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Biomedical subjects

C Davison

Publications and source records attributed to C Davison.

At least 19 recordsLinked to original sources
PubMed2006

Surfactant therapy for bronchiolitis in critically ill infants.

BACKGROUND: Viral bronchiolitis is a common cause of respiratory failure in infants and children, and accounts for a significant portion of intensive care unit (ICU) admissions during seasonal epidemics. Currently there is no evidence to support the use of anything but supportive care for this disease. Surfactant is a potentially promising therapy; alterations in its composition have been described in bronchiolitis, and it may play a role in the host immunity for this disease. OBJECTIVES: The objective of this review was to assess the efficacy of exogenous surfactant for the treatment of bronchiolitis in mechanically ventilated infants and children. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 1, 2006); MEDLINE (1966 to Week 1, February 2006); and EMBASE (1990 to September 2005). We reviewed reference lists of relevant articles and contacted experts in the field. SELECTION CRITERIA: Randomised controlled trials (RCTs) comparing surfactant with placebo or surfactant with no surfactant in mechanically ventilated infants and children with viral bronchiolitis. DATA COLLECTION AND ANALYSIS: Two authors independently extracted data and assessed trial quality. Unpublished data were requested from trial authors when necessary. MAIN RESULTS: Three trials containing a total of 79 patients met the inclusion criteria. No mortality or adverse effects associated with surfactant administration were reported in any of these trials. In the three trials, use of surfactant was associated with a decrease in duration of mechanical ventilation by 2.6 days (95% confidence interval (CI) -5.34 to 0.18 days; P value 0.07) and a decrease in ICU length of stay by 3.3 days (95% CI -6.38 to -0.23 days; P value 0.04). In two studies with 59 patients, in which duration of mechanical ventilation in the control groups was more comparable, surfactant was associated with a decrease in ventilator days by 1.21 days (95% CI 0.75 to 1.67 days) and a decrease in ICU stay by 1.81 days (95% CI 1.19 days to 2.42 days). Individually the studies reported some short term benefit of surfactant on pulmonary mechanics and gas exchange. AUTHORS' CONCLUSIONS: Available data on surfactant were not sufficient to provide reliable estimates of its effects in mechanically ventilated infants and children with bronchiolitis. Future studies should be adequately powered and will need to address unresolved questions regarding which surfactant preparation may be best suited for the treatment of bronchiolitis, the appropriate dose and administration interval, and how the choice of ventilator strategy may modify its effects.

Bronchiolitis, Viral↗
PubMed2005

The effect of changing from one to two views at incident (subsequent) screens in the NHS breast screening programme in England: impact on cancer detection and recall rates.

AIM: To assess the effect on cancer detection and recall rates of changing from one to two views for incident (subsequent) screens. METHODS: Controlled, comparative, observational study of programmes in NHS breast screening programme in England. SUBJECTS: women aged 50-64 years were screened by the NHSBSP between 1 April 2001 and 31 March 2003. RESULTS: The effect of changing to two-view mammography was a 20% increase in overall incident screen cancer detection rate, with the biggest effect seen for small (<15 mm) invasive cancers. This increased detection rate was achieved with an 11% drop-in recall rate. CONCLUSION: The introduction of two-view mammography for incident screens has resulted in considerable improvements in overall NHS breast screening performance.

Aged↗
PubMed2001

Do silicone breast implants cause rheumatologic disorders? A systematic review for a court-appointed national science panel.

OBJECTIVE: To assist in evaluating expert testimony and scientific evidence presented in law suits brought against silicone breast implant manufacturers, a US District Court Order established a National Science Panel to assess whether existing studies provide scientific evidence of an association between silicone breast implants and systemic classic/accepted connective disease, atypical connective disease, and certain signs and symptoms identified by plaintiffs in the law suits. Local disorders potentially associated with these implants were not addressed in this review. Therefore, we performed a systematic review of published studies on the association between silicone breast implants and systemic connective tissue disorders. METHODS: Data from relevant studies (human cohort, case-control, or cross-sectional studies with > or = 10 participants and appropriate controls) were identified through literature searches of Medline, Current Contents, HealthStar, Biological Abstracts, EMBase, Toxline, and Dissertation Abstracts. Two independent reviewers, using standard collection forms, extracted data from the included studies. Adjusted relative risks (RRs) in cohort studies and odds ratios (ORs) in case-control and cross-sectional studies were reported if provided; otherwise, unadjusted RRs and ORs were calculated. RESULTS: Twenty-four studies meeting inclusion criteria were identified. No association was evident between breast implants and any established or atypical connective tissue disorder. There was discordance among studies in reports of arthralgias, lymphadenopathy, myalgias, sicca symptoms, skin changes, and stiffness. CONCLUSION: The panel found no evidence to support expert testimony suggesting an association between silicone breast implants and connective diseases. Discordance for symptoms may reflect differences in symptoms included in various categories, the small number of cases, and the effect of having single subjects with > 1 symptom represented in analyses of each symptom reported. The process presented here is an early example of the use of independent scientific panels to help courts clarify scientific evidence in legal proceedings.

Breast Implants↗
PubMed2001

A radiation hybrid map of mouse genes.

A comprehensive gene-based map of a genome is a powerful tool for genetic studies and is especially useful for the positional cloning and positional candidate approaches. The availability of gene maps for multiple organisms provides the foundation for detailed conserved-orthology maps showing the correspondence between conserved genomic segments. These maps make it possible to use cross-species information in gene hunts and shed light on the evolutionary forces that shape the genome. Here we report a radiation hybrid map of mouse genes, a combined project of the Whitehead Institute/Massachusetts Institute of Technology Center for Genome Research, the Medical Research Council UK Mouse Genome Centre, and the National Center for Biotechnology Information. The map contains 11,109 genes, screened against the T31 RH panel and positioned relative to a reference map containing 2,280 mouse genetic markers. It includes 3,658 genes homologous to the human genome sequence and provides a framework for overlaying the human genome sequence to the mouse and for sequencing the mouse genome.

Animals↗
PubMed2001

A comparison of stereoscopic and monoscopic evaluation of optic disc topography using a digital optic disc stereo camera.

AIMS: To compare stereophotographic and monophotographic optic disc assessments made using a digital optic disc stereo camera. METHODS: Stereo digital optic disc photographs of 150 selected patients who had presented to a glaucoma clinic were assessed by two masked observers on separate occasions using (1) the stereophotographs and a stereoviewer, (2) a single image from the same stereopair. Results were analysed for both right and left eyes separately. 95% tolerance limits for change (TC) and intraclass correlation coefficients (ICC) were calculated and a multivariate analysis using a general linear model for repeated measures was performed. RESULTS: A total of 201 optic disc images of 150 patients (84 females, 108 left eyes) were analysed. Mean age of patients was 64 years. The results for right eyes are as follows (similar results were obtained for left eyes). Intraobserver (stereoscopic compared to monoscopic) measurements of: horizontal cup:disc ratios (CDR), ICC = 0.5995 and 0.7269, TC = 34% and 27%; vertical CDR, ICC = 0.8298 and 0.817, TC = 25% and 27%; area CDR, ICC = 0.7757 and 0.8259, TC = 28% and 25%; circumference CDR, ICC = 0.7618 and 0.8103, TC = 28% and 25%. Interobserver measurements of: horizontal CDR, ICC stereoscopic (SS) = 0.7287; monoscopic (MS) = 0.5030; TC SS = 30%; MS = 32%; vertical CDR, ICC SS = 0.8439; MS = 0.7106; TC SS = 25%; MS = 31%; area CDR, ICC SS = 0.8392; MS = 0.6276; TC SS = 26%; MS = 32%; circumference CDR, ICC SS = 0.8433; MS = 0.6438, TC SS = 26%; MS = 31%. Systematic bias between observers and between methods was within acceptable limits. CONCLUSIONS: This study using a digital stereo camera indicates that there may be little benefit of stereoscopic imaging over monoscopic imaging despite demonstrating small but inconsistent differences between both observers and methods.

Adult↗
PubMed2000

Hospital outbreak of Salmonella virchow possibly associated with a food handler.

A foodborne outbreak of salmonella infection at a private hospital in London in 1994 was found to be associated with eating turkey sandwiches prepared by a food handler. One patient, nine staff, and a foodhandler's baby were confirmed to have Salmonella enterica serotype virchow, phage type 26 infection. The attack rate was estimated to be 5% among the approximately 200 patients and staff at risk. A food handler reportedly became ill days after, but her baby days before, the first hospital case. Although it appeared to be a single outbreak, antibiogram analysis, supplemented by plasmid profile typing, demonstrated that there were two strains of S. virchow involved, one with resistance to sulphonamides and trimethoprim and a second sensitive to these antimicrobial drugs. Mother and child had different strains. The investigation demonstrated the importance of full phenotypic characterization of putative outbreak strains including antimicrobial susceptibility testing. Outbreaks of foodborne infection in hospitals are preventable and are associated with high attack rates and disruption of services. There is a need for good infection control policies and training of all staff involved in patient care as well as in catering services. Consultants in Communicable Disease (CCDCs) should include private hospitals in their outbreak control plans. Good working relations between Infection Control Doctors (ICDs) in the private health sector and their local CCDCs are important if outbreaks are to be properly investigated.

Adult↗
PubMed2000

Are perceptions of a family history of heart disease related to health-related attitudes and behaviour?

It has been argued that perceptions of familial tendencies to disease are common and important in decisions about health-related behaviours. Indeed, it has been suggested that the increased 'geneticization' of society may lead to an increased fatalism about health, which could undermine initiatives aimed at reducing coronary-prone behaviour. To date, much of the research on lay perceptions of inheritance has been based on people at high risk of particular genetic disorders or on qualitative research with small general population samples. Here we investigate perceptions of a family history of heart disease, using quantitative techniques, to test hypotheses about the relationship between a perceived family history (pFH), coronary 'candidacy' and adherence to health promotion advice which were raised by earlier anthropological work. We find that reported perceptions of a family history of heart disease are common, particularly amongst women in middle-age. In isolation a pFH is not related to current smoking; however, the odds of smoking are lower for those with a pFH of heart disease when account is also taken of other attitudinal factors (the 'salience' of heart disease and the strength of adherence to conventional coronary health promotion.

Adolescent↗
PubMed1996

Sorsby's fundus dystrophy in the British Isles: demonstration of a striking founder effect by microsatellite-generated haplotypes.

Sorsby's fundus dystrophy (SFD) has been mapped to a genetic interval of 8 cM between loci D22S275 and D22S278. A total of 15 families, unrelated on the basis of genealogy and expressing the SFD phenotype were identified from a large data base of genetic eye disease families originating from diverse parts of the British Isles. The identification of the same Ser181Cys mutation cosegregating with disease in each family led us to consider the hypothesis of a founder effect being present. In all families studied, the same relatively infrequent allele (occurring in just 11% of the control group) was associated with disease at marker locus D22S280. A highly significant disease-associated haplotype, spanning across 3 cM of the SFD locus, was conserved in 11 of the 15 families (68% of all affected chromosomes); a further extended haplotype spanning up to 7 cM, was identified in 5 families (27% of SFD-associated chromosomes) and possibly represents the ancestral haplotype. This haplotype analysis has refined the TIMP3 gene localization to a 1- to 3-cM interval between marker loci D22S273 and D22S281 and provides strong evidence for a single mutational event being responsible for the majority of SFD identified in the British Isles.

Alleles↗
PubMed1996

Colobomatous microphthalmia with midfacial clefting: part of the spectrum of branchio-oculo-facial syndrome?

A young male infant was noted at birth to have bilateral cleft lip and palate, bilateral microphthalmos and ocular colobomata, and a dysplastic left kidney. His mother had similar ophthalmological findings and milder facial anomalies which included abnormality of the philtrum and bilateral congenital nasolacrimal duct obstruction. His maternal grandmother had mild facial anomalies including a short philtrum and bilateral congenital nasolacrimal duct obstruction but had no evidence of any ocular abnormalities. The spectrum of abnormalities seen in this family are similar to those described in the branchio-oculo-facial syndrome, a rare dominantly inherited syndrome in which there are a number of developmental abnormalities of the eye, face, and kidney. Although the precise cause of this syndrome is unknown, it is likely to be caused by mutations in a gene responsible for the ordered closure of the foetal fissure and fusion of facial structures.

Adult↗
PubMed1996

The Chief Scientist reports. ... Mental health hearings for elderly people with dementia.

The aim of the study reported here was to examine the feasibility of mental health hearings, modelled along the lines of the Children's Hearings, for handling legal and ethical problems that arise in managing the personal and financial affairs of elderly people with dementia. The study involved interviews with professionals, as well as a postal survey. The findings indicated that technically irregular solutions to problems were commonplace. Over half of the professionals surveyed thought that mental health hearings would help solve disputes.

Aged↗
PubMed1995

Lifecourse and lifestyle: the social and cultural location of health behaviours.

Drawing on two qualitative studies carried out independently in the U.K. this paper examines the cultural construction of physical and social ageing, and the part this plays in commonsense assessments of daily health relevant behaviour. The concepts of lifecourse and lifestyle are examined as they are presented in both social scientific and lay discourse. The collaborative inductive analysis was based on the observation from both studies that respondents regularly accounted for health and illness, and their associated behaviours, in terms of individuals perceived social circumstances and obligations. Position in the lifecourse was regularly used to express and encapsulate these constellations of socio-cultural processes and variables. The analysis focuses on there stage of the lifecourse as identified by respondents; and examines how these were related in lay discourse to particular health-relevant behaviours or lifestyles. It is concluded that it is important for health promotion to work with rather than against cultural norms and every day principles of social organisation in order better to understand lay perceptions of what constitutes acceptable health-relevant behaviour.

Adult↗
PubMed1995

Screening by nurses and junior doctors to detect malnutrition when patients are first assessed in hospital.

Four hundred and fifty four ward nurses and 319 junior doctors in 70 hospitals were interviewed about the last patient they had admitted, using a brief questionnaire. The availability of weighing scales and height measuring equipment was assessed by observers who visited the wards of 107 hospitals. Two thirds of nurses and doctors asked patients about recent food intake; half of the nurses and three quarters of the doctors asked about unintentional weight loss. Answers to the questions were recorded in the notes on 52-80 per cent of occasions. Two thirds of nurses weighed the patient, but only 11 per cent (%) measured height; approximately 80% of results were recorded. Most nurses and doctors who asked no questions about nutrition and made no measurements failed to do so because they regarded them as unimportant. Weighing scales were adequately provided, but height measuring equipment was available in only 17% of wards.

Journal Article↗
PubMed1994

Lay evaluation of health and healthy lifestyles: evidence from three studies.

The maintenance of good health in the well population is an important goal of modern general practice. This often takes the form of encouraging patients to lead healthier lives, particularly where diet, exercise, alcohol and smoking are concerned. The fact that many people appear not to follow 'healthy lifestyle' advice suggests that more needs to be known about how relatively simple health promotion messages are understood and evaluated by the lay public. In this paper, findings from three independent qualitative social research projects in Scotland and Wales are analysed together. As qualitative social research is usually carried out with small numbers of informants, the work reported here represents an unusual opportunity for a large amount of interview and observational data to be analysed. The findings indicate that lay evaluation processes use subtle ideas of balance to weigh up the desirability of behaviour change, and that the practice of 'trading-off' positive and negative aspects of health-related behaviour is widespread. Conclusions for health promotion in the general practice setting are drawn. In particular it is suggested that the local knowledge held by the primary care team, and the opportunities for one-to-one interaction which exist in the general practice setting, are extremely important resources, given the highly personal nature of public evaluations of lifestyle change.

Adult↗
PubMed1992

The limits of lifestyle: re-assessing 'fatalism' in the popular culture of illness prevention.

This paper is concerned with the development of preventive medicine in the field of Coronary Heart Disease. It is based on an in-depth, ethnographic investigation into the popular culture of prophylactic behaviour carried out in South Wales (U.K.) during 1988 and 1989. The focus of the data and analysis presented here is the operation of cultural norms and practices related to the understanding and explanation of the cause and distribution of illness and death from heart ailments. The paper illustrates how the everyday cultural practice of 'lay epidemiology' is involved in accounting for illness misfortune and in assessing the potential benefits of prophylactic behaviour change. A central issue dealt with here is the relationship of lifestyle to environment in the popular understanding of chronic disease. Lay notions of luck, fate, destiny, randomness and chaos in the distribution of heart disease are explored. In conclusion, some implications for health education in this field are put forward.

Adult↗
PubMed1992

Two methods for assessing the risk-factor composition of the HIV-1 epidemic in heterosexual women: southeast England, 1988-1991.

OBJECTIVE: The prevalence of HIV-1 in the heterosexual population in southeast England between 1988 and 1991 was examined using two methods. DESIGN AND METHODS: First, district neonatal seroprevalence was compared on a geographical basis to social and demographic variables reflecting risk-factor prevalence. Second, over the same period eight children who developed AIDS within the first 12 months of life were born. RESULTS: The differences in seroprevalence between districts could be explained by the proportion of livebirths to women born in parts of Africa. An estimated 92% of neonatal seropositives could be associated with this demographic variable. The proportions of livebirths to women born in other countries, the prevalence of notified injecting drug use, and area measures of social deprivation, were only poorly related to HIV seroprevalence, and had no additional explanatory value. Seven of the eight (87.5%) children who developed AIDS in the first year were born to black women from Africa. CONCLUSIONS: Both methods suggest that a high proportion of heterosexually transmitted HIV in southeast England has been imported.

Adult↗
PubMed1991

Lay epidemiology and the rationality of responses to health education.

Health education has long been seen as an important component of primary care, and under the new contract has become routine. It is important to consider the likely impact of general practitioners' endeavours in the light of the experience of health education to date. Despite decades of efforts directed towards reducing the population's adherence to practices deemed harmful to health, it must be acknowledged that the impact of such activity has been disappointing. This paper considers some cultural origins of public scepticism to health education messages, and argues for a more balanced presentation of current knowledge concerning the causes of disease and the probability that individuals will benefit by changing their behaviour.

Attitude to Health↗