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Biomedical subjects

Richard Thompson

Publications and source records attributed to Richard Thompson.

52 records · Page 3Linked to original sources
PubMed2003

Age and sex of drivers associated with child pedestrian injuries.

In 2002 there were 237 road traffic collisions (RTCs) involving a child pedestrian in Derbyshire. Complete details were available for 200 RTCs. There was a significantly lower proportion of female drivers (34.5%) than expected according to the number of female drivers registered nationally (43%). Similarly, there was a greater proportion of drivers under the age of 40 years involved in RTCs with children as pedestrians (58.5%) than anticipated (42.1%). Drivers between the ages of 17-20 and 31-40 years were significantly more likely to be involved in an RTC with a child as a pedestrian. Male drivers and drivers under the age of 40 years are more likely to be involved in RTCs with children as pedestrians. Educational publicity campaigns to reduce driver speeds in urban areas need to be targeted at those drivers most likely to be involved in an RTC with a child.

Accidents, Traffic↗
PubMed2002

Body position and obstructive sleep apnea in children.

STUDY OBJECTIVES: In adults, sleep apnea is worse when the patient is in the supine position. However, the relationship between sleep position and obstructive apnea in children is unknown. The objective of this study was to evaluate the relationship between obstructive apnea and body position during sleep in children. DESIGN: Retrospective analysis of the relationship between body position and obstructive apnea in obese and non-obese children. SETTING: Tertiary care pediatric sleep center. PATIENTS: Otherwise healthy children, aged 1-10 years, undergoing polysomnography for suspected obstructive sleep apnea syndrome. Obese and non-obese children were evaluated separately. INTERVENTIONS: Retrospective review of the relationship between sleep position and obstructive apnea during polysomnography. MEASUREMENTS AND RESULTS: Eighty polysomnograms from 56 non-obese and 24 obese children were analyzed. Body position was determined by a sensor during polysomnography, and confirmed by review of videotapes. Children had a lower obstructive apnea hypopnea index when supine vs. prone, and shorter apneas when supine then when on their side. There was no difference in apnea duration between the supine and prone positions. Obese and non-obese children showed similar positional changes. CONCLUSIONS: Children with obstructive sleep apnea, in contrast to adults, breathe best when in the supine position.

Child, Preschool↗
PubMed2002

A strategic approach to the development of capillary electrophoresis chiral methods for pharmaceutical basic compounds using sulfated cyclodextrins.

Enantioseparations of basic pharmaceutical compounds were investigated using different types of sulfated cyclodextrins as chiral selectors. A general strategy for method development was described, together with enantiomeric separations of a number of pharmaceutical related compounds. Based on this strategy, systematic method development approaches for several selected compounds were performed by modifying method parameters, such as the concentration of the chiral selectors, buffer pH, type of organic modifiers, buffer type, temperature and applied voltage. The results of the investigation elucidated the separation mechanism. Many practical aspects were also discussed through several specific examples in order to demonstrate how to develop and validate a precise, sensitive, accurate and rugged separation.

Cyclodextrins↗
PubMed2002

Emotional disorders in primary care.

Individuals with emotional disorders are more likely to use primary medical care than specialty mental health services, but these disorders are likely to be undetected or inadequately treated. Recognition of the importance of primary medical care for the treatment of mental disorder has resulted in pressing new research priorities. One set of issues concerns the adequacy of existing nosological systems for conceptualizing emotional disorder in primary care and identifying need for treatment. Another concerns the difficulties translating efficacious treatment into effective strategies that can be integrated into the competing demands of primary medical care. Psychologists have played only a limited role in defining and addressing emerging questions. Irreversible changes in mental health services have created the need for the development of a psychosocial perspective for what would otherwise be defined as narrowly biomedical issues.

Humans↗
PubMed2002

Marital quality, coping with conflict, marital complaints, and affection in couples with a depressed wife.

This study compared three groups of women--outpatient depressed, inpatient depressed, and community control--and their husbands on a range of variables including marital functioning and styles of coping with conflict. Outpatient depressed couples reported greater marital distress and more destructive and less constructive tactics for resolving conflict than did community control couples. They also were more likely to have been previously married and to express regrets about having married their current husbands. There were smaller and less consistent differences for couples with inpatient depressed spouses, although inpatient couples with younger wives were similar to outpatient depressed couples. Both groups of depressed women and their husbands reported fewer expressions of affection and more complaints about the marriage than did control couples. Results are discussed in terms of interpersonal perspectives on depression.

Adaptation, Psychological↗
PubMed2002

Establishment of cereal endosperm expression domains: identification and properties of a maize transfer cell-specific transcription factor, ZmMRP-1.

In maize, cells at the base of the endosperm are transformed into transfer cells that facilitate nutrient uptake by the developing seed. ZmMRP-1 is the first transfer cell-specific transcriptional activator to be identified. The protein it encodes contains nuclear localization signals and a MYB-related DNA binding domain. A single gene copy is present in maize, mapping to a locus on chromosome 8. ZmMRP-1 is first expressed soon after fertilization, when the endosperm is still a multinuclear coenocyte. The transcript accumulates in the basal nucleocytoplasmic domain that gives rise to transfer cells after cellularization. The transcript can be detected throughout transfer cell development, but it is not found in mature cells. ZmMRP-1 strongly transactivates the promoters of two unrelated transfer cell-specific genes. The properties of ZmMRP-1 are consistent with it being a determinant of transfer cell-specific expression. Possible roles for ZmMRP-1 in the regulation of endosperm and transfer cell differentiation are discussed.

Amino Acid Sequence↗
PubMed2002

An assessment of suicide in an urban VA Medical Center.

This study characterizes those patients of an urban VA Medical Center (VAMC) who had committed suicide. A cause-of-death search of the 1,075 veterans from the VAMC's case rolls who died during 1998 was conducted. For confirmed and suspected suicides, a chart review was conducted, noting psychiatric history and recent contact with the VAMC. Nineteen patients were either confirmed or suspected suicides. Few of these patients had made recent contact with the VAMC, although the majority of them had received psychiatric services from the VA at some time. The proportion of deaths due to suicide was similar in African American and White patients. Rates of suicide were elevated, primarily because of the high proportion of patients receiving psychiatric treatment. Elderly suicides were less likely to have had psychiatric services or previous psychiatric diagnoses than were younger suicides. Patients with past contact with psychiatric services may be especially at risk of suicide, particularly as contact with these services diminishes. Elderly patients in medical settings with undiagnosed or undertreated psychiatric disorders are also likely to have elevated risk for suicide. These findings demonstrate the importance of acknowledging that risk factors for suicide are specific to sites or populations; this information can be used in allocating resources for developing site-specific strategies for prevention.

Academic Medical Centers↗
PubMedDate not supplied

Distress, psychiatric morbidity, and prescriptions for psychotropic medication in a breast cancer waiting room sample.

We examined relationships among psychiatric screening, the prevalence of psychiatric morbidity, and prescription rates for psychotropic medication in a waiting room sample of breast cancer patients (N=113). Rates of distress (29%), major depressive disorder (MDD; 9%), and generalized anxiety disorder (GAD; 6%) were low and similar to those found in primary care settings. A substantial proportion of patients (52%) had received psychotropic medication during treatment, including almost half (48%) of those without a current psychiatric diagnosis. Most individuals with MDD received pharmacotherapy during cancer treatment (80%), although only half of those with GAD were treated. Overall high rates psychotropic medication negatively impacted the efficiency of screening, and individuals with elevated distress were about 6 times less likely to represent a case of untreated psychiatric morbidity than to be a new case. We conclude that the risk of psychiatric morbidity attributable to breast cancer may be lower and treatment rates for psychiatric morbidity higher than previously believed and that screening is unlikely to provide efficient identification of untreated psychiatric morbidity. Adequacy of follow-up care is unclear and medication may be prescribed nonspecifically. The low rate of untreated psychiatric morbidity may signal a need for multisite collaborations to generate adequate numbers of participants in clinical trials.

Adult↗
PubMedDate not supplied

The pilot study of a telephone disease management program for depression.

Most depressed patients are seen and treated exclusively by primary care clinicians. However, primary care patients with depression are often not adequately treated. The aims of this pilot study were to measure the impact of a telephone disease management program on patient outcome and clinician adherence to practice guidelines, measure the relationship of clinician adherence to patient outcome, and explore the measurement of patient adherence to clinician recommendations and its impact on patient outcomes. Thirty-five primary care practices in the University of Pennsylvania Health System were randomized to telephone disease management (TDM) or "usual care" (UC). All patients received a baseline and a 16-week follow-up clinical evaluation performed over the telephone. Those from TDM practices also received follow-up contact at least every 3 weeks, with formal evaluations at weeks 6 and 12. These interval contacts were designed to facilitate patient and clinician adherence to a treatment algorithm based on the Agency for Health Research and Quality (AHRQ) practice guidelines. Depressive symptoms evaluated with the Community Epidemiologic Survey of Depression (CES-D) scale as well as guideline adherence were the primary outcome measures. Sixty-one patients were enrolled in this pilot project. The overall effect for CES-D scores over time was significant, (P <.001), indicating that those participating in the trial (both TDM and UC groups) showed significant improvement. The interaction between intervention condition and time was also significant (P <.05), indicating that TDM patients improved significantly more over time than did UC patients. A greater proportion of TDM patients had CES-D scores <16 by Week 16 (66.7 versus 33.3%; chi(2), P <.05). The improvement in depression outcome for the TDM group was related to its impact on improving clinician adherence to depression treatment algorithms. The TDM pilot did not show a statistically significant effect on improving patient adherence to clinician recommendations, however. This preliminary data suggests that TDM for depression improves both clinician guideline adherence and patient outcomes in the acute phase of depression. The effect on patient outcome is at least partially explained by the effect of TDM on clinician adherence to depression treatment algorithms.

Acute Disease↗
PubMedDate not supplied

Development and mapping of SSR markers for maize.

Microsatellite or simple sequence repeat (SSR) markers have wide applicability for genetic analysis in crop plant improvement strategies. The objectives of this project were to isolate, characterize, and map a comprehensive set of SSR markers for maize (Zea mays L.). We developed 1051 novel SSR markers for maize from microsatellite-enriched libraries and by identification of microsatellite-containing sequences in public and private databases. Three mapping populations were used to derive map positions for 978 of these markers. The main mapping population was the intermated B73 x Mo17 (IBM) population. In mapping this intermated recombinant inbred line population, we have contributed to development of a new high-resolution map resource for maize. The primer sequences, original sequence sources, data on polymorphisms across 11 inbred lines, and map positions have been integrated with information on other public SSR markers and released through MaizeDB at URL:www.agron.missouri.edu. The maize research community now has the most detailed and comprehensive SSR marker set of any plant species.

Chromosome Mapping↗
PubMedDate not supplied

Suicidality in older African Americans: findings from the EPOCH study.

The authors examined the current frequency of suicidality and associated characteristics in a sample of 835 African-American older adult residents of six urban public housing developments who consented to participate in an intervention trial of mobile outreach. The frequency of passive and active suicidal ideation was 2.5% and 1.4%, respectively. Characteristics of individuals with both active and passive suicidality included elevated anxiety, social dysfunction, somatic symptoms, low social support, lack of a confidant, and low religiosity. Characteristics of those with passive, but not active, ideation also included older age, lower levels of education, elevated depressive symptoms, poorer cognitive functioning, and having recently discussed emotional problems with a healthcare provider. The characteristics of those reporting active, but not passive, ideation included having a history of mental health treatment and reporting no instrumental support. Multivariate analyses indicated that depression and religiosity were uniquely associated with passive suicidal ideation, and life satisfaction and religiosity were uniquely associated with active suicidal ideation. The authors discuss implications of these findings and offer suggestions for research and clinical practice.

Black or African American↗
PubMedDate not supplied

Using the minimum data set 2.0 mood disturbance items as a self-report screening instrument for depression in nursing home residents.

OBJECTIVE: Seeking to enhance nursing home residents' involvement in their care, the authors examined whether the Minimum Data Set, Version 2.0 (MDS) Mood Disturbance items could be administered by self-report. They compared the MDS to the Geriatric Depression Scale (GDS) in terms of its association with depression diagnosis. METHODS: Subjects (N=204) were nursing home residents who were interviewed with a psychiatric diagnostic instrument, the GDS, and a self-report version of the MDS mood disturbance items. RESULTS: Analyses of variance and receiver operating characteristics analyses demonstrated that MDS items distinguished subjects with any versus no depression about as well as did the GDS. This pattern held within cognitive, gender, and ethnicity subgroups. CONCLUSION: The MDS Mood Disturbance items can be reliably and validly administered via self-report to persons scoring at least 12 on the Mini-Mental State Exam.

Aged↗