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Biomedical subjects

M Edwards

Publications and source records attributed to M Edwards.

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

Reducing recurrence in child protective services: impact of a targeted safety protocol.

Statewide implementation of a child safety assessment protocol by the Illinois Department of Children and Family Services (DCFS) in 1995 is assessed to determine its impact on near-term recurrence of child maltreatment. Literature on the use of risk and safety assessment as a decision-making tool supports the DCFS's approach. The literature on the use of recurrence as a summative measure for evaluation is described. Survival analysis is used with an administrative data set of 400,000 children reported to DCFS between October 1994 and November 1997. An ex-post facto design tests the hypothesis that the use of the protocol cannot be ruled out as an explanation for the observed decline in recurrence following implementation. Several alternative hypotheses are tested: change in use of protective custody, other concurrent changes in state policy, and the concurrent experience of other states. The impact of the protocol to reduce recurrence was not ruled out.

Child↗
PubMed2001

Coregulation of balance between children's prosocial approaches and acts of compliance: a pathway to mother-child cooperation?

Examined the free-field interaction of 32 mother-child dyads who volunteered to participate in a 1-hr home observation. Observers coded mother instructions, child compliance, and child prosocial approaches plus mothers' social attention as potential reinforcers for the children's compliance and social approaches. Herrnstein's matching law was used to analyze covariations between mothers' attention and the children's 2 responses. This analysis was followed by correlational and sequential probability analyses to determine linkages between these 2 child responses and the children's willingness to obey their mothers' instructions. Results showed consistent matching between mothers' social attention and the children's production of prosocial approaches and acts of compliance. An index of the proportions of these 2 responses also covaried with the children's compliance probabilities, and the prosocial approach component was the direct covariate. These findings are discussed within an interactional synchrony framework in which children's willingness to obey their mothers is influenced by opportunities for the dyad to engage each other in specific forms of social interaction.

Adult↗
PubMed2001

Nursing management of constipation in housebound older people.

In this article two algorithms are suggested for use by district nurses in the management of constipation in dependent older people at home. Prescribing for this group of patients requires a complex assessment of medical and social factors as 24-hour supervision is not always available and local health and social service resources may impact on the level of care that is available in terms of the provision of food and drink and the taking of medicines.

Aged↗
PubMed2001

Improving psychosocial assessment in oncology.

A project that encouraged nurses to give greater emphasis to cancer patients' psychological, social and spiritual concerns, and not only to the condition's physical effects, reflects one target outlined in The NHS Cancer Plan.

Holistic Nursing↗
PubMed2000

Imaging the phase of an evolving bose-einstein condensate wave function

We demonstrate a spatially resolved autocorrelation measurement with a Bose-Einstein condensate and measure the evolution of the spatial profile of its quantum mechanical phase. Upon release of the condensate from the magnetic trap, its phase develops a form that we measure to be quadratic in the spatial coordinate. Our experiments also reveal the effects of the repulsive interaction between two overlapping condensate wave packets and we measure the small momentum they impart to each other.

Journal Article↗
PubMed2000

Malignant melanoma in patients with multiple endocrine neoplasia type 1 and involvement of the MEN1 gene in sporadic melanoma.

Multiple endocrine neoplasia type 1 (MEN 1) is a familial cancer syndrome associated primarily with endocrine tumors of the parathyroids, enteropancreas and anterior pituitary. However, tumors of mesenchymal origin such as angiofibroma and collagenoma of the skin have also been associated with the syndrome. This highlights the possibility of an association between MEN 1 and some other types of tumors. Here we report 7 cases of primary malignant melanoma occurring in 7 MEN 1 families, all patients exhibiting classic features of MEN 1. Based on these findings and the previous implication of multiple melanoma tumor suppressor(s) in 11q, including the MEN1 region, we have investigated the involvement of the MEN1 gene in melanoma tumorigenesis. Mutation analysis was performed on a panel of 39 sporadic metastatic melanomas, 13 melanoma cell lines and 20 melanoma families without CDKN2A or CDK4 germline mutations. In addition, 19 sporadic metastatic tumors were screened for loss of heterozygosity (LOH) in 11q13. LOH was detected in 6 tumors (32%), and in 4 of the tumors the pattern of LOH suggested that the deletion included the MEN1 gene locus. A novel somatic nonsense mutation in exon 7 (Q349X) was identified in 1 sporadic tumor which also showed loss of the wild-type allele. We conclude that the MEN1 gene plays a role in the tumorigenesis of a small subgroup of melanoma.

Adult↗
PubMed2000

Elderly people. Old testament.

Primary care groups need to address the needs of elderly people. Elderly people and their carers should be consulted about services. Elderly service users can be enthusiastic participants in consultation initiatives.

Aged↗
PubMed2000

First- and second-order processing in transient stereopsis.

Large-field stimuli were used to investigate the interaction of first- and second-order pathways in transient-stereo processing. Stimuli consisted of sinewave modulations in either the mean luminance (first-order stimulus) or the contrast (second-order stimulus) of a dynamic-random-dot field. The main results of the present study are that: (1) Depth could be extracted with both the first-order and second-order stimuli; (2) Depth could be extracted from dichoptically mixed first- and second-order stimuli, however, the same stimuli, when presented as a motion sequence, did not result in a motion percept. Based upon these findings we conclude that the transient-stereo system processes both first- and second-order signals, and that these two signals are pooled prior to the extraction of transient depth. This finding of interaction between first- and second-order stereoscopic processing is different from the independence that has been found with the motion system.

Depth Perception↗
PubMed2000

On-Q system for managing trocar site pain after operative laparoscopy.

The On-Q system provides long-term pain relief with continuous infusion of a local anesthetic directly into the trocar site after operative laparoscopy. An elastometric pump filled with bupivacaine HCl and a catheter, inserted by the surgeon, delivers 48 hours of anesthesia (100 ml) at a rate of 2 ml/hour. The pump is secured to the outer surgical dressing or to the patient's clothing with tape or an E clip provided in the package. The system can be removed by the patient when the infusion is complete.

Anesthesia, Local↗
PubMed2000

Audit of a children's epilepsy clinic.

A newly established tertiary epilepsy clinic at Guy's Hospital, London was evaluated using a structured questionnaire. Fifty parents of children with epilepsy completed this questionnaire, with some contribution from the children. While a high degree of satisfaction was obtained by the parents and where appropriate the children, specific questions about additional resources implied a large number of unmet needs. This raises methodological issues about the value of open-ended questions in audit questionnaires. In addition, concerns were expressed about many areas, some of which had direct medical implications that were not always raised with the doctors. It is concluded that the service has benefited from both clinical and neuropsychological support. The audit has prompted a number of improvements, including establishing a discussion group for adolescents.

Adolescent↗
PubMed2000

Changes in the incidence of childhood autism and other autistic spectrum disorders in preschool children from two areas of the West Midlands, UK.

The incidence of childhood autism and other autistic spectrum disorders (ASDs) in preschool children was determined for two areas of the West Midlands between 1991 and 1996. Children diagnosed before the age of 5 years and residing within the study areas at diagnosis were detected from the records of four child development centres. The incidence rate per 10,000 children per year for the combined areas was 8.3 for all children with ASDs, 3.5 for classical childhood autism (CA), and 4.8 for other ASDs. Rates were similar in both areas, despite differences in social deprivation and proportions of ethnic minorities. While rates for classical CA increased by 18% per year, a much larger increase (55% per year) was seen for 'other ASDs', suggesting that clinicians are becoming increasingly able and/or willing to diagnose ASDs in preschool children.

Autistic Disorder↗
PubMed2000

Development of a wide bore flow through microwave digestion device for the determination of trace metals in soil.

A flow through microwave digestion device has been developed for the determination of Cd, Cr, Mn, Ni and Pb in soil by aqua regia extraction. This device differs from existing commercially available devices as it uses a double pumping action to replace the back pressure regulator traditionally used to achieve internal pressurisation. An acid front has also been included to overcome problems associated with the dilution of acid in samples due to dispersion. Recoveries between 95 and 105% of certified values were achieved with standard deviations of less than 4% for certified reference soil (BCR 143R). A sample throughput of 6 samples per hour was achieved in the optimised system. The performance of the device was tested by digesting real soil samples ground through a 250 microns sieve and slurried without the use of surfactants. A comparison of analytical performance for analysing real samples was made between the microwave flow method and a thermal method.

Environmental Monitoring↗
PubMed2000

Linking general practices to the medical schools: qualitative issues.

The University Linked Practices (ULP) programme links general practices involved in undergraduate medical education with computer services provided through the school of medicine and dentistry. In-depth interviews were conducted with 26 staff involved in teaching undergraduate medical students in 15 general practices across east London and Essex. The interview schedule focused on the use of the computer, IT experience and training needs and the use of the computer network as a resource in undergraduate teaching. It is important to work with curriculum planners to ensure that computers are fully integrated into new courses.

Computer Literacy↗
PubMed2000

Phase II study of 6-thioguanine, procarbazine, dibromodulcitol, lomustine, and vincristine chemotherapy with radiotherapy for treating malignant glioma in children.

We conducted a single-arm phase II study to evaluate the efficacy and safety of radiotherapy combined with 6-thioguanine, procarbazine, dibromodulcitol, lomustine, and vincristine (TPDCV) chemotherapy for treating malignant astrocytoma in children and anaplastic ependymoma in patients of all ages. Between 1984 and 1992, 42 patients who had malignant astrocytomas (glioblastomas multiforme, anaplastic astrocytomas, or mixed anaplastic oligoastrocytomas) were treated with TPDCV chemotherapy and radiation therapy. Of these patients, 40 were younger than 18 years, but 2 were older (22 and 23 years) when treated. Cranial radiation averaged 58 Gy. TPDCV chemotherapy was given for 1 year or until progression. Between 1989 and 1991, 17 patients with malignant ependymoma were treated with TPDCV chemotherapy and craniospinal radiation. Radiation was given at an average dose of 54 Gy to the tumor, 28 Gy to the whole brain, and 31 Gy to the spinal axis. TPDCV chemotherapy was given for 1 year or until tumor progressed. Of the patients with glioblastoma multiforme, 13 of 17 died; the median time to progression was 49 weeks, and median survival was 85 weeks. The four patients surviving at this writing were followed a median 537 weeks (range 364-635 weeks). Of the patients with nonglioblastoma malignant astrocytoma, 14 of 25 died; the median time to progression was 224 weeks. Median survival was not reached in this group. The median follow-up for those surviving was 494 weeks. For the patients with ependymoma, 11 of 17 died with a median time to progression of 141 weeks. The median follow-up for the eight who survive was 469 weeks. Nine patients died with a median survival of 183 weeks. The combination of TPDCV and radiotherapy has activity against childhood anaplastic astrocytoma, glioblastoma multiforme, and anaplastic ependymoma. The results of this study for children with glioblastoma were comparable to results in the literature, while the results for children with anaplastic astrocytoma appeared better than most reports. The combination of TPDCV chemotherapy and radiation therapy for anaplastic ependymomas appears to be active and at least as good as published reports using radiation therapy alone.

Adolescent↗
PubMed2000

Psychogenic non-epileptic seizures: management and prognosis.

AIM: To determine the outcome and identify predictive factors in children with psychogenic non-epileptic seizures (PNES). METHOD: The biographies of 35 children with PNES, attending a tertiary paediatric neurology centre, were reviewed. RESULTS: Thirty five children attending the department between 1987 and 1997 were evaluated at a mean follow up of 4.6 years. The age range was 6-18 years. Twenty four were girls and 11 were boys. Eleven patients had a diagnosis of epilepsy with PNES, the remainder having PNES alone. Cause fell into four categories: a history of violence, abuse, or neglect; a high level of anxiety; dysfunctional family relationships; and attention seeking or avoidance behaviour. Management in all but five cases involved assessment and follow up by a child psychologist or child psychiatrist. The outcome was encouraging, with 66% of patients becoming PNES free. A further 23% have > 50% reduction in the frequency of PNES. Only two have had no reduction. Outcome was best in the group without epilepsy. CONCLUSION: These results suggest that the prognosis of PNES is better in children than in adults, perhaps because causes are more likely to be external to the child, more easily identified, and more amenable to prompt intervention. The importance of good assessment, good communication, and a treatment plan that includes both symptom management and addressing the precipitating and perpetuating factors is emphasised.

Adolescent↗
PubMed2000

Development of the Handicap Assessment and Resource Tool (HART).

An important determinant of whether people can live in community settings is the absence of significant handicap. People with considerable disabilities can live without handicap if they have adequate supports. Handicap, rather than disability, limits peoples' residence options. Disability assessment tools are commonly used to guide where people can live--these assess neither the resources available nor the personal-care handicap present. The Handicap Assessment and Resource Tool (HART) was designed to provide information about the personal-care issues (clothing, hygiene, nutrition, mobility, safety, residence and supports) relevant to choice of residence. The HART was tested by occupational therapists who are frequently expected to provide recommendations regarding disabled clients' residence options. It is a client-centred tool that addresses key occupational performance components of personal care. Pilot testing in hospital and community settings shows the HART is a comprehensive and practical tool that is acceptable to users and clients.

Activities of Daily Living↗
PubMed2000

Parotid nodular fasciitis in a mobile phone user.

We describe the first case of nodular fasciitis affecting the deep lobe of the parotid gland in a 39-year-old male telephone engineer and its possible association with the high usage of mobile phones.

Adult↗