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Biomedical subjects

C Bradley

Publications and source records attributed to C Bradley.

At least 55 records · Page 3Linked to original sources
PubMed2000

Unpublished rating scales: a major source of bias in randomised controlled trials of treatments for schizophrenia.

BACKGROUND: A recent review suggested an association between using unpublished scales in clinical trials and finding significant results. AIMS: To determine whether such an association existed in schizophrenia trials. METHOD: Three hundred trials were randomly selected from the Cochrane Schizophrenia Group's Register. All comparisons between treatment groups and control groups using rating scales were identified. The publication status of each scale was determined and claims of a significant treatment effect were recorded. RESULTS: Trials were more likely to report that a treatment was superior to control when an unpublished scale was used to make the comparison (relative risk 1.37 (95% CI 1.12-1.68)). This effect increased when a 'gold-standard' definition of treatment superiority was applied (RR 1.94 (95% CI 1.35-2.79)). In non-pharmacological trials, one-third of 'gold-standard' claims of treatment superiority would not have been made if published scales had been used. CONCLUSIONS: Unpublished scales are a source of bias in schizophrenia trials.

Humans↗
PubMed2000

The casualisation of nursing jobs: a management response to having to do more with less.

Restructuring of health care has raised a number of issues affecting nurses and nursing which have been documented over the last half decade. However, comparatively little attention has been given to staffing arrangements, particularly in relation to casualisation. This empirical South Australian study identifies three management responses to the current climate: working nurses harder, working smarter and casualising nursing jobs. The paper suggests that the identified trend to increasing casualisation, which is likely to point towards a national nursing labour market trend, needs to be considered in terms of cost and workload issues. It also suggests that the question of where responsibility for the professional development of casual nurses rests needs to be addressed.

Contract Services↗
PubMed2000

School-based research: problems of access and consent.

Public schools are enticing yet intimidating places to conduct research on children and adolescents. A public school provides a large potential subject pool; however, obtaining access to that subject pool can seem impossible with all the layers of permissions that must be obtained. If the study is federally funded, additional regulations apply. This article presents practical and proven approaches to obtaining access to and approval from schools or school systems, as well as parental consent, to conduct school-based research.

Adolescent↗
PubMed2000

More good than harm: a randomised controlled trial of the effect of education about familial risk of diabetes on psychological outcomes.

BACKGROUND: Offspring of people with type 2 diabetes underestimate their risk of developing the disease and know little about primary prevention. However, education about risk might cause psychological harm. AIM: To examine cognitive and psychological effects of education about personal risk. METHOD: Patients with type 2 diabetes were recruited from randomly selected general practices. One of their adult offspring was randomly selected and randomly allocated into one of three groups: 1. Group 1: given an initial interview, education, and a final interview; 2. Group 2: given an initial and final interview; and 3. Group 3: given one interview only. Psychological outcomes were assessed using Hospital Anxiety and Depression Scale (HAD) and Positive Well-Being Scale (PWB) scores. RESULTS: Sixty-nine per cent (105/152) of eligible offspring participated. Ninety-one per cent (96/152) completed the study. Comparing first and final interviews, in Group 1, significantly fewer responders at final interview (after education) thought that their risk of developing diabetes was 'low' (65% versus 41%, P = 0.027), while in Group 2, there was no significant change in risk perception (P = 0.13). Significantly fewer people in the educated group (Group 1, final interview) than in the control group (Group 3) thought their risk of developing diabetes was 'low' (41% versus 77%, P = 0.002). Risk education did not affect total HAD scores or PWB scores significantly. CONCLUSION: Educating offspring of people with type 2 diabetes in this way about their risk of diabetes and possible preventive strategies increases their perception of personal risk but does not cause psychological harm.

Adult↗
PubMed1999

The development of an individualized questionnaire measure of perceived impact of diabetes on quality of life: the ADDQoL.

The objectives of the study were to design and develop a questionnaire to measure individuals' perceptions of the impact of diabetes on their quality of life (QoL). The design of the ADDQoL (Audit of Diabetes Dependent QoL) was influenced by patient-centred principles underlying the SEIQoL interview method. Respondents rate only personally-applicable life domains, indicating importance and impact of diabetes. Fifty-two out-patients with diabetes and 102 attending diabetes education open days provided data for psychometric analyses. Each of the 13 domain-specific ADDQoL items was relevant and important for substantial numbers of respondents. Factor analysis and Cronbach's alpha coefficient of internal consistency (0.85) supported combination of items into a scale. Insulin-treated patients reported greater impact of diabetes on QoL than table/diet-treated patients. People with microvascular complications showed, as expected, greater diabetes-related impairment of QoL than people without complications. Unlike other QoL measures, the ADDQoL is an individualized questionnaire measure of the impact of diabetes and its treatment on QoL. Preliminary evidence of reliability and validity is established for adults with diabetes. Findings suggest that the ADDQoL will be more sensitive to change and responsive to differences than generic QoL measures.

Activities of Daily Living↗
PubMed1999

A survey of the advertising of nine new drugs in the general practice literature.

OBJECTIVE: To undertake a survey of the advertising of new drugs in the general practice literature as part of a larger study investigating the factors which influence the introduction of new drugs into clinical practice. METHOD: The advertisements for nine new drugs from a range of therapeutic groups were monitored for 30 months in 12 journals, which are received by most GPs. The amount of prescribing, in defined daily doses, of each new drug by 50 GPs, selected as regular users of a teaching hospital, was also recorded during this period. RESULTS: Of the journals, 798 issues were surveyed (93% of the total published). The total number of advertisements was almost 33 000, of which 2163 (6.6%) were for the study drugs. The pattern of advertising of each study drug was very complex and varied from month to month and between journals. There was no consistent pattern in the way the drugs were advertised, with large variations in the amount and timing of advertisements. The prescribing data showed wide variations in the number of GPs prescribing each drug and in the amount prescribed. CONCLUSION: There was no clear relationship between the extent of the advertising of a drug and the amount of prescribing by the GPs. This suggests that advertising in journals is only one of many factors which are important in influencing GPs to prescribe new drugs. However, the study may have been insufficiently comprehensive to capture complex relationships between advertising and prescribing.

Advertising↗
PubMed1999

Diabetes mellitus in the family: perceptions of offspring's risk.

AIMS: The study aimed to explore the beliefs and concerns of people with Type 2 diabetes mellitus (DM) about their children's risk of developing the disease and the possibilities for prevention. METHODS: Questionnaires were posted to all patients with Type 2 DM in four randomly selected general practices in South London. Two hundred and thirteen (73%) responded. The main outcome measures were: estimated risk of Type 2 DM in their offspring; worry about diabetes in their offspring; knowledge about the possibilities for prevention of Type 2 DM and its complications. RESULTS: Of the 159 respondents with children, at least 35% and perhaps as many as 64% underestimated the risk of their offspring developing Type 2 DM; 44% thought it possible to reduce the risk of Type 2 DM and its complications; 28% thought altering diet and 6% taking exercise might be useful preventive strategies; 49% worried about their children developing diabetes. CONCLUSIONS: Although risk of Type 2 DM was underestimated for their children and little was known about prevention, about half of the respondents worried about their children developing diabetes. Education and counselling about risk and prevention are needed. This is important in view of growing interest in and opportunities for both the primary and secondary prevention of Type 2 DM.

Adult↗
PubMed1999

The Yck2 yeast casein kinase 1 isoform shows cell cycle-specific localization to sites of polarized growth and is required for proper septin organization.

Casein kinase 1 protein kinases are ubiquitous and abundant Ser/Thr-specific protein kinases with activity on acidic substrates. In yeast, the products of the redundant YCK1 and YCK2 genes are together essential for cell viability. Mutants deficient for these proteins display defects in cellular morphogenesis, cytokinesis, and endocytosis. Yck1p and Yck2p are peripheral plasma membrane proteins, and we report here that the localization of Yck2p within the membrane is dynamic through the cell cycle. Using a functional green fluorescent protein (GFP) fusion, we have observed that Yck2p is concentrated at sites of polarized growth during bud morphogenesis. At cytokinesis, GFP-Yck2p becomes associated with a ring at the bud neck and then appears as a patch of fluorescence, apparently coincident with the dividing membranes. The bud neck association of Yck2p at cytokinesis does not require an intact septin ring, and septin assembly is altered in a Yck-deficient mutant. The sites of GFP-Yck2p concentration and the defects observed for Yck-deficient cells together suggest that Yck plays distinct roles in morphogenesis and cytokinesis that are effected by differential localization.

Casein Kinase I↗
PubMed1999

Smokeless tobacco use in adolescents: the Cardiovascular Health in Children (CHIC II) Study.

Smokeless tobacco has seen a resurgence of popularity among adolescents despite its association with oral cancer and altered cardiovascular function. This study examined age, gender, ethnicity, self-esteem, physical activity, parental smoking, and socioeconomic status as predictors of smokeless tobacco use among middle school children. Subjects included 1,211 youth (White (64%), Black (24%), Hispanic (6%), and Other (6%); age 12.2) participating in the Cardiovascular Health in Children and Youth (CHIC II) study. All data were collected by questionnaire. Factors related to ever using smokeless tobacco included older age (p < .001), being male (p < .001), lower self-esteem (p < .001), and having parents who currently (p = .02) or formerly (p = .05) smoked. Hispanics reported a higher current usage rate than other ethnic groups (p < .001). White youth in the lowest socioeconomic status were most likely to be experimental users (p = .007), while those in the high socioeconomic status were more likely to be current users (p = .006). Physical activity was not associated with smokeless tobacco use.

Adolescent↗
PubMed1999

Using reflexivity to optimize teamwork in qualitative research.

Reflexivity is often described as an individual activity. The authors propose that reflexivity employed as a team activity, through the sharing of reflexive writing (accounts of personal agendas, hidden assumptions, and theoretical definitions) and group discussions about arising issues, can improve the productivity and functioning of qualitative teams and the rigor and quality of the research. The authors review the literature on teamwork, highlighting benefits and pitfalls, and define and discuss the role for reflexivity. They describe their own team and detail how they work together on a project investigating doctor-patient communication about prescribing. The authors present two reflexive tools they have used and show through examples how they have influenced the effectiveness of their team in terms of process, quality, and outcome.

Communication↗
PubMed1999

Doing more with less in nursing work: a review of the literature.

The paper explores the literature on changes in nursing work. It examines the suggestion that changes in work practices are management responses to cost cutting imperatives. Nursing labour force issues such as staffing roles and staffing mix, the push for flexibility in the workforce and casualisation are discussed. The paper concludes that given the rise of casual work in the general Australian workforce, research needs to be conducted on the extent of casualisation of nursing, and the implications this may have for nursing practice, professional development and on the nursing labour market.

Humans↗