The case for conducting clinical research in contact lens practice.
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Biomedical subjects
Publications and source records attributed to M McParland.
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On an 8-bed adolescent psychiatric unit, 69 patients were rated over the course of more than one year [corrected]. A set of rating scales was used to determine the relationships of treatment and therapeutic alliance difficulties with staff ratings of patient qualities, family issues, and treatment outcome. Findings underscore the clinical relevance of treatment difficulty and therapeutic alliance in conceptualizing the therapeutic action of the hospital treatment.
Twelve patients with spinal cord injury and 2 diabetics with secondary anejaculation underwent 26 sessions of electro-ejaculation, using a technique which has previously been popular only in veterinary medicine. Ejaculate was obtained on 21 occasions. Semen quality was adequate for cryostorage on 9 occasions (8 patients); on 8 occasions (5 patients) it was used for immediate artificial insemination of the partner. To date, there has been 1 pregnancy resulting in a live birth.
There are few studies of treatment difficulty with children and adolescents. The authors describe a preliminary phase of research in this area, specifically the development of a set of rating scales to assess factors in treatment difficulty, a study of interrater reliability, and factor analyses of the content of these scales. The next steps in this ongoing research project are outlined.
Two methods of statistical analysis were used to evaluate the results from an infertility clinic (the couple-months method and Cox regression analysis). The results were in general agreement and validated the couple-months method. The total trying time, sperm motility, sperm density and results of the wife's investigation were all shown to be highly significant prognostic factors. The age of either husband or wife, semen volume, sperm morphology, size of the testes, presence of a varicocele, serum LH and serum testosterone all failed to give significant additional prognostic information. High serum FSH and testis asymmetry both gave weak additional prognostic information. The benefit of attendance at the infertility clinic was evaluated in two ways: firstly by testing whether the event of clinic attendance altered prognosis and secondly by examining the results of a broad range of treatments. The results showed that attendance at the clinic with subsequent treatment did not improve the chance of fertility. The main benefit from clinic attendance was that the couple could be given an accurate prognosis and supportive counseling.