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Biomedical subjects

R Harrington

Publications and source records attributed to R Harrington.

At least 37 records · Page 2Linked to original sources
PubMed2001

The Maudsley long-term follow-up of child and adolescent depression. 1. Psychiatric outcomes in adulthood.

BACKGROUND: Strong links exist between juvenile and adult depression but comorbid conduct disorder in childhood may mitigate this continuity. AIMS: To test the impact of comorbid conduct disorder on psychiatric adult outcomes. METHOD: A group of 149 subjects assessed at the Maudsley Hospital in the period 1970-1983 and meeting DSM-IV criteria for major depressive disorder with (n=53) or without (n=96) conduct disorder were interviewed 20 years later. Data were collected on the lifetime history of psychiatric disorders. RESULTS: Adult depressive recurrence was high for major depression (62.4%) and any depression (75.2%), and survival analyses showed no difference between the two groups. The group with conduct disorders had higher rates of drug misuse and dependence, alcoholism and antisocial personality disorders. CONCLUSIONS: Adolescent depression carries an elevated risk of adult depression irrespective of comorbidity. Comorbid conduct disorder in childhood is associated with raised rates of other psychiatric outcomes.

Adolescent↗
PubMed2001

The Maudsley long-term follow-up of child and adolescent depression. 2. Suicidality, criminality and social dysfunction in adulthood.

BACKGROUND: Strong links exist between juvenile and adult depression, but comorbid conduct disorder may be associated with worse adult social difficulties. AIMS: To test the impact of comorbid conduct disorder on social adjustment and dysfunction, suicidality and criminality of adults who had had depression as youths. METHOD: Subjects (n=149) assessed at the Maudsley Hospital in 1970-1983 and meeting DSM-IV criteria for major depressive disorder with (CD-MDD; n=53) or without (MDD; n=96) conduct disorder were interviewed 20 years later. Data were collected on lifetime psychiatric disorders and adult social/personality functioning. Death certificates and criminal records were obtained. RESULTS: The suicide risk was 2.45%, and 44.3% of the sample had attempted suicide once in their lives. Compared with the MDD group, the CD-MDD group had higher rates of suicidal behaviours and criminal offences, and exhibited more pervasive social dysfunction. CONCLUSIONS: Adolescent depression is associated with raised risks of adult suicidality and with persistent interpersonal difficulties. Youths with CD-MDD show more severe and pervasive social dysfunction.

Adolescent↗
PubMed2001

Examining the comorbidity of ADHD-related behaviours and conduct problems using a twin study design.

BACKGROUND: Although attention-deficit hyperactivity disorder (ADHD) and conduct disorder (CD) frequently co-occur, the underlying mechanisms for this comorbidity are not well understood. AIMS: To examine whether ADHD and conduct problems share common risk factors and whether ADHD+CD is a more heritable variant of ADHD. METHOD: Questionnaires were sent to 2846 families. Parent-rated data were obtained for 2082 twin pairs and analysed using bivariate genetic analysis and a liability threshold model approach. RESULTS: The overlap of ADHD and conduct problems was explained by common genetic and non-shared environmental factors influencing both categories. Nevertheless, the two categories appeared to be partly distinct in that additional environmental factors influenced conduct problems. It appeared that ADHD+CD was a genetically more severe variant of ADHD. CONCLUSIONS: Conduct problems and ADHD share a common genetic aetiology; ADHD+CD appears to be a more severe subtype in terms of genetic loading as well as clinical severity.

Adolescent↗
PubMed2001

Feeding behaviour of the aphid Rhopalosiphum padi (Hemiptera: Aphididae) on nitrogen and water-stressed barley (Hordeum vulgare) seedlings.

Electrical penetration graphs (EPGs) were used to examine the probing behaviour of adult apterous Rhopalosiphum padi (Linnaeus) on barley seedlings grown under conditions of nitrogen or water stress. Aphids took significantly longer to reach and ingest from sieve elements of nitrogen-deficient seedlings than from nitrogen-sufficient seedlings but there were no such differences between water-stressed or well-watered seedlings. On both nitrogen and water-stressed seedlings the average length of each individual period of salivation into the sieve element was significantly greater compared with their respective unstressed controls.

Animals↗
PubMed2000

Randomised comparison of the effectiveness and costs of community and hospital based mental health services for children with behavioural disorders.

OBJECTIVE: To test the hypothesis that a community based intervention by secondary child and adolescent mental health services would be significantly more effective and less costly than a hospital based intervention. DESIGN: Open study with two randomised parallel groups. SETTING: Two health districts in the north of England. PARTICIPANTS: Parents of 3 to 10 year old children with behavioural disorder who had been referred to child and adolescent mental health services. INTERVENTION: Parental education groups. MAIN OUTCOME MEASURES: Parents' and teachers' reports of the child's behaviour, parental depression, parental criticism of the child, impact of the child's behaviour on the family. RESULTS: 141 subjects were randomised to community (n=72) or hospital (n=69) treatment. Primary outcome data were obtained on 115 (82%) cases a year later. Intention to treat analyses showed no significant differences between the community and hospital based groups on any of the outcome measures, or on costs. Parental depression was common and predicted the child's outcome. CONCLUSIONS: Location of child mental health services may be less important than the range of services that they provide, which should include effective treatment for parents' mental health problems.

Child↗
PubMed2000

Deliberate self-poisoning in adolescence: why does a brief family intervention work in some cases and not others?

In a randomized trial of a brief family intervention with adolescents who had deliberately poisoned themselves, we have previously reported that, within the group of patients who did not have major depression, the family intervention was significantly superior to routine care in reducing suicidal thinking. The present paper examined whether efficacy was related to changes in family functioning or other possible mediating variables. Potential mediators included family functioning, hopelessness, depression, adolescent problem-solving and compliance with treatment. The efficacy of the family intervention in reducing suicidal ideation within the non-depressed sub-group was probably not mediated by changes in these variables. The implications of this finding are discussed.

Adolescent↗
PubMed2000

Direct detection of infectious HIV-1 in blood using a centrifugation-indicator cell assay.

Plasma HIV RNA is a useful surrogate marker for predicting HIV-1 disease progression in infected individuals but provides no information regarding the infectious viral titer. Traditional assays of infectious HIV-1 are, however, time consuming, insensitive, use non-standardized reagents and are subject to selection bias introduced by prolonged cultivation. In this pilot study infectious HIV-1 was detected directly in patient plasma using the indicator line HeLa-CD4-CCR5-LTR/beta-gal in a centrifugation-culture method. Replication competent HIV-1 was identified within 2 days of tissue culture inoculation in six (26%) of 23 plasma specimens. The capability of a new cell line, MT4-CCR5-tat, to amplify plasma HIV-1 was also tested. HIV was cultivated from ten (71%) of 14 specimens using MT4-CCR5-tat cells before titering the virus with the indicator cell assay. Using these stable cell lines in refined versions of this assay it may be feasible to develop rapid, simple methods for titering infectious plasma HIV-1 and for testing the susceptibility of the virus to antiretroviral drugs.

Blood↗
PubMed2000

Global networking for assessment of impacts of global change on plant pests.

Global change encompasses changes in atmospheric composition, climate and climate variability, and land cover and land use. The occurrence of these changes and their interactive effects on biological systems are worldwide; thus, an effective global change research and impact assessment program must be based on international and interdisciplinary research and communication. With this in mind, several collaborative research networks with a focus on global change have been established in the biological sciences. They include the Global Change and Terrestrial Ecosystems (GCTE) Core Project of the International Geosphere-Biosphere Programme (IGBP) which aims to predict the effects of global change on terrestrial ecosystems, including agriculture and production forestry. Because of the importance of plant pests (arthropods, microbial pathogens, weeds) as yield-reducing factors in agriculture and as early indicators of global change, GCTE initiated a network Activity on "Global Change Impacts on Pests, Diseases and Weeds" with the overall goal of developing a predictive capability for impact assessment and adaptation. The network's specific objectives, contributing research projects, initial results and future challenges are discussed.

Journal Article↗
PubMed2000

A family-based and case-control association study of the dopamine D4 receptor gene and dopamine transporter gene in attention deficit hyperactivity disorder.

Attention deficit hyperactivity disorder (ADHD) is a highly heritable psychiatric condition of early childhood onset characterised by marked inattention, hyperactivity and impulsiveness. Molecular genetic investigations of ADHD have found positive associations with the 480-bp allele of a VNTR situated in the 3' untranslated region of DAT1 and allele 7 of a VNTR in exon 3 of DRD4. A number of independent studies have attempted to replicate these findings but the results have been inconsistent. We used both family-based and case control approaches to examine these polymorphisms in a sample of 137 children diagnosed with ICD-10, DSM-IV or DSM-III-R ADHD. We found no evidence of association with the DAT1 polymorphism, despite a sample size that has up to 80% power to detect a previously reported effect size. We observed a significant increase in the DRD4 7 repeat allele amongst ADHD probands (21.7%) and their parents (18.9% in mothers, 22.3% in fathers), compared to ethnically matched controls (12.8%). However TDT analysis showed no preferential transmission of allele 7 to ADHD probands.

Adult↗
PubMed2000

Design of the blockade of the glycoprotein IIb/IIIa receptor to avoid vascular occlusion (BRAVO) trial.

BACKGROUND: Platelets play a key role in the pathogenesis of atherosclerosis, thrombosis, and acute coronary and cerebrovascular syndromes. Inhibition of platelet function by acetylsalicylic acid (aspirin) has been shown to reduce the incidence atherothrombotic events in patients with coronary, cerebrovascular, or peripheral vascular disease. Thienopyridine agents, however, including ticlopidine and clopidogrel, inhibit the adenosine diphosphate receptor and have modestly superior effects compared with aspirin on reduction of death, myocardial infarction, and stroke among a broad group of patients with vascular disease. More effective antithrombotic agents are still required to treat patients at high risk for recurrent vascular events. METHODS: Lotrafiban, a selective, nonpeptide antagonist of the human platelet fibrinogen receptor (glycoprotein [GP] IIb/IIIa [alphaIIb/beta3 integrin]), blocks the binding of fibrinogen to the GP IIb/IIIa receptor, which is the final common pathway of platelet aggregation. Lotrafiban at doses of up to 50 mg twice daily was well-tolerated in a 12-week, double-blind, placebo-controlled, dose-ranging study in patients with recent myocardial infarction, unstable angina, transient ischemic attack, or stroke when added to aspirin therapy. On the basis of these results, a dosing regimen was selected for the phase III Blockage of the Glycoprotein IIb/IIIa Receptor to Avoid Vascular Occlusion (BRAVO) trial based on pharmacodynamics and drug tolerability. In the pivotal BRAVO study, lotrafiban therapy is being evaluated in patients who have had a recent myocardial infarction, unstable angina, transient ischemic attack, or ischemic stroke, or who present at any time after a diagnosis of peripheral vascular disease combined with either cardiovascular or cerebrovascular disease. RESULTS: The efficacy evaluation will be based on a composite end point of clinical events (death by any cause, myocardial infarction, stroke, recurrent ischemia requiring hospitalization, or urgent ischemia-driven revascularization). The target enrollment is 9200 patients worldwide. Approximately 700 centers will participate and will be distributed within 30 countries across North America, Europe, Australia, and Asia.

Administration, Oral↗
PubMed2000

Does the definition of ADHD affect heritability?

OBJECTIVE: A twin study design was used to examine the genetic validity of attention-deficit hyperactivity disorder (ADHD)-related phenotypes. METHOD: Questionnaires covering ADHD symptoms were sent to the families of 2,846 school-age twins. Parent-rated symptoms were obtained for 2,082 twin pairs and teacher-rated symptoms were available for 1,470 twin pairs. RESULTS: Broadly defined parent-rated, teacher-rated, and "pervasive" (both parent- and teacher-rated) ADHD categories were found to be highly heritable. Significant shared environmental effects were also detected for teacher-rated ADHD. A common genetic factor was found to have a modest influence on both parent- and teacher-rated symptom scores and categories, but additional genetic and environmental influences were also found forteacher-rated ADHD. Consistent with previous findings, ADHD symptom scores were again found to be highly heritable. Maternal contrast effects were found for the Rutter A scale items but could not be detected for the DuPaul ADHD rating scale. CONCLUSIONS: Broadly defined pervasive ADHD appears to be as heritable as ADHD behaviors defined by maternal reports alone. A common genetic factor influences maternally rated and teacher-rated ADHD but does not account for all of the genetic variance for teacher-rated ADHD. ADHD symptom scores are highly heritable, and maternal contrast effects appear to vary for different measures.

Adolescent↗
PubMed2000

Developing child mental health services in developing countries.

There is an urgent need to pay attention to the mental health of children in developing countries. Professionals confronted with this task face a number of challenges. Services have to be planned in a rational way, keeping in mind the needs of local populations. These needs will often exceed the available resources, and it will be necessary to set priorities. Feasible and cost-effective models of service delivery then have to be developed to meet these needs. This annotation provides a framework within which mental health needs of children can be assessed, priorities established, and services organised. This is illustrated with examples of relevant activities undertaken in low-income developing countries over the last two decades.

Child↗
PubMed2000

Safety testing of needle free, jet injection devices to detect contamination with blood and other tissue fluids.

Needle free jet injection guns have been used extensively in both veterinary and human health to deliver both vaccine and drugs, but in recent years, concerns have mounted for their potential to transmit blood borne disease agents among consecutive vaccinates. A Ped-O-Jet type jet injection device was used to deliver serial subcutaneous injections of 0.5 mL saline (as a surrogate for vaccine) into calves and pigs, with intervening ejectates collected in vials to represent what the next vaccinate would have received. An enzyme linked immunosorbant assay was developed to detect species specific albumin as a marker for blood, using calibration standards from known dilutions of bovine or porcine blood. Assay sensitivity of 20 pL/mL corresponded to the estimated minimal chimpanzee infectious dose of 10 pL for hepatitis B virus. The methodology and available results for evaluating the safety of jet injector devices are reported.

Animals↗
PubMed2000

Complementary approaches to the assessment of personality disorder. The Personality Assessment Schedule and Adult Personality Functioning Assessment compared.

BACKGROUND: Current concepts and measures of personality disorder are in many respects unsatisfactory. AIMS: To establish agreement between two contrasting measures of personality disorder, and to compare subject-informant agreement on each. To examine the extent to which trait abnormality can be separated from interpersonal and social role dysfunction. METHOD: Fifty-six subjects and their closest informants were interviewed and rated independently. Personality functioning was assessed using a modified Personality Assessment Schedule (M-PAS), and the Adult Personality Functioning Assessment (APFA). RESULTS: Subject-informant agreement on the M-PAS was moderately good, and agreement between the M-PAS and the APFA, across and within subjects and informants, was comparable to that for the M-PAS. This was equally the case when M-PAS trait plus impairment scores and trait abnormality scores were used. CONCLUSIONS: The M-PAS and the APFA are probably assessing similar constructs. Trait abnormalities occur predominantly in an interpersonal context and could be assessed within that context.

Adult↗
PubMed1999

Climate change and trophic interactions.

With confirmation of anthropogenically induced climate change, the spotlight is on biologists to predict and detect effects on populations. The complexity of interactions within and between the biotic and abiotic components involved makes this a tough challenge, and most studies have consequently considered effects of only single climate variables on single species. However, some have gone further, and recently published long-term datasets now offer opportunities that complement new experimental approaches that span trophic levels. With these datasets, predicting relative shifts in temporal and spatial associations could be among the most tractable problems.

Journal Article↗
PubMed1999

Reliability of the Salford Needs Assessment Schedule for Adolescents.

BACKGROUND: For adolescents, there is no specific needs assessment instrument that assesses significant problems that can benefit from specified interventions. A new instrument (S.NASA) was developed by incorporating and adapting three well established adult needs assessment instruments. The S.NASA covers 21 areas of functioning including social, psychiatric, educational and life skills. METHOD: Client and carer interviews were conducted by different researchers. A week later the interviews were repeated using a crossover design. Significant (cardinal) problems were generated from the clinical interviews using a pre-defined algorithm. Final need status (three categories) was made by clinicians assessing the cardinal problems against defined interventions. The interventions were generated from discussions with clinicians and a survey of appropriate professionals working with adolescents. RESULTS. Pre-piloting led to the final version being administered to 40 adolescents from secure units, forensic psychiatric and adolescent psychiatric services. There were 25 males and 15 females, mean age 15.5 years. Overall there were moderate to good inter-rater and test-retest reliability coefficients, the test-retest reliability coefficients for the total scores on the needs assessment interviews ranged from 0.73 to 0.85. Consensual and face validity was good, the adolescents and staff finding the instrument useful and helpful. CONCLUSIONS: This new needs assessment instrument shows acceptable psychometric properties. It should be of use in research projects assessing the needs and the provision of services for adolescents with complex and chronic problems.

Adolescent↗