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Biomedical subjects

A R Gatrad

Publications and source records attributed to A R Gatrad.

At least 19 recordsLinked to original sources
PubMed2002

Palliative care for Muslims and issues before death.

National and European directives have now enshrined within European law the requirement that healthcare professionals provide their patients with culturally appropriate and sensitive care. Although well intentioned, many health professionals find it difficult to translate these directives into practice. Barriers to providing culturally competent care include racism, institutional discrimination and gaps in our understanding of the interface between culture and health--this latter factor reflecting the lack of training in transcultural health care. In this paper, we concentrate on issues relating to the provision of palliative care near death to Muslims of South Asian origin in the UK, although much of what is said will equally be applicable to Muslims from other parts of the world. This is the first of two articles giving insights into the palliative care of Muslims. The second article 'Palliative care of Muslims and issues after death' will appear in a later issue.

Adult↗
PubMed2001

Medical ethics and Islam: principles and practice.

A minimum level of cultural awareness is a necessary prerequisite for the delivery of care that is culturally sensitive. In this paper we simplify and highlight certain key teachings in Islamic medical ethics and explore their applications. We hope that the insights gained will aid clinicians to better understand their Muslim patients and deliver care that pays due respect to their beliefs.

Child↗
PubMed2000

A completed audit to reduce hospital outpatients non-attendance rates.

An audit loop for patients failing to attend a paediatric outpatient department was completed by repeating the analysis three years after interventions were put into place. The 1995 study had shown non-attendance for clinic visits was 34%, varying from 32.5% for Europeans and 50% for Asian patients. A follow up study in 1998 showed a fall to 12.04% and 13.5%, respectively, with an overall rate of 12.3%. The Manor Hospital NHS Trust had the lowest non-attendance rate of the 30 hospitals in the West Midlands region for the year 1996-7.

Ambulatory Care↗
PubMed1997

Comparison of Asian and English non-attenders at a hospital outpatient department.

Failure to attend the outpatient department for a clinic appointment was studied separately among white (English) and Asian patients, with particular emphasis on the reasons for non-attendance among the Muslims. Overall, Asian patients failed to attend more than the English ones (p < 0.001). 'Follow up' and new Asian patients had significantly higher rates of non-attendance than follow up and new English patients (p < 0.001 in both cases respectively). Muslim boys defaulted more than Muslim girls (p < 0.001), but no such difference was noted among Sikhs, Hindus, or English patients. During the study period (January-December 1995) nearly half (47%) the Muslims did not attend due to religious reasons (for example, fasting during the month of Ramadan), communication difficulties, and the child being on holiday abroad. Failure to attend the outpatient department is significantly higher for ward generated outpatient appointments compared with appointments after previous outpatient attendance for the English and the Asians (p < 0.001 and p < 0.001 respectively). Recommendations for improving outpatient attendance are made for Muslim patients in the hope that these principles can be extrapolated to other ethnic minority groups.

Asia↗
PubMed1994

Preschool weights and heights of Europeans and five subgroups of Asians in Britain.

Heights and weights of five subgroups of Asian (545) and European children (685) were recorded after birth, at 1 year, 2 years, and at 5 years. Asian children were divided into Muslim Gujarati, Muslim Pakistani, Muslim Bangladeshi, Hindu, and Sikh. Although the Europeans were significantly the heaviest at birth (3.42 kg boys and 3.26 kg girls) when compared with any of the other groups, it was the Sikhs who had the best weight gain. They were also the heaviest at 5 years when compared with other groups, including the Europeans (20.13 kg and 19.22 kg for Sikh boys and girls respectively compared with 18.83 kg and 18.42 kg for European boys and girls respectively). Hindus had the lightest birth weight. Their weight at 5 years (17.41 kg boys and 16.93 kg girls) and that of the Muslim Gujaratis (17.27 kg boys and 17.20 kg girls) was comparable and was lowest, whereas that of the Bangladeshis at this age was the greatest among the Muslims (18.56 kg for boys and 17.87 kg for girls). Sikh boys and girls were found to be the tallest of all the groups, including the Europeans, at all periods of measurements--including at 5 years when the Sikh boys and girls were 3 cm and 1.5 cm taller than the European boys and girls. Hindus were the shortest of all the groups throughout the period of study.

Asia↗
PubMed1991

Prevention of perinatal transmission of hepatitis B virus (HBV): a comparison of two prophylactic schedules.

Perinatal transmission of hepatitis B virus (HBV) from HBsAg carrier mothers who were HBeAg+, antiHBe+, or negative for both HBe markers, was interrupted using either 4 doses of vaccine, or one dose of hepatitis B immunoglobulin (HBIG) at birth, combined with 4 doses of vaccine. In those infants who received HBIG at birth, the antiHBs titre was significantly higher at 1 and 2 months old, but at 6, 9, and 18 months old, there was no significant difference. Among the infants of carrier mothers who did not display HBeAg (i.e., were antiHBe+, or negative for both HBe markers), a transient subclinical infection would have been expected in around 10% had there been no intervention. No evidence of such infection was detected, and no difference in outcome was found between the two treatment groups. Amongst infants born to HBeAg+ carrier mothers, infection occurred in 1 out of 8 who had received HBIG and vaccine, and in 3 of 8 who had received vaccine only. The difference in outcome was not statistically significant, but the numbers analysed were small. The infections which occurred in spite of prophylaxis may be attributable to in utero infection, poor response to vaccine by the infant, or to the mother having a particularly high HBV-DNA level. HBIG given at birth to infants of HBeAg+ carrier mothers may enhance the protection of infants who are destined to be poor responders to vaccine.

Carrier State↗
PubMed1990

Hepatitis B vaccine in the prevention of perinatally transmitted hepatitis B virus infection: final report on a West Midlands pilot study.

A four-dose vaccination schedule was used to interrupt perinatal transmission of hepatitis B virus from carrier mothers to their babies. Of 49 babies immunised and successfully followed up, 43 (88%) became immune: 15 out of 21 (71%) of babies born to HBeAg + mothers became immune, the other 6 becoming the only carrier babies in the study. Without immunisation a carrier rate in excess of 70% would have been expected in this high-risk group. Vaccine alone, given in a rapid immunisation schedule, protected the majority of babies at risk. In those babies in whom the carrier state occurred in spite of immunisation, infection may have taken place in utero, or the infant may have failed to produce adequate antibody in response to the vaccine.

Carrier State↗
PubMed1988

Blood lead, ethnic origin, and lead exposure.

A survey of blood lead concentrations is reported in a group of 199 young Walsall children (3-6 years of age). The geometric mean blood lead concentration was 0.47 mumol/l (range 0.2-1.6 mumol/l). There were no significant differences in blood lead concentrations between groups of children with different ages, sex, ethnic origin, or environment.

Child↗
PubMed1984

Consanguinity and complex cardiac anomalies with situs ambiguus.

A survey of British born Asian and English populations of children with congenital cardiac anomalies showed an increased incidence in the Muslim Asian population of complex lesions with visceral heterotaxia. There is a very high incidence of parental consanguinity among Muslim Asian children with complex congenital cardiac anomalies that is even higher than in the general Muslim Asian population of the area studied. The evidence suggests an important recessive genetic component in complex cardiac lesions with visceral heterotaxia, but segregation analysis does not support pure recessive inheritance.

Abnormalities, Multiple↗