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Biomedical subjects

L C Gray

Publications and source records attributed to L C Gray.

14 recordsLinked to original sources
PubMed1995

Predictors of length of stay in a geriatric assessment and rehabilitation unit.

This study aimed to determine predictors of length of stay within a geriatric assessment and rehabilitation unit at Bundoora Extended Care Centre. We conducted a retrospective examination of demographic and medical characteristics of the patients, and the characteristics of admission care programs (assessment, rehabilitation, booked and emergency respite care, and interim care), and determinants and predictors of length of stay. The mean length of stay was 28 days, varying from 12 to 50 days between care programs. Diagnostic category, stream of care and activities of daily living score were the major predictors of length of stay, together accounting for 20 per cent of the variance (R2 = 0.20).

Activities of Daily Living↗
PubMed1994

Report of first year's operation of an ortho-geriatric service.

An ortho-geriatric service operated by Bundoora Extended Care Centre and Preston and Northcote Community Hospital was established in 1991 to improve rehabilitative care and discharge planning of elderly hip fracture patients. 123 patients were treated during the first year of the service's operation. There was a 25 per cent reduction in the acute hospital length of stay, an increased proportion of patients discharged home and a decreased need for post-acute rehabilitation in comparison to figures for 1989, leading to a substantial reduction in the total number of bed-days occupied in the hospital system as a whole by hip fracture patients. An ortho-geriatric service is an effective means of helping to improve both patient and hospital centred outcomes for a condition which will be seen ever more commonly in the future.

Aged↗
PubMed1992

A population-based study of assessed applicants to long-term nursing home care.

OBJECTIVE: To examine the characteristics of all individuals assessed as requiring nursing home care arising from a population living within a defined geographical region and to study the manner in which they presented for assessment. DESIGN: Clinical assessment by a physician in geriatric medicine with the assistance of other disciplines. SETTING: Regional Geriatric Assessment Service. SUBJECTS: All persons recommended for nursing home care within the study period. RESULTS: The major diseases contributing to the need for nursing home care were organic brain disorders (60%) and stroke (32%). Dementia was present in 64% of cases; significant behavioral disturbance in 18%; severe communication disorders were frequent. The majority (86%) had been ill for greater than 1 year. The mode of presentation was acute in 9%, acute-on-chronic in 46%, and chronic in 45%. It was associated with significant differences in case characteristics including the location at the time of assessment, diagnoses, duration of illness, physical dependency, communication disorders, behavioral disturbance, and skilled nursing care requirements. CONCLUSIONS: These observations suggest that progression to nursing home care varies considerably. Strategies directed toward the prevention of institutionalization should be organized in recognition of these variations.

Aged↗
PubMed1992

Respite service to family caregivers by the senior companion program: an urban-rural comparison.

The Senior Companion Program (SCP), a federally sponsored program, aims to enlist older volunteers to provide in-home services to the homebound elderly. A survey of 48 sample SCP projects providing family caregiver services reveals a distinctly different trajectory of urban and rural project development. In both environments, the longer a project has been in existence, the greater the number of volunteers in service. However, the number of clients served increases for urban projects, but not for rural projects. Relatedly, the unmet need for family caregiver services, the number of referrals unserved by the project, is considerably greater in rural areas. These results suggest that because of factors unique to rural areas, the expansion of clientele may be more restricted in rural settings compared to that in urban settings, thereby implying that rural-urban differences should be reflected in project planning and implementation.

Aged↗
PubMed1992

Grading system for the selection of patients with congenital aural atresia.

It is generally recognized that surgery for congenital aural atresia is difficult. In an effort to select those patients who have the greatest chance of success, we have developed a grading scheme based on the preoperative temporal bone CT scan and the appearance of the external ear. Patients are graded on a possible best score of 10. The stapes is assigned the highest rating (2 points), while all other entrees on the scale are 1 point. The grade assigned preoperatively has been shown to correlate well with the patient's chance of success, herein defined as a postoperative speech reception threshold of 15 to 25 dB. A patient with a preoperative grade of 8/10 would, therefore, have a 80 percent chance of achieving this threshold. Patients with scores of 5/10, or less, are not considered surgical candidates, because the risk of the operation would outweigh the potential benefits. We have found that the grading system allows us to avoid impossible surgical cases while allowing for a reasonable prediction of the hearing outcome.

Abnormalities, Multiple↗
PubMed1985

High-resolution CT scanning and auditory brain stem response in congenital aural atresia: patient selection and surgical correlation.

Thirty patients with congenital aural atresia underwent CT scanning and/or auditory brain stem response (ABR) testing in a 20-month period. Eighteen patients had unilateral atresia and 12 had bilateral atresia. Twelve patients subsequently had surgery for repair of their atresia. CT scanning was not electively done until the patient was at least 2 years of age, while ABR testing was often performed in the first few months of life. Nineteen patients had CT scanning and 27 had ABR testing. The CT technique was found to offer specific advantages not previously observed in other methods of radiographic evaluation: (1) the course of the facial nerve was more easily traced and (2) the presence (or absence) of a stapes was more easily noted. The ABR was measured for monaural air-conduction as well as mastoid-placement bone conduction click stimuli; simultaneous multielectrode two- or four-channel recordings were employed. With this measuring technique it was not only possible to enhance wave I detection but, more important, the laterality of ABR wave I could be noted.

Acoustic Stimulation↗
PubMed1984

Should a paediatrician be present at non-rotational forceps deliveries?

In a series of 500 consecutive deliveries there were 35 non-rotational forceps deliveries for delay in the second stage of labour. There was no statistically significant difference in the frequency of resuscitations in this group compared with that in 329 spontaneous vertex deliveries. It is concluded that a paediatrician need not be called routinely to these forceps deliveries when there is no evidence of fetal distress.

Female↗
PubMed1977

The geographic and functional distribution of black physicians: some research and policy considerations.

Studies of the geographic and functional distribution of physicians rarely include race of the physicians as a study variable. For black physicians, there are some rather strong justifications for doing just that: 1) their services are directed almost exclusively to black and often medically underserved communities; 2) recent efforts to reduce constraints to medical education based on race, sex, ethnicity, and income have resulted in a substantial increase in the proportion of black medical students; 3) inferring about black physicians from information on the general population of physicians given the differences in biographical and experimental characteristics is tenuous at best. Hence, an adequate information base and focused conceptualization on the educational and career patterns of black physicians are indicated. At the policy level there is a need to clarify the relationship between equity in educational (and career) opportunity and efforts to redistribute physicians.

Black or African American↗