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Biomedical subjects

E Latimer

Publications and source records attributed to E Latimer.

At least 19 recordsLinked to original sources
PubMed2000

The health promotion implications of the knowledge and attitude of employees in relation to health and safety leaflets.

Selected aspects of the efficacy of printed leaflets produced by a government health and safety agency and widely distributed by the enforcement bodies and other organisations to promote workplace health and safety are examined. It is based on a study of 30 small or medium-sized enterprises and examines the views of 120 employers and employees regarding the availability, attractiveness, relevance and usefulness of the leaflets and estimates the reader comprehension and readability of the selected leaflets. The results indicate that the selected leaflets are considered acceptable and comprehensible by the majority of respondents. As these are typical of the leaflets available in the health and safety field this is a positive outcome. The discussion focuses around the ability of the leaflets to engage and to inform and suggestions are made to encourage a wider debate on the criteria which contribute to these two aspects of leaflet use. It is contended that leaflets will continue to be important in the attempts of those involved in workplace health and safety to facilitate learning and to contribute to the overall process of behaviour change. This study raises a number of key issues regarding the future design and use of such leaflets.

Health Knowledge, Attitudes, Practice↗
PubMed2000

Fibroblast growth factor receptor-mediated rescue of x-ephrin B1-induced cell dissociation in Xenopus embryos.

The Eph family of receptor tyrosine kinases and their membrane-bound ligands, the ephrins, have been implicated in regulating cell adhesion and migration during development by mediating cell-to-cell signaling events. Genetic evidence suggests that ephrins may transduce signals and become tyrosine phosphorylated during embryogenesis. However, the induction and functional significance of ephrin phosphorylation is not yet clear. Here, we report that when we used ectopically expressed proteins, we found that an activated fibroblast growth factor (FGF) receptor associated with and induced the phosphorylation of ephrin B1 on tyrosine. Moreover, this phosphorylation reduced the ability of overexpressed ephrin B1 to reduce cell adhesion. In addition, we identified a region in the cytoplasmic tail of ephrin B1 that is critical for interaction with the FGF receptor; we also report FGF-induced phosphorylation of ephrins in a neural tissue. This is the first demonstration of communication between the FGF receptor family and the Eph ligand family and implicates cross talk between these two cell surface molecules in regulating cell adhesion.

Amino Acid Sequence↗
PubMed1998

Improving access to family support organizations: a member survey of the AMI-Quebec Alliance for the Mentally Ill.

Family support organizations such as the Quebec Alliance for the Mentally Ill (AMI-Quebec) provide services for mentally ill individuals and their families. Despite possible benefits, there is often a lengthy period between identification of mental illness and involvement of family members with family support organizations. A survey of AMI-Quebec members was undertaken to assess this delay. Of the 186 respondents, 47 percent experienced a delay of more than two years. Only 10 percent were referred to the organization by psychiatrists. The majority would have liked to have become involved with AMI-Quebec earlier. Some approved of more proactive methods of recruitment by AMI-Quebec, such as a telephone call after an initial hospitalization.

Adult↗
PubMed1997

Housing costs for adults who are mentally ill and formerly homeless.

The goal of this study was to evaluate the costs, under two different housing conditions, to the state mental health agency of caring for adults who are homeless and mentally ill. One hundred and twelve clients of the Massachusetts Department of Mental Health, living in psychiatric shelters, were randomly assigned to one of two housing types: Evolving Consumer Households or Independent Living apartments. For the next 18 months each client was followed so that the cost of treatment, case management, and housing could be collected and compared. The authors found that treatment and case management costs did not vary by housing type, but housing costs were significantly higher for those assigned to Evolving Consumer Households. Regardless of original housing assignment, treatment costs were lower for clients who remained where they were originally placed. The authors conclude that providing support for clients that increases housing stability reduces their need for treatment and that independent living arrangements may be a more cost-effective policy choice.

Adult↗
PubMed1996

A detailed comparison of physician services for the elderly in the United States and Canada.

OBJECTIVE: To assess the relative volume and price of physician services in Canada and the United States. DESIGN: A comparative analysis of 1992 claims data from Canadian provincial ministries of health and from the US Health Care Financing Administration. PATIENTS: All elderly individuals in the 3 largest Canadian provinces, Ontario, Quebec, and British Columbia, and a 1% random sample of US elderly Medicare beneficiaries not enrolled in health maintenance organizations. MAIN OUTCOME MEASURE: The volume of physician services measured in terms of the relative value units used in the Medicare fee schedule to calculate payments, with services disaggregated into clinically meaningful categories. RESULTS: Canadian elderly receive a higher volume of physician services than US elderly. Because the provinces examined paid a much lower price per service, Canada had overall lower expenditures per elderly person than the United States. Canadian elderly received 44% more evaluation and management services, but 25% fewer procedures. Canada has a disproportionately lower volume of procedures for which there is low clinical consensus as to when they are indicated. Such procedures include cataract extractions and knee replacements. CONCLUSION: The lower prices for physician services in Canada permit Canadian elderly to receive a higher volume of evaluation and management services, on the other hand, are constrained by both price and volume. These differences in the volume of physician services may be the result of differences in facility and physician supply.

Aged↗
PubMed1996

Use of mental health services by formerly homeless adults residing in group and independent housing.

OBJECTIVE: The study examined patterns of mental health service use among 112 formerly homeless mentally ill adults to determine whether clients in a staffed group living situation would need fewer types of services or lesser amounts of some services than those living independently in single apartments. METHODS: Clients in the Boston McKinney demonstration project were randomly assigned to two housing types: individual apartments or a group living situation designed to teach residents to manage the house and their own affairs with minimal staff presence. The types and amounts of services these clients used during an 18-month period were documented and compared. RESULTS: Service use by all clients was heavy, especially use of inpatient psychiatric services. It did not differ by housing type. The large majority of clients in both housing types were able to remain housed and avoid homelessness. Clients who did not stay in assigned housing for the duration of the study had higher levels of inpatient service use, including detoxification and substance abuse treatment. CONCLUSIONS: When homeless mentally ill adults are provided permanent housing and accessible mental health treatment and specialized social services, they are likely to avoid unstable housing patterns, which are associated with higher use of inpatient services.

Activities of Daily Living↗
PubMed1996

Medicaid-funded home care for the frail elderly and disabled: evaluating the cost savings and outcomes of a service delivery reform.

OBJECTIVES: In response to rising demand and increased costs for home care services for frail elderly and disabled Medicaid clients, New York City implemented cluster care, a shared-aide model of home care. Our objective: to evaluate the effects of cluster care on home care hours and costs, client functioning, depressive symptoms, and satisfaction. DATA SOURCES: Client interviews, conducted prior to implementation and again 16 months later; Medicaid claims records; home attendant payroll files; and vendor agency records. STUDY DESIGN: The study employed a pretest/posttest design, comparing 229 clients at the first seven demonstration sites to 175 clients at four comparison sites before and after cluster care implementation. Regression methods were used to analyze pre and post-intervention data. PRINCIPAL FINDINGS: Cluster care reduced costs by about 10 percent. Most savings occurred among the more vulnerable clients (those with five or more ADL/IADL limitations). Clients at cluster care sites who started out with fewer than five limitations appeared to decline somewhat more slowly than similarly impaired clients at comparison sites, while those with more than five ADL/IADLs tended to decline more rapidly. This difference was small-less than one limitation per year. Cluster care is associated with a significant decline in satisfaction but appears unrelated to depressive symptoms. CONCLUSIONS: Cluster care appears benign for home care clients with fewer limitations. For the more vulnerable, we recommend experimentation with low-cost interventions that might augment service and improve outcomes without reverting to traditional one-on-one care.

Activities of Daily Living↗
PubMed1994

Evaluation of a New Latex Agglutination Test for Fecal Lactoferrin in Travelers' Diarrhea.

The detection and diagnosis of travelers' diarrhea by fecal culture method, often insensitive, expensive, and time consuming, could well be replaced with the latex agglutination test to detect fecal lactoferrin. As an initial screening, this test could be useful to differentiate between those patients who are more likely to have an invasive enteropathogen and those patients requiring antidiarrheal chemotherapy only. Fecal samples from 92 patients with travelers' diarrhea were tested for occult blood, fecal leukocytes, and fecal lactoferrin at stool dilutions of 1:50 and 1:200. The results were compared with findings from fecal cultures for enteropathogens. Statistical analyses were performed measuring the performance of the latex agglutination test for fecal lactoferrin to calculate its sensitivity, specificity, and positive and negative predictive values. Invasive pathogens were identified in 36 (39%), and a noninvasive pathogen was found in 18, or 20%, of the cases. At the stool dilution of 1:50, fecal lactoferrin showed more sensitivity than did leukocytes or occult blood in detecting the presence of invasive enteropathogens and, with a negative predictive value of 94%, was superior in predicting their absence. At the 1:200 dilution, a lower sensitivity of 55%, but a higher specificity of 82%, compared to 55% with the 1:50 dilution, was demonstrated. The determination of fecal lactoferrin might prove to be more useful and less expensive and time consuming as an initial screening for patients presenting with travelers' diarrhea. Further evaluation and antibacterial treatment could, therefore, be reserved for those with a positive lactoferrin test.

Journal Article↗
PubMed1994

The elasticity of demand for health care in Burkina Faso: differences across age and income groups.

Like many other developing countries, Burkina Faso has been exploring how community resources can be tapped to co-finance health services. Although revenue generation is important for the viability of health services, effects on utilization and on equity of access to health care must also be considered. The authors present a logistic regression model to derive price elasticities of demand for health care based on cross-sectional survey data. While demand for health care appears inelastic overall (-0.79), subgroup analysis reveals differences in elasticity across age and income groups. Elasticities of demand for infants and children (-3.6 and -1.7) and for the lowest income quartile (-1.4) are substantially greater than overall elasticity. The method used is unusual in that it allows estimation of elasticities before the introduction of user fees. This increases the value of the information to policy makers.

Adolescent↗
PubMed1993

Magnetic resonance imaging to visualize the internal anatomy in the Baller-Gerold syndrome.

The Baller-Gerold syndrome is identified by radial aplasia with craniosynostosis. Only 12 cases have been reported previously in the literature; none of the reports describe surgical treatment for the radial aplasia. We report the case of a 10-month-old female infant with this syndrome, including severe bilateral radial clubhands. A radial anlage, which was tethering growth of the ulna, was suspected on physical examination and confirmed with magnetic resonance imaging. Resection of the anlage resulted in dramatic improvement in elbow extension, but additional follow-up will be necessary to determine the complete functional effect of the procedure.

Craniosynostoses↗
PubMed1992

Brucella abortus deficient in copper/zinc superoxide dismutase is virulent in BALB/c mice.

The gene encoding the Cu/Zn superoxide dismutase (SOD) of Brucella abortus strain 2308 was identified in a Brucella genomic library utilizing a combination of Western blotting and native gel electrophoresis. The Cu/Zn SOD gene was inactivated in vitro by ligation of a kanamycin resistance gene into the open reading frame encoding SOD. The plasmid born construct was introduced back into B. abortus by electroporation. Replacement of the wild-type Cu/Zn SOD by recombination was demonstrated by showing that both the KnR gene and the Cu/Zn SOD gene hybridized to the same band in a Southern analysis of genomic DNA. In addition, KnR strains were deficient in Cu/Zn SOD activity as assessed by lack of Cu/Zn SOD activity on a native gel and by lack of reactivity with specific serum in a Western analysis. Either strain 2308 or the Cu/Zn SOD deficient mutant injected intraperitoneally into BALB/c mice, exhibited no differences in their ability to colonize the spleen at 7 and 28 days post-inoculation. Thus, the inability to produce Cu/Zn SOD by B. abortus does not significantly impair its virulence in mice.

Animals↗
PubMed1991

Caring for seriously ill and dying patients: the philosophy and ethics.

The care of seriously ill and dying patients necessitates a philosophic and ethical basis, without which unacceptable patterns of practice may develop. Several problems are described: inadequate or unskilled communication of information, withdrawal by the physician, patient labelling and poor health care. Palliative care must be based on a philosophy that acknowledges the inherent worth and dignity of each person. In addition, it must take place within the framework of four ethical principles: autonomy, beneficience, nonmaleficience and justice. The first and most important of these is the need to regard patients as unique people with a right to compassion, gentle truth, autonomy in decision-making and excellence in physicial and psychospiritual care. Beneficence obliges us not only to relieve suffering but also to enhance the patient's quality of life whenever possible. Nonmaleficence and justice require allocation of sufficient health care resources of the type necessary to provide high-quality care and prevent patients from coming to harm.

Attitude to Death↗
PubMed1991

Auditing the hospital care of dying patients.

It is essential that hospitals (both acute and chronic care) develop a means of determining the status of care to the dying patients and their families within the institution. This paper provides a description of the components of comprehensive care for the dying patient, based on the discipline of palliative/hospice care, and their incorporation into a specific audit tool designed for assessing the hospital care of such patients. An audit conducted in an acute care hospital is provided to illustrate the potential applications of the tool and the nature of the questions it can raise in forming a basis for staff education, resource planning, and directions for further inquiry.

Canada↗