PubMed Health⌕ Search

Biomedical subjects

D Barry

Publications and source records attributed to D Barry.

At least 19 recordsLinked to original sources
PubMed2005

Fast foods - are they a risk factor for asthma?

BACKGROUND: Lifestyle changes over the last 30 years are the most likely explanation for the increase in allergic disease over this period. AIM: This study tests the hypothesis that the consumption of fast food is related to the prevalence of asthma and allergy. METHODS: As part of the International Study of Asthma and Allergies in Childhood (ISAAC) a cross-sectional prevalence study of 1321 children (mean age = 11.4 years, range: 10.1-12.5) was conducted in Hastings, New Zealand. Using standard questions we collected data on the prevalence of asthma and asthma symptoms, as well as food frequency data. Skin prick tests were performed to common environmental allergens and exercise-induced bronchial hyperresponsiveness (BHR) was assessed according to a standard protocol. Body mass index (BMI) was calculated as weight/height2 (kg/m2) and classified into overweight and obese according to a standard international definition. RESULTS: After adjusting for lifestyle factors, including other diet and BMI variables, compared with children who never ate hamburgers, we found an independent risk of hamburger consumption on having a history of wheeze [consumption less than once a week (OR = 1.44, 95% CI: 1.06-1.96) and 1+ times a week (OR = 1.65, 95% CI: 1.07-2.52)] and on current wheeze [consumption less than once a week (OR = 1.17, 95% CI: 0.80-1.70) and 1+ times a week (OR = 1.81, 95% CI: 1.10-2.98)]. Takeaway consumption 1+ times a week was marginally significantly related to BHR (OR = 2.41, 95% CI: 0.99-5.91). There was no effect on atopy. CONCLUSIONS: Frequent consumption of hamburgers showed a dose-dependent association with asthma symptoms, and frequent takeaway consumption showed a similar association with BHR.

Adult↗
PubMed2005

Obesity and asthma in 11-12 year old New Zealand children in 1989 and 2000.

BACKGROUND: There has been a concurrent increase in the prevalence of obesity and asthma in recent years in New Zealand and other countries. METHODS: Two cross sectional surveys performed in 1989 and 2000 were used to test this association in children of mean age 11.7 years. Body mass index (BMI) was calculated as weight/height2 (kg/m2) and obesity and overweight defined according to an international standard. Standard questions were used to measure the prevalence of asthma symptoms. RESULTS: Significant increases in the prevalence of reported symptoms and disease between 1989 and 2000 were not explained by a concurrent increase in the prevalence of obesity. In 2000, multivariate analysis showed that increasing BMI standard deviation score was significantly associated with current wheeze (p=0.002), inhaled steroid use (p=0.004), and the use of any medication (p=0.001). None of the associations was significantly different for boys or girls. CONCLUSION: There is some evidence for an association of obesity with asthma symptoms and treatment but this does not explain the increasing prevalence of this disease.

Asthma↗
PubMed2001

The burden of symptoms of asthma, allergic rhinoconjunctivitis and atopic eczema in children and adolescents in six New Zealand centres: ISAAC Phase One.

AIM: To describe the burden of symptoms of asthma, allergic rhinoconjunctivitis and atopic eczema in children in six New Zealand centres. METHODS: The International Study of Asthma and Allergies in Childhood (ISAAC) Phase One was undertaken in Auckland, Bay of Plenty, Hawke's Bay, Wellington, Nelson and Christchurch during 1992-1993. In each centre, approximately 3,000 six to seven year old children and 3,000 thirteen to fourteen year old adolescents were studied, a total of 37,592 participants. Both age groups answered written questionnaires and the adolescents a video questionnaire about asthma symptoms. RESULTS: The prevalences of symptoms were high, for asthma 25% and 30%, allergic rhinoconjunctivitis 10% and 19%, and atopic eczema 15% and 13% in each age group respectively. More than 40% of participants had symptoms in the last year of at least one condition, most commonly asthma. There were no significant differences among regions, except for six to seven year olds in Nelson who had significantly lower prevalences of some symptoms of asthma and allergic rhinoconjunctivitis. CONCLUSIONS: Asthma and allergies are common in New Zealand, with resultant morbidity and cost. However, there is little regional variation with the exception of lower rates in Nelson children. Explanations for these findings will be the subject of further studies.

Adolescent↗
PubMed2001

A re-analysis of a caries clinical trial by survival analysis.

The decline in caries prevalence, the increases in the level of fluoride exposure, and the lack of placebo control subjects have complicated caries clinical trials in recent times. There has been a substantial increase in the numbers of subjects required for the detection of statistically significant differences between dental products, and hence, the cost of these trials has grown enormously. This study uses a new statistical approach to the analysis of the data from these trials with the ultimate aim of providing a more sensitive method of analysis. The new approach uses survival analysis, where the outcome measure is the survival time of an individual tooth surface. It exploits recent developments in the analysis of clustered survival data where survival times within the same cluster or subject are correlated. To illustrate, the new method of analysis was used for the North Wales, UK, caries clinical trial. It is concluded that survival analysis uses most of the data available in a caries clinical trial, an outcome measure that is easily understood and may lead to a more sensitive method of analysis.

Analysis of Variance↗
PubMed2001

A worthy challenge. Interview by Mary Grayson.

Dennis R. Barry, president and chief executive officer of Moses Cone Health System and chair-elect of the American Hospital Association, describes the challenges facing health care. Change is clearly necessary, he says, and one of the keys is collaboration among health care professionals, the government and other stakeholders in the field.

American Hospital Association↗
PubMed2000

Common issues in medical professionalism: room to grow.

PURPOSE: Much of the respect and trust that society grants to physicians is based on the expectation of upholding professional values. We performed this study to assess responses to common challenges to medical professionalism and to ascertain physician satisfaction with training in professionalism. METHODS: A self-administered questionnaire containing six challenges to professionalism (acceptance of gifts, conflict of interest, confidentiality, physician impairment, sexual harassment, and honesty) with multiple-choice responses was mailed to 528 medical students and 779 house officers at the University of Colorado Health Sciences Center and to 900 randomly selected Colorado physicians. Information about previous exposure to the issue depicted in the scenarios and satisfaction with, and site of, previous education in medical professionalism was obtained. An independent panel selected the best or acceptable answers to the challenges. RESULTS: In all, 961 evaluable responses were received. More than 40% of physicians reported experience with four of the six challenges. The frequency of the best or acceptable answers to the six scenarios ranged from 12% to 86%. Best or acceptable responses were more common in physicians than in house officers, and in house officers than in medical students (P < 0.001). Practice setting and specialty type had only modest effects. The physician impairment scenario was the most challenging: Only 12% of physicians provided the best answer. Most (73%) respondents reported having 10 or fewer hours of formal course work in professionalism, and many (40%) were dissatisfied with their training in professionalism. CONCLUSIONS: While everyday challenges to professionalism are commonly encountered by trainees and practicing physicians, many practitioners are dissatisfied with their training in this area and were unable to provide an acceptable answer to these challenges.

Adult↗
PubMed2000

Foreigners in a strange land: self-construal and ethnic identity in male Arabic immigrants.

Many authors have emphasized the importance of cultural sensitivity in delivering mental health services to immigrants. Self-construal and ethnic identity are important components of the acculturative process, which may be useful in the diagnosis, assessment, and treatment of immigrant clients. This study investigated the self-construal and ethnic identity of male Arabic immigrants in the United States. Based on pilot interview data and existing measures, a Male Arabic Ethnic Identity Measure (MAEIM) was developed using a sample of 115 male Arabic immigrants. Satisfactory reliability is reported for the overall MAEIM as well as its four factor analytically derived scales, including Religious-Family Values, Sense of Belonging/Ethnic Pride, Friendship, and Ethnic Arabic Practices. Arabs reporting a strong Arabic ethnic identity had a more salient interdependent sense of self than those reporting a weaker ethnic identity. Independent self-construal was not significantly correlated with any of the individual MAEIM scales or the total MAEIM scale. The implications of these findings for research and clinical practice are discussed.

Journal Article↗
PubMed1999

Gene therapy expression vectors based on the clotting Factor IX promoter.

The liver is one of the prime targets for gene therapy, and the correction of defects in a variety of clotting factor genes is one of the main goals of liver-directed therapies. The use of transcriptional regulatory elements derived from these genes may provide for the optimal expression of transduced genes. We have applied our knowledge of the promoter structure of the clotting Factor IX gene to design optimized expression vectors for use in gene therapy. The activity of the proximal promoter has been augmented by the introduction of a multimerized upstream site which we have previously shown to be a prime regulator of the pro- moter. Introduction of this element increases promoter activity at least 20-fold over the proximal promoter alone when assayed in the human liver cell line Hep G2. This optimized promoter is significantly more active than the SV40 enhancer/early promoter. The expression of the optimized Factor IX promoter is also more persistent in the short term. The inclusion of a liver-specific locus control region, derived from the apolipoprotein E/C locus, did not further augment expression levels. These Factor IX vectors also exhibit a high degree of tissue specificity, as measured by transfection into breast and muscle cell lines.

Cell Line↗
PubMed1998

Effects of inflammation-associated acute-phase response on hepatic and renal indices in the horse.

OBJECTIVES: To determine the effect of an acute soft tissue inflammatory response on biochemical and haematological indices of hepatic and renal function in the Thoroughbred horse. PROCEDURE: Soft tissue inflammation was induced in four Thoroughbred horses by intramuscular injections of Freund's complete adjuvant. The horses were clinically examined and blood and urine samples were collected before and after the adjuvant injections. Biochemical and haematological indices were measured in samples collected and used to determine the onset of the acute-phase response and to assess hepatic and renal function at this time. RESULTS: After adjuvant injection, significant increases (P < 0.01) in total white (13.1 +/- 1.4 x 10(9)/L) and neutrophil (10.2 +/- 1.2 x 109/L) cell counts, rectal temperature (39.7 +/- 0.5 degrees C) and various plasma protein concentrations, including fibrinogen (6.6 +/- 1.2 g/L), haptoglobin (1.3 +/- 0.1 g/L) and total protein (88.1 +/- 2.7 g/L), indicated the induction of an acute-phase response. This corresponded with significant reductions (P < 0.01) in the plasma elimination half-lives (t1/2 beta) sodium bromosulphthalein (3.13 +/- 0.05 to 2.82 +/- 0.07 min) and sodium sulphanilate (38.29 +/- 4.04 to 19.60 +/- 5.68 min) and reductions in the plasma activities of aspartate aminotransferase, glutamate dehydrogenase, creatine kinase, alkaline phosphatase, gamma glutamyl transferase; the urinary creatinine clearance ratios of sodium, chloride and potassium; and the urinary gamma glutamyl transferase-to-creatinine clearance ratios. (All values mean +/- SD.) CONCLUSIONS: The effects of the acute-phase response on indices of hepatic and renal function in the horse suggest that the disposition of pharmacological agents administered at this time may be altered and that indices of acute inflammation should be interpreted cautiously.

Acute-Phase Reaction↗
PubMed1998

Eating disorders among athletes. Research and recommendations.

Research indicates that certain athletes, particularly those in sports that emphasize leanness to enhance performance or appearance (e.g., gymnastics, wrestling, figure skating, diving, and ballet), are at risk for eating disorders. Little is known about the risk for eating disorder symptoms in weight and strength training. It is concluded that, even when mild variants of eating disorders are observed in athletes, they should be given immediate attention because they may severely compromise health and performance. Practical recommendations are made for coaches and trainers to identify the physical, psychological, and behavioral symptoms of eating disorders. Finally, suggestions are made for addressing eating disorders in athletes.

Adolescent↗
PubMed1996

Differential recall bias and spurious associations in case/control studies.

Consider a case/control study designed to investigate a possible association between exposure to a putative risk factor and development of a particular disease. Let E denote the information required to specify a subject's exposure to the risk factor. We examine the effect that errors in the recorded values of E (which we denote by E*) have on inferences of an association between disease and the risk factor. We concentrate on situations where the errors in recorded exposure are such that exposure is underestimated for controls and overestimated for cases. This phenomenon is referred to as differential recall bias and may lead to spurious inferences of an association between exposure and disease. We describe how the standard inferential techniques used in the analysis of data from case/control studies may be adjusted to take account of specified mechanisms whereby E is distorted to produce E*. Such adjustments may be used to determine the sensitivity of an analysis to the phenomenon of differential recall bias and to quantify the extent of such bias that would be required to overturn the conclusions of the analysis. There remains the matter of judging whether a given distortion mechanism is reasonable in a particular context. This emphasizes the need for investigators to take account of differential recall bias in validation studies of exposure assessment techniques. The methodology developed here is applied to a recent major study investigating the possible association between lung cancer and exposure to environmental tobacco smoke. The log-odds ratio of 0.23 based on recorded exposure differs significantly from 0 (P < 0.02). However, the association is rendered non-significant by a very modest degree of differential recall bias. For example, if 3.8 per cent of exposed controls report no exposure, 3.8 per cent of unexposed cases report exposure, and all other subjects report exposure accurately, the log-odds ratio drops to 0.07 and the corresponding p-value increases to 0.49.

Adult↗
PubMed1996

A community trial of a written self management plan for children with asthma. Asthma Foundation of NZ Children's Action.

AIMS: To determine the effect of introducing an action plan to children with mild to moderate asthma, who have never used a plan before. METHODS: Children were recruited from general practitioner records with a diagnosis of asthma, and who agreed to participate, having identified that they had not used an action plan before and that they had mild or moderate asthma based upon symptoms, acute episodes and the need for preventative medication. The families were given a plan, and its use was explained to them by their general practitioner. A symptom diary was kept, and, where appropriate, peak flow measurements were recorded. A number of outcomes were measured to determine changes that could be attributed to the introduction of the plan. RESULTS: Following the introduction of the plan, the percentage of nights woken for asthma fell from 18.2% to 12.2% (P<0.001) and the number of days out of action fell from 6.4 to 4.1 (P<0.001). The requirement for acute medical treatment also fell during the intervention period with general practitioner visits falling from 129 to 42 (p<0.001). Most participants commented favourably about the usefulness of the plan in giving them a better idea of the state of their asthma at any time, and in knowing what to do about it. CONCLUSIONS: The children's action plan, when introduced into a group of asthmatic children was effective and acceptable in the self management of asthma.

Asthma↗
PubMed1995

Sp1 is phosphorylated and its DNA binding activity down-regulated upon terminal differentiation of the liver.

Using nuclear extracts prepared from rat liver it was demonstrated that binding of a transcription factor to site II of the D-site binding protein promoter could be induced by dephosphorylation of these extracts. Competition band shifts and supershift assays reveal this protein to be the general transcription factor Sp1. Phosphorylation of Sp1 appears to occur as a result of terminal differentiation of the liver. Proteins from both 1-day-old rat liver and adult liver undergoing regeneration have less of the phosphorylated form of Sp1 present with consequent increased DNA binding activity. Sp1 is similarly phosphorylated in brain, kidney, and spleen with phosphatase treatment of the extracts significantly increasing the level of DNA binding activity. Dephosphorylation of Sp1 results in a 10-fold increase in the affinity of Sp1 for its cognate site. Two-dimensional gel electrophoresis reveals that approximately 20% of the detectable protein appears to be in the phosphorylated form in adult liver extracts. Another protein with similar characteristics also appears to be present in the liver. Decreasing Sp1 DNA binding activity by phosphorylation may be an important mechanism for regulating gene expression, and possibly bringing about growth arrest during terminal differentiation.

Animals↗
PubMed1995

DNA quantification is technically feasible and of value in cervical smear samples: possible applications for determination of progression in low grade dyskaryosis.

This study evaluates the feasibility of DNA analysis of cervical intraepithelial neoplasia III (CIN III) lesions on cervical smear and formalin-fixed paraffin-embedded tissue (FFPET) blocks with a view to extending this type of analysis to milder grades of dyskaryosis. DNA ploidy was determined by image analysis using a CAS 200 Image Analyser. Seventeen patients with a diagnosis of CIN III were studied. Results show that all smear and tissue samples were non-diploid with nine aneuploid and eight tetraploid lesions. In 6/7 patients whose smears and corresponding biopsies were examined there was complete agreement as to the DNA profile. We conclude that DNA quantification is technically feasible in archival, routinely prepared cervical smears. This technique should now be applied to CINI and CINII cervical smears to determine if it is of value in identifying those lesions that will progress to CIN III. This study is particularly timely with the possibility in the near future of estimation of ploidy by image analysis using instruments such as the Highly Optimized Microscope Environment (HOME) system.

Aneuploidy↗
PubMed1995

Reduced plasma aldosterone concentrations in randomly selected patients with insulin-dependent diabetes mellitus.

Abnormalities of the renin-angiotensin system have been reported in patients with diabetes mellitus and with diabetic complications. In this study, plasma concentrations of prorenin, renin, and aldosterone were measured in a stratified random sample of 110 insulin-dependent (Type 1) diabetic patients attending our outpatient clinic. Fifty-four age- and sex-matched control subjects were also examined. Plasma prorenin concentration was higher in patients without complications than in control subjects when upright (geometric mean (95% confidence intervals (CI): 75.9 (55.0-105.6) vs 45.1 (31.6-64.3) mU I-1, p < 0.05). There was no difference in plasma prorenin concentration between patients without and with microalbuminuria and between patients without and with background retinopathy. Plasma renin concentration, both when supine and upright, was similar in control subjects, in patients without complications, and in patients with varying degrees of diabetic microangiopathy. Plasma aldosterone was suppressed in patients without complications in comparison to control subjects (74 (58-95) vs 167 (140-199) ng I-1, p < 0.001) and was also suppressed in patients with microvascular disease. Plasma potassium was significantly higher in patients than in control subjects (mean +/- standard deviation: 4.10 +/- 0.36 vs 3.89 +/- 0.26 mmol I-1; p < 0.001) and plasma sodium was significantly lower (138 +/- 4 vs 140 +/- 2 mmol I-1; p < 0.001). We conclude that plasma prorenin is not a useful early marker for diabetic microvascular disease. Despite apparently normal plasma renin concentrations, plasma aldosterone is suppressed in insulin-dependent diabetic patients.

Adolescent↗
PubMed1995

A Bayesian model for growth curve analysis.

An experiment involves K subjects where for subject i, ni, values yi1, yi2, ..., y(ini) of a random variable Y are observed at times ti1 ti2, ..., t(ini). Assume that yij = F(tij) +eij where eij are independently and identically distributed (i.i.d.) N(0, sigma2). We consider the estimation of the function F and the testing of the homogeneity hypothesis that, for [formula, see text] does not depend on t. The function F(i,t) is modelled as a Gaussian process which seeks to quantify the notions that for each i, F(i, t) is a slowly changing function of t and that for i is not equal to j, F(i, t), and F(j, T) are in some sense similar. We propose to estimate F (i, t) by its posterior mean given all of the data. This Bayes estimate is shown to be equivalent to a particular form of penalised likelihood estimation. We consider data-based methods for setting the parameters of the Gaussian process prior, develop a test of the homogeneity hypothesis, report the results of a Monte Carlo study illustrating the effectiveness of the proposed methodology, and apply the methods to a study of variations in temperature and blood pressure over the course of the menstrual cycle.

Bayes Theorem↗