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Biomedical subjects

R Cunningham

Publications and source records attributed to R Cunningham.

At least 37 records · Page 2Linked to original sources
PubMed1998

Isolation of Campylobacter jejuni from groundwater.

A pollution event which occurred at a spring in the Arnside area of Cumbria provided an opportunity to investigate whether Campylobacter jejuni could be detected in groundwater. Hydrological evidence suggested that the source of contamination was a dairy farm situated within the hydrological catchment of the polluted spring. The microbiological quality of the polluted spring was monitored during intervals over the following 12 months and compared with others in the area. Campylobacter jejuni was isolated by filter enrichment of 500 ml and 100 ml filtered volumes of groundwater. It was not isolated in the absence of faecal indicator species. Some strains of Camp. jejuni from water had identical biotypes to strains isolated from the dairy herd. This paper reports the first isolation of Camp. jejuni from groundwater using cultural methods and supports the theory that groundwater may be a vehicle for Campylobacter transmission.

Animals↗
PubMed1998

Routine antenatal screening for hepatitis B using pooled sera: validation and review of 10 years experience.

AIMS: To validate the sensitivity of universal antenatal screening for hepatitis B surface antigen (HBsAg) by testing pools of 10 sera, and to review 10 years' experience using this method. METHODS: 66,945 antenatal patients were tested between 1986 and 1996 using the pooled method. All sera from 1996 (n = 6050) were retrieved and retrospectively tested individually. An in vitro determination of the effect of pooling on sensitivity was performed by checkerboard neutralisation assay. RESULTS: 26 HBsAg positive women were detected by universal screening over 10 years; 12 had non-European surnames and five had known risk factors for hepatitis B infection. High titre anti-HBs sera in the pool reduced the sensitivity of the HBsAg assay, though the effect was only significant at low levels of HBsAg carriage. CONCLUSIONS: The prevalence of hepatitis B is extremely low in the antenatal population served by Plymouth PHL. Pooling is unlikely to reduce sensitivity enough to lead to significant preventable vertical transmission, and is a cost-effective and valid strategy in areas of low seroprevalence.

Blood Specimen Collection↗
PubMed1998

Counselling someone with severe aphasia: and explorative case study.

PURPOSE: To explore a counselling approach for a client, H.N., with a severe aphasia. METHOD: The principles of Personal Construct Therapy were used. Therapy (six sessions) was started and finished by H.N. producing a repertory grid. Sessions were patient-led but the information from the repertory grids was used to help facilitate the process. Each session was video taped. RESULTS: Analysis of therapy sessions revealed H.N. was following a pattern, if erratic. He used good conversational strategies to control the less structured sessions. The therapist was dominant when the repertory grids were produced. Statistical analysis of the repertory grids was mainly nonsignificant but there was a shift for the final grid to a greater variety of and more positive responses. General improvement in comprehension was also noted. CONCLUSION: A 'counselling' approach with someone with severe aphasia is possible. Using a repertory grid was a useful tool for understanding H.N. better. It seemed to initiate H.N. to discuss things of importance. The changes seen in him could have been due to an improvement in confidence as a communicator. This study has implications for how we can enable people with limited language to adapt to their situations.

Adaptation, Psychological↗
PubMed1997

Prospective case-control study of role of infection in patients who reconsult after initial antibiotic treatment for lower respiratory tract infection in primary care.

OBJECTIVE: To assess direct and indirect evidence of active infection which may benefit from further antibiotics in adults who reconsult within 4 weeks of initial antibiotic management of acute lower respiratory tract infection in primary care. DESIGN: Observational study with a nested case-control group. SETTING: Two suburban general practices in Arnold, Nottingham, over 7 winter months. SUBJECTS: 367 adults aged 16 years and over fulfilling a definition of lower respiratory tract infection and treated with antibiotics. 74 (20%) patients who reconsulted within 4 weeks for the same symptoms and 82 "control" patients who did not were investigated in detail at fallow up. MAIN OUTCOME MEASURES: Direct and indirect evidence of active infection at the time of the reconsultation or the follow up visit with the research nurse for the controls. Investigations performed included sputum culture, pneumococcal antigen detection, serial serology for viral and atypical pathogens and C reactive protein, throat swabs for detecting viral and atypical pathogens by culture and polymerase chain reaction, and chest radiographs. RESULTS: Demographic and clinical features of the groups were similar. Two thirds of the 74 patients who reconsulted received another antibiotic because the general practitioner suspected continuing infection. Any evidence of infection warranting antibiotic treatment was uncommon at reconsultation. The findings for the two groups were similar for the occurrence of identified pathogens; chest x ray changes of infection (present in 13%); and C reactive protein concentrations, which had nearly all fallen towards normal. Only three patients in the reconsultation group had concentrations > or = 40 mg/l. Pathogens identified at follow up in the 156 patients in both groups included ampicillin sensitive bacteria in six. Atypical infections diagnosed in 27 (Chlamydia pneumoniae in 22) and viral infections in 54 had probably been present at the initial presentation. CONCLUSION: Our study suggests that active infection, which may benefit from further antibiotics, is uncommon in patients who reconsult after a lower respiratory tract infection, and a repeat antibiotic prescription should be the exception rather than the rule. Other factors, such as patients' perception of their illness, may be more important than disease and infection in their decision to reconsult.

Adolescent↗