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Biomedical subjects

J Huntington

Publications and source records attributed to J Huntington.

At least 19 recordsLinked to original sources

Inequalities in access to healthcare faced by women who are deaf.

The Cheshire Deaf Women's Health Project undertook a research study to assess the access to healthcare of women who are deaf in Cheshire, UK. Group discussions took place with 13 women who were hard of hearing and 14 women who were Deaf Sign Language users. Questionnaires were distributed to a stratified random sample of 103 women taken from the social services register, 38 of which were returned. In order to reach more women whose first language was British Sign Language, 129 questionnaires were distributed to the leaders of various clubs and organizations for people who are deaf, and 100 of these were returned. The data revealed inequities in access to healthcare. For example, women who are deaf face a lack of awareness by health staff of how to communicate with them. The survey confirmed that these problems are of major importance to the majority of women who are deaf. For example, fewer than one in 10 deaf women said that they usually fully understand what the doctor says to them when they visit the doctor on their own. There are many other difficulties faced by women who are deaf, leading to inequalities when they are compared with hearing people. Almost half the respondents said that they would be more likely to use health services if help and/or services for deaf women were available. The introduction of various relatively simple measures would greatly help to reduce the inequalities of access to healthcare faced by deaf women. Under the terms of the Disability Discrimination Act 1995, such action is essential if providers are to avoid facing possible legal action.

Adult↗

Personal medical services. Friends and relations.

Personal medical services pilot schemes remain internally focused. In many areas hospital doctors' willingness to work with general practice has been hampered by chief executives' fear of loss of income. Health authorities have generally failed to take responsibility for the pilot schemes. There are some fears of the schemes creating inequity at local level.

Cooperative Behavior↗

Primary care. This is your pilot speaking.

An evaluation of 14 personal medical services pilot schemes has found the GPs involved welcome the reduction in paperwork. The flexibility in funding of the schemes has allowed GPs greater leeway in managing their workload. Some of the financial risks of running a practice have been removed. It is questionable whether the schemes are fully using the freedoms envisaged. Some schemes reported a lack of support from their health authority.

Contract Services↗

Effects of anesthetic technique on side effects associated with fentanyl Oralet premedication.

STUDY OBJECTIVES: To evaluate the efficacy of 5 to 10 micrograms/kg of oral transmucosal fentanyl citrate (OTFC) as an anesthetic premedication, and to determine whether propofol induction reduces postoperative nausea and vomiting (PONV) in pediatric patients premedicated with OTFC undergoing outpatient surgery. DESIGN: Prospective, randomized, double-blinded study. SETTINGS: University of Michigan Health Care Systems and University of Arizona. PARTICIPANTS: 62 ASA physical status I and II children aged 4 to 14 years (8.9 +/- 0.5 years). INTERVENTIONS: Subjects were randomly assigned to one of four groups: (1) OTFC premedication and halothane induction; (2) OTFC premedication and propofol induction; (3) placebo premedication and halothane induction; and (4) placebo premedication and propofol induction. OTFC or placebo was administered 30 minutes prior to induction, and activity (sedation), apprehension, and cooperation scores were recorded before, at 15 and 30 minutes after study drug, and on induction. All perioperative adverse events were recorded. MEASUREMENTS AND MAIN RESULTS: Children who received OTFC became drowsier and had a significant change from baseline in combined activity, apprehension, and cooperation scores, whereas those who received placebo became less cooperative at induction. Patients who received OTFC experienced more adverse events overall (p < 0.001) than patients who received placebo. Additionally, OTFC patients experienced more vomiting (p < 0.001) and pruritus (p = 0.049) than controls. The incidence of PONV in patients who received OTFC and halothane induction was 50%, compared to 30% in patients receiving OTFC and a propofol induction (p = NS). CONCLUSIONS: OTFC in doses of 5 to 10 micrograms/kg was effective in producing sedation and facilitating cooperation with induction; however, it was associated with significant PONV in our study. Although propofol induction did not significantly reduce PONV in our study, further study with a larger sample, and with propofol as the sole anesthetic, may be warranted.

Administration, Oral↗

Should pregnancy testing be routine in adolescent patients prior to surgery?

The reliability of the preoperative history obtained from adolescent patients in ruling out pregnancy was prospectively evaluated. Four hundred forty-four patients who underwent 525 procedures were questioned preoperatively regarding the possibility of pregnancy. Regardless of the history, a urine pregnancy test was ordered in accordance with institutional practice. In 508 cases, patients denied the possibility of pregnancy. Eight patients stated that they might be pregnant, and in six cases the parents responded for the patients and denied the possibility of pregnancy. Seventeen patients were not tested due to patient/parent refusal (n = 9) or inability to void (n = 8). All pregnancy tests were negative except one that was questionably negative. This patient had denied the possibility of pregnancy and had been anesthetized prior to test results. Follow-up revealed that the patient was not pregnant. Our data demonstrate that the preoperative history obtained from adolescent patients at our institution regarding their pregnancy status was in agreement with pregnancy test results. We suggest that a detailed history regarding last menstrual period, contraception, sexual activity, and the possibility of pregnancy be obtained in all postmenarchal patients presenting for surgery. Although in other populations history and pregnancy testing did not agree 100% of the time, for our adolescent population, human chorionic gonadotrophin (HCG) testing appears to be necessary only if indicated by patient history.

Adolescent↗

Join the club.

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Contract Services↗