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Biomedical subjects

E Kingstone

Publications and source records attributed to E Kingstone.

At least 19 recordsLinked to original sources
PubMed1993

The geographical distribution of psychiatrists in Canada: unmet needs and remedial strategies.

Many efforts are underway to rationalize the process of manpower planning in psychiatry. A wide variation in the geographic distribution of psychiatrists remains. A multidimensional assessment of the needs of a population is recommended, based on the epidemiology of mental disorders, professional and institutional needs, consumer estimates, and the requirements of subgroups. Counting the number of vacant positions for psychiatrists can be misleading. Professional norms for the optimal access of a population to psychiatric services and standards for the quantity and/or quality of services provided need to be developed. Potential outcome measures are suggested, along with a three-tiered system of estimating geographic needs. Deterrent factors to an optimal geographic distribution of most professionals are reviewed, along with factors specific to our residency training programs. In the short term, the benefits and limitations of recruiting foreign-trained psychiatrists are compared with those of recruiting Canadian specialists. Complementary long term strategies include the provision of financial incentives, optimal working conditions, relevant training and maintenance of competence issues, and community support.

Canada↗
PubMed1990

Left-handedness in homosexual men and women: neuroendocrine implications.

Although numerous researchers have hypothesized a biological factor in the etiology of homosexuality, there is a lack of empirical evidence. Previous investigations did not focus on behavioral functions of the brain. Using neuropsychological testing, we found an increased incidence of left-hand preference (defined as non-consistent right-hand preference) in a group of 32 homosexual women. A trend in the same direction was found in a group of 38 homosexual men. These results suggest that homosexual orientation has a neurobiological component possibly related to hemispheric functional asymmetry. The results are consistent with previous reports that (1) prenatal neuroendocrine events are a factor in the development of human sexual orientation and functional brain asymmetries, and (2) the mechanisms associated with homosexual orientation and related neuropsychological characteristics are different between the sexes, i.e. elevated levels of prenatal sex hormones in women and decreased levels in men.

Adult↗
PubMed1979

Dynamic changes of serum gamma-glutamyl transferase in chronic alcoholism.

Elevated serum gamma-glutamyl transferase (GGT) levels were found in 29% of 155 chronic alcoholics undergoing detoxification treatment. Alkaline phosphatase (AP) was increased in 16%, alanine aminotransferase--SGPT (ALT) in 12% of the patients, while 23% had elevations of either AP or ALT or both. Of the foregoing parameters, GGT was the best single indicator of liver involvement. In course of the follow-ups GGT/ALT correlation improved, but GGT/AP correlation deteriorated. In 9 patients, abstinence during follow-up was associated with progressive decrease in previously elevated serum GGT. Because of its unique sensitivity, GGT may be useful as a screening and/or monitoring aid in alcoholism.

Alanine Transaminase↗
PubMed1979

Psychopharmacology education in psychiatry.

This study has documented resident dissatisfaction with education in psychopharmacology in one large university and has proposed several solutions. These include: - increased awareness of standards of knowledge necessary for a consultant. - the establishment of a central educative office of clinical psychopharmacology to encourage dissemination of selected literature and to facilitate residents' research under supervision. - recognition that not all staff should be considered capable to provide psychopharmacology supervision and that each hospital should have a designated psychiatrist with special expertise in psychopharmacology. - developing study groups for the purpose of teaching critical evaluation of the literature. - increasing encouragement for residents' participating in clinical research - awareness of residents' difficulties in learning "emotional illness, rejection of biological therapies, and knowing what is expected or not suited to psychiatry" and appropriate actions to alter these. - increased use of audio aids, self-teaching manuals and journals to augment lectures and texts. - increased emphasis on training selected senior residents in how to teach.

Humans↗
PubMed1977

Penfluridol, a peroral long-acting neuroleptic, for the maintenance treatment of schizophrenic patients who relapse.

In a multicenter collaborative study, 28 newly readmitted schizophrenic patients, stabilized for one week on short-acting neuroleptic drugs, had their medication abruptly changed to penfluridol given once a week on an outpatient basis. The average dose required for maintenance was approximately 40 mg weekly. Analysis of BPRS evaluations carried out during the 16-week trial revealed a significant linear trend toward further improvement. Social functioning, as measured by the KAS questionnaire in the outpatient period of the trial, also revealed a significant linear trend toward improvement. Significant worsening was not found with any psychometric evaluation. Side effects, when observed, were neither frequent nor severe. Three laboratory and vital sign values showed significant changes: increase in BUN concentrations, decrease in pulse rate, and increase in body weight. The changes in weight and pulse appeared to be within relatively normal ranges, and the increase in BUN concentrations did not appear to be clinically significant. During the first part of a long-term study, penfluridol received a high degree of patient acceptability and is a welcome addition to the maintenance treatment of schizophrenia.

Adult↗
PubMed1975

Disulfiram implants in the treatment of alcoholism some mechanisms of action.

For nearly 20 years, disulfiram implanted subcutaneously, has been used in alcoholics who have failed to respond to other treatment. Significantly positive results have been reported in a large number of cases. Despite this extensive use, many questions remain as to how these effects are exerted. As the reaction to alcohol following disulfiram implantation occurs less frequently and in lower intensity than following oral ingestion, psychological mechanisms probably play a vital role. Based in part on out own recent series of cases, the following explanations are offered regarding the possible mechanisms of action: (1) high motivation to stop drinking is manifested by agreeing to the precedure and reinforced by the procedure; (2) palpable presence of hte drug in the site of implantation; (3) generally sufficient reactivity of the agent to indicate activity to the patient;(4) in obsessional patients there is a removal of the fear of resumption of drinking for an extended period of time. For the more sociopathic patients the implant appears to provide a more structured ego boundary to allow the patient to change.

Adult↗