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Biomedical subjects

K J Thomas

Publications and source records attributed to K J Thomas.

At least 19 recordsLinked to original sources
PubMed1993

Case against targeting long term non-attenders in general practice for a health check.

A study was undertaken to describe the consequences of implementing that part of the 1990 contract for general practitioners which requires them to offer health checks to all patients aged 16-74 years not seen within the previous three years. A random sample of 679 patients who had not attended for three years and 379 patients who had attended in this period were identified from 30 practice lists (including eight inner city practices) in five family health services authority areas. All patients were sent an invitation to a health check by their own practice and an attempt was made by the research team to conduct a home interview. The results showed that a considerable proportion of non-attenders were not in a position to take advantage of such an invitation; 17% of those at inner city practices were known to have received the invitation, 68% in practices elsewhere. Interviewed non-attenders (76% of those known to have received their invitation) had sociodemographic characteristics similar to the comparison group of interviewed attenders, although women aged 55-74 years were over-represented. At interview, non-attenders reported relatively less use of accident and emergency services and preventive health care and scored significantly better on all six dimensions of the perceived health status measure. Overall, 3% of all identified non-attenders in the inner city practices and 13% elsewhere accepted the invitation to a health check. Low levels of morbidity were found at health checks for those who had and who had not attended their general practitioners in the previous three years.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Validating the SF-36 health survey questionnaire: new outcome measure for primary care.

OBJECTIVES: To test the acceptability, validity, and reliability of the short form 36 health survey questionnaire (SF-36) and to compare it with the Nottingham health profile. DESIGN: Postal survey using a questionnaire booklet together with a letter from the general practitioner. Non-respondents received two reminders at two week intervals. The SF-36 questionnaire was retested on a subsample of respondents two weeks after the first mailing. SETTING: Two general practices in Sheffield. PATIENTS: 1980 patients aged 16-74 years randomly selected from the two practice lists. MAIN OUTCOME MEASURES: Scores for each health dimension on the SF-36 questionnaire and the Nottingham health profile. Response to questions on recent use of health services and sociodemographic characteristics. RESULTS: The response rate for the SF-36 questionnaire was high (83%) and the rate of completion for each dimension was over 95%. Considerable evidence was found for the reliability of the SF-36 (Cronbach's alpha greater than 0.85, reliability coefficient greater than 0.75 for all dimensions except social functioning) and for construct validity in terms of distinguishing between groups with expected health differences. The SF-36 was able to detect low levels of ill health in patients who had scored 0 (good health) on the Nottingham health profile. CONCLUSIONS: The SF-36 is a promising new instrument for measuring health perception in a general population. It is easy to use, acceptable to patients, and fulfils stringent criteria of reliability and validity. Its use in other contexts and with different disease groups requires further research.

Adolescent↗
PubMed1992

Genetic polymorphism of plasminogen and vitamin D binding protein in red deer (Cervus elaphus L.).

Genetic polymorphism was detected in the red deer (Cervus elaphus L.), plasma proteins, plasminogen (PLG) and vitamin D binding protein (GC) using antiserum to human proteins. The affinity of the antisera to deer plasma was less than 10% that of a human standard but they bound specifically to proteins of molecular weight expected for GC and PLG. Three codominant alleles of GC and five of PLG were observed. In a set 124 farmed deer calves and their parents, six calves had genotypes which were not consistent with the expectations of inheritance. Further inconsistencies were found when variation in isocitrate dehydrogenase (IDH) and transferrin (TRF) was examined. Using genetic models which included pedigree error parameters the data were shown to be consistent with genetic inheritance of all loci in a data set containing approximately 4.8% (SE 1.4%) parent-progeny pedigree mismatches. In samples from four deer populations representative of the red deer introduced to New Zealand the GC and PLG polymorphisms provided a probability of paternity exclusion (PE) of between 0.34 and 0.54 and when IDH and TRF were also included the PE was between 0.46 and 0.66. The four populations differed significantly in allele frequency, which supports historical evidence that they originate from separate introductions of small numbers of European red deer.

Animals↗
PubMed1991

Use of non-orthodox and conventional health care in Great Britain.

OBJECTIVE: To describe the characteristics of patients using non-orthodox health care and their pattern of use of conventional health care with respect to a particular problem. DESIGN: Postal survey of all 2152 practitioners of acupuncture, chiropractic, homeopathy, naturopathy, and osteopathy identified from 11 national professional association registers. Patients attending a representative sample of 101 responding practitioners completed questionnaires covering demographic characteristics, presenting problems, and use of the health service. SETTING: Practices of practitioners of non-orthodox health care in England, Scotland, and Wales. SUBJECTS: Qualified, non-medical practitioners of non-orthodox health care working in Great Britain and 2473 patients who had attended one of the sampled practitioners in an allocated time period between August 1987 and July 1988. RESULTS: An estimated 1909 practitioners were actively practising one of the study treatments in Great Britain in 1987. Of the estimated 70,600 patients seen by this group of practitioners in an average week, most (78%) were attending with a musculoskeletal problem. Two thirds of the patients were women. Only 2% were aged under 16, but 15% were aged 65 or over. One in three patients had not received previous conventional care for their main problem; 18% were receiving concurrent non-orthodox and conventional care. Twenty two per cent of the patients reported having seen their general practitioner for any reason in the two weeks before the surveyed consultation. CONCLUSIONS: Patients of non-orthodox health care, as provided by this group of practitioners, had not turned their backs on conventional health care. Non-orthodox treatment was sought for a limited range of problems and used most frequently as a supplement to orthodox medicine.

Adolescent↗
PubMed1990

Whole-brain learning. Preparing nurses for future challenges.

In the 1960s, when the design of nursing curricula moved away from the medical model and toward a model based on nursing concepts, formal rotation to the operating room was deleted from many baccalaureate programs. Nurse educators, grappling with a seriously overcrowded curriculum, argued that when a conceptual approach is used, students do not necessarily need extensive experience in nursing specialty areas, such as operating room nursing. In contrast, operating room nurses argued that diminishing the operating room experience had a negative impact on the preparation of students for the specialty. They contended that without meaningful learning experiences in the operating room, students would miss unique and valuable experiences in the operating room, and there would be less likelihood that new graduates would select this specialty. The specialty of perioperative nursing has responded to major changes in the health care industry and has expanded and clarified its professional scope. Today, the perioperative continuum provides a unique opportunity for teaching many fundamental concepts and skills of nursing practice. For example, perioperative nursing provides an opportunity for teaching concepts and principles of adaptation, safety, asepsis, patient and family teaching, teamwork, and the continuity of care. The perioperative nursing arena offers unique opportunities for nursing students to learn key concepts, issues, and skills that are relevant to many nursing practice areas. The whole-brain approach described in this article provides a model for the reevaluation and revitalization of perioperative nursing in the baccalaureate nursing curriculum.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain↗
PubMed1989

A comparison of three types of earmoulds in elderly users of post-aural hearing aids.

The objective of this study was to assess the ease of handling, comfort, and general effectiveness of three types of earmould in patients who, due to their age, could be expected to experience handling difficulties. The three mould types were, meatal tip, skeleton and skeleton with the 'top prong' removed. The results indicated that the skeleton with the top prong removed was the best in all contexts but one. It was easiest and quickest to fit and least likely to be badly fitted. Only in feedback control did it perform less well. It was concluded that it should be routinely used for elderly patients fitted with low gain hearing aids.

Aged↗
PubMed1989

Failure of familiar males to prevent alien male-induced implantation block (the Bruce effect) in laboratory mice.

Implantation failure in newly inseminated females induced by exposure to alien males (the Bruce effect) was significantly reduced when the females were housed with the stud male. By contrast, newly inseminated females housed with a familiar male during exposure to alien males exhibited a high rate of implantation failure. The results suggest that the protective effect of the stud male on implantation is not because of the familiarity of the female with his odour cues. The results are consistent with the view that the newly inseminated female mouse identifies her coital partner as an individual because she becomes 'imprinted' with his odour during the pericopulatory period.

Animals↗
PubMed1988

A study of the movement of nurses and nursing skills between the NHS and the private sector in England and Wales.

An investigation of 2165 qualified nurses joining eight NHS District Health Authorities (DHAs) and 72 private sector institutions was undertaken in order to measure the skills which move between these sectors and to estimate the likely impact on NHS nursing services of any future growth in the private sector. It was found that 42% (95% confidence interval: 36%, 48%) of the nurses joining private acute hospitals and 28% (95% CI: 21%, 37%) of those joining long-stay private nursing homes came directly from the NHS workforce. Fewer qualified nurses move from the private sector to the NHS. Private acute hospitals appear to attract recruits from a specific section of the NHS workforce: nurses under 30 years of age with specialist skills such as theatre nursing, renal nursing, intensive care and oncology.

Adult↗
PubMed1987

Induction of pseudopregnancy in pregnancy-blocked mice by re-exposure to stud males.

Re-exposure to stud males beginning on day 4 post coitum induced pseudopregnancy in a large proportion of female mice whose pregnancies were terminated by a single injection of 0.5 mg of bromocriptine on day 1 post coitum. By contrast, exposure to alien or strange males was ineffective in inducing pseudopregnancy in pregnancy-blocked females. The results suggest that the newly inseminated female retains the memory of the stud male for some days after mating. Activation of the 'memory' by pheromones of the stud males exerts a luteotrophic effect in pregnancy-blocked females resulting in the incidence of pseudopregnancy. This may account for the inability of the stud male to block pregnancy in his coital partner and also for the inability of alien males to block implantation in newly inseminated females housed with stud males.

Animals↗
PubMed1987

Low-powered ultrasound in the inhibition of tinnitus.

An experiment was performed using low-level ultrasound in an attempt to inhibit tinnitus during and after stimulation. The method used a double-blind crossover technique with a placebo. Forty subjects were tested, and they generally reported little or no change in their tinnitus, the results from placebo and ultrasound not being statistically different. It cannot be concluded, therefore, that the ultrasound we were using has any beneficial effect on tinnitus. These results do not confirm the findings of the pilot study using the same ultrasound devices (Carrick et al., 1986).

Clinical Trials as Topic↗
PubMed1985

Differences in durations of stay for surgery in the NHS and private sector in England and Wales.

Median durations of stay in England and Wales for eight "marker" operations were consistently shorter for patients in pay beds in the National Health Service than for patients in independent acute hospitals or public sector beds. This pattern was seen for both preoperative and postoperative stay and among specific age groups. Differential use of other hospitals for part of the period of care was not a factor, except for patients having hip replacement operations treated in NHS pay beds, one in seven of whom appeared to transfer to public sector care postoperatively. These findings suggest that there is scope for a possible further reduction in durations of stay in public sector beds and, within the private sector, for an assessment of whether spells in independent hospitals need be longer than in NHS pay beds.

Adolescent↗
PubMed1984

Contribution of the private sector to elective surgery in England and Wales.

From a sample of 12 959 records of patients treated in 148 of the 153 independent acute hospitals in England and Wales in 1981, it was estimated that 344 008 patients were admitted during that year. Residents of England and Wales admitted for inpatient elective surgery other than termination of pregnancy represented 162 000 of these cases. From 1980 Hospital Inpatient Enquiry data it was estimated that a further 57 000 similar elective treatments were undertaken in National Health Service pay-beds. The 219 000 patients treated in the combined private sector represented 13.2% of the total case-load in domestic inpatient elective surgery. For certain operations this proportion rose to 26%, and for some regions the private sector cases represented more than 20% of the total work-load; therefore when assessing the need for, and provision of, acute health care in England and Wales, the contribution of the private sector cannot be ignored.

Adolescent↗