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Biomedical subjects

P Mooney

Publications and source records attributed to P Mooney.

34 records · Page 2Linked to original sources
PubMed1992

Objective measurement of anxiety in hypertensive pregnant women managed in hospital and in the community.

OBJECTIVES: To determine whether pregnant hypertensives women are more anxious when monitored in hospital or at homes. DESIGN: Prospective randomized controlled trial. SETTING: Rosie Maternity Hospital and women's homes. SUBJECTS: Ninety-nine pregnant hypertensive women: 50 had their blood pressure measured telemetrically from home, and 49 had it measured in hospital. MAIN OUTCOME MEASURES: Number of episodes of monitoring, duration of monitoring, mean blood pressure during monitoring, gestational age at delivery, trait and state anxiety levels. RESULTS: There were no significant differences in anxiety levels, or in any other outcome measure, between the home and hospital groups. CONCLUSION: When blood pressure is being monitored serially in pregnant hypertensive women, there is no measurable difference in their anxiety levels, whether they are in hospital or at home.

Anxiety↗
PubMed1991

A comparative clinical study of fetal phono- and movement-sensors from Amsterdam, Cambridge and Edinburgh.

In a European collaboration, a joint project to conduct an experimental and clinical investigation of recently developed sensors from three centres (Amsterdam, Cambridge and Edinburgh) has been carried out. The Amsterdam sensor was based on an inductive principle whereas the Cambridge and Edinburgh transducers used a piezo-electric material (PVDF) as transducing element. Nine patients with varying gestational age (29-38 weeks) were measured in a clinical investigation. Recordings of fetal heart sounds (FHS) and fetal breathing movements (FBM) were made using three sensors; one from each centre. These recordings were digitized directly into a computer using a purpose-built data acquisition system. For each patient 3 min of FBM data, and 1 min of FHS data were recorded by each sensor. The FBM recordings were carried out simultaneously with ultrasound, so as to enable a correlation to be made between both recordings. The FHS recordings were carried out simultaneously with the maternal heart pulse, to discount any maternal heart influences on the resulting signals. Of the nine patients analysed, FHS were recorded in seven patients. On the other hand, it appeared difficult to identify fetal breathing movements in the FBM recordings due to the dominance of the maternal breathing component. The analysis of the FBM signals and its correlation with ultrasound could not be carried out due to the relatively poor quality of the signals detected by the sensors, given the present techniques of analysis. The evaluation of the FHS recordings showed that although there is relatively little difference between the sensors, the inductive sensor performed best.

Cardiotocography↗
PubMed1991

No difference between home and clinic blood pressure measurements in pregnancy: a computerized telemetric study.

Many decisions in pregnancy are based on one or two casual blood pressure estimations made in the antenatal clinic. No previous study has challenged the validity of this practice or attempted to discover whether there are significant differences between the blood pressures of pregnant women when they are measured in the clinic and when they are measured in their home environment. We measured the blood pressures of 35 healthy pregnant women both at the antenatal clinic and in their own homes. All the women were at between 28 and 32 weeks gestation. At both locations, ten consecutive blood pressure and pulse measurements were made at one minute intervals using a Dinamap 1846P automated blood pressure monitor. The readings taken in the clinic were supervised, whilst at home the patients used our blood pressure telemetry system without direct supervision, the results being transmitted automatically to the hospital computer via the public telephone network. The Dinamap results were analysed in detail. Each ten minute recording session was summarised in terms of the first, last, highest, lowest and mean of the systolic, diastolic and mean arterial blood pressure, and pulse measurements in that session. Also, two measures of the variability within a ten measurement series were considered, the average change in pressure or pulse from one reading to the next, and the difference between the highest and lowest readings of pressure and pulse in the series. All descriptors of the clinic and the home measurements were compared using the paired Student's t-test. Clinic and home blood pressure measurements were not significantly different from each other in any respect.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Pressure Determination↗
PubMed1990

GLUCOPAGE: a computer program for managing diabetic pregnancy.

The microcomputer is an invaluable aid in the management of diabetes mellitus because of its ability to manipulate, summarise, and produce graphical displays from blood glucose data in such a way that new trends, or the effects of changes in therapy, are more readily apparent to the clinician. Currently available software however, while adequate for most purposes, has not been written to cope with the unique problems presented by diabetic pregnancy in which large amounts of data are generated over short periods of time, insulin requirements may change rapidly, and blood glucose control must be extremely tight. We have produced a new program, GLUCOPAGE, specifically for use in the management of diabetic pregnancy. GLUCOPAGE operates in conjunction with the Ames Memory Glucometer, from which it can download data either directly or telemetrically via a modern into the host IBM PC or compatible microcomputer. Large amounts of data can be summarised in various tabular and graphical formats on screen or in printed form. A single A4-size printout, the Glucopage, provides tabular and graphical summaries of a full week's blood glucose data. Copies of the Glucopage may conveniently be filed in the case notes, given to the patient or distributed to other medical staff.

Blood Glucose Self-Monitoring↗
PubMed1990

An 'admission challenge test' to predict severe hypertension in pregnancy?

Although many pregnant women are admitted to hospital for 'high blood pressure' during the third trimester, less than a third of them will subsequently develop severe hypertension. We used a Dinamap 1846 vital signs monitor to measure the blood pressure every 5 min during the first hour in hospital of a group of 51 previously normotensive pregnant women admitted with hypertension. An average systolic pressure at or above 140 mmHg was recorded in 37% of patients and, of these, 68% went on to develop severe hypertension. Conversely, if the average systolic pressure on admission was below 140 mmHg, only 3% of patients later developed severe hypertension. In terms of sensitivity, specificity, and positive and negative predictive values of severe hypertension, the 1-hour automated blood pressure profile was superior to conventional measurements whether they were made prior to admission, on admission, or during the first 24 hours after admission.

Adult↗
PubMed1990

Blood pressure measured telemetrically from home throughout pregnancy.

Sixty-eight healthy pregnant women measured their blood pressure at home for 1 day every 4 weeks from 14 weeks' gestation until delivery. Blood pressure measurements were made with the Cambridge blood pressure telemetry system, which was composed of a Dinamap 1846 monitor linked to and controlled by a dedicated microprocessor which communicated transtelephonically with a hospital-based microcomputer. On each measurement day each woman measured her blood pressure five times: on first rising and then at 10 AM, 2 PM, 6 PM and 10 PM. At each measurement session the blood pressure was automatically taken 10 times at 1-minute intervals. A total of 23,790 individual blood pressure measurements were analyzed. Systolic, diastolic, and mean arterial blood pressures were lowest at 18 weeks' gestation, rising slowly thereafter at a rate of 0.4 mm Hg systolic and 0.2 mm Hg diastolic per week. The maternal pulse rate also increased steadily after 18 weeks at a rate of 0.25 beats/min per week. There was a strong correlation between the blood pressures at 18, 26, and 38 weeks. All blood pressure parameters were significantly lower on first rising than at other times of the day, although the differences were small: 5 mm Hg for systolic, 4 mm Hg for mean arterial, and 3 mm Hg for diastolic blood pressure. After 10 AM, however, there was no significant daytime variation in any blood pressure parameter, indicating that for most purposes the time of day at which pressure measurements are made is unimportant.

Adult↗
PubMed1988

Haematuria in rheumatoid arthritis: a follow up study.

Twenty one patients with seropositive rheumatoid arthritis and previously documented isolated haematuria were recalled at a median 7.7 years (range 3-12) after initial investigation. Eighteen subjects had previously undergone renal biopsy, which had shown mesangial glomerulonephritis in all but four cases. Renal function was found to have remained normal in all patients with previous mesangial changes despite the presence of persistent haematuria in most cases.

Arthritis, Rheumatoid↗
PubMedDate not supplied

Challenging the precepts of family-centered care: testing a philosophy.

Family-centered care (FCC) is a model of patient care delivery that encourages the inclusion of the family in the planning and provision of care. Although this model has been discussed extensively in the literature and adopted by some institutions, it is one that many have difficulty implementing. The purpose of this study was to test the elements of a FCC philosophy developed for maternal/child units at a major medical center. Questionnaires developed for this study and translated into four languages were completed by 193 parent/patient participants. The questionnaire asked participants to rate the importance of FCC interventions and report which interventions had been provided. Most of the participants were Caucasian, married, female, had an annual income of $20,000 or less, had 12 or fewer years of education, and were younger than 40 years of age. Overall, "feeling welcome when I come to the hospital" was the highest rated item by parents of hospitalized neonates and children and perinatal patients. Findings from this study will be used to implement a FCC care philosophy.

Adult↗