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Biomedical subjects

R Chamberlain

Publications and source records attributed to R Chamberlain.

At least 19 recordsLinked to original sources
PubMed2001

System effects of the Kansas Mental Health Reform Act of 1991.

This paper analyzes the impact of the Kansas Mental Health Reform Act on client outcomes. The Act is of general interest because it reflects a trial of greater accountability without major changes in financial incentives. It made Community Mental Health Centers [CMHCs] gatekeepers that were accountable for services for adults with severe and persistent mental illnesses. The Act sought reductions in hospitalizations rates, expanded use of community support services, and increased independent living. The structure of the Act and Client Status Reports allow rigorous examination of these outcomes. The number of clients served increased significantly. Even though hospital days fell by 23%, there is no clear evidence that the Act itself reduced hospital days per client. The proportion of community support program clients residing independently rose significantly; the proportion participating meaningfully in the labor market fell. The goals of the Act were realized overall, but the performance of CMHCs varied considerably.

Activities of Daily Living↗
PubMed1999

The more things change....

The main messages from the survey were that maternity care varied widely from one district to another and often varied within communities and within hospitals. Much depended on both the attitudes and preferences of the individual providing care and whether a woman was offered care as part of an innovative pilots project. In a number of areas, Changing Childbirth pilots were closed down rather than rolled out across the district, despite good results. Evidence of more woman-centred care suggests that attitudes towards women had changed more than the actual services. However, those women who were interested in a home birth were still experiencing major obstacles. Postnatal care and support for breastfeeding were identified as those aspects of care most in need of improvement.

Adult↗
PubMed1996

Host range restricted, non-replicating vaccinia virus vectors as vaccine candidates.

Three model systems were used to demonstrate the immunogenicity of highly attenuated and replication-defective recombinant MVA. (1) Intramuscular inoculation of MVA-IN-Fha/np induced humoral and cell-mediated immune responses in mice and protectively immunized them against a lethal respiratory challenge with influenza virus. Intranasal vaccination was also protective, although higher doses were needed. (2) In rhesus macaques, an immunization scheme involving intramuscular injections of MVA-SIVenv/gag/pol greatly reduced the severity of disease caused by an SIV challenge. (3) In a murine cancer model, immunization with MVA-beta gal prevented the establishment of tumor metastases and even prolonged life in animals with established tumors. These results, together with previous data on the safety of MVA in humans, suggest the potential usefulness of recombinant MVA for prophylactic vaccination and therapeutic treatment of infectious diseases and cancer.

Animals↗
PubMed1993

Human islet purification: a prospective comparison of Euro-Ficoll and bovine serum albumin density gradients.

Euro-Ficoll (EF) and bovine serum albumin (BSA) are the two most commonly used media for the density gradient purification of human pancreatic islets. The aim of this study was to compare these two media with respect to the efficiency of human islet isolation. Ten human pancreata were collagenase-digested, and samples of digest were separated on either a continuous linear density gradient of BSA or a discontinuous gradient of EF (1.108/1.096/1.037/Euro-Collins). Efficiency of islet purification was assessed by insulin and amylase assay of aliquots aspirated from the BSA gradients, and from the interfaces of the EF gradients. Islets were obtained from two interfaces in the EF gradients. Islet yield from the upper interface was generally poor (median 28% of total insulin; range 2-71%), but purity was better than for an equivalent yield using BSA [1% (0-3%) amylase contamination for EF versus 6% (0-37%) for BSA; P = 0.013]. Pooling both EF interfaces increased yield to 66% (17-81%) but markedly reduced purity [46% (0-50%) amylase for EF versus 31% (0-52%) for BSA]. In conclusion, the efficiency of human islet purification is similar, though disappointingly low, with BSA and with EF. Considerable scope exists, therefore, for improvement in the density gradient purification of human islets.

Adolescent↗
PubMed1992

Storage of human pancreatic digest in University of Wisconsin solution significantly improves subsequent islet purification.

Density-gradient purification of human pancreatic islets from the collagenase-digested pancreas relies on the exocrine tissue being denser than the islets. Cold storage of the pancreas before and after digestion causes cell swelling, which can decrease the density of pancreatic exocrine tissue and adversely affect subsequent purification. Using 14 human pancreata (seven perfused in situ with hyperosmolar citrate (HOC) and seven with University of Wisconsin solution (UW)), it is shown that storage of the pancreatic digest in UW significantly increases the density of pancreatic exocrine tissue compared with storage in minimal essential medium (MEM) (P = 0.009). This results in an improvement in islet purity (P = 0.036) for HOC- but not UW-perfused pancreata. Storage in UW for 1 h not only prevented the deterioration that occurred in MEM, but resulted in an improvement in islet purity for five of the seven HOC-perfused pancreata. Most pancreata in the UK are perfused with HOC, but storage of the digest in UW results in significantly better islet purity and, when islets cannot be purified immediately, a period of storage will often improve separation and allow islets to be purified.

Adenosine↗
PubMed1991

A decade of case management: a methodological review of outcome research.

The last decade has witnessed a burgeoning interest in case management services to people with severe mental illness. While the literature on case management is proliferating, there remains a paucity of rigorously designed outcome research. This paper provides a methodological review of that outcome research on case management, which found that the term case management is used to describe a diverse array of interventions that yield differing client outcomes. Suggestions for the direction of future inquiry are described.

Adult↗
PubMed1987

Paralytic poliomyelitis in England & Wales, 1970-84.

In 1962 the Public Health Laboratory Service (PHLS) became responsible for the Poliomyelitis Surveillance Scheme for England and Wales, which since 1970 has included the World Health Organisation (WHO) enquiry into Acute Persisting Spinal Paralysis. All the records have been kept, including those of patients who were later considered not to have had poliomyelitis. This paper reviews the cases between 1970-84 of patients normally resident in England and Wales, where the clinical features of the illness were considered by the clinician in charge to be those of poliomyelitis and in which either poliovirus was isolated or there was serological evidence of recent infection. Seventy cases met these criteria. Two patients died. A wild strain of poliovirus was isolated in 19 cases; a vaccine-like strain in 27; an intermediate strain in 5; and in 19 cases the strain was not known or there was no isolate. Eleven patients had a history of overseas travel; 17 had been vaccinated recently; and 12 had been in contact with a recent vaccine. In the remaining 30 cases, the source of the infection was not found. Other details, including the age distribution, vaccination history and the laboratory findings are discussed.

Adult↗
PubMed1984

The epidemiology of chlamydial infections in childhood: a serological investigation.

Blood samples from 382 children between the ages of one and 15 years were tested for anti-chlamydial antibody. A low prevalence of antibody against Chlamydia trachomatis was found among children under the age of seven years. Antibody against the Chlamydial agent C IOL-207 was rare before the age of five years, but was found with increasing prevalence in older children. It is suggested that the mode of transmission of the two agents is different and that C IOL-207 may be transmitted at school.

Adolescent↗
PubMed1982

Prevalence of antibodies to poliovirus in 1978 among subjects aged 0-88 years.

The antibody state of a population aged 6 months to 88 years to poliovirus types 1, 2, and 3 was determined by examining 919 sera collected in Lancashire, London, and southern and south-east England. In subjects aged over 2 years the immune state was surprisingly uniform, although the older patients had probably acquired practically all their antibodies as a result of natural infection and those under 16 through vaccination. at least 95% had detectable antibodies to at least one poliovirus type and about 60% to all three types, with the exception of a cohort of children born between 1963 and 1968, in whom the proportions were about 80% and 40% respectively. These children were born around the time of the changeover from inactivated to oral vaccine, when immunisation rates were low and there was confusion over the number of doses required. These results indicate that a complete course of vaccine or a booster dose at or around school-leaving age is necessary.

Adolescent↗
PubMed1982

Antibody to cytomegalovirus in Malta.

Antibody to cytomegalovirus (CMV) was sought in sera from Malta using immunofluorescence. Seven per cent of the infants, 36% of the school children, increasing to 100% of the adults aged over 40 years were found to have antibody. Most infection occurred in pre-school children and adults over 25 years of age. This pattern of antibody acquisition appears different from that described for other countries.

Adolescent↗
PubMed1976

Cross-sectional study of developmental test items in children aged 94 to 97 weeks: report of the British Births Child Study.

A 10 percent random sample of legitimate children drawn from a national cohort of 16,955 live births were examined between 94 and 97 weeks of age by clinical medical officers, using a screening examination designed to detect children requiring further investigation for developmental delay. Girls were more advanced than boys, particularly at verbal and personal-social items, but care is needed in interpreting the significance of differences found in a single cross-sectional examination when the child is around the mean age for acquiring a particular skill. For many questions mothers also recorded their estimations of their children's abilities; these were appreciably greater than those of the examiner, the difference varying according to the difficulty of the task and whether they were questioned before or after the examiner had carried out the test. It is suggested that the results of a single screening examination at two years will depend upon the skill of the examiner (a) to persuade a child to co-operate or to be able to assess his ability, (b) to interpret the mother's estimation of her child's skill, and (c) to distinguish between late development and delay due to a handicapping condition.

Child Development↗
PubMed1975

Physical growth in twins, postmature and small-for-dates children.

From 16 955 livebirths, which occurred throughout the United Kingdom in April 1970 during the British Births Survey, three groups of children (multiple births, postmature, and small-for-dates) were selected together with a 10% random sample. This report is concerned with the height, weight, and head circimference measruements at 22 months of age. The babies that were heavier at birth showed diminished growth velocity and the small babies catch-up growth. At 22 months the pattern of distribution of weight was much closer to the normal than that of the babies' birthweights. Differences, however, did remain.

Birth Weight↗