Think ahead to minimise risks of midwifery care.
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Female↗
Biomedical subjects
J Williams
Publications and source records attributed to J Williams.
Ease of handling and clinical efficacy of fluticasone propionate Accuhaler/Diskus inhaler compared with the Turbohaler inhaler in paediatric patients. UK Study Group.
A total of 323 children aged 4-11 years who were receiving, or had symptoms indicating a clinical requirement for, inhaled corticosteroid at a daily dose of 400 micrograms budesonide (BUD) or beclomethasone dipropionate (BDP), or 200 micrograms fluticasone propionate (FP), were randomised into this multicentre, open-label, parallel group study. Patients received either FP 100 micrograms b.d. administered via the Accuhaler/Diskus inhaler (n = 159) or BUD 200 micrograms b.d. administered via a Turbohaler inhaler (n = 164) for four weeks and recorded daily their morning and evening peak expiratory flow (PEF), asthma symptoms and use of relief medication. Device handling was assessed by a questionnaire, with responses recorded on three- or five-point ordinal scales. The primary efficacy parameter was mean percent predicted morning PEF. The device handling results showed the Accuhaler/Diskus inhaler was rated more favourably than the Turbohaler inhaler in terms of ease of correct inhaler use, ease of telling how many doses were left, ease of knowing whether a dose had been inhaled and overall liking of the device. More patients in the Accuhaler/Diskus group (85%) than in the Turbohaler group (58%) said they would be happy to receive the same device again, while 8% and 25% respectively said they would not be happy to be given it again. In addition, the change from baseline to week 4 of treatment in mean percent predicted morning PEF was greater in the FP Accuhaler/Diskus group, indicating that FP 200 micrograms daily via Accuhaler/Diskus inhaler is at least as clinically effective as BUD 400 micrograms daily via the Turbohaler inhaler.
Administration, Inhalation↗
A change for the better. Interview by Buzz Stokes.
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Awards and Prizes↗
Economic study of a two chair hygiene system.
Dental hygiene services play a major role in the economics of a dental practice. To survive the financial challenges of the '90s, an office goal should be to improve and increase hygiene productivity. The purpose of this study is to determine the economic value of a "Two Chair Hygiene System" in a dental office. The study was conducted in two separate, three month periods. In one three month period, data was collected for one hygienist working one chair. This was called the "One Chair Hygiene System". During the second three month period, data was collected for one hygienist working two chairs with an assistant; called the "Two Chair Hygiene System". The results demonstrate that a "Two Chair Hygiene System" is of economic benefit to a dental practice. The findings show an increase in the hourly hygiene production, the hourly hygiene salary and in the number of patients treated per hour. There was a decrease in the amount of hygienist time required per appointment due to efficient delegation to the assistant. The total office salary cost remained constant. The results of the study suggest a "Two Chair Hygiene System" is an efficient method of delivering hygiene services.
Dental Hygienists↗
A pre-discharge ward for acute medical patients.
UNLABELLED: We describe and evaluate a ward developed to facilitate the discharge planning of general medical patients. DESCRIPTION: A 15-bed pre-discharge ward (PDW) with a ward coordinator was established in 1995, as a counterpoise to a medical assessment unit (MAU). METHOD: Data, analysed after the first year, included diagnosis, physiotherapy and occupational therapy referrals, length of stay and discharge destination. RESULTS: During its first year, 810 patients were admitted to the PDW; 39% were male, their mean age was 75 years (range, 16-99; standard deviation, 11.3). Respiratory illness (24%) was the commonest diagnosis, 62% required physiotherapy, 51% occupational therapy and 35% needed increased social support. Discharge was as follows: 681 (84.1%) patients were discharged to their admission address, 34 (4.2%) were taken over by the department for care of the elderly, 29 (3.6%) discharged to relatives, 23 (2.8%) to residential or nursing homes, 22 (2.7%) returned to acute medical beds, 12 (1.5%) to general practitioner beds and nine patients (1.1%) died. The average length of stay during a three-month period (October-December) for all acute medical patients was 7.47 days before the MAU and PDW were opened and 7.32 days afterwards. CONCLUSIONS: The PDW provides multidisciplinary assessment and focused discharge planning for patients of general physicians. This did not prolong their stay in acute medical beds.
Adolescent↗