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V Wright

Publications and source records attributed to V Wright.

At least 91 records · Page 5Linked to original sources
PubMed1991

Valuing and rewarding employees in the changed health service.

Last November, at the IHSM conference on human resources, Vicky Wright spoke on valuing and rewarding people. Here, with David Patterson and Helen Murlis, she amplifies her argument. In a changing service pay policy must change, but change is not without risk and will not in itself revolutionise human resource management.

Employee Incentive Plans↗
PubMed1990

The arthritis impact measurement scales: an anglicized version to assess the outcome of British patients with rheumatoid arthritis.

The Arthritis Impact Measurement Scales (AIMS) is an American questionnaire designed to measure the health status of patients with arthritis. Its suitability for use with British patients with rheumatoid arthritis (RA) has been tested. A study on 30 patients high-lighted the need to anglicize the terminology and spelling. A further 30 patients found the modified questionnaire easier to complete than the original. The concurrent validity of this modified AIMS was then tested on 59 patients by comparison with two widely accepted standards. Physical function and pain scales were tested against the Stanford Health Assessment Questionnaire (HAQ). Because the HAQ has no psychological component, psychological status was compared with the Hospital Anxiety and Depression Scale (HAD). Results showed a good correlation between the scales and it is concluded that the modified version of the AIMS may be used with confidence in British patients with RA.

Adult↗
PubMed1990

What do patients and rheumatologists regard as an 'acceptable' risk in the treatment of rheumatic disease?

A questionnaire designed to ascertain the risk of adverse effects which patients with rheumatic conditions would accept for a particular therapeutic outcome was administered to 50 patients. The same questionnaire together with 'potted' histories of five of the patients was sent to 10 consultant rheumatologists. The willingness of both patients and doctors to risk side-effects varied with both the severity of the side-effect and the potential therapeutic benefit. Doctors were more willing than patients to risk death or serious disability (Wilcoxon, P less than 0.01) for a particular expected benefit. Doctors were also more willing to risk side-effects in treating seropositive rheumatoid arthritis than in treating non-articular rheumatism. No correlation was seen for patients between acceptable risk and diagnosis, pain or smoking habits. The risks which both groups stated they were willing to accept were less than those apparently associated with antirheumatic therapy. The results disagreed markedly with those of a previous study, demonstrating the importance of the methods used in this type of work.

Attitude of Health Personnel↗
PubMed1990

Patients' perceptions of staff in a department of rheumatology.

Three groups of 44 rheumatic patients were studied in a Regional Rheumatology Centre, and two out-patient clinics (one conducted by a consultant, the other by a nurse practitioner). A questionnaire determined their perceptions of staff members, their spouses, and the patients with whom they had most contact. In the usual in- and out-patient setting, patients preferred to be told about their condition by the consultant. In the clinic where they saw a nurse practitioner regularly, over half preferred to be told by her. The patients found it easier to discuss their condition with a nurse (particularly of a lower rank than a sister). Much came from spouses and other patients. The consultant and sister had important roles in reassuring the patients, but doctors were not successful in making patients feel useful and needed. Nurses were somewhat better--but not that good (30%). This was a vital role for the spouse, who nevertheless in hospital produced much anxiety, closely followed by visitors, other patients and doctors. Nurses and occupational therapists were very calming and relaxing people.

Humans↗
PubMed1990

Post-traumatic osteoarthritis--a medico-legal minefield.

A consensus view has been obtained from 108 colleagues about four major questions relating to post-traumatic osteoarthritis (OA) posed by a retired judge. In determining the likelihood of OA developing after a fracture, several factors must be taken into account. These include whether the fracture goes through the joint, the resulting angular deformity, the degree of soft tissue damage, the ensuing laxity of the joint, the presence of generalized OA, the involvement of nearby blood vessels supplying the bones of the joint and possibly the degree of immobilization. Lower limb joints are more likely to develop arthritis after injury than arm joints as they carry more load (although it would be wrong to think that arm joints were not load bearing). Occupation is a further factor. Age is thought to be important, with the elderly more at risk immediately, but the younger having longer in which to develop the disease. Younger people are less likely to develop post-traumatic OA, unless there is involvement of the epiphysis or residual angular deformity. Whilst in animals and in some fractures, degenerative changes begin immediately after damage to the joint, in most adults they take at least 2 years. The span is 2-5 years in more severe cases, including fractures of the joint line with a step in the surface, and associated dislocation. Otherwise it may take 10 years. Most of these data are anecdotal or obtained from retrospective surveys. There is great need for prospective work in this field.

Aging↗
PubMed1990

A double-blind crossover study to compare lysine acetyl salicylate (Aspergesic) with ibuprofen in the treatment of rheumatoid arthritis.

Lysine acetyl salicylate [1.8 g t.d.s. (Aspergesic 1,000 sachet)] has been compared to 400-mg ibuprofen tablets t.d.s. in a randomized double-blind trial in patients with rheumatoid arthritis using double-dummy technique. Both drugs proved effective in relieving symptoms. Three patients experienced drug-related side-effects with Aspergesic, and one patient with ibuprofen, that necessitated early discontinuation of treatment. Aspergesic was associated with a greater number of haemoglobin values falling below the normal range than ibuprofen. At the end of the study, eight out of 10 patients who expressed a preference selected Aspergesic for improving mobility whilst 15/24 selected Aspergesic for improving pain.

Adult↗
PubMed1990

Patterns of out-patients non-steroidal anti-inflammatory drug prescribing in two teaching hospital rheumatology units--implications for post-marketing surveillance.

Patterns of prescriptions or recommendations for non-steroidal anti-inflammatory drugs (NSAIDs) were examined in the out-patient departments of two teaching hospital rheumatology units [The General Infirmary, Leeds (n = 140), and Musgrave Park Hospital, Belfast (n = 77)]. In both units four drugs accounted for over 80% of prescriptions/recommendations (diclofenac, indomethacin, ibuprofen and naproxen in Leeds and flurbiprofen, nabumetone, ibuprofen and diclofenac in Belfast). In Leeds patients with pre-existing upper gastrointestinal problems were more likely to receive diclofenac whereas in Belfast they were more likely to receive nabumetone or ibuprofen. In Leeds, patients who received indomethacin tended to be young males with seronegative arthritis. These differences between drugs and between centres could have important implications for cost, design and interpretation of studies of post-marketing surveillance.

Adolescent↗
PubMed1990

Introduction to rheumatic disease.

Rheumatic diseases are very common. They comprise one of the commonest causes of consultation by patients with general practitioners and hospital specialists. There are considerable financial implications for the community, as well as morbidity for the patient. Inflammatory and non-inflammatory categories are the major subdivisions of this group of over 200 diseases. They involve the joints, the bones, the muscles and connective tissue throughout the body.

Female↗
PubMed1990

A comparison of choline magnesium trisalicylate and acetylsalicylic acid in patients with rheumatoid arthritis.

Choline magnesium trisalicylate (3.0 g/day) and enteric-coated acetylsalicylic acid (3.0 g/day) have been compared in a double-blind, crossover study on 19 patients with rheumatoid arthritis using the double-dummy technique. Patients were allocated to receive 3-weeks' treatment with each trial drug in random sequence and were assessed at Weeks-1, 0, 3 and 6. Apart from an unexplained significant improvement in grip strength (p less than 0.01) that occurred in patients on choline magnesium trisalicylate when this followed aspirin but not when it preceded it, there was no significant clinical difference between treatments in any of the clinical parameters of improvement that were measured. There was also no clear difference in the side-effects profile produced by the two drugs, but the number of patients recruited to this study was small.

Adolescent↗
PubMed1990

A clinical and biochemical assessment of a nonthiol ACE inhibitor (pentopril; CGS-13945) in active rheumatoid arthritis.

Captopril, which is a thiol containing angiotensin converting enzyme (ACE) inhibitor that has a close structural similarity to D-penicillamine, behaves as a disease modifying antirheumatic drug (DMARD) in rheumatoid arthritis (RA). In order to ascertain whether the DMARD-like properties of captopril reside in its ability to inhibit ACE or in the thiol group, we evaluated pentopril (CGS-13945) in patients with active RA. This recently synthesized drug is a nonthiol containing ACE inhibitor. Pentopril produced little clinical improvement and no biochemical improvement in a group of 15 patients with RA, many of whom were unable to tolerate it because of in-effect or side effects. A reduction in serum ACE activity and a modest fall in blood pressure suggested that the drug was exerting its pharmacological effect. Our study strengthens the argument that the therapeutic benefit of captopril in RA probably lies in its thiol group rather than in its enzyme inhibition properties, and that the thiol group may be the effective moiety in some other DMARD.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1989

Osteoarthritis.

Explore the source record for details and available documents.

Aged↗
PubMed1989

The evaluation of a nonsteroidal anti-inflammatory drug (tenoxicam) in the treatment of sleep disturbance in osteoarthritic patients.

The effects of a nocturnal nonsteroidal anti-inflammatory drug (tenoxicam) on twelve male osteoarthritic patients were investigated in a randomised, double-blind, placebo-controlled, cross-over study. Tenoxicam produced no significant changes in any of the areas evaluated which included electroencephalographic (EEG) sleep, subjective sleep, pain and early morning stiffness. The selection of patients may have contributed to this unexpected result. There was no evidence to suggest that tenoxicam caused any unwanted side-effects or affected early morning psychomotor performance. The use of the sleep EEG as an objective pain measure is discussed.

Aged↗
PubMed1989

Seronegative arthritis and the bowel.

In this chapter we have outlined the seronegative spondarthritides associated with bowel disease, excluding those discussed in separate chapters. Although, traditionally, Crohn's disease and ulcerative colitis have been dealt with separately in any discussion of seronegative arthritides, they have been discussed together here for the following reasons. Despite being pathologically distinct they show remarkable similarity in extraintestinal manifestations including any associated arthritis. Any observed differences in prevalence rates of arthritis may be secondary to the relative difficulty in diagnosing Crohn's disease, and most of the important prevalence studies were done before the more sophisticated techniques to investigate the bowel became available. This may in part explain the dramatic increase in the world-wide incidence of Crohn's disease seen in the last 30 years, particularly through the 1970s, but which has fallen off recently (Miller et al, 1974). It would seem that the body has a limited means of expressing disease processes. The final common pathway of a number of quite distinct disease entities is the concept of the seronegative spondarthritides. Exactly how the microbiological, immunogenetic and molecular factors interact to produce a particular disease end-point is currently not clearly defined, but with the increasingly sophisticated means to investigate the body at a cellular level the explanations may soon be at hand. Further controlled family studies are also needed to define the genetic relationships more precisely. We may then be able to piece the jigsaw puzzle together.

Arthritis↗