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Biomedical subjects

E Stokes

Publications and source records attributed to E Stokes.

12 recordsLinked to original sources
PubMed2006

A dental workforce review for a Midlands Strategic Health Authority.

OBJECTIVE: To explore opportunities for workforce development in NHS general dental services (GDS) in Shropshire and Staffordshire. METHOD: Secondary data sources were supplemented with a primary survey of GDS practices to build up a profile of the existing GDS workforce and its current capacity. Attitudes and perceptions on current workforce issues and potential solutions were gathered using a second survey and explored further through other qualitative techniques including interviews and a focus group discussion. RESULTS: The results confirm that there is a shortage of dentists in the area, fuelled by multiple factors including the move from NHS to private work, the decision to retire early and a growing disillusionment with NHS policies and remuneration. Modelling of alternate approaches to future dental clinical needs highlighted the opportunity for meeting the consequent workforce demands through increased involvement of hygienists and therapists. CONCLUSIONS: This study has provided local evidence to inform dental service development in Shropshire and Staffordshire. It has provided a starting point for exploring new ways of working and will contribute towards a more effective implementation of new and evolving service strategies.

Attitude of Health Personnel↗
PubMed2005

Determining Liverpool adolescents' beliefs and attitudes in relation to oral health.

Poor oral health is an important public health issue. Adolescents represent a challenging group in terms of oral health because they have vulnerable permanent teeth erupting at a time when they are establishing their independence from parental influence. Preventing oral disease by attempting to influence the behaviours that impact adversely on oral health requires an understanding of the attitudes and beliefs that underpin those behaviours. Very few studies have investigated adolescents' attitudes and beliefs in relation to dental issues. This study aimed to examine the attitudes and beliefs of adolescents towards dentistry and oral disease in order to inform future health promotion interventions. Data were collected through focus groups involving 22 13- to 14-year olds from selected secondary schools in Liverpool. A thematic analysis was applied to the data. The themes identified illustrated the attitudes and beliefs of adolescents in relation to oral health and demonstrated how adolescents justify and personally operationalize these attitudes and beliefs. A need to encourage this group to take action to perform oral health behaviours was demonstrated.

Adolescent↗
PubMed2004

Randomized clinical trial of the effects of preoperative and postoperative oral nutritional supplements on clinical course and cost of care.

BACKGROUND: Postoperative oral nutritional supplementation has been shown to be of clinical benefit. This study examined the clinical effects and cost of administration of oral supplements both before and after surgery. METHODS: This was a randomized clinical trial conducted in three centres. Patients undergoing lower gastrointestinal tract surgery were randomized to one of four groups: group CC received no nutritional supplements, group SS took supplements both before and after surgery, group CS received postoperative supplements only, and group SC were given supplements only before surgery. Preoperative supplements were given from the time it was decided to operate to 1 day before surgery. Postoperative supplements were started when the patient was able to take free fluids and continued for 4 weeks after discharge from hospital. Data collected included weight change, complications, length of stay, nutritional intake, anthropometrics, quality of life and detailed costings covering all aspects of care. RESULTS: Some 179 patients were randomized, of whom 27 were withdrawn and 152 analysed (CC 44, SS 32, CS 35, SC 41). Dietary intake was similar in all four groups throughout the study. Mean energy intake from preoperative supplements was 536 and 542 kcal/day in the SS and SC groups respectively; that 2 weeks after discharge from hospital was 274 and 361 kcal/day in the SS and CS groups respectively. There was significantly less postoperative weight loss in the SS group than in the CC and CS groups (P < 0.050), and significantly fewer minor complications in the SS and CS groups than the CC group (P < 0.050). There were no differences in the rate of major complications, anthropometrics and quality of life. Mean overall costs were greatest in the CC group, although differences between groups were not significant. CONCLUSION: Perioperative oral nutritional supplementation started before hospital admission for lower gastrointestinal tract surgery significantly diminished the degree of weight loss and incidence of minor complications, and was cost-effective.

Adult↗
PubMed1998

Drug dependence during pregnancy. Effect of an on-site support group.

OBJECTIVE: To examine the clinical and economic efficacy of an on-site support group for drug-abusing pregnant women enrolled in an urban, hospital-based obstetric clinic. STUDY DESIGN: Maternal and neonatal outcomes and medical cost data were compared for drug-abusing pregnant women who attended (n = 54) and did not attend (n = 67) a weekly substance abuse support group in the obstetric clinic. RESULTS: Clinical and economic outcomes were more favorable for support group attenders than nonattenders. Specifically, infants of support group attenders had higher birth weights and better 1-minute Apgar scores. In addition, average short-term medical care costs were nearly $1,000 (maternal) and > $1,500 (infant/neonatal) lower for support group attenders as compared to nonattenders. CONCLUSION: Support group attendance was associated with short-term clinical and economic benefits that are likely to translate into longer-term cost savings. The findings suggest that a weekly substance abuse support group can provide low-cost, well-accepted and effective therapeutic services for this high-risk population of women.

Adult↗
PubMed1997

Characteristics of graduate adult health nursing programs.

This descriptive study explored the current characteristics and emphases of graduate programs which offer adult health nursing curricula. All NLN-accredited master's programs offering the adult health focus were requested to send selected demographic information and materials/bulletins normally sent to prospective students. The Conrad and Pratt model for curriculum decision-making was used to organize results related to environmental input and curriculum design variables. Descriptive statistics were employed to analyze admission requirements, types of study permitted, length of program, type of courses (core, electives/cognates, specialty) and completion requirements. Results indicated that adult health graduate programs have multi-tracks. Students were generally attending part-time. Full-time study completion time was four to six semesters. Evening and one day per week offerings were frequently found, as were numerous innovative strategies. Prevalent admission requirements were: graduation from an NLN-accredited BSN program, current licensure, specified GPA, GRE scores, health assessment and statistics courses, professional references and possible personal interview. Most programs required core courses in theory/conceptual frameworks, issues, roles, statistics and research. Electives/cognate courses and thesis/non-thesis options were present in most programs.

Adult↗
PubMed1996

Evaluation of a self-medication program.

OBJECTIVE: To determine the effect of an inpatient self-medication program (SMP) on the ability to self-medicate, patient medication knowledge, compliance, and patient morale. DESIGN: Randomized controlled clinical trial. POPULATION: One hundred seven consecutive patients admitted to a geriatric assessment and rehabilitation program were randomized to either participate in the SMP or to receive standard care. INTERVENTION: The SMP was a three-stage program in which patients were given increasing responsibility for the administration of their own medications. MEASUREMENTS: Ability to self-medicate on discharge from hospital; medication compliance at 1 month; patient medication knowledge; Philadelphia Morale Scale. MAIN RESULTS: Participation in the self-medication program did not increase the proportion of patients who were able to self-medicate on discharge from hospital. Compliance was improved by the program. On a proportional basis, the self-medication group made significantly fewer medication errors than the control group at 1-month follow-up (0.045 vs 0.086, P < .001). There were no significant differences in morale or medication knowledge between the SMP and control groups, although both groups made significant gains in knowledge about the names, administration times, and purposes of their medications from admission to follow-up (P < .001). CONCLUSIONS: A SMP can improve compliance in geriatric patients who are discharged to the community. Participation in a SMP does not improve patients' morale nor does it improve their medication knowledge more than pharmacy counselling alone. Participation in a SMP is unlikely to increase the probability that patients will be able to self-medicate on discharge. Cognitive factors limit patients' ability to self-medicate.

Aged↗
PubMed1975

Estimates of the porosity of Bacillus licheniformis and Bacillus subtilis cell walls.

The maximum porosity of Bacillus subtilis and Bacillus licheniformis cell walls was estimated by two independent and relatively simple methods. Peptidoglycan was isolated from Bacillus subtilis cell wall preparations and used as an insoluble support for exclusion chromatography of dextrans of known average molecular size. In an alternative approach the leakage of radioactively labelled proteins from Bacillus licheniformis cells incubated in butanol-saline mixtures was measured and their size estimated by exclusion chromatography on Sephadex G-100. Under these conditions the permeability barrier of the cytoplasmic membrane was destroyed with preservation of the structural integrity of the outer cell wall. The apparent exclusion threshold of the cell wall of either organism as determined by these means corresponded to molecules with a diffusional radius of not more than 2.5 nm.

Alanine↗
PubMed1970

Cell-wall thickening in Bacillus subtilis. Comparison of thickened and normal walls.

1. Incubation of Bacillus subtilis 168 trp in a glucose-amino acids-salts medium lacking tryptophan leads to an inhibition of cellular growth without affecting cell-wall synthesis. The cell walls increased approximately two- to three-fold in thickness and at the same time the amount of mucopeptide in the cells measured chemically increased to about the same extent. 2. Synthesis of mucopeptide and teichoic acid as measured by the extent of incorporation of radioactivity continued linearly for approximately 1h and then stopped. No reason was found for the strictly limited synthesis of the wall polymers. 3. The initial rates of incorporation of [(32)P]P(i) or [(3)H]alanine into teichoic acid and of (3)H-labelled amino acids into mucopeptide were not appreciably inhibited by the addition of chloramphenicol to the glucose-amino acids-salts medium. 4. There was no selective turnover of the mucopeptide synthesized by the cells in a medium lacking tryptophan on resumption of growth in a complete medium. 5. Wall synthesis taking place during the thickening process was similar to normal wall synthesis proceeding in growing cells. Walls of different thicknesses prepared from cells incubated for various times in incomplete medium did not differ qualitatively in composition. The products of autolysis of thickened walls were isolated and the analyses indicated a close similarity in the details of their mucopeptide structure compared with the mucopeptide of cells growing in the exponential phase.

Alanine↗
PubMedDate not supplied

The effects of a supervised toothbrushing programme on the caries increment of primary school children, initially aged 5-6 years.

Children in the London Boroughs of Kensington, Chelsea and Westminster have one of the highest levels of caries in England and Wales. In 1997/98, the mean dmft for 5-year-old children was 2.83 with only 45.9% of the children being caries free. The aim of this study was to determine whether teacher-supervised toothbrushing, once a day, at school, during term time, with commercial toothpaste containing 1,450 ppm fluoride, could reduce dental caries in primary school children when compared with children from the same community who did not receive this intervention. A total of 517 children (mean age 5.63 years) were recruited for the study. Class teachers were trained individually by the same dental hygienist in an appropriate toothbrushing technique for young children. Children in the intervention group brushed once a day at school. All examinations were by visual assessment only. All teeth present were assessed using the BASCD criteria. For children in the intervention group, the overall caries increment (2.60) was significantly less (10.9%; p < 0.001) than for children in the non-intervention group (2.92). Among different tooth surfaces, the difference in caries increment between the intervention group (0.78) and the non-intervention group (1.03) was greatest for the proximal surfaces (21.4%; p < 0.01). In conclusion, this study suggests that a programme of daily teacher-supervised toothbrushing with fluoride toothpaste can be effectively targeted into socially deprived communities and a significant reduction in dental caries can thereby be achieved especially among caries-susceptible children.

Cariostatic Agents↗