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Biomedical subjects

K Stansfield

Publications and source records attributed to K Stansfield.

7 recordsLinked to original sources
PubMed2005

Physical and biochemical aspects of the flow across the Mascarene Plateau in the Indian Ocean.

This paper presents results from a detailed hydrographic survey of the Mascarene Plateau and surrounding area undertaken by the RRS Charles Darwin in June-July 2002. We examine how the westward-flowing South Equatorial Current (SEC) crosses the plateau, and how the structure of the flow determines the supply of nutrients to the surface waters. We find that the flow of the SEC across the plateau is highly dependent on the complex structure of the banks which make up the plateau, and that a large part of the flow is channelled between the Saya de Malha and Nazareth Banks. Furthermore, the SEC forms a sharp boundary between subtropical water masses from further south, which are low in nutrients, and waters from further north, which are relatively nutrient rich. Overall, the SEC delivers relatively high levels of nutrients to the near-surface waters of the central and northern regions of the plateau, compared with the southern regions of the plateau. This is partly due to uplifting of density surfaces through Ekman suction on the northern side of the SEC, and partly due to the higher levels of nutrients on those density surfaces on the northern side of the SEC. This may drive increased production of phytoplankton in these areas, which would in turn be expected to fuel increased abundances of zooplankton and higher levels of the food chain.

Journal Article↗
PubMed2001

Developing a cancer genetics service in Wales: opinions of gynaecologists on the management of women at risk of familial ovarian cancer.

In Wales, a cancer genetics service has been developing since 1998. Gynaecologists play an integral role in the management of women with a family history of ovarian cancer and we were interested in investigating referral practice and management for relatives of patients with ovarian cancer among gynaecologists in Wales. In 1999, a postal questionnaire was sent to all gynaecologists. The response rate was 51%. The questionnaire contained structured questions about current provision and a number of hypothetical scenarios to explore referral patterns to the cancer genetics service. The results of this study showed that referrals varied widely among specialists, as did the numbers who required onward referral to cancer genetics. The offer of screening to women at high risk of ovarian cancer was consistent, although there were variations in how often it was offered and the age at which it was offered. Most gynaecologists were easily able to establish when it was appropriate to refer onwards to cancer genetics, differentiating between women at high or low risk. There was some confusion about women at moderate risk of ovarian cancer. This study demonstrated the need for clear referral guidelines in Wales. Guidelines have since been distributed to all general practitioners and specialists; however, continued monitoring and further evaluation of referral practices will be necessary.

Family↗
PubMed2000

Randomized trial of a specialist genetic assessment service for familial breast cancer.

BACKGROUND: Because of the growing demand for genetic assessment, there is an urgent need for information about what services are appropriate for women with a family history of breast cancer. Our purpose was to compare the psychologic impact and costs of a multidisciplinary genetic and surgical assessment service with those of current service provisions. METHODS: We carried out a prospective randomized trial of surgical consultation with (the trial group) and without (the control group) genetic assessment in 1000 women with a family history of breast cancer. All P: values are from two-sided tests. RESULTS: Although statistically significantly greater improvement in knowledge about breast cancer was found in the trial group (P: =.05), differences between groups in other psychologic outcomes were not statistically significant. Women in both groups experienced statistically significant reductions in anxiety and found attending the clinics to be highly satisfying. An initial specialist genetic assessment cost pound 14.27 (U.S. $22.55) more than a consultation with a breast surgeon. Counseling and genetic testing of affected relatives, plus subsequent testing of family members of affected relatives identified as mutation carriers, raised the total extra direct and indirect costs per woman in the trial group to pound 60.98 (U.S. $96.35) over costs for the control subjects. CONCLUSIONS: There may be little benefit in providing specialist genetics services to all women with a family history of breast cancer. Further investigation of factors that may mediate the impact of genetic assessment is in progress and may reveal subgroups of women who would benefit from specialist genetics services.

Adult↗
PubMed1999

Is there a role for surgery in the treatment of mastalgia?

Breast pain is a common condition affecting most women at some stage in their reproductive life. Mastalgia is resistant to treatment in 6% of cyclical and 26% non-cyclical patients. Surgery is not widely used to treat this condition and only considered in patients with severe mastalgia resistant to medication. The aims of this study were to audit the efficacy of surgery in severe treatment resistant mastalgia and to assess patient satisfaction following surgery. This is a retrospective review of the medical records of all patients seen in mastalgia clinic in the University Hospital of Wales, Cardiff since 1973. A postal questionnaire was distributed to all patients who had undergone surgery. Results showed that of the 1054 patients seen in mastalgia clinic, 12 (1.2%) had undergone surgery. Surgery included 8 subcutaneous mastectomies with implants (3 bilateral, 5 unilateral), 1 bilateral simple mastectomy and 3 quadrantectomies (1 having a further simple mastectomy). The median duration of symptoms was 6.5 years (range 2-16 years). Five patients (50%) were pain free following surgery, 3 developed capsular contractures and 2 wound infections with dehiscence. Pain persisted in both patients undergoing quadrantectomy. We conclude that surgery for mastalgia should only be considered in a minority of patients. Patients should be informed of possible complications inherent of reconstructive surgery and warned that in 50% cases their pain will not be improved.

Journal Article↗
PubMed1994

A comparative study of systemized vs. random tracheostomy weaning.

The purpose of this study was to compare a systematic tracheostomy weaning procedure to a random weaning approach by asking the question: "What is the benefit to the patient of a systematic vs. random weaning process for tracheostomy removal as defined by the number of weaning attempts and post-weaning complications?" A tracheostomy weaning procedure was developed at St. Boniface General Hospital as a joint venture between the neuroscience nurses and neurosurgeons in response to a perceived clinical need. This project evaluated the systemic procedure in two neuroscience units in Manitoba on ten adult patients who met the assessment criteria for tracheostomy removal established in the procedure. The patients were monitored for thirty days post removal for complications. In addition, a retrospective chart review was completed on twenty charts of patients who had undergone random tracheostomy weaning from 1990-1992. Content analysis of the documentation immediately before, during and after each tracheostomy weaning procedure was undertaken. The results of the study indicate that there were fewer weaning attempts required for the patients with the systemized procedure than the random procedure, and although not statistically significant, there were fewer post-removal complications per patient in the systemized procedure than with the random procedure. Content analysis of the retrospective data indicates that the random tracheostomy weaning procedure was subject to the individual nurses' judgement. The systemized procedure was more standardized and conformed to the protocols in the procedure. Most importantly, the patient's comfort and safety were greatly enhanced through the use of standard tracheostomy weaning procedure.

Adult↗
PubMed1991

Adaptation of family members of brain-injured patients: perceptions of the hospitalization event.

Critical illness is a crisis for the afflicted individual as well as the family. This study was part of a larger study which undertook to add depth to the understanding of the family's experience following neurotrama and to add to the body of knowledge of family-focused nursing care. The focus of this portion of the study was the family's perception of their experience during the first week of the patient's hospitilization. Informal, unstructured interviews were conducted with ten families of patients who had been in a comatose state following a head injury which had occurred within two years of the study. Interviews were analyzed using generic-type and differentiation-type analysis. The family's perceptions of the hospitalization experience included: first hearing the news, first seeing the patient, the roles of nurse and physicians, the hospital culture, the family's physical needs, their time perspective, the ambiguity of the situation, belonging to a community of sufferers and the family's expectations for the patient's recovery. The findings of this study underline the importance of nurses as supporters of these families in their adaptation to a life-threatening event.

Adaptation, Psychological↗