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J Anderson

Publications and source records attributed to J Anderson.

At least 1,117 records · Page 62Linked to original sources
PubMedDate not supplied

The National Practitioner Data Bank: the first 18 months.

In response to a need for information on the quality of professional practice and a perceived threat to the preservation of the peer review process, as well as to concern about the cost to society of incompetent physicians, Congress passed the Health Care Quality Improvement Act of 1986. The Act established a legal basis for protecting peer review and quality assurance activities. It also established a national reporting system, the National Practitioner Data Bank (NPDB), which is intended to ensure that appropriate information is available to be used in the peer review process.

Licensure, Medical↗
PubMedDate not supplied

Creating a center of excellence.

Being able to identify your facility as a Center of Excellence characterized by quality of patient care and services, outcomes and financial performance-sets your hospital apart from others. St. Luke's Episcopal Hospital in Houston developed a three-pronged approach to quality improvement which has helped the hospital establish and maintain its position as such a Center. Other institutions can modify this approach for their own use. Service line management is the hospital's first avenue of approach, a means of aligning and coordinating staff efforts and services for a particular patient population, to achieve a better integrated service delivery system. St. Luke's also uses a case management model, a system of planning, coordinating, monitoring and delivery care on a case-by-case basis, to provide the best care at the lowest possible cost. A third strategy is outcomes management, which uses outcomes assessment information to track the experience of an aggregate patient population. A collaborative practice team oversees the research, data evaluation and determination of changes to be implemented. It also establishes the desired outcome for the patient population. St. Luke's has used these initiatives to improve care, particularly among cardiovascular patients. Ultimately, the hospital changed its methods of care as a result of this assessment. Change took time to gain favor with hospital physicians. In 1991, St. Luke's applied to HCFA's Bypass Demonstration project, in which Medicare distributes a lump sum to cover surgeons, cardiologists and other disciplines for Medicare-eligible DRG 106 and 107 patients. St. Luke's joined the project in 1993. As a result of participation in the project, Medicare allows selected sites to call themselves a Medicare Participating Center of Excellence.

Case Management↗
PubMedDate not supplied

Intramedullary nailing of femoral fractures in adolescents.

Fifty femoral shaft fractures were treated with reamed, interlocking, intramedullary nails utilizing a greater trochanteric starting point from 1991 through 1998. The 17 girls and 31 boys ranged in age from 10 to 16 years (mean, 13.2 years) at the time of injury. Average follow-up after fracture was 16 months. All fractures united, and the average leg-length discrepancy was 1 mm (range, -10 mm to +11 mm). No patient had angular or rotational deformities. No patients developed osseous necrosis of the femoral head. Despite intramedullary nailing through the greater trochanteric apophysis, articulotrochanteric distance measurements increased only 4.5 mm at the time of last follow-up. No patient developed significant proximal femoral deformity with some follow-up as far as 60 months from the time of surgery. Intramedullary nailing through a trochanteric starting point is a safe, effective method for treating femur fractures in this adolescent age group.

Adolescent↗
PubMedDate not supplied

Sage advice. Experienced physician executives share the secrets of their success. Interview by David O. Weber.

Seven successful physician executives, now retired from distinguished careers, look back over their experiences and offer advice for those who follow. Be a good doctor first, and never let business interests undermine the ethics of the health care profession. Prepare for management responsibilities with business training. Seek out mentors and develop a network of knowledgeable colleagues and advisors. Exert leadership rather than authority. Expect disappointments and arm yourself for them.

Commerce↗
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A custom-built controlled-rate freezer for small sample cryopreservation studies.

A custom-built controlled-rate freezing machine is described. It operates by automatically raising and lowering the sample carrier in a static column of liquid nitrogen vapour. It is controlled by a computer-assisted thermocouple feedback system that operates a stepper motor driving the sample carrier. The cooling protocol is divided into three phases: cooling from +5 to -5 C, initiation of ice nucleation, and cooling from -5 to -80 C. Experiments are described to validate the device over a range of different cooling rates. A freezing protocol is established to cool samples in plastic straws over a range of rates up to 80 C/min, with rapid and consistent absorption of the latent heat.

Animals↗
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Mechanism of genital transmission of SIV: a hypothesis based on transmission studies and the location of SIV in the genital tract of chronically infected female rhesus macaques.

To understand the biologic processes involved in transmission of HIV, we examined the genital tracts of chronically infected female macaques and localized SIV-infected cells. SIV was found in the genital tract of 12 of 16 animals and SIV-infected cells were located in the cervix and vagina. Inoculation of cell-free SIV into the blind vaginal pouch of hysterectomized macaques resulted in systemic infection. We propose a hypothesis to explain the early events in the genital transmission of SIV.

Animals↗
PubMedDate not supplied

Prior episode of sexually transmitted disease and subsequent sexual risk-reduction practices. A need for improved risk-reduction interventions.

Persons with a history of a sexual transmitted disease (STD) are at increased risk for infection with human immunodeficiency virus (HIV). The extent to which women with a previous history of a STD report currently practicing protective behaviors against STD transmission is examined. Specifically, whether having experienced one or more previous episodes of an STD was related to current STD/HIV preventive practices was studied. Of the study group, 36% had at least one prior STD episode. Results of bivariate analysis show no relationship between previous STDs and current STD/HIV preventive practices: 47% of women with no previous STD episode, 64% of women with 1 previous episode, and 46% of women with 2 or more previous STD episodes reported currently practicing moderate to high levels of STD/HIV prevention methods. To adjust for potentially confounding variables, logistic regression analyses were also performed. The logistic regression model included age, alcohol use with sex, drug use with sex, marital status, and perceived risk of becoming infected with an STD in the next year. Results from the logistic regression analyses also showed no relationship between prior STD episode and current level of preventive practices against STD/HIV. Variables found to be significantly associated with level of STD/HIV preventive practices were marital status, age, and drug use with sex. These findings suggest that greater advantage should be taken of the opportunities presented when women are diagnosed with an STD to teach individuals at risk of acquiring STDs or HIV to practice risk-reduction behaviors.

Adolescent↗
PubMedDate not supplied

Facing up to mastectomy.

Explore the source record for details and available documents.

Adaptation, Psychological↗