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Biomedical subjects

S Bennett

Publications and source records attributed to S Bennett.

At least 19 recordsLinked to original sources

Investigation of the risk factors for tuberculosis: a case-control study in three countries in West Africa.

BACKGROUND: Host-related and environment-related factors have been shown to play a role in the development of tuberculosis (TB), but few studies were carried out to identify their respective roles in resource-poor countries. METHODS: A multicentre case-control study was conducted in Guinée, Guinea Bissau, and The Gambia, from January 1999 to March 2001. Cases were newly detected smear positive TB patients. Two controls were recruited for each case, one within the household of the case, and one in the community. RESULTS: Regarding host-related factors, univariate analysis by conditional logistic regression of 687 matched pairs of cases and household controls showed that TB was associated with male sex, family history of TB, absence of a BCG scar, smoking, alcohol, anaemia, HIV infection, and history and treatment of worm infection. In a multivariable model based on 601 matched pairs, male sex, family history of TB, smoking, and HIV infection were independent risk factors of TB. The investigation of environmental factors based on the comparison of 816 cases/community control pairs showed that the risk of TB was associated with single marital status, family history of TB, adult crowding, and renting the house. In a final model assessing the combined effect of host and environmental factors, TB was associated with male sex, HIV infection, smoking (with a dose-effect relationship), history of asthma, family history of TB, marital status, adult crowding, and renting the house. CONCLUSION: TB is a multifactorial disorder, in which environment interacts with host-related factors. This study provided useful information for the assessment of host and environmental factors of TB for the improvement of TB control activities in developing countries.

Adult↗

Vertigo.

Explore the source record for details and available documents.

Humans↗

Sun protection initiatives in Cornwall.

Recent evidence indicates that there are significant numbers of cases of malignant melanoma in the UK. In order to assess the current position with regard to sun awareness in Cornwall, a questionnaire survey of all state primary school heads (n = 123) and a survey of a random sample of GP practices (n = 9) was carried out. The data obtained were supported by visits to libraries and Tourist Information Centres at urban and rural centres--this enabled the identification of sun awareness literature. Key health professionals who worked within the field of health promotion were also contacted. The findings showed that in Cornwall public campaigns organized around the issue of sun protection took place only sporadically, although GP surgeries usually organize a display at the appropriate time of the year. None of the public places (e.g. Tourist Information Centres, libraries) surveyed had sun protection messages on display. It is concluded that insufficient sun awareness initiatives were being undertaken in Cornwall. Although most primary schools included sun awareness education in their curriculum in a form based on the Sun Awareness Guidelines produced by the Department of Health in 1995, few schools considered further measures to protect pupils on hot and sunny days. In particular the provision of shade, the scheduling of outdoor activities and the use of sunscreen and protective clothing were not standard.

Child↗

Discal attachments of the human temporomandibular joint.

BACKGROUND: Despite its clinical significance, the anatomy of the human temporomandibular joint (TMJ) and its relationship to the lateral pterygoid muscle remains poorly described and often misrepresented in standard texts. The aim of this study was to describe how the anterior and posterior attachments of the TMJ disc vary between lateral, central and medial regions of the joint. METHODS: Ten left TMJs were removed en bloc from cadavers and serial sections were made at 3-4mm intervals. Observations were made to ascertain the anterior and posterior attachments of the disc and the joint structures were traced from standardized photographs. RESULTS: Laterally, the capsule and lateral discal ligament merged prior to their attachment at the condylar pole. Medially, muscle fibres, capsule and the disc converged on the medial pole of the condyle. There was no evidence that fibres of the upper head of the lateral pterygoid muscle inserted directly into the disc. The upper head inserted into the condyle either directly at the pterygoid fovea or via a central tendon or indirectly via the capsule. Posteriorly, the superior part of the posterior attachment of the disc attached to the cartilaginous meatus and tympanic part of the temporal bone. The inferior part of the posterior attachment of the disc attached to the posterior surface of the condyle. In four joints, this attachment was folded beneath the posterior band of the disc, creating a wedge-shaped flap that ran medio-laterally. CONCLUSION: This study is in broad agreement with other anatomical TMJ studies but there are two main points of difference. Firstly, a true muscle insertion of the superior head of the lateral pterygoid muscle to the disc was not observed. Secondly, a wedge-shaped flap of retrodiscal tissue was identified between the condyle and the disc.

Aged↗

Burnout, psychological morbidity, job satisfaction, and stress: a survey of Canadian hospital based child protection professionals.

AIMS: (1) To measure the prevalence of burnout, psychological morbidity, job satisfaction, job stress, and consideration of alternate work among multidisciplinary hospital based child and youth protection (CYP) professionals; (2) to understand the relations between these variables; and (3) to understand the reasons for leaving among former programme members. METHODS: Mailed survey of current and former members of all Canadian academic hospital based CYP programmes. Surveys for current members contained validated measures of burnout, psychological morbidity, job satisfaction/stress, and questions about consideration of alternate work. Surveys for former members examined motivation(s) for leaving. RESULTS: One hundred and twenty six of 165 current members (76.4%) and 13/14 (92.9%) former members responded. Over one third (34.1%) of respondents exhibited burnout while psychological morbidity was present in 13.5%. Job satisfaction was high, with 68.8% finding their job "extremely" or "quite" satisfying, whereas 26.2% found their job "extremely" or "quite" stressful. Psychological morbidity, job satisfaction, and job stress were not associated with any of the demographic variables measured, but burnout was most prevalent among non-physician programme members. Almost two thirds of current members indicated that they had seriously considered a change in work situation. Former members indicated that burnout and high levels of job stress were most responsible for their decision to leave and that increasing the number of programme staff and, consequently, reducing the number of hours worked would have influenced their decision to stay. CONCLUSIONS: Current levels of burnout and the large proportion of individuals who have contemplated leaving the service suggest a potential crisis in Canadian hospital based CYP services.

Adult↗

Outbreak of a new Salmonella phage type in South West England: alternative epidemiological investigations are needed.

An outbreak of Salmonella Typhimurium DT193a occurred in South West England in April-May 2003. Preliminary investigation suggested an association with the consumption of ham. A matched case-control study was implemented, together with an environmental investigation and a geographic information system (GIS) analysis. Thirty-seven cases and 38 controls were enrolled in the study. Matched analysis was based only on 23 cases, as the other cases did not nominate controls. Eighty per cent of cases and 51% of controls had eaten ham (odds ratio = 3.5, p = 0.03). Cases did not differ from controls in terms of distance from outlets providing ham. All environmental samples collected were negative. The epidemiological evidence indicated an association between this outbreak and consumption of ham, but the environmental investigation was inconclusive. Alternative methods should be considered in support of traditional epidemiological investigation.

Adolescent↗

Crop management and agronomic context of the Farm Scale Evaluations of genetically modified herbicide-tolerant crops.

The Farm Scale Evaluations of genetically modified herbicide-tolerant crops (GMHT) were conducted in the UK from 2000 to 2002 on beet (sugar and fodder), spring oilseed rape and forage maize. The management of the crops studied is described and compared with current conventional commercial practice. The distribution of field sites adequately represented the areas currently growing these crops, and the sample contained sites operated at a range of management intensities, including low intensity. Herbicide inputs were audited, and the active ingredients used and the rates and the timings of applications compared well with current practice for both GMHT and conventional crops. Inputs on sugar beet were lower than, and inputs on spring oilseed rape and forage maize were consistent with, national averages. Regression analysis of herbicide-application strategies and weed emergence showed that inputs applied by farmers increased with weed densities in beet and forage maize. GMHT crops generally received only one herbicide active ingredient per crop, later and fewer herbicide sprays and less active ingredient (for beet and maize) than the conventional treatments. The audit of inputs found no evidence of bias.

Agriculture↗

Investigation of environmental and host-related risk factors for tuberculosis in Africa. I. Methodological aspects of a combined design.

Host-related and environmental factors for tuberculosis have usually been investigated separately using different study designs. Joint investigation of the genetic, immunologic, and environmental factors at play in susceptibility to tuberculosis represents an innovative goal for obtaining a better understanding of the pathogenesis of the disease. In this paper, the authors describe methods being used to investigate these points in a West African study combining several designs. Patients with newly diagnosed smear-positive cases of tuberculosis are recruited. The effect of host-related factors is assessed by comparing each case with a healthy control from the case's household. The role of environmental factors is estimated by comparing cases with randomly selected community controls. The frequencies of candidate gene variants are compared between cases and community controls, and results are validated through family-based association studies. Members of the households of cases and community controls are being followed prospectively to determine the incidence of "secondary" tuberculosis and to evaluate the influence of geographic and genetic proximity to the index case. This type of design raises important methodological issues that may be useful to consider in studies investigating the natural history of infectious diseases and in attempts to disentangle the effects of environmental and genetic factors in response to infection.

Africa, Western↗

Investigation of environmental and host-related risk factors for tuberculosis in Africa. II. Investigation of host genetic factors.

In an accompanying paper (Am. J. Epidemiol. 2002;155:1066-73), the authors describe the design of a large multicenter study being carried out in three West African countries for investigation of the roles of environmental and host-related factors in the development of tuberculosis. In this paper, the authors review some evidence that host genetic factors play a role in susceptibility to tuberculosis. They describe the three components of the study that are designed to investigate the effect of host genetic factors on the development of tuberculosis: case-control and family-based association studies of candidate genes and analysis of affected relative pairs to screen the human genome for areas of linkage to the disease. The authors also address a number of methodological issues that arise, such as the effects of consanguinity, half-siblings, and nonpaternity. Lastly, they review opportunities to assess gene-environment interaction in the framework of the study, in light of current methodological knowledge. Consideration of these issues may be useful in the design of other studies of genetic susceptibility to infectious diseases, particularly those to be carried out in developing countries.

Africa, Western↗

The prevalence and predictors of psychological distress in patients with early localized prostate cancer.

OBJECTIVE: To determine the level of psychopathology, traumatic distress and quality of life in men with newly diagnosed clinically localized prostate cancer, the effect on these of a consultation in a combined-specialist early-prostate clinic, and predictors of psychopathology. PATIENTS AND METHODS: Eighty-eight patients were recruited from the combined clinic; they completed a battery of questionnaires including the Hospital Anxiety and Depression Scale (HADS), the revised Impact of Event Scale (IES) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, before their first appointment. Two weeks later they completed the HADS, IES and a patient-satisfaction survey. RESULTS: The overall level of psychopathology varied among the questionnaires used, from 0% on the HADS depression scale, 8% on the HADS anxiety scale and 14% on the IES. Anxiety and traumatic stress symptoms were commoner than depressive symptoms. The quality-of-life scores showed a relatively good level of functioning. Pre-morbid factors and disease status did not predict psychological distress. Younger age was mildly predictive of poorer psychological functioning. Anxiety symptoms reduced slightly after a joint clinic appointment, whereas depressive symptoms showed a slight increase. CONCLUSION: This study suggests that men with early localized prostate cancer have low levels of psychopathology overall. However, some men experience distressing psychological symptoms and it is important that future research is conducted to help develop clear guidelines on the optimal methods of detecting and managing men with prostate cancer who have mental health difficulties.

Aged↗

Disordered eating attitudes and behaviours in teenaged girls: a school-based study.

BACKGROUND: Disordered eating attitudes and behaviours are common in older teens and young women in Western countries. Recent evidence suggests that the prevalence of these disorders is rising and that the age of onset has fallen. In the present study, disturbed eating attitudes and behaviours were evaluated in a large school-based population in Ontario in order to determine their prevalence and demographic distribution. METHODS: Females, aged 12-18 years, from schools in Toronto, Hamilton and Ottawa were invited to complete questionnaires, including 3 subscales of the Eating Disorder Inventory (Drive for Thinness, Body Dissatisfaction, Bulimia), the Eating Attitudes Test-26 (EAT-26) and the Diagnostic Survey for Eating Disorders (DSED). RESULTS: Questionnaires were completed by 1739 (70%) of the 2483 adolescent females who were approached. The mean age of subjects in the sample was 14.6 (standard deviation 1.9) years. Thirteen percent of those aged 12-14 years and 16% of those aged 15-18 years had scores above the recommended cut-off (> or = 20) for disordered eating on the EAT-26. Current dieting to lose weight was reported by 23% of participants. Binge eating with associated loss of control was reported by 15% of participants, self-induced vomiting by 8.2% and the use of diet pills by 2.4%. Laxative and diuretic misuse were uncommon. Dieting was associated with an increased risk of binge-eating and purging behaviours. Older age and body mass index in the highest quartile were independently related to symptoms of eating disorders. INTERPRETATION: Disordered eating attitudes and behaviours were present in over 27% of girls aged 12-18 years and were seen to increase gradually throughout adolescence. Prevention programs to diminish the progression and impact of these disorders should be implemented and assessed.

Adolescent↗

Treatment practices for chlamydial infection in New Zealand.

AIMS: To identify prescribing and treatment practices for chlamydial infection in New Zealand. METHODS: Postal survey to doctors and nurses at all sexual health, family planning, student and youth health centres, and randomly selected general practitioners. RESULTS: There was considerable variation in treatment regimes used for chlamydial infection with few respondents treating in accordance with international guidelines regarding dose, frequency, and duration of treatment. Doxycycline (88.4%) was most commonly used to treat uncomplicated chlamydial infection in non-pregnant patients. Most respondents (70.2%) stipulated doxycycline for longer durations than the seven day regimen international guidelines recommend, with doxycycline 100 mg twice a day for ten days most frequently specified. Among the 259 respondents who would treat pregnant women with erythromycin, 51 different treatment regimens were specified, and 51.7% recorded regimens less than that recommended by international guidelines. When treating a patient presumptively, the majority of respondents tested for chlamydial infection. In contrast to other respondents, sexual health clinic staff rarely provide patients with a prescription for a patient's partner without seeing the partner. CONCLUSIONS: Standardised treatment guidelines are required for patients diagnosed with chlamydial infection. Guidelines should include recommendations for the treatment of partners, and encourage the laboratory confirmation of diagnosis.

Anti-Bacterial Agents↗

Screening and diagnostic practices for chlamydia infections in New Zealand.

AIMS: To identify screening and diagnostic practices for chlamydia infection in New Zealand. METHODS: Postal survey of doctors and nurses at all sexual health, family planning, youth and student clinics, and randomly selected general practitioners (GPs). RESULTS: Most respondents recognised chlamydia infection as a cause of pelvic inflammatory disease and infertility in females, and epididymitis and non-gonococcal urethritis in males. Ectopic pregnancy and conjunctivitis were less commonly recognised by GPs and student and youth centre doctors. Sterile pyuria and arthritis were well recognised only by sexual health doctors. Female doctors were significantly more likely to recognise signs and symptoms than male doctors. GPs were less likely than other respondents to screen for chlamydia infection. Sexual health doctors and nurses were more likely to remove cervical secretions prior to taking endocervical specimens. Contact tracing was regarded as very important by only a quarter of family planning respondents, compared with over 80% of other respondents. CONCLUSIONS: While respondents recognised most signs, symptoms, and sequelae of chlamydia infection, some important features were not well recognised. Screening practices varied, and many endocervical specimens were taken incorrectly. Given the long-term health consequences and cost of chlamydia infection sequelae, screening guidelines are urgently required.

Adolescent↗

Surveillance of sexually transmitted infections in New Zealand, 1998.

AIMS: To describe the surveillance and epidemiology of sexually transmitted infections (STIs) in New Zealand. METHODS: Sexual health clinics submitted STI data to the Institute of Environmental Science and Research (ESR). Infection rates were calculated by dividing the number of diagnoses by the number of total clinic visits. Because the denominator used to calculate infection rates changed in 1998, STI rates in 1998 cannot be directly compared with previous years and case numbers were used to identify recent trends. RESULTS: In 1998, genital warts was the most commonly diagnosed STI (4.7%), followed by chlamydia (3.0%) and genital herpes (1.0%). Approximately two-thirds of gonorrhoea, chlamydia and genital warts diagnoses were in people aged less than 25 years. Chlamydia rates were 7.3% in Maori, 7.1% in Pacific Island people, and 2.1% in European. Gonorrhoea rates were 1.6% in Maori, 1.9% in Pacific Island people and 0.2% in European. The number of chlamydia and gonorrhoea cases increased between 1995 and 1998. CONCLUSIONS: The reporting of data by age, sex and ethnicity has allowed a more useful evaluation of the incidence of STIs. The majority of STIs were diagnosed among young New Zealanders, and disproportionately high chlamydia and gonorrhoea infection rates were found among Maori and Pacific Island people.

Adolescent↗

Elliptic flow in Au+Au collisions at square root(S)NN = 130 GeV.

Elliptic flow from nuclear collisions is a hadronic observable sensitive to the early stages of system evolution. We report first results on elliptic flow of charged particles at midrapidity in Au+Au collisions at square root(S)NN = 130 GeV using the STAR Time Projection Chamber at the Relativistic Heavy Ion Collider. The elliptic flow signal, v2, averaged over transverse momentum, reaches values of about 6% for relatively peripheral collisions and decreases for the more central collisions. This can be interpreted as the observation of a higher degree of thermalization than at lower collision energies. Pseudorapidity and transverse momentum dependence of elliptic flow are also presented.

Journal Article↗

Consanguinity and the transmission/disequilibrium test for allelic association.

Consanguineous marriages, usually between first cousins or between uncle and niece, are common in certain societies. The transmission/disequilibrium test (TDT) compares the transmission from parents to an affected child of alleles at a marker locus, and differential transmission indicates linkage and allelic association between the marker locus and a disease locus. We investigate the consequences for the TDT, as a test for allelic association, of consanguineous marriages. For each parental marker mating type, we calculate the frequency of each disease mating type, and the associated probability that an offspring is affected. We use Bayes' Theorem to estimate the probability that an affected child inherits the given allele from a heterozygous parent, then combine our results across marker mating types. The effect of consanguineous marriage is usually small. For candidate genes, the effects were greater for uncle-niece marriages, for rare disease alleles, and for high genotype relative risk. For markers, the effects were generally negligible. The Type I error probability of the TDT is essentially unchanged by intermarriage, except for a purely recessive disease allele. The power of the TDT is increased for a recessive allele and decreased for a dominant allele. However, consideration of levels of consanguinity that arise in practice indicates that standard power calculations for the TDT will usually need only minor modification.

Bayes Theorem↗