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Biomedical subjects

A Oakley

Publications and source records attributed to A Oakley.

At least 19 recordsLinked to original sources
PubMed1992

Perspectives of users of the services.

This article draws on social science evidence concerning the views and experiences of those using the antenatal services. It identifies several important themes in this evidence, including the need to consider pregnancy a normal process, to provide care that is sensitive to individual circumstances and that offers continuity of care throughout the antenatal period, and the obligation on providers to assess scientifically the effectiveness of the care they give.

Communication↗
PubMed1992

Measuring the effectiveness of psychosocial interventions in pregnancy.

Questions about the effectiveness of psychosocial interventions in pregnancy are important in any overall evaluation of antenatal care. This article reviews the evidence as to the positive benefit on a range of pregnancy outcomes provided by 35 published and unpublished randomized controlled trials of psychosocial interventions.

Female↗
PubMed1991

Distribution of nerve growth factor receptor immunoreactivity in the human hippocampus.

Nerve growth factor (NGF) receptor-like immunoreactivity has been demonstrated in the normal adult human hippocampus, using minimally fixed cryostat sections obtained from snap-frozen tissue and incubated with the mouse monoclonal antibody, ME 20.4. The majority of the reactivity was associated with nerve fibre processes and their terminals. Numerous fibres were apparent in the alveus, originating from the fornix, and extending into the stratum oriens and pyramidal layer of the hippocampal formation. A more diffuse particulate reactivity, presumed to be nerve terminal, was observed around the pyramidal neurons and in the stratum radiatum, stratum lacunosum moleculare and also in the dentate fascia. The pattern of hippocampal NGF receptor immunoreactivity was broadly similar to acetylcholinesterase histochemical localization, indicating a principal localization on cholinergic axons innervating this area. Preliminary observations indicate an overall reduction in NGF receptor-immunoreactive axons and terminals in old age and Alzheimer's disease.

Acetylcholinesterase↗
PubMed1991

Using medical care: the views and experiences of high-risk mothers.

Two recurrent unsolved problems of health services practice and policy in modern industrial countries are those of social class inequalities and user dissatisfaction. This article presents data related to these issues drawn from a sample of British childbearing women deemed "at risk" by health professionals. A third focus is on the relationship between past experiences of maternity care, and the patterns of service provision and perceptions of needs and satisfaction revealed in a subsequent pregnancy. Findings show a tendency for patterns of care to be differentiated by social class, with working class women generally receiving comparatively poor service. Satisfaction with general practitioner (community-based) prenatal care is higher than with hospital care. The more socially disadvantaged women in the sample are more likely to be dissatisfied with their medical care. The three major pregnancy needs highlighted by the sample women are for more continuity of care, more sympathetic medical care, and help with household finances. Adverse previous childbearing experiences are related to more dissatisfaction in the subsequent pregnancy.

Consumer Behavior↗
PubMed1990

Infant feeding practice in mothers at risk of low birth weight delivery.

Data relating to infant feeding practices were obtained by a 6 week postnatal questionnaire from 459 women who participated in a randomised controlled trial of social support in pregnancy. They represented a 90% response rate from 507 women with a past history of a low birth weight baby before the index pregnancy. Thirty-nine per cent of the babies weighing more than 2500 g were breast fed completely. Women who experienced a delay of more than half an hour between birth and first suckling, and those who were given pethidine during labour breast fed for a shorter period, as did those who gave complementary bottle feeds. By considering the women's reasons for discontinuing or not initiating breast feeding, this paper suggests that improved social support from health professionals and others in the postnatal period can increase breast feeding success rates.

Attitude↗
PubMed1990

Low birth weight babies: the mother's point of view.

Women's feelings and beliefs about low birth weight (LBW) were obtained by postal questionnaire completed postnatally by 467 women who had participated in a randomised controlled trial of social support in pregnancy. All the women in the study had previously given birth to a LBW baby. Differences were found between beliefs about causes of LBW in general and in the women's explanations for their own LBW baby. These ambiguities were particularly noticeable in relation to smoking beliefs. The women's views on medical care; the practical and emotional problems of low birth weight; and the solutions to some of those problems are discussed. The need for more support from health professionals was given top priority. The main needs of women with a 'high risk' pregnancy were more reassurance and information, recognition of the economic hardships that can be caused, and more attention to their feelings and opinions.

Adult↗
PubMed1990

A comparison of different sources of information about pregnancy and childbirth.

Different methods of obtaining information in medical and social research present problems of interpretation for the researcher. However, there are few systematic studies on the extent of the lack of concordance yielded by different methods. This paper uses data from a randomized controlled trial of social support in pregnancy to examine this issue in relation to three methods of data collection--medical records, home interviews and a postal questionnaire--on the following topics: obstetric history; smoking, alcohol use, number of antenatal hospital visits, bleeding and depression in pregnancy; length of labour; baby's sex, birthweight and neonatal health problems; and ethnicity. Considerable discrepancies are found comparing the different data sources. These suggest that mothers may be more reliable sources of information than medical records, and that the anonymity of a postal questionnaire may provide higher estimates than home interviews on some sensitive topics, such as smoking in pregnancy.

Data Collection↗
PubMed1990

Social support and pregnancy outcome.

A total of 509 women with a history of a low-birthweight (LBW, less than 2500 g) baby were recruited from the antenatal booking clinics of four hospitals and randomized to receive either a social support intervention in pregnancy in addition to standard antenatal care (the intervention group) or standard antenatal care only (the control group). At recruitment to the study, mean gestational age was 6 weeks, mean maternal age was 28.0 years, 86% of the women had one previous LBW baby, 11% had two and 2% had had three or more. The study population was socially disadvantaged: 77% of the women were working class, 18% had unemployed partners and 41% were smoking at booking. Social support was given by four research midwives in the form of 24-h contact telephone numbers and a programme of home visits, during which the midwives provided a listening service for the women to discuss any topic of concern to them, gave practical information and advice when asked, carried out referrals to other health professionals and welfare agencies as appropriate, and collected social and medical information. Pregnancy outcomes were assessed using obstetric case-note data (obtained for 507 women) and a postal questionnaire sent to all mothers 6 weeks after delivery (94% replied). Babies of intervention group mothers had a mean birthweight 38 g higher than that of control group babies; there were fewer very low-birthweight babies in the intervention group.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude to Health↗
PubMed1986

Aspects of dermatology practice in Auckland.

In June 1984, a survey of outpatient attendances at the Auckland Hospital skin clinic was carried out. Similar data was obtained about patients attending a dermatologist in private in Auckland. There were 869 visits to the skin clinic, 36% of them new patients, and 296 visits in the private clinic, 48% new. Twenty-eight percent of patients were over 65 years old. The most common conditions seen were cutaneous malignancies (20%), solar keratoses (17%), and eczema (17%).

Acne Vulgaris↗
PubMed1985

Social support in pregnancy: the 'soft' way to increase birthweight?

This paper examines the thesis that social support in pregnancy is capable of affecting birthweight as one easily measurable aspect of pregnancy outcome. The focus of the paper is on birthweight, since low birthweight is a relatively stable and important factor in social inequalities in perinatal health. The paper reviews the published literature on social support in pregnancy including simple observational and nonrandomized intervention studies and also randomized controlled trials of 'social' interventions. The methodological problems associated with some of these studies are discussed. However, it is concluded that there is considerable evidence to suggest that intervention programmes aimed at improving the 'social' side of antenatal care are capable of affecting birthweight and other 'hard' measures of pregnancy outcome. It is suggested that traditional professional approaches to pregnancy which divide the medical from the social perspective, have acted to prevent recognition of this evidence and its relevance to maternity care policy.

Adaptation, Psychological↗