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Biomedical subjects

D M Wagner

Publications and source records attributed to D M Wagner.

9 recordsLinked to original sources
PubMed2000

Nuclear genes resolve mesozoic-aged divergences in the insect order Lepidoptera.

Compared to the number of genes available for study of both younger and older divergences, few genes have yet been identified that can strongly resolve phylogenetic splits of Mesozoic age ( approximately 65-250 mya). Thus, reconstruction of Mesozoic-age phylogenies, exemplified by basal divergences within the major orders of holometabolous insects, is likely to be especially dependent on combining multiple lines of evidence. This study tests the potential of the 18S ribosomal RNA gene for reconstructing Mesozoic-aged divergences within the insect order Lepidoptera and its ability when combined with a second, previously analyzed nuclear gene (phosphoenolpyruvate carboxykinase, PEPCK) to strongly resolve these relationships. 18S sequences were obtained for 21 taxa, representing major clades of Lepidoptera plus outgroups from the other "panorpoid orders. A well-corroborated morphology-based "test phylogeny was used to evaluate the effects of partitioning the 18S gene according to variable versus conserved domains, paired versus unpaired sites in the secondary structure, and transition versus transversion substitutions. Likelihood and unweighted parsimony analyses of the 18S data recover the "test phylogeny" almost completely, with no improvement of agreement or support provided by any form of weighting or partitioning. No conflict in signal between 18S and PEPCK was detected by the partition homogeneity test. Combined parsimony analysis yielded strong bootstrap support for nearly all relationships, much higher than for either gene alone, thereby also providing strong evidence on several hypotheses about the early evolution of lepidopteran-plant interactions. These genes in combination may be widely useful for resolving insect divergences of comparable age.

Animals↗
PubMed1986

Quality assurance. Issues and process.

As a result of company-wide involvement in quality assurance we have been able to advance the concept of participatory management though the organization's base is centralized in Kalamazoo. Despite the great size and geographical span of UHCS, regional and office management staff across North America play an integral part in guiding our future. Our QA program has given field operations the opportunity to display to management their interest and desire to be involved in the overall process. Success in the home health care industry is due in large part to the work ethic of our employees and their desire to do their jobs in a truly professional manner. It is extremely important for a multiagency organization that all of its employees in every location, know that the company is only as good as its people. After all, an organization is perceived by the public through individual employees. Thus, expectation levels for health care employees must always be heightened. Quality improvement is an ongoing effort no matter how well we do it. We keep attempting to reduce the amount of rework or correction and to achieve higher levels of productivity. Employees of any healthcare organization, large or small, need to know that the organization cannot be satisfied with where it is today. We in the health service industry must be looking toward the care we can provide, better and more efficiently, tomorrow. Quality improvement is an ongoing effort, no matter how well we do it.

Home Care Services↗
PubMedDate not supplied

The human side of quality: service oriented employees.

Motivating employees to care about the quality of the services they provide is an essential ingredient in quality improvement. In this article the author presents eight methods that employers can use to translate expectations into actions. Becoming aware of what today's employees want is the first step; money and job security are not as important as respect, challenging work that shows results, and managers who listen. Since customer relations mirror management's attitudes toward employees, caring about staff is basic in a quality service organization. Education and training of workers are also crucial, as are communication of expectations and providing prompt feedback. Employees also need reward and recognition. Hiring the right people is another necessity for quality service. Finally, managers must be leaders who can articulate values and the organization's vision in order to enlist employees in the cause of quality service.

Attitude of Health Personnel↗
PubMedDate not supplied

QA in home care: the staff nurse's challenge.

The home healthcare staff nurse faces formidable challenges that can be met only by an extraordinary commitment to quality care. Functioning autonomously much of the time, the home healthcare nurse must act as the client's case manager. Coordination of multiple services and extensive client education are vital to positive outcomes, and intervention decisions must be based on a holistic view of the client's needs and environment. Reimbursement issues under Medicare often conflict with the delivery of high-quality care. To achieve the goals of the home healthcare agency and perform optimally, the home healthcare nurse needs a supportive QA program and frequent peer review procedures.

Home Care Services↗
PubMedDate not supplied

Quality indicators: an approach to quality improvement in home healthcare.

In this article, Donna Wagner discusses using quality indicators as a means of improving quality in home healthcare. Stressing the need for an organization to have a thorough foundation in total quality management as its working context, the article demonstrates how to use quality indicators as part of a quality improvement program. Monitoring quality indicators in a home health agency will provide specific information on aspects of care that the agency has identified as measures of quality. This cost-effective monitoring can be a means of incorporating QI activities into daily work patterns.

Home Care Services↗