112 research outputs found
THE MANAGEMENT OF GAS GANGRENE WITH HYPERBARIC OXYGEN THERAPY
No full text We are grateful to Dr Robert A. Goldstone of Paterson, New Jersey, for pointing out an error in the article by M. R. Colwill and R. H. Maudsley on "The Management of Gas Gangrene with Hyperbaric Oxygen Therapy" in this Journal of November 1968, 50-B, 732. On page 742, the second line should read "They recommend the use of/ow molecular weight dextran (dextran 40, Rheomacrodex) to prevent the sludging and thrombosis that also occur . . ." The correction is important because high molecular weight dextran (dextran 70, Macrodex) would not be expected to have the desired effect. </jats:p
THE MANAGEMENT OF GAS GANGRENE WITH HYPERBARIC OXYGEN THERAPY
No full text 1. The management of gas gangrene by hyperbaric oxygen is described. 2. The mode of action, administration and risks of hyperbaric oxygen are discussed. 3. A series of seventeen cases, with one death, is recorded from a hospital unit with a small chamber, using two atmospheres in pure oxygen. </jats:p
Research surveys and their evolution: Past, current and future uses in healthcare.
No full textResearch surveys are believed to have originated in antiquity with evidence of them being performed in ancient Egypt and Greece. In the past century, their use has grown significantly and they are now one of the most frequently employed research methods including in the field of healthcare. Modern validation techniques and processes have allowed researchers to broaden the scope of qualitative data they can gather through these surveys such as an individual's views on service quality to nationwide surveys that are undertaken regularly to follow healthcare trends. This article focuses on the evolution and current utility of research surveys, different methodologies employed in their creation, the advantages and disadvantages of different forms and their future use in healthcare research. We also review the role artificial intelligence and the importance of increased patient participation in the development of these surveys in order to obtain more accurate and clinically relevant data
Impact of gender identity in the inflammatory bowel disease population: an evidence review and practical steps for gastroenterologists
No full textThere has been greater societal awareness of differences in gender identity and sexual orientation in recent years. The rates of identifying as transgender or gender non-conforming (TGNC) are increasing and are known to be higher in the younger population and will therefore be over-represented in the inflammatory bowel disease (IBD) subpopulation. However, despite this there is very little in the literature with regards to those who identify as TGNC and are diagnosed with IBD (TGNC-IBD). Many TGNC individuals have poor experiences when seeking healthcare and many physicians find it a challenging and daunting clinical situation to be faced with. We reviewed the available literature with regards to TGNC-IBD population demographics, physical, mental and sexual health considerations, medication interactions and implications for surgery in this heterogenous group. We have identified areas that need further research and suggested simple and practical steps that can be adopted in order to help healthcare providers improve the experience for TGNC individuals diagnosed with IBD and the quality of care they provide
Extinction of cue-evoked drug-seeking relies on degrading hierarchical instrumental expectancies
No full textThere has long been need for a behavioural intervention that attenuates cue-evoked drug-seeking, but the optimal method remains obscure. To address this, we report three approaches to extinguish cue-evoked drug-seeking measured in a Pavlovian to instrumental transfer design, in non-treatment seeking adult smokers and alcohol drinkers. The results showed that the ability of a drug stimulus to transfer control over a separately trained drug-seeking response was not affected by the stimulus undergoing Pavlovian extinction training in experiment 1, but was abolished by the stimulus undergoing discriminative extinction training in experiment 2, and was abolished by explicit verbal instructions stating that the stimulus did not signal a more effective response-drug contingency in experiment 3. These data suggest that cue-evoked drug-seeking is mediated by a propositional hierarchical instrumental expectancy that the drug-seeking response is more likely to be rewarded in that stimulus. Methods which degraded this hierarchical expectancy were effective in the laboratory, and so may have therapeutic potential
Disturbance of cerebral function in people exposed to drinking water contaminated with aluminium sulphate: retrospective study of the Camelford water incident
No full textObjective: To establish whether people exposed to drinking water contaminated with 20 tonnes of aluminium sulphate in the Camelford area of Cornwall in the south west of England in July 1988 had suffered organic brain damage as opposed to psychological trauma only.
Design: Retrospective study of affected people.
Participants: 55 affected people and 15 siblings nearest in age to one of the group but who had not been exposed to the contaminated water were studied.
Main outcome measures: Various clinical and psychological tests to determine medical condition and anxiety levels in affected people. Assessment of premorbid IQ (pFSIQ) with the national adult reading test, a computerised battery of psychomotor testing, and measurement of the difference in latencies between the flash and pattern visual evoked potentials in all participants.
Results: The mean (SE) pFSIQ was above average at 114.4 (1.1). The most sensitive of the psychomotor tests for organic brain disease was the symbol digit coding (SDC) test (normal score 100, abnormal less than 85). Participants performed less well on this test (54.5 (6.0)) than expected from their pFSIQ (Pless than 0.0001) and a little less poorly on the averaged less discriminating tests within the battery (86.1 (2.5), Pless than 0.0001). In a comparison with the 15 sibling pairs (affected people's age 41.0 (3.3) years vsibling age of 42.7 (3.1) years (P=0.36) the exposed people had similar pFSIQ (114.7 (2.1)) to their siblings (116.3 (2.1), (P=0.59) but performed badly on the symbol digit coding test (51.8 (16.6)) v(87.5 (4.9) for siblings, P=0.03). The flash-pattern differences in exposed people were greater than in 42 unrelated control subjects of similar age (27.33 (1.64) ms v18.57 (1.47) ms, P=0.0002). The 15 unexposed siblings had significantly better flash-pattern differences than their affected siblings (13.4 (2.4) ms v29.6 (2.9) ms, P=0.0002). No effect of anxiety could be shown on these measurements from the analysis of the anxiety scores of exposed people.
Conclusion: People who were exposed to the contaminated water at Camelford suffered considerable damage to cerebral function, which was not related to anxiety. Follow up studies would be required to determine the longer term prognosis for affected individuals
Biobanks and biomarkers: Their current and future role in biomedical research.
No full textThe importance and utility of biobanks has increased exponentially since their inception and creation. Initially used as part of translational research, they now contribute over 40% of data for all cancer research papers in the United States of America and play a crucial role in all aspects of healthcare. Multiple classification systems exist but a simplified approach is to either classify as population-based or disease-oriented entities. Whilst historically publicly funded institutions, there has been a significant increase in industry funded entities across the world which has changed the dynamic of biobanks offering new possibilities but also new challenges. Biobanks face legal questions over data sharing and intellectual property as well as ethical and sustainability questions particularly as the world attempts to move to a low-carbon economy. International collaboration is required to address some of these challenges but this in itself is fraught with complexity and difficulty. This review will examine the current utility of biobanks in the modern healthcare setting as well as the current and future challenges these vital institutions face
Using clinical cases to guide healthcare.
No full textEvidence-based practice (EBP) has been the gold standard in healthcare for nearly three centuries and aims to assist physicians in providing the safest and most effective healthcare for their patients. The well-established hierarchy of evidence lists systematic reviews and meta-analyses at the top however these methodologies are not always appropriate or possible and in these instances case-control studies, case series and case reports are utilised to support EBP. Case-control studies allow simultaneous study of multiple risk factors and can be performed rapidly and relatively cheaply. A recent example was during the Coronavirus pandemic where case-control studies were used to assess the efficacy of personal protective equipment for healthcare workers. Case series and case reports also play a role in EBP and are particularly useful to study rare diseases such as inflammatory bowel disease in transgender and gender non-conforming individuals. They are also vital in generating and disseminating early signals and encouraging further research. Whilst these methodologies have weaknesses, particularly with regards to bias and loss of patient confidentiality for rare pathologies, they have an important part to play in EBP and when appropriately utilised can significantly impact upon clinical practice
Patient experiences of gender identity and inflammatory bowel disease: a focus group study
No full textObjective
Individuals who identify as transgender or gender non-conforming (TGNC) number approximately 262 000 in England and Wales. However, they are under-represented in healthcare research and little is known about their experiences managing a chronic health condition and their unique needs. Inflammatory bowel disease (IBD) is a chronic inflammatory condition of the gastrointestinal tract which can lead to long-term complications such as surgery and colorectal cancer. Ensuring a positive patient experience is crucial to maintaining good adherence with medical therapy and compliance with regular invasive surveillance procedures to reduce the risks of these occurring. However, there is no data on the experiences of people who identify as TGNC and who suffer from IBD (TGNC-IBD) when engaging with IBD healthcare services. Our focus group aimed to provide qualitative data on the experiences of this population.
Methods
Following established qualitative research processes, and through work with Crohn’s and Colitis UK, we held a focus group with TGNC-IBD to gain, for the first time in the UK, patient-centred insight into their experiences engaging with IBD services and highlight areas that need improving.
Results
Common themes identified were healthcare professionals making assumptions regarding gender identity, poor mental health support, a lack of research into TGNC-IBD and poor facilities.
Conclusion
The findings underscore the need for improved training for healthcare providers and modification to IBD services as well as further research to address the unique needs of TGNC-IBD
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