Biomedical subjects

D J Owens

Publications and source records attributed to D J Owens.

5 recordsLinked to original sources

PubMed2000

Vascular endothelial growth factor and basic fibroblast growth factor in children with cyanotic congenital heart disease.

OBJECTIVE: Vascular endothelial growth factor and basic fibroblast growth factor are potent stimulators of angiogenesis. Children with cyanotic congenital heart disease often experience the development of widespread formation of collateral blood vessels, which may represent a form of abnormal angiogenesis. We undertook the present study to determine whether children with cyanotic congenital heart disease have elevated serum levels of vascular endothelial growth factor and basic fibroblast growth factor. METHODS: Serum was obtained from 22 children with cyanotic congenital heart disease and 19 children with acyanotic heart disease during cardiac catheterization. Samples were taken from the superior vena cava, inferior vena cava, and a systemic artery. Vascular endothelial growth factor and basic fibroblast growth factor levels were measured in the serum from each of these sites by enzyme-linked immunosorbent assay. RESULTS: Vascular endothelial growth factor was significantly elevated in the superior vena cava (P =.04) and systemic artery (P =.02) but not in the inferior vena cava (P =.2) of children with cyanotic congenital heart disease compared to children with acyanotic heart disease. The mean vascular endothelial growth factor level, determined by averaging the means of all 3 sites, was also significantly elevated (P =.03). Basic fibroblast growth factor was only significantly elevated in the systemic artery (P =.02). CONCLUSION: Children with cyanotic congenital heart disease have elevated systemic levels of vascular endothelial growth factor. These findings suggest that the widespread formation of collateral vessels in these children may be mediated by vascular endothelial growth factor.

Child↗

PubMed1996

Patient satisfaction and the elderly.

There is considerable current interest in patient satisfaction surveys; among other things they are often used to measure quality in health care. However, there are many unresolved issues concerning them, including how they might best be conducted. Some have challenged their raison d'-etre, arguing that they rely on unproven assumptions -1; Williams, Soc. Sci. Med. 38, 509, 1994]. In this paper we examine some of these assumptions in the light of a recent study of elderly patients' experience of the District Nursing Service. In doing so we argue that users' capacity, or willingness, to evaluate health care services cannot be taken for granted; that patients may have few if any expectations on which to base an evaluation of the care they receive; that the sense of dependency that patients have on service providers can impact on expressions of satisfaction and that, outside the acute sector in particular, we need to take into account the varied nature of the relationships that emerge between patient and service providers. We also argue that elderly patients cannot be treated as consumers unproblematically. While they may be seen as an extreme example, we argue, nevertheless, that many of the issues raised are relevant to much wider populations. This has general implications for research and we suggest that appropriately chosen qualitative methods can provide a useful starting point in studies which aim to establish how, to what extent and whether patients evaluate health services.

Aged↗

PubMed1994

Patient satisfaction studies: methodology, management and consumer evaluation.

Discusses how consumer evaluation studies of health-care services might be undertaken to provide valid assessments of consumer opinions and priorities, amenable to subsequent, effective management action. To do so, provides an account of the history of patient satisfaction surveys, presents a detailed examination of key examples, and discusses the well-documented strengths and weaknesses of this approach. Draws attention to recent critiques of survey methods and growing interest in qualitative research focusing on the rationale that the latter provides more useful data for managers. Argues that the search for a "best" consumer evaluation method is misplaced since appropriate methods should be determined by research objectives which themselves may vary. Points to existing analyses of relevant research which offer sound methodological guidelines and concludes by offering explicit suggestions for the future conduct of consumer evaluation research.

Health Services Research↗

PubMed1994

The meaning of parenthood and couples' reactions to male infertility.

This paper reports findings from a postal survey of 205 couples belonging to the National Association for the Childless who saw their infertility as due to the male partner. Two self-report scales used in previous studies were administered to measure personal and social identity needs as a basis for parenthood (the Meaning of Parenthood scale), and emotional distress and marital problems. Endorsement of items on the Meaning of Parenthood (MOP) scale showed only small mean gender differences for each item and a consistent item rank order for men and women. Factor analysis confirmed that the scale tapped dimensions pertaining to social and personal identity needs. For women, distress was associated with ratings on the MOP scale which emphasized the link between femininity and motherhood, while for men distress was associated with ratings which emphasized masculinity and fatherhood. Implications of the results for further research and counselling in relation to male infertility are discussed.

Adaptation, Psychological↗

PubMed1993

Male infertility and donor insemination: couples' decisions, reactions and counselling needs.

This paper reports findings of a postal survey of 205 couples belonging to the National Association for the Childless, whose infertility had been attributed to the male partner. Spontaneous resolution was seldom reported, but 36 couples had become parents by donor insemination (DI) and 28 through adoption. Almost a third of respondents had managed to resolve their childlessness. Although reasons for rejecting DI or preferring other options were offered by 60 couples, 125 had taken active steps towards it. Most of the 80 couples who had been counselled had found this helpful. Regardless of counselling, of the 76 couples who had considered whether or not to tell their children of their mode of conception, 56 (74%) stated that they had no intention of doing so. Quantitative indices from two self-report scales confirm that male infertility is commonly a source of distress, especially for the female partner. However, the data also suggest that this is not necessarily associated with chronic marital discord. Couples who had already decided for or against DI reported less distress than others. The need for mutual support may well be enhanced until the couple's quest for a child has been either achieved or abandoned.

Counseling↗