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Biomedical subjects

R G Marriott

Publications and source records attributed to R G Marriott.

6 recordsLinked to original sources
PubMed2006

Antipsychotic medication for elderly people with schizophrenia.

BACKGROUND: A large and growing number of older people across the world suffer from schizophrenia. Recommendations for their treatment are largely based on data extrapolated from studies of the use of antipsychotic medications in younger populations. In addition most manufacturers of such medications recommend prescription of reduced doses to the elderly. The evidence base for these assumptions is unclear and raises obvious questions regarding the appropriateness of such prescribing practice. OBJECTIVES: To find and assimilate good evidence of the effects of antipsychotic medication for treatment of schizophrenia in people over 65 years of age. SEARCH STRATEGY: We searched the Cochrane Schizophrenia Group's Register (May 2003). We inspected references of all included studies for further trials and contacted relevant pharmaceutical companies. SELECTION CRITERIA: All clinical randomised trials evaluating antipsychotic drugs for schizophrenia and schizophrenia-like psychoses in older people. DATA COLLECTION AND ANALYSIS: We extracted data independently. For homogenous dichotomous data, the random effects, relative risk (RR), and 95% confidence interval (CI) and, where appropriate, the numbers needed to treat (NNT) were calculated on an intention-to-treat basis. For continuous data, we calculated weighted mean differences (WMD). MAIN RESULTS: Two hundred and fifty two elderly people with schizophrenia participated in three relevant randomised controlled studies. We were unable to extract usable data on quality of life, satisfaction, service use, or economic outcomes. One small study (n=18) compared thioridazine with remoxipride (RR leaving the study early 1.0 CI 0.07 to 13.6). A second study (n=175) compared risperidone with olanzapine. Global state 'not improved/worse' was not significantly different between treatments (n= 171, RR 1.26 CI 0.8 to 1.9); mental state PANSS total endpoint scores were also equivocal (n=171, RR 0.98 CI 0.76 to 1.26) as were all cognitive function tests. The third study (subset n=59) compared olanzapine with haloperidol and mental state change scores (BPRS WMD -3.60 CI -10.8 to 3.6; PANSS WMD -6.00 CI -18.3 to 6.3) were equivocal. AUTHORS' CONCLUSIONS: Antipsychotics may be widely used in the treatment of elderly people with schizophrenia, however, based on this systematic review, there are little robust data available to guide the clinician with respect to the most appropriate drug to prescribe. Clearly reported large short, medium and long-term randomised controlled trials with participants, interventions and primary outcomes that are familiar to those wishing to help elderly people with schizophrenia are long overdue.

Aged↗
PubMed1998

The urgency and imagery in the Type A behavior pattern.

This study explored the relationship between Type A Behavior Pattern, visual imagery, and ability for time estimation. 115 subjects filled out a questionnaire which assessed them for the presence of a visual imaginary representation of time and scores on Type A or B behavior. While completing the questionnaire subject made estimates of four time intervals of 8 min., 22 sec. The treatment consisted of formal training in visual imagery representation between time estimates of intervals 3 and 4. Data were analyzed using a 2 x 2 x 4 mixed analysis of variance in which the subject variables (Type A/B, visual imaginary representation, and time (estimate) were dichotomized using median splits. The dependent measures were accuracy scores for each of the four estimation trials. Subjects with training in visual imagery representation estimated time accurately; Type A subjects with training in visual imaginary representation were the most accurate. All subjects improved over the four trials, with greatest improvement following training in visual imaginary representation. The most consistent improvement in time estimates occurred in Type A subjects. Results replicated and extended previous findings associating visual imaginary representations with more accurate time perception, especially for individuals scoring as showing Type A behavior pattern.

Adult↗
PubMed1985

Effects of dominance on group decision making: toward a stress-reduction explanation of groupthink.

Janis (1972) proposed that groupthink is essentially a stress-reduction process. Cohesive groups reduce the stress of decision making by suppressing critical inquiry. Theoretically, groupthink could be prevented in cohesive groups if the stress could be diffused by other factors. We investigated the effects of task structure (decision-making procedures) and an individual factor (dominance) on the quality of group decision making, anxiety, and symptoms of groupthink. Students (n = 112) participated in twenty-eight 4-person, mixed-sex groups. Groups composed of highly dominant members made higher quality decisions, exhibited lower state anxiety, and took more time to reach a decision. They also tended to make more statements of disagreement and agreement, and to report more group influence on the members. Decision-making procedures had little effect on the decision process.

Anxiety↗
PubMed1981

Open access to the practice nurse.

The work of practice nurses to whom patients are allowed ;open access' was analyzed. The attendance rate for the population registered with the doctors was 964 per 1,000 patients per year. It was found that in nearly half of the attendances the nurse was the person of primary contact for the health care team and that she dealt with three quarters of these cases without referral to a doctor. Further research is required into the management of these patients by the nurse. Although it is the opinion of the practice doctors that the nurses' care was adequate, open access presents them with such a wide range of problems that their work has moved ahead of the legal restrictions placed on general practitioners concerning the delegation of work.

England↗