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hobson's choice: reproductive choices for women with learning disabilities.this paper examines the present law in england and wales concerning the sterilisation of women who are unable to give valid consent to medical treatment. in particular, it considers why sterilisation is frequently presented as the only meaningful reproductive choice that can be made by or on behalf of women with learning disabilities. in addition, the paper assesses the extent to which the best interests test, as formulated by the english courts, has been successful in the promotion of dignity a ...19989757730
binomial cokriging for estimating and mapping the risk of childhood cancer.the incidences of human diseases vary from place to place, and this is also likely to be so for the risk of people developing many of them. we have analysed the spatial distribution of childhood cancer in the west midland health authority region of england from 1980 to 1984. this is a rare disease which is considered to be noncontagious. the observed frequencies of the disease in the electoral wards have been converted to proportions that estimate the risk of a child's developing it. the spatial ...19989773520
enzyme-linked immunosorbent assay based on recombinant human group c rotavirus inner capsid protein (vp6) to detect human group c rotaviruses in fecal samples.a recent study showed that 43% of a population in the united kingdom were seropositive for group c rotavirus. the higher than expected incidence may be due to limited diagnosis of acute human group c rotavirus infections because no routine test is available. human group c rotavirus infections are routinely diagnosed by electron microscopy (em) and a negative group a rotavirus enzyme-linked immunosorbent assay (elisa) result. an antigen-detection elisa was developed with hyperimmune antibodies ra ...19989774561
human enteric pathogens identified in a london teaching hospital and a rural public health laboratory: 1994.two microbiology laboratories, one serving an inner city hospital and one a rural public health laboratory, collected data on the outcome of examining faecal specimens in 1994. overall, 6.7% of the investigations were positive, but the rates were lower for hospital inpatients, for recently described pathogens, and in the absence of relevant clinical details; rates were higher for patients with a history of foreign travel. no benefit was gained by examining more than two specimens from any patien ...19989782627
the cost-effectiveness of radon mitigation in schools in northamptonshire.a comprehensive radon survey of 2372 rooms in 348 northamptonshire schools is reported, together with results of the successful mitigation of the raised radon levels found in 20 schools. from analysis of the occupancy of affected rooms and the costs of remediation a total cost of 19,400 pounds per man-sievert saved annually was derived. this is around four times more cost-effective than the radon remediation in health service premises in northamptonshire, and slightly more cost-effective than a ...19989791811
the use of patients in health care education: the need for ethical justification.this paper addresses ethical concerns emanating from the practice of using patients for health care education. it shows how some of the ways that patients are used in educational strategies to bridge theory-practice gaps can cause harm to patients and patient-practitioner relationships, thus failing to meet acceptable standards of professional practice. this will continue unless there is increased awareness of the need for protection of human rights in teaching situations. unnecessary exposure o ...19989800586
mental incapacity: some proposals for legislative reform.while the decision of the house of lords in re f in [1990] clarified somewhat the law concerning the treatment of the mentally incapacitated adult, many uncertainties remained. this paper explores proposals discussed in a recent government green paper for reform of the law in an area involving many difficult ethical dilemmas.19989800588
otitis media in children with vertically-acquired hiv infection: the great ormond street hospital experience.human immunodeficiency virus (hiv) infection continues to be a vexing problem in the pediatric population. otitis media, a common entity in immunocompetent as well as immunocompromised children, is prevalent in pediatric patients with hiv infection. recurrent infections and complications secondary to otitis media are also common in this population. the purpose of this review was to evaluate the records of a large group of children with hiv infection undergoing treatment for otitis media at a ter ...19989804022
hepatitis g virus infection in drug users in liverpool.to establish the prevalence of hepatitis g (hgv) in drug users in liverpool; to explore the risk factors for, and the effects of, hgv infection.19989821088
serum eosinophil cationic protein: distribution and reproducibility in a randomly selected sample of men living in rural norfolk, uk.it has been proposed that serum levels of eosinophil cationic protein (ecp) may be a clinically useful measure in allergic illness. the aim of this report is to describe the distribution and reproducibility of serum ecp levels in a population sample and to examine its relationship with other markers of disease.19989824406
g209a mutation in the alpha-synuclein gene is rare and not associated with sporadic parkinson's disease. 19989827625
feasibility of named antenatal hiv screening in an inner city population.the object of this study was to assess the resource use, feasibility, uptake and consumers' perspective of introducing routine named human immunodeficiency virus (hiv) testing into an inner city hospital antenatal clinic (st thomas hospital, part of guy's and st thomas hospital trust). following the introduction of a new service offering routine named hiv testing at booking appointments, the length of the appointments were recorded over a three-month period and compared with appointment lengths ...19989828970
unwanted sexual experiences reported by nursing students: implications for nurse education and training.this study examined the nature and frequency of unwanted sexual experiences in childhood and adulthood reported by nursing students, using a questionnaire developed from the sexual events questionnaire (calam & slade). the questionnaire was distributed to 109 second-year nursing students (90 female and 19 male) for anonymous completion. at the same time a further short questionnaire asked students about their perceptions of the first questionnaire, and how far their course had, up to the present ...19989840889
human herpesvirus 8: seroepidemiology among women and detection in the genital tract of seropositive women.an indirect ifa to detect antibodies against latent nuclear antigens of human herpesvirus 8 (hhv-8) was used to determine the prevalence of hhv-8 antibodies in 169 women attending a sexually transmitted diseases clinic and a human immunodeficiency virus (hiv) clinic at a london hospital. nested polymerase chain reaction was used to detect hhv-8 dna in 93 blood samples and 89 cervical brush scrapes (cbs). another 96 cbs from women attending a colposcopy clinic were also analyzed. the overall sero ...19999841845
population dynamic interference among childhood diseases.epidemiologists usually study the interaction between a host population and one parasitic infection. however, different parasite species effectively compete, in an ecological sense, for the same finite group of susceptible hosts, so there may be an indirect effect on the population dynamics of one disease due to epidemics of another. in human populations, recovery from any serious infection is normally preceded by a period of convalescence, during which infected individuals stay at home and are ...19989842732
molecular characterisation of cryptosporidium parvum from two large suspected waterborne outbreaks. outbreak control team south and west devon 1995, incident management team and further epidemiological and microbiological studies subgroup north thames 1997.polymerase chain reaction/restriction fragment length polymorphism (pcr/rflp) analysis of the cryptosporidium parvum outer wall protein (cowp) gene was applied to specimens collected from 95 patients with cryptosporidiosis associated with two suspected waterborne outbreaks, 46 sporadic human cases and 62 infected livestock from other areas, and 12 patients infected with other gastrointestinal parasites. ninety-six per cent of c. parvum isolates from patients linked to the two suspected waterborn ...19989854879
influenza surveillance in england and wales: october 1997 to june 1998.influenza caused low levels of mortality and morbidity in england and wales in the 1997/98 season. influenza viruses of the h3n2 and h1n1 subtypes were isolated in small numbers from community and hospital patients in november and december. their numbers subsequently increased to peak in february, h1n1 a week or two before h3n2. most of the h1n1 isolates were similar to the a/bayern/7/95-like virus, included in the vaccine recommended for 1997-98, whereas most h3n2 isolates were a/sydney/5/97-li ...19989854882
larks and owls and health, wealth, and wisdom.to test the validity of benjamin franklin's maxim "early to bed and early to rise makes a man healthy, wealthy, and wise."19989857121
non-consensual sterilization of the adult with learning disabilities.community nurses may be asked for advice on sterilization operations for adults with learning disabilities by worried parents/carers. this article sets out the legal position advocated by the english courts. sterilization for adults with learning disabilities is generally non-consensual. the courts cannot consent on behalf of the adult but can rule on the lawfulness of the operation. cases need not be brought before the court when the operation is to be carried out to treat a specific menstrual ...19989866467
florence nightingale and the enduring legacy of transpersonal human caring. 19989867500
recollections of professor henry barcroft, f.r.s.professor henry barcroft, md, frs, emeritus professor of physiology in st. thomas' hospital medical school in london died on 11 january 1998, aged 93. he was born in cambridge on 18 october 1904 where his father, joseph barcroft, a famous physiologist, worked with foster and langley and subsequently was appointed to the chair of physiology. henry barcroft followed in his father's footsteps. during his career as professor of physiology firstly at the queen's university of belfast and subsequently ...19989869549
a population study of chromosome 22q11 deletions in infancy.to determine the prevalence of submicroscopic deletions within chromosome band 22q11 in infants with significant heart disease and compare this with the prevalence of other chromosomal abnormalities causing significant heart disease. to determine a minimum prevalence of deletions within chromosome band 22q11 in infants in the general population.19989875047
general paralysis of the insane and aids in old age psychiatry: epidemiology, clinical diagnosis, serology and ethics--the way forward.while the incidence of general paralysis of the insane (gpi) has declined, aids (acquired immune deficiency syndrome) has emerged as a new illness. today, in england and wales, as many elderly people die from aids as from neurosyphilis, although both diagnoses are rare in this age group. both are serious medical conditions with psychiatric manifestations. for both, serological tests may identify the disease, and treatment may be of benefit, but there is considerable social stigma attached to the ...19989884913
mycobacterium kansasii and human immunodeficiency virus co-infection in london.although mycobacterium kansasii infection has long been endemic in the u.k., the disease burden and characteristics of infection in the hiv-seropositive population has not been well documented. this study addresses these issues in an inner city population that comprises a quarter of all cases of acquired immunodeficiency syndrome (aids) reported in the u.k.19989892529
phenotype of a british north carolina macular dystrophy family linked to chromosome 6q.to document the phenotype of an autosomal dominant macular dystrophy diagnosed as having north carolina macular dystrophy (ncmd) in this british family, and to verify that the disease locus corresponds with that of mcdr1 on chromosome 6q.19989924305
crystalline silica and risk of lung cancer in the potteries.to evaluate crystalline silica as a human carcinogen.19989924456
incidence, risk and prognosis of acute and chronic fatigue syndromes and psychiatric disorders after glandular fever.the role of viruses in the aetiology of both chronic fatigue syndrome (cfs) and depressive illness is uncertain.19989926075
who's being irresponsible?this article analyzes the ban imposed on the funding of sterilization by the national health services (nhs). meaning, if a man wants a vasectomy or a woman decides on a laparoscope sterilization, then they have to pay the full cost. thus, those who cannot afford to pay will be deprived of this simple, civilized measure. either they will need more contraceptive care (which costs money), or they will have more children (which costs even more). on the other hand, the health authority has differ ...19979926599
is infection control an academic study?this editorial aims to answer the question of whether infection control is an academic specialty. by considering the consequences of a lack of infection control in terms of patient morbidity and mortality and hence cost, it is easy to establish the importance of the area. infection control embraces not only developing policies for preventing the physical spread of a micro-organism but also prophylactic therapy such as vaccination and therapeutic measures such as antibiotics. infection control no ...19999949958
[ronald ross: a century of the transfer of malaria by mosquitoes].ronald ross is a brilliant and polyvalent mind. when orientated towards medicine he took the training amateurishly and ended up with a limited qualification. after 2 years as a ship doctor, he attended the compulsory complementary training in order to be admissible in the ims, the garrison life left him with plenty of time to engage in his hobby's: painting for a short while, writing, poetry and mathematics. by the end of his first term he questioned the sense of his medical activities and decid ...19989989333
evidence-based reduction of obesity: identification of a subculture's least fattening eating patterns.public health nutritional interventions, like clinical treatments in medicine or psychology, should be based on direct evidence of their efficacy relative to prior existing modalities. yet the contribution of applied human nutrition and the psychology of eating to research into ways of slowing the rise of obesity has been limited to the intake of energy nutrients and investigator-prejudged questions about appetite and food choices. in contrast, it is feasible to get members of the public to desc ...19999989917
a difficult new year for the national health service. 199910023912
geographical distribution of variant cjd in the uk (excluding northern ireland).the agent that causes variant creutzfeldt-jakob disease (variant cjd) is indistinguishable from the causative agent of bovine spongiform encephalopathy (bse). the transmission route by which human beings are infected has not been established. one hypothesis is that cases of variant cjd have resulted from exposure to the bse agent via rendering plants involved in the production of meat and bone meal, the main vehicle of the bse epidemic.199910023945
clusters of pneumocystis carinii pneumonia: analysis of person-to-person transmission by genotyping.genotyping at the internal transcribed spacer (its) regions of the nuclear rrna operon was performed on isolates of p. carinii sp. f. hominis from three clusters of p. carinii pneumonia among eight patients with haematological malignancies and six with hiv infection. nine different its sequence types of p. carinii sp. f. hominis were identified in the samples from the patients with haematological malignancies, suggesting that this cluster of cases of p. carinii pneumonia was unlikely to have res ...199810024946
low rates of ehrlichiosis and lyme borreliosis in english farmworkers.to determine the occupational significance of tick-borne zoonoses we sought serological evidence of lyme borreliosis, human monocytic ehrlichiosis (hme) and human granulocytic ehrlichiosis (hge) in a representative sample of farmworkers. although around 20% reported ticks on their domestic and companion animals, few (< 2% per year) reported being bitten by ticks. seroprevalence of lyme borreliosis (0.2%), hme (0.2%) and hge (1.5%) was low. those seropositive for hge were no more likely to report ...199810030710
government sets up inquiry into ventilation trial. 199910037613
a common msh2 mutation in english and north american hnpcc families: origin, phenotypic expression, and sex specific differences in colorectal cancer.the frequency, origin, and phenotypic expression of a germline msh2 gene mutation previously identified in seven kindreds with hereditary non-polyposis cancer syndrome (hnpcc) was investigated. the mutation (a-->t at nt943+3) disrupts the 3' splice site of exon 5 leading to the deletion of this exon from msh2 mrna and represents the only frequent msh2 mutation so far reported. although this mutation was initially detected in four of 33 colorectal cancer families analysed from eastern england, mo ...199910051005
manufacturing a human drama from a psychiatric crisis: crisis intervention, family therapy and the work of r. d. scott.there has been a recent resurgence of interest in crisis intervention within psychiatry. the idea of crisis services is not, of course, a new thing, and there is a great deal to be learnt from returning to the innovative writings of those practitioners who developed similar services in the 1960s and 1970s. this article discusses the work of the psychiatrist and family therapist r. d. scott, who developed a 24-hour family-orientated crisis intervention service in london during this era. although ...199810067486
influenza activity starts while christmas interrupts surveillance. 199910079591
statistical analysis of the age-adjusted incidence rates of human neoplasias: changes in time and space from early 1960's to mid 1980's with special reference to the steroid criminal hypothesis of carcinogenesis.our earlier reports indicated that the changes of age-adjusted incidence rates (aairs) of any 2 tumors in time and space, as investigated by the sequential regression analysis, showed a good fitness to the equilibrium model under the control of the law of mass action. the purpose of this study is to investigate the problem of whether or not the changes of aairs of individual tumors in time and space show a similar fitness to the equilibrium model of the law of mass action. the cancer risk data s ...199910085420
pathogenic presenilin 1 mutations (p436s & i143f) in early-onset alzheimer's disease in the uk. mutations in brief no. 223. online.familial alzheimer's disease (ad) is an autosomal dominant disorder characterized by memory impairment and multiple cognitive deficits which occurs in mid to late life. early onset ad has been associated with mutations in three genes, of which presenilin 1 (ps1) mutations are the most frequent. we sequenced the open reading frame from genomic dna of a series of 21 early onset ad (ad3) uk families in which there were at least two affected individuals in two or more generations with a diagnosis of ...199910090481
risk factors for tuberculosis in patients with aids in london: a case-control study.to identify risk factors for the acquired immune-deficiency syndrome (aids) associated with tuberculosis, in patients with aids attending 11 of the largest human immunodeficiency virus (hiv)/aids units in london.199910094164
how the worm was won. the c. elegans genome sequencing project.the genome sequence of the free-living nematode caenorhabditis elegans is nearly complete, with resolution of the final difficult regions expected over the next few months. this will represent the first genome of a multicellular organism to be sequenced to completion. the genome is approximately 97 mb in total, and encodes more than 19,099 proteins, considerably more than expected before sequencing began. the sequencing project--a collaboration between the genome sequencing center in st louis an ...199910098407
presence of campylobacter and salmonella in sand from bathing beaches.the purpose of this study was to determine the presence of thermophilic campylobacter spp. and salmonella spp. in sand from non-eec standard and eec standard designated beaches in different locations in the uk and to assess if potentially pathogenic strains were present. campylobacter spp. were detected in 82/182 (45%) of sand samples and salmonella spp. in 10/182 (6%). campylobacter spp. were isolated from 46/92 (50%) of samples from non-eec standard beaches and 36/90 (40%) from eec standard be ...199910098779
molecular typing of salmonella serotype thompson strains isolated from human and animal sources.one-hundred-and-thirteen isolates of salmonella serotype thompson from diverse sources in seven countries were characterized by pvuii ribotyping and is200 fingerprinting. ten pvuii ribotypes were observed. the predominant pvuii ribotype 1 represented a major clone of world-wide distribution but was not found in australia; pvuii ribotypes 2 and 3 represented minor clones. hincii ribotyping discriminated subtypes within pvuii ribotype 1: hincii ribotype 1 was distributed widely but hincii ribotype ...199910098783
the ability of non-ergonomists in the health care setting to make manual handling risk assessments and implement changes.the health care setting presents particular risks from manual handling and it is known that training in manual handling techniques is ineffective in reducing these risks when used as a stand-alone measure. the 'manual handling operations regulations 1992' requires employers to consider hazardous manual handling, advising the use of an ergonomics approach. however, it is not known how well-equipped non-ergonomists in the health care setting are to deal with this approach. therefore, the ability o ...199910098808
money, morals and medical risks: conflicting notions underlying the recruitment of egg donors. 199910099963
the clinical importance of the anaerobic energy system and its assessment in human performance. 199910102111
an anti red-tape man allowed too much rope? 199110110643
historical notes on partial hospitalization.the author addresses the historical antecedents of three important aspects of partial hospitalization: (1) therapeutic use of the milieu, (2) decentralization of hospital-based care, and (3) a pluralistic view of the human organism. in the process, a tour d'horizon of western psychiatry from the period of phillipe pinel to that of adolf meyer is provided. such an excursion into history permits a greater appreciation of the partial hospital setting and the relevance of history in the evolution of ...199010111975
stretched to the limit.everyone agrees that junior doctors work excessively long hours. the difficulty has been finding a solution to the problem within staffing limits. penelope dash and angela jones set out two ways to stretch the human resources available to make best use of them.199110114815
the lincolnshire joint emergency services initiative for staff at risk following critical incidents.this article is based on a paper presented by roderick j. orner at the annual conference of the national association for health service personnel officers, bristol, 20-21 september 1991. the scheme won the prize for innovation in hrm at the national healthcare awards for excellence in human resource management 1991.199110116145
model of care for the hospital treatment of individuals with hiv infection.this study was undertaken and completed in 1988, in an attempt to determine the reasons for admission to hospital, and the optimum care required for patients with human immunodeficiency virus related illnesses. approximately half of the total medical admissions stayed for less than a week, and patients admitted for terminal care and social care occupied a relatively small proportion of the beds. the single largest group of admissions were those for inpatient management of aids-related pneumonias ...199110116892
allocation of resources--to treat or not to treat, and who shall beg the question?two separate clusters of events in recent months have spurred public discussions over the questions of how and to what degree the public should be involved in resource allocation decisions. in england, a group of physicians unilaterally decided to deny bypass surgery to heavy smokers, and in the united states, uninsured parents of conjoined twins elected to seek separation of the twins despite heavy odds against their survival, raising questions of whether health care reform will stymie such dec ...199310129494
influenza immunisation: policies and practices of general practitioners in england, 1991/92.a large questionnaire survey of general practices in england to determine the most recent policies, perceptions, and procedures for influenza immunisation, and the extent to which individual practice characteristics were related to levels of vaccine distribution, was conducted during january and february 1992. the results indicate that the proportion of practices with influenza immunisation policies has increased considerably since the mid 1980s. however, some notable shortcomings remain and pra ...199310131862
management ... working day of a health services manager. north staffordshire hospital.physiotherapy needs to change to be relevant and appropriate to the delivery of health care in the future: departments in acute units will become smaller as therapists' expertise is required in the community. sue jackson, physiotherapy manager, north staffordshire hospital, describes the first steps in this culture change--and other professional and human resource issues.199410133762
understanding adverse events: human factors.(1) human rather than technical failures now represent the greatest threat to complex and potentially hazardous systems. this includes healthcare systems. (2) managing the human risks will never be 100% effective. human fallibility can be moderated, but it cannot be eliminated. (3) different error types have different underlying mechanisms, occur in different parts of the organisation, and require different methods of risk management. the basic distinctions are between: slips, lapses, trips, and ...199510151618
information in general medical practice: a qualitative approach.the aims of the study reported here were to describe the information-related behavior of general medical practitioners, to study information communication in general practices, and to establish guidelines for good practice. general practitioners (gps) were interviewed, and information and communication audits also involving other staff at the practices were undertaken. the main reasons why gps needed information were for patient care, managing the practice, legal and ethical matters, and teachin ...199510152474
consulting consumers. only human. 199610156286
the impact of three influenza epidemics on primary care in england and wales.the numbers of persons with influenza presenting to general practitioners in england and wales during the epidemics of late 1989, late 1993, and early 1995 are estimated to be approximately 760,00, 480,000 and 192,000, respectively. the expected numbers used to derive these estimates were obtained by averaging incidence by week over the 9 winters of 1986/87 to 1994/95, excluding those weeks in which influenza was prevalent. these 3 epidemics varied in magnitude and in the relative impact on pers ...199610160485
workforce planning. the human factor. 199710165734
impact of litigation on senior clinicians: implications for risk management.to investigate the impact of litigation on consultants and senior registrars and to establish their views on methods of reducing adverse events and litigation.199710166604
career profile. human resources. power to the people. 199710173479
towards a new health care paradigm. patient-focused care. the case of kingston hospital trust.patient-focused care (pfc) and business process re-engineering (bpr) have been advocated in the academic literature as techniques to improve both quality of service and reduce costs. seeks to separate and delineate the components of pfc and bpr and, using the case study method, describe the adoption and implementation process of pfc in medicine and maternity by one london nhs trust hospital. reports the impact of this innovation on service delivery, staff reconfiguration and multi-skilling. iden ...199710176830
hospital beds and how to survive them. 199710177035
health care in the courts. r v cambridge district health authority. 199510184446
a cytotoxic t lymphocyte antigen-4 (ctla-4) gene polymorphism is associated with autoimmune addison's disease in english patients.recent studies have demonstrated an association between a microsatellite polymorphism of the ctla-4 gene, specifically a 106 base pair allele, and both graves' disease and autoimmune hypothyroidism. the aim of the present study was to determine whether the same polymorphism of the ctla-4 gene was associated with autoimmune addison's disease.199810197076
acute respiratory infections, and influenza vaccine for 1999/2000. 199910204284
serious hazards of transfusion (shot)--annual report 1997-1998. 199910205978
limits to the value of mental health review tribunals for offender patients. suggestions for reform.reform of mental health legislation for england and wales is due. mhrts offer an important check in the balance between patient and public rights.199910211172
absence of human astrovirus rna in sewage and environmental samples.over a period of several weeks during the summer of 1996, samples of sewage, sea water, river water, sand and silt were collected from a sewage works at weston-super-mare, england and from coastal areas nearby. a sensitive reverse-transcriptase polymerase chain reaction (rt-pcr) was used to search for human astrovirus (hastv) rna in concentrates of the samples. no evidence of astrovirus was found in any sample, which suggests that contamination with these viruses is not a problem in this area du ...199910212416
burnout and aids care-related factors in hiv community clinical nurse specialists in the north of england.burnout in acquired immune deficiency syndrome (aids) care nursing is well described in the literature from a hospital based perspective. no studies into the effects of aids care and burnout have been carried out within the community setting. a two-stage, mixed method study was carried out. in stage one 30 clinical nurse specialists in human immunodeficiency virus (hiv)/aids from the north of england completed the maslach burnout inventory (mbi) and the aids impact scale. for stage two five prac ...199910215992
is technetium-99 (tc-99) radiologically significant?according to radiological protection authorities the radioisotope technetium-99 (tc-99) is not 'radiologically significant' to humans or other species. the sellafield plutonium reprocessing plant discharges large amounts of tc-99 into the irish sea; by the year 2015 a total of about 3,000 tera-becquerels of tc-99, weighing about 5 tonnes, will have been discharged. this article considers the effects of tc-99 on the environment. after discharge, tc-99 travels large distances in the ocean. levels ...199910218003
[courage--the mother of all virtues].to be a physician requires courage. to engage in the patient as a person calls for social courage. courage is needed to act rapidly and firmly in unclear clinical situations. the noble art of saying no to patients, bureaucrats and politicians calls upon courageous doctors. to resist follies and fallacies in medicine requires courage. the same virtue is necessary for the brave colleagues who try to diagnose and heal the perils within the medical fraternity. the autonomy, renewal and sustainabilit ...199910228419
international group fights for human rights. 197810236757
louise: birth of a new technology. 197810237033
all set for the coming of the safety man. 197810238743
preparing for the new hospital in maidstone: the human side of commissioning activities. 198210255965
championing minority groups. 198510271410
office furniture. are you sitting comfortably? 198610276782
racial policy. uphill struggle against injustice. 198710280260
health museums or theme parks: a new approach to intersectoral collaboration.this paper is an outline of a proposed initiative on intersectoral collaboration in health promotion--collaboration between health, tourist, cultural and entertainment sectors to provide a powerful mass educational experience about the human mind and body. there has been a recent rise in interest in using the technology of museums, science centres, exploratories and theme parks for the promotion of health. this revival is shown to have a historical tradition in the health education museum starte ...198610286864
the natural history of waiting lists--some wider explanations for an unnecessary problem.the examination of waiting list statistics suggests that long waiting times have at most a tenuous relationship with any lack of nhs resources. long waiting times offer strong evidence that nhs resources are not allocated rationally in that the conditions whose relative neglect is expressed in waiting lists are those conditions where clear benefits are likely to follow comparatively cheap treatments. this article offers two wider explanations for the fact that this seemingly irrational picture h ...198910293580
class mortality differentials, income distribution and trends in poverty 1921-1981.the official figures which appear to show a widening of class differences in health in england and wales during the post-war period have been controversial partly because they do not fit with common perceptions of what has happened to differences in the standard of living. as a result, a great deal of effort has gone into investigating suggested weaknesses in the decennial social class mortality data. though initially plausible, the artifactual and selective explanations of the widening mortalit ...198910296719
healthy move on equality. 198810302691
long-stay hospitals. working animal magic on the geriatric wards. 198410311012
a screening program for trisomy 21 at 10-14 weeks using fetal nuchal translucency, maternal serum free beta-human chorionic gonadotropin and pregnancy-associated plasma protein-a.to examine the potential impact of combining maternal age with fetal nuchal translucency thickness and maternal serum free beta-human chorionic gonadotropin (beta-hcg) and pregnancy-associated plasma protein-a (papp-a) in screening for trisomy 21 at 10-14 weeks of gestation.199910341399
general practitioners' perceptions of effective health care.to explore general practitioners' perceptions of effective health care and its application in their own practice; to examine how these perceptions relate to assumptions about clinicians' values and behaviour implicit in the evidence based medicine approach.199910356011
studies of antibiotic resistance within the patient, hospitals and the community using simple mathematical models.the emergence of antibiotic resistance in a wide variety of important pathogens of humans presents a worldwide threat to public health. this paper describes recent work on the use of mathematical models of the emergence and spread of resistance bacteria, on scales ranging from within the patient, in hospitals and within communities of people. model development starts within the treated patient, and pharmacokinetic and pharmacodynamic principles are melded within a framework that mirrors the inte ...199910365398
supervision of chiropractors: a summary of results from two surveys involving chiropractic supervisors and graduates in england and sweden.supervision of newly graduated health care practitioners takes place in many clinical settings, such as in different types of hospital departments, in general practice, and now also within the chiropractic profession. the author conducted an initial study to determine the most important issues regarding the supervision of chiropractic graduates in sweden. because it is important to define and discuss the format and contents for that part of the 1-year postgraduate education program for the newly ...199910367756
james cowles prichard's anthropology: remaking the science of man in early nineteenth-century britain. 199910370858
diaphyseal cross-sectional geometry of the boxgrove 1 middle pleistocene human tibia.cross-sectional geometric analysis of the early middle pleistocene human tibia from boxgrove, west sussex, u.k. reveals a mosaic pattern relative to other archaic homo tibiae. the specimen has relatively low percent cortical area within its cross sections. however, it exhibits the high mediolateral strength characteristic of archaic homo tibiae. scaled solely to tibial length it is robust, similar to those of the neandertals and above those of early modern and pre-late pleistocene african and as ...199910375475
a stop-codon mutation in the bri gene associated with familial british dementia.familial british dementia (fbd), previously designated familial cerebral amyloid angiopathy-british type, is an autosomal dominant disorder of undetermined origin characterized by progressive dementia, spasticity, and cerebellar ataxia, with onset at around the fifth decade of life. cerebral amyloid angiopathy, non-neuritic and perivascular plaques and neurofibrillary tangles are the predominant pathological lesions. here we report the identification of a unique 4k protein subunit named abri fro ...199910391242
effect of epstein-barr virus infection on response to chemotherapy and survival in hodgkin's disease.we have analyzed paraffin sections from 190 patients with histologically confirmed hodgkin's disease (hd) for the presence of epstein-barr virus (ebv) using in situ hybridization to detect the ebv-encoded epstein-barr virus early rnas (ebers) and immunohistochemistry to identify latent membrane protein-1 (lmp1) expression. ebv was present in the tumor cells in 51 hd cases (27%) and was mainly confined to the mixed cellularity and nodular sclerosis subtypes. there was no difference between ebv-po ...199910397711
enterovirus infections in england and wales: laboratory surveillance data: 1975 to 1994.microbiology laboratories in england and wales reported 40,366 culture confirmed isolates of echovirus (24,628; 61%) and coxsackievirus (b 11,714; 29%, a 4024; 10%) infections to the phls communicable disease surveillance centre (cdsc) in the 20 years from 1975 to 1994. nearly half of the organisms were isolated from faeces, and 5741 were isolated from cerebrospinal fluid (75% of them echovirus, 13% coxsackie b, and 12% coxsackie a). isolation rates for all enteroviruses were highest among infan ...199910402747
effect of material deprivation on epstein-barr virus infection in hodgkin's disease in the west midlands.we have used townsend scores from postcode data to compare levels of material deprivation and epstein-barr virus (ebv)-positivity for 223 patients diagnosed with hodgkin's disease (hd) in the period 1981-1997. the presence of ebv in hd tumours was determined using in situ hybridization to target the abundantly expressed ebv early rnas. ebv was detected in the malignant hodgkin and reed-sternberg cells in 47/223 hd cases (21%). there was found to be a tendency for higher townsend scores (indicati ...199910408873
the molecular basis of malonyl-coa decarboxylase deficiency.we characterized a 2.1-kb human cdna with a 1362-bp (454-amino acid) open reading frame showing 70.3% amino acid identity to goose malonyl-coa decarboxylase (mcd). we have identified two different homozygous mutations in human mcd (hmcd) by using rt-pcr analysis of fibroblast rna from two previously reported consanguineous scottish patients with mcd deficiency. the first mutation is a 442c-->g transversion resulting in a premature stop codon (s148x) in the n-terminal half of the protein. the sec ...199910417274
the gene for hypotrichosis of marie unna maps between d8s258 and d8s298: exclusion of the hr gene by cdna and genomic sequencing.hypotrichosis of marie unna (mu) is an autosomal dominant hair-loss disorder with onset in childhood. a genomewide search for the gene was performed in a large dutch family using 400 fluorescent microsatellite markers. linkage was detected with marker d8s258, and analysis of this family and a further british kindred with additional markers in the region gave a combined maximum two-point lod score of 13.42, with d8s560. informative recombinants placed the mu gene in a 2.4-cm interval between mark ...199910417283
autosomal dominant cerebellar ataxia type iii: linkage in a large british family to a 7.6-cm region on chromosome 15q14-21.3.autosomal dominant cerebellar ataxia type iii (adca iii) is a relatively benign, late-onset, slowly progressive neurological disorder characterized by an uncomplicated cerebellar syndrome. three loci have been identified: a moderately expanded cag trinucleotide repeat in the sca 6 gene, the sca 5 locus on chromosome 11, and a third locus on chromosome 22 (sca 10). we have identified two british families in which affected individuals do not have the sca 6 expansion and in which the disease is not ...199910417284
comparison of intestinal function in human immunodeficiency virus-seropositive patients in kampala and london.white homosexual men with human immunodeficiency virus (hiv) show progressive impairment of intestinal function assessed in terms of intestinal permeability and absorptive capacity. in this study we aimed to determine the effects of heterosexually acquired hiv on small-intestinal function in native africans, among whom there is a high prevalence of tropical enteropathy.199910423065
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