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Biomedical subjects

B W Lloyd

Publications and source records attributed to B W Lloyd.

At least 19 recordsLinked to original sources
PubMed2000

Recognition of television images as a developmental milestone in young children: observational study.

OBJECTIVES: To determine the age at which children with apparently normal development can recognise the television image of a cat, dog, or baby. DESIGN: Observational study. SETTING: District general hospital in north London. SUBJECTS: 797 children with apparently normal development aged between 8 and 23 months and 26 children with Down's syndrome aged 18 months. OUTCOME MEASURES: Whether or not the child recognised the television image of a cat, dog, or baby by naming, imitating, or pointing at the image. RESULTS: By 18 months of age 96% (95% confidence interval 94% to 98%) of normal children recognised the television image of a cat, dog, or baby compared with 5 of 26 (19%) children with Down's syndrome. CONCLUSION: Recognition of the television image of a cat, dog, or baby is a simple milestone, which may help in the developmental assessment of young children.

Child Development↗
PubMed1997

Evaluation of joint medical and nursing notes with preprinted prompts.

OBJECTIVE: To determine the views of doctors and nurses about two recent innovations in the structure of case notes: the use of preprinted prompts and the use of joint medical and nursing notes. DESIGN: Questionnaire survey of all doctors and nurses working on the children's wards. SETTING: Children's wards in a district general hospital. MAIN OUTCOME MEASURES: Whether or not respondents wanted to return to traditional notes; positive and negative aspects of the two innovations. RESULTS: There was an 81% response rate. 45 of 48 respondents (94%) did not want to return to traditional notes. Positive features of joint notes that were identified included: promotes team work (21/48 respondents), improves access to information (14/48), and reduces duplication (14/48). Negative features included uncertainty about identity of writer (8/48) and incompletely filled in sheets (7/48). Positive features of preprinted prompts included: less information omitted (29/48), easier to read and find information (28/48), and quicker to write (21/48). Negative features included: not enough space (19/48) and clerking too mechanical (16/48). CONCLUSION: Advantages of both innovations outweighed their disadvantages to the extent that only three out of 48 respondents wanted to return to writing traditional notes.

Adult↗
PubMed1995

Are junior doctors taught to use problem lists?

One hundred junior doctors were asked to complete a questionnaire about the training they had received in the use of problem lists. A questionnaire was sent about the training in the use of problems lists at their medical school to the Deans in all 27 British medical schools. Of the 100 junior doctors, 57 reported that problem lists 'had hardly been mentioned' at their medical school. In contrast only one of the 24 Deans who responded thought that problems lists were 'likely to be hardly mentioned' at his medical school. After graduation only 35 junior doctors had worked for a consultant who had demanded the use of problem lists and only 17 of these had worked for more than one such consultant. Most junior doctors have received little training in the use of problem lists as undergraduates and even fewer as postgraduates. Few consultants demand the use of problem lists.

Academic Medical Centers↗
PubMed1995

Can admission notes be improved by using preprinted assessment sheets?

Inpatient medical notes often fail to record important details of patient history and findings on clinical examination. To overcome problems with content and legibility of notes we introduced preprinted notes for the admission of children to this hospital. The quality of the information recorded for 100 children whose admissions were clerked with the preprinted notes was compared with that recorded for 100 whose admissions were recorded with the traditional notes. All case notes were selected randomly and retrospectively from traditional notes written from April to October 1993 and from preprinted notes written from October 1993 to April 1994. The quality of information was assessed according to the presence or absence of 25 agreed core clinical details and the number of words per clerking. In admissions recorded with the preprinted notes the mean number of core clinical details present was significantly higher than those recorded with traditional notes (24.0 v 17.6, p < 0.00001). Admissions recorded with the preprinted notes were also significantly shorter (mean 144 words v 184 words, p < 0.0001). The authors conclude that information about children admitted to hospital is both more complete and more succinct when recorded using preprinted admission sheets.

Admitting Department, Hospital↗
PubMed1991

Haemorrhagic shock encephalopathy and sudden infant death.

In 2 pairs of non-identical twins, haemorrhagic-shock encephalopathy syndrome developed in 1 co-twin while the other died of sudden infant death syndrome. The twin pairs were aged 3 and 4 months, respectively, and no cause was identified. We suggest that stress protein deficiency may underlie both syndromes.

Acute Disease↗
PubMed1991

Inspiratory time and pulmonary function in mechanically ventilated babies with chronic lung disease.

To learn if increasing inspiratory time would improve pulmonary function in mechanically ventilated babies with chronic lung disease, we measured lung mechanics and alveolar ventilation at three inspiratory times: 0.4, 0.6, and 0.8 s. Nine babies were studied. Their mean birth weight was 875 g (range, 570-1,100 g), gestational age 27 (24-34) weeks, and age 7 (4-12) weeks. Their mean oxygen requirement was 40% (29-53), ventilator rate 33/min (20-40), and mean airway pressure 8 (5-10) cmH2O. Ventilator rate was kept constant; therefore expiratory time decreased and mean airway pressure and I:E ratio increased at longer inspiratory times. At 0.6 s and 0.8 s, when compared to 0.4 s, significant increases occurred in tidal volume (10.4, 10.1, and 8.4 mL/kg, respectively), dynamic lung compliance (0.68, 0.68, and 0.53 mL/cmH2O/kg, respectively), and alveolar ventilation (6.0, 6.3, and 4.7 mL/kg/breath, respectively). Airway resistance, anatomical dead space to tidal volume ratio, and functional residual capacity were similar at the three inspiratory times. Our findings suggest that an inspiratory time greater than or equal to 0.6 s (compared to 0.4 s) increases the effectiveness of mechanical ventilation for babies with chronic lung disease.

Chronic Disease↗
PubMed1988

Controlled study of intelligence and school performance of very low-birthweight children from a defined geographical area.

The authors studied the intellectual outcome of 45 of the 47 schoolchildren who had been born with very low birthweights (less than 1501 g) in Wolverhampton between 1975 and 1978 and were free of major handicap. Their outcome was compared with that of a control group matched for age, sex, race and social class. The very low-birthweight children had lower IQs, were more likely to be performing poorly or below average at school and were more likely to show emotional disturbance. Those who had had a major neonatal illness were most likely to be performing below average at school. These results may be representative of the outcome for very low-birthweight babies born in the United Kingdom during the late 1970s.

Child↗
PubMed1985

Long-term outcome for children with minimal-change nephrotic syndrome.

A retrospective study was undertaken to assess the outcome of a cohort of 183 unselected children who presented with the nephrotic syndrome between 1963 and 1969. All subjects showed minimal glomerular changes in biopsy samples and were given conventional steroid therapy. Information was available on 152 children, now aged 14-32 years. Activity persisted longer in patients presenting at an early age. The outcome for most of the children was favourable. Only 10 patients (5.5%), all of whom presented with initial symptoms before their 6th birthday, continued to have steroid-responsive relapses in adult life. There were 11 deaths, of which 7 (4% of the series) were from avoidable complications of the disorder.

Adolescent↗
PubMed1984

Outcome of very-low-birthweight babies from Wolverhampton.

The outcome of the 159 babies weighing less than 1501 g who were born between 1975 and 1979 to women living in Wolverhampton was studied. 67 of the 68 survivors were assessed between the ages of 3 and 7 years and compared with a control group of 38 normal-birthweight siblings. Of those weighing less than 1501 g 91 (57%) died in infancy, 10 (6%) survived with major or moderate handicap, 15 (9%) had minor handicap, 42 (26%) were normal at follow-up, and 1 was untraced. 49% of the 51 school-age survivors were handicapped or were performing poorly at school, compared with 13% of 31 controls.

Child↗