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Biomedical subjects

M Heap

Publications and source records attributed to M Heap.

At least 19 recordsLinked to original sources
PubMed2003

Differences in the progress of discharged and undischarged patients in a medium secure unit: a pilot study.

This study compared 15 patients ('undischarged' group) who were showing little sign of progress in a medium secure unit (MSU) after 2 years with 15 who had been discharged from the same unit 1-2 years following admission. The two groups were compared across a number of broadly defined behavioural indices during their first 6 months and first 12 months following admission. The measures used were indices of progress to wards of lower security (highest ward status and transfers to wards of higher security) and progress in terms of leave (highest leave status and reductions in leave status). In addition, the two groups were compared on number of recorded incidents attributable to them. Discharged patients were significantly older at the time of their admission than the undischarged patients (median ages 33 and 26 years, respectively). They made more progress in their first year in terms of ward security and leave status and were responsible for fewer recorded incidents. These results were also obtained at 6 months following admission with the exception that the difference for highest ward status was not statistically significant. The findings of this small-scale study suggest that within the first 6 months of admission, it may be possible to distinguish patients who will probably make good progress in a MSU from those whose progress is likely to be very slow. Implications of the study are discussed.

Adult↗
PubMed1998

Latitudinal differences in species and community richness and in community structure of metazoan endo- and ectoparasites of marine teleost fish.

Relative species diversity of gastrointestinal helminths of 55 teleost fish species did not differ significantly at different latitudes, whereas relative species diversity of metazoan ectoparasites on the heads and gills of 108 teleost fish species showed a significant increase with decreasing latitude and from deep to surface waters. Abundance of endoparasites also was the same at all latitudes, whereas abundance of ectoparasites increased with decreasing latitude and from deep to shallow waters. A comparative analysis using phylogenetically independent contrasts supported these conclusions. Possible reasons for the differences between endo- and ectoparasites are discussed. A detailed analysis of the community structure of gastrointestinal helminths of five Antarctic and three tropical teleosts and of metazoan ectoparasites on the heads and gills of five Antarctic and seven tropical fish species showed the following: abundance and prevalence of infection of endoparasites are similar in Antarctic and tropical fish, but are much greater for tropical than for Antarctic ectoparasites. Relative species diversity of endoparasites is similar for Antarctic and tropical endoparasites, but much greater for tropical than Antarctic ectoparasites. In both Antarctic and tropical fish, different fish of the same species may have different dominant species of endo- and ectoparasites, although there is a greater range of dominant species of tropical ectoparasites, a consequence of the greater species pool available. The most dominant parasite (irrespective of species) represented 80-99% of all endoparasites of Antarctic, and about 50-80% of all endoparasites of tropical fish. The most dominant parasites (irrespective of species) represented about 90-100% of all ectoparasites of Antarctic, and about 20-70% of all ectoparasites of tropical fish, the difference a consequence of the greater species pool of tropical ectoparasites available. The data suggest that both endo- and ectoparasites live in assemblages not structured by interspecific competition.

Animals↗
PubMed1998

Nestedness in assemblages of metazoan ecto- and endoparasites of marine fish.

Assemblages of metazoan ectoparasites of 79 species and gastrointestinal helminths of eight species of marine fishes were analysed to examine whether nestedness is related to sample size, abundance, species richness, and prevalence of infection, and whether the use of z-scores or Monte Carlo simulations yields different results. No significant differences in the number of nested assemblages were found with the two methods, and neither sample size nor abundance, but prevalence of infection of ectoparasites was correlated with nestedness. Species richness was significantly correlated with nestedness only when fish species with fewer than three parasite species were not excluded. Differential colonisation probabilities are the most likely cause of nestedness.

Animals↗
PubMed1998

Hypnotic pain control: some theoretical and practical issues.

Pain management programs assist patients to use their behavioral and cognitive skills for the purpose of rendering their experience of pain as more tolerable in some way. Hypnotic procedures may be included in this perspective. Thus, hypnosis may be best conceived as a set of skills to be deployed by the individual rather than as a state. The authors contend that such an emphasis is more compatible with the approaches of some pain management practitioners who have been generally slow to acknowledge the value of hypnosis and to incorporate hypnosis in their range of treatment skills. In this article, the authors present a minimal and atheoretical definition of hypnosis, and they list the basic properties of hypnosis that may be used in the treatment of pain. For a number of reasons, it is suggested that undertaking hypnosis as though the individual were indeed being placed into a special trance state may in some cases promote an effective outcome. However, it should be acknowledged that there may be instances when the relevant skills may be more effectively engaged at the expense of a strict special trance state by targeting the specific skills that are to be used for therapeutic benefit.

Cognitive Behavioral Therapy↗
PubMed1996

The nature of hypnosis.

This paper presents an overview of the essential nature of hypnosis as it is studied and practised today. Some theoretical controversies are mentioned and historical antecedents are briefly summarized. An overview is then presented of the ways in which hypnosis is applied therapeutically. It is concluded that although clinical hypnosis has yet to be informed by a strong academic base, progress is being made to that end and its potential scope and value in clinical practice have probably yet to be realized.

Humans↗
PubMed1995

Aspects of the ecology of metazoan ectoparasites of marine fishes.

Numerous (3947) individuals of 102 marine fish species from Papua New Guinea, New Zealand, the North Sea, Antarctica, the deepsea and coast of southeastern Australia, Pacific Canada, Brazil, Argentina and the Great Barrier Reef were examined for metazoan ectoparasites. Of the 102 fish species, 86 harboured at least 1 parasite species, and only in Antarctica and the deepsea were large proportions of fish species found to be free of ectoparasites. The mean prevalence of infection was 30.1%, the average of abundances was 6.7 parasites per fish, due to very heavy intensities of some parasite species (mean median abundance 4.31). Most parasite species exhibited a clustered distribution in the host populations, as measured by variance to mean ratios, i.e. some fish were more, and others less, heavily infected than if infection were random. Core and satellite species cannot be distinguished unambiguously, because numbers of parasites on almost all hosts are too small for any bimodality to become apparent. On average, the most dominant species represented 90% of all parasite individuals of a particular fish; different parasite species were often dominant on different fish individuals of a particular host species. Both abundances and maximum intensities of infection were positively correlated with prevalence of infection. Community richness varies greatly at and between localities, with the lowest richness found in Antarctic and deepsea fish and the highest richness in tropical fish. Species richness, abundance and prevalence of infection in many fish groups (with different ecological characteristics) are strongly correlated with temperature. If fish from all localities were pooled, pelagic fish had fewer intensities and (jointly with benthopelagic fishes) fewer species than benthic fish, and planktivorous fish had lower abundances and prevalences of infection than predatory and omnivorous fish. Prevalences of infection, abundance and parasite species richness were significantly correlated with host length. Fifteen positive and 1 negative associations among species were found. This and the generally low prevalences and abundances of infection indicate that competitive interactions are probably scarce. Overall, the findings indicate that most (if not all) metazoan ectoparasite communities of marine fish live in non-saturated, little-ordered assemblages.

Animals↗
PubMed1995

A survey of the physical health status of pupils aged 10-14 years in Standards 3-5 at three schools in New Crossroads, near Cape Town in the Western Cape.

Although adolescence is most commonly associated with risk-taking behaviour, mortality due to poverty-related conditions is high among black African children aged 10-14 years. This paper describes a study carried out in October 1991 to assess the physical health status of 860 underprivileged pupils aged 10-14 years in Standards 3-5 at three schools in New Crossroads, near Cape Town. Data on nutritional status, age at menarche, blood pressure, eyesight, physical abnormalities, injuries and use of hospitals were obtained. The response rate was 90%. Of all the children, 7.2% were below the 5th percentile weight-for-age. The proportion of boys (13.1%) below the 5th percentile weight-for-age was significantly higher than that of girls (3.7%). Of all the children, 19.5% were below the 5th percentile height-for-age. The proportion of boys (24.4%) below the 5th percentile height-for-age was also significantly higher than that of girls (16.7%). The average age at menarche was 13 years, similar to that (12.8 years) reported for the UK. In 5% of the children, the diastolic blood pressure was > 90 mmHg and the findings show some increase with age. Red Cross War Memorial Children's Hospital accounted for 30.9% of hospital attendances. 'Chest' complaints (19.5%) were frequent reasons for consultations, while 15.2% of the children reported being injured, with car accidents (16.0%), fractures (27.5%) and burns (20.6%) being the most common injuries. It is suggested that the provision of a 24-hour day hospital will ease the load on the referral hospital, i.e. Red Cross War Memorial Children's Hospital.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

A tropical assemblage of ectoparasites: gill and head parasites of Lethrinus miniatus (Teleostei, Lethrinidae).

Aspects of the community ecology of metazoan ectoparasites of Lethrinus miniatus (Teleostei. Lethrinidae) from 3 localities on the Great Barrier Reef were examined. Twelve species of Monogenea, 6 of Copepoda, 2 species of adult and several larval Isopoda and 1 leech were found. Total parasite numbers reach 3500 per host, and prevalence of infection with a particular parasite species reached 100% in some species. Numbers of parasite species per fish varied from 5 to 11. Four parasite species were most dominant on different fish if intensities of infection were used to calculate dominance, one species representing about 80% of all parasite individuals on a particular fish at 2 localities and about 50% at the third locality. Ten parasite species were most dominant on different fish, if volume (biomass) was used for calculating dominance, one species representing about 55% at one and 80% of total parasite volume at 2 localities. Parasites included at least 12 congeneric species of 4 or more genera, and those (of 2 genera) occurring on the gills showed much overlap in their distribution. Congeneric Monogenea of the families Dactylogyridae and Diplectanidae occurring in the same sites differ markedly in the size and structure of their copulatory sclerites. Positive associations between species were much more common than negative ones. The bony parts of the gills (gill arches) were never found to be infected, indicating the availability of empty niches.

Animals↗
PubMed1991

Health status of hostel dwellers. Part I. Introduction, methodology and response rates.

A health status survey (October-November 1987) was carried out among the residents of the urban migrant council-built hostels outside Cape Town at Langa, Nyanga and Guguletu, at their request. The project is introduced and the basis for the interpretation of the findings is provided. Migrant labour and the resultant material and physical impoverishment provide the social context for this study. The hostel dwellers as a migrant or mobile population presented certain research challenges. The working concepts, including the notion of the 'bedhold', employed in this study to address the mobility of the population are outlined. the methodology describes how the range of criteria selected to measure health status was investigated in a single survey. The response rates suggest that surveys carried out in the urban location of a migrant labour situation do not access the poor in the broader migrant labour situation. Findings are treated with caution for what they infer for the broader migrant population.

Data Collection↗
PubMed1991

Health status of hostel dwellers. Part II. Infant mortality and prevalence of diabetes, hypertension and syphilis among adults.

The range of biomedical criteria selected to measure the health status of the residents of the urban migrant council-built hostels of Langa, Nyanga and Guguletu were investigated in a single survey. A single survey method screens health status and provides the opportunity to examine the interrelationship between findings on the different health criteria. Here a high infant mortality rate is examined against a low prevalence of diabetes, hypertension and syphilis and some of the effects of migrant labour on the health status of migrant hostel dwellers are identified. The low prevalence of disease among the Cape Town hostel residents suggests that migrant labour, by sifting out the able-bodied and employable, reproduces a 'healthy worker effect' among the migrant population with access to the city. The high infant mortality rate, in contrast, suggests that the disease burden of the migrants is being carried by the home-base population.

Adult↗
PubMed1991

Health status of hostel dwellers. Part III. Nutritional status of children 0--5 years.

The standards laid down by the National Center for Health Statistics in the USA were used to assess the nutritional status of children (0--5 years) in the Zones, an urban migrant council-built hostel complex in Langa, outside Cape Town. Of the children, 5.7% were below the 3rd percentile of weight-for-age (acute undernutrition). There was a significant difference between age categories and an increase in age was associated with an increase in proportion of children below the 3rd percentile. Acute undernutrition was significantly higher for children born outside Cape Town. There was a significant difference between age groups and percentage of children below the 3rd percentile of height-for-age (chronic undernutrition). Chronic nutritional levels were also significantly higher for children not born in Cape Town. Yet there were no significant differences between proportions of children under the 3rd percentile of height-for-weight (current nutritional status) for age category or place of birth. These results suggested that while in town children were adequately nourished, this was not the case at their home-base. Chronic undernutrition findings indicated an incremental negative effect of the poverty of the home-base on the long-term health status of hostel migrant children.

Age Factors↗
PubMed1991

Health status of hostel dwellers. Part IV. Immunisation of children.

The immunisation status of children (0-5 years) living in the Zones, an urban migrant council-built hostel in Langa, was investigated to examine the effect of migrant labour and related to this, the effect of circular or oscillating migration between Cape Town and the eastern Cape (Transkei/Ciskei) on access to this preventive health care measure. 'Road-to-Health' cards were available for 69.4% of subjects--78.8% for those born in Cape Town and 50.8% for those born in Transkei. Immunisation of 'Road-to-Health' card holders ranged from 71.8% to 95%. The range dropped to 41-79.1% if it was assumed that children without 'Road-to-Health' cards (i.e. without positive proof of immunisation) had not been immunised. Children born in Cape Town have a significantly higher immunisation coverage than children born elsewhere (Transkei accounted for 82.7% of these children). Immunisations administered in Cape Town numbered 80.6%, while 62.6% of subjects were born in Cape Town. In Transkei, payment is required for immunisation, in Cape Town it is free. By implication, cost appeared to be an important reason for low coverage in Transkei. The findings of this study suggested that hostel migrant children who had access to the Cape Town health services through working parents had better immunisation coverage than children at the home-base who seldom or never reached the city.

Child, Preschool↗
PubMed1991

Health status of hostel dwellers. Part V. Tuberculosis notifications.

Cape Town tuberculosis notification rates for the hostel dwellers of Langa and Guguletu emphasise the severity of the problem among the poor in the city. But the enormity of the problem for the broader dependent migrant population can only be surmised from these figures. It is not possible to compile a comprehensive tuberculosis profile for a geographically divided mobile population nor provide the necessary continuity of treatment under the present politically contrived disparate health care system. Control of tuberculosis cannot wait for a political solution.

Adolescent↗
PubMed1991

Health status of hostel dwellers. Part VI. Tobacco smoking, alcohol consumption and diet.

Smoking, alcohol consumption and diet were among the criteria selected to screen health status among the residents of the urban migrant council-built hostels of Langa, Nyanga and Gguletu outside Cape Town. Smoking patterns fell within the range found elsewhere. Problems associated with alcohol consumption were exacerbated by the overcrowded hostel living conditions. Dietary patterns were not examined against the concept of an 'ideal diet'. They are understood in the context of the poverty of the hostel dwellers and in the context of limited space available in the hostel environment for cooking and storage. In comparison with a home-based migrant population, the urban migrant hostel dwellers eat more frequently, more regularly and have more variety in their diet. In the light of the findings on the lifestyle indicators of the hostel dwellers, it is concluded that improved living conditions, rather than health education that focuses on individual behaviour, will have a greater impact on improvements in their health status.

Adolescent↗
PubMed1991

The quest for wholeness: health care strategies among the residents of council-built hostels in Cape Town.

The 1980s in South Africa have witnessed an extraordinary interest by health care professionals in the relevance of health care and healing systems outside the dominant biomedical system. The debate centres around the most effective way of incorporating "these other forms" of healing into the dominant system in the best interest of the patient. It is essentially a debate amongst professionals based on their perceptions of "the best interest" without any significant input from the "patients" who are the object of their concern. This paper attempts to bring into focus "patients" perceptions of different health care systems, their access to them and the rationale behind their choice of therapy. The experience of acute symptoms, especially pain, identifies an illness episode and initiates therapeutic action. Biomedical services are, most often, the first choice of the hostel dwellers. Hostel dwellers, although poor, are often prepared to pay for the services of the private biomedical practitioner. In some cases they have no other biomedical option, the lengthy delays encountered at the local government hospitals and clinics are costly for poorly paid unskilled labourers. The local government services, unlike the private practitioner, are not available at times convenient to working people.

Adult↗
PubMed1977

The effect of auditory signals on the control of the rapidity of arm movements.

An experimental study of the effect of auditory signals on the rapidity of arm movements was undertaken in 32 right-handed subjects. The task (a printed tapping test) was performed with the presence of metronome clicks intended to act as pacemakers of the subject's tapping movements. The effect of preferred hand, direction of movement (i.e. left-right and right-left) and mode of acoustic presentation (monoaural or binaural) was investigated. Results indicate that the presence of acoustic signals increases (without a concomitant decrease in accuracy) the rapidity of movements, but there is not differential increase whether the signals are delivered to the right or left ear or binaurally. Repetitive movements of the right arm are faster than those of the left; and the direction in which the movements are made influences the rapidity of performance for both arms, left-right movements being faster than those made in the right-left direction. Some theoretical intrepretations of the findings are discussed.

Adult↗