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P Yates

Publications and source records attributed to P Yates.

At least 19 recordsLinked to original sources
PubMed2007

Terminally-ill people living alone without a caregiver: an Australian national scoping study of palliative care needs.

Home-based palliative care services are facing increasing challenges in servicing the needs of clients who live alone and without a primary caregiver. The findings from the analysis of 721 services' records from three Australian states, and feedback from health professionals in interviews and postal surveys, demonstrated that there were aspects of being on one's own with a terminal illness and living at home that require a specialised approach and support. This study explored the issues of palliative care patients living alone, from a service provider perspective, and provided evidence-based information to assist with service planning. The study made recommendations to the Australian Department of Health and Ageing about services considered important in developing support structures for this growing population.

After-Hours Care↗
PubMed2006

Meeting the support and information needs of women with advanced breast cancer: a randomised controlled trial.

Addressing psychosocial and quality of life needs is central to provision of excellent care for people with advanced cancer. This study tested a brief nurse-delivered intervention to address the needs of urban women with advanced breast cancer. This study was conducted at four large urban hospitals in Australia. One hundred and five women with advanced breast cancer were recruited and randomised to receive the intervention or usual care, then asked to complete the European Organisation of Research and Treatment of Quality of life Q-C30 version (2.0) (EORTC Q-C30) (version 2) and Supportive Care Needs Survey (SCNS) at 1 month and 3 months postrecruitment. No significant differences were detected between intervention and usual care groups in the SCNS or the EORTC Q-C30 subscale scores. However, when the groups were divided into high needs (score of above 50) and low baseline needs (score of 50 or below) for each SCNS subscale, a significant difference between intervention and usual care groups was found in the psychological/emotional subscale among women with high baseline needs. In conclusions, this study demonstrated that a face-to-face session and follow-up phone call with a breast care nurse significantly reduced the psychological and emotional needs of those with high initial needs. There was no evidence of the intervention influencing the quality of life; or perceived needs of women with low initial psychological/emotional needs or perceived needs in other domains. Possibly, the intervention was not sufficiently intense to achieve an effect.

Adult↗
PubMed2006

Compartment syndrome following total knee arthroplasty: a report of seven cases.

Compartment syndrome is a rare complication of total knee arthroplasty that requires early recognition and prompt decompression in order to prevent long-term disability. We have found only one previous case report in the literature. We present a series of seven cases from four hospitals and five surgeons. Six of the cases resulted in the loss of at least one compartment, and one resulted in amputation. Four of the cases resulted in legal action. We suggest that important risk factors contributing to the development of this condition include complex surgery, soft-tissue compromise, previous surgery, and possibly vascular disease. Delay in the diagnosis and hence delay in decompression was common in our series, and in five cases appeared to be related to the use of a postoperative epidural infusion for pain relief. The presence of associated neurological compromise may have also been a significant factor in the delay to diagnosis in two cases.

Adult↗
PubMed2005

Segmental fracture of the scaphoid: report of a rare fracture pattern.

INTRODUCTION: To the best of our knowledge, there are no reports in the orthopaedic and trauma literature of true segmental fracture of the scaphoid bone. We present such a case with a brief discussion of the morphology and mechanisms of injury of scaphoid fractures and the problems they present, particularly in diagnosis. CASE HISTORY: A 43-year-old male with polytrauma sustained in a motorcycle road traffic accident was treated at our hospital. His injuries included a fracture initially thought to involve the waist of the scaphoid. Because he had bilateral upper limb injuries, we elected to treat the fracture surgically to facilitate rehabilitation. At the time of surgery, the fracture was noted to be truly segmental, an unsuspected and rare finding. The fracture was internally fixed, with a satisfactory result. DISCUSSION: Scaphoid fracture patterns are generally consistent and predictable, occurring most commonly through the waist of the bone. Mechanism for injury is thought to be hyperextension of the wrist. Comminution, with or without a butterfly fragment, is occasionally seen, as are simultaneous tuberosity fractures. We suggest that the mechanism in this case may have been multiple or secondary trauma, or an effect of loaded rotation. We highlight the need for careful imaging of the scaphoid bone prior to choosing treatment.

Accidents, Traffic↗
PubMed2005

Processing of whole femoral head allografts: validation methodology for the reliable removal of nucleated cells, lipid and soluble proteins using a multi-step washing procedure.

Following the major outbreak of BSE in the United Kingdom in the mid 1980's and the first reported cases of the human disease equivalent, vCJD, in 1996 a number of measures were taken to reduce the risk of secondary transmission of vCJD by blood or surgical instruments. Two cases of probable transmission of vCJD by blood components have now been reported. The Department of Health has recently undertaken a vCJD risk analysis for bone. Although significant uncertainties still exist in the assumptions on which the assessment is based, a few important recommendations were made. These include a recommendation that bone should be processed to remove blood and marrow and that pooling of donations is never advantageous. This study aimed to establish a method of processing whole femoral heads using disposable equipment, with the purpose of removing as much of the marrow components as possible. We are able to remove 98.2% (range 94.5-99.9%) of the nucleated cells and 98.7% (range 97.8-99.4%) of the soluble protein content from within an intact femoral head. This work confirms that the majority of blood and marrow components can be removed without the need for morselising the bone prior to washing.

Aged↗
PubMed2005

BDNF gene is a risk factor for schizophrenia in a Scottish population.

Schizophrenia is a severe psychiatric disease with a strong genetic component. Brain-derived neurotrophic factor (BDNF) has been implicated in the pathogenesis of schizophrenia and bipolar (BP) disorders. The present study has examined two polymorphisms in linkage disequilibrium in the BDNF gene, which have been variously reported as associated with schizophrenia and BP. In our study, 321 probands with a primary diagnosis of schizophrenia or schizoaffective disorder, and 263 with a diagnosis of bipolar affective disorder, were examined together with 350 controls drawn from the same geographical region of Scotland. The val66met single-nucleotide polymorphism (SNP) showed significant (P = 0.005) association for valine (allele G) with schizophrenia but not bipolar disorder. Haplotype analysis of val/met SNP and a dinucleotide repeat polymorphism in the putative promoter region revealed highly significant (P < 1 x 10(-8)) under-representation of the methionine or met-1 haplotype in the schizophrenic but not the BP population. We conclude that, although the val66met polymorphism has been reported to alter gene function, the risk may depend upon the haplotypic background on which the val/met variant is carried.

Adult↗
PubMed2005

Identifying potential risk haplotypes for schizophrenia at the DTNBP1 locus in Han Chinese and Scottish populations.

The dystrobrevin-binding protein 1 (DTNBP1) gene on chromosome 6p has emerged as a potential susceptibility gene for schizophrenia. Although a number of attempts to replicate the original association finding have been successful, they have not identified any obvious pathogenic variants or a single at risk haplotype common to all populations studied. In the present study we attempted further replication in an independent sample of 638 nuclear families from the Han Chinese population of Sichuan Province, SW China. We also examined 580 Scottish schizophrenic cases and 620 controls. We genotyped 10 single-nucleotide polymorphisms (SNPs) in DTNBP1 that were used in the original report of association, plus rs2619538 (SNP 'A') in the putative promoter region, which has also been associated with schizophrenia. In the Chinese trios we found that two SNPs (P1635 and P1765) were significantly overtransmitted, but with alleles opposite to those reported in the original studies. SNPs P1757 and P1765 formed a common haplotype, which also showed significant overtransmission. In the Scottish cases and controls, no individual markers were significantly associated with schizophrenia. A single haplotype, which included rs2619538 and P1583, and one rare haplotype, composed of P1320 and P1757, were significantly associated with schizophrenia, but no previously reported haplotypes were associated. Based on the data from the Chinese population, our results provide statistical support for DTNBP1 as a susceptibility gene for schizophrenia, albeit with haplotypes different from those of the original study. However, our lack of replication in the Scottish samples also indicates that caution is warranted when evaluating the robustness of the evidence for DTNBP1 as genetic risk factor for schizophrenia.

Alleles↗
PubMed2005

Mapping the quality of life and unmet needs of urban women with metastatic breast cancer.

Enhancing quality of life and reducing the unmet needs of women are central to the successful management of advanced breast cancer. The objective of this study was to investigate the quality of life and support and information needs of urban women with advanced breast cancer. This study was conducted at four large urban hospitals in Melbourne, Australia. A consecutive sample of 105 women with advanced breast cancer completed a questionnaire that contained the European Organization of Research and Treatment of Cancer Quality of Life Q-C30 and the Supportive Care Needs Survey. Between one quarter and a third of the women reported difficulties with their physical, role and social functioning, and a little over a quarter of the women reported poor global health status. Fatigue was a problem for most women. The highest unmet needs were in the psychological and health information domains. Almost no differences in unmet needs were detected when comparing different demographic and disease characteristics of women. Health care providers should routinely monitor the quality of life and needs of women with advanced breast cancer to ensure that appropriate treatment, information or supportive services are made available.

Adaptation, Psychological↗
PubMed2005

Association analysis of the RGS4 gene in Han Chinese and Scottish populations with schizophrenia.

We investigated the RGS4 as a susceptibility gene for schizophrenia in Chinese Han (184 trios and 138 sibling pairs, a total of 322 families) and Scottish (580 cases and 620 controls) populations using both a family trio and case-control design. Both the samples had statistical power greater than 70% to detect a heterozygote genotype relative risk of >1.2 for frequent RGS4-risk alleles. We genotyped four single nucleotide polymorphisms (SNPs) which have previously been associated with schizophrenia as either individually or part of haplotypes. Allele frequencies and linkage disequilibrium between the SNPs was similar in the two populations. In the Chinese sample, no individual SNPs or any of their haplotypes were associated with schizophrenia. In the Scottish population, one SNP (SNP7) was significantly over-represented in the cases compared with the controls (0.44 vs. 0.38; A allele; chi(2) 7.08, P = 0.011 after correction for correlation between markers by permutation testing). One two-marker haplotype, composed of alleles T and A of SNP4 and SNP7, respectively, showed individual significance after correction by permutation testing (chi(2) 6.8; P = 0.04). None of the full four-marker haplotypes showed association, including the G-G-G-G haplotype previously associated with schizophrenia in more than one sample and the A-T-A-A haplotype. Thus, our data do not directly replicate previous associations of RGS4, but association with SNP 7 in the Scottish population provides some support for a role in schizophrenia susceptibility. We cannot conclusively exclude RGS4, as associated haplotypes are likely to be surrogates for unknown causative alleles, whose relationship with overlying haplotypes may differ between the population groups. Differences in the association seen across the two populations could result from methodological factors such as diagnostic differences but most likely result from ethnic differences in haplotype structures within RGS4.

Case-Control Studies↗
PubMed2004

Barriers to effective cancer pain management: a survey of Australian family caregivers.

Cancer pain continues to be an important focus of health research and intervention development. The continuing shift of cancer care to the community increases the family caregiver's role in pain management and highlights the need to understand family experiences and also family barriers to effective pain management. This paper presents the findings of an Australian study exploring attitudinal barriers to effective pain management amongst 75 family caregivers of people with cancer attending an outpatient clinic. Approximately 75% of the caregivers demonstrated concerns or were unsure about addiction, a belief likely to impact on the use of prescribed opioids in the home. Caregivers demonstrated similar levels of concern about side-effects or whether the presence of pain indicated disease progression. These findings support research in other populations and are further evidence of the need to include family caregivers, along with patients, in intervention studies aimed at reducing the impact of these barriers on effective pain management.

Adult↗
PubMed2003

Computed tomography in suppurative ear disease: does it influence management?

The value of high resolution computerized tomography (CT) prior to routine mastoid surgery for cholesteatoma remains controversial. Doubts about sensitivity and specificity, in detecting the extent of underlying pathology and in predicting asymptomatic complications, prevent widespread adoption. This retrospective study looks at the influence of pre-operative scanning on the surgical management of chronic suppurative otitis media over an 18-month period. The radiological findings determined the choice of surgical approach, but contributed less to the decision to operate and the prediction of potential hazards. CT is of most value when the otologist can be flexible in surgical technique, tailoring it to imaging findings.

Cholesteatoma↗
PubMed2002

Hepatitis B vaccinees may be mistaken for confirmed hepatitis B surface antigen-positive blood donors.

BACKGROUND AND OBJECTIVES: Hepatitis B surface antigen (HBsAg) test sensitivities have gradually increased, and neutralizable weak HBsAg-positive donations, with no other hepatitis B virus (HBV) markers, have occasionally been found in our donor population. On investigation, these donors have admitted to receiving hepatitis B vaccine up to 5 days previously. A study was therefore initiated to monitor HBsAg reactivity amongst volunteers after receiving their first dose of hepatitis B vaccine. MATERIALS AND METHODS: Eight volunteers were tested using three HBsAg assays (Abbott Auszyme, Ortho HBsAg-3 and Abbott/Murex GE34/36) on days 0, 3, 5, 7 and 10 after administration of hepatitis B vaccine. RESULTS: Two HBsAg tests (Abbott Auszyme and Ortho HBsAg-3) did not detect HBsAg reactivity amongst the volunteers, although the Abbott Auszyme test results reached 70-80% of the manufacturer's cut-off at day 3 in two volunteers. The most recently launched assay (Abbott/Murex GE 34/36) detected seven (87%) of the eight volunteers as HBsAg reactive on day 3, and two (25%) volunteers were still reactive on day 5. CONCLUSION: The Abbott/Murex GE 34/36 assay demonstrated HBsAg reactivity in most volunteers on day 3 and in some on day 5 after vaccination. It is therefore recommended that individuals who have recently been vaccinated with hepatitis B be deferred from blood donation for at least 7 days.

Blood Donors↗
PubMed2001

Failure to confirm NOTCH4 association with schizophrenia in a large population-based sample from Scotland.

The NOTCH4 gene was recently reported to be associated with schizophrenia based on TDT analysis of 80 British trios. The strongest evidence for association derived from two microsatellites. We genotyped both loci in a large sample of unrelated Scottish schizophrenics and controls, but failed to replicate the reported association, finding instead that each putative schizophrenia-associated allele had a somewhat lower frequency in schizophrenics than in controls.

Alleles↗
PubMed2001

Quality of life experienced by patients receiving radiation treatment for cancers of the head and neck.

The purpose of this descriptive study was to explore the quality of life for 58 outpatients during and after a course of radiation treatment for cancers of the head and neck. Data were collected at three time points: T1 (first week of treatment), T2 (last week of treatment), and T3 (1 month after treatment). Patients completed two measures that assessed physical, emotional, functional, and social aspects of well-being: the Functional Assessment of Cancer Therapy: Head and Neck (FACT-H&N) and the Hospital Anxiety and Depression Scale (HADS). Repeated measures multivariate analysis of variance and post hoc t tests were performed to assess changes in quality of life over the three time points. Results indicated overall increased levels of physical and functional symptoms, head and neck specific concerns, and depression between T1 and T2. However, except for depression, there was some improvement between scores on each of these measures of physical and functional well-being between T2 and T3, although this improvement was not to the pretreatment level. The FACT subscales assessing social and emotional well-being, and the HADS subscale showed no significant changes across time. Implications of this study relate to the ongoing need for interventions to assist patients once they have completed the radiation treatment course, and to improved assessment in some areas of emotional distress.

Adult↗
PubMed2001

Efficacy and safety of sildenafil citrate in the treatment of men with mild to moderate erectile dysfunction.

BACKGROUND: Erectile dysfunction is a common, multi-factorial disorder. AIMS: To evaluate the efficacy, tolerability and frequency of use of sildenafil citrate in men with mild to moderate erectile dysfunction of no established organic cause. METHOD: This double-blind, randomised, placebo-controlled, flexible-dose, two-way crossover study was conducted at four centres in the UK in 44 men with mild to moderate erectile dysfunction of no clinically obvious organic cause. The study included two 28-day treatment periods, during which time sildenafil or placebo (25-75 mg, based on efficacy) was taken as required. RESULTS: Compared with placebo, sildenafil was associated with increases in frequency of use, erections adequate for sexual intercourse and level of sexual satisfaction (P:<0.0001). More patients receiving sildenafil stated they would use the treatment again compared with those receiving placebo (P:<0.0001). There were no discontinuations due to sildenafil treatment. CONCLUSIONS: Sildenafil is effective and well tolerated in men with mild to moderate erectile dysfunction of no clinically identifiable organic cause.

Adolescent↗
PubMed2000

Equine influenza vaccine efficacy: the significance of antigenic variation.

To investigate the level of cross-protection induced by equine influenza H3N8 vaccines derived from different lineages, two studies have been carried out with ponies vaccinated with 'American-like' and 'European-like' vaccines and experimentally challenged with a European-like strain. The results demonstrated that equine influenza vaccines clearly protect against challenge with homologous virus if serum antibody titres are sufficiently high. On the other hand, protection is incomplete even when animals vaccinated with heterologous strains have comparative antibody levels. Nevertheless, the protection afforded by heterologous viruses can be improved by stimulating high levels of antibody. It would be advisable to update equine influenza vaccine strains regularly so that they contain similar strains to variants that are circulating in the field.

Animals↗
PubMed2000

The roles of Australian chairs in clinical nursing.

Australian chairs in clinical nursing have been established in order to achieve more effective partnerships between academia and the health care sector in education, research and quality of nursing care. The aim of this study was to describe the goals, obstacles, supports and outcomes of such appointments. The study explored the perceptions of a purposive sample of Australian professors holding clinical chairs, stratified to ensure representation of both the geographical and clinical specialty diversity of the population. Eight professors were interviewed using semi-structured telephone interviews. The interviews covered three phases: role establishment, current foci and future developments. Qualitative analysis for common themes and areas of divergence was conducted with concurrent analysis providing the opportunity to seek confirmation for emerging themes. The participants highlighted the diversity of arrangements between university and health sector partners in establishing their respective roles. Clear communication was crucial to successful partnership arrangements. All roles included components of education, research and politics but the relative contribution of each of these areas depended to a large extent on the priorities of the employing partners. The participants felt the need to secure sustainable income sources and consolidate outcomes to ensure the continued viability of their positions. Clinical professorial nursing appointments provide one means of addressing perceived gaps in the links between the university and health care sectors, academia and clinicians, thus enhancing nursing education, research and politics. Through emphasizing common purpose and mutual respect, these positions can illuminate the crucial role nursing plays in Australian health care delivery.

Australia↗