Search PubMed⌕ Search

Biomedical subjects

A Robinson

Publications and source records attributed to A Robinson.

At least 595 records · Page 33Linked to original sources
PubMedDate not supplied

Disclosure of CAM use to medical practitioners: a review of qualitative and quantitative studies.

BACKGROUND: Many people use complementary or alternative medicine (CAM). It is estimated that over 50% of patients that require health care use CAM either in conjunction with, or separate from, conventional health care. Despite the popular use of CAM, patients do not always inform their conventional medicine health carers of their CAM use. The medical practitioner is in most cases the first health care professional a person contacts concerning a health care matter, and needs to have a full history of a health problem to understand and provide optimum care. This literature review aims to provide an understanding of the degree to which patients disclose their use of CAM to their medical practitioners, and their reasons for not doing so. METHOD: A comprehensive literature search identified 12 studies published between 1993 and 2002 that examined what percentage of consumers did not disclose to their medical practitioners their use of CAM, and their reasons for not doing so. RESULTS: The rate of non-disclosure of those using CAM is as high as 77% in some studies. The main reasons patients provided for not disclosing their use of CAM to their medical practitioners were concerns about a negative response by the practitioners, the belief that the practitioner did not need to know about their CAM use, and the fact that the practitioner did not ask. DISCUSSION: The pre-conceptions patients have that influence their non-disclosure may be based on three issues. First, beliefs and concerns that influence their decision-making, second personal experiences in their consultations with medical practitioners, and third, the desire for more control over their health care. Medical practitioners need to acknowledge the concerns and beliefs of patients in making their health care decisions, and work with patients so that the use of CAM is acknowledged and the patients' needs, beliefs and concerns respected.

Attitude of Health Personnel↗
PubMedDate not supplied

Death by degrees.

Explore the source record for details and available documents.

Education, Medical, Graduate↗
PubMedDate not supplied

Economic impact of using an immunostimulating agent to prevent severe acute exacerbations in patients with chronic obstructive pulmonary disease.

RATIONALE: OM-85 BV, an immunostimulant made from bacterial extracts, has been shown to reduce the risk of hospitalization for acute exacerbation in patients with chronic obstructive pulmonary disease, as well as to reduce the length of stay for all hospitalizations. METHODS: In conjunction with a placebo controlled, randomized clinical trial, a cost effectiveness analysis was carried out to assess the economic impact of using OM-85 BV. In the analysis, effectiveness was defined as the difference in the number of severe acute exacerbations, assessed by the number of hospitalizations for a respiratory problem, between the placebo and OM-85 BV-treated groups. RESULTS: The median cost to prevent one day of hospitalization for a respiratory condition was CDN$45, with a 95% CI of CDN$18 to CDN$210. Bootstrap of the study population and sensitivity analyses showed that the results were robust and not likely due to random fluctuation; 98.8% of the cost effectiveness and 96.8% of the cost-benefit ratios favoured the use of OM-85 BV. Indirect costs, defined as a need for help, were reduced by 36% in the group treated with OM-85 BV: 779 h of help compared with 1212 h in the placebo group. This trend, while not significant, is consistent with other results and suggests a decrease in the severity of exacerbations in the OM-85 BV-treated group. CONCLUSION: Given the high prevalence of chronic obstructive pulmonary disease worldwide and the high cost of acute exacerbations, immunostimulants may become a key element in the improved control of this condition.

Adjuvants, Immunologic↗
PubMedDate not supplied

High-dose (480 mg/day) tamoxifen with etoposide: a study of a potential multi-drug resistance modulator.

Tamoxifen and its principle metabolite N-desmethyltamoxifen can modulate multi-drug resistance in vitro. Tamoxifen 480 mg/day was given for 6 days with oral etoposide on days 4-6 to 17 patients with advanced solid tumours. Venous thrombosis (2 patients), reversible neurological toxicity (1 patient), and WHO grade III nausea/vomiting (3 patients) related to tamoxifen were observed but overall toxicity was manageable. One partial response occurred in 15 assessable patients. Mean plasma concentrations of tamoxifen and N-desmethyltamoxifen increased to 4.3 mumol/l and 2.7 mumol/l, respectively, by day 6. Plasma concentrations corresponding to active in vitro levels were attained by most patients.

Adult↗
PubMedDate not supplied

Visual analog scales, standard gambles, and relative risk aversion.

BACKGROUND: It has been argued that visual analog scales (VASs) elicit an individual's measurable value function. The theoretical link between an individual's measurable value function v(.) and his or her von Neumann-Morgenstem utility function u(.) appears to provide a justification for transforming VAS scores into standard gamble (SG) utilities. However, VAS scores have been found to be subject to the effects of context, which casts doubt that the procedure is properly revealing v(.). METHODS: The authors tested for the effects of context on VAS and SG scores. They also explored whether the range-frequency (R-F) model of Parducci offers a means of correcting VAS scores for the effects of context. RESULTS AND CONCLUSIONS: The R-F model may provide a means of correcting VAS scores for the effects of context, but no stable relationship exists between these corrected scores and SG utilities. Hence, there remain no grounds for transforming VAS scores into SG utilities.

Accidents, Traffic↗
PubMedDate not supplied

Sertoli-Leydig cell tumor of the ovary with heterologous elements and carcinoid: an immunohistochemical and ultrastructural study.

A Sertoli-Leydig cell tumor of the ovary is described in which there were heterologous elements consisting of enteric cysts and an evolving carcinoid. Endocrine cells in the cysts and carcinoid were found to contain gastrin and other polypeptide hormones. Aspects of the organization of the enteric epithelium, its histogenesis, and the possible relationship of this tumor to other cystic ovarian neoplasms are discussed.

Adult↗
PubMedDate not supplied

Developing a collaborative preceptor program involving registered nurses, student nurses and faculty.

This paper addresses a collaborative preceptorship program involving a group of undergraduate nursing students, their registered nurse preceptors employed on the paediatric ward of an acute care hospital, and academic staff from a university school of nursing. The project utilised a fourth generation evaluation model, adapted from action research methods, which comprised a series of parallel focussed group discussions with a registered nurse preceptor group and a student nurse group. During the project, members of the two groups explored the issues around the supervision of students in practice in an acute paediatric context. This resulted in the development of innovative approaches to the supervisory practices utilised by preceptors. It also highlighted the benefits of collaboration between universities and hospital staff in developing preceptorship programs which respond appropriately to the needs of both preceptors and students.

Clinical Competence↗
PubMedDate not supplied

Leakage of a liquid 188Re-filled balloon system during intracoronary brachytherapy. A case report.

We are reporting the first case of an accidental radioactive 188Re leakage of a liquid-filled balloon system. Different analytical methods estimated that approximately 4 mCi 188Re were released. The radiation burden was reduced considerably by the combined therapy with perchlorate and forced volume diuresis. Estimated exposures to all organs were very low with 1.8 rad. A total body nuclear scintigraphy demonstrated uniform 188Re distribution, without specific organ concentration.

Aged↗
PubMedDate not supplied

Oral bromhexine has no effect on tear and lysosyme secretion in healthy subjects.

The purpose of the present study was to determine whether bromhexine (Solvex) affects the rate of tear secretion or the concentration of lysosyme in the tear fluid in healthy subjects. The rate of tear secretion and lysosyme concentration in tear fluid were estimated in 56 healthy volunteers before and after 3 weeks of oral administration of placebo (tablets of vitamin C, 200 mg per day) followed by bromhexine tablets, 32 mg per day. Shirmer's test I was performed to evaluate the tear secretion, and the lysosyme plate method was used to detect lysosyme concentration. Shirmer's test showed similar results before and after placebo and bromhexine administration. In conclusion, oral bromhexine was found to have no effect on the rate of tear secretion, nor on the concentration of lysosyme in the tear fluid of healthy subjects.

Administration, Oral↗