PubMed HealthSearch

Biomedical subjects

B Rodgers

Publications and source records attributed to B Rodgers.

At least 19 recordsLinked to original sources

Impact of pet ownership on elderly Australians' use of medical services: an analysis using Medicare data.

OBJECTIVES: To determine whether pet ownership by elderly people is associated with lower use of health services. DESIGN: Survey of physical and mental health, and retrospective 12-month review of Medicare records of the number of general practitioner and specialist services. PARTICIPANTS AND SETTING: Elderly people living in Canberra (Australian Capital Territory) and Queanbeyan (New South Wales), surveyed in 1994 for the second stage of a larger longitudinal study. RESULTS: Elderly pet owners did not differ from non-owners on any of the physical or mental health measures or in use of health services. CONCLUSION: Given the high use of health services by older people, our findings suggest that the claim that pet ownership leads to savings in health services should be viewed with caution.

Aged

"Mental health literacy": a survey of the public's ability to recognise mental disorders and their beliefs about the effectiveness of treatment.

OBJECTIVES: To assess the public's recognition of mental disorders and their beliefs about the effectiveness of various treatments ("mental health literacy"). DESIGN: A cross-sectional survey, in 1995, with structured interviews using vignettes of a person with either depression or schizophrenia. PARTICIPANTS: A representative national sample of 2031 individuals aged 18-74 years; 1010 participants were questioned about the depression vignette and 1021 about the schizophrenia vignette. RESULTS: Most of the participants recognised the presence of some sort of mental disorder: 72% for the depression vignette (correctly labelled as depression by 39%) and 84% for the schizophrenia vignette (correctly labelled by 27%). When various people were rated as likely to be helpful or harmful for the person described in the vignette for depression, general practitioners (83%) and counsellors (74%) were most often rated as helpful, with psychiatrists (51%) and psychologists (49%) less so. Corresponding data for the schizophrenia vignette were: counsellors (81%), GPs (74%), psychiatrists (71%) and psychologists (62%). Many standard psychiatric treatments (antidepressants, antipsychotics, electroconvulsive therapy, admission to a psychiatric ward) were more often rated as harmful than helpful, and some nonstandard treatments were rated highly (increased physical or social activity, relaxation and stress management, reading about people with similar problems). Vitamins and special diets were more often rated as helpful than were antidepressants and antipsychotics. CONCLUSION: If mental disorders are to be recognised early in the community and appropriate intervention sought, the level of mental health literacy needs to be raised. Further, public understanding of psychiatric treatments can be considerably improved.

Adolescent

GP attendance by elderly Australians: evidence for unmet need in elderly men.

OBJECTIVES: To examine GP service use by elderly people and, in particular, to compare those who had not consulted a GP in one year with those who were low attenders and those who were high attenders. DESIGN: Medicare data on GP service use were matched to data collected by interview in 1990-1991 and reinterview in 1994 as part of a community study on health and well-being. SETTING: Canberra and Queanbeyan in the Australian Capital Territory. PARTICIPANTS: People aged 70 years and over, living in the community. MAIN OUTCOME MEASURES: The number of visits made to a GP in 12 months. RESULTS: Medicare data were available for 624 of the 897 participants interviewed (70%). While the women non-attenders reported similar levels of physical illness and symptoms to the low attenders, men non-attenders reported significantly higher levels of illness (P < 0.01) than the low-attender group. The health of men who were non-attenders was very similar to men who were high attenders of GP services. Men who had not seen a GP in one year reported significantly more pain (P = 0.002) and less social support than both low attenders and high attenders (P = 0.012 and P = 0.049, respectively). CONCLUSION: We identified a group of men who had not attended a GP in one year, despite significant levels of morbidity. Such a group may benefit from consultation with a GP and could be targeted in any attempt to improve elderly men's health.

Aged

Education and decline in cognitive performance: compensatory but not protective.

The association between education and cognitive change was investigated in a large community sample of elderly people followed up after 3.6 years. Lower education was predictive of decline on the Mini-Mental State Examination (MMSE) and on tests of language and knowledge, but not on tests of cognitive speed, memory or reaction time. The effects of education were not attenuated when adjusted for health, disability or activity level. The findings suggest that education slows the rate of decline on crystallized intelligence, but not other cognitive abilities. Education may compensate for neurodegenerative changes rather than protect against them.

Activities of Daily Living

Belief systems of the general public concerning the appropriate treatments for mental disorders.

A study was conducted to assess the belief systems of the general public concerning the appropriate treatments for mental disorders and correlates of these belief systems. The study was based on the results of a household survey of the general public in Australia, using a national random sample of 2,031 adults aged 18-74 years. Respondents were given a vignette describing either a person with depression or one with schizophrenia, and were asked for their opinions about the helpfulness of various professional and non-professional treatments for the person described. A principal components analysis of the helpfulness ratings gave three factors: a Medical factor with high loadings on all drug treatments (except Vitamins) and on Psychiatric ward and ECT; a Psychological factor with high loadings on Counsellor, Social Worker, Phone counselling, Psychiatrist, Psychologist, Psychotherapy and Hypnosis; and a Lifestyle factor with high loadings on Close family, Close friends, Naturopath, Vitamins, Physical activity and Get out more. The same factors emerged from ratings of the two vignettes. Mean scores on scales constructed from the items with high loadings showed that the public tend to have a negative view of medical treatments and a positive view of psychological and lifestyle ones. However, medical treatments were rated more negatively for depression than for schizophrenia, psychological treatments were rated more positively for schizophrenia, and lifestyle treatments more positively for depression. Age, sex and education of respondents showed few associations with scores on the scales, although the better educated were more in favour of psychological treatments for both depression and schizophrenia and were less opposed to medical treatments for schizophrenia. Respondents who had suffered from the symptoms described in the schizophrenia vignette were more negative towards medical treatments. These findings about public belief systems could have implications for the provision of treatment: where there is a discrepancy in belief system between the patient and the clinician there may be poor adherence to treatment.

Adolescent

Public beliefs about causes and risk factors for depression and schizophrenia.

The objective of this study was to carry out a national survey to assess the Australian public's beliefs about causes and risk factors for mental disorders. A national household survey of 2,031 Australian adults was carried out. Half the respondents were presented with a vignette describing a person with major depression and the other half with a vignette describing schizophrenia. Respondents were asked to rate whether various factors are likely causes of problems such as that described in the vignette and to rate whether various groups are at higher or lower risk. For depression, social environmental factors were often seen as likely causes, which is consistent with the epidemiological evidence. However, genetic factors were considered as a likely cause by only half the population. For schizophrenia, social environmental factors were also often seen as causes, which is in contrast to the weak epidemiological evidence for such a role. Genetic factors attracted more support as a cause of schizophrenia than of depression. These findings point to areas where the mental health literacy of the population could be improved, particularly the over-emphasis on social environmental factors in schizophrenia. Of some concern was the belief of half the population that weakness of character is a likely cause of both depression and schizophrenia. This belief implies a negative evaluation of the sufferer as a person.

Adult

The course of depression in the elderly: a longitudinal community-based study in Australia.

BACKGROUND: We report the outcome of depressive states after 3-4 years in a community sample of the elderly. METHODS: A sample of 1045 persons aged 70+ years in 1990-1 was re-interviewed after 3.6 years. RESULTS: Mortality (21.7%) and refusal or non-availability (10.4%) were higher in those who initially had had a diagnosis or symptoms of depression. Of those with an ICD-10 depressive episode in 1990-1, 13% retained that diagnosis. Of those who were not depressed initially only 2.5% had become cases. Depression was unrelated to age or apolipoprotein E genotype. The best predictors of the number of depressive symptoms at follow-up was the number at Wave 1, followed by deterioration in health and in activities of daily living, high neuroticism, poor current health, poor social support, low current activity levels and high service use. Depressive symptoms at Wave 1 did not predict subsequent cognitive decline or dementia. CONCLUSIONS: Non-random sample attrition is unavoidable. ICD-10 criteria yield more cases than other systems, while continuous measures of symptoms confer analytical advantages. Risk factors for depressive states in the elderly have been further identified. The prognosis for these states is favourable. At the community level, depressive symptoms do not seem to predict cognitive decline, as they do in referred series.

Activities of Daily Living

A prospective study of cognitive function in the elderly.

BACKGROUND: We report on the change in cognitive function in a population sample of elderly people who have been examined on two occasions more than 3 years apart. METHODS: A sample of 1135 persons aged 70-102 years was interviewed at base-line then re-interviewed 3.6 years later with the Canberra Interview for the Elderly, which included tests of episodic memory and cognitive speed as well as the Mini-Mental State Examination and the National Adult Reading Test (NART). RESULTS: Mortality and loss to follow-up reduced the sample to 736, of whom 614 completed at least one test of cognitive performance on both occasions. Cognitive performance decreased with age, except on the NART. Decline over the follow-up period increased as a function of age in all cognitive measures, except the NART. Change in cognitive scores was close to normal distribution. Incident dementia was associated strongly with age and current level of cognitive performance, but not with rate of decline. Cognitive decline and the risk of incident dementia did not differ by gender. CONCLUSIONS: A score indicating possible impairment in the very elderly carries a worse prognosis than for the younger elderly. Decline is almost universal in at least one cognitive area among those over the age of 85.

Aged

Parental divorce and adult psychological distress: evidence from a national birth cohort: a research note.

An association was found between childhood parental divorce and adult psychological distress in a British national birth cohort at ages 23 and 33. No moderating effects were found for gender, age at separation, or remarriage of the custodial parent. Participants who were young adults when their parents divorced also showed increased levels of symptomatology, whereas those who experienced parental death in childhood showed no increased risk. An interaction between parental divorce and own divorce in women, giving particularly high symptom levels, arose from a selection process in those from divorced families of origin only, with high 23-year scores predicting subsequent divorce. Own divorce was associated with an increase in distress between age 23 and 33, but this was irrespective of family of origin.

Adolescent

Antigenic variation of core, NS3, and NS5 proteins among genotypes of hepatitis C virus.

Assays that detect antibody to hepatitis C virus (HCV) are used to screen blood donors and patients with hepatitis. Current enzyme-linked immunosorbent assay (ELISA)-based methods are invariably based upon antigens from expressed recombinant proteins or oligopeptides from HCV type 1. Some HCV antigens used in screening assays are coded by regions of the HCV genome that show extensive variability; therefore, HCV type 1-based assays may be less effective for the detection of antibody elicited by infection with other genotypes. In this study, we have measured antibody reactivity of sera from 110 hepatitis C patients infected with type 1b, 3a, or 4a to genotype-specific and cross-reactive epitopes present in recombinant proteins from HCV genotypes 1b (core, NS3, and NS5), 3a (NS3, NS5), and 4a (core, NS3), corresponding to those used in current third-generation screening ELISAs. By comparing the serological reactivities of sera to type-homologous and type-heterologous antigens, we detected a significant type-specific component to the reactivity to NS3 (61 to 77% of the total reactivity) and NS5 (60% of the total reactivity). Furthermore, despite the similarities in the amino acid sequences of the core antigens of type 1b and type 4a, we also found significantly greater reactivity to type-homologous antigens, with approximately 25% of reactivity being type specific. These findings are consistent with previous findings of fivefold weaker reactivity of sera from HCV type 2- and HCV type 3-infected blood donors in the currently used third-generation ELISAs and suggest that these assays are suboptimal for screening populations in which the predominant genotype is not type 1.

Amino Acid Sequence

Development of a scale to measure symptoms of anxiety and depression in the general UK population: the psychiatric symptom frequency scale.

OBJECTIVES: The psychiatric symptom frequency (PSF) scale was developed to assess symptoms of anxiety and depression (i.e. affective symptoms) experienced over the past year in the general population. This study aimed to examine the distribution of PSF scores, internal consistency, and factor structure and to investigate relationships between total scores for this scale and other indicators of poor mental health. PARTICIPANTS: The Medical Research Council national survey of health and development, a class stratified cohort study of men and women followed up from birth in 1946, with the most recent interview at age 43 when the PSF scale was administered. MAIN RESULTS: The PSF scale showed high internal consistency between the 18 items (Cronbach's alpha = 0.88). Ratings on items of the scale reflected one predominant factor, incorporating both depression and anxiety, and two additional factors of less statistical importance, one reflecting sleep problems and the other panic and situational anxiety. Total scores were calculated by adding 18 items of the scale, and high total scores were found to be strongly associated with reports of contact with a doctor or other health professional and use of prescribed medication for "nervous or emotional trouble or depression," and with suicidal ideas. CONCLUSIONS: The PSF is a useful and valid scale for evaluating affective symptoms in the general population. It is appropriate for administration by lay interviewers with minimal training, is relatively brief, and generates few missing data. The total score is a flexible measure which can be used in continuous or binary form to suit the purposes of individual investigations, and provides discrimination at lower as well as upper levels of symptom severity.

Adult

Helpfulness of interventions for mental disorders: beliefs of health professionals compared with the general public.

BACKGROUND: The study aimed to compare the beliefs of health professionals about the potential helpfulness of various mental health interventions with those of the general public. METHOD: Surveys were carried out in Australia of 872 general practitioners, 1128 psychiatrists, 454 clinical psychologists and 2031 members of the public. Respondents were presented with a case vignette describing either a person with depression or one with schizophrenia. Respondents were asked to rate the likely helpfulness of various types of professional and non-professional help and of pharmacological and non-pharmacological interventions. RESULTS: The professionals gave much high ratings than the public to the helpfulness of antidepressants for depression, and of antipsychotics and admission to a psychiatric ward for schizophrenia. Conversely, the public tended to give much more favourable ratings to vitamins and minerals and special diets for both depression and schizophrenia, and to reading self-help books for schizophrenia. CONCLUSION: The beliefs that health practitioners hold about mental disorders differ greatly from those of the general public. There is a need for mental health education campaigns to help close the gap between professional and public beliefs.

Adolescent

Beliefs about the helpfulness of interventions for mental disorders: a comparison of general practitioners, psychiatrists and clinical psychologists.

OBJECTIVE: The aim of this study was to assess health professionals' beliefs about the helpfulness of a broad range of possible interventions for mental disorders. METHOD: The study involved a postal survey of 872 general practitioners (GPs), 1128 psychiatrists and 454 clinical psychologists. These health practitioners were presented with a vignette describing either a person with schizophrenia or one with depression. The vignettes were taken from an earlier survey of the general public. Respondents were asked to rate the likely helpfulness of various types of professional and non-professional help and of pharmacological and non-pharmacological interventions. RESULTS: Two-thirds or more of each profession agreed that the person with schizophrenia would be helped by GPs, psychiatrists, clinical psychologists, antipsychotic agents and admission to a psychiatric ward. Similarly, two-thirds agreed that the person with depression would be helped by GPs, psychiatrists, clinical psychologists, antidepressants, counselling and cognitive-behavioural therapy. However, there were also areas of disagreement. Psychiatrists were less likely than GPs and clinical psychologists to rate psychological and lifestyle interventions as helpful, while clinical psychologists were less likely to rate specifically medical interventions as helpful. Younger members of the professional groups and female members (who also tended to be younger) tended to rate a wider range of interventions for each disorder as likely to be helpful. CONCLUSIONS: Despite areas of broad agreement about treatment, health practitioners were more likely to endorse the interventions associated with their own profession. However, younger members of each profession tended take a broader view. If these age differences represent a cohort effect, health professionals may in the future show greater acceptance of the helpfulness of interventions offered outside their profession. These conclusions are limited by the methodology of the survey, which involved a questionnaire designed for the public rather than professionals.

Adult

Reported parental behaviour and adult affective symptoms. 1. Associations and moderating factors.

Associations between retrospective ratings of parental behaviour and adult affective symptoms were investigated in a British national sample. Symptom scores at ages 36 and 43 years showed low but significant correlations with care (negative) and control (positive), as measured by the Parental Bonding Instrument. Prevalence of high symptom scores was much greater in respondents with low care-high control (affectionless control) parents than in those with high care-low control parents, but there was no synergistic effect of combined care and control. Degree of affectionless control was progressively related to risk of depression. No significant gender differences were found in these associations. Findings could not be explained as spurious relationships resulting from association with other features of childhood adversity, and there was evidence that distorted recall arising from contemporaneous depressed mood was not responsible. Work is needed to establish the causal mechanisms underlying observed associations, including inter-relationships between parental style and other early adversity, and factors mediating or moderating the long-term of parental behaviour.

Adolescent

Reported parental behaviour and adult affective symptoms. 2. Mediating factors.

Potential mediators of the modest association between retrospectively rated parental behaviour and adult affective symptoms in offspring were investigated in a national longitudinal study of a cohort followed to the age of 43. Personality measures from adolescence could account for a small part of this association. Personal relationships in adulthood were more strongly associated with both parental behaviour and symptoms: marital history, emotional support, social network and availability of help in a crisis. Poor parenting did not lead to a general vulnerability to later life events, and socio-economic status and financial hardship were not implicated in the link between parental behaviour and adult symptoms. However, parental affectionless control was associated with certain types of life stressors in adulthood, i.e. interpersonal as opposed to non-interpersonal life events. Collectively, aspects of personal relationships accounted for much of the elevated symptom levels in those rating parents as low on care or high on control. Findings were consistent with the notion that interpersonal competence is important in the continuity between childhood experience and adult mental health, but other possible interpretations are discussed.

Adolescent

Downregulation of Msx-2 expression results in chondrogenesis in the medial region of the avian mandible.

Homeobox-containing genes are thought to be regulators of pattern formation during vertebrate development. We have previously characterized regions in the developing chick mandible expressing either Msx-1 or Msx-2 in terms of their chondrogenic potential, rates of cell proliferation, and their correlation with regions of cell death. These experiments suggest that Msx-1 may be involved in outgrowth of the mandibular arch, and Msx-2 may be involved in delineating the non-chondrogenic region of the medial part of the mandibular arch. To further examine the possibility that expression of Msx-2 may be involved in preventing chondrogenesis in the medial region, mandibular arch explants from stage 23 chick embryos were cultured for 4 days in media in the absence of serum but in the presence of 20-30 microM Msx-2 sense or antisense oligonucleotides (18 mers). In explants grown in either control media or with the sense oligonucleotide two rods of cartilage separated by a cartilage free area located in the medial region of the mandible were formed. In explants treated with Msx-2 antisense oligonucleotide cartilage formation was observed in the medial region of the mandible resulting in the fusion of the two bilateral rods at the midline. These results suggest a negative relationship between Msx-2 expression and chondrogenesis in the medial region of the developing mandible.

Animals

Radiographic findings after pectus excavatum repair.

Postoperative radiographic changes after pectus repair have not previously been described. We reviewed the chest radiographs of 65 children who underwent surgical repair of pectus excavatum between early 1985 and mid-1992. After operation, 64 children showed atelectasis, 38 had pleural effusions, 30 showed a congestion or edema pattern, 12 had pneumothorax, 21 showed fixation strut tilt or rotation, and 4 had pneumomediastinum. Despite the sometimes worrying radiographic appearance, these children uniformly did well clinically.

Adolescent

Weight-for-height indices of adiposity: relationships with height in childhood and early adult life.

BACKGROUND: The expense and inconvenience of accurate assessment of fat/lean body mass have engendered a reliance on weight-for-height indices in epidemiological investigations; indices which are independent of height have been considered desirable. METHODS: The relationship between weight-for-height and height was examined using the 1958 birth cohort, National Child Development Study, at ages 7, 11, 16, 23 and 33 years. For each age the sample was divided into a number of height groups; underweight, overweight and obesity were defined by relative weight (RW) and body mass index (BMI) in childhood and adulthood respectively. RESULTS: In childhood the variance of RW showed substantial and systematic associations with height. Both underweight and overweight/obesity were related to height: patterns differed by age and sex, being most evident at age 7 in both sexes, continuing at age 11 (but more so in boys), and disappearing by age 16. At age 23, underweight was more prevalent and overweight and obesity less prevalent in the taller groups due to a linear correlation between BMI and height. At age 33 obesity was less prevalent in taller groups, particularly in women. CONCLUSIONS: These findings have implications for studies of obesity comparing groups which differ in height, for example, different cohorts or social classes. In the short term, interpretation of such results should take account of the phenomenon described. In the longer term, information is needed on the relationship between height and more precise assessment of adiposity to confirm the findings of the current analysis.

Adolescent