PubMed Health⌕ Search

Biomedical subjects

V Richards

Publications and source records attributed to V Richards.

At least 19 recordsLinked to original sources
PubMed2001

Psychosis, depression and behavioural disturbances in Sydney nursing home residents: prevalence and predictors.

BACKGROUND: There is wide variation in the rates of behavioural and psychological symptoms of dementia (BPSD) reported in nursing homes. AIMS: This study aimed to investigate: (1) the prevalence of BPSD in nursing home residents using the BEHAVE-AD; (2) the relationships of BPSD with (a) demographic, (b) dementia, (c) diurnal and (d) nursing home variables; and (3) the inter-relationships between different types of BPSD, as measured by subscales of the BEHAVE-AD. RESULTS: Over 90% of residents exhibited at least one behavioural disturbance. Specifically, there was evidence of psychosis in 60%, depressed mood in 42% and activity disturbances or aggression in 82% of residents. Younger, more functionally impaired residents with a chart diagnosis of psychosis had higher BPSD rates, as did those residing in larger nursing homes. Individual BPSD were significantly intercorrelated. CONCLUSIONS: BPSD are ubiquitous in nursing home residents. Behavioural disturbances are frequently associated with psychosis and/or depression. The findings suggest the need for psychogeriatric services to nursing homes and smaller facilities.

Adult↗
PubMed2001

Use of psychotropics in Sydney nursing homes: associations with depression, psychosis, and behavioral disturbances.

The purpose of this study was to determine the prevalence of psychotropic use in nursing home residents, the extent to which psychotropic dosage is consistent with published guidelines, and the relationships between psychotropic class and psychiatric and behavioral disturbances. Six hundred forty-seven subjects, mean age 82.3 years, residing in 11 nursing homes in the eastern suburbs of Sydney, Australia, were assessed using the Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD), the Abbreviated Mental Test Scale, and the Even Briefer Assessment Scale for Depression (EBAS-DEP). Details of psychotropic prescription and diagnoses of depression, dementia, and psychosis were obtained from nursing home charts. Psychotropics were prescribed for 333 (51.5%) residents, 381 (58.9%) if "as required" (PRN) use is included. Prescription of multiple psychotropics was present in 148 (22.7%) residents. Antidepressants were prescribed for 19.8% of residents, with subtherapeutic doses less likely in residents on selective serotonin reuptake inhibitors. On logistic regression, the use of antidepressants was predicted by the affective disturbances subscale on the BEHAVE-AD. Only 30.4% of residents with significant depressive symptoms on the EBAS-DEP were prescribed antidepressants. Antipsychotics were prescribed for 21.3% residents at a mean dosage of 73 mg chlorpromazine equivalence. Residents on antipsychotics had significantly higher scores on the delusions, hallucinations, activity disturbance, and aggressiveness subscales of the BEHAVE-AD. On logistic regression, only the activity disturbance subscale and chart diagnoses of dementia and psychosis were significant predictors. Psychosis (58.8%) and behavioral disturbances (91.9%) were more prevalent in residents prescribed antipsychotics than in residents not prescribed antipsychotics (42.5% and 76.6%, respectively). High rates of behavioral and psychological symptoms of dementia remained in residents prescribed antipsychotics and high rates of depressive symptoms in residents prescribed antidepressants, suggesting a role for nonpharmacological strategies.

Aged↗
PubMed2001

Interpersonal psychotherapy for late-life depression: past, present, and future.

Interpersonal psychotherapy (IPT) has demonstrated efficacy in protecting against a recurrence of major depression in elderly subjects when used alone on a monthly basis and when combined with antidepressant medication. The authors summarize their experience using IPT over the past 10 years and discuss a variety of treatment correlates. In addition, preliminary results using IPT combined with paroxetine in depressed elders reveals no difference in remission rates between cognitively intact and cognitively impaired depressed elders.

Age of Onset↗
PubMed1989

Comparison of conventional, cook-chill, and cook-freeze foodservice systems.

Although the conventional system remains the predominant choice for hospital foodservice, alternative systems such as cook-chill and cook-freeze are prevalent as well. Many foodservice directors have reported improvements in operational and financial indicators when switching from a conventional to one of the alternative systems. Objectives for this research included determination of parameters of operating costs in conventional, cook-chill, and cook-freeze systems and comparison of costs for the three foodservice systems. Operational and financial data were collected for 33 conventional, 22 cook-chill, and 11 cook-freeze hospital foodservice systems. Results indicated little difference among the three systems for most operational and financial variables, suggesting that, in general, managers of conventional, cook-chill, and cook-freeze systems are employing similar resources to achieve their objectives. The number of full-time equivalents (FTEs) was found to be the strongest predictor of operating costs in all three systems. Data suggest that installation of a ready-food system may not lead to savings in costs.

Cooking↗
PubMed1980

Human fetal liver contains both zinc- and copper-rich forms of metallothionein.

Metallothionein was purified under anaerobic conditions from livers of human fetuses ranging from 19 weeks gestational age to term. Homogeneous metallothionein obtained in the absence of reducing agents from the soluble fraction of the tissue which contained 24% and 85% of the total liver copper and zinc, respectively, had less than 1 g atom of copper and about 3.1 g atoms of zinc/mol. Extraction with 1% 2-mercaptoethanol of the insoluble fraction of the tissue (containing 76% and 15% of the liver copper and zinc, respectively) yielded a metallothionein with approximately 2.5 g atoms of copper and 1.3 g atoms of zinc. When the whole tissue was extracted similarly by the procedure of Rydén and Deutsch ((1978) J. Biol. Chem. 253, 519), nearly equal proportions of the two metals were obtained in the soluble fraction from which metallothionein, with about 3.0 g atoms of zinc and 1.5 g atoms of copper, was purified. Thus, zinc- and copper-rich forms of metallothionein are differently distributed between the soluble and insoluble fractions of fetal liver. Nevertheless, the predominant metal in metallothionein of human fetal liver is zinc as is the case in the adult; significant amounts of copper are also present, consistent with the elevated quantity of this metal in the fetal tissue relative to the adult. Cadmium was not detected. Zinc is much more easily removed from the protein than is copper.

Amino Acids↗
PubMed1978

Tube thoracostomy.

Every primary care physician should be familiar with three methods of draining fluid or air from the pleural cavity. These methods are: (1) the insertion of a needle or Intracath catheter into the pleural space; (2) a tube thoracostomy using a Trocar catheter; and (3) a tube thoracostomy using a large intercostal tube. Complete anesthesia can be obtained with lidocaine, remembering that the intercostal nerve runs on the undersurface of the rib above. The Intracath catheter for removal of air is inserted in the second interspace anteriorally. The tube thoracostomy, using the Trocar catheter, is best done through the fourth interspace in the anterior axillary line but can be done wherever the exploratory needle shows the major fluid and air collection to be. The tube thoracostomy, using a large intercostal tube, is best done through the fourth intercostal space at the anterior axillary line. The intercostal catheter or tube should be fixed to the chest wall with sutures and then led to an underwater seal for collection of the contents of the pleural cavity.

Anesthesia, Local↗
PubMed1976

Radiographic changes after small bowel bypass for morbid obesity.

The presence of multiple intestinal air-fluid levels and the distention of jejunum and colon are common and expected sequelae of small bowel bypass procedures for morbid obesity. The radiologist must be familiar with these findings in order to avoid the misdiagnosis of bowel obstruction.

Humans↗
PubMed1975

Ultrasonic transmission holography of the eye.

Ocular ultrasonic transmission holography of the eye using equipment capable of real-time imaging has not previously been described. A method using pulsed ultrasound focused on an air/liquid interface is used to demonstate normal ocular structures including lens, optic nerve, and sclera. Intraocular foreign bodies imaged include radiopaque and nonradiopaque materials. A limit of resolution of at lease 1 mm. is demonstrated.

Eye Foreign Bodies↗
PubMed1975

Simple wounds and simple incisions.

Wound healing without complications and with minimal scarring is facilitated in minor surgical procedures by careful attention to basic surgical principles as reviewed in this article. "Langer's lines" represent the natural creases of the skin and are helpful in locating incisions. Whenever possible, incisions should be made in the skin crease, particularly in the neck or across moving parts. Some incisions, such as those required for drainage of pilonidal or perirectal abscesses, must be carefully located with specific reference to underlying structures.

Abscess↗