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Biomedical subjects

A Brett

Publications and source records attributed to A Brett.

9 recordsLinked to original sources
PubMed1992

Outcome and management of crisis pregnancy counselling.

Between October 1989 and April 1991, 215 women were seen in the pregnancy centre. Of these women, 139 were in crisis pregnancy situations. Of the remaining 76 women, 42 attended for pregnancy education, 10 for counselling regarding adoption options, eight for postabortion counselling, and 10 for other reasons. All 139 women in crisis pregnancy situations received counselling and assistance with the resolution of the specific life crises that the pregnancy precipitated and were informed about the physical and emotional effects of pregnancy, normal fetal development, and the options that were available to them. These 139 women were divided into three groups at the start of their initial interview, according to whether they planned to continue with the pregnancy (18), seek termination of pregnancy (72), or were ambivalent (49). The outcome for each of these groups has been evaluated separately. Overall 65 (47%) of the women changed an initial decision or reached their final decision regarding the future of their pregnancy during the time of counselling, and 64 (46%) ultimately continued with their pregnancies. These outcomes support the need for a specific approach to crisis pregnancy situations such as that provided at the pregnancy centre and provide support for considering the crisis pregnancy an obstetric emergency.

Abortion, Induced↗
PubMed1991

Teaching physical diagnosis in the nursing home: a prospective, controlled trial.

STUDY OBJECTIVE: To investigate the suitability of the nursing home as a site for teaching physical diagnosis to second-year medical students. DESIGN: Prospective comparison of teaching sessions in the nursing home to concurrent control sessions in acute care wards. SETTING: Nursing Home Care Unit (NHCU) and acute care hospital wards of a Veterans Affairs Medical Center. PATIENTS: Sessions with 38 NHCU patients and 68 hospital patients. MEASUREMENTS AND MAIN RESULTS: Patient interviews and student questionnaires were used to obtain responses on a 1-10 scale (1 = poor, 10 = excellent). Patient responses were very favorable in both settings for overall quality of experience (mean score NHCU vs control: 8.8 vs 8.6) and willingness to participate again (8.4 vs 8.2). Student ratings showed no significant differences for patient attitude (7.4 vs 8.4) or quality of exam (7.2 vs 7.7) while quality of history (6.0 vs 7.6) and overall quality of session (7.6 vs 8.6) were rated higher (P less than 0.05) for the control sessions. Students rated both environments highly (8.6 vs 8.4) but reported that fewer NHCU sessions were interrupted (15% vs 25%) or disrupted by noise (6% vs 30%, P less than 0.005). CONCLUSIONS: Advantages of the nursing home include readily available patients who view participation favorably, instructive physical findings, and a suitable environment. However, students rate the quality of the histories obtained there lower. This problem could be addressed by more careful patient selection and greater emphasis by course instructors on other goals of the history in addition to exploring the chief complaint.

Aged↗
PubMed1986

Tuberculosis at Green Lane Hospital 1980-1982.

An audit of tuberculosis management at Green Lane Hospital was undertaken by review of the case records of 235 cases of adult tuberculosis. There were 135 men and 100 women (mean age 47 years). Important findings include the large proportion of nonEuropeans (66%) and the frequency of drug resistance. Drug resistance was present in 29% of isolates from nonEuropean immigrants who had resided in New Zealand for a year or less. The adequacy of current medical screening of Pacific Island and South-east Asian visitors and immigrants is discussed in the context of these findings. Treatment regimens used were in accordance with accepted recommendations, although the duration (14 months in uncomplicated disease) was longer than is now thought necessary. Of the 205 patients who completed treatment under our care 186 (91%) were cured, 14 (6.8%) died, 3 (1.5%) relapsed and two defaulted. The median in hospital stay was 32 days and together with the somewhat high relapse rate (1.5%) reflects the absence of facilities for closely supervised outpatient tuberculosis treatment in Auckland.

Adolescent↗
PubMed1986

Dietary management of intestinal lymphangiectasia complicated by short gut syndrome.

The dietary management of a child with intestinal lymphangiectasia complicated by short gut syndrome following surgery at the age of 3 weeks is described. Diets containing amino acids and peptides were not tolerated due to high osmolality. Satisfactory nutrition was achieved by using a feed with low osmolality and containing whole whey protein, maltodextrin, medium-chain triglycerides (MCT) and a small amount of long-chain triglycerides (LCT) to supply essential fatty acids (RD231).

Female↗
PubMed1986

Nutritional knowledge of medical staff and students: is present education adequate?

Knowledge of nutritional principles and attitudes to nutrition education of a group of clinical medical students and junior hospital doctors were examined by questionnaire. The percentage of correct answers to factual questions was 50.8 for students and 58.5 for doctors. Both groups considered that their teaching was inadequate and over 95 per cent requested education in applied nutrition. Undergraduate instruction by both doctors and dietitians was advocated as appropriate to the final clinical years.

Attitude↗
PubMed1973

Amenorrhoea after discontinuing combined oestrogen-progestogen oral contraceptives.

Out of 210 women seen at the Middlesex Hospital with secondary amenorrhoea the 63 who developed it after stopping oral contraceptives were fully investigated. Five had organic disease sufficient to account for the amenorrhoea (one had severe diabetes, one a pituitary tumour, and three premature ovarian failure); two patients had galactorrhoea (one of whom also had the pituitary tumour); two had anorexia nervosa.Of the 63 women 40 (63%) had suffered from amenorrhoea or prolonged or irregular menstrual cycles before taking the pill, and this suggested that combined oestrogen-progestogen oral contraceptives should be used with caution for women with irregular menstruation.Nineteen patients wished to become pregnant and 12 have so far done so after treatment with clomiphene or gonadotrophins.In another study 204 women recorded when their first menstrual cycle occurred after stopping the pill. Seventy-four had a cycle longer than five weeks but only five exceeded three months, and only one of the five had more than six months' amenorrhoea. These results confirm that the incidence of amenorrhoea after stopping oral contraceptives is low.

Adult↗