Publications by authors named "Paul S McDonald"

3 Publications

  • Page 1 of 1

Serum creatine phosphokinase monitoring in patients infected with HIV.

Int J STD AIDS 2006 Jan;17(1):61-2

Worcestershire HIV Clinic, Worcestershire Acute Hospitals NHS Trust, Worcestershire Royal Hospital, Charles Hastings Way, Worcester WR5 1DD, UK.

Creatine phosphokinase (CPK) estimations are done routinely in some HIV clinics, irrespective of patient symptoms. We studied patients attending the Worcestershire HIV clinic between 1987 and 2001 to identify whether routine elevations in serum levels of CPK in patients with HIV were associated with clinical features of muscle disease (CFMD), and whether such elevations influenced patient management. There was no association between CFMD and a rise in CPK. Major rises of CPK >400 IU/L were significantly associated with CFMD. No individual had a persistent CPK rise >200 IU/L without CFMD. In the great majority of cases, there was no change in management consequent to enzyme rises. In patients with HIV infection and no CFMD, the chance of finding a major and persistent CPK rise is low. This study does not support the practice of routine monitoring of CPK in asymptomatic patients attending HIV clinics.
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http://dx.doi.org/10.1258/095646206775220487DOI Listing
January 2006

National Service Framework for Older People: stroke coordinators.

Br J Nurs 2002 Oct 24-Nov 13;11(19):1259-61, 1263-5

Department of Psychology Health and Social Care, University College Worcester.

The National Service Framework (NSF) for Older People aims to develop integrated stroke services with specialized treatment, carer involvement, secondary prevention and rehabilitation. There is an emphasis upon the role of stroke coordinators. The aim of this study was to examine the relationships between stroke coordinators and other agencies involved in stroke care, and to describe stroke coordinators' current roles. Interviews with 11 stroke coordinators across the West Midlands region took place and were evaluated using a grounded theory approach. The roles of stroke coordinators and the perceived levels of integration among stroke services varied between localities. In a few areas, a number of 'adhesive' factors helped bond the coordinator role to successful integration, while in most areas the absence of all or some of these factors made the role less effective. To meet the demands of the NSF, a stroke coordinator's role needs to be a high profile, corporate function, requiring a higher level of autonomy, accountability and responsibility, and demanding creativity and innovation from post holders.
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http://dx.doi.org/10.12968/bjon.2002.11.19.10757DOI Listing
December 2002