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Biomedical subjects

L McKie

Publications and source records attributed to L McKie.

12 recordsLinked to original sources
PubMed2005

CT or not CT--that is the question. Whether 'tis better to evaluate clinically and x ray than to undertake a CT head scan!

OBJECTIVE: To evaluate the usage of computed tomography (CT) head scanning in children at the Royal Aberdeen Children's Hospital after the publication of the National Institute of Clinical Excellence (NICE) guidelines on the management of head injury. METHODS: The Accident and Emergency case records of all children presenting with a head injury over a three month period were reviewed and the number of attendances, radiographs, and CT head scans undertaken were noted. Also noted was the number of additional CT head scans that would have been performed if the NICE guidelines had been rigidly followed. RESULTS: Five hundred and thirty seven children were included in the study: 67% were boys. Two hundred and ten (39%) had skull radiographs: six demonstrated skull fractures and eight (1.5%) underwent CT head scan, with one positive report of a skull fracture. There were no reports of intracranial abnormalities. Ninety nine (18.4%) were admitted. Strictly applying all the NICE criteria for CT scanning would have resulted in an additional 54 patients being scanned. CONCLUSION: Rigid adherence to the NICE guidelines in all children with head injuries would have resulted in an almost eightfold increase in CT head scans performed. None of these children had clinical signs of intracranial injury and would have been exposed to a large amount of ionising radiation. The use of guidelines in practice must always be considered in conjunction with clinical judgement.

Adolescent↗
PubMed2003

Eliciting the smoker's agenda: implications for policy and practice.

Existing health promotion messages and advice on smoking cessation focus upon the negative aspects of continuing to smoke and contrast these to the benefits of giving up. Benefits of cessation are invariably linked to reduced risks of illness and disease with the process of cessation framed as a largely positive and certainly a health enhancing one. In this paper we present an analysis of data from a cross-sectional, exploratory study in the city of Aberdeen, Scotland, undertaken with 54 people, aged 18-44, who are or have been smokers. The multiple and often contradictory agendas of everyday life, smoking and health are explored. Participants spoke of the dangers of smoking and the potential benefits of giving up as these are considered by health promotion and medical research. However, many smokers experienced a number of benefits from smoking (such as socialising with others and breaks from boredom), and health and social problems with the process of cessation (for example, weight gain, stress, colds, flu). Participants appeared to query the validity of the risks of continuing to smoke and yet indicate a range of health and social difficulties in giving up. The authors assert that an acknowledgement of the attractive, pleasurable aspects of smoking may be seen as unacceptable and irresponsible but this could well provide an opportunity to relate to the everyday and multiple practices of smoking and smokers themselves as illuminated by this research.

Adolescent↗
PubMed2002

Transduodenal excision of ampullary tumours.

The commonly recommended treatment for ampullary tumours--pancreaticoduodenectomy results in significant morbidity and mortality. This study is a retrospective evaluation of the procedure of transduodenal local excision of ampullary tumours. Demographics, symptoms, histological findings and outcomes were retrospectively analysed in 15 patients. Survival analysis was done by the method of Kaplan-Meier and log-rank test. The median age was 68 years (range 54-78). Endoscopic biopsy was accurate in only 41% of cases. CT scan demonstrated a mass in 50% cases. Definitive histology reported 4 adenomas, 2 carcinomas-in-situ and 9 adenocarcinomas. Median hospital stay was 13 days. There was no operative mortality. Mean duration of follow-up was 31 months (range 7-70 months). The procedure appears curative for adenomas and in-situ carcinoma. Overall 3 year actuarial survival for ampullary tumours is 65% while that for moderately differentiated carcinomas is 50%. Pre-operative investigations provide inadequate histological information. Wide local excision is a safe operation with low morbidity and good survival in carefully selected cases. However, the role of local excision for carcinoma appears to be palliative rather than curative.

Adenoma↗
PubMed1999

A critical appraisal of the draw and write technique.

The draw and write technique is increasingly popular in health education research with children. It is generally employed in the setting of the school classroom and is promoted as a 'bottom-up' approach which enhances participation by children. In this paper we critically appraise the use of this method. Against the background of a consideration of carrying out qualitative health promotion research with children we examine the origins and use of children's drawings in a number of disciplines and practice environments. We argue that, although the draw and write technique has made an important contribution to health education research, it fails to reflect the processes involved in the construction and collection of such data. A range of methodological, analytical and ethical issues are raised. We conclude that health education research with children must involve taking children seriously as social actors and query the assumption that drawing enables children to communicate their thought any more than does conversational language. We suggest that the development of research should be premised upon an appreciation of the social context and the world of the child.

Child↗
PubMed1998

The promotion of healthy eating: food availability and choice in Scottish island communities.

Communities in rural areas are in receipt of health education messages on healthy eating aimed at the population. These messages are invariably composed without regard to where people reside, and, in particular, to the availability of, and access to, foodstuffs in rural areas. In this paper the authors present data derived from a participative health needs assessment on the topic of food, diet and health. The research was conducted in a number of islands of the Western Isles of Scotland and comprised seven focus groups, 33 semi-structured interviews, one community and one policy workshop, and a final community feedback session. The needs assessment demonstrated a dichotomy between local experiences of food availability, island food cultures and the contents of healthy eating advice. As a result of the research, local people and health care professionals developed a range of activities on the topic of the traditional island diet. People noted the potentially positive elements of this diet for health but also the possibility of promoting social cohesion through the consideration of food and diet histories. In addition, lobbying at a national level was also identified as necessary to the development of a 'healthy food policy'.

Adolescent↗
PubMed1997

Health issues in remote and rural areas.

In March 1996 a conference on the theme health issues in remote and rural areas was held in Inverness. Sponsored by the Scottish Office, Highland Health Board and the Department of General Practice and Primary Care, University of Aberdeen, participants included representatives from the Scottish Office, the seven Health Boards with areas designated as remote and rural, the Health Education Board for Scotland, The Royal College of General Practitioners, voluntary sector organisations and academics. In this paper we introduce the theme and outline the debates detailed in the following three papers.

Family Practice↗
PubMed1997

Getting the message across: the development and evaluation of a health education video in general practice.

While many practices use, purchase or hire videos for health education purposes, a general practice in the North East of Scotland developed its own video. The practice staff were able to incorporate practice information and health education messages while using a local theme where all scenes in the video were either from within the town itself (where the practice is based) or within the surgery and all those appearing in the video are patients, local residents, and surgery staff. After showing in the waiting room of the surgery for two months, the video was evaluated for its potential to convey health information and its effectiveness in triggering patients to pick up specially designed healthy living leaflets on smoking, exercise, diet or alcohol that accompanied the video or to discuss health topics from the video. The evaluation showed that 84% of the patients interviewed watched the video and many provided positive comments. Whilst the video provided information in a comprehensible format and it was appreciated by many of the patients, few had picked up the leaflets or discussed any of the health issues with their GPs.

Adolescent↗
PubMed1993

Women's views of the cervical smear test: implications for nursing practice--women who have not had a smear test.

This is the first of two papers reporting the findings of a study on the views of women with regards to the cervical smear test. In this first paper the views of those who have not had a smear test are analysed. The implications of those views for nursing practice in primary health care are identified and explored. Conducted in 1989-1990, the ESRC-funded study was located in the north-east of England and drew respondents from two age groups living in working-class localities. Focusing upon the views of women who have not had a smear test, a number of conclusions were evident: (a) that the call, recall system did not invite all women in the screening target group for a smear test; (b) that beliefs and attitudes, rather than practical problems, were cited as major factors in non-attendance; and (c) that women hold strong views on aspects of service delivery they would like to see in place. Thus the organization and delivery of the service might be reviewed. However, the barriers posed by beliefs and attitudes must be further explored through community-based work encompassing all community-based health professionals.

Adult↗
PubMed1993

Women's views of the cervical smear test: implications for nursing practice--women who have had a smear test.

This is the second of two papers reporting the findings of a study on the views of women with regards to the cervical smear test. In the first paper (vol. 18, no. 6), the views of those who have not had a smear test were analysed. In this paper, the views of women who have had a smear test are identified and analysed. The implications of those views for nursing practice in primary health care are explored. Conducted in 1989-1990, the ESRC-funded study was located in the north-east of England and drew respondents from two age groups living in working-class localities. Focusing upon the views of women who have had a smear test, a number of conclusions are evident: (a) that a high proportion of respondents were screened opportunistically; (b) that negative views of the service concerned fear and embarrassment and the lack of, or inadequacy of, an explanation; (c) that positive aspects of the service were staff attitudes, convenience and familiarity; and (d) an understanding of the cytology process and the aetiology of cervical cancer was not linked to the level of (non) involvement in the screening service. Thus the organization and delivery of the service might be reviewed. However, the negative views pose a number of problems that must be further explored through primary health care work encompassing all community-based health professionals.

Adolescent↗
PubMed1993

Defining and assessing risky behaviours.

This paper presents the deliberations and conclusions of an international group of health practitioners, researchers and planners who met in 1991 to explore risky behaviours and risk assessment in the context of the World Health Organization's strategy Health for All By 2000. A definition of risky behaviours is discussed and a method of exploring risk contexts, 'a risk equation', is presented. Lay risk assessment is explored and contrasted with professional perceptions of risk as evidenced in health education campaigns. It is concluded that the application of epidemiological techniques--the study of the incidence and prevalence of risk-related and health-related behaviours--employing qualitative methods provides a useful means of exploring the social and cultural context of risk behaviour.

Attitude of Health Personnel↗
PubMedDate not supplied

Smear tactics.

Explore the source record for details and available documents.

Female↗