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Dimity Pond

Publications and source records attributed to Dimity Pond.

11 recordsLinked to original sources
PubMed2005

Reactogenicity and immunogenicity of an inactivated influenza vaccine administered by intramuscular or subcutaneous injection in elderly adults.

In many countries there is no clear recommendation regarding the preferred route of administration of inactivated influenza vaccines. In a randomised, observer blind study of 720 elderly subjects, a split, trivalent influenza vaccine was significantly more immunogenic for both A strains (H3N2 and H1N1, p = 0.0016 and 0.003, respectively) when given intramuscularly compared to subcutaneously. This difference was due entirely to a gender effect, with females in the intramuscular (IM) group having a significantly greater serological response than females in the subcutaneous (SC) group for both of these strains. Similar results were seen with local adverse effects. These data suggest that vaccination practices that ensure intramuscular injection are required for optimal administration of influenza vaccines in the elderly.

Aged↗
PubMed2005

A systematic review of the evidence for 'myths and misconceptions' in acne management: diet, face-washing and sunlight.

BACKGROUND: Lay perceptions that diet, hygiene and sunlight exposure are strongly associated with acne causation and exacerbation are common but at variance with the consensus of current dermatological opinion. OBJECTIVES: The objective of this study was to carry out a review of the literature to assess the evidence for diet, face-washing and sunlight exposure in acne management. METHODS: Original studies were identified by searches of the Medline, EMBASE, AMED (Allied and Complementary Medicine), CINAHL, Cochrane, and DARE databases. Methodological information was extracted from identified articles but, given the paucity of high quality studies found, no studies were excluded from the review on methodological grounds. RESULTS: Given the prevalence of lay perceptions, and the confidence of dermatological opinion in rebutting these perceptions as myths and misconceptions, surprisingly little evidence exists for the efficacy or lack of efficacy of dietary factors, face-washing and sunlight exposure in the management of acne. Much of the available evidence has methodological limitations. CONCLUSIONS: Based on the present state of evidence, clinicians cannot be didactic in their recommendations regarding diet, hygiene and face-washing, and sunlight to patients with acne. Advice should be individualized, and both clinician and patient cognizant of its limitations.

Acne Vulgaris↗
PubMed2005

Isotretinoin, depression and suicide: a review of the evidence.

There is currently considerable controversy regarding a proposed causal relationship between the use of isotretinoin and depression and suicide. A search was made of the MEDLINE, EMBASE and PsychINFO databases using the search terms 'isotretinoin', 'depression' and 'suicide'. Despite numerous case reports linking isotretinoin to depression, suicidal ideation and suicide, there is, as yet, no clear proof of an association. While isotretinoin, used to treat acne vulgaris, has not been demonstrated to be associated with depression or suicide, the possibility of a relatively rare idiosyncratic adverse effect remains. GPs have a role in the clinical application of these findings.

Acne Vulgaris↗
PubMed2005

Patients' perceptions of isotretinoin, depression and suicide--a qualitative study.

BACKGROUND: Isotretinoin is an effective acne medication. The evidence for it causing depression and suicide, although widely publicised, remains uncertain. METHODS: Twenty-six semi-structured interviews with patients with acne were coded and subjected to thematic analysis. RESULTS: Isotretinoin was perceived to be effective but dangerous. The most well known adverse effects were depression and suicide. DISCUSSION: The overemphasis of serious psychological adverse events in patients might discourage the use of isotretinoin by those who might benefit from it.

Abnormalities, Drug-Induced↗
PubMed2004

Diagnosis and management of dementia in general practice.

BACKGROUND: The assessment and management of dementia has changed in the past 5 years with the introduction of new drugs to combat dementia. In addition, services available for patients with dementia and the means of accessing these services is constantly changing. OBJECTIVE: This article discusses the assessment and management of dementia using two case studies. The case studies raise issues about screening and accessing the new drugs for a patient with early dementia, care planning, and the involvement of the carer for a patient with more advanced disease. DISCUSSION: As the population ages, dementia is an increasingly important part of general practice. It is important general practitioners are aware of early detection issues, and understand basic screening as well as the possibility of accessing new treatments and community management for patients with dementia.

Aged↗
PubMed2003

The role of the general practitioner and the dietitian in patient nutrition management.

There is mounting evidence that nutrition plays an important role in the aetiology and management of many diseases affecting Australians. Nutrition counselling provides a strategy for not only reducing patient suffering, but also for reducing the health care costs associated with these illnesses. At the forefront of providing nutrition counselling to Australians are General Practitioners (GPs) and Dietitians. Australian data shows that GPs encounter many patients with the chronic diseases that have nutrition in their aetiology and management. Although this presents opportunities to provide nutrition counselling, overseas literature suggests that often nutrition counselling opportunities are not taken up. At present, there is little evidence to support whether this problem exists in Australia, or the magnitude of the problem. Whilst evidence suggests there are barriers for GPs in providing nutrition counselling, there is conflicting evidence on how these influence the GP's decision to provide such counselling. Overseas studies have also identified barriers for GPs to refer to dietitians to provide nutrition counselling, however there is no evidence to identify whether these barriers exist in Australia. Whilst various strategies have been implemented to aid in the provision of effective nutrition management to the Australian public, there is little evidence on the efficacy of these. Research is needed in the above areas if effective patient nutrition management is to be implemented in Australia.

Australia↗
PubMed2002

The GPCOG: a new screening test for dementia designed for general practice.

OBJECTIVES: To design and test a brief, efficient dementia-screening instrument for use by general practitioners (GPs). DESIGN: The General Practitioner Assessment of Cognition (GPCOG) consists of cognitive test items and historical questions asked of an informant. The validity of the measure was assessed by comparison with the criterion standard of diagnoses of dementia derived from the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition). SETTING: Primary care doctors' offices. PARTICIPANTS: Sixty-seven GPs administered the GPCOG to 283 community-dwelling patients aged 50 to 74 with memory complaints or aged 75 and older. MEASUREMENTS: The Cambridge Mental Disorder of the Elderly Examination, the Abbreviated Mental Test (AMT), the Mini-Mental State Examination (MMSE), the 15-item Geriatric Depression Scale, and the 12-item Short-Form Health Survey. RESULTS: The GPCOG was reliable and superior to the AMT (and possibly to the MMSE) in detecting dementia. The two-stage method of administering the GPCOG (cognitive testing followed by informant questions if necessary)had a sensitivity of 0.85, a specificity of 0.86, a misclassification rate of 14%, and positive predictive value of 71.4%. Patient interviews took less than 4 minutes to administer and informant interviews less than 2 minutes. The instrument was reported by GPs to be practical to administer and was acceptable to patients. CONCLUSION: The GPCOG is a valid, efficient, well-accepted instrument for dementia screening in primary care.

Aged↗
PubMedDate not supplied

Diagnosing dementia in primary care: the accuracy of informant reports.

In the diagnosis of dementia, information obtained from informants or proxies is important; however, little is known about the circumstances under which informants' reports lack accuracy. This study compares informant reports of cognitive status against psychometric tests to identify the degree of, and factors associated with, discrepant reporting. Four areas of patient cognitive ability were examined: memory of recent events, ability to remember a short list of items after a delay, language/naming abilities, and working memory. Primary care practitioners recruited 248 community-dwelling patients aged 75 years or more or aged 50-74 years with suspected memory complaints; 248 friends or relatives acted as informants. More than half of the informants (60%) gave responses consistent with psychometric testing. Informants who underreported patient difficulties tended to report on patients who were diagnosed as having subclinical dementia, were less educated, and had poorer remote memory. Informants who overreported difficulties were more likely to report on those diagnosed with dementia. While informant accounts are critical for the assessment of dementia, we found that in 40% of cases these reports may be inaccurate, particularly when the patient has low education and poor remote memory or when overall cognitive difficulties are mild.

Aged↗