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Biomedical subjects

M Spiers

Publications and source records attributed to M Spiers.

17 recordsLinked to original sources
PubMed2005

Prospective analysis of stoma-related complications.

BACKGROUND: Stoma-related complication rates vary between 10% and 70%, possibly because of varying lengths of follow-up. It is thought that most of the complications improve with time. Furthermore, little is known about the commonly neglected but potentially quite distressing complications such as leakage, soiling and night-time emptying. The aim of this audit was to examine prospectively whether there was any difference in the complication rates at different time-points during the postoperative follow up period. METHOD: A prospective study on 408 consecutive patients with either colostomy or ileostomy was conducted over a period of at least 2 years. Both emergency and elective procedures were included. Stoma related complications were analysed at 10 days, 3 months, 6 months, 1 year and 2 years postoperatively. RESULTS: Both elective and emergency stomas had similar complication rates. The percentage of patients who had stenosis (1-2%), retraction (8-22%), prolapse (1-3%) or odour (6-9%) did not significantly change with time. The complication rates for skin excoriation, leakage, soiling or night-time emptying were higher amongst the ileostomy patients, and these rates did not improve with time. The proportion of patients who had parastomal hernias increased with time (from 0 to 40% in the colostomy and 0 to 22% in the ileostomy group). Daytime leakage, night-time leakage, soiling and night-time emptying were more problematic in the ileostomy group. CONCLUSIONS: The proportion of patients who had postoperative stoma-related complications did not improve with time, but the rate of parastomal hernias in both groups and night-time emptying in the ileostomy group was worse with time. Ileostomy patients had a higher incidence of skin excoriation, leakage, soiling, and night-time emptying, and they should receive additional support.

Colorectal Neoplasms↗
PubMed1995

Reliability of reliability coefficients in the estimation of asymmetry.

Although promising to provide insight into the interaction between genotype and environment, investigations into fluctuating asymmetry suffer from a lack of standardization in the reporting of measurement error. In the present paper we show, using both anthropometric and odontometric data, that the use of the reliability coefficient calculated for a bilateral measurement provides no indication of the reliability of the corresponding asymmetry estimate, because reliability of asymmetry depends on the relationship between measurement error and the difference between sides. Thus, we suggest that future investigations either provide reliability coefficients for asymmetry estimates specifically, or use methods that account for measurement error.

Anthropometry↗
PubMed1994

Social cognitive factors in brain injury-associated personality change.

Often social difficulties are the most enduring difficulties after a head injury. The social deficits most frequently reported by relatives 6-12 months post-injury include egocentric styles of social interaction characterized by family members as a change in the head-injured patient's personality style. The described characteristics of head-injured patients in terms of social perspective-taking abilities are similar to those of children reported in the cognitive developmental literature. To demonstrate the nature of the social deficits in head-injured participants, social perspective-taking paradigms in the development literature were used to construct a task to be administered to both head-injured and non-head-injured adults. Results of the comparison between the two groups suggest deficits in social perspective-taking abilities in head-injured adults similar to the level demonstrated by pre-adolescent children.

Adolescent↗
PubMed1990

Biological and neuropsychological characterization of physostigmine responders and nonresponders in Alzheimer's disease.

To assess the efficacy of oral physostigmine for the treatment of Alzheimer's disease, 20 patients were entered into a clinical trial. All patients underwent a dose-finding phase (two weeks), followed by an open trial (two weeks), and a double-blind crossover phase (two weeks drug, two weeks placebo). Extensive neuropsychological testing (Buschke Selective Reminding procedure, category generation, picture recognition, finger tapping) and measurement of systemic cholinergic parameters were measured during each of these phases. Patients were classified as physostigmine responders and nonresponders based on a priori established criteria. Using these, nine patients were found to respond to physostigmine, while 11 were classified as nonresponders. During baseline conditions, responders when compared to nonresponders were found to have higher concentrations of red blood cell (RBC) choline (Ch) and higher ratios of RBC Ch to plasma Ch. Neuropsychological tests were found to fall into one of three categories. The first group of tests were sensitive to drug effects and differentiated physostigmine responders from nonresponders; the second group was found to predict responsiveness; and the third group was neither predictive nor sensitive to drug effects.

Activities of Daily Living↗
PubMedDate not supplied

Thoughts on reform in long-term care.

The authors, drawing on their experience as administrators at Winnipeg's Deer Lodge Centre, ponder the challenges facing long-term care facilities in light of improving community-supported care, changing resident's needs, and the fragile state of today's health care economy. This article identifies the need for fresh, resident-oriented thinking among administrators and staff in the distribution of power in long-term care facilities, and proposes new social interactions that can enliven and humanize residents' and staff's mutual roles and behaviours.

Aged↗
PubMedDate not supplied

Client-centred standards: risk implications for boards and management.

The author argues that the Canadian Council on Health Services Accreditation standards have acquired the status of law and that, therefore, there may be an increased risk of legal liability inherent in the use of the council's new client-centred standards. As survey teams focus less on structure and more on the individual client, the potential for instances of substandard care to be uncovered and documented as part of the survey process escalates.

Accreditation↗