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Biomedical subjects

M Blair

Publications and source records attributed to M Blair.

At least 37 records · Page 2Linked to original sources
PubMed2000

"Micrognathozoa: A new class with complicated jaws like those of rotifera and Gnathostomulida:" journal of morphology, volume 246, number 1, october 2000

The cover caption for the October issue of Journal of Morphology (Volume 246, Number 1) incorrectly listed the size of the cover specimen, Limnognathia maerski, as 128 cm in length. This is incorrect. The correct length is 128 &mgr;m. The correct cover caption is: The type species, Limnognathia maerski nov. gen. et sp. of a new group of animals, Micrognathozoa, from Greenland was photographed using differential interference contract microscopy, Nomarski technique. Anterior of the specimen is at the top of the figure. Different internal structures such as the pharyngeal apparatus with jaws and the ovaria with eggs are seen in three dimensions. The long, stiff sensoria are best seen when the animal is living as here in this photomicrograph. This specimen is only 128 &mgr;m in length. The color in this image is not the true color of the transparent animal but is a reflection of the Nomarski technique. Photomicrograph by Reinhardt M. Kristensen. See R. M. Kristensen and P. Funch, page 1. The Editor regrets this error.

Journal Article↗
PubMed2000

Evidence-based practice and health visiting: the need for theoretical underpinnings for evaluation.

In this paper we argue that evidence-based practice, which is being introduced throughout the British National Health Service to make decisions about the allocation of limited resources, provides a welcome opportunity for health visitors to demonstrate their efficacy, skills and professionalism. However, the paper argues that to view health visiting as evidence-based is not to reduce health visiting merely to a technology through which scientific solutions are applied to social problems. Rather, health visiting needs to be viewed as a political movement, based on a particular model of society, which shapes the goals which health visitors pursue and influences the strategies they adopt to achieve their goals. The paper describes various models of health visiting as a way of showing how the goals of health visiting are always framed within a particular set of assumptions and causal explanations. The paper then turns to look at the issue of evaluating health visiting services. It is argued that evaluation should properly take account of the models which shape health visitors' goals and intervention strategies, and in turn, health visitors need to be explicit about the theoretical frameworks underpinning their interventions. Finally, it is argued that health visitors' knowledge and understanding of a range of models of society enables them to move between the various models to choose the most appropriate and effective means of intervention. Hence it is concluded that the emphasis on evidence-based practice provides health visitors with a valuable opportunity to show that their unique, professional skills and understanding are the preconditions for effective intervention.

Community Health Nursing↗
PubMed2000

The effect of home visiting programmes on uptake of childhood immunization: a systematic review and meta-analysis.

BACKGROUND: The aim of the study was to evaluate the effectiveness of home visiting programmes on the uptake of childhood immunization. METHODS: A systematic review was carried out of the literature of controlled studies evaluating home visiting programmes involving at least one post-natal visit, which included tasks within the remit of British health visiting and reporting outcomes relevant to British health visiting. Eleven studies were considered, nine of which used socio-economically disadvantaged families. The outcome measure was uptake of a range of childhood immunizations. RESULTS: Eleven studies reported uptake of immunization. Effect sizes from nine studies were included in the meta-analysis. Fixed effects models demonstrated a significant effect of home visiting for all studies and also for several subgroups of studies, but with significant heterogeneity of effect sizes. A random effects model failed to demonstrate an effect of home visiting. CONCLUSIONS: Home visiting programmes have not been shown to be effective in increasing the uptake of immunization. Other methods of increasing uptake and reducing inequalities in uptake will need to be explored.

Child, Preschool↗
PubMed2000

Does home visiting improve parenting and the quality of the home environment? A systematic review and meta analysis.

AIMS: To evaluate the effectiveness of home visiting programmes on parenting and quality of the home environment. DESIGN: Systematic review of the literature of randomised controlled trials and quasi-experimental studies evaluating home visiting programmes involving at least one postnatal visit. SUBJECTS: Thirty four studies reported relevant outcomes; 26 used participants considered to be at risk of adverse maternal or child health outcomes; two used preterm or low birth weight infants; and two used infants with failure to thrive. Only eight used participants not considered to be at risk of adverse child health outcomes. RESULTS: Seventeen studies reported Home Observation for Measurement of the Environment (HOME) scores, 27 reported other measures of parenting, and 10 reported both types of outcome. Twelve studies were entered into the meta analysis. This showed a significant effect of home visiting on HOME score. Similar results were found after restricting the analyses to randomised controlled trials and to higher quality studies. Twenty one of the 27 studies reporting other measures of parenting found significant treatment effects favouring the home visited group on a range of measures. CONCLUSIONS: Home visiting programmes were associated with an improvement in the quality of the home environment. Few studies used UK health visitors, so caution must be exercised in extrapolating the results to current UK health visiting practice. Further work is needed to evaluate whether UK health visitors can achieve similar results. Comparisons with similar programmes delivered by paraprofessionals or community mothers are also needed.

Child↗
PubMed1999

PG-4 cell plaque assay for xenotropic murine leukemia virus.

Xenotropic murine leukemia virus (X-MuLV) is often used in retrovirus elimination studies involving rodent cells. Currently, X-MuLV is measured using a focus-forming assay on mink (MiCl1 S+L-) or cat (PG-4 S+L-) cell lines. An easier and quicker PG-4 cell plaque assay, which retains the statistical reproducibility of the focus-forming assay, was developed and evaluated in this study. The PG-4 plaque assay is more sensitive than the MiCl1 focus assay for titering X-MuLV. The best results were achieved by passaging PG-4 cells at a seeding density of 4x10(6) cells/T185 flask twice a week, inoculating 3x10(5) cells/well on six-well plates and performing the assay at 35 degrees C. The overall variability of the assay was 0.30 log10 titer unit. A linear response to dilution was observed for wells containing 5-70 plaques. The limit of quantitation was 10 PFU/ml. Using six wells per dilution, the 95% confidence limit of the grand mean titer was within +/-0.5 log10.

Animals↗
PubMed1999

Action research: a useful method of promoting change in primary care?

BACKGROUND: Action research has been used successfully to promote change in disciplines other than medicine, but there are few examples of its use in primary care. OBJECTIVE: We aimed to discuss the benefits and difficulties of using action research in primary care using the example of child health surveillance provision in general practice. METHODS: Twenty-eight general practices were randomly allocated into two groups. Action research was used to promote change in 14 practices by facilitating practice meetings and by providing written feedback. The other 14 practices received written feedback alone. The two groups of practices were compared using the following: (i) semi-structured interviews with one health visitor and GP from each practice; (ii) observation of baby clinics; (iii) questionnaires to parents; and (iv) return rates of child health surveillance reviews from the personal child health record. RESULTS: All 14 practices in the action research arm of the study met as individual practice teams and decided to make changes to their provision of child health surveillance. Ten practices audited their child health surveillance as a result. More health visitors in the action research practices than in the comparison practices reported changes to child health surveillance, audit, communication and use of the personal child health record. The majority of health visitors and GPs thought involvement in the action research process was beneficial. However, we were unable to show a statistically significant difference between the two groups of practices in baby clinic provision, parent satisfaction or the return rate of child health surveillance reviews. CONCLUSION: Our study suggests that action research is a successful method of promoting change in primary care. However, measuring the impact of change is difficult.

Adult↗
PubMed1998

4-week range-finding and 1-year oral toxicity studies of sucrose acetate isobutyrate (SAIB) in the cynomolgus monkey.

Sucrose acetate isobutyrate (SAIB) is used as an emulsion stabilizer in citrus-based soft drinks. A 4-week range-finding study and a 1-year chronic toxicity study were conducted to determine the tolerance and effects of this food additive in cynomolgus monkeys. SAIB was administered by gavage in corn oil solutions to groups of one monkey of each sex in the range-finding study and four monkeys of each sex in the 1-year study. The dose levels employed in both studies were 0, 500, 1450 and 2400 mg/kg body weight. Control monkeys were given corn oil by gavage. Based on the range-finding study, the 2400 mg/kg body weight dose level of SAIB was considered to be the highest dose of SAIB in corn oil that would be tolerated in a long-term study. No differences were observed between treated and control animals in either study with respect to body weight gain, clinical chemistry, haematology, organ weights, gross necropsy or light microscopy findings that could be attributed to SAIB treatment. Results of specific tests of hepatobiliary function in the 1-year study, including serum enzymes, bilirubin and bile acids, bromsulfophthalein retention and electron microscopic studies of the liver, were also negative. It was concluded that the highest dose level fed, 2400 mg/kg body weight, was the no-observed-adverse-effect level (NOAEL).

Animal Feed↗
PubMed1997

General practitioners use of hospital and community based paediatric out-patient services in Nottingham.

The paper compares and contrasts the referral patterns of general practitioners in Nottingham for paediatric specialist opinion in a hospital and community setting. Data were collected from case notes review and medical activity data returns on 100 consecutive referrals made by GPs to a hospital paediatric consultant out-patient clinical and 100 consecutive referrals to a community based consultant clinic. Multiple diagnoses are more commonly made and recorded by community based paediatricians with a bias towards behavioural, nutrition, growth and neurodevelopmental problems. Hospital clinic staff made more system and disease based diagnoses with more investigations arranged than the community staff [53 cf. 15 (OR 6.39, 95% CI; 3.25-12.55, P = < 0.0001)]. More children under five were seen in the community clinic sample compared to the hospital sample [75 cf. 57 under fives (OR 2.26, 95% CI; 1.24-4.13, P = 0.01)]. Patients are more likely to be discharged from the hospital clinic than the community clinic after the initial visit. [59 cf. 33 (OR 2.92, 95% CI; 1.64-5.20, P = 0.0004)]. Costs per new case consultation were substantially less in the community clinic than the hospital setting. A broadly similar range of clinic problems are referred to both hospital and community based paediatricians in Nottingham. The educational and liaison value of local community paediatric clinics together with relatively easier access by parents and lower per case costs is an advantage. Commissioners of paediatric and child health services need to take into consideration these factors when purchasing out-patient specialist paediatric opinion. Further research is required into the quality and desirability of these developments.

Ambulatory Care↗
PubMed1997

Childhood developmental examination: a novel approach to teaching.

Childhood developmental assessment is an essential skill that medical students must attain during their education. The authors describe a new technique which is neither laborious nor time-consuming for both staff and students. Groups of 40 students were taught normal developmental examinations using a novel interactive approach during a lecture. The method proved successful in terms of student evaluation, cost effectiveness of medical teaching time and acceptability to the children used for the demonstration. Audio-visual equipment, available in most teaching centres, was used that was easily and cheaply installed for the purpose of the session.

Child↗
PubMed1997

Microsatellite marker development, mapping and applications in rice genetics and breeding.

Microsatellites are simple, tandemly repeated di- to tetra-nucleotide sequence motifs flanked by unique sequences. They are valuable as genetic markers because they are co-dominant, detect high levels of allelic diversity, and are easily and economically assayed by the polymerase chain reaction (PCR). Results from screening a rice genomic library suggest that there are an estimated 5700-10,000 microsatellites in rice, with the relative frequency of different repeats decreasing with increasing size of the motif. A map consisting of 120 microsatellite markers demonstrates that they are well distributed throughout the 12 chromosomes of rice. Five multiple copy primer sequences have been identified that could be mapped to independent chromosomal locations. The current level of genome coverage provided by these simple sequence length polymorphisms (SSLPs) in rice is sufficient to be useful for genotype identification, gene and quantitative trail locus (QTL) analysis, screening of large insert libraries, and marker-assisted selection in breeding. Studies of allelic diversity have documented up to 25 alleles at a single locus in cultivated rice germplasm and provide evidence that amplification in wild relatives of Oryza sativa is generally reliable. The availability of increasing numbers of mapped SSLP markers can be expected to complement existing RFLP and AFLP maps, increasing the power and resolution of genome analysis in rice.

Breeding↗
PubMed1996

The role of an advanced thermotherapy device in prostatic voiding dysfunction.

OBJECTIVES: To investigate the efficacy of an advanced transurethral thermotherapy (TUMT) device (T3, Urologix) using urodynamic analysis in addition to the standard evaluation protocol in patients with symptomatic benign prostatic hyperplasia (BPH). PATIENTS AND METHODS: Fifty men with symptomatic BPH were assessed using the AUA symptom score, uroflowmetry and ultrasonography (to determine prostatic volume and residual urinary volume) before and 6 weeks, 3, 6 and 12 months after thermotherapy. TUMT was delivered using a focused microwave energy system for 1 h in each patient, treated on an out-patient basis. Video pressure flow studies with advanced urodynamic analysis were also performed before and 3 months after treatment. RESULTS: The mean AUA symptom score decreased by 63%, the mean peak flow rate increased by 64% and the post-void residual volume decreased by 30% 3 months after treatment; this improvement was maintained at one year after treatment. Advanced urodynamic analysis showed that 52% of the patients had a decreased severity of obstruction. Furthermore, the efficiency of detrusor contraction improved in 86% of the patients. The improvement in the symptom score, flow rate and residual urine was significantly better in patients with marginal obstruction than in patients with unequivocal obstruction. CONCLUSION: Urodynamic analysis can predict the treatment outcome of TUMT and the results of thermotherapy are significantly better in patients with marginal prostatic bladder outflow obstruction.

Aged↗
PubMed1996

The quality of hospital discharge: a survey of discharge arrangements for the over-65s.

A three-phase study comprising semi-structured interviews with patients and/or their carers, follow-up postal questionnaires, and a postal survey of the views of professionals involved in the discharge of participating patients was conducted to assess the quality of arrangements for patients over 65 years of age, discharged from hospitals in Chester and Ellesmere Port in the United Kingdom. A large majority of patients (80%) felt they had been adequately consulted about arrangements for their discharge, but less than 2% of health and social care professionals considered all discharges satisfactory. This apparent disparity between patient and professional views may be explained by low levels of expectation among patients in this aspect of their care and their reluctance to express views which they fear may compromise future care. Continuing difficulties with interprofessional communication and liaison suggest that further attention to discharge management is required if improvements are to be effected.

Aged↗