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Biomedical subjects

C Drummond

Publications and source records attributed to C Drummond.

10 recordsLinked to original sources

Engaging patients with alcohol problems in treatment: the first consultation.

This paper considers the impact of the first consultation at a specialist alcohol clinic on patients' perceptions of their drink problem and on their expectations of help from three sources: an alcohol clinic, general practitioners and Alcoholics Anonymous. At intake, males had higher expectations than females of help from the alcohol clinic while people in manual occupations and those in the 'less heavy' drinking category had higher expectations of general practitioner help than other patients. Change was found to occur during the first clinic consultation so that by the end of the session patients had raised their rating of problem severity and their expectations of help from the three sources examined. Overall, patient perceptions of the clinic assessment session were positive. The study highlights the importance of obtaining a full understanding of the process of engagement in treatment and indicates the potential of a clinical assessment to effect change in patient attitudes.

Adult

The use of services for alcohol problems: general practitioner and specialist alcohol clinic.

A sample of 40 patients referred to a specialist alcohol clinic were given a full assessment by a clinician and then randomly allocated to one of two groups. The first group received continuing care from the clinic. The second group were returned to the management of their general practitioners who were offered specialist support in caring for their patients. Patients and general practitioners were followed-up 6 months after the clinic assessment. This paper reports on the uptake of clinic and general practice services by patients and examines the possible factors associated with continuing attendance, including patient attributes, service activity, patients' self-assessments of their drink problem and their expectations of help from services. Qualitative data is used to examine patients' perceptions and experiences of clinic and general practice-based care for drinking problems. The findings highlight some of the difficulties reported by patients in receiving help for their problems particularly from general practitioners.

Adult

Behaviour and psychiatric disorders of people with mental handicaps living in the community.

Psychiatric and behavioural disorders were found to be relatively common in a sample of 318 individuals with a mental handicap living in the community. Many of those referred for psychiatric assessment had other non-psychiatric problems. The presence of these other needs has been recognized, and had led to the emergence of a distinct group of professionals, therapists and support staff with whom psychiatrists need to liaise to devise an adequate and effective care plan. This study also highlights the need for the development of a methodology for assessing psychiatric disorders in people with a mental handicap.

Activities of Daily Living

Alcohol consumption, problem drinking and anti-social behaviour in a sample of college students.

A total of 125 male and 145 female students completed a written questionnaire (response rate 68%) on their consumption levels and patterns, problem drinking and vandalism and assaults associated with drinking, Prevalence of heavy drinking was broadly similar to that found in other college student samples in the UK with 25.6% of male students and 14.5% of female students drinking more than their safe limits of 35 and 21 units per week respectively. Six percent of male and one percent of female students exceeded the problem drinking threshold on the MAST. Twenty percent of the male students and 6% of the females admitted having caused at least some damage to property after having been drinking in the past 12 months. Four percent of males and 5% of females admitted 'minor' assaults. Fifty percent of males and 36% of females had witnessed damage to property and 19% of males and 10% of females had experienced some kind of assault. Vandalism and assaults were positively and independently associated with higher levels of consumption, reasons for drinking and patterns of drinking; in particular morning drinking appeared to play a role. Taking amount of drinking into account, males were more likely to commit acts of vandalism but females were more likely to commit assaults. The results reveal that alcohol-related, anti-social behaviour among students is a significant problem and that, while heavy drinking per se plays a role, other factors are also important.

Adult

Transfer of plasmid pE5-2 from Escherichia coli to Bacteroides gingivalis and B. intermedius.

A unique shuttle plasmid, pE5-2, previously constructed to mediate gene transfer from Escherichia coli to colonic Bacteroides spp. has also been transferred via conjugation from E. coli to isolates of Bacteroides gingivalis and B. intermedius. The transfer occurred at a frequency of 1.4 to 2 x 10(-7) per recipient. The presence of the plasmid in transconjugants was verified by hybridization of the total DNA of B. gingivalis recipients with sequences of the pE5-2 plasmid, as well as by standard plasmid isolation techniques.

Bacteroides

Prevalence of hemochromatosis among 11,065 presumably healthy blood donors.

There is evidence that iron loading and organ damage can be prevented in patients with hemochromatosis if prophylactic phlebotomy is employed early in the disease--findings emphasizing the importance of early detection before clinical signs occur. This study was designed to determine the efficacy of transferrin saturation as a screening tool for hemochromatosis and to assess the frequency of homozygosity for the HLA-linked hemochromatosis gene in a healthy population. We screened 11,065 presumably healthy blood donors (5840 men and 5225 women). Donors with transferrin saturations of 62 percent or more after an overnight fast were considered potential homozygotes and were asked to undergo liver biopsy and pedigree analysis. The frequency of values for transferrin saturation of 62 or higher in men was 0.008 and in women 0.003. Thirty-eight persons with values higher than 62 were studied in detail; 35 underwent liver biopsy. Liver iron stores ranged from normal to markedly increased. Twelve siblings with an identical HLA match to a proband underwent liver biopsy, and 11 had increased liver iron stores. According to likelihood analysis of the pedigrees, 26 of the 38 probands were homozygotes, and 12 were heterozygotes. The estimated frequency of homozygosity was based on the data in men, because the threshold value of 62 for the transferrin saturation identified only half as many female homozygotes as expected. The frequency of homozygosity was 0.0045, corresponding to a gene frequency of 0.067. The value of population screening is demonstrated in these studies by the detection of homozygotes before clinical manifestations of hemochromatosis occur.

Adolescent

Rethinking drug policies in the context of the acquired immunodeficiency syndrome.

This article presents a policy analysis of the needed responses to the problems associated with the acquired immunodeficiency syndrome and drug misuse that are now being experienced in the United Kingdom of Great Britain and Northern Ireland. Among the issues considered is the overall organizational and administrative capacity of a country to deal with a new acute demand and the probable need for more national centralization of planning and effort in the drug field. Policies must aim at small multiple gains rather than at master-strokes. International communication must be strengthened. The human immunodeficiency virus (HIV) epidemic requires re-examination of the penal handling of drug misusers. Treating more patients earlier may contribute significantly to prevention strategies, and methods for "harm reduction" deserve attention. Compulsory treatment or testing of HIV infection is not favoured. The importance of professional training and of research is stressed. Although the immediate focus is on one particular country's policy needs, the issues raised are of wider relevance.

Acquired Immunodeficiency Syndrome

Community-based computerized donor record systems.

Computer programs for management of donor information have been developed for the Champaign County Blood Bank, a division of the Regional Health Resource Center, Urbana, Illinois. The system provides the blood bank with reports from the donor files, incorporating the donor's last donation dates, ABO groups and Rh factors, memberships in assurance programs, and rare donor information to generate lists to meet either daily or emergency inventory needs. The system was designed to decrease time requirements for donor recruitment, improve donor base sampling, aid in support of special recruitment programs, and provide statistical profiles of the community donor base. Experiences in the development and use of the system indicate requirements for effective development of such systems include careful design, strict monitoring of performance, use of a versatile programming language, and incorporation of program modifications via staff-programmer interaction throughout implementation.

Blood Donors