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T Leary

Publications and source records attributed to T Leary.

8 recordsLinked to original sources
PubMed2003

Impact of an outreach team on re-admissions to a critical care unit.

Re-admissions have been cited as a measure of critical care quality and outreach teams have recently been introduced to improve critical care delivery. The aim of this study was to examine whether the number, causes and sequence of re-admissions to critical care altered as a result of the introduction of an outreach team. Re-admissions between April 2000 and November 2001 were examined. The reasons for re-admission were classified as (i) same pathology or disease process; (ii) new, but related, pathology; (iii) new and unrelated pathology; (iv) exacerbation of other comorbidities. During the two-year period, a total of 2546 patients were admitted to critical care of which 100 were re-admitted (49 before outreach and 51 after outreach). The reasons for re-admission did not vary before or after the introduction of the outreach team (same pathology 15 vs. 15; new, but related, pathology 17 vs. 23; new, but unrelated, 14 vs. 9; exacerbation of comorbidity 3 vs. 4, respectively, Chi-squared = 2.07, df = 3, p = 0.56). There was also no difference between the duration of stay on the general ward in between the critical care unit admissions before (median 2.93 [interquartile range 1.32-6.05] days) or after (median 2.25 [interquartile range 1.06-6.32] days) the introduction of an outreach team. As we could not detect any change in patterns of re-admissions as a result of the introduction of an outreach team, we would suggest that although outreach is an important development for critical care, its performance should be measured by other parameters.

Adult↗
PubMed2002

Assessing critical care unit performance: a global measure using graphical analysis.

Outcome measurement in critical care is difficult because of the wide variety of patients treated and the diverse therapeutic options and pathways available. Individual outcome measures for critical care are available but are naturally limited to only a single aspect of performance. Most importantly, better performance in one aspect of care may compromise the standard of care in another. A global measure of performance would be helpful. For the year 1999-2000, the five hospitals in the East Anglian Critical Care Network provided data on capacity, workload and performance. The data was transformed and displayed graphically on a radar chart so that the area of the polygon within the radar chart was proportional to each unit's overall performance. The results from the five hospitals suggest that there is little overall difference in the units' global performance but the graphical representation highlighted some individual deficiencies. Graphical analysis of complex processes such as critical care delivery may facilitate performance assessment, providing that the measures chosen, weightings assigned and scales used are standardised with care.

Bed Occupancy↗
PubMed2000

Acute injury incidence in professional county club cricket players (1985-1995).

BACKGROUND: There is a dearth of evidenced based research into sports injury in professional cricket. AIM: To investigate the incidence, nature, and site of acute injuries sustained by professional cricketers at one English county club over the period 1985-1995. METHODS: Injuries in a sample of 54 cricketers who had played in the first team for the same county cricket club in any or all seasons between 1985 and 1995 were investigated. Injury was defined as the onset of pain or a disability resulting from either training for or playing cricket, which caused the player to seek medical attention. RESULTS: An acute injury rate of 57.4 injuries per 1000 days of cricket played was found, with most injuries sustained during April, the month in which the least number of days were played. The lower limb was the region most vulnerable to injury, accounting for 44.9% of all injuries, followed by the upper limb (29.4%), the trunk (20.0%), and the head and neck (5.7%). No significant difference in injury incidence among player positions was found. CONCLUSION: There is a need for a system of epidemiological data collection and development of a national cricket injury database to help predict, reduce, and prevent injury at all levels of the game.

Adult↗
PubMed1999

Convulsions and respiratory arrest in association with desmopressin administration for the treatment of a bleeding tonsil in a child with borderline haemophilia.

Desmopressin (DDAVP) may be used to augment the action of factor VIII in mild haemophilia. Its use has been associated with serious adverse effects. We report a case of a three-year-old child with a family history of haemophilia who suffered complications due to severe acute hyponatraemia following the administration of this drug for post-tonsillectomy bleeding.

Adenoidectomy↗
PubMed1996

Interpersonal circumplex.

The social and intellectual climate of the late 1940s and early 1950s in America helped nourish humanistic, person-centered views of human behavior. During that time, psychologists such as Gordon Allport, Abraham Maslow, David McClelland, Harry Murray, and Carl Rogers emphasized the positive growth potential in human character. The psychiatrist Harry Stack Sullivan proposed that personality can best be understood within the context of interpersonal transactions, and he provided a practical, street-smart understanding of psychiatric symptoms that was quite an advance over the traditional medical and psychoanalytic viewpoints. These ideas, along with the concept of dimensionalizing traits rather than categorizing them, inspired my colleagues and I to conduct our cooperative work on the interpersonal circumplex, which culminated in the publication of my monograph. Interpersonal Diagnosis of Personality (Leary, 1957).

Journal Article↗
PubMed1992

Epidermal keratinocyte self-renewal is dependent upon dermal integrity.

The epidermis is a major site of self-renewal in which there is constant replacement by cell division in the basal layers of cells lost by desquamation in the superficial layers. Such a tissue is therefore likely to contain stem cells and in this study we have examined the role of the dermis in the maintenance of epidermal self-renewal. We have developed a mouse model to address the question of whether the maintenance of epidermal self-renewal is dependent, as in the hemopoietic system, upon a heterologous cell type. Intact epidermis separated from dermis at the dermo-epidermal junction or epidermis derived from disaggregated epidermal cells, can reconstitute a stratified squamous epithelium when grafted onto the lumbo-dermal fascia of the mouse or onto an experimentally induced granulation tissue bed. However, we have shown that, after grafting, the clonogenic capacity of the keratinocytes declines sharply and the colonies that are produced are incapable of self-renewal in vitro. Although initially hyperplastic, these epidermal grafts assume an atrophic appearance after 40-70 d and this may be related to the loss of self-renewal observed in vitro. With both experimental murine grafts and clinical grafts the failure of keratinocytes to self-renew can be alleviated, partially, by the presence of the dermis in full-thickness or split-thickness grafts, which implies that the dermis has a functional role in epidermal stem cell maintenance. The relevance of these observations to the clinical experience with cultured autologous keratinocyte sheets as wound dressings to patients is discussed.

Animals↗
PubMedDate not supplied

Justification of pulse oximeter costs for paramedic prehospital providers.

OBJECTIVE: To assess the potential cost savings of decreasing prehospital oxygen utilization by using pulse oximetry to identify those patients who do not require supplemental oxygen. METHODS: A prospective, controlled trial was performed comparing rates of oxygen utilization by paramedics with and without access to pulse oximetry. Consecutive patient encounters over a ten-week period were randomized by day of presentation. Pulse oximeters were made available on alternate days. On those days, patients whose oxygen saturations were less than 95% were treated with supplemental oxygen. RESULTS: The use of pulse oximeters incurred a saving of 0.14 "D"-size oxygen cylinders per call. For the authors' service, this translates to a potential saving of $2,324 (C)/vehicle/year. CONCLUSION: For regions with patient demographics similar to the authors', the initial cost of providing paramedics with pulse oximeters may be offset by savings in oxygen consumption. A formula is provided to allow individual ambulance services to calculate the potential savings for their service.

Adult↗