Publications

euthanasia in england: courts, committees and consistency.	part i of this paper considers three competing ethical approaches to the valuation of human life: "vitalism', 'inviolability', and 'worth'. part ii argues that, largely as a result of the case of airedale nhs trust v bland, english law relating to 'euthanasia' (the intentional shortening of a patient's life, by act or omission, as part of his/her medical care) is in a morally and intellectually inconsistent state, incorporating inviolability by prohibiting doctors from intentionally killing pati ...	1997	9573717
fluoride profiles in the cementum and root dentine of human permanent anterior teeth extracted from adult residents in a naturally fluoridated and a non-fluoridated area.	to determine the effect of water fluoride concentration on the fluoride profile across the entire thickness of the cementum and root dentine of human permanent anterior teeth in adults.	1997	9610297
informed consent and psychiatric research.	the general problem with research is that its purpose does not necessarily benefit an individual patient now. in psychiatry the specific problem is that psychiatric patients may have a reduced mental competence, because of their illness. thus the specific clinical problems of the research subjects may impede the ethical requirements of the research. to try to solve this conundrum, we may need to move away from a vision of psychiatric ethics which is rights and individual based, and find another, ...	1997	9616960
population genetics of the fraxe and fraxf gcc repeats, and a novel cgg repeat, in xq28.	most of the rare folate sensitive fragile sites cloned to date arise from expansion of a cgg:ccg trinucleotide repeat array. analysis of the cag repeat at the huntington disease (hd) locus showed a positively skewed repeat distribution leading to the proposal that microsatellites are subject to a mutational bias toward expansion. such a mutational bias predicts an increase in mean repeat size at all microsatellite loci. we present an analysis of repeats at two fragile site loci, fraxe and fraxf, ...	1997	9415475
who's being irresponsible?	this article analyzes the ban imposed on the funding of sterilization by the national health services (nhs). meaning, if a man wants a vasectomy or a woman decides on a laparoscope sterilization, then they have to pay the full cost. thus, those who cannot afford to pay will be deprived of this simple, civilized measure. either they will need more contraceptive care (which costs money), or they will have more children (which costs even more). on the other hand, the health authority has differ ...	1997	9926599
workforce planning. the human factor.		1997	10165734
impact of litigation on senior clinicians: implications for risk management.	to investigate the impact of litigation on consultants and senior registrars and to establish their views on methods of reducing adverse events and litigation.	1997	10166604
career profile. human resources. power to the people.		1997	10173479
towards a new health care paradigm. patient-focused care. the case of kingston hospital trust.	patient-focused care (pfc) and business process re-engineering (bpr) have been advocated in the academic literature as techniques to improve both quality of service and reduce costs. seeks to separate and delineate the components of pfc and bpr and, using the case study method, describe the adoption and implementation process of pfc in medicine and maternity by one london nhs trust hospital. reports the impact of this innovation on service delivery, staff reconfiguration and multi-skilling. iden ...	1997	10176830
hospital beds and how to survive them.		1997	10177035
behind the crumbling walls; the re-working of a former asylum's geography.	this paper attempts to examine the effects of deinstitutionalization on a former asylum's human and physical geography, through a case study of st lawrence's hospital, bodmin, uk. it researches the inevitably impermanent geography of an asylum in the process of being 'run down'. the paper includes an empirical account of the rationalization of a former asylum, reconstructing an east to west migration of activities across the site. it deals with st lawrence's as a 'stigmatized' place unable to es ...	1997	10671001
u v w (attorney general intervening).	court decision: 2 family law reports 282; 1997 february 19 (date of decision). the family division court dismissed the application by miss u. for child support of twins, who were conceived using donor sperm and in vitro fertilization, from mr. w. after an unsuccessful attempt with in vitro fertilization in england, miss u. and mr. w., british residents, had gone to italy for a second round of in vitro fertilization, this time using a laser implantation technique. because mr. w.'s sperm was disco ...	1997	16998997
information sharing in semen donation: the views of donors.	the authors report on a comparative questionnaire study of semen donors at two london clinics offering donor insemination (di). results presented here include donors' attitudes towards the storage of identifying information on the uk human fertilisation and embryology authority's central register, the importance of anonymity when donating, feelings about being traced by di offspring, and views on the release of identifying donor information to mature offspring. donors from the two clinics were f ...	1997	9032834
effectiveness of influenza vaccine in reducing hospital admissions during the 1989-90 epidemic.	the effectiveness of influenza vaccine in reducing hospital admissions for pneumonia, influenza, bronchitis, or emphysema was assessed by a case-control study of people aged 16 years and older who were admitted to 10 leicestershire hospitals between 1 december 1989 and 31 january 1990. hospital and general practitioners' records for 156 admissions (the cases) and 289 controls matched for age and sex were reviewed. information was collected on demography, the usual place of residence (institution ...	1997	9042032
suggestive evidence for linkage of schizophrenia to markers on chromosome 13 in caucasian but not oriental populations.	previously we reported suggestive evidence for linkage of schizophrenia to markers on chromosome 13q14.1-q32. we have now studied an additional independent sample of 44 pedigrees consisting of 34 taiwanese, 9 english and 1 welsh family in an attempt to replicate this finding. narrow and broad models based on research diagnostic criteria or the diagnostic and statistical manual of mental disorders, third edition, revised, were used to define the schizophrenia phenotype. under a dominant genetic m ...	1997	9050933
influenza update: influenza b virus now predominates in england and wales.		1997	9057339
hypertension management in general practice.	the views of 542 general practitioners (gps) and 64 consultant physicians about the management of patients with hypertension in general practice were sought by postal questionnaire. 325 (60%) of the gps and 45 (70%) of the consultant physicians completed the questionnaire. for a 40-year-old man with no other cardiovascular risk factors most general practitioners would intervene with drugs at blood pressure levels specified in published guidelines, whereas many local consultants and older gps wou ...	1997	9059374
is there an association between preconception paternal x-ray exposure and birth outcome? the alspac study team. avon longitudinal study of pregnancy and childhood.	diagnostic x-rays are performed commonly on men of reproductive age, yet little is known about the potential effects of these x-rays on the future unborn children of such men. this study examines the possibility that preconception diagnostic x-ray studies of fathers may adversely effect their newborns. the authors used prospectively collected data from the avon longitudinal study of pregnancy and childhood (alspac) for 7,678 birth records for women who gave birth in the county of avon, england, ...	1997	9063345
is htlv-1 status another antenatal screening test that we need?	human t-lymphocytic virus type 1 (htlv-1) carriage is associated with a 2% to 5% lifetime risk of developing a severe, if not fatal, disease. in our inner london antenatal population, we found that the carrier rate was 0.3%. the antenatal transmission rate is known to be very low, but if the infant is breastfed the transmission rate is up to 25%. it is therefore possible to interrupt the transmission cycle by advising against breastfeeding. the ethical and fiscal issues surrounding antenatal tes ...	1997	9070151
outbreaks of campylobacter infection: rare events for a common pathogen.	campylobacter has been the commonest enteric pathogen isolated from humans in england and wales since 1981, but few cases are linked to outbreaks. twenty-one general outbreaks of campylobacter infection in england and wales were reported to the phls communicable disease surveillance centre from 1992 to 1994. seven hundred and six people were affected, nine cases were admitted to hospital, and no deaths were reported. the mean attack rate was 46.2% (sd 25.7%) and the mean duration of illness was ...	1997	9080726
outbreak of campylobacter enteritis in a residential school associated with bird pecked bottle tops.	an outbreak of gastroenteritis caused by campylobacter infection was identified in may 1995 in a residential school in gloucestershire for children with special needs. eight primary and four secondary cases were identified, mostly confined to one house in the school; faecal specimens from three cases grew campylobacter jejuni. a retrospective cohort study showed that drinking pasteurised milk from bottles with damaged tops was associated with illness in primary cases (p = 0.01). bird pecking of ...	1997	9080727
analysis of the apo e/apo c-i, angiotensin converting enzyme and methylenetetrahydrofolate reductase genes as candidates affecting human longevity.	genetic factors are likely to affect human survival, since twin studies have shown greater concordance for age of death in monozygotic compared to dizygotic twins. coronary artery disease is an important contributor to premature mortality in the uk. accordingly, we have chosen genes associated with cardiovascular risk, apo e/apo c-i, angiotensin converting enzyme (ace) and methylenetetrahydrofolate reductase (mthfr), as candidates which may affect longevity/survival into old age. an association ...	1997	9105559
are rates of ageing determined in utero?	epidemiological studies have shown that poor early growth is associated with cardiovascular and other degenerative diseases. this has been explained by programming, whereby undernutrition and other influences which restrict early growth permanently change the structure and physiology of the body. the long-term effects of poor early nutrition on ageing have been demonstrated in animals but not studied in man.	1998	12675097
small town development and urban illiteracy: comparative evidence from leicestershire marriage registers 1754-1890.	"based on the analysis of anglican marriage registers for the period 1754 to 1890, the article explores patterns of illiteracy in three small leicestershire [england] towns with contrasting economic functions. illiteracy levels were closely related to urban occupational and social structures, which also affected distinct gender differentials. evidence [of] the effect of literacy on age at marriage and marriage distance suggests that demographic behaviour and spatial interaction were determined m ...	1998	12178166
pulsed-field electrophoretic fingerprinting of salmonella indiana and its epidemiological applicability.	eight xba i-generated pulsed-field profile (pfp) types and four subtypes within one of the most common pfp types have been identified in salmonella indiana from patients, poultry and human food in england and wales in the three-year period from january 1994 to december 1996. two pfp types have predominated, pfp x1 and pfp x2. although the pfp x1 type was identified throughout the study period, the pfp x2 type was not identified until late 1995, subsequently becoming the most common pfp type in h ...	1998	15244064
clusters of pneumocystis carinii pneumonia: analysis of person-to-person transmission by genotyping.	genotyping at the internal transcribed spacer (its) regions of the nuclear rrna operon was performed on isolates of p. carinii sp. f. hominis from three clusters of p. carinii pneumonia among eight patients with haematological malignancies and six with hiv infection. nine different its sequence types of p. carinii sp. f. hominis were identified in the samples from the patients with haematological malignancies, suggesting that this cluster of cases of p. carinii pneumonia was unlikely to have res ...	1998	10024946
low rates of ehrlichiosis and lyme borreliosis in english farmworkers.	to determine the occupational significance of tick-borne zoonoses we sought serological evidence of lyme borreliosis, human monocytic ehrlichiosis (hme) and human granulocytic ehrlichiosis (hge) in a representative sample of farmworkers. although around 20% reported ticks on their domestic and companion animals, few (< 2% per year) reported being bitten by ticks. seroprevalence of lyme borreliosis (0.2%), hme (0.2%) and hge (1.5%) was low. those seropositive for hge were no more likely to report ...	1998	10030710
a cytotoxic t lymphocyte antigen-4 (ctla-4) gene polymorphism is associated with autoimmune addison's disease in english patients.	recent studies have demonstrated an association between a microsatellite polymorphism of the ctla-4 gene, specifically a 106 base pair allele, and both graves' disease and autoimmune hypothyroidism. the aim of the present study was to determine whether the same polymorphism of the ctla-4 gene was associated with autoimmune addison's disease.	1998	10197076
manufacturing a human drama from a psychiatric crisis: crisis intervention, family therapy and the work of r. d. scott.	there has been a recent resurgence of interest in crisis intervention within psychiatry. the idea of crisis services is not, of course, a new thing, and there is a great deal to be learnt from returning to the innovative writings of those practitioners who developed similar services in the 1960s and 1970s. this article discusses the work of the psychiatrist and family therapist r. d. scott, who developed a 24-hour family-orientated crisis intervention service in london during this era. although ...	1998	10067486
epidemiological study of guillain-barré syndrome in south east england.	to determine the incidence, treatment, and outcome of guillain-barré syndrome in south east england.	1998	9436731
lack of association of a taq 1 polymorphism of the human myelin oligodendrocyte glycoprotein gene with multiple sclerosis in a population of patients from the southampton area.		1998	9436746
[ronald ross: a century of the transfer of malaria by mosquitoes].	ronald ross is a brilliant and polyvalent mind. when orientated towards medicine he took the training amateurishly and ended up with a limited qualification. after 2 years as a ship doctor, he attended the compulsory complementary training in order to be admissible in the ims, the garrison life left him with plenty of time to engage in his hobby's: painting for a short while, writing, poetry and mathematics. by the end of his first term he questioned the sense of his medical activities and decid ...	1998	9989333
population dynamic interference among childhood diseases.	epidemiologists usually study the interaction between a host population and one parasitic infection. however, different parasite species effectively compete, in an ecological sense, for the same finite group of susceptible hosts, so there may be an indirect effect on the population dynamics of one disease due to epidemics of another. in human populations, recovery from any serious infection is normally preceded by a period of convalescence, during which infected individuals stay at home and are ...	1998	9842732
molecular characterisation of cryptosporidium parvum from two large suspected waterborne outbreaks. outbreak control team south and west devon 1995, incident management team and further epidemiological and microbiological studies subgroup north thames 1997.	polymerase chain reaction/restriction fragment length polymorphism (pcr/rflp) analysis of the cryptosporidium parvum outer wall protein (cowp) gene was applied to specimens collected from 95 patients with cryptosporidiosis associated with two suspected waterborne outbreaks, 46 sporadic human cases and 62 infected livestock from other areas, and 12 patients infected with other gastrointestinal parasites. ninety-six per cent of c. parvum isolates from patients linked to the two suspected waterborn ...	1998	9854879
influenza surveillance in england and wales: october 1997 to june 1998.	influenza caused low levels of mortality and morbidity in england and wales in the 1997/98 season. influenza viruses of the h3n2 and h1n1 subtypes were isolated in small numbers from community and hospital patients in november and december. their numbers subsequently increased to peak in february, h1n1 a week or two before h3n2. most of the h1n1 isolates were similar to the a/bayern/7/95-like virus, included in the vaccine recommended for 1997-98, whereas most h3n2 isolates were a/sydney/5/97-li ...	1998	9854882
larks and owls and health, wealth, and wisdom.	to test the validity of benjamin franklin's maxim "early to bed and early to rise makes a man healthy, wealthy, and wise."	1998	9857121
non-consensual sterilization of the adult with learning disabilities.	community nurses may be asked for advice on sterilization operations for adults with learning disabilities by worried parents/carers. this article sets out the legal position advocated by the english courts. sterilization for adults with learning disabilities is generally non-consensual. the courts cannot consent on behalf of the adult but can rule on the lawfulness of the operation. cases need not be brought before the court when the operation is to be carried out to treat a specific menstrual ...	1998	9866467
florence nightingale and the enduring legacy of transpersonal human caring.		1998	9867500
recollections of professor henry barcroft, f.r.s.	professor henry barcroft, md, frs, emeritus professor of physiology in st. thomas' hospital medical school in london died on 11 january 1998, aged 93. he was born in cambridge on 18 october 1904 where his father, joseph barcroft, a famous physiologist, worked with foster and langley and subsequently was appointed to the chair of physiology. henry barcroft followed in his father's footsteps. during his career as professor of physiology firstly at the queen's university of belfast and subsequently ...	1998	9869549
a population study of chromosome 22q11 deletions in infancy.	to determine the prevalence of submicroscopic deletions within chromosome band 22q11 in infants with significant heart disease and compare this with the prevalence of other chromosomal abnormalities causing significant heart disease. to determine a minimum prevalence of deletions within chromosome band 22q11 in infants in the general population.	1998	9875047
general paralysis of the insane and aids in old age psychiatry: epidemiology, clinical diagnosis, serology and ethics--the way forward.	while the incidence of general paralysis of the insane (gpi) has declined, aids (acquired immune deficiency syndrome) has emerged as a new illness. today, in england and wales, as many elderly people die from aids as from neurosyphilis, although both diagnoses are rare in this age group. both are serious medical conditions with psychiatric manifestations. for both, serological tests may identify the disease, and treatment may be of benefit, but there is considerable social stigma attached to the ...	1998	9884913
mycobacterium kansasii and human immunodeficiency virus co-infection in london.	although mycobacterium kansasii infection has long been endemic in the u.k., the disease burden and characteristics of infection in the hiv-seropositive population has not been well documented. this study addresses these issues in an inner city population that comprises a quarter of all cases of acquired immunodeficiency syndrome (aids) reported in the u.k.	1998	9892529
phenotype of a british north carolina macular dystrophy family linked to chromosome 6q.	to document the phenotype of an autosomal dominant macular dystrophy diagnosed as having north carolina macular dystrophy (ncmd) in this british family, and to verify that the disease locus corresponds with that of mcdr1 on chromosome 6q.	1998	9924305
crystalline silica and risk of lung cancer in the potteries.	to evaluate crystalline silica as a human carcinogen.	1998	9924456
incidence, risk and prognosis of acute and chronic fatigue syndromes and psychiatric disorders after glandular fever.	the role of viruses in the aetiology of both chronic fatigue syndrome (cfs) and depressive illness is uncertain.	1998	9926075
lionel sharples penrose (1898-1972): aspects of the man and his works, with particular reference to his undertakings in the fields of intellectual disability and mental disorder.	the penrose club, named after professor l. s. penrose, is a society of academic psychiatrists in the uk with a particular focus on research in the sphere of intellectual disability. the inaugural lecture of the club was delivered at the institute of psychiatry, london, on 29 november 1996. it is distinctly fitting that this lecture should appear in print in the journal of intellectual disability research in the centenary year of professor penrose's birth, both because of his major pioneering con ...	1998	9617693
allograft bone transplantation: a sheffield experience.	there has been an increase in demand for allograft bone in recent years. this type of bone provides an excellent material to fill in bony defects, but could be associated with an incidence of infection. any newly established tissue bank has to meet the very stringent criteria to process and store bone and maintain a donor and recipient database to avoid transmission of infection. the sheffield tissue bank has been functioning since 1989 and until 1993 has provided bone allografts to 220 patients ...	1998	9623384
lung cancer mortality in nickel/chromium platers, 1946-95.	to investigate mortality from lung cancer in nickel/chromium platers.	1998	9624277
detectable levels of serum aflatoxin b1-albumin adducts in the united kingdom population: implications for aflatoxin-b1 exposure in the united kingdom.	this study aimed to estimate aflatoxin b1 (afb1) exposure in the united kingdom population by measuring levels of serum afb1-albumin (alb), using immunoassay and high-performance liquid chromatography (hplc) with fluorescence detection. a self-questionnaire on dietary habits from 104 volunteers (47 men and 57 women) in york was completed, and blood samples were collected. serum alb was extracted, and afb1-lysine (lys), the digest product of afb1-alb, was isolated and measured. a sensitive elisa ...	1998	9610795
the middle pleistocene human tibia from boxgrove.	the boxgrove tibia was discovered in 1993, associated with middle pleistocene fauna, and lower palaeolithic archaeology. the sediments at boxgrove were deposited during a temperate interglacial episode and ensuing cold stage. they thus represent a wide range of modes and environments of deposition. archaeological remains have been excavated from all the major stratigraphic units, giving a continuity of occupation for this part of southern england over a 10(4) year timescale, through markedly cha ...	1998	9614636
the impact of influenza and influenza-like illness on productivity and healthcare resource utilization in a working population.	four hundred and eleven subjects who either reported to occupational health at onset of influenza or influenza-like illness (i/ili) symptoms or on return to work completed questionnaires on entry to the study and after 28 days. on average they were incapacitated or confined to bed for 2.4 days, missing 2.8 days from work per episode of illness. on return to work, they reported reduced effectiveness and inability to resume normal activity until a mean 3.5 days after the onset of symptoms. each pa ...	1998	9614766
the changing moral landscape of human reproduction: two moments in the history of in vitro fertilization.	ethical attitudes toward in vitro fertilization (ivf) have varied historically. this paper discusses the changes in views about the morality of human ivf by exploring the response to a pair of critical moments in the history of this reproductive technology: the announcement of the first successful ivf experiment by john rock and miriam menkin in 1944 and the first successful ivf live birth of louise brown in 1978. by exploring public and private reactions to these two events in the context of wi ...	1998	9615566
national outbreak of salmonella senftenberg associated with infant food.	eight cases of salmonella senftenberg infection in infants were identified in the first half of 1995 in england, five were indistinguishable s. senftenberg strains. a case-control study showed an association between illness and consumption of one brand of baby cereal (p = 0.03). the cereal manufacturer reported isolating s. senftenberg in june 1994 from an undistributed cereal batch. outbreak strains and the cereal strain were all plasmid-free in contrast to other human isolates of s. senftenber ...	1998	9593480
review of counselling in a transfusion service: the london (uk) experience.	donor (and recipient) counselling within the transfusion service in the uk has grown in volume and complexity over the last 10 years. the addition of new tests for donated blood and the growth of bone marrow transplantation have increased the demands on counselling staff. new initiatives, such as the hcv look-back programme, have required an extension of the skills and knowledge of staff involved in counselling.	1998	9595639
an outbreak of influenza in four nursing homes in sheffield.		1998	9599917
human violence: a treatable epidemic.	domestic violence is common, afflicting at least one in 15 of the population. the victims are usually women and children and the perpetrators often the traditional male head of the family. it commonly leads to a form of post-traumatic stress disorder manifested as psychiatric illness in women and violent crime in men. it is proposed that a major underlying factor is a failure of attachment in infancy. this form of violence can be prevented by better health care before and after birth, particular ...	1998	9532959
increasing incidence of antibiotic resistance in shigellas from humans in england and wales: recommendations for therapy.	since 1983 the incidence of resistance to ampicillin in shigella dysenteriae, sh. flexneri, and sh. boydii infections in england and wales has increased from 42% to 65% and the incidence of resistance to trimethoprim, from 6% to 64%. furthermore, of 1524 strains received in 1995-1996, 46% were resistant to both of these antimicrobials. for sh. sonnei almost 50% of isolates were resistant to ampicillin or trimethoprim and 15% were resistant to both of these antimicrobials. these results demonstra ...	1998	9533726
influenza activity in england and wales remains low.		1998	9549169
postmodernity and a hypertensive patient: rescuing value from nihilism.	much of postmodern philosophy questions the assumptions of modernity, that period in the history of the western world since the enlightment. these assumptions are that truth is discoverable through human reason; that certain knowledge is possible; and furthermore, that such knowledge will provide a basis for the ineluctable progress of mankind. the enlightenment project is underwritten by the conviction that knowledge gained through the scientific method is secure. in so far as biomedicine inher ...	1998	9549679
localization of a gene (cord7) for a dominant cone-rod dystrophy to chromosome 6q.		1998	9634506
hugh alistair reid obe md: investigation and treatment of snake bite.	alistair reid was an outstanding clinician, epidemiologist and scientist. at the penang general hospital, malaya, his careful observation of sea snake poisoning revealed that sea snake venoms were myotoxic in man leading to generalized rhabdomyolysis, and were not neurotoxic as observed in animals. in 1961, reid founded and became the first honorary director of the penang institute of snake and venom research. effective treatment of sea snake poisoning required specific antivenom which was produ ...	1998	9637363
'you don't want to lose your ovaries because you think 'i might become a man". women's perceptions of prophylactic surgery as a cancer risk management option.	this preliminary study provides insight into the meaning of prophylactic surgery as a risk management strategy for women who have a familial risk of breast or ovarian cancer. data were collected during observations of genetic consultations and in semi-structured interviews with 41 women following their attendance at genetic counselling. the option of prophylactic surgery was raised in 29 consultations and discussed in 35 of the post-clinic interviews. fifteen women said they would consider havin ...	1998	9638787
progress in the development of helicobacter pylori strain typing methods.	helicobacter pylori is very different from other gram negative bacteria that inhabit the human gastroduodenal tract. its success in adapting to colonise and persist in the stomach is reflected in key features such as unique chemical structure and architecture of lipopolysaccharide, sheathed flagella, genomic diversity, and potent urease activity. strain diversity within the species is well established and so the challenge is to exploit variations in these features for developing relevant epidemi ...	1998	9644129
an outbreak of multi-drug-resistant tuberculosis in a london teaching hospital.	we describe the epidemiology and control of a hospital outbreak of multi-drug-resistant tuberculosis (mdr-tb). a human immunodeficiency virus (hiv)-negative patient with drug-sensitive tuberculosis developed mdr-tb during a period of unsupervised therapy. she was admitted to an isolation room in a ward with hiv-positive patients, but the room, unbeknown to hospital staff, was at positive-pressure relative to the main ward. seven hiv-positive contacts developed mdr-tb. the diagnosis in the second ...	1998	9651855
transfer across the human gut of environmental plutonium, americium, cobalt, caesium and technetium: studies with cockles (cerastoderma edule) from the irish sea.	our previous studies have indicated lower values of the gut transfer factor ('f1 values') for plutonium and americium in winkles (littorina littorea) than adopted by icrp. the present study was undertaken primarily to investigate whether this observation extends to other species. samples of cockles (carastoderma edule) from ravenglass, cumbria were eaten by volunteers who provided 24 h samples of urine and faeces. urine samples indicated f1 values for cockles which were higher than for winkles; ...	1998	9656190
discharges of krypton from sellafield, 1951-1997, and the resultant doses to members of the public.	the radionulide 85kr, which has a half-life of 10.72 years, is produced, almost exclusively, by reprocessing operations during which the fission product is released from irradiated nuclear fuel by chemical dissolution. reprocessing plants at sellafield, in cumbria, have released the noble gas to atmosphere since operations commenced in 1952. historically, krypton discharges were classified for security reasons, although these have been monitored and published by bnfl for each year since 1977. th ...	1998	9656191
[the man behind paget's syndrome. he gave name to diseases of the skeleton, breast and vulva].		1998	9656637
the maastricht strain and england strain of rat cytomegalovirus represent different betaherpesvirus species rather than strains.	the major immediate early (mie) locus of the maastricht strain of rat cytomegalovirus (rcmv) was found to comprise five exons of which the first is noncoding. the first three exons are spliced to either exon 4, generating ie1, or exon 5, generating ie2. an additional splicing event unique to rcmv (maastricht) was identified in exon 5, resulting in a 466-bp deletion. ie1 transcripts were detected exclusively during the ie phase of infection in vitro, whereas ie2 transcripts were detected during b ...	1998	9657952
effect of paternal alcohol consumption before conception on infant birth weight. alspac study team. avon longitudinal study of pregnancy and childhood.	previous studies of paternal drinking and fetal growth in both animals and human have produced conflicting results. we evaluated the association between paternal drinking before conception and infant birth weight in a cohort of 9,845 liveborn singleton infant born to couples who participated in the avon longitudinal study of pregnancy and childhood (alspac), alspac is a population-based cohort study in which women and their partners completed several self-administered questionnaires over the cou ...	1998	9664637
overtaking road-accidents: differences in manoeuvre as a function of driver age.	nine-hundred and seventy-three police road-accident files describing overtaking accidents were sampled from the headquarters of nottinghamshire constabulary, england, for the years 1989-1993. salient facts were extracted from each case, including the exact manoeuvre involved, the principle explanatory factors, the driver(s) most at fault, and the drivers' ages. two kinds of reliability measure for case interpretations. indicated high levels of consistency. two induced exposure measures were used ...	1998	9666242
causes of mortality and non-fatal conditions among grey seals (halichoerus grypus) found dead on the coasts of england, wales and the isle of man.	a survey of the diseases detectable in 141 grey seals stranded on the coasts of england and wales away from breeding colonies was carried out between mid-1989 and early 1997. the most common fatal conditions in pups less than three weeks of age were trauma (24 per cent of deaths) and dystocia (12 per cent); in pups more than three weeks of age thy were starvation (22 per cent) and pneumonia (22 per cent); in juveniles they were drowning in fishing gear (30 per cent) and starvation (19 per cent), ...	1998	9682418
the epidemiology of cryptosporidiosis: application of experimental sub-typing and antibody detection systems to the investigation of water-borne outbreaks.	a technique based on the analysis of banding patterns obtained by sds-page western-blotting of an oocyst wall antigen obtained from faeces has been evaluated to subtype cryptosporidium parvum tyzzer, 1912. this technique appears to have sufficient stability to recognise multiple types of this parasite. a similar western-blotting technique has also been used to assess antibody responses to cryptosporidial antigens in human sera. two systems were developed: one against three antigens of apparent m ...	1998	9684318
the role of the general practitioner in the community care of people with hiv infection and aids: a comparative study of high- and low-prevalence areas in england.	policy for the care of people suffering from hiv and aids has changed over the past decade. schemes for shared primary and secondary care have been met with varying success, and patients may be reluctant to become involved. no systematic evaluation comparing the views of primary care providers and users in areas of varying hiv prevalence has been published.	1998	9692281
inherited retinal telangiectasia with glial proliferation.	we describe five patients from a family of pakistani origin with inherited retinal telangiectasia and glial proliferation. characteristics of this condition include: variable visual loss; peripapillary retinal telangiectasia with vascular incompetence on fluorescein angiography; glial proliferation; cystoid macular edema or altered macular pigment; retinal hemorrhage; and abnormal electroretinopathy. we discuss the similarities with and distinguishing features from other documented conditions an ...	1998	9713794
an outbreak of salmonella enteritidis phage type 19 infection associated with cockles.	an outbreak of infection with salmonella enteritidis was detected because some of the cases lived near each other. swift investigation identified cockles as the vehicle of infection. the cockles had been gathered and cooked by a member of the public. phage typing of the s. enteritidis revealed phage type 19, which is rarely seen in the united kingdom. the outbreak illustrates the need for care in handling and preparation of shellfish for human consumption. catering establishments should be wary ...	1998	9718836
a five year survey of inoculation injuries in exeter.	a new policy was introduced in exeter as part of the process of improving the management of inoculation injuries. completion of detailed questionnaires by injured health care workers has enabled us to monitor their occurrence. this has helped in the management of individual incidents, provided valuable data for staff education, prevented injuries, and identified deficiencies in compliance with procedures.	1998	9718846
gps, schoolgirls and sex. a cross cultural background comparison of general practitioner attitudes towards contraceptive service provision for young adolescent females in scotland.	no previous studies have examined the influences of cultural background on the provision of contraceptive services to females under 16 years of age. a research project was undertaken to investigate any differences between general practitioners trained in the united kingdom and those trained in the indian sub-continent in relation to contraceptive service provision to females under 16 years of age. a self-completion postal questionnaire survey was distributed to 230 unrestricted principal general ...	1998	9719710
cattle tb crisis? human implications.		1998	9734978
the use of specialist palliative care services by patients with human immunodeficiency virus-related illness in the yorkshire deanery of the northern and yorkshire region.	to examine the use of palliative care services by patients affected by human immunodeficiency virus (hiv) in hospices which do not specialize in the care of hiv patients, a tape-recorded, semistructured interview was carried out in 12 hospices in the uk. the interview explored concerns about such provision, as well as actual issues encountered. the study revealed that all 12 hospices accepted referrals for people affected by hiv and had clear working practices on infection control. between 1990 ...	1998	9743834
the value of screening for down's syndrome in a socioeconomically deprived area with a high ethnic population.	to assess the utility of biochemical antenatal screening for down's syndrome in a socioeconomically deprived area with a high proportion of asian women from the indian subcontinent.	1998	9746377
the natural history of fetomaternal alloimmunization to the platelet-specific antigen hpa-1a (pla1, zwa) as determined by antenatal screening.	immunization against the human platelet antigen (hpa)-1 alloantigen is the most common cause of severe fetal and neonatal thrombocytopenia. fetal therapy has substantial risks and its indications need better definition. of 24,417 consecutive pregnant women, 618 (2.5%) were hpa-1a negative of whom 385 entered an observational study. all were hla-drb3*0101 genotyped and screened for anti-hpa-1a. their partners and neonates were hpa-1 genotyped and the latter were assessed by cord blood platelet co ...	1998	9746765
hobson's choice: reproductive choices for women with learning disabilities.	this paper examines the present law in england and wales concerning the sterilisation of women who are unable to give valid consent to medical treatment. in particular, it considers why sterilisation is frequently presented as the only meaningful reproductive choice that can be made by or on behalf of women with learning disabilities. in addition, the paper assesses the extent to which the best interests test, as formulated by the english courts, has been successful in the promotion of dignity a ...	1998	9757730
binomial cokriging for estimating and mapping the risk of childhood cancer.	the incidences of human diseases vary from place to place, and this is also likely to be so for the risk of people developing many of them. we have analysed the spatial distribution of childhood cancer in the west midland health authority region of england from 1980 to 1984. this is a rare disease which is considered to be noncontagious. the observed frequencies of the disease in the electoral wards have been converted to proportions that estimate the risk of a child's developing it. the spatial ...	1998	9773520
enzyme-linked immunosorbent assay based on recombinant human group c rotavirus inner capsid protein (vp6) to detect human group c rotaviruses in fecal samples.	a recent study showed that 43% of a population in the united kingdom were seropositive for group c rotavirus. the higher than expected incidence may be due to limited diagnosis of acute human group c rotavirus infections because no routine test is available. human group c rotavirus infections are routinely diagnosed by electron microscopy (em) and a negative group a rotavirus enzyme-linked immunosorbent assay (elisa) result. an antigen-detection elisa was developed with hyperimmune antibodies ra ...	1998	9774561
human enteric pathogens identified in a london teaching hospital and a rural public health laboratory: 1994.	two microbiology laboratories, one serving an inner city hospital and one a rural public health laboratory, collected data on the outcome of examining faecal specimens in 1994. overall, 6.7% of the investigations were positive, but the rates were lower for hospital inpatients, for recently described pathogens, and in the absence of relevant clinical details; rates were higher for patients with a history of foreign travel. no benefit was gained by examining more than two specimens from any patien ...	1998	9782627
the cost-effectiveness of radon mitigation in schools in northamptonshire.	a comprehensive radon survey of 2372 rooms in 348 northamptonshire schools is reported, together with results of the successful mitigation of the raised radon levels found in 20 schools. from analysis of the occupancy of affected rooms and the costs of remediation a total cost of 19,400 pounds per man-sievert saved annually was derived. this is around four times more cost-effective than the radon remediation in health service premises in northamptonshire, and slightly more cost-effective than a ...	1998	9791811
the use of patients in health care education: the need for ethical justification.	this paper addresses ethical concerns emanating from the practice of using patients for health care education. it shows how some of the ways that patients are used in educational strategies to bridge theory-practice gaps can cause harm to patients and patient-practitioner relationships, thus failing to meet acceptable standards of professional practice. this will continue unless there is increased awareness of the need for protection of human rights in teaching situations. unnecessary exposure o ...	1998	9800586
mental incapacity: some proposals for legislative reform.	while the decision of the house of lords in re f in [1990] clarified somewhat the law concerning the treatment of the mentally incapacitated adult, many uncertainties remained. this paper explores proposals discussed in a recent government green paper for reform of the law in an area involving many difficult ethical dilemmas.	1998	9800588
otitis media in children with vertically-acquired hiv infection: the great ormond street hospital experience.	human immunodeficiency virus (hiv) infection continues to be a vexing problem in the pediatric population. otitis media, a common entity in immunocompetent as well as immunocompromised children, is prevalent in pediatric patients with hiv infection. recurrent infections and complications secondary to otitis media are also common in this population. the purpose of this review was to evaluate the records of a large group of children with hiv infection undergoing treatment for otitis media at a ter ...	1998	9804022
hepatitis g virus infection in drug users in liverpool.	to establish the prevalence of hepatitis g (hgv) in drug users in liverpool; to explore the risk factors for, and the effects of, hgv infection.	1998	9821088
serum eosinophil cationic protein: distribution and reproducibility in a randomly selected sample of men living in rural norfolk, uk.	it has been proposed that serum levels of eosinophil cationic protein (ecp) may be a clinically useful measure in allergic illness. the aim of this report is to describe the distribution and reproducibility of serum ecp levels in a population sample and to examine its relationship with other markers of disease.	1998	9824406
g209a mutation in the alpha-synuclein gene is rare and not associated with sporadic parkinson's disease.		1998	9827625
feasibility of named antenatal hiv screening in an inner city population.	the object of this study was to assess the resource use, feasibility, uptake and consumers' perspective of introducing routine named human immunodeficiency virus (hiv) testing into an inner city hospital antenatal clinic (st thomas hospital, part of guy's and st thomas hospital trust). following the introduction of a new service offering routine named hiv testing at booking appointments, the length of the appointments were recorded over a three-month period and compared with appointment lengths ...	1998	9828970
unwanted sexual experiences reported by nursing students: implications for nurse education and training.	this study examined the nature and frequency of unwanted sexual experiences in childhood and adulthood reported by nursing students, using a questionnaire developed from the sexual events questionnaire (calam & slade). the questionnaire was distributed to 109 second-year nursing students (90 female and 19 male) for anonymous completion. at the same time a further short questionnaire asked students about their perceptions of the first questionnaire, and how far their course had, up to the present ...	1998	9840889
identification of a large deletion, spanning exons 4 to 11 of the human factor xiiia gene, in a factor xiii-deficient family.	inherited deficiency of factor xiiia subunit (fxiiia) is an autosomal recessive disorder that is characterized by a life-long bleeding tendency and complications in wound healing. molecular genetic studies have shown the deficiency can be due to small sequence changes within the fxiiia gene, such as point mutations or microdeletions. on molecular analysis of the fxiiia gene in an fxiii-deficient patient, of united kingdom origin, we identified a putative homozygous missense mutation, arg408gln. ...	1998	9414279
childhood energy intake and adult mortality from cancer: the boyd orr cohort study.	to examine the relation between energy intake in childhood and adult mortality from cancer.	1998	9501710
immediate and long term outcome of human parvovirus b19 infection in pregnancy.	to estimate more precisely the risk of fetal loss and congenital abnormalities after maternal parvovirus b19 infection, and to assess the long term outcome for surviving infants.	1998	9501782
the incidence of aids-defining illnesses in 4883 patients with human immunodeficiency virus infection. royal free/chelsea and westminster hospitals collaborative group.	acquired immunodeficiency syndrome (aids)-defining illnesses are known to occur at different levels of immunosuppression, and the incidence of diagnoses may also vary according to the cd4 lymphocyte count strata. information about the incidence of disease at different levels of immunosuppression would help clinicians monitoring patients and would allow prophylaxis to be targeted at the most appropriate population.	1998	9508227
distribution of borrelia burgdorferi s.l. spirochaete dna in british ticks (argasidae and ixodidae) since the 19th century, assessed by pcr.	the distribution of borrelia burgdorferi sensu lato, the lyme borreliosis agent, was surveyed in british ticks in the collection of the natural history museum, london. alcohol-preserved specimens of eight species of ticks known to attack humans were studied: ixodes ricinus, i. hexagonus, i. uriae, i. trianguliceps, dermacentor reticulatus, haemaphysalis punctata, rhipicephalus sanguineus and argas vespertilionis. the sample comprised all life stages and originated from a wide range of host speci ...	1998	9513944
a qualitative and quantitative survey of forensic odontologists in england and wales, 1994.	forty forensic odontologists in england and wales, as listed for the british association for forensic odontology in spring 1994, were surveyed by post. the 27 responses received, representing 67.5 per cent of those surveyed, were collated. the aims of the survey were to establish the distribution of experience between those forensic odontologists; to confirm the geographic areas covered by them; to establish the most likely source of introduction to forensic work; to ascertain the proportion of ...	1998	9481076