Biomedical subjects

Ian Harvey

Publications and source records attributed to Ian Harvey.

44 records · Page 3Linked to original sources

PubMed2002

Oral health care education and its effect on caregivers' knowledge and attitudes: a randomised controlled trial.

OBJECTIVES: The effect of an oral health care education programme (OHCE) upon nursing home caregivers was assessed in a randomised controlled trial. METHODS: A self-administered questionnaire assessed oral health care knowledge and attitudes at baseline among 369 caregivers working in 22 nursing homes. Homes were randomly allocated to two groups. The intervention was a workplace OHCE. Caregivers assessed the value of the presentations. Questionnaires were re-administered 1 month (time 2) and 6 months (time 3) after the OHCE was delivered. The knowledge and attitude score means of the groups were compared. Open-ended questions solicited qualitative data. RESULTS: Questionnaire response rates at the three time points ranged from 76.3% to 85.4%. Two-thirds of caregivers employed at the time of the intervention attended the presentations. The OHCE was favourably assessed in 79% of responses. The intervention group significantly improved their scores over the control group at times 2 and 3 for knowledge (P<0.003) and attitude (P<0.001). Analysed across both arms at baseline, the main predictors for knowledge and attitude scores were age and dental attendance pattern. Qualitative responses showed an acceptance of caregivers' roles in oral health care and criticism of existing provision within homes. CONCLUSIONS: The OHCE was well received and resulted in improved oral health care knowledge and attitudes. When viewed with separately reported trial results of clients' oral health status, knowledge and attitude score improvements coincided with improved delivery of oral health care.

Adolescent↗

PubMed2002

What determines the use of home care services by elderly people?

The objective of the present study was to investigate the determinants of use of statutory and private home care services by older people living in the community. A questionnaire was distributed to a stratified random sample of 2,000 elderly people living in the community registered with 11 general practices in a British city (equal numbers of men and women, aged 65-74 years, and 75 years or over). The outcome measures were the use of statutory or private home care services in the previous 3 months. Logistic regression was used to explore potential determinants of the use of these services. The response rate was 79%. Increasing age, not owning a car and being a widow(er) were associated with greater use of both statutory and private home care services, as was worse self-reported overall health. Worse physical functioning, worse emotional health, problems with cognition, foot problems and a greater number of falls were determinants of use of statutory and private services. Older age on leaving full-time education was associated with increased use of private home care services. Problems with eyesight were determinants for both types of home care services for women, but only private services for men. For women, leakage of urine was associated with greater use of private services. Social networks and social support were not generally associated with use of these services after controlling for demographic factors. Understanding the determinants for the use of both statutory and private home care services is important because of the increasing numbers of elderly people in the population and the policy to maintain older people in their own homes. Purchasers and providers should be able to address at least some of the modifiable predictors.

Aged↗

PubMed2002

Non-genital warts.

Explore the source record for details and available documents.

Administration, Topical↗

PubMed2002

Falls and the use of health services in community-living elderly people.

Falls are common and often preventable in older people. This short report describes substantial unmet need in relation to falls. Although falling, nearly falling, fear of falling, and activity restriction are common, many people do not seek assistance from healthcare professionals. Only 2% of those who had attended their general practioner (GP), a casualty department, or had been admitted to hospital after a fall were taking drugs to protect against osteoporosis. People who have fallen or are at a risk of falling need to be identified, and local policies and information regarding treatment for osteoporosis are needed.

Accidental Falls↗

PubMed2002

Non-genital warts.

Explore the source record for details and available documents.

Administration, Topical↗

PubMed2000

Dementia and the Over-75 Check: the role of the primary care nurse.

Primary care nurses are very likely to provide a substantial part of the routine care for patients with dementia. In order to examine the knowledge and attitudes of the primary care nurses who undertake the Over-75 Check, towards assessing and managing patients with symptoms of dementia, and to assess their level of support for a clinical practice guideline, a postal questionnaire survey was undertaken of primary care nurses responsible for the Over-75 Check in 209 general practices in Gloucester, Avon and Somerset. The questionnaire ascertained some demographic information about the nurses, their training and the practice routine for the Over-75 Check. It also included a case vignette describing a typical presentation of dementia at an Over-75 Check. A 65% response rate was achieved. Only one-fifth of respondents ever used formal validated cognitive tests as part of the Over-75 Check. In response to the vignette, nearly 10% took no action at all and a further 25% simply referred the patient on. Amongst the remainder there was considerable variation regarding the tasks considered to be within their remit. The respondents strongly supported the introduction of guidelines. Given the variation in professional responsibilities between practices, it is proposed that a clinical practice guideline covering diagnosis, assessment and management of dementia should address the practice as a whole rather than be targeted to specific professionals. The guideline should prompt professionals carrying out an Over-75 Check to recognize symptoms of dementia and raise awareness of the range of tasks which need to be undertaken in confirming diagnosis, assessing needs and managing patients. Results from this study suggest that improved training and increased autonomy for primary care nurses would improve access to services for these patients and their carers.

Journal Article↗

PubMed1996

Voltammetry of Plastocyanin at a Graphite Electrode: Effects of Structure, Charge, and Electrolyte.

Comparative voltammetric studies on Anabaena variabilis plastocyanin (positively charged at neutral pH) and spinach and poplar plastocyanins (negatively charged at neutral pH) have been undertaken at an edge-plane graphite electrode as a function of ionic strength, pH, and Mg(2+) concentration at 3 degrees C. The aim was to provide a more detailed understanding of the influence of the electrode-protein (solution) interfacial characteristics, as well as the variation of the formal potential with both the nature of the plastocyanin species and the pH. As might be expected, some of the interfacial properties associated with the positive charge on A. variabilis plastocyanin are the opposite of those observed with the negatively charged plastocyanins. For example, the linear diffusion component of the mass transport process for A. variabilis plastocyanin under the conditions of cyclic voltammetry is decreased and the radial diffusion component is increased by the addition of Mg(2+), whereas the reverse occurs with poplar and spinach plastocyanins. The voltammetrically determined reversible potentials for A. variabilis plastocyanin are considerably less positive than those for spinach and poplar plastocyanins, in agreement with values calculated from chemically based redox studies. Ionic strength effects, as determined by addition of NaClO(4) over the concentration range 0.005-0.20 M, are negligible for all three proteins. The addition of Mg(2+) causes a significant shift in the reversible potential toward more positive values for spinach and poplar plastocyanin but only a small positive shift for A. variabilis plastocyanin. The difference is attributed to a specific binding effect. The addition of Mg(2+) also dramatically alters the pH dependence of the reversible potential, indicating that the equilibrium between the protonated and unprotonated forms of reduced plastocyanin is modified by binding of Mg(2+) to the protein. It is concluded that the effects of biologically relevant redox-inactive cations such as Mg(2+) or Ca(2+) have to be considered carefully in studies of the redox chemistry of metalloproteins.

Journal Article↗

PubMedDate not supplied

The Bristol Foot Score: developing a patient-based foot-health measure.

We sought to develop a patient-centered foot-health assessment tool by conducting in-depth interviews, focus groups, and surveys of relevant patient groups. A total of 400 hospital- and community-based podiatric patients took part in the development of the Bristol Foot Score, which was refined from a 41-item self-administered questionnaire to one containing 15 items. Podiatric patients easily understood the final questionnaire, and rates of completion were excellent. Overall reliability was high (Cronbach alpha = .9036), and application of the Bland and Altman technique suggested that the foot score produced stable measurements over time. Statistically significant differences were detected in scores before and after toenail surgery, indicating that the Bristol Foot Score is sensitive to change. A poor level of concordance was found between the Bristol Foot Score and a Chiropody Assessment Criteria Score routinely used by podiatrists to assess the need for podiatric care. The Bristol Foot Score reflects patients' perceptions of their own foot health, providing a useful additional tool for evaluating the efficacy of interventions and describing foot health within populations.

Adolescent↗