Biomedical subjects

Michael King

Publications and source records attributed to Michael King.

45 records · Page 3Linked to original sources

PubMed2003

An overview of attenuation and scatter correction of planar and SPECT data for dosimetry studies.

A number of factors impact the accuracy of activity quantitation in planar and single photon emission computed tomographic (SPECT) imaging. Two important such factors are attenuation and scattering in the medium containing the activity. The first removes photons which otherwise would have been included in the images, and the second adds events to the images from photons which would not have otherwise been imaged. A number of methods have been developed to compensate for these biases to activity quantitation. This review will briefly introduce planar quantitation which is commonly used for dosimetric purposes, and then present a slightly more detailed overview of SPECT quantitation which is arguably more accurate. It will conclude by cautioning users of commercial reconstruction software to validate it for quantitation before using it for dosimetric purposes.

Algorithms↗

PubMed2003

The impact of cancer on sexual function: a controlled study.

BACKGROUND: Little is known about sexual problems in patients with cancer. AIMS: To estimate 1) the prevalence and characteristics of sexual dysfunction in patients undergoing treatment for cancer, 2) how sexual dysfunction varies with stage of illness. METHOD: Cross-sectional study of outpatients with cancer attending palliative care and oncology services and matched patients without cancer attending general practice. Patients completed a questionnaire on sexual function designed in a feasibility study, the Derogatis subscale on sexual satisfaction, the GHQ12 and the EuroQol. RESULTS: Patients with all types of cancer are willing to talk about their sex lives and the impact of the disease on their sexual function. This impact was significant when compared to the comparison group of general practice attendees of the same age. Palliative care patients were affected more than other cancer patients. CONCLUSION: This work may lead to greater awareness among healthcare professionals that patients with all types of cancer may experience sexual difficulties. Addressing potential sexual problems during the course of disease may give patients confidence to discuss such issues as they occur, thus avoiding embarrassment or aggravation of the problems later in their illness.

Cross-Sectional Studies↗

PubMed2003

Mental health and quality of life of gay men and lesbians in England and Wales: controlled, cross-sectional study.

BACKGROUND: Little is known about the mental health of gay men and lesbians living in Europe. AIMS: To compare psychological status, quality of life and use of mental health services by lesbians and gay men with heterosexual people. METHOD: Cross-sectional study in England and Wales using 'snowball' sampling. RESULTS PARTICIPANTS: 656 gay men, 505 heterosexual men, 430 lesbians and 588 heterosexual women. Gay men were more likely than heterosexual men to score above threshold on the Clinical Interview Schedule, indicating greater levels of psychological distress (RR 1.24, 95% CI 1.07-1.43), as were lesbians compared with heterosexual women (RR 1.30, 95% CI 1.11-1.52). Gay men and lesbians were more likely than heterosexuals to have consulted a mental health professional in the past, deliberately harmed themselves and used recreational drugs. Lesbians were more likely to have experienced verbal and physical intimidation and to consume more alcohol than heterosexual women. CONCLUSIONS: Awareness of mental health issues for gay men and lesbians should become a standard part of training for mental health professionals, who need to be aware of the potential for substance misuse and self-harm in this group and of the discrimination experienced by many lesbians.

Adolescent↗

PubMed2003

Specialist treatment versus self-help for bulimia nervosa: a randomised controlled trial in general practice.

BACKGROUND: Little is known about general practice management of patients with eating disorders. AIM: To compare the effectiveness of a general practice-based, self-help approach to the treatment of bulimia nervosa with that of specialist outpatient treatment. DESIGN OF STUDY: A prospective, parallel group, randomised controlled trial. SETTING: General practices and specialist eating disorder clinics in London. METHOD: Patients were recruited from general practitioner (GP) referrals to specialist eating disorder clinics. Thirty-four patients were randomised to receive the self-help intervention in general practice and thirty-four were randomised to the clinic intervention. Patients randomised to the self-help arm of the trial worked through a manual based on cognitive behaviour principles, while keeping in contact with their GPs. Those randomised to receive specialist treatment were managed in the specialist clinic to which they had been referred. The main outcome measure was the Bulimic Investigatory Test Edinburgh score, assessed at baseline and at six and nine months. Secondary measures were eating pathology, depression, and social adjustment. RESULTS: A total of 74% and 80% of patients were followed up at six and nine months respectively. An intention-to-treat analysis revealed that, while bulimic symptoms declined in both groups over time, there was no significant difference in outcome between the two groups. CONCLUSION: The findings lend support to the idea that patients with bulimia nervosa can be treated in general practice and that this approach warrants further investigation.

Adult↗

PubMed2002

Spiritual beliefs may affect outcome of bereavement: prospective study.

OBJECTIVE: To explore the relation between spiritual beliefs and resolution of bereavement. DESIGN: Prospective cohort study of people about to be bereaved with follow up continuing for 14 months after the death. SETTING: A Marie Curie centre for specialist palliative care in London. PARTICIPANTS: 135 relatives and close friends of patients admitted to the centre with terminal illness. MAIN OUTCOME MEASURE: Core bereavement items, a standardised measure of grief, measured 1, 9, and 14 months after the patients' death. RESULTS: People reporting no spiritual belief had not resolved their grief by 14 months after the death. Participants with strong spiritual beliefs resolved their grief progressively over the same period. People with low levels of belief showed little change in the first nine months but thereafter resolved their grief. These differences approached significance in a repeated measures analysis of variance (F=2.42, P=0.058). Strength of spiritual belief remained an important predictor after the explanatory power of relevant confounding variables was controlled for. At 14 months the difference between the group with no beliefs and the combined low and high belief groups was 7.30 (95% confidence interval 0.86 to 13.73) points on the core bereavement items scale. Adjusting for confounders in the final model reduced this difference to 4.64 (1.04 to 10.32) points. CONCLUSION: People who profess stronger spiritual beliefs seem to resolve their grief more rapidly and completely after the death of a close person than do people with no spiritual beliefs.

Adaptation, Psychological↗

PubMed2002

Effectiveness of teaching general practitioners skills in brief cognitive behaviour therapy to treat patients with depression: randomised controlled trial.

OBJECTIVE: To assess the effectiveness of teaching general practitioners skills in brief cognitive behaviour therapy. DESIGN: Parallel group, cluster randomised, controlled trial of an educational package on cognitive behaviour therapy. SETTING: General practices in north London. PARTICIPANTS: 84 general practitioner principals and 272 patients attending their practices who scored above the threshold for psychological distress on the hospital anxiety and depression scale. INTERVENTION: A training package of four half days on brief cognitive behaviour therapy. MAIN OUTCOME MEASURES: Scores on the depression attitude questionnaire (general practitioners) and the Beck depression inventory (patients). RESULTS: Doctors' knowledge of depression and attitudes towards its treatment showed no major difference between intervention and control groups after 6 months. The training had no discernible impact on patients' outcomes. CONCLUSION: General practitioners may require more training and support than a basic educational package on brief cognitive behaviour therapy to acquire skills to help patients with depression.

Adolescent↗

PubMed2002

Sexual molestation of males: associations with psychological disturbance.

BACKGROUND: There are no epidemiological data in Europe on associations between sexual molestation in males and psychological disturbance. AIMS: To investigate whether sexual molestation in males is a significant predictor of psychological disturbance. METHOD: We recruited men attending general practice and genitourinary medicine services. Participants took part in a computerised interview about sexual molestation as children or adults. We ranked reported sexual experiences into three categories of decreasing severity. Each category was treated as an independent predictor in a multivariate analysis predicting different types of psychological disturbance. RESULTS: Men who reported child sexual abuse were more likely to report any type of psychological disturbance. Men who reported sexual molestation in adulthood were 1.7 (1.0-2.8) times more likely to have experienced a psychological disorder, but self-harm was the single most likely problem to occur (odds ratio=2.6, range=1.3-5.2). Men reporting 'consenting' sexual experiences when aged under 16 years also were more likely to report acts of self-harm (odds ratio=1.7, range=0-2.8). CONCLUSIONS: Sexual abuse as a child or adult is associated with later psychological problems. All forms of sexual molestation were predictive of deliberate self-harming behaviour in men.

Adolescent↗

PubMed2002

Advance directives for patients compulsorily admitted to hospital with serious mental illness. Randomised controlled trial.

BACKGROUND: An advance directive is a statement of a person's preferences for treatment, should he or she lose capacity to make treatment decisions in the future. AIMS: To evaluate whether use of advance directives by patients with mental illness leads to lower rates of compulsory readmission to hospital. METHOD: In a randomised controlled trial in two psychiatric services in inner London, 156 in-patients about to be discharged from compulsory treatment under the Mental Health Act were recruited. The trial compared usual psychiatric care with usual care plus the completion of an advance directive. The primary outcome was the rate of compulsory readmission. RESULTS: Fifteen patients (19%) in the intervention group and 16 (21%) in the control group were readmitted compulsorily within 1 year of discharge. There was no difference in the numbers of compulsory readmissions, numbers of patients readmitted voluntarily, days spent in hospital or satisfaction with psychiatric services. CONCLUSIONS: Users' advance instruction directives had little observable impact on the outcome of care at 12 months.

Adult↗

PubMed2001

Psychotherapists' approaches to gay and lesbian patients/clients: A qualitative study.

We used qualitative research methods to examine the core issues relating to the approaches of psychodynamic and psychoanalytic psychotherapists to gay and lesbian patients and clients. The paper begins with a review of the psychoanalytic approaches to gay and lesbian sexuality and continues with material of a clinical nature, providing information about the experience of lesbians and gay men in psychotherapy. It also explores the attitudes of therapists towards gay and lesbian sexuality by discussing a range of psychoanalytic theories and their application to clinical work with patients and clients.

Journal Article↗