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Biomedical subjects

David Browning

Publications and source records attributed to David Browning.

6 recordsLinked to original sources
PubMed2005

Mapping care pathways for the elderly.

PURPOSE: Aims to describe a project carried out within Hampshire Social Services investigating potential care pathways for older people after discharge from hospital and to show the potential of the simulation methodology in such situations. DESIGN/METHODOLOGY/APPROACH: A discrete-event simulation was used to determine the system capacities and to estimate the likely associated reimbursement costs. FINDINGS: A prototype simulation model was developed showing the potential value of this approach. RESEARCH LIMITATIONS/IMPLICATIONS: Restrictions in data access shifted the focus from quantitative service mapping to a more descriptive approach. PRACTICAL IMPLICATIONS: Currently, many older patients experience delayed discharge from acute beds because of capacity limitations in Social Services' traditional post-acute care services. At the same time, new regulations require Local Authorities to reimburse NHS Acute Trusts if hospital discharge is delayed solely due to inadequate provision of social care assessments and services. In order to overcome the so-called "bed-blocking" problem, a new range of services termed "Intermediate Care" has been introduced to offer alternative options for older patients. These services are examined in terms of capacity and appropriateness. ORIGINALITY/VALUE: This paper fulfils an identified need to record and evaluate the new post-acute packages introduced by the Social Services and NHS and proposes simulation as one of the most suitable methodologies for such objectives.

Aftercare↗
PubMed2002

Pilot study to assess the presence of Chlamydia trachomatis in urine from 18-30-year-old males using EIA/IF and PCR.

CONTEXT: To increase detection, urine samples from young males could be opportunistically tested for Chlamydia trachomatis. OBJECTIVE: To determine C. trachomatis prevalence in urine, optimum specimen and compare sensitivity/feasibility of routine use of different testing methods. DESIGN: Group A, 'sterile' pyuria samples June 1998-January 1999, tested by enzyme immunoassay (EIA) and, if reactive, by immunofluorescence (IF). Subsequently batch-tested by polymerase chain reaction (PCR). Group B, consecutive urine samples October 1998-January 1999; batch-tested by PCR. SETTING: Microbiology laboratory. SAMPLES: From males aged 18-30 years; group A = 71, group B = 83. MAIN OUTCOME MEASURES: Chlamydia trachomatis positive if EIA- and IF- or PCR-positive. RESULTS: Group A: 12 EIA/IF-positive; 9/12 and 15 EIA-negative samples PCR-positive. Group B: 11 PCR-positive; 8/11 showed 'sterile' pyuria. CONCLUSIONS: Opportunistic testing of urine from young men shows a significant number of C. trachomatis infections. 'Sterile' pyuria samples are optimal. EIA/IF are less sensitive than PCR but can be routinely performed and detect a significant proportion of cases.

Adolescent↗
PubMed2002

To show our humanness--relational and communicative competence in pediatric palliative care.

The death of a child is perhaps the worst tragedy a family ever has to endure. The communication that occurs among children, parents, and healthcare professionals at the end of a child's life must be grounded in caring, and compassionate relationships. These relationships require particular skills, knowledge and attitudes that are not fully addressed in many approaches to communication training currently available to practitioners. This essay proposes elements of a pedagogy for relational and communicative competence in pediatric palliative care that is rooted in ethical and ethnographic principles.

Adolescent↗