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Biomedical subjects

R Fry

Publications and source records attributed to R Fry.

54 records · Page 3Linked to original sources
PubMed1989

Thought disorder: current assessment, techniques, and future trends.

The early accounts of thought disorder were based primarily on abnormalities in the speech patterns of schizophrenic patients. Researchers have attempted to study and assess this phenomenon based on the verbal behaviors of individuals believed to experience disordered thinking. However, verbal dysfunction may not be the most accurate means of assessing thought disorder in psychiatric patients. A review of studies which have attempted to examine aspects of schizophrenic symptomatology suggests that the self-report technique may be a viable alternative for assessing disordered thought. Schizophrenic patients are able to give accurate accounts of experiences relating to their illness. We believe that the self-report technique may provide a reliable method for thought disorder assessment. Based on this assumption, we are currently in the process of developing a self-report scale which assess 13 constructs we believe to be associated with thinking. In a small sample of subjects, the questionnaire was able to differentiate schizophrenic subjects from normals.

Cognition Disorders↗
PubMed1988

Dysthymia: a randomized study of cognitive marital therapy and antidepressants.

Preliminary data from a randomized study of the effectiveness of combined marital therapy and antidepressant medication in the treatment of dysthymic married women is presented. The study compares doxepin with placebo, and a marital therapy designed to enhance intimacy through facilitating self-disclosure between spouses with a more supportive and educational therapeutic approach. After ten weeks of combined treatment, the dysthymic women show statistically significant improvement on all the depression measures as well as on the intimacy scale. A trend is developing for greater reduction of depressive symptomatology in the group treated with self-disclosure. The evidence appears to suggest the possibility that the presence of a patient's husband as a supportive figure may of itself be a potent therapeutic manoeuvre in the treatment of dysthymic women.

Clinical Trials as Topic↗
PubMed1980

Actinomycete-like organisms in cervicovaginal smears.

The prevalence of organisms resembling actinomycetes in cervicovaginal smears in women wearing an intrauterine contraceptive device (IUCD) was analysed prospectively in a screened private patient population with regard to the type of device used. The overall prevalence was 1,69%, with the greatest prevalence of 11,76% observed in Dalkon shield wearers. The significance of finding actinomycete-like organisms in smears is discussed in relation to the recent reports implicating the genus Actinomyces as a pathogen in some cases of pelvic infection in IUCD users.

Actinomyces↗
PubMed1976

The value and dangers of gynaecological cytology.

The value of gynaecological cytology is briefly summarised, possible pitfalls from the viewpoint of the clinician and the laboratory are enumerated, and the importance of quality control and the necessity of research to validate mass screening programmes are emphasised.

Adenocarcinoma↗
PubMed1976

Workshop: improving worker coordination in health care delivery.

Patient management teams are able to diagnose and begin to solve their own problems with the help of a self-instructional health team development (HTD) program. In this case, the focus is on those task-related issues which limit team effectiveness.

Delivery of Health Care↗
PubMedDate not supplied

The challenge of trauma clinical trials: facilitation through understanding.

Coordinating trauma clinical trials is a relatively new role for trauma nurses. The authors examine the specific roles and responsibilities of the clinical research nurse coordinator (CRNC) within the surgical intensive care unit. Historical evolution of this challenging role is reviewed, and specific responsibilities of the CRNC are discussed. Additionally, ethical considerations and conclusions are presented.

Clinical Trials as Topic↗
PubMedDate not supplied

Understanding birthing mode decision making using artificial neural networks.

BACKGROUND: This study examined obstetricians' decisions to perform or not to perform cesarean sections. The aim was to determine whether an artificial neural network could be constructed to accurately and reliably predict the birthing mode decisions of expert clinicians and to elucidate which factors were most important in deciding the birth mode. METHODS: Mothers with singleton, live births who were privately insured, nonclinic, non-Medicaid patients at a major tertiary care private hospital were included in the study (N = 1508). These mothers were patients of 2 physician groups: a 7-obstetrician multispecialtygroup practice and a physician group of 79 independently practicing obstetricians affiliated with the same hospital. A feedforward, multilayer artificial neural network (ANN) was developed and trained. It was then tested and optimized until the most parsimonious network was identified that retained a similar level of predictive power and classification accuracy. The performance of this network was further optimized using the methods of receiver operating characteristic (ROC) analysis and information theory to find the cutoff that maximized the information gain. The performance of the final ANN at this cutoff was measured using sensitivity, specificity, classification accuracy, area under the ROC curve, and maximum information gain. RESULTS: The final neural network had excellent predictive accuracy for the birthing mode (classification accuracy = 83.5%; area under the ROC curve = 0.924; maximum information = 40.4% of a perfect diagnostic test). CONCLUSION: This study demonstrated that a properly optimized ANN is able to accurately predict the birthing mode decisions of expert clinicians. In addition to previously identified clinical factors (cephalopelvic disproportion, maternal medical condition necessitating a cesarean section, arrest of labor, malpresentation of the baby, fetal distress, andfailed induction), nonclinical factors such as the mothers' views on birthing mode were also found to be important in determining the birthing mode.

Decision Making↗
PubMedDate not supplied

Employment outcomes of persons following traumatic brain injury: pre-injury, post-injury, and supported employment.

This paper provides a prospective analysis of the pre-injury, post-injury and supported employment work histories of 20 persons who survived a severe head injury. All persons had a very limited or inconsistent work history post-injury, due to the severity of the injury. Data are presented on the placement outcomes and include factors such as wages, hours worked, months of employment and type of occupation. The supported employment model is described and the job coach approach is presented in some detail. The most significant finding of this preliminary report is that, as an aggregate group, supported employment was able to facilitate restoration of vocational capacity from pre-injury levels based on total months worked.

Activities of Daily Living↗
PubMedDate not supplied

Critical factors associated with the successful supported employment placement of patients with severe traumatic brain injury.

A number of investigations have recently demonstrated the effectiveness of supported employment programmes in improving the vocational status of clients with traumatic brain injuries. The present study investigated a sample of 39 individuals participating in a return to work programme emphasizing a supported employment approach to identify key functional characteristics which differentiated successful and unsuccessful clients. Clinical ratings of employment specialists were used to identify two groups of individuals rated least and most difficult to place and maintain. Results indicated that the two groups differed markedly on key employment outcomes. Individuals rated most difficult tended to be younger, possess functional limitations such as visual and fine motor impairments, and display significant deficits in numerous work-related skills. Recommendations are made for applying these findings to assessment, placement, and training activities within vocational rehabilitation programmes for persons with traumatic brain injuries.

Adult↗