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Biomedical subjects

F Webster

Publications and source records attributed to F Webster.

9 recordsLinked to original sources
PubMed1999

Randomized double-blind trial of beta-carotene and vitamin C in women with minor cervical abnormalities.

A double-blind, placebo-controlled, randomized, factorial study using a daily oral administration of 30 mg beta-carotene and/or 500 mg vitamin C was conducted in 141 women with colposcopically and histologically confirmed minor squamous atypia or cervical intra-epithelial neoplasia (CIN) I. Over approximately 2 years of follow-up, 43 lesions regressed to normal and 13 progressed to CIN II. The regression rate was slightly higher, but not significantly so, in those randomized to beta-carotene compared to no beta-carotene (hazard ratio = 1.58, 95% CI: 0.86-2.93, P = 0.14) and slightly lower, but not statistically significant, for those randomized to vitamin C compared to no vitamin C (hazard ratio = 0.65, 95% CI: 0.35-1.21, P = 0.17). In a model with no interaction, the progression rate was slightly higher in those randomized to beta-carotene (hazard ratio = 1.75, 95% CI: 0.57-5.36, P = 0.32) and also in those randomized to vitamin C (hazard ratio = 2.40, 95% CI: 0.74-7.80, P = 0.13). Neither of these were statistically significant. However, there was some evidence of an interaction effect of the two compounds on the progression rate (P = 0.052), with seven of the progressed lesions occurring in those randomized to both vitamins compared to a total of six in the three other groups. The currently available evidence from this and other trials suggests that high doses of these compounds are unlikely to increase the regression or decrease the progression of minor atypia and CIN I.

Adult↗
PubMed1998

DRG cost weights--getting it right.

Inadequate cost weights are a major problem in casemix funding systems. Clinicians should understand the basis for the cost weights underpinning the hospital payment system in their State and their own hospital. Clinician managers need valid patient costing data if they are to benchmark and improve cost-effectiveness while maintaining and enhancing quality. The cost model approach for determining cost weights has inherent limitations, and, the alternative, detailed patient costing, requires efficient hospital information technology systems. A simplified approach to patient costs, which uses existing hospital data systems, may be useful for smaller hospitals. A better classification system and funding formulas incorporating reliable cost weights derived from patient costing should overcome many of the deficiencies in the current casemix payments systems.

Australia↗
PubMed1998

Surgeons' opinions about the NHMRC clinical practice guidelines for the management of early breast cancer.

OBJECTIVE: To explore the opinions of surgeons about the NHMRC clinical practice guidelines for the management of early breast cancer (the Guidelines) and their views about and use of the accompanying Consumer's guide. DESIGN: Cross-sectional telephone survey. PARTICIPANTS AND SETTING: Surgeons throughout Australia who manage breast cancer, designated as "breast" or "general" (members or non-members of the Royal Australasian College of Surgeons' Section of Breast Surgery) and "urban" or "rural". RESULTS: Among 150 respondents (64% response rate) more than 80% of surgeons reported having read all or most of the Guidelines and believed they were useful in improving women's management and wellbeing, easy to understand, evidence-based, a good summary of recent evidence, and that they would assist agreement between women and healthcare providers. Surgeons agreed with most of the recommendations in the Guidelines, but 26% disagreed that "women should ideally be treated by a specialist who treats a large number of similar patients and who has access to the full range of treatment options in a multidisciplinary setting". In terms of medicolegal implications, 41% believed that the Guidelines would protect clinicians, while, of the 37% of surgeons who believed that they would expose doctors to increased problems, significantly more breast than general surgeons believed this (50% v. 19%; P < 0.001). Only 37% of surgeons routinely gave the Consumer's guide to all or more than half their patients. CONCLUSIONS: Surgeons are generally positive about the Guidelines, but certain issues should be addressed if they are to be optimally implemented, including confusion about the medicolegal implications, perceived difficulties with providing multidisciplinary care and poor use of the Consumer's guide.

Academies and Institutes↗
PubMed1998

Weaning.

Explore the source record for details and available documents.

Animals↗
PubMed1996

Development of a casemix classification system for inpatient rehabilitation services: stage 1 of the Victorian Rehabilitation Project.

This study examines the feasibility of classifying rehabilitation patients according to relative cost and proposes an option for a casemix classification and payment system for rehabilitation services in Victoria. The classification system proposed has 16 mutually exclusive groups based on patient diagnosis, change in functional status, admission functional status and age, using patient length of stay as a proxy for cost. Data relating to five hospitals were collected over three months during 1994, resulting in 483 inpatient episodes from a variety of impairment groups. The data were analysed using an analysis of variance model (PC Group), with the resulting model accounting for 30 per cent of the variance in length of stay. The study also considers the implications of incentives to contain cost and concludes by suggesting that such a payment system would be feasible to implement following further research to validate and refine the system.

Activities of Daily Living↗
PubMed1985

A study of the influence of ovulation stimulants and oral contraception on twin births in England.

A study of 111 mothers of twins in Nottinghamshire, England, in 1981-82 showed that at least 12 had used ovulation stimulants, compared to 2 of 102 mothers of singletons. Thus, the use of ovulation stimulants increased the twinning rate of this population by about 10 percent; this may explain the recently noted levelling off in the secular decline in twinning rates. In contrast to a recent study in France, no association between twinning and prior use of oral contraceptives was seen.

Contraceptives, Oral↗
PubMed1985

A report on voluntary sterilisation with special reference to minors and women who are intellectually disabled.

There are no specific legislative provisions regulating sterilisation in any State or Territory in Australia and there is a dearth of general case law on the subject. To determine the law relating to sterilisation, we need to consider both criminal and civil liability. In the absence of specific statutory provisions, it is necessary to examine the common law and the possible application of non-specific statutory provisions in both areas.

Adolescent↗