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Biomedical subjects

D Harper

Publications and source records attributed to D Harper.

At least 73 records · Page 4Linked to original sources
PubMed1986

An outbreak of gastroenteritis on a passenger cruise ship.

In an outbreak of gastroenteritis on board a cruise ship 251 passengers and 51 crew were affected and consulted the ship's surgeon during a 14-day period. There was a significant association between consumption of cabin tap water and reported illness in passengers. Enterotoxigenic Escherichia coli were isolated from passengers and crew and coliforms were found in the main water storage tank. Contamination of inadequately chlorinated water by sewage was the most likely source of infection. A low level of reported illness and late recognition of the outbreak delayed investigation of what was probably the latest in a series of outbreaks of gastrointestinal illness on board this ship. There is a need for a national surveillance programme which would monitor the extent of illness on board passenger cruise ships as well as a standard approach to the action taken when levels of reported illness rise above a defined level.

Disease Outbreaks↗
PubMed1986

Change with time in patients' reactions to committal.

The influence of time on patients' reactions to involuntary committal is a variable seldom considered in reports. The reactions to committal of thirty-four subjects interviewed one week/one month/three months/six months post committal are reported. Generally committal was viewed neutrally. The major changes in attitudes related to knowledge of the fact of committal and of rights of appeal. The importance of these findings for the management of committed patients is stressed.

Adult↗
PubMed1986

The benefit of lithium carbonate adjunct in refractory depression--fact or fiction?

Our group attempted to validate previous claims of rapid success with lithium carbonate adjunct therapy in antidepressant-resistant depression. Seven depressed patients volunteered for a study of placebo controlled, double-blind design. During their treatment on general hospital psychiatric wards, these patients received antidepressant medication for a period of at least 21 days. While continuing to receive antidepressant medication after the 21 day period, four of the patients then received lithium carbonate, and three received placebo. This combination pharmacological therapy continued for a 48 hour period. After this time, six of the seven patients showed no significant improvement. The remaining patient, who had received lithium carbonate, improved markedly over the 48 hour period. However, this patient relapsed within one week. A review of the two most extensive studies claiming significant results with the lithium carbonate adjunct therapy was performed. We feel that they, as presented, leave serious doubt as to the validity of their conclusions. We conclude that on the basis of our work up to this point in time and the analysis of previous reports claiming otherwise, no valid evidence exists for a consistent therapeutic effect of lithium carbonate adjunct in antidepressant-resistant depression. It was also found that methodologic contamination necessitated the exclusion of an additional six patients from the double-blind trial. We conclude that in order to objectively examine the rapidly expanding field of biological psychiatry, teaching of clinical staff in basic research procedure should be stressed as a part of routine ward orientation.

Adult↗
PubMed1986

Mental illness and the media: Part II. Content analysis of press coverage of mental health topics.

The public image of psychiatry has been tarnished in recent years. In order to determine the extent to which press coverage has contributed to negative attitudes towards psychiatry, we conducted a content analysis of a random selection of newspaper articles which appeared over a twenty-year period in two different newspapers. We found that although there had been some minor, cosmetic changes over the years, such as more appropriate headlines and more direct quotes from psychiatric experts, on the whole, content and attitudes had changed very little. An accuracy check of media reporting of forensic cases over a 20-year period revealed that when reporters have access to written material, the accuracy levels are greatly improved.

Attitude to Health↗
PubMed1986

The clinical oral examination in psychiatry: association between subscoring and global marks.

Fifteen academic psychiatrists rated a videotaped clinical oral examination done in the Royal College format. In addition to assigning an overall mark, the raters completed a detailed scoring form. The ratings of the case presentation and discussion accounted for most of the variance in the overall mark. The rating of the interview difficulty and establishment of rapport were weaker predictors. Implication of these findings for the trainees and the examiners are discussed.

Canada↗
PubMed1985

Mental illness and the media: an assessment of attitudes and communication.

Media coverage of psychiatric issues will reflect or influence public perceptions of the mentally ill. In order to explore the relationship between psychiatry and the media, an attitudinal questionnaire was administered to a systematic sample of 20 reporters, 20 psychiatrists, 20 medical outpatients with no psychiatric history, and 40 psychiatric inpatients. In addition, 4 psychiatric patients who had personal experience with media coverage were interviewed to determine the impact. Their stories are presented as clinical vignettes. The results of the questionnaire survey show that media reporters are no less accepting of mental illness than the other groups. A regression analysis of attitudinal predictors elicit education as more significant than age and media exposure. Yet low scores for the coverage by the media of mental illness were given by all groups with psychiatrists tending to be most critical. Reasons offered by reporters included "sensationalism sells" along with cost and time factors. Recommendations for both reporters and psychiatrists groups were collated, aiming at improving communication and ensuring a more positive emphasis and greater accuracy of media coverage of mental health issues.

Adult↗
PubMed1984

Water fittings as sources of Legionella pneumophila in a hospital plumbing system.

An extensive study of the plumbing systems in Kingston Hospital was made over the three years following the 1980 outbreak of legionnaires' disease. The introduction of chlorination and raising the water temperature controlled the outbreak but failed to decontaminate water outlets in the wards. Legionella pneumophila was isolated from rubber washers in shower fittings, and laboratory experiments demonstrated the ability of L pneumophila to grow in water in contact with these rubber components. All the components in the hospital's fittings were replaced with an approved type, and since then L pneumophila has not been isolated from water or components.

Chlorine↗
PubMed1984

Computer-assisted instruction and diagnosis of radiographic findings.

Recent advances in computer technology, including high bit-density storage, digital imaging, and the ability to interface microprocessors with videodisk, create enormous opportunities in the field of medical education. This program, utilizing a personal computer, videodisk, BASIC language, a linked textfile system, and a triangulation approach to the interpretation of radiographs developed by Dr. W. L. Thompson, can enable the user to engage in a user-friendly, dynamic teaching program in radiology, applicable to various levels of expertise. Advantages include a relatively more compact and inexpensive system with rapid access and ease of revision which requires little instruction to the user.

Computer-Assisted Instruction↗
PubMed1984

A study of the reliability of the clinical oral examination in psychiatry.

A study of the variability between raters in scoring an oral clinical examination in psychiatry in the format of the certification by the Royal College of Physicians and Surgeons of Canada is reported. A video-taped examination from another centre was rated independently by academic psychiatrists, nonacademic psychiatrists and residents. Considerable inter-rater differences between and within these groups were found. In particular, the averaging of the marks of pairs of raters as occurs in the actual certification resulted in the outcome depending to a considerable degree on the chance pairings of raters. These findings support a number of previous studies and emphasize the need to train examiners and to develop clearer rating criteria.

Canada↗
PubMed1984

Patients' attitudes at the time of their commitment.

The discussion concerning who should be committed and by whom, has dominated the psychiatric literature for many years (1). More recently, the issue of whether committal allows merely for incarceration in the least restrictive alternative or whether it also entitles patients to be treated against their will, if necessary, has also received attention (2-5). As yet, few studies have attempted to define the characteristics of the committed population (6-11). Even fewer studies have attempted to define what patients themselves thought of their committal to hospital (12-15) and for the most part, have not obtained their opinions regarding the broader issues of committal that are being debated in the professional literature. This study seeks to elicit the opinions of patients in these matters.

Attitude to Health↗
PubMed1983

On evaluating patient satisfaction: methodological issues.

The survey of patient satisfaction with the mental health services provided is recommended but involves a methodological dilemma. Concerns include a definition problem, the delineation of a representative sample, the selection of a survey technique and the type of questions to be used. A literature review and the authors' own experience with the process are presented. The investigation of patient satisfaction while, as yet, limited in the critical information it can provide for the evaluation of services, will help pinpoint areas where the most patient dissatisfaction exists. The process can also be useful therapeutically, but patient satisfaction, although an important outcome measure, is not systematically related to other measures of treatment success. Methodological suggestions to improve the validity of the data gathered conclude the paper.

Commitment of Persons with Psychiatric Disorders↗
PubMed1983

Psychiatric training in gender specific psychology and goals for women in therapy.

A questionnaire addressing itself to the necessity of psychiatric training in gender specific issues and therapists' attitudes towards women in treatment was answered by almost half the total number of residents in psychiatric programs across Canada in the spring of 1980. Although the majority felt that training in gender specific psychology was a necessity, our survey indicated only a small proportion of Canadian programs (2 out of the 16 psychiatric schools) have incorporated this into their present curricula. An overview of the survey showed residents to agree with the following attitudes regarding women in therapy: 1) women's conflicts should be considered in the framework of their developmental life cycle and reproductive issues; 2) women do not present the same conflicts, goals and values as men; 3) therapy should help women to become more autonomous and assertive in the home and at work; and 4) women's primary goal should not necessarily be seen as that of caregivers and homemakers. Further, the residents expressed the beliefs that sex role ideology could interfere with therapy and that the "traditional hierarchy of power" should not be replicated between therapist and patient.

Adult↗