Biomedical subjects

C T Naugler

Publications and source records attributed to C T Naugler.

4 recordsLinked to original sources

PubMed2000

Development and validation of an improving prescribing in the elderly tool.

OBJECTIVE: To apply recently published consensus panel guidelines to a series of hospital inpatient charts to develop and validate a brief screening tool for potentially inappropriate prescriptions in the elderly. SETTING: A 400-bed acute care hospital in London, Ontario. METHODS: Three hundred and sixty-one consecutive inpatient charts, 185 from a clinical teaching unit (CTU) and 176 from a geriatric assessment unit (GAU) were examined for potentially inappropriate prescriptions as listed by McLeod et al. The potentially inappropriate prescribing practices detected were used to develop the Improving Prescribing in the Elderly Tool (IPET). Construct validity was examined by looking for a predicted difference in the rate of potentially inappropriate prescriptions between the CTU and the GAU. Interrater reliability was determined by applying the IPET to a new series of 100 charts. RESULTS: Forty-two of 361 individuals (12.5%) had 45 potentially inappropriate prescriptions representing 14 different potential drug/disease interactions; these were used to construct the IPET. A demonstrated difference in the rate of potentially inappropriate prescriptions between the CTU and GAU indicated construct validity. The interrater reliability of the IPET (kappa) when applied to a new series of 100 charts was 1.0. INTERPRETATION: The IPET is a brief, reliable and valid tool based on the published literature that may be used to screen for potentially inappropriate prescriptions in the elderly.

Aged↗

PubMed1997

Chlamydia trachomatis genital infection.

OBJECTIVE: To determine family physicians' approaches to detecting, managing, and preventing genital Chlamydia trachomatis infection and their perceptions of barriers to prevention. To determine whether sex of physician is associated with differences in clinical approach to chlamydia, with levels of effort aimed at its prevention, and with perceived barriers to preventive efforts. DESIGN: Questionnaires were sent to a random sample of family physicians. SETTING: All health regions in Nova Scotia. PARTICIPANTS: Two hundred fifty-seven Nova Scotia family physicians. MAIN OUTCOME MEASURES: Responses to survey questions analyzed for association of practice behaviours with sex of physician. RESULTS: Response rate was 60%. Most physicians performed diagnostic tests for chlamydia on all patients. Responses indicated that 17% would test for C trachomatis during an annual Papanicolaou test in a low-risk 30-year-old, 61% would test a high-risk 21-year-old man, and 89% would test a pregnant 17-year-old. Therapies physicians might use were judged appropriate in 96% of responses. Only 51% indicated they would ever discuss false-positive test results with patients. Men physicians were less likely than women to ask 75% or more of their adolescent patients about sexual activity or to educate them about prevention of sexually transmitted diseases. Women physicians saw time and the fee schedule as less serious barriers to prevention than men did. CONCLUSIONS: Some physicians are not managing C trachomatis well. We should explore situations where gaps in performance are associated with sex of physician.

Adolescent↗

PubMed1996

A case-control study of fluctuating dermatoglyphic asymmetry as a risk marker for developmental delay.

In traits which are normally bilaterally symmetrical, asymmetries may arise as a result of genomic or environmental stress. Such asymmetries are called fluctuating asymmetry. Symmetry is known to be decreased in a variety of disorders of developmental origin, and thus could potentially serve as a risk marker for disorders with a developmental component. We examined this idea by conducting a case-control study of 49 developmentally delayed children and 51 controls. Using two dermatoglyphic characters as a measure of symmetry (finger print concordance and A-B triradial ridge count difference), we found odds ratios of 2.32 (95% CI 0.65-3.17) and 2.11 (95% CI 0.57-3.27); depending on which character was measured. These results suggest that fluctuating asymmetry may have potential as a risk marker for developmental disorders, and that this area of research warrants further research.

Case-Control Studies↗

PubMed1996

Fluctuating asymmetry and disorders of developmental origin.

Environmental and/or genetic stresses may cause a breakdown in developmental homeostasis, resulting in increased bilateral asymmetry of morphological traits. The degree of these deviations (termed "fluctuating asymmetry") is thought to correlate with the severity of the stress. If these stresses also play a role in the appearance of developmental disorders, then increased morphological asymmetry may serve as a risk marker for disorders of developmental origin. This would be possible if 1) the environmental stress that caused a breakdown in developmental stability also contributed to the appearance of the disorder, and/or 2) the genetic predisposition (liability) to the disorder and increased susceptibility to fluctuating asymmetry have a common cause. Although a number of authors have reported associations between increased fluctuating asymmetry and disorders of presumed developmental origin, the usefulness of fluctuating asymmetry as a risk marker has not been established. One obstacle to this assessment is the lack of odds ratios reported by previous authors.

Child↗