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Biomedical subjects

R Boyd

Publications and source records attributed to R Boyd.

At least 19 recordsLinked to original sources
PubMed2005

Development of a condition-specific measure of quality of life for children with cerebral palsy: empirical thematic data reported by parents and children.

BACKGROUND: Although there is increasing recognition that quality of life (QOL) and health-related quality of life (HRQOL) are important outcome variables in clinical trials for children with cerebral palsy, there are substantial limitations in existing measures of QOL. This study identify themes of QOL for children with cerebral palsy and their parents to guide the development of a new condition-specific QOL scale. METHODS: A qualitative study of parent and child views on QOL composition was conducted, using a grounded theory framework. Families participated in semistructured interviews on QOL until thematic saturation was reached (n = 28 families). RESULTS: Overall, 13 themes emerged from the interviews: physical health, body pain and discomfort, daily living tasks, participation in regular physical and social activities, emotional well-being and self-esteem, interaction with the community, communication, family health, supportive physical environment, future QOL, provision of, and access to services, financial stability, and social well-being. CONCLUSIONS: Research with parents and children with cerebral palsy, representative of severity across the disease spectrum and socio-economic status, reinforced and expanded on the traditional themes that have underpinned QOL measurement development. This has implications not only for the development of a new QOL scale for children with cerebral palsy, but also for clinical interventions and community care management.

Activities of Daily Living↗
PubMed2005

Pilot study of a paediatric emergency department oral rehydration protocol.

OBJECTIVE: To ascertain if the use of a paediatric oral rehydration protocol in the emergency department changed rates of admission, total time spent in hospital, total time spent in the emergency department, or number of unscheduled returns to the emergency department. METHODS: A two month time period was analysed before and then after the adoption of an oral rehydration protocol for children presenting to the emergency department with symptoms suggestive of gastroenteritis. The rates of admission, total time spent in hospital, total time spent in the emergency department, and the rate of unscheduled returns were analysed using Fisher's exact and Wilcoxon testing for non-parametric data. RESULTS: The adoption of a paediatric rehydration protocol was associated with a significant reduction in admission rates (before = 22.5%, after 5.1%; p = 0.048) and mean total hospital time (before = 7 hours 54 minutes, after = 2 hours 17 minutes; p = 0.017). There was no significant difference in time spent in the emergency department (before = 1 hour 25 minutes, after 1 hour 35 minutes, p = 0.3). The number of unscheduled returns did not change significantly (p = 0.3). CONCLUSION: Adoption of a paediatric rehydration protocol significantly reduces admission rates and total time spent in hospital for children presenting to the emergency department with symptoms of gastroenteritis. The mean time spent in the actual emergency department does not significantly increase. The rate of unscheduled returns does not change.

Adolescent↗
PubMed2005

Pressurised metered dose inhalers with spacers versus nebulisers for beta-agonist delivery in acute asthma in children in the emergency department.

OBJECTIVES: Wet nebulisers are widely used for beta-2 agonist delivery in Australasian emergency departments (ED). An increasing body of work suggests that pressurised metered dose inhalers with spacers (pMDI-S) are as effective. This study aims to investigate the effect on admission rates, total time in the ED, and total time in hospital after initiation of routine pMDI-S treatment for mild to moderate asthma in children presenting to the ED. METHODS: Children with a discharge diagnosis of asthma were identified over sequential 3 month time periods. In the first period, wet nebuliser treatment was routine and in the subsequent trial period pMDI-S treatment was instituted as routine. Admissions rates, total time in hospital, and total time in the ED were recorded for each group. RESULTS: Admission rates fell significantly from 31% to 20.6% after routine use of pMDI-S treatment. There was a non-significant trend to an increase in total ED and total hospital times. CONCLUSION: Introduction of routine pMDI-S treatment in the paediatric ED results in a significant drop in admission rates but no significant change in total hospital times or total ED times.

Acute Disease↗
PubMed2005

Capillary versus venous bedside blood glucose estimations.

OBJECTIVES: To determine the mean difference and correlation between capillary and venous bedside glucose estimation in comparison to laboratory blood glucose analysis in emergency department (ED) patients. METHODS: Blood glucose levels were synchronously analysed using a bedside blood glucometer on capillary and venous derived samples from consenting ED patients aged >12 years. The venous sample was sent for comparative testing using a laboratory based multichannel analyser. Mean difference and correlation coefficients were determined. RESULTS: A total of 20 subjects (aged 13-88 years) were enrolled, with 100% data capture. The mean laboratory glucose was 7.075 mmol/l. The mean capillary blood glucose was 7.66 mmol/l (mean difference compared with mean laboratory glucose 0.58 mmol/l; 95% confidence interval 0.3 to 0.9). The mean venous derived blood glucometer glucose was 7.99 mmol/l (mean difference compared with mean laboratory glucose 0.91 mmol/l; 95% CI 0.6 to 1.2). The correlation coefficient for the laboratory blood glucose versus the capillary blood glucometer glucose was 0.97 mmol/l (p<0.001). The correlation coefficient for the laboratory blood glucose and the venous blood glucometer glucose was 0.96 (p<0.001). Variation occurred between the glucometer and the laboratory blood glucose results. CONCLUSIONS: There is a small but significant difference in the blood glucose results analysed on a bedside glucometer when the samples are taken from capillary or venous sources. Although good correlation is the norm between venous and capillary derived samples, caution must be exercised in accepting the results as equivalent or using either as substitutes for a laboratory blood glucose result.

Adolescent↗
PubMed2003

Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Glucagon for the treatment of symptomatic beta blocker overdose.

A short cut review was carried out to establish whether the intravenous glucagon can support blood pressure in beta blocker overdose. A total of 51 papers were found using the reported search, of which six presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.

Adrenergic beta-Antagonists↗
PubMed2002

Whiplash associated disorder in children attending the emergency department.

AIMS: To determine the incidence, severity, and clinical course of whiplash associated disorder (WAD) in children aged 4-16 years involved as passengers in car crashes. METHODS: Prospective surveillance of all paediatric attendances to three English urban emergency departments after car crashes over an eight month period. An initial structured telephone interview at day 2 after the car crash was performed. This was followed by clinical review of symptomatic patients on day 5 after the crash using the Quebec Task Force criteria for outcome assessment, with subsequent clinical review at 14, 28, and 56 days or until earlier symptom resolution. RESULTS: 105 children were identified as having been involved in car crashes as passengers. Forty nine children (47%) experienced symptoms of a WAD. Twenty nine children developed symptoms within 24 hours with the remainder developing symptoms by 48 hours. Forty children experienced a WAD grade 1 and nine children suffered a WAD grade 2 injury. The mean duration of symptoms was 8.8 days (range 3-70, SD 10.7). WAD grade 2 symptoms lasted significantly longer than WAD grade 1 symptoms. CONCLUSIONS: The incidence of WAD in children in this series was higher than in other studies. The clinical course was more favourable than that reported for adults.

Accidents, Traffic↗
PubMed2001

Expression and cellular distribution during development of the peptide transporter (PepT1) in the small intestinal epithelium of the rat.

Immunocytochemical distribution in rat small intestine of PepT1, the oligopeptide transporter responsible for nutritionally important peptide uptake from the adult small intestinal lumen, has been measured during development using an antibody to the C-terminal sequence of PepT1. Distribution is exclusively in the apical brush border of enterocytes from both prenatal and mature animals. However, immediately after birth immunolocalisation of PepT1 extends to the subapical cytoplasm and to the basolateral membrane of enterocytes. No staining is found in crypts or over Goblet cells. Our results imply that the peptide transporter at the basolateral membrane in adult rats must be distinct from PepT1. They also shed new light on the trafficking of PepT1 in enterocytes.

Animals↗
PubMed2001

Why people punish defectors. Weak conformist transmission can stabilize costly enforcement of norms in cooperative dilemmas.

In this paper, we present a cultural evolutionary model in which norms for cooperation and punishment are acquired via two cognitive mechanisms: (1) payoff-biased transmission-a tendency to copy the most successful individual; and (2) conformist transmission-a tendency to copy the most frequent behavior in the population. We first show that if a finite number of punishment stages is permitted (e.g. two stages of punishment occur if some individuals punish people who fail to punish non-cooperators), then an arbitrarily small amount of conformist transmission will stabilize cooperative behavior by stabilizing punishment at some n -th stage. We then explain how, once cooperation is stabilized in one group, it may spread through a multi-group population via cultural group selection. Finally, once cooperation is prevalent, we show how prosocial genes favoring cooperation and punishment may invade in the wake of cultural group selection.

Cooperative Behavior↗
PubMed2001

CD4(+)CD8(+)TCR(low) thymocytes express low levels of glucocorticoid receptors while being sensitive to glucocorticoid-induced apoptosis.

While signaling by either the TCR or glucocorticoid receptor (GR) can induce apoptosis in thymocytes, recent studies have shown that combining these signals results in survival of CD4(+)CD8(+) thymocytes. Although glucocorticoids (GC) in this way may directly affect T cell selection, no data are available addressing GR expression in thymocyte subsets and in individual cells within subsets. We studied GR expression by combining immunofluorescence cell surface staining for CD4, CD8 and TCR with intracellular staining of GR in four-color cytometry. Significant differences of GR expression were observed in various thymocyte subsets, although a homogeneous distribution of GR expression in individual thymocyte subsets emerged. The highest GR expression was found in CD4(-)CD8(-)TCR(-) thymocytes, and decreased during development via the CD4(-)CD8(+)TCR(-) subpopulation into the CD4(+)CD8(+)TCR(low) subset. Interestingly, the latter population, although expressing less than half the GR density of CD4(-)CD8(-)TCR(-) cells, is the most sensitive subset to GC-induced apoptosis. Up-regulation of TCR expression by the CD4(+)CD8(+)TCR(low) subset to CD4(+)CD8(+)TCR(high) cells was accompanied by a parallel increase in GR expression. The latter finding and the presence of a homogeneous distribution of GR in each thymocyte subset provides an experimental basis for the concept that GR can antagonize TCR-mediated signals at a constant rate relative to TCR expression.

Animals↗
PubMed2001

Critical remarks on the use of terrestrial moss (Hylocomium splendens and Pleurozium schreberi) for monitoring of airborne pollution.

Duplicate samples of the two terrestrial moss species Hylocomium splendens and Pleurozium schreberi, which are widely used to monitor airborne heavy metal pollution, have been collected from eight catchments spread over a 1,500,000 km2 area in northern Europe. These were analysed for a total of 38 elements by inductively coupled plasma-mass spectrometry, inductively coupled plasma-atomic emission spectrometry and cold vapour-atomic absorption spectometry techniques. Results show that the moss species can be combined without interspecies calibration for regional mapping purposes. For the majority of elements the observed within-catchment variation is large--big composite samples over a large area should thus be collected when moss is to be used for monitoring purposes. For the majority of elements the input of dust governs moss chemistry. For a reliable 'contamination' signal over a sizeable area a major source is needed. Some elements show a dependence on climate/vegetation zone. In coastal areas the input of marine aerosols will alter the chemical signal obtained from moss samples.

Air Pollutants↗
PubMed2001

A note on the use of conservation practices in U.S. agriculture.

This article measures the effect of an increase in productivity attributable to an increase in soil organic carbon associated with the increase in the use of conservation practices in agriculture in the United States. Both the direct and indirect effects are calibrated. The analytical approach used consists of a dynamic computable general equilibrium model composed of 14 producing sectors, 10 consuming sectors, seven household categories classified by income, and a government. The results suggest that the impact of a change in productivity is an increase in output over a six year period starting in 1998 in field crops. The most significant impact is felt in the livestock sector. This is because field crops are a major input in the production of livestock. The food processing sector also exhibits a relatively large increase because of the increase in inputs of both field crops and livestock. Manufacturing output increases primarily because overall investment rises and most investment utilizes manufacturing goods. The other producing sectors are generally unaffected by the increase in agricultural production due to an increase in soil organic carbon. Coincident with the increase in the production of field crops is a relatively large decrease in the price of field crops. Other noticeable price reductions occur in the livestock sector and the food processing sector. For the consuming sectors, the consumption of food and alcohol and tobacco increase but consumption in all of the other sectors remains basically unchanged. Prices in the food and alcohol and tobacco sectors decline by about 1% while the prices in the other sectors remain static. Household welfare increases in the aggregate by only 0.1% with this increase occurring uniformly across all household categories. Revenue received by the government increases a modest 2% in response to an increase in output and, hence, an increase in taxes paid. The results indicate that there are significant production benefits for several sectors that can be realized by an increase in the use of conservation practices in agricultural production which, in turn, enhances soil organic carbon. There are a number of policy options available to promote the use of conservation practices. These include education and technical assistance, financial assistance, research and development, land retirement, and regulation and taxes.

Agriculture↗