Accuracy of patient recall of opportunistic smoking cessation advice in general practice

OBJECTIVE: To determine the accuracy of patient recall of a question about smoking in a specified consultation in general practice; the accuracy of smokers' recall of advice to stop smoking; and predictors of accurate recall. DESIGN: Analysis of 1075 audiotapes was compared blind with matching patient questionnaires administered after the consultation to calculate sensitivity and specificity for patient recall as a dichotomous variable. Predictors of recall were determined by logistic regression. SETTING: General practitioner training practices, New South Wales, Australia. SUBJECTS: Thirty-four trainees and consecutive samples of their patients 16-65 years of age. RESULTS: Patient recall of a question about smoking had a high false positive rate of 21% but a sensitivity of 93%. Smokers over-reported advice to stop smoking (specificity 82%; sensitivity 92%). Predictors of accuracy of a question about smoking included patient sex (women 1.58 times more likely than men to be accurate); smoking status (smokers 1.7 times as likely as non-smokers to be accurate); and interval since consultation (those who completed their questionnaires within a week were 1.84 times more likely to be accurate). CONCLUSIONS: Patient recall is systematically biased towards over-reporting of a question about smoking status and, among smokers, of advice to quit. Although we recommend its continued application in health services evaluation, findings should be interpreted with caution, particularly if subjects are male or the interval between recall of smoking cessation advice and the occasion of service in which it might have occurred is considerably delayed.


     

Frequent clones of p53-mutated keratinocytes in normal human skin

The multiple genetic hit model of cancer predicts that normal individuals should have stable populations of cancer-prone, but noncancerous, mutant cells awaiting further genetic hits. We report that whole-mount preparations of human skin contain clonal patches of p53-mutated keratinocytes, arising from the dermal-epidermal junction and from hair follicles. These clones, 60-3000 cells in size, are present at frequencies exceeding 40 cells per cm2 and together involve as much as 4% of the epidermis. In sun-exposed skin, clones are both more frequent and larger than in sun-shielded skin. We conclude that, in addition to being a tumorigenic mutagen, sunlight acts as a tumor promoter by favoring the clonal expansion of p53-mutated cells. These combined actions of sunlight result in normal individuals carrying a substantial burden of keratinocytes predisposed to cancer.     

Photonic Demodulator With Sensitivity Control

A current assisted photonic demodulator for use as a pixel in a 3-D time-of-flight imager shows nearly 100% static demodulator contrast and is operable beyond 30 MHz. An integrated tunable sensitivity control is also presented for increasing the distance measurement range and avoiding unwanted saturation during integration periods. This is achieved by application of a voltage on a dedicated drain tap showing a quenching of sensor sensitivity to below 1%     

Haemolytic activity of Aeromonas species isolated in Libya

Twenty seven Aeromonas strains (5A. hydrophila, 8A. sobria and 14A. caviae) isolated from children with diarrhoea and 34 Aeromonas strains (9A. hydrophila, 7A. sobria an 18A. caviae) isolated from children without diarrhoea were tested from haemolysin production. The results obtained showed that haemolysin production using human, horse or sheep erythrocytes was significantly associated with A.hydrophila and A sobria but not with A.caviae, regardless of whether these strains were isolated from children with or without diarrhoea. Human or horse rather than sheep erythrocytes are recommended for use in the haemolysin assay.     

Ligands with affinity to specific sequences of DNA base pairs. X. Synthesis and binding of netropsin analogs, containing a chelating copper ion peptide, with DNA

An analogue of netropsin has been synthesized consisting of two N-propylpyrrolcarboxamide units linked covalently to a copper-chelating tripeptide Gly-Gly-L-His by means of two and three glycine residues. Binding to DNA and synthetic polynucleotides of netropsin analogue containing three glycine residues between Gly-Gly-L-His tripeptide and the N-end of netropsin analogue (His-Nt) has been studied. It is shown that this netropsin analogue chelates a copper ion with 1:1 stoichiometry, similar to a free Gly-Gly-L-His peptide. It is found that this netropsin analogue occupies 3 to 4 base pairs upon binding to poly(dA).poly(dT) and poly[d(AT)].poly[d(AT)] polymers, irrespective of whether it binds in Cu(2+)-ligated or unligated forms. Binding constants and binding site sizes have been calculated for netropsin analogue complexes with DNA, poly(dA).poly(dT) and poly[d(AT)].poly[d(AT)] polymers at the [Cu2+]/[His-Nt] ratio equal to 0 and 1.0. In the three-component system including His-Nt and Cu(2+)-His-Nt, cooperative effects are recognized which can be explained by heterodimer generation on interaction of His-Nt and Cu(2+)-His-Nt at adjacent binding sites.     

Dendritic remodelling of retinal ganglion cells during development of the rat

Investigation of the morphology of ganglion cells in the cat retina has shown that a remarkable reduction in the number of dendritic spines and branches occurs during development of the alpha and beta cell classes. To learn whether dendritic remodelling represents a generalized mechanism of mammalian retinal ganglion cell development, we have examined the morphology of ganglion cells in the retina of the developing rat. The present study has concentrated on type II cells, which retain a great number of dendritic spines and branches in the adult and comprise a large proportion of the population of rat retinal ganglion cells. To reveal fine dendritic and axonal processes, Lucifer yellow was injected intracellularly in living retinae maintained in vitro. Size and complexity of the dendritic trees were found to increase rapidly during an initial stage of development lasting from late fetal life until approximately postnatal day 12 (P12). Dendrites and axons of immature ganglion cells expressed several transient morphological features comprising an excessive number of dendritic branches and spine-like processes, and short, delicate axonal sidebranches. The following developmental stage was characterized by a remarkable decrease in the morphological complexity of retinal ganglion cells and a slowed growth of their dendritic fields. The number of dendritic branches and spines of types I and II retinal ganglion cells declined after P12 to reach a mature level by the end of the first postnatal month. Thus, even cells that retain a highly complex dendritic tree into the adult state undergo extensive remodelling. These results suggest that regressive modifications at the level of the dendritic field constitute a generalized mechanism of maturation in mammalian retinal ganglion cells.     

Extended fundamental frequency analysis of the LCC resonant converter

Fundamental frequency techniques are used to analyze the series-parallel resonant converter under heavy load conditions, both with a continuous, but distorted parallel capacitor voltage waveform, and with a discontinuous capacitor voltage waveform. The analysis is validated with results from an experimental prototype. The application of the technique to the parallel-loaded L-C resonant converter is also considered.     

Trypanosoma cruzi: nitrogenous-base-containing phosphatides in trypomastigote forms--isolation and chemical analysis

Increasingly clinicians attempt to base decisions regarding patient management on the results of clinical studies in addition to expert opinion and their own practical experience. In this article, the author reviews the published studies available to assist clinicians to make evidence-based decisions in three topics related to small volume red blood cell (RBC) transfusions for preterm infants; namely, studies examining the effects of RBC transfusions on possible symptoms of anemia such as tachypnea, apnea or other cardiorespiratory irregularities, studies investigating the collection and transfusion of umbilical cord blood and finally studies addressing the duration of storage and use of additive solutions for RBCs for transfusion to neonates. Based on the review of these studies, guidelines for small volume RBC transfusions in preterm infants are suggested.