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Biomedical subjects

L Gale

Publications and source records attributed to L Gale.

11 recordsLinked to original sources
PubMed1999

The role of low progesterone and tension as triggers of perimenstrual chocolate and sweets craving: some negative experimental evidence.

Approximately half of the 40-50% of North American women who crave chocolate or sweets do so principally in the perimenstrum, the part of the menstrual cycle surrounding the onset of menstruation. We test two hypotheses about the events that trigger these cravings: 1) the premenstrual drop in progesterone levels; or 2) dysphoria or tension in the perimenstruum. Chocolate craving, sweets craving, and other perimenstrual symptoms were rated daily for six menstrual cycles by a sample of women with severe premenstrual syndrome (PMS). Forty-four women satisfied criteria for cyclicity in chocolate craving, and 44 for sweet craving, determined during the first two cycles. Thirty-four subjects satisfied criteria for craving of both chocolate and sweets. After placebo treatments during the third cycle, subjects were randomly assigned, double blind, to administration of placebo, oral micronized progesterone, or alprazolam (a tranquillizer). Treatments were administered from the beginning of the third week to the second day postonset of menstruation during the fourth to sixth months of study. Neither progesterone nor alprazolam decreased chocolate or sweets craving.

Adult↗
PubMed1997

Why a traditional health outcomes approach will fail in health care and a possible solution.

This paper challenges the assumption that improved knowledge of health outcomes and their causation will lead to more rational decision-making, resulting in improved care at lower costs. The assumption implies that the health system completely controls all those functions, factors and initiatives that can affect the implementation of the standard. These include policies, procedures, applications of techniques, skill mix of staff, inter-team interaction, communication systems, education, and so on. Changes in policy do not automatically mean a change in practice. Implementation is often approached in a manner that is perceived by staff as punitive, focusing on changing the individual rather than the system in which they work. Not only is this approach opposite to basic total quality management principles, but it also fails to acknowledge that most of the improvements arising from the health outcomes approach are a result of staff being prepared to continuously work harder, often ignoring the 'system', to maintain their high standard. However, continuing deterioration in the system in which they work sets the scene for an accident or incident to occur. The answer lies in revisiting the traditional quality assurance cycle and acknowledging that health care has never been able to effectively 'close the feedback loop', that is, the health system is continuously increasing the sophistication of data collection techniques without giving equal consideration to what needs to be done to ensure effective implementation and evaluation. This paper outlines how Campbelltown Health Service directly addressed this issue through its process of achieving international certification to ISO 9002:1994.

Australia↗
PubMed1997

A new hinged tip laryngoscope.

The McCoy laryngoscope undoubtedly improves the view of the vocal cords during difficult tracheal intubation. An inherent design problem with the McCoy blade is the need to relax the grip on the laryngoscope handle at the point when stability is most necessary. A new hinged tip blade is described which is operated by a button mechanism on a secondary handle that runs adjacent to the standard handle. This modification offers the possibility of better stability and ease of manipulation whilst maintaining all the benefits of the McCoy blade.

Equipment Design↗
PubMed1997

Down's syndrome is strongly associated with coeliac disease.

BACKGROUND: There is evidence of an increased prevalence of coeliac disease in Down's syndrome. AIMS: To investigate the association, patients with Down's syndrome and matched controls were examined. METHODS: Fifty nine patients with Down's syndrome residing in government institutions in the Hunter region of New South Wales were studied. Four were excluded (terminally ill = 1, uncooperative = 3). Each of 55 patients was matched for age, sex, and residence with a control patient. Patients with both positive IgA and IgG antigliadin antibodies were considered for endoscopical duodenal biopsy. RESULTS: Twenty one patients and two controls had raised IgA and IgG antibodies (chi 2 = 19.4; p < 0.001). Tissue was obtained in 18 patients. Two had characteristic flat, five pronounced lymphocytic infiltration not diagnostic of coeliac disease, two giardiasis, and eight were normal. In one the tissue was not suitable for analysis. There were few differences between the subgroups in their anthropomorphic, biochemical, or haematological findings. CONCLUSIONS: The prevalence of coeliac disease in these 51 patients with Down's syndrome is at least two (3.9%; 95% confidence interval (95% CI) 0%-9.2%) and could be as many as seven (13.7%; 95% CI 4.3%-23.2%). In this community the prevalence of coeliac disease in Down's syndrome is increased more than 100-fold (x135-473).

Adult↗
PubMed1994

Five years of total quality management: Campbelltown Hospital.

There are many articles in the health literature outlining either a framework for total quality management (TQM) or a success story. There is a dearth of literature reflecting the shortcomings of total quality management during implementation. Yet many of the world's most successful companies learn by reflecting about their past, for example, British Petroleum, IBM, Boeing, Xerox. This paper describes, from a general manager's perspective, the practical application of total quality management to a hospital setting over five years. The paper outlines the important ingredients to success and the shortcomings encountered along the way. Supporting literature is cited where appropriate. Strategies that were implemented contrary to common total quality management thinking are highlighted. The paper concludes with an outline of the four key lessons learnt over the five-year period.

Decision Making, Organizational↗
PubMed1993

'From little things, big things grow'--a history of the development of cooperation between Aboriginal health services and the South Western Sydney Area Health Service.

Aboriginal people suffer from the worst health of any identifiable group in Australia due to profound disadvantages experienced by them since European colonisation of Australia. The Aboriginal community of south-west Sydney represents almost 25 per cent of Sydney's Aboriginal population. Since 1990 the Tharawal Aboriginal Corporation, the South Western Sydney Area Health Service and staff of the Office of Aboriginal Health (NSW Department of Health) have been cooperating to improve the health of Aboriginal people in south-west Sydney. The Working Group on Aboriginal Health has produced a Strategic Plan for Aboriginal Health in South Western Sydney. This cooperation has come from the development of trust, the identification of local needs and the elaboration of local solutions.

Community Health Services↗
PubMed1986

A ventilator for use in nuclear magnetic resonance studies.

The problem of ventilating small animals during nuclear magnetic resonance studies has been solved by using a T-piece system with a remotely controlled non-magnetic expiratory valve. This system does not affect the NMR signal, has minimal internal compliance and expiratory resistance, permits accurate control of peak airway pressure, and may be of use when animals have to be ventilated in hazardous surroundings.

Animals↗
PubMed1975

Superego factors in alcoholics.

This paper discusses superego fixations and regressions that predispose to and are caused by alcoholism. Two continua of superego functioning are explored, (1) the extent of internalization vs. externalization and (2) regulation of behavior vs. self-castigation. The superego constellations in guilty, binge, sociopathic, and deteriorated alcoholics are delineated to explain the interaction of a treatment program with these patients.

Alcohol Drinking↗