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Biomedical subjects

K Rigby

Publications and source records attributed to K Rigby.

At least 19 recordsLinked to original sources
PubMed2007

Implications of inadequate parental bonding and peer victimization for adolescent mental health.

Previous studies have indicated significant associations between relatively poor mental health of children and both perceived negative parenting and exposure to peer victimization at school. This paper examines their relative contribution to the mental status of adolescent school children. Questionnaires were administered to Australian school children (n=1432) aged 12-16 years. These contained reliable self-report measures of mental health (the GHQ) parental bonding (the PBI) and degree of peer victimization. As predicted, multiple regression analyses indicated that low levels of perceived parental care, high parental control and frequent peer victimization were each significantly and independently associated with relatively poor mental health. Together, they accounted for some 17% and 27% of variance in the mental health status of adolescent boys and girls, respectively. Theoretical and practical implications of these findings are considered. Limitations of the study are also discussed (deleted).

Adolescent↗
PubMed2006

Randomised clinical trial, observational study and assessment of cost-effectiveness of the treatment of varicose veins (REACTIV trial).

OBJECTIVES: To establish the cost-effectiveness of surgery and sclerotherapy for the treatment of varicose veins. DESIGN: Randomised controlled trials (RCTs) were carried out for conservative treatment, sclerotherapy and surgery for varicose veins. An economic analysis was carried out alongside the randomised trial. Economic modelling was undertaken based on the primary data collection and a literature review (database searches undertaken in April 2000 and updated in March 2001). SETTING: Primary data collection was from a large district general hospital and a teaching hospital both in England over a 2-year period from January 1999. Cost-effectiveness analysis and economic modelling were carried out using an NHS perspective. PARTICIPANTS: A total of 1009 patients were recruited. INTERVENTIONS: Thirty-four patents were randomised in Group 1 (minor varicose veins with no reflux, randomised between conservative treatment and sclerotherapy), 77 in Group 2 (moderate varicose veins with reflux, randomised between surgery and sclerotherapy) and 246 in Group 3 (severe varicose veins with reflux, randomised between conservative treatment and surgery). The remaining 652 patients formed the observational part of the study. MAIN OUTCOME MEASURES: The cost-effectiveness analysis was based on NHS treatment costs for the 2002--3 financial year, and utilities based on the Short Form 6D (SF-6D) preference-based health measure. For the clinical trial, the outcome measures were health-related quality of life (HRQoL) [Short Form with 36 Items (SF-36), EuroQol quality of life questionnaire (EQ-5D), visual analogue scale (VAS) and standard gamble], symptomatic relief, anatomical extent (for which a new classification was developed and validated), patient satisfaction and the incidence of complications. RESULTS: Of the RCTs, only the Group 3 trial was large enough to provide clear results. This showed that surgical treatment produced better results than conservative treatment in terms of HRQoL, symptomatic relief, anatomical extent and patient satisfaction. Clinical outcomes of surgery and sclerotherapy showed significant improvement in the extent of varicose veins, symptomatic and HRQoL parameters. Cost-effectiveness analysis based on the Group 3 trial showed that the surgery produced an estimated discounted benefit of 0.054 quality-adjusted life-year (QALY) over a 2-year period, with an additional discounted cost of pound 387.45, giving an incremental cost-effectiveness ratio (ICER) of pound 7175 per QALY. Economic modelling suggested that surgery produced a still greater benefit when considered with a 10-year time horizon, with an ICER of pound 1936 per QALY. Injection sclerotherapy produced an incremental benefit of approximately 0.044 QALY at a cost of pound 155 when compared with conservative treatment, giving an ICER of pound 3500 per QALY. When surgery was compared with sclerotherapy, surgery produced greater benefit with a lower ICER (showing extended dominance). CONCLUSIONS: Standard surgical treatment of varicose veins by saphenofemoral ligation, stripping and multiple phlebectomies is a clinically effective and cost-effective treatment for varicose veins, with an ICER well below the threshold normally considered appropriate for the funding of treatments within the NHS. Injection sclerotherapy also appears to be cost-effective, but produces less overall benefit, with a higher ICER than surgery for patients with superficial venous reflux. In minor varicose veins without reflux, sclerotherapy is likely to provide a small average benefit with acceptable cost-effectiveness. Research is needed into methods for accurate and acceptable utility evaluations for conditions with relatively minor effect on HRQoL and also for a validated and standardised method of classification for varicose veins.

Adolescent↗
PubMed2001

Ways of coping and the health of relatives facing drug and alcohol problems in Mexico and England.

AIMS: To compare two contrasting socio-cultural groups in terms of parameters relating to the stress - coping - health model of alcohol, drugs and the family, and to test hypotheses derived from the model in each of the two groups separately. DESIGN: Cross-sectional, comparative and correlational, using standard questionnaire data, supplemented by qualitative interview data to illuminate the findings. PARTICIPANTS: One hundred close relatives, mainly partners or parents, from separate families in Mexico City, and 100 from South West England. Data sources. Coping Questionnaire (CQ), Family Environment Scale (FES), Symptom Rating Test (SRT), Semi-structured interview. FINDINGS: Mean symptom scores were high in both groups, and not significantly different. The hypothesis that relatives in Mexico City, a more collectivist culture, would show more tolerant - inactive coping was not supported, but there was support for the prediction that relatives in South West England would show more withdrawal coping. This result may be as much due to differences in poverty and social conditions as to differences in individualism - collectivism. As predicted by the stress - coping - health model, tolerant - inactive coping was correlated with symptoms, in both groups, after controlling for family conflict, but there was only limited support for a moderating role of coping. Wives of men with alcohol problems in Mexico City, and wives of men with other drug problems in South West England, reported particularly high levels of both engaged and tolerant - inactive coping. CONCLUSIONS: Tolerant - inactive coping may be bad for relatives' health: causality may be inferred but is not yet proved. Certain groups are more at risk of coping in this way. Qualitative data help understand the nature of tolerant - inactive coping and why it occurs despite the view of relatives themselves that it is counter-productive.

Adaptation, Psychological↗
PubMed2000

Effects of peer victimization in schools and perceived social support on adolescent well-being.

It has been suggested that the mental health of schoolchildren can be undermined by repeated bullying at school and further exacerbated by having inadequate social support. To evaluate this claim, the General Health Questionnaire (GHQ) was administered anonymously to 845 adolescent schoolchildren attending coeducational secondary schools in South Australia, together with measures of the extent to which each reported being bullied at school and the social support available to them. Multiple regression analyses indicated that for both sexes frequent peer victimization and low social support contributed significantly and independently to relatively poor mental health.

Adolescent↗
PubMed1999

Countering bullying at an australian secondary school with students as helpers.

To counter bullying at an Australian coeducational secondary school, staff and students co-operated in developing and implementing appropriate policies and procedures. Questionnaires assessing the incidence of bullying and related attitudes were completed by students in Years 7, 9, 10 and 11 in 1995 and again in 1997. Significant reductions in levels of victimization were recorded for Year 7 students only. Significantly increased support for anti-bullying initiatives was found among senior students (Years 10 and 11). Anti-bullying activities directed and undertaken by students themselves received most approval from peers.

Adolescent↗
PubMed1999

Towards the safer use of warfarin II: results of a workshop.

The use of oral anticoagulation therapy (ACT) is expanding. Due to the combination of the narrow therapeutic range and relatively unpredictable pharmacokinetics and pharmacodynamics, there are relatively high risks involved in using this treatment. The purpose of this paper is to present the results of a focus group's canvassing of ways to improve the management of the use of oral anticoagulants. Recommendations proposed include: (i) better patient selection; (ii) more patient involvement and research into the appropriateness of the current use of ACT in Australia; (iii) increased production, dissemination and implementation of ACT guidelines; (iv) assessment of home and practice ACT monitoring; and (v) research into the effectiveness of academic detailing and the use of management plans by dedicated ACT educators.

Anticoagulants↗
PubMed1999

Adverse events in health care: setting priorities based on economic evaluation.

Adverse events arising from health-care management, rather than a disease process, may place as great a burden on society as all other forms of injury put together. By analysing data from the Quality in Australian Health Care Study (a retrospective review of 14 179 medical records representative of admissions to Australian acute care hospitals in 1992), and applying costing techniques based on Diagnosis Related Group (DRG) cost weights, it is possible to compare the economic impacts of different kinds of adverse events. This can assist in determining priorities for interventions. However, due to limitations inherent in DRG cost weights, there is a need to employ further techniques to refine the costing base of adverse events so that it more closely reflects their resource use. Decisions to invest resources in strategies that reduce the risk of adverse events can then be properly informed by economic data.

Australia↗
PubMed1999

Peer victimisation at school and the health of secondary school students.

BACKGROUND: Although previous studies have indicated that children who are frequently bullied by peers at school have below average health, both the generalisability of such findings across age groups and how they can be best explained have remained unclear. AIMS: (i) To examine whether reported peer victimisation is related to current levels of physical and mental health among early and late secondary school students and (ii) to determine whether degree of reported victimisation in early years of secondary schooling can predict the health status of students when they are in senior class. SAMPLE: Students were selected from those attending the first two years of schooling at a South Australian high school in 1994 (N = 276) and the last two years in 1997 (N = 126). These included a subsample (N = 78) who were assessed at school at both times. METHOD: Students completed questions which included measures of degree of peer victimisation and mental and physical health. RESULTS: For the total sample assessed in 1994, but not that of 1997, reported victimisation was significantly correlated with relatively poor physical and mental health. For the re-tested subsample, high levels of peer victimisation in the pre-testing predicted poor physical health for both sexes and poor mental health in girls. CONCLUSION: Relatively poor health was characteristic of students reporting frequent victimisation by peers in early secondary schooling and also of senior students who reported being bullied frequently three years earlier, suggesting a causal connection.

Adolescent↗
PubMed1999

Suicidal ideation among adolescent school children, involvement in bully-victim problems, and perceived social support.

Relationships among suicidal ideation, involvement in bully-victim problems at school, and perceived social support were investigated with samples of adolescent students (N = 1103 and N = 845) attending secondary school in South Australia. Results obtained from self-reports and peer nomination procedures to identify bullies and victims indicated that involvement in bully-victim problems at school, especially for students with relatively little social support, was significantly related to degree of suicidal ideation.

Adolescent↗
PubMed1999

The use of a proforma improves colorectal cancer pathology reporting.

The detail and accuracy of pathological reporting for colorectal cancer is becoming increasingly recognised as important in the overall management of the patient. However, there is criticism of the variable standards of reporting. We assessed how the use of a proforma affected the completeness of reporting within one hospital. Data on all colorectal cancer patients attending one teaching hospital has been collected prospectively over a 15 month period from 1997 to 1998. The Royal College of Surgeons/Association of Coloproctology proforma lists all items considered to be essential for a complete pathological report of colorectal cancer. Its introduction in September 1997 allowed us to compare reporting before the proforma to that after. Of 54 patients, 46 (85%) had one or more items missing from their report before introduction of the proforma compared with only 8/44 (18%) patients after the proforma (P < 0.001). Circumferential resection margins and apical node status were the items most often absent, being significantly more frequently reported after the proforma (P < 0.05 and P < 0.001, respectively). There was no difference in the median number of lymph nodes harvested after proforma introduction. The introduction of the proforma has not only resulted in improvements in reporting, but has increased the dialogue between surgical oncologists and pathologists. These features should result in improved overall management of the colorectal cancer patient.

Colorectal Neoplasms↗
PubMed1998

Tolerate, engage or withdraw: a study of the structure of families coping with alcohol and drug problems in south west England and Mexico City.

AIMS: To explore the structure underlying individual differences in the ways family members cope with drinking or drug problems. DESIGN: Cross-sectional interview and questionnaire study of a series of family members in two contrasting socio-cultural groups. SETTING: Mexico City and South West England. PARTICIPANTS: Two hundred and seven family members from separate families, three-quarters women, one-quarter men, mostly partners or parents. DATA: Long semi-structured interviews; the Coping Questionnaire (CQ). FINDINGS: Factor and subscale analyses of the CQ data and textual analysis of the interview reports were used to test the hypothesis that the underlying structure to coping could be described in terms of eight or nine coherent and distinct ways of coping. Neither form of analysis gave strong support to this hypothesis. CONCLUSIONS: It is concluded that the structure of coping can best be described in terms of three broad coping positions: tolerating, engaging and withdrawing. These conclusions challenge some previous assumptions about functional and dysfunctional ways of coping with excessive appetitive behaviour in the family.

Adaptation, Psychological↗
PubMed1997

Cooperativeness and bully/victim problems among Australian schoolchildren.

The relationship was examined between the self-reported cooperativeness of Australian secondary-school students and their involvement in peer abuse at school, both as bullies and as victims. An 18-item Likert-type measure, the Cooperativeness Scale, was developed, and its reliability and concurrent validity were supported by the results of its application to two samples of Australian students (N = 176 and N = 763, respectively) attending different coeducational secondary schools, the first in a predominantly middle-class area and the second in a lower class socioeconomic area. At both schools, girls scored higher in cooperativeness than boys. Students at the second school also anonymously completed multiple measures of the extent of their involvement during the current year in bullying, victimization, or both. As predicted, correlations and multiple regression analyses supported the hypothesis that relatively low levels of cooperativeness were characteristic, not only of both boys and girls who engaged in bullying, but also, to a lesser extent, of those who were frequently victimized by their peers at school.

Adolescent↗
PubMed1996

Can resource use be extracted from randomized controlled trials to calculate costs? A review of smoking cessation interventions in general practice.

The ability to extract information on resource use from randomized controlled trials can provide the groundwork for systematically compiling health economic reviews of health interventions. A review of the brief smoking interventions in general practice demonstrates that not all the necessary information can be extrapolated from these trials, and cost data will have to be supplemented from other sources.

Cost-Benefit Analysis↗
PubMed1996

Health economic reviews. Are they compiled systematically?

Attempts to perform economic reviews of randomized controlled trials frequently lack a systematic approach. This conclusion is consistent with the findings of previous analyses of review articles in other fields, which have highlighted the failure to apply the same degree of rigor to this type of research synthesis that the scientific community has come to expect from primary research articles.

Bibliometrics↗
PubMed1993

Australian school children's self appraisal of interpersonal relations: the bullying experience.

The extent and nature of bullying among South Australian primary school children and their self appraisals of peer relations were investigated in a survey of 412 primary school children between the ages of 7 to 13 years. It was found that 10% of boys and 6% of girls were subject to peer group bullying and for 8% of such children the bullying episodes lasted 6 months or more. Factor analysis of styles of interpersonal relating amongst children identified three independent factors including a tendency to bully, to be victimized and to act in a pro-social manner. The tendency to be victimized correlated negatively with self appraisals of the number of friends, popularity, happiness at school and feelings of safety at school. The findings are discussed in relation to research linking negative self appraisals of interpersonal competence with isolation and proneness to depression in later years.

Adolescent↗
PubMed1993

School children's perceptions of their families and parents as a function of peer relations.

Links were examined between three dimensions of peer relating at school among Australian children and selected family and parental background factors. Questionnaires containing measures of children's tendencies to bully others, to be victimized, and to act in a prosocial manner were administered to boys and girls (N = 1,012) aged 11 to 16 years. In addition, subjects completed a standardized 42-item measure of family functioning and reliable scales assessing attitudes toward, and relationships with, their mother and father. When differences in age were controlled for, multiple regression results for both boys and girls indicated that the tendency to bully peers and the tendency to act prosocially were independently predictive of family functioning and attitudes toward, and relationships with, each parent, negatively for bullying and positively for prosocial behavior. The tendency to be victimized by peers at school among girls was found to be associated with poorer family functioning and more negative attitudes toward mothers; negative relations with absent fathers in single-parent families characterized boys who reported being victimized at school.

Adolescent↗