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Biomedical subjects

K Hood

Publications and source records attributed to K Hood.

At least 37 records · Page 2Linked to original sources
PubMed2001

Efficiency of searching the grey literature in palliative care.

A systematic review into palliative care team effectiveness was undertaken which has, inherent in its methodology, grey literature searching. Over 100 letters were written to a systematically chosen range of service providers, commissioners, and experts in combination with requests for information in six UK national cancer/palliative care organization newsletters. In addition, the System for Information on Grey Literature (SIGLE ) database was searched. As a result, 25 document hard copies were received. The documents were, in all but one case (this one study was also highlighted by the SIGLE search), not relevant as they were predominated by annual reports, service descriptions, and needs assessments. In terms of obtaining unpublished studies for possible inclusion in the review, this comprehensive search was unsuccessful and, therefore, it would appear that grey literature searching is not a useful tool in palliative care systematic reviews.

Data Collection↗
PubMed2001

BION system for distributed neural prosthetic interfaces.

We have developed the first in a planned series of neural prosthetic interfaces that allow multichannel systems to be assembled from single-channel micromodules called BIONs (BIOnic Neurons). Multiple BION implants can be injected directly into the sites requiring stimulating or sensing channels, where they receive power and digital commands by inductive coupling to an externally generated radio-frequency magnetic field. This article describes some of the novel technology required to achieve the required microminiaturization, hermeticity, power efficiency and clinical performance. The BION1 implants are now being used to electrically exercise paralyzed and weak muscles to prevent or reverse disuse atrophy. This modular, wireless approach to interfacing with the peripheral nervous system should facilitate the development of progressively more complex systems required to address a growing range of clinical applications, leading ultimately to synthesizing complete voluntary functions such as reach and grasp.

Animals↗
PubMed2001

A case study of nurse management of upper respiratory tract infections in general practice.

BACKGROUND: Nurses increasingly manage acute illness in United Kingdom (UK) general practice. Few data exist about patients routinely consulting with these nurses. There are concerns that providing this additional service will lower thresholds for consulting with an overall increase in workload. Upper respiratory tract infection (URTI) is the commonest reason for consulting. Inappropriate antibiotics promote resistant bacteria. Nurse management of URTI is an ideal opportunity to promote self-care and nonantibiotic management. AIMS: To describe the effects of a specially trained practice nurse managing URTI in a general practice in Cardiff, UK. METHODS: Descriptive study. RESULTS: Data were collected on 132 patients consulting with the nurse. We also collected data on 234 patients consulting general practitioners (GPs) in the same practice. Patients seen by the nurse were younger and less likely to be given antibiotics at the time of their index illness than those who saw GPs (7% vs. 93%; P < 0.001). During the year following the consultation with the nurse, patients consulted slightly less often and received antibiotics for URTI less often compared with the year preceding this consultation (P=0.02). Their consultation rate for all conditions did not change. The consultation rates for URTI of the patients managed by the GPs remained constant and consultations for all conditions increased (P < 0.01). CONCLUSIONS: Nurse management of URTI did not lower patients' threshold for future consulting, and patients who saw her were prescribed antibiotics less often.

Adolescent↗
PubMed2001

Occupancy of serotonin transporters by paroxetine and citalopram during treatment of depression: a [(11)C]DASB PET imaging study.

OBJECTIVE: Selective serotonin reuptake inhibitors are commonly used to treat major depression; however, the percentage of serotonin (5-HT) transporter (5-HTT) sites occupied during clinical dosing is unknown. This study measured the proportion of 5-HTT sites blocked during paroxetine and citalopram treatment of depression and assessed the relationship between serum paroxetine levels and the proportion of 5-HTT sites blocked. METHOD: Twelve medication-free depressed patients completed a 6-week trial of either paroxetine (N=8) or citalopram (N=4). Striatal 5-HTT binding potential was measured with [(11)C]DASB and positron emission tomography, before and after 4 weeks of treatment. The binding potential is proportional to receptor density. Striatal 5-HTT binding potential was measured twice in six healthy subjects and once in 11 healthy subjects. RESULTS: A significant decrease in striatal 5-HTT binding potential was found after either treatment, compared to changes found over a 4-week period in healthy subjects. For patients treated with 20 mg/day of paroxetine (N=7), the mean proportion of 5-HTT sites occupied was 83%. For patients treated with 20 mg/day of citalopram (N=4), the mean 5-HTT occupancy was 77%. 5-HTT occupancy increased in a nonlinear relationship with serum levels of paroxetine such that a plateau of occupancy around 85% occurred for serum paroxetine levels greater than 28 microg/liter. CONCLUSIONS: During treatment with clinical doses of paroxetine or citalopram, approximately 80% of 5-HTT receptors are occupied. This change in 5-HTT binding potential is greater than the known physiological range of changes in 5-HTT binding potential but may be necessary for some therapeutic effects.

Adult↗
PubMed2001

Benchmarking using simulated clinical scenarios: a feasibility project.

'Benchmarking' clinical practice and integrating such data with national guidelines offers a way of establishing standards for use in clinical governance. We report on a feasibility project for benchmarking clinical practice in one topic area (otitis media) using simulated clinical scenarios. Consistency and variations in clinical management were identified for different scenarios. Participants perceived the process likely to reflect actual practice and effect change in clinical management.

Acute Disease↗
PubMed2000

Judging the 'weight of evidence' in systematic reviews: introducing rigour into the qualitative overview stage by assessing Signal and Noise.

The 'weight of evidence' in a topic area can be judged by assessing the 'Signal' from available research publications and tempering the importance attached by the level of 'Noise' (the inverse of methodological quality). This assessment process has validity and reliability and can be applied to the 'qualitative overview' stage of systematic reviews. This enables the important themes and areas of relevance to the research question to be identified. Important findings from individual papers may also be identified providing further information which may not be evident from quantitative analysis. The findings from these more qualitative stages of analysis complement, but do not replace, quantitative analysis.

Data Interpretation, Statistical↗
PubMed2000

A study of the effects of the appointment of a clinical nurse educator in one Victorian emergency department.

The Clinical Nurse Educator (CNE) project saw the appointment and evaluation of a CNE position in the Emergency Department at Dandenong Hospital, Australia. The study aimed to identify the educational needs of nursing staff, the self reported levels of knowledge of nursing staff, the perceptions of nursing staff surrounding education and clinical support and to compare responses over the 6 month period to identify any statistically significant changes. Data was collected at three intervals during the study period and the responses compared using the Kruskal-Wallis test(H). Since the appointment of the CNEs, the reported levels of knowledge increased for all areas of emergency nursing included in the study. Tutorials, in-service education sessions, direct clinical support and self-directed learning packages were reported to be useful educational methods. There were increases in the reported adequacy of in-service education (P = 0.0000), level of clinical support and satisfaction with current level of knowledge in emergency nursing. Nursing staff found the process of basic and advanced life support assessment less intimidating (P = 0.0031), more important and less affected by workload constraints of the ED (P = 0.0002). The reported thoroughness of orientation of new employees (P = 0.0005) and levels of clinical support and education when orientated to the triage role (P = 0.0225) also increased.

Clinical Competence↗
PubMed2000

Does experience predict knowledge and behavior with respect to cutaneous melanoma, moles, and sun exposure? Possible outcome measures.

A prospective survey of 3105 adults in 16 randomly selected group practices was conducted to test whether individuals with a personal experience, family history, or other contact with malignant melanoma display more knowledge and appropriate behavior with regard to melanomas and sun exposure than those with no such experience. Although patients with previous contact with the condition were more likely to check for moles, were more aware of the significance of changes in the shape of moles, and were more aware of the necessity for prompt treatment, they were not more knowledgeable about other important signs or more likely to protect themselves from sun exposure. Direct experience or contact with melanoma appeared to have some positive effects on knowledge, but there is no room for complacency for those at increased risk or those treating them. Both primary and secondary prevention for people who are vulnerable could be undertaken in primary care.

Adolescent↗
PubMed2000

Identifying which women will stop breast feeding before three months in primary care: a pragmatic study.

BACKGROUND: In Britain only 42% of women who initiate breast feeding are still breast feeding at four months, despite well documented health benefits. AIM: To explore whether sociodemographic and social support information collected routinely by health visitors at the new birth assessment can help predict which women will give up breast feeding before three months. METHOD: A survey of 279 consecutive births in three general practices in an inner-London borough. Health visitors collected sociodemographic, infant feeding, and social support data at the new birth assessment 10 to 14 days after birth and at an immunisation visit at three to four months after birth. A data collection form was piloted and used by health visitors as part of their routine clinical care. Stepwise logistic regression was performed on 160 women who initiated breast feeding to identify predictors for those who would still be breast feeding at three months. RESULTS: Three variables were found to be significantly associated with breast feeding at three months. Younger women and women with moderate to poor emotional support as assessed by their health visitor were less likely to still be breast feeding at three months. White women who left full-time education at age 16 years or below are least likely to be breast feeding at three months but educational level is not a significant predictor for women from other ethnic backgrounds. CONCLUSION: This pragmatic study illustrates how information collected during routine clinical care by health visitors can help predict which women will give up breast feeding before three months. This could be useful to identify women whose social support needs are not being met and who may benefit from local initiatives. Infant feeding researchers should consider the influence of ethnicity and levels of social support on breast feeding outcomes.

Adolescent↗
PubMed1999

Efficient literature searching in diffuse topics: lessons from a systematic review of research on communicating risk to patients in primary care.

Using the example of communication about risk in a primary care setting, this paper puts forward a method of developing and evaluating a detailed search strategy for locating the literature for a systematic review of a 'diffuse' subject. The aim of this paper is to show how to develop a search strategy that maximizes both recall and precision while keeping search outputs manageable. Six different databases were used, namely Medline, Embase, PsychLIT, CancerLIT, Cinahl and Social Science Citation Index (SSCI). The searches were augmented by hand-searching, contacting authors, citation searching and reference lists from included papers. Other databases were searched but yielded no extra references for this subject matter. Of the 99 papers included, 80 were indexed on Medline. The Medline search strategy identified 54 of them and the remaining 26 were located on other databases. The 19 further unique references were found using the other databases and methods of retrieval. A combination of several databases must be used to maximize recall and to increase the precision of searches on individual databases, thus improving the overall efficiency of the search.

Databases, Bibliographic↗
PubMed1999

Psychological distress associated with waiting for results of diagnostic investigations for breast disease.

This paper presents the results of a multi-method research project investigating the psychological distress associated with waiting for results of diagnostic investigations in a delayed-results breast clinic. A cohort of 126 women completed standardized psychometric instruments to assess anxiety, mood and coping over 3 days. Semi-structured interviews were conducted with 20 respondents. The findings indicate that waiting sustained but did not exacerbate psychological distress. Peri-diagnostic anxiety, depression, uncertainty and confusion were associated with anxiety levels immediately following triple assessment. Women leaving the clinic with low anxiety retained this composure throughout the peri-diagnostic period. Those in the moderate and high anxiety groups recorded sustained anxiety, depression, uncertainty and confusion, with mean scores comparable to and exceeding those reported by psychiatric out-patients. Coping during the waiting period was typically accomplished by emotion-focused strategies. Qualitative data suggested the delayed-results clinic structure may facilitate psychological preparation for test results.

Journal Article↗
PubMed1999

A possible effect of different light sources on pregnancy rates following gamete intra-fallopian transfer.

A retrospective study of 34 sequential gamete intra-Fallopian transfer (GIFT) procedures suggested a significant effect on pregnancy rates associated with the different laparoscopic light sources, with a pregnancy rate of 50% in 22 cycles using a halogen light source and 9% in 12 cycles using a xenon light source. Other explanatory variables were explored, but none was to have a significant effect on the pregnancy rate. Further investigation revealed that the xenon light source emitted more ultraviolet light than the conventional halogen light source--suggesting a possible detrimental effect of ultraviolet light on the gametes in the GIFT procedure.

Adult↗
PubMed1998

Differences in sexual risk behaviour between young men and women travelling abroad from the UK.

BACKGROUND: Identification of people who most frequently engage in sexual risk behaviour while travelling abroad would be useful for the design and targeting of health education and promotion campaigns. METHODS: Eligible participants were people living in the UK aged 18-34 years who had travelled abroad without a partner in the previous 2 years. Respondents were first screened for eligibility as part of representative face-to-face and telephone surveys by a market research company. Eligible individuals who agreed to take part then underwent a computer-assisted telephone interview. Reinterviewing continued until 400 eligible people had been contacted. We also interviewed a control group of 568 young people who had travelled abroad without a partner in the previous 2 years but who did not report a new sexual relationship during their travels. FINDINGS: One in ten of the eligible participants reported sexual intercourse with a new partner. Travellers who reported a new sexual relationship abroad were also likely to report large numbers of sexual partners at home. Of the 400 people who had a new sexual partner abroad, 300 (75%) used condoms on all occasions with the new partner. Logistic regression modelling showed differences between men and women in those factors linked to the practice of unsafe or safer sex while travelling. For men, patterns of condom use abroad with casual partners (p<.0001) reflected patterns of use at home (p<0.001), whereas for women, patterns of condom use varied according to their partners' backgrounds (p<.0001). INTERPRETATION: Condoms are widely used among young travellers, but patterns of use vary by sex. Campaigns about sexual health targeted at international travellers should continue, not least because young people who meet new sexual partners abroad may be a convenient proxy group for that minority of the population who report most sexual partners at home. Such campaigns should be designed differently for men and women.

Adolescent↗
PubMed1996

Staff attitudes towards family presence during resuscitation.

The presence of family members in the resuscitation room of an Emergency Department (ED) is a controversial issue. This has been the subject of discussion in recent years and has received a lot of publicity. Allowing family to be present with their relative in the time leading up to their dying moments may help initiate the grieving process and dealings with subsequent death. This study found that there are occasions where families are present informally during resuscitation attempts in metropolitan hospitals around Melbourne. The experiences of staff have been given voice, with comments from those involved. A survey of ED workers was conducted to examine staff attitudes and to identify the major factors of concern about family presence during resuscitation. The willingness of staff to consider the option was revealed by this study. Examination of issues relevant to this proposal reveal many concerns for ED workers. These issues must be addressed in order to gain commitment and support from staff. The main concerns are discussed and possible solutions suggested. Ideas for developing guidelines to prepare staff and possible visitors into the resuscitation room are included for those wishing to develop and pilot such a project in their own department.

Attitude of Health Personnel↗
PubMed1994

Evaluation of new transport medium for detection of herpes simplex virus by culture and direct enzyme-linked immunosorbent assay.

The transport medium Multi-Microbe Media (M4) was evaluated prospectively by culture and direct enzyme-linked immunosorbent assay (ELISA) for detection of herpes simplex virus from 473 specimens. In addition, 377 specimens in Bartels Viral Transport Medium were evaluated. By using culture as a "gold standard," the ELISA sensitivity was approximately 85%, while the specificities exceeded 96% for both media.

Antigens, Viral↗