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Biomedical subjects

D A West

Publications and source records attributed to D A West.

29 records · Page 2Linked to original sources
PubMed1982

Suicide potential: evaluation by nonpsychiatrists.

Since most people who commit suicide visit a physician in the week to year preceding the act, the physician is in a unique position to intervene before it is too late. If the patient has already made an attempt or gesture, the physician must evaluate the risk of suicide by inquiring into the patient's situation and state of mind and the circumstances of the act. The most common types of psychopathology in those who make a suicide attempt or gesture are depression and borderline personality. To detect suicidal patients who have not yet made an attempt or gesture, the physician must be alert to subtle cues, particularly somatic complaints.

Humans↗
PubMed1980

Emergency psychiatric home visiting: report of four years experience.

An Emergency Psychiatric Home Visiting Team made 624 visits to 443 patients in a 4 year period. In situations where patients were frequently psychotic, violent, or threatening violence, the team was sucessful at facilitating emergency care and defusing crisis situations. The team was equivocally successful at preventing hospitalization. Facilitation of hospitalization often became a more important function than prevention. Few visits were for suicidal behavior. No team member was ever harmed in the course of a visit. The team also served as a major psychiatric care provider and social support to a group of chronic patients and families who utilized the service multiple times.

Adult↗
PubMed1979

A framework for the emergency evaluation of the suicidal patient.

With increasing frequency, emergency room personnel face the anxiety of assessing suicide potential. The authors have developed and present here a mnemonic (SAD CHILDREN) which should facilitate the evaluation of potential in attempted or threatened suicide patients.

Emergency Service, Hospital↗
PubMed1978

Emotional problems of the severely burned patient.

In this article we have tried to present an overview of some of the common emotional responses and problems seen in severely burned patients. We have suggested that first consideration be given to learning what sort of person the patient is and becoming familiar with what the burned patient experiences. General preventive measures were suggested that included establishment of clear communication between patient and staff so that the patient has the best understanding possible of the nature of the injury and the treatment, allowing the patients as much control as possible in the treatment process, and providing adequate analgesic medication. We have described what may be observed when patients become anxious, fearful, angry, depressed, regressed, and psychotic, and have attempted to facilitate an understanding of what is occurring in patients showing these responses. Some common reactions of medical and nursing staff to the various emotional reactions were mentioned. In the final section we attempted to deal briefly with the responses of children and measures that can be taken with them. Most of the therapeutic measures suggested can be carried out by nonpsychiatric personnel if they are able to be empathetic and in touch with their own reactions to patients and to utilized common sense.

Adult↗
PubMed1977

Reversal of bedrest-induced orthostatic intolerance by lower body negative pressure and saline.

Six healthy male volunteers underwent two 1-week periods of bedrest, each preceded and followed by 2-week control and recovery periods. The daily metabolic diet contained 150 mEq of sodium. Following one 7-d bedrest period, each man was subjected to LBNP at a level of --30 mm Hg for 4 h while consuming 1000 ml of beef bouillon containing 154 mEq of sodium. After the other bedrest period, each man simply consumed the bouillon without LBNP treatment during 4 h of continued bedrest. Measurements of plasma volume and orthostatic tolerance were made before and after each treatment period. After combined LBNP and saline therapy, plasma volume and response to LBNP testing, as measured by heart rate and systolic BP, showed a return to pre-bedrest levels. Saline consumption alone had a lesser effect. With continuation of bedrest in three subjects, the beneficial effects of these measures appeared to be largely gone after 18 h.

Adult↗
PubMedDate not supplied

The Columbia Registry of Information and Utilization Management Trials.

OBJECTIVE: T systematically locate, register, and abstract information used in comparing effects of various information services (computerized and noncomputerized) and utilization management interventions on the process and outcome of patient care. DESIGN: Manual and electronic database searches located reports that met three main criteria: 1) randomized controlled trial; 2) information or utilization management intervention in the study group with no similar intervention in the control group; and 3) effect of the intervention on the process and/or outcome of patient care had been measured. Published reports were registered in the Columbia Registry. RESULTS: Nearly 600 reports were collected from 24 countries and 189 different publications. Frequently tested interventions included patients or physician education, telephone follow-up, patient or physician reminders, and home care services. Frequently reported effect variables included hospitalization rate, length of stay, immunization rate, and mortality rate. Standardized formal tools were developed for the separation and abstraction of practical information and methodologic details from the collected trial reports. CONCLUSIONS: The registry provides a new source of information for meta-analyses, traditional reviews, and executive summaries of quality improvement of health services. The streamlined knowledge engineering process of quality evaluation and abstraction of critical information can generate helpful information for practitioners and researchers simultaneously.

Cost-Benefit Analysis↗
PubMedDate not supplied

Profitable capitation requires accurate costing.

In the name of costing accuracy, nurses are asked to track inventory use on per treatment basis when more significant costs, such as general overhead and nursing salaries, are usually allocated to patients or treatments on an average cost basis. Accurate treatment costing and financial viability require analysis of all resources actually consumed in treatment delivery, including nursing services and inventory. More precise costing information enables more profitable decisions as is demonstrated by comparing the ratio-of-cost-to-treatment method (aggregate costing) with alternative activity-based costing methods (ABC). Nurses must participate in this costing process to assure that capitation bids are based upon accurate costs rather than simple averages.

Capitation Fee↗