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Biomedical subjects

C Chalmers

Publications and source records attributed to C Chalmers.

At least 19 recordsLinked to original sources
PubMed2002

Randomized controlled trial of the Alexander technique for idiopathic Parkinson's disease.

OBJECTIVE: To determine whether the Alexander Technique, alongside normal treatment, is of benefit to people disabled by idiopathic Parkinson's disease. DESIGN: A randomized controlled trial with three groups, one receiving lessons in the Alexander Technique, another receiving massage and one with no additional intervention. Measures were taken pre- and post-intervention, and at follow-up, six months later. SETTING: The Polyclinic at the University of Westminster, Central London. SUBJECTS: Ninety-three people with clinically confirmed idiopathic Parkinson's disease. INTERVENTIONS: The Alexander Technique group received 24 lessons in the Alexander Technique and the massage group received 24 sessions of massage. MAIN OUTCOME MEASURES: The main outcome measures were the Self-assessment Parkinson's Disease Disability Scale (SPDDS) at best and at worst times of day. Secondary measures included the Beck Depression Inventory and an Attitudes to Self Scale. RESULTS: The Alexander Technique group improved compared with the no additional intervention group, pre-intervention to post-intervention, both on the SPDDS at best, p = 0.04 (confidence interval (CI) -6.4 to 0.0) and on the SPDDS at worst, p = 0.01 (CI -11.5 to -1.8). The comparative improvement was maintained at six-month follow-up: on the SPDDS at best, p = 0.04 (CI -7.7 to 0.0) and on the SPDDS at worst, p = 0.01 (CI -11.8 to -0.9). The Alexander Technique group was comparatively less depressed post-intervention, p = 0.03 (CI -3.8 to 0.0) on the Beck Depression Inventory, and at six-month follow-up had improved on the Attitudes to Self Scale, p = 0.04 (CI -13.9 to 0.0). CONCLUSIONS: There is evidence that lessons in the Alexander Technique are likely to lead to sustained benefit for people with Parkinson's disease.

Activities of Daily Living↗
PubMed2002

Hysterectomy and ovarian function: levels of follicle stimulating hormone and incidence of menopausal symptoms are not affected by hysterectomy in women under age 45 years.

OBJECTIVE: To investigate levels of follicle stimulating hormone (FSH), as a measure of ovarian function and menopausal symptoms prior to and following hysterectomy in women under the age of 45 years. DESIGN: This was a prospective controlled study. SAMPLE: A total of 56 hysterectomy patients and 34 controls, up to the age of 42 years, were recruited. METHODS: Women undergoing hysterectomy were recruited prior to their operation and were matched, where possible, with controls for age, parity and smoking. Five blood samples were taken over 2 years, two before the operation (or at a 1-month interval in the control group) and then at 6 months, 1 year and 2 years. Questionnaires were completed at each sampling to assess symptoms associated with reduced estrogen secretion. RESULTS: No significant differences in FSH levels between patients and controls were found. Modest differences in FSH levels between different time-points were identified (p = 0.03), but this disappeared if age and smoking were included as covariates. For the questionnaire data, there were no significant differences between the two groups on the somatic and vasomotor scales, but for psychological symptoms the patients scored significantly higher than the controls (p = 0.007), particularly at the pre-operation time-point. CONCLUSION: The study found no evidence of compromise of ovarian function, as reflected in FSH levels, within 2 years of hysterectomy. Psychological symptoms were higher in women undergoing hysterectomy both before and after the operation.

Adult↗
PubMed2001

Maintaining contact with people with severe mental illness: 5-year follow-up of assertive outreach.

BACKGROUND: Assertive outreach is a central strand of Government mental health policy in England. Are different long-term models of mental health care which include assertive outreach associated with different service user outcomes and cost? METHOD: We conducted a multi-site 5-year follow-up study of people with severe mental illness. From 0 to 18 months all three sites had Intensive Case Management (ICM) teams practising assertive outreach. From 18 to 60 months one team sustained ICM, one team merged and another was disbanded. All 131 original ICM team clients were the study participants. Outcome was measured in terms of sustained engagement with statutory mental health services, psychiatric symptoms, social functioning, resource use and cost. RESULTS: All 120 live participants were traced. Only four people had no service contact; when contacted by a researcher they appeared to be coping well. No incidents of serious violence were discovered. No differences existed between teams in the mean total symptom or total social functioning change scores at follow-up, after controlling for baseline differences. No differences existed in mean cost between teams during the first 18 months. Mean (standard deviation) annualised costs varied considerably in the 18-60 month period: sustained team Pound Sterling13,734 (10,820); integrated team Pound Sterling11,037 (13,603); disbanded team Pound Sterling5,742 (7,007) (F=4.4, 105 df, p=0.015). CONCLUSION: Continued specialist assertive outreach service models have higher costs than non-specialist services for no apparent benefit. In the long term new assertive outreach services should have procedures in place to transfer people to lower intensity and lower cost care.

Case Management↗
PubMed1998

A short questionnaire (IRQ) to assess injecting risk behaviour.

AIM: To develop a short injecting risk questionnaire (IRQ) to measure sharing of injecting equipment. DESIGN: Matrix design with quota assignment, designed to compare the questionnaire when used by interview and self-completion, in agency and community settings, by agency staff and fieldworkers, with different injectors (age < 26 vs. 26+; male vs. female, opiate vs stimulant injectors), and in different geographical areas. SETTINGS: Drug treatment and helping agencies, and community settings, in England. PARTICIPANTS: Drug users who had injected in the last 4 weeks. MEASUREMENTS: Questions measured different aspects of equipment sharing. Questionnaire performance assessed by question acceptability, test-retest (parallel forms) reliability, inter-rater reliability, inter-instrument reliability, internal reliability, construct validity and internal collateral validity. Statistical tests included product moment correlation, principal components analysis, and Cronbach's alpha. FINDINGS: The questionnaire was highly acceptable. Test-retest correlations were all high and significant, questions performed well in all conditions, with no differences by site (agency vs. out-of-contact), order (interview or self-completion first), administration (staff vs. fieldworker), elapsed time or subject characteristics. The questionnaire had high internal reliability (Cronbach's alpha > +0.86), and items measured a similar domain with all questions loading highly (> 0.32) on a single factor which accounted for > 42% of the variance. The complete IRQ elicited higher reports of equipment sharing (77%) than a single question (56%). CONCLUSIONS: IRQ performs well in a variety of settings, when administered in different ways to different kinds of IDUs. A single question on 'sharing' elicits fewer positive responses than the use of multiple questions about different sharing practices.

Adult↗
PubMed1997

A collaborative European study of personal inhalable aerosol sampler performance.

Following the adoption of new international sampling conventions for inhalable, thoracic and respirable aerosol fractions, a working group of Comité Européen de Normalisation (CEN) drafted a standard for the performance of workplace aerosol sampling instruments. The present study was set up to verify the experimental, statistical and mathematical procedures recommended in the draft performance standard and to check that they could be applied to inhalable aerosol samplers. This was achieved by applying the tests to eight types of personal inhalable aerosol sampler commonly used for workplace monitoring throughout Europe. The study led to recommendations for revising the CEN draft standard, in order to simplify the tests and reduce their cost. However, some further work will be needed to develop simpler test facilities and methods. Several of the samplers tested were found to perform adequately with respect to the inhalable sampling convention, at least over a limited range of typical workplace conditions. In general the samplers were found to perform best in low external wind speeds, which are the test conditions thought to be closest to those normally found in indoor workplaces. The practical implementation of the CEN aerosol sampling conventions requires decisions on which sampling instruments to use, estimation of the likely impact that changing sampling methods could have on apparent exposures, and adjustment where necessary of exposure limit values. The sampler performance data obtained in this project were affected by large experimental errors, but are nevertheless a useful input to decisions on how to incorporate the CEN inhalable sampling convention into regulation, guidance and occupational hygiene practice.

Europe↗
PubMed1996

Does hysterectomy in a premenopausal woman affect ovarian function?

Women undergoing a hysterectomy without oophorectomy in their premenopausal years would expect to benefit from continued secretion of oestrogens to protect them from the conditions and symptoms associated with the climacteric and postmenopause. However, there is conflicting evidence regarding the effect of premenopausal hysterectomy on ovarian function. Some research indicates an increase in incidence and severity of menopausal symptoms following removal of the uterus, despite the ovaries remaining in place; others have failed to find evidence of a decrease in ovarian endocrine secretion, implying that the ovaries are unaffected. This article reviews the conflicting evidence regarding the effect of hysterectomy on ovarian function as well as examining evidence for counter-current exchange between the ovarian and uterine blood supplies. An hypothesis is put forward to explain how removal of a woman's uterus may affect her ovarian function.

Arteries↗
PubMed1996

Prevalence of markers for hepatitis B virus and HIV-1 among drug injectors in London: injecting careers, positivity and risk behaviour.

Concerns about the risks of HIV infection among drug injectors have eclipsed concerns about the prevalence and transmission of hepatitis, and in particular hepatitis B virus infection. Findings are reported from surveys undertaken with two separate community-recruited samples of drug injectors in London collected in 1992 (n = 505) and in 1993 (n = 507). Anonymized confirmed testing of saliva shows 51.5% of drug injectors in 1992 and 47.9% in 1993 to be antibody positive to the core antigen of hepatitis B virus (anti-HBc). Approximately half of the drug injectors confirmed as anti-HBc positive were unaware that they had been infected with hepatitis. Anti-HIV-1 prevalence was considerably lower at 7.0% in 1992 and 6.9% in 1993. Multivariate analyses showed anti-HBc positivity to be most likely among older injectors with longer injecting careers who had a history of having shared used needles and syringes. HIV-1 positivity was also associated with a history of having shared injecting equipment as well as with recent sharing (i.e. in the last 6 months). Unlike anti-HBc positivity, there were no associations between HIV-1 positivity and age or length of injecting career. Younger injectors with shorter injecting careers were more likely to report recent sharing of used injecting equipment than older injectors with longer injecting careers. We note the potential for continued transmission of HBV and HIV-1, particularly among younger injectors. We recommend an integrated strategy to maximize the health of drug injectors, of which HIV and HBV prevention is a part. There is a need to widen the availability of HBV vaccinations for HBV negative drug injectors and their sexual partners and for clear guidelines to drug injectors about the relative efficacy of bleach to disinfect injecting equipment of HBV and HIV.

Adolescent↗
PubMed1992

The role of significant life events in discriminating help-seeking among illicit drug users.

This paper examines the role of significant life events in distinguishing two samples of illicit drug users: 120 help-seekers (the "agency group") and 120 not seeking help (the "non-agency group"). We examined 10 life areas clustered around the general categories of "substance use," "social functioning," and "emotional and interpersonal functioning." A range of objective and self-reported information was collected regarding each life area covering the 12 months prior to interview. Analysis revealed that the agency group experienced a greater number of negatively perceived drug-related life events than the non-agency group. These life events were also more likely to have occurred in recent months, prompting reported "concern" and "need for help" among the agency group. Additionally, length of use of current primary drug was seen to be a contributory variable in distinguishing between the groups.

Adult↗
PubMed1992

Help-seeking among illicit drug users: some differences between a treatment and nontreatment sample.

A number of both medical and nonmedical disciplines have expressed concern regarding the large numbers of individuals that fail to present to services, despite experiencing problems similar to those of active help-seekers. Such a concern is most pertinent in the field of substance misuse, particularly in terms of the role of injecting drug users in the spread of HIV and AIDS. This study looked at two samples of problem drug takers in London: 120 seeking help (the "agency group") and 120 not seeking help (the "non-agency group"). A number of factors were examined to distinguish the two groups, including sociodemographic profiles, drug histories, and self-reported "concern" and "need for help" in a wide variety of life areas. Data analysis highlighted the significance of "concern" and "need for help" in specified life areas.

Adaptation, Psychological↗
PubMed1989

Luteinizing hormone response to an oestradiol challenge in 5 intersex pigs possessing ovotestes.

After challenge with oestradiol benzoate, the mean maximum LH concentration in 5 XX intersex pigs possessing ovarian and testicular tissue, or only testicular tissue, was 2.10 (+/- 0.41) ng/ml compared with 8.9 ng/ml in mature domestic gilts. These results indicate that exposure of the pig brain to testosterone before Day 30 of gestation is important, or that early testicular secretions other than testosterone are involved in the determination of brain gender. The observation that some intersex pigs show normal oestrous cycles implies that the response to these prenatal factors is primarily quantitative rather than qualitative.

Animals↗
PubMed1981

A study of an urban health centre: factors influencing contact with mothers and their babies.

Some insight into the use of primary care team was provided by a study of encounters with families with infants. The demand for primary care was large, and varied greatly depending on the circumstances of the family. Using statistical models, five possible influences on contact were examined - the presence of other children in the family, distance from the surgery, the family's socioeconomic grouping, maternal age, and maternal depression. Having more than one child and living close to the surgery increased the likelihood of a home visit by the doctor. There were proportionately more visits by the health visitors to first-time mothers who were depressed, and this was unaffected by distance. The baby clinic clinic was a popular meeting place, particularly for first-time mothers, and attendance showed no obvious social class bias. The degree of help sought by mothers, in terms of the number of contacts, appeared disproportionate to the child's physical problems. This indicates that more research is needed into the appropriateness of many contacts, and the extent to which the practice team is the most effective source of help.

Adolescent↗
PubMed1976

Medicines and elderly people: a general practice survey.

All 151 patients of 75 years and over in one practice were visited at home to survey their health and how they managed their medicines. Altogehter 87% were on regular treatment, 34% taking three or four different drugs each day. Most were responsible for their own drugs and managed them well, but many left their drugs in exposed places and were uncertain about how to dispose of unwanted medicines. Overall they were prescribed about three times the number of drugs prescribed for the general population, and women took twice as many drugs regularly as men. Although many drugs were obtained directly from a pharmacist, his advice was rarely sought. Most were labelled, but more explicit instructions about indications for taking the drug would have been helpful, and information about hoarded drugs would have been enhanced by dispensing and expiry dates. Treatment was facilitated when patients brought their drugs to the consultation and careful records were made of repeat prescriptions. As so many patients take three or more different types of drugs each day a container in which a day's supply could be laid out would be useful.

Aged↗