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Alastair Hay

Publications and source records attributed to Alastair Hay.

7 recordsLinked to original sources
PubMed2007

Psychological factors and use of antiepileptic drugs: pilot work using an objective measure of adherence.

Given the current emphasis on the "concordance" prescribing model, a study was designed to determine the influence of patients' beliefs about epilepsy, beliefs about medication and a range of neuroepilepsy variables on drug adherence among a sample of epilepsy patients. A special feature of the study was the use of a credible objective measure of drug adherence. Psychological health was also assessed. Thirty-seven patients were recruited from a local epilepsy clinic. Beliefs about epilepsy (illness representations), beliefs about epilepsy medication, anxiety, depression, neuroepilepsy status and adherence were all measured. Data were collected via clinical interview and questionnaire methods. Adherence with drug treatment was determined by an objective measure using low-dose phenobarbital as an indicator of adherence and, or, measurement of antiepileptic drug levels. Neither illness representations nor beliefs about epilepsy drugs were related to adherence. With the exception of time since last seizure, which was positively related to adherence, neuroepilepsy variables were unrelated to adherence. A number of significant associations between cognitive representations of epilepsy and mood were found.

Adolescent↗
PubMed2006

Controlling exposure to chemicals: a simple guide.

Controlling exposure to chemicals in the workplace has been made easier by the use of a guide published by the U.K. Health and Safety Executive (HSE). Known as COSHH (Control of Substances Hazardous to Health Regulations) Essentials, the guide is a simple five-step procedure to devise appropriate control strategies to reduce exposures to various substances under different conditions. U.K. health and safety law requires risk assessments prior to use of hazardous substances and installation of appropriate control strategies before work commences. A 1996 survey of 1500 safety managers and trade union safety representatives revealed that the majority had little understanding of occupational safety limits for chemicals. Small- and medium-sized companies had little understanding of limits, and most could not develop control strategies. A new approach was required. COSHH Essentials is it. Developed over 3 years by a working group of hygienists and toxicologists representing HSE, industry, trade unions, and independent experts, the guide is now available in both paper-based and internet versions. It applies a hazard banding approach validated by data for 111 substances that have well-founded U.K. occupational exposure limits. New users select an appropriate hazard band for chemicals based on risk phrases. Details about dustiness for powders or volatility for liquids are inserted, and the guide allocates substances to one of four exposure bands linked, in turn, to specific control strategies. Now accessible through the HSE web site, COSHH Essentials will offer control strategies for both single chemicals and whole processes. To date over 300,000 risk assessments have been carried out using the internet version of COSHH Essentials.

Air Pollutants, Occupational↗
PubMed2005

Changes to methadone clearance during pregnancy.

OBJECTIVE: Measurement of plasma methadone concentration to investigate the rate of clearance of methadone prescribed for heroin dependence in the first, second and third trimesters of pregnancy. A secondary objective was to evaluate the outcome of pregnancy. METHODS: Longitudinal within subject study of nine pregnant opioid dependent subjects prescribed methadone at the Leeds Addiction Unit, an outpatient community based treatment centre. Plasma concentration versus time data for methadone was collected during each trimester and post-partum for our subjects. Data was available for the first and second trimesters for 4/9 cases. All but one of the subjects provided data during the third trimester and data post-partum was collected from three respondents. Measurements of methadone levels in plasma were carried out using high performance liquid chromatography (HPLC). RESULTS: Trough mean plasma methadone concentrations reduced as the pregnancies progressed from 0.12 mg/L (first trimester) to 0.07 mg/L (third trimester). The weight-adjusted clearance rates gradually increased from a mean of 0.17 to 0.21 L/hr/kg during pregnancy, although patterns differed substantially between the nine women. An assessment of relative clearance of methadone using two patients for whom we have had all three CL values (trimester 1-3) demonstrated notable change of CL (P = 0.056) over time. Eight of our subjects delivered (3 males), within two weeks of their due date the ninth (male) was premature (21 days). The mean length of gestation was 39.7 weeks (SD = 10 days) and none of the neonates met criterion for 'low birth weight' mean = 3094, SD = 368 g). Five neonates spent time (0.5-28 days) in a special care baby unit (SCUBU) and 4 of these displayed signs of methadone withdrawal. CONCLUSIONS: General Practitioners and hospital doctors should recognise the significant benefits of prescribing methadone for heroin-dependent women during pregnancy. We recommend that if a pregnant opioid user complains of methadone withdrawal symptoms (i.e. that the methadone dose does not "hold" them) the prescribing clinician takes this observation seriously and considers a more detailed assessment. Further work on key factors undergoing changes during pregnancy accounting for differences in methadone metabolism in the mother, fetus and neonate are required.

Adolescent↗
PubMedDate not supplied

Skin injuries caused by new riot control agent used against civilians on the West Bank.

A new riot control agent, used by the Israeli army against civilians protesting about the Separation Wall on the West Bank, has been reported as causing severe skin injuries. We obtained one of the munitions and have identified the contents as capsaicin with an inert carrier and a dispersal agent. This corresponds to the commercially available 'Pepperball Tactical Powder'. Skin injuries of the severity described have not previously been reported with this agent, and would be difficult to manage for clinicians who were unaware of the nature of the agent.

Arabs↗