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Biomedical subjects

B Stafford

Publications and source records attributed to B Stafford.

12 recordsLinked to original sources
PubMed2001

Inpatient palliative medicine is evidence based.

Specialist palliative care services have previously been studied to see whether their intervention is of benefit. However, there is a lack of data on whether interventions in individual palliative care units are evidence based. This study looked at 32 problems and 114 interventions over 1 month in January 2000 in an inpatient palliative care unit. These interventions were then researched to see if there had been trials showing their benefit. The results were then classified: 81% were evidence based (randomized controlled trials 48%, evidence from other trials 27%, convincing non-experimental evidence 6%). This compares favourably with studies performed in other areas of medicine.

Evidence-Based Medicine↗
PubMed2000

Hip protectors improve falls self-efficacy.

OBJECTIVES: To investigate the effect of use of external hip protectors on subjects' fear of falling and falls self-efficacy (belief in their own ability to avoid falling). DESIGN: Randomized controlled trial. SETTING: Aged-care health services in Sydney, Australia. PARTICIPANTS: 131 women aged 75 years or older, who had two or more falls or one fall requiring hospital admission in the previous year and who live at home. Sixty-one subjects were in the intervention group and 70 in the control group. INTERVENTION: Use of external hip protectors and encouragement to use the protectors by an adherence nurse. MEASUREMENTS: At the time of enrolment into a wider study examining the effect of hip protectors on hip fractures, participants recruited at home completed an assessment of fear of falling and falls efficacy as measured by the Falls Efficacy Scale and the Modified Falls Efficacy Scale. At 4-month follow-up, these scales were readministered by an observer who was not aware of the allocation of the participant to intervention or control groups. RESULTS: Fear of falling and falls self-efficacy, as measured by the Falls Efficacy and Modified Falls Efficacy Scales, were similar at baseline in both groups. Fear of falling was present at follow-up in 43% of subjects using hip protectors and 57% of the control group (chi2 = 2.58, P = 0.11). Hip protector users had greater improvement in falls self-efficacy at follow-up as measured by the Falls Efficacy Scale (t = 2.44, P = 0.016) and the Modified Falls Efficacy Scale (t = 2.08, P = 0.039). CONCLUSION: Hip protectors improve falls self-efficacy. As users of hip protectors feel more confident that they can complete tasks safely, they may become more physically active and require less assistance with activities of daily living.

Accidental Falls↗
PubMed1993

A phase II evaluation of tamoxifen in unresectable or refractory meningiomas: a Southwest Oncology Group study.

Twenty-one patients with nonresectable refractory meningiomas were registered on a study giving tamoxifen 40 mg per M2 b.i.d. for four days, then 10 mg b.i.d. thereafter. Nineteen were eligible and evaluated for response. One patient (5%) achieved an MRI-documented partial response while two had a minor response measured on CT scan which was of short duration (4 and 20 months). Six patients (32%) remained stable for a median duration of 31 + months while ten (53%) demonstrated progression. Twenty-two percent (22%) reported subjective improvement though this did not correlate with objective improvement in all cases. At present, a definite recommendation for the use of tamoxifen in refractory meningiomas cannot be made. Further evaluation of hormonal therapy of meningiomas with a consensus for definition of endpoints for evaluation of response in view of the difficulty of evaluating radiologic findings with clinical outcome, is needed.

Female↗
PubMed1992

The building blocks of a quality day treatment program: the business plan.

This article undertakes two interrelated tasks in order to illustrate the business plan as a dynamic part of the day treatment planning process. To ensure an understanding of basic concepts, it walks the day treatment program planner through the elements of a generic business plan. Building upon this foundation, the paper provides the day treatment program planner with detailed information regarding the various uses to which the material gathered for the business plan may be employed.

Day Care, Medical↗
PubMed1991

The building blocks of a quality day treatment program: the needs assessment.

This paper is the first in a series of papers which discuss the many necessary ingredients that combine to produce a quality day treatment program. The theme of this article is the assessment of market needs. Included are (1) an introduction to the concepts of needs, (2) a discussion of the movement from need to change in society, (3) an examination of the process of quantifying needs, and (4) a brief description of several different types of needs assessments. The conclusion provides a description of each salient point and indicates its use in day treatment program development.

Data Collection↗
PubMed1980

Determination of organic acids in biological fluids by ion chromatography: plasma lactate and pyruvate and urinary vanillylmandelic acid.

We describe the general aspects of ion chromatography and how on-line counted ion-exchange techniques can be utilized to determine pyruvic and lactic acids in plasma and vanillymandelic acid in urine. Pyruvate and lactate are extracted from deproteinized plasma by use of an ion-exclusion resin. After elution from the resin, the plasma extract is chromatographed on an anion-exchange column, with 0.66 mmol/L sodium bicarbonate as the mobile phase. The effluent is detected with an electrical conductivity cell. Vanillylmandelic acid is extracted from diluted urine by use of an anion-exchange resin. After elution from resin, the urine extract is chromatographed on an ion-exclusion column, followed by electrochemical detection. We evaluated the procedures for precision, linearity, analytical recovery, intefering substances, and correlation with an established procedure. the combination of a preliminary resin extraction, an ion chromatographic separation, and a conductivity or electrochemical detector results in rapid, specific methods that can be adapted for use in the clinical laboratory. Preliminary data for other organic acids are presented.

Carboxylic Acids↗
PubMed1979

Morphine persistence in rat brain and serum after single doses.

The disposition of morphine in rat brain and serum was determined over 48 hr after subcutaneous doses. Free morphine was measured by a specific assay using 3H-labeling together with high-pressure liquid chromatography separation, with a sensitivity of 1 nM (0.3 ng of morphine per ml). This study revealed the persistence of free morphine in nanomolar concentrations over at least 24 hr after a single analgesic dose. The terminal half-life of morphine elimination was 5 hours. Total radioactivity was retained in the body at much higher concentrations. Similar disposition of [C-1-3H]morphine and [N-14CH3] morphine ruled out any major metabolic alterations at these positions, including N-demethylation. Irreversible binding to insoluble tissue components, which has previously been linked to tolerance, was observed only to the extent of less than 20% of total tissue radioactivity and was not unique to brain tissue. The persistence of morphine and its metabolites may be related to protracted opiate effects such as withdrawal symptoms after addiction.

Animals↗
PubMedDate not supplied

Pregnant teens: differential pregnancy resolution and treatment implications.

Profiles on three groups of pregnant teens in a comprehensive social service agency were identified: those who followed through with a parenting plan, those who followed through with an adoption plan, and those who switched from an adoption plan to a parenting plan. Pregnant teens who switched plans were identified as high risk in terms of health histories and psychosocial profiles. Since they represent as much as one-third of the total population, service plans must be made for them that focus on these risk areas. This article addresses the identification of new subgroups in the universe of pregnant teenagers, and treatment implications.

Adolescent↗