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Biomedical subjects

L Webster

Publications and source records attributed to L Webster.

51 records · Page 3Linked to original sources
PubMed1992

A survey of Minnesota home care agencies' perceptions of physician behaviors.

A survey of Minnesota home care agencies assessed perceptions of and satisfaction with the home care practices, knowledge, and skills of Minnesota family physicians and other primary care physicians. We found that physicians did not make many home visits and that agencies were moderately dissatisfied with that practice. Family physicians visited significantly more frequently than other primary care physicians and, in rural areas, received significantly higher satisfaction ratings from agencies. The areas most frequently noted that could benefit from improvement of physician skills/knowledge regarding home care were: better home care clinical skills (38.5% of respondents), knowledge of home care technology and capabilities (37%), and knowledge of reimbursement policies and practice (29%).

Clinical Competence↗
PubMed1991

The home care practice and attitudes of Minnesota family physicians.

OBJECTIVE: Assess home care practice and attitudes of Minnesota family physicians (FPs). DESIGN: Mailed survey. SETTING: State of Minnesota. PARTICIPANTS: Members of the Minnesota Academy of Family Physicians, 80% of the FPs practicing in the state. INTERVENTION: A 55-item mailed, self-complete questionnaire regarding general practice and personal physician characteristics (18 questions), specific questions regarding geriatric and home care practice and related attitudes (37 questions); up to four reminder or follow-up surveys were sent. MAIN OUTCOME MEASURES: Descriptive summary of FP home care practice and attitudes. RESULTS: Eighty percent of surveys were completed, 76% of responding physicians made at least one home visit in the previous year, and 92% of home visits were to geriatric patients. Discriminant function analysis identified six significant (P less than 0.001) variables that explained 52% of the variance (r2 = 0.52, Wilks Lambda = 0.48) in home visiting behavior between frequent home visiting FPs (greater than 24 visits/year) and non-visiting FPs. FPs most likely to do home visiting were older and tended to have small group or solo practices in rural settings. CONCLUSION: The survey documented continued decline (from previously published surveys) of physician home visiting behavior and widespread dissatisfaction with reimbursement. However, attitudes regarding home care provided by other professionals were highly positive.

Attitude of Health Personnel↗
PubMed1991

A comparison between computer-controlled and set work rate exercise based on target heart rate.

Good exercise prescriptions provide work rates (WRs) that maintain heart rates (HR) in a target zone and at a percent of maximum metabolic equivalent (%METmax). HR and MET were evaluated from computer-controlled and set WR (constant speed) sessions (20 min at 65% METmax). Computer-controlled WR used a control algorithm to adjust speed and grade to maintain the target HR. The set WR (mean +/- S.D.) HR (139 +/- 8 bpm) was lower (p less than 0.05) than the target (147 +/- 3 bpm) and computer-controlled HRs (153 +/- 5 bpm). The set WR MET (8.6 +/- 2.2) was not different than the target (8.6 +/- 2.2), but both were lower than computer-controlled exercise (9.7 +/- 2.2). Computer-control time in target HR zone (16 +/- 5 min) was significantly (p less than 0.004) greater than set WR exercise (6 +/- 5 min). Computer-controlled WR was significantly better in maintaining target HR and the MET values were not physiologically different than target WRs.

Adult↗
PubMed1987

Effect of the 1983 Mental Health Act on the management of psychiatric patients.

Two principal objectives of the 1983 Mental Health Act were to decrease the use of emergency orders and to give patients on observation orders the right of appeal. Statistics were collected from the 13 hospitals that admit acute psychiatric patients in the Greater Manchester area, and the figures for 1980-1 were compared with those for 1984-5. Changes in use of the different sections were examined in university units, large psychiatric hospitals, and district general hospital units. The use of emergency orders decreased and the use of treatment orders increased; the use of observation orders remained unchanged. Many more patients exercised their right of appeal in 1984-5, but the number discharged by tribunals remained small. The nurses' holding power was used infrequently. The different types of hospital are now more concordant in their use of these orders than before the 1983 act.

Commitment of Persons with Psychiatric Disorders↗
PubMed1983

Subtypes of Legionella pneumophila serogroup 1 associated with different attack rates.

From January, 1982, through February, 1983, 20 cases of nosocomial legionnaires' disease caused by Legionella pneumophila serogroup 1 were identified in two adjoining hospital buildings, UH and RH. Although the buildings housed similar patient populations and the hot water systems in each were colonised with similar numbers of L pneumophila serogroup 1, 19 cases (1.03/1000 discharges) occurred in UH and only 1 case (0.08/1000 discharges) occurred in RH. Three subtypes of L pneumophila serogroup 1 were defined by plasmid content and monoclonal antibody binding patterns; two were unique to the environmental and patient isolates from UH and one was unique to RH. The marked differences in the attack rates suggest that the UH subtypes may be more pathogenic than the RH subtype and that the subtyping of L pneumophila might be a useful tool for studying the epidemiology of legionnaires' disease.

Cross Infection↗
PubMed1977

Cystic fibrosis screening by sweat analysis: a critical review of techniques.

Currently employed methods for the assay of electrolytes in sweat, relevant to the diagnosis of cystic fibrosis, are critically evaluated with particular reference to the measurement of electrical conductivity. Attention is drawn to the factors responsible for potentially large errors. On the basis of experimentation, supported by laboratory practice, recommendations are made for the reduction of these errors to clinically acceptable levels. Data concerning sodium and potassium content, electrical conductivity and osmolality of undiluted sweat collections are compared. The feasibility and comparative advantages of measuring sweat osmolality with a vapour pressure osmometer are discussed.

Child↗
PubMedDate not supplied

Implications from a field study regarding the relationship between polycyclic aromatic hydrocarbons and glutathione S-transferase activity in mussels.

An aluminium smelter on the west coast of Scotland discharges an aqueous effluent containing polycyclic aromatic hydrocarbons (PAHs) at the head of Loch Leven. The loch also supports two mussel (Mytilus edulis) farms. Data are presented on burdens of PAHs in the soft tissues of mussels and the effect of these contaminants on glutathione S-transferase (GST) activity in mussel hepatopancreas. GST activity is shown to be correlated with total PAH burden and also with the concentrations of certain individual PAHs. These field data show that high molecular weight PAHs are closely correlated to GST activity, whereas low molecular weight PAHs are not. This suggests that 5- and 6-ring PAHs have a more pronounced role than 2- to 4-ring compounds in inducing GST activity in mussels from Loch Leven. It is proposed that it may be more appropriate to link GST activity with 5- and 6-ring compounds only, rather than with the total PAH burden.

Animals↗
PubMedDate not supplied

Different levels of mussel (Mytilus edulis) DNA strand breaks following chronic field and acute laboratory exposure to polycyclic aromatic hydrocarbons.

Levels of polycyclic aromatic hydrocarbons (PAHs) including benzo[a]pyrene (B[a]P) were at least seven-fold higher in mussels sampled from a polluted site (Loch Leven, in Scotland, UK) compared to a nearby clean reference site (Loch Etive) throughout the year 2000. Levels of DNA strand breaks (alkaline COMET assay) using both gill and digestive gland nuclei were similar at both sites despite the difference in contaminant load (total PAH). In contrast, mussels collected from a reference site (Port Quin, Cornwall, UK) had an increase in DNA strand breaks in digestive gland cells following laboratory exposure to B[a]P-dosed Isochrysis galbana. However, after 14 days high dose (20 ppb-exposed diet) animals had returned to levels similar to the controls. There was no evidence of increased necrosis or apoptosis after treatments. The results from these two studies suggest that an adaptive response may prevent ongoing DNA damage in mussels exposed to high levels of B[a]P and PAH contamination.

Adaptation, Physiological↗
PubMedDate not supplied

Management of sexual problems in diabetic patients.

Sexual dysfunction is common in diabetes, with both male and female patients suffering problems with libido, arousal and orgasm. Erectile failure is particularly common and can be treated effectively by pharmacological and mechanical methods. However, psychological and relationship factors may still be important. A comprehensive diabetes care service should routinely offer treatment for sexual dysfunction.

Diabetes Complications↗