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Biomedical subjects

M A Plant

Publications and source records attributed to M A Plant.

At least 19 recordsLinked to original sources
PubMed1995

Stability of standardized patients' performance in a study of clinical decision making.

BACKGROUND: Standardized patients (SPs) have been used extensively in teaching, but their reliability for use in research has been infrequently addressed. This study analyzes the reliability of performance of 13 SPs during 228 doctor-patient encounters in a year-long study related to the diagnosis of depression. METHODS: Patient scenarios were based on real patient cases. Four of the five cases had major depressive disorder. Two to three SPs were coached to enact each of the five case scenarios. Medical encounters were videotaped. Interview content was extracted onto a standardized checklist. Interaction between physician and patient was measured by the Interactional System for Interview Evaluation. Tests of SP performance reliability included the: 1) consistency of symptoms volunteered, 2) stability of affect and behavior, and 3) association of SP performance to detection of depression. RESULTS: The mean number of SP performances was 20.8 (SD = 5.8), with a range of 6 to 28. Problems with reliability emerged in one of the five patient cases. Results otherwise revealed high intra-performance and inter-performance reliabilities. Detection of depression was consistent across SPs and with the rates reported in the literature. CONCLUSIONS: This study provides evidence that performances, within and among SPs, remained consistent, even when intervals between performances were as long as 3 months.

Adult↗
PubMed1994

Psychosocial interest, medical interviews, and the recognition of depression.

OBJECTIVES: To measure primary care physicians' attitudes toward psychosocial issues, determine their relationship to the style of the medical interview, and assess whether attitudes and interview behaviors lead to correct diagnosis in patients with depression. DESIGN: Physicians were videotaped while interviewing four patients standardized with criteria symptoms of major depression. Physicians were unaware of the mental health focus of the study. SETTING: Patient examining rooms. PARTICIPANTS: Physicians were eligible for recruitment if they were board certified or eligible in family practice or internal medicine, practiced primary care medicine, and were listed in regional directories. Standardized patients were recruited from the community. MAIN OUTCOME MEASURES: Attitudes toward psychosocial issues (measured by the Physician Belief Scale), interview content (measured by review of the videotaped encounters), interview behaviors (measured by the Interaction Analysis System for Interview Evaluation), and a listing of depression in the differential diagnosis (determined by physician debriefing interviews). RESULTS: Forty-seven community-based practitioners participated. Forty-eight percent of interviews resulted in a diagnosis of depression. Physician Belief Scale scores were not significantly correlated with patient-centered interviewing, psychosocial questions, inquiry about depression symptoms, or a depression diagnosis. Longer interviews were more likely to result in a depression diagnosis. CONCLUSIONS: High interest in psychosocial issues was not associated with patient-centered interviewing behaviors, questions about psychosocial or depression symptoms, or depression diagnoses. However, certain patient-centered interviewing behaviors, particularly those defined as "affective," did lead to the recognition of depression.

Adult↗
PubMed1992

Stress, alcohol, tobacco and illicit drug use amongst nurses: a Scottish study.

This paper examines levels of stress amongst a representative sample of 600 qualified nurses in the Lothian Region of Scotland. The results indicated a number of significant variations in the patterns of stress amongst different subgroups of nurses. The highest stress levels amongst females were evident amongst medical nurses while the lowest levels were reported by those in psychiatry. No comparable differences were evident amongst males in different fields of nursing. Stress was also associated with the use of alcohol, but not with tobacco smoking. Illicit drug use was associated with stress amongst females. Amongst both males and females the variable most predictive of stress was concern about AIDS. Amongst females, administrative workload was an equally important predictor. It is concluded that as the HIV/AIDS epidemic spreads efforts will be needed to support nursing staff and to reduce stress levels.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Knowledge about aging and Alzheimer's disease among baccalaureate nursing students.

Alzheimer's disease (AD) is a debilitating disease that poses many physical, social, psychological, and management problems for family and professional caregivers. Nursing students' ability to meet this challenge was measured using Palmore's (1988) Facts on Aging Quiz, Version 2 (FAQ2) and the Alzheimer's Disease Knowledge (ADK) Test developed by Dieckmann, Zarit, Zarit, and Gatz (1988). No significant difference in ADK Test scores was found for students who had previous personal or educational experiences with AD. However, older students, seniors, and those who reported knowing more about AD had significantly better scores on the ADK Test. Knowledge about AD was not found to be related to knowledge of aging, and subjects as a group were found to exhibit a negative bias toward the elderly as measured by Palmore's FAQ2.

Adult↗
PubMed1991

Alcohol, tobacco and illicit drug use amongst nurses: a Scottish study.

This paper examines patterns of self-reported alcohol, tobacco and illicit drug use amongst a representative sample of 600 qualified nurses in the Lothian Region of Scotland. General levels of alcohol use were not exceptional. Even so, levels of tobacco smoking and the use of illicit drugs were higher than for the general population. Female psychiatric nurses were significantly more likely than female medical or surgical nurses to smoke tobacco, to drink heavily and to have experienced adverse alcohol-related consequences.

Alcoholism↗
PubMed1991

Teenagers and alcohol: results of a Scottish national survey.

During 1990 a survey was conducted of the self-reported drinking habits and alcohol-related knowledge and beliefs of a national sample of 7009 Scottish teenagers. The study group were age 14-16. Results indicated that only 3% of respondents had never consumed alcohol. The great majority of teenagers reported consuming only moderate quantities of alcohol. Even so 18.9% of males and 10.3% of females reported consuming 11 or more units on their last drinking occasion. The proportion of teenagers classified as 'heavy drinkers' increased markedly between the ages of 14 and 16. This study confirmed earlier findings indicating that Scottish teenagers are more likely than those in England to drink heavily and rather less frequently.

Adolescent↗
PubMed1991

HIV/AIDS risks, alcohol and illicit drug use among young adults in areas of high and low rates of HIV infection.

The results are presented of a survey of HIV/AIDS related risks amongst young adults in two urban areas in Scotland. This exercise elicited data from random samples of those aged 16-30 in Muirhouse and Easterhouse. Muirhouse has a high rate of HIV infection, mainly related to intravenous drug use. Easterhouse has a much lower rate of recorded HIV infection. A total of 1,378 individuals were successfully interviewed. Levels of knowledge about risks of HIV infection were relatively high. Even so levels of condom use were low. Respondents in Muirhouse reported high levels of personal knowledge of HIV infected people. In addition 8% of those in Muirhouse and 3% of those in Easterhouse reported having had sex with a person who was HIV infected. Few of such encounters had involved condom use. The combination of alcohol consumption and sexual activity was reported by 82% of respondents. Twelve per cent had combined sexual activity and illicit drug use. Overall patterns of self-reported HIV/AIDS related risks in the two study areas were very similar.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Alcohol, AIDS risks and commercial sex: some preliminary results from a Scottish study.

During 1988 self-report data were elicited from a study of 102 male and 103 female sex workers (prostitutes) in Edinburgh. Respondents were contacted by 'snowballing', mostly in licensed premises. This was reflected by high levels of self-reported alcohol and illicit drug use. Respondents reported that both alcohol and illicit drug use were commonplace in relation to their work and that many of their clients were under alcohol or drug effect at the time of contact. Condom use was unrelated to sex workers' alcohol or drug use, but was significantly associated with sex workers' assessments of the proportions of their clients also under the influence of illicit drugs.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Alcohol, AIDS risks and sex industry clients: results from a Scottish study.

During 1988 and 1989 self-reported data were obtained from 206 males and three females who had paid for physical sexual services. Respondents were contacted by "snowballing", mainly with the assistance of sex workers. The study group reported that both alcohol and illicit drug use were commonplace during their contact with prostitutes. No general association between alcohol and drug use and 'risky sex' was evident. Even so amongst males who had anal sex with males alcohol consumption was inversely related to condom use.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Alcohol, sex and AIDS.

The association between alcohol consumption and AIDS risks is examined. It is concluded that chronic heavy drinking or alcohol consumption levels consistent with alcohol dependence or alcohol-related liver disease does damage the immune system. In addition alcohol consumption influences sexual behaviour for a variety of psychological, social and physical reasons. Attention is focused on the disinhibiting effects of alcohol and the popular belief that drinking may be used to facilitate or excuse otherwise unacceptable behaviour. Several studies indicate that alcohol consumption is associated with 'high risk' sexual behaviour. Accordingly drinking appears to be a risk factor for potential exposure to HIV infection and for relapse into 'high risk' sexual activities. Evidence does not support the conclusion that alcohol is a cofactor in the course of AIDS-related illnesses.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Teenage heavy drinkers: alcohol-related knowledge, beliefs, experiences, motivation and the social context of drinking.

During 1988 and 1989 a survey was conducted of the drinking habits and alcohol-related beliefs of a national sample of teenagers in England. Data were obtained from 6,244 respondents virtually all aged 14-16. Heavy drinkers were significantly more likely to report drinking in a mixed sex group than were other teenagers. They were also more likely than others to have drunk illegally in licensed premises, and were distinctive from other teenagers in relation to their self-reported reasons for drinking and their alcohol-related beliefs.

Adolescent↗
PubMed1989

Risks of AIDS among workers in the "sex industry": some initial results from a Scottish study.

OBJECTIVE: To determine the extent to which workers in the "sex industry" in Edinburgh engage in activities with a high risk of infection with HIV. DESIGN: Cross sectional, single phase survey in which respondents were located by a non-random method ("snowballing"). SETTING: Research project coordinated by the Alcohol Research Group, Edinburgh. SUBJECTS: 205 Sex workers (102 male, 103 female) interviewed between July and December 1988. END POINT: Strategies to reduce risk of AIDS among people who buy and sell sexual services. MEASUREMENTS AND MAIN RESULTS: Data were elicited by a standardised interview which related to over 300 variables. A fifth of the study group had used drugs intravenously, and one in 12 reported that they had been found to be seropositive on HIV testing. Roughly a quarter of the study group sometimes engaged in unprotected sex with clients for more money, and a similar proportion sometimes did not seek medical advice even if they had genital or anal symptoms. CONCLUSIONS: People who buy and sell sexual services should be priority targets for health education and strategies to reduce their risk of AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1989

The sex industry, alcohol and illicit drugs: implications for the spread of HIV infection.

A review is presented of the association between the sex industry and the use and misuse of alcohol and illicit drugs. It is concluded that both the latter are associated with 'high risk' sexual activities and that heavy drinking and illicit drug use are commonplace amongst prostitutes and their clients. Outside Africa evidence suggests that in some, though by no means all, areas prostitutes have low or zero levels of HIV seropositivity. It is concluded that far more information is needed on the patterns of AIDS-related knowledge, beliefs, attitudes and behaviours amongst male and female prostitutes and their clients. Vigorous policies are needed to increase levels of knowledge about AIDS risks amongst prostitutes and their clients and to foster the adoption of 'safer sex' practices.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Alcohol, sex and risks of HIV infection.

A complex association between alcohol consumption and sexual behaviour has long since been established. During 1985 a survey of 335 young adults was conducted in South East Scotland. Information was elicited about sexual behaviour, alcohol and other psychoactive drug use. The results indicate that amongst both males and females, age of first sexual intercourse was positively associated with age of first alcohol use, as well as with current use of tobacco and illicit drugs. Respondents who had consumed alcohol immediately prior to first sexual intercourse were markedly less likely than others to have used condoms or other forms of contraception. It is concluded that the use of alcohol and other drugs has clear relevance to unprotected sexual activities and the spread of HIV infection. Future health education should give due weight to this connection.

Acquired Immunodeficiency Syndrome↗