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Biomedical subjects

D Crossley

Publications and source records attributed to D Crossley.

14 recordsLinked to original sources
PubMed2005

The experience of shame in older psychiatric patients: a preliminary enquiry.

Shame is a complex set of attitudes, feelings and behaviours that tend to motivate hiding and, if provoked, can lead to conflict with others. It is also related to the exercise of power within the relationship of care and therefore may be a relevant factor if older adults are forced to accept increased dependency. There are no systematic enquiries into shame processes and older psychiatric patients. The experience of trait and situational shame and psychopathology was explored with 50 older psychiatric patients, using a range of questionnaire measures. As predicted, trait shame correlated significantly with anxiety and depression scores. There was preliminary evidence to suggest that being in need of others may be shame-provoking for some patients and may have a bearing on why some patients fear dependency, conceal symptoms and have conflicted relationships with carers.

Aged↗
PubMed2000

Presumptive sialadenosis in a cat.

A cat was presented with signs associated with enlargement of the mandibular salivary glands. Histological findings were normal, consistent with a diagnosis of sialadenosis, and the cat responded to symptomatic treatment with oral phenobarbitone.

Animals↗
PubMed2000

Ontogeny of cholinergic and adrenergic cardiovascular regulation in the domestic chicken (Gallus gallus).

Adrenergic and cholinergic tone on the cardiovascular system of embryonic chickens was determined during days 12, 15, 19, 20, and 21 of development. Administration of the muscarinic antagonist atropine (1 mg/kg) resulted in no significant change in heart rate or arterial pressure at any developmental age. In addition, the general cardiovascular depressive effects of hypoxia were unaltered by pretreatment with atropine. In addition, the ganglionic blocking agent hexamethonium (25 mg/kg) did not induce changes in heart rate. The beta-adrenergic antagonist propranolol (3 mg/kg) induced a bradycardia of similar magnitude on all days studied, with a transient hypertensive action on days 19-20, indicating the existence of an important cardiac and vascular beta-adrenergic tone. Injections of the alpha-adrenergic antagonists prazosin or phentolamine (1 mg/kg) reduced arterial pressure significantly on all days of incubation studied. Collectively, the data indicate that embryonic chickens rely primarily on adrenergic control of cardiovascular function, with no contribution from the parasympathetic nervous system.

Adrenergic alpha-Antagonists↗
PubMed1998

Hypoxia elicits an increase in pulmonary vasculature resistance in anaesthetised turtles (Trachemys scripta).

In mammals and birds, low oxygen levels in the lungs cause a constriction of the pulmonary vasculature. This response is locally mediated and is considered to be important for local matching of perfusion and ventilation. It is not known whether reptiles respond in a similar fashion. The present study describes the effects of altering lung oxygen levels (at a constant FCO2 of 0.03) on systemic and pulmonary blood flows and pressures in anaesthetised (Nembumal, 50 mg kg-1) and artificially ventilated turtles Trachemys scripta. During severe hypoxia (1.5-3 kPa PO2), pulmonary blood flow decreased in all animals; systemic blood flow increased, resulting in an increased net right-to-left shunt blood flow. The redistribution of blood flows was associated with reciprocal changes in the vascular resistances within the pulmonary and the systemic circulations (Rpul and Rsys, respectively). At 1.5 kPa O2, Rpul increased from 0.09 0.01 to 0.15 0.03 kPa ml-1 min kg during normoxia (means 1 s.e.m., N=5). Concurrently, Rsys tended to decrease from a normoxic value of 0.12 0.01 to 0.09 0.02 kPa ml-1 min kg (P=0.08). The effects of hypoxia on the haemodynamic variables persisted following atropinisation (1 mg kg-1) and cervical vagotomy, suggesting that the increased Rpul during hypoxia is locally mediated. This study therefore demonstrates that turtles exhibit hypoxic pulmonary vasoconstriction, although the threshold is low compared with that of mammals.

Adrenal Medulla↗
PubMed1997

Effects of varying levels of positive end-expiratory pressure on intracranial pressure and cerebral perfusion pressure.

OBJECTIVE: To determine the influence of positive end-expiratory pressure (PEEP) on intracranial pressure and cerebral perfusion pressure. DESIGN: Neurosurgical intensive care patients requiring intracranial pressure monitoring and mechanical ventilation were studied in a randomized, controlled study. SETTING: Tertiary care, neurosurgical intensive care unit. PATIENTS: Eighteen patients were enrolled in the study. Patients had posttraumatic head injuries (n = 9), subarachnoid hemorrhage (n = 7), obstructive hydrocephalus (n = 1), and intracerebral hemorrhage of unknown cause (n = 1). INTERVENTIONS: Patients had PEEP levels of 5, 10, and 15 cm H2O applied to their lungs. MEASUREMENTS AND MAIN RESULTS: Changes in intracranial pressure, mean arterial pressure, and cerebral perfusion pressure were measured. The results were analyzed separately for patients with normal and increased intracranial pressure (> 15 mm Hg). PEEP at 5 cm H2O had no effect on intracranial pressure in the group with normal intracranial pressure. However, PEEP at 10 and 15 cm H2O produced a significant (p < .05) increase in intracranial pressure (1.9 and 1.5 mm Hg, respectively). In the group with increased intracranial pressure, no significant change in intracranial pressure occurred at any of the PEEP levels used. In both groups, cerebral perfusion pressure was unchanged throughout. CONCLUSIONS: In patients with normal intracranial pressure, PEEP at 5 cm H2O did not significantly alter intracranial pressure. The clinical relevance of the intracranial pressure increase at PEEP levels of 10 and 15 cm H2O is questionable because cerebral perfusion pressure did not change and remained > 60 mm Hg. In patients with increased intracranial pressure, higher levels of PEEP did not significantly change intracranial pressure or cerebral perfusion pressure.

Adult↗
PubMed1997

The challenge of evaluating a child bereavement programme.

This paper will discuss the challenge of evaluating the efficacy of child bereavement services. Such services are being developed and it is essential that expansion is based on research and evaluation. A literature review details the limited research which has so far been conducted on such interventions. The paper then addresses four key components regarding child bereavement programme evaluation: preliminary evaluation of the Winston's Wish programme; the feasibility and validity of using an experimental method in the evaluation of child bereavement services; the identification of appropriate measures-what are we really attempting to measure with regard to child bereavement interventions; and the importance of measuring the family dynamics of grief-how can we incorporate the Dual Process Model?

Bereavement↗
PubMed1992

Assessment of psychological care in general practice.

OBJECTIVE: To pilot a method of assessing psychological care by general practitioners. DESIGN: Prospective examination of psychological care given in general practice by using general health questionnaire with predetermined quantifiable and case specific indices of outcome established at the original consultation. SETTING: Rural general practice in Clwyd, North Wales. SUBJECTS: 447 consecutive adult general practice attenders. MAIN OUTCOME MEASURES: Three month follow up consultation rates, one year retrospective consultation rates, continuity of care, changes in general health questionnaire scores at follow up, general satisfaction, and acceptability of outcome measures. RESULTS: The principal and trainee identified 72 patients with psychological problems, 46 of whom had new conditions. 133 patients scored over 6 on the 28 item general health questionnaire, 33 of whom were identified as new cases by the general practitioners. 62 patients were seen at follow up, including 23 patients identified by the questionnaire but not by the doctor. The doctors used diagnostic terms to describe the presenting condition in 38 cases. At three month follow up the general health questionnaire scores had fallen by more than 5 points in 22/39 patients identified and managed by doctors and 11/23 identified by the questionnaire. The agreed index of good outcome was almost or completely achieved by 20 of the 39 patients managed by doctors. CONCLUSION: Quantifiable methods of evaluating the quality of the structure, process, and outcome of psychological care can be achieved in general practice.

Community Mental Health Services↗
PubMed1992

Safety of anticoagulation in the elderly: reasons for discontinuing therapy.

We have conducted a retrospective study on the reasons for discontinuing anticoagulants in 50 patients over the age of 75 years compared with 198 adults under 75 years to determine the safety of therapy in the elderly. Venous thromboembolism and arterial embolization were the most common indications for therapy in the elderly and the median duration of therapy in all patients was 7 months (9 days-22 years). There were no deaths attributable to anticoagulants. There was no significant difference in the proportion of elderly patients who stopped treatment because of bleeding compared with 198 patients under 75 years (5/50 (10%) vs 12/198 (6.1%), P = 0.26), nor in the rate of bleeding between the two groups (5/52.5 (9.5%) treatment-years vs 12/249 (4.8%) treatment-years, P = 0.15). This complication rate does not suggest that age per se is a risk factor in the use of oral anticoagulants.

Age Factors↗
PubMedDate not supplied

Clutch effects explain heart rate variation in embryonic frogs (Cave Coqui, Eleutherodactylus cooki).

Few physiological studies to date have focused on whether variation among sibling groups during development can account for often large, intraspecific physiological variation. In this study, we measured heart rate in the direct-developing frog Eleutherodactylus cooki throughout its embryonic development and examined heart rate variation among egg clutches comprising from 10 to 40 eggs. Clutches were collected in the wild in Yubucoa, Puerto Rico, and individual eggs were maintained under equivalent conditions in the lab. Heart rate showed large increases during development, rising from about 40 beats min(-1) in the earliest stages to about 110 beats min(-1) at hatching. The effect of stage (averaged across clutches) was highly significant (P<0.001). However, repeated-measures MANOVA also revealed that there were highly significant effects on heart rate associated with both clutch (variation among clutches averaged across development; P<0.001) and clutch-stage interactions (differences among clutches in the developmental change in heart rate; P<0.0001). These effects and interactions reveal that throughout development, heart rate in siblings is much more similar than in nonsiblings and that sib groups follow different heart rate trajectories during their development. Collectively, these data indicate that "clutch effects" caused by genetic and/or maternal influences can strongly affect patterns of heart function during development within cave coqui populations. This phenomenon also occurs in bird eggs and armadillo neonates, suggesting that physiological variation attributable to clutch effects might be a widespread phenomenon in vertebrates.

Animals↗