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Biomedical subjects

J Carson

Publications and source records attributed to J Carson.

At least 19 recordsLinked to original sources
PubMed2001

The effect of ice warning signs on ice-accident frequencies and severities.

Signing of non-permanent road surface conditions, such as ice, is difficult because hazard formation, location, and duration are unpredictable. Subsequently, many state transportation departments have begun to question the sensibility of expending material and personnel resources to maintain ice warning signs when little proof exists of their effectiveness in improving highway safety. This research statistically studies the effectiveness of ice warning signs in reducing accident frequency and accident severity in Washington State. Our findings show that the presence of ice warning signs was not a significant factor in reducing ice-accident frequency or ice-accident severity. However, we were able to identify significant spatial, temporal, traffic, roadway and accident characteristics that influenced ice-accident frequency and severity. The identification of these characteristics will allow for better placement of ice warning signs and improvements in roadway and roadside design that can reduce the frequency and severity of ice-related accidents.

Accidents, Traffic↗
PubMed2001

Miniaturized tests for computer-assisted identification of motile Aeromonas species with an improved probability matrix.

AIMS: To develop miniaturized tests for the phenotypic identification of motile Aeromonas species using an improved probability matrix. METHODS AND RESULTS: Conventional tests were miniaturized for use in 96-well plates, and their performance assessed using 60 aeromonads comprising type and reference strains as well as clinical, fish and water isolates. A revised probability matrix for Aeromonas hybridization groups 1-14, including A. allosaccharophila, A. bestiarum, A. encheleia and A. popoffii, was developed. Using 26 tests, all the reference strains were correctly identified with the revised probability matrix, and 80% of the isolates were correctly identified at a Willcox probability level of 95%. CONCLUSION: The compact test format, coupled with a robust identification matrix, provides a convenient basis for identifying motile aeromonads. SIGNIFICANCE AND IMPACT OF THE STUDY: The identification system for identifying aeromonads will be of use to medical and veterinary laboratories undertaking disease diagnosis.

Aeromonas↗
PubMed2001

Rapid, high-throughput extraction of bacterial genomic DNA from selective-enrichment culture media.

AIMS: To create a fast, sensitive and inexpensive high-throughput method for the extraction of bacterial genomic DNA from selective-enrichment culture media. METHODS AND RESULTS: Lysis of bacteria was achieved using guanidinium isothiocyanate, and DNA was extracted using 96-well glass microfibre filtration plates. Extraction-PCR detected the presence of 1 cfu Yersinia ruckeri and 16 cfu Lactococcus garvieae 200 microl(-1) sample of selective-enrichment medium. CONCLUSION: An efficient method for high-throughput extraction of bacterial genomic DNA from selective-enrichment culture media was achieved. SIGNIFICANCE AND IMPACT OF THE STUDY: This method enables detection of covert bacterial infections in fish. The simultaneous extraction of large numbers of samples allows for its use in bacterial monitoring programmes and quarantine.

Bacteria↗
PubMed2001

Canines as sentinel species for assessing chronic exposures to air pollutants: part 1. Respiratory pathology.

A complex mixture of air pollutants is present in the ambient air in urban areas. People, animals, and vegetation are chronically and sequentially exposed to outdoor pollutants. The objective of this first of 2 studies is to evaluate by light and electron microscopy the lungs of Mexico City dogs and compare the results to those of 3 less polluted cities in MEXICO: One hundred fifty-two clinically healthy stray mongrel dogs (91 males/61 females), including 43 dogs from 3 less polluted cities, and 109 from southwest and northeast metropolitian Mexico City (SWMMC, NEMMC) were studied. Lungs of dogs living in Mexico City and Cuernavaca exhibited patchy chronic mononuclear cell infiltrates along with macrophages loaded with particulate matter (PM) surrounding the bronchiolar walls and extending into adjacent vascular structures; bronchiolar epithelial and smooth muscle hyperplasia, peribronchiolar fibrosis, microthrombi, and capillary and venule polymorphonuclear leukocytes (PMN) margination. Ultrafine PM was seen in alveolar type I and II cells, endothelial cells, interstitial macrophages (Mtheta), and intravascular Mtheta-like cells. Bronchoalveolar lavage showed significant numbers of alveolar macrophages undergoing proliferation. Exposure to complex mixtures of pollutants-predominantly particulate matter and ozone-is causing lung structural changes induced by the sustained inflammatory process and resulting in airway and vascular remodeling and altered repair. Cytokines released from both, circulating inflammatory and resident lung cells in response to endothelial and epithelial injury may be playing a role in the pathology described here. Deep concern exists for the potential of an increasing rise in lung diseases in child populations exposed to Mexico City's environment.

Age Distribution↗
PubMed2001

Canines as sentinel species for assessing chronic exposures to air pollutants: part 2. Cardiac pathology.

The principal objective of this study is to evaluate by light and electron microscopy (LM, EM) the heart tissues in stray southwest and northeast metropolitan Mexico City (SWMMC, NEMMC) dogs and compare their findings to those from 3 less polluted cities (Cuernavaca, Tlaxcala, and Tuxpam). Clinically healthy mongrel dogs, including 109 from highly polluted SWMMC and NEMMC, and 43 dogs from less polluted cities were studied. Dogs residing in cities with lower levels of pollutants showed little or no cardiac abnormalities. Mexico City and Cuernavaca dogs exhibited LM myocardial alterations including apoptotic myocytes, endothelial and immune effector cells, degranulated mast cells associated with scattered foci of mononuclear cells in left and right ventricles and interventricular septum, and clusters of adipocytes interspersed with mononuclear cells. Vascular changes included scattered polymorphonuclear leukocytes (PMN) margination and microthrombi in capillaries, and small venous and arteriolar blood vessels. Small veins exhibited smooth muscle cell hyperplasia, and arteriolar blood vessels showed deposition of particulate matter (PM) in the media and adventitia. Unmyelinated nerve fibers showed endoneural and epineural degranulated mast cells. EM examination of myocardial mast cells showed distended and abundant rough endoplasmic reticulum with few secretory granules. Myocardial capillaries exhibited fibrin deposition and their endothelial cells displayed increased luminal and abluminal pinocytic activity and the formation of anemone-like protrusions of the endothelium into the lumen. A close association between myocardial findings, lung epithelial and endothelial pathology, and chronic inflammatory lung changes was noted. The myocardial changes described in dogs exposed to ambient air pollutants may form the basis for developing hypothesis-driven mechanistic studies that might explain the epidemiological data of increased cardiovascular morbidity and mortality in people exposed to air pollutants.

Air Pollutants↗
PubMed2001

Expression of oestrogen and progesterone receptors by mast cells alone, but not lymphocytes, macrophages or other immune cells in human upper airways.

BACKGROUND: Nasal polyposis often coexists with asthma in airway inflammatory conditions characterised by the infiltration of a range of immune cells. A potentially important role for ovarian hormones has been implicated in airway inflammation but the cellular target for such action is not known. METHODS: Expression of oestrogen receptors (ER) and progesterone receptors (PR) was examined using immunohistochemistry in formalin fixed nasal polyp tissues from 47 subjects. The cells positive for ER or PR were confirmed by spatial location, dual immunolabelling, and histochemical staining. RESULTS: Consistent with the known features of nasal polyps, CD4+ (T helper/inducer), CD8+ (cytotoxic/suppressor), CD68+ (macrophages), mast cells, eosinophils and neutrophils were all clearly detected by their relevant monoclonal antibodies or appropriate histochemical staining, but only mast cells tested positive for ER/PR labelling with their polyclonal and monoclonal antibodies. The frequencies for expression were 61.7% for ER positive and 59.6% for PR positive cells. The expression of ER/PR was independent of patient sex and age but was highly correlated with the numbers of mast cells (r = 0.973, p<0.001 for ER; r = 0.955, p<0.001 for PR). Fewer than 5% of mast cells were found to be negative for ER/PR expression. CONCLUSIONS: Mast cells alone, but not lymphocytes, macrophages, or other immune cells, express ER/PR in human upper airways. Numerous ER/PR positive mast cells exist in nasal polyps, indicating that this may be a major route for the involvement of sex hormones in airway inflammation when exposed to the higher and varying concentration of oestrogen and progesterone characteristic of females.

Adolescent↗
PubMed2000

Luminous vibriosis in rock lobster Jasus verreauxi (Decapoda: Palinuridae) phyllosoma larvae associated with infection by Vibrio harveyi.

Studies were conducted to determine the cause of outbreaks of luminous vibriosis in phyllosoma larvae of the packhorse rock lobster Jasus verreauxi reared in an experimental culture facility. On 2 separate occasions mortalities of up to 75% over a period of 4 wk were observed in 4th to 5th and 8th to 10th instar phyllosomas at water temperatures of 20 and 23 degrees C, respectively. Affected larvae became opaque, exhibited small red spots throughout the body and pereiopods, and were faintly luminous when viewed in the dark. Histopathology showed that the gut and hepatopancreas tubules of moribund phyllosomas contained massive bacterial plaques. The hepatopancreas tubules of moribund larvae were atrophic and some contained necrotic cells sloughed into the lumen. Dense, pure cultures of a bacterium identified as Vibrio harveyi were isolated from moribund larvae. The disease syndrome was reproduced by in vivo challenge and V. harveyi was successfully reisolated from diseased larvae after apparently healthy larvae were exposed by immersion to baths of more than 10(4) V. harveyi ml(-1) at 24 degrees C. Injured larvae were more susceptible to infection than were healthy larvae. Survival of larvae experimentally and naturally exposed to V. harveyi was improved when antibiotics were administered via bath exposures.

Animals↗
PubMed1999

Induction, characterisation and pathogenicity in rainbow trout Oncorhynchus mykiss (Walbaum) of Lactococcus garvieae L-forms.

Difficulties with induction and cultivation of L-forms, particularly those derived from Gram positive parent cells, have constrained to some degree the ability to evaluate the pathogenicity of these morphotypes. Induction of L-forms of Lactococcus garvieae was undertaken using either charcoal or inactivated horse serum media supplemented with ampicillin, benzylpenicillin or erythromycin, the drug of choice for treatment of infections in rainbow trout, Oncorhynchus mykiss, (Walbaum), and NaCl as an osmotic stabiliser. Lysozyme treated cells could be cultured in a cell wall deficient state using media consisting of charcoal, NaCl and either ampicillin or benzylpenicillin. The influence of some amino acids for induction of L-forms was assessed by disc diffusion and combined interaction. Analysis of variance of colony counts indicated that the amino acids glycine, DL-methionine, L-threonine and L-serine (P<0.03), and the presence of charcoal were beneficial and that inactivated horse serum was detrimental to L-form development. Electron microscopy revealed that the cell wall of L-forms was missing and this cell had a greatly expanded volume compared to parent cells. Electrophoresis of whole cell proteins showed some variation of electropherotype between parent and L-form cells. L-forms expressed greater quantities of proteins with molecular mass of 36 and 66 kDa and parent cells contained greater quantities of proteins of molecular mass 29, 43 and 60 kDa. Additional proteins of molecular mass 32, 44 and 53 kDa were present in L-form extracts, and in parent cells of 34, 38, 40, 42, 85 and 123 kDa which may represent cell wall associated proteins or alterations in expression due to different growth rates. Intraperitoneal challenge of rainbow trout with L-forms failed to produce overt infection even in immune-suppressed fish, but L-forms were shown by indirect fluorescent antibody test to remain inkidney tissue. Fish were susceptible to infection when challenged with parent cells of L. garvieae.

Animals↗
PubMed1999

Subjective quality of life, psychopathology, satisfaction with care and insight: an exploratory study.

We have investigated the determinants of global subjective quality of life (GSQOL) using data from a controlled trial of intensive case management for the severely mentally ill. In a multiple regression analysis depression, age, objective quality of life and domain-specific quality of life together explained 59% of the variance in GSQOL. GSQOL was not significantly correlated with measures of positive psychotic symptomatology, insight or attitudes to treatment but was correlated with satisfaction with care (r = .21, p = .011). Change in GSQOL over 18 months was correlated with change in domain-specific quality of life (r = -.45, p = .002) and depression (r = -.43, p = .01): multiple regression analysis confirmed that both variables had an independent effect on change in GSQOL.

Adult↗
PubMed1999

Psychological training improves mental health and job-finding among unemployed people.

The negative psychological effects of unemployment are well documented: lowered self-esteem and confidence, social isolation, anxiety, depression, reduced life satisfaction, hopelessness about the future. Further, it has been established that these effects often prevent re-employment. The need for interventions to help unemployed people to minimise such psychological effects is clearly warranted, yet little psychological assistance is usually given. This paper describes a psychological intervention based on cognitive behavioural therapy (CBT), the principles of which have been successfully applied through individual psychotherapy to several psychiatric disorders. We adapted these principles to create a group-training programme for a non-psychiatric group--long term (>12 months) unemployed. The results demonstrated that significantly more of the CBT group than the control group improved on measures of mental health, as well as on success in job-finding: four months after the completion of training 34% of the CBT group c.f. 12% of the control group had found full-time work. Taking part-time and temporary work into account, these figures increased to 49% (CBT group) and 28% (control group), indicating the value of psychological interventions in reducing the negative psychological effects of unemployment, and helping the unemployed find jobs.

Adult↗
PubMed1998

Occupational stress and community mental health nursing: what CPNs really said.

The Claybury Nursing Stress Study assessed the levels of occupational stress experienced by both ward-based and community nurses. This paper presents the results obtained from a qualitative analysis of statements made by community psychiatric nurses during a questionnaire based interview. Key areas identified by CPNs as relevant to stress and coping are reported and suggestions for further, qualitative research in this area are made.

Adaptation, Psychological↗
PubMed1998

Clinical supervision: insider reports of a private world.

An exploratory study, funded by the Department of Health, London and the Scottish Home and Health Department, Edinburgh, was conducted over an 18-month period to provide an informed view on possible assessment tools that could be used to assess the impact of clinical supervision (CS) in nursing and to report on the CS activities in 23 selected sites in England and Scotland. The study not only examined the utility of several standardized research instruments, to be reported separately, but also explored the experience of a small sub-sample of nurses (n = 34) engaged in CS, as supervisors and supervisees. Interviews were undertaken to help better understand some of the issues involved around the domains of structure, process and outcome. Respondents reported an enthusiasm for the opportunity to talk meaningfully to a trusted colleague about their personal circumstances at work. Such opportunities were particularly welcomed by nurses who wished to reflect upon their own practice with patients, especially when dealing with their clinical conditions which were upsetting, or otherwise challenging, and sometimes harrowing. Substantive and methodological areas of interest for future research are suggested.

Adult↗
PubMed1998

Intensive case management for the severely mentally ill. Controlled trial.

BACKGROUND: The aim was to compare the efficacy of intensive clinical case management (ICM) with standard community care in the management of 'hard to treat' patients with a severe mental illness. METHOD: A randomised controlled trial was carried out in East Lambeth, a deprived area of inner London. Seventy people with psychosis designated as 'hard to treat' by referring teams were included; 35 were randomised to ICM (case load eight patients per worker), and 35 to standard care, which offered follow-up by a community psychiatric nursing service (30 patients per worker). Outcome measures were admissions and hospital bed utilisation; contact with services; symptomatology; social behaviour; social functioning; quality of life; patients' satisfaction with care at 9 and 18 months. RESULTS: There were no differences in patients' symptoms, social behaviour or social functioning. Quality of life was significantly improved in patients receiving ICM at 9 months. Satisfaction with care was significantly greater among case-managed patients. All ICM patients remained in contact with services throughout the study, while six control patients were refusing all contact with services at 18 months. CONCLUSIONS: ICM failed to improve the clinical outcome of 'hard to treat' patients. The service was successful in maintaining contact with patients, was greatly appreciated and had a positive effect on their perceived quality of life.

Adolescent↗
PubMed1997

Effect of cognitive-behavioural training on job-finding among long-term unemployed people.

BACKGROUND: The principles of cognitive-behavioural therapy (CBT) have been applied successfully through individual psychotherapy to several psychiatric disorders. We adapted these principles to create a group--training programme for a non-psychiatric group-long-term (> 12 months) unemployed people. The aim was to investigate the effects of the programme on measures of mental health, job-seeking, and job-finding. METHODS: 289 volunteers (of standard occupational classification professional groups) were randomly assigned to a CBT or control programme, matched for all variables other than specific content, that emphasised social support. 244 (134 CBT, 110 control) people started the programmes and 199 (109 CBT, 90 control) completed the whole 7 weeks of weekly 3 h sessions (including three CBT, seven control participants who withdrew because they obtained employment or full-time training). Questionnaires completed before training, on completion, and 3-4 months later (follow-up data available for 94 CBT, 89 control) assessed mental health, job-seeking activities, and success in job-finding. Analyses were based on those who completed the programmes. Participants were not aware that two interventions were being used. Investigators were aware of group allocation, but were accompanied in all programmes by co-trainers who were non-investigators. FINDINGS: Before training, 80 (59%) CBT-group participants and 59 (54%) controls scored 5 or more on the general health questionnaire (GHQ; taken to define psychiatric caseness). After training, 29 (21%) and 25 (23%), respectively, scored 5 or more (p < 0.001 for both decreases). Improvements in mean scores with training on the GHQ (between-group difference 3.91, p = 0.05) and in other measures of mental health were significantly greater in the CBT group than in the control group. There were no significant differences between the groups in job-seeking activity during or after training, but significantly more of the CBT group than of the control group had been successful in finding full-time work (38 [34%] vs 13 [13%], p < 0.001), by 4 months after completion of training. INTERPRETATION: These results suggest that group CBT training can improve mental health and produce tangible benefits in job-finding. Application of CBT among the unemployed is likely to benefit both individuals and society in general.

Adult↗
PubMed1997

Case management: a week in the life of a clinical case management team.

This paper describes the work of a clinical case management core team (four nurses and an occupational therapist) during the course of a week. Information was gathered through non-participant observation of the team by two independent researchers. Transcripts produced from the data recorded were examined. From this, seven categories of activity were identified: planned client contact; unplanned client contact; family/carer contact; liaison; administration; team information sharing and supervision, training and personal development. These categories were felt to encompass the range of activities practised by the team. The amount of time that case managers spent engaged in these core functions was calculated. Detailed examples are presented. Results are discussed with reference to Kanter's components and principles of clinical case management.

Adult↗
PubMed1997

Stress in mental health nursing: findings from the Mental Health Care survey.

Organisational and administrative concerns topped the list of stressors reported by a national sample of hospital and community mental health nurses. Seven of the ten top stressors were listed by both groups. Community nurses also listed inadequate service provision and lack of time to plan treatment. Hospital nurses were most stressed by inadequacy of staffing cover in potentially dangerous situations and low morale at work. Jerome Carson et al believe the findings indicate an urgent need for change at senior NHS management and administration level.

Adult↗
PubMed1996

Macrophages and apoptotic cells in human colorectal tumours.

The numerical relationship between tumour associated macrophages (TAM) and apoptotic cells in 12 human colorectal tumours was evaluated. TAM were labelled immunohistochemically and apoptotic cells were visualized by counterstaining with haematoxylin and eosin (H&E). The stereological techniques, Cavalieri's estimator of volume and the Disector were used to estimate both tumour volume and numerical density of both cell types. The occurrence of TAM per unit volume of tissue increased with increasing tumour volume to a maximum in a tumour of 110.5 cm3, after which numbers declined. Levels of apoptosis also increased with tumour volume though more erratically than levels of TAM and declined for tumour volumes greater than 80 cm3. This is the first report of an attempt to assess the relationship between apoptotic cells and TAM in human tumours.

Apoptosis↗