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Biomedical subjects

C Chambers

Publications and source records attributed to C Chambers.

At least 19 recordsLinked to original sources
PubMed2007

A comparison between subjective outcome score and moderate radial shortening following a fractured distal radius in patients of mean age 69 years.

Radial shortening has been associated with a poor functional outcome following a fractured distal radius. This paper reports the results of evaluation by the patient rated wrist evaluation (PRWE) score of 60 patients (mean age 69) who underwent closed reduction and K-wire fixation of distal radial fractures. In this patient group, no association was found between moderate radial shortening, either at injury or fracture union, and this subjective outcome score. A significant association was found between the assessment of these fractures by the Frykman classification and the PRWE score (P=0.01).

Aged↗
PubMed2003

New skills for a new age: leading the introduction of public health concepts in healthcare curricula.

Health policy in the UK is going through significant changes. At the heart of the transformation is a dedicated focus on public health. The new primary-care-based health system will not only be premised on a specialist public health workforce, but also on broader based public-health-oriented health professionals. Within primary care, widening the foundation of health professionals with public health competencies suggests that higher education bodies will need to adapt their curricula to an approach that highlights population-based health principles, preventive philosophy, and public health concepts and methods. The first part of this paper describes the mapping of the public health content of healthcare curricula at one university in England, based on the 10 public health standard areas of competencies of the Faculty of Public Health Medicine. The second part examines, through the findings of a strengths, weaknesses, opportunities, threats (SWOT) analysis, the factors that advocates for a public-health-oriented educational strategy must examine before embarking on the instigation and development of public health concepts in the healthcare curricula. The aspects that necessitate consideration include strengths such as the prevailing policy, market forces, commitment, and motivation to the effort, and the availability of resources, information and external contacts. Features such as political drive and advocacy, interest in the education debate, collaborative links through joint working and partnerships, and ongoing internal reforms and restructuring could all act as opportunities. However, resistance and anxiety are to be expected, the operationalization of the effort and empowerment of those leading it need to be thought about, and issues of control and interests are critical. The presence of conflicting priorities and competition or the lack of vision and directives, or uncertainty about change, could act as threats and barriers to the effort. If shifting the 'traditional' healthcare curricula to a more 'innovative' public-health-oriented one is to be a success, administrators of educational change will need to take into account a 'melange' of factors and stakeholders involved in a gradual and incremental process.

Curriculum↗
PubMed2001

Analysis of single-molecule mechanical recordings: application to acto-myosin interactions.

Several laboratories have now developed methods to make single-molecule mechanical recordings from interacting pairs of biological molecules. The mechanical work done (product of force and distance) by a single biomolecular interaction is usually of the same order as thermal energy. Recordings made from non-processive, intermittently interacting, molecular motors such as acto-myosin therefore contain a large background of thermal noise. We have applied Page's test to analyse mechanical interactions between muscle myosin II's and F-actin recorded using an optical tweezers based single-molecule mechanical transducer. We compare Page's test with other variance-based methods and find it to be a robust method for analysing both simulated and real data sets. We discuss some of the problems associated with automatic detection of transient mechanical events in noisy data signals, and show that if the start and end points of individual events are known accurately then the events may be synchronised and combined to give more detailed information about different mechanical states.

Actomyosin↗
PubMed2001

Pregnancy outcome following gestational exposure to venlafaxine: a multicenter prospective controlled study.

OBJECTIVE: Because there are no studies available on the safety of venlafaxine during pregnancy, the authors' goal in this study was to determine whether venlafaxine increases the risk for major malformations. METHOD: Data on 150 women exposed to venlafaxine during pregnancy in seven pregnancy counseling centers were compared with data from studies of pregnant women who 1) received selective serotonin reuptake inhibitor antidepressants (SSRIs) (N=150) and 2) who received nonteratogenic drugs (N=150). RESULTS: Among the 150 women who were exposed to venlafaxine during pregnancy, 125 had live births, 18 had spontaneous abortions, and seven had therapeutic abortions; two of the babies had major malformations. There were no significant differences between these women and the two comparison groups on any of the measures analyzed. CONCLUSIONS: These results suggest that the use of venlafaxine during pregnancy does not increase the rates of major malformations above the baseline rate of 1%-3%.

Abnormalities, Drug-Induced↗
PubMed2000

Pinpointing when T cell costimulatory receptor CTLA-4 must be engaged to dampen diabetogenic T cells.

Engagement of the T cell costimulatory receptor CTLA-4 can potently down-regulate an immune response. For example, in a T cell receptor transgenic mouse model of autoimmune diabetes, CTLA-4 interactions keep pancreatic islet-reactive T cells in check, evidenced by the finding that mAb blockade of CTLA-4 rapidly provokes diabetes in animals that would not normally succumb until many months later. Interestingly, this effect is only observed early in the course of disease, before insulitis is stably entrenched. Here, we have exploited a highly synchronous and easily manipulable transfer system to determine precisely when CTLA-4 must be engaged to check the diabetogenicity of islet-reactive T cells. Our results indicate that CTLA-4 interactions during initial priming of the T cells in the pancreatic lymph nodes are not determinant. Rather, the critical interactions occur when the T cells secondarily reencounter their antigen in the target organ, the pancreatic islets. In addition, we made use of CTLA-4-deficient mice to bolster our interpretation that CTLA-4 engagement has a dampening rather than an enhancing influence on diabetes progression.

Abatacept↗
PubMed2000

Gas exchange and heart rate in the harbour porpoise, Phocoena phocoena.

The respiratory physiology, heart rates and metabolic rates of two captive juvenile male harbour porpoises (both 28 kg) were measured using a rapid-response respiratory gas analysis system in the laboratory. Breath-hold durations in the laboratory (12 +/- 0.3 s, mean +/- SEM) were shorter than field observations, although a few breath-holds of over 40 s were recorded. The mean percentage time spent submerged was 89 +/- 0.4%. Relative to similarly-sized terrestrial mammals, the respiratory frequency was low (4.9 +/- 0.19 breaths.min-1) but with high tidal volumes (1.1 +/- 0.011), enabling a comparatively high minute rate of gas exchange. Oxygen consumption under these experimental conditions (247 +/- 13.8 ml O2.min-1) was 1.9-fold higher than predicted by standard scaling relations. These data together with an estimate of the total oxygen stores predicted an aerobic dive limit of 5.4 min. The peak end-tidal O2 values were related to the length of the previous breath-hold, demonstrating the increased oxygen uptake from the lung for the longer dives. Blood oxygen capacity was 23.5 +/- 1.0 ml.100 ml-1, and the oxygen affinity was high, enabling rapid oxygen loading during ventilation.

Animals↗
PubMed2000

Eye movements and lexical access in spoken-language comprehension: evaluating a linking hypothesis between fixations and linguistic processing.

A growing number of researchers in the sentence processing community are using eye movements to address issues in spoken language comprehension. Experiments using this paradigm have shown that visually presented referential information, including properties of referents relevant to specific actions, influences even the earliest moments of syntactic processing. Methodological concerns about task-specific strategies and the linking hypothesis between eye movements and linguistic processing are identified and discussed. These concerns are addressed in a review of recent studies of spoken word recognition which introduce and evaluate a detailed linking hypothesis between eye movements and lexical access. The results provide evidence about the time course of lexical activation that resolves some important theoretical issues in spoken-word recognition. They also demonstrate that fixations are sensitive to properties of the normal language-processing system that cannot be attributed to task-specific strategies.

Cognition↗
PubMed1999

A controlled evaluation of assessments by doctors and nurses in a magistrates' court mental health assessment and diversion scheme.

In this study, assessments of prisoners by doctors and nurses were compared in a provincial magistrates' court mental health assessment and diversion scheme, and outcomes were compared with the outcomes of those for whom no assessments were available during a control period. Substance misuse was relatively common and psychosis uncommon in the prisoners referred. Assessment by doctors enabled magistrates to reduce remands in custody of persons suspected of suffering from mental disorder and to grant bail in more cases. Only a small proportion of prisoners were admitted to hospital and although doctors and nurses recommended out-patient treatment in many cases, the attendance rate was low. Doctors were more likely than nurses to identify prisoners with medical needs that needed to be brought to the attention of the prison health care service, and to recommend out-patient psychiatric treatment and identify relevant medicolegal issues. Prisoners assessed by nurses were less likely than those assessed by doctors to attend alcohol or drug treatment services if recommended to do so. Prisoners who were admitted to hospital after a remand in custody spent longer on remand if assessed by nurses compared with those assessed by doctors.

Adolescent↗
PubMed1998

A role for CTLA-4-mediated inhibitory signals in peripheral T cell tolerance?

Occupancy of the antigen receptor is not sufficient for activation of naïve T cells--additional co-stimulatory signals are required that can be provided only by 'professional' antigen-presenting cells. This two-signal model for T cell activation has been thought to provide a mechanism for the induction and maintenance of peripheral tolerance. Work over the past six years has demonstrated that the relevant co-stimulatory receptor on T cells is the molecule CD28. Recent data shows that the CD28 homologue CTLA-4 plays a role in negative regulation of T cell responses. Here we suggest that CTLA-4 may also serve as an attenuator of T cell-activating signals, raising the threshold of stimulation required to obtain full activation. The inhibitory signals mediated by CTLA-4 may provide an additional mechanism for the maintenance of peripheral tolerance.

Abatacept↗
PubMed1998

A new ambulatory classification and funding model for radiation oncology: non-admitted patients in Victorian hospitals.

The Victorian Department of Human Services has developed a classification and funding model for non-admitted radiation oncology patients. Agencies were previously funded on an historical cost input basis. For 1996-97, payments were made according to the new Non-admitted Radiation Oncology Classification System and include four key components. Fixed grants are based on Weighted Radiation Therapy Services targets for megavoltage courses, planning procedures (dosimetry and simulation) and consultations. The additional throughput pool covers additional Weighted Radiation Therapy Services once targets are reached, with access conditional on the utilisation of a minimum number of megavoltage fields by each hospital. Block grants cover specialised treatments, such as brachytherapy, allied health payments and other support services. Compensation grants were available to bring payments up to the level of the previous year. There is potential to provide incentives to promote best practice in Australia through linking appropriate practice to funding models. Key Australian and international developments should be monitored, including economic evaluation studies, classification and funding models, and the deliberations of the American College of Radiology, the American Society for Therapeutic Radiology and Oncology, the Trans-Tasman Radiation Oncology Group and the Council of Oncology Societies of Australia. National impact on clinical practice guidelines in Australia can be achieved through the Quality of Care and Health Outcomes Committee of the National Health and Medical Research Council.

Abstracting and Indexing↗
PubMed1998

Orientation to community in a family practice residency program.

BACKGROUND: Family practice residencies are expected to include opportunities for trainees to learn about population-based approaches to health care delivery. METHODS: To prepare them for community projects later in training, first-year residents were introduced to a community-oriented primary care (COPC) curriculum by an interdisciplinary team with representatives from public health and academic family medicine. During their mid-year orientation month, the residents spent three afternoons in community settings, each year focusing on a different public health issue. The residents spent the first afternoon discussing principles of community medicine, the COPC model, and planning community interviews. The second afternoon, they interviewed in the community. The residents reported and evaluated on the third afternoon. RESULTS: During the 3 years described, most residents participated with enthusiasm, later reporting increased awareness and use of community resources. However, months after the third experience, a comparison of clinic records before and after the orientation showed no difference in the residents' inclusion of the health issue studied in managing their patients, although social workers and other non-physician faculty team members reported that residents consulted them more frequently following the community orientation. CONCLUSIONS: It is important to provide residents with an efficiently designed and attractive community orientation early in training. An interdisciplinary team should plan and coordinate their experiences, but all faculty should role model good community behavior. Although the 1996 residents described behavioral changes following this brief orientation, this was not documented by a chart review.

Adolescent↗
PubMed1997

Association properties of betaB2- and betaA3-crystallin: ability to form dimers.

The beta-crystallins are a major constituent of the mammalian lens, where they associate into dimers, tetramers and higher order aggregates. Appropriate association of lens crystallins is important for lens transparency. To examine the associative properties of betaB2-crystallin, we have expressed mouse betaB2-crystallin using a baculovirus system. Recombinant mouse betaB2-crystallin has an estimated monomer molecular weight of 24 kDa by SDS-PAGE, appropriate immunoreactivity and appropriate secondary structure as assessed by circular dichroism analysis. The recombinant betaB2-crystallin associates into a homodimer with a weight average molecular mass of 39 kDa. The betaB2-crystallin homodimer has an estimated Kd of 5 x 10(-6) M, slightly greater than that of betaA3-crystallin, 0.8 x 10(-6) M. When recombinant betaB2-crystallin is combined with recombinant betaA3-crystallin, a heterodimer is formed within 10 min of incubation at room temperature. When equilibrium is reached in 4-6 h, approximately half of each crystallin associates into heterodimers. Subunit exchange between betaB2-crystallin and betaA3-crystallin occurs readily in the absence of any denaturing agents. Thus, rbetaA3-rbetaB2 heterodimer formation can occur under conditions similar to those found in the eye lens.

Animals↗
PubMed1996

Farnesol is not the nonsterol regulator mediating degradation of HMG-CoA reductase in rat liver.

A recent report, in which cultured tumor cells were used, identified farnesol as the nonsterol mevalonate-derived metabolite required for the accelerated degradation of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase (C. C. Correll, L. Ng, and P. A. Edwards, 1994, J. Biol. Chem. 269, 17390-17393). We examined this proposed linkage in animals by measuring hepatic farnesol levels and rates of HMG-CoA reductase degradation under conditions previously shown to alter the stability of the reductase. In normal rats, the hepatic farnesol level, quantified by high-pressure liquid chromatography, was 0.10 +/- 0.08 microgram/g and the half-life of HMG-CoA reductase was 2.5 h. Administration of mevalonolactone at 1 g/kg body wt to provide all nonsterol metabolites in addition to cholesterol increased farnesol levels 6-fold without significantly affecting the half-life of the reductase. Treatment of rats with zaragozic acid A, an inhibitor of squalene synthase, raised hepatic farnesol levels 10-fold and decreased the half-life of HMG-CoA reductase to 0.25 h. However, feeding lovastatin to rats did not lower hepatic farnesol levels despite a marked stabilization of HMB-CoA reductase protein. Moreover, intubation of rats with 500 mg/kg body wt of farnesol failed to decrease the half-life of HMG-CoA reductase protein, alter the levels of enzyme activity, or change of the levels of immunoreactive protein despite an increase of 1000-fold in hepatic farnesol levels. These observations indicate that farnesol per se does not induce accelerated degradation of HMG-CoA reductase in rat liver.

Animals↗
PubMed1996

Working women's sexual risk taking in Jamaica.

Although the rates of HIV are increasing among female populations in developing countries, there is little information available about factors influencing sexual risk taking among working class women. This paper describes some of the issues discussed by two groups of 58 women working in Jamaica: Informal Commercial Importers and women working in the Freezone. These women discuss their economic vulnerability, expectations about the role of men as providers, multiple partners, perceptions of children as resources and concern about physical abuse as factors that could influence decisions about condom use. The implications of these findings are discussed for their impact on intervention programs targeting working class women in Jamaica.

Adult↗
PubMed1996

Diabetes-mediated decreases in ovarian superoxide dismutase activity are related to blood-follicle barrier and ovulation defects.

The activity of nitric oxide (NO) has been implicated as an important mediator in ovarian function, including the regulation of the blood-follicle barrier and ovulation. Both clinical and experimental diabetes have been found to impair endothelial-dependent vascular activity through the inactivation of NO. It has also been shown that diabetes-induced inactivation of NO can be rescued with administration of insulin as well as with free radical scavengers such as superoxide dismutase (SOD). In this study, we report decreases in both ovulation and the activity of the blood-follicle barrier in insulin-dependent diabetic prepubertal mice treated with exogenous gonadotropic hormones. Moreover, these ovarian defects are rescued with administration of insulin, nitroprusside, L-arginine, and the free radical scavengers citiolone and 4,5-dihydroxy-1,3-benzene disulfonic acid (Tiron). We found that the activity of Cu/Zn SOD in the ovaries of diabetic mice used in this study is decreased by 48% compared to that in nondiabetic mice. In contrast, inhibition of SOD activity in nondiabetic mice induces defects in the blood-follicle barrier and ovulation similar to those observed in diabetic mice. Lastly, we report the localization of endothelial nitric oxide synthase, inducible NOS, Cu/Zn SOD, and the LH receptor to the same population of endothelial cells surrounding the preovulatory follicle, supporting our hypothesis that the signaling of ovarian NO within the ovarian microvasculature at the time of ovulation may be compromised in these diabetic mice as a consequence of the loss of the protective activity of Cu/Zn SOD.

1,2-Dihydroxybenzene-3,5-Disulfonic Acid Disodium ↗