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  • Adrenoceptor blocking agents: labetalol  (1)
  • Open access  (1)
  • Open access, Health services research, Neurology, Qualitative research  (1)
  • Open access, Health services research, Rehabilitation medicine, Sports and exercise medicine  (1)
  • 1
    Digitale Medien
    Digitale Medien
    Evaluation of I.V. labetalol for treatment of posttraumatic hyperdynamic state (1984)
    Springer
    Intensive care medicine 10 (1984), S. 133-137 
    Details
    ISSN: 1432-1238
    Schlagwort(e): Adrenoceptor blocking agents: labetalol ; Multiple trauma ; Hyperdynamic state
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract A hyperdynamic state, characterized by an elevated blood pressure and tachycardia is frequently seen during the first few days following severe multiple trauma. We examined the cardiovascular effects of the alpha and beta adrenoceptor blocking agent labetalol in patients presenting a hyperdynamic cardiovascular state some days after major trauma. Ten patients with a heart rate-systolic blood pressure product (RPP) of more than 2000 during 6 consecutive hours, despite normovolaemia, adequate ventilation, analgesia and sedation were investigated. After a mean dose of 2.1±1.2 mg·kg-1 (mean±SD) of labetalol injected intravenously over a 10-min period, heart rate decreased from 117±28 to 102±19 beats·min-1, systolic arterial pressure from 25±3.5 to 18.5±2.7 kPa, diastolic pressure from 11±1.7 to 9.5±1.7 kPa, mean arterial blood pressure from 15.5±2.1 to 12.4±2.1 kPa, and the RPP from 2880±867 to 1853±373. The beneficial effect of this dose lasted 24 h in 8 of 10 patients without additional administration. No important side effects such as cardiac arrhythmias, hypotension, or bronchospasm were noted. We conclude that labetalol used in fractional intravenous doses permits an adequate treatment of a “hypertension-tachycardia syndrome” in severely injured patients.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF00265802
    Standort Signatur Einschränkungen Verfügbarkeit
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    Artikel (Nationallizenzen)
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  • 2
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    Why do patients with stroke not receive the recommended amount of active therapy (ReAcT)? Study protocol for a multisite case study investigation (2015)
    BMJ Publishing
    In: BMJ Open
    Details
    Publikationsdatum: 2015-08-27
    Beschreibung: Introduction Increased frequency and intensity of inpatient therapy contributes to improved outcomes for stroke survivors. Differences exist in the amount of therapy provided internationally. In England, Wales and Northern Ireland it is recommended that a minimum of 45 min of each active therapy should be provided at least 5 days a week provided the therapy is appropriate and that the patient can tolerate this. Sentinel Stroke National Audit Programme (2014) data demonstrate this standard is not being achieved for most patients. No research been undertaken to explore how therapists in England manage their practice to meet time-specific therapy recommendations. The ReAcT study aims to develop an in-depth understanding of stroke therapy provision, including how the guideline of 45 min a day of each relevant therapy, is interpreted and implemented by therapists, and how it is experienced by stroke-survivors and their families. Methods and analysis A multisite ethnographic case study design in a minimum of six stroke units will include modified process mapping, observations of service organisation, therapy delivery and documentary analysis. Semistructured interviews with therapists and service managers (n=90), and with patients and informal carers (n=60 pairs) will be conducted. Data will be analysed using the Framework approach. Ethics and dissemination The study received a favourable ethical opinion via the National Research Ethics Service (reference number: 14/NW/0266). Participants will provide written informed consent or, where stroke-survivors lack capacity, a consultee declaration will be sought. ReAcT is designed to generate insights into the organisational, professional, social, practical and patient-related factors acting as facilitators or barriers to providing the recommended amount of therapy. Provisional recommendations will be debated in consensus meetings with stakeholders who have not participated in ReAcT case studies or interviews. Final recommendations will be disseminated to therapists, service managers, clinical guideline developers and policymakers and stroke-survivors and informal carers.
    Schlagwort(e): Open access, Health services research, Neurology, Qualitative research
    Digitale ISSN: 2044-6055
    Thema: Medizin
    Publiziert von BMJ Publishing
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 3
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    Community-based Rehabilitation Training after stroke: protocol of a pilot randomised controlled trial (ReTrain) (2016)
    BMJ Publishing
    In: BMJ Open
    Details
    Publikationsdatum: 2016-10-08
    Beschreibung: Introduction The Rehabilitation Training (ReTrain) intervention aims to improve functional mobility, adherence to poststroke exercise guidelines and quality of life for people after stroke. A definitive randomised controlled trial (RCT) is required to assess the clinical and cost-effectiveness of ReTrain, which is based on Action for Rehabilitation from Neurological Injury (ARNI). The purpose of this pilot study is to assess the feasibility of such a definitive trial and inform its design. Methods and analysis A 2-group, assessor-blinded, randomised controlled external pilot trial with parallel mixed-methods process evaluation and economic evaluation. 48 participants discharged from clinical rehabilitation despite residual physical disability will be individually randomised 1:1 to ReTrain (25 sessions) or control (exercise advice booklet). Outcome assessment at baseline, 6 and 9 months include Rivermead Mobility Index; Timed Up and Go Test; modified Patient-Specific Functional Scale; 7-day accelerometry; Stroke Self-efficacy Questionnaire, exercise diary, Fatigue Assessment Scale, exercise beliefs and self-efficacy questionnaires, SF-12, EQ-5D-5L, Stroke Quality of Life, Carer Burden Index and Service Receipt Inventory. Feasibility, acceptability and process outcomes include recruitment and retention rates; with measurement burden and trial experiences being explored in qualitative interviews (20 participants, 3 intervention providers). Analyses include descriptive statistics, with 95% CI where appropriate; qualitative themes; intervention fidelity from videos and session checklists; rehearsal of health economic analysis. Ethics and dissemination National Health Service (NHS) National Research Ethics Service approval granted in April 2015; recruitment started in June. Preliminary studies suggested low risk of serious adverse events; however (minor) falls, transitory muscle soreness and high levels of postexercise fatigue are expected. Outputs include pilot data to inform whether to proceed to a definitive RCT and support a funding application; finalised Trainer and Intervention Delivery manuals for multicentre replication of ReTrain; presentations at conferences, public involvement events; internationally recognised peer-reviewed journal publications, open access sources and media releases. Trial registration number NCT02429180 ; Pre-results.
    Schlagwort(e): Open access, Health services research, Rehabilitation medicine, Sports and exercise medicine
    Digitale ISSN: 2044-6055
    Thema: Medizin
    Publiziert von BMJ Publishing
    Standort Signatur Einschränkungen Verfügbarkeit
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    PAPER CURRENT
  • 4
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    Ethnicity-specific factors influencing childhood immunisation decisions among Black and Asian Minority Ethnic groups in the UK: a systematic review of qualitative research (2017)
    BMJ Publishing Group
    Details
    Publikationsdatum: 2017-05-13
    Beschreibung: Background Uptake of some childhood immunisations in the UK is lower among those from some Black and Asian Minority Ethnic (BAME) backgrounds. This systematic review of qualitative research sought to understand the factors that are associated with ethnicity that influence the immunisation decisions of parents from BAME backgrounds living in the UK. Methods Databases were searched on 2 December 2014 for studies published at any time using the terms ‘UK’ and ‘vaccination’ and ‘qualitative methods’ (and variations of these). Included articles comprised participants who were parents from BAME backgrounds. Thematic synthesis methods were used to develop descriptive and higher order themes. Themes specific to ethnicity and associated factors are reported. Results Eight papers were included in the review. Most participants were from Black (n=62) or Asian (n=38) backgrounds. Two ethnicity-related factors affected immunisation decisions. First, factors that are related to ethnicity itself (namely religion, upbringing and migration, and language) affected parents' perceived importance of immunisations, whether immunisations were permitted or culturally acceptable and their understanding of immunisation/the immunisation schedule. Second, perceived biological differences affected decision-making and demand for information. Conclusions Factors related to ethnicity must be considered when seeking to understand immunisation decisions among parents from BAME backgrounds. Where appropriate and feasible, vaccination information should be targeted to address beliefs about ethnic differences held by some individuals from some BAME backgrounds.
    Schlagwort(e): Open access
    Print ISSN: 0143-005X
    Digitale ISSN: 1470-2738
    Thema: Medizin
    Publiziert von BMJ Publishing Group
    Standort Signatur Einschränkungen Verfügbarkeit
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    PAPER CURRENT
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