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Biomedical subjects

R Dobson

Publications and source records attributed to R Dobson.

86 records · Page 5Linked to original sources
PubMed1997

Early supported hospital discharge following acute stroke: pilot study results.

OBJECTIVE: To establish the feasibility and method of evaluation of an early supported hospital discharge policy for patients with acute stroke. DESIGN: A randomized controlled trial comparing an early supported discharge service to conventional care. SETTING: Three acute hospitals in Newcastle upon Tyne. SUBJECTS: Ninety-two eligible patients with acute stroke admitted between 1 February 1995 and 31 January 1996. MAIN OUTCOME MEASURES: Placement, length of stay, readmission rates, mortality, functional ability (Nottingham Extended Activities of Daily Living (ADL) Scale), handicap (Oxford Handicap Scale), global health status (Dartmouth Coop Function Charts) and carer stress (General Health Questionnaire 30 item). RESULTS: The median length of stay for patients randomized to early supported discharge was 13 days compared to 22 days in the conventional care group (p = 0.02). The median Barthel ADL index at seven days post stroke of patients randomized to early supported discharge was 15, and 13 for those randomized to conventional care (NS). At three months post stroke the median Nottingham EADL score of patients randomized to early supported discharge was 10 compared to 7 for those who received conventional care (NS). There were no statistically significant differences in the global health status of patients or carer stress. CONCLUSION: An early supported discharge service following acute stroke with individualized rehabilitation in the community is feasible and can be evaluated by a randomized controlled trial but a larger multicentre trial is needed before such a service is widely adopted.

Activities of Daily Living↗
PubMed1997

Warfarin anticoagulation in primary care: a regional survey of present practice and clinicians' views.

The demand for anticoagulation services is rising. Warfarin anticoagulation has been shown to reduce the risk of stroke in patients with non-valvular atrial fibrillation by 68%. This raises issues about how services are best organized to initiate and monitor anticoagulation in this potentially large group of patients. We report the results of a regional postal survey undertaken to describe the views of general practitioners and consultants regarding warfarin anticoagulation in light of this potentially high increase in demand.

Anticoagulants↗
PubMed1995

Validation of a population screening questionnaire to assess prevalence of stroke.

BACKGROUND AND PURPOSE: A cross-sectional survey is the best method for determining the prevalence of a chronic condition such as stroke. Before embarking on a large population study, a valid screening instrument is necessary. This study aimed to validate a self-completion postal screening questionnaire for assessing lifetime history of stroke. METHODS: A random sample of 2000 people aged 45 years and over was selected from the Family Health Services Authority register. A brief self-completion questionnaire requesting self-reported history of stroke was mailed to each individual. Responders reporting a history of stroke received a request for a standardized home assessment visit. Confirmation of the diagnosis of stroke was made based on information from the home visit together with multiple sources of case ascertainment. False-negative responses and assessment of nonresponse bias were documented. RESULTS: The response rate for the questionnaire was 88%. Of the sample, 120 (6%) who were wrongly registered were excluded; 173 (10%) of the 1663 responders reported a history of stroke. The question "Have you ever had a stroke?" had a sensitivity of 95% and a specificity of 96%. CONCLUSIONS: This simple self-completion questionnaire is a valid means of screening for cases of stroke in the community and could form the basis for subsequent studies of prevalence and health needs.

Aged↗
PubMed1990

Derivatization of benz[a]anthracene metabolites for detection by laser excited Shpol'skii spectrometry.

The polar metabolites of polycyclic aromatic compounds (PACs) are of significant oncological interest. In contrast to parent PACs, isomer selective detection of polar PACs by laser excited Shpol'skii spectrometry (LESS) is severely limited by excessively broadened spectra and rapid photodegradation in n-alkane solvents. To minimize these limitations a 10-min derivatization procedure was developed to produce corresponding methoxy compounds, that exhibit the Shpol'skii effect. By use of the extraction and permethylation procedure, the selective detection of a mixture of hydroxy-benz[a]anthracene isomers spiked at the low picogram level into urine and blood matrices was achieved. A detection limit for 1-hydroxybenz[a]anthracene was 0.6 part per trillion, or 12 fg (0.05 fmol) on a 20-microL sample.

Benz(a)Anthracenes↗
PubMed1983

Recognizing and helping the suicidal patient in chiropractic practice.

The assessment of a patient's suicide risk is often difficult for the busy practitioner. The present article examined chiropractic interns' and doctors' ability to recognize suicide lethality factors in their patients. On a suicide lethality scale, chiropractic interns and doctors scored significantly lower than a sample of physicians and psychologists and did not score significantly differently than ministers and college students. There was no significant difference between the scores of chiropractic interns and doctors. The article discusses important factors in assessing patient's suicide risk, such as: current mood; suicide plan; and present life circumstances. Suggestions for helping the suicidal patient in co-operation with a psychiatrist or psychologist are presented.

Chiropractic↗
PubMed1972

Concurrent performances: rate and accuracy of free-operant oddity responding.

In pigeon's oddity performances, maintained by variable-interval reinforcement of pecks on the odd key of three keys in a triangular array, accuracy and response rate varied inversely with the rate of variable-interval reinforcement scheduled concurrently for pecks on a fourth, spatially isolated key. But when variable-interval and extinction components alternated in a multiple schedule for pecks on the spatially isolated key, oddity accuracy was greater during variable-interval components than during extinction components. Oddity response rate was not affected systematically by the alternating components. Changeovers between the oddity keys and the spatially isolated key were frequent during variable-interval components; responding occurred almost exclusively on the oddity keys during extinction components. This difference in performance during the two components was eliminated by arranging stimulus-correlated variable-interval reinforcement in the multiple schedule on the spatially isolated key: a stimulus was presented in the variable-interval components only when reinforcement became available, thereby reducing responding on this key to near-zero levels in both components while maintaining the variable-interval reinforcement. The effect of the multiple-schedule components on oddity accuracy was not altered, however, and thus apparently depended directly on concurrent reinforcement and not on differential sequential properties of concurrent responding during the two components.

Journal Article↗