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Biomedical subjects

R Aldrich

Publications and source records attributed to R Aldrich.

16 recordsLinked to original sources
PubMed2001

Agenda-setting in health reform: the role of community.

This paper presents a number of issues surrounding the setting of agendas for health care reform. We argue the need for increased community involvement, as well as the necessity to wrest health-care decision-making from health care professionals, or at least to ensure that such decision-making is informed by community values. We attempt to answer a few questions: who sets the health reform agenda and who should set it, how is the agenda set and why is this critical, when and where is the agenda set, and how should the agenda be set in the future?

Australia↗
PubMed2000

Mechanism of capsid assembly for an icosahedral plant virus.

Capsids of spherical viruses share a common architecture: an icosahedral arrangement of identical proteins. We suggest that there may be a limited number of common assembly mechanisms for such viruses. Previous assembly mechanisms were proposed on the basis of virion structure but were not rigorously tested. Here we apply a rigorous analysis of assembly to cowpea chlorotic mottle virus (CCMV), a typical, small, positive-strand RNA virus. The atomic resolution structure of CCMV revealed an interleaving of subunits around the quasi-sixfold vertices, which suggested that capsid assembly was initiated by a hexamer of dimers (Speir et al., 1995, Structure 3, 63-78). However, we find that the capsid protein readily forms pentamers of dimers in solution, based on polymerization kinetics observed by light scattering. Capsid assembly is nucleated by a pentamer, determined from analysis of the extent of assembly by size-exclusion chromatography. Subsequent assembly likely proceeds by the cooperative addition of dimers, leading to the T = 3 icosahedral capsid. At high protein concentrations, the concentration-dependent nucleation reaction causes an overabundance of five-dimer nuclei that can be identified by classical light scattering. In turn these associate to form incomplete capsids and pseudo-T = 2 capsids, assembled by oligomerization of 12 pentamers of dimers. The experimentally derived assembly mechanisms of T = 3 and pseudo-T = 2 CCMV capsids are directly relevant to interpreting the structure and assembly of other T = 3 viruses such as Norwalk virus and pseudo-T = 2 viruses such as the vp3 core of blue tongue virus.

Bromovirus↗
PubMed1997

Opportunistic blood lead testing in a paediatric inpatient population.

We report a simple protocol which has potential to estimate community paediatric blood lead levels using opportunistic testing. Permission to use leftover blood for a lead assay was sought from parents or guardians of 397 children one month to 13 years of age who were admitted to general paediatric wards of John Hunter Hospital, Newcastle, between May and August 1993 and who had blood for a full blood count taken for any reason. Results were reviewed by a medical officer and returned to parents. Where a child's blood lead level was of concern according to National Health and Medical Research Council guidelines, the child was referred to a specialist paediatrician for clinical assessment. Written consent was received from the parents or guardians of 95.5 per cent of eligible children (n = 379); 93.4 per cent of responders (354 of 379) had blood suitable for testing, giving an overall result rate of 89.2 per cent (354 of 397). The mean blood lead level for the whole group was 5.3 micrograms/dL. The highest blood lead level for any age group was 6.4 micrograms/dL in the 36 to < 60 month age group. Stratification by geographical area showed a trend in increasing blood lead with increasing population density and areas where lead polluting industries exist. The approximate cost per result achieved was $40. This opportunistic survey method provides a promising technique for obtaining data on community blood lead levels. It may be a practical and resource-efficient alternative to large-scale community surveys. Further studies are under way to validate the method as a community surveillance tool.

Adolescent↗
PubMed1991

All-terrain vehicle injuries in central Wisconsin: a continuing problem.

All-terrain vehicles (ATVs) have become well recognized as associated with injuries. This recognition has resulted in attempts at education and regulation to reduce the number and severity of injuries and number of deaths. The Marshfield Clinic and St. Joseph's Hospital surveyed all-terrain vehicle accidents in the Emergency Department in 1985 and again in 1988 and followed these patients for at least 1 year after the injury. Between the two dates, extensive educational and legislative activity had taken place. The actual number of all-terrain vehicle accidents had increased. The characteristics of victims who were involved in all-terrain vehicle accidents did not change. The actual number of accidents associated with three-wheeled ATVs did not appreciably decrease but the number of accidents associated with four-wheeled ATVs did increase. To date, it is not clear that legislative and educational activities are effective in reducing the number of ATV accidents or in changing the pattern of the accidents.

Adolescent↗
PubMed1990

The awareness of the risk of elevated cholesterol levels and knowledge about cholesterol-lowering action in Australia.

We report on a survey of the frequency of the assessment of cholesterol levels and blood pressure in the Australian population. Attitudes to risk-factor modification for cardiovascular disease also were evaluated and emphasis was placed on the assessment of knowledge about dietary modification in relation to cardiovascular disease. Respondents in this survey more frequently reported that they had undergone a blood pressure assessment than that they had had their blood cholesterol levels measured (96% and 46% of respondents, respectively). The proportion (5%) of respondents who recalled a cholesterol assessment with elevated cholesterol levels was found to be substantially lower than was that for participants in the 1983 National Heart Foundation Risk Factor Prevalence Study (19% of men and 21% of women had cholesterol levels of more than 6.5 mmol/L). Very few (9%) respondents in this survey nominated that they would reduce their dietary fat intake in order to modify their risk of developing cardiovascular disease. However, a greater number of respondents answered appropriately when asked about their potential modification of specific food items. More than 80% of respondents reported that they would reduce their intake of fried foods, although fewer would minimize their intakes of dairy products and meat. Women and respondents with a higher level of education were found to be more likely to respond appropriately. In addition, of those respondents who recalled ever having had their blood cholesterol level measured, those who reported that they had an elevated cholesterol level were more likely to indicate appropriate dietary modifications compared with those who reported normal cholesterol levels. Cholesterol reduction continues to be an important public-health issue in Australia. The results of this survey indicate that there is a need for both increased identification of individuals with elevated cholesterol levels in the population and further educational programmes about the relationship among cholesterol, diet and cardiovascular disease.

Adult↗