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Biomedical subjects

T Harding

Publications and source records attributed to T Harding.

36 records · Page 2Linked to original sources
PubMed1991

Treatment of opiate withdrawal on entry to prison.

Forty-nine opiate-dependent persons entering remand prison were treated with methadone over 5-10 days in decreasing doses according to standard practice of the prison medical service. The prisoners were mainly young, unmarried men with an average of 5 years regular opiate use and an average of four previous imprisonments; 45% were known to be HIV infected, although routine testing was not carried out. Ten were on methadone maintenance prior to imprisonment. Urine analysis on entry detected an average of three psychoactive substances, principally opiates, benzodiazepines and cannabis. Prescribed starting doses of methadone were not correlated to independently assessed withdrawal severity. Starting doses were related to prisoners' requests and to their age. Withdrawal severity decreased after 4 days treatment but symptom relief was incomplete. Treating withdrawal symptoms on entry to prison poses unsolved ethical and practical problems.

Adult↗
PubMed1989

Evaluating the work of ethical review committees: an observation and a suggestion.

Eight research protocols which had previously been approved by Ethical Research Committees (ERCs) were reviewed in simulated review committees set up during a symposium on medical ethics. Only three protocols were considered to provide fully adequate information to allow ethical review and only one protocol was thought to provide sufficient guarantees on the ethical issues raised by the proposed research. For five other protocols additional safeguards were considered necessary, in particular covering the problem of informed consent. Two protocols were considered to raise unresolvable ethical issues. This artificial exercise does not establish that review by ERCs is ineffective. It does highlight the lack of objective criteria in ethical review. Peer review by exchange of protocols between ERCs could assist in increasing the consistency in the application of ethical standards.

Ethical Review↗
PubMed1989

Psychiatric symptoms, cognitive stress and vulnerability factors. A study in a remand prison.

In a consecutive sample of 208 male prisoners interviewed on the tenth day (T1) after entry, high levels of psychiatric symptoms as measured by the GHQ were recorded. These GHQ scores were strongly correlated with perceived worries and concerns of the prisoners ('cognitive stress'). After 60 days of detention (T2), a significant fall in GHQ scores was observed, and they were still correlated with cognitive stress. A significant negative correlation between cognitive stress at T1 and GHQ scores at T2 was observed. The relationship between potential vulnerability factors (life experiences, social network, personality factors) and GHQ scores was not strong at either T1 or T2. Psychiatric symptoms are common during the early phase of imprisonment but are not durable.

Adjustment Disorders↗
PubMed1988

[The drug addict in prison: Medical response and its limitations].

Over the past twenty years, the proportion of drug dependent inmates has risen dramatically in the prisons of Western Europe. In the Geneva romand prison, where about 30% of entries present problems of opiate abuse and dependence, treatment of withdrawal symptoms with decreasing doses of methadone over a period of 5-10 days has been available since 1974. The rational of this treatment policy is to limit immediately disabling symptoms during the stressful period following imprisonment, when the prisoner has to make important decisions concerning the criminal proceedings in which he is involved. On the other hand, methadone maintenance treatment is not provided within the prison, even for patients on methadone maintenance programs prior to imprisonment. This paper traces the evolution of withdrawal treatments with methadone over the period 1974-1987 in relation to the total number of entries, the age and sex distribution. During the three year period 1985-1987, we found that 6% of prisoners had received at least one course of withdrawal treatment. Many drug dependent individuals have repeated arrests: we found that 27% of those receiving withdrawal treatment in a three year period had more than one treatment. The frequency of suicidal gestures (including wrist slashing) and suicide was not greater during the withdrawal phase than at other times. A number of therapeutic approaches to opiate withdrawal now exist. No method seems clearly to be the treatment of choice within the prison environment. Arrest and imprisonment imply enforced withdrawal in a context of conflict and stress without the possibility of close medical supervision or psychological support.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1984

The reliability of dangerousness assessments. A decision making exercise.

One hundred and ninety three raters drawn from six countries and representing different professional groups considered 16 case histories. Raters were asked to indicate what degree of 'dangerousness' they attributed to each individual and what they considered to be the optimal management. The level of agreement between raters concerning the assessment of dangerousness was generally low, the level of 60 per cent being reached for only 4 cases out of 16. Psychiatrists did not reach a higher level of agreement on the ratings of dangerousness than non-psychiatrists. Psychiatrists had a tendency to rate individuals as more dangerous than did non-psychiatrists. The results of this exercise do not support the use of 'dangerousness' as a scientifically or operationally valid concept.

Dangerous Behavior↗
PubMed1982

A microcomputer system for prescription, calculation, verification and recording of radiotherapy treatments.

The design of a microcomputer system for the reduction of mistakes in radiotherapy is described. The system covers prescription entry, prescription and treatment calculations, and verification and recording of the treatment set-up. A telecobalt unit was interfaced to the system and in the first 12 months 400 patients have been prescribed and 5000 treatment fields verified. The prescription is entered by the medical officer using an interactive program and this prescription provides the reference for verifying the treatment set-up. The program allows amendments to the prescription to be made easily during the treatment course. The treatment parameters verified are field size, wedge and treatment time. The system uses bar-codes for patient and field identification. A reduction in the number of mistakes has been achieved and future developments are discussed.

Computers↗
PubMedDate not supplied

PRESC: an interactive program for radiation therapy prescriptions.

An interactive program for prescribing radiotherapy treatments has been developed with the aim of improving radiation dose accuracy by preventing mistakes in quantitative data handling and calculations. The program also aims to decrease the time required to prescribe treatments and check the calculations. The interactive dialogue closely follows present, manual methods of prescription. The program provides a comprehensive choice of treatment options which either individually or in combination cover all the treatments carried out on the Cobalt units for which the program was designed. Each of the treatment options has been highly optimized to reduce the amount of data entered and for ease of use. The program allows changes to the prescription at time of entry and during the treatment course. The treatment sheet and patient record resulting from the interactive dialogue are discussed and compared with the existing system. The modular program structure is described and some of the results from use of the program are discussed. Possible future improvements are outlined.

Computers↗