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Biomedical subjects

David Gill

Publications and source records attributed to David Gill.

5 recordsLinked to original sources

Dementia care: mental health effects, intervention strategies, and clinical implications.

Caring for elderly people with dementia is associated with well-documented increases in burden, distress, and decrements in mental health and wellbeing. More severe behavioural, cognitive, and functional impairments in a patient are associated with higher levels of burden and distress. Distress increases with care hours per week, number of tasks, and declining coping and support resources. Demographic factors also affect levels of burden and distress. Promising, evidence-based interventions exist, but substantial economic and policy barriers preclude their widespread dissemination. Health-care policy makers should consider addressing these barriers; clinicians and families must campaign for reimbursement; and clinical researchers must develop more potent preventive interventions. In this article we review how dementia care affects the mental health of the carer and identify interventions that might be useful in mitigating carer burden and distress.

Animals↗

Pharmacist-supported medication review training for general practitioners: feasibility and acceptability.

OBJECTIVES: To investigate the feasibility and acceptability of training for general practitioners (GPs) in medication review provided by practice pharmacists. METHODS: Within the setting of a Scottish Local Health Care Co-operative incorporating 17 general practices, practice pharmacists delivered a 1-hour practice-based group training session to interested GPs, covering a systematic approach to medication review and case studies. One session of funded locum cover was provided for each GP to review up to 6 patients of his or her choice. Practice pharmacists and GPs reviewed patient notes together before GPs saw patients alone. Subsequently pharmacists abstracted data from medical records. Medication-related issues identified during reviews and resultant actions were categorised. The views of GPs on the training were obtained by postal questionnaires. RESULTS: Training was received by 51/74 GPs from 10/17 practices. In 174 reviews analysed, differences in patient medication use from computer records, ineffective medication and missing computer diagnoses were identified most frequently. There was a median of 5 actions per patient, including a median of 2 changes in prescribed drugs. Only 3 reviews resulted in no actions, while 80% of patients had at least 1 prescribing record change. A total of 27 (61%) GPs returned questionnaires; most considered medication review important and were satisfied with the training. Confidence in conducting reviews increased in 14 (52%) GPs. Many indicated they would increase reviews, but time was a barrier for almost all. Although few considered contract or accreditation to be motivating factors, most agreed the training would help them achieve standards for both. CONCLUSIONS: Training by pharmacists was feasible and acceptable, but time constraints may limit the translation of reviews into routine practice.

Attitude of Health Personnel↗

Necrobiotic xanthogranuloma occurring within linear morphoea.

A 32-year-old woman with linear morphoea of her left arm was noted to have a yellowish atrophic plaque within the linear morphoea. Review of photographs taken on her first visit 3 years previously revealed that the lesion had been present and had increased in size over the 3 years. Necrobiotic xanthogranuloma (NXG) was diagnosed on biopsy. Paraproteinaemia was not detected. The NXG was surgically excised and it has not recurred in 12 months of follow up.

Adult↗