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Biomedical subjects

J Littlewood

Publications and source records attributed to J Littlewood.

At least 19 recordsLinked to original sources
PubMed2000

Primary health care in Saudi Arabia: applying global aspects of health for all, locally.

Primary health care in Saudi Arabia: applying global aspects of health for all, locally This paper describes the application of primary health care principles in the Islamic Kingdom of Saudi Arabia. It arose from a doctoral supervisory experience on a joint programme for women students, operating between a British and Saudi Arabian University. The research looked at nutritional advice given by diploma-level nurses to pregnant women attending primary health care centres in Saudi Arabia. The supervisor supported research that drew on internationally recognized trends in nursing research (the reflexive learner) whilst attending to local requirements and conventions of the culture. The student was encouraged explicitly to site the research within the framework of Islamic teaching and Saudi culture. The Qur'an was used as an overarching framework within which the tenets of primary health care were explored. This was seen to be crucial in addressing World Health Organisation and the International Council of Nurses' views on contextualizing nursing for the greatest benefit of the population. This was of particular relevance in Saudi Arabia where research carried out in the community by women is novel, and as yet there are no nurse theorists from within Saudi culture.

Attitude to Health↗
PubMed2000

A survey of postgraduate education programmes and research interests of GPs in community trusts in an inner city area.

Following discussions with medical lecturers in a postgraduate centre, a questionnaire was sent to all the general practitioners (GPs) in three selected Community Trusts in an inner city area. Besides their qualifications and research interests, the GPs were asked for their views on continuing education. The results showed that opportunities for collaborative education with other members of the primary care groups (PCGs) would be possible if it focused on research methods and 'Health of the Nation' targets. The results showed that up to 61% of the GPs who responded had carried out research and had collaborated with nurses on the research projects. There was considerable variation across the Community Trusts in relation to the experience and interests of the GPs. The formation of the PCGs and joint commissioning offered an excellent opportunity for both collaborative educational opportunities and research. As the interests of the GPs is so diverse, some thought about consolidating and harnessing their interests and expertise in order to influence local and national research agendas may be of value.

Attitude of Health Personnel↗
PubMed1999

Improvement of nebulised antibiotic delivery in cystic fibrosis.

AIM: To investigate deposition patterns and to assess the delivery rate of two nebuliser systems in children with cystic fibrosis (CF). METHODS: Thirty three children with CF on regular treatment with nebulised antibiotics had radioisotope scans performed using technetium-99m labelled aerosol antibiotic generated by a Ventstream nebuliser (median mass diameter (MMD), 3.3 microm; delivery rate, 0. 075 ml/min) under conditions similar to their routine home practice. The inhomogeneity of the images was scored on a 1-10 rating scale (a low score indicating even distribution of the antibiotic), and stomach deposition was measured as a percentage of overall deposition. Twenty patients had a repeat scan using an Optimist nebuliser (MMD, 1.8 microm; delivery rate, 0.02 ml/min). RESULTS: The mean inhomogeneity scores were 5.4 in the Ventstream group and 3. 5 in the Optimist group. Mean stomach deposition was 17.3% in the 33 patients using the Ventstream nebuliser. There was an inverse relation between height and stomach deposition (r = 0.69). In the 20 patients who had both nebulisers, the mean percentages of stomach deposition for the Ventstream and Optimist nebulisers were 11.8% and 1.6%, respectively. The Ventstream nebuliser delivered antibiotic at an average 2.8 times faster rate than the Optimist nebuliser. IMPLICATIONS: A smaller particle size results in a more homogenous distribution of the antibiotic in the lungs with decreased stomach deposition. This should not be seen as a recommendation to use the Optimist nebuliser because more antibiotic was delivered to most parts of the lung with the Ventstream because of its increased delivery rate.

Administration, Inhalation↗
PubMed1999

Against women: are we looking after our general practitioners? GPs' views of the 1990 part-time contract.

A postal survey was conducted looking at the roles and experiences of General Practitioners on part-time contracts. This involved their perception of the attitudes of their colleagues and patients to their part-time status, and the consequences of these for their professional development. Of the 130 General Practitioners with part-time contracts in the one Regional Health Authority that was being surveyed 77.7% responded; 74.3% of the respondents were women. Of the women General Practitioners who responded to this particular question, the predominant age-bands were 31-40 years [41.4% (41)] and 41-50 [19.2% (19)], whilst male General Practitioners were more evenly spread across the age bands. The results showed that the majority of General Practitioners took up part-time contracts to enable them to look after their dependants, though a sizeable minority wished for free time or to relieve stress from a full-time contract. Forty percent said that they felt excluded from decision making about continuity of patient care and practice policy. Just under forty percent also stated that their workload was excessive in comparison with their full-time counterparts. Further, many expressed the opinion that they were financially penalised. The cost effective correlation between the increased availability of General Practitioners (particularly women) for patient care, and the costly medical education and training of such General Practitioners not being 'wasted' for several years was also noted together for the need for ongoing (or continual) medical education and training. The findings of this survey suggest there are many unresolved issues involved in satisfactory part-time contracting arrangements for General Practitioners. This particularly affects women General Practitioners. Whilst the RCP policy statement addresses education and training for general practice, the question of not losing out in relation to training opportunities and promotion is not addressed. The unresolved effects of the intra-professional differences in opportunities may affect the inter-professional functioning of the primary health care team and ultimately continuity and quality of care for patients.

Adult↗
PubMed1998

Mothers' understanding of their children's bodies.

Children under 6 months, brought to the accident and emergency department (A&E) are distressed by problems often related to digestion. Parental knowledge of their children's bodies showed relatively little differentiation between structures. They made clear distinctions between the quality of their baby's crying and the problem. Parents made decisions to seek help on the basis of the quality of their child's crying and thereby its associated disorder. Telephone advice for parents may be the way forward in service provision, and will therefore require more exacting knowledge from the parents. The research approach used in the study--cognitive mapping--appeared to be acceptable to the mothers, as a way of eliciting representations.

Adult↗
PubMed1994

Serum cortisol levels are related to moods of elation and dysphoria in new mothers.

Serum cortisol levels were measured in 163 women on the third day after childbirth. Significantly elevated levels of cortisol were found to be associated with the "blues," and significantly lower levels characterized women who exhibited mild hypomania (the "highs"). Low levels of cortisol were independently associated with epidural anesthesia, while elevated levels were related to assisted delivery. There was no significant association with breast or bottle feeding. Changes in serum cortisol were thus found to parallel the mild bidirectional changes in affect that frequently follow childbirth.

Adult↗
PubMed1994

Postnatal care following premature birth.

There is a growing awareness that women who give birth prematurely have a particular need for specialist after-care and support. Jane Littlewood and Lesley Taylor report the findings of a study to examine the differing experiences of postnatal care reported by women following full-term and premature birth.

Female↗
PubMed1993

Understanding the meaning of wounds.

Little research has been done to address patients' understanding of wounds and how that might interfere with treatment and healing. This article tackles the issue by examining the meaning of wounds to patients. The origin of the wound and the patients' environment can make a difference to how patients view treatment and healing. The author identifies how this knowledge can be incorporated into nurses' assessment of wounds.

Humans↗
PubMed1993

Screening elderly people: a multidisciplinary concern.

The Elderly Screening Survey was carried out in 1990 as a follow-up to a similar study completed by the Centre for the Study of Primary Care in 1988. The aim of these two studies was to look at national differences in the types of screening programmes for elderly people and, specifically, to look at who carries out these programmes. The Elderly Screening Studies of 1988 and 1990 can be located within the ongoing debates about screening. In particular, given the implications of the general practitioner contract arrangements, these studies provide information on the discussion about the role and involvement of community nurses in screening older people. The results suggest that screening programmes for this age group had become more tailored to 'age-related need' in 1990 as compared to 1988. In 1990, districts were more likely to employ a wider variety of nursing personnel in carrying out screening schedules. Furthermore, it was evident that more districts were employing district nurses and practice nurses to implement screening assessments than in 1988. Attention is drawn to the lack of guidelines at district level on screening activities. The need to re-assess training provision particularly for practice nurses is highlighted.

Community Health Nursing↗
PubMed1990

Psychosexual functioning after the treatment of cancer of the vulva. A longitudinal study.

Ten couples, the women beginning treatment for carcinoma of the vulva, participated in a 2-year longitudinal study on sexual functioning before and after treatment. Sexual functioning was measured on admission and at 6, 12, and 24 months posttreatment. Sexual functioning was made operational in terms of current sexual behavior, sexual motivation, sexual (dis)satisfaction, and the perception of genital sensations of sexual arousal. An age-matched nonpatient control group was added to the study and the impact of physical variables was also evaluated. Within 1 year, all women who were sexually active before the treatment had resumed their sexual activities. At the 6-month assessment an increase in relational sexual dissatisfaction could be detected. Over the remaining observation period the women's satisfaction with sexual interaction with the partner was not found to be different from their pretreatment satisfaction and not different from the satisfaction in the control group, in spite of the physical damage and persisting poor perception of genital symptoms of sexual arousal during lovemaking. Satisfaction with sexual interaction with the partner under these circumstances appears to be more an expression of satisfaction with the intimate aspects of the sexual relationship than of satisfaction with the physiologic arousal aspects of the sexual relationship. It is argued that psychological and social variables are more crucial for sexual rehabilitation than physical variables. Therefore, psychosocial issues constitute the most promising focus for intervention.

Adult↗
PubMed1989

A model for nursing using anthropological literature.

This paper describes the usefulness of the incorporation of medical anthropology into the nursing process. It suggests that in order to plan comprehensive patient care, much more attention needs to be paid to lay concepts of illness and causation of illness. This must take place at the assessment stage. If it does not, the nurse and the patient may be working towards conflicting goals of care which may prevent healing.

Anthropology↗
PubMed1989

Psychiatric morbidity, platelet monoamine oxidase and tribulin output in headache.

A significantly higher proportion of patients with headache showed scores in the psychopathological range of the General Health Questionnaire (GHQ) compared with controls, with ratings particularly high on the anxiety and depression subscales. Across the whole group, there was a significant negative correlation between platelet monoamine oxidase (MAO) activity and GHQ score overall, and with the anxiety and depression subscales. There was a significant positive correlation between platelet MAO activity and urinary output of the endogenous MAO inhibitor, tribulin. Within the migraine group, there was a significant negative correlation between tribulin output and GHQ score. These findings suggest that the biochemical nature of the anxiety associated with migraine may differ from that in other conditions such as generalized anxiety disorder where high platelet MAO activity and high tribulin output have been reported.

Affective Symptoms↗