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Biomedical subjects

L Sharp

Publications and source records attributed to L Sharp.

33 records · Page 2Linked to original sources
PubMed1995

Oesophageal and gastric cancer in Scotland 1960-90.

In Scotland over the last 31 years the incidence of gastric cancer has significantly declined by 0.6% per annum in males and 1.1% in females. In contrast, for oesophageal cancer, incidence rates have risen significantly by 3.0% and 2.0% per annum in males and females respectively. Increasing incidence of both adenocarcinomas and squamous carcinomas of the oesophagus in men and squamous and recently adenocarcinomas in women has been observed. This cannot be entirely accounted for by a growth in the proportion of histologically verified (HV) tumours over time. The incidence of adenocarcinoma of the stomach increased over the study period, most likely because of increasing proportions of HV tumours and improved diagnostic precision. Areas with high levels of deprivation in Scotland are strongly associated with high rates of oesophageal cancer in men, and of gastric cancer in both men and women. All these observations are discussed in the context of current knowledge of risk factors for these diseases.

Adenocarcinoma↗
PubMed1995

Regulated underexpression and overexpression of the FliN protein of Escherichia coli and evidence for an interaction between FliN and FliM in the flagellar motor.

The FliN protein of Escherichia coli is essential for the assembly and function of flagella. Here, we report the effects of regulated underexpression and overexpression of FliN in a fliN null strain. Cells that lack the FliN protein do not make flagella. When FliN is underexpressed, cells produce relatively few flagella and those made are defective, rotating at subnormal, rapidly varying speeds. These results are similar to what was seen previously when the flagellar protein FliM was underexpressed and unlike what was seen when the motility proteins MotA and MotB were underexpressed. Overexpression of FliN impairs motility and flagellation, as has been reported previously for FliM, but when FliN and FliM are co-overexpressed, motility is much less impaired. This and additional evidence presented indicate that FliM and FliN are associated in the flagellar motor, in a structure distinct from the MotA/MotB torque generators. A recent study showed that FliN might be involved in the export of flagellar components during assembly (A. P. Vogler, M. Homma, V. M. Irikura, and R. M. Macnab, J. Bacteriol. 173:3564-3572, 1991). We show here that approximately 50 amino acid residues from the amino terminus of FliN are dispensable for function and that the remaining, essential part of FliN has sequence similarity to a part of Spa33, a protein that functions in transmembrane export in Shigella flexneri. Thus, FliN might function primarily in flagellar export, rather than in torque generation, as has sometimes been supposed.

Amino Acid Sequence↗
PubMed1994

Cancer incidence in a population potentially exposed to radium-226 at Dalgety Bay, Scotland.

Cancer incidence in the Dalgety Bay area of Fife, Scotland, was examined following the detection of radium-226 particles by routine radiation monitoring. The study was confounded by rapid population growth, demographic change and the relatively high socioeconomic status of the Dalgety Bay population. Health Board Primary Care Division records were used to calculate population estimates and Carstairs deprivation score was used to adjust for socioeconomic characteristics. In the period 1975-90, 211 residents were registered as having cancer compared with 214.21 expected from Scottish national rates. Of specific cancers possibly associated with radiation, the incidence of stomach, liver, lung, bone, prostate, bladder and kidney cancer and lymphoma were lower than expected while colon, rectum, pancreas, skin, breast and thyroid cancer and multiple myeloma and leukaemia were higher. There were three cases of childhood leukaemia compared with 1.22 expected. The only statistically significant differences observed were for pancreas (11 cases, O/E 2.28), lung (25 cases, O/E 0.65) and non-melanoma skin (36 cases, O/E 1.50). Stomach cancer was of borderline statistical significance (four cases, O/E 0.40). Adjustments for socioeconomic factors accounted for the apparently low incidence of stomach and lung cancer and, to a lesser extent, skin cancer, which remained of borderline statistical significance. Results in relation to pancreas cancer were unchanged. The observations of raised incidence of pancreas and skin cancer arose in the context of a survey of 17 cancer sites, from which the finding of two or more statistically significant results is not unusual (P = 0.21), and the numbers of cases involved were small. The epidemiological evidence for an association between radiation exposure and pancreas cancer risk is weak. Stronger evidence exists for an association with skin cancer. In the present study the anatomical distribution of the 36 cases was similar to that found elsewhere in Scotland.

Adolescent↗
PubMed1994

Leukaemia and non-Hodgkin's lymphoma: incidence in children and young adults resident in the Dounreay area of Caithness, Scotland in 1968-91.

STUDY OBJECTIVE: To review the incidence of leukaemia and non-Hodgkin's lymphoma in children and young adults in the area less than 25 km from the Dounreay nuclear installation and the remainder of the Kirkwall postcode area in the full time period for which data are now available (1968-91), and to determine whether the excess incidence reported in the period up to 1984 has continued in subsequent years. DESIGN: Geographical incidence study. SETTING: The Kirkwall postcode area of Scotland. SUBJECTS: Children and young adults resident in the area in the period 1968-91. MAIN RESULTS: Observed numbers of cases of leukaemia and non-Hodgkin's lymphoma and observed to expected ratios with expected numbers based on Scottish national rates were determined. In 1968-91, 12 cases were observed compared with 5.2 expected in the zone < 25 km from the Dounreay plant (p = 0.007). In the latest period, 1985-91, which has not previously been examined, four cases were observed compared with 1.4 expected (p = 0.059). CONCLUSION: The observation of an excess of borderline statistical significance in 1985-91 following the substantial excess incidence which occurred in the early 1980s suggests that the incidence of leukaemia and non-Hodgkin's lymphoma in this area should continue to be a matter of concern. The phenomenon of high incidences of childhood and young adult leukaemia and lymphoma near some nuclear installations in isolated areas is yet to be explained, but certain aspects of the data examined in the present report are consistent with the hypothesis of an infectious aetiology for leukaemia in very young children.

Adolescent↗
PubMed1993

Respiratory symptoms questionnaire for asthma epidemiology: validity and reproducibility.

BACKGROUND: There is a need for a new respiratory symptoms questionnaire for use in epidemiological research in asthma. METHOD: A questionnaire was designed following a pilot study in 78 subjects. It contains nine questions on symptoms such as wheeze and difficulty with breathing in defined circumstances such as exercise and sleep. It was completed by 211 adults and validated by comparison with a self reported history of asthma and with bronchial hyperresponsiveness to histamine. Its short term reproducibility was measured by three repeat administrations over two weeks. RESULTS: Subjects with asthma (n = 33), particularly those having had an asthma attack in the last year (n = 23), were more likely to report any symptom and to report a greater number of symptoms than those without asthma. The same relationship was found for bronchial hyperresponsiveness and symptoms. Either two or more, or three or more, symptoms appeared to be good indices of self reported asthma and bronchial hyperresponsiveness, or both, with a high sensitivity (65-91%) and specificity (85-96%). Reproducibility was good, with few subjects changing the number of symptoms reported by more than one symptom and none by more than four symptoms. The results compared favourably with those from questions on phlegm production from the MRC questionnaire and were better than those reported for the MRC wheeze questions. CONCLUSIONS: The questionnaire will be useful for epidemiological research on asthma and could form part of a new standardised questionnaire with wide applications.

Adult↗
PubMed1992

Psychosocial problems during child health supervision visits: eliciting, then what?

An explicit goal of child health supervision visits is to gather information and provide guidance about the psychosocial problems of children and families. The purpose of this study was to determine the extent to which parents had opportunities to express psychosocial concerns and the nature of physicians' responses to these concerns during health supervision visits. The authors analyzed videotapes of child health supervision visits by 34 children aged 5-12 years to 34 pediatric and family medicine residents. Coding systems with acceptable interobserver reliability were developed to assess (1) the nature of opportunities provided to express concerns, (2) categories of psychosocial problems expressed by parents and children, and (3) the nature of physicians' responses. In 88% of the child health supervision visits, opportunities were created by the physician to discuss psychosocial concerns or were spontaneously raised by the parent or child. In half of the visits, parents or children expressed a total of 30 psychosocial concerns. Psychosocial problems raised included conduct/behavior problems (47%), insecurity (13%), family, sibling, or social problems (13%), learning difficulties (10%), somatization (7%), and other (10%). Physicians' responses to these psychosocial concerns were as follows: 17% ignored the concern; 43% asked further exploratory questions but provided no information, reassurance, or guidance; 3% reassured the parent; 27% responded with psychosocial information and/or action; 3% responded with medical information and/or action; and 7% responded with a combination of these latter two modes of actions. Pediatric residents were more likely to respond to more disruptive behavioral concerns (r = .60, P less than .05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Case-control study of leukaemia and non-Hodgkin's lymphoma in children in Caithness near the Dounreay nuclear installation.

OBJECTIVE: To examine whether the observed excess of childhood leukaemia and non-Hodgkin's lymphoma in the area around the Dounreay nuclear installation is associated with established risk factors, or with factors related to the plant, or with parental occupation in the nuclear industry. DESIGN: Case-control study. SETTING: Caithness local government district. SUBJECTS: 14 cases of leukaemia and non-Hodgkin's lymphoma occurring in children aged under 15 years diagnosed in the area between 1970 and 1986 and 55 controls matched for sex, date of birth, and area of residence within Caithness at time of birth. MAIN OUTCOME MEASURES: Antenatal abdominal x ray examination; drugs taken and viral infections during pregnancy; father's occupation; father's employment at Dounreay and radiation dose; distance of usual residence from the path of microwave beams, preconceptional exposure to non-ionising radiation in the father; and other lifestyle factors. RESULTS: No raised relative risks were found for prenatal exposure to x rays, social class of parents, employment at Dounreay before conception or diagnosis, father's dose of ionising radiation before conception, or child's residence within 50 m of the path of microwave transmission beams. Results also proved negative for all lifestyle factors except an apparent association with use of beaches within 25 km of Dounreay. However, this result was based on small numbers, arose in the context of multiple hypothesis testing, and is certainly vulnerable to possible systematic bias. CONCLUSION: The raised incidence of childhood leukaemia and non-Hodgkin's lymphoma around Dounreay cannot be explained by paternal occupation at Dounreay or by paternal exposure to external ionising radiation before conception. The observation of an apparent association between the use of beaches around Dounreay and the development of childhood leukaemia and non-Hodgkin's lymphoma might be an artefact of multiple testing and influenced by recall bias.

Case-Control Studies↗
PubMed1991

Increasing patient knowledge, satisfaction, and involvement: randomized trial of a communication intervention.

A brief educational intervention to promote effective communication between physicians, children, and parents during pediatric office visits was designed and tested. A randomized clinical trial involving 141 children (5- to 15-year-olds) tested the effectiveness of the intervention to improve the process and outcome of medical care. The intervention was contained in three brief videotapes (one each for parents, physicians, and patients) and in accompanying written materials. Materials were designed to build skills and motivation for increased child competence and participation during pediatric medical visits. Control subjects saw health education videotapes and received materials comparable in length with those of experimental subjects. Postintervention medical visit process was analyzed using videotapes of visits. Visit outcomes, assessed with standardized instruments and interviews, included children's rapport with physicians, children's anxiety, children's preference for an active health role, children's recall of information, parents' satisfaction with the medical visit, and physician satisfaction. Results indicated that physicians in the intervention group, compared with their counterparts in the control group, more often included children in discussions of medical recommendations (50% vs 29%, t = 2.39, P less than .05); that children in the intervention group, compared with control children, recalled more medication recommendations (77% vs 47%, P less than .01) and reported greater satisfaction and preference for an active health role; and that the intervention and control groups did not differ in parent satisfaction, physician satisfaction, or child anxiety. The results suggest that a brief educational intervention administered during waiting room time can positively impact physician-child rapport and children's preference for an active role in health and their acquisition of medical information.

Adult↗
PubMed1987

Pygmalion and the student: age and classroom differences in children's awareness of teacher expectations.

This study explores age and classroom differences in children's awareness of teacher expectations and in the relation between awareness and self-expectations. In a sample of 579 children and their teachers in 30 first- (6-7-year-olds), third- (8-9-year-olds), and fifth-grade (10-11-year-olds) classrooms, assessed in the fall, younger children were found to be less accurate than fifth graders in predicting teacher expectations and in reporting differential patterns in their own interactions with the teacher. Yet first graders identified classroom differences in the degree of differential teacher treatment toward high and low achievers that were associated with differences in the expectations that high and low teacher-expectancy students reported for themselves. Fifth graders appeared more likely than younger children to mirror teacher expectancies in their self-descriptions regardless of the degree of differential treatment reported in the classroom environment.

Achievement↗