Search PubMed⌕ Search

Biomedical subjects

D M Baer

Publications and source records attributed to D M Baer.

At least 73 records · Page 4Linked to original sources
PubMed1986

Regulation of physicians' office laboratories. The Idaho experience.

Timely availability of reliable test results enhances the office practitioner's ability to provide high-quality care that is personally satisfying to patients. Modern technology allows physicians to have such timely information available through test analyses performed in an office laboratory. Studies of physicians' office laboratories in Idaho found the performance, initially, to be unacceptably variable for many hematology, urinalysis, clinical chemistry, and microbiology tests. State regulation, requiring each office laboratory to comply with quality assurance guidelines and to participate in a proficiency testing program, resulted in a marked improvement in the proficiency level of office laboratory testing in Idaho. With the increasing dispersion of clinical laboratory technology, it is essential that standards of practice for the office laboratory be developed that ensure, within reasonable limits, the reliability of test information used in patient care. If widespread acceptance of such standards cannot be developed with a voluntary approach, states should consider regulation of office laboratories within their jurisdiction. Compliance with standards of practice, voluntarily or as a result of regulation, should promote quality performance in the office laboratory and allow the physician to use confidently the timely test information in dealing with diagnostic and management problems in patient care.

Facility Regulation and Control↗
PubMed1986

Acquired immune deficiency syndrome in homosexual men with Hodgkin's disease. Three case reports.

Fatal opportunistic infections developed in three homosexual men with Hodgkin's disease. Widely disseminated Kaposi's sarcoma developed in one, and another had persistent lymphadenopathy with a biopsy specimen showing benign follicular hyperplasia two years before the diagnosis of Hodgkin's disease. Physicians are alerted to the possible association of Hodgkin's disease and the acquired immune deficiency syndrome (AIDS). They are cautioned to consider the diagnosis of Hodgkin's disease in homosexual men with lymphadenopathy and warned of the risk of serious infections in homosexual men receiving therapy for Hodgkin's disease.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Autopsy diagnoses can increase DRG reimbursement.

To determine how missed clinical diagnoses revealed at autopsy might affect third-party payment through DRGs, the authors performed a retrospective comparison of clinical and pathologic diagnoses in 100 consecutive cases that came to autopsy. In 13 of these cases, the autopsy findings resulted in a change in DRG assignment, which could have produced an additional $14,235 for the hospital.

Autopsy↗
PubMed1986

Proficiency of office microbiology testing.

Microbiology proficiency testing results from smaller physicians' office laboratories in the state of Pennsylvania are reviewed. Possible reasons for lower performance levels are discussed, and some approaches to improving microbiology proficiency in this setting are suggested.

Ambulatory Care↗
PubMed1986

Quality control in the office laboratory.

Assuring quality of testing is as important in the doctor's office laboratory as it is in the hospital and independent laboratory. However, the office laboratory's problems and needs are different from those of the larger lab, and the professional laboratorian's solutions are not always appropriate for the office laboratory. It is necessary to recognize that the education and skill levels of the office laboratory staff preclude some of the quality control methods used in professionally staffed laboratories. For some test systems, new control methods will need to be developed. The professional laboratorian can provide valuable assistance to the doctor's office laboratory in assuring quality.

Laboratories↗
PubMed1986

Assessing an office chemistry instrument.

Selection of appropriate testing systems depends on the characteristics and needs of the office. Clinical practice needs, work flow needs, and the analyst's ability must be balanced against the level of system complexity, automation, quality characteristics, and cost.

Chemistry, Clinical↗
PubMed1984

Reducing self-injury and corresponding self-restraint through the strategic use of protective clothing.

We examined the use of protective clothing to reduce a retarded male's face-punching and leg-kicking and two corresponding forms of self-restraint--arm and leg self-restraint. The resident was observed each day in three sessions of randomly ordered conditions (one condition per session): without any protective clothing, with a padded helmet, and with a padded helmet and padded slippers. Use of the padded helmet substantially reduced face-punching and arm self-restraint. The addition of padded slippers reduced leg-kicking and leg self-restraint. These results suggest a practical and effective means of controlling self-injury and self-restraint. They are also consistent with the possibility that the resident's arm restraint was maintained in part by escape or avoidance of face-punching and that his leg restraint was maintained in part by escape or avoidance of leg-kicking.

Adolescent↗
PubMed1983

Protocol for the study of drug interferences in laboratory tests: cefotaxime interference in 24 clinical tests.

We developed a protocol to study interference by cefotaxime and one of its major metabolites with 24 common chemical tests. Serum pools simulating specimens from healthy adults of both sexes, pregnant women, patients with liver disease, cardiac disease, or renal disease, and patients receiving gentamicin and tobramycin were supplemented with high and low concentrations of cefotaxime and desacetylcefotaxime. Using a discrete analyzer (the American Monitor Parallel), we tested 12 replicate samples from each condition for 24 analytes. Although statistically significant changes were found in many tests, 85% of the differences were less than 15% of the control value and more than half were less than 5%. The apparent concentration of creatinine was not significantly changed. Test results for phosphorus were increased in patients who were receiving gentamicin and tobramycin. No other changes were considered clinically significant.

Blood Chemical Analysis↗
PubMed1982

Training family therapists: an experimental analysis.

This study implemented and evaluated a training program (a written manual, videotaped models, rehearsal, role plays, and performance feedback) designed to teach five subjects the skills to become effective family therapists. The study examined the therapists' use of three target behaviors: instructing, informing, and praising. The therapists, each paired with a parent and a preschool-aged child (2 1/2-4 1/2 yr old), were trained in the clinic to use, and to teach to the parents, several behavioral skills (e.g., praising, planned ignoring, and time-out) relevant to teaching children compliance to parental instructions. A multiple-baseline design across triads (therapist/parent/child) demonstrated that after the training program was instituted, the therapists increased their rates of instructing, praising, and informing the parents; all parents increased attention to compliance, decreased attention to noncompliance, and increased rates of praise to their children; and all children increased their compliance and decreased their noncompliance.

Behavior Therapy↗
PubMed1981

"Do I have to be good all day? The timing of delayed reinforcement as a factor in generalization.

Delayed reinforcement, sometimes delivered just after the setting in which the critical behavior had occurred (Early), and sometimes delivered only after several further settings had been encountered (Late), was used to improve a variety of behaviors in seven preschool children, and to control their generalization. Performance of those behaviors was measured in two classroom settings: the Contingent setting, within which performance of the specified behavior determined the latter (Early or Late) reinforcement, and the Generalization setting, in which there were no experimental contingencies, immediate or delayed, for the performance of the same behavior. Performances by all children in the Contingent setting were controlled by delayed reinforcement, whether Early or late. All children showed consistent generalization from the Contingent setting to the Generalization setting during the Late condition, when reinforcement was delivered at the end of the school day. Generalization did not occur during the Early condition, when reinforcement was provided immediately after the Contingent setting (prior to the Generalization setting), unless that condition had been preceded by a Late condition (as it was for S6 and S7). The results suggest that the Late timing of delayed reinforcement was an effective and efficient generalization-promotion technique for performances that did not generalize spontaneously.

Behavior Therapy↗
PubMed1981

Teachers' generalized use of delay as a stimulus control procedure to increase language use in handicapped children.

In Experiment 1, classroom teachers were taught to delay their offers of help in naturally occurring situations, and thereby to provide additional opportunities for language use by six moderately retarded language-delayed children. The teachers introduced this delay technique in a multiple-baseline design across the six children. As delays were used, child verbal initiations increased. Follow-up assessment showed that teachers were maintaining greater than baseline levels of the delay technique after 10 weeks. Experiment 2 replicated the findings of Experiment 1, and included a more thorough maintenance assessment, while focusing on teachers' generalization of the delay technique. Teachers were found to generalize their use of delay to 56% of their monitored untaught opportunities. The two experiments show that (a) the delay technique is quick to teach and simple to implement, (b) delays do provide opportunities for children to initiate, (c) teachers can generalize their use of delay to novel self-selected situations, and (d) teachers can maintain their use of delays over time.

Behavior Therapy↗