Search PubMed⌕ Search

Biomedical subjects

T Burns

Publications and source records attributed to T Burns.

At least 73 records · Page 4Linked to original sources
PubMed1997

The primary care of patients with schizophrenia: a search for good practice.

The proportion of patients with schizophrenia who lose contact with the secondary services is between 25% and 40%. The general practitioner remains the health care professional most likely to be in contact with such patients. A consensus group of 14 members met on four occasions, reviewed the relevant literature, and developed good-practice guidelines in five areas: establishing a register and organizing regular reviews; comprehensive assessments; information and advice for patients and carers; indications for involving specialist services; and crisis management. The guidelines are presented and their supporting evidence summarized.

Consensus Statements as Topic↗
PubMed1997

Positive approaches to dementia care in the home.

Healthcare providers must select appropriate interventions for dementia patients as they assist families in the struggle to understand the changes in loved ones and to learn how to effectively manage the caregiving challenges. This Dementia Care Program prescribes appropriate strategies for the patient's remaining functional abilities as cognition declines. The interdisciplinary approach of nursing and occupational therapy allows for a careful assessment and the use of strategies designed to facilitate optimal function and prevent or reduce behavioral disturbances common in dementia patients. Use of the Allen Cognitive Levels provides a framework that permits more precise care plans and more successful interventions for both professionals and families who care for those with dementing disorders.

Alzheimer Disease↗
PubMed1996

Photodynamic effects of toluidine blue on human oral keratinocytes and fibroblasts and Streptococcus sanguis evaluated in vitro.

BACKGROUND AND OBJECTIVE: Some oral bacteria are susceptible to killing by red light after their sensitization with toluidine blue O (TBO). The photochemotherapy of periodontal disease in vivo would require a therapeutic window where bacteria could be killed without adjacent normal tissue damage. STUDY DESIGN/MATERIALS AND METHODS: The laser-induced effects of TBO on normal human gingival keratinocytes and fibroblasts have been studied in vitro. For the assessment of viability, the CellTiter 96TM AQueous Non-Radioactive Cell Proliferation Assay was used. RESULTS: TBO was cytotoxic at low concentrations (5.0 micrograms/ml). Sensitization of keratinocytes and fibroblasts with 2 and 5.0 micrograms/ml TBO, respectively, for 5 min and exposure to light from a 7.3 mW Helium/Neon (HeNe) laser for up to 2 min (0.876J) did not reduce cell viability. However, killing of Streptococcus sanguis was achieved following exposure to HeNe light for 75 sec (0.547J) in the presence of TBO at a concentration of 2.5 micrograms/ml. CONCLUSION: The development of a system for the lethal photosensitization of bacteria responsible for periodontal disease may be possible.

Dose-Response Relationship, Drug↗
PubMed1996

Mood, learned resourcefulness and perceptions of control in type 1 diabetes mellitus.

A cohort of 90 insulin-dependent diabetics was examined to explore the relationship between physiological measures of control, learned resourcefulness, and the patients' perceptions of their own and their doctor's control over the diabetes. The doctors' perceptions of control over diabetes were measured. The patient's perceptions of control over diabetes were also measured. The patient's perceptions of control are compared with their doctor's views about medical and patient responsibility for controlling the condition. Patients in this study, overall, have a low level of psychiatric morbidity, with only 7% depressed and with a lower anxiety level than those reported in other published studies. It was found that patients who view control of good outcomes to be in the hands of their doctors fare worse as far as physiological control is concerned. There was little congruence between the attitudes of doctor and patient pairs about responsibility for controlling the diabetes mellitus. The most important clinical implication of the study is that there appears to be a relationship between poor physiological control and a passive, dependent approach to the condition.

Adolescent↗
PubMed1996

Killing of Streptococcus sanguis in biofilms using a light-activated antimicrobial agent.

The aim of this study was to determine whether Streptococcus sanguis, when in a biofilm, could be killed using a light-activated antimicrobial agent. Biofilms were grown on hydroxyapatite, irradiated with up to 12.2 J of light from a gallium aluminium arsenide laser in the presence of aluminium disulphonated phthalocyanine (AlPcS2) and survivors enumerated. No significant decrease in the viable count was found when either the AlPcS2 or the laser light was used alone. There was a light dose related decrease in the viable counts of irradiated AlPcS2-treated biofilms. No viable streptococci were detectable following irradiation with 12.2 J of laser light.

Aluminum↗
PubMed1996

Immunological characterization of rice tungro spherical virus coat proteins and differentiation of isolates from the Philippines and India.

Rice tungro spherical virus (RTSV) has an RNA genome of more than 12 kb with various features which classify it as a plant picornavirus. The capsid comprises three coat protein (CP) species, CP1, CP2 and CP3, with predicted molecular masses of 22.5, 22.0 and 33 kDa, respectively, which are cleaved from a polyprotein. In order to obtain information on the properties of these proteins, each was expressed in E. coli, purified as a fusion to the maltose-binding protein and used for raising a polyclonal antiserum. CP1, CP2 and CP3 with the expected molecular masses were detected specifically in virus preparations. CP3 is probably the major antigenic determinant on the surface of RTSV particles, as was shown by ELISA, Western blotting and immunogold electron microscopy using antisera obtained against whole virus particles and to each CP separately. In some cases, especially in crude extracts, CP3 antiserum detected several other proteins (40-42 kDa), which could be products of CP3 post-translational modification. No serological differences were detected between the three CPs from isolates from the Philippines, Thailand, Malaysia and India. The CP3-related 40-42 kDa proteins of the Indian RTSV isolate have a slightly higher electrophoretic mobility (42-44 kDa) and a different response to cellulolytic enzyme preparations, which allows them to be differentiated from south-east Asian isolates.

Antibodies, Viral↗
PubMed1996

Mental health care systems and their characteristics: a proposal.

The last 30 years have seen a significant growth in health service evaluation literature in the field of mental health. Much of the best of this research has taken the form of random control trials of an experimental service against "standard' or generic care. Interpretation of these results has ben hampered by incomplete and inconsistent approaches to describing the experimental services, and often inadequate or completely non-existent characterization of the control service. In addition, the health care system in which the treatment programme is embedded is known to have important consequences for outcome. A proposal is advanced for a structured service description as a routine component for health services research reporting. Two worked examples are given, and a number of areas of ambiguity are highlighted.

Delivery of Health Care↗
PubMed1996

What do general practitioners and community mental health teams talk about? Descriptive analysis of liaison meetings in general practice.

BACKGROUND: Liaison meetings between psychiatrists and general practitioners are now well established. Much has been written about their purpose and structure but little about their content. AIM: A study aimed to describe the clinical focus of meetings between a community mental health team and general practitioners and the nature of the professionals' interactions. METHOD: Audiotapes of six consecutive monthly meetings between a community mental health team and general practitioners in two general practices were analysed. RESULTS: Attendance rates among professionals were over 70%. Over 90% of discussion time was focused on patient-centred clinical matters. Almost two thirds of interactions were focused on patients receiving ongoing joint care; few interactions were devoted to new referrals or to patients who had not been assessed. Psychotic patients, although accounting for 15% of referrals, occupied 54% of patient-centred discussion time. Most interactions consisted of reciprocal information exchange between members of the community mental health team and general practitioners. CONCLUSION: The high attendance rates indicate that both general practitioners and community mental health team members considered these meetings as high priority. The steady move towards management of severely ill psychiatric patients in the community rather than in hospital requires close collaboration between primary and secondary care teams. The meetings described in this paper appear to be a simple, manageable and sustainable response to this need.

Communication↗
PubMed1995

Randomised controlled trial of teaching general practitioners to carry out structured assessments of their long term mentally ill patients.

OBJECTIVE: To assess the impact of teaching general practitioners to carry out structured assessments of their long term mentally ill patients. DESIGN: Randomised controlled trial. SETTING: Sixteen group general practices in South Thames (west) region. SUBJECTS: 440 adults disabled by long term mental illness. INTERVENTIONS: Patients were identified by using practice data with help from local psychiatric and social services. In eight practices the practitioners were taught a structured assessment schedule to use with patients every six months for two years. MAIN OUTCOME MEASURES: Changes in drug treatments, referrals, consultation rates, and recording of preventive health data in the two years after intervention. RESULTS: Follow up data were available on 373 patients (84.7%). At least one structured assessment was recorded for 127 patients in the intervention group but only 29 had four assessments recorded. Participating practitioners considered the structured assessment to be time consuming and reported that it did not often lead directly to changes in treatment or referrals. Changes in treatment with neuroleptic drugs and referrals to community psychiatric nurses, however, were significantly more frequent in the intervention group (differences for intervention group minus control group adjusted for activity in two years before intervention were 14.3% (95% confidence interval 4.3% to 24.33%; P < 0.01) for neuroleptic drugs and 13.3% (2.0% to 24.6%; P < 0.05) for referrals). There were no significant differences in psychiatric admissions, use of the Mental Health Act, drug overdoses, prescriptions, referrals or admissions for physical problems, consultation rates, continuity of care, or recording of preventive data. CONCLUSIONS: Teaching general practitioners about the problems of long term mentally ill patients may increase their involvement in patients' psychiatric care. Regular structured assessments do not seem feasible in routine surgery appointments. More training for general practitioners and increased resources such as more nurse time may be necessary if improvements in care of long term mentally ill patients in general practice are to be generalised.

Adult↗
PubMed1995

Bacteria in supragingival plaque samples can be killed by low-power laser light in the presence of a photosensitizer.

The purpose of this study was to determine whether bacteria in supragingival plaque samples could be killed by low-power laser light in the presence of a suitable photosensitizer. Plaque samples were obtained from 10 volunteers, treated with either toluidine blue O (TBO) or aluminum disulphonated phthalocyanine (AlPcS2), and then exposed to light from a helium/neon (HeNe) or gallium aluminium arsenide (GaAs) laser respectively. Following irradiation, substantial reductions were achieved in the total anaerobic count as well as in the number of viable streptococci and actinomyces present in the samples. In the absence of laser light, the sensitizers themselves had little effect on the viability of the bacteria in the plaque samples. The HeNe/TBO combination appeared to be more effective than the GaAs/AlPcS2 combination, achieving log10 reductions of 2.95, 5.40 and 3.34 in the total anaerobic count, streptococci and actinomyces respectively with a light energy dose of 1.31 J. If effective in vivo, lethal photosensitization may be useful as a means of eliminating plaque bacteria from a carious lesion prior to its restoration.

Actinomyces↗
PubMed1995

Educational assessment of general practice experience for psychiatric trainees.

Eighteen psychiatric trainees spent 6 months each as general practice trainees. The educational impact of the experience was assessed by a self-assessment questionnaire, a semi-structured interview and a videotaped interview with a psychiatric patient. Each assessment was conducted at a baseline and after 12 months. A control group of 14 trainees was recruited from the same rotation. On the self-assessment questionnaire, the study registrars rated their abilities to solve general medical problems significantly improved compared to controls. They had also acquired greater understanding of the limitation of their knowledge and their legal responsibilities towards their patients. The semi-structured interview failed to distinguish between the two groups. Videotapes for rating at baseline and follow-up were available for only 17 of the trainees. Assessment of the tapes used the Maguire Scale and the Interview Behaviour Scale. Neither scale demonstrated any intervention effect. The interviews were all characterized by a preponderance of 'closed psychological' and 'checking-out' questions. It appears that psychiatric trainees' interviewing styles had not been influenced by the experience. This study suggests that psychiatric trainees gain greater confidence in their role as a doctor and greater understanding of the scope and nature of general practice by such an attachment. It is unclear whether or not supplementary interviewing skills had been acquired which were not utilized in the taped interview, which conforms very much to traditional psychiatric examination behaviour. Trainees were reassured that they had increased their knowledge without losing any of their specific professional skills.

Education, Medical, Continuing↗