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John Fletcher

Publications and source records attributed to John Fletcher.

11 recordsLinked to original sources
PubMed2006

Developing a tier I CAMHS foundation course: report on a 4-year initiative.

Despite a growing recognition of the strategic importance of the UK's Tier 1 in supporting children and young people with mental health needs, detailed descriptions of the developmental hurdles and content of such courses remain obscure. There are a number of initiatives being undertaken nationally to remedy this and the aim of this article is to contribute the authors' experience to what is becoming a burgeoning national endeavour. Particular attention is drawn to the problems of developing volume multiagency trainings in areas of significant social deprivation and mental health morbidity but innovation is needed to balance the competing needs for quality, penetration into Tier 1, pressures on staff time and managers' release constraints. A core syllabus is tentatively suggested, with additional skills components, and a teaching session is explored in detail to illustrate the authors' methodology and approach.

Adolescent↗
PubMed2006

Using a geographic information system to identify areas with potential for off-target pesticide exposure.

In many countries, numerous tests are required as part of the risk assessment process before chemical registration to protect human health and the environment from unintended effects of chemical releases. Most of these tests are not based on ecological or environmental relevance but, rather, on consistent performance in the laboratory. A conceptual approach based on Geographic Information System (GIS) technology has been developed to identify areas that are vulnerable to nontarget chemical exposure. This GIS-based approach uses wind speed, frequency of those winds, pesticide application rates, and spatial location of agricultural crops to identify areas with the highest potential for pesticide exposure. A test scenario based on an incident in Idaho (USA) was used to identify the relative magnitude of risk from off-target movement of herbicides to plants in the conterminous United States. This analysis indicated that the western portion of the Corn Belt, the central California valley, southeastern Washington, the Willamette Valley of Oregon, and agricultural areas bordering the Great Lakes are among those areas in the United States that appear to have the greatest potential for off-target movement of herbicides via drift. Agricultural areas, such as the Mississippi River Valley and the southeastern United States, appears to have less potential, possibly due to lower average wind speeds. Ecological risk assessments developed for pesticide registration would be improved by using response data from species common to high-risk areas instead of extrapolating test data from species unrelated to those areas with the highest potential for exposure.

Environmental Pollutants↗
PubMed2006

Integrated services for frail elders (SIPA): a trial of a model for Canada.

The complex formed by chronic illness, episodes of acute illness, physiological disabilities, functional limitations, and cognitive problems is prevalent among frail elderly persons. These individuals rely on assistance from social and health care programs, which in Canada are still fragmented. SIPA (Services intégrés pour les personnes âgées fragiles) is an integrated service model based on community services, a multidisciplinary team, case management that retains clinical responsibility for all the health and social services required, and the capacity to mobilize resources as required and according to the care protocol. The SIPA demonstration project used an experimental design, with random allocation of the 1,230 participants from two areas of Montreal to an experimental and a control group. The costs of institutional services were $4,270 less for those in the SIPA group compared to the control group; the costs of community care were $3,394 more. The proportion of persons waiting in acute care hospitals for nursing home placement was twice as high in the control group as in the SIPA group. The costs of acute hospitalizations for persons in the SIPA group with ADL disabilities were at least $4,000 lower than those for persons in the control group. In conclusion, the SIPA trial showed that it is possible to undertake ambitious and rigorous demonstration projects in Canada. These results were obtained without an increase in the overall costs of health and social services, without reducing the quality of care, and without increasing the burden on elderly persons and their relatives.

Aged↗
PubMed2004

Clinical efficacy of metal stents for the treatment of focal abdominal aortic stenosis.

Seven patients (four women and three men) who underwent primary stenting of infrarenal abdominal aortic stenosis over a 4-year period are reported. The patients ranged between 44 and 77 years of age. All were referred for treatment of disabling claudication. Self-expanding stents with balloon assistance were used. A single complication, a retroperitoneal haematoma, requiring surgical intervention occurred in one patient. Patients had either complete resolution of symptoms (five of seven) or a substantial decrease in their claudication symptoms. Primary stenting is a safe and effective treatment for severe abdominal aortic stenosis.

Adult↗
PubMed2003

Identification of surface molecular hydrates on solid sulfuric acid films.

Infrared spectroscopic and secondary ion mass spectrometric studies reveal the presence of a stable molecular hydrate on the surface of condensed thin films of ionic sulfuric acid hydrates. This surface species is observed to play a role in the interaction of ammonia, reacting rapidly until the material is depleted. A slower, continuous process is also observed, attributed to a diffusion-limited reaction between incoming NH3 and H3O+ located at or near the surface.

Journal Article↗
PubMed2002

Molecular evolution of Turnip mosaic virus: evidence of host adaptation, genetic recombination and geographical spread.

Turnip mosaic virus (TuMV), a species of the genus Potyvirus, occurs worldwide. Seventy-six isolates of TuMV were collected from around the world, mostly from Brassica and Raphanus crops, but also from several non-brassica species. Host tests grouped the isolates into one or other of two pathotypes; Brassica (B) and Brassica-Raphanus (BR). The nucleotide sequences of the first protein (P1) and coat protein (CP) genes of the isolates were determined. One-tenth of the isolates were found to have anomalous and variable phylogenetic relationships as a result of recombination. The 5'-terminal 300 nt of the P1 gene of many isolates was also variable and phylogenetically anomalous, whereas the 380 nt 3' terminus of the CP gene was mostly conserved. Trees calculated from the remaining informative parts of the two genes of the non-recombinant sequences by neighbour-joining, maximum-likelihood and maximum-parsimony methods were closely similar, and so these parts of the sequences were concatenated and trees calculated from the resulting 1150 nt. The isolates fell into four consistent groups; only the relationships of these groups with one another and with the outgroup differed. The "basal-B" cluster of eight B-pathotype isolates was most variable, was not monophyletic, and came from both brassicas and non-brassicas from southwest and central Eurasia. Closest to it, and forming a monophyletic subgroup of it in most trees, and similarly variable, was the "basal-BR" group of eight BR pathotype Eurasian isolates. The third and least variable group, the "Asian-BR" group, was of 22 BR-pathotype isolates, all from brassicas, mostly Raphanus, and all from east Asia mostly Japan. The fourth group of 36 isolates, the "world-B" group, was from all continents, most were isolated from brassicas and most were of the B-pathotype. The simplest of several possible interpretations of the trees is that TuMV originated, like its brassica hosts, in Europe and spread to the other parts of the world, and that the BR pathotype has recently evolved in east Asia.

3' Untranslated Regions↗