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Biomedical subjects

E M Russell

Publications and source records attributed to E M Russell.

35 records · Page 2Linked to original sources
PubMed1984

Aerobic exercise training and improved neuropsychological function of older individuals.

The effects of a four month aerobic exercise conditioning program on neuropsychological test performance, depression indices, sensory thresholds, and visual acuity of 55-70 year old sedentary individuals were evaluated. Aerobically trained subjects were compared with two age-matched control groups of subjects: those who trained with strength and flexibility exercises and others who were not engaged in a supervised exercise program. The aerobically trained subjects demonstrated significantly greater improvement on the neuropsychological test battery than did either control group. Depression scores, sensory thresholds, and visual acuity were not changed by aerobic exercise. The pattern of results suggests that the effect of aerobic exercise training was on central rather than on peripheral function. We speculate that aerobic exercise promoted increased cerebral metabolic activity with a resultant improvement in neuropsychological test scores.

Aged↗
PubMed1984

Choice and change in health care in Britain.

Health authorities in Britain are under pressure to shift the balance of health care towards long-term patients and non-hospital services. Financial cut-backs mean that changes in priorities can no longer be implemented from development monies alone and there is a need to take resources from existing services. At first glance, the least difficult option appears to be to make savings in the ways in which care is delivered rather than to cut or abolish whole services or to reduce 'standards' of care. However there are factors other than resource constraints which influence the ability of health authorities to choose and implement shifts of resources; they include professional and technical developments, lay expectations and health service management structures and processes. These factors and their implications are reviewed and issues are identified which are amenable to research by existing groups of research workers.

Automation↗
PubMed1981

Learning about rehabilitation.

Not many teaching hospitals or practices in Britain can offer a single service specialty of rehabilitation as a forum for undergraduate learning, and it is therefore necessary either to create a simulated programme or to draw together a range of services or specialties solely for teaching purposes. In this paper, a short medical undergraduate course at Aberdeen University Medical School, using the second approach, is described. The focus of the course was on the doctor's role, in every patient and specialty, in the active prevention of temporary or permanent dependence and the ultimate aim was to create in medical students a more positive attitude to holistic patient management. A problem-solving framework was used, in which the students were asked to draw up a provisional problem list for patients from nearly all specialties seen in the post-acute phase in Aberdeen hospitals and in the recovering or adapted state at home. In was hoped that in the process of compiling the data-base students would gain some knowledge of the functional consequences of illness and of the profession and services which might be able to help. Students then met clinical staff to discuss their problem lists and the doctor's role in preventing or treating functional problems. Subjective assessments of the course by students and staff suggest that, although the students had difficulty at first in seeing the doctor's role in relation to functional problems, by the end of the course most had acquired, through discussion of particular patients, awareness of the importance of that role in assessment and patient education. On the basis of this attempt, the course will be continued but with some modifications.

Education, Medical, Undergraduate↗
PubMed1976

The behaviour of red kangaroos (Megaleia rufa) on hot summer days.

To investigate the functional significance of the behaviour of large mammals in hot, arid conditions, field observations were made of the behaviour of red kangaroos. The behaviour of individual animals was recorded in detail during hot summer days and measurements of the prevailing temperature and radiation environment were made. Changes in the postures adopted by animals during the day are described in relation to environmental conditions; and the occurrence of certain postures and behaviours at periods of greatest heat stress is reported.

Adaptation, Physiological↗
PubMed1975

Costs of detecting and treating cancer of the uterine cervix in North-East Scotland in 1971.

In 1971 the Aberdeen cytology service handled 22,291 cervical smears--threequarters from women participating in a screening programme and the rest from women with symptoms who were referred to hospital. As a result of screening, 56 preclinical cases of cancer of the cervix uteri were treated in hospital; 13 others were classified as less than preclinical. Of the gynaecological patients 20 had clinical cancer and 29 had less than preclinical lesions. From estimates of the costs of running the cytology service and of hospital inpatient costs it is possible to derive figures for detecting and treating preclinical cases and investigating and treating clinical cases. The cost to the Health Service of detecting and treating each preclinical case was slightly less (445 pounds) than that for impatient treatment of each clinical case (487 pounds). However, if mass screening were abandoned cytology would almost certainly continue for women referred to hospital with symptoms, and, if the costs of taking and examining these smears is taken into account, the cost per clinical case treated nearly doubles to 835 pounds. Had outpatient and other follow-up costs been included, the difference in service costs would be even greater. Comparison of these figures assumes the controversial point that preclinical cancer will always progress to invasive carcinoma if left untreated and takes no account of inflation and discounting.

Carcinoma in Situ↗
PubMedDate not supplied

Measuring outcome of diabetes: a retrospective survey.

The feasibility of using hospital discharge data to monitor six outcome indicators for diabetes care was assessed by reviewing retrospectively the occurrence of these events recorded in hospital records. The population studied was that of the Orkney Islands (19,500) over a 10-year period (1976-1985). During that time, 230 Orkney diabetic patients were treated in Orkney and/or Aberdeen hospitals. The six outcome indicators were: hospital admission rates for diabetic patients (609 in 230 patients), hospital admission rates specifically for diabetic ketoacidosis (29 in 20 patients), rates of diabetes-related lower limb amputations (36 in 23 patients), perinatal mortality rates related to maternal diabetes (nil), visual loss or blindness (13 eyes in 9 patients) and end-stage renal failure (one patient). Scottish Morbidity Returns (which collect data similar to that in the Hospital In-patient Enquiry in England) were shown by case note review to underestimate these outcomes by 41%. Cardiovascular disease, cerebrovascular disease, and peripheral vascular disease accounted for half of all in-patient bed use by diabetic patients (6077 of 13,951 days). The routinely available Scottish hospital discharge data, which are collected for a different purpose, are not sufficiently accurate or complete to reflect variations in actual diabetic events.

Amputation, Surgical↗
PubMedDate not supplied

Problems in using health survey questionnaires in older patients with physical disabilities. Can proxies be used to complete the SF-36?

BACKGROUND: The SF-36 Health Survey questionnaire has been proposed as a generic measure of health outcome. However, poor rates of return and high levels of missing data have been found in elderly subjects and, even with face-to-face interview, reliability and validity may still be disappointing, particularly in cognitively impaired patients. These patients may be the very patients whose quality of life is most affected by their illness and their exclusion will lead to biased evaluation of health status. A possible alternative to total exclusion is the use of a proxy to answer on the patient's behalf, but few studies of older people have systematically studied patient-proxy agreement. OBJECTIVE: To compare the agreement between patients, lay and professional proxies when assessing the health status of patients with the SF-36. METHODS: The SF-36 was administered by interview to 164 cognitively normal, elderly patients (Mini-mental State Examination 24 or more) referred for physical rehabilitation. The SF-36 was also completed by a patient-designated lay proxy (by post) and a professional proxy. Agreement between proxies and patients was measured by intraclass correlation coefficients (ICCs), and a bias index. RESULTS: Professional proxies were better able to predict the patients' responses than were the lay proxies. Criterion levels of agreement (ICC 0.4 or over) were attained for four of the eight dimensions of the SF-36 by professional proxies, but for only one dimension by lay proxies. In professional proxies, the magnitude of the bias was absent or slight (<0.2) for six of the eight dimensions of the SF-36 with a small (0.2-0.49) negative bias for the other two. Lay proxies showed a negative bias (i.e. they reported poorer function than did the patients themselves) for seven of the eight dimensions of the SF-36 (small in two and moderate (0.5-0.79) in five). CONCLUSIONS: For group comparisons using the SF-36, professional proxies might be considered when patients cannot answer reliably for themselves. However, in the present study, lay proxy performance on a postal questionnaire showed a strong tendency to negative bias. Further research is required to define the limitations and potentials of proxy completion of health status questionnaires.

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