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Biomedical subjects

L Hayes

Publications and source records attributed to L Hayes.

At least 37 records · Page 2Linked to original sources
PubMed1995

Australian trends in mortality by socioeconomic status using NSW small area data, 1970-89.

This ecological study examines trends in socioeconomic differentials in mortality in New South Wales, Australia, over a 20-year period (1970-89). The proportion unskilled was used as the indicator of socioeconomic status and its selection justified. Using census data aggregated by Local Government Area, the relationship between mortality and socioeconomic status was examined using quintiles based on the proportion unskilled in the population. Local Government Areas were also sorted into quintiles using mortality rates (0-74 years) to describe change in mortality differentials over time. Socioeconomic differentials were more evident in the relatively homogeneous Local Government Areas within the Sydney Statistical Division than in the remaining NSW Statistical Divisions which are more heterogeneous and predominantly rural. Although there has been an overall decline in mortality for males and females, and for high and low status groups, over this period the relative socioeconomic differentials have not declined. For the most recent period (1985-89) there appears to be some widening of differentials for males. The NSW state trends are generally similar to those reported for Britain and for other industrialised countries, suggesting that this is a common trend and that policies to reduce inequalities have not been effective.

Adolescent↗
PubMed1995

Unequal access to midwifery care: a continuing problem?

For women of an ethnic minority the maternity services have been described as inappropriate, inaccessible and inadequate. It is hoped that the contents of this paper will raise awareness amongst health professionals of the continuing problems faced by women trying to overcome a language barrier.

Communication↗
PubMed1994

Attitude change amongst nursing students towards Australian aborigines.

A pre-test and post-test impact evaluation design was used to determine if attendance at a workshop conducted by Australian aboriginal health personnel improved the attitudes of nursing students towards Aborigines. A three-hour workshop attended by first year nursing students comprised an introduction, video and discussion. A self-administered questionnaire, consisting of socio-demographic background questions and attitude rating scale, was used to measure students' attitudes before and after the workshop. The Wilcoxon signed rank test and paired t-test were used to test for significant improvement in students' total attitude scores. Multiple regression analysis was conducted to determine if socio-demographic variables contributed to the changes in the students' attitude scores. Complete data were collected from 246 students. Results indicate improvement in attitude scores. Socio-demographic variables did not contribute to these scores.

Adult↗
PubMed1994

Molecular epidemiology of trachoma in a Gambian village.

The application of a diagnostic and genotyping technique based on the polymerase chain reaction (PCR) to the study of trachoma epidemiology in the Gambian village of Jali is reported. PCR based on the major outer membrane protein (MOMP) gene of Chlamydia trachomatis appears to be more sensitive than either isolation or antigen detection by enzyme immunoassay; it had a specificity of 95% and sensitivity of 51% against clinical signs. PCR genotyping identified genotypes A and B of Chlamydia trachomatis circulating in Jali. Sequencing revealed a Pst1 restriction endonuclease site in the amplified MOMP gene of some B strains but not others; Pst1 digestion of the PCR product proved an easy method of distinguishing these strains. The distribution of serotypes and B strain variants shows a significant degree of household clustering (p < 0.001). PCR based genotyping combined with strain typing provides a new and powerful epidemiological tool for the study of transmission events in trachoma.

Antigens, Bacterial↗
PubMed1994

Early onset Parkinson's disease. Part 1: The patient's story.

Tremors, soreness, and reduced motor control led a 35-year-old woman to her family doctor. The unwelcomed diagnosis was early onset Parkinson's disease. Meeting a family physician with whom she can jointly manage the disease has given this patient courage to face the future.

Adaptation, Psychological↗
PubMed1993

Recombinant human interleukin-11 stimulates megakaryocytopoiesis and increases peripheral platelets in normal and splenectomized mice.

The effects of recombinant human interleukin-11 (rhIL-11) on in vivo mouse megakaryocytopoeisis were examined. Normal C57Bl/6 mice and splenectomized C57Bl/6 mice were treated for 7 days with 150 micrograms/kg rhIL-11 administered subcutaneously. In normal mice, peripheral platelet counts were elevated compared with vehicle-treated controls after 3 days of rhIL-11 treatment and remained elevated until day 10. Splenectomized mice treated with rhIL-11 showed elevated peripheral platelet counts that were similar in magnitude to normal rhIL-11-treated mice. However, on day 10 the platelet counts in rhIL-11-treated, splenectomized mice were no longer elevated. Analysis of bone marrow megakaryocyte ploidy by two-color flow cytometry showed an increase, relative to controls, in the percentage of 32N megakaryocytes in both normal and splenectomized animals treated with rhIL-11. In normal mice, the number of spleen megakaryocyte colony-forming cells (MEG-CFC) were increased twofold to threefold relative to controls after 3 and 7 days of rhIL-11 treatment, whereas the number of bone marrow MEG-CFC were increased only on day 7. The number of MEG-CFC in the bone marrow of rhIL-11-treated, splenectomized mice was increased twofold compared with controls on both days 3 and 7 of the study. These data show that in vivo treatment of normal or splenectomized mice with rhIL-11 increased megakaryocyte progenitors, stimulated endoreplication of bone marrow megakaryocytes, and increased peripheral platelet counts. In addition, results in splenectomized mice showed that splenic hematopoiesis was not essential for the observed increases in peripheral platelets in response to rhIL-11 administration.

Animals↗
PubMed1992

Health promotion in the general practice consultation: a minute makes a difference.

OBJECTIVE: To see whether extending appointment length from seven and a half minutes or less to 10 minutes per patient would increase health promotion in general practice consultations. DESIGN: Controlled trial of 10 minute appointments. Consultations were compared with control surgeries in which the same doctors booked patients at their normal rate (median six minutes per patient). SETTING: 10 general practices in Nottinghamshire. SUBJECTS: 16 general practitioners were recruited. Entry criteria were a booking rate of eight or more patients an hour, a wish for longer consultations, and plans to increase appointment length. MAIN OUTCOME MEASURES: Duration of consultations; recording of blood pressure, weight, and cervical cytology in the medical record; recording of advice about smoking, alcohol, diet, exercise, and immunisation in the medical record; reporting of the above activities by patients. RESULTS: Mean consultation times were 8.25 minutes in the experimental sessions and 7.04 and 7.16 minutes in the control sessions. Recording of blood pressure, smoking, alcohol consumption, and advice about immunisation was significantly more frequent in the experimental sessions, and the proportion of consultations in which one or more items of health education were recorded in the medical notes increased by an average of over 6% in these sessions. Patients more often reported discussion of smoking and alcohol consumption and coverage of previous health problems in the experimental sessions. There was little change in discussion of exercise, diet, and weight or cervical cytology activity. CONCLUSIONS: Shortage of time is a major factor in general practitioners' failure to realise their potential in health promotion. General practice should be organised so that doctors can run 10 minute appointment sessions.

Adult↗
PubMed1992

Comparative autonomic responses of the cat and rabbit bladder and urethra.

The cat and the rabbit have both been utilized extensively in the study of lower urinary tract function. Previous studies have demonstrated that although both the cat and rabbit bladder are approximately the same weight, the in-vitro cat bladder can generate over 6 times the intravesical pressure of the rabbit bladder. The current study was designed to compare the ability of the isolated bladder to generate pressure with the pressures required to maintain flow through the isolated urethra for both the cat and the rabbit. The results can be summarized as follows. 1) The cat bladder is visibly much thicker than the rabbit bladder, and in vitro cystometry demonstrates that it is far less compliant than the rabbit bladder. 2) Over 20 cm.H2O pressure is required to begin flow through the isolated cat urethra preparation, whereas 5 cm.H2O begins flow through the rabbit urethra. 3) Increasing the flow rate (up to 7-fold) through both the isolated cat and rabbit urethra increases intraurethral pressure only slightly. 4) Both the isolated cat and rabbit urethra respond strongly to field stimulation and alpha-adrenergic stimulation (relative to the opening pressure required to begin flow), but not to cholinergic stimulation. 5) Field stimulation following pre-stimulation by methoxamine induces a strong relaxation of the pre-stimulated cat urethra, but an additive contraction in the pre-stimulated rabbit urethra. These studies demonstrate that in order for the cat to empty its bladder, it must generate a comparatively high intravesical pressure, whereas the rabbit is required to generate a relatively low intravesical pressure.

Animals↗
PubMed1992

Effect of pinacidil on spontaneous and evoked contractile activity.

Uninhibited bladder contractions have been associated with a variety of bladder dysfunctions including outlet obstruction, neurogenic bladder, incontinence, and other neurologic and nonneurogenic bladder disorders. One class of compounds that is gaining popularity and support for the treatment of hyperreflexia is potassium channel openers, such as pinacidil and cromakalim. In general, these agents act by hyperpolarizing the smooth muscle membrane, resulting in an increase in membrane stability which in turn would be expected to inhibit spontaneous and evoked contraction. It is the purpose of this study to compare the potency and selectivity of pinacidil at inhibiting both hyperreflexia in vivo, and several forms of in vitro contractile stimulation in the rabbit. The following is a summary of the results. (1) Pinacidil is an effective inhibitor of hyperreflexia in the in vivo rabbit model. (2) Pinacidil is a substantially more potent inhibitor of the amplitude of the hyperreflexia than the frequency. (3) Pinacidil was substantially more potent at inhibiting the contractile response to 2-Hz stimulation than to 32-Hz stimulation, but was equally effective at inhibiting field stimulation of the bladder base and body. (4) Pinacidil was significantly more potent at inhibiting the peak response to field stimulation than the rate of tension generation. (5) Pinacidil was equally potent and effective at inhibiting the phasic and tonic components of the response to field stimulation. (6) Pinacidil was a more potent inhibitor of methoxamine stimulation of the bladder base than bethanechol stimulation of the bladder body. (7) Pinacidil was a noncompetitive or mixed inhibitor of both methoxamine and bethanechol stimulation, whereas it was a competitive inhibitor of KCl stimulation.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1992

Macrophage colony-stimulating factor gene expression in vascular cells and in experimental and human atherosclerosis.

The infiltration of monocytes into the vascular wall and their transformation into lipid-laden foam cells characterizes early atherogenesis. Macrophages are also present in more advanced human atherosclerotic plaques and can produce many mediators that may contribute to lesion formation and progression. Macrophage colony-stimulating factor (MCSF) enhances the proliferation and differentiation of monocyte progenitors and is required for the survival and activation of mature monocytes and macrophages. The authors therefore examined the expression of the MCSF gene in cultured human vascular endothelial (EC) and smooth muscle cells (SMC) as well as in atheromatous lesions from rabbits and humans. Growth arrested EC and SMC contain a low level of MCSF mRNA. Bacterial lipopolysaccharide (LPS), recombinant human interleukin-1 alpha (IL-1 alpha) or tumor necrosis factor alpha (TNF alpha) induced MCSF mRNA accumulation in a concentration-dependent manner in both EC and SMC. These stimuli induced large increases in MCSF mRNA with peak induction between 4-8 hours after treatment. LPS, IL-1 alpha, and TNF alpha stimulated EC and SMC also showed increased fluorescent antibody staining for MCSF protein and released immunoreactive MCSF in a time-dependent manner. In contrast, phorbol 12-myristate 13-acetate (PMA) was a less potent inducer of MCSF gene expression and iron-oxidized low-density lipoproteins (ox-LDL) did not increase consistently MCSF mRNA or the synthesis and secretion of immunoreactive protein. Northern analysis of mRNA isolated from the atheromatous aorta of rabbits fed a 1% cholesterol diet for 10 weeks showed elevated MCSF mRNA compared with controls. Immunostaining of atheromatous arterial lesions of rabbits demonstrated MCSF protein in association with intimal SMC as well as macrophages. Furthermore, polymerase chain reaction (PCR) analysis of MCSF mRNA in human atheromata showed higher levels than found in nonatherosclerotic arteries and veins. Since the authors found no mRNA for the MCSF receptor, c-fms, in cultured EC or SMC macrophages are likely the primary target for MCSF within atheromatous vessels. The authors therefore investigated the effects of MCSF on monocyte functions related to foam cell development. Treatment of cultured human monocytes with recombinant human MCSF (10(3) U/ml, 72 hr) led to the accumulation of mRNA for the acetyl-LDL (scavenger) receptor and apolipoprotein E (apo E). These studies establish that vascular EC and SMC produce substantial MCSF in response to a variety of stimuli. The local production of MCSF during atherogenesis may contribute to macrophage survival and proliferation or activate specific macrophage functions such as expression of the scavenger receptor and secretion of apo E.

Animals↗
PubMed1991

Experimental hyperreflexia: effect of intravesical administration of various agents.

In anesthetized rabbits, we can induce a significant degree of spontaneous activity in the urinary bladder by placing a ligature around the proximal portion of the external urethra. Previous studies characterized the activity as primarily reflex in nature, since intravesical hexamethonium selectively inhibited the hyperreflexia. In this current study we determined the effect of intravesical administration of a variety of compounds to inhibit the induced hyperreflexia. The following agents were tested at concentrations of 1, 10, 100 and 500 mumol/l (intravesically): verapamil, cromakalim, nifedipine, diltiazem, and atropine; lidocaine was tested in 0.05, 0.5 and 5% solutions. The results are summarized as follows: (1) Lidocaine was the most effective agent tested, virtually eliminating both the amplitude and frequency of the spontaneous activity at the lowest concentration (0.5%). (2) Verapamil and nifedipine were somewhat more potent than cromakalim and diltiazem. Atropine sulfate was the least potent, inhibiting both the amplitude and frequency of the hyperreflexia by less than 50% at 500 mumol/l. (3) In all cases, the amplitude of the spontaneous activity was inhibited to a significantly greater degree than the frequency of the spontaneous activity. (4) In general, there was no effect of any of the agents on mean arterial pressure at 1 or 10 mumol/l. At 100 and 500 mumol/l, all agents except for lidocaine and cromakalim decreased arterial pressure. These two agents produced no consistent fall in blood pressure at any concentration. In conclusion, the acute hyperreflexic (rabbit) preparation provides a highly reproducible and consistent model for the study of the effect of drugs on hyperreflexia.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

Linkworkers in antenatal care: facilitators of equal opportunities in health provision or salves for the management conscience?

A number of reports have highlighted non-English speaking Asian women as being at risk from limited health care provision (eg Whitehead, 1987). Of particular relevance to the present survey is their low uptake of antenatal care which may contribute to the above-average perinatal mortality rates for this group. In an attempt to ameliorate this problem, a Linkworker service was introduced in a number of multi-racial health districts. The survey reported here was an attempt to establish the efficacy of this service. From an initial sample of 30 health districts, 20 replies were obtained which provided some valuable insights on the current status of the Linkworker provision. In summary, the responses indicated that there is a worrying mis-match between client need and service planning, largely because relevant information about supply and demand is not collated. The net result is that many of the at-risk group are still denied the full and appropriate services of the Linkworker. It is concluded that if Linkworker provision is seen as a valuable commodity in enhancing equal opportunities in health care, then the service needs to be systematised. If it is perceived to be of little demonstrable value, then it should be scrapped. In either case, some clear policy decisions are required.

Asia↗
PubMed1991

Longer booking intervals in general practice: effects on doctors' stress and arousal.

A controlled trial was carried out to determine whether longer booking intervals at surgeries affected general practitioners' self-assessed levels of stress and arousal. Sixteen general practitioners from 10 practices took part. Surgery sessions with patients booked at 10 minute intervals (experimental sessions) were compared with the doctors' usual booking intervals of between 7.5 and 5.0 minutes (control sessions). Stress and arousal were assessed by the general practitioner before and after each surgery session using a mood adjective check list. The study included 109 experimental and 184 control sessions. The median consultation length increased from six minutes in the control sessions to seven minutes in the experimental sessions. At the end of the experimental sessions, stress scores were lower, and arousal scores higher than at the end of the control sessions (P less than 0.001). There were no significant differences between experimental and control sessions in stress or arousal at the start of the sessions. Favourable mood changes were seen more consistently in the experimental sessions than control sessions, with less than a quarter of doctors showing increased stress or decreased arousal after sessions relative to before. It is concluded that longer booking intervals are of psychological advantage to general practitioners.

Adult↗
PubMed1990

Basal and stimulated release of substance P from dissociated cultures of vagal sensory neurons.

Substance P, the widely distributed 11 amino acid neuropeptide, is present in up to 20% of vagal sensory cell bodies and the fibers emanating from them. To study the factors regulating the release of SP, vagal sensory (nodose or nodose/jugular) ganglia were obtained from neonatal rats and dissociated using neutral protease. Survival of plated neurons on collagen substrate was 10-20% at 2 weeks and 20-30% when neurons were plated over previously dissociated rat atriacytes. Substance P content was low in cultures for the first several days, then rose linearly to 0.1-0.2 pg/surviving neuron. Substance P was released into a 4.5 mM potassium medium at a steady rate of 0.036%/min. In 50 mM K+ supplemented medium, total release during 20 min increased 5-8-fold and steady-state release increased 4-5-fold to 0.15%/min. The sensory neuron specific excitatory neurotoxin, capsaicin, evoked SP release in similar amounts to 50 mM K+. Both net K(+)- and capsaicin-evoked, but not basal release were completely inhibited by 3.5 mM cobalt chloride. Bradykinin, 1-100 nM, stimulated SP release 2-4 times above basal levels. Forskolin and phorbol ester also increased SP release 1.5-3 times basal amounts. In summary, substance P is present in cultured vagal sensory neurons in amounts similar to in vivo and is released in response to sensory specific stimuli. These cultures should allow exploration of some of the tissue specific factors regulating neurotransmitter release in the sensory vagus nerve.

Animals↗