Assessment of effects of ethanol self-administration on social interactions in alcoholics.
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Biomedical subjects
Publications and source records attributed to R Griffiths.
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Volunteer chronic alcoholic subjects were exposed to a discrete-trail choice procedure within a residential research setting. Twelve daily trials occurred at 20 min intervals. In each trial a subject chose between 2 mutually exclusive options involving either receipt of money or the opportunity for socializing. The effect of ethanol self-administration was evaluated by requiring randomly over days that a subject consume either 8 drinks of orange juice or 8 drinks of ethanol (89.12 g ethanol total). For all 4 subjects, the mean rate of choosing socialization over money was significantly greater on sessions involving ethanol self-administration than on sessions involving orange juice self-administration.
Following 5 minutes of global ischemia, local cerebral blood flow (LCBF) was shown to have an initial reactive hyperemia that was followed, within the first hour, by persistent hypoperfusion (Part I). Intracranial pressure (ICP) was never elevated during the period of poor reperfusion. These experiments attempted to reverse the state of subnormal LCBF by inducing hypercarbia or hyocarbia or maintaining normocarbia. Although hypocarbia did increase LCBF at several electrode sites, neither the intracerebral steal syndrome nor the "squeeze" syndrome are a dominant consequence of hypercarbia in this model of global ischemia. Hypercarbia was consistently more effective in elevating LCBFs and in recovery of the electrocorticogram. It appears that, in the absence of raised ICP, hypercarbia may be preferred to normal or low PACO2,. Even though hypercarbia was superior to normocarbia or hypocarbia, hypercarbia was not a completely satisfactory regimen for reversing the state of poor reperfusion.
The Australian National Diagnosis Related Groups (AN-DRGs) classification is intended to assign acute admitted patient episodes to classes which are iso-resource and clinically homogeneous. It has been widely used to good effect, but its performance has been questioned with respect to the classification of patients with chronic conditions. The primary aim of this study was to investigate the extent to which AN-DRGs classify episodes of care for a chronic disorder (in this case diabetes) into classes which are relatively homogeneous in terms of clinical attributes and the resources used in the provision of care. The records of 2094 patients admitted during 1994-95 to four hospitals in the Illawarra Area Health Service with at least one diabetes diagnosis recorded in the discharge summary were reviewed. We found that the source data used for assignment contained errors of medical documentation, abstraction and sequencing, and coding. The sampled patients were distributed among many AN-DRGs in a way which was neither clinically coherent nor obviously descriptive of resource-use differences. The AN-DRG logic appears to ignore or otherwise under-estimate the effects of diabetes as a secondary diagnosis.
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Breast skin temperatures have been monitored at 30-min intervals throughout wake-span for the whole or part of the menstrual cycle of women aged 20-37 years using both manual and automatic (chronobra) methods of measurement. Circadian breast skin temperature rhythms have been mathematically characterized and rhythm parameters assessed in relation to the estimated time of ovulation. Data generally indicate that there is a peri-ovulatory rise in breast temperature. Computer simulation and practical experiments, based on changes in the residual sums of squares from target values obtained for days in the cycle prior to ovulation, have indicated that this peri-ovulatory increase in temperature is possibly detectable within 24 h. The use of the chronobra and associated statistics may be of value in signalling the onset of the infertile phase of the menstrual cycle.
The focus of healthcare has shifted from examining the process (what is done) to measuring what is achieved (outcomes). While various tools have been developed to measure inpatient outcomes, there is no specific measure of outcomes for community-based care. A collaborative research project involving the University of Wollongong and the Illawarra Area Health Service has been established to address the gap in patient reporting and evaluation. This paper describes the initial phase of a research project using the Nominal Group Technique (NGT) to develop outcome measures appropriate to community health. The NGT is a technique that uses groups of stake holders to obtain information. Nominal groups are unlike focus groups in that NGT seek responses to predetermined and structured questions. Other aspects of outcome measurement, such as casenote audits and addressing the client's perspective are being considered later in the project. This paper focuses largely upon the process of using the NGT to develop outcomes and to encourage the participation in the research project by community nurses. It was vital from the outset to generate a sense of ownership of both the process and the findings and the NGT was seen as a process that would enable both the development of outcome statements and active participation.