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John Drury

Publications and source records attributed to John Drury.

4 recordsLinked to original sources
PubMed2006

Detection of thyroid dysfunction in early pregnancy: Universal screening or targeted high-risk case finding?

CONTEXT: Maternal subclinical hypothyroidism during pregnancy is associated with various adverse outcomes. Recent consensus guidelines do not advocate universal thyroid function screening during pregnancy but recommend testing high-risk pregnant women with a personal history of thyroid or other autoimmune disorders or with a family history of thyroid disorders. OBJECTIVE: The objective of the study was to assess efficacy of the targeted high-risk case-finding approach in identifying women with thyroid dysfunction during early pregnancy. DESIGN/SETTING: This was a single-center cohort study. PATIENTS/OUTCOME MEASURES: We prospectively analyzed TSH, free T4 and free T3 in 1560 consecutive pregnant women during their first antenatal visit (median gestation 9 wk). We tested thyroperoxidase antibodies in 1327 (85%). We classified 413 women (26.5%), who had a personal history of thyroid or other autoimmune disorders or a family history of thyroid disorders, as a high-risk group. We examined whether testing only such a high-risk group would pick up most pregnant women with thyroid dysfunction. RESULTS: Forty women (2.6%) had raised TSH (>4.2 mIU/liter). The prevalence of raised TSH was higher in the high-risk group [6.8 vs. 1% in the low-risk group, relative risk (RR) 6.5, 95% confidence interval (CI) 3.3-12.6, P < 0.0001]. Presence of personal history of thyroid disease (RR 12.2, 95% CI 6.8-22, P < 0.0001) or other autoimmune disorders (RR 4.8, 95% CI 1.3-18.2, P = 0.016), thyroperoxidase antibodies (RR 8.4, 95% CI 4.6-15.3, P < 0.0001), and family history of thyroid disorders (RR 3.4, 95% CI 1.8-6.2, P < 0.0001) increased the risk of raised TSH. However, 12 of 40 women with raised TSH (30%) were in the low-risk group. CONCLUSION: Targeted thyroid function testing of only the high-risk group would miss about one third of pregnant women with overt/subclinical hypothyroidism.

Adult↗
PubMed2006

A primary health care curriculum in action: the lived experience of primary health care nurses in a school of nursing in the Philippines: a phenomenological study.

Primary health care (PHC) nursing is widely practiced in the Philippines yet little is published about the nurses working in this field nor by these nurses. This paper describes a PHC nursing curriculum conducted in an island in the south of the Philippines and examines the experience of nurses working as faculty and simultaneously providing service to the local community. Data were collected from a convenience sample of faculty by interview and analysed using Huserrlian (descriptive) phenomenology and Colaizzi's method of data analysis. From 102 formulated meanings emerged four theme clusters: teaching PHC; external influences; the working reality and practicing PHC, and these are presented with exemplars from the interviews. The data gives a clear impression of the experience of implementing PHC and working with small communities and highlights the educational and clinical issues inherent in this unique model. The insights gained from the analysis of the interviews are contrasted with current literature and recommendations for future research are made.

Adaptation, Psychological↗
PubMed2005

The phenomenology of empowerment in collective action.

Recent research has hypothesized that empowerment can arise from collective action through collective self-objectification (CSO), defined as action that actualizes participants' social identity against the power of dominant groups. Activists (N = 37) described several experiences that made them feel empowered (and disempowered). Among the various explanations they offered for these feelings, the most prominent were CSO, unity, and support (or their absence). CSO was also predictive of reports of positive emotion, although unity was the best predictor of reports of further involvement. Overall, the study suggests that actualizing one's social identity through collective action has personal as well as political significance.

Affect↗