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Biomedical subjects

B Vaughan

Publications and source records attributed to B Vaughan.

At least 37 records · Page 2Linked to original sources

Contraceptive use projections: 1990 to 2010.

Factors that will affect both contraceptive use and choice of method during the next 20 years are reviewed. Two factors are predictable: the changing age distribution of women and the revised upper-age limits for oral contraceptive use, with the effect of the latter as yet unknown. Less predictable factors include the number of women in each age group at risk for pregnancy, the effects of delayed childbearing and sterilization, and the impact of new contraceptive methods. Unpredictable factors include adverse publicity about oral contraceptives and breast cancer, concern about sexually transmitted diseases and acquired immunodeficiency syndrome, and changes in the availability of legal abortion. Numbers of women using oral contraception, other reversible methods, sterilization, and no method are projected from 1990 to 2010 under the assumption that use patterns in each age group resemble those observed in 1988. We conclude that discrepancies between projections of contraceptive use and fact are likely to occur because of the unpredictable nature of these few important variables.

Abortion, Legal↗

Birth spacing and child mortality in Bangladesh and the Philippines.

This analysis uses data from Bangladesh and the Philippines to demonstrate that children who are born within 15 months of a preceding birth are 60 to 80% more likely than other children to die in the first two years of life, once the confounding effects of prematurity are removed. The risks associated with short conception intervals are confined to children who are also high birth order; they persist in the presence of controls for prior familial child mortality, breast-feeding, mother's age, and socioeconomic status. In Bangladesh but not in the Philippines, these effects are confined to the neonatal period.

Bangladesh↗

Education for primary nursing.

It is argued in this paper that since practice is context bound, there can be no 'blueprint' offered through a formal educational programme for primary nursing. It is suggested that what may be needed is support on a much broader basis to help nurses to move from the relative safety of traditional approaches to work to the much riskier independent professional model of practice implicit in primary nursing. Three key areas have been identified which could be incorporated within an educational programme, namely development of self as an independent practitioner with the requisite skills of self-directed learning, the ability to accept responsibility discriminatingly and to account for practice through a well-established knowledge base; development of interpersonal skills required for the close personal nurse/client relationships required of primary nurses alongside appropriate support mechanisms; an understanding of the context in which practice occurs in order that the broad principles of primary nursing can be adapted to local needs. In this way, people may be helped to move from a dependency on central control and decision-making to become independent creative practitioners who are able to develop a local organisational model which suits their personal situation.

Education, Nursing, Continuing↗

A short illustrated history of magnetic resonance imaging.

The principles of Magnetic Resonance Imaging (MRI) evolved during the late 1970s and early years of the following decade. The author was fortunate in being able to visit many of the pioneer research projects in the U.K. and U.S.A. and attend two conferences. This paper briefly describes these projects and their role in the evolution of the present technology, illustrated by photographs obtained from colour slides taken during these visits.

History, 20th Century↗

Contraceptive failure and continuation among married women in the United States, 1970-75.

Using data from the National Survey of Family Growth (NSFG), this study reports differentials in contraceptive use-failure and continuation among married women aged 15-44 years in the United States. Failure rates differed by contraceptive intention. Within categories of intention, these rates differed by method, age, race, and parity. Users of modern methods had higher continuation rates than users of traditional methods. These results indicate that a woman's motivation is an important factor in long-term successful use of available contraceptive methods and that more effective and easier to use methods need to be developed.

Adolescent↗

Intestinal neoplasia in horses.

BACKGROUND: Intestinal neoplasia of horses is inadequately described. HYPOTHESIS: Intestinal neoplasia of horses has characteristic clinicopathologic features. ANIMALS: Thirty-four horses with intestinal neoplasia. METHODS: Retrospective study. RESULTS: Anamnesis, clinical signs, clinicopathologic and pathologic findings in 34 adult horses diagnosed histologically with intestinal neoplasia were reviewed. The horses ranged in age from 2 to 30 years (mean 16.6 years at presentation). The Arabian breed was most represented and there was no sex predisposition. The most common presenting complaints were weight loss, colic, anorexia, and fever. The most consistent clinical signs were poor body condition, tachycardia, tachypnea, fever, and diarrhea. Useful diagnostic tools included rectal examination, routine blood analyses, abdominocentesis, ultrasonographic examination, rectal biopsy, and exploratory laparotomy. Alimentary lymphoma was the most common intestinal neoplasia identified, followed by adenocarcinoma and smooth muscle tumors. The small intestine was the most common segment of intestine affected for all neoplasms. Intestinal neoplasia was diagnosed antemortem in 13 of 34 (38%) horses. The median time from onset of clinical signs to death or euthanasia was 1.9 months. The discharge rate was 15%. Although the longest survival was observed in horses with jejunal adenocarcinoma, all horses were eventually euthanized because of intestinal neoplasia. CONCLUSIONS: Arabian horses were 4.5 times more likely to have intestinal neoplasia diagnosed than were other breeds.

Age Factors↗

Extended roles.

Explore the source record for details and available documents.

Humans↗

Contraceptive failure, method-related discontinuation and resumption of use: results from the 1995 National Survey of Family Growth.

CONTEXT: Half of all pregnancies in the United States are unintended. Of these, half occur to women who were practicing contraception in the month they conceived, and others occur when couples stop use because they find their method difficult or inconvenient to use. METHODS: Data from the 1995 National Survey of Family Growth were used to compute life-table probabilities of contraceptive failure for reversible methods of contraception, discontinuation of use for a method-related reason and resumption of contraceptive use. RESULTS: Within one year of starting to use a reversible method of contraception, 9% of women experience a contraceptive failure--7% of those using the pill, 9% of those relying on the male condom and 19% of those practicing withdrawal. During a lifetime of use of reversible methods, the typical woman will experience 1.8 contraceptive failures. Overall, 31% of women discontinue use of a reversible contraceptive for a method-related reason within six months of starting use, and 44% do so within 12 months; however, 68% resume use of a method within one month and 76% do so within three months. Multivariate analyses show that the risk of contraceptive failure is elevated among low-income women and Hispanic women. Low-income women are also less likely than other women to resume contraceptive use after discontinuation. CONCLUSIONS: The risks of pregnancy during typical use of reversible methods of contraception are considerably higher than risks of failure during clinical trials, reflecting imperfect use of these methods rather than lack of inherent efficacy. High rates of method-related discontinuation probably reflect dissatisfaction with available methods.

Adult↗

Are all contraceptive failures unintended pregnancies? Evidence from the 1995 National Survey of Family Growth.

CONTEXT: The incidence of unintended pregnancy has long been used as a primary indicator of the state of reproductive health. However, the definition--and therefore the measurement--of this indicator has been elusive. METHODS: Data from the 1995 National Survey of Family Growth (NSFG) were used to compare levels of unintended pregnancy among contraceptive users based on two definitions--the standard definition based on women's reports of contraceptive failure, and the NSFG definition based on pregnancy timing (wanted then, wanted later, or not wanted then or in the future). An attitudinal scale was used to examine women's feelings about their unintended pregnancy. RESULTS: Of pregnancies classified as contraceptive failures under the standard definition, only 68% were unintended pregnancies--94% of those ending in abortion and 60% of those ending in birth. Just 59% of women with a contraceptive failure classified as an unintended pregnancy reported feeling unhappy or very unhappy about their pregnancy, while 90% of those with a failure classified as an intended pregnancy reported being happy or very happy. CONCLUSIONS: Measures of wantedness based on women's feelings about their pregnancy may correlate more closely with important pregnancy outcomes than do traditional measures of intendedness.

Adult↗