Biomedical subjects

Deborah McLeod

Publications and source records attributed to Deborah McLeod.

22 records · Page 2Linked to original sources

PubMed2002

The Ottawa ankle rules for the use of diagnostic X-ray in after hours medical centres in New Zealand.

AIMS: The aims of this study were to measure baseline use of Ottawa ankle rules (OAR), validate the OAR and, if appropriate, explore the impact of implementing the Rules on X-ray rates in a primary care, after hours medical centre setting. METHODS: General practitioners (GPs) were surveyed to find their awareness of ankle injury guidelines. Data concerning diagnosis and X-ray utilisation were collected prospectively for patients presenting with ankle injuries to two after hours medical centres. The OAR were applied retrospectively, and the sensitivity and specificity of the OAR were compared with GPs clinical judgement in ordering X-rays. The outcome measures were X-ray utilisation and diagnosis of fracture. RESULTS: Awareness of the OAR was low. The sensitivity of the OAR for diagnosis of fractures was 100% (95% CI: 75.3 - 100) and the specificity was 47% (95% CI: 40.5 - 54.5). The sensitivity of GPs clinical judgement was 100% (95% CI: 75.3 - 100) and the specificity was 37% (95% CI: 30.2 - 44.2). Implementing the OAR would reduce X-ray utilisation by 16% (95% CI: approx 10.8 - 21.3). CONCLUSIONS: The OAR are valid in a New Zealand primary care setting. Further implementation of the rules would result in some reduction of X-rays ordered for ankle injuries, but less than the reduction found in previous studies.

Adult↗

PubMed2002

Factors influencing alcohol consumption during pregnancy and after giving birth.

AIMS: This study explored the demographic profile of women consuming alcohol during pregnancy and after giving birth, as part of a larger cohort study of smoking during pregnancy. METHODS: This was a prospective study of a cohort of 665 women registered with a maternity care provider organisation for antenatal care in Wellington. Data were collected from postal questionnaires sent at intervals during gestation and the postnatal period. The questionnaires elicited information about smoking, alcohol consumption and demographic data. RESULTS: At 24 weeks gestation, 74% of women reported not consuming any alcohol in the preceding seven days. Women who were pregnant for the first time, women who experienced nausea, women who were socio-economically deprived and women who smoked were less likely to report having consumed alcohol. At six weeks after giving birth the number of women reporting not consuming any alcohol in the preceding seven days decreased to 46%. Socio-economic deprivation was associated with abstention and tertiary education with alcohol consumption. CONCLUSIONS: Approximately a quarter of women continue to drink alcohol during pregnancy. Health education aiming to reduce alcohol consumption in pregnancy needs to take into account the profile of women who drink during pregnancy.

Adult↗

PubMed2002

Factors influencing continuation of breastfeeding in a cohort of women.

The objective of this study was to prospectively explore the influence of women's experiences in preparing for and establishing breastfeeding on the duration of breastfeeding. A cohort of 490 women was surveyed at intervals during pregnancy and after giving birth. Data were collected on breastfeeding outcomes and experiences and analyzed using multiple logistic regression. After controlling for sociodemographic variables, women were less likely to be still fully breastfeeding at 6 to 10 weeks postpartum if they believed they needed more breastfeeding information prior to delivery or had experienced breastfeeding problems. Women were less likely to be fully breastfeeding at 4 months postpartum if they had experienced breastfeeding problems. This prospective study demonstrated the influence of women's preparedness for breastfeeding and their experiences in establishing breastfeeding on breastfeeding duration. Improvements in prenatal education about breastfeeding and management of breastfeeding problems are likely to increase breastfeeding duration.

Breast Feeding↗

PubMedDate not supplied

Smoking cessation and nicotine replacement therapy in current primary maternity care.

AIM: To determine attitudes, activity and confidence among general practitioners and midwives about smoking cessation practice, and use of nicotine replacement therapy (NRT) during pregnancy and breastfeeding. METHOD: A postal survey of 780 New Zealand health professionals providing maternity care. RESULTS: 274 GPs (82 practising obstetrics) and 184 midwives responded (RR: 64%), with most (88% GPs, 77% midwives) regarding providing smoking cessation advice integral to their job. Only about half gave smoking cessation advice to most pregnant women who smoked. They were uncertain about the safety of NRT use in pregnant and breastfeeding women. Most respondents requested more information about NRT use. DISCUSSION: Smoking cessation practice falls short of respondents' beliefs about good practice and current recommendations.

Attitude of Health Personnel↗