD) when first diagnosed in the preschool years. Patterns of ODD symptomatology, comorbidity, persistence of disorder, and predictors of diagnostic outcome were examined in clinic-referred preschool boys. METHOD: Boys (aged 4-5.5 years) with a DSM-III-R diagnosis of ODD were prospectively followed over a 2-year period. Multiple assessment procedures were used, including a modified version of the Diagnostic Interview Schedule for Children and parent and teacher ratings. RESULTS: Ninety-two boys (mean age 56.9 months) with ODD were followed; 42 had comorbid attention-deficit hyperactivity disorder (ADHD). Among 79 boys assessed 2 years later, 76% had ODD, ADHD, or both. Of those, 25% had other diagnoses as well, primarily anxiety and/or mood disorders. Conduct disorder was rare. Subjects with comorbid ODD/ADHD at intake were significantly more likely to have a psychiatric disorder at follow-up, especially ADHD alone. CONCLUSIONS: The findings suggest that ODD in the preschool period is a clear indicator of high risk, especially when co-occurring with ADHD. Further investigation of individual patterns of ODD symptom expression is recommended.

Anxiety Disorders↗
PubMed1999

Investigation and management of patients with pleuritic chest pain presenting to the accident and emergency department.

The assessment of a patient with pleuritic chest pain calls for a high degree of clinical acumen and a high degree of suspicion that the diagnosis might be pulmonary embolism. This area is one of the most difficult in A&E medicine (and indeed chest medicine). One error is to "think the best" when considering the diagnosis in such patients but experience soon teaches to "think PE" and diagnose less serious conditions only when pulmonary embolism has been excluded. A key consideration is the presence of risk factors. Because the diagnosis is difficult, there should be no hesitation in requesting a senior opinion or referring to the inpatient medical team. We have produced an algorithm (fig 1) for the investigation and management of pleuritic chest pain as discussed in this article. Three questions relating to this article are: (1) Can pulmonary embolism be the diagnosis in a patient with pleuritic chest pain but a normal chest radiograph, ECG, and arterial blood gases? (2) What is the chest radiograph abnormality which is most likely to alert you to the possibility of pulmonary embolism? (3) What percentage of patients with a low clinical suspicion of pulmonary embolism but a high probability V/Q scan will have pulmonary embolism demonstrated on pulmonary angiography? The three key references are The PIOPED Investigators, Dalen, and Fennerty.

Algorithms↗
PubMed1999

Biological monitoring to assess exposure from use of isocyanates in motor vehicle repair.

OBJECTIVES: To develop a method for the measurement of a metabolite of hexamethylene diisocyanate (HDI), an isocyanate, and use it to assess the exposure of sprayers employed in motor vehicle repair shops. METHODS: Urine samples were taken from sprayers wearing personal protective equipment and spraying in booths or with local exhaust ventilation, from bystanders, and from unexposed subjects. Samples were analyzed for a metabolite of HDI, hexamethylene diamine (HDA), by gas chromatography-mass spectrometry (GC-MS). RESULTS: HDA was detected in four sprayers and one bystander out of 22 workers. No HDA was detected in the urine of unexposed subjects. CONCLUSIONS: Exposure to isocyanates still occurs despite the use of personal protective equipment and the use of a booth or extracted space. Health surveillance is likely to be required to provide feedback on the adequacy of controls even if such precautions are used and to identify cases of early asthma. Biological monitoring can provide a useful additional tool to assess exposure and the adequacy of controls in this group of exposed workers.

Automobiles↗
PubMed1999

Attitudes and experiences of restaurateurs regarding smoking bans in Adelaide, South Australia.

OBJECTIVES: To determine compliance with a voluntary code of practice (VCP) for restricting smoking in restaurants and to canvass the attitudes of restaurateurs towards tougher smoking restrictions. DESIGN: Cross-sectional survey conducted in 1996 using a telephone questionnaire. SETTING: Metropolitan restaurants and cafes in Adelaide, South Australia. PARTICIPANTS: 276 (86.8%) of a sample of randomly selected owners and managers. MAIN OUTCOME MEASURES: Restaurant non-smoking policies, reported and anticipated change in business, and restaurateurs' attitudes towards smoking restrictions. RESULTS: 26.8% of restaurants had a total smoking ban; 40.6% restricted smoking some other way; and 32.6% permitted unrestricted smoking. Only 15.1% of restaurants with a ban or restrictions had used the VCP to guide the development of their policy, and only half of these were complying with it. Although 78.4% of those with bans and 84.4% of those with restrictions reported that their non-smoking policy had been associated with either no change or a gain in business, only 33.3% of those allowing unrestricted smoking expected that this would be the case, if they were to limit smoking. A total of 50.4% of restaurateurs, including 45.3% of those with no restrictions, agreed that the government should ban smoking in all restaurants. CONCLUSIONS: The VCP made an insignificant contribution to adoption of non-smoking policies, and compliance with the code was poor. Despite concerns about loss of business, there was considerable support for legislation which would ban smoking in all dining establishments.

Attitude to Health↗
PubMed1999

Lessons from 12 years of comparative risk projects.

Can an analytical tool for comparing environmental risks and policy activities be used to evaluate their relative efficacy in ultimately changing the allocation of public funds? Some insight is possible through a review of comparative risk projects that have been carried out at the city, state, and national levels, as well as among Indian tribes, over the past 12 years. The lessons from this review should apply to the field of public health. For every comparison of environmental issues, such as clean-air standards with fish consumption advisories, there is a parallel discussion of public health priorities and strategies, such as antismoking and pregnancy prevention programs, immunization programs and disease surveillance efforts, or well-baby clinics and food safety programs. Lessons from comparative risk projects and processes may offer the public health community new ways of thinking about using stakeholder assessment processes in developing public health policy.

Environmental Health↗