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Biomedical subjects

D Whittington

Publications and source records attributed to D Whittington.

13 recordsLinked to original sources
PubMed2005

A primary care-based needs assessment of people with multiple sclerosis.

BACKGROUND: Multiple sclerosis (MS) is a common cause of chronic progressive neurological disability where reduction in quality of life is an important feature. Many GPs have MS patients with a range of disabilities. Little is known about the supply of medical and community services and how this compares with demand. AIM: We aim to describe a community based sample of MS patients and investigate how disease characteristics, benefits, services accessed and perceived needs relate to sense of wellbeing. DESIGN: Cross-sectional survey. SETTING: Participants were recruited from a representative network of 30 GP practices across Northern Ireland. METHOD: MS patients answered a professionally administered questionnaire and agreed to their medical records being examined. Information was collected about their medical condition, sociodemographic characteristics, receipt of benefits and services, perceived needs and sense of wellbeing. RESULTS: Of the 149 participants, 23% were mildly affected (Kurtzke's Expanded Disability Status Scale [EDSS] 0-4.5), 41% were moderately disabled (EDSS 5.0-6.5) and 36% were severely disabled (EDSS 7.0-9.5). Disability was related to employment, receipt of benefits and services. Physiotherapy was a commonly perceived need. Other perceived needs differed between the moderately and severely disabled groups. Scores relating to wellbeing were related to disability and perceived needs. CONCLUSIONS: The relationship between use of medical and community services and disability is important for planning service provision. We have shown that perceived needs are related to wellbeing. In a progressive illness these developing needs could be anticipated.

Adult↗
PubMed2002

Migration, site-specificity and development of Benedenia lutjani (Monogenea: Capsalidae) on the surface of its host, Lutjanus carponotatus (Pisces: Lutjanidae).

Life-history attributes of the capsalid monogenean Benedenia lutjani, a parasite of Lutjanus carponotatus from the Great Barrier Reef, Queensland, Australia, were investigated from experimental infections. Oncomiracidia of B. lutjani invaded and attached at any site on the fish, but more commonly invaded body surfaces. Immature specimens then migrated to the pelvic fins. Development of the reproductive organs of B. lutjani corresponded with migratory movements on the host. Parasite aggregation on the pelvic fins coincided with the development of functional male reproductive organs and some protandrous worms that possessed a vagina appeared to be inseminated. Migration to, and aggregation on, the branchiostegal membranes (membranous folds posterior to the opercula) coincided with the onset of sexual maturity and commencement of egg production by parasites. The rate of parasite development and the timing of migratory events on the host were influenced by water temperature. All specimens of B. lutjani reached sexual maturity between 12 and 14 days p.i. at 24 degrees C and between 8 and 10 days p.i. at 27 degrees C. Anterior hamuli grew continually during a 16-day experiment at 27 degrees C and 25-day experiment at 23 degrees C and their length appeared to provide a suitable index to estimate parasite age. The possible adaptive significance of the migratory behaviour, site-specificity and its link with changes in parasite development are discussed.

Animals↗
PubMed2000

Finding time for patients: an exploration of nurses' time allocation in an acute psychiatric setting.

This article explores the proportion of work time psychiatric nurses spend in potentially psychotherapeutic one-to-one communication with patients. Twenty staff nurses from three acute admission wards in a psychiatric hospital in Northern Ireland were observed. The time spent in a selection of routine activities was recorded using a specially developed observation system Nurses' Daily Activity Recording System (NURDARS). The main findings were: (i) less than half of the working day (42.7%) was spent in patient contact, and (ii) the proportion of work time which was devoted to potentially psychotherapeutic interaction with patients was very small (6.75%). The implications and limitations of the study are discussed and suggestions are made for the management and practice of psychiatric nursing, for the education of psychiatric nurses, and for further research.

Acute Disease↗
PubMed1998

Efficacy of doxycycline and ciprofloxacin against experimental Yersinia pestis infection.

The efficacies of ciprofloxacin and doxycycline prophylaxis and therapy were assessed against experimental pneumonic plague infections induced by two strains of Yersinia pestis in a mouse model. When exposed to an aerosol of Y. pestis strain GB, containing 8.39 x 10(5) +/- 4.17 x 10(4) cfu, the retained dose was 7.3 x 10(3) +/- 2.3 x 10(3) cfu. When exposed to an aerosol of Y. pestis strain CO-92, containing 1.86 x 10(5) +/- 7.4 x 10(3) cfu, the retained dose was 3.4 x 10(4) +/- 2.6 x 10(3) cfu. Both strains resulted in a respiratory and systemic infection closely resembling human pneumonic plague. Ciprofloxacin prophylaxis and therapy was successful against both strains for up to 24 h after challenge, but not after 48 h. Both doxycycline prophylaxis and therapy regimens were ineffective against both strains, although strain CO-92 was more susceptible in vitro to doxycycline than strain GB and supra-MIC levels were achieved in the serum and lungs of the animal.

Animals↗
PubMed1997

Does ice immersion influence ankle joint position sense?

The purpose of this study was to determine whether a fifteen minute ice immersion treatment influenced the normal ankle joint position sense at 40% and 80% range of inversion and to establish the length of treatment effect through monitoring the rewarming process. Forty nine healthy volunteers between the ages of 17 and 28 were tested. Subjects were screened to exclude those with a history of ankle injuries. The subject's skin temperature over antero-lateral aspect of the ankle was measured using a thermocouple device during the fifteen minutes ice intervention and thirty minutes post-intervention. Testing of ankle joint position sense using the pedal goniometer was performed before and after a clinical application of ice immersion. The testing required the subject to actively reposition their ankle at 40% and 80% of their total range of inversion. The majority of subjects experienced numbness of the foot and ankle by the fifth or sixth minute during ice immersion. One minute after immersion skin temperatures averaged 15 degrees C + 1.7 degrees C. Skin temperature was seen to rise relatively rapidly for the first ten minutes and then slowed considerably. Subjects had not returned to the pre-test skin temperatures by thirty minutes. A significant difference in ankle joint position sense (p < 0.0499) following fifteen minutes of ice immersion was found. However, the magnitude of this difference (0.5 degree) would not be deemed significant in clinical practice. The research found no significant difference in joint position sense between 40% and 80% of the range of inversion both before and after cryotherapy. These findings suggest that the clinical application of cryotherapy is not deleterious to joint position sense and assuming normal joint integrity patients may resume exercise without increased risk of injury.

Adult↗
PubMed1997

Patient's perceptions of quality in a Northern Ireland hospital trust: a focus group study.

Explores the value of focus group methodology in a patient satisfaction initiative intended to identify quality improvement targets in a large general hospital. Analyses the transcripts from ten focus groups selected from hospital discharge lists, using simple cut-and-paste techniques. Finds that the focus group methodology was successful in amplifying feedback previously gleaned from surveys. Highlights patients' tolerance of shortcomings and their appreciation of staff providing high quality care while under pressure. Concludes that patients regard the National Health Service as deteriorating generally.

Aftercare↗
PubMed1997

Laboratory diagnosis of plague.

In response to an outbreak of a plague-like disease in India, the Public Health Laboratory Service (PHLS) in the UK distributed advice on the isolation and identification of Yersinia pestis. Some of the procedures outlined were evaluated using a number of isolates of Y. pestis, complemented with in-house techniques detecting virulence genes or their products. These laboratory investigations are limited in that they are either only indicative or they take too long (48 hours or more), and thus represent a serious delay to the patient. Successful patient management must be based on a case history, and therapy should be started immediately. Laboratory diagnosis will subsequently rule out most pathogens which cause similar infections, yet will still require confirmation by a reference laboratory.

Bacteriological Techniques↗
PubMed1996

Suicide in Northern Ireland: a comparison of two quinquennia (1982-1986 and 1987-1991).

This study compares government records of death by suicide, in Northern Ireland, during two quinquennia in the decade 1982-1991. Specifically these quinquennia are 1982-1986 and 1987-1991. During the latter quinquennium there was an increase in rate for males in most age groups, except the 45-54 and the over 65 years age groups. However, females had an increase rate in the 15-24 and 35-54 years age groups, but have a decreased rate in the other age groups. There has been a decrease in the rate of suicides by poisoning with solids and liquids for both sexes. However, male suicide rates by more violent methods have increased substantially during the latter quinquennium. Three cohorts of males, those in the 15-24, 25-34, and 55-64 age groups, have shown substantial increases during the latter quinquennium. Suggestions for psychiatric intervention strategies are made.

Accidents↗
PubMed1994

Student midwives' learning experience on the wards.

This paper is based on an investigation into the learning experiences of student midwives in the clinical setting in one maternity unit in the Republic of Ireland. A questionnaire approach was adopted for the data collection and 42 student midwives participated in the study. A number of factors were identified which appear to influence students' experiences of 'learning on the job'. The quality of their clinical teaching and their observations of the way in which trained staff practise midwifery may influence their decision to continue practising midwifery following registration. These findings clearly point to the importance for midwives to reassert their true role as 'independent practitioners' of normal maternity care.

Adult↗
PubMed1986

A study of the justification for intensive tick control in Kenyan rangelands.

Sixty male weaner cattle at the National Range Research Station, Kiboko, Kenya were placed in four groups of 15 animals under four different tick control regimens for 16 months. The treatment groups were: spraying with acaricide weekly, spraying every three weeks, spraying whenever group mean tick infestations reached more than 200 per animal (once only in the course of the study) and a control unsprayed group. The cattle were weighed monthly. There were no significant differences between the liveweight gains of the groups during a period of severe drought and during the following period of compensatory weight gain. The untreated group gained more weight than the other groups. Cattle died in all groups, but without significant differences between the groups; the long drought and associated malnutrition were the prime cause of death. Rhipicephalus pravus and R pulchellus were the dominant tick species with fewer Amblyomma gemma, Hyalomma truncatum and small numbers of Boophilus decoloratus and R evertsi. These ticks transmit anaplasmosis, babesiosis and cowdriosis in the study area. Total tick counts reached 750 on individual animals but group means rarely reached more than 200 because of high resistance to ticks in some animals. Host resistance ranking within groups was virtually constant throughout the experiment. The study showed that intensive tick control is not required in the semi-arid areas of Africa.

Animals↗
PubMed1986

Encoding contour shape by curvature extrema.

Curvature extrema provide significant information about the shape of an image contour, such as a silhouette, and are the basis for the Hoffman-Richards codon representation for shape. This representation based on curvature easily translates into a binary string that will describe the abstract shape of any smooth image curve. The computation of the basic shape primitives requires dealing with two ever-pervasive problems: contour noise and scale. We show how contour noise can be estimated given knowledge of the shape of the filter used to compute curvature from the edge list of the contour. To handle the scale problem, we use an adaptation of Witkin's scale space. Our algorithm differs from Witkin's by using a notion of parts to set criteria for significant structures.

Algorithms↗