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Biomedical subjects

A J Morris

Publications and source records attributed to A J Morris.

At least 19 recordsLinked to original sources
PubMed2006

The orthodontic condition of children in the United Kingdom, 2003.

BACKGROUND: The 2003 Children's Dental Health Survey is the fourth in a series of decennial national children's dental health surveys in the United Kingdom. AIMS: This paper reports on the orthodontic condition of children aged 12 and 15 years. METHODOLOGY: A representative sample of children across the UK were invited to participate in a clinical dental examination in school. Two thousand, five hundred and ninety-five 12-year-olds and 2,142 15-year-olds were examined. Current and past orthodontic treatment and type of appliance worn were recorded. Orthodontic treatment need was assessed by the Modified IOTN in those not undergoing treatment. A postal questionnaire sought parents' views on the orthodontic condition of their children and perceived need for treatment. RESULTS: At age 12, 35% were judged to have an orthodontic treatment need, 57% had no need and 8% were wearing an appliance. The corresponding figures at age 15 were, 21% (need), 65% (no need) and 14% (wearing appliance). A higher proportion of girls (p < 0.05) were wearing an appliance than boys. A greater proportion of 15-year-olds were undergoing treatment than in the 1993 and 1983 surveys and the use of fixed appliances had increased. CONCLUSIONS: In this representative sample of UK children, one in five were still judged as having an orthodontic treatment need at age 15 years, as determined by the modified index of orthodontic treatment need. However, considerable variation was observed between professional and lay perceptions of need.

Adolescent↗
PubMed2006

The reported impact of oral condition on children in the United Kingdom, 2003.

BACKGROUND: The 2003 Children's Dental Health Survey is the fourth in a series of decennial national children's dental health surveys of the United Kingdom. AIMS: This paper is concerned with how children are reported to have been affected by their oral condition during the 12 month period immediately preceding the survey and how this relates to the children's experience of caries, their dental attendance behaviour and their social class. METHOD: The information was gathered by self-completion questionnaire distributed to the parents of half of the sample who were clinically examined in the dental survey. RESULTS: Some form of impact was reported by the parents of 22% of five-year-olds, 26% of eight-year-olds, 34% of 12-year-olds and 28% of 15-year-olds. The pattern of responses to the eight impact questions was broadly similar across age groups. The most frequently reported type of impact was pain in all age groups. Impacts on oral function, self-confidence, orally related activity and on the child's emotions were experienced by 4-10% of children of all ages. Fewer children (1-2%) were reported to have experienced more far reaching impacts affecting their social functioning, general health and life overall. CONCLUSIONS: Most children were reported not to have experienced any of the problems covered by the questionnaire. Of those who did, most reported a single problem and for most this was pain. Nevertheless there was a group of children for whom oral function, self-confidence, orally related activity, emotions, social functioning, their health or their life in general were reported to have been affected by their oral condition. The nature of dental care which is appropriate for such children needs to be determined.

Adolescent↗
PubMed2006

Patterns of care and service use amongst children in the UK 2003.

BACKGROUND: The 2003 Children's Dental Health Survey is the fourth of the 10-yearly surveys of children's oral health in the United Kingdom. AIM: To detail the reported experience of dental services and dental treatment amongst children in the UK. METHOD: A self-completion questionnaire was distributed to a 50% sub-sample of parents or carers of the children who were clinically examined in the 2003 UK Child Dental Health Survey. This included questions relating to parental and child experience of dental services and dental treatment. RESULTS: The proportion of UK five-year-olds reported as not having visited the dentist fell from 14% in 1983 to 6% in 2003 and the proportion reported as having visited the dentist before the age of two rose from 7% in 1983 to 31% in 2003. Over 80% of all children were reported to seek regular dental check-ups. Around 10% were reported to have had some difficulty in accessing NHS dental care while 5% of five-year-olds were reported to have experienced a general anaesthetic for dental procedures in 2003. Dental attendance was associated with social class and mothers' reported attendance patterns. CONCLUSIONS: In line with previously reported trends, the 2003 survey of children in the United Kingdom shows improvements in several areas but some aspects of attendance pattern continue to be associated with social class and mothers' attendance pattern. It is of concern that 10% of five-year-olds reported having experienced extractions and 5% general anaesthesia for dental treatment.

Adolescent↗
PubMed2006

Non-carious tooth conditions in children in the UK, 2003.

BACKGROUND: The 2003 Children's Dental Health Survey is the fourth of the 10-yearly surveys of children's oral health. AIM: To report the prevalence of three non-carious tooth conditions in children in the UK. METHOD: A representative sample of children five, eight, 12 and 15 years of age were examined by calibrated examiners in schools across the UK. The dental examination included accidental damage to incisors, tooth surface loss (TSL) and enamel opacities (age 12 only). A postal questionnaire sought parental and child views on marks on teeth which could not be removed by brushing. RESULTS: The proportion of children sustaining accidental damage to permanent incisors decreased to 11% of 12 and 13% of 15-year-olds, but the majority of accidental damage remained untreated. TSL was found on 53% of five-year-olds and on approximately a third of 12 and 15-year-olds. There was a statistically significant change for TSL on permanent teeth at age 15 where 27% upper incisors had TSL palatally in 1993 compared to 33% in 2003. Thirty-four per cent of 12-year-old children had enamel opacities on one or more of their teeth compared with 36% in 1993. CONCLUSIONS: Tooth surface loss remains a common finding in children in the UK. A large proportion of accidental damage to teeth remains untreated.

Adolescent↗
PubMed2005

Faecal calprotectin in the assessment of Crohn's disease activity.

BACKGROUND: Clinical and laboratory assessment of activity in Crohn's disease (CD) correlate poorly with endoscopic findings. Calprotectin is a calcium-binding protein abundant in neutrophil cytosol, and extremely stable in faeces. Faecal calprotectin (FC) is an excellent surrogate marker of neutrophil influx into the bowel lumen. AIM: To assess whether FC concentration from a spot stool sample reliably detects active inflammation in patients with CD. DESIGN: Cross-sectional comparative study. METHODS: Subjects had a previously confirmed diagnosis of CD and were suspected on clinical grounds to be in the midst of a relapse. Thirty-five entered the study; they underwent radiolabelled white cell scanning (WCS) and had a stool sample collected for calprotectin measurement on the same day. A Crohn's disease activity index (CDAI) was also calculated for each. The WCS scans were scored at six standard sites to give a mean total, 'extent', 'severity' and 'combined extent and severity' scores. RESULTS: FC was significantly and positively correlated with mean total (r = 0.73, p < 0.001), 'extent' (r = 0.71, p < 0.001), 'severity' (r = 0.64, p < 0.001) and combined 'extent and severity' WCS scores (r = 0.71, p < 0.001). A cut-off of faecal calprotectin > 100 microg/g gave a sensitivity of 80%, specificity of 67%, positive predictive value of 87% and a negative predictive value of 64% in identifying those with and without any inflammation on WCS. There was, however, no significant correlation between CDAI and mean total WCS score (r = 0.21, p = 0.24), nor between CDAI and FC (r = 0.33, p = 0.06). DISCUSSION: While the CDAI does not accurately reflect inflammatory activity in CD, a one-off FC reliably detects the presence or absence of intestinal inflammation in adult patients with CD, compared to WCS.

Adult↗
PubMed2005

Cannula-associated Staphylococcus aureus bacteraemia: outcome in relation to treatment.

BACKGROUND: Despite the frequency of cannula-associated Staphylococcus aureus bacteraemia (CASAB) there is uncertainty regarding the duration of treatment required. AIM: To determine the relationship between the duration and type of treatment for CASAB and subsequent relapse with deep-seated S. aureus infection. METHODS: We prospectively studied 276 patients with CASAB. Patients were followed for at least 8 weeks after completion of antibiotic treatment. Initial and subsequent isolates of S. aureus were compared using molecular methods to determine strain similarity. RESULTS: Initial mortality was 9% (26 of 276) and a complicating focus of infection presented during initial treatment in 6% (15 of 250) of the survivors. There were nine relapses of deep-seated infection from the strain causing the original infection. Relapses were equally common following peripheral CASAB and central CASAB. There was no relationship between the duration of treatment and the rate of relapse of deep-seated infection (P = 0.24). This observation held true regardless of whether the duration of treatment was analysed as < or = 7 versus > or = 8, < or =10 versus > or =11, or < or=14 versus > or =15 days (P = 0.62, 0.87 and 0.16, respectively). CONCLUSION: Episodes of peripheral CASAB pose an equal risk of relapse to central cannula-related episodes. Although further studies are needed to determine the optimal treatment of CASAB, our study strongly suggests that more than 14 days treatment is excessive for most patients who respond promptly to cannula removal and antibiotic treatment.

Adolescent↗
PubMed2005

Analysis of factors predictive of mortality in alcoholic hepatitis and derivation and validation of the Glasgow alcoholic hepatitis score.

INTRODUCTION: Alcoholic hepatitis is associated with a high short term mortality. We aimed to identify those factors associated with mortality and define a simple score which would predict outcome in our population. METHODS: We identified 241 patients with alcoholic hepatitis. Clinical and laboratory data were recorded on the day of admission (day 1) and on days 6-9. Stepwise logistic regression was used to identify variables related to outcome at 28 days and 84 days after admission. These variables were included in the Glasgow alcoholic hepatitis score (GAHS) and its ability to predict outcome assessed. The GAHS was validated in a separate dataset of 195 patients. RESULTS: The GAHS was derived from five variables independently associated with outcome: age (p = 0.001) and, from day 1 results, serum bilirubin (p<0.001), blood urea (p = 0.019) and, from day 6-9 results, serum bilirubin (p<0.001), prothrombin time (p = 0.002), and peripheral blood white blood cell count (p = 0.001). The GAHS on day 1 had an overall accuracy of 81% when predicting 28 day outcome. In contrast, the modified discriminant function had an overall accuracy of 49%. Similar results were found using information at 6-9 days and when predicting 84 day outcome. The accuracy of the GAHS was confirmed by the validation study of 195 patients The GAHS was equally accurate irrespective of the use of the international normalised ratio or prothrombin time ratio, or if the diagnosis of alcoholic hepatitis was biopsy proven or on the basis of clinical assessment. CONCLUSIONS: Using variables associated with mortality we have derived and validated an accurate scoring system to assess outcome in alcoholic hepatitis. This score was able to identify patients at greatest risk of death throughout their admission.

Bilirubin↗
PubMed2004

Facilitators and barriers to improving the quality of referrals for potential oral cancer.

The quality and content of referral letters are important for prioritisation of patients who may have oral cancer. Referrals letters to the Oral Medicine Clinic at Birmingham Dental Hospital were analysed and practitioners interviewed. Whilst acceptable for general purposes, most letters did not contain sufficient information to allow effective prioritisation. Interviews disclosed a misunderstanding amongst practitioners about the way in which referrals were handled. A number of barriers to increasing the information included in letters were identified. Referral guidelines and a standardised proforma might help improve the ability of the service to operate a fast-track system.

Communication Barriers↗
PubMed2004

Soma-germ line competition for lipid phosphate uptake regulates germ cell migration and survival.

Lipid phosphates can act as signaling molecules to influence cell division, apoptosis, and migration. wunen and wunen2 encode Drosophila lipid phosphate phosphohydrolases, integral membrane enzymes that dephosphorylate extracellular lipid phosphates. wun and wun2 act redundantly in somatic tissues to repel migrating germ cells, although the mechanism by which germ cells respond is unclear. Here, we report that wun2 also functions in germ cells, enabling them to perceive the wun/wun2-related signal from the soma. Upon Wun2 expression, cultured insect cells dephosphorylate and internalize exogenously supplied lipid phosphate. We propose that Drosophila germ cell migration and survival are controlled by competition for hydrolysis of a lipid phosphate between germ cells and soma.

Animals↗
PubMed2003

Dental erosion -- changing prevalence? A review of British National childrens' surveys.

OBJECTIVES: To investigate the change in the prevalence of dental erosion, over time, by a review of the data from the published national dental surveys of young people in the UK. A subsidiary objective was to investigate the relationship between erosion and possible associated risk factors. DESIGN: The review was based on cross-sectional prevalence studies incorporating a clinical dental examination and structured interviews. SAMPLE: The data were collated from the 1993 UK childrens' dental health survey and the dental report of the two National Diet and Nutrition Surveys (NDNS) of children aged 1(1/2)-4(1/2) in 1992/3 and 4-18 years in 1996/7. The criteria used for data collection were comparable between the three different studies. RESULTS: Comparing the data from the different studies, the prevalence of erosion was seen to increase from the time of the childrens' dental health survey in 1993 and the NDNS study of 4-18-year-olds in 1996/7. There was a trend towards a higher prevalence of erosion in children aged between 3(1/2) and 4(1/2) and in those who consumed carbonated drinks on most days compared with toddlers consuming these drinks less often. Drinks overnight were associated with an increased prevalence of erosion. More 4-6-year-olds with reported symptoms of gastro-oesophageal reflux had erosion compared with symptom-free children. On multivariate analysis, the strongest independent association with erosion was geography, with children living in the North having twice the odds of having erosion compared with those in London and the South-east. CONCLUSIONS: Comparing prevalence data from cross-sectional national studies indicates that dental erosion increases between different age cohorts of young people over time. Dietary associations with erosion are present but weak. Similarly, there is an association apparent between erosion, symptoms of gastro-oesophageal reflux and socio-demographic variables such as region of domicile, social class, and receipt of social benefits.

Adolescent↗