PubMed Health⌕ Search

Biomedical subjects

A Farmer

Publications and source records attributed to A Farmer.

At least 19 recordsLinked to original sources
PubMed1992

Recent changes in the surgical management of T1/2 breast cancer in England.

Following the results of a study undertaken in 1985, a second survey was undertaken to examine whether there had been any changes in England in the surgical management of patients with a T1/2/NOMO breast cancer. The major findings were that: (i) there was a significant increase in the number of surgeons who would undertake breast conservation surgery; (ii) there was a significant increase in the number of surgeons who would discuss breast reconstruction where mastectomy was the preferred form of treatment; (iii) that significantly more surgeons would offer the patient a choice of surgery when there was more than one surgical option; and (iv) that significantly more surgeons had access to a breast specialist nurse and/or a cancer counsellor. These changes are consistent with the recommendations of the 1986 King's Fund Consensus' Conference for breast cancer treatment.

Adult↗
PubMed1991

The effect of self-administered faecal occult blood tests on compliance with screening for colorectal cancer: results of a survey of those invited.

To determine the relative importance of health beliefs and the characteristics of different methods of faecal occult blood screening in predicting acceptance of the test a self completed questionnaire was offered to 590 patients registered with a practice in an Oxfordshire market town. The patients were an age-sex stratified random sample of those who had been offered screening as part of a trial in which one of three different faecal occult blood screening tests, two of which were self-reported, had been offered. The overall adjusted response rate was 70.1%. Those who complied with the test had more positive attitudes to the implications of a positive test, to treatment and to the value of screening in general. The experience of a close relative or friend with bowel cancer was associated with an increased likelihood of compliance [odds ratio = 15.2 (9.4-24.3)]. Three were marked differences between the tests in the proportions of patients finding them 'messy' or 'disgusting' (Haemoccult 72.0%, Coloscreen 48.0%, Early Detector 55.4% chi 2 Haemoccult vs. self-reported = 5.05 P less than 0.05), and the odds of finding the procedure disgusting were significantly higher among patients who did not complete the test [odds ratio 6.9 (3.1-15.5)].

Attitude to Health↗
PubMed1991

Schizophrenia, bipolar disorder and depression. A discriminant analysis, using 'lifetime' psychopathology ratings.

Discriminant and canonical variate analyses were performed using 302 patients, on whom ratings of lifetime psychopathology and course of illness has been made. DSM-III diagnoses were used to form the criterion groups. Bipolar disorder emerged as a distinct grouping, but there are reasons for dissatisfaction with its definition. The remaining patients formed a 'schizodepressive continuum', but this also had a tendency to bimodality. It is possible that the distinction between schizophrenia and depression was obscured by inadequacies in the data and the inclusion of excessive numbers of patients with schizoaffective depression in this study.

Adolescent↗
PubMed1990

Problems and pitfalls of the family history positive and negative dichotomy: response to Dalén.

The authors defend the proposition that the simple division of schizophrenia into family history positive versus family history negative in the hope of uncovering etiological heterogeneity is too naive for a multifactorial disorder as contrasted with rare, mendelizing genetic conditions. Dalén is correct to forecast that a monolithic homogeneity view about the origins of schizophrenia is likely to be refuted and that it is important to pursue such a strategy. Using computed tomographic brain scan results and the simple dichotomy of family history positive versus family history negative as an illustration, we show the weakness (lack of statistical power) of the strategy. The problem arises from the fact that a negative family history for schizophrenia characterizes the vast majority of schizophrenic patients just as it does for insulin-dependent diabetes, another genetically influenced multifactorial disorder. A continuum from more genetic to less genetic variation in the etiology of schizophrenia fits the available familial patterns of risk.

Diseases in Twins↗
PubMed1990

Organization of care for diabetic patients in general practice: influence on hospital admissions.

The aim of this study was to determine whether there is a relationship between the structure of care for diabetes in general practice and the corresponding admission rates for diabetic patients to hospital. A questionnaire was sent to 350 group or single handed practices in the Oxford region and a retrospective analysis was made of admission rates using hospital activity analysis. Admission rates were adjusted for the age structure of the practices. The degree of organization of care was determined by drawing up a composite score from the answers to the questionnaire and comparing practices with few, average and many facilities. There was a significant trend in the rates of admission across the groups of practices: those with few facilities made 16.2 admissions per 10,000 population over two years, those with average facilities 13.8 admissions, and those with many facilities 14.0 admissions (chi-squared trend = 6.88, 1 df, P less than 0.01). These findings support the hypothesis that organized general practice care reduces the rate of hospital admissions, although there are many other influences on the admission rate from any one practice.

Diabetes Mellitus↗
PubMed1990

Experiences of patients with false positive results from colorectal cancer screening.

A survey was conducted to study the experiences of patients with false positive results for colorectal cancer. The study patients were participants in a randomized trial of compliance with different methods of colorectal cancer screening by faecal occult blood testing. Fifty four out of fifty six patients (96.4%) with false positive results agreed to be interviewed. An age and sex matched control group of 112 patients with negative test results was identified --92 (82.1%) returned questionnaires. Thirteen of the patients with false positive results (24.1%) and 19 controls (20.7%) were to some extent distressed by the initial letter inviting them to participate in the screening programme. Thirty seven of the patients with false positive results (68.5%) felt some degree of distress at the initial positive test result and 19 (35.2%) some distress because of delays experienced in the process of being screened. Ten false positive patients had colonoscopy and the median waiting time for this procedure was 10 days--half of the patients found this wait distressing. Nevertheless, 53 of the patients with false positive results (98.1%) felt that it had been worthwhile to have had the test. Generally, colorectal screening was as acceptable to the patients who experienced false positive results as to those with negative results.

Adult↗
PubMed1988

The Composite International Diagnostic Interview. An epidemiologic Instrument suitable for use in conjunction with different diagnostic systems and in different cultures.

The Composite International Diagnostic Interview (CIDI), written at the request of the World Health Organization/US Alcohol, Drug Abuse, and Mental Health Administration Task Force on Psychiatric Assessment Instruments, combines questions from the Diagnostic Interview Schedule with questions designed to elicit Present State Examination items. It is fully structured to allow administration by lay interviewers and scoring of diagnoses by computer. A special Substance Abuse Module covers tobacco, alcohol, and other drug abuse in considerable detail, allowing the assessment of the quality and severity of dependence and its course. This article describes the design and development of the CIDI and the current field testing of a slightly reduced "core" version. The field test is being conducted in 19 centers around the world to assess the interviews' reliability and its acceptability to clinicians and the general populace in different cultures and to provide data on which to base revisions that may be found necessary. In addition, questions to assess International Classification of Diseases, ninth revision, and the revised DSM-III diagnoses are being written. If all goes well, the CIDI will allow investigators reliably to assess mental disorders according to the most widely accepted nomenclatures in many different populations and cultures.

Cross-Cultural Comparison↗
PubMed1988

Comparison for aphasic and control subjects of eye movements hypothesized in neurolinguistic programming.

Neurolinguistic programming's hypothesized eye movements were measured independently using videotapes of 10 nonfluent aphasic and 10 control subjects matched for age and sex. Chi-squared analysis indicated that eye-position responses were significantly different for the groups. Although earlier research has not supported the hypothesized eye positions for normal subjects, the present findings support the contention that eye-position responses may differ between neurologically normal and aphasic individuals.

Aphasia↗
PubMed1987

Cerebral ventricular enlargement in chronic schizophrenia: consistencies and contradictions.

A study of cerebral ventricular size measured as ventricle to brain ratio (VBR) using computerised tomographic brain scan in chronic schizophrenics provided no support for suggestions that there are significant differences between patients who fall into different clinical subtypes. We found no significant difference in VBR between patients with and without a family history of schizophrenia or between those with or without paranoid symptoms. Applying Crow's classification, contrary to expectations, Type 1 patients had significantly larger ventricles than those with 'mixed' symptomatology (both Type 1 and Type 2 features). We also applied a variety of operational criteria which attempt to define schizophrenia as a whole: of these only Schneider's first-rank symptoms (FRS) yielded conclusive results--FRS-positive patients had significantly larger mean VBR than those without such symptoms. Previously, it has been suggested that ventricular enlargement is more closely associated with 'negative' than with 'positive' symptoms.

Adult↗
PubMed1987

Is there really a split in schizophrenia? The genetic evidence.

Although the clinical presentation and course of schizophrenia is highly variable, it is unclear whether this reflects heterogeneity at an aetiological level. The genetic evidence is reviewed concerning 'traditional' clinical subtypes as more novel categories derived from multivariate statistical methods and Crow's type I-type II classification. Recent data based on a twin series and re-analysis of older published family material suggest that attempts to divide up schizophrenia have resulted in splits between two or more categories of disorder which occupy different positions on the same continuum of liability. Thus, apparent heterogeneity is more likely to be due to quantitative difference in familial-genetic loading rather than qualitative differences. Similarly, the hypothesis that schizophrenia can be broadly divided into two groups, one genetic and the other non-genetic has little to support it. It seems improbable that any further useful and genetically relevant subdivision of schizophrenia can be effected on purely clinical grounds. Further progress awaits developments in the discovery of endophenotypes and the application of molecular genetic marker strategies.

Adult↗