Biomedical subjects
A House
Publications and source records attributed to A House.
Psychosocial problems of patients on the renal unit and their relation to treatment outcome.
Eighty patients on a renal unit were interviewed to assess their psychiatric status and social functioning, and 68 survivors were re-interviewed one year later. Psychiatric disorders, which were mainly mood disorders, were inversely related to duration of treatment, and had reduced considerably at follow-up. Social disability was more stable and was related to abnormal personal relationships and to treatment status. Psychiatric disorder was only weakly associated with social disability or physical outcome at follow-up. Despite psychiatric and social problems, 11 patients commented positively on some aspect of their experience of life since starting treatment.
The psychiatric and social characteristics of patients with functional dysphonia.
Of 121 consecutive outpatients seen in an ENT clinic who received a diagnosis of functional dysphonia, 71 who were referred to the speech therapy department were interviewed. Sixty one (86%) were women, and the mean age of the group was 47.6 yr. The commonest voice disorder was huskiness or hoarseness, and only five patients had a pure 'whispering' dysphonia. There was little evidence of major psychiatric disorder in the group: eight patients had a past psychiatric history; two had histrionic personality disorder, and 22 (33%) had clinically diagnosable mood disorders which were mainly anxiety/tension states. This descriptive study formed the background for an investigation of the psychosocial stressors preceding onset of functional dysphonia.
Affective prosody in the reading voice of stroke patients.
Patients with right or left hemisphere strokes were studied for the nature of emotion conveyed in speech, during the reading of three short passages chosen for the differing emotional tone of their content. Both groups of patients had prosodic qualities which led their speech to be rated as like that of depressed patients and different from that of non-depressed controls. None of the stroke patients had significant depression or anxiety at the time of testing, so this prosodic quality is presumed to relate directly to brain damage.
Depressive syndromes in the year following onset of a first schizophrenic illness*.
A complete, unselected series of 68 patients who were seen during their first episode of an undoubtedly schizophrenic illness, and followed up one year later (for 56 patients) is described clinically. Depressive symptoms were common at onset, and 22% of patients could have been considered cases of depression from these symptoms alone. At follow-up, depressive symptoms had reduced in prevalence and only 7% of subjects were depressed cases. Only two cases of depression at follow-up had not been cases at onset. These changes could not be attributed to the use of antidepressants or ECT. Depressive syndromes could be distinguished from akinesia and the negative syndromes. The findings indicate that depression cannot be attributed solely to the administration of neuroleptics.
A simple non-invasive method to measure the cough reflex in dogs.
INTRODUCTION: This study describes a method to measure the cough reflex in dogs that is simple to perform, requires no surgical intervention and can be used to profile efficacy and side-effect liabilities of antitussive drugs. METHODS: Experiments were performed in propofol-anesthetized dogs in which cardiopulmonary functions were non-invasively monitored before and after the induction of cough produced by spraying 0.75 ml of distilled water into the trachea. RESULTS: The magnitude of the cough response, measured by the frequency and amplitude was not different for individual dogs performed with repeated trials on different days. Treatment with the opioid antitussive drug, torbutrol (0.055-0.0055 mg/kg, s.c.) inhibited the cough frequency but not the amplitude induced by the water challenge. Furthermore, side effects of torbutrol were identified as mild respiratory depression and an anesthetic-sparing effect with propofol. DISCUSSION: This method offers many distinct advantages to evaluate efficacy of antitussive drugs including the fact that no surgery is required, it takes only 15-20 min to complete an experiment, and it can be used to simultaneously profile antitussive and side effect liabilities of drugs developed for the treatment of cough.
National survey of radionuclide gastric emptying studies.
A survey was mailed to all institutions in Canada licensed to use radiopharmaceuticals. Questions addressed meal type; mode of preparation; and means, ranges and SD of emptying times. Seventy-eight per cent of 222 facilities responded, including all 55 teaching centres. Eighty-five per cent of teaching and 56% of nonteaching centres perform solid phase gastric emptying studies (GES). The majority use 99mTc sulphur colloid (Tc-SC) added to eggs before cooking as the standard meal. Twenty-five per cent of teaching and 21% of nonteaching centres perform liquid phase GES. Most use a watery solution of 111Indiethylenetriamine pentaacetic acid. Gastric emptying for solid phase GES, expressed as time for 50% emptying (mean t1/2), varied from 42 to 105 mins for centres using the Tc-SC egg meal. Twenty-eight per cent of teaching centres used +/- 2 SD to define their normal range, 26% used +/- 1 SD, 6% used +/- 1.5 SD, and 40% did not know the number of SD used. Twenty per cent of nonteaching centres used +/- 2 SD, 12% used +/- 1 SD and 68% did not know how many SD were used. For liquid phase GES, mean t1/2 varied from 20 to 60 mins. Eighteen per cent of centres used healthy volunteers to establish or validate normal ranges. There is substantial variability among the normal ranges for radionuclide solid and liquid phase GES in both teaching and nonteaching centres across Canada. A minority of facilities have established or validated their own normal ranges in healthy volunteers. There is a need for a more standardized protocol and range of normal, with internal validation by each institution.
The relationship between instructional and assessment accommodations in an inclusive state accountability system.
We investigated the kinds of instructional and assessment accommodations students with disabilities receive, and the extent to which instructional accommodations match assessment accommodations. Most students who had IEPs in specific content areas received instructional accommodations in those areas, and there were no differences by disability type. We provide data on the specific types of accommodations used. Overall, students' assessment accommodations matched their instructional accommodations, though many students received testing accommodations that had not been received in instruction. Implications are discussed for IEP teams who make decisions about instructional and assessment accommodations.
Self-poisoning and self-injury in adults.
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Understanding deliberate self-harm.
This article is derived from a summary of the available research evidence published in the December issue of Effective Health Care (NHS Centre for Reviews and Dissemination, 1998). It aims to help nurses understand patients who present after deliberately harming themselves and explains why their problems should be taken seriously and what interventions are most likely to be effective.
Mood disorders in the first year after stroke.
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General hospital services for deliberate self-harm. Haphazard clinical provision, little research, no central strategy.
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Job satisfaction and psychological morbidity in medical house officers.
The aim of this study was to examine levels of job satisfaction and psychological morbidity in preregistration house physicians working partial shift rotas, full shift rotas, or traditional on-call rotas. The study was carried out at two teaching hospitals in one city, and consisted of a prospective within-subject crossover study at hospital A and a parallel simple descriptive study at hospital B. Sixty preregistration house physicians were included in the study. At hospital A the house officers worked shifts for part of their post and traditional on-call rotas for the remainder. At hospital B the house officers worked a modified on-call rota throughout. The outcome measures used were the 30 item General Health Questionnaire and a self-report job satisfaction scale. Measures were administered at hospital A towards the end of each distinct rota period (on-call or shift) and simultaneously administered at hospital B. Results showed that full shifts were associated with greater psychological morbidity and lower job satisfaction than traditional on-call rotas. Partial shifts were rated more favourably but were nonetheless unpopular. There was a marked difference between hospitals. It would seem that some 'new deal' rotas may increase psychological morbidity and reduce job satisfaction.
The early repetition of deliberate self harm.
The objective was to determine the pattern of repeated deliberate self harm (DSH) in a busy inner-city teaching hospital. We undertook a retrospective cohort analytical study for all 1,576 DSH patients seen for assessment over a two-year period. Age, sex and previous DSH were noted at index episode (562 (36%) reported a previous history). Each patient was followed up for 12 months and repetition of DSH was recorded. DSH was repeated by 193 (12%) within one year, 138 (72%) once and 55 (28%) more than once. Repetition was more common and occurred much more quickly in those with a previous history than those without (relative risk: 3.4). Median time to repetition was 12 weeks but about 10% repeated within a week. The results were similar for men and women. This implies that previous history is the single most useful predictor in the repetition of DSH. Repetition occurs quickly and most rapidly in those who have previously harmed themselves. Intervention aimed at reducing repetition of self harm must be delivered within days, not weeks.
Nurses who kills--damned if you do....
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