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11.
LESLEY BOULTON MB CHB FRACO DO Ophthalmologist 《Clinical & experimental ophthalmology》1986,14(4):365-371
The Low Vision Clinic at the Palmerston North Hospital has now been oerating for 70 years. Over the course of these ten years a number of factors have emerged which can be as readily applied to general ophthalmological practice as to low vision practice. The philosophy of low vision care is one of which all ophthalmologists should be aware and includes factors to be taken into account when dealing with children, people in the workplace, and everyday factors involved in daily living activities, all of which are equally relevant in routine ophthalmological practice. This paper endeavours to share some thoughts on these factors and also discusses means by which the visually handicapped can be helped in areas where specialist low vision services are not readily available. 相似文献
12.
Comparison of trichloroethylene and enflurane as adjuncts to nitrous oxide and relaxant anaesthesia 总被引:1,自引:0,他引:1
Forty women who underwent gynaecological surgery were randomly allocated to receive trichloroethylene, enflurane, or enflurane plus fentanyl as adjuncts to nitrous oxide/relaxant anaesthesia with controlled ventilation. No serious cardiac dysrhythmias were seen in any group. Each patient was observed postoperatively for 4 hours by a nurse blind to the technique used, and questioned at 24 hours by a similarly blinded anaesthetist. Recovery after trichloroethylene was not significantly prolonged although postoperative analgesia by visual analogue was better, opiate analgesia was required less frequently and there was less nausea and vomiting than in either of the enflurane groups. We argue for the continued use of trichloroethylene by this technique, because it costs one hundred times less than enflurane and because of the potential morbidity of the postoperative opiate dosage required after enflurane. 相似文献
13.
14.
E.Paul Kirk MB BS J. Santa MD T. Heckler MBA M. Collins MD 《American journal of obstetrics and gynecology》1998,178(6):1222-1228
OBJECTIVE: Our purpose was to assess whether legislative action influenced the role of obstetrician-gynecologists as primary care physicians. STUDY DESIGN: An observational study was performed on the basis of a questionnaire sent to 410 obstetrician-gynecologists and 27 medical directors of managed-care organizations. RESULTS: Of 67% of obstetrician-gynecologists and 96% of medical directors who responded, there was agreement as to the content of primary care, but a minority (38%) of obstetrician-gynecologists identified themselves as primary care providers. A minority of medical directors (35%) felt that obstetrician-gynecologists should serve in that role. Both obstetrician-gynecologists and medical directors felt that legislation had little impact. CONCLUSION: The reticence of obstetrician-gynecologists to assume a major role in primary care appears to be the result of an uneasiness with accepting a more comprehensive role in patient management and gatekeeping. They appear comfortable with the more traditional roles but feel that training and experience has not prepared them well for the management of more complex medical problems. (Am J Obstet Gynecol 1998;178:1222-8.) 相似文献
15.
Creating empowering meaning: an interactive process of promoting health with chronically ill older Canadians 总被引:2,自引:1,他引:1
McWilliam C; Stewart M; Brown J; McNair S; Desai K; Patterson M; Del Maestro N; Pittman B 《Health promotion international》1997,12(2):111-123
Many health promotion approaches afford education about disease prevention
and enhancement of one's health status. But strategies for enabling older
people with chronic illness to better mobilize their resources for everyday
living still require development. This practical action research study
explored the experiences of 13 purposefully selected older persons who
participated in a health promotion intervention premised on the adult
education theory of perspective transformation. Findings illuminate health
promotion through a holistic interactive process in which professional and
chronically ill older person together evolved a caring relationship and
enhanced conscious awareness of life and health experiences. Five
health-promoting strategies were identified: building trust and meaning;
connecting; caring; mutual knowing; and mutual creating. Researchers
suggest several important directions to refine professional practice
approaches and health care delivery systems in order to promote the health
of older persons with chronic conditions. 相似文献
16.
17.
Patients'attitudes to rectal drug administration 总被引:2,自引:0,他引:2
One hundred adult patients attending for day case surgery were surveyed by anonymous questionnaire in order to determine their attitudes to rectal drug administration. Fifty four patients did not want an analgesic drug (diclofenac sodium) administered rectally whilst under anaesthesia, all preferring to take it orally if available. Ninety eight patients thought that drugs administered per rectum should always be discussed with them beforehand and a few had very strong feelings about this route of administration. We suggest that prescribers of rectal diclofenac should always discuss it with patients pre-operatively. Whilst many are happy to have suppositories, some young patients are sensitive about this and prefer to take such medication by mouth. 相似文献
18.
Barry J. Nicholls MB ChB FFARCS Bruce F. Cullen MD 《Journal of clinical anesthesia》1988,1(2):115-129
Trauma is the leading cause of death for persons aged 1 to 38 years. Successful management is facilitated by prehospital endotracheal intubation, transport to regional trauma centers, rapid resuscitation by an on-site team of trained physicians, timely operative intervention, and provision of care by well-prepared anesthesiologists familiar with the potential complications typical of traumatized patients. No particular anesthetic agent or technique is ideal. Causes for intraoperative hypotension include hypovolemia, hemopneumothorax, pericardial tamponade, an intracranial mass, acidosis, and hypothermia. The anesthesiologist should play an active role in all phases of trauma management, including provision of postoperative intensive care and pain relief. 相似文献
19.
C. R. Goucke MB ChB FFARACS J. P. Keaveny MB BCh BAO FFARCS B Kay DMSc MB ChB FFARCS T. E. J. Healy MSc MD FFARCS M. Ryan MB ChB FFARCS 《Anaesthesia》1990,45(4):329-331
Eighty-two outpatients who received general anaesthesia for surgical removal of maxillary or mandibular third molars were given either diclofenac 75 mg or nefopam 20 mg intramuscularly for postoperative pain control. They and the control group were also allowed oral paracetamol as required. The results showed that there was no significant pain relief from these single intramuscular injections. 相似文献
20.
Robert D Bourke MB BS John Pyle MB BS; FRACO FRACS † 《Clinical & experimental ophthalmology》1994,22(1):77-80
Herpes zoster ophthalmicus (HZO) commonly causes isolated ophthalmoplegic syndromes. Visual loss caused by optic neuritis secondary to HZO can be reversible or irreversible. HZO rarely presents as an orbital apex syndrome, when an association with meningo-encephalitis has been reported. We report a case of orbital apex syndrome secondary to HZO treated with systemic steroids and acyclovir. Our patient suffered no systemic complications and displayed a rapid resolution of optic neuropathy. We discuss this case in the light of previous reports and explore the possible pathogenic mechanisms involved. 相似文献