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Biomedical subjects

L Roberts

Publications and source records attributed to L Roberts.

At least 55 records · Page 3Linked to original sources
PubMed2000

Intercessory prayer for the alleviation of ill health.

BACKGROUND: Prayer is an ancient and widely used intervention for alleviating illness and promoting good health. This review focuses specifically on intercessory prayer, which is organised, regular and committed, and those who practise it will almost inevitably hold some committed belief that they are praying to God. Whilst the outcomes of trials of prayer cannot be interpreted as 'proof/disproof' of God's response to those praying, there may be an effect of prayer not dependent on divine intervention. This may be quantifiable, making this investigation of a most widely used health care intervention both possible and important. OBJECTIVES: To review the effectiveness of prayer as an additional intervention for those with health problems already receiving standard medical care. SEARCH STRATEGY: ATLA (1949-1997), Biological Abstracts (1985-1999), CINAHL (1982-1999), The Cochrane Schizophrenia Group's Register (December 1999), CCTR of the Cochrane Library (Issue 4, 1999), EMBASE (1980-1999), MEDLINE (1966-1999) and PsycLIT (1887-1999), Sociofile (1974-1996) and Sociological Abstracts (1963-1999) were methodically searched. All references of articles selected were searched for further relevant trials. SELECTION CRITERIA: Randomised trials of personal, focused, committed and organised intercessory prayer on behalf of anyone with a health problem were considered. Outcomes such as achievement of desired goals, death, illness, quality of life and well-being for the recipients of prayer, those praying and the care-givers were sought. DATA COLLECTION AND ANALYSIS: Studies were reliably selected and assessed for methodological quality. Data were extracted by two reviewers working independently. Dichotomous data were analysed on an intention-to-treat basis. MAIN RESULTS: There was no evidence that prayer affected the numbers of people dying from leukaemia or heart disease (OR 1.11, CI 0.79-1.56, n=1424). Intercessory prayer did not clearly decrease the odds of people with heart problems experiencing a bad or intermediate outcome (OR 0.8, CI 0.64-1.00, n=1444) but this finding was moved towards the null by inclusion of a negative assumption for those who were dropped from the analysis in one study. Prayer increased the odds of readmission to the Coronary Care Unit (OR 1.54 CI 1.02-2.33, n=1406) but these results are made significantly negative by the inclusion of an assumption of poor outcome for those not accounted for in the final analyses. REVIEWER'S CONCLUSIONS: Data in this review are too inconclusive to guide those wishing to uphold or refute the effect of intercessory prayer on health care outcomes. In the light of the best available data, there are no grounds to change current practices. There are few completed trials of the value of intercessory prayer, and the evidence presented so far is interesting enough to justify further study. If prayer is seen as a human endeavour it may or may not be beneficial, and further trials could uncover this. It could be the case that any effects are due to elements beyond present scientific understanding that will, in time, be understood. If any benefit derives from God's response to prayer it may be beyond any such trials to prove or disprove.

Humans↗
PubMed2000

Histomorphological features of chorionic villi at 10-14 weeks of gestation in trisomic and chromosomally normal pregnancies.

This study examines histomorphometric features in chorionic villi obtained by chorionic villus sampling (CVS) at 11-14 weeks of gestation from 124 ongoing pregnancies (38 with trisomy 21, 14 with trisomy 18, 11 with trisomy 13 and 61 chromosomally normal controls). In the trisomy 21 group there was an inverse relationship between fetal nuchal translucency thickness (NT) and villus diameter and number of capillaries per villus cross-section. In about half of the cases there was perivillous fibrinoid present, and the amount of this increased with gestation. Compared to the chromosomally normal group, in trisomy 18 the villus diameter was smaller and the number of capillaries per villus cross-section was reduced. In the trisomy 21 group, villi had an increased percentage of two layered trophoblast present and an increased proportion of villus capillaries with nucleated red blood cells present. In all three trisomies, but particularly in trisomies 18 and 13, both the amount of basophilic stippling of the basement membrane and the proportion of cases with stippling was increased. These results provide data on the possible mechanisms of increased fetal NT and on abnormal placental development in fetal trisomies.

Chorionic Villi↗
PubMed2000

Reconviction after discharge from a regional secure unit.

There are at present no published data on criminal conviction following discharge from medium-secure psychiatric facilities in the United Kingdom. The results of an audit at the Kent Forensic Psychiatry Service found a 7% rate for serious offences in an average follow-up period of three years and five months, a figure similar to high-security hospital studies. Only one serious offence was unknown to the clinical team. Reports on larger samples are awaited.

Crime↗
PubMed2000

Effect of infection control measures on the frequency of upper respiratory infection in child care: a randomized, controlled trial.

BACKGROUND: Acute upper respiratory infections are common in children who attend child care, and preventing transmission of disease in this setting depends on actions by child care staff. We set out to discover whether transmission of respiratory infections in child care could be reduced by improved infection control procedures. METHODS: We performed a cluster, randomized, controlled trial of an infection control intervention conducted in child care centers in 1 city in Australia. The intervention was training of child care staff about transmission of infection, handwashing, and aseptic nosewiping technique. Implementation of the intervention was recorded by an observer. Illness was measured by parent report in telephone interviews every 2 weeks. RESULTS: There were 311 child-years of surveillance for respiratory symptoms. By multivariable analysis, there was no significant reduction in colds in intervention center children across the full age range. However, a significant reduction in respiratory illness was present in children 24 months of age and younger. When compliance with infection control practices was high, colds in these children were reduced by 17%. CONCLUSIONS: This trial supports the role of direct transmission of colds in young children in child care. The ability of infection control techniques to reduce episodes of colds in children in child care was limited to children 24 months of age and under.

Australian Capital Territory↗
PubMed2000

Effect of infection control measures on the frequency of diarrheal episodes in child care: a randomized, controlled trial.

BACKGROUND: Diarrheal infections are common in children who attend child care, and preventing transmission of disease in this setting depends on actions by child care staff. We set out to discover whether transmission of gastrointestinal infections in child care could be reduced by improved infection control procedures. METHODS: We performed a cluster randomized, controlled trial of an infection control intervention conducted in child care centers for 1 city in Australia. The intervention was training of child care staff about transmission of infection and handwashing and focused on both staff and child behavior. Implementation of the intervention was recorded by an observer. Illness was measured by parent report in telephone interviews every 2 weeks. RESULTS: There were 311 child-years of surveillance for diarrheal episodes. The rate of episodes of diarrhea was 1.9 per child-year in intervention centers and 2.7 per child-year in control centers. Multivariable analysis showed that diarrheal episodes were significantly reduced in intervention center children by 50%. However, the impact of the intervention was confined to children over 24 months of age. For those centers in which children's compliance with handwashing was high, diarrheal episodes were reduced by 66%. CONCLUSIONS: This trial supports education about infection control, for staff and children in child care, as a means of reducing transmission of diarrhea. Reduction in episodes of diarrhea in children in child care was limited to children over 24 months of age.

Australian Capital Territory↗
PubMed1999

Australia's notifiable diseases status, 1998. Annual report of the National Notifiable Diseases Surveillance System.

In 1998 there were 85,096 notifications to the National Notifiable Diseases Surveillance System; slightly lower than in 1997 (89,579). The number of measles cases remained low, and well below the number reported in the outbreak years of 1993 and 1994. Rubella notifications further decreased and remained low in 1998. The Measles Control Campaign from August to November 1998, did not impact significantly on the number of measles or rubella cases reported for 1998. Notifications of Haemophilus influenzae type b reached a record low since surveillance began in 1991, and appeared to have stabilised at a low rate since the introduction of the conjugated vaccine in 1992. The previously reported outbreak of pertussis in 1997 tapered off in early 1998. Food-borne disease, or detection of disease, appeared to be on the rise with an increase in notification rates of campylobacteriosis and salmonellosis. Notifications of hepatitis A decreased, correcting the previous high number of notifications in 1997. Sexually transmissible diseases (STDs) increased. Notifications for chlamydial infection were the highest for all sexually transmitted diseases and third highest for all notifiable diseases. Notifications of gonococcal infection also continued to rise and have doubled since 1991, whilst notifications for syphilis increased slightly after falling steadily over recent years. Arbovirus infections of concern in 1998 were dengue outbreaks in Far North Queensland and the first case of Japanese Encephalitis for mainland Australia, highlighting the importance of surveillance of arboviruses and vectors for their detection and management.

Australia↗
PubMed1999

Repeat donor HLA-DR mismatches in renal transplantation: is the increased failure rate caused by noncytotoxic HLA-DR alloantibodies?

INTRODUCTION: Data from the UCLA/UNOS and Collaborative Transplant Studies Registries indicate that mismatched HLA-DR alloantigens expressed on a former donor renal allograft should not be repeated because of significantly poorer long-term survival. METHODS: Retransplant candidates waiting for another renal allograft were screened for HLA class II alloantibodies (aAb) using direct complement-dependent cytotoxicity and several sensitive aAb binding assays. RESULTS: When screened by complement-dependent cytotoxicity, 46% of the patients were aAb negative. In contrast, using aAb binding assays, 90% of the patients had HLA-DR aAb specific for previous HLA-DR allograft mismatches. Most important, no directly cytotoxic HLA-DR antibody was detected in 9 of 27 patients. CONCLUSION: Our studies suggest that crossing the same HLA-DR mismatch in a subsequent transplant may result in poorer survival due to underlying donor-specific HLA-DR aAb. If confirmed in a retrospective study of retransplant patients, B cell donor cross-matches using antiglobulin complement-dependent cytotoxicity or flow cytometry would appear essential if this barrier were to be crossed.

Antibody Specificity↗
PubMed1999

Annual report of the National Influenza Surveillance Scheme, 1998.

The National Influenza Surveillance Scheme includes data from sentinel general practice consultations for influenza-like illness, laboratory reports of influenza and absenteeism rates from a national employer. The 1998 season was dominated by an increase in influenza A in all States and Territories and low influenza B activity. All influenza A isolates were characterised as influenza A (H3N2). Peak activity in 1998 was recorded in July and August. Data are coordinated, analysed and disseminated at a national level and published in Communicable Diseases Intelligence during the influenza season.

Age Distribution↗
PubMed1999

Obesity. About the size of it.

Severe obesity is on the increase in Britain and accounts for considerable excess hospital costs. The benefits of new treatments need to be assessed in terms of psychological, as well as physical, benefits to patients. Programmes aimed at changing lifestyles will be effective only when obesity is considered in terms of all its effects on the individual.

Comorbidity↗