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Biomedical subjects

K Andrews

Publications and source records attributed to K Andrews.

At least 91 records · Page 5Linked to original sources
PubMed1985

Geriatric medicine--the style of practice.

The three main styles of geriatric practice in the UK at present are: combined acute and rehabilitation with separate long-stay wards (37.5%), separate acute, rehabilitation and long-stay wards (24.4%) and combined acute, rehabilitation and long-stay wards (21.1%). The first of these has the highest bed/population ratio, the second the highest discharge rate per bed and per population and the third has the highest consultant/bed ratio. There is some relationship between style of practice and geographical characteristics of the area. The numbers of specialist units (ortho-geriatrics etc.) are also described.

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PubMed1985

Incidence and correlates of incontinence in stroke patients.

The incidence of incontinence in a series of 135 consecutive stroke patients was 51% (urine) and 23% (feces) within one year. In 75% the urinary incontinence started within the first two weeks, and in 41% it had cleared during that time. Incontinence at onset is associated with measures of severity of stroke (and of immobility for fecal incontinence). Among 92 survivors at one year, 15% were incontinent of urine, a proportion that rose in two- and three-year survivors to 23 to 24%, but by four years was again 14%, a level similar to that of the general elderly population. It is concluded that incontinence is more commonly a by-product of immobility and dependency than of involvement of the neurologic pathways, and most of it is transient.

Activities of Daily Living↗
PubMed1985

Social implications of multiple pathology.

The degree of multiple pathology in 184 consecutive patients admitted to a geriatric unit was recorded using the 13 commonest conditions present at the time of admission to provide a standard group of disorders for comparison. All of the conditions were chronic in nature, and 35% of the patients had a combination of four or more of these present. Multiple pathology was associated with poor prognosis in terms of mortality and the need for long-term institutional care. Families, including those who were elderly, continued to support most of the frail elderly people even in the presence of multiple pathology. This emphasizes the social implications of multiple pathology and the need for support and information in the management of long-term disability.

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PubMed1985

What would physiotherapists in geriatric medicine do if they had more staff?

Forty-one per cent of UK physiotherapy departments responding to a questionnaire felt that they had sufficient staff, and these had more physiotherapists per elderly population than those who felt that they had insufficient staff. At present 77% of therapist time is spent in direct patient contact. There were areas where it appeared that an excessive amount of time was being spent in administration etc. Therapists felt that, with more staff, there would be an increase in the intensity of treatment, group therapy, work with long-stay patients and more pre-discharge home visits. Very few units would carry out research even if more time was available.

Geriatrics↗
PubMed1985

Rehabilitation of conditions associated with old age.

Rehabilitation of the elderly is largely concerned with the management of degenerative disorders and is often complicated by multiple pathology, low expectations (by staff rather than the patient) and social inadequacies. Rehabilitation offers a potential for the management of falls by environmental control and balance training. Other conditions common in the elderly, such as Parkinson's disease, stroke, peripheral vascular disease, lower limb amputation, pressure sores, and fracture of the femur, also respond to rehabilitation techniques. In addition to these conditions the management of the demented long-stay patient is discussed.

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PubMed1985

What would occupational therapists do if they had more staff?

Eighteen per cent of 203 departments responding to a questionnaire felt they had sufficient staff, and this group had, on average, significantly more therapists than those who felt that they had insufficient staff. Treatment was mainly concentrated on individual therapy though, in some units, excessive time was spent on administration and travelling. Very little therapy time was spent on diversional activities but this was one area, along with treating more patients and increasing pre-discharge home visits, which they would like to develop if more staff were available. Little additional time would be spent in research, teaching or community therapy.

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PubMed1984

Private rest homes in the care of the elderly.

Sixteen private rest homes were visited to assess their facilities and the types of disability of the residents. Apart from one home, which was a hotel for the elderly, all the homes provided care for physically and mentally frail elderly people over the long term. Although care was good the trends in the use of the homes are worrying, and stricter regulations are required to ensure appropriate levels of care. Greater support is also required from district nursing services.

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PubMed1984

The influence of age on the clinical presentation and outcome of stroke.

Of 135 patients who survived the first 2 weeks following a stroke 25% were under the age of 65 years, 40% between 65 and 74 years and 35% were 75 years of age or older. Those under 65 years had a lower incidence of a previous history of lower limb arthritis, balance problems, and limited mobility but a greater incidence of ischaemic heart disease than those 65 years and over. This younger age group had a lower mortality and were more likely to progress beyond severe degrees of disability. However, if only those who survived the first year are included, then there was no difference in outcome between the age groups. In none of the parameters studied was there any difference between those 65 to 74 years of age and those 75 years and over. It was, however, those over the age of 74 years who were more likely to require long-term institutional care. These findings suggest that, although elderly 1-year survivors had a similar level of functional recovery to younger patients, other factors, probably social, affected the eventual placement of stroke patients.

Activities of Daily Living↗
PubMed1983

Urinary incontinence secondary to drugs.

With the current rapid introduction of new drugs on the market, drug toxicity and side effects have received increasing publicity in the literature. Bladder dysfunction, however, rarely has been reported as an adverse effect. The possible mechanisms in the induction of urinary incontinence by three main groups of drugs, the neuroleptics, the antihypertensive agents, and the drugs used in the treatment of neurogenic bladder obstruction, are reviewed. These drugs are thought to act peripherally at sympathetic neurons or through a centrally-mediated effect.

Antihypertensive Agents↗
PubMed1982

Stroke: does side matter?

Of 135 patients seen two weeks following a stroke and followed up for one year, 69 had a right hemiplegia and 66 left-sided weakness. Disturbance of the level of consciousness at the onset and confusion following the stroke were more common in those with right hemiplegia. Confusion, when present, improved more often in those with right hemiplegia. Neither severity nor functional outcome was associated with laterality. Elderly patients with right hemiplegia were more likely to be admitted to hospital, and of those admitted there were significantly more patients with a right hemiplegia admitted to general wards and of those with left hemiplegia to geriatric units. Radios, but not television, were more often used by those patients with left hemiplegia. Most bedside containers were placed on the patients right side irrespective of the side of the lesion.

Adult↗
PubMed1982

The recovery of the severely disable stroke patient.

Fifty-three stroke patients with severe functional loss at two weeks, following the stroke were followed up for one year. No improvement occurred in 47% during this time and this was associated with abnormalities of muscle tone, incontinence of urine or faeces, perceptual disorders and previous disabilities affecting locomotion. Remedial therapy continued for long periods especially in the group who did not improve. It is suggested that rehabilitation resources could have been used more appropriately. Further research is required to determine whether intensive therapy is of value in the severely disabled stroke patient especially those with perceptual and cognitive dysfunction.

Activities of Daily Living↗