Biomedical subjects

R Scrivener

Publications and source records attributed to R Scrivener.

11 recordsLinked to original sources

PubMed2002

Retinopathy of prematurity in the UK I: the organisation of services for screening and treatment.

AIMS: To ascertain how closely services for the screening and treatment of retinopathy of prematurity (ROP) were organised on a national level in 1995. METHODS: Questionnaires about the local arrangements for the screening and treatment of retinopathy of prematurity (ROP) were sent to the entire consultant membership (n = 648) of the Royal College of Ophthalmologists (RCOphth) and to the clinical directors (n = 259) of neonatal units and other units caring for preterm babies in the UK in 1995. RESULTS: 568/648 of UK consultants (88%) and 15 non-consultant ophthalmologists and 210/259 paediatricians (81%) and 19% paediatricians in non-neonatal units responded. Thirty-one per cent responding ophthalmologists were involved in the ROP service: of these 64% screened babies, 34% screened and treated babies, while 1% ophthalmologists treated ROP but did not screen. Ninety-six per cent units caring for preterm babies had their babies screened for ROP and for almost 95% of the screening took place in the neonatal unit. About 8200 babies were screened in 1994; 277 developed stage 3, of whom 54% received treatment. Nine per cent (n = 14) and 5% (n = 8) treated babies became blind in one and both eyes respectively. A sessional commitment was identified for 9% ophthalmologists, but for less than half this was included in the contracted work programme. Sixty-five ophthalmologists treated babies with ROP, but only 10 treated more than five babies in 1994. Training needs were identified by 71 respondents. CONCLUSIONS: Several aspects of ROP screening and treatment services require improvement. Hopefully, reducing the number of identified screeners would increase skills, confidence and the ability to recognise severe disease requiring treatment, and also facilitate incorporation of this work into consultant work plans.

Blindness↗

PubMed2002

Retinopathy of prematurity in the UK II: audit of national guidelines for screening and treatment.

AIMS: To ascertain how closely in 1995, neonatologists and ophthalmologists were adhering to the national guidelines for the screening of retinopathy of prematurity (ROP, 1990) and those for screening and treatment (1995). METHODS: Questionnaires about the local arrangements for the screening and treatment of retinopathy of prematurity were sent to the entire consultant membership (n = 648) of the Royal College of Ophthalmologists (RCOphth) and to the clinical directors (n= 259) of neonatal units in the UK in 1995. RESULTS: One hundered and eighty-three ophthalmologists in the UK were identified as undertaking ROP screening and/or treatment, and ROP screening took place in 207 neonatal units. Seventy-seven per cent of the ophthalmologists either complied with or exceeded recommendations for determining which babies required screening, while 7% used criteria that would have resulted in substantially fewer babies being screened. Only 17% units and 12% ophthalmologists provided written information for parents, although 66% ophthalmologists talked to the parents of babies they screened. There was a lack of clarity about responsibilities for ensuring the continuation of screening on transfer to another hospital or on discharge to home. There was a wide range of views on the ophthalmic criteria that determined when screening examinations could cease and on the indications for treatment. CONCLUSIONS: While ROP screening is almost universally adopted in the UK, there is a need for the process to be more efficient and effective. Despite the delay in reporting this survey several issues remain extant and future guidelines should clarify and refine the criteria for screening and treatment. There is a need for improved communication with parents, and particularly for written information.

Humans↗

PubMed1996

A survey of the management of breast cancer in England and Wales.

The management of breast cancer is controversial. In order to obtain an overview of the way that surgeons manage breast cancer in England and Wales and to assess trends in management by comparisons with the results of previous surveys a postal questionnaire was sent to all consultant general surgeons in England and Wales (n = 985). The response rate was 61%. Fine-needle aspiration is now the preferred technique to obtain a tissue diagnosis by 85% of surgeons. The majority of surgeons now treat early breast cancer either by breast-conserving surgery or offer the patient the choice of conservation or mastectomy. Comparisons with previous surveys carried out in the last 10 years suggest that fewer surgeons now recommend mastectomy. In all, 83% of surgeons indicated that they would biopsy the ipsilateral axilla routinely. Opinion is divided with regard to treatment of breast cancer in the elderly and treatment of an incompletely excised tumour, although the majority perform a mastectomy for a local recurrence after conservative surgery. Follow-up was regarded as worthwhile by 90%, but the majority do not routinely do follow-up investigations on asymptomatic patients apart from mammography. This study has shown very little consensus regarding the management of breast cancer in England and Wales. We suggest that the management of breast cancer should be in the hands of those with a special interest in the subject, as these surgeons will be more aware of ongoing clinical trials and current literature, more patients will then be entered into clinical trials and further trials instigated.

Age Factors↗

PubMed1993

Regional variation in the surgical treatment of early breast cancer.

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Attitude of Health Personnel↗

PubMed1986

Behavioural differences of school-age children who were small-for-dates babies.

Twenty-one children aged between five and nine years who were small for gestational age (SFD) at birth and whose intra-uterine head growth was shown by ultrasonography to be slowing before 35 weeks were observed in a special room, using video-cameras. Their behaviour was compared with that of 21 matched control children who had had normal birthweight. The children in the SFD group were quieter, more compliant and less active than the control group, and their play behaviour suggested that they were less advanced developmentally. The behaviour of the mothers of the SFD group showed that they were aware of their child's problems and tried to compensate for it by teaching the child while they were waiting for the observational session to start, by sitting closer to the child during a drawing test, and by using more words to explain it.

Body Height↗

PubMed1981

Electronic measurement of locomotion by means of pressure-sensitive floor mats.

This paper describes a method of adapting an observation room to record a child's position in the room and to give an index of the amount of locomotion. The adaptation consisted of under-carpet pressure mats, linked electronically to digital counters. This recording system showed a highly significant correlation with observational measurements of the same aspects of behaviour. It has potential as an aid in the diagnosis of abnormal behaviour states.

Child↗

PubMed1977