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Biomedical subjects

M Drury

Publications and source records attributed to M Drury.

At least 19 recordsLinked to original sources
PubMed1996

Pharmaceutical trials in general practice: the first 100 protocols. An audit by the clinical research ethics committee of the Royal College of General Practitioners.

OBJECTIVE: To assess the outcome of 100 general practice based, multicentre research projects submitted to the ethics committee of the Royal College of General Practitioners by pharmaceutical companies or their agents between 1984 and 1989. DESIGN: Analysis of consecutive submitted protocols for stated objectives, study design, and outcomes; detailed review of committee minutes and correspondence in relation to amendment and approval; assessment of final reports submitted at conclusion of studies. SUBJECTS: 82 finally approved protocols, embracing 34,523 proposed trial subjects and 1195 proposed general practice investigators. MAIN OUTCOME MEASURES: Success at enrolling subjects and investigators; commencement and completion data; validity of final report's assessment of efficacy, safety, tolerability, and acceptability; and method of use and dissemination of findings. RESULTS: 18 studies were not approved and 45 had to be amended. Randomised controlled trials comprised 46 of the original submissions. Remuneration considerations, inadequate information or consent sheets, pregnancy safety, the need to discontinue existing therapy, and suboptimal scientific content were major reasons for rejecting studies or asking for amendments. Of the 82 approved studies 8 were not started. Shortfalls of investigators (of 39%) and trial subjects (of 37%) and an overall 23% withdrawal rate were responsible for a significant incidence of inconclusive results. Within the six year follow up interval, only 19 of the studies had been formally published. CONCLUSIONS: This audit identified substantial ethical concerns in the process of approving multicentre general practice pharmaceutical research.

Clinical Protocols↗
PubMed1994

Dominant situational determinants of sexual risk behaviour in gay men.

OBJECTIVE: To examine the interplay between situational, social and psychological factors in gay men's decisions about HIV risk behaviour, using multiple hypothetical situations. METHOD: The sample included 79 gay men from Sydney recruited through flyers, press advertisements or personal contact at gay venues. Subjects were presented with 20 hypothetical situations graphically on a computer, which included different levels of attraction to partner, intoxication, attractiveness to partner, condom availability, desire for anal sex by subject, insistence of partner on using a condom and time constraints in each situation. Subjects used a computerized graphic rating scale to indicate the likelihood of unprotected anal sex in each situation, the frequency with which they had experienced the hypothetical situation in real life and satisfaction with their response. The probability of having unsafe anal sex in any given situation was the dependent variable. All other variables were predictors. RESULTS: A vector of predictors accounted for 30% of the variance (r = 0.54). Ratings of the probability of anal sex increased with the frequency that subjects had experienced hypothetical situations in real life, attraction to partner, attractiveness to partner and time elapsed since real life experience similar to the hypothetical one. Ratings of the probability of anal sex decreased with condom availability. CONCLUSIONS: Our results suggest that interventions must address the way that individuals interact with their partner and their environment in order to be successful.

Condoms↗
PubMed1993

Effects of fluoxetine on the oral environment of bulimics.

The purpose of this study was to evaluate in a double-blind placebo-based study the effects of fluoxetine over a period of 16 weeks on the frequency of binging and purging and on fluctuations in the levels of cariogenic organisms and saliva secretion rate of patients (n = 30) with bulima nervosa. Profile analysis suggested that, over the course of the study, binging and purging frequency and Streptococcus sobrinus salivary levels decreased significantly in the fluoxetine group as compared with the placebo group. Our finding that S. sobrinus levels decreased 16 weeks after subjects were on medication suggests that the salivary levels of these organisms could serve as an objectively measured indicator of patient compliance with antibulimic therapy.

Analysis of Variance↗
PubMed1992

Diagnostic value of pleural fluid cytology in occult Boerhaave's syndrome.

When Boerhaave's syndrome presents with atypical clinical features and eludes prompt diagnosis, delays in surgical therapy increase complications and mortality. We present a patient with occult Boerhaave's syndrome who had nondiagnostic esophageal contrast studies and thoracic computed tomography. Pleural fluid cytologic analysis established the presence of esophageal rupture by detecting undigested food particles.

Esophageal Diseases↗
PubMed1991

Using a notification card to improve communication between community pharmacists and general practitioners.

A pilot scheme was set up to evaluate a notification card to be used by community pharmacists when referring patients to their general practitioner, with the aim of improving communication. Six community pharmacists and 15 general practitioners took part in the study. During the 18 month study period 120 cards were issued by pharmacists. The majority of patients (71%) advised to see their general practitioner by the pharmacist did so. Fourteen cards (12%) were issued for suspected adverse drug reactions. The card was received positively by patients, doctors and pharmacists.

Communication↗
PubMed1990

Practice formularies.

Explore the source record for details and available documents.

Drug Information Services↗
PubMed1989

Formation of alanine and glutamine in chick (Gallus domesticus) skeletal muscle.

1. Incubation of extensor digitorum communis muscles from fed chicks in the presence of plasma concentrations of branched-chain amino acids (BCAA) increased the formation of glutamate, glutamine and alanine. This effect was inhibited by 1.5 mM L-cycloserine. 2. 2-Oxoisocaproate (0.1 and 0.5 mM) increased the formation of leucine but decreased that of glutamate, glutamine and alanine. 3. NH4Cl (0.3 mM) increased the formation of glutamine, and decreased the release and intracellular concentrations of glutamate and alanine. 4. Our results demonstrate that alanine and glutamine are synthesized de novo in chick skeletal muscle and demonstrate the similarity in alanine and glutamine synthesis in skeletal muscle between the domestic fowl and mammals.

Alanine↗
PubMed1988

Description and evaluation of a course for practice nurses.

There is increasing awareness of the needs of practice nurses for continuing education and both the report of the community nursing review and the government's white paper Promoting better health have stressed this. A course for practice nurses is described in which the curriculum was based on previous research into their requirements. An evaluation of the course demonstrated changes in the attitude towards the work of the practitioner and an overall increase in confidence of the group. Perceptions of the course and the relevance of the content were also measured. The cost of the course is given and the future direction of training discussed.

Adult↗
PubMed1988

A nurse practitioner in general practice: patient perceptions and expectations.

A study exploring the acceptability of a nurse practitioner to a random sample of 126 patients is reported. Sixty per cent of patients either approved of the concept and expressed willingness to consult the nurse or held no strong views. Fifty three per cent of the 61 patients who had seen her already were prepared to see her again. Fifty four per cent of patients had difficulty in differentiating between the role of the nurse practitioner and the doctor and the perceived differences included qualifications, ability to prescribe drugs and the severity of the condition dealt with. Women were nearly three times more likely than men to consult a nurse practitioner. Good communication skills were reported to be among the most sought after qualities of those whom patients consult about their health problems.

Consumer Behavior↗