A.Balfour Sclare

Bio: A.Balfour Sclare is an academic researcher from University of Glasgow. The author has contributed to research in topics: Asthma & Programmed Instruction as Topic. The author has an hindex of 3, co-authored 4 publications receiving 60 citations. Previous affiliations of A.Balfour Sclare include Southern General Hospital.

The use of closed circuit television in teaching psychiatry to medical students.

Abstract: Closed circuit television (CCTV) has been used by medical teachers in a number of British and American universities in recent years. Surgery, pathology, and psychiatry have been prominent among the medical specialties considered most suitable for the use of audio-visual aids in teaching. No doubt this is due to the fact that, for various reasons, the inclusion of a group of observers within the teacher’s immediate field of skilled activity is likely to impede that activity. Preoccupation with the technical details of closed circuit television has tended in many quarters to preclude evaluation of t h i s teaching aid. Smith and Wyllie (1969, and Smith, Wyllie, Foote, and Caridis (1966), however, compared the use of CCTV with orthodox case demonstrations in the teaching of surgery to medical students and found that the medium possessed certain measurable advantages. Yonge (1965) had a similar experience in teaching clinical psychiatry. Timbury ind MacLean (1966)~ using a questionnaire method after a CCTV teaching experiment had ended, reported that this technique possessed a number of advantages. The present investigation had the aim of measuring shifts of attitude and assimilation of information produced by closed circuit television used in teaching psychiatry to medical students. In these respects closed circuit television was compared with case demonstration and programmed learning. The experiment was carried out with the technical facilities of the Television Service at the University of Glasgow.

Does Psychotherapy Benefit Neurotic Patients?: A Reanalysis of the Smith, Glass, and Miller Data

Abstract: • Smith, Glass, and Miller examined the benefits of psychotherapy in 475 controlled studies. Their data were reexamined, and only studies of patients coded as having neuroses, true phobias, and emotional-somatic complaints and who had sought treatment were included in the present analysis. The results of 81 controlled trials were integrated statistically using the metaanalytic technique. The findings provide further evidence on the efficacy of psychotherapy. The condition of the typical patient after treatment was better than that of 77% of untreated controls measured at the same time. The rate of relapse in the first two years was small. The behavior and psychodynamic verbal therapies appeared to be superior to other therapies. The relation between severity of illness and choice of therapy is unknown. This factor could account for some of the differential effects but does not vitiate the main finding.

Long-term care and dementia services: an impending crisis

Abstract: Background and Objectives: since the transfer of long-stay care to the independent sector, provision of places in care homes in the United Kingdom has varied in response to market trends, and has shown a consistent fall in the past 10 years. People with dementia constitute the largest diagnostic group affected by these changes, and are also likely to be the group that will determine future need. We therefore estimated the number and proportion of older residents in care homes who suffer from dementia relative to all those with dementia in the United Kingdom and projected future levels of demand on the basis of this data. Design and Method: the number of dementia cases in long-stay care was estimated from a random sample survey in south-east England and compared with data on age-specific prevalence. Projections of future demand were based on UK population projections for the next 40 years. Main Result: over half of all people with dementia in the United Kingdom are in care homes. The number of available long-stay places in care homes has fallen by one-sixth over the past decade. Projection of future demand suggests that well over double the present total places in care homes would be required by 2043 to maintain the present ratio of institutional to community services for dementia. Conclusion:thisfindingsuggestsanimpendingcrisisofavailability.Amorerealisticscenariocallsforinvestmentinaffordable domiciliary care of good quality, but it will also depend on the acceptance of the fact that the main function of long-stay care for old people is now to provide for advanced cases of dementia, with consequent requirement for improvement in staff ratios and training.

Urban–rural differences in the associations between social deprivation and psychiatric service utilization in schizophrenia and all diagnoses: a case-register study in Northern Italy

Abstract: Service utilization measures from the psychiatric case registers for urban South-Verona and rural Portogruaro in North East Italy for the period 1983-9 were used to identify associations with socio-demographic variables from the 1981 census in schizophrenia and related disorders as well as in all diagnoses. The patterns of service use were broadly similar, except that Portogruaro has significantly more community contacts, and has about twice the treated incidence and prevalence of schizophrenia. The census data showed that unmarried and unemployed people were more likely to live alone in the urban than in the rural area. In South-Verona the most strongly associated predictor variables, both for schizophrenia and all diagnoses, are: living alone, unemployment, percentage of the total population who are dependents and the percentage who are divorced, separated or widowed. In contrast, in Portogruaro there were no consistent associations between census and service use variables. Stepwise multiple regression models using three census predictor variables accounted for over 85% of the variance in South-Verona utilization rates. The results indicate that the strongly predictive associations previously described in England hold in urban South-Verona, but not in rural Portogruaro, and may be related to the effect of cities in clustering seriously disabled psychiatric patients in areas of low-cost housing where they live in relative social isolation.

Psychological interventions for adults with asthma.

Abstract: Background Many people have asthma, and for some their symptoms may be triggered by psychological factors. In addition, compliance with medical therapy may have a psychological dimension. Therefore, psychological interventions aim to reduce the burden of symptoms and improve management of the disease. Objectives To assess the effectiveness of psychological interventions for adults with asthma. Search strategy The Cochrane Airways Group Specialised Register and PsycINFO were searched with pre-defined terms up until May 2007. Selection criteria Randomised controlled trials published in any language assessing the effects of a psychological intervention compared with a form of control in adult participants were included in the review. Our primary outcome was healthcare resource defined as: hospitalisation, emergency room visits and/or GP visits Data collection and analysis Two reviewers assessed the relevance of abstracts identified by electronic searching and retrieved agreed studies for further scrutiny. The studies that met the inclusion criteria were assembled and data extracted. Main results Fifteen studies, involving 687 participants, were included in the review. Study quality was poor and sample sizes were frequently small. However, some pooled effects were analysed. Three studies measured our primary outcome but individually did not report significant differences between treatment and control. The use of 'as needed' medications was reduced in two studies, (47 patients), by relaxation therapy (OR 4.47, CI 1.22 to 16.44). There was no significant difference in FEV1 for relaxation therapy in four studies of 150 patients, (SMD -0.01, CI -0.41 to 0.40). Quality of life, measured using the Asthma Quality of Life Questionnaire in two studies, (48 patients), showed a positive effect following CBT (WMD 0.71, CI 0.23 to 1.19). Peak Expiratory Flow outcome data in two studies, (51 patients), indicated a significant difference in favour of bio-feedback therapy (SMD 0.66, CI 0.09 to 1.23) but no significant difference following relaxation therapy (WMD 43 L/min, CI -5 to 92 L/min). There was no statistically significant improvement in depression levels following relaxation therapy (SMD 0.17, CI -0.25 to 0.59). The remainder of the findings between studies were conflicting. This may have been due to the different types of interventions used and the deficiencies in trial design. Authors' conclusions This review was unable to draw firm conclusions for the role of psychological interventions in asthma due to the absence of an adequate evidence base. Larger, well-conducted and reported randomised trials are required in this area, in order to determine the effects of these techniques in the treatment of asthma in adults.