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Biomedical subjects

P Harker

Publications and source records attributed to P Harker.

7 recordsLinked to original sources

Mobile orthoptic service for primary screening of visual disorder in young children.

A mobile orthoptic service was begun in 1976. General practitioners, clinic doctors, and health visitors referred 4544 preschool children to the service in 18 months. Of the children referred, no defect was detected in 3138 (69%), 927 (20%) were recalled for a second assessment within 12 months, and 479 (11%) were referred for treatment. Out of 261 who received treatment in Oxford, 24 (9%) received aftercare. Benefits of the service included a 25% decrease during 1976-7 in inappropriate referrals of preschool children to the specialist hospital. The chance of inappropriate referral was reduced by a factor of 30 if a child was referred to the mobile service instead of to the eye hospital. A prevention programme such as the mobile orthoptic service can improve the rate of detection of visual disorder in young children, while providing the support needed by primary-care doctors and nurses for visual screening of preschool children easily and cheaply.

Adolescent

Infant feeding and overweight in two Oxfordshire towns.

In a study of feeding and growth in the first year of life in two Oxfordshire market towns, the frequency of overweight babies was the same for the 'intervention' town (where a research health visitor gave intensive advice to mothers on feeding) as for the control town. Eighteen per cent of bottle-fed infants and three per cent of those breast fed were overweight at one year. It seems that an increase in the number of health visitors does not affect the frequency of overweight infants, but it may be that a greater emphasis on breast feeding might reduce the frequency.

Bottle Feeding

Primary immunisation and febrile convulsions in Oxford 1972-5.

A three-year study of febrile convulsions in Oxford with comprehensive notification from general practice and hospitals showed a 3% risk for all children of suffering at least one febrile convulsion by the age of 5 years. Children were most at risk between 6 and 27 months, and febrile convulsions were most likely to be prolonged in children aged 9-15 months. The association between febrile convulsions and primary immunisations in the preceding 28 days was compared in case and control children, matched for age and sex. Results suggested that such association was a chance relationship with age. If association was direct, the febrile convulsion rates per 1000 immunisation doses were estimated as follows: diphtheria, pertussis, tetanus--0-09 per 1000; poliomyelitis--0-6 per 1000; and measles--0-9 per 1000. Hence if any of these vaccines had a secific causal relationship with febrile convulsions, these rates would probably have been much higher.

Child

Attaching community psychiatric nurses to general practice.

A scheme for attachment of psychiatric nurses from hospital to group practice in Oxford is described. One community psychiatric nurse can work satisfactorily with eight general practitioners covering a population of about 18,000. From analysis of a working year, it is concluded that this arrangement improves the care of patients in the community by providing psychiatric help at times when it was previously unavailable or unacceptable.The implications of such a scheme for the workings of the primary health care team and the hospital psychiatric service are considered, and a case is made for a further study involving a comparison between practices with and without the attachment of a community psychiatric nurse.

Community Mental Health Services