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W Fergusson

Publications and source records attributed to W Fergusson.

24 records · Page 2Linked to original sources
PubMed1996

Differential influences on asthma self-management knowledge and self-management behavior in acute severe asthma.

AIM: While asthma education increases knowledge, it is less clear whether education influences actual patient behavior. To determine whether there are differences between asthma self-management knowledge and the actual behavior of patients during an acute severe asthma attack and to determine which clinical and psychosocial factors are associated with knowledge and behavior. METHODS: Validated hypothetical scenarios describing the development of life-threatening asthma and patients' reported actual behavior were scored (out of 25) using a system based on Thoracic Society of Australia and New Zealand and British Thoracic Society criteria. RESULTS: In 137 patients admitted to the hospital with severe asthma, the pattern of the index attack was slow onset (> or = 6 h) in 96%. The score for the hypothetical attack (knowledge) was 13.8 +/- 4.6, while that for the timeline (behavior) was 10.2 +/- 3.9 (p < 0.001) with 56% and 84%, respectively, having a score of less than 15 (regarded as inadequate). Certain components showed marked discrepancy (eg, appropriately seeking medical help 82% vs 52% (p < 0.001) and calling ambulance 61% vs 23% (p < 0.001). Factors such as physician-patient relationship, previous asthma morbidity, availability of peak flowmeter, action plan, and oral steroids correlated positively with both measures. Knowledge was negatively associated with being non-European, with anxiety, pessimism, and stigmatization. Behavior (but not knowledge) was negatively associated with lack of knowledge of what to do in the index attack, previous emotional counseling, and business failure. Those factors associated with the difference between knowledge and behavior scores (knowledge-behavior gap) were being non-European, anxiety, pessimism, and stigmatization, concerns about medical costs, and the only income for the household being a Social Security benefit. CONCLUSION: There are marked differences between patients' self-management knowledge and their actual behavior, particularly in terms of potentially life-saving actions. Psychological, health-care, and socioeconomic factors have a powerful and differential influence on knowledge and behavior. Improved understanding of the discrepancies between knowledge and behavior and which factors influence them may lead to more effective asthma educational interventions.

Acute Disease↗
PubMed1983

An HLA-DR negative acute leukaemia which stimulates MLC and CMC responses.

We describe an acute myelomonocytic leukaemia (E72) devoid of cell-surface HLA-DR antigens, but capable of inducing cellular responses. Leukaemia E72 induced proliferation of normal lymphocytes in primary mixed lymphocyte culture (MLC), which was only weakly inhibited by anti-DR sera. Depletion of a small percentage (congruent to 4%) of DR+ cells on a cell-sorter failed to abrogate the capacity of E72 to stimulate MLC and cell-mediated cytotoxicity (CMC) responses. We found that normal lymphocytes primed with E72 responded in secondary MLC to lymphocytes and leukaemias, suggesting that the lymphocyte-activating determinant (LAD) on E72 is not leukaemia-specific. In addition, E72 induced CMC responses to both leukaemias and lymphocytes. We suggest that E72 may express a novel HLA or non-HLA LAD.

Aged↗
PubMedDate not supplied

Normal adult values, diurnal variation, and repeatability of nasal nitric oxide measurement.

Reports of elevated nasal nitric oxide (NO) levels in allergic rhinitis suggest that nasal NO levels could be a valuable marker of upper airway inflammation, provided that the reproducibility of nasal NO measurement is acceptable. The aims of this study were to evaluate the precision with which nasal NO levels can be measured at single point in time, and to quantify within-day and between-day variation. Nasal NO was measured using a modified chemiluminescence analyzer. Population data were normally distributed, as judged by testing for skewness and kurtosis. NO levels were not related to age or gender, and there was no evidence of diurnal variation. Sampling rates of 250 mL/minute and 500 mL/minute at a single point in time had acceptable reproducibility (coefficients of variation 10.2% and 6.6%, respectively). However, within-day variation (coefficient of variation 13.4%) and between-day variation (coefficient of variation 11.8%), at a sampling rate of 500 L/minute, were substantially higher. These findings highlight the importance of taking measurement variation into account, in the interpretation of NO levels, in clinical research and, potentially, in routine practice. In individual patients, an alteration of 20-25% in NO levels is required, to ensure that change is genuine and not ascribable to the noise of measurement.

Adolescent↗