Small study implicates PCBs in breast cancer.
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Adipose Tissue↗
Biomedical subjects
D Milne
Publications and source records attributed to D Milne.
The laboratory diagnosis of male Chlamydia trachomatis infections--a time for change?
We carried out a two-phased study comparing the effectiveness of first-catch early morning urine (FCU) samples against urethral swabs for the detection of C. trachomatis in men. Four hundred and seventeen new and re-booked consecutive men, who attended the Department of Genito-Urinary Medicine, Bristol, having held their urine overnight, were recruited. Patients who had received antimicrobial chemotherapy in the preceding 2 months were excluded. Early morning FCU samples were obtained from 208 men followed by urethral swabs for the detection of C. trachomatis (phase I) and this order of collection was reversed for the remaining 209 patients (phase 2). A last-catch urine (LCU) was also obtained from all patients. All urethral and urine samples were examined by an amplified enzyme immunoassay (IDEIA, Dako Diagnostics Ltd). Initially, discordant samples were critically examined by direct immunofluorescence (Syva, 'Microtrak') which was used as the 'gold' standard in this study. We have shown that overall 42 and 4.7% of our symptomatic and asymptomatic male patients respectively were positive for C. trachomatis antigen by IDEIA. Furthermore 86.4 and 91.0% (phases 1 and 2) of the total C. trachomatis positive samples were detected by examination of an FCU sample. In contrast only 66.0 and 65.5% (phases 1 and 2) of the total positives were identified by examination of an urethral swab. These results show that an FCU sample not only has the advantage of being a non-invasive procedure but is also a very sensitive method, compared to swabbing the urethra for the detection of C. trachomatis.(ABSTRACT TRUNCATED AT 250 WORDS)
Antigens, Bacterial↗
IgG antibody and delayed-type hypersensitivity responses in nude mice grafted with thymic epithelium.
This study compared the ability of foetal thymic epithelium depleted of lymphocytes and dendritic cells, by low temperature or deoxyguanosine (dGuo) treatment in organ culture, to reconstitute T-cell function in nude mice. It is shown that renal capsule grafts of either type could promote the development of functional T lymphocytes in the periphery, as judged by in vivo assays. Both syngeneic and allogeneic thymic epithelium endowed nude mice with the capacity to mount IgG antibody and delayed-type hypersensitivity (DTH) responses to the T-dependent antigen ovalbumin (OVA). Functional reconstitution was accompanied by the appearance of Thy-1-bearing cells in the spleens of thymic grafted nude mice. The results from allogeneically grafted recipients show that a substantial population of peripheral T cells was present that collaborated with B cells and other antigen-presenting cells (APC) which do not express major histocompatibility complex (MHC) molecules of the thymus donor haplotype.
Animals↗
Smoking in pregnancy: relation of birth weight to maternal plasma carotene and cholesterol levels.
Not all mothers who smoke during pregnancy deliver small infants. Nutritional supplementation during pregnancy apparently protects the fetuses of some mothers. Our previous studies showed that plasma levels of carotene and cholesterol were correlated with birth weight. The present study examined the association between mid-pregnancy plasma levels of carotene and cholesterol and subsequent birth weight. In a prospective study of 388 women (47.8% smokers), levels of plasma nutrients and demographic and anthropometric measurements were obtained at 19 and 36 weeks' gestation and related to indices of infant size at birth. In non-smokers, the level of plasma cholesterol at mid-pregnancy correlated positively with birth weight. In contrast, in mothers who smoked more than ten cigarettes daily, the relationship of cholesterol to birth weight was dependent on the simultaneously observed level of plasma carotene. When plasma cholesterol and carotene concentrations were both low at mid-pregnancy, birth weight was low. On the other hand, when the carotene level was high and the cholesterol level low, birth weight was at least equivalent to that of non-smokers. The interactive effect of smoking, cholesterol, and carotene on birth weight was significant (P = .017) after adjusting for gestational age, sex, prenatal care, race, previous low birth weight infants, parity, weight at mid-pregnancy, and total weight gain during pregnancy. Among smokers, the smallest infants were born to mothers having the greatest decrease in plasma carotene between 19-36 weeks' gestation. Smokers whose plasma carotene remained constant or increased had larger infants; a similar association was not observed for cholesterol.(ABSTRACT TRUNCATED AT 250 WORDS)
Anthropometry↗
New measures for the formative and summative evaluation of a post-basic psychiatric nursing education course.
The case for the formative and summative evaluation of training courses is presented prior to focusing upon the development of two new measures designed to gauge the effectiveness of a short course of training. Results derived from these two measures are presented from two successive English National Board 953 courses ('Developments in Psychiatric Nursing'). The findings indicated that our measures were reliable and valid indices of learning and so could facilitate formative evaluation. However, in terms of summative evaluation the post-course scores were low and so the case for a revised course was presented. Implications were drawn for the routine evaluation of post-qualification courses.
Certification↗
Psychological problems in general practice patients: two assumptions explored.
Research is needed into the scientific basis for psychologists' 'specialist' model of service to general practitioners. This study evaluated two predictions of this service to general practitioners. This study evaluated two predictions of this model: firstly, that patients with psychological problems can be identified reliably; secondly, that they tax GPs' resources and ability disproportionately. To test these, psychologists observed 448 GP consultations. The GP and psychologist independently rated the involvement of psychological factors; the GP recorded his satisfaction with, and the psychologist the duration of, the consultation. Patients completed scales of psychiatric and social dysfunction. Both predictions were confirmed. Agreement between GPs' and psychologists' ratings of the presence of psychological factors was higher than reported previously, and not explained by the small correlation of psychiatric morbidity with each. Problems identified by GPs as psychological were associated with longer, repeated and less satisfying consultations.
Adult↗
A re-evaluation of the clinical psychologist in general practice.
Recent evaluations have questioned the early claims that psychologists make a valuable clinical contribution in general practice. In particular, it has been suggested that the promising outcomes have been the result of a 'worst year' phenomenon and that psychologists only slightly accelerate clinical improvement. This paper describes a small but relatively comprehensive evaluation of the work of a clinical psychologist. Analyses of economic and clinical data on 22 patients referred by the general practitioner indicated that the psychologist made a distinctive clinical contribution by improving personal coping strategies and reducing distress among patients with more chronic problems who did not show any such changes during a waiting list period. It is concluded that the recent negative evaluations of the clinical psychologist in general practice may have been misleading and premature.
England↗
Parallel forms of the Knowledge of Behavioral Principles as Applied to Children questionnaire: an independent, multi-centred, British replication.
The psychometric properties of the test entitled Knowledge of Behavioral Principles as Applied to Children and two shortened forms of this test were investigated in two samples of British subjects. The first consisted of 162 psychiatric nurses, psychiatrists, occupational therapists, physiotherapists and clinical psychologists attending behaviour modification courses. The second consisted of 49 teachers and nurses, all working with the mentally retarded, who completed the test by post. The whole test and the two sets of parallel forms all showed good internal consistency and sensitivity to change. Some shrinkage during replication was found. The 25-item forms showed evidence of the properties of parallel forms (equal means, standard deviations and standard errors) in both samples. The 10-item forms were also parallel in sample 1. However the 10-item forms did not remain parallel in sample 2 and so cannot always be recommended.
Behavior Therapy↗
Is a problem shared a problem shaved? An evaluation of hairdressers and social support.
Despite growing interest in social support as a moderator of stress, few studies have attempted to demonstrate the effects of a psychological intervention in this domain. Hairdressers are an acknowledged source of social support and a randomly selected group (n = 8) were given structured training in the provision of social support to their customers. In comparison with a group of their untrained colleagues (n = 7), repeated measures indicated a significant training effect in terms of the hairdressers' understanding and proficiency in providing social support, while a generalization effect was suggested by customers' ratings of their perceived 'helpfulness'.
Adaptation, Psychological↗
Professional coping.
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Adaptation, Psychological↗
An evaluation of the effects of shift rotation on nurses' stress, coping and strain.
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Adaptation, Psychological↗
Effect of browned and unbrowned corn products intrinsically labeled with 65Zn on absorption of 65Zn in humans.
Experimental browned and unbrowned corn products were formulated and processed from unenriched, degermed yellow corngrits. The browned product (cornflakes) contained more insoluble dietary fiber and bound more zinc (in vitro) than the unbrowned product (corngrits). During processing some of the cornflakes and corngrits were combined with a small amount of yellow corn endospermhull intrinsically labeled with 65Zn. The intrinsically labeled corn products were fed, in a crossover design, as components of two breakfasts to six normal, unconfined volunteers. Each volunteer absorbed more 65Zn from the corngrits than from the cornflakes. The reduced 65Zn absorption from cornflakes was attributed to heating and toasting reaction products, possibly Maillard, which bound zinc and consequently made the zinc less available for absorption.
Absorption↗
Planning and evaluating innovations in nursing practice by measuring the ward atmosphere.
A controlled evaluation of nurses' and patients' perceptions of the hospital ward atmosphere served to both define problems and evaluate the corrective changes that were implemented in a psychiatric day hospital. The results indicated that nurses and patients held similarly unfavourable views of the ward at a baseline assessment, including low levels of support, involvement, spontaneity and programme clarity. This finding then served as the basis for systematic changes, including staff training, the regrouping of patients, and revising the therapeutic programme. A repeat evaluation then indicated that these changes had significantly improved the ward atmosphere from the perspective of both nurses and patients. It is concluded that this approach holds considerable promise for the implementation of changes in nursing practice.
Adult↗
Teaching behaviour therapy to psychiatrists with a structured learning format.
A 5-day, in-service training in behaviour therapy, which was attended by six psychiatrists, is described. The course covered principles of behavioural assessment and therapy within a structured learning format. The results of this systematic approach are presented in terms of six measures, administered before and after training. Two of these assessed attitudes to treatment, one gauged knowledge of behavioural principles and the remaining three evaluated the psychiatrists' skills in some key areas of behaviour therapy. Statistically significant improvements were found on the knowledge questionnaire and on one skill measure. These results were compared to those obtained by a control group (n = 18) and a course-trained group (n = 65) of qualified psychiatric nurses. The main conclusion drawn was that the course succeeded as an efficient learning programme, developing understanding and skills of value both clinically and in terms of collaborative teamwork.
Behavior Therapy↗
Effect of dietary supplements on acute mountain sickness.
Four fit young men participating in a high altitude mountaineering expedition took part in a 15-day trial of two high-calorie dietary supplements. They ate either a high carbohydrate or a high fat supplement, alternating every 3 days. All dietary intake was recorded. Subjects completed a daily questionnaire assessing the severity of symptoms. Within a single-subject design no statistically significant differences were obtained between the severity of symptoms and dietary carbohydrate or total calories. This suggested that the dietary supplements had no effect on symptoms, a finding that is discrepant with the existing literature. However, we did find that subjects consumed more calories while on the high carbohydrate supplement.
Adult↗
Assessing the value of professional development for health visitors and their clients.
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Community Health Nursing↗
Effect of food supplementation (WIC) during pregnancy on birth weight.
Of 824 women screened, 410 were enrolled at midpregnancy in a prospective, randomized, controlled nutrition intervention study. Of these, 226 were predicted as likely to have small or large babies, 184 to have average-sized babies. Two hundred thirty eight mothers received USDA Women, Infants and Children (WIC) Food Supplementation vouchers from midpregnancy, 172 did not. Leukocyte protein synthesis (as a cell model) was significantly higher (p = 0.009) by 36 weeks gestation in supplemented mothers. Mean birth weight of their babies was greater, 3254 vs 3163 g, (+91 g) p = 0.039, adjusted for sex, gestational age, prenatal visits, pregnancy interval, smoking, and previous low birth weight infants. Controlling for entry weight obviated the significance of the difference, except for WIC supplemented smokers (greater than 10 cigarettes/day) whose babies were significantly heavier by +168 g (p = 0.017) than those of unsupplemented smokers. WIC partially protects fetal growth in smokers.
Birth Weight↗
'The more things change the more they stay the same': factors affecting the implementation of the nursing process.
One of the biggest problems currently facing the nursing profession is that of implementing the nursing process. Innovations in health care often elicit obstructions, and objective data which might help us to understand and overcome these implementation problems are lacking. The present study considered these problems by contrasting two groups of psychiatric nurses both of whom had received an in-service course in behaviour therapy. One group went on to implement this training by conducting behavioural nursing care plans with their patients, whereas the second group did not do so. A retrospective analysis of 25 variables associated with these groups of nurses indicated that neither subject variables, test scores nor learning during the course were good predictors of the nurses' implementations of the nursing process. An alternative basis for predicting and facilitating implementation is discussed. This focuses on institutional variables which may exert more control over the use of the nursing process than the personal characteristics of individual nurses. The implications of this analysis are important for the selection, training and motivation of nurses.
Adult↗