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Biomedical subjects

A R Cox

Publications and source records attributed to A R Cox.

At least 19 recordsLinked to original sources
PubMed2004

Adverse drug reaction teaching in UK undergraduate medical and pharmacy programmes.

OBJECTIVES: To assess the extent of teaching about the Committee on Safety of Medicine's Yellow Card scheme and adverse drug reactions within UK Schools of Medicine and Pharmacy. METHODS: A self-completed questionnaire sent to all heads of undergraduate schools of medicine and pharmacy within the UK. RESULTS: The majority of undergraduate syllabi feature the Yellow Card Scheme. Knowledge of the Yellow Card Scheme was assessed in 79% of pharmacy programmes and 57% of medical schools. Specialist speakers on the Yellow Card Scheme were infrequently used. Fewer than half of respondents provided students with a guide to reporting ADRs (43% pharmacy and 43% medical). There is some disagreement about the value of supplying students with printed material about the Yellow Card Scheme. Half of medical Schools did not think that supplying 'Current Problems In Pharmacovigilance' would be useful. CONCLUSIONS: It was found that in both medicine and pharmacy, courses differed substantially in teaching about the Yellow Card Scheme and adverse drug reactions (ADRs). There is scope for increased involvement of the Medicines and Healthcare products Regulatory Agency in undergraduate education, in line with recommendations from the National Audit Office.

Adverse Drug Reaction Reporting Systems↗
PubMed2004

BANs to rINNS.

Medical errors are increasingly being highlighted as an unnecessary cause of morbidity and mortality. Such situations are increasingly likely to occur if each country has its own improved name for each individual drug, particularly as healthcare staff are becoming increasingly mobile across the world. Standardization of drug names will help reduce the risk of such errors. However because of the change between BANs and rINNS there is potential for short-term problems. Healthcare staff need to be aware of such problems to try and minimize the damage they could potentially cause. In the longer term these name changes will hopefully prevent errors from occurring.

Drug Prescriptions↗
PubMed2003

The safety of spironolactone treatment in patients with heart failure.

INTRODUCTION: Spironolactone is increasingly being used in the treatment of heart failure. However, it has been associated with cases of hyperkalaemia. The common use of angiotensin-converting enzyme (ACE) inhibitors and angiotensin-2 receptor (AT2) antagonists in heart failure increases the risk of hyperkalaemia. OBJECTIVE: To identify the risk of spironolactone withdrawal, hyperkalaemia and severe hyperkalaemia in patients prescribed spironolactone together with either an ACE inhibitor or an AT2 antagonist. METHODS: Retrospective identification and analysis of patients co-prescribed an ACE inhibitor or an AT2 antagonist with spironolactone. Patients' records were linked to their biochemical results and the doses of spironolactone, ACE inhibitor and AT2 antagonists received by them. RESULTS: We found that a higher proportion of patients in our cohort stopped taking spironolactone compared with the Randomised Aldactone Evaluation Study and a higher proportion developed hyperkalaemia, a predicted adverse effect of spironolactone combination with an ACE inhibitor or an AT2 antagonist. Patients with diabetes mellitus and those with a haematocrit below 0.36, were more likely to develop hyperkalaemia than those without these traits. CONCLUSIONS: Spironolactone is a common cause of hyperkalaemia when used in combination with either an ACE inhibitor or an AT2 antagonist. This reinforces the need for care when extrapolating the results of clinical trials to daily clinical practice.

Adult↗
PubMed2001

Adverse drug reactions in patients admitted to hospital identified by discharge ICD-10 codes and by spontaneous reports.

AIMS: We studied the international classification of disease (ICD) hospital discharge codes to find unreported adverse drug reactions (ADRs), and asked doctors about their attitudes to reporting some of these cases. METHODS: We examined the ICD codes assigned on discharge to identify ADRs and compared these with spontaneous reports made to the Committee on Safety of Medicines (CSM). Doctors involved were sent brief résumés of cases and asked if they would report them. RESULTS: 49 of 21 365 patient episodes were coded on discharge as ADRs, of which 33 were 'reportable'. Fourteen spontaneous reports were received by the CSM during the same period. The two groups did not overlap. 25 of 60 doctors responded to our questionnaire, and would have reported only 8 of 75 cases outlined. CONCLUSIONS: The ICD coding allowed us to identify important ADRs which most doctors would not report spontaneously.

Adverse Drug Reaction Reporting Systems↗
PubMed2001

Job security for occupational health and safety professionals in the 21st century. What you need to know about the institute of medicine (2000) report.

The IOM study does an admirable job of discussing trends affecting the future of workers and the workplace. Based on theses trends, there will be vast unmet needs, as well as tremendous opportunities, for occupational health and safety professionals, particularly occupational health nurses, to help meet these needs. Individual occupational health and safety professionals will do well to study the trends, assess their current knowledge and skills, and seek the education and training required to develop and enhance the necessary competencies. They will need to: pay special attention to areas of behavioral health, work organization, communication (especially risk commnication), management, team learning, work force diversity, information systems, prevention interventions, health care delivery systems, and evaluation methods (IOM, 2000). They will need to develop, document, and communicate new and creative models for providing occupational health and safety services. Also, see the Advisory, "Job Security for the 21st Century," on page 164A.

Clinical Competence↗
PubMed1998

Expanding horizons. Integrating environmental health in occupational health nursing.

1. Environmental hazards are ubiquitous. Many exist in the workplace or occur as a result of work process exposures. 2. Environmental health is a natural component of the expanding practice of occupational health nursing. 3. AAOHN's vision for occupational and environmental health will continue to set the standard and provide leadership in the specialty.

Databases, Factual↗
PubMed1997

Bacterial N-acyl-homoserine-lactone-dependent signalling and its potential biotechnological applications.

N-acyl homoserine lactones are bacterial signalling molecules involved in regulating diverse metabolic functions, particularly those relating to virulence, in concert with cell density. Each aspect of the signalling pathway, from production and recognition of the signal to expression of the target genes, offers a potential opportunity for exploitation. Attention is now focusing on the development of novel methods for bacterial enumeration, modulation of bacterial virulence and flexible, coordinated expression of heterologous genes through the use of N-acyl-homoserine-lactone-based systems.

Bacteria↗
PubMed1994

Advancing the profession of occupational health nursing: AAOHN's strategic planning process.

1. AAOHN's strategic plan for 1993-98 was developed through a collaborative effort with emphasis on member input. 2. A model for the strategic plan which emphasized data acquisition and analysis was developed. 3. A revised mission statement and standards for occupational health nursing practice, along with expanded scope of practice, were developed.

Decision Making, Organizational↗