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Biomedical subjects

C Byrne

Publications and source records attributed to C Byrne.

At least 127 records · Page 7Linked to original sources
PubMed1989

Role of community pharmacies in prevention of AIDS among injecting drug misusers: findings of a survey in England and Wales.

OBJECTIVE: To determine the current and potential roles of community pharmacists in the prevention of AIDS among misusers of injected drugs. DESIGN: Cross sectional postal survey of a one in four random sample of registered pharmacies in England and Wales. SETTING: Project conducted in the addiction research unit of the Institute of Psychiatry, London. SUBJECTS: 2469 Community pharmacies in the 15 regional health authorities in England and Wales. MAIN OUTCOME MEASURES: Willingness of pharmacists to sell injecting equipment to known or suspected misusers of drugs; pharmacists' attitudes to syringe exchange schemes, keeping a "sharps" box for use by misusers of drugs, and offering face to face advice and leaflets; and opinions of community pharmacists on their role in AIDS prevention and drug misuse. RESULTS: 1946 Questionnaires were returned, representing a response rate of 79%. This fell short of the target of one in four pharmacies in each family practitioner committee area in England and Wales, and total numbers of respondents were therefore weighted in inverse proportion to the response rate in each area. The findings disclosed a substantial demand for injecting equipment by drug misusers. After weighting of numbers of respondents an estimated 676 of 2434 pharmacies were currently selling injecting equipment and 65 of 2415 (3%) were participating in local syringe exchange schemes; only 94 of 2410 pharmacies (4%) had a sharps box for used equipment. There was a high degree of concern among pharmacists about particular consequences of drug misusers visiting their premises, along with a widespread acceptance that the community pharmacist had an important part to play. CONCLUSIONS: Promoting the participation of community pharmacists in the prevention of AIDS among misusers of injected drugs is a viable policy, but several problems would need to be overcome before it was implemented.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Learning clinical teaching skills at the baccalaureate level.

Nurses returning to work after obtaining their baccalaureate degree in nursing find increased expectations to participate in student and staff clinical education. Often these nurses are not prepared for this role. This paper describes a project that involved final year post-diploma registered nurse students in the clinical teaching of second year basic degree students in a baccalaureate nursing programme. Results of a pilot study to determine if the perceptions of the students involved in the teaching project changed following the experience, show a more positive change in teacher behaviours in these student tutors compared to students doing a traditional clinical experience. Course evaluations indicate the experience increased knowledge and comfort in clinical teaching and point to positive changes in the perceptions of behaviours conducive to clinical teaching.

Clinical Competence↗
PubMed1988

Gender differences in variables associated with psychosocial adjustment to a burn injury.

The purpose of this study was to determine whether variables associated with psychosocial adjustment to a burn injury vary by gender. Male and female burned subjects (N = 260) were compared on their functional disability, disfigurement, coping responses, social resources, and psychosocial adjustment to a burn injury. Both men and women had adjusted psychosocially to their burn injury. Less functional disability (r = .57, p less than .001) for men and greater problem-solving (r = .57, p less than .001) for women were the most important variables in explaining psychosocial adjustment to a burn injury. In the future, researchers need to be cognizant of gender differences and consider men and women as separate populations.

Adaptation, Psychological↗
PubMed1988

Ontario Child Health Study: reliability and validity of the general functioning subscale of the McMaster Family Assessment Device.

The reliability and validity of the 12-item General Functioning (GF) subscale of the McMaster Family Assessment Device (FAD) is reported here. Psychometric properties of the FAD have been previously determined, but no independent assessment has been made of the GF subscale, which was used to measure family functioning in the Ontario Child Health Study (OCHS). Reliability was measured by Chronbach's alpha and split-half correlation. Validity was assessed by hypothesizing the relationships expected between the GF scores and other family variables included in the OCHS data set. The results indicate good reliability, and all hypotheses of validity were supported. The brevity and ease of administering the GF subscale recommend it for further use in survey research in which a global assessment of family functioning is required.

Adolescent↗
PubMed1988

Ontario Child Health Study: patterns of ambulatory medical care utilization and their correlates.

Data from a large epidemiologic survey of Ontario children 4 to 16 years of age are presented concerning the frequency and correlates the use of ambulatory medical care services during a 6-month period in which a universal, first-dollar health insurance plan was used. Patterns of use of ambulatory medical care are described for three settings: doctor's offices, emergency rooms, and hospital outpatient departments. A group of children who are frequent users of ambulatory medical care (defined as using three or more services in 6 months) consumed nearly two thirds of all services. Two regression equations are presented--one predicting use/nonuse of ambulatory medical care and the other predicting the total number of visits for medical care. Although only a small proportion of the variance in use/nonuse and amount of use was explained, the major determinant of both ambulatory medical care use and frequency of use was the child's physical health status as perceived by the parent. Younger child, urban area of residence, the number of chronic medical problems of the child, and higher level of maternal education also contributed to the explanation of use v nonuse. Among ambulatory medical care users, high users were more likely to be described as having mental health problems and have parents who had been treated for "nerves." Family size and socioeconomic variables were not important factors in use, suggesting that universal health insurance reduces some barriers to ambulatory medical care for children.

Adolescent↗
PubMed1987

Ontario Child Health Study. II. Six-month prevalence of disorder and rates of service utilization.

We studied the six-month prevalence of four child psychiatric disorders (conduct disorder, hyperactivity, emotional disorder, and somatization) and patterns of service utilization for mental health and social services, ambulatory medical care and special education by different regions of Ontario, urban-rural residence, and age and sex groupings. Among children 4 to 16 years of age, the overall six-month prevalence rate of one or more of these disorders was 18.1%. The prevalences of hyperactivity and one or more disorders were significantly higher in urban areas than rural areas. The utilization data indicated that children with these psychiatric disorders, compared with children without these disorders, were almost four times more likely to have received mental health or social services in the six months preceding this study. However, five of six of these children had not received these specialized services in the previous six-month period. Over 50% of the children in the province had received ambulatory medical care in the last six months. Over 15% of the children in the province had received special education services at some time thus far in their school careers. Implications of these findings, especially for the provision of child mental health services, are discussed.

Adolescent↗
PubMed1987

Effect of human insulin administration on urinary acidification in patients with insulin-dependent diabetes.

A previous study has shown that oral glucose administration results in a transient fall in urinary acid excretion in humans. The present study was undertaken to determine the effect of physiologic doses of insulin on urinary acidification while maintaining serum glucose concentration constant. This was accomplished by using a euglycemic insulin clamp method. Eight patients with insulin-dependent diabetes and no clinical or laboratory evidence of detectable renal disease were studied. Data obtained during two 2-hour periods of steady state insulin infusion rates of 0.2 and 0.5 mU/kg/min were compared. This resulted in steady state serum free insulin levels of 15 +/- 0.1 and 39 +/- 0.6 uU/ml respectively. Urinary pH and bicarbonate excretion rate rose while the excretion rates of titratable acid, ammonium and net acid fell significantly with increased insulin administration. These changes occurred in the absence of any significant changes in serum glucose, potassium, Ca2+ or phosphorus concentrations or urinary excretion rates of Na+, K+, phosphorus or Ca2+. These data suggest that increased insulin levels within the physiological range can result in a transient fall in the rate of urinary acid excretion. These findings confirm previous observations in animals and suggest that insulin may be the cause of post prandial urinary "alkaline tide".

Adult↗
PubMed1986

The effect of modified transurethral sphincterotomy on autonomic dysreflexia.

Autonomic dysreflexia continues to be a major problem in spinal cord injury patients. In our report 16 patients with spinal cord lesions above the T6 level and a history of autonomic dysreflexia also had detrusor-sphincter dyssynergia. Of these patients 12 (75 per cent) had evidence of dysreflexia during cystometry. In addition, the dysreflexic response in blood pressure was shown to correlate with the high intravesical and urethral pressures measured during cystometry. Modified transurethral sphincterotomies subsequently were performed on all patients as recommended therapy for detrusor-sphincter dyssynergia. Repeat cystometry revealed significant decreases in intravesical and urethral pressures compared to before sphincterotomy (p less than 0.001) along with an associated significant decrease in blood pressure (p less than 0.01). Other dysreflexic responses also were markedly attenuated. These results suggest an association among detrusor-sphincter dyssynergia, high intravesical and urethral pressures, and autonomic dysreflexia. Our data indicate further that the frequency and magnitude of autonomic dysreflexia can be diminished significantly by modified external sphincterotomy.

Adult↗
PubMed1985

Psychosocial adjustment of burn survivors.

The purpose of this study was to assess the magnitude and predictors of psychosocial adjustment in burn victims. It was postulated that once individuals sustain a burn, their long-term psychosocial adjustment is a function of their present coping responses, social resources, burn severity and time since burn. It was expected that these variables could also be used to identify individuals at risk for psychosocial maladjustment. A historical cohort analytical survey of 340 randomly selected adults and the mothers of 145 children who had sustained either major or minor burns during the past 12 years were administered the Coping Scale, Participation in Social and Recreational Activities Index, Social Support and the Psychosocial Adjustment to Illness Scale. The children's mothers also completed the Family Environment Scale and the Child Behaviour Checklist. In summary, the variance in psychosocial adjustment among adults was related to unemployment, loss of occupational status, avoidance coping, and little involvement in recreational activities. Together, these variables explained 40 per cent of the variance in psychosocial adjustment. Severity of the burn and time since the burn were not related to psychosocial adjustment. The prevalence of psychosocial maladjustment among the adults was 10 per cent and 15.7 per cent among children. Psychosocial adjustment among children was not related to the severity of the burn. The less adjusted children could be distinguished from adjusted children on the basis of their mothers' adjustment and methods of coping. The findings tended to refute the commonly held view that post-burn adjustment is associated with burn severity and suggests psychosocial adjustment is a function of both coping responses and social resources.

Achievement↗
PubMed1985

Prevention of metabolic alkalosis induced by gastric fluid loss using H2 receptor antagonist.

Gastric fluid loss is a common cause of metabolic alkalosis. We studied various acid-base parameters in 20 patients undergoing continuous nasogastric (NG) suctioning for periods ranging from 3 to 17 days. Ten patients received cimetidine 300 mg intravenously every 6 hr (cimetidine-treated group). The remaining 10 patients received an antacid compound through the NG tube (control group). The rise in plasma bicarbonate concentration was significantly greater in the control group as compared to the cimetidine-treated group. As expected, gastric acid output was considerably lower in the cimetidine-treated group than in the control group. We conclude that cimetidine administration may be used in preventing metabolic alkalosis associated with gastric fluid loss by inhibiting gastric secretion of HCl.

Adolescent↗
PubMed1985

Effects of glucose feeding on renal electrolyte and H+ transport.

Changes of urinary pH, titratable acidity, ammonium, bicarbonate and PCO2, as well as plasma insulin and various plasma and urine electrolytes were studied in 15 normal individuals during a 5-hr glucose tolerance test. After glucose ingestion, urine pH and bicarbonate excretion rose while urine titratable and total acidity, ammonium, Na, K, Cl, phosphorus and PCO2 fell significantly. Serum bicarbonate rose while serum potassium, phosphorus, and anion gap decreased following oral glucose administration. Glucose feeding and the resultant rise in insulin are, therefore, associated with a considerable reduction in urine acidity and Na, K, Cl, and phosphorus excretion. While a significant fall in urinary Na, K and phosphorus has been shown to occur following glucose and insulin administration, their effect on renal H+ excretion in man has not been investigated previously. The mechanism of the observed fall in urine acidity is not clear and requires further investigation.

Adolescent↗
PubMed1985

Electrocardiography and echocardiography in patients with chest pain and mitral leaflet prolapse.

34 patients with catheter verified, haemodynamically trivial mitral leaflet prolapse with chest pain and normal coronary arteries were studied. Nineteen had no auscultatory signs of MLP despite clear catheter or echocardiographic evidence of prolapse. Infero-lateral repolarisation changes on the resting electrocardiogram were present in 29%. 50% had false positive exercise tests. M-mode echocardiography proved diagnostically disappointing but sector scans revealed mitral leaflet prolapse in 62%. The apical 4 chamber acoustic window was markedly superior to the parasternal long axis acoustic window.

Adult↗
PubMed1984

Methodological problems in studies of burn survivors and their psychosocial prognosis.

As the psychological adjustment of burn survivors is a subject of increasing interest, 21 studies on psychosocial adjustment to burns in adults and children are reviewed. These studies are commonly cited as a basis for determining the direction of future research. Eight methodological guidelines are applied to these studies of prognosis. Limitations are identified with the major focus of the paper being to assist in the development of more rigorous methodology in order to promote the optimal rehabilitation for burn survivors.

Adaptation, Psychological↗