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Biomedical subjects

A L Morris

Publications and source records attributed to A L Morris.

At least 37 records · Page 2Linked to original sources
PubMed1987

Assessment of private dental practice: implications for dental education.

The development and testing methods for assessing the quality of private general dental practice are described. The assessment instrument, evolved through the contributions of a panel of private practitioners, provides for the evaluation of the structure, process, and outcome of practice. General practitioners, trained as evaluators, tested the instrument in 300 urban group, urban nongroup, and rural practices in 14 states. The distribution of assessment scores for the entire project sample is compared with those of the sample dentists who graduated before and after 1974. The implications of the project and its results to dental education are discussed.

Dental Care↗
PubMed1985

Response of general practitioners to a national dental office evaluation program. Office of Quality Assurance.

The methods used and the results achieved in an effort to solicit 300 volunteers to test the feasibility of a dental office assessment instrument have been described. In response to personal letters to general practitioners in 14 states, 13.9% returned a card indicating a willingness to consider participation. The response rate from different states ranged from 8% to 21.7% with the response being more favorable from states with fewer dentists. Year of graduation from dental school had little effect on the rate of response. Rural dentists responded at a slightly more favorable rate. Of dentists responding, 71% did so within 2 weeks and 90% within the first month after receiving the solicitation. Mail solicitation can be used successfully in recruiting private practitioners for participation in an in-office practice assessment program.

Adult↗
PubMed1983

Suspect myocardial infarction: hospital management and prognosis.

The management of 442 consecutive patients admitted for suspect acute myocardial infarction (?MI) was compared at two urban hospitals. The community hospital utilized an unmonitored observation unit (OU) more frequently than did the university hospital (39% vs. 9%, respectively). Progression to acute myocardial infarction (AMI) occurred in 25% of admissions, 5-7% of whom died. Mortality without AMI was rare. Availability of the OU appeared to result in reduced coronary care unit (CCU) utilization and in shorter hospital stays for low-risk patients who comprised fully 37% of hospital admissions. Low- and high-risk subgroups (12% vs. 34% risk of AMI) were identified by normal versus abnormal admission electrocardiograms (EKG). Two-thirds of the low-risk patients with AMI were diagnosed by the next hospital day. A normal EKG on both the day of admission and on the second hospital day identified a population with less than 1% risk of in-hospital AMI. The increased use of non-CCU facilities for many ?MI patients appears to be appropriate. However, only randomized allocation trials, which were never performed for patients with definite AMI, would establish the relative efficacy of CCU versus non-CCU treatment.

Adult↗
PubMed1983

Acute myocardial infarction: survey of urban and rural hospital mortality.

Mortality rates for acute myocardial infarction (AMI) in the province of Manitoba were studied by a retrospective, randomized survey of urban and rural hospital records. Urban hospitals had formal coronary care unit (CCU). Selected rural hospitals lacked CCUs but usually possessed portable monitoring and defibrillation equipment. Twenty-seven percent of 852 cases in the study population died. The mortality rate for unequivocal AMI was 14% to 15% to both urban and rural hospitals. Patients with possible AMI had high mortality rates in both facilities (41% to 45%). Subgroup analysis of the definite AMI population failed to reveal statistically significant differences in urban vs rural mortality, although a consistent trend toward superior performance in urban centers was found. The magnitude of the potential of a rural hospital intervention program to reduce the AMI mortality nevertheless appeared to be small.

Aged↗
PubMed1983

The role of the nursing school in the academic health center: report of a study.

This paper highlights for the nursing education community selected data from a recently completed study of the organization and governance of academic health centers, conducted under the auspices of the Association of Academic Health Centers and funded by the W.K. Kellogg Foundation. It is hoped that the limited information presented here will stimulate interest in the larger study. Presented and discussed are data derived from three different questionnaires used in the study. Top administrators in academic health centers were surveyed in order to produce information on the structural components and hierarchical relationships in contemporary academic health centers, the processes by which decisions are made and conflicts are resolved, and the conditions which administrators envision for their institutions in the future. Deans of nursing schools were part of the survey group, and their responses are examined along with those of deans of other health professional schools.

Academic Medical Centers↗
PubMed1982

Resolved: that a fifth year of dental education be a requirement. Remarks for the affirmative.

Evidence has been presented that leading deans of dental schools and leaders of the AADS support the assertion that the current four-year dental curriculum is overcrowded. Furthermore, it has been shown that the magnitude of the problem of overcrowding is regarded as serious and has been so recognized for at least twenty years. Evidence was also presented that educators, students, and the practicing profession support the assertion that the current four-year curriculum does not prepare students adequately for dental practice. Evidence was then presented that the overcrowding and inadequacies of the current curriculum cannot be corrected by merely manipulating or restructuring curricular elements within the context of predental and four years of predoctoral education. Finally, it was shown that, in the opinion of educators and students, the overcrowding and inadequacies of the current four-year curriculum can be overcome by establishing a fifth year of dental education as a requirement.

Clinical Competence↗
PubMed1981

Role of the pericardium and intact chest wall in the hemodynamic response to positive end-expiratory pressure ventilation.

The mechanism for the reduction of both systemic arterial blood pressure and cardiac output (CO) and for the elevation of intravascular pressure which accompanies positive end-expiratory pressure ventilation (PEEP) remains uncertain. The role of the intact pericardium and the chest wall has not been defined. This study examines cardiac transmural pressure with PEEP (0, 4, 8, and 16 cm H2O) administration in nine closed chest, anesthetized, normovolemic dogs utilizing direct measurements of intrapericardial pressure. The experiment was repeated following pericadiectomy and left thoracotomy. The closed chest dogs exhibited significant reductions in blood pressure and CO without detectable changes in transmural pressure. With combined pericardiectomy and left thoracotomy, the responses of both CO and blood pressure to PEEP were similar to those observed with the chest closed. Absolute right atrial pressures were similar at all levels of PEEP and were independent of the presence of the pericardium and the intact chest wall. The rise in absolute left atrial pressure observed with these structures intact was completely abolished by pericardiectomy and left thoracotomy. Thus the major hemodynamic effects of PEEP, namely changes in blood pressure and CO, cannot be accounted for by changes in transmural pressure or influences from the intact chest wall and pericardium.

Animals↗
PubMed1981

Interschool relationships in academic health centers.

Within academic health centers there exists a well-established "pecking order" which influences daily life. Interschool relationships are inextricably bound to fundamental interprofessional relationships and ultimately to the relationships of individuals from different professions. This paper explores the behavior of individual professionals in seeking an understanding of the way things happen, or do not happen, between schools in academic health centers. Interschool relationships in administration, basic science education, and interdisciplinary clinical education are discussed.

Academic Medical Centers↗
PubMed1981

Coordination and development of a graduate dental education system.

Graduate dental education will undergo marked expansion as increasing numbers of graduating dentists seek advanced training in general dentistry. In order to respond to the public's expectations for primary dental care, the profession should take steps that prevent overspecialization. The fundamental question is what proportion of the dental manpower work force should be primary dental care providers, not how many specialists are needed. Many institutions, organizations, and agencies have legitimate roles related to graduate dental education. Modification of these roles is neither necessary nor indicated if the profession can develop a mechanism for influencing the numbers and mix of graduate education programs available in the future. Suggestions are made for the organization and function of such an influencing mechanism.

Delivery of Health Care↗
PubMed1981

The role of schools of allied health in the academic health center: report of a study.

This paper highlights selected data from a recently completed study of the organization and governance of academic health centers. The study was conducted under the auspices of the Association of Academic Health Centers and was funded by the W.K. Kellogg Foundation. It is hoped that the limited information presented here will stimulate interest in the larger study. Data derived from three different questionnaires used in the study are presented and discussed. Top administrators in academic health centers were surveyed to produce information on the structural components and hierarchical relationships in contemporary academic health centers, the processes by which decisions are made and conflicts are resolved, and the conditions that administrators envision for their institutions in the future. Deans of schools of allied health were part of the survey group, and their responses are examined along with those of deans of other health professional schools.

Administrative Personnel↗
PubMed1980

Adherence of Candida albicans and other Candida species to mucosal epithelial cells.

To study the possible involvement of candidal adherence in mucosal colonization, we examined the in vitro adherence capabilities of seven Candida species. Adherence was evaluated by direct microscopic examination and by a quantitative radiometric adherence test. The results indicate that C. albicans adheres to vaginal and buccal epithelial cells to a significantly greater degree (P less than 0.01) than the other species tested. C. tropicalis and C. stellatoidea demonstrated moderate adherence capabilities, while C. parapsilosis adhered only to a slight degree. Other species failed to interact with isolated mucosal cells. These findings suggest that there is a relationship between the adherence capabilities of the Candida species and their abilities to colonize mucosal surfaces, since those species which adhere are those which most frequently colonize mucosal surfaces. C. albicans was found to be adherent under a variety of environmental conditions. Stationary-phase blastospores of C. albicans were found to be more adherent than logarithmic-phase yeasts, and larger blastospore cell-to-epithelial cell ratios resulted in greater adherence values. The actual number of adherent yeasts varied considerably when epithelial cells were obtained from different donors.

Adhesiveness↗
PubMed1980

The dental school's role in academic health centers: report of a study.

This paper highlights for the dental education community selected data from a recently completed study of the organization and governance of academic health centers, conducted under the auspices of the Association of Academic health Centers and funded by the W. K. Kellogg Foundation. It is hoped that the limited information presented here will stimulate interest in the larger study. Data derived from three questionnaires used in the study are presented and discussed. Top administrators in academic health centers were surveyed to assemble information on the structural components and hierarchical relationships in contemporary academic health centers, the processes by which decisions are made, the way in which conflicts are resolved, and the conditions that administrators envision for their institutions in the future. Dental school deans were part of the survey group, and their responses are examined along with those of deans of other health professional schools.

Academic Medical Centers↗
PubMed1978

Unusual vascular complications of dissecting thoracic aortic aneurysms.

Nondissecting, chronic, thoracic aortic aneurysms (TAA) may be associated with such vascular complications as aorto-cardiac, aorto-superior vena caval (SVC) and aorto-pulmonary arterial (PA) fistual formation, and/or SVC or PA compression. Dissecting TAA have been associated with these lesions far less often. This report summarizes the occurence and outcome of the following complications of dissecting TTA: (1) SVC obstruction; (2) aorto-right and -left atrial, aorta-right ventricular and aorto-PA fistula formation; (3) compression of the PA and (4) hematoma of the interatrial septum. Two patients are described with aortic dessection complicated by: (1) SVC obstruction and aorto-left atrial fistula; and (2) aorto-PA fistula. These complications are rarer with aortic dissection, because of the acute, catastrophic nature of this lesion. When dissection is chronic, however, arteriovenous fistulae are often well tolerated, and urgent surgical intervention seems to be unnecessary.

Aged↗