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Andrew Morris

Publications and source records attributed to Andrew Morris.

29 records · Page 2Linked to original sources
PubMed2003

Requirements for the crash protection of older vehicle passengers.

This study compares injury outcomes in vehicle crashes involving different age groups of belted passengers. Two datasets were considered. Firstly, UK national data revealed that younger passengers are much more likely to be involved in crashes per million miles travelled compared to older passengers although older passengers are much more likely to be killed or seriously injured compared to younger passengers. Secondly, in-depth vehicle crash injury data were examined to determine some of the underlying reasons for the enhanced injury risk amongst older passengers. In crashes of approximately equal severity, the older passenger group were significantly more likely to be fatally injured in frontal crashes (p<0.001). However young passengers were as equally likely to be killed in struck-side crashes compared to the older group. The results also showed that older passengers sustained more serious injuries to the chest region in frontal crashes compared with the younger aged group (p<0.0001) and it is this body region that is particularly problematic. When the data were analysed further, it was found that a large proportion of passengers were female and that in the majority of cases, the seat belt was responsible for injury. Since by the year 2030, 1 in 4 persons will be aged over 65 in most OECD countries, the results suggest a need for intervention through vehicle design including in-vehicle crashworthiness systems that take into account reduced tolerance to impact with ageing.

Abbreviated Injury Scale↗
PubMed2003

The effect of height on injury outcome for drivers of European passenger cars.

Statistical analysis of the UK in-depth accident database has been used to establish the characteristics of the 'small driver' at increased risk of injury. Drivers less than 160 cm in height are shown to have a significantly higher than average probability of AIS 2+ head and AIS 2+ pelvis and lower extremity injury. Subject trials have been used to establish the seating preferences of small stature drivers together with a comparison group drawn from the population as a whole.

Abbreviated Injury Scale↗
PubMed2003

Quality measurement of care for people with type 2 diabetes in Tayside, Scotland: implications for the new UK general practice contract.

BACKGROUND: The new United Kingdom general practice contract proposes that up to a third of general practitioners' income will come from achieving quality targets. AIM: To examine selected quality markers in terms of their robustness to case-mix variation and chance effects, and in the attribution of quality to practices. STUDY DESIGN AND METHODS: Data were extracted from a population-based diabetes clinical information system in Tayside, Scotland, for patients with type 2 diabetes registered in 67 practices with complete ascertainment. RESULTS: Most practices would have received relatively high levels of payment for the process measures examined. Outcome measures appeared more challenging. Case-mix adjustment for age, sex, and postcode-assigned deprivation altered measured performance by up to 7%, but payment by up to 14%. Despite no strong evidence of any real difference in quality, chance effects meant that there was greater apparent variability for smaller practices from year to year. Hospital attendance was common, but highly variable between practices. CONCLUSION: Case-mix adjustment to allow fairer comparison is routine in national performance indicators, and ignoring it risks making the new contract quality framework inequitable. Because of chance effects, smaller practices may have greater year-to-year variability in income. Reflecting National Health Service structure, the new contract provides no incentives for integrated care and offers a perverse incentive to refer more patients to hospital. There are trade-offs between the validity of measures, and the cost and bureaucracy of collecting data. The planned evaluation of the new contrast should examine the effectiveness and equity of the quality framework, and rapidly act on deficiencies found.

Diabetes Mellitus, Type 2↗
PubMed2002

Haplotype analysis of the PPARgamma Pro12Ala and C1431T variants reveals opposing associations with body weight.

BACKGROUND: Variation at the PPARG locus may influence susceptibility to type 2 diabetes and related traits. The Pro12Ala polymorphism may modulate receptor activity and is associated with protection from type 2 diabetes. However, there have been inconsistent reports of its association with obesity. The silent C1431T polymorphism has not been as extensively studied, but the rare T allele has also been inconsistently linked to increases in weight. Both rare alleles are in linkage disequilibrium and the independent associations of these two polymorphisms have not been addressed. RESULTS: We have genotyped a large population with type 2 diabetes (n = 1107), two populations of non-diabetics from Glasgow (n = 186) and Dundee (n = 254) and also a healthy group undergoing physical training (n = 148) and investigated the association of genotype with body mass index. This analysis has demonstrated that the Ala12 and T1431 alleles are present together in approximately 70% of the carriers. By considering the other 30% of individuals with haplotypes that only carry one of these polymorphisms, we have demonstrated that the Ala12 allele is consistently associated with a lower BMI, whilst the T1431 allele is consistently associated with higher BMI. CONCLUSION: This study has therefore revealed an opposing interaction of these polymorphisms, which may help to explain previous inconsistencies in the association of PPARG polymorphisms and body weight.

Adult↗
PubMed2002

Involvement of phospholipases D1 and D2 in sphingosine 1-phosphate-induced ERK (extracellular-signal-regulated kinase) activation and interleukin-8 secretion in human bronchial epithelial cells.

Sphingosine 1-phosphate (S1P), a metabolite of sphingomyelin degradation, stimulates interleukin-8 (IL-8) secretion in human bronchial epithelial (Beas-2B) cells. The molecular mechanisms regulating S1P-mediated IL-8 secretion are yet to be completely defined. Here we provide evidence that activation of phospholipases D1 and D2 (PLD1 and PLD2) by S1P regulates the phosphorylation of extracellular-signal-regulated kinase (ERK) and IL-8 secretion in Beas-2B cells. S1P, in a time- and dose-dependent manner, enhanced the threonine/tyrosine phosphorylation of ERK. The inhibition of S1P-induced ERK phosphorylation by pertussis toxin and PD 98059 indicated coupling of S1P receptors to G(i) and the ERK signalling cascade respectively. Treatment of Beas-2B cells with butan-1-ol, but not butan-3-ol, abrogated the S1P-induced phosphorylation of Raf-1 and ERK, suggesting that PLD is involved in this activation. The roles of PLD1 and PLD2 in ERK activation and IL-8 secretion activated by S1P were investigated by infecting cells with adenoviral constructs of wild-type and catalytically inactive mutants of PLD1 and PLD2. Infection of Beas-2B cells with the wild-type constructs resulted in the activation of PLD1 and PLD2 by S1P and PMA. Also, the enhanced production of [(32)P]phosphatidic acid and [(32)P]phosphatidylbutanol in the presence of butan-1-ol and the increased phosphorylation of ERK by S1P were blocked by the catalytically inactive mutants hPLD1-K898R and mPLD2-K758R. Transient transfection of Beas-2B cells with human PLD1 and mouse PLD2 cDNAs potentiated S1P-mediated IL-8 secretion compared with vector controls. In addition, PD 98059 attenuated IL-8 secretion induced by S1P in a dose-dependent fashion. These results demonstrate that both PLD1 and PLD2 participate in S1P stimulation of ERK phosphorylation and IL-8 secretion in bronchial epithelial cells.

Bronchi↗
PubMed2002

Aortic injuries in side impacts: a preliminary analysis.

Injuries to the aorta are among the more serious injuries that result from vehicle impacts, and may often be fatal. This paper examined the incidence of aortic injuries in the US and UK using real-world crash data. The main outcome of interest was the level of risk associated with each principal direction of force for drivers and front seat passengers with respect to sustaining aortic injuries. The results indicate that the risk of sustaining an injury to the aorta is greater for near side crashes than for far side crashes. Further, it is apparent that given a near side crash, the risk of an aortic injury is greater on the left side of the body (and left side of the vehicle) than on the right. It was also found that the delta-V of crashes where occupants sustained an injury to the aorta was considerably higher than crashes where occupants did not sustain aortic injuries. It was speculated that the anatomical asymmetry of the thorax might play a role in the differences seen in injury risk associated with different impact directions. Limitations and further planned research are discussed.

Accidents, Traffic↗
PubMed2002

An overview of requirements for the crash protection of older drivers.

For some time now, it has been recognised that a major shift is occurring in the population age distributions of most motorised countries resulting in a growing number of older persons with an increasing need for mobility. It is expected that the mobility of older persons will become even more reliant on the motor vehicle as European countries in particular undergo transitions towards decentralisation and suburbanisation and because of the well-established longevity factor. As a group, older drivers do not currently represent a major road safety problem in most Western societies when compared with other age groups such as the young. However, they are involved in significantly more serious injury and casualty crashes per head of population. Furthermore, as older drivers are likely to become a more significant problem in the years ahead, it is now necessary to examine some vehicle design factors that affect the safety of the older driver in a crash.

Accidents, Traffic↗