Search PubMed⌕ Search

Biomedical subjects

R Irons

Publications and source records attributed to R Irons.

9 recordsLinked to original sources
PubMed2001

Will alternative immediate care services reduce demands for non-urgent treatment at accident and emergency?

OBJECTIVES: To estimate the potential of general practice, minor injury units, walk in centres and NHS Direct to reduce non-urgent demands on accident and emergency (A&E) departments taking into account the patient's reasons for attending A&E. METHODS: A questionnaire survey and notes review of 267 adults presenting to the A&E department of a large teaching hospital in Sheffield, England, triaged to the two lowest priority treatment streams, was conducted over seven weeks. Using defined criteria, patients were classified by the suitability of the presenting health problem to be managed by alternative immediate care services or only by A&E, and also by the likelihood, in similar circumstances, of patients presenting to other services given their reasons for seeking A&E care. RESULTS: Full data were obtained for 96% of participants (255 of 267). Using objective criteria, it is estimated that 55% (95% CI 50%, 62%) of the health problems presented by a non-urgent population attending A&E are suitable for treatment in either general practice, or a minor injury unit, or a walk in centre or by self care after advice from NHS Direct. However, in almost one quarter (24%) of low priority patients who self referred, A&E was not the first contact with the health services for the presenting health problem. The reason for attending A&E cited most frequently by the patients was a belief that radiography was necessary. The reason given least often was seeking advice from a nurse practitioner. Taking into account the objective suitability of the health problem to be treated elsewhere, and the reasons for attending A&E given by the patients, it is estimated that, with similar health problems, as few as 7% (95% CI 3%, 10%) of the non-urgent A&E population may be expected to present to providers other than A&E in the future. CONCLUSIONS: The increasing availability of alternative services offering first contact care for non-urgent health problems, is likely to have little impact on the demand for A&E services.

Adult↗
PubMed1994

Space exploration and toxicology: a new frontier.

Results of the microbial and immunological studies discussed above clearly illustrate an in-flight or post-flight blunting of the cellular immune mechanism in humans and test animals, coincident with a relative increase in pathogenic microorganisms. This situation predicts an increased incidence of in-flight infectious disease events. To prevent this from occurring, most observers agree that a robust program of preflight and in-flight immunological and microbiological monitoring, combined with an effective countermeasures program, are required for optimally successful long-duration spaceflight.

Animals↗
PubMed1984

Immunosuppression following 7,12-dimethylbenz[a]anthracene exposure in B6C3F1 mice. I. Effects on humoral immunity and host resistance.

It has previously been demonstrated that the polycyclic aromatic hydrocarbon (PAH), benzo(a)pyrene (B[a]P), suppresses the terminal step in B-cell differentiation, resulting in a decrease in antibody production to T-dependent and B-2 T-independent antigens. The purpose of this study was to ascertain if this effect was common to carcinogenic PAHs or specific for B[a]P. The PAH 7,12-dimethylbenz[a]anthracene (DMBA) was administered to B6C3F1 female mice by ten sc injections of 0.5, 5, or 10 micrograms/g over a 2-week period (i.e., total dose of 5, 50, and 100 micrograms/g). Immune function and host resistance assays were performed 3 to 5 days following the last injection. The 10 micrograms/g dosage resulted in a marked decrease in spleen weights and spleen and bone marrow cellularity, while thymus and body weights were not significantly altered. The ability to generate B-lymphocyte colonies in vitro from spleen precursor cells was also suppressed at the 10 micrograms/g dose. Exposure to DMBA at 5 micrograms/g or greater resulted in a reduction of up to 97% in the number of IgM plaque-forming cells in response to the T-dependent antigen sheep red blood cells (SRBC). The IgG response to SRBC was similarly depressed. The IgM response to the hapten-conjugated T-independent antigens trinitrophenyl-lipopolysaccharide (TNP-LPS) (specific for B-1 cells) and trinitrophenyl (TNP)-Ficoll (specific for B-2 cells) was also depressed (88 and 97%, respectively) at 10 micrograms/g. DMBA exposure resulted in an increased susceptibility to challenge with the PYB6 transplantable sarcoma and the bacterium Listeria monocytogenes, in contrast to B[a]P exposure, which had no effect on host resistance assays. Thus, DMBA, a more potent carcinogen than B[a]P, produces a more extensive B-cell suppression than B[a]P as well as alters host resistance to tumor and bacterial challenge.

9,10-Dimethyl-1,2-benzanthracene↗
PubMedDate not supplied

When is domestic violence a hidden face of addiction?

This article reviews studies that address the comorbidity of domestic violence, addictive disorders, and sexual abuse, and presents a model in which domestic violence parallels the chief features of chemical dependency. Domestic violence and addictive disorders share a number of behavioral features, including loss of control, continuation of behavior despite adverse consequences, preoccupation or obsession, development of tolerance, and family involvement. Domestic violence predisposes the next generation to both domestic violence and addictive disorders. Sexual abuse within the family of origin and/or the couple relationship is a common feature of both domestic violence and substance addiction, and predisposes to both disorders in the next generation. Clinicians encountering patients who are perpetrators or victims of domestic violence or sexual trauma, or have addictive disorders, must assess for the presence of comorbid problems.

Adult↗