"Does the healing hurt?" Nurse assault. Interview by Patricia Marck.
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Hospitals, Psychiatric↗
Biomedical subjects
A Ross
Publications and source records attributed to A Ross.
High cell density fermentation of recombinant Escherichia coli with computer-controlled optimal growth rate.
In recent years recombinant DNA technology has enabled us to produce various proteins of therapeutic importance with microorganisms. As an appropriate host organism, E. coli plays a dominant role. Yields of E. coli dry cell mass in shaker flask culture range from 1-2 g/L, whereas in fermentors up to 10 g dry cells/L can be achieved. ZIMET and GBF have developed a high cell density fermentation process that produces E. coli (on a glucose/mineral salt medium) up to more than 100 g dry cells/L in a special fed-batch mode. This cultivation strategy prevents oxygen limitation and hence the accumulation of acetate and other metabolic byproducts. The specific growth rate can be adjusted so that product formation reaches its optimum value. An example of the production of alpha1-interferon is presented. The high cell density fermentations were realized in 30- and 450-L Chemap fermentors (ZIMET) and in a three-stage bioreactor scale-up system (72, 300, and 1,500 L) developed in cooperation with GBF and B. Braun Melsungen AG. Multiloop controllers were used to control the process variables.
Biotechnology↗
Prediction of intention to exercise of individuals who have suffered from coronary heart disease.
The aim of the study was to understand the intention to exercise of individuals who suffer from CHD. A group of 161 cardiac patients completed a questionnaire that investigated intentions, attitudes, subjective norms, perceived barriers, habits, perceived difficulties, and personal normative beliefs with respect to exercising, as well as perceived severity of and perceived vulnerability to re-infarction. Regression of intention yielded an R2 of .41 (p less than .0001), with perceived barriers, habits, and perceived difficulties as the significant predictors. MANOVA indicated that high and low intenders differed (p less than .01) according to their perception of three barriers: difficulties in time management, difficulties in psychological adaptation, and laziness. These results suggest that new guidelines should be adopted for the development of cardiac rehabilitation exercise programs.
Coronary Disease↗
The perspective of the industry.
This article calls for the development of a process to build a national consensus to assist in developing a critically needed national health policy. The physician's role in leading initiatives for major change is emphasized. Failure of physicians to participate as advocates of change will detrimentally affect the health of the nation and diminish the level of public respect and trust.
Health Care Rationing↗
High cell density cultivation of Escherichia coli at controlled specific growth rate.
A high cell density cultivation (HCDC) for growth of Escherichia coli in an especially designed glucose/mineral salt medium is proposed. The HCDC essentially starts as a batch process which is followed by a two-phase fed-batch cultivation. After unlimited growth at mu max = 0.45 h-1 in the batch part, growth was controlled at a reduced specific growth rate (mu = 0.11 h-1 less than mu max) over a period of 3 doubling times in which the biomass concentration increased from 12 to 95 g 1(-1) (phase 1 of fed-batch cultivation). Control of growth (mu) was realized by a PO2 control loop (by variation of glucose feeding) and a mu control loop (by variation of agitation speed N) while the actual mu was calculated from the off-gas composition. If the agitation rate cannot be increased anymore the mu controller is switched off (end of phase 1). In the following phase 2, mu declines, however, the still acting pO2 (glucose) controller guarantees sufficient O2 supply till the end of the cultivation with a biomass concentration of 110 g 1(-1) (dry mass). The proposed HCDC suppresses generation of inhibitory by-products and the high yield coefficients indicate the economy of the process.
Bacteriological Techniques↗
[Cytobrush quality assurance in endocervical smears].
The reliability of cervical cytology for the detection of premalignant and malignant disease is dependent on proper sampling of the transformation zone. The use of a cervical brush to collect enough endocervical cells is more effective, than the use of the conventional cotton swab.
Cervix Uteri↗
The effect of race on waiting time in two urban emergency departments.
This study examines the relation between patient race and waiting time in two urban Emergency Departments, located in the northeastern United States. Consecutive patients presenting with lacerations make up the subjects in the study. In order to control for the effect of disease severity, we restricted the sample to patients presenting with small, single lacerations requiring sutures. Patients who were intoxicated, had experienced syncope, had been involved in motor vehicle accidents, or who required tests or consultation were excluded. Taking socio-demographic (age, sex, insurance status) and clinical variables (location of laceration, time of day, day of week) into account, we found no substantial difference in total time spent in the Emergency Departments between whites and non-whites.
Attitude of Health Personnel↗
Patient care in the year 2000.
This paper takes a futuristic, crystal-ball look at patient care in the 1990s and 2000. It approaches the future from two perspectives. First, having assumed that the conflicts and frustrations associated with the existing health-care system have come to a boil and in fact a "revolution" in health care has occurred, what will the patient experience in the way of personal health services? The second perspective approaches it from the management viewpoint and provides a personal glimpse (and prediction) of what will be required for health-service executives who manage and direct a futuristic health service system.
Delivery of Health Care↗
[The impartial observer. Interview by Søren Palsbo].
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Community Health Nursing↗
Helping Medicare beneficiaries choose health insurance: the illness episode approach.
Lacking objective, comprehensible information about health care coverage options, Medicare beneficiaries rarely understand the consequences of alternative purchasing decisions. We describe the Illness Episode Approach, a method providing information on Medicare itself, Medigap policies, and HMOs. The method presents calculations of seniors' out-of-pocket costs under different insurance options for 13 common illnesses.
Aged↗
Qualitative and quantitative assessment of geographic clustering of population samples selected using different methods of random digit dialing.
Random digit dialing is a method commonly used to select random population samples in epidemiologic research. Although random digit dialing is generally presumed to provide representative samples, coverage and nonresponse errors may affect the degree to which the sample is representative. The present investigation was undertaken to determine whether the geographic distributions of samples selected using variations of the basic random digit dialing technique accurately reflect the underlying population distribution, and if not, whether such samples tend to be either more or less dispersed than the populations from which they were selected. Data regarding control groups from three case-control studies conducted from 1983-1986 were utilized. The residence addresses of 998 controls were located and assigned an X-Y coordinate and census tract designation within a three-county geographic area in northwest Washington State. Initially, the spatial distributions of controls were examined graphically in relation to the age-sex structure of the underlying population. No differences in geographic pattern were apparent. A more formal statistical evaluation was conducted based on centrographic techniques utilizing two measures to describe the spatial distribution of a set of points. Results indicate that the samples chosen were neither more nor less dispersed than the underlying populations. However, the geographic centers of samples selected using primary numbers tended to be shifted from the centers of their respective populations. Several possible explanations for such shifts are considered, and extensions of the analytical approach are suggested in relation to the further evaluation of population sampling and the investigation of space-time aggregations of disease.
Adult↗
Point pattern analysis of the spatial proximity of residences prior to diagnosis of persons with Hodgkin's disease.
There is some evidence to suggest that the etiology of Hodgkin's disease includes an infectious component. One approach to investigating this possibility is a formal assessment of the geographic and temporal variation in the incidence of the disease. The present study was designed to better evaluate space-time patterns of residence prior to diagnosis of persons with Hodgkin's disease. Lifetime residential histories were obtained from 279 incident cases of Hodgkin's disease diagnosed between 1974 and 1982 in a defined population in northwestern Washington State, and a similar number of population controls matched to the cases by age, sex, and socioeconomic status. A method of point pattern analysis was modified for use in this context to compare the spatial proximity of case residences to that expected under the null assumption of no difference between the spatial pattern of case and control residences. Analyses were applied within temporal groupings of residences specified a priori assuming 1) no specified latency, 2) four different 5-year latent intervals, and 3) three age at exposure intervals. Assuming no latency, there is no evidence that case residences are more or less clustered than would be expected by chance. Assuming latent intervals of up to 15 years prior to diagnosis, case residences are less clustered than expected, particularly among those who developed Hodgkin's disease after the age of 40 years. In contrast, there is suggestive evidence that persons diagnosed with Hodgkin's disease after age 40 years lived closer together than expected as young children and teenagers. These results illustrate the need to focus such analyses on specific time intervals defined a priori to most likely represent periods of greatest etiologic relevance. To the extent that these findings are not the result of some unknown artifact of the method itself, they may serve to focus additional attention on childhood environment as a particularly important period in the etiology of this disease. Furthermore, the analytic method employed may be useful in identifying space-time clustering using population-based data in other etiologic settings.
Adolescent↗
Free intra-peritoneal gas--an unusual aetiology.
The presence of free gas under one or both hemidiaphragms on an erect chest x-ray is most frequently the result of recent abdominal surgery or, in the absence of such surgery, is almost always indicative of a perforated abdominal viscus. A case is reported of a patient in whom pneumoperitoneum was discovered incidentally on a chest x-ray following extensive pelvic manipulation for acute inversion of the uterus.
Adult↗
Upper respiratory tract infection in children, domestic temperatures, and humidity.
STUDY OBJECTIVE: The aim of the study was to seek for a possible association between the incidence of upper respiratory tract infections and air temperature and humidity in the home. DESIGN: Recordings of temperature and relative humidity were made in living rooms and children's bedrooms over a six month period and related to incidence of upper respiratory tract infection. SETTING: The study was carried out in one general practice of 10,000 patients. PATIENTS: 297 children aged 24-59 months were studied, selected in random order from the practice age-sex register. MEASUREMENTS AND MAIN RESULTS: Temperature and humidity recordings were made with thermohygrograph recorders over six days. Upper respiratory tract infections were recorded (a) retrospectively over the previous 12 months, and (b) during the study period. Past history of acute otitis media and recent family history of respiratory infection were also obtained. No significant association was found between the variables, although the bedrooms of children with reported upper respiratory tract infections were cooler overnight than those of non-infected children (mean difference 0.8 degrees C, 95% confidence limits 0.7 degrees C). No association was found between reported or recorded upper respiratory tract infections and age or type of home, family size, level of occupancy, social class, or smoking habits. Only 15 children (5%) were identified by their parents as having had asthma, but 58 (19.5%) had had a "wheezy chest". A greater proportion of children who wheezed slept in cooler bedrooms, had gas fires rather than central heating, and had more smokers in the house. CONCLUSIONS: No association between upper respiratory tract infection and domestic temperature or humidity levels could be shown in this study. Since dampness is repeatedly presented as a health risk, further study is required.
Child, Preschool↗
Detection of young children in need of reading help. Evaluation of specific reading disability formulas.
To determine whether formula-based definitions of specific reading disability (SRD) were related to the actual classroom performance of children aged 7 1/2, the authors applied five definitions of SRD to a cohort of 243 children. The children were followed from birth and not selected on the basis of cognitive, reading, or academic performance criteria. The authors determined the concurrent validity of each of the formulas by comparing the prediction of each definition to whether the child received additional reading help in the classroom. Although the years behind method was significantly better than other approaches, no method identified more than 48 percent of the children who were given additional reading help. This study questions the ability of formula-based definitions adequately to identify young children with reading dysfunction.
Child↗
Optimism and health-relevant cognitions after a myocardial infarction.
The relationship between dispositional optimism (LOT) and health-relevant cognitions after a myocardial infarction was examined with 158 patients (mean age = 52.7 +/- 8.1 yr.). Patients above the median on optimism (i.e., optimists) scored significantly lower on perceived susceptibility, perceived severity, and experienced fear than did pessimists. However, no difference on perceived self-efficacy was reported between optimists and pessimists. It is concluded that these results provide further evidence for the LOT's construct validity.
Adaptation, Psychological↗
Is that broccoli growing in the rose garden?
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Conflict, Psychological↗
Primary sarcoma of the lung: potential dangers of immunocytochemistry.
A case is presented of a successfully resected primary pulmonary sarcoma in a 27-year-old man, followed by an eight-year disease-free follow-up. Details of the histological findings are presented, and the factors associated with good prognosis discussed. Immunocytochemical stains were carried out this year when the case was reviewed, and not at the time of resection. Had the immunostains been available at the time, the results would have suggested that the tumour might be a secondary deposit, and so have caused needless anxiety to the patient and his physicians.
Adult↗