Outbreak of Clostridium difficile infection in an English hospital linked to hypertoxin-producing strains in Canada and the US.
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Bacterial Toxins↗
Biomedical subjects
Alyson Smith
Publications and source records attributed to Alyson Smith.
Assessment of quality of life in later life: development and validation of the QuiLL.
The aim was to develop a quality of life (QOL) instrument, informed by older people, carers and professionals in older peoples' services, for use by community care staff as part of their assessment, care-planning and outcome monitoring procedures. The multi-phase development project involved: qualitative interviews to generate the item pool; pre-testing; preliminary field-testing; and final testing in a community survey and in health and social care settings. The process was informed by over 100 interviews with older people, carers, professionals, academics and policy-makers. Two products emerged following data-reduction: a research instrument (64 items), and a shorter assessment tool suitable for routine use in clinical, therapeutic or case-management practice (27 items, taking 7-15 min to complete). A community survey using the research instrument achieved a 71% response rate (n = 249). Ninety six percent of people found the domain content of the assessment tool relevant, and 80% considered the items covered were important. Both instruments have good internal consistency (alpha = 0.85). Inter-rater reliability was good for research staff, but poor between them and operational staff. Little objective change took place during the 3-month follow-up study, but where it did the direction was consistent with subjective change. The instrument needs to be applied in different contexts to assess interventions of known impact. Together with daily living and health status measures it can form part of a comprehensive assessment for older people.
Activities of Daily Living↗
Analysis of the conserved N-terminal domains in major ampullate spider silk proteins.
Major ampullate silk, also known as dragline silk, is one of the strongest biomaterials known. This silk is composed of two proteins, major ampullate spidroin 1 (MaSp1) and major ampullate spidroin 2 (MaSp2). Only partial cDNA sequences have been obtained for these proteins, and these sequences are toward the C-terminus. Thus, the N-terminal domains have never been characterized for either protein. Here we report the sequence of the N-terminal region of major ampullate silk proteins from three spider species: Argiope trifasciata, Latrodectus geometricus, and Nephila inaurata madagascariensis. The amino acid sequences are inferred from genomic DNA clones. Northern blotting experiments suggest that the predicted 5' end of the transcripts are present in fibroin mRNA. The presence of more than one Met codon in the N-terminal region indicates the possibility of translation of both a long and a short isoform. The size of the short isoform is consistent with the published, cDNA based, N-terminal sequence found in flagelliform silk. Analyses comparing the level of identity of all known spider silk N-termini show that the N-terminus is the most conserved part of silk proteins. Two DNA sequence motifs identified upstream of the putative transcription start site are potential silk fibroin promoter elements.
Amino Acid Sequence↗
The FAST Alcohol Screening Test.
Using the Alcohol Use Disorders Identification Test (AUDIT) as the gold standard, the Fast Alcohol Screening Test (FAST) was developed for use in busy medical settings. AUDIT questionnaires were completed by 666 patients in two London accident & emergency (A&E) departments. Using a principal components analysis, as well as sensitivity and specificity indices, a two-stage screening test was developed, using four of the AUDIT items. The first stage involved one item that identified >50% of patients as either hazardous or non-hazardous drinkers. The second stage made use of the other three items to categorize the rest. The performance of this four-item questionnaire was then tested across a range of settings. Opportunistic samples of 100 patients completed AUDIT questionnaires in each of the following National Health Service settings: A&E department, fracture clinic, primary health centre and a dental hospital. It was concluded that the four-item FAST questionnaire had good sensitivity and specificity, across a range of settings, when the AUDIT score was used as the gold standard. The FAST questionnaire is quick to administer, since >50% of patients are categorized using just one question.
Adult↗