Biomedical subjects
M Liddell
Publications and source records attributed to M Liddell.
Random comparison of 'virtual patient' models in the context of teaching clinical communication skills.
AIMS: Two types of virtual patient designs can be distinguished: a 'narrative' structure and a 'problem-solving' structure. This study compares the same virtual patient with two different structures within the domain of communication skills. METHODS: Two virtual patients were constructed around the same case, one emphasizing a narrative and one a problem-solving model. Use of these packages was trialled with undergraduate medical students over 2 years. Students were randomly assigned to tutorials using the virtual patients, and their communication skills were compared with baseline performance by a separate group. Outcome was assessed by evaluation of an interview with a simulated patient. RESULTS: There was no significant difference between the three groups in overall communication skills. However there was a significant improvement in the communication skills of the narrative group when compared only with the problem-solving group. Additionally, various aspects of communication skills, such as use of open-ended questions and appropriate language, showed significant differences between the three groups. CONCLUSION: There is some evidence to support the value of a narrative design for virtual patients which are to be used to teach communication skills, which encourages further investigation.
Variation in DCP1, encoding ACE, is associated with susceptibility to Alzheimer disease.
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Association between a PS-1 intronic polymorphism and late onset Alzheimer's disease.
Previous work suggests an association between allele 1 and the 1-1 genotype of an intronic polymorphism in the presenilin-1 (PS-1) gene and late onset Alzheimer's disease. We found an excess of the 1-1 genotype in our late onset clinical sample (p = 0.006, one-tailed) but not in our postmortem confirmed sample, which instead exhibited an excess of allele 1 (p = 0.02, one-tailed). No interaction between PS-1 and ApoE genotype was detected and the findings remained significant when the effects of ApoE were taken into account (p = 0.03, one-tailed). These results suggest that the PS-1 polymorphism, or a locus in linkage disequilibrium with it, acts as a risk factor for late onset AD.
Rational prescribing and professional standards.
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Confirmation of association between the e4 allele of apolipoprotein E and Alzheimer's disease.
The Apo E genotype of 86 patients with Alzheimer's disease (AD) and 77 age matched controls was determined by digestion of Apo E PCR products with the restriction enzyme CfoI. The frequency of the e4 allele was significantly increased in the patient group (0.33) as compared with controls (0.12). This effect was seen in patients with a family history and in sporadic cases. The odds ratio in homozygotes for the e4 allele was 11.24 (95% confidence interval 2.45-51.50). There was no relationship between age of onset and Apo E genotype. There was no linkage disequilibrium between the apolipoprotein E locus and a TaqI polymorphism at the Apo CII locus, and no allelic association between Apo CII and AD.
Improving GP-pharmacist communication for enhanced patient care.
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General practitioners and pharmacists interprofessional communication.
This draft joint statement by the Royal Australian College of General Practitioners and the Pharmaceutical Society of Australia Ltd is published here for comment as a national initiative. All suggestions received will be considered before a final statement is adopted.
Role of amyloid beta-protein in Alzheimer's disease.
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Characterization of stimulator cells for alloreactive cytotoxic-T-lymphocyte responses in vivo.
Mouse spleen cells were fractionated and tested for their ability to induce alloreactive cytotoxic-T-lymphocyte responses in vivo. The cells with allostimulatory potential are enriched maximally in a population of low density, Ig-negative, Thy 1-negative cells. This fraction has the cytochemical and ultrastructural characteristics of cells of the early myeloid series and not those of typical dendritic cells or macrophages. These myeloid cells represent a new subset of accessory cells which could be a potential source of allostimulation in organ grafts. They should be considered along with other accessory cell types as potential elements which induce transplantation responses.
Primary T-cell responses to minor alloantigens. II. Analysis of accessory cell requirements for the development of cytotoxic T lymphocytes.
The accessory cell requirements of cytotoxic T-lymphocyte (CTL) responses directed at multiple minor alloantigens are examined using a short-term, combined in-vivo and in-vitro protocol. The development of cytotoxic activity in vitro from T cells sensitized in vivo requires low-density accessory cells derived from the immunizing strain which have to be H-2 compatible with the responder population. The accessory activity of these cells can be by-passed by interleukin-2 (IL-2)-containing supernatant. Since IL-2 is a product of helper T (Th) cells secreted upon activation by antigen recognized in context of self H-2 and is known to stimulate antigen-activated cytotoxic T-lymphocyte precursors (CTL-P) non-specifically to effector CTL function, the results indicate that accessory cells interact in an H-2 restricted fashion with helper rather than cytotoxic T-lymphocyte precursors. The low-density accessory cells active in this system do not express Fc receptors (FcR) and are present in both the adherent and non-adherent fractions of spleen or lymph nodes.