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Biomedical subjects

J Carter

Publications and source records attributed to J Carter.

At least 307 records · Page 17Linked to original sources
PubMedDate not supplied

Job satisfaction of HIMs working in Victorian hospitals.

The growing demand for Health Information Managers (HIMs) in Victorian hospitals has increased the importance of job satisfaction in maximising performance and ensuring high retention levels both within the profession and the state. This report outlines the results of a job satisfaction questionnaire completed by a sample of HIMs working in Victorian hospitals. The questionnaire focuses on task design, autonomy, performance feedback and professional development opportunities. While the study demonstrates a scope for improvement, it also highlights the general satisfaction of the Victorian HIM population.

Adult↗
PubMedDate not supplied

A comparison of diabetic foot ulcer patients managed in VHA and non-VHA settings.

OBJECTIVE: To compare patients with diabetes and new onset foot ulcers treated in Veterans Health Administration (VHA) and non-VHA settings. METHODS: The treatment of patients with new onset diabetic foot ulcers was prospectively monitored in three VHA and three non-VHA hospitals and outpatient settings until ulcer healing, amputation, or death. RESULTS: Of the 302 individuals enrolled in this study, 47% were veterans receiving VHA care. There were no significant differences between veterans and nonveterans in baseline wound classification, diabetes severity, or comorbid conditions. Veterans received significantly fewer sharp debridements, total contact casts, and custom inserts than their nonveteran counterparts, and they had significantly more x-rays, local saline irrigations, IV antibiotics, and prescriptions for bed rest. The percentage of amputations was higher in veterans but did not achieve statistical significance. CONCLUSIONS: Many commonly held stereotypes of veteran men were not found. Veterans and nonveterans with foot ulcers were similar in terms of health and foot history, diabetes severity, and comorbid conditions. There was considerable variation in treatment of diabetic foot ulcers between VHA and non-VHA care. Yet this variation did not result in statistically significant differences in ulcer outcomes.

Aged↗
PubMedDate not supplied

Are we having fun yet?

Are you stressed out? Is your in box taller than you are? Do you have suicide hotline on speed dial? If you're not having fun at work, you're not alone.

Adaptation, Psychological↗
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Tell me why.

Explore the source record for details and available documents.

Cost Control↗
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Gd-DTPA enhancement of posterior epidural scar: an experimental model.

Because of the tremendous clinical and physiological importance of anterior epidural scar, an easily produced and reproducible model to assess potential pathways for lessening its formation is a necessity. We speculated whether posterior epidural scar (produced by the less complex surgery of laminectomy alone) could be considered equivalent to anterior scar from an imaging standpoint; that is, enhancement following Gd-DTPA irrespective of scar age. Posterior epidural scar in dogs showed the highest degree of enhancement 1 month after surgery, with a rapid decline thereafter out to 4 months postsurgery to a level equivalent to that of paraspinal muscle. Gd-153-DTPA time/activity curves paralleled the Gd-DTPA findings. Light microscopy showed granulation tissue after 1 month, and mature scar with large amounts of collagen 4 months after surgery. Electron microscopy showed tight capillary endothelial junctions. An appropriate model for epidural scar, which has imaging characteristics similar to human anterior scar, necessitates an extensive lumbar laminectomy with anterior epidural dissection. A simple laminectomy, while easily performed, does not provide a physiologically correct time course of enhancement.

Animals↗
PubMedDate not supplied

Tribal differences in diabetes: prevalence among American Indians in New Mexico.

The prevalence of diagnosed diabetes among American Indians in New Mexico with varied genetic and cultural backgrounds is reported. Utilizing community-based registries, the prevalence in persons ages 35 years and older ranged from 9.8 percent among Jicarilla Apache Indians to 28.2 percent among Zuni Indians. All rates were significantly higher than the U.S. rate of 5.3 percent for the same age group. In addition, in three of the five tribal groups examined, the rates of diagnosed diabetes in Indians less than 35 years of age (range from 0.5 percent to 1.3 percent) were significantly higher than the U.S. rate of 0.4 percent for the same age group. The prevalence rates of diagnosed diabetes found in this study of American Indians in New Mexico were intermediate between those for the United States as a whole and the Pima Indians of southern Arizona. Reasons for the variations and the relative contribution of obesity, fitness, or genetic risk in the development of diabetes need further study.

Adult↗
PubMedDate not supplied

Assessment of extradural degenerative disease with Gd-DTPA-enhanced MR imaging: correlation with surgical and pathologic findings.

To test whether gadolinium-DTPA-enhanced MR would increase the conspicuity of extradural degenerative disease in the previously unoperated patient, we prospectively studied a group of 30 patients with symptoms suggestive of disk disease. Surgical findings and pathologic correlations were used as an objective measure of accuracy. Gadolinium-DTPA increased the confidence of diagnosis at one of eight operated cervical levels (six patients) and changed the diagnosis from extradural degenerative disease to tumor in one patient. The mechanism of enhancement of the epidural space and peridiskal region appears to be related to accumulation of contrast material within the epidural venous plexus, as well as to epidural fibrosis associated with disk disruption and herniation. While the immediate clinical utility of gadolinium-DTPA for morphologic analysis seems limited to difficult cervical spine cases, the presence of enhancement as a marker of epidural fibrosis and attempted healing may prove to be of great importance in studying the natural history and basic pathophysiology of degenerative disk disease.

Adult↗
PubMedDate not supplied

Development of a Database Management System for an obstetrics unit.

This article discusses the use of computer technology in expediting and simplifying the retrieval of data generated from clinical practice. The article describes the collaboration between academic faculty and nurse clinicians in developing a computerized database to report birth statistics incurred by a busy obstetrical unit. A secondary purpose of the article is to assist the reader in understanding the importance of planning the content to be entered into the database and to become familiar with the basics of developing a database that could be used to sort and retrieve data. Facilitators and barriers to the development of a database management system in clinical practice are also discussed.

Database Management Systems↗
PubMedDate not supplied

Chronobiology of human blood pressure in the light of static (room-restricted) automatic monitoring.

Systematic 24-h automatic physiologic monitoring has obvious merits, even without rhythmometry. It can lead more readily to the recognition of odd-hour blood pressure elevation (e.g., of 'evening' or 'morning' hypertension). Such a condition can constitute an initial diagnosis or it may be found under treatment that may seem to be satisfactory if its effects are assessed only on the basis of a conventional check at a casual, possibly 'wrong' time. The mere inspection of a 24-h record, however, does not necessarily allow one to make objective quantitative global statements as to a change in pattern, e.g., after a given intervention. This paper illustrates how by rhythmometry, some of the uncertainties of a subjective interpretation of a record may be removed by practitioners of medicine, as well as basic scientists interested in mechanisms of blood pressure variability. This is possible since a large part of blood pressure variability can be accounted for by its circadian periodic behavior. We herein present a methodology for data collection and analysis that allows the objective quantification of blood pressure rhythm parameters in health and disease and the derivation of reference standards for such parameters. The chronobiologic approach thus makes it possible to define 'hypertension' objectively, and to distinguish between 'mesor-' and 'amplitude-hypertension', i.e., between an elevation in overall mean and one in the predictable extent of variability. Moreover, chronobiology has shown that mesor-hypertension may be preceded by an elevation in circadian amplitude only (amplitude-hypertension). Parameter tests readily allow the assessment, in relation to an objective reference standard, of these conditions, with a defined probability. Similarly, response to drug or non-drug therapy can be established and a given intervention optimized by timing treatment. Using chronobiologic tools in cardiovascular research provides new insights into possible mechanisms underlying mesor- and amplitude-hypertension. The teaching of the chronobiology of blood pressure and autorhythmometry in schools has been proven to be feasible and has been recommended as a step toward self-help for health care.

Adolescent↗