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Biomedical subjects

P Griffiths

Publications and source records attributed to P Griffiths.

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

Portable biofeedback apparatus for treatment of anal sphincter dystonia in childhood soiling and constipation.

Biofeedback is an effective treatment for anal sphincter dysfunction in many cases of childhood constipation and soiling. Conventional methodologies centre on clinic-based manometric apparatus but are compromised by equipment being thinly available and practice sessions often infrequent. To counter these shortcomings, we have designed a portable anorectal biofeedback apparatus (the Easograph) for domiciliary use. It can be lent to families, enabling carers to mediate what is an intrinsically sensitive procedure. In this paper, we provide a technical description of the device which is based on an inexpensive pressure transducer. Casework experience suggests it is reliable in operation and readily understood by users. In a pilot study of eight patients treated with the apparatus, five achieved bowel continence after lifelong soiling in one to eight weeks of daily practice. We believe this is an innovative approach that has good potential for treating faecal retentive and expulsive disorders in childhood associated with poor anal sphincter control.

Anal Canal↗
PubMedDate not supplied

Heterosexual vaginal and anal intercourse amongst London heroin and cocaine users.

A community-derived sample of 392 heroin users and 145 cocaine users were interviewed about their drug use and sexual behaviour, with (optional) collection of saliva specimen for linked anonymous HIV/HBV testing. The heroin sample was stratified (50/50) across current treatment and non-treatment status. For cocaine users 80% were not in current contact with any treatment. Overall levels of sexual activity were several times higher than reported in recent national surveys. Last-year prevalence of heterosexual anal intercourse was 23% and 20% for heroin-using males and females respectively (last-month figures--12% and 10%); and 23% and 15% for cocaine-using males and females respectively (last-month figures--7% and 9%). Two-thirds of subjects rarely or never used condoms during heterosexual anal intercourse. For females, receptive anal intercourse was positively related to a history of sex-for-money activity, high scores of severity of dependence, and injecting as a current route of use.

Adolescent↗
PubMedDate not supplied

Compulsory removal of competent adults from their homes.

The National Assistance Act 1948 was enacted in order to provide the legal framework for the care and support of society's ill and socially deprived. In certain limited circumstances, Section 47 of this Act permits the compulsory admission of competent adults to hospital or to other types of residential care. The fine balance between protection from harm and respect for personal freedom is not served well by this Act which has its origins in Poor Law legislation. It is no longer in accordance with current practice and therefore needs to be reviewed. This could be achieved by setting up regulatory systems to protect the rights of individuals considered to be in need of compulsory admission. However, it seems likely that the only way to protect the individual's civil liberties effectively is by changing the existing law.

Adult↗
PubMedDate not supplied

Drug information systems, early warning, and new drug trends: can drug monitoring systems become more sensitive to emerging trends in drug consumption?

Drug Information Systems (DIS) are called upon to provide an early warning of emerging trends in drug use. However, little theoretical attention is directed toward exploring conceptual issues in this area. In this paper a typology of existing DIS is offered. Among the features that distinguish DIS are their structure (human network or organization systems) and the range of information sources used. Indicators of drug use can be placed on a continuum of sensitivity ranging from leading edge indicators to lagged indicators. Sensitivity implies volatility as sensitive indicators also react to fluctuations that do not become trends. DIS conventionally are largely reliant upon lagged indicators. What is required are DIS that combine a critical information processing function with the ongoing systematic collection of data from a range of data sources.

Data Collection↗
PubMedDate not supplied

Evaluating nurse-led inpatient units.

This article highlights findings from three studies into nurse-led inpatient units. The results are not the same in each case, particularly with regard to length of stay, and the authors discuss the possible reasons for this. Further work is needed to develop NLIUs and identify cost savings.

Cost Savings↗
PubMedDate not supplied

Evaluation of nurse-led in-patient care.

This paper describes research aimed at identifying the patient population deemed suitable for a nursing-led ward for in-patients. One hundred and sixty-seven patients were referred to the unit after a mean stay in acute areas of 26 days. The range of stays was zero to 193 days. The mean age of patients was 76 with a range from 40 to 97. Ninety-five per cent of patients transferred to the ward had been referred for 'rehabilitation'. Certain diagnostic groups such as 'infection' and 'injury' which are liable to lead to mobility problems appeared frequently among patients transferred. However, a variety of diagnoses were identified. The service is potentially suitable for a wide range of patient groups who are defined by nursing need, not medical diagnosis.

Adult↗
PubMedDate not supplied

Clinical outcomes for nurse-led in-patient care.

An earlier paper described an in-patient population that was identified as potentially able to benefit from nurse-managed in-patient care. This paper describes a pilot experimental study aimed at measuring the impact of transfer to a nurse-led unit. Outcomes for 71 patients considered for transfer to the nurse-led ward were compared with a control group of 48 patients who remained under medically managed care for the duration of their stay. Large but non-significant improvements in length of stay were found in the treatment group. There was a significantly lower incidence of pressure sores, urinary tract infections and chest infections. There were no differences in mortality. The author urges a cautious interpretation of results and emphasises the need for replication.

Clinical Nursing Research↗
PubMedDate not supplied

In search of the pioneers of nurse-led care.

Nurse-led services are becoming more common in the UK. The first of three articles comparing developments in the USA and the UK, this looks at the origins of nurse-led units to discover what lessons may be learnt for the changes that have affected the Loeb Center in New York, a pioneer in the field.

Clinical Nursing Research↗
PubMedDate not supplied

In search of therapeutic nursing: subacute care.

A form of 'intermediate' care exists in the USA which parallels the work of nurse-led units in the UK. This article describes subacute care, the term used for in-patient facilities for post-operative care and rehabilitation, and looks at its application in the USA. The work of such units is detailed and compared with similar units in the UK.

Hip Prosthesis↗
PubMedDate not supplied

In search of therapeutic nursing: maxi-nurses.

The third article in this series examines two nurse-led units where access to the service is controlled by nurses. However, in many ways they could not be more different. The special care unit in the USA provides rehabilitative care for patients discharged from intensive care, while the nursing centre in Canada offers a drop-in service offering advice to local people.

Community Health Services↗