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  • 1
    Title: ¬The¬ human nervous system : an introduction. CD-ROM
    Author: Hall, Marion
    Contributer: Olias, Gisela , Robinson, David , The Open University
    Publisher: Berlin u.a. :Springer,
    Year of publication: 2000
    Type of Medium: Book
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  • 2
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 107 (2000), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To assess the effect of smoking on the incidence of pre-eclampsia and on perinatal outcome in twin pregnancy.Design Retrospective study using Aberdeen Maternity and Neonatal Databank.Setting Grampian, Orkney and Shetland.Population All 1575 twin pregnancies delivered in the years 1969–1971 and 1976–1997 (when smoking data were available).Methods In all twin pregnancies the effects of smoking on pre-eclampsia were analysed by parity and gestation at delivery. The effect of smoking upon late miscarriage and perinatal outcome was analysed without subdivision.Main outcome measures Pre-eclampsia and perinatal outcome.Results Primiparae had significantly higher rates of pre-eclampsia than multiparae and were'delivered significantly earlier. The incidence of pre-eclampsia in smokers was significantly lower only in multiparae. Length of gestation was significantly shorter in multiparous smokers. The effect of smoking on pre-eclampsia appeared to be direct in multiparae but possibly indirect in primiparae (by causing earlier delivery). Smokers had a higher late miscarriage rate than nonsmokers.Conclusions In twin pregnancy the apparent protective effect of smoking against pre-eclampsia is significant only in multiparae, suggesting that in primiparae the smoking effect is overwhelmed by the other reasons for the development of pre-eclampsia. Smoking in twin pregnancy is not recommended due to the worse fetal outcome rates.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To evaluate the effectiveness of national guidelines and local protocols in improving hospital care (process and outcome) for women with menorrhagia and for women with urinary incontinence.Design 2×2 balanced incomplete block controlled before and after study.Setting Gynaecology units in four district general hospitals across Scotland.Intervention National guidelines were adapted locally to protocols, which were disseminated at specific local educational meetings and implemented by placing a copy of the appropriate protocol in women's hospital casenotes prior to consultation.Population Four hundred and ninety-seven women with menorrhagia and 449 women with urinary incontinence.Main outcome measures Process of care within six key areas of clinical practice: initial hospital assessment; appropriate use of hospital investigations; inappropriate use of hospital investigations; appropriate first line treatments; appropriate pre-surgery assessment; and use of surgical treatments. Outcome of care using condition-specific outcome measures and four domains of SF-36 at zero, six and twelve months following intervention.Results There were significant improvements with the introduction of guidelines and protocols in two (initial hospital assessment and appropriate pre-surgery assessment) of the six key areas of clinical practice assessed. In the other areas there were no significant improvements or deteriorations observed. There was no evidence of effect of guidelines and protocols on the condition-specific outcome measures or on the four domains of the SF-36.Conclusions There were only very modest benefits observed from the introduction of guidelines and protocols on the hospital management of the two conditions. The reasons for this lack of impact of the guidelines is unclear. Experience of this study raises important methodological issues for future research in this area.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 102 (1995), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To assess the validity and reliability of a measure of sexual function for premenopausal women.Design A self-administered sexual function questionnaire, derived from the Sabbatsberg Sexual Self-Rating Scale, and other health measures were given to women who were randomly sampled from the community health index.Subjects One hundred and forty-eight premenopausal women aged between 45 and 49 years.Main outcome measures The content validity, internal consistency and construct validity of the revised sexual rating scale.Results One hundred and thirty-seven women (92 %) responded to the main questionnaire and 89 (60%) completed the sexual rating scale, which possessed a high level of internal consistency; scores on the sexual ratings scale had small to moderate correlations with the measures of health, two of which (depression and role limitations attributable to emotional problems) were sufficient to explain 25 % of the variation in the sexual functioning scores.Conclusion Questions derived from the Sabbatsberg sexual self-rating scale have been used to construct a simple, acceptable, valid and reliable measure of sexual functioning for women in the 45 to 49 years of age group. Such a measure could be widely used as an adjunct to clinical and more general measures of health in order to assess the impact of interventions on sexual functioning within clinical trials.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To determine whether the higher levels of obstetric intervention and maternity service use among older women can be explained by obstetric complications.Design A retrospective analysis of routinely collected data from the Aberdeen Maternity and Neonatal Databank.Participants All residents of Aberdeen city district delivering singleton infants at the Maternity Hospital 1988-1997 (28,484 deliveries).Main outcome measures Odds ratios for each intervention in older maternal age groups compared with women aged 20-29. Interventions considered include obstetric interventions (induction of labour, augmentation, epidural use, assisted delivery, caesarean section) and raised maternity service use (more than two prenatal scans, amniocentesis, antenatal admission to hospital, admission at delivery of more than five days, infant resuscitation, and admission to the neonatal unit).Methods Logistic regression was used to investigate the association between maternal age and the incidence of interventions. The odds ratios for each intervention were then adjusted for relevant obstetric complications and maternal socio-demographic characteristics.Results Levels of amniocentesis, caesarean section, assisted delivery, induction, and augmentation (in primiparae) are all higher among older women. Maternity service use also increases significantly with age: older women are more likely to have an antenatal admission, more than two scans, a hospital stay at delivery of more than five days, and have their baby admitted to a neonatal unit. Controlling for relevant obstetric complications reveals several examples of effect modification, but does not eliminate the age effect for most interventions in most groups of women.Conclusions Higher levels of intervention among older women are not explained by the obstetric complications we considered.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    BJOG 108 (2001), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 101 (1994), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To derive clinical standards for singleton birthweight in a population based on area of residence.Design Analysis of variables recorded in Aberdeen Maternity and Neonatal Databank, calculating for each birth a standardised birthweight score, taking account of determining factors.Subjects All singleton live births of 32 to 42 weeks gestation to Aberdeen City District residents from 1979 to 1983.Results Basic standards of birthweight are presented correcting for gestational age, sex of the baby and parity of the mother. Birthweight is not normally distributed and empirical data are presented rather than smoothed curves. Adjustment for maternal height is straightforward but adjustment for maternal weight must take account of the gestation at which the woman was weighed. A method of calculating the appropriate correction for height and weight is described in detail.Conclusion Birthweight is not normally distributed at each week of gestation. Standardisation for parity, gestation and sex of the baby is essential, but adjustment for maternal size is complex.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 104 (1997), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A retrospective case record review of obstetric urinary tract injury in the Grampian region from 1976 to 1993 identified 16 cases of bladder injury (0.1 per 1000 deliveries, 1.4 per 1000 caesarean sections and four cases of ureteric injury (0.03 per 1000 deliveries, 0.27 per 1000 caesarean sections). Diagnosis of bladder injury was immediate, but of ureteric injury often delayed. Although the injury rates are lower than previously reported and previously reported risk factors not confirmed, this audit has resulted in guidelines for junior staff, compliance with which will be monitored, and every case of urinary tract injury will be reviewed.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 103 (1996), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
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