Search PubMed⌕ Search

Biomedical subjects

R Telford

Publications and source records attributed to R Telford.

17 recordsLinked to original sources
PubMed2002

Obstacles to effective treatment of depression: a general practice perspective.

BACKGROUND: The Clinical Standards Advisory Group (CSAG) was asked by UK health ministers to advise on the standards of clinical care attainable for people with depression. The GP survey reported here is one part of a multicomponent UK-wide study of services for depression that also included visits to a sample of services and structured patient telephone interviews. OBJECTIVES: The aim of this study was to survey GPs' perceptions of the availability and quality of primary and community-based services for people with depression, and to seek their views on barriers to the provision of good clinical services. METHODS: A structured postal questionnaire was sent to all GPs (3530) in the 11 geographical areas visited during the CSAG study. RESULTS: A total of 1703 (48%) GPs returned the questionnaire. The main obstacles to providing a good service for people with depression included not having enough time, a lack of services to refer to and difficulty in accessing services. More than half of the respondents (58%) were aware of guidelines for the management of depression, and 62% had attended a teaching session on depression within the last 3 years. Factors that influenced GPs to refer people with depression to other services were risk to the patient, a clear need for specialist treatment and the need for assessment. Overall, GPs appeared to be satisfied with the quality of specialist services. CONCLUSIONS: GPs appeared to view obstacles to providing effective treatment of depression as being more allied to external issues, in particular service provision, rather than internal factors such as their own knowledge and skills. The study revealed continuing concerns over excessive workload, and longstanding difficulties with the interface between primary and secondary mental health services.

Community Mental Health Services↗
PubMed1996

Lithium toxicity.

We report a case of severe lithium toxicity precipitated by a thiazide diuretic and compounded by an angiotensin converting enzyme inhibitor. There was severe vasodilatation refractory to noradrenaline.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1996

Psychological problems following minor head injury: a prospective study.

Fifty people admitted to hospital with a predominantly minor head injury were interviewed six months and three years later. As a group, they showed evidence of post-traumatic stress disorder consistent with the DSM-III-R (American Psychiatric Association, 1987) definition, and psychological distress as measured by the Impact of Event scale and the General Health Questionnaire. In addition, changes in self-concept were measured and a prominent theme emerged of the discontinuity in the participants' sense of self following the head injury. These changes showed a significant relationship with psychological symptoms. Occupational and social functioning of the participants is also reported. It is suggested that disturbance and change following minor head injury is common and can be chronic.

Adolescent↗
PubMed1982

Observations on the Object Learning Test of the Kendrick Battery for the Detection of Dementia.

This paper examines some shortcomings in the design and validation of the Object Learning Test of the Kendrick Battery. Certain issues which are important to ensure standardized administration of the test have not been considered, and the scoring procedures penalize some correct responses. Line drawings on the cards are occasionally ambiguous, and some of the repeat drawings are reproduced with unnecessary alterations. The parallel forms of the test are not matched for word frequency of the names of the objects. Questions are raised concerning the cut-off point for ascribing dementia and the statements of confidence in test diagnosis.

Dementia↗
PubMed1980

Echocardiographic assessment of cardiac chamber size and left ventricular function in aerobically trained athletes.

We compared the echocardiographic assessment of left ventricular function in 20 aerobically trained male athletes (VO2 max 61 ml/kg/min) with 20 control subjects of similar age and size (VO2 max 37 ml/kg/min). On average, the left ventricle was larger in athletes and the extent of myocardial contraction (fractional shortening) was reduced. In nine athletes, fractional shortening was less than our laboratory lower limit of normal (26%) and in four athletes the left ventricle was enlarged and fractional shortening was reduced. However, the peak rate of circumferential shortening was not reduced in athletes. We concluded that athletes have normal myocardial contractility but some have a reduced extent of myocardial contraction which could be mistaken for the effects of myocardial disease.

Adolescent↗
PubMed1978

A comparison of some physiological and psychological effects of Motival (fluphenazine and nortriptyline) and diazepam in normal subjects.

1 The effects in normal subjects of a single oral dose of Motival (one tablet, containing fluphenazine 0.5 mg and nortriptyline 10 mg) on the contingent negative variation (CNV), reaction time, heart rate, blood pressure and self-rating scales for alertness, anxiety, tension, detachment and depression were compared with those of diazepam (5 mg and 7.5 mg) and placebo or propranolol (60 mg). 2 After diazepam (5 mg: twelve subjects and 7.5 mg: seven subjects) there was a significant decrease in CNV magnitude while after Motival (twelve subjects) there was no significant alteration in CNV magnitude compared to placebo. 3 After diazepam (7.5 mg: seven subjects) there was also a fall in subjective ratings for alertness and tension; this fall was significantly greater than the changes after Motival which did not reduce subjective ratings for alterness or tension below "average" levels. Anxiety ratings did not differ significantly between the two drugs. Changes after propranolol were intermediate in all scales. 4 It is concluded that under these conditions diazepam caused central nervous system depression while Motival did not.

Blood Pressure↗
PubMed1978

Cognitive functions in manic-depressives: effects of lithium and physostigmine.

Cognitive functions were investigated in seven manic depressive patients while on lithium, after two weeks off lithium, and after a subcutaneous injection of physostigmine while on lithium. Test performance was unaffected by lithium, but after physostigmine the I.Q. score of a shortened version of the WAIS was significantly increased.

Bipolar Disorder↗
PubMed1973

Stimulant and depressant effects of cigarette smoking on brain activity in man.

Cigarette smoking was found to alter the E.E.G. negativity associated with attention: the 'contingent negative variation' was increased in some smokers and decreased in others. This finding is consistent with the known dual action of nicotine to stimulate or depress neural activity and suggests a means of investigating the effects of other centrally-acting drugs on the human brain.

Contingent Negative Variation↗
PubMed1972

The effects of cigarette smoking on the response to stress in a driving simulator.

1. Some behavioural and physiological responses of cigarette smokers and non-smokers exposed to varying degrees of stress in a driving simulator were compared.2. When the smokers were smoking a cigarette, some of their reaction times to light signals differed significantly from those of non-smokers, some being longer and some shorter. These differences disappeared when the smokers were not smoking.3. Of the physiological measurements, only heart rate differed significantly between smokers and non-smokers, being higher at all levels of stress in the smokers. There were no significant differences in blood pressure, calf blood flow and respiration rate between smokers and non-smokers.4. The results of the Cattell Sixteen Personality Factor Questionnaire showed that the smokers were significantly more extroverted and self-reliant than the non-smokers.5. The results are discussed in relation to the pharmacology of cigarette smoking. It is concluded that the differences in reaction times and heart rates between smokers and non-smokers were a consequence of cigarette smoking.

Adolescent↗