855 resultados para Campbell, John S.


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Issues. Numerous studies have reported that brief interventions delivered in primary care are effective in reducing excessive drinking. However, much of this work has been criticised for being clinically unrepresentative. This review aimed to assess the effectiveness of brief interventions in primary care and determine if outcomes differ between efficacy and effectiveness trials. Approach. A pre-specified search strategy was used to search all relevant electronic databases up to 2006. We also hand-searched the reference lists of key articles and reviews. We included randomised controlled trials (RCT) involving patients in primary care who were not seeking alcohol treatment and who received brief intervention. Two authors independently abstracted data and assessed trial quality. Random effects meta-analyses, subgroup and sensitivity analyses and meta-regression were conducted. Key Findings. The primary meta-analysis included 22 RCT and evaluated outcomes in over 5800 patients. At 1 year follow up, patients receiving brief intervention had a significant reduction in alcohol consumption compared with controls [mean difference: -38 g week(-1), 95%CI (confidence interval): -54 to -23], although there was substantial heterogeneity between trials (I(2) = 57%). Subgroup analysis confirmed the benefit of brief intervention in men but not in women. Extended intervention was associated with a non-significantly increased reduction in alcohol consumption compared with brief intervention. There was no significant difference in effect sizes for efficacy and effectiveness trials. Conclusions. Brief interventions can reduce alcohol consumption in men, with benefit at a year after intervention, but they are unproven in women for whom there is insufficient research data. Longer counselling has little additional effect over brief intervention. The lack of differences in outcomes between efficacy and effectiveness trials suggests that the current literature is relevant to routine primary care.

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El análisis de los ensayos de John Tyndall, Fragments of Science, permite identificar la teoría atómica, el principio de conservación de la energía y el evolucionismo darwinista como los elementos constitutivos del andamiaje teórico del naturalismo científico. As, en su ensayo “On the Study of Physics se resumen sus brillantes facetas como educador y divulgador científico, desarrolladas fundamentalmente en el seno de la Royal Institution. En la lectura “On Force”, Tyndall da por finalizada la controversia Joule- Mayer sobre la primacía del descubrimiento del principio de conservación de la energía, a la vez que plantea algunas de las claves de la lucha por el liderazgo en el seno de la comunidad científica. El discurso presidencial ante la British Association de 1874 en Belfast ejemplifica el coraje de Tyndall en su empeño por demarcar los territorios de la ciencia y la religión, a la luz de los nuevos desafíos científicos. En el trasfondo subyacen los procesos de secularización de la sociedad y de profesionalización de una comunidad científica heterogénea. El compromiso cívico que Tyndall demuestra en “The Belfast Address” es digno corolario de una vida y obra que permite situarlo como paradigma de lo que, en la terminología de Turner, se ha dado en denominar científico público.

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Report published by the DHSSPS in May 1996. The Cancer Working Group, chaired by the Chief Medical Officer Henrietta Campbell, highlighted the need for changes to cancer services and made a number of key recommendations for the future development of these services.

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The Minister for Health and Children has requested that an independent review be carried out of the circumstances surrounding the employment of a UK based Consultant Psychiatrist, Dr John Harding-Price, to a locum psychiatrist position with the South Eastern Health Board (SEHB) while he was suspended by the General Medical Council (GMC) in the United Kingdom and consequently the subject of legal proceedings by the Medical Council in Ireland. The Consultant was continuously registered with the Medical Council since 1968. Download the document here

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John Fitzgerald Letter Click here to download PDF 39kb

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St. John's wort, a popular over-the-counter drug for treatment of depression, might reduce concentrations of drugs such as cyclosporin and indinavir and lead to drug resistance and treatment failure. No studies as yet have examined its influence on methadone plasma levels. The trough methadone plasma levels were measured in four patients (2 males, median age: 31 years; range 19 - 40 years) in methadone maintenance treatment just before the introduction of St. John's wort (900 mg/d) and after a median period of 31-day treatment (range 14 - 47). The study was proposed to addict patients about to start an antidepressant therapy. Introduction of St. John's wort resulted in a strong reduction of (R,S)-methadone concentration-to-dose ratios in the four median patients included, with a median decrease to 47 % of the original concentration (range: 19 % - 60 % of the original concentration). Two patients reported symptoms that suggested a withdrawal syndrome. Thus, prescription of St. John's wort might decrease methadone blood levels and induce withdrawal symptoms which, if not correctly identified and handled (by changing the antidepressant or by increasing the methadone dose), might cause unnecessary discomfort to the patient, lead to resumption of illicit drug uses, or be a risk factor for discontinuation of the methadone or antidepressant treatment.