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Biomedical subjects

N Edwards

Publications and source records attributed to N Edwards.

At least 127 records · Page 7Linked to original sources
PubMed1975

Septoplasty. Rational surgery of the nasal septum.

The Submucous Resection (S.M.R.) operation ascribed to Killian, still widely taught as the standard surgical treatment of obstructive septal deformities, has serious deficiencies in many common clinical situations. The reasons for this are critically discussed in the light of the surgical anatomy and physiology of the nose as a whole. The rational, conservative and versatile principle of septoplasty has evolved over half a century, until today the author considers that it should largely supersed the old S.M.R. The principles and the indications for septoplasty are discussed. The basic septoplasty procedure used by the author is described with practical details, together with all the variations and extensions possible as far as a complete septo-rhinoplasty. The importance is stressed of accurate assessment of the whole nasal problem and precise correction of all primary and secondary obstructive factors.

Cartilage↗
PubMed1975

Post-laryngectomy vocal rehabilitation using expired air and an external fistula method.

The advantages and problems of fistula speech in post-laryngectomy vocal rehabilitation are discussed. A pilot study of laryngectomees has shown the practical advantages and low risk of a primary one-stage external vocal fistula construction at the time of laryngectomy, allowing very early fistula speech. These results indicate the need for an intensive program to develop a definitive surgical procedure and prosthesis, with a view to applying the method to all types of laryngectomees.

Air↗
PubMedDate not supplied

Twelve years and more than 30,000 nurse-midwife-attended births: the Los Angeles County + University of Southern California women's hospital birth center experience.

This article describes the setting, policies, practices, and outcomes of the nurse-managed in-hospital birth center at Los Angeles County + University of Southern California Women's Hospital, where women are selected upon admission for birth center care. A retrospective review of available data was made; when compared with hospital records, the primary data source was found to be 96% accurate. Results of the review indicated that from 1981 to 1992, there were 36,410 birth center admissions and 30,311 births, all attended by nurse-midwives; no intrapartum maternal or fetal deaths occurred among all admissions. The intrapartum transfer rate averaged 17%, and declined steadily from a high of 28% in 1982 to a low of 7% in 1990. More in-depth review showed an overall primary cesarean birthrate of 1.8% and an operative birthrate of 4% among the 25,890 admissions and 22,490 births from 1985 to 1992. Detailed postpartum and newborn outcomes from 1982 to 1986 showed a neonatal intensive care unit admission rate of 1.5% and a one-week newborn readmission rate of 1.3% among newborns discharged within 12 to 24 hours; 85% of all newborns returned for follow-up care. This large longitudinal experience demonstrates excellent outcomes that can be achieved when nurse-midwives, working cooperatively with a multidisciplinary health care team, provide in-hospital birth center care to a predominately low-income Hispanic population using a variety of less-traditional intrapartum management techniques. Broader implications for making alternative maternity care services available for low-income women with nurse-midwives and nurses playing a central role are discussed.

Adolescent↗
PubMedDate not supplied

Factors associated with cane use among community dwelling older adults.

Guided by the Theory of Planned Behavior (TPB), this study examined factors associated with cane use among community dwelling older adults. Data were collected in a cross-sectional survey of a convenience sample of 106 community residing older adults in Ottawa, Canada. Using a stepwise discriminant analysis, subjective norms, attitudes, and age surfaced as the key variables associated with cane use in this sample. The discriminant function accounted for 67% of the variance in cane use and correctly classified 91% of cases (Wilks's lambda = 0.33, lambda2 = 110.12, df = 3, p < 0.0001). The findings provide evidence for the utility of the TPB in its application to understanding cane use behaviors of older persons and have important implications for the design of theory-based fall prevention interventions to enhance the acceptance and effective use of mobility aids.

Accidental Falls↗
PubMedDate not supplied

Development and evaluation of the cane use cognitive mediator instrument.

BACKGROUND: Canes are among the most underutilized assistive devices for older persons. A significant obstacle to understanding cane use behaviors of older adults is the lack of instruments measuring factors that may influence seniors' decisions to accept or reject these devices. OBJECTIVES: Guided by the Theory of Planned Behavior, this study involved the development and evaluation of an instrument to measure cognitive determinants of cane use among community-living older adults. METHOD: The two-phase design involved: a) instrument formation including item generation from four focus group interviews with seniors (n = 30), expert panel evaluation (n = 10), and pilot testing (n = 10); and b) instrument validation in a cross sectional survey (n = 106). RESULTS: Psychometric analyses of survey data provided empirical evidence of the construct validity and reliability of the instrument. Principal components analysis verified the hypothesized four-factor solution, explaining 63.2% of variance. Independent t-tests yielded statistically significant differences (p < 0.001) in mean scores between the two contrasting groups of cane users (n = 51) and nonusers (n = 55) with respect to each of the four factors identified. Alpha coefficients of 0.81 to 0.96 indicated high internal consistency of the instrument. CONCLUSIONS: The instrument can be used by clinicians and researchers to assess seniors' salient beliefs about the consequences of cane use, guide tailored intervention strategies to promote acceptance and effective use, and evaluate the effectiveness of interventions.

Aged↗
PubMedDate not supplied

The integration of problem-based learning strategies in distance education.

The authors explore the redesign of a traditional distance nursing program to integrate problem-based learning (PBL) strategies. Using pre- and postcourse questionnaires, learning satisfaction was compared between students who attended the PBL course face-to-face and those who received the course via audio-teleconferencing. Tutor and student perceptions of PBL via audio-teleconferencing are also described. Study results suggest that audio-teleconferencing is an effective means of delivering PBL by distance education.

Adult↗
PubMedDate not supplied

International collaborative workshops. A 6-year partnership between Canada and China.

Interprofessional exchanges such as workshops are common activities in international development programs. The authors describe processes used to select, implement, and evaluate six collaborative workshops held in Tianjin, China, between 1990 and 1995. These workshops targeted curricular change for a baccalaureate nursing program in Tianjin Medical University. Our experience highlights the importance of understanding the assumptive base for change, developing an institutional memory in both partner universities, introducing interactive teaching methods congruent with Chinese value systems, and using a formative evaluation strategy to foster cross-cultural dialogue and mutual understanding among project partners.

Canada↗
PubMedDate not supplied

A tale of two systems: the changing academic health center.

Major changes in academic health centers (AHCs) may not be confined to the United States. Both Partners HealthCare System in Boston and University College London School of Medicine/University College Hospital Trust in London have recently undergone mergers, downsizing, and cost cutting on unprecedented scales. A comparison of the recent histories of these eminent AHCs reveals striking similarities in the clinical and academic pressures bearing down upon them and in their responses. It also reveals important differences in their situations and actions, traceable in large part to the contrasting roles of governments and markets in the health care economies of these two countries.

Academic Medical Centers↗