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Biomedical subjects

A Jacoby

Publications and source records attributed to A Jacoby.

At least 55 records · Page 3Linked to original sources
PubMed1993

The impact of counselling with a practical statistical model on patients' decision-making about treatment for epilepsy: findings from a pilot study.

To ascertain the impact of a computer-based predictive model on patients' decisions about continuing treatment of their epilepsy, 72 subjects were asked to complete questionnaires prior to and following counselling with the model. The subjects were attending the neurology out-patient clinic in a large UK hospital, and were identified from medical records as eligible for withdrawal of AEDs. The effect of counselling with the model was to make the majority of patients opt to continue AED therapy. Positive or negative framing of risk information appeared to influence the decisions of patients who were initially uncertain about continuing treatment, as did patients' perceptions of the clinician's views. The prognostic model appeared to allow relatively complex statistical information to be conveyed to patients in an accessible form. We suggest its use will aid clinicians in counselling patients and will help patients reach better-informed decisions about treatment.

Counseling↗
PubMed1992

Epilepsy and the quality of everyday life. Findings from a study of people with well-controlled epilepsy.

Epilepsy is a stigmatising disorder and available evidence suggests that its diagnosis can have important psychosocial consequences and severely reduce the quality of an individual's everyday life. A number of studies have examined the psychosocial aspects of living with epilepsy, but these have generally involved groups of patients with severe or intractable epilepsy, so that the prevalence of problems may be over-estimated. The present study examined psychosocial functioning in a group of people in whom epilepsy was well-controlled; the majority had been seizure-free for at least two years. In doing so, it drew upon a model of quality of life which incorporated physical, social and psychological domains. Among this group of people, psychosocial functioning and adjustment to epilepsy appeared high, with low reported levels of distress. This is an important finding, not least for people with epilepsy themselves.

Activities of Daily Living↗
PubMed1992

Development of patient satisfaction questionnaires: I. Methodological issues.

OBJECTIVES: To develop a method for conducting postal surveys of patients' views and experiences of general practitioner care and to produce an off the shelf tool for general practice audit. DESIGN: Prospective study of performance of two patient questionnaires assessing accessibility to services (questionnaire 1) and interpersonal aspects of care (questionnaire 2) in comparing general practices. SETTING: Five general practices in Newcastle upon Tyne. PATIENTS: 3800 patients aged 16 and over, 1900 randomly drawn from family health services authority lists for each practice (questionnaire 1) and 1900 drawn from practice records (questionnaire 2). MAIN MEASURES: Response rates and technical evaluation of performance of the questionnaires (reliability, item nonresponse, ineligible response, sensitivity, and validity). RESULTS: Response rate for questionnaire 1 was 77% (range 69% to 83%) and to questionnaire 2, 82% (77% to 86%). Analysis of respondents and nonrespondents showed that significantly more women, people aged 65 or more, and those consulting in the past six months returned the questionnaires. Technical evaluation indicated good face validity and content validity and good internal consistency. CONCLUSIONS: A standardised off the shelf tool for audit was developed, and it will be a valuable model for future audits in general practice.

England↗
PubMed1992

Coping and adjustment of spouses of critically ill patients with cardiac disease.

An acute cardiac illness represents a significant stressor to both patients and families. In a convenience sample of 100 spouses of critically ill adults, the relationships among personality factors, coping responses, social network, age, education, and emotional and physical distress were investigated. Results indicated a significant positive relationship between positive personality factors and problem-focused coping and between negative personality factors, emotion-focused coping, and emotional and physical distress. As expected, spouses who reported more negative personality factors and used greater emotion-focused coping scored higher on emotional and physical distress. Moreover, spouses who scored higher in emotional distress reported greater physical distress. No statistically significant relationships were found among the variables of personality factors, problem-focused coping, and support provided by the spouses' social network and the outcome variables of emotional and physical distress. Regression analysis revealed negative personality factors, emotion-focused coping, and education explained 52% of the variance in emotional distress. Future studies using experimental design are needed to evaluate the influence of a multitude of factors on coping and health outcome of spouses of critically ill patients with cardiac disease.

Adaptation, Psychological↗
PubMed1991

Seizure frequency, patient-perceived seizure severity and the psychosocial consequences of intractable epilepsy.

It is generally recognised that the assessment of treatment effects in epilepsy using seizure frequency as the only outcome measure may lack sensitivity. A patient-based seizure severity scale has been developed and initial results confirm its reliability and validity. As part of the further development of this scale it is important to explore the relationship between seizure severity, seizure frequency and the psychosocial consequences of intractable epilepsy. One hundred patients with medically refractory partial seizures completed a quality of life questionnaire including measures of physical (seizure severity and frequency), social and psychological well-being (anxiety, depression, self-esteem, locus of control and happiness). Multivariate analysis demonstrated that individual psychological variables were best predicted by other psychological variables. However, when these were removed from analysis, seizure severity was the most significant predictor of self-esteem (P = 0.005), locus of control P = 0.039) and anxiety (P = 0.048). Seizure frequency did not contribute significantly to the variance of any of the psychological factors. These results highlight the importance of considering seizure severity when assessing treatment effects in epilepsy and provide further evidence for the construct validity of a novel patient-based seizure severity scale.

Activities of Daily Living↗
PubMed1990

Possible factors affecting response to postal questionnaires: findings from a study of general practitioner services.

Poor response rates affect the validity of results from postal questionnaires. The effect of three controllable factors upon response rates was examined in a recent study of patients' experiences and views of general practitioner services. The factors studied were the institution from which questionnaires were dispatched, the length of the questionnaire and the inclusion of a potentially sensitive question about ethnic origin. Questionnaires sent out by local Family Practitioner Committees were more likely to be returned than those sent out by a London-based independent research unit, but there were no differences in the nature of replies obtained. Neither the length of the questionnaire nor the inclusion of the potentially sensitive question affected response rates. The results of the study indicate that Family Practitioner Committees wishing to carry out postal surveys of users of general practitioner services can obtain satisfactory response rates.

Consumer Behavior↗
PubMed1990

Management strategies and patient needs: the provision of nursing care in the community.

Community nurse managers in 17 health districts in England were interviewed about their strategies for identifying and coping with unmet need for nursing care in the community, and their efforts to plan community nursing services and to meet changing levels of demand for care. The managers were found to have access to a wide range of information for planning services, but this information did not always seem to be used most effectively. The managers' efforts to identify unmet need were often piecemeal and unco-ordinated, and this may have been, in part, because managers were facing difficulties in meeting existing demands for services. As a result, several were beginning to set priorities for care. Faced by increasing demand and limited finance, it seems likely that managers will continue to do so, and will develop more stringent criteria for nursing care.

Community Health Nursing↗
PubMed1976

Antimetabolites produced by microorganisms. XIII. The synthesis and microbiological production of a novel amino acid, L-2-amino-4-(2-aminoethoxy) butanoic acid.

A novel amino acid, L-2-amino-4-(2-aminoethoxy-)-butanoic acid, was isolated from a fermentation broth of Streptomyces sp. X-11,085. It was shown to be identical with the chemical reduction product of an antimetabolite antibiotic, L-2-amino-4-(2-aminoethoxy)-trans-3-butenoic acid, a co-product in the fermentation. Addition of the title compound to the fermentation led to an enhanced yield of the antimetabolite suggesting that the saturated amino acid serves as a precursor for the antimetabolite.

Aminobutyrates↗
PubMed1975

The contribution made by school milk to the nutrition of primary schoolchildren.

1. The contribution of school milk to the nutrition of 396 Kent primary schoolchildren aged 8-11 years was assessed using information collected in a survey which included a weighed-diet record, a socio-economic questionnaire and a medical examination. 2. Over half the children (59% for boys, 54% for girls) drank school milk every school day of the diet-record week. 3. Children who drank school milk every school day, when compared with those not drinking it, had a significantly higher mean daily intake of liquid milk, a higher total daily intake of several important nutrients including animal protein, calcium, thiamin and riboflavin, and a diet richer in Ca and riboflavin (boys) and animal protein and Ca (girls). They were also less likely to have intakes of Ca and riboflavin below the recommended daily intakes for these nutrients, (Department of Health and Social Security, 1969). 4. The increased nutritional intake associated with school milk consumption was not related to any differences in height, weight, arm circumference or skinfold thickness. 5. There was no evidence that school milk consumption was associated with obesity (as assessed clinically).

Animals↗
PubMed1975

Influence of some social and environmental factors on the nutrient intake and nutritional status of schoolchildren.

Only children had significantly higher intakes of many nutrients and nutrients/1000 kcal than other children. A higher proportion of only children was found to be obese. There were no significant differences according to birthrank in intakes by children. There were more obese children among the fatherless than those with fathers, in particular among those whose mothers were widowed. However, this was not accounted for by the present dietary findings, since fatherless children had lower intakes of carbohydrate and added sugar. There were no differences in nutrient intake or intake/1000 kcal by mother's country of origin or her level of education, or by disposable income.

Adolescent↗
PubMed1975

School meals and the nutrition of schoolchildren.

The contribution of school meals to the nutrition of 778 primary and secondary schoolchildren attending schools in Kent was assessed using information collected during a survey made in 1968-70 which included a weighed diet record, a socioeconomic questionnaire, and a medical examination. Younger children, those from larger families, those without fathers, and those whose mothers worked were more likely to take school meals. Significantly more children from lower social classes and without fathers received them free. School meals made an important contribution to the nutrition of schoolchildren. Children who took them had higher weekday lunchtime nutrient intake during term-time. Children in lower social classes, larger families, and without fathers who took school meals obtained a higher proportion of their weekday intake of nutrients from lunchtime than other children. This applied in particular to nutrients important for growth. School meals consumed by children in the study broadly met the standard set by the Department of Education and Science. The mean energy and protein content of school meals consumed in the study was slightly lower and the mean fat content higher than the standard set for the meal. The mean sugar content was about one-third higher than the suggested amount of sugar to be included in a school meal. There was no evidence that children who took school meals were taller, heavier, had greater skinfold thickness, or were more likely to be assessed as obese than other children.

Adolescent↗