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C Griffiths

Publications and source records attributed to C Griffiths.

At least 37 records · Page 2Linked to original sources

A deaf child's language acquisition verified through text retelling.

The researchers studied a method of mediation with a deaf second grader. Language needs were identified through transcription of the child's retellings of weekly basal stories. These were either targeted for adult-mediated conversations during reading activities or left "untargeted but tracked." During two intervention phases, the student's performance on semantic and syntactic features of interest incorporated into retellings improved when an adult facilitated; when an adult was intentionally unavailable to mediate retellings, documentation of positive linguistic changes indicated internalization or acquisition of these features. Analysis of language behaviors that did not improve during unmediated retellings indicated a need for continued mediation. Untargeted but tracked behaviors that went unchanged during data collection further documented that language behavior changes resulted from adult mediation, not maturation. The child achieved 1 year's reading growth during the data collection period (1 academic year) on the Gates-MacGinite Test of Reading (hearing norms; W. MacGinite & R. MacGinite, 1989). Text retelling methodology proved useful, although group design study is warranted.

Child↗

Development of text structure knowledge as assessed by spoken and signed retellings of a deaf second-grade student.

Encouraged by research documenting improved reading comprehension when the components of text structure are realized by students who are deaf or hard of hearing (e.g., Kluwin & Papalia, 1989; Schirmer & Bond, 1990), the researchers analyzed 28 texts retold by the same second-grade deaf child. Methodology provided for analysis of transcripts of the child's weekly text retellings across a Baseline Phase, Intervention Phase 1, and Intervention Phase 2 of data collection. Initially, stimulus for the retellings was provided by narrative and expository text in a second-grade basal reader adopted by the school and used by staff in the child's deaf education program, in keeping with the district's inclusion philosophy. During Intervention Phase 2, instructional-level stories were added and analyzed. Quality of adult mediation was manipulated during intervention. Improvements in the child's ability to include specific elements of text structure were documented over 9 months. A 12-month increase in reading ability and improved narrative ability (evidenced by school district curriculum-based assessment) were also documented.

Child↗

It takes a village and time... a collaborative case study.

Today's approach to health care presents a challenge to those providers who work with patients with multifaceted complex issues that require the time and the efforts of several clinicians. These patients do not easily fit into a short-term, predetermined mold of care. This is an ongoing issue that warrants further investigation. This article presents a collaborative case study that chronicles the case of a patient who had multiple problems, such as homelessness, depression, substance abuse, anger, and serious emotional and physical scars contributing to a damaged self-image. In this case, three clinicians in three programs collaboratively assisted the patient in his complicated trek toward an improved quality of life.

Alcoholism↗

Hospital admissions for asthma in east London: associations with characteristics of local general practices, prescribing, and population.

OBJECTIVE: To determine the relative importance of appropriate prescribing for asthma in explaining high rates of hospital admission for asthma among east London general practices. DESIGN: Poisson regression analysis describing relation of each general practice's admission rates for asthma with prescribing for asthma and characteristics of general practitioners, practices, and practice populations. SETTING: East London, a deprived inner city area with high admission rates for asthma. SUBJECTS: All 163 general practices in East London and the City Health Authority (complete data available for 124 practices). MAIN OUTCOME MEASURES: Admission rates for asthma, excluding readmissions, for ages 5-64 years; ratio of asthma prophylaxis to bronchodilator prescribing; selected characteristics of general practitioners, practices, and practice populations. RESULTS: Median admission rate for asthma was 0.9 (range 0-3.6) per 1000 patients per year. Higher admission rates were most strongly associated with small size of practice partnership: admission rates of singlehanded and two partner practices were higher than those of practices with three or more principals by 1.7 times (95% confidence interval 1.4 to 2.0, P < 0.001) and 1.3 times (1.1 to 1.6, P = 0.001) respectively. Practices with higher rates of night visits also had significantly higher admission rates: an increase in night visiting rate by 10 visits per 1000 patients over two years was associated with an increase in admission rates for asthma by 4% (1% to 7%). These associations were independent of asthma prescribing ratios, measures of practice resources, and characteristics of practice populations. CONCLUSIONS: Higher asthma admission rates in east London practices were most strongly associated with smaller partnership size and higher rates of night visiting. Evaluating ways of helping smaller partnerships develop structured proactive care for asthma patients at high risk of admission is a priority.

Adolescent↗

Substrate specificity of IphP, a cyanobacterial dual-specificity protein phosphatase with MAP kinase phosphatase activity.

The substrate specificity of the cyanobacterial dual-specificity protein phosphatase, IphP, was explored using a variety of potential substrates. The enzyme displayed phosphomonoesterase activity toward a broad range of peptide, protein, and low molecular weight organophosphate compounds. It displayed little or no hydrolase activity toward phosphodiesters, phosphoramides, carboxyl esters, or sulfoesters. However, it did display measurable pyrophosphatase activity, especially toward ADP and ATP. Among the low molecular weight phosphomonoesters, the presence of an aromatic ring either as part of the leaving group alcohol or immediately adjacent thereto, as in 5'-AMP, was a strong positive determinant for hydrolysis. Among peptide and protein substrates, a rough, but imperfect, correlation between charge character and hydrolysis was noted in which proteins and phosphorylation sites of an acidic nature seemed favored. Heparin affected IphP activity in a substrate-dependent manner. Toward small organophosphates, heparin had no significant effect, but it was inhibitory toward most protein and peptide substrates. However, toward phosphoseryl casein and MAP kinase, it enhanced activity as much as 10-fold. This enhancement was attributed to the ability of heparin to bind to these substrate proteins, as well as IphP, and recruit them to the same microenvironment.

Adenosine Diphosphate↗

Conventional urodynamics and ambulatory monitoring in the definition and management of bladder outflow obstruction.

PURPOSE: We determined whether ambulatory urodynamics and new objective methods of defining bladder outflow obstruction might improve the classification of bladder outflow obstruction over conventional urodynamics (cystometrography), and whether such measures might improve prediction of the outcome of prostatectomy. MATERIALS AND METHODS: A prospective study was performed of 122 men undergoing prostatectomy for symptoms and low flow rates. Cystometrography and ambulatory urodynamics were performed before and 6 months after prostatectomy but did not influence selection for operation. Methods of classifying obstruction included the Abrams-Griffiths nomogram, Schäfer linear passive urethral resistance relation and Griffiths urethral resistance factor. RESULTS: The proportion of cases defined as obstructed did not differ on ambulatory urodynamics or cystometrography or when the Abrams-Griffiths nomogram was compared to the linear passive urethral resistance relation or urethral resistance factor. Significant improvements after prostatectomy were noted in flow rates (p < 0.001), residual urine (p < 0.001), voiding pressure (p < 0.001) and symptom scores (p < 0.001). Ambulatory urodynamics were more sensitive than cystometrography in detection of detrusor instability but detrusor instability did not correlate with outcome. Voiding pressures were greater during ambulatory urodynamics (p < 0.02). The outcome of obstructed cases (on Abrams-Griffiths nomogram during ambulatory urodynamics) was better (79% good outcome) than that of nonobstructed or equivocally obstructed cases (55% good symptomatic outcome, p < 0.05). CONCLUSIONS: Men proved to have obstruction on the basis of pressure and flow measurements applied to a nomogram have better outcomes after transurethral resection of the prostate but sophisticated or computer derived methods of classification of obstruction did not improve prediction.

Aged↗

Do clinical guidelines introduced with practice based education improve care of asthmatic and diabetic patients? A randomised controlled trial in general practices in east London.

OBJECTIVE: To determine whether locally developed guidelines on asthma and diabetes disseminated through practice based education improve quality of care in non-training, inner city general practices. DESIGN: Randomised controlled trial with each practice receiving one set of guidelines but providing data on the management of both conditions. SUBJECTS: 24 inner city, non-training general practices. SETTING: East London. MAIN OUTCOME MEASURES: Recording of key variables in patient records (asthma: peak flow rate, review of inhaler technique, review of asthma symptoms, prophylaxis, occupation, and smoking habit; diabetes: blood glucose concentration, glycaemic control, funduscopy, feet examination, weight, and smoking habit); size of practice disease registers; prescribing in asthma; and use of structured consultation "prompts." RESULTS: In practices receiving diabetes guidelines, significant improvements in recording were seen for all seven diabetes variables. Both groups of practices showed improved recording of review of inhaler technique, smoking habit, and review of asthma symptoms. In practices receiving asthma guidelines, further improvement was seen only in recording of review of inhaler technique and quality of prescribing in asthma. Sizes of disease registers were unchanged. The use of structured prompts was associated with improved recording of four of seven variables on diabetes and all six variables on asthma. CONCLUSIONS: Local guidelines disseminated via practice based education improve the management of diabetes and possibly of asthma in inner city, non-training practices. The use of simple prompts may enhance this improvement.

Adult↗

Heterologous expression and enzymatic properties of a selenium-independent glutathione peroxidase from the parasitic nematode Brugia pahangi.

A full-length cDNA from the parasitic nematode Brugia pahangi encoding a secreted homolog of glutathione peroxidase in which the codon for the active site selenocysteine is substituted naturally by a cysteine codon has been expressed in Spodoptera frugiperda (insect) cells via Autographa californica nuclear polyhedrosis virus (baculovirus). The recombinant protein was glycosylated and secreted from the cells in tetrameric form. The purified protein showed glutathione peroxidase activity with a range of organic hydroperoxides, including L-alpha-phosphatidylcholine hydroperoxide, but no significant activity against hydrogen peroxide. Glutathione was the only thiol tested that served as a substrate for the enzyme, which showed no activity with the thioredoxin system (thioredoxin, thioredoxin reductase, and NADPH). No glutathione-conjugating activity was detected against a range of electrophilic compounds that are common substrates for glutathione S-transferases. The apparent (pseudo)m for glutathione was determined as 4.9 mM at a fixed concentration of linolenic acid hydroperoxide (3 microM). The enzyme showed low affinity for hydroperoxide substrates (apparent Km for linolenic acid hydroperoxide and L-alpha-phosphatidylcholine hydroperoxide of 3.8 and 9.7 mM, respectively at a fixed glutathione concentration of 3 mM).

Animals↗