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Biomedical subjects

G Kent

Publications and source records attributed to G Kent.

At least 37 records · Page 2Linked to original sources
PubMed1996

Ownership and uses of human tissue: does the Nuffield bioethics report accord with opinion of surgical inpatients?

OBJECTIVE: To compare opinion of surgical inpatients with the conclusions of the report of the Nuffield Council on Bioethics regarding the ownership and uses of human tissue. DESIGN: Survey of results of questionnaires completed by patients. SETTING: Large teaching hospital. SUBJECTS: 384 postoperative adult surgical patients. RESULTS: There was strong support among patients for the use of tissues in medical education, research, and science with the exception of those tissues which may transmit disease to others. Few patients (39; 10%) believed that they retained ownership of tissue removed at surgery. Most believed that the tissue belonged to the hospital (103; 27%), to nobody (103; 27%), or to the laboratory (77; 20%). Most patients had not been given any information about the possible uses of their tissues after removal. CONCLUSIONS: Surgical inpatients seem to endorse the conclusions of the Nuffield report regarding the ownership and uses of human tissue. The recommendations regarding patient information and consent procedures should be implemented at the earliest opportunity.

Adult↗
PubMed1996

In vivo measurements of ion transport in long-living CF mice.

The Cftr (Cystic Fibrosis Transmembrane Conductance Regulator) gene codes for an epithelial chloride (C1) channel essential for fluid secretion into the respiratory and gastrointestinal tract and from exocrine glands. Mice lacking CFTR function due to a disruption of Cftr exon 10 or exon 1 (Cftr (m1UNC/m1UNC) or Cftr(m1HSC/m1HFC) mice, respectively) generally suffer from severe gastrointestinal disease resulting in death shortly after birth or at the time of weaning. However, a subgroup of the Cftr(m1HSC/m1HSC) mice have been characterized which exhibit relatively mild intestinal pathology resulting in a noncompromised lifespan compared to the more severely affected Cftr(m1UNC/m1UNC) mice. We compared the ion transport capacity of the intestinal mucosa of the mildly and severely affected CF mice using the in vivo technique of rectal potential difference (PD) measurement and found that the net calcium-activated chloride conductance toward the lumen was much greater in the rectum of mildly affected mice than in the severely affected mice. Hence, the milder phenotype may be related to the expression of a factor which enhances the net calcium-activated chloride conductance into the lumen of the intestinal tract.

Amiloride↗
PubMed1996

Shared understandings for informed consent: the relevance of psychological research on the provision of information.

The achievement of informed consent from patients and potential research participants is considered a basic requirement in clinical care and clinical research, but ethicists have paid little attention to the psychological processes and social factors involved in sharing information between individuals. Although many studies on consent have provided useful results, they are rarely informed by basic research in the social sciences. As a result, there are a large number of methodological and conceptual issues which have not been adequately addressed. The purpose of this paper is to illustrate how the work of cognitive and social psychologists can provide insights that are both relevant and valuable to the process of attaining consent. Research in these areas within psychology has indicated that there are important individual differences in how much information people require and that patients' current state of mind can affect estimates of probability, thus making analogue studies misleading. Collaboration between psychologists and ethicists would be of great value in identifying likely areas of mutual interest, particularly the choice of language in consent forms and information sheets, the design of consent forms, the amount of information provided, and the specification of risks and benefits.

Data Display↗
PubMed1996

Patient reactions to met and unmet psychological need: a critical incident analysis.

Patients with cancer must deal with a variety of psychological and social difficulties, but the extent to which staff assist patients with these difficulties is not clear. Using the Critical Incident Technique (CIT), patients attending a Cancer Centre were asked to describe situations in which their emotional needs were, and were not, met by staff. Although most patients were able to describe a situation in which their needs were met by staff, 23% also described a situation in which this was not the case. These latter incidents were often related to anxiety, confusion and a wish to sever links with the hospital. Patients who reported that their needs were not met requested more staff time and further information about their diagnosis and treatment.

Adaptation, Psychological↗
PubMed1996

Psychologic effects of vitiligo: a critical incident analysis.

BACKGROUND: Qualitative and quantitative studies have shown that cutaneous diseases can have significant effects on psychologic well-being and social functioning in a variety of interpersonal situations. OBJECTIVE: Our purpose was to assess the nature and extent of the social and psychologic difficulties associated with vitiligo using a combination of qualitative and quantitative methods. METHODS: Six hundred fourteen members of the U.K. Vitiligo Society completed a questionnaire that included the 12-item version of the General Health Questionnaire (GHQ) and an open-ended question concerning the effects of the disease on their life. RESULTS: Thirty-five percent of the respondents scored above the threshold on the GHQ. Analysis of the qualitative data indicated that vitiligo affects lives in a variety of ways consistent with perceived stigma and that some categories of response (such as avoidance of activities and negative reactions by others) were associated with higher GHQ scores. CONCLUSION: Many persons with vitiligo show indications of significant distress that are related to specific types of social encounters and emotional disturbance.

Adolescent↗
PubMed1996

Visual signals and the communication abilities of children.

The communication abilities of children of differing ages (4-, 6-, and 11 years) were compared. The children performed two communication tasks and were interviewed in both face-to-face and audio-only contexts. While older children adapted to the loss of visual signals the younger age groups did not and their communication suffered. It appears that a significant amount of information which young children transmit occurs in a non-verbal format, and that visual signals are less demanding for young listeners. Such findings have implications for professionals working with young children since they show the importance of addressing both the child's visual signals and one's own.

Age Factors↗
PubMed1996

The content and characteristics of auditory hallucinations in Saudi Arabia and the UK: a cross-cultural comparison.

This study investigated the content and characteristics of auditory hallucinations reported by 75 patients in Saudi Arabia (SA) and the UK. Each patient was asked to report on the content and characteristics of their hallucinations with regard to several dimensions, including loudness, frequency, clarity and perceived validity. In general, the characteristics of the voices did not vary between the SA and UK patients, but the content differed between cultures. Much of the content of the hallucinations of SA patients was religious and superstitious in nature, whereas instructional themes and running commentary were common in the UK patients. The results suggest that cultural differences need to be taken into account when applying psychological methods to this group of patients.

Adult↗
PubMed1996

Development of a scale to measure the social and psychological effects of severe dental anxiety: social attributes of the Dental Anxiety Scale.

This paper describes the development of a scale designed to measure the extent to which severe dental anxiety or phobia affects patients' social wellbeing outside of the dental setting. Items initially selected on the basis of clinical experience were administered to two groups: 78 patients seeking help for severe anxiety and 88 patients attending the general clinic of a dental hospital. Items on the scale discriminated between these two groups and also between patients who were reluctant to attend even when experiencing symptoms and those who attend more regularly. Although the scale correlated moderately well with Corah's Dental Anxiety Scale, factor analysis indicated that its items assess the effects of severe anxiety on the two domains of psychological reactions and social inhibition as they occur as indirect effects of dental care. The scale could be included in assessments designed to measure the social and psychological effects of severe dental anxiety.

Adult↗
PubMed1996

Phenotypic abnormalities in long-term surviving cystic fibrosis mice.

Mouse models for cystic fibrosis (CF) with no CFTR function (Cftr-/-) have the disadvantage that most animals die of intestinal obstruction shortly after weaning. The objective of this research was to extend the lifespan of CF mice and characterize their phenotype. Weanlings were placed on a nutrient liquid diet, and histologic and functional aspects of organs implicated in the disease were subsequently examined. Approximately 90% of Cftr-/- mice survived to 60 d, the majority beyond 100 d. Cftr-/- mice were underweight and had markedly abnormal intestinal histology. The intestinal epithelia did not respond to challenges with agents that raised intracellular cAMP, consistent with the absence of functional CFTR. No lesions or functional abnormalities were evident in the lungs. Liquid-fed Cftr-/- mice were infertile, although some males weaned to a solid diet were fertile before they died. Thus, we have succeeded in using dietary means to prolong the lives of Cftr-/- mice.

Animals↗
PubMed1996

Exocrine pancreatic alterations in long-lived surviving cystic fibrosis mice.

We investigated the development of the exocrine pancreas in Cftr-/- mice in comparison with age-matched littermates (Cftr+/+, Cftr+/-) up to 100 d postnatally. Controls were weaned either to mouse chow or a liquid diet; Cftr-/- mice were weaned solely to a liquid diet. Solid-fed control mice gained weight and showed a progressive increase in pancreatic protein, DNA, amylase, lipase, trypsin, and chymotrypsin activities. Liquid-fed control mice showed similar postnatal somatic and pancreatic growth, except that amylase and lipase activities were lower than in the solid-fed controls. Cftr-/- mice exhibited significantly lower body and pancreatic weights than did controls. Pancreatic protein content and enzyme activities (notably amylase and lipase) were consistently lower than in the age-matched litter-mates fed either diet. The reduction in lipase activity in Cftr-/- mice was noted before weaning. We concluded that the liquid diet influenced postnatal exocrine pancreatic development in mice. However, a further reduction in postnatal pancreatic growth and enzymatic activities in the Cftr-/- mice was noted. These alterations could be due to the primary cystic fibrosis defect, although secondary factors, such as malnutrition induced by decreased dietary intake or abnormal absorptive capacity, may be responsible.

Amylases↗
PubMed1996

Detection and classification of inappropriate hospital stay.

OBJECTIVE: To study the reliability and validity of concurrent review of hospital-bed utilization carried out by a trained nurse. DESIGN: Analysis of interrater reliability and validity of utilization review. SETTING: Tertiary care hospital associated with a university. PATIENTS: Eighty patients randomly selected from 203 patients admitted to the hospital. INTERVENTIONS: Appropriateness of days of stay in hospital was classified prospectively, on the basis of clinical judgement, by two nurses working independently, by a third nurse working with the Appropriateness Evaluation Protocol (AEP) and by a multidisciplinary review panel of nurses and physicians working retrospectively with the use of data gathered by the first nurse. MAIN OUTCOME MEASURES: Agreement between different rates on the number of and reason for inappropriate admission days, total number of inappropriate days and of inappropriate days due to delayed discharge, to diagnostic procedures or to inefficient medical management. RESULTS: Agreement between the two nurses who used clinical judgement was substantial (kappa or the intraclass correlation coefficient [RI] 0.77 to 0.98 on the number of and reason for inappropriate admission days, on the total number of inappropriate hospital days and on days due to delayed discharge, diagnostic procedures or inefficient medical management. Agreement was moderate (RI 0.47) on the number of inappropriate day's stay awaiting surgery. Agreement was substantial (kappa or RI 0.69 to 0.94) between the two nurses who used clinical judgement and the panel, except on the total number of inappropriate days; however, for this variable, exclusion of one case increased the RI from 0.35 to 0.80. Agreement was substantial between the two nurses who used clinical judgement and the nurse who used the AEP on appropriateness of admission days and the number of inappropriate days. Agreement between the panel and the nurse who used the AEP on the number of inappropriate days rose from 0.36 to 0.88 when the one outlying case was excluded. Some admissions were classified as premature when the AEP was used, whereas other raters considered the admissions unnecessary. There was poor agreement between the nurse who used the AEP and the other raters on the number of inappropriate days' stay awaiting surgery or diagnostic tests. CONCLUSIONS: Data collection and judgement of appropriateness of hospital stay by a trained nurse is feasible and reliable. A nurse working prospectively and a panel working retrospectively sometimes disagree. The AEP provides a similar estimate of the number of inappropriate days but may be insensitive to patient factors that influence the timing of admission.

Female↗
PubMed1996

Factors affecting responses on Dermatology Life Quality Index items among vitiligo sufferers.

Finlay and Khan have recently suggested that the Dermatology Life Quality Index (DLQI) can be used to measure the effects of dermatological conditions on the quality of patients' lives. The aims of this study were to assess its applicability in a nonclinic sample of vitiligo sufferers and to measure its relationship with questionnaires designed to measure a variety of psychological and demographic factors. The DLQI was completed by 614 members of the Vitiligo Society in a postal survey. The results supported the validity of the DLQI for this sample. DLQI scores were related to perceived stigma (a version of Ginsburg and Link's psoriasis stigma questionnaire), recent experiences, self-esteem (Rosenberg's scale), personal distress (both a symptom checklist and the 12-item General Health Questionnaire) and race, suggesting that levels of disability might be reduced by interventions that target these variables.

Adolescent↗
PubMed1995

Differential stimulation of somatostatin but not neuropeptide Y gene expression by quinolinic acid in cultured cortical neurons.

Somatostatin (SS) and neuropeptide Y (NPY) are coproduced in a subpopulation of neurons that are selectively resistant to NMDA neurotoxicity. We have previously reported that quinolinic acid (QUIN), an NMDA receptor agonist, augments SS mRNA in cultured fetal rat cortical neurons. This study examines coregulation of SS and NPY by QUIN and NMDA in cultured cortical neurons and compares the effects of these agents with those of forskolin and phorbol 12-myristate 13-acetate (PMA), known to activate SS and NPY gene transcription by protein kinase A- and protein kinase C-dependent mechanisms. In addition, transcriptional regulation of the SS gene was investigated by acute transfection of cortical cultures with an SS promoter-chloramphenicol acetyltransferase (CAT) construct. QUIN and NMDA displayed dose-dependent fourfold augmentation of levels of mRNA for SS but not for NPY. In contrast, forskolin and PMA increased both SS and NPY mRNA levels. QUIN- and NMDA-mediated induction of SS mRNA was blocked by the NMDA receptor antagonist (-)-2-amino-5-phosphonovaleric acid and displayed regional brain specificity because it was not observed in fetal hypothalamic cell cultures. In time course studies, the effects of QUIN/NMDA on SS mRNA occurred after a latency of 8 h, indicating a delayed effect. Cortical cells transfected with pSS-750 CAT showed three- to fourfold stimulation of CAT activity with forskolin but not by QUIN or NMDA. These data reveal a dose-dependent, tissue-specific, NMDA receptor-mediated stimulation of SS but not NPY mRNA.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1995

Can we prevent accidental injury to adolescents? A systematic review of the evidence.

OBJECTIVES: As part of the Department of Health strategy The Health of the Nation, a systematic review of published and unpublished literature relating to the effectiveness of interventions in reducing accidental injury in the population aged 15-24 years was carried out. METHODS: The literature was reviewed under the standard setting headings of road, work, home, and sports and leisure, and graded for quality of evidence and strength of recommendation using a scale published in the UK national epidemiologically based needs assessment programme. RESULTS: The most effective measures appear to be legislative and regulatory controls in road, sport, and workplace settings. Environmental engineering measures on the road and in sports have relatively low implementation costs and result in fewer injuries at all ages. There is little evidence that purely educational measures reduced injuries in the short term. Community based approaches may be effective in all age groups, and incentives to encourage safer behaviour hold promise but require further evaluation. The potential of multifactorial approaches seems greater than narrowly based linear approaches. CONCLUSIONS: Few interventions to reduce injury in adolescents have been rigorously evaluated using good quality randomised controlled trials, and where such evidence is available, fewer have been shown to be definitely worthwhile. Many studies relied on surrogate measures rather than actual injury rates, and substantial issues relating to the efficacy or implementation of preventive measures in adolescent and young adult populations remain unresolved.

Accident Prevention↗