Search PubMed⌕ Search

Biomedical subjects

G McCord

Publications and source records attributed to G McCord.

15 recordsLinked to original sources
PubMed1999

Detection of cancerous masses for screening mammography using discrete wavelet transform-based multiresolution Markov random field.

When cancerous masses are embedded in and camouflaged by varying densities of parenchymal tissue structures, they are difficult to visually detect on mammograms. We present a novel algorithm based on the discrete wavelet transform (DWT) and multiresolution markov random field (MMRF) that will single out the suspicious masses to assist the attending radiologist in making decisions.

Algorithms↗
PubMed1998

The consultation and referral process. A report from NEON. Northeastern Ohio Network Research Group.

BACKGROUND: Consultation and referral are essential components of the practice of primary care. Despite this, little is known about the factors that contribute to the success of a referral. We examined the short-term outcomes of communication between family physicians and consultants during the referral process. METHODS: The study setting was six family practice centers in northeastern Ohio. All eligible physicians at each center participated in data collection by means of a card study. Data was recorded on any patient who received a referral to a physician or nonphysician provider during the month of July 1994. One year later, referrals were followed up by physician questionnaire. RESULTS: Three hundred nine of 5172 total patients were referred (5.97 referrals per 100 office visits). At follow-up, the family physicians reported that 63% of patients had visited the consultant, 14% had not, and the physician had no knowledge of the actions taken by the other 23%. The referring physician received feedback from the consultant regarding 55% of the patients referred. Receipt of feedback was strongly related to communication by the family physician to the consultant at the time of referral. Physicians who received feedback were the most satisfied with communication from the consultant and the care their patient had received. CONCLUSIONS: Primary care physicians can influence the likelihood of receiving feedback from a consultant by initiating communication with the consultant. A referral wherein the physicians involved do not communicate with one another results in physician dissatisfaction. Primary care physicians must practice strategies to improve the referral process.

Adolescent↗
PubMed1996

To stay or not to stay: factors influencing family practice residents' choice of initial practice location.

BACKGROUND AND OBJECTIVES: This study examined what factors influence US third-year family practice residents' choice of location of their first practice. METHODS: A survey was developed by the members of Northeastern Ohio Network to assess the influence of factors related to family, education, geography, finances, the medical community, and others on the selection of practice location. Surveys were sent to all program directors listed in the American Academy of Family Physicians 1994 Directory of Family Practice Residency Programs to be distributed to all third-year family practice residents. The program directors indicated the type of residency program, the number of surveys distributed, and the number returned, then forwarded completed surveys to the investigators. RESULTS: Two hundred fifty-nine of the 380 programs (68%) with PGY-3 residents responded. Of the programs that responded, 1,012 residents (64%) of a possible 1,578 completed surveys. Estimated from the directory, 812 residents from non-responding programs did not complete the survey for an overall response rate among residents of 42% (1,012/[1,578+812]). Family-related items seem to have the most influence on choice of practice location and are more important to married people. More than 50% of residents want to practice in the same size community in which they grew up. Money-related factors were not rated as highly as expected. CONCLUSIONS: Several factors appear to be important to family practice residents when selecting their first practice location. Hospitals interested in retaining their graduates can maximize their success by concentrating on these areas.

Adult↗
PubMed1995

Predictive factors for early mortality after percutaneous endoscopic gastrostomy.

BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) is a safe access procedure for enteral nutrition. The purpose of this investigation is to identify predictive factors for early mortality after PEG. METHODS: A retrospective review of the hospital records of 416 patients undergoing PEG from June 1, 1989, through December 31, 1991, was conducted. Patient demographics, admitting diagnosis, indication for PEG, risk factors for early mortality, and cause and date of death were reviewed. Logistic regression analysis was used to develop a model to predict early mortality after PEG. The follow-up period ranged from 1 to 30 months. RESULTS: The overall mortality rate in this review was 227 of 416 patients (54.6%). The 7- and 30-day case fatality rates were 39 of 416 (9.4%) and 97 of 416 (23.3%), respectively. Logistic regression analysis showed that urinary tract infection (odds ratio (OR) = 3.05; 95% confidence interval (CI) = 1.45-6.43) and previous aspiration (OR = 6.86; 95% CI = 3.27-14.4) were predictive factors for death at 1 week after PEG. Patients who had both risk factors had a 48.4% probability of dying within 7 days after PEG insertion, whereas those who had no risk factors had a 4.3% probability of death. Urinary tract infection (OR = 2.00; 95% CI = 1.17-3.41), previous aspiration (OR = 3.62; 95% CI = 2.00-6.55), and age greater than 75 years (OR = 2.49; 95% CI = 1.47-4.21) were predictive factors for death at 1 month after PEG. Patients who had all three risk factors had a 67.1% probability of death at 1 month while those who had no risk factors had a 10% probability of death. CONCLUSIONS: A subgroup of patients exists that has a very high mortality rate after PEG. Less invasive ways of nutritionally supporting these high-risk patients should be evaluated.

Adolescent↗
PubMed1989

Risk of imbalance in elderly people with impaired hearing or vision.

We evaluated the effect of impaired hearing and vision on balance in a sample of 977 elderly people residing in the community. Of the sample, 21% reported balance problems, 27% vision problems, and 30% hearing problems. The increased relative risk for balance problems was 1.7 for each 10-year age increment. Women were 1.7 times more likely to report balance problems than were men. The relative risk of imbalance with impaired vision decreased with age from 2.8 in those aged 65-69 years to 1.0 in those over 85 years. There was no age-hearing interaction, the relative risk for impaired hearing is 1.6. It appears that impaired vision and hearing are important risk factors for imbalance and perhaps falls and injury.

Accidental Falls↗
PubMed1986

A strategy to increase appointment keeping in a pediatric clinic.

This paper reports the results of two related studies. The first, a prospective study, investigated the relationship between appointment keeping at a pediatric clinic and parents' self-perceived time utilization skills as measured by a subscale of Wessman's Temporal Experience Questionnaire (TEQ). Using a logistic regression analysis to adjust for the effect of telephone reminders, low scorers on the time utilization subscale were twice as likely as high scorers to miss their appointments. The second study was a test of the value of using knowledge of parents' subjective time perspectives as part of a strategy to increase appointment keeping. The goal of this study was to achieve equivalent missed appointment rates between high and low scorers on the TEQ. Parents attending the clinic were asked to complete the questionnaire, and they were then stratified into two groups. High scorers, those who initially had a low probability of missing appointments, received a single reminder. Low scorers, those who initially had a high probability of missing appointments, received two reminders. Two alternate forms of reminders were randomly allocated within each scoring strata. Equivalent missed appointment rates were observed between parents who scored low and those who scored high on the TEQ. The study also investigated two other questions. Information on the importance of the visit had no effect. Postcard reminders were as effective as telephone reminders and were more cost efficient.

Adult↗
PubMed1985

Interpretation of moderately elevated MMPI scores for normal subjects.

Two opposing views concerning the interpretation of moderately elevated MMPI scores of normal subjects have appeared in the literature. Whereas some authors have suggested that such scores indicate negative characteristics less severe than those suggested by more extremely elevated scores for psychiatric patients, other authors have suggested that such scores may be indicative of more positive characteristics. The present study attempted to determine the relative validity of these two opposing views. Correlates of MMPI clinical scales were determined for 101 male and 101 female college students who had no clinical T-score greater than 75. Subjects described themselves using the Adjective Check List (ACL), and they were also described by peers using the ACL. Point-biserial correlations between MMPI scores and self and peer endorsements on the ACL were computed. For both self and peer data more significant correlations were found than expected by chance. Most of the correlates involved negative characteristics, offering some support for the interpretive approach based on an attenuation of negative descriptors derived for psychiatric patient samples.

Adult↗
PubMed1983

Developmental and reading ability differences in accessing information from semantic memory.

A categorical judgment task was utilized to investigate the relationships between word recognition skills and reading achievement at several grade levels. In the first experiment skilled and unskilled readers from Grades 2, 4, and 6 made cognitive decisions about pairs of words using either graphemic, lexical, or semantic information. In Experiment 2 skilled, average, and unskilled readers from Grades 1, 3, and 5 made semantic decisions about word or picture pairs. The speed and accuracy of word encoding, lexical access, and semantic memory access processes varied as a function of reading ability. These results suggest that inefficient word recognition skills can contribute to reading deficiencies as can deficiencies in semantic memory organization.

Achievement↗
PubMedDate not supplied

Intra-aortic balloon pump complications: A five-year retrospective study of 283 patients.

OBJECTIVE: To determine the type, incidence, and risk factors for complication with the intra-aortic balloon pump. DESIGN: Descriptive, chart review. SETTING: Midwestern community teaching hospital. PATIENTS: Two hundred eighty-three patients with 287 intra-aortic balloon pump insertions from January 1, 1990, to December 31, 1994. OUTCOME MEASURES: Complications of therapy. RESULTS: Seventeen percent of balloon insertions resulted in minor complications, and 14 patients had major complications. Polychotomous logistic regression was used to determine which study risk factors were predictive of the development of minor or major complications in patients. Patients with longer balloon duration had an increased risk of a major complication; whereas smokers and patients with lower body mass index had an increased probability of the development of a minor complication.

Adult↗