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Biomedical subjects

A Reynolds

Publications and source records attributed to A Reynolds.

At least 55 records · Page 3Linked to original sources
PubMed1994

Pressure-reducing capability of Conforma II mattress overlay.

Pressure readings over the sacral and trochanter areas were obtained on 30 healthy adult volunteers. An anatomically contoured mattress overlay (Conforma II) was compared to a standard hospital mattress. The difference in the mean pressures over the sacral areas represented a 52% reduction in pressure, whereas, a 46% pressure reduction was obtained over the trochanter area. Body weight was significantly associated with higher mean pressures.

Adult↗
PubMed1993

Family characteristics and preschool abilities of children of substance abusers.

Intercorrelations among subtest scores of 39 children on the subtests of the Denver Developmental Screening Test II and their 39 parents' scores on the three subscales of the Family Relationship Dimension of the Family Environment Scale ranged from -.09 to .18. None were statistically significant. Parents and children were in a program for substance abusers and their young children.

Aptitude↗
PubMed1993

Critical care experience for baccalaureate nursing students.

The projected need for critical care nurses can be met through the collaborative efforts of nursing education and nursing service. An approach as implemented at our institution with the support of community agencies can be mutually beneficial. It is generally recognized that new graduates tend to seek employment where they had positive student experiences. Although few students may choose critical care as a career, the majority will have a positive memory, which is supportive of the unique contribution of critical care nursing within the scope of the health and care of patients and their families.

Clinical Competence↗
PubMed1992

Surgeons' views of day surgery: is there a consensus among providers?

Managers and purchasers of health services are being encouraged to expand day surgery as a means of providing high-quality care and reducing costs per case and waiting times. This study examined general surgeons' views of day surgery with particular reference to day case inguinal hernia repair. A postal questionnaire was completed by 240 consultants (85 per cent) in four Regional Health Authorities. Only 11 per cent were regularly undertaking day case inguinal hernia repair, a further 44 per cent held positive attitudes towards this form of treatment and 45 per cent were not interested, with attitudes varying by age and region. Major constraints perceived by those with positive attitudes were the lack of facilities at a hospital level and problems of community services. Negative attitudes were associated with concerns about post-operative complications and pain, and assumptions about patients' preferences. This demonstrates a considerable range in surgeons' attitudes to day surgery despite its formal endorsement by professional bodies, and identifies what are perceived as the organizational and clinical barriers to its wider introduction. It is suggested that eliciting provider views and concerns forms an important requirement for the successful implementation of organizational change.

Ambulatory Surgical Procedures↗
PubMed1991

Audit from preschool developmental surveillance of vision, hearing, and language referrals.

Referrals from preschool medical examinations were followed up for two years to assess attendance rate, waiting time for appointment, appropriateness of the referral, the diagnosis and management of the condition. Altogether 184 children were referrals for ophthalmology, 285 for audiology, and 195 for speech therapy. The median waiting time for an appointment was 46 days in ophthalmology, 175 days in audiology, and 83 days in speech therapy. The poorest attendance rate was identified in speech therapy (75%). Approximately 60% of examined children had a justified referral to ophthalmology and 20% had a clear defect. Over half the children in audiology (55%) had an altered impedance or hearing impairment. Of those with a hearing problem kept under review only half improved spontaneously. In speech therapy 80% of those assessed had a language problem. Many health problems were detected for which parents were unaware or did not use the service. Parental awareness alone will not uncover the sizable level of lingual and sensorial problems in inner city areas. This audit identified specific deficiencies in the provision of services and a number of organisational changes are suggested to improve their effectiveness.

Age Factors↗
PubMed1991

Are current techniques of inguinal hernia repair optimal? A survey in the United Kingdom.

Data was collected on the techniques currently employed in adult inguinal hernia repair by means of a postal questionnaire to consultants in four Regional Health Authorities in England. Questionnaires were returned by 240 consultants (85%). This identified a considerable range in methods of repair, with a Moloney nylon darn being the sole method used by 35% of consultants, and the Shouldice technique, either alone or in combination with other methods, being used by 20%. Overall, 51% employ a subcuticular suture for skin closure, and traditional skin sutures are used by 31%. There was no association between consultant's date of qualification or subspecialty and type of repair. Consultants qualifying after 1969 are most likely to use a subcuticular suture. Some 14% of all consultants and 19% of those qualifying since 1969 employ a Shouldice procedure and a subcuticular suture.

Adult↗
PubMed1990

Research design.

Explore the source record for details and available documents.

Child↗
PubMed1989

Demand for DNA probe testing in three genetic centres in Britain (August 1986 to July 1987).

We report a preliminary analysis of the data collected during the first year of the evaluation of clinical genetics in the context of DNA probes in three genetic centres, to show the pattern of the demand for genetic services in the three centres and the services used in meeting that demand. The analysis includes information on 10,185 persons from 2852 families. The results are presented according to mode of inheritance and according to the most common disorders for which DNA probes have been used in the three centres. The results indicate that the use of DNA probes is now a major element of activity in genetic departments, and that as long as indirect DNA probe testing is the predominant manner of using recombinant technology, the clinical input will be an important element of the costs, probably more so than that of the DNA laboratories, as a large number of family members needs to be tested. In most cases centres have concentrated activity on DNA testing for common and severe genetic disorders. However, there are disorders, such as familial hypercholesterolaemia, which have not been part of the established pattern of services. Conversely, a relatively high number of families have been studied for some disorders of very low incidence. This suggests that the number of DNA laboratories should be limited. The precise arrangements will need to be established. With such services the distribution of DNA testing facilities for different disorders can be controlled to limit duplication. The model followed in Scotland based on collaboration between centres is worth considering. We have detected very large differences in take up rate of services within and between regions. Although many factors may contribute to these differences, ease of access and lay and professional awareness are probably the most important. This is supported by the fact that more patients from the same or neighbouring DHAs attend the genetic centre than from those further away. We also concluded that published guidelines for clinicians in general on the uses of DNA probes, the type of families that could benefit, and the centres to which referrals should be sent would be very useful in increasing coverage and maximising the effectiveness of the services. Since this may increase demand, this educative tool should be coordinated and agreed by the Departments of Health with all the genetic departments and centres in the country.

DNA Probes↗
PubMed1989

Who uses child health clinics and why: a study of a deprived inner city district.

The role of child health clinics in an inner London district was examined by a survey of attenders at 52 baby clinic sessions run by the health authority and a review of the uptake of screening. Differences between social groups were examined using A Classification of Residential Neighbourhoods (ACORN) which is based on census data and requires only the full postcode to classify people. Clinic attendance was frequent among all social groups when a child was aged under six months but then declined, mainly reflecting changing needs. About one-half of the attenders saw the clinic doctor, often following referral by the health visitor, with 15% consulting about physical health problems. Differences occurred between ACORN groups in their frequency and reasons for clinic attendance after six months of age and rates of referral following developmental screening. This suggests that ACORN may be of value in monitoring service use and identifying groups with particular needs for services.

Ambulatory Care Facilities↗
PubMed1987

Neuroradiologic evaluation of sacral abnormalities in imperforate anus complex.

Neurologic impairment and sacral spinal anomalies are a finding in children with imperforate anus. The neurologic deficits previously had been considered static rather than progressive. Recent experience at this institution has documented the frequent association of imperforate anus patients having bony sacral and other spinal deformities with progressive neurologic dysfunction. These deficits are related to underlying spinal cord anomalies, which may be amenable to neurosurgical correction. To investigate the nature and frequency of such lesions, spinal cord imaging was done in these patients. From July 1976 to June 1985, 106 patients with imperforate anus were screened with plain radiographs of the sacral spine; 37 (35%) patients had abnormalities. Of these, 26 have been evaluated with a variety of spinal cord imaging techniques, including magnetic resonance imaging (18), digital metrizamide myelotomography (14), computed tomography (10), metrizamide myelography (5), or ultrasound (4). Four patients were lost to follow-up, and seven have not yet been studied. Fifteen of the 26 patients (53%) had one or more abnormal studies. Thirteen were considered to have progressive dysfunction with operable lesions and have undergone neurosurgical correction. At follow-up, there was improved leg function in five patients and improved bladder function in two patients. No patient had additional neurologic deficits after surgery. Because of the high incidence of progressive but potentially correctable myelodysplasias in patients with coexisting anorectal and sacral anomalies, routine radiographic screening of the spine is recommended, followed by spinal cord imaging and neurosurgical evaluation if warranted.

Abnormalities, Multiple↗
PubMed1987

The St. Thomas's Hospital maternity case notes study: a randomised controlled trial to assess the effects of giving expectant mothers their own maternity case notes.

At an antenatal clinic in St. Thomas's Hospital, London, 246 expectant mothers were randomly allocated to hold either their own maternity case notes or the standard co-operation card. Information was collected on three occasions during their care on attitudes and health behaviour. Clinical outcomes were recorded and the effects of the two systems on clinic administration were observed. More of the notes group expressed satisfaction with most aspects of their care and delivery and significantly more of the notes group felt well informed and satisfied with their companion during labour. There were no differences in clinical outcomes between the two groups except that, for no identifiable systematic reason, there were more assisted deliveries among the notes group. A number of administrative advantages resulted from mothers holding their own notes and although initial reservations were found amongst professional staff interviewed at the start of the study, the results proved persuasive and the practice of giving mothers their own notes is now to be extended throughout the department.

Adult↗