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Biomedical subjects

A Oakley

Publications and source records attributed to A Oakley.

At least 55 records · Page 3Linked to original sources
PubMed1996

A phase I clinical study of the antipurine antifolate lometrexol (DDATHF) given with oral folic acid.

Lometrexol is an antifolate which inhibits glycinamide ribonucleotide formyltransferase (GARFT), an enzyme essential for de novo purine synthesis. Extensive experimental and limited clinical data have shown that lometrexol has activity against tumours which are refractory to other drugs, notably methotrexate. However, the initial clinical development of lometrexol was curtailed because of severe and cumulative antiproliferative toxicities. Preclinical murine studies demonstrated that the toxicity of lometrexol can be prevented by low dose folic acid administration, i.e. for 7 days prior to and 7 days following a single bolus dose. This observation prompted a Phase I clinical study of lometrexol given with folic acid supplementation which has confirmed that the toxicity of lometrexol can be markedly reduced by folic acid supplementation. Thrombocytopenia and mucositis were the major toxicities. There was no clear relationship between clinical toxicity and the extent of plasma folate elevation. Associated studies demonstrated that lometrexol plasma pharmacokinetics were not altered by folic acid administration indicating that supplementation is unlikely to reduce toxicity by enhancing lometrexol plasma clearance. The work described in this report has identified for the first time a clinically acceptable schedule for the administration of a GARFT inhibitor. This information will facilitate the future evaluation of this class of compounds in cancer therapy.

Acyltransferases↗
PubMed1995

Cutaneous adverse drug reactions in a hospital setting.

AIMS: A prospective survey of the number and nature of cutaneous adverse drug reactions in a hospital setting. METHOD: Six month survey of cutaneous adverse drug reactions in hospital inpatients (April to October 1992). All patients were reviewed by a specialist dermatologist who assessed the adverse drug reaction as being: (1) type A adverse reaction (ie, expected, eg, acne vulgaris from systemic steroids; (2) type B adverse reaction (ie, unexpected, eg, allergic reaction; (3) not drug related; and (4) other/do not know. RESULTS: Sixty patients were reviewed; 38/60 patients (63%) had a cutaneous reaction related to their drug therapy or in-patient care. Of these, 7 had a nonallergic adverse drug reaction (type A). A further 31 had a type B adverse reaction: 27 had an allergic reaction to a systemic drug and 4 had an allergic contact dermatitis to a topical agent. 17 patients had cutaneous signs unrelated to their drug therapy, mostly a primary skin disorder (eg, eczema, psoriasis, etc). Of the remaining 5 patients it was not possible to determine the cause of the cutaneous reaction. The most common drugs associated with adverse drug reactions were the penicillin group of antibiotics, followed by frusemide, prednisone, allopurinol and carbamazepine. CONCLUSIONS: Adverse drug reactions are common and may result in additional morbidity to patients. However, only half of the cutaneous adverse reactions seen were secondary to allergy. As the diagnosis of an allergic reaction to drugs may have important therapeutic implications, review by a specialist dermatologist may be indicated.

Adolescent↗
PubMed1995

Health and cancer prevention: knowledge and beliefs of children and young people.

OBJECTIVE: To collect information from children and young people about their knowledge of and attitudes towards cancer and their understanding of health and health related behaviours to inform future health promotion work. DESIGN: Questionnaire survey of 15-16 year olds, and interviews with play materials with 9-10 year old children. SETTING: Six inner city, suburban, and rural schools. SUBJECTS: 226 children aged 15-16 years and 100 aged 9-10 years. MAIN OUTCOME MEASURES: Knowledge about different types of cancer; beliefs about health; sources of information; quality of research data obtainable from young children about cancer and health. RESULTS: Both samples knew most about lung cancer, but there was also some knowledge of breast and skin cancer and leukaemia. Smoking, together with pollution and other environmental factors, were seen as the dominant causes of cancer. Environmental factors were mentioned more often by the inner city samples. Television and the media were the most important sources of information. Young people were more worried about unemployment than about ill health. More than half the young people did not describe their health as good, and most said they did not have a healthy lifestyle. Children were able to provide detailed information about their knowledge and understanding by using drawings as well as interviews. CONCLUSIONS: Children and young people possess considerable knowledge about cancer, especially about lung cancer and smoking, and show considerable awareness of predominant health education messages. Despite this knowledge, many lead less than healthy lifestyles. Health is not seen as the most important goal in life by many young people; the circumstances in which many children and young people live are not experienced as health promoting.

Adolescent↗
PubMed1995

Sexual health education interventions for young people: a methodological review.

OBJECTIVES: To locate reports of sexual health education interventions for young people, assess the methodological quality of evaluations, identify the subgroup with a methodologically sound design, and assess the evidence with respect to the effectiveness of different approaches to promoting young people's sexual health. DESIGN: Survey of reports in English by means of electronic databases and hand searches for relevant studies conducted in the developed world since 1982. Papers were reviewed for eight methodological qualities. The evidence on effectiveness generated by studies meeting four core criteria was assessed. Judgments on effectiveness by reviewers and authors were compared. PAPERS: 270 papers reporting sexual health interventions. MAIN OUTCOME MEASURE: The methodological quality of evaluations. RESULTS: 73 reports of evaluations of sexual health interventions examining the effectiveness of these interventions in changing knowledge, attitudes, or behavioural outcomes were identified, of which 65 were separate outcome evaluations. Of these studies, 45 (69%) lacked random control groups, 44 (68%) failed to present preintervention and 38 (59%) postintervention data, and 26 (40%) omitted to discuss the relevance of loss of data caused by drop outs. Only 12 (18%) of the 65 outcome evaluations were judged to be methodologically sound. Academic reviewers were more likely than authors to judge studies as unclear because of design faults. Only two of the sound evaluations recorded interventions which were effective in showing an impact on young people's sexual behaviour. CONCLUSIONS: The design of evaluations in sexual health intervention needs to be improved so that reliable evidence of the effectiveness of different approaches to promoting young people's sexual health may be generated.

Adolescent↗
PubMed1995

Behavioural interventions for HIV/AIDS prevention.

OBJECTIVES: The aim of this study was to identify and critically review behavioural interventions in the HIV prevention and sexual health fields. METHODS: Electronic and hand searches were conducted to retrieve relevant published and unpublished reports of outcome evaluations. A methodological review was carried out to identify those with sufficient methodological strengths to generate reliable conclusions as to effectiveness. Soundly designed studies were defined as those which met the four core criteria of employing control groups, providing pre- and post-intervention data and reporting on all targeted outcomes. RESULTS: A total of 68 separate reports of outcome evaluations were located. Only 18 were judged to be methodologically adequate. Major problems found were lack of a control group or non-equivalent/unbalanced control groups, small sample sizes, failures to report pre-intervention measures, short follow-up, and high attrition rates. Academic reviewers were more likely than the authors of papers to judge reports of evaluations as providing insufficient information to assess effectiveness. CONCLUSION: Evaluation design in this field needs to be improved. Recommendations include more use of randomized controlled trials and the raising of publication standards by journals.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Supporting vulnerable families: an evaluation of Newpin.

Newpin (the New Parent Infant Network) was set up in 1980 to provide support for vulnerable families. But according to a new study, while nearly half the women referred to four Newpin centres went on to make use of its services, a larger proportion did not: either the support package offered was felt to be inappropriate, or the referral was inappropriate, or the women were simply lost to the system. Ann Oakley et al argue that voluntary sector initiatives should be subjected to the same rigorous scrutiny for cost-effectiveness as the statutory sector.

Adult↗
PubMed1994

Hungarian midwives and their practice: a national survey.

In 1975 the Hungarian educational system for midwives was shortened from a three year programme to one of ten months duration in order to provide a more immediate supply of midwives in a relatively short period of time, and to reduce the costs associated with midwifery education. Ten years after the educational programme change, a national survey of Hungarian midwives (n = 290) was conducted by the European Regional Office of the World Health Organization and the Hungarian Ministry of Health. This study describes the effects of the two educational programmes and years of practice on Hungarian midwives' self-perception of competency, satisfaction and summative score of responsibility and autonomy. Significantly different group mean scores on variables related to competency and satisfaction were found for the two groups.

Adult↗
PubMed1994

Hartnup disease presenting in an adult.

A young woman presented with pellagra. Her symptoms were precipitated by prolonged lactation and increased activity. Dietary intake of niacin was within recommended guidelines. Chromatography of urinary amino acids was diagnostic of Hartnup disease, an inherited disorder usually presenting in childhood. Her symptoms resolved with oral nicotinamide.

Adult↗
PubMed1992

Perspectives of users of the services.

This article draws on social science evidence concerning the views and experiences of those using the antenatal services. It identifies several important themes in this evidence, including the need to consider pregnancy a normal process, to provide care that is sensitive to individual circumstances and that offers continuity of care throughout the antenatal period, and the obligation on providers to assess scientifically the effectiveness of the care they give.

Communication↗
PubMed1992

Measuring the effectiveness of psychosocial interventions in pregnancy.

Questions about the effectiveness of psychosocial interventions in pregnancy are important in any overall evaluation of antenatal care. This article reviews the evidence as to the positive benefit on a range of pregnancy outcomes provided by 35 published and unpublished randomized controlled trials of psychosocial interventions.

Female↗