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increased rates of preterm delivery are associated with the initiation of highly active antiretrovial therapy during pregnancy: a single-center cohort study.it remains controversial whether in human immunodeficiency virus (hiv)-positive pregnant women an increased rate of preterm delivery is associated with highly active antiretroviral therapy (haart). since 1995 the management and outcome of all hiv-infected pregnant women delivering at st. mary's hospital london have been prospectively documented. the prevalence of preterm delivery and the correlation between gestational age and type of antiretroviral therapy were sought: preterm delivery occurred ...200717624841
gmc hearing against wakefield and colleagues opens. 200717626928
catastrophic flooding origin of shelf valley systems in the english channel.megaflood events involving sudden discharges of exceptionally large volumes of water are rare, but can significantly affect landscape evolution, continental-scale drainage patterns and climate change. it has been proposed that a significant flood event eroded a network of large ancient valleys on the floor of the english channel-the narrow seaway between england and france. this hypothesis has remained untested through lack of direct evidence, and alternative non-catastrophist ideas have been en ...200717637667
incorporating bioaccessibility in detailed quantitative human health risk assessments.current english policy and practice allows, and in places encourages, site specific estimates of arsenic oral bioavailability to be used in detailed quantitative human health risk assessment. english land contamination legislation does not differentiate between natural and man made arsenic soil contamination. english planning guidance requires developers to demonstrate that new houses are fit for purpose, including ensuring that there are no unacceptable risks to human health from soil contamina ...200717654139
bioaccessibility of arsenic in mine waste-contaminated soils: a case study from an abandoned arsenic mine in sw england (uk).this study characterises the total as concentrations and as bioaccessibility in 109 soils from devon great consols mine, an abandoned cu-as mine in devon, sw england, uk and discusses the soil and mineralogical factors that influence the bioaccessibility of this element. these data provide the basis for developing more accurate exposure estimates for use in human health risk assessments. the median value of the percent bioaccesible as of 15% for these as rich soils contaminated by mining activit ...200717654145
the effect of crank inertial load on the physiological and biomechanical responses of trained cyclists.the existing literature suggests that crank inertial load has little effect on the responses of untrained cyclists. however, it would be useful to be aware of any possible effect in the trained population, particularly considering the many laboratory-based studies that are conducted using relatively low-inertia ergometers. ten competitive cyclists (mean vo(2max) = 62.7 ml x kg(-1) x min(-1), s = 6.1) attended the human performance laboratories at the university of wolverhampton. each cyclist com ...200717654231
ancient human mtdna genotypes from england reveal lost variation over the last millennium.we analysed the historical genetic diversity of human populations in europe at the mtdna control region for 48 ancient britons who lived between ca ad 300 and 1000, and compared these with 6320 modern mtdna genotypes from england and across europe and the middle east. we found that the historical sample shows greater genetic diversity than for modern england and other modern populations, indicating the loss of diversity over the last millennium. the pattern of haplotypic diversity was clearly eu ...200717666375
type 2 diabetes whole-genome association study in four populations: the diagen consortium.type 2 diabetes (t2d) is a common, polygenic chronic disease with high heritability. the purpose of this whole-genome association study was to discover novel t2d-associated genes. we genotyped 500 familial cases and 497 controls with >300,000 hapmap-derived tagging single-nucleotide-polymorphism (snp) markers. when a stringent statistical correction for multiple testing was used, the only significant snp was at tcf7l2, which has already been discovered and confirmed as a t2d-susceptibility gene. ...200717668382
isolation and antimicrobial sensitivities of kluyvera spp. from humans in england, wales and northern ireland, 2005-2006. 200717669632
risk of serious neurologic disease after immunization of young children in britain and ireland.we sought to investigate the risk of serious neurologic disease after immunization in early childhood.200717671057
spitalfields knees study--a photographic challenge.this paper reports a study into human lower limb anatomy based on the spitalfields collection of human skeletons at the natural history museum, london. the objective was to document knee alignment in a range of rotations, and also to define the topography of the knee surfaces. the work was a collaborative between the medical illustration department and the orthopaedic surgical team. this project involved photographic challenges that required development of versatile techniques in order to genera ...200717671905
public awareness that hpv is a risk factor for cervical cancer.we assessed awareness of human papillomavirus (hpv) in a population sample of british women (n=1620) using similar questions to those in a survey in 2002. only 2.5% cited hpv as the cause of cervical cancer without prompting; up from 0.9% in 2002. public education about hpv is urgently needed.200717687335
using pharmacokinetic/pharmacodynamic modelling in safety pharmacology to better define safety margins: a regional workshop of the safety pharmacology society.this meeting was convened to encourage the incorporation of empirical and mechanism-based pharmacokinetic/pharmacodynamic (pk/pd) modelling into safety pharmacology to improve the predictability of nonclinical investigations for human outcomes. these technologies make use of mathematical expressions relating measured variables to derive essential parameters for describing responses and predicting the behaviour of biological systems to a drug. hence, empirical pk/pd modelling is intended to defin ...200717688390
expansive learning in the university setting: the case for simulated clinical experience.this paper argues that simulated practice in the university setting is not just a second best to learning in the clinical area but one which offers the potential for deliberation and deep learning [eraut, m., 2000. non-formal learning, implicit learning and tacit knowledge in professional work. journal of educational psychology, 70, 113-136]. the context of student learning in an undergraduate midwifery programme is analysed using human activity theory [engeström, y., 2001. expansive learning at ...200717689430
a survey of the preparedness for an influenza pandemic of general practitioners in the west midlands, uk.there is a lack of evidence regarding the preparedness of general practitioners (gps) to respond to pandemic influenza. a postal questionnaire survey was conducted to explore the self-perceived pandemic preparedness of gps in the west midlands, united kingdom, and to determine differences between urban and non-urban gps. the postal questionnaire was sent out to 773 gps in november 2005, and a reminder was sent in january 2006. in all, 427/773 (55%) questionnaires were returned, and 56% of respon ...200717690927
qualitative evaluation of an electronic prescribing and administration system.to provide a formative socio-technical evaluation of a pilot implementation of an integrated electronic prescribing, automated dispensing, barcode patient identification and electronic medication administration record (emar) system on one ward.200717693675
collaboration with the voluntary sector in setting up an early medical abortion service in the pct.the 1967 abortion act and the 1990 human fertilisation and embryology act amendment allow abortions in acute hospitals or licensed premises only. provision of abortions in community unlicensed premises is unlicensed and not legal. at abortion assessment, counselling, chlamydia testing and/or treatment/partner notification and a contraceptive package is included. this works towards the overall aim of reducing unwanted pregnancies and reducing the burden of sexually transmitted infections in the c ...200717701802
multiple stable isotope (18o, 13c, 15n and 34s) analysis of human hair to identify the recent migrants in a rural community in sw england.relationships between recent migration and hair delta(18)o values were examined for 40 people living in a rural community in sw england. the isotopic contents of 35 'local' hair samples were compared with those of 5 recently arrived individuals (from australia, canada, chile, germany and the usa). the hair delta(18)o values of these 'visitors' were +7.9 (omaha, usa), +11.2 (jena, germany), +12.1 (osorno, chile), +12.6 (montreal, canada) and +14.3 per thousand (adelaide, australia). the hair valu ...200717705338
il23r variation determines susceptibility but not disease phenotype in inflammatory bowel disease.identification of inflammatory bowel disease (ibd) susceptibility genes is key to understanding pathogenic mechanisms. recently, the north american ibd genetics consortium provided compelling evidence for an association between ileal crohn's disease (cd) and the il23r gene using genome-wide association scanning. external replication is a priority, both to confirm this finding in other populations and to validate this new technique. we tested for association between il23r and ibd in a large indep ...200717484863
combined evidence from three large british association studies rejects tucan/card8 as an ibd susceptibility gene. 200717484911
mgmt inhibitors--the trinity college-paterson institute experience, a chemist's perception.the dna repair protein, o(6)-alkylguanine-dna alkyltransferase (mgmt) can confer resistance to the cancer chemotherapeutic effects of the class of dna damaging drugs generally referred to as the o(6)-alkylating agents. inactivation of mgmt is thus a practical approach to improving the efficacy of such agents. an account is given of the collaboration between groups at trinity college, dublin and the paterson institute, manchester which led to the development of the mgmt inactivating drug, patrin ...200717485250
british citizens in a regional community of southeastern spain with a pre-clinical organ xenotransplantation program. a study of attitude toward xenotransplantation.it is important to find out about the social acceptance of xenotransplantation, especially in populations where there are pre-clinical xenotransplantation projects, and therefore the possibility of xenotransplantation to humans. in the native population of southeastern spain this situation is well-known, but in recent years there has been an important social change because of a considerable migrational flow into spain, especially from the british isles.200717489867
the northwick park tragedy--protecting healthy volunteers in future first-in-man trials.the development of potentially powerful drugs which may become effective in the treatment for disorders currently difficult to manage presents the pharmaceutical industry and the scientific community with a major challenge. such drugs with novel modes of action and the capacity to modify the body's immune system could also be very toxic. the possibility became a tragic reality on march 13th 2006 when tgn1412 was given to six healthy volunteers at northwick park hospital. all six became seriously ...200717489872
microbial source tracking: a forensic technique for microbial source identification?as the requirements of the water framework directive (wfd) and the us clean water act (uscwa) for the maintenance of microbiological water quality in 'protected areas' highlight, there is a growing recognition that integrated management of point and diffuse sources of microbial pollution is essential. new information on catchment microbial dynamics and, in particular, the sources of faecal indicator bacteria found in bathing and shellfish harvesting waters is a pre-requisite for the design of an ...200717492088
perspectives on injuries in snowboarders.adopting effective injury prevention practices continues to be problematic within snowboarding and the participation of older individuals is associated with an appreciable injury burden. the haddon matrix provides an important framework for developing injury prevention interventions. since prevention behaviour must 'fit' within individual aspirations, our study investigated the meanings and behaviours associated with snowboarding and injury prevention and then applied the findings to the establi ...200717711064
why sexual health promotion misses its audience: men who have sex with men reading the texts.sexual health promotion aimed at men who have sex with men (msm) is not achieving its objective of reducing the incidence of new infections of sexually transmitted diseases, notably hiv/aids, in the msm population. the paper aims to raise awareness of possible unintended consequences when using visual culture and advertising techniques in the field of sexual (and other) health promotion and public health messages.200717713183
detection of escherichia coli in biofilms from pipe samples and coupons in drinking water distribution networks.fluorescence in situ hybridization (fish) was used for direct detection of escherichia coli on pipe surfaces and coupons in drinking water distribution networks. old cast iron main pipes were removed from water distribution networks in france, england, portugal, and latvia, and e. coli was analyzed in the biofilm. in addition, 44 flat coupons made of cast iron, polyvinyl chloride, or stainless steel were placed into and continuously exposed to water on 15 locations of 6 distribution networks in ...200717720845
prevalence of human papillomavirus antibodies in young female subjects in england.sera from 1483 female subjects in england aged 10-29 years were tested. the age-standardised seroprevalence was 10.7% (95% confidence intervals 9.0-12.3) for human papillomavirus (hpv) 6, 2.7% (1.8-3.6) for hpv 11, 11.9% (10.2-13.6) for hpv 16, 4.7% (3.5-5.8) for hpv 18, and 20.7% (18.6-22.7) for any of the four types.200717726462
'incongruous juxtapositions': the chimaera and mrs mck.a century ago, the german botanist hans winkler (best known for coining the term 'genome') accomplished two novel transplantations. first, he produced a single plant that grafted together two completely disparate species: tomato and nightshade. second, he chose the descriptive word 'chimaera' to name his innovation, transplanting the term from mythology to biology. this paper features mrs mck, the first human chimera, and thus follows the term from botany to clinical medicine. her remarkable sto ...200717727951
varicella-zoster-virus genotypes in east london: a prospective study in patients with herpes zoster.a total of 298 patients with herpes zoster were recruited as part of 2 community-based studies in east london between 1998 and 2003. single nucleotide-polymorphism analysis of 4 regions (genes 1, 21, 37, and 60) found that most genotypes were european strains c and b, representing 58% and 21% of all samples collected. no change in the proportion of these european clades has occurred during the past 80 years, strongly supporting the hypothesis that these strains are indigenous to the united kingd ...200717763323
[shocking body art experience]. 200717393872
european bat lyssavirus type 2: human exposure in england. 200717900428
the systematic monitoring of transfusion microbiology test kit performance.the transfusion microbiology test systems monitoring group (tmtsmg) was established as a national blood service (nbs) working group to monitor the performance of the microbiology screening assays used within the nbs testing laboratories. the group's primary objective was to ensure that technical performance (especially sensitivity, specificity and wastage) remains consistent with that established during validation. this includes the identification and investigation of significant variation in pe ...200717903142
walter whitehead: a brief history of the man and his varnish. 200717928112
quantifying the evolutionary dynamics of language.human language is based on grammatical rules. cultural evolution allows these rules to change over time. rules compete with each other: as new rules rise to prominence, old ones die away. to quantify the dynamics of language evolution, we studied the regularization of english verbs over the past 1,200 years. although an elaborate system of productive conjugations existed in english's proto-germanic ancestor, modern english uses the dental suffix, '-ed', to signify past tense. here we describe th ...200717928859
developments in influenza vaccination coverage in england, scotland and wales covering five consecutive seasons from 2001 to 2006.this study aims at assessing trends in influenza vaccination coverage from 2001 to 2006 in great britain, at understanding drivers and barriers to vaccination and at identifying vaccination intentions for influenza season 2006/2007. in seasons 2001/2002 to 2005/2006, telephone-based household surveys representative of the population from age 16 were conducted, with about 2000 interviews per season (10,095 in total). overall influenza vaccination coverage rate in great britain reached 25.9% in se ...200717942197
marathon man. interview by dina leifer.mark dabbs is a remarkable nurse who iscommitted to patients and the wider community. as an unofficial ambassador, he represents his home town of walsall around the world.200717944134
the use of chaperones for intimate examinations: the patient perspective based on an anonymous questionnaire.the objective of the study was to identify genitourinary (gu) medicine patients' opinions concerning the offer and provision of chaperones and to audit adherence to clinic policy. an anonymous questionnaire was completed by patients after their examination in two gu medicine clinics in central and north london. in total, 750 patients were given questionnaires, of which 627 (84%) were completed and returned. less than half (45%) reported that they had been offered a chaperone. there was an associ ...200717945044
the first description of the palmaris brevis muscle.giovanni battista canano was born in italy in 1515 and his work has gone mostly unknown. very few copies of this anatomist and physician's book are known to exist. interestingly, canano reported and depicted what we believe, to be the first description of the palmaris brevis muscle. this description would be some 200 years prior to what is thought to be the earliest mention of this muscle by william cheselden in his book, the anatomy of the human body, published in 1713.200717950193
morbidity, mortality, and response to treatment by children in the united kingdom and ireland with perinatally acquired hiv infection during 1996-2006: planning for teenage and adult care.recent evidence suggests that decreases in morbidity and mortality in cohorts of adults infected with human immunodeficiency virus (hiv) are showing signs of reversal. we describe changes over time in these characteristics and in the response to treatment among children in the united kingdom and ireland with perinatally acquired hiv infection, many of whom are now adolescents.200717806062
serological responses to cryptosporidium in human populations living in areas reporting high and low incidences of symptomatic cryptosporidiosis.one approach to investigating differences in the reported incidence of disease is to measure the extent of exposure to the organism in question by testing for a specific antibody response. igg responses to cryptosporidium sporozoite antigens of low molecular size in adults have been shown to be consistent and of sufficient intensity to act as reliable markers of exposure. this study used a western blot procedure to investigate the relative intensity of igg antibody responses to the 15/17-kda cry ...200717850343
how can hepatitis c be prevented in the long term?significant advances have been made in preventing hiv infection among injectors but we still know little about preventing hepatitis c (hcv). both prevalence and incidence of hepatitis c can remain high among idus even in the context of widespread implementation of harm reduction programmes. we need to develop new ways to fill the knowledge gap regarding hcv prevention. one way is to learn from the experts--those idus who, after long-term injection in social milieus of high hepatitis c prevalence ...200717854720
diagnosis of human metapneumovirus by immunofluorescence staining with monoclonal antibodies in the north-east of england.since its discovery in 2001 human metapneumovirus (hmpv) has been shown to be a significant cause of human respiratory disease, responsible for 5-8% of respiratory infections in hospitalised children. diagnosis hitherto has been largely carried out by reverse tanscriptase polymerase chain reaction (rt-pcr) but immunofluorescence staining of cells from nasopharyngeal secretions (if) offers advantages for some laboratories and may produce a more rapid result in urgent cases. we have recently demon ...200717869169
barriers to the use of e-health technology in nurse practitioner-patient consultations.this paper examines primary care nurse practitioners' (nps') use of information available via e-health technology (eht) within consultations. it explores which information resources nps use in clinical decision making, their comparative use of electronic versus paper-based and human information resources, the reasons behind their choices and how the use of different resources impacts on patient interactions.200717877872
historical account: francis william aston: the man behind the mass spectrograph.francis william aston was among the most accomplished physicists of the 20th century. a nobel laureate and fellow of the royal society, his research career spanned four decades. during this time, he provided experimental proof for the existence of isotopes of many of the chemical elements and recorded their masses using several, hand-built mass spectrographs. a rather private man who lived alone in trinity college for much of his adult life, aston remains a somewhat elusive and mysterious figure ...200717881785
sir robert boyle and his unique case report on depressed cranial fracture.sir robert boyle is one of the foremost english scientists in history. he received his inspiration from the scientific approaches initiated by galileo and his disciple, torricelli. through rigorous experimentation, boyle established the fundamental gas laws as we know them today. although not a physician himself, he contributed enormously to the practice of medical sciences. his voluminous observations and writings represent a landmark in the history of human thought. this article summarizes the ...200717881978
the bagenal letters.in 2006 mrs john bagenal made a gift to the british dental association archive of part of the correspondence of her late husband john stuart bagenal. the 13 letters were written to his family during the spring and summer of 1940, when, having enlisted as a private in royal army medical corps, he was posted to colchester for training as a dental clerk-orderly. the letters are an invaluable record of the process by which new units of the army dental corps were staffed by other ranks, and show a yo ...200717965692
children's participation in vaccine research: parents' views.vaccine studies that evaluate the persistence of protection following immunisation require subjects to continue participation in a research protocol over many years. as parents' attitudes and opinions may change over time, and with experience of research, it is important to consider the factors influencing parents' decision-making about their child's continued participation in such prolonged vaccine studies.200717970358
outbreaks of influenza and influenza-like illness in schools in england and wales, 2005/06.in england and wales, clinical reports from primary care showed that influenza activity for the season 2005/06 only rose above the base line for four weeks during february 2006. however, outbreaks of influenza-like illness and/or gastrointestinal infection in schools began to be reported to the health protection agency, centre for infections in early january 2006. to quantify the type, size and the spread of these outbreaks a reporting form was distributed to local health protection units in eng ...200717991395
fisheries: nets versus nature. 200717994077
suitability of two carbon dioxide-baited traps for mosquito surveillance in the united kingdom.rapidly changing environments and an increase in human movement around the globe have contributed to a rise in new and emerging diseases, many of which are arthropod borne. the threat posed to the united kingdom by such diseases is uncertain, and there is a real need to understand the distribution, seasonality and behaviour of potential vectors in the country. at present, there is no standard method for routine mosquito surveillance in the uk. here we compared the catching efficiency of two carb ...200717997872
privates on parade: soldiers, medicine and the treatment of inguinal hernias in georgian england.hernias were prevalent among servicemen, typically recruited from amongst the malnourished. civilian medical practice deemed the rupture incurable, taking a palliative approach. for the military this was unacceptable: wastage rates due to ruptures were high, servicemen were valuable commodities. examples here are used to illustrate that experimentation was a contentious activity, reliant on the whims of patronage and war-time budgets. although military hospitals provided a good venue to engage i ...200718005547
'a cheap, safe and natural medicine'. religion, medicine and culture in john wesley's primitive physic. 200718005552
palliative. "a good death is part of life".some 500,000 adults die in england every year but only 20 per cent get their wish to die at home. while institutional death is now the norm, quality varies with 21 per cent of care homes and hospitals failing to meet minimum standards on dignity and privacy. the forthcoming end-of-life strategy is expected to guarantee choice, consistent high quality and equity.200718019268
flu: effect of vaccine in elderly care home residents: a randomized trial.to determine whether assessing seroprotection after influenza vaccine and administering booster vaccination where not achieved reduces hospitalization and death. to estimate the overall seroprotection rate of influenza vaccine.200718081669
resituating the principle of equipoise: justice and access to care in non-ideal conditions.the principle of equipoise traditionally is grounded in the special obligations of physician-investigators to provide research participants with optimal care. this grounding makes the principle hard to apply in contexts with limited health resources, to research that is not directed by physicians, or to nontherapeutic research. i propose a different version of the principle of equipoise that does not depend upon an appeal to the hippocratic duties of physicians and that is designed to be applica ...200718210980
model answers or trivial pursuits? the role of mathematical models in influenza pandemic preparedness planning.the panzootic of h5n1 influenza in birds has raised concerns that the virus will mutate to spread more readily in people, leading to a human pandemic. mathematical models have been used to interpret past pandemics and outbreaks, and to thus model possible future pandemic scenarios and interventions. we review historical influenza outbreak and transmission data, and discuss the way in which modellers have used such sources to inform model structure and assumptions. we suggest that urban attack ra ...200719432634
correlates of parents' reports of acceptability of human papilloma virus vaccination for their school-aged children.routine human papilloma virus (hpv) vaccination for 12-13-year-old girls will be introduced in the uk from september 2008. the aim of the present study was to identify correlates of parents' anticipated uptake of hpv vaccination for their sons and daughters.200819061552
analysis of germline gli1 variation implicates hedgehog signalling in the regulation of intestinal inflammatory pathways.ulcerative colitis (uc) and crohn's disease (cd) are polygenic chronic inflammatory bowel diseases (ibd) of high prevalence that are associated with considerable morbidity. the hedgehog (hh) signalling pathway, which includes the transcription factor glioma-associated oncogene homolog 1 (gli1), plays vital roles in gastrointestinal tract development, homeostasis, and malignancy. we identified a germline variation in gli1 (within the ibd2 linkage region, 12q13) in patients with ibd. since this ib ...200819071955
[a tale of 2 cities. the dispute over the true origins of the royal society].when the royal society was founded in november 1660 it took scientific societies already existing in other european countries as its model. however, at a time when the new mathematical and experimental sciences were still generally without a secure institutional foundation there was also great interest in the new society on the part of scientists and scholars abroad. soon visitors such as christiaan huygens and balthazar de monconys were able to report positively on its practical orientation, wh ...200820617612
geostatistical conditional simulation for the assessment of contaminated land by abandoned heavy metal mining.abandoned mine workings can undoubtedly cause varying degrees of contamination of soil with heavy metals such as lead and zinc has occurred on a global scale. exposure to these elements may cause to harm human health and environment. in the study, a total of 269 soil samples were collected at 1, 5, and 10 m regular grid intervals of 100 x 100 m area of carsington pasture in the uk. cell declustering technique was applied to the data set due to no statistical representativity. directional experim ...200818214925
a survey of tuberculosis clinic provision in england and wales.this paper presents the methods and findings of a survey of current service configuration in tuberculosis screening, treatment and prevention in england and wales, which was conducted as part of the development of the national institute for health and clinical excellence guidelines on tuberculosis for the country.200818222510
imported chicken meat as a potential source of quinolone-resistant escherichia coli producing extended-spectrum beta-lactamases in the uk.escherichia coli producing ctx-m-15 enzyme began to rapidly spread in the uk from around 2003 but other types also occur, notably ctx-m-14. we examined breasts from uk-reared (n = 62) and imported (n = 27) chickens as potential sources of quinolone-resistant e. coli with bla(ctx-m) genes. a further 40 samples for which the country of rearing could not be identified were examined.200818222958
selectivity of black death mortality with respect to preexisting health.was the mortality associated with the deadliest known epidemic in human history, the black death of 1347-1351, selective with respect to preexisting health conditions ("frailty")? many researchers have assumed that the black death was so virulent, and the european population so immunologically naïve, that the epidemic killed indiscriminately, irrespective of age, sex, or frailty. if this were true, black death cemeteries would provide unbiased cross-sections of demographic and epidemiological co ...200818227518
characterisation of salmonella enterica serotype typhimurium isolates from wild birds in northern england from 2005 - 2006.several studies have shown that a number of serovars of salmonella enterica may be isolated from wild birds, and it has been suggested that wild birds may play a role in the epidemiology of human and livestock salmonellosis. however, little is known about the relationship between wild bird s. enterica strains and human- and livestock- associated strains in the united kingdom. given the zoonotic potential of salmonellosis, the main aim of this study was to investigate the molecular epidemiology o ...200818230128
human factors in anaesthetic practice: insights from a task analysis.despite a growing recognition of the role of human error in anaesthesia, it remains unclear what should be done to mitigate its effects. we addressed this issue by using task analysis to create a systematic description of the behaviours that are involved during anaesthesia, which can be used as a framework for promoting good practice and highlight areas of concern.200818238839
ownership and uses of human tissue: what are the opinions of surgical in-patients?to investigate whether patient opinion about the uses of tissue removed at therapeutic operations has changed since the adverse publicity surrounding the alder hey and bristol royal infirmary inquiries, and to see whether it aligns with the human tissue act 2004.200818256118
self-care and adherence to medication: a survey in the hypertension outpatient clinic.self-care practices for patients with hypertension include adherence to medication, use of blood pressure self-monitoring and use of complementary and alternative therapies (cam) the prevalence of cam use and blood pressure self-monitoring have not been described in a uk secondary care population of patients with hypertension and their impact on adherence to medication has not been described. adherence to medication is important for blood pressure control, but poor adherence is common. the study ...200818261219
smoke-free hospitals - the english experience: results from a survey, interviews, and site visits.according to the provisions of the health act 2006, nhs acute trusts had to become smoke-free by july 2007. mental health trusts were granted a further year before all indoor smoking areas have to be removed. this study was carried out to determine the extent of smoke-free policy implementation in english nhs acute and mental health trusts, and to explore challenges and impacts related to policy implementation.200818282278
comprehensive analysis of tagging sequence variants in dtnbp1 shows no association with schizophrenia or with its composite neurocognitive endophenotypes.in a previous study we identified a relatively homogeneous subtype of schizophrenia characterized by pervasive cognitive deficit, which was the exclusive contributor to our findings of linkage to 6p25-p24. the 6p region contains dysbindin (dtnbp1), considered to be one of the major schizophrenia candidate genes. while multiple studies have reported association between genetic variation in dtnbp1 and schizophrenia, the findings have been inconsistent and controversial, leading to recent calls for ...200818314870
exploitation and enrichment: the paradox of medical experimentation.modern medicine is built on a long history of medical experimentation. experiments in the past often exploited more vulnerable patients. questionable ethics litter the history of medicine. without such experiments, however, millions of lives would be forfeited. this paper asks whether all the "unethical" experiments of the past were unjustifiable, and do we still exploit the poorer members of the community today? it concludes by wondering if harris is right in his advocacy of a moral duty to par ...200818316459
the role of mannose-binding lectin in susceptibility to infection in preterm neonates.preterm neonates are susceptible to infection due to a combination of sub-optimal immunity and increased exposure to invasive organisms. mannose-binding lectin (mbl) is a component of the innate immune system, which may be especially important in the neonatal setting. the objective of this study was to investigate the impact of mbl on susceptibility and severity of infection in preterm neonates during their first month of life. one hundred fifty eight preterm neonates were genotyped for mbl muta ...200818317236
'do you feel that your life is empty?' the clinical utility of a one-off question for detecting depression in elderly care home residents. 200818346981
association of genetic variants at 8q24 with breast cancer risk.recent whole genome association studies of prostate, breast, and colorectal cancer have identified susceptibility loci on 8q24. we genotyped three variants associated with prostate cancer (rs10090154, rs13254738, and rs7000448), one associated with both prostate and colorectal cancer (rs6983267), and one associated with breast cancer (rs13281615) in a series of 1,499 breast cancer cases and 1,390 controls. 1,267 (85%) of the cases had two primary breast cancers. our analysis provides further evi ...200818349290
septal aperture of the humerus in a mediaeval human skeletal population.humeral septal aperture is studied in a large mediaeval skeletal series from england. the aims are to investigate associations between septal aperture and sex, age, side and humeral robusticity; and to evaluate any associations with relative projection of ulna coronoid and olecranon processes. in this way, it is hoped to shed light on age at occurrence and the causation of the trait. results showed a paucity of cases in juveniles. in adults, the trait was more common in left bones and in females ...200818350584
episodic sexual transmission of hiv revealed by molecular phylodynamics.the structure of sexual contact networks plays a key role in the epidemiology of sexually transmitted infections, and their reconstruction from interview data has provided valuable insights into the spread of infection. for hiv, the long period of infectivity has made the interpretation of contact networks more difficult, and major discrepancies have been observed between the contact network and the transmission network revealed by viral phylogenetics. the high rate of hiv evolution in principle ...200818351795
[bovine tuberculosis--human to human transmission is possible]. 200818370350
causes of preventable drug-related hospital admissions: a qualitative study.to explore the causes of preventable drug-related admissions (pdras) to hospital.200818385404
comparison of campylobacter populations in wild geese with those in starlings and free-range poultry on the same farm.wild geese are a potential source of campylobacter infection for humans and farm animals and have been implicated in at least two large waterborne disease outbreaks. there have been few investigations into the population biology of campylobacter in geese, carriage rates are reported to vary (0 to 100%), and no genetic characterization of isolates has been performed. fecal samples collected from wild geese in oxfordshire, united kingdom, were culture positive for c. jejuni (50.2%) and c. coli (0. ...200818390684
dog-human and dog-dog interactions of 260 dog-owning households in a community in cheshire.this study investigated the nature and frequency of the contacts that occur between dogs, and between dogs and people, by means of a questionnaire survey of 260 dog-owning households in a community in cheshire, uk. the contacts were highly variable and were affected by the size, sex and age of the dog, individual dog behaviours, human behaviours and human preferences in the management of the dog. a number of situations were identified that may be important in relation to zoonoses, including slee ...200818390853
prevalence of type-specific hpv infection by age and grade of cervical cytology: data from the artistic trial.human papillomavirus (hpv) infection causes cervical cancer and premalignant dysplasia. type-specific hpv prevalence data provide a basis for assessing the impact of hpv vaccination programmes on cervical cytology. we report high-risk hpv (hr-hpv) type-specific prevalence data in relation to cervical cytology for 24,510 women (age range: 20-64; mean age 40.2 years) recruited into the artistic trial, which is being conducted within the routine nhs cervical screening programme in greater mancheste ...200818392052
modelling and prediction of weekly incidence of influenza a specimens in england and wales.we propose a rather simple model, which fits well the weekly human influenza incidence data from england and wales. a standard way to analyse seasonally varying time-series is to decompose them into different components. the residuals obtained after eliminating these components often do not reveal time dependency and are normally distributed. we suggest that conclusions should not be drawn only on the basis of residuals and that one should consider the analysis of squared residuals. we show that ...200818394206
estimates of daily net endogenous acid production in the elderly uk population: analysis of the national diet and nutrition survey (ndns) of british adults aged 65 years and over.dietary intake has been shown to influence acid-base balance in human subjects under tightly controlled conditions. however, the net effect of food groups on alkali/acid loading in population groups is unclear. the aims of the present study were to: (1) quantify estimates of daily net endogenous acid production (neap) (meq/d) in a representative group of british elderly aged 65 years and older; (2) compare and characterise neap by specific nutrients and food groups likely to influence dietary ac ...200818394215
measles on the edge: coastal heterogeneities and infection dynamics.mathematical models can help elucidate the spatio-temporal dynamics of epidemics as well as the impact of control measures. the gravity model for directly transmitted diseases is currently one of the most parsimonious models for spatial epidemic spread. this model uses distance-weighted, population size-dependent coupling to estimate host movement and disease incidence in metapopulations. the model captures overall measles dynamics in terms of underlying human movement in pre-vaccination england ...200818398467
liver cirrhosis, other liver diseases, pancreatitis and subsequent cancer: record linkage study.to determine the risk of cancer in cohorts of patients with alcoholic cirrhosis, other alcoholic liver diseases, other and unspecified cirrhosis, primary biliary cirrhosis, viral hepatitis, acute pancreatitis and chronic pancreatitis compared with the risk in a control cohort.200818403939
campylobacter infection of broiler chickens in a free-range environment.campylobacter jejuni is the most common cause of bacterial gastroenteritis worldwide, with contaminated chicken meat considered to represent a major source of human infection. biosecurity measures can reduce c. jejuni shedding rates of housed chickens, but the increasing popularity of free-range and organic meat raises the question of whether the welfare benefits of extensive production are compatible with food safety. the widespread assumption that the free-range environment contaminates extens ...200818412548
exploring knowledge and skills on hiv in student nurses and midwives.a cross-sectional survey design using a self-administered questionnaire was sent to a sample of 62 final-year student nurses and midwives to describe their knowledge of, skills related to, and attitudes towards, human immunodeficiency virus/acquired immune deficiency syndrome. out of the 47 respondents who return the questionnaire, only 53% stated that they had received class instruction on the topic and 63.8% claimed to have increased their knowledge mainly from reading professional journals. a ...200818414260
brian macmahon (1923-2007): founder of modern epidemiology.brian macmahon was born in sheffield, uk in 1923. he served as chair of the department of epidemiology at harvard school of public health for more than 30 years. he was admired as a noble and generous man and respected for his shining intellect, scientific integrity, and broad culture. he set the pace for modern epidemiology and led the way for a whole school of epidemiologists who are now spread around the nation and the world. he made major scientific contributions, received several distinguis ...200818415024
longitudinal study of the molecular epidemiology of campylobacter jejuni in cattle on dairy farms.multilocus sequence typing (mlst), an accurate and phylogenetically robust characterization method for population studies of campylobacter, was applied to campylobacter jejuni isolates (n = 297) from the fecal samples of cattle from five dairy farms in cheshire, united kingdom, collected throughout 2003. the population dynamics of the c. jejuni strains, as identified by the occurrence of sequence types and clonal complexes, demonstrated variations within and between cattle populations over time. ...200818424539
drotrecogin alfa (activated): real-life use and outcomes for the uk.in march 2001, the results of the recombinant human activated protein c worldwide evaluation in severe sepsis (prowess) study were published, which indicated a 6.1% absolute reduction in 28-day mortality. drotrecogin alfa (activated; drotaa) was subsequently approved for use in patients with severe sepsis.200818430215
j.s. haldane and some of his contributions to physiology.although the oxford conferences began in 1978 as a result of the inspiration of dan cunningham and others at the university laboratory of physiology in oxford, the roots of the meetings can be traced to john scott haldane (1860-1936) and his colleagues at the turn of the century. indeed, the laboratory (or its predecessor) has had an exemplary persistence (some might say an obsession) with the role of oxygen and, particularly, carbon dioxide in the control of breathing for over 100 years. an ear ...200818085239
the 1918-1919 influenza pandemic in england and wales: spatial patterns in transmissibility and mortality impact.spatial variations in disease patterns of the 1918-1919 influenza pandemic remain poorly studied. we explored the association between influenza death rates, transmissibility and several geographical and demographic indicators for the autumn and winter waves of the 1918-1919 pandemic in cities, towns and rural areas of england and wales. average measures of transmissibility, estimated by the reproduction number, ranged between 1.3 and 1.9, depending on model assumptions and pandemic wave and show ...200818156123
detection and surveillance for animal trichinellosis in gb.the zoonotic disease trichinellosis is considered one of the re-emerging diseases with surveillance and control methods constantly gaining more importance worldwide. recent change in european union (eu) legislation introduces trichinella-free production, and the possibility of risk-based monitoring for trichinella in pigs. this has increased the role of wildlife surveillance programmes and their impact on protecting human health as well as highlighted the need for harmonised surveillance protoco ...200818160221
walter moxon, md, fcrp (1836-1886): the cerebro-vascular system and the syndrome of "congestion of the brain": an analysis of his 1881 croonian lectures.walter moxon, md, frcp lived, practiced medicine, taught and wrote in the mid- to late- nineteenth-century victorian england, mostly at guy's hospital, london. he was widely informed in the "art of physic," writing on a range of issues from cerebral lateralization of articulate speech to angina pectoris. the present paper will trace briefly his contributions to the newly discovered asymmetry of articulate speech in the left frontal lobe (1866) and will in more detail trace and analyze his 1881 c ...200818161599
comparison of candida albicans strain types among isolates from three countries.multi-locus sequence typing data for 217 candida albicans isolates cultured since 1990 from blood and vaginal samples in japan, england/wales and the usa were analysed for geographically related variations. while no significant differences were found between distributions of diploid sequence types (dsts) in blood vs. vaginal isolates, there were highly significant differences in the clade distributions of isolates from the three geographical sources. clade 2 strains were predominantly isolates f ...200818165151
assessing levels of contaminants in breast milk: methodological issues and a framework for future research.to assess the scale of the possible exposure by the breast-fed infant to potentially harmful substances in breast milk, methodologically robust studies are essential. many studies in this field, however, do not report details of crucial issues such as recruitment and milk sampling. the aims of the study reported here were to develop robust methods for the study of contaminants in breast milk, and to develop a framework for future research and population monitoring. three cohorts of women and bab ...200818173786
clinical trials and healthy volunteers. 200818174206
sir humphry davy: boundless chemist, physicist, poet and man of action.the years 2007 and 2008 mark the bi-centenary of two brilliant discoveries by sir humphry davy: the isolation of sodium and potassium (1807) and the subsequent first observation (1808) of the beautiful blue and bronze colours now known to be characteristic of the solvated electron(1) in potassium-ammonia systems. in celebration of these dazzling discoveries, we reflect on davy's many extraordinary contributions to science, technology and poetry. humphry davy, a truly great man, of cornish spirit ...200818175370
chronic kidney disease prevalence in a uk residential care home population.chronic kidney disease (ckd) is common ( approximately 30%) in non-institutionalized older people but little is known about the prevalence of ckd amongst older people living in residential care.200818029370
excavating past population structures by surname-based sampling: the genetic legacy of the vikings in northwest england.the genetic structures of past human populations are obscured by recent migrations and expansions and have been observed only indirectly by inference from modern samples. however, the unique link between a heritable cultural marker, the patrilineal surname, and a genetic marker, the y chromosome, provides a means to target sets of modern individuals that might resemble populations at the time of surname establishment. as a test case, we studied samples from the wirral peninsula and west lancashi ...200818032405
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