Search PubMed⌕ Search

Biomedical subjects

D F Peck

Publications and source records attributed to D F Peck.

At least 19 recordsLinked to original sources

Saliva alcohol concentrations in accident and emergency attendances.

OBJECTIVES: Although alcohol is known to play a key part in accidents, no UK study has assessed alcohol concentrations in a comprehensive sample of accident and emergency (A&E) attenders. This study set out to do this, and examine the relation between alcohol concentrations and the severity, type and circumstances of presentation, and the sociodemographic characteristics of patients. METHODS: A survey was conducted of all new A&E attenders (aged 10 years or over). Two 24 hour periods for each day of the week were covered in 6, 7 or 11 hour sessions over a two month period. Alcohol concentrations were assessed from saliva samples using a disposable device. Data were collected from 638 attenders, of whom 544 provided saliva samples; the remainder refused or were unable to participate. RESULTS: Positive saliva alcohol readings were obtained in 22% of attenders (95%CI 19% to 26%); this increased to 25% if others were included (for example, those who refused to participate but were judged to be intoxicated). Alcohol was associated with 94% of incidents of self harm, 54% of non-specific/multiple complaints, 47% of collapses, 50% of assaults, and 50% of patients admitted to hospital. Higher concentrations of alcohol were found from Friday to Sunday, between midnight and 0900, and in patients aged 41 to 60. Among people with positive alcohol results, those attending with a companion had higher concentrations than those attending alone. There were no significant differences between men and women in alcohol concentrations. DISCUSSION: These findings show that alcohol use is an important factor in A&E attendance, but it should not be assumed that there is a causal relation between alcohol use and injury. Several accident related and sociodemographic variables were predictive of alcohol use before attending. The overall level of prediction was too weak to permit accurate identification of drinkers for screening purposes, but routine alcohol concentration assessments may be justified in the high risk groups identified in this study. A&E departments may be convenient and fruitful settings for brief interventions with early problem drinkers.

Adolescent↗

The consistency of neuropsychological assessments performed via telecommunication and face to face.

Previous studies have suggested that cognitive assessments of adult psychiatric patients can be carried out as reliably via teleconsultation as they can face to face. However, the designs of these studies have often been less than satisfactory. The present study used videoconferencing at 128 kbit/s for the cognitive assessment of individuals with a history of alcohol abuse. Twenty-seven participants were given a range of assessments with two equivalent forms. One of the forms was given via videoconferencing and the other face to face. All participants were assessed using both media and the order of presentation was balanced across participants. Aspects of participant satisfaction with teleconsultations were also assessed, on 10-point scales. The teleconsultations were significantly longer (mean 40.7 min, SD 6.4) than the face-to-face sessions (mean 33.0 min, SD 5.3). For most of the outcome measures, cognitive assessment via teleconsultation produced similar results to face-to-face assessment. Most participants expressed high overall satisfaction with the teleconsultation (mean rating 8.2). The average ratings for the sound quality (mean 7.6) and visual quality of the equipment (mean 7.9) were also high. The findings imply that it is not necessary for patients and neuropsychologists to be present at the same location for cognitive assessments to be carried out.

Adult↗

Psychological sequelae of mountain accidents: a preliminary study.

Studies of the victims of road traffic accidents and of violent crime have shown that a significant minority continue to display mood disorders and posttraumatic symptoms one year later; however, few studies have been conducted on victims of other kinds of accident. Thirty-one subjects admitted to hospitals after a mountain accident in the Scottish Highlands were followed up at 3-month intervals over 9 months to determine the prevalence of psychological sequelae; a variety of questionnaires were used to measure mood and other psychological effects. A large minority experienced at least mild depression and other negative consequences at follow-up, despite relatively minor physical injuries; subjects who experienced intrusive thoughts and avoidance of accident-related phenomena demonstrated the least recovery.

Accidents↗

Prevalence of asthma and wheeze in the Highlands of Scotland.

To establish the prevalence of asthma and wheeze in 12 year old children in a region with low background pollution levels, a population of children resident in the Highland Region of Scotland was studied by questionnaire supported by objective data. A respiratory questionnaire was distributed to the parents of 1919 children aged from 12-13 years and attending secondary schools in the educational divisions of Lochaber, Ross and Cromarty, and Inverness including Skye in Highland Region to ascertain history of wheeze and parental awareness of a diagnosis of asthma. Peak expiratory flow (PEF) measurements were carried out before and after a standardised exercise test. Ozone levels were noted. Questionnaires were completed by 1825 parents (95% of those invited) and 1702 (93%) of those returning questionnaires took part in the exercise test. The overall prevalence of reported asthma was 14% and wheeze 25%. Defined as a fall in PEF of more than 15% with exercise, the overall prevalence of exercise induced bronchospasm was 9%. In Skye the prevalence of reported asthma was 17%, wheeze 28%, and exercise induced bronchospasm 30%. There were no significant differences between areas for reported asthma or wheeze. There was, however, a highly significant difference between areas for exercise induced bronchospasm, most of which was accounted for by the very high incidence in Skye, which is one of the most rural of the areas studied. The results of this study do not support the hypothesis that asthma is commoner in urban than rural areas, whether we compare the Highlands with the rest of the UK or areas within the Highlands, or whether we examine reported symptoms or exercise induced bronchospasm. The results do not support an association between atmospheric pollution and the prevalence of asthma.

Adolescent↗

Survey of out-patient satisfaction in a general hospital.

This paper describes a brief questionnaire designed to assess patient satisfaction with outpatient services at a general hospital. Its application in the evaluation of services in a hospital in the Highland Area of Scotland is outlined, demonstrating how it can be used to highlight aspects of services that are satisfactory, and those that require improvement.

Adult↗

Climatic variables and admissions for mania: a reanalysis.

Differencing and cross-correlations are useful and straightforward methods for dealing with relationships between variables measured over short periods of time. Without such transformations of time-series data, spurious relationships may emerge and the true nature of underlying relationships may be obscured. This reanalysis of data from Carney et al. (1989) suggests that there is a strong relationship between amount of sunshine in a month and admissions for mania one month later.

Bipolar Disorder↗

Do self-report measures of affect agree? A longitudinal study.

As part of a study of the association between changes in mood and migraine attacks, daily self-report data on anxiety and depression were collected from 37 female patients attending a migraine clinic. A combination of the Irritability Depression Anxiety (IDA) Scale and two visual analogue scales (VAS) was used. The IDA and VAS measures of anxiety and depression were significantly associated in only 55 and 61 per cent of patients respectively.

Adult↗

The sex industry, alcohol and illicit drugs: implications for the spread of HIV infection.

A review is presented of the association between the sex industry and the use and misuse of alcohol and illicit drugs. It is concluded that both the latter are associated with 'high risk' sexual activities and that heavy drinking and illicit drug use are commonplace amongst prostitutes and their clients. Outside Africa evidence suggests that in some, though by no means all, areas prostitutes have low or zero levels of HIV seropositivity. It is concluded that far more information is needed on the patterns of AIDS-related knowledge, beliefs, attitudes and behaviours amongst male and female prostitutes and their clients. Vigorous policies are needed to increase levels of knowledge about AIDS risks amongst prostitutes and their clients and to foster the adoption of 'safer sex' practices.

Acquired Immunodeficiency Syndrome↗

Unemployment and illegal drug use: concordant evidence from a prospective study and national trends.

Data from a previous study of 1036 young people in the Lothian region that indicated an association between unemployment and illegal drug use were examined in more depth to investigate the inter-relation between duration of unemployment and the use of illegal drugs, alcohol, and tobacco. After factors such as social class background and educational qualifications had been taken into account a weak but significant association was found between duration of unemployment and illegal drug use. No such association was found for alcohol or tobacco. Similar results were obtained from an analysis of national statistics related to unemployment and illegal drug use. Both sets of data thus indicate that illegal drug use is moderately associated with unemployment.

Cannabis↗

Effect of attitudes and beliefs on exercise tolerance in chronic bronchitis.

In 50 patients with chronic bronchitis the relation was assessed between exercise tolerance and pulmonary function and psychological factors, including subjective perception of exertion, mood, general psychiatric disturbance, and the attitudes and beliefs held by patients concerning themselves, their illness, and its treatment. Ventilatory capacity was significantly correlated with but a poor predictor of exercise tolerance. Subjective perception of exertion was most closely correlated with exercise tolerance. The distance walked in a 12-minute exercise test was significantly correlated with measurements of mood and with several attitudes and beliefs. Attitudes and beliefs greatly outweighed measurements of mood and ventilatory capacity as components in a multiple regression predicting distance walked in 12 minutes. This method of psychological assessment emphasises the importance of attitudes and beliefs in respiratory disability and may have useful applications in rehabilitation in other chronic diseases.

Adult↗

Psychological factors contributing to disproportionate disability in chronic bronchitis.

Disability in fifty chronic bronchitis patients was measured by the twelve-minute walking test. The degree of disability was examined in relation to lung function and a measure of disproportion of disability was derived. This measure was significantly related to a number of attitude measures, in particular the patients' beliefs about treatment and treatment outcome, but was not strongly related to psychiatric disturbance on the GHQ. However, high levels of psychiatric disturbance were found within the overall sample.

Adult↗