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Biomedical subjects

K G Power

Publications and source records attributed to K G Power.

At least 37 records · Page 2Linked to original sources
PubMed1994

The impact of travel acquired illness on the world traveller and family doctor and the need for pre-travel health education.

This retrospective study involved a 20% quota, age and sex stratified sample of people over 16 years of age, presenting to a group medical practice over a period of one year (N = 1568). A standardised, computer-scored, self-report questionnaire was administered. The response rate was 98.3%. 42% of respondents had travelled outwith the UK in the previous year. Of those, 42% had become ill whilst abroad. In 20.5% of cases the illness settled without treatment. However, 26% of the patients required consultation with a doctor whilst abroad and 48.4% of those becoming ill required further attention from the family doctor on return home. 5% of ill travellers were admitted to hospital abroad. 8% of all travellers did not have medical insurance cover. A large and significant population of travellers become ill whilst abroad, and travel-acquired illness has a large impact on general practice, with 1 in 5 travellers seeking GP consultation on return home. Improved practice-generated pre-travel health advice might decrease this burden on primary care.

Adolescent↗
PubMed1994

Controlled comparison of the characteristics of patients with panic disorder.

BACKGROUND: Increased general practice attendance rates have been associated with the diagnosis of mental illness but panic disorder has not been specifically investigated in this respect. In addition, studies have failed adequately to assess type and frequency of secondary care referral and patterns of psychotropic prescription in patients with panic disorder in relation to matched controls. AIM: This study set out to compare subjects with panic disorder with age and sex matched controls on measures of general practice consultation rate; psychotropic and non-psychotropic drug use; referral to secondary care, laboratory and radiological tests and hospital admissions; history of illness and complaints; and psychiatric comorbidity. METHOD: The study was carried out in nine practices in the Forth Valley area. One hundred patients with panic disorder, previously diagnosed using DSM III-R criteria, were identified and matched by age and sex with controls. Data were collected by review of general practice case notes. RESULTS: Subjects with panic disorder had significantly higher rates of general practice consultation over the 10 year period prior to DSM III-R diagnosis of panic disorder than controls. Subjects with panic disorder had also been prescribed a significantly greater number of psychotropic and non-psychotropic medications over this period, had had more secondary care investigations and had higher rates of mainly minor illness and related complaints than controls. High comorbidity of panic disorder with depression which had been diagnosed over the 10 year period prior to DSM III-R diagnosis of panic disorder was found. CONCLUSION: The results of this study describe a population of subjects with panic disorder who are long-term heavy users of primary care services. The results also suggest an association between panic disorder and both minor illness and psychiatric comorbidity over the 10 year period prior to DSM III-R diagnosis of panic disorder.

Adult↗
PubMed1993

Comparison of eating disorders and other dietary/weight groups on measures of perceived control, assertiveness, self-esteem, and self-directed hostility.

Anorexic and bulimic patients were compared to obese dieters, nonobese dieters, and normal controls on measures of perceived control, assertiveness, self-esteem, self-directed hostility, and psychiatric caseness. The anorexic and bulimic groups both scored significantly differently in the expected direction from the other three groups on all measures. There were no significant differences between the anorexic and bulimic groups and in turn, no significant differences among the obese, nonobese dieters, and normal controls. Results are in keeping with the notion that perceived control, low assertiveness, low self-esteem, and self-directed hostility are characteristics of eating disorder patients that differentiate them from individuals who display dietary/weight features, as well as from normal controls.

Adult↗
PubMed1993

Elderly people's views of an annual screening assessment.

A survey was carried out in order to identify elderly patients' perceptions of their health status, their health worries and their opinions regarding health screening before and after the introduction of an annual screening programme. Pre- and post-assessment self report, structured questionnaires and standardized, objectively scored, functional and medical assessments were used. The cohort was an age and sex stratified, 20% sample of those aged 75 years and over (133 patients). Results showed that 96% of patients before the assessment and 98% of patients afterwards, considered the annual assessment useful. The domiciliary visit by the health visitors resulted in one third of those patients who perceived themselves to be in good health and three quarters of those who perceived themselves to be in poor health becoming less worried about their health. Only two patients became more worried. Half of those objectively assessed as being in the medium health risk group and 68% of those in the high health risk group became less worried about their health after screening. Despite the majority of patients having welcomed the assessment their visit resulted in false, and potentially harmful, reassurance for a considerable number of individuals objectively assessed as being at medium and high health risk. An adverse consequence of health screening in elderly people may be inappropriate reassurance for those objectively assessed to be at risk. However, screening procedures are a means to an end, not an end in themselves. The identification of those at high risk should see subsequent implementation of services, investigations and increased support to relieve suffering, so it may have been that patients felt less anxious because they were anticipating relief of their problems.

Aged↗
PubMed1992

Comparison of sexual behaviour and risk of HIV transmission of Scottish inmates, with or without a history of intravenous drug use.

The sexual behaviour and intravenous drug use (IVDU) of a sample of 559 inmates (480 males and 79 females) was investigated. Sexual behaviour and IVDU prior to imprisonment, during imprisonment, and that expected after release, was assessed. Alterations in sexual behaviour as a means of HIV risk reduction was also assessed in relation to IVDU status. Prior to imprisonment most IVDUs and non-IVDUs engaged in unprotected intercourse. Sexual behaviour during imprisonment, as reported by inmates, was almost negligible for both groups. Expected sexual behaviour after imprisonment differed little from that before imprisonment for both IVDUs and non-IVDUs. Selecting partners more carefully and reducing their number was the most common method of HIV risk reduction for both IVDUs and non-IVDUs prior to imprisonment and was expected to be increasingly so after release. There was little difference in the sexual behaviour of IVDUs and non-IVDUs prior to imprisonment, during imprisonment, and as expected after release. However, IVDU inmates were more likely to have had an IVDU sexual partner than did non-IVDU inmates. Those IVDU inmates who had an HIV test, and those who had an IVDU sexual partner, were more likely to expect to continue IVDU after imprisonment. IVDU inmates, who had an IVDU sexual partner, were also more likely to have shared injected equipment but no more likely to have sterilized injecting equipment than did IVDU inmates whose sexual partner was not involved with IVDU. Results are discussed in relation to risk of HIV transmission for IVDUs and their sexual partners.

Adolescent↗
PubMed1992

Intravenous drug use and HIV transmission amongst inmates in Scottish prisons.

The intravenous drug use behaviour and HIV risk reduction strategies used by a group of Scottish inmates prior to prison, during imprisonment and as expected after release was investigated. From a sample of 559 inmates (480 males and 79 females) 27.5% were involved in IVDU prior to imprisonment, 7.7% on at least one occasion during a period of imprisonment and 14.7% expected to do so after release. Prior to imprisonment 17.3% had shared needles, 5.7% at some time during imprisonment and 4.3% expected to do so after release. Some form of HIV risk reduction strategies were practised by the majority of IVDU inmates prior to imprisonment, during imprisonment and were expected to continue after release. The most at risk inmates were those who continued to share injecting equipment without reduction and without sterilizing. The reduction in IVDU and needle sharing during imprisonment in comparison to prior to imprisonment was paralleled by a self-perceived reduction of personal risk from HIV during imprisonment.

Adult↗
PubMed1990

Four Systems Anxiety Questionnaire (FSAQ): a self-report measure of somatic, cognitive, behavioral, and feeling components.

This article presents the development of a 60-item self-report known as the Four Systems Anxiety Questionnaire (FSAQ). The FSAQ assesses anxiety on four components: somatic, cognitive, behavioral, and feeling. The FSAQ was given to 218 first-year university students, 54 anxiety patients attending clinical psychology departments, and 14 agoraphobic patients pre- and postpsychological treatment. Results reveal satisfactory reliability and validity levels. In addition, we proved that the FSAQ is sensitive to change following psychological treatment.

Adult↗
PubMed1990

Controlled comparison of the characteristics of long-term benzodiazepine users in general practice.

From three general practices, served by 11 principals, 205 long-term benzodiazepine users were identified and matched for age and sex with controls. Benzodiazepine users had significantly higher rates of previous physical illness, consultation and non-psychotropic drug consumption than controls. The characteristics of those receiving prescriptions for benzodiazepine hypnotics alone, anxiolytics alone and anxiolytics plus hypnotics were also investigated. Significant differences emerged between these three groups. Patients receiving hypnotics only were older, had a history of more physical illness and had received more non-psychotropic medication than patients receiving anxiolytics only. The anxiolytic plus hypnotic group had previously received more hypnotics and were currently receiving more medication than the group receiving anxiolytics alone. The results are discussed in relation to current concerns about benzodiazepine dependence and withdrawal.

Adult↗
PubMed1990

Controlled comparison of pharmacological and psychological treatment of generalized anxiety disorder in primary care.

A sample of 101 patients with generalized anxiety disorder were randomly allocated to one of five groups--diazepam, placebo, cognitive-behaviour therapy, diazepam plus cognitive-behaviour therapy, or placebo plus cognitive-behaviour therapy--and treated over 10 weeks in a primary care setting. All groups received a similar amount of contact with the psychologist and general practitioner. The greatest improvement in ratings of severity of symptoms and overall change in symptoms occurred with cognitive-behaviour therapy combined with diazepam; cognitive-behaviour therapy alone also performed well and cognitive-behaviour therapy plus placebo performed slightly less well. Diazepam alone showed improvement relative to placebo alone. There was a high level of agreement between ratings by the general practitioners, psychologist, and the patients of the response to treatment. At six months follow-up there was no difference between treatment groups in the proportion of patients receiving psychotropic medication after the end of the study. However, cognitive-behaviour therapy, either alone or in combination with drug or placebo, showed the lowest incidence of referral for psychological or psychiatric treatment at six months follow-up.

Adult↗
PubMed1988

The effects of long-term benzodiazepine treatment and graded withdrawal on psychometric performance.

Twelve patients were assessed prior to and during 4 weeks' graded withdrawal from long-term benzodiazepine treatment. A control group of ten healthy drug-free individuals were assessed over the same period. Psychometric measures included Four Choice Reaction Time--Decision (FCRT-D), Four Choice Reaction Time--Movement (FCRT-M), Sensory Threshold Detection (STD) and Key Tapping Rate (KTR). Patients anxiety level was monitored using the Hamilton Rating Scale (HAM) and a Visual Analogue Self-Report Measure (VASR). There was no evidence of psychometric practice effects and no significant changes in patients anxiety ratings. Prior to withdrawal the patient group showed significantly impaired performance compared to the control group on FCRT-D and STD, tasks primarily involving visual sensory information processing, but there were no differences between the two groups on FCRT-M and KTR, tasks primarily involving motor speed. During withdrawal the patient group showed significant improvements compared to the control group on FCRT-D and STD.

Adult↗
PubMed1988

A comparison of sources of nursing stress and job satisfaction among mental handicap and hospice nursing staff.

This study compares sources of nursing stress and job satisfaction among 181 mental handicap and 24 hospice nurses. It was hypothesized that nursing stress varies as a consequence of nursing specialty. Analysis of variance revealed differing features of nursing stress between the two specialties. Hospice nurses reported stress as primarily associated with death and dying and inadequate preparation to meet the emotional needs of patients and their families, while mental handicap nurses reported stress related to workload, conflict with other nurses and nursing environment. The results suggest that two additional factors that did not differ between specialties require further examination, namely patient behaviour and purposelessness of nursing care. Job satisfaction also differed between specialties with hospice nurses reporting higher satisfaction with supervision, co-workers, and pay, and lower satisfaction with promotion in comparison to mental handicap nurses. Within the mental handicap groups nursing stress correlated with job satisfaction, state-trait anxiety and non-psychotic psychiatric disturbance in predicted directions. Analysis of the above variables with respect to mental handicap nursing grade was also undertaken. Overall results indicate the importance of nursing specialty as a major factor influencing nursing stress.

Hospices↗
PubMed1985

Controlled study of withdrawal symptoms and rebound anxiety after six week course of diazepam for generalised anxiety.

A group of patients suffering from anxiety, as assessed by general practitioners and psychologists using research criteria for generalised anxiety, were treated with either diazepam or placebo double blind for six weeks. This active treatment period was preceded by a one week single blind placebo "wash in" period and followed by a two week single blind placebo "wash out" period. The results suggest that diazepam can produce rebound anxiety and withdrawal symptoms when used in moderate doses and for what has previously been regarded as a safe length of time. If replicated these results have implications for the therapeutic use of benzodiazepines.

Adult↗
PubMed1985

Life stress, medical lethality, and suicidal intent.

Eighty parasuicide patients were studied. The importance of life stress, age, and General Health Questionnaire score as predictors of the suicidal intent and medical lethality which they exhibited was examined. Medical lethality and suicidal intent were closely related: those whose parasuicide resulted in high lethality differed from those showing low lethality in their degree of suicidal intent, but did not differ in life stress, age, or GHQ score. Although both life stress and GHQ score were significantly correlated with suicidal intent, the GHQ score accounted for a greater proportion of the variance. These results suggest a more complex relationship between life stress, GHQ score, and suicidal intent than is often assumed.

Adolescent↗