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Biomedical subjects

M Jones

Publications and source records attributed to M Jones.

At least 361 records · Page 20Linked to original sources

Verb use in specific language impairment.

The aim of the present study was to use longitudinal data to provide a detailed profile of early word combinations by children with SLI. Three children with SLI were videotaped during mother-child interactions in the home over a 2-year period. The data obtained were compared to MLU-matched samples of normal language-learning children from Wells' (1981) longitudinal database, which provided a control for the linguistic measures used in this study. A range of analyses were carried out on controlled data samples in order to determine how the children with SLI's early utterances compared with those of MLU-matched normal language peers. The measures were specifically designed to assess the children's use of verbs and verb morphology because recent research has suggested that verbs may play a central role in the acquisition process, and children with SLI may have particular problems with verbs. We found that children with SLI used verbs less frequently, nouns more frequently, and were more input-dependent than their MLU-matched peers. The children with SLI used verb bare stems incorrectly more often than their MLU-matched counterparts. However, further analyses showed that this high frequency of incorrect bare stems may be at least partly due to the fact that children with SLI have particular difficulties using auxiliaries. Furthermore, the proportion of verb use that consisted of General All Purpose (GAP) verbs for children with SLI was similar to that of the MLU-matched children. The above findings were compared with those from other relevant studies of lexical diversity in children with SLI, and the potential implications of these data for theories of SLI language development were discussed, particularly with reference to Marchman and Bates' (1994) "critical mass" hypothesis.

Child Language↗

Evaluating the impact of in-patient bed reduction and community nurse increases in one English Mental Healthcare Trust.

This Mental Health Task Force funded project was designed to evaluate the impact of organizational changes in Northampton, a traditional English Mental Healthcare Trust. Services in Northampton were typically provided by a large 'watertower' Victorian hospital on the outskirts of the town. The hospital had been, over a period of some years, reducing the use of in-patient beds. In February 1995 a further 10 beds were withdrawn enabling the closure of a complete building and the re-deployment of some staff into the community. By reducing in-patient beds, and increasing the number of community staff it was hoped that there would be a significant effect upon both hospital admissions, length of stay with resultant cost savings, and an increase in community nurse-patient contacts. To establish baselines quantitative data were gathered about pre-existing acute and community services, with comparisons made from qualitative and quantitative data gathered during the initial change period. Information was collected concerning in-patient admissions within the acute services, community psychiatric nurse (CPN) caseloads including new admissions, care delivery costs and interviews with service managers. The project found that changes in the general patient profile could not be attributed solely to the reduction in available beds but there did appear to be a direct correlation between bed reduction, increase in percentage bed occupancy and more demanding CPN caseloads. Concern was expressed about the ability of community staff to meet the needs of an increasingly female (age 20-39 years) user group. Savings to the Trust were estimated at Pounds 300,000 per annum. The paper concludes with recommendations for future changes.

Adult↗

Building a relationship: communications and relationships between staff and stroke patients on a rehabilitation ward.

Communications among staff and patients on a stroke rehabilitation ward form the focus of this article, which reports on some aspects of a larger study using a grounded theory approach. Tape-recorded interviews were transcribed and analysed concurrently according to recommendations for the approach. A main theme entitled building a relationship was identified, and this process was found to occur in a context varying from participative at one end of a continuum to hierarchical at the other. Building a relationship was found to be influenced by role, personal qualities and organizational context. Appropriate relationships between role-holders were subject to negotiation, leading to a resulting congruence or incongruence between participants' expectations of each other and their roles. Personal qualities were brought into play in the process, with patients' views of staff and staff views of patients both being influential. Some of these views seemed to parallel what has been described in earlier literature as 'the sick role' and the labelling of patients as 'good' or 'bad'. Responses to personal qualities led to nurses ascribing meaning to patients' behaviour in terms of adjustment to their stroke, giving time to them to help them to adjust, and withdrawal and handing over to other staff if this strategy failed. Organizational context also had an influence on building a relationship, with time constraints being identified particularly by nurses, and the need to fit in the most essential aspects of care. Place was also important, in that nurses were confined to the ward as a work location, whereas other therapists and doctors worked in other places and sometimes had the facility to take patients off the ward to concentrate on therapy. The findings are discussed against the background of related literature and the conclusion is drawn that the crucial role of nurses in rehabilitation is not recognized and valued, and that shortages of resources-especially suitably qualified and trained nursing staff-are a negative influence on building the relationships which are vital to successful rehabilitation.

Cerebrovascular Disorders↗

Decreased survival in patients with co-existent rheumatoid arthritis and bronchiectasis.

The aim was to compare the 5 yr survival in patients with rheumatoid arthritis (RA) alone, bronchiectasis (Br) alone and RA plus Br (RA-Br). A case-control study was carried out in which 32 patients with RA-Br were matched for age (within 5 yr), sex and (where possible) disease duration with 32 patients with RA alone. An additional comparison group of 31 unselected patients with Br was chosen. All patients were followed for 5 yr. Patients with RA-Br were 7.3 times more likely to die than the general population, 5.0 times more likely than the RA group and 2.4 times more likely than the Br group. An increased risk of death within the RA-Br group was associated with a history of smoking, more severe RA and steroid usage. The co-existence of RA and Br is associated with a poor 5 yr survival.

Adult↗

Psychiatric disorder among American Indian adolescents: prevalence in Northern Plains youth.

UNLABELLED: This article presents data on the prevalence of psychiatric disorders among American Indian adolescents, using DSM-III-R criteria. OBJECTIVE: To generate current prevalence data using a structured diagnostic instrument, the Diagnostic Interview Schedule for Children, Version 2.1C (DISC-2.1C). METHODS: Youths from a Northern Plains tribe who had participated in an earlier study comprised the sample. At reinterview, respondents were between 14 and 16 years of age, when Indian adolescents are thought to be at particularly high risk for manifesting emotional disorders. One hundred nine of the original sample of 251 were still in schools on the reservation. Trained indigenous lay interviewers administered the DISC-2.1C to respondents in a private setting within the school. RESULTS: The findings indicate that rates of some psychiatric problems (e.g., disruptive behavior disorders, substance-related disorders, and their comorbidity) are high among these high school students. CONCLUSIONS: These data, as well as national statistics, suggest that, compared with non-Indian populations, a greater percentage of Northern Plains adolescents manifest significant psychiatric symptoms which warrant treatment.

Adolescent↗

Different Trypanosoma cruzi strains promote neuromyopathic damage mediated by distinct T lymphocyte subsets.

The proliferative response of CD4 and CD8 T lymphocytes obtained from C3H/HeN mice chronically infected with Trypanosoma cruzi strains that differ in virulence, tropism and immunogenicity, was assayed against skeletal muscle, sciatic nerve and spinal cord homogenates. Although both CD4 and CD8 T lymphocytes from mice infected with the RA strain strongly proliferated against the nervous system, no response against skeletal muscle antigens was detected. CD4 and CD8 T lymphocytes from mice infected with the K-98 clone (from CA-I strain) showed low proliferative response against all the antigens assayed. To determine whether the proliferation patterns showed correlation with T cell-mediated neuromuscular damage, passive cell transfer studies were performed. Fifteen days after transfer of CD4 T cells from RA-infected donors (CD4-RA), normal syngeneic recipients displayed exclusively nervous tissue damage, such as perineural, endoneural and/or meningeal inflammatory infiltrates, with predominance of CD4 T cells. Fifteen days after transfer of CD4 T lymphocytes from mice infected with K-98 (CD4-K98), recipients showed inflammatory infiltrates only in skeletal muscle, where CD4 T lymphocytes and macrophages were predominant cells. Recipients of CD8 T cells from RA-infected mice (CD8-RA) showed lesions in both spinal cord and sciatic nerves. Higher percentages of CD8 T cells were observed in comparison with the recipients of CD4-RA or CD4-K98. In contrast, CD8 T cells from K-98-infected donors (CD8-K98) did not induce tissue damage. These results provide evidence that mice infected with T. cruzi populations that differ in their biological characteristics show diverse immune mechanisms that may be involved in the pathogenesis of peripheral nervous system damage.

Adoptive Transfer↗

Clinical responses to ingested fungal alpha-amylase and hemicellulase in persons sensitized to Aspergillus fumigatus?

alpha-Amylase and hemicellulase, derived from culture of Aspergillus species, are commonly added to flour as improvers during baking. Two cases of women occupationally sensitized to alpha-amylase who developed allergic symptoms after eating baked bread have been reported. With a randomized, controlled study design, we have investigated whether similar responses occur in those sensitized to Aspergillus species. Seventeen subjects with positive skin prick tests to Aspergillus fumigatus were studied. Symptomatic and physiologic responses after ingestion of bread baked with alpha-amylase and hemicellulase were compared, in a crossover fashion, with those after ingestion of bread baked without enzymes. No increase in respiratory or other symptoms, lung function, or nonspecific bronchial hyperreactivity was reported after ingestion of the enzyme-containing bread. We conclude that important clinical reactions to alpha-amylase and hemicellulase in baked bread do not frequently occur in those sensitized to Aspergillus species.

Adult↗

Cortisol concentrations in post competition horse urine: a French and British survey.

The purpose of the present report was to estimate the population parameters of cortisol concentrations in urine, an endogenous hormone used as a 'doping' agent and for which an international threshold (1.0 micrograms/ml) has been proposed. Two data bases (French and UK) corresponding to 112 and 142 samples, respectively were considered. Urine was collected under specific post competition conditions. Cortisol concentrations were obtained by validated methods (HPLC for the French samples, and GC-MS for UK samples). No difference was observed between the 2 data sets and statistical analyses were carried out on the two merged files. The overall geometric mean cortisol concentration was 48 ng/ml. Distribution was not Gaussian. A log-normal distribution was not rejected (for P > 0.05). Using the log-normal distribution, it was calculated that the probability of exceeding a cortisol concentration in urine of 1.0 micrograms/ml was 1.1 x 10(-4). It was concluded that the actual international threshold is specific i.e. robust with regard to the risk of erroneously declaring an unmedicated horse as positive.

Animals↗

Circular forms of unintegrated human immunodeficiency virus type 1 DNA and high levels of viral protein expression: association with dementia and multinucleated giant cells in the brains of patients with AIDS.

Thirty-one histologically abnormal brains from patients with AIDS were studied in order to establish the relationship between multinucleated giant cells, viral protein expression, the various forms of human immunodeficiency virus type 1 (HIV-1) DNA, and clinical evidence of dementia. Unintegrated HIV-1 DNA of 2 to 8 kb was found in 22 of the 31 brains. Multinucleated giant cells without any other pathology were found in 14 cases; unintegrated 1-long terminal repeat (1-LTR) circular forms of HIV-1 DNA and strongly positive immunohistochemistry for gp41 and p24 were found in most of these brains. Most of these patients had a clinical diagnosis of HIV-1-associated dementia and cerebral atrophy. In all the other brains studied, 1-LTR circles were absent and immunohistochemistry for gp41 and p24 was usually negative. Very few of these patients had a clinical diagnosis of dementia. Sequence comparison of the LTR region from integrated HIV-1 DNA with that from unintegrated 1-LTR circular forms of HIV-1 DNA in 12 cases showed no significant differences. A further comparison of these brain-derived LTR sequences with LTR sequences derived directly from lymphoid tissue also showed strong sequence conservation. The V3 loop of the virus from the brain was sequenced in 6 cases and had a non-syncytium inducing-macrophage-tropic genotype. Our results show that (i) although unintegrated HIV-1 DNA was present in most brains from patients with AIDS, molecular evidence of high levels of viral replication was associated with the presence of multinucleated giant cells and dementia, and that (ii) the HIV-1 LTR is not a determinant of neurotropism. These observations suggest that replication of HIV-1 and not just the presence of HIV-1 DNA within giant cells makes the important contribution to central nervous system damage.

AIDS Dementia Complex↗

Predictors of health care seeking for irritable bowel syndrome: a population based study.

BACKGROUND: It has been suggested that psychological factors rather than symptoms drive subjects with irritable bowel syndrome (IBS) to seek medical care, but this issue has not been tackled in a population based study. AIM: To identify whether psychological factors or abuse explain health care seeking for IBS. METHODS: A sample of residents of Penrith (a Sydney suburb representative of the Australian population) selected randomly from the electoral rolls (that by law include the entire population > or = 18 years) was mailed a validated self-report questionnaire. Measured were gastrointestinal symptoms including the Manning (and Rome) criteria for IBS, health care seeking, neuroticism (Eysenck Personality Questionnaire), psychological morbidity (General Health Questionnaire: GHQ) and sexual, physical and emotional abuse (including the standardised Drossman questions). RESULTS: Among 730 subjects, 96 (13%, 95% confidence interval (CI) 11-16%) had IBS by the Manning criteria. Of those with IBS, 73% (95% CI 63-81%) had sought medical care for abdominal pain or discomfort. Only increasing pain severity (odds ratio (OR) = 2.10, 95% CI 1.11-3.95) and duration of pain (OR = 1.53, 95% CI 1.10-2.13) were independently associated with seeking health care for IBS. Pain severity was also predictive of recent care seeking (OR = 1.74, 95% CI 1.12-1.96). Neuroticism, psychological morbidity and abuse history were not significant predictors. CONCLUSION: Psychological factors do not seem to explain health care seeking among community subjects with IBS.

Australia↗

SPECT, CT, and MRI in head injury: acute abnormalities followed up at six months.

Neuroimaging with single photon emission computed tomography (SPECT) using the cerebral blood flow tracer 99Tc(m)-HMPAO has been used to study acute functional alterations after head injury and residual abnormalities at six month follow up in 32 patients. Comparison has been made with anatomical abnormalities defined acutely with CT and on follow up with MRI. SPECT showed slightly more abnormalities than CT in the acute phase (49 regions of abnormally low tracer uptake on SPECT and 45 lesions on CT). Twenty two of the acute SPECT abnormalities were in normal regions on CT. At follow up MRI showed more abnormalities than SPECT (30 on SPECT and 48 on MRI). Ten of the SPECT deficits were in regions with normal MRI. Comparison of the intensity of late and early SPECT deficits showed that only four early deficits deteriorated whereas 28 improved. Only five of 27 lesions seen on both acute SPECT and CT resolved compared with 16 of 22 lesions seen on SPECT but not on CT. Regions of abnormally high tracer uptake were detected in the acute stage in five of the patients. No high focal uptake was evident on follow up. Ten patients with a residual SPECT abnormality and eight with residual MRI lesions were graded clinically in the upper band of good recovery.

Adolescent↗

Placebo-controlled biofeedback blood pressure effect in hypertensive humans.

The role of biofeedback in blood pressure control remains ill-defined because of nonspecific (placebo) effects, small study numbers, and the technical limitations of continuous pressure feedback. Clarification of its potential is awaited by those seeking a nonpharmacological approach to blood pressure control. This study examines the capability for systolic pressure lowering of 5 mm Hg or more using continuous pressure feedback in a statistical sample of untreated, well-characterized, mildly hypertensive individuals. Subjects were randomized in a double-blind study to active or placebo biofeedback. Placebo consisted of a modified contingency approach, using a partial disguise based on a digital high pass filter with 15 elements. Blood pressure-lowering capability was assessed during two laboratory sessions. Continuous visual feedback resulted in 11 of 28 subjects on active treatment and 12 of 28 on placebo treatment lowering their systolic pressure by 5 mm Hg or more (11 +/- 5.6 and 12 +/- 8.4 mm Hg, respectively; P = NS). Prestudy pressure was well-matched (153 +/- 9/97 +/- 4 and 154 +/- 8/98 +/- 4 mm Hg, respectively). An initial small difference in diurnal profile did not change. These findings indicate that among mildly hypertensive individuals, almost half can lower systolic pressure at will for short periods. This capability is independent of the real or placebo nature of the feedback signal. We conclude that there is no specific short-term biofeedback pressure-lowering capability in hypertensive individuals. Further exploration is needed to determine whether specific components of the placebo effect can be delineated, whether personality characteristics influence the response, and whether further biofeedback training can alter the outcome.

Adult↗

Decreasing disruptive behavior by adolescent boys in residential care by increasing their positive to negative interactional ratios.

An intervention for disruptive boys in residential care involving increases in positive to negative interactional ratios is described. The target of the intervention was daily problem behavior. Results from a pooled time series analysis of the data revealed a significant decrease in behavior problems (one problem per boy per day) during the intervention for the boys as a group. Results from comparisons of mean behavior problems during baseline and intervention revealed decreases for five of the six boys. Results from a multiple baseline across boys revealed experimental control for three of the six. The results are discussed in terms of response contingent reinforcement and systemic behavior analyses. The benefits of combined group and single subject data analyses are also discussed.

Adolescent↗