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Biomedical subjects

P Edwards

Publications and source records attributed to P Edwards.

176 records · Page 10Linked to original sources
PubMedDate not supplied

Predictors of bereavement outcome for family carers of cancer patients.

AIMS: The psychological outcome of family carers after bereavement is an important issue in evaluating palliative care services. Palliative care services have the potential to provide preventive psychosocial intervention to family carers prior to bereavement, but are faced with the need to identify those who may have greatest risk of adverse outcome. This prospective study examines predictors of psychological outcome for family carers of cancer patients following bereavement based on factors identified at referral to a palliative care agency. METHODS: Cancer patients and their family carer were consecutively recruited and assessed on a range of clinical and psychological measures at referral to a palliative home care service in a metropolitan centre (Time 1). Carers were again assessed following the death of the patient, on average at 4 months post-bereavement (Time 2), using measures of bereavement symptoms and psychological morbidity. RESULTS: 178 carers were assessed on both occasions. The chief predictors of carer psychological symptoms and severity of grief at follow-up were psychological symptom scores at the time of referral (Time 1). Factors also measured at Time 1 were significant predictors of symptoms and grief scores at Time 2: greater number of adverse life events, carer's coping responses, past bereavement and separation experiences, the relationship with the patient, and greater severity of patient's illness at the time of palliative care referral. CONCLUSIONS: The findings indicate clinical risk factors for adverse short-term bereavement outcome that can be identified in family carers during palliative care treatment, that have implications for identifying the psychological needs of carers, and that form a potential basis for interventions to enhance the psychological outcome for family carers.

Adaptation, Psychological↗
PubMedDate not supplied

Hazardous air pollutants formation from reactions of raw meal organics in cement kilns.

Thermally induced chlorination, condensation, and formation reactions of raw meal organic surrogates were investigated on different types of surfaces. The System for Thermal Diagnostic Studies provided a powerful tool to study these reactions under defined reaction conditions, which were related to typical conditions in the preheater zone of cement kiln. Experiments were conducted with benzene and benzene/myristic acid (C6H6/C13H27COOH) mixtures in a quartz reactor containing different chlorinating catalysts/reagents over a temperature range of 300-500 degrees C. Reaction products were trapped in-line and analyzed by GC-MS. A mixture of chlorides of calcium, potassium, aluminium and iron was highly effective for chlorination/condensation reactions of benzene and benzene/myristic acid mix at temperatures above 300 degrees C. The same behavior was observed only when calcium chloride and potassium chloride were used as chlorinating catalyst/reagent. This result showed that transition metal chlorides like FeCl3 are not necessary for chlorination/condensation of organics under post-combustion conditions. Methylene chloride was the major chlorinated product followed by chloroform and various other C1, C2 and C6 chlorinated products. Yields of chlorinated aliphatics were highest at 400 degrees C for both benzene and benzene/myristic acid mix. C6 products were mainly mono- to hexa-chlorinated benzenes with trace amounts of chlorinated phenols. The major chlorinated products observed in this study (i.e., methylene chloride, chloroform, chloroethanes and monochlorobenzene) were also present as major chlorinated hydrocarbons in the cement kiln field emission data.

Journal Article↗
PubMedDate not supplied

Psychological care of the haemodialysis patient.

The psychological care of patients at the haemodialysis unit is becoming an increasingly important aspect of the overall treatment of patients with end-stage renal failure. As more is understood and reported regarding the impact of psychological factors on physical processes it becomes crucial that good quality psychological care is delivered to patients by nurses working at the haemodialysis unit. This study aimed to look at haemodialysis patients' perceptions of their treatment to discover if a dialysis centre in Southern England might benefit from a more formal system of psychological care. The data revealed four main themes that were of particular importance to the participants of this study: The New Self, Coping, Medical Concerns and Psychological Care. Within these areas of importance, the need for good quality information, the need for a suitable dialysis environment and the importance of social and family support were evident. Although the psychological care system that was in place at the unit appeared to be working well a more formal system of care might improve the patient experience.

Activities of Daily Living↗
PubMedDate not supplied

SPLATT combined with tendo achilles lengthening for spastic equinovarus in adults: results and predictors of surgical outcome.

During a 4-year period, split anterior tibial tendon transfer (SPLATT) was performed on 42 adults with cerebrospastic equinovarus deformity. Twenty-one patients (24 feet) had a minimum 1-year follow-up, which included detailed documentation of foot appearance position and function as well as ambulatory status. Thirteen patients were male and 8 were female. Average age of the patients was 41 years. Seventeen patients were independent ambulators with orthoses, one was a maximally assisted ambulator. Three patients with spastic quadriparesis were nonambulatory. All patients had uniform surgical technique and postoperative management. This paper presents the results of SPLATT and identifies risk factors for poor surgical outcomes. After an average follow-up of 39 months, 83% of the feet were rated as having good or excellent results. All ambulatory patients had improved gait and 35% of them were able to discontinue their orthoses. Poor surgical outcomes were associated with nonambulatory status in brain injured patients (P = .018). Salvage of failed SPLATT is discussed.

Achilles Tendon↗
PubMedDate not supplied

Euthanasia. The issue of resuscitation.

Euthanasia in this country is illegal, but issues surrounding 'do not resuscitate' guidelines raise the questions on the right to a death with dignity for many nurses. In this paper the author discusses the statement by the British Medical Association and the Royal College of Nursing on cardiopulmonary resuscitation and advises health practitioners to use this statement as a guideline for their own policy and framework in hospitals and not to accept this framework as implicit.

Ethics, Medical↗