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Biomedical subjects

G Bliss

Publications and source records attributed to G Bliss.

4 recordsLinked to original sources

The Carmarthen audit project.

Experience within East Dyfed Mental Health Services of using externally designed audit tools has indicated a lack of ownership of the audit process by clinical staff. A project has been developed to initiate standard setting and measurement at clinical level, with an assumption that the development of an audit culture through an audit process is synonymous with ownership. An external appraisal system is being developed which can validate internal standard setting and measurement.

Community Mental Health Services↗

Tear film stability and tear surface tension.

Surface tension has been measured by the method of Ferguson and Kennedy on small (0.3-0.4 microliter) samples of tears from 65 normal and 35 dry eyes. Non-invasive break-up time (NIBUT) was also measured on the same patients as an indication of tear film stability. The mean (+/- SD) surface tension value was 43.6 +/- 2.7 mN/m for normals, and 49.6 +/- 2.2 mN/m for dry eyes. All NIBUT values for dry eyes were below 20 sec (8.9 +/- 5.1 sec, mean +/- SD, n = 35) while 53% of normal values were 30 sec or over. A negative correlation was found between surface tension and NIBUT for both dry eyes and normals. Comparison of surface tension results for tears and a variety of standard solutions indicated that mucus makes the greatest contribution, even at low concentrations, but the effect of proteins can be large, especially in inflammatory states where serum proteins leak from conjunctival vessels. The measurement of surface tension is simple and direct, and in conjunction with the NIBUT value can help in classification of tear quality in questionably dry eye cases.

Adolescent↗

The effectiveness of therapy in improving finger extension in stroke patients.

Twenty post-stroke patients were assigned to one of three treatment conditions or to a control group to test whether exercises, determined in a previous study to recruit maximal extensor digitorum participation, would improve finger extension function over time. The exercises were resisted grasp, resisted extension, and ballistic extension. Improved function was defined as increased active range of motion, speed of reversal of movement, and ability to grasp and release cylinders. Significantly more subjects assigned to ballistic or resisted extension conditions improved in their ability to rapidly reverse movement over the course of treatment as opposed to those assigned to resisted grasp or control conditions. However, Kruskal-Wallis nonparametric analyses of variance indicated that no exercise improved all three components of function significantly more than another or the control condition. Since no clear difference was found between the control and treatment conditions, it was concluded that motor unit recruitment as an attribute of activity is insufficient to improve function in post-stroke patients. The strength of this conclusion is limited by a chance imbalance of patient assignment in which significantly more patients assigned to resisted and ballistic extension conditions were at a higher level of recovery of motor control.

Aged↗