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Biomedical subjects

H Roberts

Publications and source records attributed to H Roberts.

At least 55 records · Page 3Linked to original sources
PubMed1998

Ectopic pregnancy in lower segment uterine scar.

A case of ectopic pregnancy in a lower uterine segment scar following previous Caesarean section is reported. A significant scar defect may result in deep implantation within the myometrium with the risk of persistent pain and bleeding followed inevitably by uterine rupture. In this report we discuss a number of management options. Except in the special situation of superficial implantation in a shallow scar defect where there is ultrasound evidence of continuity of the gestational sac with the uterine cavity we would strongly advise termination of the pregnancy.

Cesarean Section↗
PubMed1997

Socioeconomic determinants of health. Children, inequalities, and health.

This article describes a growing body of evidence showing the adverse effects of the widening income gap on the health and welfare of children and young people. The effects of this go well beyond morbidity and mortality and can also be seen in the areas of crime, violence, and educational attainment. There is a need for evidence based policy in this area, but meanwhile there is scope for intervention in pregnancy and the early years, and good evidence that this is effective. A number of well evaluated interventions not necessarily directly related to health, such as early learning programmes and social support for parents, promise to have beneficial health effects.

Child↗
PubMed1997

Assessing social work effectiveness in child care practice: the contribution of randomized controlled trials.

This article discusses the role of randomized controlled trials (RCTs) in evaluating the impact of social work interventions with children. While recognizing the difficulties of applying RCTs to all aspects of practice, we argue that controlled trials can provide the most convincing evidence of the impact of social work activities on the welfare of children and families. Accumulating evidence of the effectiveness of interventions, we propose, should constitute the core business of social work research. To this end, it is necessary to recognize the primacy of the randomized controlled trial in exploring the relationship between social work activities and client outcomes.

Child↗
PubMed1997

Unemployment and health: the quality of social support among residents in the Trent region of England.

OBJECTIVE: To examine the quality of social support among unemployed residents in Trent, England. DESIGN: Secondary analysis of data generated by those of working age drawn from a postal lifestyle survey of the adult population of Trent region. SUBJECTS AND SETTING: Subjects were 6987 individuals (males 16-64 years and females 16-59 years of age), of whom 9.9% (689/6987) were unemployed. MAIN OUTCOME MEASURES: Responses about the quality of social support obtained from three key questions. RESULTS: Generally, the unemployed reported poorer quality of social support than employed persons (p < 0.0001) on all three key elements examined: 31% v 17% respectively had no practical support; 19% v 10% had no help with solving problems, and 21% v 10% had no emotional support. Only 57% of the unemployed had all three of these elements compared with 75% of the employed. Unemployment and lack of social support had independent and deleterious effects on perceptions of general health and mental health. Relationships remained after allowing for the possible confounding effects of age, gender, and household composition. CONCLUSIONS: There is a relationship between unemployment and poorer quality of social support which may help to explain some of the increased morbidity and mortality experienced by this group, especially that related to mental health.

Adolescent↗
PubMed1997

Lifestyle surveys--the complete answer?

STUDY OBJECTIVES: These were as follows: to study incompleteness of data, herein called item non-response, generated by a self completion questionnaire; to identify the characteristics of item non-responders and the types of questions liable to high item non-response rates; and to discuss possible reasons for item non-response. DESIGN: Item non-response patterns in 12,307 responders (62%) to a representative postal survey based on a stratified sample drawn from family health services authorities' (FHSA) registers were investigated. MAIN OUTCOME MEASURES: Data were analysed for item non-response in three groups depending on when the questionnaire was returned (wave analysis). The overall completion rate of the questionnaire was examined and the natural logarithm of the proportion of completed questions was used as an outcome variable in multiple regression analysis. Item nonresponse to key questions and questions of different types was examined. RESULTS: Wave analysis: the overall completion rate of the questionnaire was 86% in questionnaires returned before the first reminder and 83%-84% in those sent back after subsequent reminders. Overall pattern of item non-response; respondents failed to complete a mean of 15% and a median of 10% of the questionnaire. All questions in the questionnaire had some item non-response, ranging from 1% to 85%. Completion rates were associated with gender, age, indicators of lower socioeconomic status, and general health status. Individual questions: particular types of questions were liable to have higher item non-response, for example, linked binary questions. CONCLUSIONS: Item non-response in population postal surveys is likely to present problems in the interpretation of data by introducing bias additional to that of total non-response. Item non-response does not increase greatly with later returns, suggesting that the quality of data across responses generated by two reminders is similar. There are obstacles to reducing item non-response, such as respondent error or socioeconomic and health characteristics of the general population, that cannot be totally overcome. However, the evidence that individuals tend to complete only options within questions that apply to them and their positive behaviour is useful information for those designing questionnaires and interpreting survey data.

Adolescent↗
PubMed1997

Family planning needs and STD risk behaviours of female psychiatric out-patients.

BACKGROUND: There are few studies concerning the family planning needs of female chronic psychiatric patients. We aimed to determine the contraceptive needs and sexually transmitted disease (STD) risk-behaviours of female psychiatric out-patients. METHOD: Sixty-six female out-patients with major psychiatric disorders, including schizophrenia, bipolar disorder and mood disorders, completed a semi-structured interview (response rate = 63%) and were individually matched for age and ethnicity with 66 women who had never been treated for psychiatric illness. They answered questions on child-rearing and on their methods of contraception in relation to their attitudes towards pregnancy, as well as on their risk for STDs. RESULTS: Compared with controls, the female patients reported having had significantly more induced abortions and were significantly more likely to have given up their own children for others to raise. Heterosexually active psychiatric patients were significantly more likely than controls to have had more than one male sexual partner, to have been pressured into unwanted sexual intercourse, and to report having had sexual intercourse with a suspected bisexual over the preceding year. CONCLUSIONS: These results underscore the priority for developing programmes that reduce female psychiatric patients' risk for unwanted pregnancies and STDs.

Adult↗
PubMed1996

Prioritizing performance measures for geriatric medical services: what do the purchasers and providers think?

We sought the views of purchasers and provider managers in the South and West Region on the relative priorities of 15 possible performance measures of a geriatric medical service. Using a postal questionnaire, subjects were asked to rank the measures in order of priority. Improving patients' quality of life was judged the most important measure by all groups except for the purchasing chief executives, who placed it second to improving patients' physical function (which was overall the second most important measure). The lowest priority was given to measurement of levels of activity and reducing mortality rates. Priorities were similar to those found with patients and geriatricians in a previous study, and supports the development and use of performance measures of disability and the quality of life of patients.

Activities of Daily Living↗
PubMed1996

Adolescents' use of prescribed drugs and over-the-counter preparations.

BACKGROUND: The objectives of this paper are to present data on the self-reported use of prescribed and over-the-counter drugs among young people aged 11-12 and 14-15 years and to examine factors associated with the use of prescribed drugs, over-the-counter painkillers and cough and cold treatments. METHOD: Data were collected from a representative sample of pupils aged 11-12 years old and 14-15 years old attending 85 schools in Trent Region. Results are based on replies from approximately 8500 pupils in each year group. Pupils were asked to self-report usage by ticking a list of prescribed and non-prescribed drugs or medicines. RESULTS: Girls aged 14-15 years are more likely than others to have used at least one of the drugs in the previous week, with 40 per cent of girls in this age group having used a non-prescribed painkiller. Young people with a long-term illness or previous injuries are more likely to report having used prescribed drugs and/or over-the-counter painkillers. Family car-ownership, a proxy for socio-economic status, is not associated with the use of those drugs examined in more detail. CONCLUSIONS: The levels of use of over-the-counter drugs, particularly those with potential side effects, indicate that further studies are needed to examine patterns of use in more detail and that health education about self-medication is appropriate among young people aged 11-12 years and above.

Adolescent↗
PubMed1996

Resuscitating the elderly: what do the patients want?

OBJECTIVES: To study the resuscitation preferences, choice of decision-maker, views on the seeking of patients' wishes and determinants of these of elderly hospital in-patients. DESIGN: Questionnaire administered on admission and prior to discharge. SETTING: Two acute geriatric medicine units (Southampton and Poole). PARTICIPANTS: Two hundred and fourteen consecutive consenting mentally competent patients admitted to hospital as emergencies. RESULTS: Resuscitation was wanted by 60%, particularly married and functionally independent patients and those who had not already considered it. Not wanted resuscitation was associated with lack of social contacts. Sixty-seven per cent welcomed enquiry about their preferences and 78% wanted participation in decision, 43% as sole decision-maker. Wishing to choose oneself was associated with not wanting resuscitation, prior knowledge of it, and lack of a spouse. Patients' opinions remained stable during their admission. CONCLUSIONS: Discussion of resuscitation is practical on hospital admission without causing distress and the views expressed endure through the period of hospitalisation. Elderly patients' attitudes depend partly on personal health and social circumstances. This may assist doctors when patients are unable to participate themselves.

Aged↗
PubMed1995

Knowledge of blood cholesterol reduction in community residents.

This study examined the cholesterol knowledge of inner-city community residents, who are representative of individuals in lower socio-economic groups. "Cholesterol Pursuit," a 10-item cholesterol knowledge test distributed by the National Heart, Lung, and Blood Institute, was administered to 316 residents in eight local grocery stores. The average percentage of correct answers was 65.8%. Community residents in a large, urban city were fairly knowledgeable about blood cholesterol reduction, but there were misconceptions concerning the importance of eggs, fish oil, and olive oil, and with foods marked "no cholesterol." White community residents appeared to be slightly better informed about reducing blood cholesterol. Identification of misperceptions concerning cholesterol will guide future education programs for these specific communities.

Adult↗
PubMed1994

Expression of ricin B chain in Spodoptera frugiperda.

DNA encoding ricin B chain was derived from preproricin genomic DNA and ligated into the baculovirus transfer vector, pAcGP67A. Co-transfection of Spodoptera frugiperda Sf9 cells with BaculoGold DNA was followed by limiting dilution purification of recombinant baculovirus. Infection of SF9 cells at a multiplicity of infection of 1 in the presence of 25 mM lactose produced 3 mg/l of soluble, glycosylated, 34 kDa protein immunoreactive with monoclonal and polyclonal antibodies to ricin B chain. The recombinant ricin B chain had similar lectin-binding activity to plant ricin B chain. The recombinant protein reassociated with ricin toxin A chain similarly to ricin toxin B chain and the recombinant heterodimers had similar cell cytotoxicity to ricin.

Animals↗
PubMed1994

Setting priorities for measures of performance for geriatric medical services.

We undertook a two-round Delphi study of the views of consultant geriatricians in three Health Regions on the relative appropriateness of 12 possible performance measures for geriatric services. We compared geriatricians' responses with those of 44 cognitively-intact day hospital patients. Of 138 geriatricians, 89 responded to the first round postal survey, 84 to the second round. The rank order of geriatricians' suggestions did not change from round one to round two, and there was convergence of opinion with a significant decrease in the coefficients of variation of the ranks (p < 0.05, Wilcoxon Test). Geriatricians and patients gave high priority to 'reducing disability' and 'improving quality of life', and low priority to 'reducing mortality'. Geriatricians gave higher priority than patients to 'consumer satisfaction', 'problem resolution' and 'efficient use of resources'. Patients gave higher priority to 'reducing burden on carers', 'measures of service activity' and 'avoiding institutional care'. The study shows that it is possible to obtain a consensus amongst geriatricians about the priorities for measuring the performance of geriatric medical services. Similarities to and differences from patients' views illustrate the need to engage more than one group in the debate about appropriate measures of performance. Findings in both groups give support to recent attempts to develop and use assessment methods for the measurement of disability and quality of life in clinical practice.

Activities of Daily Living↗