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Biomedical subjects

J A Malcolm

Publications and source records attributed to J A Malcolm.

At least 19 recordsLinked to original sources
PubMed1994

Hospital administrators' tolerance of staff needlestick injuries.

OBJECTIVE: To survey hospital administrators regarding their opinions of an acceptable frequency of staff needlestick injury and the frequency that would prompt additional preventive action. DESIGN: A simple anonymous questionnaire sent to 960 administrators with one reminder. Data were collected regarding hospital size and community role, whether human immunodeficiency virus (HIV)-infected patients had ever been treated, presence of an infection control practitioner, estimation of the proportion of staff vaccinated against hepatitis B, and opinions as to the acceptable frequency of needlestick accidents and the accident frequency, requiring additional action. SETTING: 240 public hospitals in New South Wales, Australia. PARTICIPANTS: The executive officers, directors of medical services, directors of nursing, and safety officers of the hospitals surveyed. RESULTS: The response rate was 50%. Administrators' opinions of acceptable accident frequency increased with hospital size and (independently of size) with experience with HIV-infected patients, and with the presence of a full-time infection control practitioner. Accident frequencies judged to require additional preventive action were higher than injury frequencies regarded as acceptable. CONCLUSIONS: The hospital administrators surveyed accept staff needlestick injuries as inevitable, the more so in hospitals that have treated known HIV-infected patients and that have full-time infection control practitioners.

Accidents, Occupational↗
PubMed1992

Changes in drug treatment and case fatality of patients with acute myocardial infarction. Observations from the Newcastle MONICA Project, 1984/1985 to 1988/1990.

OBJECTIVE: To describe changes in medications administered to patients with acute myocardial infarction between 1984/1985 and 1988/1990 and changes in case fatality. DESIGN: Descriptive study from the Newcastle MONICA Project, which monitors all heart attacks in men and women aged 25 to 69 years in the Lower Hunter Region of New South Wales. SUBJECTS: All patients admitted to hospital with a "definite" acute myocardial infarction who survived at least 28 days during periods in 1984/1985 (513 events) and 1988/1990 (790 events). MAIN OUTCOME MEASURES: Changes in drugs being taken immediately before the onset of the myocardial infarction, prescribed during hospitalisation and on discharge from hospital, and changes in case fatality rates. RESULTS: From the first time period to the second there were significant increases in the use of aspirin, calcium channel blockers, angiotensin-converting enzyme (ACE) inhibitors and hypolipidaemic agents, and significant reductions in the use of diuretics. In 1988/1990, 34% of patients with a definite myocardial infarction received thrombolytic therapy compared with fewer than 1% in 1984/1985. Among those patients who survived at least one hour from onset of symptoms, the case fatality rate declined from 13.5% to 7.9% (change -5.6%; 95% confidence limits, -8.9%, -2.2%). CONCLUSION: Large changes in drug treatment of patients with acute myocardial infarction have occurred in the second half of the 1980s. These may be responsible for the reduction in case fatality. Nevertheless, use of drugs of proven effectiveness in acute care and for secondary prevention is surprisingly low in this population.

Adult↗
PubMed1992

First public report for physicians due this summer.

Public reporting of physician-specific information by the Pennsylvania Health Care Cost Containment Council begins this summer with the release of a report of physician-specific surgical data. Physicians should be aware that the release of such information may have a significant impact on decisions made by patients or potential patients.

Coronary Artery Bypass↗
PubMed1992

Plans proceed to publish physician-specific data.

Physicians should be aware that the release of physician-specific information by the Pennsylvania Health Care Cost Containment Council (PHC4) may have a significant impact on decisions made by patients or potential patients. This article, which outlines PHC4's proposed Research Plan about coronary artery bypass graft (CABG) surgery and related issues, is a follow-up to "First Report Card for Physicians Due This Summer" [Pennsylvania Medicine, May 1992]

Coronary Artery Bypass↗
PubMed1991

Trends in ischaemic heart disease in the Hunter Region of New South Wales 1985-1989.

OBJECTIVE: To find out whether trends in rates of non-fatal myocardial infarction (MI) parallel trends in rates of coronary death. DESIGN: A population-based observational study involving continuous surveillance of all suspected heart attacks or coronary deaths from 1985 to 1989. STUDY POPULATION: Residents of the Hunter Region of New South Wales aged under 70 years. MAIN OUTCOME MEASURES: Rates of non-fatal definite or possible MI or fatal MI or coronary death, as defined by the diagnostic criteria of the WHO MONICA Project. RESULTS: For men, mortality rates declined by an average of 16.2 per 100,000 per year (95% confidence interval [CI]: -23.8, -8.7); rates of non-fatal definite MI declined by 16.2 per 100,000 (95% CI: -27.8, -4.6); rates of non-fatal possible MI increased initially and then stabilised. For women smaller changes occurred in the same directions. CONCLUSION: In this population trends in rates for non-fatal definite MI paralleled the declines in mortality rates. Rates for less severe non-fatal possible MI did not follow this pattern, perhaps reflecting increased medical attention to chest pain.

Adult↗
PubMed1991

HIV and nutrition.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗