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T H Hassard

Publications and source records attributed to T H Hassard.

6 recordsLinked to original sources
PubMed1990

Evaluating medical performance in the diagnosis and treatment of occupational health problems: a standardized patient approach.

Primary care physicians must identify and manage work-related disease, yet it is unclear whether training is adequate to accomplish this. This study examines the performance of 110 candidates, including 93 4th-year medical students, in the diagnosis and treatment of a standardized patient with occupational illness. Results indicated that the students did substantially better than the medical practitioners who had not received recent training. Although a strong correlation existed between candidates performance on the occupational health (OH) case and overall score on 19 non-occupational health cases, the competency measure that most determined performance on the OH case was interpersonal skills. A correlation also existed between working knowledge, data collection and data interpretation skills overall, and performance on the OH case; diagnostic skills, test selection, test interpretation, and case management skills overall showed no such correlation. The findings highlighted the importance of emphasizing interpersonal skills in training physicians to appropriately manage occupational medical cases, and illustrated the usefulness of standardized patients in teaching and evaluating occupational medical skills.

Adult↗
PubMed1978

Ossicular replacement prostheses.

To find a way of improving the results of ossicular reconstruction in ears that were rendered hard of hearing by chronic otitis media, the suitability of two biocompatible materials has been investigated. After three years' experience with Proplast and two years with Plastipore, it is concluded that for ears which lack an incus and stapes arch, these materials provide results at least as good as those previously reported with homologous materials and have the advantage of easy manipulation, timesaving, and ready availability. As with all foreign material in the chronically infected middle ear, the risks of extrusion cannot be ignored. The results so far indicate that this problem can be overcome with the use of cartilage film to separate the prosthesis from the tympanic membrane.

Auditory Threshold↗
PubMedDate not supplied

Eighteen years experience in stapedectomy. The case for the small fenestra operation.

The postoperative findings in almost 800 stapedectomized ears were analyzed to evaluate the proposition that complication rates in stapedectomy were affected by the size of footplate fenestration. It was concluded that small fenestra stapedectomy (diameter 0.4 mm) provided similar hearing gains to those achieved with standard techniques, that articulation problems occurred to a similar extent as with wire loop prostheses, and that there was a significantly lower incidence of a) fistual and b) immediate and delayed severe sensorineural hearing loss than with any other technique. There was also significantly less deterioration in bone conduction thresholds at 4 kHz after three years postoperatively. The incidence of severe immediate sensorineural loss in large fenestra stapedectomy (half or more of footplate removed) was significantly influenced by factors such as age, preoperative bone conduction thresholds and oval window pathology. A retrospective analysis provided no information which might predict oval window pathology. Additional information gained from the analysis indicated that with all types of stapedectomy, bone conduction did not deteriorate significantly more rapidly in the operated as compared to the unoperated ear, whereas in unoperated ears, deterioration in bone conduction was significantly greater in ears with mixed hearing losses than when the loss was purely sensorineural. It was concluded that small fenestra stapedectomy was currently the operation of choice because with it, the threat of cochlear dysfunction both immediately, and in the long term, was significantly less.

Bone Conduction↗