Biomedical subjects
D Thompson
Publications and source records attributed to D Thompson.
The care and use of surgical instruments.
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Social security benefits for lupus patients.
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Determination of fluoroquinolone residues in animal tissues using Escherichia coli as indicator organism.
Three strains of Escherichia coli (ATCC 128, 10536, and 25922) and one strain of Bacillus subtilis (ATCC 3491) were compared as indicator microorganisms in microbial inhibition tests for their ability to detect fluoroquinolone residues. E. coli strains 128 and 10536 were most susceptible to fluoroquinolone residues, with detection limits of 35-50 micrograms/kg for enrofloxacin. Of the 2 strains, E. coli 10536 was slightly less susceptible. Ciprofloxacin was detected consistently by E. coli 128 at 30 micrograms/kg. Other fluoroquinolone drugs of veterinary interest detected by E. coli 128 were sarafloxacin and difloxacin at 100-250 micrograms/kg concentration. E. coli 25922 yielded 100% sensitivity in detection of enrofloxacin only at the 250 micrograms/kg concentration, and ciprofloxacin and sarafloxacin at 200 micrograms/kg. B. subtilis detected only enrofloxacin 100% of the time at 250 micrograms/kg. The E. coli strains tested were insensitive to other antibacterials commonly used in animals, with the exception of ceftiofur which was detected by E. coli 128 and 10536 at 500 micrograms/kg. The B. subtilis strain was not effective in detecting the fluoroquinolone drugs, whereas the E. coli strains were selective for the fluoroquinolones. E. coli 128 was 100% effective in detecting enrofloxacin and ciprofloxacin in spiked diaphragm homogenate samples at 50 micrograms/kg. Of the microorganisms tested, E. coli strain ATCC 128 was highly suitable as an indicator microorganism in a microbial inhibition assay for selective detection of fluoroquinolone antibacterial residues in animal tissues.
Judging the effectiveness of clinical pathways for pneumonia: the role of risk adjustment.
CONTEXT: Although observational studies suggest that clinical pathways may decrease costs and improve quality in hospitalized patients with community-acquired pneumonia, inferences from these studies are limited by potential selection bias and inadequate case-mix adjustment. OBJECTIVE: To compare the assessment of a clinical pathway for community-acquired pneumonia with and without adjusting for patient characteristics and disease severity. DESIGN: Retrospective cohort study. PATIENTS AND SETTING: Consecutive series of adult patients admitted with clinical diagnosis of community-acquired pneumonia, treated with either a clinical pathway (which included guidelines for antibiotics, tests, and ancillary care) or usual care. MAIN OUTCOME MEASURES: Total hospital charges, length of stay, clinical deterioration (requiring mechanical ventilation or intensive care unit transfer), and in-hospital mortality. We used multiple linear and logistic regression to adjust for patient case mix. RESULTS: Compared with patients receiving usual care (n = 275), patients in the pathway group (n = 97) were more likely to be treated by family physicians than specialists and had lower pneumonia severity scores. In the unadjusted analysis, total hospital charges were lower among pathway patients ($2456; 95% CI, $175 to $4737; P = 0.04); in the adjusted analysis, the difference in total charges was smaller (average reduction $1807; CI, $4164 lower to $549 higher; P = 0.13). In the unadjusted analysis, length of stay was lower among pathway patients (1.8 days lower; CI, 3.9 lower to 0.4 higher; P = 0.12); in the adjusted analysis, the difference in length of stay was smaller (0.9 days lower; CI, 3.2 lower to 1.3 higher; P = 0.4). Although unadjusted analysis showed significantly lower in-hospital mortality in pathway patients, this difference was not confirmed in the adjusted analysis. CONCLUSIONS: Clinical pathways may reduce costs and improve quality of care in community-acquired pneumonia. In nonrandomized studies, however, selection bias and case-mix differences may explain some of the apparent effectiveness.
Long-term care financing. To achieve significant change, a functional national approach is needed.
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Through the years with Dr. David Thompson. Interview by Franziska Schoenfeld.
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There's something about matron.
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Asphalt jungle. A global land rush is gobbling up the space and resources needed for agriculture and wildlife. Only the cockroaches are thrilled.
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Pediatric nutrition surveillance.
This article illustrates trends observed in recent data from the Pediatric Nutrition Surveillance System (PedNSS) and provides recommendations for nutrition intervention, nutrition monitoring, health advances as well as health concerns in the PedNSS population.
Quality care: alternative research.
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"Well, was it worth it?" The value of teletutorials for bachelor of nursing students.
The Deakin University Faculty of Nursing conducts a Bachelor of Nursing degree which is available via the distance education mode. The faculty has as its central focus the value of nursing practice and espouses a belief in students' active learning. This paper examines the use of teletutorials as a process for realising the philosophy of the faculty in relation to students' learning outcomes. Although expensive in terms of financial and human resources, teletutorials bridged the gap between the faculty's philosophical statements and students' perceptions and needs.
Too busy for assessments?
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The coronary patient and his spouse.
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When is a specialist not a specialist?
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