1
|
Havlickova P, Crossley J, Gardian Z, Dycka F, Kuta Smatanova I, Franta Z. Structural and functional studies of TBEV non-structural protein 5. Acta Cryst Sect A 2022. [DOI: 10.1107/s2053273322093925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
|
2
|
Abstract
INTRODUCTION Neurocognitive models of hallucinations posit theories of misattribution and deficits in the monitoring of mental or perceptual phenomena but cannot yet account for the subjective experience of hallucinations across individuals and diagnostic categories. Arts-based research methods (ABRM) have potential for advancing research, as art depicts experiences which cognitive neuropsychiatry seeks to explain. METHODS To examine how incorporating ABRM may advance hallucination research and theories, we explore data on the lived experiences of hallucinations in psychiatric and neurological populations. We present a multiple case study of two empirical ABRM studies, which used participant-generated artwork and artist collaborations alongside interviews. RESULTS ABRM combined with interviews illustrated that hallucinations were infused with sensory features, characterised by embodiment, and situated within lived circumstances. These findings advance neurocognitive models of hallucinations by nuancing their multimodal nature, illustrating their embodied feelings, and exploring their content and themes. The process of generating artworks aided in disclosing difficult to discuss hallucinations, promoted participant self-reflection, and clarified multimodal details that may have been misconstrued through interview alone. ABRM were relevant and acceptable for participants and researchers. CONCLUSION ABRM may contribute to the development of neurocognitive models of hallucinations by making hallucination experiences more visible, tangible, and accessible.
Collapse
Affiliation(s)
- Katie Melvin
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK.,Leicestershire Partnership NHS Trust, Leicester, UK.,Innovation, Technology and Operations Division, School of Business, University of Leicester, Leicester, UK
| | | | - John Cromby
- Innovation, Technology and Operations Division, School of Business, University of Leicester, Leicester, UK
| | - Jon Crossley
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK.,Leicestershire Partnership NHS Trust, Leicester, UK
| | - Jane R Garrison
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Graham K Murray
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - John Suckling
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| |
Collapse
|
3
|
Melvin K, Crossley J, Cromby J. The feeling, embodiment and emotion of hallucinations in first episode psychosis: A prospective phenomenological visual-ecological study using novel multimodal unusual sensory experience (MUSE) maps. EClinicalMedicine 2021; 41:101153. [PMID: 34877510 PMCID: PMC8633969 DOI: 10.1016/j.eclinm.2021.101153] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 09/12/2021] [Accepted: 09/22/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Research and practice typically focus upon unimodal hallucinations, especially auditory verbal hallucinations. Contemporary research has however indicated that voice-hearing may co-occur within a broader milieu of feelings, and multimodal hallucinations may be more common than previously thought. METHODS An observational design asked participants to prospectively document the feeling and modality of hallucinations for one week prior to an interview. Novel visual diary methods involving drawing, writing and body-mapping generated 42 MUSE maps (multimodal unusual sensory experience), analysed with a participatory qualitative method. Twelve people took part: all experiencing hallucinations daily, accessing early intervention in psychosis services, given psychotic-spectrum diagnoses, and living in the community. The study took place during a seven-month period in 2018 at Leicestershire and Rutland's Psychosis Intervention and Early Recovery service (UK). FINDINGS All documented hallucinations co-occurred with bodily feelings. Feelings were localised to specific body areas, generalised across the body and extended beyond the body into peripersonal space. Co-occurring emotional feelings most commonly related to confusion, fear and frustration. INTERPRETATION Hallucinations were characterised by numerous feelings arising at once, often including multimodal, emotional, and embodied features. Within this study, the immediate feeling of hallucination experiences were readily communicated through prospective, visual, and ecological information gathering methods and particularly those which offer multiple modes of communication (e.g. body-map, visual, written, oral). Uptake of visual, ecological and prospective methods may enhance understandings of lived experiences of hallucinations.Funding: University of Leicester.
Collapse
Affiliation(s)
- Katie Melvin
- University of Leicester, Department of Neuroscience, Psychology and Behaviour, George Davies Centre, University of Leicester, 15 Lancaster Road, Leicester, LE1 7HA
- Leicestershire Partnership National Health Service (NHS) Trust, George Davies Centre, University of Leicester, 15 Lancaster Road, Leicester, LE1 7HA
- University of Leicester, Division of Innovation, Technology and Operations, Brookfield Campus, 266 London Road, Leicester, LE2 1RQ
- Corresponding Author
| | - Jon Crossley
- University of Leicester, Department of Neuroscience, Psychology and Behaviour, George Davies Centre, University of Leicester, 15 Lancaster Road, Leicester, LE1 7HA
- Leicestershire Partnership National Health Service (NHS) Trust, George Davies Centre, University of Leicester, 15 Lancaster Road, Leicester, LE1 7HA
| | - John Cromby
- University of Leicester, Division of Innovation, Technology and Operations, Brookfield Campus, 266 London Road, Leicester, LE2 1RQ
| |
Collapse
|
4
|
Abstract
BACKGROUND Psychosis, characterised by altered perceptions or interpretations of reality, remains a contested area. Lately, perspectives and conceptualisations of psychosis that have traditionally been more peripheral have gained greater recognition. Both the British Psychological Society and Critical Psychiatry Network have highlighted some contentious areas in recent publications. AIMS The aim was to use critical narrative analysis to consider what facilitates and inhibits medical professionals with clinical experience of psychosis to engage with the topic of psychosis as a contentious area. METHOD Semi-structured interviews were conducted with 12 medical professionals, who were at trainee or qualified level with a minimum of 6 months' clinical experience within psychiatry, across three Trusts within the United Kingdom. This purposive sample had a diverse range of perspectives regarding psychosis. Critical narrative analysis comprising six distinct stages, informed the analysis. RESULTS Participants positioned themselves broadly within one of three groups: biological psychiatrists, critical psychiatrists and those more conflicted. Narrative analysis was undertaken for each participant before being integrated for this article. The research highlighted several factors which either limit or facilitate opportunities within the psychiatric profession to engage with a plurality of views regarding psychosis. These included the significance of power and hierarchy within the profession, the role of dialogue and the prevalence of reflexivity within the profession. CONCLUSION A pattern was identified of psychiatrists generally associating with like-minded others and not engaging with wider evidence regarding psychosis, partly as a result of the inherent threats to the power and hierarchy of the profession. This led to new ideas being widely unknown or undervalued, potentially to the disservice of clinical practice.
Collapse
Affiliation(s)
- Therese O'Donoghue
- Department of Neuroscience, Psychology and Behaviour, George Davies Centre, University of Leicester, Leicester, UK
| | - Jon Crossley
- Department of Neuroscience, Psychology and Behaviour, George Davies Centre, University of Leicester, Leicester, UK
| |
Collapse
|
5
|
Macdonald M, Crossley J, Ellis K, Dudding N, Lyon R, Smith JHF, Tidy JA, Palmer JE. Prevalence of high-grade cervical intraepithelial neoplasia in women with persistent high-risk HPV genotypes and negative cytology. Cytopathology 2018; 29:133-142. [DOI: 10.1111/cyt.12516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2017] [Indexed: 11/27/2022]
Affiliation(s)
- M. Macdonald
- Department of Gynaecological Oncology; Sheffield Teaching Hospitals NHS Foundation Trust; Sheffield UK
| | - J. Crossley
- Department of Cytology; Sheffield Teaching Hospital NHS Foundation Trust; Sheffield UK
| | - K. Ellis
- Department of Cytology; Sheffield Teaching Hospital NHS Foundation Trust; Sheffield UK
| | - N. Dudding
- Department of Cytology; Sheffield Teaching Hospital NHS Foundation Trust; Sheffield UK
| | - R. Lyon
- Sheffield Teaching Hospitals NHS Foundation Trust; Sheffield UK
| | - J. H. F. Smith
- Department of Histopathology; Sheffield Teaching Hospitals NHS Foundation Trust; Sheffield UK
| | - J. A. Tidy
- Department of Gynaecological Oncology; Sheffield Teaching Hospitals NHS Foundation Trust; Sheffield UK
| | - J. E. Palmer
- Department of Gynaecological Oncology; Sheffield Teaching Hospitals NHS Foundation Trust; Sheffield UK
| |
Collapse
|
6
|
Abstract
Using key words online databases were searched to identify relevant publications to review the use of Human papilloma virus (HPV) in cervical screening. The mode of cervical screening in the UK has been decided but implementation plans have yet to be announced. The protracted uncertainty surrounding the initial announcement to move to HPV primary screening together with the lack of a national steer has resulted in a flight of staff which threatens the provision of the current and future service. The transition will be a challenging time but analysis of data from more than 176,000 women has shown clear evidence of a reduction in the incidence of cancer where HPV testing is used. There will however, be a population of women who are cytologically negative but high-risk HPV positive and the management of these women will be key to maximising the benefits of HPV primary screening. As cervical cytology becomes increasingly rare its effectiveness and role in cervical screening will come under scrutiny and we must ensure the specificity of reporting is maintained in order for it to survive.
Collapse
Affiliation(s)
- B Crossley
- a Cytopathology , St James's University Hospitals NHS Trust , Leeds , UK
| | - J Crossley
- a Cytopathology , St James's University Hospitals NHS Trust , Leeds , UK
| |
Collapse
|
7
|
Melluish S, Crossley J, Tweed A. An Evaluation of the Use of Simulated Patient Role-Plays in the Teaching and Assessment of Clinical Consultation Skills in Clinical Psychologists' Training. Psychology Learning & Teaching 2016. [DOI: 10.2304/plat.2007.6.2.104] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Simulated patient role-plays (SPRs) with trained actors are a recent development in the training of clinical psychologists. This paper reports on the introduction and evaluation of SPRs as both a method used to teach clinical consultation skills and as a method to formatively assess trainee clinical psychologists' acquisition of these skills. The evaluation used a number of focus groups with clinical psychology trainees, programme staff and clinical supervisors to explore the acceptability of these methods in teaching and assessment, the experience of using them and the impact on trainees' learning. Focus group interviews were transcribed verbatim and analysed using template analysis. The core theme from the analysis concerned the capacity of SPRs to authentically recreate a clinical environment and capture the trainee's clinical practice. The concept of authenticity is discussed in relation to clinical skills teaching and the wider profession of clinical psychology.
Collapse
|
8
|
Palmer JE, Ravenscroft S, Ellis K, Crossley J, Dudding N, Smith JH, Tidy JA. Does LLETZ excision margin status predict residual disease in women who have undergone post-treatment cervical cytology and high-risk human papillomavirus testing? Cytopathology 2015; 27:210-7. [DOI: 10.1111/cyt.12260] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2015] [Indexed: 11/28/2022]
Affiliation(s)
- J. E. Palmer
- Department of Gynaecological Oncology/Jessop Wing Colposcopy Unit; Sheffield Hospitals NHS Trust; Sheffield UK
| | - S. Ravenscroft
- Doncaster and Bassetlaw NHS Foundation Trust; Doncaster UK
| | - K. Ellis
- Department of Cytology; Sheffield Hospitals NHS Trust; Sheffield UK
| | - J. Crossley
- Department of Cytology; Sheffield Hospitals NHS Trust; Sheffield UK
| | - N. Dudding
- Department of Cytology; Sheffield Hospitals NHS Trust; Sheffield UK
| | - J. H. Smith
- Department of Cytology; Sheffield Hospitals NHS Trust; Sheffield UK
- Department of Histopathology & Cytology, Sheffield Hospitals NHS Trust; Sheffield UK
| | - J. A. Tidy
- Department of Gynaecological Oncology/Jessop Wing Colposcopy Unit; Sheffield Hospitals NHS Trust; Sheffield UK
| |
Collapse
|
9
|
Cross PA, Hodgson C, Crossley J, Crossley B. Development of a technical external quality assurance scheme in non-gynaecological cytology in UK. Cytopathology 2015; 26:71-4. [DOI: 10.1111/cyt.12245] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2015] [Indexed: 11/28/2022]
Affiliation(s)
- P. A. Cross
- Department of Pathology; The Pathology Centre; Queen Elizabeth Hospital; Gateshead Tyne and Wear UK
| | - C. Hodgson
- UK NEQAS CPT; Department of Pathology; The Pathology Centre; Queen Elizabeth Hospital; Gateshead Tyne and Wear UK
| | - J. Crossley
- Department of Cytology; Royal Hallamshire Hospital; Sheffield UK
| | - B. Crossley
- The Royal Oldham Hospital; Oldham Lancashire UK
| |
Collapse
|
10
|
Innamaa A, Dudding N, Ellis K, Crossley J, Smith JH, Tidy JA, Palmer JE. High-risk HPV platforms and test of cure: should specific HPV platforms more suited to screening in a ‘test of cure’ scenario be recommended? Cytopathology 2014; 26:381-7. [DOI: 10.1111/cyt.12223] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2014] [Indexed: 10/24/2022]
Affiliation(s)
- A. Innamaa
- Department of Gynaecological Oncology/Jessop Wing Colposcopy Unit; Sheffield Hospitals NHS Trust; Sheffield UK
| | - N. Dudding
- Department of Cytology; Sheffield Teaching Hospitals NHS Foundation Trust; Sheffield UK
| | - K. Ellis
- Department of Cytology; Sheffield Teaching Hospitals NHS Foundation Trust; Sheffield UK
| | - J. Crossley
- Department of Cytology; Sheffield Teaching Hospitals NHS Foundation Trust; Sheffield UK
| | - J. H. Smith
- East Pennine Cytology Training Centre; Department of Histopathology & Cytology; Sheffield Hospitals NHS Trust; Sheffield UK
| | - J. A. Tidy
- Department of Gynaecological Oncology/Jessop Wing Colposcopy Unit; Sheffield Hospitals NHS Trust; Sheffield UK
| | - J. E. Palmer
- Department of Gynaecological Oncology/Jessop Wing Colposcopy Unit; Sheffield Hospitals NHS Trust; Sheffield UK
| |
Collapse
|
11
|
Abstract
The present article reports on the variation of mental health resources across the globe and considers the merits or otherwise of the process of globalization in low- and middle-income countries (LMIC), with a specific emphasis on Ethiopia. Although globalization has gained momentum in recent years, there is a concern that the globalization of Western mental health frameworks is problematic, as these concepts have been developed in a different context and do not accommodate the current diversity in understanding in LMIC countries. The importance of understanding the mental health frameworks of LMIC like Ethiopia, prior to considering if and how aspects of high-income countries (HIC) conceptualizations may be appropriately imported, is therefore reflected upon. Traditional approaches in managing mental health difficulties and possible reasons for the limited engagement with clinical psychology in Ethiopia are considered. Current developments within the fields of mental health and clinical psychology in Ethiopia are discussed, and the need to develop more local research in order to increase understanding and evaluate treatment interventions is recognized. Further consideration and debate by Ethiopian mental health professionals as well as those from HIC are recommended, to promote both reciprocal learning and new local discourses about mental health.
Collapse
Affiliation(s)
- Rachel Swancott
- Clinical Psychology Unit, University of Leicester , Leicester , UK
| | | | | |
Collapse
|
12
|
Dudding N, Crossley J. Sensitivity of cytology and HPV testing. Cytopathology 2014; 25:268-9. [DOI: 10.1111/cyt.12169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- N. Dudding
- Department of Cytology; Sheffield Teaching Hospitals; UK
| | | |
Collapse
|
13
|
Weller JM, Misur M, Nicolson S, Morris J, Ure S, Crossley J, Jolly B. Can I leave the theatre? A key to more reliable workplace-based assessment. Br J Anaesth 2014; 112:1083-91. [PMID: 24638231 DOI: 10.1093/bja/aeu052] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The value of workplace-based assessments such as the mini-clinical evaluation exercise (mini-CEX), and clinicians' confidence and engagement in the process, has been constrained by low reliability and limited capacity to identify underperforming trainees. We proposed that changing the way supervisors make judgements about trainees would improve score reliability and identification of underperformers. Anaesthetists regularly make decisions about the level of trainee independence with a case, based on how closely they need to supervise them. We therefore used this as the basis for a new scoring system. METHODS We analysed 338 mini-CEXs where supervisors scored trainees using the conventional system, and also scored trainee independence, based on the need for direct, or more distant, supervision. As supervisory requirements depend on case difficulty, we then compared the actual trainee independence score and the expected trainee independence score obtained externally. RESULTS Compared with the conventional scoring system used in previous studies, reliability was very substantially improved using a system based on a trainee's level of independence with a case. Reliability improved further when this score was corrected for case difficulty. Furthermore, the new scoring system overcame the previously identified problem of assessor leniency and identified a number of trainees performing below expectations. CONCLUSIONS Supervisors' judgements on trainee independence with a case, based on the need for direct or more distant supervision, can generate reliable scores of trainee ability without the need for an onerous number of assessments, identify trainees performing below expectations, and track trainee progress towards independent specialist practice.
Collapse
Affiliation(s)
- J M Weller
- Centre for Medical and Health Sciences Education, Faculty of Medical and Health Sciences, University of Auckland, 2 Park Rd, Grafton, Auckland 1010, New Zealand Department of Anaesthesia, Auckland City Hospital, 2 Park Rd, Grafton, Auckland 1010, New Zealand
| | - M Misur
- Department of Anaesthesia, Auckland City Hospital, 2 Park Rd, Grafton, Auckland 1010, New Zealand
| | - S Nicolson
- Department of Anaesthesia, Auckland City Hospital, 2 Park Rd, Grafton, Auckland 1010, New Zealand
| | - J Morris
- Department of Anaesthesia, Royal Melbourne Hospital, Grattan Street, Parkville, VIC 3052, Australia
| | - S Ure
- Department of Anaesthesia, Wellington Hospital, Riddiford Street, Newtown, Wellington 6021, New Zealand
| | - J Crossley
- Academic Unit of Medical Education, University of Sheffield, 85 Wilkinson Street, Sheffield S10 2GJ, UK
| | - B Jolly
- University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia
| |
Collapse
|
14
|
Affiliation(s)
- N. Dudding
- Department of Cytology; Sheffield Teaching Hospitals
| | - J. Crossley
- Department of Cytology; Royal Hallamshire Hospital; Sheffield UK
| |
Collapse
|
15
|
Gupta N, John D, Dudding N, Crossley J, Smith JHF. Factors contributing to false-negative and potential false-negative cytology reports in SurePath™ liquid-based cervical cytology. Cytopathology 2012; 24:39-43. [DOI: 10.1111/j.1365-2303.2012.00992.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
16
|
Gupta N, Dudding N, Crossley J, Payyappilly SJ, Smith JHF. Outcome of SurePath™ cervical samples reported as borderline nuclear change by cytological subtype and high-risk HPV status. Cytopathology 2012; 23:402-7. [DOI: 10.1111/j.1365-2303.2012.00976.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
17
|
Abstract
BACKGROUND To date minimal research has investigated adolescent psychiatric inpatient care from a service-user perspective. METHOD Semi-structured interviews were conducted with 10 adolescents with experience of psychiatric inpatient care. Interviews were analysed using the grounded theory method (Glaser & Strauss, 1967). RESULTS A core category, 'Living in an Alternative Reality', reflected the unusual nature of the hospitalisation experience. Adolescents reported feelings of restriction and disconnection and used various relational and practical strategies to cope with hospitalisation. CONCLUSIONS Results suggest that psychiatric hospitalisation can cause strong affective reactions in adolescents, and may affect psychological constructs such as identity and self-esteem.
Collapse
Affiliation(s)
- Catherine Haynes
- Coventry Eating Disorders Service, James Brindley House, Coventry Canal Basin, St.Nicholas Street, Coventry, CV1 4LY, UK. E-mail:
| | - Alison Eivors
- Leicestershire CAMHS Adolescent Eating Disorders Service, Leicester, UK
| | - Jon Crossley
- University of Leicester, Department of Clinical Psychology, UK
| |
Collapse
|
18
|
Crossley J, Marriott J, Purdie H, Beard JD. Prospective observational study to evaluate NOTSS (Non-Technical Skills for Surgeons) for assessing trainees' non-technical performance in the operating theatre. Br J Surg 2011; 98:1010-20. [PMID: 21480195 DOI: 10.1002/bjs.7478] [Citation(s) in RCA: 111] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2011] [Indexed: 11/11/2022]
Abstract
BACKGROUND Most surgical assessment has been aimed at technical proficiency. However, non-technical skills also affect patient safety and clinical effectiveness. The NOTSS (Non-Technical Skills for Surgeons) assessment instrument was developed specifically to assess the non-technical skills of individual surgeons in the operating theatre. This study evaluated NOTSS as a real-world assessment, with a mix of minimally trained assessors. The evaluation criteria were feasibility, validity and psychometric reliability. METHODS In a standard evaluation of NOTSS, 56 anaesthetists, 39 scrub nurses, two surgical care practitioners and three independent assessors provided 715 assessments of 404 surgical cases of 15 index procedures across six specialties performed by 85 surgical trainees. RESULTS The assessment was feasible, but important implementation challenges were highlighted. Most respondents considered the method valid, but with reservations about assessing cognition. The factor structure of scores, and their positive relationships with other measures of experience and performance, supported validity. Trainees' non-technical skill scores were relatively procedure-independent and achieved good reliability (generalizability coefficient 0·8 or more) when six to eight assessors observed one case each. CONCLUSION Minimally trained assessors, who are typically present in operating theatres, were sufficiently discriminating and consistent in their judgements of trainee surgeons' non-technical skills to provide reliable scores based on an achievable number of observations.
Collapse
Affiliation(s)
- J Crossley
- Academic Unit of Medical Education, University of Sheffield, Sheffield, UK
| | | | | | | |
Collapse
|
19
|
Kelly DR, Crossley J, Lough M, Rushmer R, Greig GJ, Davies HTO. Diagnosing a learning practice: the validity and reliability of a learning practice inventory. BMJ Qual Saf 2011; 20:209-15. [DOI: 10.1136/bmjqs.2009.032425] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
20
|
Beard JD, Marriott J, Purdie H, Crossley J. Assessing the surgical skills of trainees in the operating theatre: a prospective observational study of the methodology. Health Technol Assess 2011; 15:i-xxi, 1-162. [DOI: 10.3310/hta15010] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- JD Beard
- Sheffield Vascular Institute, Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | | | | | | |
Collapse
|
21
|
Marriott J, Purdie H, Crossley J, Beard JD. Evaluation of procedure-based assessment for assessing trainees' skills in the operating theatre. Br J Surg 2010; 98:450-7. [PMID: 21254025 DOI: 10.1002/bjs.7342] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2010] [Indexed: 11/10/2022]
Abstract
BACKGROUND Procedure-based assessment (PBA) is used within most UK surgical training programmes for assessing trainees' procedural skills in the operating theatre. All postgraduate assessment methods require evidence to support their implementation. The aims were to evaluate the validity, reliability and acceptability of PBA. METHODS Eighty-one trainees in six surgical specialties were assessed performing common procedures; 749 PBAs were provided across 348 operations by 57 clinical supervisors and four independent assessors. RESULTS Construct validity was demonstrated by correlation of PBA scores with measures of surgical training and experience. Reliability (G exceeding 0·8) of the adjusted total item score and global summary score for a given procedure was achieved using four and three assessor judgements respectively; assessing a mix of procedures required more cases/assessors because performance is procedure specific. The acceptability of PBA for assessment and feedback within surgical training was predominantly positive among clinical supervisors and trainees. CONCLUSION PBA demonstrated good overall validity and acceptability, and exceptionally high reliability. Trainees should be assessed adequately for each given procedure.
Collapse
Affiliation(s)
- J Marriott
- Department of Reproductive and Developmental Medicine, University of Sheffield, Sheffield, UK
| | | | | | | |
Collapse
|
22
|
Wright D, Bradbury I, Malone F, D’Alton M, Summers A, Huang T, Ball S, Baker A, Nix B, Aitken D, Crossley J, Cuckle H, Spencer K. Cross-trimester repeated measures testing for Down’s syndrome screening: an assessment. Health Technol Assess 2010; 14:1-80. [DOI: 10.3310/hta14330] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- D Wright
- University of Plymouth, Centre for Health and Environmental Statistics, Plymouth, Devon, UK
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Homewood E, Tweed A, Cree M, Crossley J. Becoming Occluded: The Transition to Motherhood of Women with Postnatal Depression. Qualitative Research in Psychology 2009. [DOI: 10.1080/14780880802473860] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
24
|
|
25
|
Affiliation(s)
- J Crossley
- Sheffield Children's Hospital, Western Bank, Sheffield S10 3TA, UK.
| |
Collapse
|
26
|
Crossley J. Letter regarding the post of Advanced Biomedical Scientist Practitioner. Cytopathology 2003; 14:304. [PMID: 14510899 DOI: 10.1046/j.1365-2303.2003.00091.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
27
|
Cuckle H, Arbuzova S, Spencer K, Crossley J, Barkai G, Krantz D, Muller F, Nikolenko M, Aitken D, Hallahan T, Macri J, Buchanan PD. Frequency and clinical consequences of extremely high maternal serum PAPP-A levels. Prenat Diagn 2003; 23:385-8. [PMID: 12749035 DOI: 10.1002/pd.600] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
A multicentre study was carried out to determine the frequency and clinical consequences of extremely high maternal serum pregnancy-associated plasma protein (PAPP)-A. There was a total of 79 pregnancies with PAPP-A exceeding 5.0 multiples of the gestation-specific median in a series of 46 776 pregnancies tested (0.2%) at the 7 collaborating centres. Five pregnancies were lost to follow-up, one miscarried and one with Noonan's syndrome was terminated. Of the remaining 72 that ended in a live birth, one infant had gastroschisis and five pregnancies had obstetric complications: pre-eclampsia, pregnancy-induced hypertension, gestational diabetes and two with growth retardation. Among women with high PAPP-A and no complications or adverse outcomes, there was no evidence of a substantial change in the levels of other Down syndrome markers or the extent of nuchal translucency. Three analytical methods were used to assay PAPP-A and yielded different frequencies of extremely high levels (0.05%, 0.4% and 0.6%) possibly owing to cross-reaction with another substance. We conclude that women with high PAPP-A can be reassured that there is no reason to suppose that the outcome of pregnancy will differ from those with normal levels, provided other markers are normal. If, as more centres move their Down syndrome screening practice to the first trimester, additional cases emerge with Noonan's syndrome or gastroschisis and raised PAPP-A, this advice will need to be modified.
Collapse
Affiliation(s)
- H Cuckle
- Reproductive Epidemiology, University of Leeds, UK.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Gibson JL, Macara LM, Crossley J, Aitken D, Cameron AD. Middle cerebral artery Doppler: the value of a non-invasive test of fetal anaemia in the management of alloimmunised pregnancies. J OBSTET GYNAECOL 2003. [DOI: 10.1080/718591713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
29
|
|
30
|
|
31
|
Cohen SG, Crossley J, Khedouri E, Zand R, Klee LH. Inversion of Stereospecificity in Hydrolysis by α-Chymotrypsin. The Acetoxyl Substituent. J Am Chem Soc 2002. [DOI: 10.1021/ja00894a034] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
32
|
Crossley J, Telford D, Macheta AT, James A, Grogono A, Bowman D, Jones EW, Lloyd-Thomas J, Logan R, Conner A, Stein A, Graham R, Harris PE. Marjorie Olive Bennett (nee Dunster) Leonard Roy Griffiths Eric Bernard Grogono Dorothy Grace Hervey Frank Charles Naldrett ("Pat") Holden Howard Lloyd-Thomas Catherine Logan (nee Aicken) James Henry Miller Hartwin Siegfried Sadowski David Alexander Sime. West J Med 2000. [DOI: 10.1136/bmj.321.7252.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
33
|
Hsu JJ, Spencer K, Aitken DA, Crossley J, Choi T, Ozaki M, Tazawa H. Urinary free beta hCG, beta core fragment and total oestriol as markers of Down syndrome in the second trimester of pregnancy. Prenat Diagn 1999; 19:146-58. [PMID: 10215073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
In a study of 69 random urine samples from cases of Down syndrome and 405 samples from unaffected pregnancies, we have assessed the value of various candidate markers that have been proposed as tools for screening for Down syndrome. We found that the marker urine free beta hCG in Down syndrome had a median MoM of 3.53 (95 per cent confidence interval 2.48-4.68) and at a 5 per cent cut-off would have identified 49 per cent (34/69) of cases. Urine beta core had a median MoM of 4.95 (3.87-8.62) and at a 5 per cent cut-off would have identified 39 per cent (27/69) of cases. Total oestriol had a median MoM of 0.65 (0.55-0.80) and at a 5 per cent cut-off would have identified 35 per cent (24/69) of cases. In conjunction with maternal age, the modelled detection rate increased to 55.8 per cent for free beta hCG, 49.8 per cent for beta core and 48.8 per cent for total oestriol. In combination free beta hCG, total oestriol and maternal age would have detected 68 per cent of cases for a 5 per cent false-positive rate. Using analyte ratios to obviate the need to correct for urine dilution in our study (rather than correcting to a fixed creatinine concentration) was not shown to be as effective as correcting using urine creatinine. Urine markers on the whole are unlikely to be of practical screening value considering the 85 per cent to 90 per cent detection rates achievable in the first trimester using a combination of ultrasound and maternal serum biochemistry.
Collapse
Affiliation(s)
- J J Hsu
- Department of Obstetrics and Gynaecology, Chang Gung Memorial Hospital, Taipei, Taiwan, ROC
| | | | | | | | | | | | | |
Collapse
|
34
|
Reynolds TM, Dunstan F, Nix B, Williams K, Crossley J, Holding S, Krantz D, Wright D, Bray I, Spencer K. Response to: Wald, N.J., Hackshaw, A.K. (1997). Combining ultrasound and biochemistry in first-trimester screening for Down's syndrome, Prenat. Diagn., 17, 821-829. Prenat Diagn 1998; 18:511-9. [PMID: 9621388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|
35
|
Reynolds TM, Dunstan F, Nix B, Williams K, Crossley J, Holding S, Krantz D, Wright D, Bray I, Spencer K. Letter. Response to: Wald, N.J. and Hackshaw, A.K. (1997). Combining ultrasound and biochemistry in first‐trimester screening for Down's syndrome,
Prenat. Diagn.
,
17
, 821–829. Prenat Diagn 1998. [DOI: 10.1002/(sici)1097-0223(199805)18:5<511::aid-pd389>3.0.co;2-#] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- T. M. Reynolds
- Clinical Chemistry, Queen's Hospital, Burton‐on‐Trent, U.K
| | - F. Dunstan
- Medical Statistics Department, University Hospital of Wales, Cardiff, U.K
| | - B. Nix
- Mathematics and Statistics Department, University College of Cardiff, Cardiff, U.K
| | - K. Williams
- Mathematics and Statistics Department, University College of Cardiff, Cardiff, U.K
| | - J. Crossley
- Genetics Department, Yorkhill Hospital, Glasgow, U.K
| | - S. Holding
- Clinical Chemistry Department, Hull Royal Infirmary, Hull, U.K
| | - D. Krantz
- NTD Laboratories, New York, NY, U.S.A
| | - D. Wright
- Mathematics and Statistics Department, Plymouth University, Plymouth, U.K
| | - I. Bray
- Mathematics and Statistics Department, Plymouth University, Plymouth, U.K
| | - K. Spencer
- Clinical Biochemistry Department, Harold Wood Hospital, Romford, U.K
| |
Collapse
|
36
|
Cox G, Crossley J, Xing Z. Macrophage engulfment of apoptotic neutrophils contributes to the resolution of acute pulmonary inflammation in vivo. Am J Respir Cell Mol Biol 1995; 12:232-7. [PMID: 7865221 DOI: 10.1165/ajrcmb.12.2.7865221] [Citation(s) in RCA: 270] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
For resolution of inflammation to occur, it is necessary both to limit leukocyte influx and to clear now redundant cells from the tissues. Recent evidence from in vitro studies suggests that clearance may be an active process, accomplished in part by macrophage engulfment of intact cells that have undergone programmed cell death or apoptosis. However, the kinetics of these events and their association with the resolution of acute inflammatory responses in vivo remain to be elucidated. To investigate these events, we examined an animal model of acute, limited, neutrophilic pulmonary inflammation. Cells were obtained by bronchoalveolar lavage (BAL) of rats at various time points after intratracheal administration of lipopolysaccharide (LPS). Apoptotic neutrophils were rarely seen in BAL from control animals but were detected after neutrophil influx had occurred in response to LPS challenge. Macrophage engulfment of these cells was identified at light microscopy and confirmed at electron microscopy. The proportion of macrophages that had engulfed apoptotic neutrophils was maximal 24 h after LPS challenge and declined thereafter as total neutrophil numbers fell. During the resolution phase, the alveolar macrophages became positive for peroxidase, indicating the presence of neutrophil granule contents in their cytoplasm. These observations demonstrate that apoptosis of leukocytes indeed occurs during the course of an acute inflammatory response in vivo and that the emergence of apoptotic neutrophils and macrophage engulfment of these cells are temporally correlated with the resolution of acute inflammation.
Collapse
Affiliation(s)
- G Cox
- Fr. Sean O'Sullivan Research Centre, St. Joseph's Hospital, Hamilton, Ontario, Canada
| | | | | |
Collapse
|
37
|
Sallenave JM, Shulmann J, Crossley J, Jordana M, Gauldie J. Regulation of secretory leukocyte proteinase inhibitor (SLPI) and elastase-specific inhibitor (ESI/elafin) in human airway epithelial cells by cytokines and neutrophilic enzymes. Am J Respir Cell Mol Biol 1994; 11:733-41. [PMID: 7946401 DOI: 10.1165/ajrcmb.11.6.7946401] [Citation(s) in RCA: 232] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The regulation of the activity of potentially harmful proteinases secreted by neutrophils during inflammation is important for the prevention of excessive tissue injury. Secretory leukocyte proteinase inhibitor (SLPI), also called antileukoprotease (ALP) or mucus proteinase inhibitor (MPI), is a serine proteinase inhibitor that has been found in a variety of mucous secretions and that is secreted by bronchial epithelial cells. We recently reported the presence of SLPI and of an elastase-specific inhibitor (ESI), also called elafin, in the supernatants of two cell lines, NCI-H322 and A549, which have features of Clara cells and type II alveolar cells, respectively. We showed in addition that epithelial cell lines produce the elastase-specific inhibitor as a 12 to 16 kD precursor of the elafin molecule (6 kD) called pre-elafin. In the present study, we show that NCI-H322 cells produced higher amounts of both inhibitors than A549 cells and that basal production of SLPI in both cell lines is higher than the production of elafin/pre-elafin. In addition, we show that interleukin-1 beta and tumor necrosis factor induce significant SLPI expression and are major inducers of elafin/pre-elafin expression. Moreover, induction is greater in A549 cells than in NCI-H322 cells. The implications of these findings for the peripheral airways are twofold: (1) alveolar epithelial cells may respond to cytokines secreted during the onset of inflammation by increasing their antiprotease shield; (2) elafin/pre-elafin seems to be a true local "acute phase reactant" whereas SLPI, in comparison, may be less responsive to local inflammatory mediators.
Collapse
Affiliation(s)
- J M Sallenave
- Department of Pathology, McMaster University, Hamilton, Ontario, Canada
| | | | | | | | | |
Collapse
|
38
|
Hart HF, Hart WG, Crossley J, Perrie AM, Wood DJ, John A, McOmish F. Effect of terminal (dry) heat treatment on non-enveloped viruses in coagulation factor concentrates. Vox Sang 1994; 67:345-50. [PMID: 7701804 DOI: 10.1111/j.1423-0410.1994.tb01271.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Terminal dry heat treatment effectively inactivated hepatitis A virus (HAV) and canine parvovirus added to high-purity factor VIII. After 24 h at 80 degrees C, HAV infectivity was reduced by > or = 4.3 log10 TCID50, as measured in a newly developed infectivity assay. The same reduction in virus titer was achieved after 2 h and before 6 h at 90 degrees C. Inactivation of hepatitis A virus was also seen in the freeze-drying step prior to heat treatment with an approximately 2.0 log10 reduction in titer. Similar results were obtained with a high-purity factor IX concentrate. Canine parvovirus was also inactivated at both temperatures, with residual infectivity being undetected after 48 h at 80 degrees C or 10 h at 90 degrees C. Canine parvovirus was not affected by lyophilisation. Canine parvovirus measurements by PCR did not reflect the levels of infectivity measured by the tissue-culture-based method. The addition of the terminal dry heat treatment to solvent/detergent could effectively eliminate the potential contamination of solvent/detergent-treated coagulation factor concentrates by non-lipid-enveloped viruses. However, careful evaluation for any increased induction of non-antigens for factor VIII, as a consequence of such treatment, is needed before use in patients can be recommended.
Collapse
Affiliation(s)
- H F Hart
- Protein Fractionation Centre, Scottish Blood Transfusion Service, Edinburgh, UK
| | | | | | | | | | | | | |
Collapse
|
39
|
Cameron AD, Murphy KW, McNay MB, Mathers AM, Kingdom J, Aitken DA, Crossley J, Imrie S, Lowther G. Midtrimester chorionic villus sampling: an alternative approach? Am J Obstet Gynecol 1994; 171:1035-7. [PMID: 7943067 DOI: 10.1016/0002-9378(94)90029-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Our purpose was to audit midtrimester chorionic villus sampling after a positive maternal serum screening test for autosomal trisomy. STUDY DESIGN From January 1990 until July 1993 chorionic villus sampling was offered to all screened positive women. RESULTS Five hundred fifty-one mothers had chorionic villus sampling. The mean age was 31.7 years. The mean gestational age was 18.2 weeks. The mean time for direct karyotyping was 4.4 days and for culture results 20.2 days. Results were obtained in 99.6% of samples: direct plus culture results in 94%, direct results alone in 2.3%, and culture results alone in 3.3%. Fourteen pregnancies had abnormal karyotypes. There were five cases of placental mosaicism and one false-positive result. The loss rate was 0.4%. CONCLUSION Midtrimester chorionic villus sampling, which is easier to perform than cordocentesis, provides a rapid and reliable karyotype. The complication rate is comparable to that of other invasive procedures.
Collapse
Affiliation(s)
- A D Cameron
- Department of Obstetrics and Gynaecology, Queen Mother's Hospital, Yorkhill, Glasgow, United Kingdom
| | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Abstract
Serious incidents of pyrrolizidine alkaloidosis of cattle in 10 herds exposed to the Australian native plant, Senecio lautus (Asteraceae), were seen in central Queensland during 1988-1992. The deaths of 226 cattle were recorded. A mean of 8% of cattle died in affected groups (range 2 to 58%). Sickness and deaths usually occurred some months after access to S lautus. Typically, affected cattle lost body condition to the point of emaciation before dying and had persistent diarrhoea. Some animals developed abnormal behaviour and died after a shorter illness. Liver specimens from affected cattle in all herds contained lesions consistent with pyrrolizidine alkaloidosis. Thin layer chromatography of extracts of blood and liver samples from cattle from 5 herds detected pyrrolic metabolites. The identity of these was confirmed by mass spectroscopy on samples from one herd. Unseasonal autumn and winter rain after a dry summer appeared to favour growth of S lautus at the expense of other pasture species. A subsequent dry period promoted consumption of S lautus and was followed by a cluster of poisoning incidents.
Collapse
Affiliation(s)
- J W Noble
- Queensland Department of Primary Industries, Emerald
| | | | | | | | | | | | | |
Collapse
|
41
|
Abstract
It has been postulated that behavioural differences between normal males and those with an additional X or Y chromosome may be related to pre- or postnatal hormonal variations. The prenatal hormone status was investigated using amniotic fluid obtained at antenatal diagnosis between 16 and 20 weeks gestation from fetuses with sex chromosome abnormalities and from controls of the same gestational age. After log transformation, the (geometric) mean testosterone levels were XY 439.4 pmol/l, range 165-1,027 (n = 29), XYY 490.7 pmol/l, range 224-1,092 (n = 20); and XXY 419 pmol/l, range 87-1,021 (n = 20). There were no significant differences between the three male groups and all three were significantly higher than the XX fetuses at 147.0 pmol/l, range 41-474 (p < 0.001). These findings give no support to the hypothesis that prenatal testosterone levels contribute to later behavioural characteristics.
Collapse
Affiliation(s)
- S G Ratcliffe
- Medical Research Council, Human Genetics Unit, Western General Hospital, Edinburgh, UK
| | | | | | | | | | | |
Collapse
|
42
|
Omran M, McLoone P, Stone D, Aitken D, Crossley J. Factors limiting the effectiveness of prenatal screening for anencephaly and spina bifida in a high-risk area. Paediatr Perinat Epidemiol 1993; 7:461-8. [PMID: 8290385 DOI: 10.1111/j.1365-3016.1993.tb00427.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The effectiveness of a prenatal screening programme in reducing the birth prevalence of anencephaly and spina bifida (ASB) is influenced by three principal factors: the proportion of affected pregnancies screened (uptake), the proportion of affected pregnancies detected on screening (sensitivity) and the proportion of affected pregnancies terminated when detected (compliance). The purpose of the study was two-fold: to develop an epidemiologically-based method for the retrospective monitoring of these three factors and to attempt to quantify their relative importance in relation to the outcome of screening. Data on births and terminations associated with ASB for the period 1976-1986 were obtained from the Glasgow Register of Congenital Anomalies and from the Department of Medical Genetics, Yorkhill Hospitals. Increasing proportions of affected pregnancies screened, detected and terminated were observed, to a greater degree for anencephaly than for spina bifida. The relationships between uptake, sensitivity, compliance and terminations are described in the form of a simple arithmetic expression. In policy terms, further efforts are required to increase all three in order to improve the effectiveness of screening for spina bifida.
Collapse
Affiliation(s)
- M Omran
- Public Health Research Unit, University of Glasgow, UK
| | | | | | | | | |
Collapse
|
43
|
Stepień H, Agro A, Crossley J, Padol I, Richards C, Stanisz A. Immunomodulatory properties of diazepam-binding inhibitor: effect on human interleukin-6 secretion, lymphocyte proliferation and natural killer cell activity in vitro. Neuropeptides 1993; 25:207-11. [PMID: 8247258 DOI: 10.1016/0143-4179(93)90104-i] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
We have examined the influence of diazepam binding inhibitor (octadecaneuro-peptide, DBI33-50) on cell mediated immune responses including LPS-stimulated monocyte IL-6 secretion, PHA induced lymphocyte proliferation and NK cell function in humans. All studies were performed in vitro on isolated human peripheral blood mononuclear cells in the absence or presence of synthetic DBI33-50. It has been shown that DBI33-50, in concentration between 10(-6)-10(-8) M, enhances the LPS-induced secretion of IL-6, as determined by specific bioassay for this monokine. On the other hand DBI33-50 (10(-6)-10(-12) M), had no significant effect on either PHA-induced lymphocyte proliferation or NK cell function. This data suggests a possible immunomodulatory role for DBI33-50 as an endogenous neuropeptide, which stimulates IL-6 secretion by human monocytes.
Collapse
Affiliation(s)
- H Stepień
- Institute of Endocrinology, Medical University of Lódź, Poland
| | | | | | | | | | | |
Collapse
|
44
|
Morrow RJ, Whittle MJ, McNay MB, Raine PA, Gibson AA, Crossley J. Prenatal diagnosis and management of anterior abdominal wall defects in the west of Scotland. Prenat Diagn 1993; 13:111-5. [PMID: 7681976 DOI: 10.1002/pd.1970130205] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
An attempt was made to identify all the cases of abdominal wall defects occurring in the West of Scotland over a 7-year period to determine the current incidence, prenatal diagnosis, management, and prognosis for fetuses and neonates with abdominal wall defects. Cases were identified because they presented either for prenatal diagnosis, or to the Department of Pathology following termination or spontaneous pregnancy loss, or as neonates to the Neonatal Surgical Department. The incidence of abdominal wall defects was found to be 1 in 2500 births. Exomphalos was diagnosed before birth in 66 per cent of cases, and in 30 per cent of cases it was associated with another major abnormality. There was a 20 per cent intact survival in the cases diagnosed prenatally who had no fetal anomaly and who opted to continue with the pregnancy. Gastroschisis was diagnosed before delivery in 70 per cent of cases, and in the group who continued with the pregnancy there was an intact survival of 77 per cent. Body stalk anomalies were all diagnosed prenatally and terminated. Maternal serum alpha-fetoprotein was elevated in 89 per cent of the cases with exomphalos and in 100 per cent of the cases with gastroschisis and body stalk anomalies in which it was tested.
Collapse
Affiliation(s)
- R J Morrow
- Department of Midwifery, Queen Mother's Hospital, Glasgow, U.K
| | | | | | | | | | | |
Collapse
|
45
|
Abstract
Building on Werley's nursing minimum data set, the authors identified a nursing management minimum data set (NMMDS). This collection of core data elements is needed by nurse administrators to make management decisions and compare effectiveness across institutions.
Collapse
|
46
|
Crossley J. Captain Thomas Dover, his background and early years. West Engl Med J 1991; 106:96-7. [PMID: 1820089 PMCID: PMC5115078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
47
|
Abstract
A 77-year-old woman developed a widespread erythematous rash after treatment with the calcium antagonist, diltiazem, which resulted in an exacerbation of the angina for which the drug was originally described. Drugs which may give widespread cutaneous side-effects should be used with caution in patients with compromised cardiac function.
Collapse
|
48
|
Affiliation(s)
- N J Reynolds
- Department of Dermatology, Bristol Royal Infirmary
| | | | | | | |
Collapse
|
49
|
Abstract
We report the case of a 63-year-old Caucasian female, with reno-vascular hypertension, who developed a generalized skin eruption with lichenoid histological features, induced by nifedipine. A repeat challenge with nifedipine confirmed that it was the causative agent.
Collapse
Affiliation(s)
- N J Reynolds
- Department of Dermatology, Bristol Royal Infirmary, U.K
| | | | | | | |
Collapse
|
50
|
Abstract
We describe a patient with long-standing Parkinson's disease who noted that his white hair turned grey and darkened 8 months after the addition of carbidopa to his established levodopa (L-dopa) therapy and 4 months after the introduction of bromocriptine.
Collapse
|