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Biomedical subjects

T A Carney

Publications and source records attributed to T A Carney.

14 recordsLinked to original sources
PubMed2001

The prevalence of bacteriuria in older institutionalized patients.

We set out to determine the prevalence of bacteriuria in elderly patients institutionalised in 10 homes in Northumberland. Single mid-stream urine (MSU) specimens were collected from 161 asymptomatic patients aged 64-101 years. Thirty-four (21%) samples had > 100 white blood cells (WBC/microliter) on microscopy as well as a significant bacteriuria of > 10(8) bacteria/l, being suggestive of a true urinary tract infection. A total of 115(71%) samples had < 100 WBC. Seventy-five (46%) samples could be described as 'contaminated' or 'infection unlikely' but of these only 31 (19.2% of all samples) were reported as 'contaminated' by the laboratory. This study confirms previous work in America to indicate the high level of bacteriuria in institutionalised elderly patients as well as the very high number (46%) who may show bacteriuria but no rise in the number of WBC suggesting contamination only. Nurses and GPs must be very cautious in interpreting MSU results from such patients.

Aged↗
PubMed2001

Frequent attenders in general practice: a retrospective 20-year follow-up study.

We describe a 20-year retrospective study of 58 patients with a cross-matched control group in one practice, who initially attended more than 12 times in 1975. The study establishes that frequent attendance is not consistent; the majority of high-attending patients in general practice revert over a short period of time to a normal consulting pattern. Diseases, rather than patients, appear to dictate high consulting rates. Consistent high attendance is largely owing to multiple pathology.

Adult↗
PubMed1987

Characteristics of general practitioners with high and low recall rates.

This study showed that general practitioners altered their workload and the clinical content of their practice by the number of patients that they asked to return and the number of doctor-initiated consultations that they carried out. Doctors with a high recall rate, who asked more of their patients to return, saw more chronic illness and investigated their patients' illnesses more. They were more likely to visit their patients and to make two or more diagnoses, their second diagnosis having an even greater bias to chronic illness. When they did give a prescription it was likely to be for two or more items at a consultation. They involved the primary health care team more and their patients were more likely to be elderly, female and of a higher social class. The low recall doctors asked few patients to return, saw less chronic illness and more acute episodic types of illness. They were more likely to see their patients in surgery and make a single diagnosis and give either none or one prescription. They were less likely either to involve the primary health care team or to investigate their patients. Their patients were younger, male and of a lower social class. Personality, undergraduate education, and postgraduate training seemed to be major influences on these differing characteristics. The results have implications for partnership, individual doctors and patients in the provision of whole person medicine.

Acute Disease↗
PubMed1980

A comparison of workload and morbidity recording by partners in a group practice.

A survey was carried out of one year's workload and morbidity recording by three partners in a semi-rural teaching practice. Despite an equal workload of patient contacts there were shown to be statistically significant differences between the partners in the number of return consultations, the sex and age of the patients seen, and in nine diagnostic groups. The statistically significant differences in the latter groups appear to have been caused by variations in policy for recalling patients and the different sex and age groups of the patients consulting the partners, not by diagnostic preferences. A lack of previous experience affected one group. The partners did not find the discussion of these differences to be threatening.

Adolescent↗
PubMed1979

Clinical experience of a trainee in general practice.

A survey of one year's trainee clinical experience in a semi-rural teaching practice is reported.The trainee saw significantly more acute minor illness and significantly less chronic illness than a principal in general practice. He also saw less life-threatening illness, psychiatry, obstetrics, and gynaecology.The balance of clinical experience gained in the trainee year is questioned. Careful monitoring, and perhaps control of the trainee workload by trainer and trainee, could provide a more balanced clinical experience of general practice.

Clinical Competence↗