PubMed Health⌕ Search

Biomedical subjects

D Ruta

Publications and source records attributed to D Ruta.

11 recordsLinked to original sources
PubMed2003

Pilot study: quality of life assessment of postnatal fatigue and other physical morbidity.

Postnatal morbidity is increasingly recognized, but standard assessments may not capture what is most important to the woman with such morbidity in terms of her quality of life. The Mother-Generated Index (MGI) is a proposed postnatal quality-of-life instrument which allows the mother to determine both content and scoring. In this pilot study we found that although a degree of psychological and physical morbidity (including tiredness) is common, and may be very significant, for most women these factors are low-grade, and other aspects of their lives are more important. A quality-of-life approach allows the mother to determine her own postnatal assessment, and encourages practitioners to view her more holistically.

Adolescent↗
PubMed1999

Hemispheric-synchronisation during anaesthesia: a double-blind randomised trial using audiotapes for intra-operative nociception control.

The possible antinociceptive effect of hemispheric-synchronised sounds, classical music and blank tape were investigated in patients undergoing surgery under general anaesthesia. The study was performed on 76 patients, ASA 1 or 2, aged 18-75 years using a double-blind randomised design. Each of the three tapes was allocated to the patients according to a computer-generated random number table. General anaesthesia was standardised and consisted of propofol, nitrous oxide 66%/oxygen 33%, isoflurane and fentanyl. Patients breathed spontaneously through a laryngeal mask and the end-tidal isoflurane concentration was maintained near to its minimum alveolar concentration value of 1.2%. Fentanyl was given intravenously sufficient to keep the intra-operative heart rate and arterial blood pressure within 20% of pre-operative baseline values and the fentanyl requirements were used as a measure of nociception control. Patients to whom hemispheric-synchronised sounds were played under general anaesthesia required significantly less fentanyl compared with patients listening to classical music or blank tape (mean values: 28 microgram, 124 microgram and 126 microg, respectively) (p < 0.001). This difference remained significant when regression analysis was used to control for the effects of age and sex.

Acoustic Stimulation↗
PubMed1999

Audit of antibiotic prophylaxis for surgical patients in three hospital trusts in Tayside. Tayside Area Clinical Audit Commitee.

OBJECTIVE: To compare achievement of previously agreed standards for administration of antibiotic prophylaxis for surgical patients in the three acute trusts in Tayside. SETTING: Angus, Dundee Teaching Hospitals and Perth & Kinross Trusts. MAIN OUTCOME MEASURES: Administration of antibiotic prophylaxis and achievement of three general standards of administration. STUDY DESIGN: Prospective case note audit. RESULTS: In total, 341 operations were audited. The range of operations performed in each trust was different and the achievement of standards was sensitive to case mix. For example, prophylaxis was given to 82% of all eligible orthopaedic patients but only 64% of eligible patients in obstetrics & gynaecology. Comparison between trusts was therefore confined to six procedures (166 operations) which were performed regularly in all three. There were significant differences between trusts in the rate of administration to patients undergoing operations for which prophylaxis was indicated (from 84% [95% CI 75-92] to 93% [CI 89-98]) and in the proportion of patients in whom prophylaxis was continued for less than 24 hours (from 78% [CI 68-89] to 97% [CI 93-100]). Administration of prophylaxis within two hours of surgery was achieved following more than 95% of operations in all three trusts. However, second doses were given to only five of 44 (11%) of patients whose operations lasted more than two hours. CONCLUSIONS: Achievement of standards in all three trusts was good in comparison with recently published audits from other UK and European centres but there was still room for improvement, particularly in administration of second doses for prolonged operations. Regular audit of prophylaxis administration and duration should be implemented. Comparisons between trusts or units should be based on a common set of operations.

Antibiotic Prophylaxis↗
PubMed1997

Measuring health-related quality of life in rheumatoid arthritis: validity, responsiveness and reliability of EuroQol (EQ-5D).

The EuroQol (EQ-5D) generic health index comprises a five-part questionnaire and a visual analogue self-rating scale. The questionnaire may be used as a health index to calculate a 'utility' value or as a health profile. The validity, reliability and responsiveness of EQ-5D were tested in 233 patients with rheumatoid arthritis stratified by functional class. EQ-5D demonstrated moderate to high correlations with measures of impairment and high correlations with disability measures. Stepwise regression models showed that EQ-5D utility values and visual analogue scores were explained best as a function of pain, disability, disease activity and mood (R2 approximately 70%), although other variables (side-effects, years of education) were required to explain the visual analogue scores. The EQ-5D health index and visual analogue scale are more responsive than any of the other measures, except pain and doctor-assessed disease activity. The reliability of the EQ-5D index and EQ-5D visual analogue scale is as good or better than that of all other instruments except the Health Assessment Questionnaire. Some patients with severe long-standing disease had health states which attracted utility values below zero, i.e. from a societal perspective they were regarded as being in states 'worse than death'. The practical and ethical implications of these utility valuations are discussed, and at present the utility values should be used and interpreted with caution. With this caveat, EQ-5D is simple to use, valid, responsive to change and sufficiently reliable for group comparisons. It is of potential use as an outcome measure in clinical trials, audit and health economic studies, but further work is required on its performance in other clinical contexts and on the interpretation of the utility values.

Adult↗
PubMed1997

Seat restraint use, previous driving history, and non-fatal injury: quantifying the risks.

AIMS: To quantify the increased risk of non-fatal injury when children travel unrestrained in a car, and to identify other preventable risk factors. METHODS: Case-control study of 78 children presenting to an accident and emergency (A&E) department having sustained an injury while travelling in a car, and 97 children attending an A&E outpatient clinic with conditions unrelated to road traffic accidents. RESULTS: Seat restraint was associated with a 93% lower risk of child accident injury. A driver with points on the licence was over five times more likely to have had an accident resulting in child injury than a driver without points. Child accident injury was also associated with the driver's accident history. CONCLUSIONS: These data allow the effect of achieving new target levels of seat restraint use to be estimated. Strategies aimed at reducing the risk of further accident among drivers with a history of accident may have a beneficial impact on childhood accident injuries.

Accidents, Traffic↗
PubMed1995

Feasibility of monitoring patient based health outcomes in a routine hospital setting.

OBJECTIVE: To assess the feasibility of monitoring health outcomes in a routine hospital setting and the value of feedback of outcomes data to clinicians by using the SF 36 health survey questionnaire. DESIGN: Administration of the questionnaire at baseline and three months, with analysis and interpretation of health status data after adjustments for sociodemographic variables and in conjunction with clinical data. Exploration of usefulness of outcomes data to clinicians through feedback discussion sessions and by an evaluation questionnaire. SETTING: One gastroenterology outpatient department in Aberdeen Royal Hospitals Trust, Scotland. PATIENTS: All (573) patients attending the department during one month (April 1993). MAIN MEASURES: Ability to obtain patient based outcomes data and requisite clinical information and feed it back to the clinicians in a useful and accessible form. RESULTS: Questionnaires were completed by 542 (95%) patients at baseline and 450 (87%) patients at follow up. Baseline health status data and health outcomes data for the eight different aspects of health were analysed for individual patients, key groups of patients, and the total recruited patient population. Significant differences were shown between patients and the general population and between different groups of patients, and in health status over time. After adjustment for differences in sociodemography and main diagnosis patients with particularly poor scores were identified and discussed. Clinicians judged that this type of assessment could be useful for individual patients if the results were available at the time of consultation or for a well defined group of patients if used as part of a clinical trial. CONCLUSIONS: Monitoring routine outcomes is feasible and instruments to achieve this, such as the SF 36 questionnaire, have potential value in an outpatient setting. IMPLICATIONS: If data on outcomes are to provide a basis for clinical and managerial decision making, information systems will be required to collect, analyse, interpret, and feed it back regularly and in good time.

Adolescent↗
PubMed1993

A prospective study of non-fatal childhood road traffic accidents: what can seat restraint achieve?

A prospective study of children attending an Accident and Emergency Department was carried out at the Royal Aberdeen Children's Hospital, to determine the association between injury risk and seat restraint usage, and to estimate the likely impact of seat restraint usage at various target levels on the incidence of non-fatal injuries. The subjects were all 91 cases of non-fatal childhood road traffic accidents attending the casualty department between December 1989 and November 1990. The main outcome measures were relative risks of three grades of injury severity and four types of non-fatal injury, population attributable risk fractions and estimated likely reduction in incidence of non-fatal injury at three set target levels of seat restraint usage. It was found that 42 (46 per cent) children presenting to the A&E Department were unrestrained; 78 (85.7 per cent) children sustained some injury. The relative risk for children travelling unrestrained in a car for all injuries combined is 1.7 (95 per cent confidence interval (CI) 1.17-2.45), the relative risk for head injury is 3.13 (1.78-5.51) and for face injury 3.03 (1.44-6.37). The risk of sustaining any moderate or worse injury was 3.25 (1.05-10.07). It is estimated that 24.4 per cent (minimum 5.5 per cent; maximum 45 per cent) of all non-fatal injuries sustained by a child car passenger can be prevented if all children are restrained in a child safety seat or seat restraint; 49.5 per cent of head injuries (minimum 43.4 per cent; maximum 71.9 per cent) and 48.4 per cent of face injuries (minimum 21.9 per cent; maximum 75.3 per cent) are preventable.(ABSTRACT TRUNCATED AT 250 WORDS)

Accidents, Traffic↗