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Biomedical subjects

R W Morris

Publications and source records attributed to R W Morris.

At least 145 records · Page 8Linked to original sources
PubMed1987

Measles immunisation: feasibility of a 90% target uptake.

A three part investigation of the factors that might influence uptake of immunisation was carried out in Maidstone Health Authority; this included studies of the computer system and attitudes of parents and professionals. Several problems with immunisation scheduling, information transfer between general practitioners and clinics and the computer centre, and validity of computer information were identified. The attitudes of parents, relatives, and friends were generally favourable, although parents reported a lack of knowledge about the disease and vaccine and lack of advice from professionals. Perceived contraindications to immunisation, particularly a history of measles, were important reasons for non-uptake. Professionals' perceptions of contraindications, however, were at variance with Department of Health and Social Security guidelines and none of the recorded contraindications was valid. Calculations of potential uptake suggest that a 90% target uptake is feasible and recommendations are made for changes in services.

Attitude of Health Personnel↗
PubMed1987

Teeth and benign oesophageal stricture.

In patients undergoing upper gastrointestinal endoscopy, benign oesophageal strictures were significantly more frequent (p less than 0.01) in those with severe tooth loss than in controls of the same age. This may be because of edentulous patients eating less solid and more liquid food, which would otherwise dilate the lower oesophagus, or poor salivary flow leading to both tooth loss and impaired neutralisation of refluxed gastric acid, or malnutrition. No association was found, however, between either oesophagitis or hiatus hernia and dentition.

Adult↗
PubMed1987

Case study of psychophysiological diary: infradian rhythms.

A 4-year case study was made of a 42-year-old white woman as seen through the psychophysiological diary. There was an awakening diary and a bedtime diary composed of 125 variables. The data are divided into two series: series I containing a manic episode, and series II as a control. Spectral analysis shows infradian rhythms in hypoglycemia and fear (11 days) and time to fall asleep (5 days). Depressed feelings showed a circatrigintan (28-day) rhythm, which was not correlated with menses. Mania had an annual rhythm (spring) but no circatrigintan or less rhythm. The following correlations have a P value less than or equal to 0.01: mania was directly correlated with number of sleeping pills, time to really wake up, need for rest, moodiness, and helplessness, and indirectly with expectations, pressure at work, sense of time, and emotional state. Interestingly, awakening pulse is directly correlated with awakening temperature, number of sleeping pills, bedtime pulse, tiredness at bedtime, hypoglycemia, and fear. Bedtime pulse is directly correlated with awakening pulse and awakening temperature. Both pulse and temperature at bedtime are directly correlated with negative variables such as tiredness, moodiness, helplessness, and depression, and inversely correlated with positive variables such as happiness, loving, performance at work, and thinking efficiency. This study demonstrates a significant correlation between physiological variables.

Adult↗
PubMed1987

Circadian and circannual rhythms of emergency room drug-overdose admissions.

All Drug Abuse Warning Network (DAWN) records for 1983 from the University of Illinois Emergency Room were collected: a total of 264 drug-overdose (DOD) admissions. Cosinor, multiple linear regression, cross-tab multivariate, and spectral periodicity statistical analyses were performed on the raw data with particular use made of the BMDP statistical package. More DODs present themselves for admission to the ER around the 1820 hr than any other time of the circadian period. Sex, age, and race have no effect on this circadian relationship. No circatrigintan rhythms were found for any sex, race, or age group. However, there is a circannual rhythm for total DOD admissions with more admissions in late July than any other time of the year. Women, however, appear to exhibit a significantly earlier annual acrophase (late May) than males in early August. There is no evidence for circannual, circadiseptan, circaseptan or circabiseptan rhythms for blacks or hispanics. However, whites, particularly males, show evidence of biweekly (i.e., Monday and Friday) as well as circannual rhythms. Multivariate analyses of circannual rhythms vs. age indicated no significant rhythms for the under-21-year-old but a highly significant circannual rhythm for the over-20-year-old. Therefore, ER personnel should be attentive to the sex, age, and race of their patients in order to gain a degree of predictability as to when the greatest number of patients might present themselves at the ER for treatment of their DOD. Awareness of the temporal effects on DOD admissions can thus improve the quality of ER treatment for DOD patients.

Adult↗
PubMed1987

Validation and application of a liquid-chromatographic/enzymatic assay for individual bile acids in the serum of rats.

A liquid-chromatographic technique with a post-column enzymatic reaction and fluorescence detection was validated for analysis of individual bile acids in the serum of rats. Extraction recoveries averaged 91.1% (SD 6.9%) for all bile acids. The assay was sensitive (minimum detection of 16.8 pmol per 100-microL injection), linear (r greater than 0.999 for concentrations ranging between 45 and 112,500 pmol per 100-microL injection), and reproducible (mean CVs for three different concentrations of standards and a serum pool ranged from 4.4% to 12.2%). In rats treated for three days with either neomycin, carbon tetrachloride, alpha-naphthylisothiocyanate, or total bile-duct ligation (five animals per group), total concentrations of bile acids were significantly increased (P less than 0.004). Concentrations of 16 of 17 individual bile acids differed significantly between groups (P less than 0.04). Examination of the relative concentrations (percent of total) of individual bile acids by canonical discriminant analysis placed each animal into the appropriate treatment or control group. Use of this technique in toxicological studies can help detect and identify specific types of disruptions in the enterohepatic circulation of bile acids.

1-Naphthylisothiocyanate↗
PubMed1987

Parents' attitudes to measles immunization.

A study of a cohort of children in Maidstone Health Authority examined the reasons for the failure to achieve targets for the uptake of measles immunization. Parents were interviewed before they were notified about measles immunization to determine their attitudes, beliefs and intentions regarding measles immunization and a further review was held with those whose child had no record of the immunization by the age of 20 months. The initial interview showed that most parents have a favourable attitude to measles immunization. However, many lacked knowledge, especially about valid contraindications, and claimed not to have received advice from a doctor or health visitor. The most common reasons for non-uptake of measles immunization were: the child had already had measles, concern about contraindications and delay owing to illness. This points to the importance of increasing doctors' and health visitors' knowledge of Department of Health and Social Security guidelines regarding valid contraindications and to the role of health visitors in promoting uptake. However there is also evidence that the gap between actual and target levels of uptake may be less than official figures suggest.

Attitude to Health↗
PubMed1986

The "five minute" consultation: effect of time constraint on clinical content and patient satisfaction.

An experiment was carried out in which patients who were seeking appointments for a consultation in a general practice in south London attended consulting sessions booked at 5, 7.5, or 10 minute intervals. The particular session that the patient attended was determined non-systematically. The clinical content of the consultation was recorded on an encounter sheet and on audio-tape. At the end of each consultation patients were invited to complete a questionnaire designed to measure satisfaction with the consultation. The stress engendered in doctors carrying out surgery sessions booked at different intervals of time was also measured. At surgery sessions booked at 5 minute intervals, compared with 7.5 and 10 minute intervals, the doctors spent less time with the patients and identified fewer problems, and the patients were less satisfied with the consultation. Blood pressure was recorded twice as often in surgery sessions that were booked at 10 minute intervals compared with those booked at 5 minute intervals. There was no evidence that patients who attended sessions booked at shorter intervals received more prescriptions, were investigated or referred more often to hospital specialists, or returned more often for further consultations within four weeks. There was no evidence that the doctors experienced more stress in dealing with consultations that were booked at 5 minute intervals than at consultations booked at 7.5 and 10 minute intervals, though they complained of shortage of time more often in surgery sessions that were booked at shorter intervals.

Appointments and Schedules↗
PubMed1986

The "five minute" consultation: effect of time constraint on verbal communication.

In a study in which patients were allocated non-systematically to surgeries booked at 5, 7.5, and 10 minute intervals 623 consultations were taperecorded. In surgeries booked at longer intervals doctors used the extra time to take a fuller history from their patients. In surgeries booked at 10 minute intervals doctors spent more time explaining the patient's problem, explaining the proposed management, and in discussing prevention and health education, these increases not being evident in surgeries booked at 7.5 minute intervals.

Appointments and Schedules↗
PubMed1986

Assessment of new radioimmunoassay kit for determining urinary albumin at low concentrations: comparison with radial immunodiffusion.

The assay characteristics of a new radioimmunoassay kit for determining urinary albumin at low concentrations were studied. The sensitivity for urinary albumin was 2 mg/l, the analytical range 2 to 40 mg/l, and interassay coefficient of variation less than 12%. In a method comparison study entailing diabetic urine samples covering an albumin concentration of 2 to 150 mg/l the kit compared adequately with radial immunodiffusion (mean difference between methods = 2 mg/l; residual standard deviation = 4.6 mg/l), absolute variation between methods increasing with the concentration. The kit required much less skill than radial immunodiffusion but its capital and running cost were higher.

Albuminuria↗
PubMed1986

Phlegm production and lung function among cigarette smokers changing tar groups during the 1970s.

In 1971-3 data on smoking habits, cigarette brand smoked, morning phlegm production, and lung function were recorded for factory workers as part of the Heart Disease Prevention Project. These men were reassessed in 1984 and those who had always smoked cigarettes from the same tar group were compared with those who had dropped one tar group (mean decreases of 6.6 mg tar, 0.1 mg nicotine) and two tar groups (mean decreases of 11.9 mg tar, 0.5 mg nicotine). Over the 13 years, men who had dropped one tar group were significantly more likely (p less than 0.05) to stop producing phlegm, but the effect was less marked for those who had dropped two tar groups. The mean fall in FEV1 was similar in all three groups, but 95% confidence limits showed that although dropping one tar group could be associated with at most a saving of 84 ml over the follow up period, there could be little extra benefit from dropping two tar groups. In 1984, all three groups of smokers excreted similar amounts of nicotine metabolites in the urine, suggesting that men who had dropped two tar groups compensated for the reduced nicotine yield of their cigarettes. This could account for the lack of a dose response relationship between reduction in the tar yield of cigarettes and cessation of phlegm and fall in FEV1.

Follow-Up Studies↗
PubMed1986

Validity of smokers' information about present and past cigarette brands--implications for studies of the effects of falling tar yields of cigarettes on health.

Four hundred and twenty nine current smokers and ex-smokers who had provided details 12 years previously completed a self administered questionnaire about their present and past smoking habits, and two weeks later current smokers supplied an empty cigarette packet. The tar group and brand name of the current cigarette given on the questionnaire were compared with details on the packet, and the brand alleged to have been smoked 12 years ago was compared with that actually recorded at that time. Only 55% of "low middle" tar cigarettes as indicated by returned packets had been correctly identified in the questionnaire. The brand name was the same in the questionnaire and on the packet in 74% of cases. The recalled brand was confirmed by past records in only 49% of cases. It is concluded that current smokers should be asked to return an empty packet or packets of the cigarette brand or brands usually smoked with a self administered questionnaire and that follow up studies of populations for which brands of cigarette smoked were previously recorded might be more valid than studies relying on recall.

Health↗
PubMed1986

Assessment of immunochemical methods for determining low concentrations of albumin in urine.

Four immunochemical methods (radioimmunoassay, RIA; radial immunodiffusion, RID; immunoturbidimetry, IT; enzyme-linked immunosorbent assay, ELISA) for measuring urinary albumin at low concentrations were assessed for their assay characteristics and practicability. Precision and accuracy were comparable between the methods when studied individually. We made a method comparison, with RIA as reference, using urine samples from diabetic patients with albumin concentrations ranging from 1 to 120 mg/L. There was no significant systematic difference between RID and RIA, but IT and ELISA gave consistently lower values than RIA, the mean differences being 1.8 (p less than 0.01) and 9.7 mg/L (p less than 0.001), respectively. Random error, compared with that for RIA, was in increasing order: RID (residual SD = 3.8 mg/L); IT (4.3 mg/L); ELISA (7.3 mg/L). The difference between the methods increased with the albumin concentration. Operational cost was highest with IT, lowest with RIA. Capital cost was highest with RIA and lowest with RID, which required most technical skill. ELISA had intermediate overall costs.

Albuminuria↗
PubMed1986

A simple, inexpensive urine test of smoking.

Three novel colorimetric methods of detecting urinary nicotine metabolites called the barbituric acid, diethylthiobarbituric acid (DETB) and DETB-extraction methods were evaluated for use as a simple cheap objective test of smoking. Urine samples were collected from 103 male smokers and 78 male nonsmokers working at two London factories. The smokers recorded the number of cigarettes smoked over the previous 36 hours. All three methods correctly classified the smokers. The DETB-extraction method had a lower false-positive rate (averaging 3% on morning and afternoon urine samples) than either the DETB or barbituric acid methods (12% and 6% respectively) and was the best procedure for classifying subjects as 'smokers' or 'non-smokers'. Using a quantitative variant of the barbituric acid method, there was a significant correlation (r = 0.85, p less than 0.001) between the urinary nicotine metabolites/creatinine ratios and number of cigarettes smoked. However, the ratios for smokers of 6-15, 16-25, and 26 or more cigarettes overlapped considerably. The methods can be performed very rapidly and reagent costs are equivalent to less than one penny per test.

Barbiturates↗
PubMed1985

A simple, inexpensive urine test of smoking.

Three novel colorimetric methods of detecting urinary nicotine metabolites called the barbituric acid, diethylthiobarbituric acid (DETB), and DETB extraction methods were evaluated for use as a simple, cheap, objective test of smoking. Urine samples were collected from 103 male smokers and 78 male non-smokers working at two London factories. The smokers recorded the number of cigarettes smoked over the previous 36 hours. All three methods correctly classified the smokers. The DETB extraction method had a lower false positive rate (averaging 3% on morning and afternoon urine samples) than either the DETB or the barbituric acid method (12% and 6% respectively) and was the best procedure for classifying subjects as "smokers" or "non-smokers." When a quantitative variant of the barbituric acid method was used there was a significant correlation (r = 0.85, p less than 0.001) between the ratios of urinary nicotine metabolites to creatinine and the number of cigarettes smoked. The ratios for smokers of 6-15, 16-25, and 26 or more cigarettes, however, overlapped considerably. The methods can be performed very rapidly and the reagent cost is equivalent to less than 1p per test.

Barbiturates↗
PubMed1985

Investigations into the relations between respiratory illness in children, gas cooking and nitrogen dioxide in the U.K.

In 1977 an association was reported between the prevalence of respiratory illness and use of gas for cooking at home in a national sample of six to 11 year olds living in England and Scotland (p less than .10). Other variables such as social class and number of cigarette smokers at home did not seem to explain the association. As the gas cooker is an unflued appliance emitting a variety of pollutants during gas combustion it was suggested that indoor air pollution might explain the finding. Nitrogen dioxide (NO2) was suspected so a series of studies was conducted to investigate the distribution of levels of NO2 in the home, the relative contribution of sources of NO2 to indoor exposure and the relation between respiratory illness in six to 11 year olds and levels of NO2 in the home. The gas cooker was found to be one of the main sources of NO2 in the home. Winter weekly averages in kitchens with gas cookers had a mean of 112.2 ppb (n = 428, range 5-317 ppb). Levels in electric cooking kitchens were significantly lower (n = 87, mean 18 ppb, range 6-188 ppb). Studies of health indicated a relation between respiratory illness and bedroom levels of NO2 over the range 4-169 ppb (p .10). Results for living room levels of NO2 suggested a similar but non-significant relationship (p greater than .10). No relation was found for kitchen levels of NO2. For schoolchildren any effect on health from indoor NO2 is likely to be weak. However other sections of the population such as infants and the elderly who may spend more time indoors and are particularly susceptible to respiratory illness need to be studied to assess fully the impact that NO2 may be having on health.

Child↗