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Biomedical subjects

H W Foster

Publications and source records attributed to H W Foster.

9 recordsLinked to original sources
PubMed1991

Accommodating to restrictions on residents' working hours.

In 1988, New York became the first state to implement regulatory measures limiting housestaff work hours. Because restrictions on residents' work hours will have such profound and far-reaching implications for how obstetrics and gynecology residencies are conducted, the Council on Resident Education in Obstetrics and Gynecology (CREOG) requested that a survey be conducted to solicit information from program directors of U.S. obstetrics and gynecology residencies who had already begun to alter their call schedules. Two hundred and ninety-six programs were contacted, and representatives of those that had implemented changes were requested to respond. Eighty-two responses were received; 26 of these contained information that could be collated. From these 26 responses the authors have structured a prototypic call schedule and presented its application. A key feature necessary to implement the new type of schedule is the use of a night float system. It is concluded that changes can and will be made by obstetrics and gynecology residencies. Creative scheduling, as described in this article, is essential and will facilitate the task; however, the current standards of education and patient care will be difficult to maintain without additional economic and human resources.

Gynecology↗
PubMed1991

Resident scheduling: night float programs.

Obstetrics and gynecology residency programs have traditionally involved long hours in the hospital. In recent years, in an attempt to determine whether work hours could be reduced while at least maintaining resident education and patient care, many program directors have instituted night float systems. In New York State, these systems must adhere to rigid hospital code requirements (limiting total hours worked and with specific mandates regarding time away from the hospital); in other areas, these requirements are not as limiting. At the request of the Council on Resident Education in Obstetrics and Gynecology, residency program directors and residents in the United States and Canada were sent a survey regarding whether they had a night float program, how it was structured, and what changes it was perceived to have caused. Responses were received from 193 program directors (65%) and 302 residents. Major differences were noted in the structure of the programs within New York state compared with those outside the state. In New York, 63% of the programs had residents in all 4 years participating in the night float; this was true for only 10% of the programs outside New York. In New York state, the programs were required to adhere to state hospital code requirements limiting hours on duty and mandating the specifics of time off, whereas the programs outside New York did not necessarily adhere to these restrictive requirements. Twelve characteristics were evaluated regarding changes that were perceived to have occurred as a result of the night float program.(ABSTRACT TRUNCATED AT 250 WORDS)

Gynecology↗
PubMed1989

The High-Risk Young People's Program. A summing up.

For over five years, 21 teaching hospitals and 54 community cosponsors provided health services to young people at risk for sociomedical problems, i.e., to young people living in communities characterized by high rates of teen pregnancy, sexually transmitted disease, drug abuse, alcohol abuse, accidents, homicide, suicide, and mental illness. With support from The Robert Wood Johnson Foundation, the 20 grantees of the High-Risk Young People's Program developed projects whose collective goal was to expand services to high-risk youth and improve their health. This goal was to be achieved by a direct provision of medical services, training health providers in the care of high-risk youth, consolidating categorical youth services into single, comprehensive care sites, and securing long-term support for these new services and training activities. During the grant period, 114 fellows, 974 residents, 453 medical students, and 126 graduate nurses trained at project sites. Patient visits, which totaled 47,203 the first year, reached 84,754 the second year, and were reported at 89,024 in the fourth year. Sixteen of the 20 projects secured 117 grants worth nearly $7 million. We conclude that the projects were successful in training health care providers and in securing additional support for Program purposes, but were less successful in expanding services beyond the initial pilot for clinical care.

Adolescent↗
PubMed1976

Removal of the normal uterus.

The uterus is often justifiably removed when anatomically it is a normal organ. Unfortunately, such surgery often is viewed with suspicion because there is failure to communicate the justification to patients and uninformed critics. An effort is made in this manuscript to categorize procedures and thus more clearly delineate the indications for removal of the normal uterus. Reviewed is a total of 485 hysterectomies performed over a ten-year period in a medical school affiliated hospital providing training in obstetrics and gynecology for second-year residents and for third- and fourth-year medical students. Eighty-two of the 485 uteri removed (16.9%) were considered anatomically normal by the criteria set forth. The morbidity associated with these cases was minimal.

Female↗
PubMed1975

Gestational variation of fatty acid composition of human amniotic fluid lipids.

The amount of total lipids of the amniotic fluid of normal human subjects increases progressively with gestational age and is found to be maximum in labor at term. The lecithin/sphingomeylin ratio, which invariably increased with gestational age, is 2:1 or greater beyong 34 weeks of pregnancy and becomes maximum at term labor. No definite correlation exists between the palmitic acid content of total lipids and gestational age; but the palmitic acid content of the lecithin fraction increases with gestational age and this increase is markedly accelerated near the 34th week of pregnancy. Also it is observed that the arachidonic acid of cholesterol esters increases with gestational age. Therefore, it is suggested that both the palmitic acid level of lecithin and the arachidonic acid level of cholesterol esters might serve as more reliable indices that current methods being employed for the assessment of fetal lung maturity.

Amniotic Fluid↗