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Biomedical subjects

D Cowan

Publications and source records attributed to D Cowan.

65 records · Page 4Linked to original sources

The assessment of self-care capacity in geriatric psychiatric patients by objective and subjective methods.

A simple performance test was developed and used to evaluate a sample of psychiatric geriatric patients on their capacity for self-care. Evaluations were made by asking the patient to demonstrate certain essential activities of daily living. The objective test, compared with patients' subjective reports, was found to be a more valid measuring instrument of functional impairment and more useful as a diagnostic and prognostic tool Test scores correlated with independent clinical assessments of mental status and physical conditions, as well as with short-term outcome of hospitalization. The scale is easy and quick to administer and has many applications for the treatment and management planning of patients.

Activities of Daily Living↗

The usefulness of a psychological test battery.

This paper discusses the usefulness of a battery of psychological tests administered to a group of psychiatric geriatric patients in New York and London, as an assessment of cognitive impairment. Two of the tests, the Paired Associate Learning Test, and the Digit Copying Test, were highly related to the diagnosis of organic brain syndrome or functional disorder made independently by a psychiatrist in a clinical interview. Prognostic predictions in disagreement cases were no better or no worse by psychiatric diagnosis than by psychological tests. Compared to a simple clinical test of disorientation derived from the psychiatric interview, psychological tests were more highly correlated to independent measures of patients' self-care capacity and duration of hospitalization, but equally related to psychiatric diagnosis. The verbal subtest proved to be the more useful of the psychological tests given. The logistics and difficulties of administering psychological tests to this specialized population are discussed, e.g. patients' physical limitations, communication problems; as well as efforts in this study to minimize these problems.

Aged↗

Screening and assessment of childhood deafness: experience from a centralized multi-disciplinary service.

A paediatric hearing assessment unit was set up in Lothian in 1978 to provide a clear referral pathway for children with suspected sensorineural hearing impairment and particularly for those children detected by the health visitor screening test. Over a 6-year-period the incidence of bilateral sensorineural deafness was 1.3/1000 suggesting that all children in the region were being seen. The mean age of diagnosis fell significantly over this period. Children in high risk groups, through adverse perinatal events or a positive family history, were not detected any earlier than other children. They were therefore not contributing to this improved earlier age of diagnosis. These findings support the continuation of health visitor screening but changes in practice are needed to encourage earlier diagnosis in high-risk groups.

Acoustic Impedance Tests↗

Alcohol versus natural drying for newborn cord care.

OBJECTIVE: To compare alcohol cleaning and natural drying of newborn umbilical cords. DESIGN: Prospective, randomized controlled trial. SETTING: Tertiary-level university teaching hospital and level II community hospital. PARTICIPANTS: Of 1,876 singleton full-term newborns enrolled, 1,811 completed the study. INTERVENTIONS: Newborns, from birth until separation of the cord, were randomized to either (a) umbilical cleansing with 70% isopropyl alcohol at each diaper change or (b) natural drying of the umbilical site without special treatment. MAIN OUTCOME MEASURES: Umbilical infection, cord separation time, maternal comfort, and cost. RESULTS: No newborn in either group developed a cord infection. Primary care providers obtained cultures for cord concerns in 32 newborns (1.8%), with colonization for normal flora, Staphylococcus aureus, and Group B streptococcus proportionately equal in alcohol and air dry groups. Cord separation time was statistically significantly different (alcohol group, 9.8 days; natural drying group, 8.16 days; t = 8.9, p = < .001). Mothers described similar comfort with cord care and relief with cord separation. Costs of alcohol drying while in the hospital were greater than those of natural drying. CONCLUSIONS: (a) Evidence does not support continued use of alcohol for newborn cord care; (b) health care providers should explain the normal process of cord separation, including appearance and possible odor; and (c) health care providers should continue to develop evidence to support or eliminate historic practices.

2-Propanol↗

Make your small practice thrive. Physicians moving from big practices to small must know the business side of medicine.

Trying to gain a measure of control over their working lives, some physicians are abandoning large group practices for smaller groups. Large groups enjoy whole teams of people performing vital business tasks. Small practices rely on one or two key physicians and managers to tackle everything from customer service to marketing, medical records to human resources. Learn valuable tips for thriving in a small environment and using that extra control to achieve job satisfaction.

Benchmarking↗

Blood pressure and lead levels in children.

Blood lead and hypertension are associated in adults. We attempted to duplicate this finding in a presumably more susceptible group of children. Small but statistically significant negative corelations were found between blood pressure and lead levels in these children. This indicated to us that the proposed positive relationship did not exist, and that the failure to detect such a relationship was not due to small sample size.

Black or African American↗