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131.
Daniel Blake Nicola J Roberts Martyn R Partridge 《Primary care respiratory journal》2007,16(5):319-320
A pilot study was undertaken to assess the respiratory component of primary care nurses' working time. 13 nurses were interviewed and 10 completed a diary during one working week. The nurses spent a mean 6.6% of their time caring for those with respiratory disease and were of the opinion that during this time they undertook 68% of the management of long term respiratory illness in the practices. More time was spent with those with asthma than with other respiratory conditions and the nurses felt that they were appropriately trained for the tasks undertaken. However, with more training they felt that they could undertake more basic care of those patients with COPD, and more advanced care of those patients with asthma. 相似文献
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133.
M Janghorbani S Rockway C S Mooers E M Roberts B T Ting M D Sitrin 《The Journal of nutrition》1990,120(3):274-279
We examined the effect of chronic selenite supplementation on whole body and selected organ selenium (Se) accumulation, urine excretion of total Se and trimethylselenonium ion, and Se balance in adult male rats. Animals were housed in metabolic cages and given either deionized water or water containing 4 micrograms of Se/mL as selenite for 30 d. Absorption of selenite was nearly complete, with only approximately 10% of ingested Se appearing in feces. There was a rapid rise in urinary Se that reached a plateau within a few days and accounted for 54 +/- 2% of the intake. Excretion of trimethylselenonium ion (TMSe) in urine increased rapidly, representing 35-40% of urinary Se in the supplemented animals compared with only 2% for the control group. In one experiment, rats were killed at 30 d and total carcass Se was measured using isotope dilution analysis. Supplemented rats had only a modest increase in whole body Se (94 +/- 4 micrograms Se vs. 66 +/- 3 in controls). Calculation of Se balance in the supplemented rats showed that approximately 35% of ingested Se could not be accounted for by urine plus fecal losses combined with the portion retained in the carcass. The results from this study demonstrate that under the condition of supplementation at 4 micrograms of Se/mL of drinking water, pathways other than urinary and fecal excretion may account for a substantial portion of Se loss. 相似文献
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136.
H G French S W Burke J M Roberts C E Johnston T Whitecloud J O Edmunds 《Journal of pediatric orthopedics》1987,7(1):69-71
Six patients with upper cervical spine ossicles and Down syndrome from a study population of 184 are described. The average age was 20.6 years at the time of diagnosis. Three of the patients were involved in tumbling. Radiographic anatomy of the ossicles and the dens, as well as serial radiographs in three of the six patients, suggest that this represents an avulsion of the upper end of the dens rather than an occipital vertebrae, ossiculum terminale, or os odontoideum, as previously described. The authors advocate restriction of high-risk activities for all patients with Down syndrome. 相似文献
137.
Twelve patients with progressive renal failure were placed on a very low protein diet supplemented by an essential amino acid-keto acid mixture for six to twelve months. Total daily intake was 0.04 g nitrogen/kg and 50 kcal/kg. Eight subjects had a significant change in the slope of reciprocal plasma creatinine, becoming less steep and in two cases positive. GFR did not improve, but in four patients the decline over twelve months was less than 0.5 mliter/min. There were significant falls in blood and urinary urea, serum phosphate PTH and calcium X phosphate product. Body wt decreased during the first three months. Arm muscle circumference fell by 0.9 cm (P less than 0.005). Serum albumin and transferrin levels did not change significantly. Muscle mass and plasma creatinine fell simultaneously in several patients. Creatinine excretion per kg muscle mass, assessed anthropometrically, declined by 21% in the first three months. This diet may slow the decline in renal function in a proportion of patients. However, muscle mass can be lost. Serum protein levels do not accurately reflect nutritional changes. A fall in plasma creatinine may not be due to improved GFR but instead to altered creatinine metabolism. 相似文献
138.
Assessment of fracture healing by spectral analysis 总被引:1,自引:0,他引:1
H H Doemland R R Jacobs J Spence F G Roberts 《Journal of medical engineering & technology》1986,10(4):180-187
The 'in vivo' impulse response of long bones was investigated with the object of assessing the reliability of data taken under various conditions. The ultimate goal of the research is to develop a non-invasive method of monitoring the healing of long bones. A spectrum analyser was developed specifically for this investigation and is presented here. 相似文献
139.
Melinda Braskett MD Robert L. Roberts MD PhD 《Clinical Pediatric Emergency Medicine》2007,8(2):96-103
The potential for morbidity and mortality in patients who have PID with febrile and nonfebrile illness is extremely high. Familiarity with the clinical manifestations of PID and collaboration with a pediatric immunologist are prerequisites for optimal short-term care of these complex patients. Conservative management with empiric broad-spectrum antimicrobials, early and aggressive surgical debridement of abscesses, and admission at a tertiary pediatric care center are often indicated. 相似文献
140.
Shared care: a review of the literature 总被引:7,自引:1,他引:6
This review examines broad issues of concern regarding the primary/secondarycare interface. The main purpose was to identify areas of goodpractice which could be adapted for more general use. One ofthe most fundamental aspects identified was communication, whichis discussed in some detail. Also covered are shared prescribingand disease management. The data suggest that the most effectivesystem(s) of shared care has yet to be established. Furtherqualitative and economic evaluations are required, taking intoaccount patient preferences. Although the literature does describecertain practice exemplars, it is clear that inter- and intra-professionalcommunication continues to be a problem. Whilst informationtechnology may provide some of the solutions, it is concludedthat a culture change, which compels health professionals tomake sharing of patient information a much higher priority,is reauired. Keywords. Shared care, seamless care, hospital, general practice, family practice. 相似文献