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Biomedical subjects

J Curzio

Publications and source records attributed to J Curzio.

17 recordsLinked to original sources
PubMed2001

Competencies of midwives with single or dual qualifications at the point of registration in Scotland.

OBJECTIVE: to compare and contrast competencies of midwives with single or dual qualifications at the point of registration in Scotland. DESIGN: self-completing survey using the Glasgow Royal Maternity Hospital's Skills' Inventory by midwives at the point of registration and by Supervisors of Midwives analysed using non-parametric statistical tests. Content analysis of semi-structured interviews with experienced midwives and Supervisors of Midwives. SETTING: midwifery education and practice settings throughout Scotland. PARTICIPANTS: 157 midwives at the point of registration, 166 Supervisors of Midwives. MEASUREMENTS: Mann-Whitney and Kruskal Wallis analysis of skills of midwives at the point of registration in prenatal, labour, post-natal, neonatal areas and extended skills areas. FINDINGS/IMPLICATIONS FOR PRACTICE: all newly qualified midwives in Scotland, regardless of their educational preparation, are capable of providing care for women and babies in normal midwifery situations. While support for the direct entry programmes has been clearly demonstrated, this is not unanimous, although as more direct entry midwives take up positions, attitudes are becoming more positive.

Adult↗
PubMed1998

Outcomes of transposition of the great arteries in the ear of atrial inflow correction.

OBJECTIVE: To examine long term morbidity and mortality following atrial inflow corrective procedures for transposition of the great arteries (TGA) and to investigate factors that influence morbidity and mortality. DESIGN: Retrospective cohort study from a single centre. SETTING: Cardiology and cardiothoracic surgical unit in a large tertiary referral centre. PATIENTS: All 130 patients who had TGA diagnosed between August 1972 and May 1988 and were considered suitable for atrial inflow correction; 109 of these underwent surgery (operative cohort: 84 Mustard operations and 25 Senning operations); 95 survived to hospital discharge (hospital surviving cohort). MAIN OUTCOME MEASURES: Death and cardiac events. RESULTS: There were relatively good long term results from atrial inflow correction for TGA with 5, 10, and 15 year survivals of 77.3%, 75.9%, and 71.3%. However, there was an appreciable incidence of late cardiac death and events, with 5, 10, and 15 year cardiac event-free survivals of 74.5%, 67.1%, and 39.6%. Supraventricular tachycardia was the only significant risk factor for late cardiac death (relative risk 8.72, 95% confidence interval, 2.86 to 26.64). Senning patients had better event-free survival (p = 0.04). CONCLUSIONS: Atrial inflow correction for TGA has a reasonably good 15 year survival (71.3%), but there is an appreciable incidence of late cardiac deaths and events (15 year event-free survival 39.6%). The Senning procedure is preferable to the Mustard procedure for cases unsuitable for arterial switching.

Adolescent↗
PubMed1992

Placebo-controlled trial of doxazosin in management of patients with hypertension and hypercholesterolaemia.

The blood pressure (BP)- and lipid-lowering activities of the alpha 1-antagonist, doxazosin, were investigated in hypertensive, hypercholesterolaemic patients. Thirty-one patients satisfactorily completed the study, and there was no significant difference between doxazosin and placebo in terms of reported adverse events. After 3-month treatment, BP was significantly reduced by doxazosin by 24/14 mm Hg supine and by 33/22 mm Hg erect as compared with corresponding reductions of 2/9 and 2/2 mm Hg with placebo. There were concomitant improvements in the plasma lipid profile with, in particular, significant net reductions of 30% for triglycerides and 20% for apoprotein B. There was no adverse effect on glucose metabolism. The principal aim of this study was assessment of the clinical utility and acceptability of doxazosin in a heterogeneous population of patients with several cardiovascular risk factors. The results confirm that doxazosin is an effective antihypertensive agent that has modest additional beneficial effects on the plasma lipid profile.

Aged↗
PubMed1988

Risk-benefit of specific antihypertensive regimens: relevance of metabolic and haemodynamic effects of alpha 1-blockers.

1. Existing strategies for the control of high blood pressure have had a disappointing impact on coronary heart disease--the major cause of death in hypertension. 2. There is a need for more work to identify the relationship between blood pressure, atheroma and other risk factors. 3. A more aggressive approach to treatment may be indicated, especially in high risk groups. 4. In addition to treatment of blood pressure, other major risk factors (lipids and smoking) must be tackled. 5. Alternative treatment regimens with different mechanisms of action and/or effects on lipids should be evaluated in practice. 6. Selective alpha 1-blockers have potential haemodynamic advantages, improve the lipid profile and are well tolerated as first or second line therapy.

Adrenergic beta-Antagonists↗
PubMed1987

The influence of beta-adrenoceptor antagonists with and without partial agonist activity on exercise tolerance and muscle lactate production.

Epanolol is a beta-adrenoceptor antagonist with partial agonist activity, a property which could be useful in reducing the fatigue associated with beta blockers. In a double-blind, randomized, crossover study we have investigated the effects of metoprolol 100 mg b.d., epanolol 100 mg b.d., and epanolol 200 mg b.d. on blood pressure, heart rate, and exercise-induced fatigue in 10 hypertensive men. Fatigue was measured subjectively by the Borg rating scale and objectively by blood lactate concentrations. Resting and exercise heart rates were lower with metoprolol than with either dose of epanolol. Preexercise standing diastolic blood pressure was lowered by metoprolol, but there were no other treatment effects on blood pressure. Exercise-induced fatigue was not altered by any treatment, whether measured subjectively or objectively. These results do not support the hypothesis that partial agonist activity improves exercise tolerance in hypertensive patients treated with beta-adrenoceptor antagonists.

Adolescent↗
PubMed1985

Bucindolol in essential hypertension.

The effects of bucindolol a new nonselective beta blocker were studied after short-term dosing and for up to six months in eight patients with essential hypertension. Bucindolol 100 mg acutely lowered supine and erect systolic and diastolic pressure without orthostatic features and without increases or decreases in heart rate. Plasma noradrenaline increased, but plasma renin activity fell. Long-term dosing of 100-400 mg/day led to modest decreases in blood pressure. The duration of the hypotensive effect after multiple dosing ranged from six to ten hours. After long-term dosing there was evidence of marked nonselective beta blockade but not of alpha 1 blockade from the responses to intravenous isoprenaline and phenylephrine respectively. In six out of eight patients the plasma creatinine phosphokinase rose transiently above the normal range. The increase appeared to be of muscle origin and was associated with myalgia in one patient. Bucindolol is a nonselective beta blocker, possibly with other vasodilator properties. These do not appear to be mediated by alpha blockade.

Adrenergic beta-Antagonists↗
PubMedDate not supplied

Getting research into practice: developing oral hygiene standards.

In 1997, the then Victoria Infirmary NHS Trust established a nursing research and practice development committee (NRPDC) to implement evidence-based practice in nursing care in response to its nursing strategy for 1998-2000. A survey of nursing projects was undertaken in 1996 and repeated in spring of 1998. Initially, 107 projects were identified which included 58 reviews of the literature. In 1998, 95 projects were identified with 42 reviews of literature. The number of research projects being undertaken by nurses in the trust increased from four to 15 and the number of audits increased from nine to 45. The NRPDC established a link nurse system to assist in developing practice at ward level and they have been offering a series of educational seminars. Oral hygiene was the first topic tackled trustwide, with a mouth care standard developed and staff knowledge subsequently surveyed 6 months after it was put into practice. Results demonstrated a good level of knowledge for general oral hygiene among trained and untrained staff. However, specialist oral care and care of stomatitis require some further updating. This survey has identified the increasing sophistication of the projects being undertaken by the nursing staff across the trust and the support they are receiving. This arrangement has provided the opportunity to demonstrate the impact of having a senior researcher available for advice at trust level. The NRPDC can improve the quality of evidence-based care delivered within the trust and it can provide a model for the implementation of evidence-based practice.

Clinical Protocols↗
PubMedDate not supplied

The Nursing Research Initiative for Scotland.

The Nursing Research Initiative for Scotland (NRIS) was established at the end of 1994, one of seven research units core funded by the Chief Scientist Office (CSO) of the Scottish Office. It is a national unit, so although its central base is in Glasgow, it works with nurses, other direct care staff and academics throughout Scotland.

Academies and Institutes↗
PubMedDate not supplied

Wound care. Discharged but not forgotten.

A pilot study assessed a methodology for establishing the incidence of post-discharge surgical wound infections. An infection rate of 13% was recorded. The eight patients who developed infections generated 35 clinical episodes. This could have resource implications for early discharge after surgery.

Adult↗
PubMedDate not supplied

A comparison of a 12-hour and eight-hour shift system.

Despite the increasing use of, and discussion about, 12-hour shifts there has been little assessment of its impact in the UK. A study was carried out to compare two medical wards that had been operating a 12-hour shift for more than one year with two medical wards that had continued with a conventional shift system over the same period. Staff questionnaires and interviews, patient interviews, documentation review and analysis of a number of organisational issues were undertaken to evaluate the effect of the shift pattern worked. There were no significant differences between the shift patterns. However, some aspects of the 12-hour shift produced more favourable responses from the staff: less fatigue was reported by those working the 12-hour shift and documentation was more complete on these wards. However, the length of time available for the handover was identified as a problematic area. This work demonstrates the complexities in evaluating patterns of work.

Absenteeism↗