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Biomedical subjects

P Wright

Publications and source records attributed to P Wright.

At least 73 records · Page 4Linked to original sources
PubMed1999

A rationalised virological electron microscope specimen testing policy. PHLS North West Viral Gastroenteritis and Electron Microscopy Subcommittee.

The aim of this project was to produce guidance for a rationalised virological electron microscopy specimen testing policy for PHLS North West, to facilitate centralisation of a groupwide diagnostic electron microscopy service on a single site. Careful specimen selection to limit numbers and the groupwide use of commercially available enzyme immunoassays has allowed PHLS North West to reduce the number of specimens prepared for electron microscopy. The rationalised virological electron microscopy specimen testing policy has enabled a diagnostic electron microscopy service to be provided from a single site with a manageable workload. Implementation of this specimen testing policy by PHLS North West has been successful and may be applicable to other laboratories (or groups of laboratories) to maximise the use of expensive electron microscopy facilities.

Aged↗
PubMed1999

Effect of a physiotherapist-led training programme on attitudes of nurses caring for patients after stroke.

BACKGROUND: A multidisciplinary project team developed a five-month physiotherapist-led training programme designed to enhance nurses' rehabilitation skills. AIMS: Investigation of the effects of the training programme on nurses attitudes to patients with stroke. METHOD: An attitude questionnaire was completed by the participating nurses before and after the training programme. In a complementary qualitative evaluation the nurses' expectations and views of the training programme were explored. RESULTS: Analysis of the attitude questionnaire indicated that the programme was successful in positively influencing the nurses' attitudes (median of the change in score 2, p = 0.005). The qualitative interviews reflected a similar outcome. CONCLUSIONS: Quantitative and qualitative evaluation indicates that the training programme had some effect in changing nurses' attitudes to treating patients after a stroke. Such a training programme could be a useful contribution to post-stroke care.

Attitude of Health Personnel↗
PubMed1999

Collaboration between community nurses and nursing faculty using substance abuse prevention focus groups.

Collaboration between community nurses and nurses from a university who conducted focus groups is discussed. The focus groups explored why low-income, inner-city, white women of childbearing age did not abuse drugs. This partnership effort resulted in positive, successful outcomes for both groups of nurses and yielded culturally sensitive information that may be useful in preventing substance abuse. Methods of facilitating this collaboration and results of our joint endeavors are explored.

Adult↗
PubMed1998

Opportunities for and challenges of computerisation.

Information technology offers many potential advantages over paper for the storage and retrieval of patients' data. Enthusiasts predict that soon all records will be stored and viewed on computer, but others are more sceptical. The failure of some computer-based records may be due to poor information design. This paper explores how computers broaden the range of design options but points out that more attention to design is required for computer-based than for paper-based records.

Attitude to Computers↗
PubMed1998

How to limit clinical errors in interpretation of data.

We all assume that we can understand and correctly interpret what we read. However, interpretation is a collection of subtle processes that are easily influenced by poor presentation or wording of information. This article examines how evidence-based principles of information design can be applied to medical records to enhance clinical understanding and accuracy in interpretation of the detailed data that they contain.

Attention↗
PubMed1998

Helping clinicians to find data and avoid delays.

One major criticism of paper medical records is the time and effort required to find data items or to gain an overview. Computerisation does not necessarily help. To help clinicians find data faster and with less effort, everyone designing and writing in records needs to understand how and why we search records and the design features that make searching easier. This paper describes how clinicians search medical records and how to improve record design, whether on paper or computer, to help clinicians find all the data they need without delay.

Documentation↗
PubMed1998

Design should help use of patients' data.

Checklists and other tools help doctors to use published evidence in clinical practice. Two other important sources of evidence, however, are the patient and his or her medical record. This series aims to advance the practice of evidence-based medicine by helping in redesign of medical records, drawing on insights from psychology, information design, and medical informatics; and by promoting changes analogous to those occurring in the medical literature. The four papers look at: the uses of medical records and importance of organising them so doctors can use the data they contain; different methods doctors use to search for data and how design of records can help or hinder these approaches; how we interpret data once found, and how record formatting assists this process; and the issues raised by computerisation of records.

Evidence-Based Medicine↗
PubMed1998

A transmission/disequilibrium study of the DRB1*04 gene locus on chromosome 6p21.3 with schizophrenia.

Patients with schizophrenia rarely develop rheumatoid arthritis, an autoimmune disease that exhibits genetic association with the HLA DRB1*04 gene. We previously investigated the hypothesis that schizophrenia is negatively associated with DRB1*04, and found that only half the expected number of schizophrenic patients had this gene when compared with controls. We now report the results of DRB1*04 genotyping in pedigrees multiply affected with schizophrenia. Polymerase chain reaction amplification and sequence-specific oligonucleotide probes were used to determine the DRB1 genotypes of the 187 members of 23 pedigrees multiply affected with RDC schizophrenia. DQA1, DQB1 and DPB1 genotypes were similarly determined. We analysed data using the extended transmission/disequilibrium test and found a trend for the preferential non-transmission of DRB1*04 alleles from heterozygous parents to their schizophrenic offspring (16 of 23 alleles not transmitted, chi 2 = 3.5, p = 0.06). We found no evidence for a gene of major effect using GENEHUNTER for parametric and non-parametric linkage analysis. The results from this small sample need to be interpreted with caution, but they are in keeping with previous reports and suggest that HLA DRB1*04 alleles may be associated with a reduced risk of schizophrenia.

Alleles↗
PubMed1998

Study of the effect of gamma-irradiation on bovine serum samples on the ability of monoclonal antibodies to detect invariant antigens of Trypanosoma congolense, T. vivax and T. brucei in enzyme-linked immunosorbent assays.

Samples of bovine serum from uninfected and African trypanosomes-infected animals were tested before and after gamma-irradiation, using three sandwich enzyme-linked immunosorbent assays (ELISA). Each test system utilized a different monoclonal antibody, reputedly allowing the specific detection of conserved-invariant cytoplasmic antigens of trypanonosomes, T. congolense, T. vivax, and T. brucei, respectively. Results have identified two groups of samples. The first contained samples where there were unequivocal ELISA results indicating positivity and negativity, for non-irradiated samples. In this group, irradiation had no effect on the diagnostic sensitivity of the assays. All samples shown to be positive before irradiation remained positive and those shown to be negative, remained negative. There was, however, a statistically significant reduction in signal in each of the ELISAs following irradiation. The second group contained samples identified before irradiation as flanking the diagnostic negative/positive threshold of OD > or =0.05. These showed a negative bias after irradiation of the order of OD -0.01, which was shown to be statistically significant by paired t-statistics. Without correction of the given diagnostic negative/positive threshold, bovine sera with OD values around the threshold were expected to deliver more false negative test results upon irradiation. This was confirmed when serological data were compared with parasitological findings; where three times more false negative test results were found from irradiated serum samples. Consequently, for this group of irradiated bovine samples tested by ELISA, the re-adjustment of the diagnostic negative/positive threshold of the ELISAs using defined irradiated serum samples is recommended; otherwise, the frequency of false negative results might be increased.

Africa, Eastern↗
PubMed1998

Effect of density and weight of load on the energy cost of carrying loads by donkeys and ponies.

Two experiments were designed to compare the energy used in carrying loads by donkeys and ponies. In the first experiment 3 donkeys and 3 ponies were compared on treadmills in the UK. Density of load (lead shot or straw) had no significant effect on the energy cost of carrying loads; however, the energy cost of carrying a load decreased significantly (p < 0.001) as the weight of the load increased (in donkeys 6.44, 4.35 and 3.03 J/kg load/m, in ponies 5.82, 3.75 and 3.68 J/kg load/m, for loads of 13, 20 and 27 kg/100 kg liveweight (M) respectively). Differences between species were not significant. In the second experiment energy expenditures were determined in 3 donkeys carrying loads equivalent to 40 kg/100 kg M over gently undulating gravel tracks in Tunisia. Energy costs of carrying the load were 2.34 (SE 0.07) J/kg load/m. The results of both experiments showed that provided the load is balanced, density does not significantly affect the energy cost of carrying; however, as the load increased then the unit energy cost of carrying it decreased. This suggest that it is more efficient in terms of energy used to carry loads equivalent to 27 to 40 kg/100 kg M than it is to carry lighter loads to less than 20 kg/100 kg M.

Animals↗
PubMed1998

Physician knowledge and attitudes towards molecular genetic (DNA) testing of their patients.

OBJECTIVE: To better define the knowledge and attitudes of practicing physicians about genetics; specifically molecular genetics. Further, to examine differences between four practice specialties and to assess variables that affect both knowledge and attitudes. DESIGN: A mail-in survey was sent to a random sample of non-geneticist physicians, with a second copy sent to non-responders. Questions included sociodemographic variables, sources of current knowledge and education in genetics, clinical experience with genetic disease, self-confidence in providing genetic counseling, attitudes towards referring patients to a genetic center, awareness of molecular genetic testing and attitudes towards its use in clinical practice and population screening. SETTING: Responses were obtained from over 900 practicing physicians in the Canadian province of Ontario (population 10 million). Genetic services are provided through nine major and several outreach centers. Molecular diagnostic services are provided through six provincially funded laboratories. There are no direct costs to the patient for any genetic service. PARTICIPANTS: A random sample of family physicians, obstetricians, pediatricians and internists was surveyed from both private and hospital based practices. RESULTS AND CONCLUSION: Responses varied by specialty, years from graduation, gender, and type of practice. Pediatricians and obstetricians were more knowledgeable about genetics, had more interaction with genetic services and were more supportive of their utility. A major proportion of physicians continue to rely upon undergraduate and medical school courses for knowledge, and the specialties showed different preferences for seeking information. A majority of physicians considered their knowledge of genetics to be adequate, but a minority were confident to provide genetic counseling for simple genetic scenarios. Relatively few had actually made use of DNA diagnostic services and there was relatively poor knowledge of what services were available.

Adult↗
PubMed1998

Computer anxiety: a comparison of pen-based personal digital assistants, conventional computer and paper assessment of mood and performance.

The recent growth of pen-based devices, such as the Personal Digital Assistant (PDA), offer mobility and a more natural interface than that of a conventional computer. The feasibility and application of the PDA for mood and cognitive assessment were investigated by examining possible interactions of individual characteristics and administration medium. Previous studies have provided evidence that individual characteristics of 'computer anxiety' and 'private self-consciousness' divergently covaried with mood scores measured by computer and paper methods. To investigate the relationship between individual characteristics and medium effects, 136 paid participants were allocated to and completed mood assessment tasks and a short battery of cognitive tasks by either the computer, PDA or the paper method. Self-ratings of mood measured by these three modalities covaried divergently with measures of computer anxiety and private self-consciousness. In addition, computer anxiety covaried with reaction time on the visual search task obtained on computers, but there was no such relationship when measured by a PDA. These results show that computer anxiety can affect the results of assessments of cognitive function as well as of mood ratings, and suggest that pen-based systems may have advantages over conventional computers in this respect.

Adolescent↗
PubMed1998

Sports related injuries in Scottish adolescents aged 11-15.

OBJECTIVES: To measure the age and sex distribution of self reported sports and leisure injuries in a 12 month retrospective recall period among a representative national sample of Scottish adolescents, and to examine the characteristics (gender, age, handedness, and level of sports participation) of sports related injuries in relation to injuries sustained during other activities. DESIGN/SETTING: Self completion questionnaire survey administered in schools during April-June 1994. SUBJECTS: 4710 pupils aged 11, 13, and 15 years drawn from a representative sample of 270 classes with returns from 224 classes (83% completion rate). RESULTS: 42.1% of the sample reported a medically attended injury. These were significantly more frequent among boys but there were no significant age differences in overall frequency of injury. Sport related injuries accounted for 32.2% of all medically attended injuries. As with all injuries, frequency was greater in boys than girls at all ages, and there are differences in the pattern of lesions in sports and nonsports injuries. Lower limb injuries were more frequent than upper limb injury in sports (57.6 v 23.9%), whereas there were no differences in non-sports injuries (31.5 v 31.3%). Age and handedness differences in sports injury rates were also identified. High sports participation was significantly associated with a higher risk of injury in general and sports related injury in particular. CONCLUSION: Age, gender, handedness, and level of sports participation have been shown to be implicated in differential risk of sports related injury. Reducing sports injury among adolescents should be a priority, but research into the injury profiles of different sports is needed before detailed injury prevention strategies can be developed.

Abbreviated Injury Scale↗
PubMed1998

Measures of injury severity in childhood: a critical overview.

Many different methods for assessing injury severity have appeared in the literature. This paper discusses the commonly used measures, many of which are subjective and depend on clinical practice or sociological factors. Even if apparently objective measures are used their appropriateness for use in children is questionable. Particular problems occur with scoring or categorising events such as poisoning, choking, and near drowning. Researchers need to reach a consensus on injury severity reporting to ensure comparability between studies and programs for injury prevention.

Adult↗
PubMed1998

Neuroendocrine evidence that clozapine's serotonergic antagonism is relevant to its efficacy in treating hallucinations and other positive schizophrenic symptoms.

OBJECTIVE: The authors examined the effect of prolonged clozapine treatment on central serotonergic (5-HT) function in schizophrenia. METHOD: Prolactin responses to the 5-HT releasing agent d-fenfluramine were measured in two groups of 10 schizophrenic subjects. The first group was tested twice, before and after a mean of 10 weeks of clozapine treatment. The second group was tested after a mean of 20 months of clozapine treatment. RESULTS: The prolactin response was significantly blunted in these 20 patients treated with clozapine. There was a significant positive correlation between d-fenfluramine-evoked prolactin release and the overall positive symptom score and the hallucination and delusion subscores of the Scale for the Assessment of Positive Symptoms. CONCLUSIONS: Blunted 5-HT-mediated prolactin responses in schizophrenic patients receiving clozapine monotherapy for up to 20 months were correlated with reductions in positive symptoms. This suggests that 5-HT antagonism is relevant to clozapine's efficacy in alleviating hallucinations and other positive schizophrenic symptoms.

Adult↗
PubMed1998

The preparticipation physical examination and its current status in Oklahoma.

Every year several thousands of preparticipation physical examinations (PPE) are performed for high school athletes. The main goal is to provide health and safety for the high school athletes. A 1997 monograph sets forth recommended guidelines for the PPE. The objective of this paper is to review the monograph and compare it to the current practice within Oklahoma. The form provided by the Oklahoma Secondary School Activities Association lacks proper screening questions, especially for cardiac disease and exercise induced asthma. The recommendations in the monograph provide an excellent foundation from which uniform guidelines can be developed. Oklahoma should strongly consider adopting the monograph's form or updating the current form.

Adolescent↗
PubMed1997

A community outbreak of Vero cytotoxin producing Escherichia coli O157 infection linked to a small farm dairy.

A community outbreak of infection with Vero cytotoxin producing Escherichia coli O157 (VTEC 0157) occurred in a small area of north west England in 1996. An outbreak control team was established to investigate the outbreak and implement control measures. Nine people developed symptomatic infections with VTEC O157, and a further three were found to be excreting the bacteria. All were infected with the same genotype of VTEC O157. Three children under 5 years of age and one adult were admitted to hospital. One child developed haemolytic uraemic syndrome. All cases recovered. All primary cases had consumed milk from a particular farm dairy. No other common foods were identified. The farm dairy had a faulty pasteuriser and the potential for post pasteurisation contamination existed. VTEC O157 was isolated from a milk sock specimen and from two cows, but these strains differed from that infecting the cases. All local doctors and the public were alerted and advised about preventative measures. Distribution of unpasteurised milk from the farm was discontinued as was the sale of pasteurised milk when the faulty pasteuriser was discovered. A replacement pasteuriser was installed and checked before milk was released for human consumption. No conclusive evidence of the origin of this outbreak was found, but the farm was the most probable source. The investigations raised concerns about the distribution of VTEC O157 colonised dairy cattle, the natural history of such colonisation, the effectiveness of pasteurisation with respect to the elimination of VTEC O157, and the effectiveness of current legislation for the prevention and control of milkborne infection.

Adult↗