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Biomedical subjects

J Jones

Publications and source records attributed to J Jones.

At least 199 records · Page 11Linked to original sources
PubMed2000

Low-cost video-films in the teaching of undergraduate and postgraduate medical students.

The high cost of producing good-quality video-films for teaching has hindered the use of this method, which has been shown to improve significantly the efficiency of teaching and the retention of knowledge. During the last five years, a series of short video-films has been produced using inexpensive video-cameras and home video-recording and editing equipment. A variety of techniques were developed to allow recording of lecture presentations, while using the equipment as a teaching aid, without the need for technical staff. The positioning of the camera, the monitor, the slide projector and lighting were critical to the productions. Similar productions at low cost were obtained from recordings of operating theatre sessions, tutorials and clinical ward rounds. A survey of students exposed to teaching with video-film as part of a lecture presentation confirmed that the subject matter being taught was more easily understood and enjoyable and generated more discussions on than other forms of teaching.

Education, Medical, Graduate↗
PubMed2000

Perceptions of flexible training in medicine.

Most flexible trainees believe that their full-time colleagues perceive flexible training as flawed in some way. However, most consultants and full-time trainees actually view flexible trainees and their posts in a positive light.

Attitude of Health Personnel↗
PubMed2000

Minor burn management: an Australian regional perspective.

Minor burns are commonly treated in hospital emergency departments. This study aimed to identify the nursing management of minor burns in hospitals in the Queensland region of Australia. A total of 200 questionnaires were distributed to hospitals with emergency departments in this region. The semi-structured questionnaire enquired about the respondents' initial and ongoing management of minor burns. Fifty completed questionnaires were returned, a response rate of 25%. Most respondents (80%) were registered nurses and the rest enrolled nurses. The respondents' practice was compared with that recommended in the literature. Their practice reflected the variations found in the literature, suggesting that some may not be as effective or efficient as others. The authors conclude that further research is required on the efficacy of products used in minor burn management.

Australia↗
PubMed2000

Technical report: precautions regarding the use of aerosolized antibiotics. Committee on Infectious Diseases and Committee on Drugs.

In 1998, the Food and Drug Administration (FDA) approved the licensure of tobramycin solution for inhalation (TOBI). Although a number of additional antibiotics, including other aminoglycosides, beta-lactams, antibiotics in the polymyxin class, and vancomycin, have been administered as aerosols for many years, none are approved by the FDA for administration by inhalation. TOBI was approved by the FDA for the maintenance therapy of patients 6 years or older with cystic fibrosis (CF) who have between 25% and 75% of predicted forced expiratory volume in 1 second (FEV(1)), are colonized with Pseudomonas aeruginosa, and are able to comply with the prescribed medical regimen. TOBI was not approved for the therapy of acute pulmonary exacerbations in patients with CF nor was it approved for use in patients without CF. Currently, no other antibiotics are approved for administration by inhalation to patients with or without CF. The purpose of this statement is to briefly summarize the data that supported approval for licensure of TOBI and to provide recommendations for its safe use. The pharmacokinetics of inhaled aminoglycosides and problems associated with aerosolized antibiotic treatment, including environmental contamination, selection of resistant microbes, and airway exposure to excipients in intravenous formulations, will be discussed.

Administration, Inhalation↗
PubMed2000

Delay in onset of awareness of acute hypoglycemia and of restoration of cognitive performance during recovery.

OBJECTIVE: To examine the time course for the onset of, and recovery from, acute hypoglycemia in healthy subjects. RESEARCH DESIGN AND METHODS: Eight healthy male volunteers were studied on 2 occasions in random order using a hyperinsulinemic (1.5 mU x kg(-1) x min(-1)) glucose clamp technique. During control studies, euglycemia (5.01 +/- 0.02 mmol/l) was maintained for 225 +/- 3 min. On the other occasion, after a euglycemic baseline period, arterialized plasma glucose was allowed to fall rapidly to 2.65 +/- 0.02 mmol/l, then maintained at this nadir for 90 min before euglycemia was rapidly restored. RESULTS: Cognitive function assessed by a battery of sensitive tests (4-choice reaction time, Stroop word, and color-word test) became impaired immediately at onset of hypoglycemia (P < 0.05 for all in the hypoglycemic study vs. those in the euglycemic study). Counterregulatory hormone responses (epinephrine, norepinephrine, glucagon, cortisol, and growth hormone) and symptomatic awareness of hypoglycemia (assessed by a questionnaire) were relatively delayed, being detected 20 min after the onset of hypoglycemia. There was no diminution (adaptation) of any responses, cognitive, humoral, or symptomatic, during sustained hypoglycemia. During recovery, the 4-choice reaction time continued to be abnormal even after resolution of symptomatic awareness (P = 0.025). CONCLUSIONS: During hypoglycemia, cognitive performance may become impaired before symptomatic awareness. During recovery from hypoglycemia, recovery of cognitive function lags behind the restoration of glucose levels and resolution of symptoms. Our findings have implications for the design of studies examining experimental hypoglycemia and need to be investigated in people with diabetes.

Adult↗
PubMed2000

Comparison of the biochemical effects of testosterone and estrogen on bone markers in surgically menopausal women.

Twenty-five women with a previous total abdominal hysterectomy with bilateral salpingo-oophorectomy (TAH BSO) were given estradiol 50 mg implants at baseline, followed at 16 weeks with the combination of estradiol 50 mg and testosterone 100 mg. Blood samples were taken at 8-weekly intervals over 32 weeks. Serum levels of estradiol, testosterone, sex hormone binding globulin (SHBG) and agents involved in skeletal growth (growth hormone (GH), insulin-like growth factor 1 (IGF-1), carboxy terminal pro-peptide of type 1 pro-collagen (PICP; a bone formation marker) and cross-linked carboxy terminal telopeptide (ICTP; a marker of bone resorption)) were measured. Serum PICP levels increased significantly after estradiol alone (p = 0.0032) but the addition of testosterone had no significant effects on bone markers GH and IGF-1. These biochemical changes confirm previous studies, which found that the addition of testosterone did not augment the effect of estradiol implants on bone mineral density. Although physiological hormone replacement therapy in oophorectomized women would include replacement of both estradiol and testosterone, this may not to be necessary for prevention of osteoporosis where adequate serum estradiol levels are reached.

Adult↗
PubMed2000

Big issues, small systems: managing with information in medical research.

This subject of this article is the design of a database system for handling files related to the work of the Molecular Genetics Department of the International Blood Group Reference Laboratory. It examines specialist information needs identified within this organization and it indicates how the design of the Rhesus Information Tracking System was able to meet current needs. Rapid Applications Development prototyping forms the basis of the investigation, linked to interview, questionnaire, and observation techniques in order to establish requirements for interoperability. In particular, the place of this specialist database within the much broader information strategy of the National Blood Service will be examined. This unique situation is analogous to management activities in broader environments and a number of generic issues are highlighted by the research.

Blood Banks↗
PubMed2000

Anti-psychotic drug prescribing trends in primary care in Scotland 1994-97.

OBJECTIVE: To describe trends in the use of anti-psychotic drugs prescribed in Primary Care in Scotland. DESIGN: Information on prescription numbers and costs were obtained from the Pharmacy Prescribing Division. SETTING: Scotland 1994-1997. Results Prescriptions for anti-psychotic drugs in Primary Care in Scotland increased by 28% in the period April 1994-December 97. In the same period, quarterly costs increased from 523,971 Pounds to 1,339,215 Pounds, an increase of 155%. Ninety per cent of the increase is accounted for by use of the five drugs risperidone, sertindole, olanzapine, clozapine and quetiapine. Health Board areas vary markedly in their uptake of the new drugs. CONCLUSION: The use of new anti-psychotic drugs in Scotland represents a substantial additional investment in mental health care. This has happened with little discussion or debate. Scotland needs to make explicit decisions on the place of newer anti-psychotics in treatment, and on the balance between investing in these drugs and investing in other aspects of mental health services.

Antipsychotic Agents↗
PubMed1999

Evaluation of the protective immunogenicity of the N, P, M, NV and G proteins of infectious hematopoietic necrosis virus in rainbow trout oncorhynchus mykiss using DNA vaccines.

The protective immunogenicity of the nucleoprotein (N), phosphoprotein (P), matrix protein (M), non-virion protein (NV) and glycoprotein (G) of the rhabdovirus infectious hematopoietic necrosis virus (IHNV) was assessed in rainbow trout using DNA vaccine technology. DNA vaccines were produced by amplifying and cloning the viral genes in the plasmid pCDNA 3.1. The protective immunity elicited by each vaccine was evaluated through survival of immunized fry after challenge with live virus. Neutralizing antibody titers were also determined in vaccinated rainbow trout Oncorhynchus mykiss fry (mean weight 2 g) and 150 g sockeye salmon Oncorhynchus nerka. The serum from the 150 g fish was also used in passive immunization studies with naive fry. Our results showed that neither the internal structural proteins (N, P and M) nor the NV protein of IHNV induced protective immunity in fry or neutralizing antibodies in fry and 150 g fish when expressed by a DNA vaccine construct. The G protein, however, did confer significant protection in fry up to 80 d post-immunization and induced protective neutralizing antibodies. We are currently investigating the role of different arms of the fish immune system that contribute to the high level of protection against IHNV seen in vaccinated fish.

Animals↗
PubMed1999

Randomised controlled trial of effectiveness of Leicester hospital at home scheme compared with hospital care.

OBJECTIVE: To compare effectiveness of patient care in hospital at home scheme with hospital care. DESIGN: Pragmatic randomised controlled trial. SETTING: Leicester hospital at home scheme and the city's three acute hospitals. PARTICIPANTS: 199 consecutive patients referred to hospital at home by their general practitioner and assessed as being suitable for admission. Six of 102 patients randomised to hospital at home refused admission, as did 23 of 97 allocated to hospital. INTERVENTION: Hospital at home or hospital inpatient care. MAIN OUTCOME MEASURES: Mortality and change in health status (Barthel index, sickness impact profile 68, EuroQol, Philadelphia geriatric morale scale) assessed at 2 weeks and 3 months after randomisation. The main process measures were service inputs, discharge destination, readmission rates, length of initial stay, and total days of care. RESULTS: Hospital at home group and hospital group showed no significant differences in health status (median scores on sickness impact profile 68 were 29 and 30 respectively at 2 weeks, and 24 and 26 at 3 months) or in dependency (Barthel scores 15 and 14 at 2 weeks and 16 for both groups at 3 months). At 3 months' follow up, 26 (25%) of hospital at home group had died compared with 30 (31%) of hospital group (relative risk 0. 82 (95% confidence interval 0.52 to 1.28)). Hospital at home group required fewer days of treatment than hospital group, both in terms of initial stay (median 8 days v 14.5 days, P=0.026) and total days of care at 3 months (median 9 days v 16 days, P=0.031). CONCLUSIONS: Hospital at home scheme delivered care as effectively as hospital, with no clinically important differences in health status. Hospital at home resulted in significantly shorter lengths of stay, which did not lead to a higher rate of subsequent admission.

Adult↗
PubMed1999

Economic evaluation of hospital at home versus hospital care: cost minimisation analysis of data from randomised controlled trial.

OBJECTIVES: To compare the costs of admission to a hospital at home scheme with those of acute hospital admission. DESIGN: Cost minimisation analysis within a pragmatic randomised controlled trial. SETTING: Hospital at home scheme in Leicester and the city's three acute hospitals. PARTICIPANTS: 199 consecutive patients assessed as being suitable for admission to hospital at home for acute care during the 18 month trial period (median age 84 years). INTERVENTION: Hospital at home or hospital inpatient care. MAIN OUTCOME MEASURES: Costs to NHS, social services, patients, and families during the initial episode of treatment and the three months after admission. RESULTS: Mean (median) costs per episode (including any transfer from hospital at home to hospital) were similar when analysed by intention to treat-hospital at home 2569 pounds sterling (1655 pounds sterling), hospital ward 2881 pounds sterling (2031 pounds sterling), bootstrap mean difference -305 (95% confidence interval -1112 to 448). When analysis was restricted to those who accepted their allocated place of care, hospital at home was significantly cheaper-hospital at home 2557 pounds sterling(1710 pounds sterling), hospital ward 3660 pounds sterling (2903 pounds sterling), bootstrap mean difference -1071 (-1843 to -246). At three months the cost differences were sustained. Costs with all cases included were hospital at home 3671 pounds sterling (2491 pounds sterling), hospital ward 3877 pounds sterling (3405 pounds sterling), bootstrap mean difference -210 (-1025 to 635). When only those accepting allocated care were included the costs were hospital at home 3698 pounds sterling (2493 pounds sterling), hospital ward 4761 pounds sterling (3940 pounds sterling), bootstrap mean difference -1063 (-2044 to -163); P=0.009. About 25% of the costs for episodes of hospital at home were incurred through transfer to hospital. Costs per day of care were higher in the hospital at home arm (mean 207 pounds sterling v 134 pounds sterling in the hospital arm, excluding refusers, P<0.001). CONCLUSIONS: Hospital at home can deliver care at similar or lower cost than an equivalent admission to an acute hospital.

Aged↗