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Biomedical subjects

P Hobbs

Publications and source records attributed to P Hobbs.

13 recordsLinked to original sources
PubMed1992

Psychiatric service use: a cohort study of first attenders.

A retrospective cohort study was undertaken of all 1047 first-ever psychiatric service attenders to Christchurch general psychiatric services in 1981. All episodes of care were examined to the end of 1989. Only 24% of contacts were as an inpatient. Long-term contacts and frequent presenters formed only 15% of the sample. Nearly all cases not immediately discharged remained within the adult general service. Demographic and clinical variables and patterns of resource use are discussed.

Adolescent↗
PubMed1991

Energy and respiratory metabolism in cystic fibrosis: the influence of carbohydrate content of nutritional supplements.

The basal energy expenditure (BEE) in a group of adolescent and young adult patients with cystic fibrosis (CF) with mild lung disease was 97 +/- 6% of that predicted by the Harris-Benedict equation (which estimates BEE by age, sex, height, and weight). The BEE of a group with more severe lung disease was 117 +/- 5% of that predicted by the Harris-Benedict equation, due primarily to a 14% greater oxygen consumption (VO2) and 24% greater CO2 production (VCO2) compared with milder lung disease (p less than 0.05). The measured BEE in the patients with mild lung disease correlated well with the predicted BEE, but variably underestimated that of patients with more advanced lung disease. The influence of low carbohydrate (Pulmocare) and higher carbohydrate (Instant Breakfast) nutritional supplements on the energy and pulmonary metabolism was compared in 10 malnourished CF patients with moderate to severe lung disease. Their BEE before ingesting the supplements was 120% of that predicted by the Harris-Benedict equation. Their VCO2 increased 9-19% for the 3 h after ingesting 500 kcal/M2 of Pulmocare, and 25-30% after ingesting Instant Breakfast (p less than 0.05). The respiratory quotient (RQ) was significantly greater for Instant Breakfast than Pulmocare. The minute ventilation (VE) rose 10-13% for the 3 h after ingesting Pulmocare, versus 27-31% after ingesting Instant Breakfast, but the difference was not significant. The metabolic expenditure rose 13-16% for the 3 h after ingesting both formulas. We concluded that CF patients have increasing difficulty maintaining their nutrition as their pulmonary disease progresses, in part because of a 17-20% increase in their BEE.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

Response by women aged 65-79 to invitation for screening for breast cancer by mammography: a pilot study.

OBJECTIVE: To determine whether there is sufficient benefit to be gained by offering screening for breast cancer with mammography to women aged 65-79, who are not normally invited for screening. DESIGN: Pilot study of women eligible for screening but not for personal invitation. The results of this study were compared with the results of routinely screened younger women (aged 50-64) from the same general practice. SETTING: One group general practice in south Manchester. PATIENTS: The 631 women aged 65-79 on the practice list. A total of 42 (7%) were excluded by the general practitioner, and 22 (4%) invitation letters were returned by the post office. MAIN OUTCOME MEASURES: Response rates to invitation for screening assessed by three indices: crude population coverage ratio, crude invited population coverage ratio, and corrected invited population coverage ratio. RESULTS: 344 Patients aged 65-79 (61% of those invited, excluding those who could not be traced) were screened compared with 77% of women aged 50-64. The three response indices were higher for younger women than older: crude population coverage ratio = 66.5%, crude invited population coverage ratio = 69.3%, corrected invited population coverage ratio = 76.8% for women aged 50-64, compared with 54.5%, 58.4%, and 60.7% respectively for women aged 65-79. All four biopsies done in the older women gave positive results, giving a cancer detection rate of 11.6/1000 compared with 4.1/1000 among younger women. CONCLUSIONS: These results show that there is a potential for high attendance at routine screening by older women if they are invited in the same way as younger women. If these results are found elsewhere the costs and benefits of screening older women should be reassessed.

Aged↗
PubMed1987

Breast self-examination: how committed are women? How committed are we?

Breast self-examination (BSE), increasingly promoted as a good health habit, is gaining recognition by surgeons as a significant factor in tumour size and staging at diagnosis. Clinically-based reports leave unanswered important behavioural questions and pay scant attention to the quality of the teaching or of the practice of BSE. This paper argues that if BSE is to be used as the coarse-screening modality of which it seems to be capable, we must apply to it the same criteria as to other screening modalities. Since BSE ipso facto must be undertaken by the women herself, it is a screening in which subject behaviour is crucial. Promotion of BSE requires not only behaviour change but also maintenance and support. Behavioural aspects are discussed in relation to a recent major study of the teaching and practice of BSE.

Behavior↗
PubMed1987

Synthesising research findings and practical experience to formulate principles in cervical screening.

Compared particularly with Scandinavian countries, the effects of cervical screening in the United Kingdom have been disappointing, both in terms of women screened and in relation to incidence and mortality. The underlying problem is the under-representation of women most at risk of cervical cancer in the screened population. In this paper we examine two possible hypotheses for such under-representation: one concerns the behavioural aspects of women's failure to attend and the second the effect of the organisation of current screening services on their attendance. We outline the features that an effective service would need to incorporate and propose principles for the development of a screening system designed to maximise the potential of the cervical smear test.

Behavior↗
PubMed1985

Attendance for cervical screening--whose problem?

Despite the existence of an effective screening technique for cancer of the cervix, incidence and mortality from this disease have not declined in the United Kingdom. The basic problem is that women most at risk of the disease are under-represented in the screened population. The evidence for two different points of view to explain this situation is examined. These viewpoints are the failure of the women to attend, and the failure of the service to meet the needs of women. This paper argues that the evidence supports the view that the organisation of the existing screening service impedes the maximum participation of at-risk women. We discuss the features that an effective service needs to incorporate, and put forward principles for the development of a more effective screening system, namely, that it should be provider-initiated and user-oriented.

Attitude to Health↗
PubMed1976

Screening for breast cancer.

The feasibility of mass population screening for breast cancer by clinical examination and x-ray mammography was studied. The results indicate that such a programme could be conducted effectively by non-medical staff and be safe from the dangers of irradiation. The response rate of women invited for screening suggests that such a service is acceptable to the general public. The additional work load produced by screening would not overburden the existing surgical services.

Aged↗
PubMedDate not supplied

The behavioural aspects of breast and cervical screening.

The clinical potential of any screening modality is unlikely to be realised unless a majority of the target group participates in the screening. Behavioural studies of screening observe a negative correlation with lower social class, income, education and with higher age. Education and persuasion programmes have increasingly been designed with these factors in mind. More recent studies, however, indicate that the way in which the screening service is made available to women affects their perceptions of it and, therefore, their participation at least as much as social factors; and properly designed presentation may even cancel out the effect of age and social class. This paper describes and discusses the studies which have led to the development of a consumer-oriented, service initiated (COSI) approach.

Age Factors↗