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Biomedical subjects

D Harding

Publications and source records attributed to D Harding.

At least 19 recordsLinked to original sources

Risk and prevention of type II diabetes: offspring's views.

BACKGROUND: People with a parent with type II diabetes have an increased risk of the disease. There is increasing evidence for the possibility of prevention, particularly by attaining and maintaining normal weight and adequate levels of physical exercise. No prior studies have reported awareness of risk and prevention in this high-risk group. AIM: To explore beliefs about personal risk of diabetes and prevention in people with a parent with type II diabetes. DESIGN OF STUDY: A total of 254 adults with type II diabetes were identified from five randomly selected practices in south London. Self-report questionnaires were sent to 152 eligible offspring of these patients. A total of 105 of the offspring returned the self-report questionnaires and participated in the study. SETTING: Five randomly selected practices in south London. METHODS: Patients with type II diabetes in five randomly selected practices in south London were asked if we might contact their offspring. One randomly selected offspring (over 18 years of age) from each family completed a self-report questionnaire. RESULTS: Of 254 adults with type II diabetes 152 had eligible offspring. A total of 105 (69%) of the offspring participated in the study. A total of 69 (66%) of these offspring believed their personal risk of developing diabetes was 'low'. At least 28 (28%) and maybe as many as 73 (70%) underestimated the risk of diabetes in offspring. Compared with the number thinking their current risk was low significantly more (95 versus 69) thought that their risk would be low if neither of their parents had diabetes. Fifty-seven (54%) thought prevention was possible. Sixteen thought taking more exercise was important for prevention and only seven thought that weight control was important. Many had good general knowledge about diabetes and its complications but awareness of the relationship between diabetes and cardiovascular disease was poor. CONCLUSIONS: People with a parent with type II diabetes are usually aware that they have an increased risk of diabetes. However, they often underestimate that risk and know little about potentially useful preventive strategies. They need accurate information about these matters if they are to reduce their risk of diabetes and its complications.

Adult↗

Picture archiving and communication systems project management using web-based tools.

As the technology of picture archiving and communications systems (PACS) improves and implementation becomes more widespread, the project management of deploying substantially large, multiple-facility systems becomes an integral part of success. A successful deployment requires project support from the initial planning and surveying to the final acceptance, even encompassing support during active use of the PACS. The sharing of information between project stakeholders of a PACS implementation can be daunting at times, but with the flexibility of the worldwide web, this aspect can be eased. This report speaks to the tools and usability of the worldwide web to disseminate project management information for planning, implementation, and support of any PACS implementation--anywhere. This sharing of knowledge prepares the end user for what will be available for them when the complete systems is in place, allowing for a smoother migration to PACS.

Humans↗

Functional significance of endothelin B receptors in mediating sinusoidal and extrasinusoidal effects of endothelins in the intact rat liver.

Endothelins (ET) are important regulators of the hepatic microcirculation that act through different receptor subtypes. We investigated functional significance of ET(B) receptors in mediating microhemodynamic effects of ETs in normal and endotoxin (lipopolysaccharide [LPS])-primed rat liver. LPS priming (Escherichia coli O26:B6; 1 mg. kg(-1)) selectively increased ET(B) mRNA and led to a shift in available receptors to the ET(B) subtype. IRL 1620 (an ET(B) agonist) increased portal pressure in a dose-dependent manner, and the increase in ET(B) expression was associated with prolonged portal pressor response in isolated livers. However, lactate dehydrogenase (LDH) release was attenuated and sinusoidal blood flow was better maintained upon ET(B) stimulation in vivo. In isolated livers, portal constriction as well as release of LDH, were substantially increased in the presence of N(omega)-nitro-L-arginine methyl ester (L-NAME), an inhibitor of nitric oxide synthase (NOS). In vivo microscopic assessment of sinusoidal perfusion during ET(B) stimulation revealed a disruption of the flow pattern including frequent reversal of the flow direction without significant sinusoid constriction. Sinusoidal flow decreased even further after discontinuation of IRL 1620. Both effects were mediated at extrasinusoidal sites that probably included postsinusoidal sites. However, after pretreatment with L-NAME, IRL 1620 evoked a significant sinusoidal constriction that colocalized with the body of the stellate cell. We propose that ET(B1)-induced NOS activity attenuates ET(B2) (and presumably ET(A))-mediated portal pressor response and stellate cell constriction. Transcriptional activation of the ET(B) gene may have a permissive effect on liver blood flow and protect against hepatocellular damage under pathophysiological conditions associated with endotoxemia.

Animals↗

More good than harm: a randomised controlled trial of the effect of education about familial risk of diabetes on psychological outcomes.

BACKGROUND: Offspring of people with type 2 diabetes underestimate their risk of developing the disease and know little about primary prevention. However, education about risk might cause psychological harm. AIM: To examine cognitive and psychological effects of education about personal risk. METHOD: Patients with type 2 diabetes were recruited from randomly selected general practices. One of their adult offspring was randomly selected and randomly allocated into one of three groups: 1. Group 1: given an initial interview, education, and a final interview; 2. Group 2: given an initial and final interview; and 3. Group 3: given one interview only. Psychological outcomes were assessed using Hospital Anxiety and Depression Scale (HAD) and Positive Well-Being Scale (PWB) scores. RESULTS: Sixty-nine per cent (105/152) of eligible offspring participated. Ninety-one per cent (96/152) completed the study. Comparing first and final interviews, in Group 1, significantly fewer responders at final interview (after education) thought that their risk of developing diabetes was 'low' (65% versus 41%, P = 0.027), while in Group 2, there was no significant change in risk perception (P = 0.13). Significantly fewer people in the educated group (Group 1, final interview) than in the control group (Group 3) thought their risk of developing diabetes was 'low' (41% versus 77%, P = 0.002). Risk education did not affect total HAD scores or PWB scores significantly. CONCLUSION: Educating offspring of people with type 2 diabetes in this way about their risk of diabetes and possible preventive strategies increases their perception of personal risk but does not cause psychological harm.

Adult↗

Should preterm infants born after 29 weeks' gestation be screened for intraventricular haemorrhage?

OBJECTIVES: To determine whether the current incidence of intraventricular haemorrhage (IVH) of grade 2 or more is high enough in preterm infants born after 29 weeks gestation to justify the cost of screening with ultrasound and to explore clinical indicators for risk of IVH in the more mature preterm infant. METHODS: This cohort study examined the incidence and severity of IVH in 800 preterm infants born between January 1992 and August 1996, of whom 436 were born after 29 weeks. Demographic and clinical details were collected from a prospectively maintained database. The Medicare schedule charge rate for cerebral ultrasound was used to calculate costs. RESULTS: 1.1% of preterm babies born after 29 weeks gestation who had routine ultrasound scans had an IVH of grade 2 or 3, no infant had a grade 4 IVH. Two infants had a grade 3 IVH, both of which were symptomatic. IVH was poorly predicted by other clinical criteria. Using the Medicare schedule to estimate costs, detecting the five grade 2 or 3 IVH cost A$42,000. CONCLUSIONS: The incidence of grade 2-4 IVH is low in infants born after 29 weeks gestation. Screening of this population is expensive and probably not justified. It may be most appropriate to scan these infants only if their condition raises concern.

Australia↗

(Re)constructing relationships with grandparents: a turning point analysis of granddaughters' relational development with maternal grandmothers.

This study explores how granddaughters account for the development of their relationships with their maternal grandmothers. The retrospective interviewing technique was used to elicit turning points in their relational histories. Analysis of the turning point content revealed several different types of turning points that reflected both normative and idiosyncratic events. Increases in relational closeness resulted from decreases in geographic separation, engaging in shared activities, deaths or serious illnesses in the family, and family disruptions. Decreases in closeness were associated with negative experiences with the grandmother, increases in geographic separation, and the transition to college. Granddaughters reported that turning points related to death or serious illness and participation in shared activities were the most significant ones in their relationships with maternal grandmothers.

Adolescent↗

Granddaughters' accounts of the influence of parental mediation on relational closeness with maternal grandmothers.

This study explores granddaughters' reports of the nature and impact of parental mediation on the development of their feelings of closeness toward their maternal grandmothers. Results from close-ended questions assessing granddaughters' perceptions of parental mediation and relational closeness indicated that closeness was predicted by mediation involving: visits alone with grandmothers, the absence of criticism of grandmothers, communication indicating the grandmothers were important persons, and less influence on conversations or activities. Qualitative analysis of granddaughters' accounts of the influence of parents illustrated what they perceived to be important issues in mediation. Additionally, accounts revealed the role of other family members in the relationship mediation process.

Adolescent↗

The Gross Motor Performance Measure: validity and responsiveness of a measure of quality of movement.

BACKGROUND AND PURPOSE: This article presents the results of a study to validate a measure of gross motor performance for its capacity to detect changes in the quality of movement in children with cerebral palsy aged 0 to 12 years. SUBJECTS AND METHODS: On two occasions, 4 to 6 months apart, physical therapists from three children's treatment centers assessed 106 children with cerebral palsy, 18 children who had sustained an acute head injury, and 29 nondisabled children. Validity was demonstrated by comparing changes on the measure across diagnoses, severity, and age groups. RESULTS: Several a priori hypotheses were supported; however, relationships with parent and therapist ratings were not clearly demonstrated. CONCLUSION AND DISCUSSION: The measure was found to be differentially responsive to changes in "stable" and "responsive" groups.

Analysis of Variance↗

Use of title.

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Advertising↗

Chromosomal mapping of a human phenol UDP-glucuronosyltransferase, GNT1.

A 5' fragment of a full-length cDNA clone encoding a human phenol UDP-glucuronosyltransferase was used to produce a specific probe for this gene. DNA isolated from a panel of 18 human-rodent somatic cell hybrids was analysed by Southern-blot hybridization. The results indicate that this UDP-glucuronosyltransferase is encoded by a single gene, designated GNT1, located on human chromosome 2.

Blotting, Southern↗

Development of human liver UDP-glucuronosyltransferases.

The development of multiple UDPGT activities towards eight substrates has been studied in fetal term and adult post-mortem (less than 5 h after death) liver samples. Most fetal and term liver activities were less than 14% of adult values, except that towards 5-hydroxytryptamine which was present in fetal and term liver at adult levels. The majority of UDPGT activities develop to adult levels within 10-20 weeks postnatally, and even premature (30 weeks) which survive for up to 10 weeks will develop these enzyme activities. Immunoblot analysis of human liver microsomes and cDNA cloning of human UDPGT shows the existence of the family of isoenzymes in man, and it is important to determine the developmental pattern of individual drug glucuronidating enzymes in liver. Immunoblot analysis of developing liver shows the presence of two major UDPGT polypeptides in fetal liver, whereas more than five are observed in adult liver. The investigation of substrate specificity of individual UDPGTs by expression of cloned genes in COS-7 cells and the use of antibodies will facilitate the identification of enzymes present in perinatal liver.

Cloning, Molecular↗

Elemental and structural studies of the rat galactose cataract.

A series of rat galactose lenses, from 1 to 20 days on the 50% galactose diet, were frozen in the whole eye, and fractured from pole to pole in the frozen state. Lyophilized half-lenses were prepared for analysis by energy dispersive spectrometry (EDS). Following elemental analysis, some specimens were embedded and sectioned for histological studies. Elemental X-ray maps, and/or profiles, were made for K, Na, Cl, Ca, P, and S. As early as two days on the galactose diet, a crescent-shaped region ("streak") of Cl, Na, and Ca gain, and K loss develops near the equatorial surface. Between this region and the equatorial surface are the nucleated differentiating fiber cells which maintain low Cl, Na, and Ca, and high K (viable equatorial zone, VEZ). With time the "streak" expands anteriorly, centrally and posteriorly, eventually (by 20 days) including most of the lens. The VEZ, including the epithelium, however, is non-reactive to the galactose diet, which is deleterious to the fully differentiated fiber cells. Eventually, the VEZ undergoes a characteristic morphological change, apparently due in part to changes in its physical environment.

Animals↗