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Biomedical subjects

M King

Publications and source records attributed to M King.

At least 145 records · Page 8Linked to original sources
PubMed1997

Psychiatrists and their patients: views on forms of dress and address.

BACKGROUND: Dress styles and forms of address vary among psychiatrists. METHOD: A semi-structured interview was administered to a sample of psychiatric in-patients, and a questionnaire was sent to junior and consultant psychiatrists, to identify preferences for dress styles and terms of address. RESULTS: Forty-nine (71%) of the in-patient sample participated. A preference was found for smart attire and white coats. Of the 69 (80%) doctors returning questionnaires, the majority supported smart dress as the most appropriate attire. Most patients preferred to be called by their first name while addressing doctors by title and surname. Junior doctors preferred to use first names when talking to patients while almost all consultants used title and surname. Doctors of all grades liked to be called by their title and surname. CONCLUSIONS: Paying more attention to the way we present ourselves and interact at work may help to facilitate the therapeutic alliance.

Adolescent↗
PubMed1997

The discipline and literature of general practice.

In response to a review recently carried out by the Royal College of General Practitioners, the British Journal of General Practice is soon to be issued in a new and expanded format. While continuing to develop its primary role as a leading scientific journal of record, the journal will accommodate a monthly selection of integrated news, information and features. The editorial board welcomes the opportunities provided by these changes, but wishes to emphasize the continuing importance of general practice as a scientific discipline in its own right and to reaffirm its commitment to the publication of high-quality, peer-reviewed original research papers. It is hoped that the newlook journal will have a wide appeal. But, as the first-and still the foremost-journal of general practice in the world, it will continue to be a journal of record serving both its authors and the academic community worldwide.

Family Practice↗
PubMed1997

Do low-risk prenatal patients really need a screening glucose challenge test?

BACKGROUND: It is common practice to routinely screen pregnant women for gestational diabetes. The screening technique typically used is the 1-hour 50-g oral glucose tolerance test (OGTT), with a subsequent 3-hour 100-g OGTT for women whose 1-hour test was positive. This process can be both time-consuming and inconvenient for patients. Additionally, its sensitivity and specificity are estimated to be 70% and 87% respectively, and data about the effect of screening and treatment on low-risk pregnancy outcomes are limited. The objective of this study was to reassess the value of routine screening of all pregnant patients with a 1-hour glucose challenge test. METHODS: At a university-based family practice center with a predominantly low-risk population, a retrospective analysis was performed of all patients (n = 595) who received prenatal care and gave birth between January 1988 and December 1993. Among women in whom gestational diabetes was diagnosed on the basis of glucose tolerance testing, we identified those with risk factors for the disease, and examined whether a selective screening program based on risk factors alone would have resulted in correct diagnoses of gestational diabetes. RESULTS: Of the 595 patients, 544 (91.4%) were screened with a 1-hour 50-g OGTT. This initial screening test was positive in 76 women (12.8%). Of these, 58 (76.3%) then had a 3-hour 100-g OGTT, and 13 received a diagnosis of gestational diabetes. Nine of these 13 women had risk factors for gestational diabetes. We determined that less than 1% of prenatal patients without risk factors for gestational diabetes were ultimately found to have gestational diabetes. CONCLUSIONS: Screening with a 1-hour 50-g OGTT only those women who have identifiable risk factors for gestational diabetes is a reasonable approach to identifying the disease in a low-risk population. All pregnant women should have a thorough history taken to determine whether they have risk factors for gestational diabetes.

Adolescent↗
PubMed1996

Averting a world food shortage: tighten your belts for CAIRO II.

We are going to have to eat what the world will produce with all its failings, not what it could produce without them. Trends in global food production are therefore all important. These are now giving cause for anxiety, in that the rate of increase of global grain yields has been slowing seriously. Locally, the food security of some demographically trapped communities is so dire that, like China, they need one child families. The 1994 Cairo population conference (Cairo I) took future food supplies for granted and took no account of demographic entrapment: the conference should be recalled urgently as CAIRO II.

Edible Grain↗
PubMed1996

Health in Nepal.

Explore the source record for details and available documents.

Family Planning Services↗
PubMed1996

Trauma data collection using a customised trauma registry: a New Zealand experience.

AIM: To describe the process of selection and adaptation of a trauma registry and the initial experience with its use. METHOD: The decision-making processes involved in selection of a data set and computer software are described. The problems associated with collection of data, recording and analysis are outlined. RESULTS: In the 6 months from 1 January to 30 June 1995, 615 patients were entered on the Auckland Hospital trauma registry. 590 patients were discharged or transferred alive and 25 (4.1%) died in hospital. Median length of stay of survivors was 6 days (mean 9.03 days) with median ICU stay being 0 days (mean 0.81 days). A range of difficulties including data collection, recording and analysis were experienced. CONCLUSION: Despite some teething problems, establishment of a trauma registry has proven to be an achievable task within the trauma service. Recording of data which allows assessment of the quality of care, resource use and outcome has been possible. Effectiveness of the trauma service has been enhanced by the availability of this data.

Data Collection↗
PubMed1996

Reduction in viscoelasticity in cystic fibrosis sputum in vitro using combined treatment with nacystelyn and rhDNase.

The objective of this study was to evaluate the individual and combined effects of Nacystelyn (NAL) and rhDNase in vitro on the rheological properties of cystic fibrosis (CF) sputum. Sputum samples were collected from 11 CF patients and subjected to the following protocols: 1) negative control sample without any treatment; 2) positive control sample incubated with 0.02 ml of normal saline; 3) incubation of CF sputum with 0.02 mL DNase (25 micrograms/mL in normal saline) at 37 degrees C to achieve 2.5 micrograms/g final sputum concentration (approximately 100 nM); 4) incubation of CF sputum with 0.02 mL NAL (30.9 micrograms/mL in normal saline) at 37 degrees C to achieve 3.09 micrograms/g final sputum concentration (10 microM); and 5) combination of protocols 3 and 4 with half the concentration of each drug. The samples in protocols 2 through 5 were incubated for 30 minutes at 37 degrees C. For each protocol, spinnability by filancemeter and viscoelasticity (log G*) by magnetic microrheometer were measured at baseline and 30 minutes. Treatment of the sputum with rhDNase alone or NAL alone decreased spinnability more than control treatment with saline. Combining NAL with rhDNase at half the concentration of each drug significantly decreased spinnability more than either treatment by itself. There were no significant changes in log G* or the derivative parameters, mucociliary clearability index (MCI) and cough clearability index (CCI). The enhanced reduction in sputum spinnability by the combination of NAL and rhDNase indicates additative effects between these two mucolytic treatments. These results suggest that combined treatment with rhDNase and NAL should be considered as a potential therapy for CF patients.

Acetylcysteine↗
PubMed1996

Selecting valid in vitro biocompatibility tests that predict the in vivo healing response of synthetic vascular prostheses.

We have investigated the usefulness of six in vitro biocompatibility tests in predicting the healing performance of polyester vascular prostheses as observed in previous canine in vivo trials. Vascular grafts were evaluated by using (i) a direct contact (DC) assay, (ii) an extract dilution (ED) assay on murine fibroblast cells, (iii) a DC assay on endothelial cells, (iv) a complement activation study, (v) a leucocyte activation study of CD18 integrin subunit expression on human polymorphonuclear cells (PMNs) and (vi) interleukin-2 receptor expression on lymphocytes. Uncleaned polyester grafts had previously been associated with poor healing and gelatin-impregnated polyester grafts with delayed but satisfactory healing, whereas commercially cleaned polyester grafts had demonstrated excellent healing. Lightweight and heavyweight knitted and woven polyester grafts supplied specifically for this project were studied, each with a different surface condition, i.e. commercially available (CP), uncleaned (UP) and impregnated with gelatin (GP). The UP grafts induced fibroblast cytotoxicity according to the ED assay, poor migration and viability of endothelial cells, and an elevated expression of CD18 and interleukin-2 receptor on PMNs and lymphocytes, respectively. In contrast, the CP grafts promoted good endothelial cell growth, no evidence of cytotoxicity and a weaker cell activation, and the GP grafts were found to be non-cytotoxic, to exhibit a good cellular response and to moderate cell activation. The complement activation assay and the DC assay on fibroblasts were found to be less useful and less discriminating. From this, it is concluded that the two cell activation measurements, the DC assay on endothelial cells and ED assay on fibroblasts, are useful in predicting the in vivo healing response of arterial polyester substitutes.

Analysis of Variance↗
PubMed1996

Is general practitioner decision making associated with patient socio-economic status?

This paper presents a preliminary exploration into the relationship between decisions made by general practitioners (GPs) and the socio-economic status (SES) of patients. There is a large literature on the association between SES, health state and the use of health services, but relatively little has been published on the association between SES and decisions by clinicians once a patient is in the health system. The associations between GP decision making and the patient's SES, health status, gender and insurance status are examined using logit analysis. Three sets of binary choices are analysed: the decision to follow up; to prescribe; and to perform or to order a diagnostic test. Secondary data on consultations for a check up/examination were used to explore these relationships. The results suggest that SES is associated independently with the decision to test and the decision to prescribe but not with the decision to follow up. Patients of high SES are, ceteris paribus, more likely to be tested and less likely to receive a prescription compared with patients of low SES. Women are more likely to be tested and to receive a prescription than men. These findings have implications for the pursuit of equity as a goal of health services policy.

Adolescent↗
PubMed1996

Measuring diabetes-related attitudes: the use of a USA-developed instrument with Australian nurses.

The revised Diabetes Attitudes Scale (DAS) was completed by nearly 1000 nurses and nursing students in South Australia. Confirmatory factor analysis was used to compare the factor structure with that previously obtained in the USA with patients with diabetes. The instrument was found to be robust. It was concluded that only one item of the 50-item scale is unsuitable for inclusion in studies which aim to compare patient and health professional attitudes.

Attitude of Health Personnel↗
PubMed1996

Dieting in sixth grade predicts alcohol use in ninth grade.

Recent studies of community-based populations have shown that the comorbidity seen in clinical studies of individuals with eating disorders and substance abuse extends in a graded manner to subclinical levels of each dysfunction as well as to adolescent populations. We hypothesized that frequency of dieting in the sixth grade would predict later alcohol use in middle school students. Data from 1,905 participants in a middle school health promotion project were analyzed. We found a positive, graded relationship between the frequency of dieting in the sixth grade and the frequency of alcohol intake in the ninth grade. We also found that frequency of dieting in sixth grade was a more powerful predictor of future drinking than such parameters as others' approval of alcohol use, perceptions of peer use of alcohol, and personal feelings of shyness and self-satisfaction. Implications of these findings are discussed.

Adolescent↗
PubMed1996

Dermatofibrosarcoma protuberans treatment and reconstruction: a case study.

An ever-increasing number of cutaneous cancers are being excised using Mohs micrographic surgery. Mohs micrographic surgery may be the treatment of choice for facial and scalp dermatofibrosarcoma protuberans since this technique enhances reconstruction options and decreases the chance for recurrence of this uncommon tumor. With the development of tissue expansion techniques, the options for reconstructive closure of these scalp defects have increased. A coordinated effort between patient, family and the medical staff increases efficiency and overall treatment success. At one Midwestern hospital, this coordinated effort begins at the time of diagnosis and involves both the nurses and physicians in the dermatology and plastic surgery departments. The Mohs micrographic surgery is performed by the dermatologist and the reconstruction performed by the plastic surgeon.

Child↗
PubMed1996

Down syndrome with partial duplication and del (21) syndrome: study protocol and call for collaboration. Study I: Clinical assessment.

We report on the clinical and cytogenetic assessment of five cases of Down syndrome phenotype with either a partial duplication of chromosome 21 or a normal karyotype, and we quote a case of del (21q) syndrome. Down syndromes with a partial duplication of chromosome 21 (as well as cases of del (21q), which are partly the phenotypic countertype of trisomy 21) are of paramount importance in the understanding of genes involved in the phenotype of Down syndrome. The goal is to find the relevant genes implicated in the main traits of Down syndrome (i.e. mental retardation, Alzheimer disease, and serious visceral malformations). Such a goal, in our opinion, cannot be reached just by publishing the genotype and the phenotype of a small cohort of patients: 1. a sufficient number of accurate cases is needed, and 2. data have to be computerized for definite conclusions to be reached. The main aims of this report are to present our study protocol and to invite colleagues to participate in a collaborative study in order to collect a maximum of these (rare) cases.

Adolescent↗