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Biomedical subjects

E Kearney

Publications and source records attributed to E Kearney.

11 recordsLinked to original sources
PubMed2006

Patient satisfaction in radiation oncology.

As part of a quality improvement exercise at the Perth Radiation Oncology Centre, a survey was undertaken to ascertain the current level of patient satisfaction with the information they were receiving from their treating radiation oncologist. In addition, the effect of radiation on patients' anxiety levels was investigated. Two questionnaires were given to patients having radical radiotherapy for malignancy. The first questionnaire consisted of the Information Satisfaction Questionnaire and the State Trait Anxiety Index. It was given to patients before the commencement of their course of radiotherapy. The second questionnaire consisted of the State Trait Anxiety Index and was given at the completion of their radiotherapy. A total of 120 patients completed both the questionnaires. The majority of patients were satisfied/very satisfied with the explanation of their illness and radiation toxicities. Fewer patients were satisfied with the explanation of lifestyle (e.g. diet, exercise, smoking) and practical issues such as parking and treatment costs. The patients showed a statistically significant reduction in both their State and Trait Anxiety scores following radiotherapy. Following this study, we have developed new information booklets addressing lifestyle and practical issues, which were not being adequately addressed as shown in this study. Our next study will assess the effect of these new information booklets.

Adult↗
PubMed2005

At HOME in Scotland: validation of the home observation for measurement of the environment inventory.

BACKGROUND: This study used the Home Observation for Measurement of the Environment (HOME) Inventory to measure aspects of the quality and quantity of psychological stimulation and cognitive support available in the home environment of a sample of Scottish children and to examine the effectiveness of this measure in a British context. METHODS: Forty-seven families who had previously attended parent-training programmes at family centres were assessed. The Middle Childhood (MC) and Early Adolescent (EA) version of the HOME were used with children aged between 8 and 13 years old. Measures of family adversity were also taken. RESULTS: There were no significant differences in the demographics of the MC-HOME and EA-HOME groups nor in their total HOME scores. Total HOME scores were compared with independent measures of family adversity. The results of the MC-HOME and the EA-HOME were similar to results reported for socially deprived American samples. DISCUSSION: This Scottish sample had similar MC-HOME and EA-HOME scores as previously reported in American samples and the HOME scores related strongly to family adversity, supplying a proximal link between social conditions and the environment of children. These results suggest that the HOME Inventory is reliable and has concurrent validity with measures of social adversity in a British sample.

Adolescent↗
PubMed2001

Non-specialist management of acute renal failure.

In a 12-month prospective study of the initial management of patients with acute renal failure (ARF) in East Kent (population 593 000), we evaluated the initial management of ARF and assessed what proportion of ARF may have been preventable. Patients were seen and assessed on a daily basis, and were followed until discharge from hospital or death; survivors were subsequently followed for 3 years. Overall, 288 patients developed ARF (486 per million population/year). Mean age at presentation was 73 years (range 14-96). Initial assessment was often suboptimal, and key features in investigation and initial management were often lacking. In 108 cases, ARF was iatrogenic and/or potentially preventable (53 preventable, 99 iatrogenic, 44 both). Overall survival was 56% at discharge from hospital, 35% at 1-year follow-up, 31% at 2 years, and 28% at 3 years. In discharged patients, recovery of function was complete in 69%. A significant proportion of ARF is preventable. Clear guidelines, easily accessible at the point of care, could aid the diagnostic evaluation of the patient with ARF and indicate where referral for a specialist opinion is appropriate.

Acute Kidney Injury↗
PubMed1994

Three-year follow-up of the Oxford Cholesterol Study: assessment of the efficacy and safety of simvastatin in preparation for a large mortality study.

We report the results of a randomized single-centre study designed to assess the effects of simvastatin on blood lipids, blood biochemistry, haematology and other measures of safety and tolerability in preparation for a large-scale multicentre mortality study. Six hundred and twenty-one individuals considered to be at increased risk of coronary heart disease were randomized, following a 2-month placebo 'run-in' period, to receive 40 mg daily simvastatin, 20 mg daily simvastatin or matching placebo. Their mean age was 63 years, 85% were male, 62% had a history of prior myocardial infarction (MI), and the mean baseline total cholesterol was 7.0 mmol.l-1. Median follow-up in the present report is 3.4 years. Eight weeks after randomization, 40 mg daily simvastatin had reduced non-fasting total cholesterol by 29.2% +/- 1.1 (2.03 +/- 0.08 mmol.l-1) and 20 mg daily simvastatin had reduced it by 26.8% +/- 1.0 (1.87 +/- 0.07 mmol.l-1). Almost all of the difference in total cholesterol at 8 weeks was due to the reduction in LDL cholesterol (40.8% +/- 1.6 and 38.2% +/- 1.4 among patients allocated 40 mg and 20 mg of simvastatin daily respectively), but simvastatin also reduced triglycerides substantially (19.0% and 17.3%) and produced a small increase in HDL cholesterol (6.4% and 4.8%). These effects were largely sustained over the next 3 years, with 40 mg daily simvastatin producing a slightly greater reduction in total cholesterol at 3 years (25.7% +/- 1.9 reduction) than did 20 mg daily simvastatin (22.2% +/- 1.8). There were no differences between the treatment groups in the numbers of reports of 'possible adverse effects' of treatment or of a range of different symptoms or conditions (including those related to sleep or mood) recorded at regular clinic follow-up. Mean levels of alanine aminotransferase, aspartate aminotransferase and creatine kinase were slightly increased by treatment, but there were no significant differences between the treatment groups in the numbers of patients with significantly elevated levels. A slightly lower platelet count in the simvastatin group was the only haematological difference from placebo, with no difference in the numbers of patients with low platelet counts. In summary, the simvastatin regimens studied produced large sustained reductions in total cholesterol, LDL cholesterol and triglyceride and small increases in HDL cholesterol. They were well tolerated, with no evidence of serious side-effects during the first 3 years of this study.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1991

The effect of intravenous clonidine on the forearm circulation.

The effect of two doses of clonidine on forearm blood flow was compared with an inert treatment using mercury strain gauge venous occlusive plethysmography. In the clonidine treated groups, forearm blood flow was unaffected in the resting state, but decreased sharply with tracheal intubation. In the saline group, blood flow increased with intubation. Forearm vascular resistance increased in the clonidine treated groups, but decreased in the saline group. These results suggest that clonidine has a peripheral action in anaesthetised normotensive individuals, and is not a purely centrally acting drug.

Adult↗
PubMed1990

Rural/urban differences of diabetes--impaired glucose tolerance, hypertension, obesity, glycosolated haemoglobin, nutritional proteins, fasting cholesterol and apolipoproteins in Fijian Melanesians over 40.

Two populations of Fijian Melanesians over 40 years of age were compared. The first population was located in a remote rural area and the other in an urban environment. There was no significant difference between the two populations in age, height and diastolic blood pressure. Highly significant differences were observed in mean weight, body mass index, prevalence of impaired glucose tolerance, prevalence of diabetes, mean glycosolated haemoglobin, mean systolic blood pressure, fasting cholesterol, immunological albumin, immunological transferrin, and A1 and B apolipoproteins. The higher value was associated with urban living. Thus urban living is associated with obesity, impaired glucose tolerance, diabetes, higher systolic blood pressure, higher levels of fasting lipids and increased risk factors for cardiovascular disease.

Apolipoprotein A-I↗
PubMed1987

Adaptation of coenzyme stimulation assays for the nutritional assessment of vitamins B1, B2 and B6 using the Cobas Bio centrifugal analyser.

Adaptation of coenzyme stimulation assays for the nutritional assessment of thiamine, riboflavin and pyridoxine on the Cobas Bio centrifugal analyser are described. Whole blood was collected into acid-citrate dextrose, which preserves the erythrocytes, prior to assay for several days. Washed erythrocytes stored at -70 degrees C and subsequently thawed, showed altered enzyme activities. The methods offer improved precision over existing procedures and take advantage of the high throughput capabilities of the instrumentation.

Anorexia Nervosa↗
PubMed1980

Fibre-optic bronchoscopy in small cell lung cancer: findings pre and post chemotherapy.

The aim of our study was to evaluate the role of fibre-optic bronchoscopy both in diagnosing patients with small cell lung cancer, and in assessing remission status following combination chemotherapy. Diagnostic bronchoscopic examination was performed in 40 patients and revealed that in all cases the lesion was located in the central bronchi. Following combination chemotherapy remission status in 18 patients was assessed by comparing the findings at repeat bronchoscopy with those of chest radiology. In ten patients there was no relationship between the findings at bronchoscopic examination and the chest radiograph (normal or abnormal). Adequate assessment of response of small cell lung cancer to therapy requires bronchoscopy in addition to chest radiology.

Bronchoscopy↗
PubMed1979

Interdisciplinary inpatient warfarin education program.

An educational program on warafarin counseling for inpatients of a 200--bed community hospital which uses both pharmacy and nursing personnel is described. Following a physician's request for the educational service, a registered nurse arranged for the patient to view a slide presentation of anticoagultants and provided a booklet designed to reinforce the learning objectives for the warfarin education program. After the patient viewed the film and read the booklet, a pharmacist or nurse made a follow-up visit to answer questions and reinforce the objectives. The checklist of learning objectives was completed by the pharmacist or nurse and remained in the patient's chart as a permanent record of medication counseling. Forty-five request for warfarin patient education were received during the program's first six months of operation. The pharmacist spent an average of 30 minutes with each patient; the nurse spent an average of 15 to 20 minutes with each patient. The average time required of nursing and pharmacy service to provide the program was one and two hours per week, respectively. The warfarin education program provides an important patient service with a reasonable expenditure of time by pharmacy and nursing personnel.

Hospitals, Community↗
PubMed1977

Interdisciplinary diabetic team in a community hospital.

An interdisciplinary diabetic team which provides inpatient and outpatient diabetic instructional services in a 200-bed community hospital is discussed. The team consists of a pharmacist, a dietitian, and a registered nurse, each of whom is assigned to a specific area of diabetic education. Instructional objectives include coordination of teaching efforts by hospital personnel, standardization of education, and development of evaluation procedures. Upon notification of a physician request for diabetic team services, a form which contains competency-based instructional objectives and patient referral questions is placed in the patient's chart. Diabetic instruction may then be initiated by ward personnel or a member of the diabetic team. Outpatient classes are offered for those who desire or require additional or indepth instruction.

Adolescent↗