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Biomedical subjects

R Richmond

Publications and source records attributed to R Richmond.

At least 19 recordsLinked to original sources
PubMed2006

Global dissemination of a tobacco curriculum in medical schools.

OBJECTIVE: To identify medical schools who had received, and were using, the tobacco curriculum called the Smokescreen Education Programme (SEP) and to determine the factors related to its introduction into medical schools. DESIGN: This was a worldwide survey of university-based medical schools who had previously requested copies of the SEP. A questionnaire asking about receipt and use of the SEP (Q1) was mailed to 129 medical schools (response rate 71%). Respondents to Q1 who had received the SEP and agreed to complete a further questionnaire were sent Questionnaire 2 (Q2). RESULTS: Seventy-four per cent of medical schools who had received the SEP stated that they were using it. Over three quarters of medical schools that responded to Q2 had addressed the teaching of tobacco and related diseases and were using the SEP. The majority reported that the SEP had greater benefits over current methods of teaching about tobacco. CONCLUSIONS: Progress has been made in addressing the teaching of tobacco and related diseases in a self-selected number of medical schools worldwide. The SEP is a curriculum that appears to have utility across countries and cultures, providing the flexibility to incorporate pertinent information.

Curriculum↗
PubMed2004

An evaluation of the surface changes in PMMA biomaterial formulations as a result of toothbrush/dentifrice abrasion.

OBJECTIVES: The objective of this study was to evaluate the abrasion resistance and surface roughness of two injection-molded poly(methylmethacrylate) denture base materials (SR-Ivocap 'Plus', Ipsyl 60 RV), and also one compression-molded material (Trevalon). A fourth group of specimens (prepared from Trevalon using the injection-molding procedure) was compared to the compression-molded specimens. METHODS: Ten specimens were prepared according to manufacturers' instructions. An experiment involving toothbrush and dentifrice abrasion was performed on all specimens from each of the materials and the cumulative percentage weight-loss was calculated after 100,000 brush strokes. A series of surface roughness profile measurements were also obtained from each specimen within the groups. The data were analysed by using the Kolmogorov-Smirnov test. A level of significance of 0.017 was set in order to adjust for multiple comparisons between the three sets of materials. RESULTS: There was found to be no statistically significant difference between the three groups of materials in terms of percentage weight-loss, and no statistically significant difference between the Trevalon specimens when injection-molded or compression-molded. In terms of surface roughness, however, SR-Ivocap 'Plus' recorded the lowest surface roughness profile of the three groups. It was found that there was a statistically significant difference (P<0.017) between this material and Ipsyl RV 60 (producing the highest roughness), and compression-molded Trevalon. Furthermore, there was found to be no statistically significant difference between injection-molded and compression-molded specimens of Trevalon with regard to surface texture. SIGNIFICANCE: From a clinical standpoint, the surface roughness results suggest SR-Ivocap 'Plus' to be the material most likely to produce the least suitable substrate for the accumulation of denture plaque.

Acrylic Resins↗
PubMed2000

Evaluation of a workplace brief intervention for excessive alcohol consumption: the workscreen project.

BACKGROUND: The workplace provides a useful setting for early identification and intervention with individuals who have unhealthy lifestyles. The objective was to evaluate the effects of a workplace-based lifestyle intervention (Workscreen) to reduce excessive drinking. METHOD: There were eight Australia Post networks randomly allocated to experimental and control conditions, comprising 67 worksites and 1206 employees. The experimental condition involved a broad spectrum lifestyle campaign, incorporating support from management, employee awareness of health, and brief interventions for high-risk behaviors, including excessive alcohol use. Focus groups identified relevant cultural factors. Changes in workplace culture and employee behavior were assessed 10 months after baseline. Males and females were analyzed separately. RESULTS: Over half of APOST employees participated at each screening point. In the experimental condition 61% of employees overall and 58% of those identified as excessive drinkers in Phase 1 responded to the lifestyle campaign by attending health assessments. Analyses focusing on the organization as a whole did not reveal significant reductions in excessive alcohol consumption among men or women. However, a significant reduction in number of drinks was observed in the experimental condition among women for whom completion of baseline and follow-up could be confirmed (P < 0.001). CONCLUSIONS: The present study indicates that a workplace-based lifestyle campaign can assist self-selected employees in reducing their alcohol consumption. There was a moderately high level of participation among those identified as drinking excessively, which supports our approach of embedding a low-intensity alcohol program within the context of a broader health promotion campaign.

Adolescent↗
PubMed1999

Successful treatment of severe muscle necrosis with intravenous immunoglobulin.

Intravenous immunoglobulin (IVIG) is an effective treatment for a range of conditions believed to have an autoimmune basis, including inflammatory muscle disease. We describe a patient with muscle disease characterized by severe necrosis without clinical or biopsy evidence of inflammation or vasculitis, who responded to treatment with IVIG.

Biopsy↗
PubMed1998

Expanding knowledge among Aboriginal service providers on treatment options for excessive alcohol use.

Approaches to the prevention of alcohol problems among Aboriginal people in Australia have tended to emphasize primary and tertiary prevention, while neglecting secondary prevention or early intervention. In contrast, members of the wider Australian community can now access a variety of early interventions through general practice, in hospital settings and through drug and alcohol treatment agencies. As part of a survey of the use of brief interventions, 178 agencies throughout Australia were interviewed, and findings are presented from the 29 agencies in this sample which provided services primarily for Aboriginal people. Approximately half offered a variety of approaches including brief interventions, with goals of moderation; the other half were entirely abstinence-orientated. These findings are discussed in the context of expanding the options that might be offered by Aboriginal-run agencies.

Journal Article↗
PubMed1998

Screening for unhealthy lifestyle factors in the workplace.

OBJECTIVE: To examine (1) the prevalence of four lifestyle behaviours among Australia Post employees and (2) employees' perceptions of the role of the workplace in promotion of lifestyle change. DESIGN: A cross-sectional survey using a self-administered questionnaire involved 688 employees working in Australia Post throughout metropolitan Sydney. MAIN OUTCOME MEASURES: Prevalence related to age and sex of alcohol consumption, cigarette smoking, inadequate exercise, perception of excessive weight. RESULTS: 36% of men and 11% of women reported drinking alcohol at levels considered hazardous or harmful; 33% of men and 25% of women reported smoking; 51% of men and 62% of women thought they were overweight; 30% of men and 39% of women did not exercise regularly. Younger respondents were more likely to report drinking hazardously or harmfully, were smokers and had multiple risk factors. A majority of respondents thought that their employer should be interested in employee's lifestyle issues, particularly excessive drinking (63%). However, few considered seeking advice from the workplace regarding smoking (16%), weight (25%) and excessive alcohol consumption (12%). CONCLUSIONS: These results show that many of Australia Post employees have unhealthy lifestyle behaviours. While employees perceive that the workplace has an important role in promoting healthy lifestyles among staff, few are presently willing to seek advice from the workplace regarding these issues. Promotion of healthy lifestyles in Australian workplaces is a potentially important public health advance that could reduce the incidence of diseases associated with high-risk lifestyle behaviours.

Adolescent↗
PubMed1998

Optimisation of cyclophosphamide therapy in systemic vasculitis.

There is no doubt that the prognosis for systemic vasculitides has been considerably improved by the use of immunosuppressive agents, chiefly cyclophosphamide. Increasingly, we are becoming aware of the enormous burden of chronic 'grumbling' disease, the high incidence of relapse and the longer term effects of toxic therapy in these patients. The general approach is more intense therapy (with intermittent high dose 'pulses' or lower dose continuous cyclophosphamide) in the initial phase of therapy to induce remission, followed by a less toxic therapy in the maintenance phase (either longer intervals between pulses or a switch to a less toxic drug, such as azathioprine). The pathogenetic mechanisms in vasculitis, which are becoming more precisely defined, are diverse, but cyclophosphamide remains the drug of choice. A number of different cyclophosphamide regimens are in use, which reflects the current dilemma of trying to balance effectiveness with toxicity in diseases where the quality of long term survival remains unsatisfactory. Evidence from controlled trials does not support major differences in immediate outcome between different regimens of cyclophosphamide. Future studies need to address the use of agents designed to interfere precisely with the underlying pathogenetic mechanisms. Alternative approaches should also be considered, for example the use of sublethal doses of cyclophosphamide, with autologous bone marrow rescue, which may achieve long lasting remission or even cure.

Controlled Clinical Trials as Topic↗
PubMed1997

Hepatitis B markers in heterosexual patients attending two genitourinary medicine clinics in the West Midlands.

OBJECTIVE: To determine the prevalence of hepatitis B virus (HBV) infection in heterosexual patients attending two genitourinary medicine (GUM) clinics in the West Midlands and to examine whether heterosexual activity is a risk factor for acquiring HBV infection with the view to extend HBV vaccination policies to cover this group. DESIGN: HBV markers were determined in the GUM study group and compared with that of the control groups. Responses to a questionnaire were used to examine sexual behaviour patterns that may be related to heterosexual acquisition of HBV infection. SETTING: The West Midlands, UK April 1992-January 1993. SUBJECTS: 788 male patients and 688 female patients attending GUM clinics were compared with 498 male blood donors and 563 females attending antenatal clinics for the seroprevalence of HBV markers. Potential risk factors related to heterosexual activity were assessed in 1436 patients in the study group. MAIN OUTCOME MEASURES: Prevalence of HBV markers in the GUM study group and the controls. The possible use of the risk factors examined as predictors for acquiring HBV infection. RESULTS: The seroprevalence of hepatitis B core antibody (anti-HBc) in GUM patients was 1.9% and 0.5% in the control group. In the study groups the prevalence of anti-HBc from Birmingham was 3.2% while that from Coventry was 0.8%. The low seroprevalence of HBV prevented a multiple logistic analysis. A limited regression analysis showed that being non-white (p < 0.001) and duration of sexual activity (p = 0.013) were risk factors for HBV infection. However, these two factors were poor predictors of the risk to exposure to HBV infection. CONCLUSION: The prevalence of HBV infection in heterosexual patients in the West Midlands is very low and does not provide any indications to broaden HBV vaccination into heterosexual patients attending GUM clinics. Risk factors were poor predictors of the exposure to HBV infection. This is partially due to the low prevalence of HBV infection in this study. Further studies are required before definitive conclusions are made regarding the potential predictive value of risk factors.

Adult↗
PubMed1997

Ethical dilemmas in providing tobacco to developing countries: the case of China.

We should recognize that we have a responsibility to people who live outside our own borders, and view ourselves as part of the global community. Looking at China we are faced with ethical dilemmas which require consideration. First, there is the ethical dilemma of business versus health. The opening and development of the tobacco business in China, which includes vigorous marketing, is considered against the health consequences of tobacco use which is estimated to cost 600,000 lives annually in China, rising to 2 million by 2,025 without effective tobacco control programmes. A second ethical dilemma is employment versus impoverishment, in which the opportunities for work in the tobacco industry are considered against a background of malnutrition caused in part by a proportion of household budgets used to buy tobacco, and the erosion of the land, as trees are used to produce tobacco. Gains have already been made in tobacco control in China, with the way open for much development in the future.

China↗
PubMed1996

Effects of brief counselling among male heavy drinkers identified on general hospital wards.

Although the prevalence of heavy alcohol consumption among patients of general hospitals is well documented, no study has yet reported an effect of counselling on the ward in reducing the level of consumption among such patients after discharge. This study was designed to evaluate brief counselling to reduce alcohol consumption among male heavy drinkers identified on general hospital wards. Male patients were screened on wards of four teaching hospitals in Sydney, Australia. Identified heavy drinkers (n = 174) showing predominantly low levels of alcohol dependence were allocated to one of two forms of brief counselling (skills-based counselling or brief motivational interviewing) or to a non-intervention control group. Blind follow-up for 123 patients (71%) was carried out approximately 6 months after discharge from hospital and self-reports of alcohol consumption were compared with collateral sources of information. Patients who received counselling showed a significantly greater mean reduction in a quantity-frequency measure of weekly alcohol consumption than controls but there were no significant differences in reduced consumption between the two intervention groups. However, patients who were deemed "not ready to change" showed greater reductions if they had received brief motivational interviewing than if they had received skills-based counselling. The implications of these findings for counselling male in-patients to reduce alcohol consumption are discussed.

Journal Article↗
PubMed1996

Restrictions on tobacco and alcohol use in Australian work-places.

In a telephone survey of 455 of the top 600 companies in Australia, around three-quarters reported the existence of restrictions on both smoking and alcohol in the workplace. Forty-six percent of companies had a total ban on smoking at work, 31% had designated limited areas where employees were permitted to smoke, and 23% had no policy on smoking. Seventy-seven percent of companies encouraged a total alcohol-free work environment. The larger the company, the more likely it was to have restrictions on smoking in the work-place, but there was no relationship between the size of the company and alcohol restrictions. Government organizations were more likely to have restrictions on smoking than non-government organizations, but this difference was not apparent for alcohol restrictions. The major reasons given for smoking restrictions were related to health and comfort, while those for alcohol were related to work productivity and safety.

Journal Article↗