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Richard Butler

Publications and source records attributed to Richard Butler.

5 recordsLinked to original sources

Psychological problems in children with bedwetting and combined (day and night) wetting: A UK population-based study.

OBJECTIVE: To investigate the psychological problems associated with bedwetting and combined (day and night) wetting in children aged around 7(1/2) years. METHODS: Participants were a cohort of over 8000 children enrolled in the population-based Avon Longitudinal Study of Parents and Children. Parents completed postal questionnaires assessing common childhood psychological problems, and children were asked about behavior, friendships, bullying, and self-esteem in clinical interviews. The rates of psychological problems were compared in children with bedwetting, combined wetting, and in children with no wetting problems. RESULTS: The study found a higher rate of parent-reported psychological problems in children with bedwetting and combined wetting compared with those with no wetting problems. Children with combined wetting were particularly at risk for externalizing problems. There was little difference with the child-reported measures. CONCLUSIONS: Bedwetting and combined wetting are associated with parent-reported psychological problems and combined wetting confers an increased risk for externalizing problems.

Child↗

Exploring the differences between mono- and polysymptomatic nocturnal enuresis.

OBJECTIVE: Recently the heterogeneity of nocturnal enuresis has been manifest in the distinction between mono- and polysymptomatic forms, based on the absence or presence of bladder overactivity, respectively. Although this classification has important clinical implications, there is a lack of empirical work relating to associated symptom expression and psychological functioning. The aim of this study was to identify variables associated with the two forms of nocturnal enuresis by means of a large population survey. MATERIAL AND METHODS: From a cohort of 11,021 parents surveyed as part of the Avon Longitudinal Study of Parents and Children when their children were aged 7(1/2) years, 8242 questionnaires were returned, with 7935 children meeting the inclusion criteria. Parents were invited to complete a questionnaire containing items relating to bedwetting, toileting behaviour, day-time wetting, bowel functioning and psychological variables. RESULTS: A total of 194 children met the Diagnostic and Statistical Manual of Mental Disorders-IV definition of nocturnal enuresis, of whom 133 (68.5%) were classified as monosymptomatic and 61 (31.5%) as polysymptomatic. Those with the polysymptomatic form were significantly more likely to have multiple episodes of bedwetting, to show signs (such as fidgeting) of needing to urinate during the day, to need a reminder to toilet during the day and to have day-time wetting and soiling. CONCLUSIONS: The proportion of mono- to polysymptomatic nocturnal enuresis was 2:1. Children with the polysymptomatic form had a number of associated bladder and bowel problems. Clinically it is important to distinguish between the two types of nocturnal enuresis in order to identify the most appropriate treatment intervention.

Child↗

High level waste tank closure project: ALARA applications at the Idaho National Engineering and Environmental Laboratory.

Bechtel BWXT Idaho, Maintenance and Operating Contractor for the Department of Energy at the Idaho National Engineering and Environmental Laboratory, has emptied, cleaned, and sampled six of the eleven 1.135 x 10(6) L high level waste underground storage tanks at the Idaho Nuclear Technology and Engineering Center, well ahead of the State of Idaho Consent Order cleaning schedule. Cleaning of a seventh tank is expected to be complete by the end of calendar year 2004. The tanks, with associated vaults, valve boxes, and distribution systems, are being closed to meet Resource Conservation and Recovery Act regulations and Department of Energy orders. The use of remotely operated equipment placed in the tanks through existing tank riser access points, sampling methods and application of as-low-as-reasonably-achievable (ALARA) principles have proven effective in keeping personnel dose low during equipment removal, tank, vault, and valve box cleaning, and sampling activities, currently at 0.03 Sv.

Decontamination↗

Problem-based learning and the medical school: another case of the emperor's new clothes?

For almost four decades, problem-based learning (PBL) has been the stated cornerstone of learning in many medical schools. Proponents of PBL cite the open nature of the learning experience where students are free to study in depth, unencumbered by the burdens of broad courses based on the memorization of facts; detractors, on the other hand, cite the lack of breadth and factual knowledge required for professional qualification. Both points of view have merit. Professional schools have a different set of needs and requirements, and it is these that drive the curriculum and learning philosophies. The constraints of the professional school are so different from those of the purely academic environment that PBL, while admirably suited to the latter, is just problem solving in the former.

Education, Medical↗

ErbB2 is required for muscle spindle and myoblast cell survival.

Signaling mediated by ErbB2 is thought to play a critical role in numerous developmental processes. However, due to the embryonic lethality associated with the germ line inactivation of erbB2, its role in adult tissues remains largely obscure. Given the expression of ErbB2 at the neuromuscular junction, we have created a muscle-specific knockout to assess its role there. This resulted in viable mice with a progressive defect in proprioception due to loss of muscle spindles. Interestingly, a partial reduction of ErbB2 levels also reduced the number of muscle spindles. Although histological analysis of the muscle revealed an otherwise normal architecture, induction of muscle injury revealed a defect in muscle regeneration. Consistent with these observations, primary myoblasts lacking ErbB2 exhibit extensive apoptosis upon differentiation into myofibers. Taken together, these results illustrate a dual role for ErbB2 in both muscle spindle maintenance and survival of myoblasts.

Animals↗