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Biomedical subjects

H Firth

Publications and source records attributed to H Firth.

At least 19 recordsLinked to original sources

Client satisfaction with the New Zealand National Poisons Information Service.

A telephone survey of a random sample of callers to the New Zealand National Poisons and Hazardous Chemicals Information Centre (NPC) was undertaken to assess public satisfaction with, and knowledge of, the NPC and to determine whether the NPC was meeting the needs of its users. The response from a sample of 433 individuals (354 members of the general public and 79 health professionals) was 79%. Maori and Pacific Island people were under--represented in the sample. Overall the level of satisfaction with the NPC was high with 91% of the respondents finding the information they received very useful. If the NPC had not been available, 81% of the public would have sought advice from a medical facility and 59% would have visited such a facility. It was estimated that the NPC could be saving the public health services in New Zealand (NZ) up to NZ $1.3 million annually. It was concluded that the NPC was meeting the needs of current users, although greater public awareness and improved access are needed particularly for Maori and Pacific Island people.

Awareness

Needle stick injuries in country general practice.

AIMS: The aims of this study were to determine the frequency of needle stick injury (NSI) in general practice, to determine what measures were being taken to protect against needle stick injury, and to gather other information regarding work practices, risk perception, and knowledge of transmission. METHODS: A postal survey was undertaken of all general practitioners and one practice nurse per practice address in selected areas of New Zealand. RESULTS: The response rate was 82%. An incidence rate of 22 needle stick injuries in 100 health care workers per 6 month period was found. For general practitioners alone the incidence rate was 25 in 100 per 6 month period and for practice nurses it was 17 in 100 per 6 month period. Recommended precautionary measures were not being followed by most individuals. CONCLUSIONS: Needle stick injury is a substantial problem in general practice and exposes general practitioners and practice nurses to a serious risk of infection from bloodborne transmissible agents. All patients should be considered to pose a potentially high risk of infection and recommended precautionary measures should be followed at all times.

Accidents, Occupational

Chorion villus sampling and limb deficiency--cause or coincidence?

Chorion villus sampling (CVS) is a widely used technique in first trimester prenatal diagnosis. In the early 1990s, two clusters of babies with limb defects following CVS were reported, raising the possibility of a causal association between early CVS and transverse limb deficiency. The evidence for this association is reviewed and shows a diminishing risk for transverse limb deficiency with advancing gestation. The risk of limb deficiency extends through the period of limb morphogenesis and slightly beyond; falling from levels 10-20-fold above background at nine weeks and below, to levels approaching (or only a few-fold above) background at 11 weeks and beyond.

Chorionic Villi Sampling

Differential allelic expression of a fibrillin gene (FBN1) in patients with Marfan syndrome.

Marfan syndrome is a connective-tissue disorder affecting cardiovascular, skeletal, and ocular systems. The major Marfan locus has been identified as the FBN1 gene on chromosome 15; this codes for the extracellular-matrix protein fibrillin, a 350-kD constituent of the 8-10-nm elastin-associated microfibrils. We identified five MFS patients who were heterozygous for an RsaI restriction-site dimorphism in the 3' UTR of the FBN1 gene. This expressed variation was used to distinguish the mRNA output from each of the two FBN1 alleles in fibroblast cultures from these five patients. Three of the patients were shown to produce < 5% of the normal level of FBN1 transcripts from one of their alleles. This null-allele phenotype was not observed in 10 nonmarfanoid fibroblast cell lines.

Adult

Occupational injuries in Dunedin.

Attendances for work-related injury at the accident and emergency department, Dunedin Hospital over a 10 week period are described. The number of workers attending from Dunedin city, St Kilda and Green Island boroughs was 655, the overall rate being 15.8/1000 workers. The injury rate varied according to age, sex, ethnicity, occupation and industry. Laceration, strain/sprain and foreign body in the eye were the most common injuries and machinery was the commonest cause of injury. Small factories had significantly higher rates for lost time injuries compared with large factories. Serious under reporting of occupational injury to the Department of Labour was identified.

Absenteeism

A systematic comparison of feedback and staff discussion in changing the ward atmosphere.

The efficacy of therapeutic programmes depends on several characteristics of the treatment environment. For this reason therapists are increasingly directing their efforts towards changing the social characteristics of treatment units. This study aimed to promote change in social climate by providing nursing staff with structured information about their unit. The 'real' and 'ideal' social climate of the unit was defined and assessed using the Ward Atmosphere Scale. All staff were asked to complete it during an assessment period. Feedback about their perception of the unit was provided to staff in two ways. One group of staff received written feedback only; a second group received in addition the opportunity to discuss the feedback and strategies for reducing the real-ideal discrepancies in four once-monthly meetings. The effect of the feedback on the social climate of the unit was ascertained by further assessment using the WAS and from interviews with all staff. The evaluation suggested that the feedback had contributed to changes in several procedures in the unit and to a reduction in the real-ideal discrepancies for the systems maintenance elements. The effect was greater for the group of staff who had the opportunity to discuss the feedback in a formal setting.

Communication

Professional depression, 'burnout' and personality in longstay nursing.

Conceptualizations of 'burnout' vary between authors. Some descriptions of burnout show strong similarities to depression in the work setting, or 'professional depression' as described by Oswin [Children Living in Long Stay Hospitals, 1978. Heinemann, London]. This study supported such a similarity, and demonstrated a considerable extent of depressed mood amongst nursing staff in longstay settings, which was particularly significant amongst male staff. A number of distinct 'burnout' responses were evident amongst staff including not only 'professional depression' and depersonalization but also the avoidance of problems and decisions. Ambiguity about supervisors' expectations and success in meeting such expectations were associated with increased scores on each of these variables. Personality appeared to be related to staff's responses. Staff prone to direct hostility inwards on themselves were more likely to show an avoidance of problems and decisions. Those staff prone to direct hostility outwards were more likely to report an awareness of depersonalization toward others. Both these processes may in different ways affect patient care and relationships with other professionals.

Adult

Interpersonal support amongst nurses at work.

The needs for support of staff in human services work are often stated, but less often is the nature of such support clearly specified. This study attempts to clarify the nature of effective support from a superior, as perceived by qualified nursing staff working in psychiatric, mental handicap and medical settings. 'Personal respect', 'empathic attention' and 'absence of interpersonal defensiveness' appeared to be important components to such support. Staff on the same ward showed a high degree of agreement in judgements of their superior's personal respect and empathic attention, but perceived interpersonal defensiveness appeared more specific to perceptions or interactions between particular staff. Greater degrees of 'personal respect' experienced by staff were associated with reduced role ambiguity and reduced emotional exhaustion ('burnout'). The empathic attention reported as given by ward charge nurses was highly correlated with the personal respect they reported receiving from their own superior. These results support approaches which see respect, empathy and genuineness as important ingredients in helping relationships.

Adult

Burnout and professional depression: related concepts?

In 1978 Oswin documented a process of 'professional depression' affecting some nursing staff in long-stay hospitals. This study tested the hypothesis that 'professional depression' in long-stay nursing and 'emotional exhaustion' as a component of burnout describe a similar phenomenon. This hypothesis was supported. The results are consistent with Cherniss' characterization of burnout, which appears to show considerable similarities to the concept of depression. In this study professional depression demonstrated a substantial correlation with depressed mood. Personality demonstrated significant relationships with burnout variables, extrapunitive hostility correlating with hardening toward others, intropunitiveness with avoidance as a coping response. These findings, although confined to hospital nurses, support the usefulness of approaches stressing the interaction between the work environment and the individual.

Adult