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A Atkinson

Publications and source records attributed to A Atkinson.

At least 55 records · Page 3Linked to original sources
PubMed1989

The implementation of a multicentred randomized controlled trial in the evaluation of the experimental National Health Service nursing homes.

This paper reviews the implementation of a pragmatic multicentred randomized controlled trial in the evaluation of three experimental nursing homes. The organization of services for the care of elderly people varied between the three centres, and each used different criteria for selecting subjects for the trial and different methods of seeking informed consent. Data presented show that in each centre two truly randomized samples have been selected. However, differences between centres, in the characteristics of selected subjects, reflect the implementation of the trials in each of the centres. These findings emphasize the importance of good collaboration between health professionals providing the service, an independent research team, and the establishment of rigorous criteria for inclusion and exclusion of subjects at the outset.

Aged↗
PubMed1989

Measurement of outcomes within a multicentred randomized controlled trial in the evaluation of the experimental NHS nursing homes.

This paper reports outcome data from a multicentred randomized controlled trial (RCT) undertaken as part of the evaluation of the experimental NHS nursing homes. A small sample size within centres and differential non-response due to death and physical or mental frailty limits the statistical power of this trial and biases subject-reported outcomes toward the views of elderly people who were less frail. There were no significant differences in survival or personal well-being, or changes in behavioural ability, mental state or perceived health status between propositi and controls. There were significant differences in the views of responding propositi and controls suggesting that the experimental NHS nursing homes were preferred by residents. The results of this pragmatic trial suggest that there is no evidence to conclude that NHS nursing homes should not be provided as NHS continuing-care accommodation. Policy decisions should also take account of the other studies undertaken as part of the evaluation. Further research is needed to develop more appropriate outcome measures for this client group.

Aged↗
PubMed1989

Sequence variability of three alleles of the self-incompatibility gene of Nicotiana alata.

Three alleles of the self-incompatibility gene of Nicotiana alata have been cloned and sequenced. A comparison of the sequences shows a surprisingly low level of homology (56%) and the presence of defined regions of homology and variability. The homologous regions include the N-terminal sequence, most of the cysteine residues and glycosylation sites, as well as other blocks throughout the sequence. We interpret these conserved regions as "framework" and nonconserved regions as "hypervariable," following the terminology used to describe analogous regions in the IgG supergene family. The low level of overall homology forms the basis of a general method for isolating S-allele-specific cDNAs. Allele-specific antibodies can be generated using synthetic peptides corresponding to one of the variable regions. When applied to sections of the pistil, these antibodies label the intercellular matrix in the stigma and transmitting tissue of the style and the cell walls in the epidermis of the placenta. HindIII digestion of genomic DNA generates a characteristic pattern of S-gene fragments for each genotype. These restriction fragment length polymorphisms can be used to assign S-genotype to progeny arising from breeding experiments.

Alleles↗
PubMed1988

Should QALYs be programme-specific?

One reason for the development of quality adjusted life years (QALYs) is to facilitate comparison across health care programmes in terms of productivity per unit of expenditure. However, some approaches to QALY measurement have also been developed using 'programme-specific' dimensions of quality of life. Using data, from a longitudinal trial of long-term care for elderly people, it is shown in this paper that an 'across-programme' method of quality of life measurement is less sensitive to changes in elderly people's health states than programme-specific methods more commonly used in the field of evaluating long-term care. It is argued that the same problem is likely to arise in evaluating care for other common chronic conditions like mental handicap, chronic conditions of childhood and terminal cancer. It is concluded that more work should be carried out comparing across-programme and programme-specific measures of quality of life, otherwise it will be difficult to determine whether certain groups in society are being discriminated against in health service resource allocation due to an insensitive across-programme measure of outcome.

Activities of Daily Living↗
PubMed1988

QALYS and long-term care for elderly people in the UK: scales for assessment of quality of life.

QALYs have developed in the UK as a tool for comparing the outcome of health care procedures in a single index over time. This tool can then be used, along with information on costs of procedures, in decision-making about health service resource allocation. It is shown that the attributes of disability and distress, on which QALYs are presently based in the UK, are insensitive to changes in the health status of elderly people in long-term care when compared to other measures of quality of life which are frequently used in studies of older people. Thus, if the use of QALYs increases, they should be based on attributes appropriate to the groups studied, otherwise certain groups may be discriminated against in health service resource allocation owing to the use of an insensitive measure of outcome.

Aged↗
PubMed1985

The production and properties of a tissue plasminogen activator from normal epithelial cells grown in microcarrier culture.

A plasminogen activator with different biochemical and physical properties to the one obtained from Bowes melanoma cells has been isolated from a normal epithelial cell line derived from guinea-pig keratocytes (GPK). Cell growth and enzyme production is carried out in microcarrier cultures using up to 15 g Cytodex 3 per litre. Cells are maintained in optimum conditions by the use of a closed perfusion loop and the system has been scaled up to 20 litres. Initially enzyme production was in serum-free medium following a growth phase in serum supplemented medium. However, the discovery that the cells produce the enzyme mainly during the replicative phase has led to investigating the use of serum-substitutes and growth factors on cell growth and enzyme production. The aim is to harvest the enzyme after the growth phase which precludes the use of high (greater than 1%) serum concentrations. The biochemical and biophysical properties of the enzyme are described.

Animals↗
PubMed1983

The role of calcium in the mechanical behaviour of bone.

Plugs of fresh post mortem human patellar subchondral bone were soaked for three weeks in an organic solvent (ethanol) which contained a chelating agent (EDTA). This technique selectively removes the calcified inorganic component without disrupting the structure of the remaining bone matrix. These plugs, together with untreated plugs as controls, were treated in unconfined compression at a fixed strain rate and allowed to relax to evaluate the contribution made by the calcium component to the physical and time-dependent properties of subchondral bone.

Adolescent↗
PubMed1980

Phenotypic and genotypic characterization of some thermophilic species of Bacillus.

Some thermophilic species of Bacillus were characterized using biochemical tests, antibiotic sensitivity, bacteriocin and bacteriophage sensitivity, esterase patterns, DNA hybridization and % G+C content. The three caldo-active strains of bacilli isolated by Heinen (1971) were compared with strains of B. stearothermophilus. Eight of the strains examined showed characteristics which enabled them to be placed in the three main taxonomic groups suggested by Walker & Wolf (1971). Two strains showed characteristics of both groups 1 and 3. Examination of genotype data showed taxonomic groupings which differed from those based on phenotypic characterization.

Anti-Bacterial Agents↗
PubMed1980

Isolation and characterization of a mutant of Escherichia coli K12 synthesizing DNA polymerase I and endonuclease I constitutively.

A mutant of Escherichia coli K12, highly resistant to ultraviolet radiation, has been isolated. Preliminary tests show that this mutant is also resistant to mitomycin C, nalidixic acid, fluorouracil and thymineless death. The mutant strain apparently repairs its damaged DNA more efficiently than wild-type E. coli K12 strains and, to do so, constitutively produces 35 times more DNA polymerase I and 12 times more endonuclease I than the wild-type strain.

DNA Polymerase I↗
PubMed1978

Vitreous morphology after perforating injury treated by primary vitrectomy.

Perforating eye injuries result in patterns of damage which vary greatly in extent and severity. In undertaking reconstruction of the injured eye the ophthalmologist requires instruments and materials designed for handling each type of traumatized tissue. Problems associated with injury to the vitreous are logically dealt with by purpose-built vitrectomy instruments with the object of attaining a satisfactory and safe vitreous configuration in a visually useful eye.

Eye Injuries↗
PubMed1977

Primary vitrectomy as a preventive surgical procedure in the treatment of severely injured eyes.

The results of treating 72 severely injured eyes by primary vitrectomy combined with anterior and posterior segment reconstruction are presented. This approach aims at improving the visual prognosis by allowing fundus examination and immediate retinal surgery where indicated, and by preventing the more severe complications associated with vitreous and anterior segment disorganisation. The prospects for improved visual results and the problems encountered, particularly secondary haemorrhage, are discussed.

Adolescent↗
PubMed1977

Results of primary vitrectomy in severe perforating ocular injuries.

Vitrectomy in the initial treatment of perforating injuries is indicated when lens damage involves the posterior capsule, when anterior segment disruption involves vitreous, with extensive vitreous haemorrhage and overt or suspected retinal damage, in removal of a non-magnetic intraocular foreign body and in perforating injury with endophthalmitis. The visual results in 72 eyes followed for up to 6 years are: blind or enucleated 19 (26%), acuity less than 0.1 in 14 (19%), 0.1-0.4 in 18 (25%) and 0.5 or better in 21 (30%). Retinal detachment occurred in 27 eyes with successful reattachment in 18 (66%).

Eye Diseases↗
PubMed1976

[A method of closing fistulae from drainage blebs to the out-side after glaucoma operations (author's transl)].

A method for closing fistulae in drainage blebs after anti-glaucoma surgical procedures is described. Its aim is to line internally and support the wall of the bleb, including the fistula, with subconjunctival tissue. The decisive factor in achieving this is the firm anchoring of the subconjunctival tissue pulled down between the corneo-scleral opening and the thin conjunctival tissue layer.

Conjunctiva↗