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Biomedical subjects

P Freeman

Publications and source records attributed to P Freeman.

At least 55 records · Page 3Linked to original sources
PubMed1993

Australian Community Health Association Practice Standards and their application for primary health care in Papua New Guinea.

This paper describes the Australian Community Health Association Practice Standards (CHASP) and their application in the CHASP review process as a model that could be emulated to improve the quality of primary health care delivery in Papua New Guinea. The characteristics which could be beneficially emulated in Papua New Guinea are the comprehensive nature of the standards and their wide applicability, the balance contained in their development and application between the inputs of technical expertise and local involvement, and the structured nature of the CHASP review process itself. A model is proposed of how the CHASP standards and review process could be fruitfully used in Papua New Guinea to improve the quality of rural health care delivery.

Australia↗
PubMed1993

Community nutrition survey in an urban settlement in Papua New Guinea.

Results of a small nutrition survey carried out in an urban settlement in Port Moresby are presented. Anthropometric, dietary and socioeconomic data were collected on 90 children under five years old and 78 adults. 30% of the children under five years old were below 80% weight for age. Of the 31% of adults found to be undernourished, the majority were females aged less than 30 years. With respect to dietary information, most families appear to eat a variety of foods though no attempt was made to measure quantity of foods consumed. Rice is the single most popular food, with 69% of adults having consumed it the previous day. Despite the high reliance on purchased foods, income appears to be low with the majority of people relying on money from relatives and the sale of home produce. The recommendations made for appropriate health and nutrition education may be applicable for other growing settlement populations in and around Port Moresby and other urban centres of Papua New Guinea.

Adult↗
PubMed1993

A culturally orientated curriculum for Aboriginal health workers.

A culturally orientated, competence-based curriculum has been developed for Aboriginal community health workers in the Pitjantjatjara Homelands of South Australia. Among the difficulties encountered were problems associated with delivering holistic health care to a widely dispersed, seminomadic population in a remote semidesert area, the perception that Western health care is exclusively curative, and the high turnover of non-Aboriginal nursing and medical staff.

Community Health Workers↗
PubMed1992

Clinical research and statistical analysis of a visual field awareness system.

This article discusses the clinical research and applications of the statistical analysis of a system called "The Visual Field Awareness System." This medical lens system allows patients with a visual field loss to 1) scan toward area of the loss, to see objects sooner and more clearly, and 2) demonstrate increased function and safety. Seventy-nine percent (27 of 34) of the patients in the sample received and accepted the prism treatment. Of this group, a minimum of 70 percent (19 of 27) continue to benefit from this treatment strategy. Statistically significant predictors of success are discussed. This study demonstrates that patients suffering visual field loss may show functional benefit by the utilization of this prism treatment along with vision rehabilitation.

Adult↗
PubMed1991

Recombinant human erythropoietin in the anemia of prematurity: results of a placebo-controlled pilot study.

Experimental and clinical data implicate inadequate erythropoietin production as an important reason that infants acquire this anemia and suggest that recombinant human erythropoietin (r-HuEPO) might be used to treat or prevent it. We therefore randomly assigned 20 small premature infants (birth weight less than or equal to 1250 gm) who were highly likely to require erythrocyte transfusions for anemia of prematurity to receive 6 weeks of treatment with either intravenously administered r-HuEPO (at a dose of 100 units/kg twice each week) or a placebo. Hematologic measurements, transfusion requirements, and growth were followed during therapy and for 6 months thereafter. Treated (EPO) and control babies did not differ with respect to weight, hematocrit, overall mean absolute reticulocyte count, calculated erythrocyte mass, or rate of growth. However, reticulocyte counts increased earlier in patients given r-HuEPO. Six of ten babies in the EPO group, and 8 of 10 assigned to the control group, received at least one erythrocyte transfusion during treatment. For all infants the amount of blood sampled for laboratory tests was strongly predictive of the volume of packed erythrocytes transfused (r = 0.890; p = 0.0001). Of nine infants who had less than 20 ml packed erythrocytes removed for laboratory tests, none of four given r-HuEPO received a transfusion, whereas three of five infants assigned to the placebo group received one. No toxic effects were attributable to r-HuEPO, and no significant changes in leukocyte or platelet counts occurred during treatment. Reticulocyte counts were correlated with simultaneous platelet counts and were inversely related to absolute neutrophil counts in both study groups. We conclude that r-HuEPO administration is safe and feasible at the dose studied. Additional controlled trials utilizing higher doses of r-HuEPO and larger numbers of patients are justified.

Anemia, Neonatal↗
PubMed1991

Some factors affecting acceptance of family planning in Manus.

This paper examines selected factors affecting the acceptance and delivery of modern family planning from health centres in Manus. A survey was carried out of mothers attending Maternal and Child Health clinics and a written questionnaire was given to health workers. The survey of mothers demonstrated the importance of the husband's approval for contraceptive practice and showed that knowledge about traditional methods of family planning is widespread. The health workers' questionnaire demonstrated a high level of dissatisfaction with the current family planning program delivered by health clinics: 45% found the program ineffective; 68% wrote that health workers' attitudes discouraged mothers from attending for family planning. The perceived and actual benefits and costs of children and the role of men should be assessed locally before planning future family planning programs. Widespread retraining and motivating of health workers is essential if improved coverage is to be achieved through health services. The efficacy of alternative methods of delivery of family planning such as local community-based and social marketing programs should also be investigated.

Age Factors↗
PubMed1989

Striving for excellence in breast reconstruction: the salvage of poor results.

Poor results in breast reconstruction can often be salvaged by turning to alternative techniques when the original treatment strategy has not produced optimum results. To do this, the surgeon must be willing to admit to aesthetic failures and correct them. If this is done honestly and vigorously, the multiplicity of methods presently available can allow us to turn many of our failures into successes. Five patients are presented to illustrate these principles and suggest some specific strategies for improving mediocre or poor results.

Adult↗
PubMed1985

Hearing loss in Australian divers.

Permanent hearing loss of the sensorineural type has been demonstrated to be an occupational hazard of professional SCUBA divers. An audiometric survey was performed on a group of professional abalone divers, all of whom had experienced excessive exposure to dysbaric conditions. The results of this survey revealed that, even allowing for the very liberal requirements of the Australian Standard for divers, over 60% had unacceptable sensorineural, high frequency deafness. In half these cases deafness was unilateral, and in half bilateral. Making allowance for age, two-thirds had hearing loss to a degree which is compensable, according to the method of the National Acoustic Laboratories (1974) for determining proportional loss of hearing.

Adult↗
PubMed1985

Inhalation of carbon dioxide mixtures for sensorineural deafness. Evaluation of a rebreathing method.

A laboratory study in 11 healthy subjects was conducted to evaluate the performance of a rebreathing device as a means of raising the effective carbon dioxide level in the inspiratory mixture. In all subjects, there was a sustained rise in end-tidal carbon dioxide levels and a transient rise in end-tidal nitrogen tensions associated with an equivalent fall in end-tidal oxygen levels. Although the rise in end-tidal carbon dioxide tensions was variable, the mean elevation for the 11 subjects (from 36 to 43 mm Hg) was not equivalent to elevations reported to follow inhalation of 5% carbon dioxide mixtures. Nevertheless, the volume of the device was sufficient to cause a marked depression of the end-tidal oxygen level (to 67 mm Hg) in one subject. Despite the simplicity and cost-effectiveness of the rebreathing method, it cannot be recommended in the treatment of sudden or fluctuant sensorineural deafness.

Carbon Dioxide↗
PubMed1985

A method of assessment during vocational training: report of a pilot study.

Problems arising from the present rate of failure of vocational trainees in the MRCGP examination are outlined; and the role of formative assessment during training in reducing this rate is considered. A study is described in which trainees in a number of centres were assessed by a method designed to measure specified cognitive abilities and areas of knowledge. The method, based on written papers, provides each candidate with a profile of performance and generates comparative standards. Reliability of marking, the distribution of candidate-scores within and between areas of assessment and techniques for monitoring the effectiveness of questions are reported. Use of the method by College as an educational service to trainees is considered, along with its potential as a Part I MRCGP examination.

Education, Medical, Graduate↗
PubMed1982

Serological survey of the prevalence of Toxoplasma gondii antibodies in rams in sheep flocks in New South Wales.

Serum samples from 5724 rams on 534 farms in New South Wales were tested in the indirect fluorescent antibody test for toxoplasmosis. Nine per cent of rams had titres of 64 or higher and 41% of flocks had either one or more rams with a titre of 64 or higher. There were significant differences in the geographical distribution of infected flocks, ranging from 57.8% of flocks infected on the tablelands to 41% on the slopes and 22.4% on the plains. There were significantly more infected commercial flocks (47.5%) than stud flocks (32.9%). The results indicated that the prevalence of infection was influenced by management, with a higher prevalence of infection in flocks kept under an intensive or semi-intensive system of management.

Animals↗
PubMed1978

The effects of damage to the renal tubular cell population in growing rats.

Intraperitoneal injection of mercuric chloride in the rat was used to study the effect of tubular injury on renal growth in intact and in unilaterally nephrectomised animals. If a reduction in the size of the tubular cell pool was effected, hypertrophy of surviving cells, rather than hyperplasia, would be the dominant response in treated animals. The remaining kidney in animals which had undergone nephrectomy showed hyperplasia without hypertrophy. However, unilaterally nephrectomised animals treated with mercuric chloride showed evidence of hypertrophy only, with no hyperplasia.

Acute Kidney Injury↗