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Biomedical subjects

D Casey

Publications and source records attributed to D Casey.

At least 19 recordsLinked to original sources
PubMed2000

Comparison of wet combing with malathion for treatment of head lice in the UK: a pragmatic randomised controlled trial.

BACKGROUND: Concern about the effectiveness and toxicity of insecticide lotions has led to promotion of mechanical methods to remove head lice. We compared the effectiveness of "bug-busting" (wet combing with a fine-toothed comb) and malathion lotion. METHODS: We screened 4037 schoolchildren in two counties in Wales, UK (intermediate resistance to malathion). Of 167 found to have head lice, 81 (aged 3-14 years) were eligible to participate in a randomised controlled trial that compared mechanical removal of lice by a commercial kit every 3-4 days for 2 weeks with two applications of 0.5% malathion lotion 7 days apart; parents carried out both treatments. The outcome measure was the presence of live lice 7 days after the end of treatment. Analyses were by intention to treat. FINDINGS: 74 children completed the study and 72 were included in the analysis. The cure rate was 38% (12 of 32) for bug-busting and 78% (31 of 40) for malathion. Children assigned bug-busting were 2.8 (95% CI 1.5-5.2) times more likely than those assigned malathion to have lice at the end of treatment (p=0.0006). INTERPRETATION: Malathion lotion was twice as effective as bug-busting, even in an area with intermediate resistance. Policies advocating bug-busting as first-line treatment for head lice in the general population are inappropriate. Assessment of the outcome of treatment 1-2 weeks after completion is essential for successful management. Only about 50% of participants complied fully with treatment, so future trials should be pragmatic in design, avoid false incentives, and study representative samples of children.

Adolescent↗
PubMed2000

The Roper, Logan and Tierney (1996) model: perceptions and operationalization of the model in psychiatric nursing within a health board in Ireland.

This study aimed to determine whether the Roper, Logan & Tierney model was an appropriate model for planning nursing care for clients who are mentally ill. Data were collected from two sources in one Health Board region in Ireland. A care plan audit was used to evaluate the extent to which the Roper, Logan & Tierney model was used to assess, plan and evaluate nursing care in nursing documentation. Qualitative interviews with nurses explored their experiences of using the model and their perceptions of the model's usefulness and appropriateness for planning care. Both data sets were complementary, the qualitative data often providing contextual information which helped put the findings into perspective. It was found that there was little evidence that the Roper, Logan and Tierney model guided care planning and that goals and nursing interventions were frequently not explicitly documented. Interviews with nurses indicated that they lacked educational preparation for using the model and found the model constraining and physically orientated. The appropriateness of the Roper, Logan and Tierney model for planning care for clients who are mentally ill is questioned. It is suggested that nurses need to be adequately prepared if they are to use a model appropriately. Consideration should be given when selecting a model as to its 'fit' with the needs of the client group and the ward team philosophy.

Attitude of Health Personnel↗
PubMed2000

Is infection control in residential homes neglected?

We investigated the potential for cross infection during the cleaning of commodes in residential homes in one health authority in order to investigate why residential institutions are the commonest setting for outbreaks of infectious intestinal disease. Most homes used commodes, but half lacked a designated sluice area for cleaning them after use and in half soiled commodes were cleaned in bathroom or toilet washbasins, baths, showers, or toilet pans, creating a risk of cross infection.

Cross Infection↗
PubMed1999

The V89L polymorphism in the 5alpha-reductase type 2 gene and risk of prostate cancer.

5alpha-Reductase type 2, the predominant prostatic isozyme of this protein, converts testosterone to dihydrotestosterone. It has been hypothesized that individuals with greater 5alpha-reductase activity are at increased risk for prostate cancer (CaP). A single nucleotide polymorphism of the 5alpha-reductase type 2 gene (SRD5A2) gives rise to a substitution of leucine (leu) for valine (val) at codon 89 (V89L), the presence of which may affect serum androstanediol glucuronide (AAG) levels. We studied the effect of this polymorphism on the risk of prostate cancer in a prospective, nested, case-control design within the Physicians' Health Study. In all controls (n = 799), the leu allele frequency was 0.30. Among the 386 controls with plasma AAG levels available, there was no significant association between AAG levels and V89L genotype. We also detected no significant association between risk for CaP and genotype [odds ratio: val/val = 1.0 (reference), leu/val = 0.96 (95% confidence interval, 0.76-1.20), and leu/ leu = 0.84 (95% confidence interval, 0.57-1.24)]. These data do not support a moderate to large effect of the SRD5A2 V89L polymorphism on plasma AAG levels or CaP risk in this predominantly Caucasian cohort, although a small effect cannot be completely excluded.

3-Oxo-5-alpha-Steroid 4-Dehydrogenase↗
PubMed1999

The Massachusetts Behavioral Health Program year 5: transition to a new managed care organization.

Year 5 of the Massachusetts Behavioral Health Program was a transition to management by a new private managed care organization. Fifty-eight providers interviewed for an ongoing panel survey reported slightly lower levels of quality, access, utilization, and length of stay than a year earlier. Relationships with providers and advocates improved after an initial difficult period, while consumer and family involvement at all levels remained low. The greatest changes in managed care appeared to take place during the initial transition from fee-for-service care, but intractable problems continue, and full participation of stake-holders seems difficult to achieve.

Attitude of Health Personnel↗
PubMed1998

Dose from syringe procedures during technetium-99m radiopharmaceutical preparation.

UNLABELLED: We examined the dose from 99mTc contained in syringes and shielded vials to assess in detail the dose burdens in a central pharmacy. METHODS: Absorbed-dose rates at the end of the plunger of a shielded syringe, when 99mTc is contained either in the syringe or in a shielded vial from which the activity would be drawn, were measured with CaF2 dosimeters. The dose rates also were calculated with a Monte Carlo model. RESULTS: When activity was contained in either 3-ml or 10-ml disposable syringes shielded by lead glass, the absorbed-dose rates were 1.35-1.62 mGy hr-1 GBq-1 (5-6 mrad hr-1 mCi-1). When the activity was contained in either a shielded elution or product kit vial, the absorbed-dose rates at the end of the syringe plunger were about 0.40 mGy hr-1 GBq-1 (1.4-1.5 mrad hr-1 mCi-1). These results were reproduced with reasonable accuracy by Monte Carlo simulations. CONCLUSION: The dose burden per unit of activity handled from 99mTc in procedures using syringes is likely to be two to five times larger than the dose burden from calibrating generator eluate. The Monte Carlo simulations suggest that lead K x-rays may be responsible for a significant fraction of the total dose to the fingers and hand of the pharmacist when lead-glass syringe shields are used.

Equipment Design↗
PubMed1996

What's happening with consumer participation?

Consumer empowerment, both individually and within the service, is a growing trend in mental health. This trend is such that consumers are having more input into the service being provided. Shared control is a wave of the future, thereby increasing consumer empowerment not only within the service but within our own lives. The road is long and there are many bumps along the way for both the consumer and the health worker, yet the results of consumers leading quality lifestyles gives other consumers hope that they too can be capable of being active participants rather than relying on others to take care of them.

Consumer Advocacy↗