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Biomedical subjects

R Power

Publications and source records attributed to R Power.

At least 55 records · Page 3Linked to original sources
PubMed1993

Prehospital resuscitation by Irish GP's: a preliminary report.

Two hundred and eleven Irish GP's responded to a questionnaire survey of their experiences of prehospital resuscitation. Seventy per cent had attempted CPR in a prehospital setting and a success rate of 21% was reported. A defibrillator had been used in the prehospital setting by 10% of the respondents with a reported success rate of 11%. Over 80% considered that they would benefit from further training in CPR and the use of a defibrillator. The implications of these results for the development of an Irish cardiac "chain of survival" are discussed.

Cardiopulmonary Resuscitation↗
PubMed1992

Pre-hospital management of acute myocardial infarction.

Two-hundred and eleven Irish GPs responded to a questionnaire survey of their experience and management of acute myocardial infarction (MI) and their attitudes to the use of thrombolytic therapy Three-quarters of the respondents felt they dealt with three or more MIs per year; most felt that the majority of MIs were initially seen by a GP. Diagnosis is based on clinical findings; only 11% routinely take an ECG. Management is largely oriented to relief of pain but intravenous narcotics are only used by a minority. Hospital referral for suspected acute MI was the preferred choice for almost all GPs in a variety of patient-care scenarios. Home care for MI was chosen only for a minority of elderly patients when some hours had elapsed since the onset of symptoms. Definitive guidelines on the pre-hospital use of thrombolysis are not yet available. However, eighty per cent of respondents in this study feel that thrombolysis is beneficial and many feel that it has value in the pre-hospital situation. Respondents identified educational, organisational and financial problems to be overcome before this could happen.

Adult↗
PubMed1992

A computerized information system for monitoring and evaluating substance misuse services.

A computerized, comprehensive information system for the managerial monitoring and evaluation of local substance misuse service delivery is presented. It is based on a model which comprises basic elements of service provision such as, client caseload, time management and workload, work and client satisfaction, in both quantitative and qualitative terms. Findings from its initial implementation in a community drug team and drug dependency units in one of the London District Health Authorities are discussed. The possibility of using this evaluation package by drug and alcohol agencies themselves for the purpose of self-evaluation and monitoring as well as quality assurance is also discussed.

Journal Article↗
PubMed1992

Assessing AIDS prevention for injecting drug users; some methodological considerations.

There is an urgent need to develop strategies aimed at reducing the spread of HIV infection amongst injecting drug users. It is essential that any such initiatives are monitored and evaluated. It is the contention of this paper that evaluation should be rigorous, flexible and comparative. To achieve this we need to examine the basic principles of evaluation, both in terms of service delivery and process evaluation, as well as outcome measures. In the evaluation task it is important to distinguish clearly and unequivocally between implementation and impact, aims and objectives. At the practical level, researchers need to give due consideration to liaison with agency staff. Methodologically, issues such as demonstrating impact and rival explanations must be addressed. The paper concludes by proposing and illustrating a model for evaluation that has particular relevance to community-base initiatives aimed at reducing the spread of HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1992

The role of significant life events in discriminating help-seeking among illicit drug users.

This paper examines the role of significant life events in distinguishing two samples of illicit drug users: 120 help-seekers (the "agency group") and 120 not seeking help (the "non-agency group"). We examined 10 life areas clustered around the general categories of "substance use," "social functioning," and "emotional and interpersonal functioning." A range of objective and self-reported information was collected regarding each life area covering the 12 months prior to interview. Analysis revealed that the agency group experienced a greater number of negatively perceived drug-related life events than the non-agency group. These life events were also more likely to have occurred in recent months, prompting reported "concern" and "need for help" among the agency group. Additionally, length of use of current primary drug was seen to be a contributory variable in distinguishing between the groups.

Adult↗
PubMed1992

Help-seeking among illicit drug users: some differences between a treatment and nontreatment sample.

A number of both medical and nonmedical disciplines have expressed concern regarding the large numbers of individuals that fail to present to services, despite experiencing problems similar to those of active help-seekers. Such a concern is most pertinent in the field of substance misuse, particularly in terms of the role of injecting drug users in the spread of HIV and AIDS. This study looked at two samples of problem drug takers in London: 120 seeking help (the "agency group") and 120 not seeking help (the "non-agency group"). A number of factors were examined to distinguish the two groups, including sociodemographic profiles, drug histories, and self-reported "concern" and "need for help" in a wide variety of life areas. Data analysis highlighted the significance of "concern" and "need for help" in specified life areas.

Adaptation, Psychological↗
PubMed1992

Awareness of heart attack signals and cardiac risk markers amongst the general public in Dublin.

Following myocardial infarction, early access to medical care is essential. In order to assess the ability to recognise and manage heart attack and its risk factors, 302 members of the public were surveyed. A surprisingly comprehensive knowledge base was revealed, together with apparently appropriate ideas about the management of myocardial infarction and its risk factors. The significance of this finding is discussed in the light of the well documented delays by members of the public in summoning help when they suspect heart attack.

Adult↗
PubMed1991

Towards a process evaluation model for community-based initiatives aimed at preventing the spread of HIV amongst injecting drug users.

An action research model is presented for the evaluation of community-based interventions. The short- and long-term application of this model is illustrated by means of a study of a community drug team which was initiated to prevent the spread of HIV infection amongst substance misusers in south-west London. A client caseload of 155 was monitored over a year-long period and the results used to evaluate the extent to which the CDT had achieved its stated aims and objectives. Other tools used in the evaluation and monitoring were surveys of generic, specialist and general practitioner services, and needs assessment of samples of drug users. The potential of the model is explored, both in terms of its research role and in facilitating service development. The value of action research methodology in assessing HIV/AIDS prevention is stressed.

Adolescent↗
PubMed1990

Purification and characterization of acetylcoenzyme A: deacetylvindoline 4-O-acetyltransferase from Catharanthus roseus.

The enzyme acetylcoenzyme A:deacetylvindoline 4-O-acetyltransferase (EC 2.3.1.-) (DAT), which catalyzes the final step in vindoline biosynthesis in Catharanthus roseus, was purified 3300-fold using ammonium sulfate precipitation followed by gel filtration, anion exchange, hydroxyapatite, and affinity chromatographies. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) of the purified DAT showed the presence of two major proteins having Mr values of 33,000 and 21,000, whereas native PAGE showed three protein bands, and isoelectric focusing-PAGE one diffuse protein band (pI = 4.7-5.3) plus two minor protein bands (pI = 5.7 and 6.1). Purified DAT possessed Km values of 6.5 microM and 1.3 microM for acetylcoenzyme A and deacetylvindoline, respectively, and Vmax values of 12.6 pkat/microgram protein (acetylcoenzyme A) and 10.1 pkat/micrograms protein (deacetylvindoline). Inhibition of DAT by tabersonine, coenzyme A, and cations (K+, Mg2+, and Mn2+) was observed, while the pH optimum of this enzyme was determined to be 7.5 to 9.

Acetyl Coenzyme A↗
PubMed1990

Resuscitation skills among the general public in Dublin.

Evidence exists that many of the victims of cardiac arrest due to ischemic heart disease can be resuscitated if cardiopulmonary resuscitation (CPR) and defibrillation are made available in the minutes following collapse. In order to evaluate the ability of the general public in Dublin to perform CPR appropriately, 225 people were asked when CPR was indicated and how cardiac arrest was diagnosed and then asked to perform CPR on a mannequin. In the knowledge sections, 45% gave an appropriate indication for CPR and 34% gave appropriate criteria for diagnosing cardiac arrest. However, only eight participants were able to perform CPR correctly and only six (2.6%) had both the correct skills and knowledge. There is an urgent need to improve the public's knowledge of and ability to perform CPR as part of an overall strategy to decrease mortality from ischemic heart disease in Ireland.

Educational Status↗
PubMed1989

Participant observation and its place in the study of illicit drug abuse.

Participant observation has long been utilized as a valuable research methodology in the study of illicit drug abuse. It should not be viewed in isolation, but seen as an essential complement to the quantitative analysis of trends in drug use, such as epidemiological studies and the monitoring of services for drug users. Fieldwork conducted at the Drug Indicators Project and other relevant studies highlight the practical and ethical problems faced by the participant observer, including issues of access, co-operation and confidentiality. This is particularly pertinent when working with drug users not in contact with services. When working with drug users in a treatment context, the need to be flexible and sensitive to the needs of agency staff is stressed, and the ways in which participant observers can operate as volunteers are explored. Contemporary concern about HIV infection, AIDS, and risk behaviour amongst drug users, raises the potential for an expansion and redefinition of the role of the participant observer to take on some of the functions of health educator, and two options are suggested.

Humans↗
PubMed1989

In-patients' views of the helpful aspects of group psychotherapy: impact of therapeutic style and treatment setting.

Selected in-patients admitted to an acute psychiatric unit over a seven-month period were offered group psychotherapy which incorporated an interactional focus. At discharge group members were offered out-patient group therapy. Patients' perceptions of therapy were examined by means of a 'helpful event' questionnaire. The study supports previous findings but it is suggested that the interactional focus boosted the value ascribed by patients to vicarious learning. Psychological exploration became of more major importance in out-patient therapy.

Adaptation, Psychological↗
PubMed1988

Aspects of the relationship between cognitive theories and therapies of depression.

Cognitive theories of depression are examined with respect to the relationship between cognition and affect, the assumption that cognitions are accessible and open to modification, and the adequacy of cognitive accounts of the onset and maintenance of depression. The role of social and familial factors in maintaining depression and the extent to which negative cognitions may be based on accurate perceptions of the social milieu are considered. The relationship between cognitive therapy for depression and cognitive theories of depression is noted.

Affect↗
PubMed1983

Sweat tests to diagnose cystic fibrosis in adults.

Twenty five patients with cystic fibrosis and 25 controls were studied to define a sweat sodium concentration in adults that could be taken as diagnostic of cystic fibrosis. Some of the controls had a sweat sodium concentration of over 50 mmol(mEq)/l, and thus cystic fibrosis should be diagnosed in an adult only when two measurements of sweat sodium concentration are above 70 mmol/l. In cases in which the sweat sodium concentration was borderline a suppression test using fludrocortisone improved the accuracy of diagnosis; this test entails recording the lowest concentration reached after administration of the drug. A scatter diagram of the baseline sweat sodium concentrations plotted against the lowest concentration attained after suppression with fludrocortisone may aid the diagnosis further.

Adolescent↗