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Biomedical subjects

D N Brooks

Publications and source records attributed to D N Brooks.

At least 73 records · Page 4Linked to original sources
PubMed1983

Post-concussional symptoms, financial compensation and outcome of severe blunt head injury.

Two groups, each of 21 cases of severe blunt head injury, were compared. Patients in one group were pursuing claims for financial compensation while patients in the other were not. Patients were assessed on cognitive tests, and both patients and relatives were interviewed at 3, 6 and 12 months after injury. There were few differences between claimants and non-claimants: post-concussional symptoms were common in both, cognitive performance was equal, and the reports given by relatives of changes in the patients were very similar. However, the reports given by patients themselves differed with claimants reporting slightly more symptoms than non-claimants.

Adolescent↗
PubMed1983

Personality and behavioural change after severe blunt head injury--a relative's view.

A close relative of 55 severely head injured adults rated the personality of the patient at 3, 6 and 12 months after injury, using a Yes/No judgement, and analogue scales comprising bipolar adjectives. The relative assessed the "current" as well as the "premorbid" personality at each time. Personality change was associated with many negative scores on the analogue scale, and increasing negative scores were associated with high "subjective burden" on the relative. Severity of injury (post-traumatic amnesia) was of no significance in predicting the extent or pattern of personality change.

Adolescent↗
PubMed1981

The short-term outcome of severe blunt head injury as reported by relatives of the injured persons.

A close relative of 55 severely head injured adults (post-traumatic amnesia greater than or equal to 2 days) was interviewed 3, 6 and 12 months after injury to obtain information about psychosocial changes in the patient. The problems most frequently reported were emotional disturbances, poor memory, and subjective symptoms, with physical disability much less common. The amount of stress experienced by relatives did not diminish between 3 and 12 months, and was related to the incidence of mental and behavioural changes in the patient. The question of whether or not compensation was being claimed did not appear to influence the outcome.

Activities of Daily Living↗
PubMed1981

Use of post-aural aids by National Health Service patients.

The amount of use made of post-aural aids issued through the National Health Service was investigated by monitoring the discharge rate of zinc air cells supplied to two matched groups of patients. Each group consisted of 36 subjects, the first group received an aid in the normal routine manner but without any extra counselling. The second group received both pre- and post-issue counselling. Subjective reports for the patients on use showed some degree of exaggeration, though not as much as was seen in a previous study of users of body-worn aids. Use was substantially greater with the head-worn aids than with the body-worn models previously supplied through the NHS. Use has at least doubled on average and the percentage of non-users has fallen. Counselling (as provided through the Manchester Scheme) appears to effect a significant reduction in the percentage of non-users regardless of the type of aid supplied. Use among those receiving counselling is significantly greater than in those not so being helped. Use tends to diminish with increasing age of the subjects on application for assistance. It tends to increase over the first year of use, but the rate of change is dependent on many factors. In this study, no relationship was found between hearing-aid use and hearing loss, but this may be due to the rather close clustering of hearing losses of subjects under consideration. No relationship was found between use and living circumstances (alone or with family, etc.) but this is more likely to reflect the weakness of the measurement tool than any real differences. No relationship was found between use and stated duration of hearing loss or across the sexes. The zinc air cell proved to be a very satisfactory method of assessing use, and could be used for initial assessment of use in newly issued patients to identify those making poor use of the aid who might be in need of counselling or other forms of assistance.

Age Factors↗
PubMed1981

Pre-issue assessment and counselling as a component of hearing-aid provision.

Historically hearing-aid uptake and use in the United Kingdom has been poor. One contributory factor is believed to have been lack of basic knowledge about hearing loss and the benefits and problems of amplification. The scheme operating in South Manchester is described, wherein potential hearing aid users receive counselling both before and after the provision of the aid. The pre-fitting interview is partly for assessment purposes--determining the communication problems of the individual and family in order that the most appropriate assistance can be provided--and partly for counselling purposes, including attitude modification (if appropriate) and development of realistic expectations. The post-fitting counselling utilizes selected and trained volunteers who visit hearing-aids users in their homes at carefully chosen intervals. Additionally the great majority (95%) of hearing-aid users are reviewed by the Hearing Therapist at the Clinic about 1 month after issue. Evidence from Studies carried out in Manchester suggest that such a service considerably increases both use of and satisfaction with hearing aids.

Attitude↗
PubMed1980

Long term results of treatment of middle ear effusion.

Ten years follow-up of 48 patients (33 boys, 15 girls) with middle ear effusion treated by adeno-tonsillectomy, antral lavage and paracentesis is presented. Using the modified but stricter classification of Tos and Poulsen, the results compare well (Table V). Agreement between otoscopy and impedance measurement was remarkably high. It was noted that the greater the number of repeated paracenteses, the higher the compliance rose above normal, but there was no relation to the viscosity of the fluid found. In ears in which grommets were used, only in 10 per cent was the tympanic membrane found to be normal at otoscopy and impedance measurement, as compared with 55 per cent of ears which did not receive a ventilation tube. Poor pneumatization of mastoids indicated a poor prognosis. Sinus infection was present in the majority of cases treated. Another finding of interest was a patulous Eustachian tube in six patients--one bilateral and five unilateral. Despite the vast amount of literature published describing various combinations of treatment in the management of middle ear effusion, the challenge remains. Long term follow-up results for various methods employed would be welcome.

Adenoidectomy↗
PubMed1980

Cognitive sequelae in relationship to early indices of severity of brain damage after severe blunt head injury.

A group of 89 severely head injured patients was tested psychologically within two years of injury, and test performance was related to indices of brain damage. Duration of coma (Glasgow Coma Scale) bore little relationship to later cognitive outcome but duration of post-traumatic amnesia significantly predicted cognitive performance. Patients with an operated haematoma performed better than non-operated cases, reflecting a selection bias. The side of haematoma was not significant, nor were the presence, or type, or side of skull fracture.

Adolescent↗
PubMed1980

Pigmented paravenous retinochoroidal atrophy.

Pigmented paravenous retinochoroidal atrophy is an uncommon fundus disorder with a striking clinical presentation. It is characterized by the bilateral symmetrical appearance of posterior pole abnormalities including granular pigment cuffs around the larger retinal veins and their bifurcations and variable degrees of retinochoroidal atrophy about the affected veins and the optic disc. The maculas are spared of clinically observable abnormalities, and the vast majority of patients with this disorder are asymptomatic. Most of the approximately four dozen cases previously reported in the scientific literature have been discovered during routine ophthalmoscopy. The visual prognosis for patients with pigmented paravenous retinochoroidal atrophy is quite good. Two cases of this disorder are presented in order to draw attention to the clinical characteristics and the management of patients with a diagnosis of pigmented paravenous retinochoroidal atrophy.

Adult↗
PubMed1979

Counselling and its effect on hearing aid use.

The objective of this study was to determine if subjects who received pre- and post-issue counselling made better use of their National Health Service body-worn hearing aids than those who received no counselling. Assessment was by both subjective and objective methods, the latter employing a small use-time measuring device concealed within the aid. The findings suggested that subjects issued with hearing aids in the conventional NHS manner used their hearing aids even less than indicated by previous studies and achieved a low competence in handling. Significantly better use was made of their aids by subjects given a moderate amount of counselling. These patients were also considerably more adept in handling their aids and achieved a greater reduction in social hearing handicap than the non-counselled patients.

Aged↗
PubMed1979

Aural rehabilitation of hearing-impaired adults (official policy of the British Society of Audiology).

This report, which outlines the official policy of the British Society of Audiology on the aural rehabilitation of hearing impaired adults, (a) estimates the prevalence of hearing impairment in adults in the United Kingdom; (b) identifies the main problems associated with hearing impairment in adults; (c) outlines the main aural rehabilitative procedures and (d) puts forward recommendations for future developments in this area.

Adult↗
PubMed1979

Hearing aid candidates--some relevant features.

The age of individual seeking NHS aids has risen steadily since the service was commenced, and the median age is now over 70 years. The major type of hearing loss observed is sensorineural, but a substantial proportion of hearing aid candidates still have a significant conductive element in their hearing loss. This latter group of patients tend to be significantly younger than those without middle ear involvement. The hearing loss when applying for a hearing aid tends to be around 50 dB but is age dependent, younger subjects coming with smaller hearing losses. The most disturbing information obtained on questioning applicants was the long time lapse between recognition of hearing impairment and application for a hearing aid. This averaged almost ten years. The true delay is probably considerably greater than this and must have a substantial bearing on the outcome of hearing aid fitting. Public education and counselling of hearing aid users are suggested as vita needs.

Age Factors↗
PubMed1979

Psychological consequences of blunt head injury.

89 severely closed head injured cases were tested on measures of verbal learning, and verbal and nonverbal intelligence, and their performance was compared with that of 30 orthopaedic cases. Head injured cases had severe deficits on all the tests. Severity of injury (judged by post-traumatic amnesia duration) was significantly related to poor performance on the learning and nonverbal intelligence tests, but not on the verbal intelligence test. The effect of injury on the family was studied in a further group of 35 head injured cases, showing that family burden within six months of injury was related to the presence of childish behaviour and loss of interest in the patient, together with other behavioural and affective changes. Physical deficits were not significant in this respect.

Adolescent↗
PubMed1979

Cognitive recovery during the first year after severe blunt head injury.

Cognitive recovery was examined in 24 severe closed head injured patients tested at 3, 6 and 12 months after injury, and 12 patients tested, in addition, at one month. A retested non-head injured control group was used, and where appropriate, alternative test forms were employed to control for practice effects. Tests of intellectual, perceptual/constructional skills, linguistic and memory functions were used, showing that by 12 months the only statistically significant differences between head injured and control patients were on learning and constructional tasks. Individual patients showed widely varying recovery patterns which made prediction of recovery difficult.

Adolescent↗