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Biomedical subjects

A Crockett

Publications and source records attributed to A Crockett.

13 recordsLinked to original sources
PubMed2000

Distinguishing chronic obstructive pulmonary disease from asthma.

Asthma and chronic obstructive pulmonary disease (COPD) are the most common chronic respiratory diseases in the UK. Good management of both diseases results in better symptom control and improved quality of life for the patient, but will rely on all members of the primary healthcare team sharing the aims of management as well as helping to implement those goals. The two diseases share many clinical features and similar drugs can be used to treat them both. However there are important clinical differences which help to distinguish them from each other. The management of the two diseases differs in drug regimens and in the long-term aims of management. This article clarifies the important features that distinguish asthma from COPD and which allow patients to receive the best specific management.

Adult↗
PubMed1999

Program budgeting and marginal analysis: a case study in chronic airflow limitation.

Program budgeting and marginal analysis is a method of priority-setting in health care. This article describes how this method was applied to the management of a disease-specific group, chronic airflow limitation. A sub-program flow chart clarified the major cost drivers. After assessment of the technical efficiency of the sub-programs and careful and detailed analysis, incremental and decremental wish lists of activities were established. Program budgeting and marginal analysis provides a framework for rational resource allocation. The nurturing of a vigorous program management group, with members representing all participants in the process (including patients/consumers), is the key to a successful outcome.

Budgets↗
PubMed1996

Can resource use be extracted from randomized controlled trials to calculate costs? A review of smoking cessation interventions in general practice.

The ability to extract information on resource use from randomized controlled trials can provide the groundwork for systematically compiling health economic reviews of health interventions. A review of the brief smoking interventions in general practice demonstrates that not all the necessary information can be extrapolated from these trials, and cost data will have to be supplemented from other sources.

Cost-Benefit Analysis↗
PubMed1996

Health economic reviews. Are they compiled systematically?

Attempts to perform economic reviews of randomized controlled trials frequently lack a systematic approach. This conclusion is consistent with the findings of previous analyses of review articles in other fields, which have highlighted the failure to apply the same degree of rigor to this type of research synthesis that the scientific community has come to expect from primary research articles.

Bibliometrics↗
PubMed1992

The continuing impact of home oxygen therapy for respiratory patients on a hospital budget.

Home oxygen therapy for chronic lung disease is a prominent example of an increasing tendency for the provision of adaptive medical technologies by tertiary-level hospital outreach. Flinders Medical Centre has carefully monitored its home oxygen service using cost-centre management. Despite strict prescription criteria and cost-saving technological advance, this budget remains under continued pressure. Demand from eligible patients is increasing, and their enhanced survival means that numbers accumulate over the years. Unfortunately, long-term community support does not fit easily into conventional hospital budgetting. Hospitals at present do not explicitly record the benefits nor bring to account the cost savings from maintaining patients in the community. Several intermediate improvements are suggested.

Bed Occupancy↗
PubMed1992

Patient compliance with colorectal cancer screening in general practice.

A randomized controlled trial to test patient compliance with screening for colorectal cancer in association with general practice health checks was carried out in six practices (three urban and three rural). A total of 1588 patients aged 45-64 years were randomized to one of four intervention groups. In the first group patients were posted a Haemoccult test (Kline Beckman) kit. This group was not invited for a health check. In the second group patients were posted the Haemoccult test kit, together with an invitation to attend for a health check. In the third group patients were posted an invitation for a health check, which explained that the patient would be offered the Haemoccult test kit by the nurse at the health check. In the fourth group patients were just invited for a health check. It was found that combining faecal occult blood testing with the health check did not reduce attendance at the health check--43.5% of patients attended when the Haemoccult test kit was offered by the nurse at the health check, 43.6% attended when a test kit was included with the invitation to attend the health check and 42.9% attended when the health check invitation was posted on its own. Overall, compliance with Haemoccult testing was not significantly increased by associating it with a health check (26.2% versus 25.5%) but compliance was higher when the faecal occult blood testing kit was enclosed with the health check invitation than when it was offered at the health check (31.7% versus 20.6%, P less than 0.001). It is easier and cheaper to combine various screening procedures. Although the overall use of the Haemoccult test in the study population was low, there is no reason why the relatively higher compliance rate obtained on posting the test kit with a health check invitation cannot be achieved in previously unscreened populations with higher expected compliance rates. However, faecal occult blood screening for colorectal cancer should not be undertaken on a population basis until its effectiveness in reducing mortality has been proven by randomized trial.

Colonic Neoplasms↗
PubMed1989

Spirometric standards for healthy male lifetime nonsmokers.

The FVC, FEV1.0, FEF25-75%, and FEV1.0/FVC (%) were measured in 162 males aged 18.9-78.6 yr using a Stead-Wells spirometer. Multiple regression equations were generated to predict these lung parameters from the best weighted combination (p less than or equal to 0.05) of age, standing height, sitting height, biacromial breadth, and chest expansion (FVC: R = 0.843, SEE = 513 ml BTPS; FEV1.0: R = 0.850, SEE = 436 ml BTPS; FEF25-75%: R = 0.665, SEE = 997 ml/s BTPS; FEV1.0/FVC: R = 0.537, SEE = 4.95%). The lower limit of normality was defined as the predicted value minus the 95% confidence interval (one-tailed test). Cross-validation of other FVC, FEV1.0, and FEF25-75% equations in the literature indicate that all the FVC and FEV1.0 ones are unsuitable for the sample and instrumentation used in this investigation.

Adult↗
PubMed1988

Lung volume standards for healthy male lifetime nonsmokers.

Functional residual capacity (FRC), residual volume (RV), vital capacity (VC), and total lung capacity (TLC) were measured in 162 men aged 18.9 to 78.6 years using a multiple breath helium dilution technique. Multiple regression equations were generated to predict these lung parameters from the best weighted combination (p less than or equal to 0.05) of age, mass, standing height, body surface area, sitting height, biacromial breadth, end-tidal chest girth, expanded chest girth, and chest expansion (FRC: R = .748, SEE = 504 ml; RV: R = .725, SEE = 301 ml; VC: R = .808, SEE = 537 ml; TLC: R = .808, SEE = 551 ml; RV/TLC: R = .778, SEE = 4.15 percent). The range of normality was defined as the predicted value +/- the 95 percent confidence interval (two-tailed test). Cross-validation of other FRC, RV, VC, and TLC equations in the literature indicated that they were unsuitable for use with our data.

Adolescent↗
PubMed1987

Relative body fat and anthropometric prediction of body density of female athletes.

Ninety-one percent (n = 182) of the female members of South Australian representative squads in 14 sports volunteered to act as subjects. Twenty-seven percent of them had represented Australia. The underwater weighing method together with the measurement of residual volume (RV) by helium dilution were used to determine body density (BD); the percent body fat (% BF) was then computed according to Siri. A stepwise multiple regression analysis yielded a correlation coefficient (R) of 0.863 between the criterion (BD) and the best weighted sum of predictors (anthropometric variables): BD (g X cm-3) = 1.14075-0.04959 (log10 sigma triceps, subscapular, supraspinale and calf skinfolds in mm) + 0.00044 (age in decimal years)-0.000612 (waist girth in cm) + 0.000284 (height in cm)-0.000505 (gluteal girth in cm) + 0.000331 (breast girth in cm). Only those predictors which resulted in a statistically significant increase in R (p less than or equal to 0.05) were included. The standard error of estimate of 0.00597 g X cm-3 was equivalent to 2.7% BF at the mean. This equation was shown to be largely population specific. There was a range of 7.6-35.8% of BF and the overall mean 18.5% was significantly lower (p less than 0.001) than that of 23.4% obtained on a moderately active reference sample of similar age (n = 135). If group sizes of only one or two are regarded as too small for meaningful comparison, then the lowest mean of 13.5% was achieved by the long-distance runners (n = 14). The highest averages were registered by the heavyweight rowers (24.2%; n = 7) and soccer players (22.0%; n = 11). The overall average for games players (n = 107) was 19.4%.

Adipose Tissue↗
PubMed1972

Veno-arterial difference in alpha 1 -antitrypsin levels.

alpha(1)-Antitrypsin levels, determined by radial immunodiffusion, were found to be higher in the venous than in the arterial blood of patients with pulmonary infections and in patients with obstructive airflow diseases. Large differences occurred in patients with both abnormalities. No difference was found in patients with other kinds of lung disease or in patients without lung disease. The veno-arterial difference probably occurs as blood passes through the lungs and probably results from alteration of the immunological properties of the alpha(1)-antitrypsin, perhaps by attachment to proteases, rather than absorption into the lung tissue. Further studies are needed to define the diseases in which this antienzyme plays an active part and to determine the mechanisms causing the difference.

Adult↗