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Biomedical subjects

S Jowett

Publications and source records attributed to S Jowett.

13 recordsLinked to original sources
PubMed1997

A review of near patient testing in primary care.

AIMS AND OBJECTIVES: The aim was to identify publications relating to near patient testing (NPT), the use of alternative delivery systems between laboratory and general practice, including electronic data interchange (EDI), and computerised diagnostic decision support (CDDS), in the primary care setting to answer the following questions. What is the availability of NPT for primary care? What evidence is available to support the clinical effectiveness of NPT? What evidence is available on the accuracy and reliability of NPT within primary care? What evidence is available on the cost-effectiveness of different NPTs? How may CDDS improve the effectiveness of NPT? What evidence is available that compares NPT and existing laboratory services? What evidence is available on the cost-effectiveness of EDI or alternative delivery systems? HOW THE RESEARCH WAS CONDUCTED: Eight databases were searched, and the bibliographies from relevant publications checked for completeness. Unpublished work and publications not included in the databases were obtained by personal contact with collaborators, and from a postal survey sent to heads of academic departments of general practice and clinical chemistry and to researchers active or interested in the field worldwide. Questionnaires were also sent to 150 commercial organisations. Publications that met agreed definitions and reported original data were included in the systematic review. Of the 1057 publications identified, 102 (92 related to NPT, eight to CDDS, and two to EDI) were passed to the reviewers for appraisal of validity. The limited amount of published research relating to any particular NPT prohibited meta-analysis. Scoring systems to assess the validity of evaluations were also difficult to apply. RESEARCH FINDINGS: A wide variety of NPT systems have been developed. In general, the quality of the methods reported in the literature was poor. The issue of patient convenience and acceptability has not been adequately addressed. No evaluations of alternative delivery systems met the review criteria. No studies have evaluated the telephone or fax machine as a means of reporting results. For EDI, the majority of papers were descriptive. EDI and alternative delivery systems are not a replacement for NPT when the provision of an immediate result might have an impact on the quality of care. EDI may have clinical and cost advantages over traditional means of communication, but this has not been evaluated. The advisory role of the laboratory can be supported by CDDS. The use of CDDS and NPT has not, however, been fully evaluated. Few economic analyses have been conducted, and most were simple cost analyses. There are insufficient data for conclusions to be drawn on the cost-effectiveness of NPT in primary care. RECOMMENDATIONS: FURTHER SYSTEMATIC REVIEWS: Subject-specific systematic reviews are required that include laboratory and secondary care studies, and consider the potential for altering current management and patient acceptability. Priority topics include: biochemistry profiles on desktop analysers; cholesterol testing; urinalysis for the diagnosis of urinary tract infection; anticoagulation control; NPTs for the identification of acute infection. (ABSTRACT TRUNCATED)

Cost-Benefit Analysis↗
PubMed1995

Nurse education in the 1990s--the implementation of the pre-registration Diploma course (Project 2000).

This paper reports on a four-year longitudinal study of the implementation of Project 2000. Interviews were conducted with a variety of staff involved in the changes, as well as with a sample of students who were seen at several points during the course and once after completion. The rationale for adopting a qualitative methodology is explored and the strengths of this approach for gaining an understanding of such a complex series of changes are outlined. Some of the findings pertaining to the introduction of the Diploma course are presented and some points for consideration as courses are reviewed and developed are included.

Curriculum↗
PubMed1988

Hospital and community liaison links in nursing: the role of the liaison nurse.

Since the 1960s there has been an awareness of a 'care-gap' when patients are transferred between hospital and home. In the United Kingdom, attempts to improve continuity of care have included the development of the role of the hospital/community liaison nurse. The liaison role has evolved in different ways and no systematic evaluation has occurred. This paper reports the findings of an exploratory study into the structure and process of the liaison role. It is suggested that the role is effective in enhancing continuity of care, but that modifications accompanied by educational and organizational changes would improve current practice.

Clinical Nursing Research↗
PubMed1985

Skin disease and handicap: an analysis of the impact of skin conditions.

This research sought to quantify the handicapping effect of skin conditions in a far more rigorous way than had previously been attempted. One hundred people who had attended a hospital outpatient clinic during a specified period for treatment of their acne, psoriasis or eczema were interviewed in their homes. A comprehensive and structured interview schedule was used and interviewees were encouraged to talk at length about the impact that their skin conditions had had on their lives. Detailed data were collected that show the serious effect that these diseases can have in several domains. The findings record not only the physical discomfort and inconvenience sufferers may meet but also the consequences for their personal and social life and daily functioning. There is evidence from interviewees' employment experiences of limited opportunities, and functional and interpersonal difficulties in the workplace. 64% of people said that their skin disease affected their socio-economic activity. The extent to which sufferers experienced embarrassment, anxiety, a lack of confidence and depression is documented. 40% of people felt that their social life was affected and there was evidence of particular stresses and demands in personal relationships. The social impact of skin disease is discussed.

Acne Vulgaris↗
PubMedDate not supplied

Sleep problems in pre-school children: a review of the literature.

This paper reviews the literature on sleep problems in pre-school children, aiming to raise awareness of the current knowledge in this field. The article begins with a discussion of the prevalence of sleep problems in young children. Disorders of initiating and maintaining sleep are by far the most common type of sleep problem in this age group, and are therefore the focus of this review. The effects of sleep disturbance are examined, focusing on how parents often feel desperate and in need of support outside the family. The causes of sleep problems are considered and the complexity in identifying causal factors is highlighted. The article continues with an exploration of the treatment of sleep problems, suggesting that much of the advice given to parents is contradictory. The literature demonstrates that the use of medication is common, but it appears that this method of treatment is of limited benefit. It seems that behaviour modification or a psychodynamic approach may be much more successful, and the use of self-help manuals/booklets has been shown to be useful by some authors. Finally, preventative strategies are discussed highlighting the need for further research in this area.

Behavior Therapy↗
PubMedDate not supplied

Scanning skills.

Explore the source record for details and available documents.

Female↗
PubMedDate not supplied

Make marketing your business.

Drawing on a recent report commissioned by the Department of Health, the authors discuss some of the implications of the NHS internal market reforms for nurses, midwives and health visitors. They focus on ways in which marketing techniques and strategies can be used by these professionals in their workplaces to improve the quality of care to clients. The views and experiences of some practitioners and managers are presented to show the potential benefits of this more proactive and market-oriented approach to health.

Community Health Nursing↗