Search PubMed⌕ Search

Biomedical subjects

J Dean

Publications and source records attributed to J Dean.

153 records · Page 9Linked to original sources
PubMedDate not supplied

Identifying skilled management and evaluation needs of home health care patients.

This article describes the development of an assessment inventory to identify home care clients needing skilled management and evaluation services. Evidence supporting the inventory's content, criterion-related and predictive validity is presented. The inventory accurately predicted those patients readmitted within 60 days of discharge. Home health care nurses found the inventory easy to use without being time consuming. Use of the inventory by home health care nurses will permit care agencies to more easily document the need to continue care and reduce recidivism and cost while increasing care quality.

Aged↗
PubMedDate not supplied

Global action to prevent war: a programme for government and grassroots efforts to stop war, genocide and other forms of deadly conflict.

At the end of history's bloodiest century and the outset of a new millennium, we have an opportunity to fulfil one of humanity's oldest dreams: making the world largely free of war. Global changes make this goal achievable. Nuclear weapons have shown the folly of war. For the first time, there is no war and no immediate prospect of war among the main military powers. For the first time, many proven measures to prevent armed conflict, distilled in the crucible of this century's wars, are available. If systematically applied, these measures can sharply decrease the frequency and violence of war, genocide, and other forms of deadly conflict. To seize the opportunity, nations should adopt a comprehensive programme to reduce conventional armaments and armed conflict. This programme will complement and strengthen efforts to eliminate nuclear arms. To assure its ongoing worldwide implementation, the conventional reduction programme should be placed in a treaty framework. We propose a four-phased process, with three treaties, each lasting five to ten years, to lay the groundwork for the fourth treaty, which will establish a permanent international security system. The main objectives of the treaties are to achieve: 1. A verified commitment to provide full transparency on conventional armed forces and military spending, not to increase forces during negotiations on arms reductions, and to increase the resources allocated to multilateral conflict prevention and peacekeeping. 2. Substantial worldwide cuts in national armed forces and military spending and further strengthening of United Nations and regional peacekeeping and peace-enforcement capabilities. 3. A trial of a watershed commitment by participating nations, including the major powers, not to deploy their armed forces beyond national borders except in a multilateral action under UN or regional auspices. 4. A permanent transfer to the UN and regional security organizations of the authority and capability for armed intervention to prevent or end war, accompanied by further substantial cuts in national armed forces and increases in UN and regional forces. This programme offers many valuable features: a global framework for conventional forces that parallels the nuclear Non-Proliferation Treaty; a verified no-increase commitment for national armed forces based on full data exchange; a commitment to undertake prescribed confidence-building measures, including limits on force activities and deployments; a commitment to a specified plan for increased funding of UN and regional peacekeeping capabilities; a commitment to strengthen international legal institutions; and after a trial period, a lasting commitment by each participant not to unilaterally deploy its armed forces beyond its borders, but instead to give the responsibility for peacekeeping and peace enforcement to international institutions. This programme of phased steps to reduce armed forces and strengthen peacekeeping institutions will make war rare. It will foster the spread of zones of peace like those in North America and Western Europe where, after centuries of violence, international and civil war have given way to the peaceful settlement of disputes.

Homicide↗
PubMedDate not supplied

Simulation of complex movements using artificial neural networks.

A simulated network for controlling a six-legged, insect-like walking system is proposed. The network contains internal recurrent connections, but important recurrent connections utilize the loop through the environment. This approach leads to a subnet for controlling the three joints of a leg during its swing which is arguably the simplest possible solution. The task for the stance subnet appears more difficult because the movements of a larger and varying number of joints (9-18: three for each leg in stance) have to be controlled such that each leg contributes efficiently to support and propulsion and legs do not work at cross purposes. Already inherently non-linear, this task is further complicated by four factors: 1) the combination of legs in stance varies continuously. 2) during curve walking, legs must move at different speeds, 3) on compliant substrates, the speed of the individual legs may vary unpredictably, and 4) the geometry of the system may vary through growth and injury or due to non-rigid suspension of the joints. This task appears to require some kind of "motor intelligence". We show that an extremely decentralized, simple controller, based on a combination of negative and positive feedback at the joint level, copes with all these problems by exploiting the physical properties of the system.

Animals↗
PubMedDate not supplied

Alcohol and smokeless tobacco effects on the CD-1 mouse fetus.

Tobacco products and alcohol are commonly used as nonmedicinal drugs by pregnant women, and both are known to cause various effects on the fetus and the newborn. The objective of this study was to examine the fetal effects of both drugs when administered individually and simultaneously to pregnant CD-1 mice at moderate dosages. Specifically, we wanted to determine whether or not the effect on the fetus of these two biologically active substances was additive, ameliorative, or synergistic. A total of 65 CD-1 dams were divided among four groups receiving either ST equivalent to 8 mg/kg nicotine, ethanol (ETOH) 1.8 g/kg, a combination of ST+ETOH in the same dosages, or D-glucose (controls and ST alone) to supply calories equivalent to the dose of ethanol. Mice were dosed three times per day on gestational days 6-15. On gestational day 17 all dams were killed, fetal and placental weights recorded, and the number of resorbed, dead, and malformed fetuses noted. The mean maternal plasma drug levels were: nicotine-321 ng/ml and ethanol-0.105 g%. No significant differences were observed in maternal weight gain, litter size, or in the incidence of resorptions, deaths and/or malformations. Fetal weights were reduced in all three treatment groups (P less than 0.05), with the greatest reduction (13% decrease) recorded in the ST group, followed by a 9% decrease in the ETOH group, and a 7% decrease in the ST+ETOH group. Placentas of the ST group weighed significantly less (P less than 0.05) than controls. Ossification of the fetal skeleton, observed in ten sites, was affected to the greatest extent in the ST group, followed by the ETOH and ST+ETOH groups. Craniofacial measurements were significantly affected (P less than 0.05) in all three treatment groups, compared to controls. We conclude that under these experimental conditions, in terms of fetal growth and ossification, ST had the greatest effect, followed by ETOH and ST+ETOH. The interaction of ST+ETOH was neither additive, synergistic, nor ameliorative.

Analysis of Variance↗
PubMedDate not supplied

Primary care residents and the management of hypercholesterolemia.

A survey of primary care residents' attitudes, beliefs, and knowledge and a medical record audit were used to assess barriers to appropriate detection, identification, and management of hypercholesterolemia. Previous studies have focused on either self-reports or audits alone. This study compares survey results to recorded clinical performance. Family practice and internal medicine residents were compared to determine if previous findings were specialty-specific. The results of the survey indicate that, even prior to the publication of the National Cholesterol Education Program, residents demonstrated positive attitudes and appropriate knowledge of risk levels, in contrast with previous reports on practicing physicians. The medical record audit, however, showed that residents were not providing care that approximated their own recommendations for hypercholesterolemia management. Results of the survey and audit demonstrated little or no difference between specialty groups. The results indicated that training in management skills and reducing practice barriers are important to improve resident physicians' management of patients with hypercholesterolemia. The use of a survey and audit provide a useful needs assessment for designing educational programs.

Attitude of Health Personnel↗