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genital warts and cost of care in england.objectives to estimate the total number of cases of, and cost of care for, genital warts (gws) in england, to inform economic evaluations of human papillomavirus vaccination. methods the number of gw cases seen in general practices (gps) and in genitourinary medicine (gum) clinics was estimated using the general practice research database and the gum clinic activity dataset. the overlap in care of cases in the two settings was estimated. the calculated costs of care in gp and hospitals were adde ...201121813567
international spread of an epidemic population of salmonella enterica serotype kentucky st198 resistant to ciprofloxacin.national salmonella surveillance systems from france, england and wales, denmark, and the united states identified the recent emergence of multidrug-resistant isolates of salmonella enterica serotype kentucky displaying high-level resistance to ciprofloxacin. a total of 489 human cases were identified during the period from 2002 (3 cases) to 2008 (174 cases). these isolates belonged to a single clone defined by the multilocus sequence type st198, the xbai-pulsed-field gel electrophoresis cluster ...201121813512
antinuclear antibodies are associated with tumor necrosis factor receptor i gene polymorphism in patients with rheumatoid arthritis.objectives: antinuclear antibodies (ana) are a common feature of autoimmune diseases such as rheumatoid arthritis (ra). herein, we investigate the relationship between ana and polymorphism in the tumour necrosis factor receptor (tnfr) genes. methods: serum titers of ana at diagnosis were measured in 267 patients with ra and a single nucleotide polymorphism (snp) in each of the tnfr-i (36a/g) and tnfr-ii (676t/g) genes was genotyped by polymerase chain reaction restriction fragment length polymor ...201121813053
embryo futures and stem cell research: the management of informed uncertainty.in the social worlds of assisted conception and stem cell science, uncertainties proliferate and particular framings of the future may be highly strategic. in this article we explore meanings and articulations of the future using data from our study of ethical and social issues implicated by the donation of embryos to human embryonic stem cell research in three linked assisted conception units and stem cell laboratories in the uk. framings of the future in this field inform the professional mana ...201121812792
the beauty of anatomy: visual displays and surgical education in early-nineteenth-century london.summary:the early-nineteenth-century artist, anatomist, and teacher sir charles bell saw anatomy and art as closely related subjects. he taught anatomy to artists and surgeons, illustrated his own anatomical texts, and wrote a treatise on the use of anatomy in art. the author explores the connections among visual displays representing human anatomy, aesthetics, and pedagogical practices for bell and a particular group of british surgeon-anatomists. creating anatomical models and drawings was tho ...201121804185
evaluation of the experiences of family members whose deceased relative donated tissues at the nhsbt dedicated donation facility in speke, liverpool.donation of human tissue for transplant and research has historically been facilitated within the hospital mortuary. in 2006 nhsbt tissue services opened the dedicated donation facility [ddf], the first facility in the uk dedicated to the donation of tissues under strictly controlled conditions. nine family members who had agreed and experienced the transfer of their deceased relative to the ddf for tissue donation participated in a service evaluation applying qualitative data collection methods ...201121785945
tick (ixodes ricinus) abundance and seasonality at recreational sites in the uk: hazards in relation to fine-scale habitat types revealed by complementary sampling methods.the seasonal risk to humans of picking up ixodes ricinus ticks in different habitats at 3 recreational sites in the uk was assessed. a comprehensive range of vegetation types was sampled at 3-weekly intervals for 2 years, using standard blanket-dragging complemented by woollen leggings and square 'heel flags'. ticks were found in all vegetation types sampled, including short grass close to car parks, but highest densities were consistently found in plots with trees present. blankets picked up th ...201121771540
conventional versus acupuncture-like transcutaneous electrical nerve stimulation on cold-induced pain in healthy human participants: effects during stimulation.objectives: to compare the hypoalgesic effects of conventional transcutaneous electrical nerve stimulation (tens) (high frequency, low intensity) and acupuncture-like tens (al-tens, low frequency, high intensity) on cold-induced pain. design: randomized controlled parallel group study comparing the effects of strong non-painful al-tens, conventional tens and placebo (no current) tens on cold-pressor pain threshold (cpt) and pain intensity. two baseline (pre-intervention) measures and three dur ...201121771255
combined analysis of chrna5, chrna3 and cyp2a6 in relation to adolescent smoking behaviour.cyp2a6 influences smoking uptake in adolescence. genetic variation in the chrna5-chrna3 region influences smoking behaviour in adults. however, their combined effects on smoking in adolescence have not been tested to date. we present data on 1450 adolescents from the ten towns heart health study (tthhs) extensively phenotyped for smoking-related traits during adolescence. single nucleotide polymorphisms from chrna5 and chrna3 (previously associated with smoking), were typed in our study populati ...201121765098
'an old man in a dry month' 201121750021
loss to follow-up among adults attending human immunodeficiency virus services in england, wales, and northern ireland.: to assess the extent to which human immunodeficiency virus (hiv)-diagnosed adults attending hiv-services in england, wales, and northern ireland are lost to follow-up or attend services intermittently.201121844719
the epidemiology of sporadic human infections with unusual cryptosporidia detected during routine typing in england and wales, 2000-2008.summaryroutine typing of 14 469 isolates from human cryptosporidiosis cases between 2000 and 2008 revealed that 7439 (51-à4%) were cryptosporidium (c.) hominis, 6372 (44-à0%) c. parvum, 51 (0-à4%) both c. hominis and c. parvum, 443 (3-à1%) were not typable and 164 (1-à1%) were other cryptosporidium species or genotypes. of the latter, 109 were c. meleagridis, 38 c. felis, 11 c. ubiquitum, one c. canis, two horse, two novel and one skunk genotype. c. hominis monkey genotype and c. cuniculus were ...201121733255
nhs resource allocation: a question of funding?the article explores the implications of using human rights principles as a basis to challenging a resource allocation decision by a primary care trust in the courts. it explores the implications of the recent decision in r (condliff) v north staffordshire nhs trust [2011] and the prospects for development of future litigation.201121841679
association between ivus findings and adverse outcomes in patients with coronary artery disease the viva (vh-ivus in vulnerable atherosclerosis) study.the purpose of this study was to determine whether thin-capped fibroatheromata (tcfa) identified by virtual histology intravascular ultrasound (vh-ivus) are associated with major adverse cardiac events (mace) on individual plaque or whole patient analysis.201121835382
bath breakfast project (bbp) - examining the role of extended daily fasting in human energy balance and associated health outcomes: study protocol for a randomised controlled trial [isrctn31521726].abstract: background: current guidance regarding the role of daily breakfast in human health is largely grounded in cross-sectional observations. however, the causal nature of these relationships has not been fully explored and what limited information is emerging from controlled laboratory-based experiments appears inconsistent with much existing data. further progress in our understanding therefore requires a direct examination of how daily breakfast impacts human health under free-living cond ...201121740575
squamous cell carcinoma of the oral cavity rarely harbours oncogenic human papillomavirus.although it is now well established that a significant proportion of oropharyngeal squamous cell carcinomas (scc) harbour oncogenic human papillomavirus (hpv) sequences, the frequency with which these sequences are detected in oral scc (excluding oropharyngeal subsites) is highly variable. in an attempt to establish the true prevalence of hpv-16 and hpv-18 subtypes in oral scc, we screened 142 consecutive cases from a uk cohort using both conventional pcr with consensus primers and type-specific ...201121689967
a cross-sectional audit of the uptake of seasonal and h1n1 influenza vaccination amongst patients with rheumatoid arthritis in a london hospital. 201121722505
introduction to the department for environment, food and rural affairs (defra) predict 2 tamar estuary research workshop: pathological risk evaluation using "health status-related" biomarkers. 201121683997
bilateral asymmetry of the humerus during growth and development.the development of handedness throughout growth can be investigated by using bilateral asymmetry of the humerus as a proxy for this trait. a large skeletal sample of nonadults from english archaeological sites was examined using standard metric techniques to assess when right-sided asymmetry first appears in the human skeleton. results of this work indicate a change in directional asymmetry during growth and development, with infants and young children exhibiting no significant asymmetry and old ...201121702005
mortality in neurofibromatosis 1: in north west england: an assessment of actuarial survival in a region of the uk since 1989.neurofibromatosis 1 (nf1) is a comparatively common autosomal dominant disorder. however, relatively few studies have assessed lifetime risk; and information about the effect of nf1 on mortality remains uncertain. nf1 patients were identified using the north west regional family genetic register, which covers the 4.1 million people living in north west england, including the regions of greater manchester, cheshire and cumbria. data relating to tumours and malignancies were obtained from the nort ...201121694737
limiting worker exposure to highly pathogenic avian influenza a (h5n1): a repeat survey at a rendering plant processing infected poultry carcasses in the uk.abstract:201121819563
in the beginning: role of autonomy support on the motivation, mental health and intentions of participants entering an exercise referral scheme.self-determination theory (deci & ryan, 2000, intrinsic motivation and self-determination in human behaviour. new york: plenum publishing) highlights the impact autonomy supportive environments can have on exercise motivation and positive health outcomes. yet little is known about whether differential effects occur as a function of which significant other is providing this support. further, no research has examined the relationship between motivation and the social environment with participants' ...201121827332
Should patents for antiretrovirals be waived in the developing world? Annual varsity medical debate - London, 21 January 2011.ABSTRACT: The 2011 Varsity Medical Debate, between Oxford and Cambridge Universities, brought students and faculty together to discuss the waiving of patents for antiretroviral therapies in the developing world. With an estimated 29.5 million infected by Human Immunodeficiency Virus (HIV) in low- and middle-income countries and only 5.3 million of those being treated, the effective and equitable distribution of anti-retroviral therapy (ART) is an issue of great importance. The debate centred aro ...201121740573
the frequency of detection of unexpected diabetes mellitus during haemoglobinopathy investigations.to establish the frequency of detection of previously undiagnosed diabetes mellitus as a result of detection of an increased glycated fraction of haemoglobin during high performance liquid chromatography (hplc) for haemoglobinopathy diagnosis.201121730263
sustainable microbial water quality monitoring programme design using phage-lysis and multivariate techniques.contamination of surface waters is a pervasive threat to human health, hence, the need to better understand the sources and spatio-temporal variations of contaminants within river catchments. river catchment managers are required to sustainably monitor and manage the quality of surface waters. catchment managers therefore need cost-effective low-cost long-term sustainable water quality monitoring and management designs to proactively protect public health and aquatic ecosystems. multivariate and ...201121962927
seasonality in the incidence of cervical carcinoma in teenagers and young adults in northern england, 1968-2005.infection with human papillomavirus is an established risk factor for cervical carcinoma. however, the role of other environmental factors is less well established. to further investigate whether other agents may be involved, the authors have analyzed seasonal variation in cervical cancer with respect to month of birth and separately month of diagnosis. all 85 cases diagnosed in 15-24-yr-olds during the period 1968-2005 were extracted from the specialist population-based northern region young pe ...201122080788
Mycoplasma pneumoniae and respiratory virus infections in children with persistent cough in England: a retrospective analysis.Persistent cough following an acute respiratory tract infection is common in children, but clinicians may find it difficult to give accurate prognostic information on likely duration of cough without a microbiologic diagnosis. This study estimates the prevalence of Mycoplasma pneumoniae (Mp) and assesses the prognostic value of detecting Mp and respiratory viruses in children with persistent cough.201121857262
integrated analysis of water quality parameters for cost-effective faecal pollution management in river catchments.in many parts of the world, microbial contamination of surface waters used for drinking, recreation, and shellfishery remains a pervasive risk to human health, especially in less economically developed countries (ledc). however, the capacity to provide effective management strategies to break the waterborne route to human infection is often thwarted by our inability to identify the source of microbial contamination. microbial source tracking (mst) has potential to improve water quality managemen ...201121324505
climate change: human influence on rainfall. 201121331034
anthropogenic greenhouse gas contribution to flood risk in england and wales in autumn 2000.interest in attributing the risk of damaging weather-related events to anthropogenic climate change is increasing. yet climate models used to study the attribution problem typically do not resolve the weather systems associated with damaging events such as the uk floods of october and november 2000. occurring during the wettest autumn in england and wales since records began in 1766, these floods damaged nearly 10,000 properties across that region, disrupted services severely, and caused insured ...201121331040
heterogeneous topographic profiles of kinetic and cell cycle regulator microsatellites in atypical (dysplastic) melanocytic nevi.atypical (dysplastic) melanocytic nevi are clinically heterogeneous malignant melanoma precursors, for which no topographic analysis of cell kinetic, cell cycle regulators and microsatellite profile is available. we selected low-grade atypical melanocytic nevi (92), high-grade atypical melanocytic nevi (41), melanocytic nevi (18 junctional, 25 compound) and malignant melanomas (16 radial growth phase and 27 vertical growth phase). tp53, cdkn2a, cdkn1a, and cdkn1b microsatellite patterns were top ...201121336261
modelling borderline and mild dysplasia associated with hpv 6 and 11 infection.low risk hpv types 6/11 are responsible for some low-grade cytological abnormalities. most economic analyses of hpv vaccination have estimated the additional benefit of hpv 6/11 protection by the quadrivalent vaccine, over the bivalent, based on reduction of genital warts but have not included reduction in repeat smears and colposcopies due to low-grade abnormalities. we investigate the contribution of hpv types 6/11 to abnormal smears and associated costs in england.201121338682
fine-scale population genetic structure and sex-biased dispersal in the smooth snake (coronella austriaca) in southern england.human-induced alteration of natural habitats has the potential to impact on the genetic structuring of remnant populations at multiple spatial scales. species from higher trophic levels, such as snakes, are expected to be particularly susceptible to land-use changes. we examined fine-scale population structure and looked for evidence of sex-biased dispersal in smooth snakes (coronella austriaca), sampled from 10 heathland localities situated within a managed coniferous forest in dorset, united k ...201121343947
can a mind have two time lines? exploring space-time mapping in mandarin and english speakers.spatial representations of time are a ubiquitous feature of human cognition. nevertheless, interesting sociolinguistic variations exist with respect to where in space people locate temporal constructs. for instance, while in english time metaphorically flows horizontally, in mandarin an additional vertical dimension is employed. noting that the bilingual mind can flexibly accommodate multiple representations, the present work explored whether mandarin-english bilinguals possess two mental time l ...201121347879
earliest directly-dated human skull-cups.the use of human braincases as drinking cups and containers has extensive historic and ethnographic documentation, but archaeological examples are extremely rare. in the upper palaeolithic of western europe, cut-marked and broken human bones are widespread in the magdalenian (~15 to 12,000 years bp) and skull-cup preparation is an element of this tradition.201121359211
the impact of new national hiv testing guidelines at a district general hospital in an area of high hiv seroprevalence.the latest uk national human immunodeficiency virus (hiv) testing guidelines, released in september 2008, state that hiv testing should be offered to all patients with indicator conditions and considered in all general medical admissions in high-prevalence areas. we audited testing rates at blackpool victoria hospital, a high-prevalence area, one year before and one year after the publication of the new guidelines. in the year after publication the rate of hiv testing in patients with indicator ...201121365059
attitudes towards human papillomavirus vaccination: a qualitative study of vaccinated and unvaccinated girls aged 17-18 years.background and methodology this study explored knowledge about human papillomavirus (hpv) and attitudes towards hpv vaccination among girls who were part of the 'catch-up' vaccination programme. interviews were carried out between march and may 2009 with girls (aged 17-18 years) who had received hpv vaccine (n=5) and girls who had opted not to receive hpv vaccine (n=5). interviews lasted approximately 25 minutes, were recorded and transcribed verbatim. the data were analysed qualitatively using ...201121367699
age-specific incidence of a/h1n1 2009 influenza infection in england from sequential antibody prevalence data using likelihood-based estimation.estimating the age-specific incidence of an emerging pathogen is essential for understanding its severity and transmission dynamics. this paper describes a statistical method that uses likelihoods to estimate incidence from sequential serological data. the method requires information on seroconversion intervals and allows integration of information on the temporal distribution of cases from clinical surveillance. among a family of candidate incidences, a likelihood function is derived by reconst ...201121373639
exploring the psychological factors involved in the ladbroke grove rail accident.ten years after the event and the question as to exactly why a driver passed a signal at danger to cause the ladbroke grove rail disaster is still an open one. this paper uses the literature on human error and cognition, combined with critical path analysis, to provide further insight. five aspects of train operation are drawn out of the known facts surrounding the incident: custom and practice in the use of the driver's reminder appliance, operation and use of the automatic warning system, the ...201121376909
value of mismatch repair, kras, and braf mutations in predicting recurrence and benefits from chemotherapy in colorectal cancer.it is uncertain whether modest benefits from adjuvant chemotherapy in stage ii colorectal cancer justify the toxicity, cost, and inconvenience. we investigated the usefulness of defective mismatch repair (dmmr), braf, and kras mutations in predicting tumor recurrence and sensitivity to chemotherapy.201121383284
phase i trial of a selective c-met inhibitor arq 197 incorporating proof of mechanism pharmacodynamic studies.the hepatocyte growth factor/c-met axis is implicated in tumor cell proliferation, survival, and angiogenesis. arq 197 is an oral, selective, non-adenosine triphosphate competitive c-met inhibitor. a phase i trial of arq 197 was conducted to assess safety, tolerability, and target inhibition, including intratumoral c-met signaling, apoptosis, and angiogenesis.201121383285
one size fits all: or horses for courses? recovery-based care in specialist mental health services.the ôçÿrecovery approachôçö to the management of severe mental health problems has become a guiding vision of service provision amongst many practitioners, researchers, and policy makers as well as service users.201121391337
hiv/aids awareness in those diagnosed with mental illness.the spread of human immunodeficiency virus (hiv) continues to increase among the general population. previous studies in this field focused mainly on the 'at-risk' groups such as homosexuals, prostitutes, intravenous drug users, bisexual men and women. mentally ill men and women remain one of the subgroups understudied and yet continue to show disproportionately high levels of seroprevalence. the purpose of this study was to elucidate awareness of the risk factors associated with hiv transmissio ...201121395913
clinical effectiveness of biphasic insulin aspart 30:70 versus biphasic human insulin 30 in uk general clinical practice: a retrospective database study.premixed, or biphasic, insulins containing varying proportions of rapid- and intermediate-acting insulin components have been developed to limit the number of daily injections for patients who require both prandial and basal insulin injections.201121397771
using an online survey of healthcare-seeking behaviour to estimate the magnitude and severity of the 2009 h1n1v influenza epidemic in england.during the 2009 h1n1v influenza epidemic, the total number of symptomatic cases was estimated by combining influenza-like illness (ili) consultations, virological surveillance and assumptions about healthcare-seeking behaviour. changes in healthcare-seeking behaviour due to changing scientific information, media coverage and public anxiety, were not included in case estimates. the purpose of the study was to improve estimates of the number of symptomatic h1n1v cases and the case fatality rate (c ...201121410965
the hammersmith hospital hematopathology case of the month: hemophagocytic lymphohistiocytosis secondary to epstein-barr virus associated t-cell lymphoma.we discuss the clinical presentation, investigations carried out, and the management issues in an elderly patient with hemophagocytic lymphohistiocytosis (hlh). the hlh was associated with an underlying epstein-barr virus positive peripheral t-cell lymphoma, not otherwise specified, and the lymphomatous cells harbored translocation t(5;9)(q11.2:p24). the 9p24 region contains the jak2 gene. the disease had a fulminant course.201121417828
the incidence and prevalence of idiopathic intracranial hypertension in sheffield, uk.background and purpose: the purpose of this study was to identify the incidence and prevalence of idiopathic intracranial hypertension (iih) in sheffield, uk. methods: a retrospective review of case notes was conducted to identify cases of iih seen between 1 january 2007 and 31 december 2008. results: sixteen (15 women and 1 man) new patients were identified to give an incidence within sheffield of 1.56/100 000/year and 2.86/100 000/year for women. the incidence of iih in obese women was 11.9 ...201121426442
explaining variation in the uptake of hpv vaccination in england.in england, two national programmes of hpv vaccination for girls have been instituted, a routine programme for 12- and 13-year-olds and a catch-up programme for 17- and 18-year-olds. uptake rates across the country have been far from uniform, and this research sought to identify factors explaining the variation in uptake by locality.201121426539
wetland conservation and sustainable coastal governance in japan and england.coastal wetlands present particular challenges for coastal governance and for the implementation of the ramsar convention, not least because coastal areas are focal points of human activity and of governance ambiguity. through the evaluation of ramsar delivery at both national and local levels in japan and england, the relationship between ramsar implementation and coastal governance was examined. in england, ramsar status is primarily treated as a nature conservation designation which limits th ...201121429531
investigating transmission of mycobacterium bovis in the united kingdom in 2005 to 2008.due to an increase in bovine tuberculosis in cattle in the united kingdom, we investigated the characteristics of mycobacterium bovis infection in humans and assessed whether extensive transmission of m. bovis between humans has occurred. a cross-sectional study linking demographic, clinical, and dna fingerprinting (using 15-locus mycobacterial interspersed repetitive-unit-variable-number tandem-repeat [miru-vntr] typing) data on cases reported between 2005 and 2008 was undertaken. a total of 12 ...201121430093
n-nitroso compounds and cancer incidence: the european prospective investigation into cancer and nutrition (epic)-norfolk study.humans are exposed to preformed n-nitroso compounds (nocs) and endogenous nocs. several nocs are potential human carcinogens, including n-nitrosodimethylamine (ndma), but evidence from population studies is inconsistent.201121430112
letter to the editor. group a streptococcal infections during the seasonal influenza outbreak 2010/11 in south east england. 201121435326
excess mortality monitoring in england and wales during the influenza a(h1n1) 2009 pandemic.summarywe present the results from a novel surveillance system for detecting excess all-cause mortality by age group in england and wales developed during the pandemic influenza a(h1n1) 2009 period from april 2009 to march 2010. a poisson regression model was fitted to age-specific mortality data from 1999 to 2008 and used to predict the expected number of weekly deaths in the absence of extreme health events. the system included adjustment for reporting delays. during the pandemic, excess all-c ...201121439100
serotonin transporter gene moderates childhood maltreatment's effects on persistent but not single-episode depression: replications and implications for resolving inconsistent results.background: genetic and environmental factors shape life-long vulnerability to depression, but most gene-environment interaction (g×e) research has focused on cross-sectional assessments rather than life-course phenotypes. this study tests the hypothesis that the g×e involving the length polymorphism in the serotonin-transporter-gene-linked-promoter-region (5-httlpr) and childhood maltreatment is specific to depression that runs a persistent course in adulthood. methods: the hypothesis is tested ...201121439648
estrogen and progesterone receptor isoform distribution through the menstrual cycle in uteri with and without adenomyosis.to test the hypothesis that the expression of the different isoforms of the estrogen receptor alpha (er-a) and beta (er-ß) and the progesterone receptor a (pr-a) and b (pr-b) would be differentially modulated in uteri with adenomyosis compared with controls and that modulation would be related to the menstrual cycle.201121444077
effect of abcb1 genotype on pre- and post-cardiac transplantation plasma lipid concentrations.genetic variation of atp-binding cassette subfamily b member 1 (abcb1) which encodes p-glycoprotein (p-gp) has been associated with lipid levels and response to statins. here, we studied these associations in patients with advanced heart failure who subsequently underwent transplantation. fasting total cholesterol (tc), low density lipoprotein (ldl) cholesterol, high density lipoprotein (hdl) cholesterol and triglycerides (tg) concentrations in 268 adult heart transplant recipients were analysed ...201121445698
children's relative clause markers in two non-mainstream dialects of english.we examined children's productions of mainstream and non-mainstream relative clause markers (e.g. that, who, which, what, where, ø) in african american english (aae) and southern white english (swe) as a function of three linguistic variables (syntactic role of the marker, humanness of the antecedent and adjacency of the noun phrase head). the data were language samples from 99 typically developing 4-6-year-olds: 61 spoke aae and 38 spoke swe. the majority of the children's relative clauses incl ...201121453062
dcdc2, kiaa0319 and cmip are associated with reading-related traits.several susceptibility genes have been proposed for dyslexia (reading disability; rd) and specific language impairment (sli). rd and sli show comorbidity, but it is unclear whether a common genetic component is shared.201121457949
"novel" brominated flame retardants in belgian and uk indoor dust: implications for human exposure.concentrations of several "novel" brominated flame retardants (nbfrs) are reported in indoor dust samples from belgian houses (n=39) and offices (n=6) and from day-care centers and schools in the west midlands of the uk (n=36). using a gc-ecni/ms method, the following nbfrs were quantified: decabromodiphenyl ethane (dbdpe) (range <20-2470 ng g(-1)), 1,2-bis(2,4,6-tribromophenoxy)ethane (btbpe) (range <0.5-1740 ng g(-1)), tetrabromobisphenol a-bis(2,3-dibromopropylether) (tbbpa-dbpe) (range <20-9 ...201121458020
edgar pask and his physiological research--an unsung hero of world war two.edgar pask died in 1966 at the age of 53. he was the professor of anaesthesia in newcastle upon tyne, and a quiet and unassuming man. but during the second world war he had been involved in a number of dangerous and remarkable experiments; these included investigating the effects of acute hypoxia related to high altitude parachute descents, resuscitation techniques and the effectiveness of lifejackets.201121465904
revival of an old problem: an increase in salmonella enterica serovar typhimurium definitive phage type 8 infections in 2010 in england and northern ireland linked to duck eggs.summarysalmonella enterica serovar typhimurium definitive phage type (dt) 8 is uncommon in humans in the uk. in july 2010, the health protection agency reported an excess isolation rate of pan-susceptible s. typhimurium dt8 in england and northern ireland. by the end of october, this amounted to 81 laboratory-confirmed human cases for all regions of england and northern ireland in 2010, an increase of 26% and 41% on 2009 and 2008, respectively. descriptive epidemiological investigation found a s ...201121470442
nurses' knowledge and risk perception towards seasonal influenza and vaccination and their vaccination behaviours: a cross-sectional survey.background: seasonal influenza has become a serious public health problem worldwide and vaccination is recognized as the most effective preventative measure. healthcare workers can be the vectors of influenza outbreaks. data suggest that nurses' vaccination remains suboptimal worldwide. objectives: to explore the relationship among nurses' knowledge, risk perception and their vaccination behaviours and the reasons for vaccination uptake. design: a cross-sectional survey. setting: participants we ...201121474136
political orientations are correlated with brain structure in young adults.substantial differences exist in the cognitive styles of liberals and conservatives on psychological measures [1]. variability in political attitudes reflects genetic influences and their interaction with environmental factors [2, 3]. recent work has shown a correlation between liberalism and conflict-related activity measured by event-related potentials originating in the anterior cingulate cortex [4]. here we show that this functional correlate of political attitudes has a counterpart in brain ...201121474316
academic and molecular matrices: a study of the transformations of connective tissue research at the university of manchester (1947-1996).this paper explores the different identities adopted by connective tissue research at the university of manchester during the second half of the 20th century. by looking at the long-term redefinition of a research programme, it sheds new light on the interactions between different and conflicting levels in the study of biomedicine, such as the local and the global, or the medical and the biological. it also addresses the gap in the literature between the first biomedical complexes after world wa ...201121486662
the study of anatomy in england from 1700 to the early 20th century.the study of anatomy in england during the 18th and 19th century has become infamous for bodysnatching from graveyards to provide a sufficient supply of cadavers. however, recent discoveries have improved our understanding of how and why anatomy was studied during the enlightenment, and allow us to see the context in which dissection of the human body took place. excavations of infirmary burial grounds and medical school cemeteries, study of hospital archives, and analysis of the content of surv ...201121496014
high-density fine-mapping of a chromosome 10q26 linkage peak suggests association between endometriosis and variants close to cyp2c19.to refine a previously reported linkage peak for endometriosis on chromosome 10q26, and conduct follow-up analyses and a fine-mapping association study across the region to identify new candidate genes for endometriosis.201121497341
the 2010 paton lecture. the sympathetic nervous system through the ages: from thomas willis to resistant hypertension.the 17th century london neuroanatomical school headed by thomas willis provided us with the first identifiable images of the sympathetic nervous system. nineteenth century giants of european physiology (bernard, waller, brown-sequard) identified these as the 'pressor nerves'. von euler's demonstration that the sympathetic transmitter was noradrenaline brought the field into the modern era. the development of ganglion-blocking drugs, by paton whose name this review commemorates, allowed comprehen ...201121551268
a uk neqas ish multicenter ring study using the ventana her2 dual-color ish assay.we performed a multicenter assessment of a new her2 dual-color chromogenic in situ hybridization (cish) test and herein report on concordance of cish data with fluorescence in situ hybridization (fish) data and intraobserver and interlaboratory scoring consistency. her2 results were evaluated using duplicate cores from 30 breast cancers in 5 laboratories using the ventana her2 dual-color ish assay (ventana medical systems, cambridgeshire, england) and in 1 central laboratory using a standard fis ...201121173138
automated diagnosis of referable maculopathy in diabetic retinopathy screening.this paper introduces an algorithm for the automated diagnosis of referable maculopathy in retinal images for diabetic retinopathy screening. referable maculopathy is a potentially sight-threatening condition requiring immediate referral to an ophthalmologist from the screening service, and therefore accurate referral is extremely important. the algorithm uses a pipeline of detection and filtering of "peak points" with strong local contrast, segmentation of candidate lesions, extraction of featu ...201122255063
observational clinical human reliability analysis (ochra) for competency assessment in laparoscopic colorectal surgery at the specialist level.background: there are no valid and reliable tools to assess competency in advanced laparoscopic surgery at a specialist level. the observational clinical human reliability analysis (ochra) may have the required characteristics of such a tool. the aim of this study was to evaluate construct and concurrent validity of ochra for competency assessment at a specialist level. methods: thirty-two video-recorded laparosc ...201122042584
saviour-sibling and the psychological, ethical and judicial issues that it creates: should english and french legislators close the pandora's box?since the advent of test-tube babies, advances in the biomedical field have risen steadily. in parallel, the scientific body has never since ceased to debate the ethical issues that they arise. this is particularly the case regarding saviour-sibling. saviour-sibling refers to a child who is conceived to cure an older brother or sister suffering from a serious family genetic disease. therefore, it is meant to give birth to a child who will provide stem-cells taken from the umbilical cord or bone ...201121870591
implementing the mental health act 2007 in british general practice: lessons from ireland.changes in mental health legislation (e.g. mental health act 2007 in england and wales, mental health act 2001 in ireland) have generally improved adherence to international human rights standards, but also present challenges to primary care providers. when mental health legislation was substantially reformed in ireland, 62.9% of general practitioners (gps) felt the new legislation was not user-friendly. majorities of gps who felt the legislation affected their practice reported increased worklo ...201122079012
human fine body hair enhances ectoparasite detection.although we are relatively naked in comparison with other primates, the human body is covered in a layer of fine hair (vellus and terminal hair) at a relatively high follicular density. there are relatively few explanations for the evolutionary maintenance of this type of human hair. here, we experimentally test the hypothesis that human fine body hair plays a defensive function against ectoparasites (bed bugs). our results show that fine body hair enhances the detection of ectoparasites through ...201122171023
salmonella virchow isolates from human and avian origins in england--molecular characterization and infection of epithelial cells and poultry.to characterize 12 salmonella virchow isolates from human and avian sources to begin to determine the genetic relationships within the serovar, determine its capacity to invade and induce inflammatory responses in human intestinal epithelial cells and investigate its ability to colonize the chicken gastrointestinal tract.201121920003
to err is human. 201121890036
email interviewing: generating data with a vulnerable population.cook c. (2011) email interviewing: generating data with a vulnerable population. journal of advanced nursing00(0), 000-000.doi: 10.1111/j.1365-2648.2011.05843.x abstract: aims.  this paper describes online recruitment and the email interviewing data collection method with women diagnosed with a viral sexually transmitted infection. the paper highlights the advantages of the method to researchers and participants when conducting research where face-to-face participation may difficult. background. ...201121999402
wigan dentist completes iron man challenge. 201121869784
[Description of the long-term effects of breast feeding in the Hungarian guidelines for infant nutrition].To identify and describe infant feeding policy documents in Hungary and compare them to the documents of other four European countries (England, Finland, Germany and Spain). The question was also addressed how the phenomenon of nutritional programming was represented in the documents.201121959937
critical care rationing: international comparisons.every country has finite resources that are expended to provide citizens with social "goods," including education, protection, infrastructure, and health care. rationing-of any resource-refers to distribution of an allotted amount and may involve withholding some goods that would benefit some citizens. health-care rationing is controversial because good health complements so many human endeavors. we explored (perceptions regarding) critical care rationing in seven industrialized countries. acade ...201122147820
large outbreak of verocytotoxin-producing escherichia coli o157 infection in visitors to a petting farm in south east england, 2009.summaryin the summer of 2009, an outbreak of verocytotoxigenic escherichia coli o157 (vtec o157) was identified in visitors to a large petting farm in south east england. the peak attack rate was 6/1000 visitors, and highest in those aged <2 years (16/1000). we conducted a case-control study with associated microbiological investigations, on human, animal and environmental samples. we identified 93 cases; 65 primary, 13 secondary and 15 asymptomatic. cases were more likely to have visited a spec ...201122093751
Brain-derived neurotrophic factor in patients with Huntington's disease.Reduced Brain-Derived Neurotrophic Factor (BDNF) levels have been described in a number of patho-physiological conditions, most notably, in Huntington's disease (HD), a progressive neurodegenerative disorder. Since BDNF is also produced in blood, we have undertaken the measurement of its peripheral levels in the attempt to identify a possible link with HD prognosis and/or its progression. Here we evaluated BDNF level in 398 blood samples including 138 controls, 56 preHD, and 204 HD subjects. We ...201121857974
Paralysed man seeks legal clarity over doctors' role in assisting suicide. 201122127142
genome-wide association study in individuals of south asian ancestry identifies six new type 2 diabetes susceptibility loci.we carried out a genome-wide association study of type-2 diabetes (t2d) in individuals of south asian ancestry. our discovery set included 5,561 individuals with t2d (cases) and 14,458 controls drawn from studies in london, pakistan and singapore. we identified 20 independent snps associated with t2d at p < 10(-4) for testing in a replication sample of 13,170 cases and 25,398 controls, also all of south asian ancestry. in the combined analysis, we identified common genetic variants at six loci ( ...201121874001
how are babies fed? a pilot study exploring primary school children's perceptions of infant feeding.breastfeeding is the optimal feeding method for human infants. in the united kingdom some women do not initiate breastfeeding, and many commence formula milk feeding after a brief period of breastfeeding. infant feeding perceptions may develop early in life, and this research aimed to explore infant feeding awareness among primary school children as a first step toward informing appropriate health education interventions.201122112335
dilemmas of citizenship: young people's conceptions of un/employment rights and responsibilities.this paper draws on the concept of ideological dilemmas in order to explore how a sample of young people constructed potentially contrary themes of liberal citizenship in discussions of un/employment. the study took place in the context of recent policy developments in the uk which have sought to place a renewed emphasis upon notions of responsible citizenship in relation to both welfare and education policy. a total of 58 participants were interviewed in 24 semi-structured group interviews. in ...201121884544
MLH1 promoter methylation, diet, and lifestyle factors in mismatch repair deficient colorectal cancer patients from EPIC-Norfolk.There is conflicting evidence for the role diet and lifestyle play in the development of mismatch repair (MMR)-deficient colorectal cancers (CRC). In this study, associations between MMR deficiency, clinicopathological characteristics, and dietary and lifestyle factors in sporadic CRC were investigated. Tumor samples from 185 individuals in the EPIC-Norfolk study were analyzed for MLH1 gene promoter methylation and microsatellite instability (MSI). Dietary and lifestyle data were collected prosp ...201121875327
Morbidity in the marshes: Using spatial epidemiology to investigate skeletal evidence for malaria in Anglo-Saxon England (AD 410-1050).Concerns over climate change and its potential impact on infectious disease prevalence have contributed to a resurging interest in malaria in the past. A wealth of historical evidence indicates that malaria, specifically Plasmodium vivax, was endemic in the wetlands of England from the 16th century onwards. While it is thought that malaria was introduced to Britain during the Roman occupation (AD first to fifth centuries), the lack of written mortality records prior to the post-medieval period m ...201122183814
influence of matrix metalloproteinase-12 on fibrinogen level.in vitro studies have shown that matrix metalloproteinase-12 (mmp12) can degrade fibrinogen, a clotting factor whose level predicts risk of advanced atherosclerosis and myocardial infarction. in this study, we found that mean plasma fibrinogen level was approximately 10-fold higher in mmp12 knockout mice than wildtype mice (p=0.0006). differential allelic expression analysis of human mmp12 gene polymorphism rs17368582 in human vascular tissues showed an allele-specific effect on mmp12 expression ...201122119538
changes in severity of 2009 pandemic a/h1n1 influenza in england: a bayesian evidence synthesis.to assess the impact of the 2009 a/h1n1 influenza pandemic in england during the two waves of activity up to end of february 2010 by estimating the probabilities of cases leading to severe events and the proportion of the population infected.201121903689
Bacteriophage lysis of enterococcus host strains: a tool for microbial source tracking?This paper describes the isolation of Enterococcus host strains, for potential use as simple bacteriophage (phage)-based microbial source tracking (MST) tools. Presumptive Enterococcus host strains were isolated from cattle feces, raw municipal wastewater, agricultural runoff, and waters impacted by farms or wastewater treatment works (WWTW) in southern England, United Kingdom (UK). All enterococcal host strains (n = 390) were first screened for their ability to detect phage in samples of ra ...201122047499
Spatial covariation between freshwater and terrestrial ecosystem services.To inform the design and implementation of land-use policies that consider the variety of goods and services people derive from ecosystems, it is essential to understand spatial patterns of individual services, how multiple services relate to each other, and how these relationships vary across spatial scales and localities. Despite the importance of freshwater as a determinant of regional economic and human demographic patterns, there are surprisingly few studies that map the provision of a rang ...201121939042
A draft genome of Yersinia pestis from victims of the Black Death.Technological advances in DNA recovery and sequencing have drastically expanded the scope of genetic analyses of ancient specimens to the extent that full genomic investigations are now feasible and are quickly becoming standard. This trend has important implications for infectious disease research because genomic data from ancient microbes may help to elucidate mechanisms of pathogen evolution and adaptation for emerging and re-emerging infections. Here we report a reconstructed ancient genome ...201121993626
self-screening for neisseria gonorrhoeae and chlamydia trachomatis in the human immunodeficiency virus clinic--high yields and high acceptability.despite antiretroviral therapy (art), incident human immunodeficiency virus (hiv) continues to rise, and sexually transmitted infections (sti) are well known for their part in hiv transmission. national guidelines recommend routine sti screening in hiv-positive individuals, but despite this, reported uptake remains low.201122082720
A double-blind atropine trial for active learning of autonomic function.Here, we describe a human physiology laboratory class measuring changes in autonomic function over time in response to atropine. Students use themselves as subjects, generating ownership and self-interest in the learning as well as directly experiencing the active link between physiology and pharmacology in people. The class is designed to concomitantly convey the importance of bias in experimentation by adopting a double-blind placebo-controlled approach. We have used this class effectively in ...201122139783
increase in invasive streptococcus pyogenes and streptococcus pneumoniae infections in england, december 2010 to january 2011.increases in invasive streptococcus pyogenes and s. pneumoniae above the seasonally expected levels are currently being seen in england. preliminary analyses suggest that the high level of influenza activity seen this winter may be contributing to an increased risk of concurrent invasive bacterial and influenza infections in children and young adults.201121315057
group a streptococcal infections during the seasonal influenza outbreak 2010/11 in south east england.we present a series of 19 cases of invasive group a streptococcal (igas) infection reported to the thames valley health protection unit from 1 december 2010 to 15 january 2011. ten patients died and a prodrome of influenza-like illness was reported in 14 cases.influenza b co-infection was confirmed in four cases,three of which were fatal. our report provides further evidence that influenza b co-infection with igas has the potential to cause significant morbidity and mortality.201121315058
prevalence of human papillomavirus antibodies in males and females in england.most studies of human papillomavirus (hpv) epidemiology have employed dna testing, which measures current infections. serum antibodies offer a longer-term marker of infection in individuals who seroconvert and can therefore provide additional information about the exposure of populations to hpv.201121317688
from containment to community: trigger points from the london pandemic (h1n1) 2009 influenza incident response.in the uk, during the first wave of pandemic (h1n1) 2009 influenza, a national 'containment' strategy was employed from 25 april to 2 july 2009, with case finding, treatment of cases, contact tracing and prophylaxis of close contacts. the aim of the strategy was to delay the introduction and spread of pandemic flu in the uk, provide a better understanding of the course of the novel disease, and thereby allow more time for the development of treatment and vaccination options.201121288544
modelling the impact of local reactive school closures on critical care provision during an influenza pandemic.despite the fact that the 2009 h1n1 pandemic influenza strain was less severe than had been feared, both seasonal epidemics of influenza-like-illness and future influenza pandemics have the potential to place a serious burden on health services. the closure of schools has been postulated as a means of reducing transmission between children and hence reducing the number of cases at the peak of an epidemic; this is supported by the marked reduction in cases during school holidays observed across t ...201121288945
no effect of 2008/09 seasonal influenza vaccination on the risk of pandemic h1n1 2009 influenza infection in england.this study reports effectiveness of trivalent influenza vaccine (tiv) against confirmed pandemic influenza infection in england using a retrospective test-negative case-control study. cases and controls were frequency matched by age, swabbing-week and region. on univariable and multivariable analysis adjusted for underlying clinical risk factors, cases were no more or less likely than controls to be vaccinated with 2008-09 or 2007-08 season tiv. adjusted vaccine effectiveness for the former was ...201121292008
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