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Biomedical subjects

M Whitfield

Publications and source records attributed to M Whitfield.

At least 37 records · Page 2Linked to original sources
PubMed1990

Effects of electronic fetal-heart-rate monitoring, as compared with periodic auscultation, on the neurologic development of premature infants.

In a multicenter, randomized clinical trial, we assessed the early neurologic development of 93 children born prematurely whose heart rates were monitored electronically during delivery and compared it with that of 96 children born prematurely whose heart rates were periodically monitored by auscultation. All the children were singletons with cephalic presentation, and all weighed less than or equal to 1750 g at birth. The mental and psychomotor indexes of the Bayley Scales of Infant Development (standardized mean score +/- SD, 100 +/- 16) and a formal neurologic examination were administered at three follow-up visits (at 4, 8, and 18 months of age, corrected for gestational age). At 18 months, the mean mental-development scores in the groups receiving electronic fetal monitoring and periodic auscultation were 100.5 +/- 2.4 and 104.9 +/- 1.8, respectively (P greater than 0.1). The mean psychomotor-development scores in the two groups at 18 months were 94.0 +/- 2.4 and 98.3 +/- 1.8, respectively (P greater than 0.1). The incidence of cerebral palsy was higher in the electronically monitored group--20 percent as compared with 8 percent in the group that was monitored by auscultation (P less than 0.03). In the electronic-fetal-monitoring group (but not in the periodic-auscultation group), the risk of cerebral palsy increased with the duration of abnormal fetal-heart-rate patterns, as assessed by retrospective review (chi 2 trend = 12.71, P less than 0.001). The median time to delivery after the diagnosis of abnormal fetal-heart-rate patterns was 104 minutes with electronic fetal monitoring, as compared with 60 minutes with periodic auscultation. We conclude that as compared with a structured program of periodic auscultation, electronic fetal monitoring does not result in improved neurologic development in children born prematurely.

Birth Weight↗
PubMed1990

Disease-centred versus patient-centred attitudes: comparison of general practitioners in Belgium, Britain and The Netherlands.

The attitudes of general practitioners in Belgium, Britain and the Netherlands have been sought to determine if they are patient-centred or disease-centred (that is, doctor-centred). The results indicated that many of the doctors held disease-centred attitudes, which in previous studies in the Netherlands and Belgium had correlated with increased prescribing of symptomatic medication, shorter consultation time, inadequate patient records and poorer standards of care within the consultation. Doctors in Belgium had the highest level of disease-centred attitudes, Dutch doctors the lowest. Possible explanations for these differences include differences in the doctor-patient relationship that exist between these countries. Although the results must be interpreted with some care, they should form a basis for discussions about doctor-patient relations and medical education in each country.

Attitude of Health Personnel↗
PubMed1990

Attitudes to risk taking in medical decision making among British, Dutch and Belgian general practitioners.

The attitudes of groups of general practitioners in Belgium, the UK and the Netherlands to risk taking in medical decision making have been determined. The results indicate that many doctors seek to minimize the risks that they take when treating patients. Doctors in Belgium had the highest levels of 'no risk-taking' attitudes with 60% preferring not to take risks; Dutch doctors had the lowest levels with only 24% preferring not to take risks. Possible explanations for this difference include the differences in doctor-patient relationship and the systems of medical education in these two countries.

Attitude of Health Personnel↗
PubMed1989

Responses by general practitioners in Avon to proposals for general practice in the white paper Working for Patients.

OBJECTIVE: To determine the views of Avon's general practitioners about the general practice proposals within the government's white paper Working for Patients. DESIGN: Postal questionnaire survey. SETTING: A county in south west England. SUBJECTS: All general practitioner principals (n = 537) under contract with Avon Family Practitioner Committee. MEASUREMENTS AND MAIN RESULTS: 492 doctors (92%) responded to the survey. More than three quarters of the respondents were opposed to the government's proposals on budgets for specific surgical procedures, prescribing, and diagnostic tests; and between 63% and 93% felt negative about advantages that might accrue from the proposals. Over three quarters of general practitioners were in favour of family practitioner committees monitoring work load, prescribing, and referrals. General practitioners in large, potentially budget holding practices held similar views to doctors in smaller practices. CONCLUSIONS: Avon's general practitioners substantially reject most of the government's proposals about general practice in the white paper Working for Patients.

Attitude of Health Personnel↗
PubMed1989

General practitioners' opinions about their responsibility for medical tasks: comparison between England and The Netherlands.

A questionnaire survey compared a sample of 371 general practitioners in the Avon region of England with 74 general practitioners in the east of the Netherlands. A list of 14 medical tasks--six technical tasks and eight chronic disease management tasks--was presented and the doctors indicated whether each task was totally, often, sometimes, seldom or not at all the responsibility of the general practitioner. The results show that English general practitioners felt more responsibility for chronic problems than the Dutch doctors whereas Dutch general practitioners felt more responsibility for technical tasks than the English. Fewer general practitioners in both countries felt responsible for technical tasks than for chronic disease. Reasons for the differences in terms of the structure of general practice and training are discussed.

Adult↗
PubMed1989

Development of sexuality in female children and adolescents.

Female sexuality (meaning sexual desire, excitement and orgasm) has been of considerable interest in psychiatry. Women's efforts to define and legitimize their own experience of their sexuality have increased in the past 25 years. However, the integration of these new views into the body of psychiatric (especially psychoanalytic) theory has not occurred very actively or successfully. Very little is known about the development of sexuality in childhood and adolescence. This paper looks at various behaviours, interests and events in women's lives that might reveal something about the development of their sexuality. The literature on female masturbation is reviewed and some sex differences high-lighted. The literature on interest in babies, the wish to have babies, and menarche is explored for possible associations with sexuality. Rather than sexuality being a central organizer of experience, it seems quite possible that experience is an organizer of sexuality. Therefore, to better understand female sexuality we need to consider the impact of experiences during childhood and adolescence.

Adolescent↗
PubMed1988

General practitioners' responsibilities to their patients.

The views of general practitioners about their responsibilities for patient care have not been canvassed. A survey of general practitioners was therefore carried out to determine their views. A postal questionnaire, in which general practitioners were asked what they saw as their responsibilities, was sent to 525 principals in Avon and completed by 424, giving a response rate of 81%. The doctors generally agreed that their responsibilities for patient care included problems related to internal medicine, such as managing diabetes and hypertension. Less consensus was found in the replies to questions about technical procedures, such as resection of ingrowing toenails, and gynaecological, orthopaedic, or psychosocial problems. The results supported the view that general practitioners are gradually abandoning technical aspects of medicine to specialists without a compensating role having been defined. In the light of this trend the responsibilities of general practitioners should be clearly defined by the profession.

Attitude of Health Personnel↗
PubMed1986

Radiologic diagnosis of periventricular leukomalacia.

Fifteen infants with clinical evidence of periventricular leukomalacia, i.e. spastic diplegia or quadriplegia and premature birth were studied. CT scans of the brain demonstrated: 1) reduction in quantity of periventricular white matter, 2) deep and prominent sulci which abutted the ventricles without interposed white matter and 3) ventriculomegaly with irregular outline of the lateral ventricles. The location and severity of abnormalities on CT scans correlated well with neurologic handicap and the known anatomic location of periventricular leukomalacia, thus demonstrating the diagnostic value of CT scanning for periventricular leukomalacia during later infancy.

Brain↗
PubMed1979

Intensive plasma exchange in rhesus isoimmunisation.

Intensive plasma exchanges were carried out in a 34-year-old pregnant woman to lower the level of circulating anti-D. The patient proved interesting from a number of serological aspects. The possible protective effect of coexistent ABO incompatibility is discussed. The effect of plasma exchanges on cytotoxic HLA antibodies is also demonstrated.

Adult↗
PubMed1979

Successful coping styles in professional women.

This paper describes the experiences of seven women mental health professionals who met in a leaderless group over a period of a year and a half. There is a discussion of the conflicts for women in four major areas--competition, dependency needs, economic success and the search for role models, and the suggestion of possible successful resolutions in these conflict areas. The resolutions are a result of individual experiences and discussions in the group.

Adaptation, Psychological↗
PubMed1978

Selective elevation of circulating prostaglandin concentrations in hyaline membrane disease in pre-term infants.

The plasma concentrations of prostaglandins E and F (PGE, PGF) and 13, 14-dihydro-15-keto-PGF (PGFM) have been measured in pre-term neonates with hyaline membrane disease (HMD) and controls. The concentrations of PGF and PGFM were significantly higher in infants having HMD with a disproportionate increase in PGFM levels for the increase in PGF found. The vasoconstrictor nature of PGF may contribute to the morbidity associated with HMD and the possible therapeutic benefit from the use of prostaglandin synthetase inhibitors is discussed.

Humans↗