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Biomedical subjects

P Underwood

Publications and source records attributed to P Underwood.

At least 19 recordsLinked to original sources
PubMed1991

An investigation of hypertension in a slum of Nakhon Ratchasima.

There is evidence that Thai people living in slums may be at high risk of developing hypertension. The present study was undertaken on a random sample of 1,000 subjects aged 20 and over living in a slum in Muang district of Nakhon Ratchasima during 1 February to 31 may 1988. This study consisted of measurements of blood pressure and body build, with administration of an interview on demographic characteristics, sociocultural factors and food frequency patterns. The results were based on 804 respondents. It was found that the prevalence of hypertension was 16.9%, nearly half of the hypertensives being mild cases. Only a low proportion of the proven cases was both aware of their condition and receiving treatment. About one fifth of the treated cases had blood pressure under 160 mm Hg systolic and 95 mm Hg diastolic. Based on these findings, it is concluded that these slum inhabitants are at high risk of developing hypertension. Community interventions are needed in order to prevent complications related to hypertension. Health education aimed at increasing community awareness of hypertension should be a major component of the community intervention.

Adult↗
PubMed1990

The effect of Orem's self-care model on nursing care in a nursing home setting.

The need of the functionally disabled for nursing care is a primary rationale for institutionalization in long-term care settings. However, maintenance of the self-care abilities that nursing home residents retain is an important component of their quality of life. Nurses are in an important position to encourage and sustain residents' abilities to participate in their care. Nevertheless, without specifying the role of the resident in care, nursing interventions may inadvertently reinforce dependency and apathy at the expense of autonomy, control and well-being. Data from nursing home care records and interviews suggest that nursing staff using Orem's Self-Care Deficit Nursing Theory differ in their nursing assessments and goals of care from staff on a control unit. Further study is recommended of the influence of the model on staff perspectives of care and on interventions which support nursing home residents' self-care ability and well-being.

Aged↗
PubMed1989

A clinical trial of a self-care approach to the management of chronic headache in general practice.

This paper reports a trial which assessed the clinical effectiveness of adding a behavioural self-management programme to the existing management of chronic headache by general practitioners (GPs). Eighty-seven chronic headache sufferers, referred to the study by 35 GPs, were randomly allocated to either a self-care group or a GP-control group. Headaches, drug usage, visits to health-care providers and time off work were self-monitored daily by all subjects for 4 weeks prior to intervention, for 4 weeks during intervention, and for 4 weeks immediately after intervention. Additionally, self-monitoring was carried out for two further 4-week periods, one at 6 months and one at 12 months post intervention. Headache records showed that the self-care program significantly enhanced GP management. This effect was well maintained. However, drug usage, visits to health-care providers and time off work did not differ significantly between the treatment and control groups. 'No-show' rates, defined as those referred by a GP but who did not attend, were high--largely due to time requirements of the self-care program. However, drop-out rates, defined as those who left the self-care groups were low. It was concluded that this behavioural self-management program was a clinically effective adjunct to general practice management of headache but its use is likely to be limited due to problems of patient enrollment.

Adult↗
PubMed1989

Morbidity coding in general practice.

If research is to be of any use the phenomena being studied must be clearly defined. Almost 30 years ago the difficulty of classifying primary care problems using the International Classification of Diseases (ICD-8) was demonstrated. This led to the development of the International Classification of Health Problems in Primary Care-2-Defined which is based on ICD-9. Despite the work that has gone into the development of ICHPPC-2-Defined, relatively little work has been undertaken to assess the validity and reliability of its use. This paper describes the results of such a study conducted as a preliminary to the use of ICHPPC-2-Defined in a study of consulting patterns in general practice. The participating general practitioners were trained in the use of ICHPPC-2-Defined and then coded problems which they identified in a set of clinical vignettes. Following the coding exercise, a review session was held in which difficulties and errors in the use of ICHPPC-2-Defined were discussed. Subsequently, the general practitioners were required to code two more sets of vignettes, which included some problems repeated from the preceding sets. Comparisons were then made of changes in the validity and reliability of coding from one round to the next. The results of the study suggest that the reliability and validity of morbidity data collected using ICHPPC-2-Defined can be increased by training sessions for the coders which focus on the main sources of error in the use of ICHPPC-2-Defined.(ABSTRACT TRUNCATED AT 250 WORDS)

Australia↗
PubMed1988

Sensitivity and specificity of endocervical curettage and the endocervical brush for the evaluation of the endocervical canal.

A series of 87 consecutive conization specimens was studied to evaluate the accuracy of endocervical curettage for the detection of dysplasia in the endocervical canal and to investigate the role of the endocervical brush for the outpatient management of patients with atypical Papanicolaou smears. For patients having cervical intraepithelial neoplasia within the endocervical canal in conization specimens, the false-negative rate observed for endocervical curettage was 45% and the false-positive rate for the detection of endocervical involvement was 25%. The false-negative rate for the endocervical brush was only 8.4%, but the false-positive rate for endocervical involvement was 62.5%. The false-negative rate of endocervical curettage could be reduced to 16.7% if an abundant volume of endocervical material (as determined by point counting) was required. The utility of endocervical curettage to detect cervical intraepithelial neoplasia in the endocervical canal appears to be dependent on the adequacy of the specimen. The determination of adequacy is a critical factor for the proper interpretation of specimens obtained by endocervical curettage.

Adult↗
PubMed1987

High levels of childhood rickets in rural North Yemen.

Despite a warm sunny climate, rickets is extremely common in children living in an isolated mountainous area of North Yemen. In a small township the overall prevalence amongst children under five years attending for vaccination was 27%. The condition was most common at the end of the first year and had disappeared by the fifth year. Marasmus was commonly associated with rickets. Children from the rural villages outside the township had significantly lower rates of rickets. Several factors may contribute to the very high rates of rickets in rural Yemen. However, lack of exposure to sunlight as a consequence of particular cultural practices is likely to be the most important. The major social and behavioural factors which restrict the young child access to sunlight are outlined, and possible remedies discussed.

Child↗
PubMed1987

Cultural change, growth and feeding of children in an isolated rural region of Yemen.

This paper reports a study on the growth and feeding patterns of children from an isolated region of North Yemen. Marasmus was extremely common and was associated with poor infant feeding practices--particularly the widespread use of bottled milk--and frequent infections. Despite the appearance of a homogeneous traditional society, there were significant differences in the growth of children from adjacent areas. Children from a small township serving as the administrative centre of the region grew more poorly and had a higher mortality than those from the immediate rural hinterland. While poorer living conditions and more frequent infections may explain much of the worse growth and higher mortality of the township children, it is likely less adequate patterns of feeding, particularly greater use of artificial milk, also contribute significantly to the observed difference in growth. Despite the remote rural setting of the study, feeding patterns and growth may be influenced by a number of social factors associated with 'urbanisation'.

Acculturation↗