Biomedical subjects
T Arie
Publications and source records attributed to T Arie.
Efficient cloning of ascomycete mating type genes by PCR amplification of the conserved MAT HMG Box.
Cloning of mating type (MAT) genes from ascomycetes has been hampered by low conservation among them. One of the pair of MAT genes, represented by MAT-2 of Cochliobolus heterostrophus (a loculoascomycete) and mt a of Neurospora crassa (a pyrenomycete), encodes a protein with a conserved DNA binding motif called the high mobility group (HMG) box. PCR with primer pairs corresponding to the borders of the C. heterostrophus and the N. crassa HMG boxes generated an approximately 0.3-kb product from genomic DNAs of MAT-2 and mt a strains, respectively, but not from MAT-1 and mt A strains. The C. heterostrophus primers amplified approximately 0.3-kb products from DNA of most loculoascomycete genera tested but not from DNA of pyrenomycete genera; this specificity was reversed with the N. crassa primers. The validity of the PCR procedure was documented by near sequence identity between the C. heterostrophus MAT-2 HMG box and PCR products from several Cochliobolus spp. and by cosegregation of the PCR product with mating type in progeny of Setosphaeria turcica and of Cryphonectria parasitica. Regions of the MAT locus flanking the HMG box were readily cloned using the TAIL-PCR procedure with a combination of random and specific primers.
Education in geriatric psychiatry.
The UK has seen many significant developments during the last 30 years in geriatric psychiatry, with emphasis on multi-disciplinary working and on the integration of services for the elderly. Accompanying these changes has been a growing public consciousness of the psychiatric disorders of later life and of the needs of old people and their carers. With a huge increase this century in the proportion of very elderly people, care of the elderly has achieved greater recognition in the medical training of both generalists and specialists. Greater emphasis also is being given to gerontology, both social and biological. In this paper the authors examine recent developments in medical education in the UK and show how changing approaches to medical training are shaping developments in geriatric psychiatry education. They describe recent innovations in both teaching styles and assessment methods and consider how developments in Computer Aided Learning can be applied to the teaching of geriatric psychiatry.
Some legal aspects of mental capacity.
This article discusses some practical matters which arise when competence to make decisions is in question. Consent, testamentary capacity, powers of attorney, the Court of Protection, "living wills," and research on people with dementia are briefly considered.
Dementia and 'borderline dementia' in Britain: 8-year incidence and post-screening outcomes.
Survivors from a nationally representative sample of elderly people originally screened in 1985 were reassessed in 1989 and again in 1993. On each occasion respondents were rated as cognitively impaired, borderline impaired or unimpaired (using a brief information/orientation scale), with the validity of these ratings assessed in subsequent clinical interviews. Where follow-up screening was not possible, information was derived from death certificates and hospital case-notes. Over 8 years (1985-93) the overall incidence rate per person-year at risk was 1.58%, giving age-specific rates of 0.72, 1.32, 1.63, 3.46, 2.55 and 1.41% for the age groups 65-69, 70-74, 75-79, 80-84, 85-89 and > or = 90 respectively. Of 43 individuals classified at screening as borderline impaired in 1985 and 1989, 19 were diagnosed as demented at clinical interviews conducted within 16 weeks of screening. Four-year follow-ups among the remaining 24 showed that 15 had died, while 6 showed a worsened cognitive status. Controlling for both age and sex, aggregated 4-year mortality was significantly higher among those defined at screening in 1985 and 1989 as either impaired or borderline, when compared with the unimpaired.
Accidents involving older people: a review of the literature.
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Tetrahydroaminoacridine and Alzheimer's disease.
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Incidence of dementia in a representative British sample.
In a four-year follow-up study of 1042 elderly people (aged 65 years or older), randomly sampled from the community, levels of dementia were assessed using a two-phase case-finding procedure (screening followed by clinical interview) among survivors. Clinical information on those not reinterviewed was provided by death certificates, hospital case notes, or postal questionnaires. The weighted four-year cumulative incidence of dementia was 3.7% (95% confidence intervals: 2.4%-5.0%), with age-specific rates of 0.9%, 2.8%, 5.2%, 9.0%, and 8.7% for the age groups 65-69, 70-74, 75-79, 80-84, and 85-89 years respectively. While consistent with data from other British regions, it remains likely that these rates underestimate true incidence.
Incidence of dementia: preliminary findings from the Nottingham Longitudinal Study of Activity and Ageing.
In a 4-year follow-up of 1,042 randomly sampled elderly people (aged 65+), levels of dementia were assessed using a two-phase case finding procedure (screening followed by clinical interview) among survivors. Clinical information on those not re-interviewed was provided by death certificates, hospital case notes or postal questionnaires. The unweighted 4-year cumulative incidence of dementia was 4.3%, with age-specific rates of 0.9, 2.8, 5.2, 9.0 and 8.7% for the age groups 65-69, 70-74, 75-79, 80-84, and 85-89, respectively.
UK survey of psychiatric services for the elderly: direction for developing services.
As an important step in health care planning for the elderly, a systematic descriptive study of ten psychogeriatric services was undertaken in the United Kingdom. A definite trend emerged of a reduction in the number of hospital beds as community services developed. Health authorities tended to establish a clinical base in general hospitals rather than in mental hospitals. The recent effect of the rapid growth of the private nursing home sector is also described. Some rough guidelines are provided for the basic resources needed to establish a comprehensive service including one assessment bed and one day place per 1,000 elderly persons; the number of long-stay beds depends on the number of places available in the private sector. While the Canadian health care system differs in some fundamental ways from that in the UK, the principles and guidelines derived from the UK experience may be applied to meet the psychiatric needs of the elderly in Canada.
Are drugs targeted at Alzheimer's disease useful? 2. Insufficient evidence of worthwhile benefit.
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Psychogeriatrics.
Psychogeriatrics--the psychiatry of old age--became an official specialty in the NHS in 1989. Until the 1960s interest in the mental disorders of old age had been largely confined to research, but today special psychiatric services for old people are widely established, and the care of mentally ill old people is recognized as a major issue by professional workers, governments and the lay public, not only in developed countries but also in the Third World. Britain has led this movement.
Tetrahydroaminoacridine (THA) in Alzheimer's disease.
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Prevalence, frequency, and duration of hypnotic drug use among the elderly living at home.
Details of consumption of hypnotic drugs derived from a nationally representative sample of elderly people were analysed in terms of the prevalence, duration, and likely frequency of use. Of 1020 randomly selected subjects aged 65 and over 16% (166) reported using (mainly benzodiazepine) hypnotic drugs, and of these 89% reported having taken such a drug the night before the interview. Most of these users (73%) had been taking hypnotic drugs for more than one year, with 25% reporting drug use for more than 10 years. These results suggest that for most elderly users of hypnotic drugs, patterns of consumption encourage the development of cumulative effects and benzodiazepine dependence.
Questions in the psychiatry of old age.
The last ten to fifteen years have been a time of rapid development in the psychiatry of old age. Biological research on the dementias has moved forward impressively, but significant too has been the development in many countries of local services specially designed to meet the needs of old people with mental disorders, and of those who look after them. Such services are built on the experience both of psychiatry and of geriatrics, but have also broken new ground: the UK experience is described. The facts have belied earlier misgivings about the potential of this field of work to attract and satisfy able staff in the health professions; indeed, this work has developed with style and enthusiasm, and with widespread educational programmes and growing research activity. This paper reviews briefly these developments and considers some broader issues of policy as they bear on the care of mentally ill old people. Considered also is tentative evidence that the dementias of old age may be becoming less prevalent. Finally, current studies in Nottingham which look at the social associations of old age mental disorders are briefly described and the implications are considered of the broadening of the base of 'psychogeriatrics' which such studies represent.
Characteristics of subjective insomnia in the elderly living at home.
Profiles of sleeping habits, subjective sleep quality, and mental and physical well-being were obtained from 1023 elderly individuals randomly sampled from the Nottinghamshire Family Practitioner Committee's records. Subjective insomnia at least 'sometimes' was reported by 37.9% of the sample. Discriminant analysis of selected health and demographic variables indicated that symptoms of anxiety, sex and self-ratings of health were the factors most influential in predicting reports of problem sleep. Thus, respondents classified as subjective insomniacs tended to have significantly higher anxiety scores, to be women, and to rate their health as below average. Relative to the non-insomniac respondents, those complaining of sleep problems also perceived their sleep latency as longer, and their total sleep as shorter. These results emphasize that, in addition to apparently 'normal' age-related changes in the structure of sleep, subjective insomnia in old age may often be mediated by the physical and psychological disorders which can accompany ageing.
Causes of ill health among a random sample of old and very old people: possibilities for prevention.
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Dementia and Parkinson's disease associated with diffuse cortical Lewy bodies.
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