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Biomedical subjects

P Roberts

Publications and source records attributed to P Roberts.

231 records · Page 13Linked to original sources
PubMedDate not supplied

Noninvasive ventilation for the management of pulmonary hypertension associated with congenital heart disease in children.

The use of noninvasive ventilation to support children with secondary pulmonary hypertension has not previously been reported. We present four children with secondary pulmonary hypertension in association with complex congenital and acquired cardiorespiratory anomalies who have been successfully managed in hospital and then discharged into the community on noninvasive ventilation, thus placing them in environments more suited for growth and development.

Child, Preschool↗
PubMedDate not supplied

Activity in a modified open-field apparatus: effect of diazepam and prenatal stress.

We examined the effect of prenatal stress exposure on sensitivity to diazepam. The stress exposure consisted of handling pregnant rats 5 minutes daily from the 14th to 21st day of gestation. Male offspring were tested at 60 days of age in a modified open-field apparatus 30 minutes after injection with diazepam (0, 1, 5 mg/kg). The 5 mg/kg dose of diazepam depressed the frequency and duration of crossover, rearing, headpoke and corner activities. Rearing was not affected by the 1 mg/kg dose of diazepam. Defecation was increased by the 1 mg/kg dose, but was decreased by 5 mg/kg of diazepam. Prenatal stress exposure altered responsiveness to diazepam on only crossover activity and on defecation. Prenatally stressed animals exhibited an increase in crossover at the low dose of diazepam, while control offspring were insensitive to this dose level. Also, there were more boli in prenatally stressed rats treated with 1 mg/kg diazepam, while the 5 mg/kg dose of the drug decreased the number of boli. The other measures showed a trend in the same direction but the differences were not statistically significant. Thus our results indicate that prenatal stress has very specific effects on the sensitivity of adult offspring to diazepam.

Animals↗
PubMedDate not supplied

The effect of drink familiarity on tolerance to alcohol.

Cues associated with familiar alcoholic drinks such as beer may, through repeated association with the unconditioned stimulus properties of alcohol, acquire the status of classically conditioned stimuli. It has been proposed that such drug-related conditioned stimuli mediate drug tolerance. Thus, the aim of the present experiment was to test this proposition on cognitive, subjective, and psychophysiological indicators of alcohol tolerance using human subjects. Two groups of subjects received alcohol in the form of a familiar drink (beer) or an unfamiliar drink (blue peppermint mixture). Both drinks contained the same dose of alcohol and were consumed at the same rate. Although conditioned heart rate and skin conductance responses occurring while subjects looked at and tasted the test drinks were weak, there were strong indicators of conditioned tolerance on the performance measures following consumption. Subjects who consumed the unfamiliar drink were significantly poorer on cognitive and motor tasks, and they rated themselves more intoxicated than did those who consumed the familiar drink.

Adolescent↗
PubMedDate not supplied

Gauge Capability Analysis: classical versus ANOVA.

In order to use Statistical Process Control (SPC) efficiently and effectively in today's modern industrial environment, it is essential to analyze and determine the extent of gauge variability. The variation that occurs on a control chart is essentially a combination of product and gauge variation. Studies of measurement or gauge variation are absolutely a waste of resources unless they can lead to a substantial reduction in process variability or to an improvement in process and product quality. The goal of gauge capability analysis is an understanding and quantification of the various sources of variability present in the measurement process. The purpose of this paper is to illustrate the fundamental difference between Classical Gauge Capability Analysis (CGCA) and the use of a more powerful approach based on the Analysis of Variance (ANOVA). The author recommends that the latter approach is more useful and powerful in the presence of an interaction between the parts and the operators involved in the measurement process. An example is illustrated in the paper to demonstrate the two approaches.

Analysis of Variance↗
PubMedDate not supplied

A multinational comparison of aphasia management practices.

The effect of restructuring of healthcare on the quality, quantity, and nature of aphasia management is largely unknown. The current study is the first to examine access, diagnostic, treatment, and discharge patterns of patients with aphasia in Australia, Canada, the UK, the US private sector (US-Private), and the US Veterans Health Administration in the Department of Veterans Affairs (US-VA). The authors developed a 37-item survey to be completed by clinicians working with aphasic patients. The survey focused on eight areas: access to care, evaluation procedures, group treatment, number and duration of treatment sessions, limitations of the number of sessions, termination of treatment, follow-up practices, and resumption of treatment. 394 surveys were distributed and 175 were returned completed (44% return rate). Respondents represented a range of ages, work experiences, and work settings. There was considerable consistency among respondents from our five healthcare systems. Results suggest that patients may be routinely denied treatment in direct contradiction to the research literature. Just as we carefully monitor the progress of patients receiving our treatment, we are obliged to monitor the effects of managed care on our patients, fellow clinicians, and our profession.

Americas↗
PubMedDate not supplied

Assessing students' clinical performance.

In this article the authors review the history of clinical assessment and describe the development and implementation of an evidence-based assessment strategy for clinical practice prepared for the Diploma in Nursing curriculum at Keele University.

Clinical Competence↗
PubMedDate not supplied

Total teamwork--the Mayo Clinic.

Typical of the Mayo Clinic is its century-old team approach to treating patients. Physicians work in teams, with each team driven by the medical problems involved in a case and by the patient's preferences. Occasionally, a team will be expanded or even taken apart and reassembled. At Mayo, diagnosing a complex problem, proposing treatment and slotting the patient for surgery can happen within 24 hours of the diagnosis. The overall effect at Mayo is one of orderliness, function and, above all, vigor. Even as other medical institutions are cutting staff and reducing services, Mayo is a robust, thriving organization with revenues of $2.9 billion and a staff of roughly 30,500. Each year, more than 400,000 patients visit its seven facilities. Mayo's administrators continue to invent (and reinvent) the business side of medicine. Having developed one of the world's first systems of centralized patient records, Mayo is able to keep costs low enough to admit patients from all income levels. "The best interest of the patient is the only interest to be considered" is a motto that has become a Mayo standard on how best to practice medicine. Fearful of becoming complacent and watchful of the risks posed by its deliberative style, the clinic constantly looks for new and fresh ideas.

Decision Making, Organizational↗