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H C Goodman

Publications and source records attributed to H C Goodman.

15 recordsLinked to original sources
PubMed1978

Telephone management of acute pediatric illnesses.

To evaluate the telephone management of five common acute pediatric problems, a "programmed mother" made unidentified cells to five pediatric nurse practitioners, 28 pediatric house officers and 23 pediatricians in practice. Calls were tape recorded and scored for history taking, disposition and interviewing skill. Nurse practitioners averaged 79.6 per cent of the total possible theoretical score for history taking, house officers 69.1 per cent, and practicing pediatricians 52.6 per cent (P less than 0.001). For disposition, nurse practitioners averaged 71.1 per cent of the maximum score, in contrast to 60.1 per cent for house officers and 58.9 per cent for practicing pediatricians. Similarly, nurse practitioners had significantly higher (P less than 0.001) scores for interviewing skills. No significant differences were found among house officers in the first, second and third years in history taking, disposition or interviewing skills. We conclude that pediatric nurse practitioners manage common pediatric problems by telephone better than house officers or practicing pediatricians and that better training for this aspect of practice is needed.

Acute Disease↗
PubMed1976

Childhood antecedents of adult obesity. Do chubby infants become obese adults?

We investigated whether obese infants tend to become obese adults. Records of subjects born between 1945 and 1955 were reviewed to select three cohorts based on weight in the first six months of age, which exceeded the 90th percentile at least once, ranged between 25th and 75th percentiles or was below 10th percentile at least once. Three hundred and sixty-six subjects, now between 20 and 30 years of age, were located and their present height and weight determined. Thirty-six per cent of those exceeding the 90th percentile as infants were overweight adults, as compared to 14 per cent of the average age and light-weight infants. A significant increase (chi square = 17.2, p less than 0.001) in adult obesity was evident when the infant exceeded the 75th percentile that was independent of his height. Social class, educational level, and parental weight all correlated with adult weight (p less than 0.001). Sex and ordinal position of birth did not. The data suggest that infant weight correlates strongly with adult weight independently of other factors considered.

Adolescent↗
PubMed1972

Virus-associated immunopathology: animal models and implications for human disease. 1. Effects of viruses on the immune system, immune-complex diseases, and antibody-mediated immunologic injury.

The tissue damage caused by virus infection has been traditionally explained by the ability of viruses to multiply in cells and thereby injure or destroy them. Recent evidence suggests, however, that lesions may also be caused by the host's immune response to viral antigens and that the immune system itself may be perturbed by some viruses. This memorandum reviews recent developments in viral immunopathology, with special reference to animal model systems, and indicates the possible relevance of the new concepts and techniques for certain diseases of man. Certain viruses, notably the leukaemia viruses and some of those causing persistent infections, depress the host's ability to mount an antibody response to antigens, while other viruses may enhance the antibody response. Cell-mediated immunity may also be depressed. Another immunopathological manifestation of virus infection is immune-complex disease. When viruses or their antigens persist in the circulation they combine with specific antibody, and the resulting complexes lodge in various sites, especially the kidney. Further combination with complement leads to the release of tissue-damaging substances. A third condition associated with virus infection is antibody-mediated immunologic injury. Both oncogenic and non-oncogenic viruses frequently induce new antigens on the surface of the cells they invade. When antibody attaches to these antigens in the presence of complement, the cells are destroyed.

Animals↗
PubMed1972

Virus-associated immunopathology: animal models and implications for human disease. 2. Cell-mediated immunity, autoimmune diseases, genetics, and implications for clinical research.

Part 2 of this memorandum describes further mechanisms whereby the interaction of a virus with the host's immune system may lead to tissue damage. Cell-mediated immunity plays a vital role in promoting recovery from virus infections, but under some circumstances tissue damage may be caused by the reaction of immune cells with viral antigens. When mice are infected with lymphocytic choriomeningitis virus neonatally or as adults while receiving immunosuppressive drugs, widespread invasion of cells is seen but there is little overt disease. If, however, normal adults are infected or if immune cells are transfused into tolerant mice, cell injury and death follow. Viruses have long been suspected of contributing to the pathogenesis of autoimmune diseases. Antibodies directed against normal cell constituents have been reported in several virus infections. Viruses may conceivably unmask or release host antigens, alter host antigens and act as "helper determinants", or perhaps in other ways provoke immune responses against normal body constituents. The immunopathological manifestations caused by viruses may also be influenced by the host's genetic makeup. Certain observations indicate that, in addition to controlling susceptibility to virus infection, genetic factors partly determine the effectiveness of the immune response. The memorandum calls attention to the possible implications of these concepts and findings for clinical research. Some of the diseases of animals and man that serve as models for studies of virus-associated immunopathology are briefly described.

Anemia↗
PubMedDate not supplied

Evening telephone call management by nurse practitioners and physicians.

History-taking, disposition, and telephone communication skills of pediatric nurse practitioners, pediatric house officers, and practicing pediatricians were assessed and compared. To evaluate the management of five common acute pediatric problems, a "programmed mother" made 148 unidentified calls to these health professionals during evening hours. The calls were tape recorded, and scored for history-taking, disposition, and interviewing skills. The scoring system, developed by a panel of 11 experts, assessed the relevance and completeness of each history obtained. Nurse practitioners averaged 79.6 percent of the total possible score, as compared to 52.6 percent for pediatricians (p less than .001). When disposition was similarly analyzed, the nurse practitioners scored significantly higher than pediatricians. Analyzing only those items of history-taking and disposition deemed most critical by the panel, nurse practitioners included 91 percent and pediatricians only 55 percent (p less than .001). Parameters of interviewing skill were scored by the interviewer and each author with agreement of 80 percent or above; nurse practitioners obtained significantly higher scores than pediatricians (p less than .001). Calls handled by nurses averaged 7.4 minutes, those by pediatricians 3.2 minutes (p less than .001). Nurse practitioners, it was concluded, can safely and effectively share responsibility with physicians for night and weekend telephone call coverage for a pediatric practice with adequate physician back up.

Child↗