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Biomedical subjects

L Cooke

Publications and source records attributed to L Cooke.

18 recordsLinked to original sources
PubMed2001

Doctors' professional values: results from a cohort study of United Kingdom medical graduates.

OBJECTIVES: To examine young doctors' views on a number of professional issues including professional regulation, multidisciplinary teamwork, priority setting, clinical autonomy and private practice. METHOD: Postal survey of 545 doctors who graduated from United Kingdom medical schools in 1995. RESULTS: Questionnaires were returned by 95% of the cohort (515/545). On issues of professional regulation, teamwork and clinical autonomy, the majority of doctors held views consistent with current General Medical Council guidance. The majority supported the right of doctors working in the NHS to engage in private practice. Most respondents thought that public expectations of doctors, medicine and the NHS were too high, and that some form of rationing was inevitable. On many issues there was considerable variation in attitudes on the basis of sex and intended branch of medicine. CONCLUSIONS: The results highlight the heterogeneity of the profession and the influence of specialty and gender on professional values. Doctors' attitudes had also been shaped by broader social changes, especially debates surrounding regulation of the profession, rising public expectations and the need for rationing of NHS care.

Adult↗
PubMed2000

Searching for one versus two identical targets: when visual search has a memory.

A recent study has suggested that observers' visual explorations of the external world can proceed unimpaired when the visual environment precludes the operation of memory processes (as, for instance, when the display elements change locations every 100 ms). One theoretical limitation of this study was that distractors were the only elements that had the potential to be tagged during visual search. The present study sought to clarify the amnesic-search hypothesis by investigating whether memory processes can guide search in other contexts in which targets also have the potential to be tagged. Accordingly, the experimental conditions of the previous study were repeated using a different search task in which observers had to decide whether one target or two were present among a variable number of similar distractors. Under these search conditions, the present findings provided strong evidence that memory processes can guide visual search.

Adult↗
PubMed1999

Education and training in the senior house officer grade: results from a cohort study of United Kingdom medical graduates.

INTRODUCTION: This paper shows the findings from a survey of 439 senior house officers undertaken as part of the British Medical Association cohort study of 1995 medical graduates. The aim of the study was to assess the quality of senior house officer training in the United Kingdom. METHOD: In July 1997 a postal questionnaire was sent to a sample of 545 doctors who graduated from medical school in 1995. Responses were received from 515 (95%). Only those doctors who had worked as a senior house officer in the previous 12 months were included in the analysis (n = 439). RESULTS: Encouraging results are that 69% of the senior house officers surveyed had discussed their progress directly with their consultant, and 24% rated their supervision by their consultant as 'excellent'. Of concern are the findings that 47% of respondents did not receive protected teaching time and 16% were unable to take study leave. DISCUSSION: The study revealed wide variability in the quality of training received by senior house officers in the United Kingdom. Whilst some respondents - notably those in general practice, accident and emergency, paediatrics and psychiatry - had enjoyed a high standard of education and training, it was clear that a minority of posts continue to offer little if any educational value to the post holder. The results point to a need for a more systematic approach to maintaining standards in senior house officer training with greater incentives for under-performing trusts.

Attitude↗
PubMed1998

Papillon-Lefèvre syndrome: a case report.

This case report discusses a very rare condition; Papillon-Lefèvre Syndrome. This is an autosomal recessive condition in which the main features are hyperkeratosis of the palms and the soles and severe periodontal destruction.

Child, Preschool↗
PubMed1996

Is erythrocyte alkaline phosphatase activity a marker of zinc status in humans?

The identification of an enzyme activity that responds to changes in Zn intake may serve as a useful biomarker for Zn status. Alkaline phosphatase (ALP) is a dimeric protein with each subunit containing two Zn atoms. The activity of ALP in erythrocytes (E) decreases as a result of a low Zn diet, which suggests that this enzyme may be a marker of Zn status. To investigate this further, we determined the response of E-ALP in six healthy subjects following supplementation with 50 mg Zn (4.2 x RDI) daily for 4 wk. A small but significant increase in plasma Zn was observed with supplementation (p < 0.05), whereas there was no significant change in E-Zn over the same period. Plasma and E-Cu showed no change. Conversely, the activity of E-ALP increased in all subjects from 1.7 +/- 0.5 to 5.9 +/- 0.7 U/g protein (mean +/- SE) (p < 0.0001). The small change observed in plasma Zn is not biologically significant in view of the many documented factors that influence its concentration. Our data support the hypothesis that E-ALP is a marker of Zn status in humans.

Adult↗
PubMed1994

Differences in beta adrenergic receptor agonist affinity between cardiac myocytes and coronary arterioles in canine heart.

Beta adrenergic receptors (beta AR) are localized in several tissue compartments of the heart, including cardiac myocytes, coronary arteries and coronary arterioles, but it is unclear whether there are differences between tissues in beta AR coupling to G protein. The goal of these studies was to use receptor autoradiography to analyze beta receptor agonist binding characteristics in different tissue compartments of dog heart, including ventricular myocytes (predominantly beta-1) and coronary arterioles (predominantly beta-2). Frozen sections were incubated in [125I]-pindolol with the beta agonist isoproterenol in the absence and presence of 0.1 mM sodium 5'-guanylylimidodiphosphate (GppNHp, a nonhydrolyzable GTP analog) and analyzed by gamma counting or autoradiography. Nonlinear curve-fitting analyses of ventricular section radioactivity indicated that in the absence of GppNHp, the data were consistent with a two-site fit, with 88% of the receptors in the high-affinity state. In autoradiographic analyses, GppNHp displaced the agonist binding curve to a greater extent in arterioles (approximately 100-fold) than in myocytes (approximately 10-fold). This suggests that beta receptors on arterioles are more tightly coupled to G protein than are beta receptors on myocytes. Thus these studies suggest that 1) beta AR on arterioles are coupled more tightly to G protein than are beta AR on myocytes, possibly because of differences in beta receptor subtype, and 2) more beta AR are in the high-affinity state than has been reported previously in more traditional analyses on membrane preparations.

Adrenergic beta-Agonists↗
PubMed1975

DNA synthesis in isolated HeLa cell nuclei. Evidence for in vitro initiation of synthesis of small pieces of DNA and their subsequent ligation.

Optimum conditions for a DNA synthesizing system based on isolated nuclei have been described (Krokan, H., Bjorklid, E., and Prydz, H. (1975), Biochemistry, preceding paper in this issue) [3H]TTP-labeled nascent DNA produced during very short pulses was analyzed by centrifugation in alkaline sucrose gradients. More than 80% of the radioactivity appeared in 2-4S pieces (primary DNA pieces). It would therefore seem that the synthesis of DNA is discontinuous both in the 5' leads to 3' and in the 3' leads to 5' directions. The size of the primary DNA pieces increases from 2-4 S up to 14 S with increasing pulse length. Evidence is presented that this increase is not caused by ligation between 2-4S primary pieces. Pulse-chase experiments showed that in this nuclear system primary pieces were ligated to a product generally larger than 30 S. Evidence is also given for the initiation of primary DNA pieces in vitro.

Cell Fractionation↗
PubMedDate not supplied

Changes in the referral pattern of child patients from the GDS to the CDS following the introduction of capitation in October 1990. General Dental Services. Community Dental Services.

OBJECTIVE: To observe the changes in the criteria for, rate of, and pattern of, referral of child patients from the General Dental Services (GDS) to the Community Dental Services (CDS) which may have occurred following the introduction of capitation as the method of remuneration for general dental practitioners (GDPs) for the treatment of child patients in The new contract 1990. DESIGN: GDP referral criteria and attitude to capitation were assessed in two districts (North Downs and Weybourne Trusts) using a questionnaire distributed to 179 GDPs. Reasons for referral, and treatment received within the CDS, were collated from the dental records of referred children, before and after the introduction of capitation. RESULTS: The response rate from the GDPs was 87%, of whom 82% had referred child patients to the CDS. The results showed that 65% of GDPs indicated a preference for treatment of children under a fee per item system, whereas only 17% favoured capitation. Although 60% believed that their referral of patients to the CDS had not changed following capitation, an analysis of the referred children's dental records revealed that there had actually been a 57% increase in the number of referrals from GDPs to CDS following the introduction of capitation. The GDPs considered the most important referral criteria were for non cooperation or general anaesthesia. More cooperative children had been referred and more routine restorative procedures, less inhalation sedation and deciduous extractions were carried out following the introduction of capitation. CONCLUSIONS: This study has shown that following the introduction of capitation there had been an increase in the number of referrals from the GDS to the CDS.

Adolescent↗
PubMedDate not supplied

Biliary excretion of iopanoate glucuronide by the rat.

Biliary excretion, plasma decay, and tissue distribution of 125I after a single intravenous dose (13 mumol/kg) of 125I-Iopanoate and 125I-iopanoate glucuronide were compared in control and phenobarbital-pretreated rats under either anesthesia. In control animals the plasma decay of iopanoate glucuronide following iopanoate glucuronide administration was significantly greater than that after iopanoate administration. Biliary clearance following iopanoate glucuronide was approximately 20 times greater than that after iopanoate; within 60 min, 82% of the dose of iopanoate glucuronide, compared to 23% of the dose of iopanoate, was recovered in bile. Phenobarbital pretreatment significantly increased the biliary excretion following iopanoate administration but had no effect on that following iopanoate glucuronide. The urinary excretion after both agents was less than 3% of the administered dose within the 60-min experimental period. The data suggest that intracellular metabolism and/or binding may account for the marked difference in the biliary excretion of iopanoate glucuronide following iopanoate as compared to that after administration of iopanoate glucuronide.

Animals↗