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Biomedical subjects

R Kemp

Publications and source records attributed to R Kemp.

At least 37 records · Page 2Linked to original sources
PubMed1996

Compliance therapy in psychotic patients: randomised controlled trial.

OBJECTIVE: To determine whether compliance therapy, a cognitive-behavioural intervention, could improve compliance with treatment and hence social adjustment in acutely psychotic inpatients, and if so, whether the effect persisted six months later. DESIGN: Randomised controlled trial of compliance therapy and non-specific counselling, each comprising 4-6 sessions lasting 10-60 minutes. SETTING: Acute psychiatric admissions ward serving an inner London catchment area. SUBJECTS: 47 patients with psychosis. MAIN OUTCOME MEASURES: Informant and observer reported measure of compliance; observer assessed global functioning after intervention and three and six months later; self-rated attitudes to drug treatment after the intervention and one month later; symptom scores after intervention and six months later. RESULTS: 25 patients received compliance therapy and showed significantly greater improvements in their attitudes to drug treatment and in their insight into illness and compliance with treatment compared with the control group. These gains persisted for six months. The intervention group was 5.2 times more likely than the control group to reach a criterion level of compliance (95% confidence interval 1.5 to 18.3). Global functioning showed a tendency to improve more in the intervention group after a delay (odds ratio 3.0 (0.8 to 11.5) to reach the criterion level at six months). Four subjects given compliance therapy and six in the control group were readmitted during follow up (odds ratio 2.0 (0.48 to 8.2)). CONCLUSIONS: Compliance therapy is a pragmatic method for improving compliance with drug treatment in psychotic inpatients and its gains persist for at least six months. Overall functioning may also be enhanced.

Acute Disease↗
PubMed1996

Perception and recognition of normal and negative faces: the role of shape from shading and pigmentation cues.

A face is surprisingly difficult to recognise when presented in photographic negative, and negation has also been shown to affect simple perceptual judgments about a face. Two possible explanations for this effect are examined. In the shape-from-shading explanation it is argued that negating an image results in an impossible pattern of shading, and that this disrupts the formation of a three-dimensional representation of the surface geometry of the face. In an alternative account for this effect it is suggested that identification errors occur as a consequence of changes to the apparent pigmentation of the face caused by negating the image. Three experiments are reported which are designed to test these explanations by using novel colour-image transformations in which the hue and luminance components of images are independently manipulated. The results of these studies suggest that although changes to the apparent pigmentation of a face might result in identification errors in some situations, the loss of shape-from-shading cues is a more important cause of the negation effect. The role of these two sources of information in the recognition of normal faces is also discussed.

Face↗
PubMed1996

Australia's 'free-ride' in pharmaceuticals: can it last?

The pharmaceutical subsidy scheme in Australia works in the public interest by keeping prices low while assuring access to drugs across most of the drug classes. By separating the approval to market drugs from the decision to subsidise them, the Commonwealth is able to take advantage of its position--to 'free-ride' on research and development expenditure in other countries. The first part of this paper examines the factors which allow Australia to free-ride. The second part explores some international and domestic factors which may influence the sustainability of the free-riding strategy.

Australia↗
PubMed1996

Psychological predictors of insight and compliance in psychotic patients.

BACKGROUND: A possible neuropsychological basis for poor insight in psychosis has been proposed. Consistent supporting evidence for this is lacking. METHOD: Seventy-four consecutive acutely psychotic in-patients who were recruited for a randomised controlled trial of compliance therapy were given a battery of neuropsychological tests, along with a comprehensive clinical assessment, before and after the intervention. RESULTS: Performance on neuropsychological tests improved during the patients' admission and treatment in hospital, as did symptoms and levels of insight. Cognitive function showed no relationship to insight and compliance initially, and very little after the intervention. Factors related to insight and compliance prior to discharge included: diagnosis, attitudes to medication, side-effects, being a detained patient, and whether or not compliance therapy was given. CONCLUSIONS: Clinical variables and attitudes to treatment appear to be more relevant to compliance and the development of insight in acute psychosis than neuropsychological impairment.

Adolescent↗
PubMed1995

A case study of female genital self-mutilation in schizophrenia.

A case of deliberate genital self-mutilation in a woman with familial schizophrenia is presented. Such behaviour, though well recognized in females with severe personality disorders, is extremely rare in female psychotics. The genital mutilation may be partially understood as a consequence of delusionally motivated action against a background of low self-esteem, premorbid body-image preoccupation, forced early sexual activity and hence profound ambivalence towards adult sexuality. Dealing with this constructively was hampered by a cognitive style characterized by impaired reasoning and reality testing. Tests of reasoning, judgement and reality testing showed deficits, and computed tomography revealed dilatation of the left frontal ventricular system. Both neuropsychological and psychodynamic factors appeared to be of relevance in this case.

Adult↗
PubMed1993

Direct observation of driving, self reports of driver behaviour, and accident involvement.

Forty-eight drivers answered a set of written questions about their driving style and drove a pre-defined, mixed urban and motorway route under observation. For 20 drivers there was a second observer in the car to check on inter-observer reliability. Relationships were examined between self-reports of driver behaviour and observers' reports, and between both of these and the number of accidents in which the drivers had been involved in the past three years. The results indicated that there was good inter-observer agreement on a number of important variables including speed, calmness, and attentiveness. Inter-observer reliability for other variables was less good; among these were preferred distance to car in front, use of indicators, and aggressiveness. Observers also showed good agreement on overall ratings of driver skill and safety. Observed speed on the motorway correlated well with drivers' self reports of normal driving speed. Observer ratings of calmness correlated significantly with self-reports of calmness. Also observer ratings of attentiveness and carefulness correlated significantly with self-reports of deviant driving behaviour. Observed speed on the motorway showed a clear positive correlation with self-reported accident involvement. The results indicate that self-reports of certain aspects of driver behaviour can be used as surrogates for observational measures, thus providing a convenient extension to the researcher's methodological armoury. One such aspect is speed which appears to play an important role in accident involvement.

Accidents, Traffic↗
PubMed1993

Effect of low and moderate doses of alcohol on driving hazard perception latency and driving speed.

Both driving speed and speed of detection of potentially hazardous events while driving have been found to correlate positively with accident rates across individuals. Alcohol ingestion is also known to increase risk of a traffic accident. This paper reports two double-blind, placebo-controlled studies: one on the effect of alcohol on driving speed and the other on the effect of alcohol on time taken to detect potential traffic hazards. Moderate drinkers aged between 30 and 55 took part. Each subject underwent three experimental conditions on separate days: no alcohol, low alcohol (0.025% BAC) and moderate alcohol (0.05% BAC). The order of conditions was counterbalanced. The moderate alcohol dose increased mean time taken to respond to hazards (2.5 s in no alcohol condition compared with 3.2 s in moderate alcohol condition) but did not affect mean driving speed (indexed by time taken to travel sections of a fixed route; 19.3 s in no alcohol compared with 19.0 s in moderate alcohol). The results support the view that at least part of the excess risk of accident associated with alcohol ingestion is attributable to an increase in the time taken to respond to traffic hazards.

Adult↗
PubMed1993

Osteomyelitis due to Mycobacterium haemophilum in a patient with AIDS.

A case of osteomyelitis resulting from infection with Mycobacterium haemophilum in a patient with the Acquired Immunodeficiency Syndrome (AIDS) and Hodgkin's disease is described. The clinical features and response to therapy are examined and compared to previous reported cases. Mycobacterium haemophilum infection in immunocompromised patients usually results in cutaneous lesions but osteomyelitis may be the presenting feature. Tissue samples should be obtained early for microbiological examination and treatment should consist of surgical debridement and appropriate antimicrobial therapy.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Preparation and characterization of basolateral plasma-membrane vesicles from sheep parotid glands. Mechanisms of phosphate and D-glucose transport.

A procedure is described for the preparation of basolateral membrane vesicles from the acinar cells of the sheep parotid gland. The ouabain-sensitive K(+)-activated phosphatase activity was enriched 30-fold over the tissue homogenate; 45% of this activity was recovered in the final membrane fraction. The presence of membranes from other organelles was negligible. Evidence is presented for the location of Na(+)-dependent symporters for phosphate and D-glucose on the basolateral membrane.

Animals↗
PubMed1990

Sensitivity to the displacement of facial features in negative and inverted images.

Subjects have previously been reported to show difficulties in recognising faces which are either inverted or in photographic negative. Experiments are reported in which a two-alternative forced-choice technique was used to measure sensitivity for distinguishing faces which have been modified by having the eyes moved vertically or horizontally. Subjects were less sensitive to such changes for inverted faces or negative faces, and were even less sensitive for faces that were both inverted and negative. No such effects were found for a control stimulus consisting simply of three solid circles in the same positions as the eyes and mouth of a face. When the stimuli consisted of eyes, nose, and mouth, but without a surround, no evidence of inversion or negation effects was found, which suggests that a facial surround is necessary. When the stimulus consisted of a facial surround with the eyes, nose, and mouth replaced by solid circles, effects of negation were found, but no effects of inversion. This dissociation of the effects of negation and inversion may suggest that they are the result of different underlying mechanisms.

Adult↗
PubMed1988

Brucellosis complicated by aortic valve endocarditis.

A 30 year old veterinary surgeon developed a febrile illness with serological evidence of Brucellosis. He was known to have aortic valve disease and during the course of the illness, the clinical features of endocarditis became evident, with a vegetation visible echocardiographically on the aortic valve. Because of persisting fever despite appropriate antibiotic therapy, aortic valve replacement with a viable cryopreserved allograft aortic valve was undertaken. Organisms consistent with Brucella species were demonstrated in the excised vegetation. The patient received a six week course of antibiotics and his post-operative course was uneventful.

Adult↗