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Tim Coleman

Publications and source records attributed to Tim Coleman.

28 records · Page 2Linked to original sources
PubMed2004

Consent rates for video-recording general practice consultations: effect of ethnicity and other factors.

We sought consent for video-recording general practice consultations from 260 consecutive attenders in nine surgeries. Intensive fieldwork including language support, from both the researcher and professional interpreters, was undertaken. The overall consent rate was 77.3%. No significant differences in consent rates were found between white and south Asian patients, even after controlling for age, gender and self-reported understanding of English. No differences in consent rates were found with respect to age, gender and self-reported understanding of English.

Adult↗
PubMed2003

An integrated functional genomics screening program reveals a role for BMP-9 in glucose homeostasis.

A coordinated functional genomics program was implemented to identify secreted polypeptides with therapeutic applications in the treatment of diabetes. Secreted factors were predicted from a diverse expressed-sequence tags (EST) database, representing >1,000 cDNA libraries, using a combination of bioinformatic algorithms. Subsequently, approximately 8,000 human proteins were screened in high-throughput cell-based assays designed to monitor key physiological transitions known to be centrally involved in the physiology of type 2 diabetes. Bone morphogenetic protein-9 (BMP-9) gave a positive response in two independent assays: reducing phosphoenolpyruvate carboxykinase (PEPCK) expression in hepatocytes and activating Akt kinase in differentiated myotubes. Purified recombinant BMP-9 potently inhibited hepatic glucose production and activated expression of key enzymes of lipid metabolism. In freely fed diabetic mice, a single subcutaneous injection of BMP-9 reduced glycemia to near-normal levels, with maximal reduction observed 30 hours after treatment. BMP-9 represents the first hepatic factor shown to regulate blood glucose concentration. Using a combination of bioinformatic and high-throughput functional analyses, we have identified a factor that may be exploited for the treatment of diabetes.

Animals↗
PubMed2003

"I'll give up smoking when you get me better": patients' resistance to attempts to problematise smoking in general practice (GP) consultations.

This paper focuses on general practice consultations where the issue of patients' smoking is raised and problematised by general practitioners (GPs) by linking it to their presenting or ongoing medical conditions. The data are taken from a larger study in one country of the UK, of the factors influencing discussion of smoking between GPs and patients who smoke. Consultations have been examined informed by the conversation analysis literature, with a focus on patients' resistance to doctors' problematisation of smoking. It is argued that, despite evidence from other areas of health care that advice is most effective when it is personalised, and despite GPs' expressed views that a preferred way of topicalising smoking is to make links to a patient's current medical problems, this is not generally the case in these consultations. Linking smoking to current problems commonly results in explicit resistance from patients of a kind that is rarely seen in other medical consultations. It is postulated that this results from the moral implications of linking a person's health status with their own behaviour, thereby undermining their claim to legitimate illness and to medical help.

Family Practice↗
PubMed2003

Discussion of NRT and other antismoking interventions in UK general practitioners' routine consultations.

Nicotine replacement therapy (NRT) is an effective smoking cessation treatment, but little information is available about how primary care physicians use the therapy. We investigated the quality of UK general practitioners' (GPs') advice against smoking, including how frequently they recommend NRT to smokers. We compared the characteristics of smokers whom GPs recommended use NRT with smokers who did not receive GP recommendations. We conducted a cross-sectional survey of 3,525 adult patients attending 35 UK GPs over a 16-month period. Of those surveyed, 2,955 eligible patients (83.8%) completed preconsultation questionnaires, and 1,026 (34.7%) were regular smokers, with 927 (90.4%) of the regular smokers completing postconsultation questionnaires. Of those completing the questionnaires, 20.2% (95% CI, 17.7% to 22.9%) or 187 recalled discussion of smoking with their GPs and of these, 66.3% (95% CI, 60.1% to 74.1%) or 124 perceived that they had been given an unequivocal message to stop smoking. Although 60.4% of smokers (606 of 1,004) (95% CI, 57.3% to 63.3%) or smoked more than 10 cigarettes daily, only 17.6% (95% CI, 12.9% to 23.7%) or 33 of those recalling antismoking advice reported discussion of NRT. Accordingly, GPs discussed NRT with only a minority of smokers who might benefit from the therapy. Intending to give up smoking in the next 4 weeks was the only variable independently associated with smokers' recall of discussing NRT (OR=2.58 [95% CI 1.20% to 5.57%]). The study findings thus provide only limited information to support the notion that UK GPs recommend NRT in an evidence-based manner. Now that NRT is available by prescription from UK GPs, further research is needed to monitor whether this effective antismoking therapy is being prescribed appropriately.

Administration, Cutaneous↗
PubMed2003

Comparison of the smoking behaviour and attitudes of smokers who believe they have smoking-related problems with those who do not.

BACKGROUND: Motivation to stop smoking is associated with smokers' possessing substantial smoking-related morbidity or believing that they have symptoms caused by smoking, but it is not clear if this holds for smokers attending general practice consultations. OBJECTIVE: Our aim was to compare the attitudes and behaviour of smokers attending their GP with symptoms that they believe are smoking related with those who do not. METHOD: A cross-sectional, pre-consultation survey of patients attending GPs in Leicester, UK was carried out. RESULTS: A total of 83.8% (2955/3525) of people attending GPs completed the questionnaire and 34.7% were smokers. Multiple logistic regression showed that where smokers perceived that their problems were smoking related they were more likely to have tried stopping in the past [odds ratio (OR) 1.78, 95% confidence interval (CI) 1.26-2.67], to want to stop smoking (OR 1.83, CI 1.15-2.9) or to intend to stop in the near future (OR 1.58, CI 1.03-2.43). CONCLUSION: Smokers who attend GPs' routine consultations and believe that they have smoking-related problems are more motivated to stop than others. This suggests that it is important for GPs to ascertain patients' views about the aetiology of their symptoms before discussing smoking with them.

Adult↗
PubMed2002

A new method for describing smokers' consulting behaviours which indicate their motivation to stop smoking: an exploration of validity and reliability.

BACKGROUND: Smokers vary in their readiness to try stopping smoking, but there currently are no objective tools for identifying smokers' consulting behaviours which indicate their level of motivation to try stopping smoking. OBJECTIVE: The aim of this study was to investigate the construct validity and inter-observer reliability of the Smokers' Motivation Code (SMC). METHODS: General practice consultations between 29 different Leicestershire GPs and their patients were video-recorded. In 47 consultations, regular or occasional smokers discussed smoking with their GPs and their consulting behaviour was coded using the SMC. The reliability of three different observers' codings was investigated. Construct validity was also investigated by comparing smokers' consulting behaviours coded using the SMC with measures of motivation to stop smoking recorded on pre-consultation questionnaires. RESULTS: Two pairs of observers achieved good reliability when using the SMC to code smokers' consulting behaviours during a subset of 11 video-recorded consultations. For readiness behaviours (indicating motivation to stop smoking), kappas were 0.82 and 0.65, and for resistance behaviours (indicating little motivation to stop smoking), kappas were 0.74 and 1.0. For the 37 consultations attended by regular smokers, complete pre-consultation questionnaires were obtained. Smokers displaying readiness behaviours were significantly more likely than others to report having tried to stop in the past year, thinking about or trying to stop and to agree that their health would improve if they stopped smoking. Smokers displaying resistant behaviours were significantly less likely to report thinking about stopping/trying to stop smoking. CONCLUSION: We have provided some evidence to support the construct validity and inter-observer reliability of the SMC and have identified some consulting behaviours which might indicate smokers' motivation to stop smoking. Further work is needed to determine whether smokers' consulting behaviour can be used to predict future quit attempts.

Adult↗
PubMed2002

Comparison of the smoking behaviour and attitudes of smokers who attribute respiratory symptoms to smoking with those who do not.

General practitioners' (GPs') advice against smoking helps smokers to stop; unfortunately, GPs cannot predict which patients will quit following advice. This postal questionnaire survey suggests that where smokers attribute their respiratory symptoms to smoking, they are eight times (95% confidence interval [CI] = 3.0-23.3) more likely to believe that their health will improve if they stop smoking and six times (95% CI = 1.4-23.3) more likely to intend to stop smoking.

Adult↗
PubMed2002

Factors associated with the provision of anti-smoking advice in general practice consultations.

Guidelines urge general practitioners (GPs) to discuss smoking with patients as frequently as possible. Using data collected before and after consultations, this study confirms that GPs are more likely to discuss smoking in the context of smoking-related problems. Encouraging GPs to make greater use of problem-orientated opportunities to discuss smoking may have more effect on rates of advice giving than urging them to advise all smokers.

Adult↗
PubMed2001

Enhancement of nuclear factor-kappa B acetylation by coactivator p300 and HIV-1 Tat proteins.

Nuclear factor (NF)-kappaB transcription factors are involved in the control of a large number of normal cellular and organismal processes, such as immune and inflammatory responses, developmental processes, cellular growth, and apoptosis. Transcription of the human immunodeficiency virus type 1 (HIV-1) genome depends on the intracellular environment where the integrate viral DNA is regulated by a complex interplay among viral regulatory proteins, such as Tat, and host cellular transcription factors, such as NF-kappaB, interacting with the viral long terminal repeat region. CBP (CREB-binding protein) and p300, containing an intrinsic histone acetyltransferase (HAT) activity, have emerged as coactivators for various DNA-binding transcription factors. Here, we show that the p50 subunit as well as the p50/p65 of NF-kappaB, and not other factors such as SP1, TFIIB, polymerase II, TFIIA, or p65, can be acetylated by CBP/p300 HAT domain. Acetylation of p50 was completely dependent on the presence of both HAT domain and Tat proteins, implying that Tat influences the transcription machinery by aiding CBP/p300 to acquire new partners and increase its functional repertoire. Three lysines, Lys-431, Lys-440, and Lys-441 in p50 were all acetylated in vitro, and a sequence similarity among p50, p53, Tat, and activin receptor type I on these particular lysines was observed. All proteins have been shown to be acetylated by the CBP/p300 HAT domain. Acetylated p50 increases its DNA binding properties, as evident by streptavidin/biotin pull-down assays when using labeled NF-kappaB oligonucleotides. Increased DNA binding on HIV-1 long terminal repeat coincided with increases in the rate of transcription. Therefore, we propose that acetylation of the DNA binding domain of NF-kappaB aids in nuclear translocation and enhanced transcription and also suggest that the substrate specificity of CBP/p300 can be altered by small peptide molecules, such as HIV-encoded Tat.

Acetylation↗