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Biomedical subjects

T Draycott

Publications and source records attributed to T Draycott.

12 recordsLinked to original sources
PubMed2005

A randomised controlled trial of a new handheld vacuum extraction device.

OBJECTIVE: To evaluate the effectiveness of a new handheld vacuum delivery device. DESIGN: Randomised controlled trial. SETTING: Southmead Hospital, Bristol, UK. POPULATION: One hundred and ninety-four women requiring delivery with vacuum extraction. METHODS: Women were recruited into the study while still in early labour. If during delivery, vacuum extraction was indicated they were then randomly allocated to either a new handheld vacuum device, the Kiwi Omnicup, or to a 'standard' vacuum cup selected by the obstetrician. The 'standard group' consisted of the silastic (66/98, 67%) or the metal cups (32/98, 33%). Study data were recorded at completion of the delivery and at 24-48 hours. An additional brief symptom questionnaire was completed by the mother at 10 days postnatally. Statistical analyses were done on an 'intention-to-treat' basis. MAIN OUTCOME MEASURES: The primary outcome was the successful completion of delivery with the allocated instrument. Secondary outcomes were substantial fetal scalp trauma and substantial maternal trauma. RESULTS: The Omnicup was associated with a significantly higher failure rate than the standard cup [34%vs 21%, odds ratio (OR) = 1.9 (1.01-3.6)]. This difference persisted after adjusting for confounding factors [adjusted OR = 2.25 (1.01-5.0)] and resulted in significantly more forceps deliveries in the Kiwi Omnicup group [22%vs 10%, unadjusted OR = 2.5 (1.1-5.5)]. The caesarean section rates were similar in both groups [9.4%vs 8.2%, OR = 1.2 (0.4-3.2)]. Rates of substantial scalp trauma and maternal trauma were similar in both groups. However, there were more cases of jaundice in the standard cup group [2.3%vs 12.0%, unadjusted OR = 0.18 (0.04-0.82) and adjusted OR = 0.10 (0.01-0.88)]. CONCLUSIONS: The Omnicup is not as successful at achieving a vaginal delivery as the combination of the currently used vacuum cups.

Female↗
PubMed2001

Medical education with the Internet: a pilot training programme in reproductive medicine.

Following a detailed information technology survey in the South West Deanery, an Internet educational programme in reproductive medicine was constructed, delivered and assessed. The course followed a problem-based approach using case studies, using an education website and electronic mail (e-mail) to communicate between trainees and trainers. Independent evaluation revealed a high level of satisfaction for both trainees and trainers with an increase in trainees' confidence to deal with patients following the course. This study suggests that the Internet may be used effectively to deliver postgraduate medical education, if the training programme is designed appropriately to computer infrastructure and the computer literacy of the users.

Education, Distance↗
PubMed2000

Cocaine misuse treatment in England.

Three methods were used to identify the treatments given to cocaine misusers in England, and to make a preliminary assessment of effectiveness. First, a postal survey of all known drug misuse treatment services ascertained approximate numbers of cocaine misusers presenting and receiving a specified range of treatments. Secondly, staff at selected services were interviewed regarding treatment policies, and asked to subjectively rate short-term and long-term effectiveness. Thirdly, a cohort of individuals in treatment were studied prospectively to assess changes in drug usage and associated problems. Fifty percent of services responded to the survey, but there was known to be significant duplication in service listings and it is considered that a representative pattern of clinical activity has been detected. Approximately half those services had recently treated cocaine misusers, mainly using counselling, residential rehabilitation, and pharmacological treatments, in which 32 different medications were identified. Acupuncture was prominent in a minority of services. Staff interviews suggested several principles in managing cocaine misusers, while all treatments were rated as being more effective in short-term relief of withdrawal features than in enabling longer-term abstinence. The treatment cohort were mostly in residential rehabilitation, and marked reductions in drug use and related clinical and social problems were demonstrated.

Journal Article↗
PubMed1999

Information Technology for postgraduate education: survey of facilities and skills in the South West Deanery.

OBJECTIVE: To determine the Information Technology (IT) infrastructure available to, and IT skills of, obstetric specialist registrars across the South West Deanery. DESIGN: Open prospective study. SETTING: NHS Hospitals in the South West Deanery. METHODS: Two separate surveys. Firstly, the computer equipment available to trainees was determined at each hospital in the deanery on site using a software programme. Secondly, IT skills of a sample of 22 specialist registrars were assessed using a checklist at a series of four workshops. MAIN OUTCOME MEASURES: Computers with sufficient specification to use CD-ROMs, to access the Internet, and to support data-, audio- and video-conferencing. The number of trainees with IT skills to use a computer-aided learning package and the Internet. RESULTS: Sixty-six percent of trainees have access to a computer with a CD-ROM drive. Sixty-six percent also have access to the Internet at their place of work. Thirteen percent have access to data-conferencing but there were no computers in the Deanery able to support audio- or video-conferencing. Twenty-five percent of trainees have no IT skills and require basic training in the use of computers. Thirty-six percent of our sample would require training to be able to use computer-based tutorials programs. Seventy-seven percent of trainees require training to be able to use the Internet without assistance. CONCLUSION: A significant minority of trainees do not have access to computers with sufficient specification to run basic tutorial programmes or access the Internet. Similarly, a large minority of trainees do not even have a basic knowledge of computer technology and IT training is required for the majority of trainees for them to reap the potential benefits which computer-based tutorials systems and the Internet can give.

Computers↗
PubMed1998

Junior doctors. Night vision.

By establishing separate timetables for senior house officers and registrars, an obstetrics and gynaecology department has been able to reduce out-of-hours work while offering training relevant to the doctors' proposed careers. Following the establishment of a daily, open-access gynaecology clinic, extending the role of midwives has reduced the out-of-hours workload of junior doctors. Emergency admissions, a major feature of out-of-hours work, have fallen by a quarter.

Appointments and Schedules↗
PubMed1997

The managed care of early pregnancy problems.

There is an increasing trend towards non-invasive diagnosis and conservative treatment for early pregnancy problems. Although there are enormous potential benefits for women being treated thus, the ideal treatment methods and diagnostic algorithms have yet to be elucidated. Further large-scale studies are required.

Abortion, Spontaneous↗