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Biomedical subjects

R Power

Publications and source records attributed to R Power.

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

Assessing HIV prevention among injecting drug users in European Community countries: a review.

By September 30th 1991, 19,579 cases of AIDS among injecting drug users had been reported in Europe. HIV seroprevalence rates among drug injectors vary from less than 5% in some cities, to over 50% in others. Since the estimated number of drug injectors in Europe is between 750,000 and 1,000,000, HIV is a considerable threat to drug injectors, their sex partners and their off-spring, affecting large numbers of citizens in the European region. This paper gives an overview of the magnitude of the drugs/AIDS problem in the European region, and the concrete measures that have been taken to prevent HIV infection among drug users. Data from the evaluation of methadone programmes, needle and syringe exchange schemes and data on sexual behaviour change of drug users are critically reviewed. Limitations of the methods used for the evaluation of prevention activities are also discussed. Based on all the material reviewed, the main conclusions are the following: AIDS is a greater threat to public health than problem drug use, more accurate and reliable evaluation methods need to be utilized at European Community level, a combination of prevention measures should be used in order to reduce the further spread of HIV infection among injecting drug users.

AIDS Serodiagnosis↗
PubMed1994

Potential development of community oriented HIV outreach among drug injectors in the UK.

Given the current epidemiological and behavioural risk profile of HIV infection among injecting drug users in the UK, the main strategic task continues to be to develop interventions to prevent the spread of HIV infection. Outreach to drug injectors is an important part of the wider UK HIV prevention strategy. This paper reviews critically and reassesses practically the role of outreach interventions among drug injectors in the UK. It is argued that despite the development of innovative outreach activity, the full potential of outreach has not been realized due to its theoretical orientation and in-built structural limitations. Outreach has predominantly operated with an 'individual' orientation, aiming to work with individual clients to help them to change their behaviour, gain access to services, or to become better users of services. The main thesis of this paper is that current outreach provision needs to be complemented by 'community change' models which seek to engender changes in the social etiquette of drug use within communities of drug injectors. The paper argues that the social networks through which HIV may be transmitted are the same social networks that may be coopted for HIV prevention. Future outreach services must turn to these networks as a way of targeting and encouraging changes among broad populations of drug injectors. Such models might use indigenous advocates, working within social networks, supported by community outreach facilitators.

Community Health Services↗
PubMed1993

Prehospital resuscitation by Irish GP's: a preliminary report.

Two hundred and eleven Irish GP's responded to a questionnaire survey of their experiences of prehospital resuscitation. Seventy per cent had attempted CPR in a prehospital setting and a success rate of 21% was reported. A defibrillator had been used in the prehospital setting by 10% of the respondents with a reported success rate of 11%. Over 80% considered that they would benefit from further training in CPR and the use of a defibrillator. The implications of these results for the development of an Irish cardiac "chain of survival" are discussed.

Cardiopulmonary Resuscitation↗
PubMed1992

Pre-hospital management of acute myocardial infarction.

Two-hundred and eleven Irish GPs responded to a questionnaire survey of their experience and management of acute myocardial infarction (MI) and their attitudes to the use of thrombolytic therapy Three-quarters of the respondents felt they dealt with three or more MIs per year; most felt that the majority of MIs were initially seen by a GP. Diagnosis is based on clinical findings; only 11% routinely take an ECG. Management is largely oriented to relief of pain but intravenous narcotics are only used by a minority. Hospital referral for suspected acute MI was the preferred choice for almost all GPs in a variety of patient-care scenarios. Home care for MI was chosen only for a minority of elderly patients when some hours had elapsed since the onset of symptoms. Definitive guidelines on the pre-hospital use of thrombolysis are not yet available. However, eighty per cent of respondents in this study feel that thrombolysis is beneficial and many feel that it has value in the pre-hospital situation. Respondents identified educational, organisational and financial problems to be overcome before this could happen.

Adult↗
PubMed1992

Assessing AIDS prevention for injecting drug users; some methodological considerations.

There is an urgent need to develop strategies aimed at reducing the spread of HIV infection amongst injecting drug users. It is essential that any such initiatives are monitored and evaluated. It is the contention of this paper that evaluation should be rigorous, flexible and comparative. To achieve this we need to examine the basic principles of evaluation, both in terms of service delivery and process evaluation, as well as outcome measures. In the evaluation task it is important to distinguish clearly and unequivocally between implementation and impact, aims and objectives. At the practical level, researchers need to give due consideration to liaison with agency staff. Methodologically, issues such as demonstrating impact and rival explanations must be addressed. The paper concludes by proposing and illustrating a model for evaluation that has particular relevance to community-base initiatives aimed at reducing the spread of HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1992

The role of significant life events in discriminating help-seeking among illicit drug users.

This paper examines the role of significant life events in distinguishing two samples of illicit drug users: 120 help-seekers (the "agency group") and 120 not seeking help (the "non-agency group"). We examined 10 life areas clustered around the general categories of "substance use," "social functioning," and "emotional and interpersonal functioning." A range of objective and self-reported information was collected regarding each life area covering the 12 months prior to interview. Analysis revealed that the agency group experienced a greater number of negatively perceived drug-related life events than the non-agency group. These life events were also more likely to have occurred in recent months, prompting reported "concern" and "need for help" among the agency group. Additionally, length of use of current primary drug was seen to be a contributory variable in distinguishing between the groups.

Adult↗
PubMed1992

Help-seeking among illicit drug users: some differences between a treatment and nontreatment sample.

A number of both medical and nonmedical disciplines have expressed concern regarding the large numbers of individuals that fail to present to services, despite experiencing problems similar to those of active help-seekers. Such a concern is most pertinent in the field of substance misuse, particularly in terms of the role of injecting drug users in the spread of HIV and AIDS. This study looked at two samples of problem drug takers in London: 120 seeking help (the "agency group") and 120 not seeking help (the "non-agency group"). A number of factors were examined to distinguish the two groups, including sociodemographic profiles, drug histories, and self-reported "concern" and "need for help" in a wide variety of life areas. Data analysis highlighted the significance of "concern" and "need for help" in specified life areas.

Adaptation, Psychological↗
PubMed1992

Awareness of heart attack signals and cardiac risk markers amongst the general public in Dublin.

Following myocardial infarction, early access to medical care is essential. In order to assess the ability to recognise and manage heart attack and its risk factors, 302 members of the public were surveyed. A surprisingly comprehensive knowledge base was revealed, together with apparently appropriate ideas about the management of myocardial infarction and its risk factors. The significance of this finding is discussed in the light of the well documented delays by members of the public in summoning help when they suspect heart attack.

Adult↗
PubMed1991

Towards a process evaluation model for community-based initiatives aimed at preventing the spread of HIV amongst injecting drug users.

An action research model is presented for the evaluation of community-based interventions. The short- and long-term application of this model is illustrated by means of a study of a community drug team which was initiated to prevent the spread of HIV infection amongst substance misusers in south-west London. A client caseload of 155 was monitored over a year-long period and the results used to evaluate the extent to which the CDT had achieved its stated aims and objectives. Other tools used in the evaluation and monitoring were surveys of generic, specialist and general practitioner services, and needs assessment of samples of drug users. The potential of the model is explored, both in terms of its research role and in facilitating service development. The value of action research methodology in assessing HIV/AIDS prevention is stressed.

Adolescent↗
PubMed1990

Purification and characterization of acetylcoenzyme A: deacetylvindoline 4-O-acetyltransferase from Catharanthus roseus.

The enzyme acetylcoenzyme A:deacetylvindoline 4-O-acetyltransferase (EC 2.3.1.-) (DAT), which catalyzes the final step in vindoline biosynthesis in Catharanthus roseus, was purified 3300-fold using ammonium sulfate precipitation followed by gel filtration, anion exchange, hydroxyapatite, and affinity chromatographies. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) of the purified DAT showed the presence of two major proteins having Mr values of 33,000 and 21,000, whereas native PAGE showed three protein bands, and isoelectric focusing-PAGE one diffuse protein band (pI = 4.7-5.3) plus two minor protein bands (pI = 5.7 and 6.1). Purified DAT possessed Km values of 6.5 microM and 1.3 microM for acetylcoenzyme A and deacetylvindoline, respectively, and Vmax values of 12.6 pkat/microgram protein (acetylcoenzyme A) and 10.1 pkat/micrograms protein (deacetylvindoline). Inhibition of DAT by tabersonine, coenzyme A, and cations (K+, Mg2+, and Mn2+) was observed, while the pH optimum of this enzyme was determined to be 7.5 to 9.

Acetyl Coenzyme A↗
PubMed1990

Resuscitation skills among the general public in Dublin.

Evidence exists that many of the victims of cardiac arrest due to ischemic heart disease can be resuscitated if cardiopulmonary resuscitation (CPR) and defibrillation are made available in the minutes following collapse. In order to evaluate the ability of the general public in Dublin to perform CPR appropriately, 225 people were asked when CPR was indicated and how cardiac arrest was diagnosed and then asked to perform CPR on a mannequin. In the knowledge sections, 45% gave an appropriate indication for CPR and 34% gave appropriate criteria for diagnosing cardiac arrest. However, only eight participants were able to perform CPR correctly and only six (2.6%) had both the correct skills and knowledge. There is an urgent need to improve the public's knowledge of and ability to perform CPR as part of an overall strategy to decrease mortality from ischemic heart disease in Ireland.

Educational Status↗
PubMed1989

Participant observation and its place in the study of illicit drug abuse.

Participant observation has long been utilized as a valuable research methodology in the study of illicit drug abuse. It should not be viewed in isolation, but seen as an essential complement to the quantitative analysis of trends in drug use, such as epidemiological studies and the monitoring of services for drug users. Fieldwork conducted at the Drug Indicators Project and other relevant studies highlight the practical and ethical problems faced by the participant observer, including issues of access, co-operation and confidentiality. This is particularly pertinent when working with drug users not in contact with services. When working with drug users in a treatment context, the need to be flexible and sensitive to the needs of agency staff is stressed, and the ways in which participant observers can operate as volunteers are explored. Contemporary concern about HIV infection, AIDS, and risk behaviour amongst drug users, raises the potential for an expansion and redefinition of the role of the participant observer to take on some of the functions of health educator, and two options are suggested.

Humans↗