Biomedical subjects

N E Mayo

Publications and source records attributed to N E Mayo.

43 records · Page 3Linked to original sources

PubMed1989

Determining medical fitness to drive: physicians' responsibilities in Canada.

Current legislation indicates that physicians in Canada have a legal responsibility to know which medical conditions may impede driving ability, to detect these conditions in their patients and to discuss with their patients the implications of these conditions. The requirements to report unfit drivers vary among the provinces, and the interpretations of the law vary among the courts; therefore, physicians' risks of liability are unclear. Physicians may be sued by their patients if they fail to counsel the patients on the dangers of driving associated with certain medications or medical conditions. Physicians may also face legal action by victims of motor vehicle accidents caused by their patients if the court decides that the physicians could have foreseen the danger of their patients' continuing to drive. Physicians' legal responsibilities to report patients with certain medical conditions override their ethical responsibilities to keep patients' medical histories confidential.

Accidents, Traffic↗

PubMed1989

Predicting falls among patients in a rehabilitation hospital.

A retrospective case-control study within a cohort was carried out to identify factors associated with falling by patients in a rehabilitation hospital. The cohort comprised all patients admitted during a 2-year period from 1984 to 1986. Cases were those who fell one or more times during their hospitalization. For each case, one control matched on sex and date of admission, was chosen. Material from the first year of the cohort (201 cases and 201 controls) was used to define a model to estimate the risk of falling. Of the more than 100 variables considered in the conditional logistic regression models, stroke, incontinence, anticonvulsant medications, and topical eye preparations were significantly associated with the risk of falling. Analyses carried out on the second year of the cohort (155 cases and 155 controls) confirmed the predictive ability of these four variables. By combining the material from both subcohorts we were able to determine that a program to reduce falls directed towards stroke patients and incontinent patients alone could, theoretically, prevent 44% of first falls.

Accidental Falls↗

PubMed1989

Destinations of stroke patients discharged from the Montreal area acute-care hospitals.

The destinations of stroke patients after discharge from acute-care hospitals were studied to ascertain the current use of health care resources. The 1984-1985 acute-care hospital discharge listings for the province of Quebec were consulted to identify 3,045 adults of the Montreal area who were discharged, deceased or alive, with a primary or secondary diagnosis of stroke. The relation between the length of stay (i.e., the time to death or discharge to long-term care, rehabilitation, or home) and the explanatory variables (age, sex, neighborhood socioeconomic status, type of stroke, and university affiliation of the discharging hospital) was assessed using Cox's proportional hazards models. Older patients and those with hemorrhagic strokes had the highest risk of death. However, patients with hemorrhagic strokes were more likely to survive if admitted to a university teaching hospital. Older patients, those with nonhemorrhagic strokes, and those admitted to university teaching hospitals were more likely to be discharged to long-term care. A greater proportion of patients discharged to rehabilitation centers were young, lived in a high-socioeconomic-status neighborhood, and had suffered a nonhemorrhagic stroke. Patients had a significantly higher probability of going home if they were young, had had a nonhemorrhagic stroke, had been admitted to a university teaching hospital, or were male.

Age Factors↗

PubMed1988

Observer variation in assessing spinal curvature and skeletal development in adolescent idiopathic scoliosis.

Accurate measurements of spinal curvature and skeletal development are crucial in planning treatment and assessing curve progression in adolescent idiopathic scoliosis (AIS). An inter-rater agreement trial was undertaken to estimate the reliability of measuring these spinal parameters. Two orthopaedic surgeons and two trained technicians from a scoliosis clinic independently read 30 anteroposterior roentgenograms of AIS patients. Skeletal maturity was assessed using the six-point Risser sign scale, and spinal curvature was measured using the method of Cobb. Excellent agreement was observed in evaluating Risser signs (Kappa = 0.8) and primary Cobb angles (intra-class correlation coefficient, Rho = 0.98). The standard deviation of inter-observer error in measuring primary Cobb angles was 2.5 degrees, and the intra-reader error, based on one observer's reassessments of 15 films, was 1.9 degrees. Inter-rater agreement for assessing secondary Cobb angles was much lower (Rho = 0.52) because small curves (less than 20 degrees) were often not noticed. Differences in agreement between surgeons and technicians were relatively minor. These results indicate that personnel trained at this clinic are able to assess these spinal parameters reliably.

Adolescent↗

PubMed1981

The effect of a home visit on parental compliance with a home program.

This study was designed to test the hypothesis that one home visit would improve parental compliance to a physical therapy program prescribed for children with delayed motor development. Eighteen mothers and their infants were randomly assigned to two groups, only one of which received the home visit. After one month of following the regimen at home, the parents were evaluated for the degree to which they complied with the prescribed physical therapy program. The motor development of their child was also reassessed. Although mothers who received a home visit showed a higher rate of compliance, the difference was not significant. However, mothers of children with severely delayed motor development demonstrated a significantly higher rate of compliance than did mothers of moderately delayed children (p < .01). The improvement in the developmental level of the children whose parents had received a home visit was demonstrated to be greater. The small number of subjects and several limitations in experimental design preclude drawing any definitive conclusions.

Child, Preschool↗

PubMed1978

Patient compliance: practical implications for physical therapists. A review of the literature.

Patients do not always follow medical advice. This literature review describes the extent to which patients fail to comply, methods of measuring compliance, factors affecting compliance, and programs to obtain maximal compliance. Although most of the literature on patient compliance stems from drug studies, physical therapists can gain valuable information from these studies. Some of the practical implications for physical therapists are presented.

Attitude to Health↗

PubMedDate not supplied

Disablement following stroke.

PURPOSE: Stroke is the most disabling chronic condition, newly affecting 35000 persons in Canada each year. Because of declining fatality, a growing number of persons will have to cope with stroke-related disability. The purpose of this paper is to describe the disabilities experienced by persons with stroke during the first year and explore the evolution of impairment, disability, handicap and health-related quality of life. SUBJECTS: The data for this paper come from a series of longitudinal and cross-sectional studies, collectively known as the McGill Stroke Rehabilitation Research Program. RESULTS: Within the first week post-stroke, getting out of bed and walking over a short distance, even with assistance, was a strong predictor of discharge home. Most of the improvement in measures of impairment and disability occurred during the first month and, by 3 months, there was still considerable room for improvement in all measures: 85% of persons were still impaired on gait speed, 78% had not reached age-specific norms for upper extremity function, 68% still demonstrated slow physical mobility, 37% needed some assistance with basic activities of daily living and 29% were still impaired on balance. By 1 year, 73% of persons scored the maximum for basic activities of daily living but 51 and 67% of persons reported their physical health and mental health to be lower than expected. Among a hardy group of stroke survivors, still living in the community 1 year post-stroke, the most striking area of difficulty was endurance, as measured by the 6 minute walk test. Those subjects well enough to complete this task (50% of sample) were able to walk, on average, only 250 metres, equivalent to 40% of their predicted ability. This series of snapshots taken at different points in time suggests that much of the improvement in impairment and disability occurs during the first month and then reaches a plateau. Handicap and quality of life continue to be issues later. Rehabilitation strategies need to consider the multifaceted nature of disablement, which in itself changes with time post-stroke.

Activities of Daily Living↗