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Biomedical subjects

Stephen Brown

Publications and source records attributed to Stephen Brown.

39 records · Page 3Linked to original sources

Continuing professional development: medico-legal aspects of epilepsy.

Generally protection against possible litigation and good clinical practice go hand in hand. Situations in which the law has special relevance for people with epilepsy, those who work with them, and their clinicians are reviewed with special reference to the topics of driving, employment, duties of social carers, the clinician's everyday role, the responsibilities of researchers and epilepsy and the criminal law. What constitutes professional negligence is discussed, with special reference to the United Kingdom. Clinicians are advised to think clearly, write clearly, communicate clearly and have a good relationship with their patients.

Anticonvulsants↗

Effects of Snoezelen room, Activities of Daily Living skills training, and Vocational skills training on aggression and self-injury by adults with mental retardation and mental illness.

Multi-sensory stimulation provided in a Snoezelen room is being used increasingly for individuals with mental retardation and mental illness to facilitate relaxation, provide enjoyment, and inhibit behavioral challenges. We observed aggressive and self-injurious behavior in three groups of 15 individuals with severe or profound mental retardation and mental illness before, during, and after being in a Snoezelen room. All participants were receiving psychotropic medication for their mental illness and function-derived behavioral interventions for aggression, self-injury, or both. Using a repeated measures counterbalanced design, each group of participants was rotated through three experimental conditions: Activities of Daily Living (ADL) skills training, Snoezelen, and Vocational skills training. All other treatment and training activities specified in each individual's person-centered plan were continued during the 10-week observational period. Both aggression and self-injury were lowest when the individuals were in a Snoezelen room, followed by Vocational skills training and ADL skills training. The levels in the Snoezelen room were significantly lower than in both the other conditions for aggression but only in ADL skills training for self-injury. The difference in levels before and after Snoezelen were statistically significant with self-injury but not with aggression. The order of conditions showed no significant effect on either behavior. Snoezelen may provide an effective context for reducing the occurrence of self-injury and aggression.

Activities of Daily Living↗

Effectiveness of single detachable COOK coils in closure of the patent ductus arteriosus.

OBJECTIVE: To assess the efficacy and safety of single detachable coils in the closure of PDAs. METHODS: Review of cases in which a single detachable coil was implanted. The diameter of the ampulla was used to select coil size. Diameters of the PDA, ampulla and residual shunts were measured. RESULTS: There were 36 patients with a mean minimal ductal diameter of 2.2 +/- 0.6 mm. Immediately after implantation, 46% of the patients had residual shunts and after 24 hours, only 28%. A final spontaneous closure rate of 94% was observed after 21 months. There was a significant (p < 0.01) difference when minimal PDA diameter of those who had complete closure within 24 hours (median: 2 mm, interquartile range: 1.7-2.3 mm) was compared to those with a residual shunt (median: 2.5 mm, interquartile range: 2.3-3.2 mm). Negligible complications were experienced. CONCLUSIONS: Single Cook detachable coils are effective for PDA closure with a low complication rate if properly selected. There is a high rate of spontaneous closure of trivial residual shunts. In patients with a minimal ductal diameter > or = 2 mm and a residual shunt, more coils may be considered.

Adolescent↗