Biomedical subjects
Publications and source records attributed to J E Swan.
The referral process is an important means of obtaining patients and it is necessary to determine ways of influencing the referral process to increase the patient base. This article reports research based on a survey of the referral habits of 806 primary care physicians. The results are examined in the context of physician receptivity to marketer-controlled versus health services sources of referral information.
Tumors of the skull base in general are considered among the more difficult head and neck pathological entities to treat surgically; some surgeons, in fact, consider lesions in this area inoperable. The most appropriate and safest surgical approach to lesions of the anterior and lateral skull base can be devised only with accurate and precise pre-operative assessment. The literature demonstrates the constant evolution of and search for more efficient less invasive, and safe surgical approaches to this region. With the development of a more exact three-dimensional, interactive anatomical "road map" for each patient's disease and anatomy, the skull base surgeon can not only achieve a more accurate pre-operative assessment leading to a less invasive and less morbid approach, but also can continue to develop and refine new approaches without fear of actual morbidity and mortality. An interdisciplinary team approach, the advent and continued development of faster high performance computers, and the development of new and innovative rendering algorithms can lead to surgical simulation. A prototype of an interactive system has been developed. The system will be iteratively modified through a stepwise evaluation of its clinical usefulness by continually reassessing the system with clinical trials. The current state of the system and the potential benefits are presented.
Current medical imaging systems are developed for the purpose of data management. Evaluations of these systems are usually done by assessing users' subjective appreciation rather than objectively gauging performance influence. The present report discusses the evaluation of a medical image presentation system prototype utilizing a cognitive approach. Experimental results showed hypothesized performance improvement attributed to advanced presentation techniques. However, this improvement was almost inadvertently masked by users' previous strategies and interactions with new technology. Overall these data demonstrate the potential benefit of implementing such a system in actual practice as well as provide an example of applying the cognitive approach in evaluating the usability of medical systems.
Primary care physicians have several external sources of information available when referring a patient to a specialist. The most-used sources were a fellow physician, followed by the specialist, the patient or the patient's family, and to a lesser extent, hospital-controlled sources including referral directories, call services, and sales representatives. The authors tested a cost-benefit model where source usage was predicted to increase as the costs of using the source decreased and benefits increased.
Patient-based determinants of quality and satisfaction play an important role in choosing a health care provider. This study identifies five attributes of health care delivery that define patients' perceptions of quality and satisfaction. Managerial implications for diagnosing quality concerns of patients are discussed.
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Patient satisfaction surveys are widely used tools. However, they provide limited managerial information. Additional, useful insights can be gained by analyzing factors that determine satisfaction. This study reports on fulfillment of expectations equity and satisfaction survey items as predictors of overall satisfaction with, and intentions to use, a hospital.
Chaetomium cellulolyticum, a newly isolated cellulolytic fungus, showed 50-100% faster growth rates and over 80% more final biomass-protein formation than Trichoderma viride, a well-known high cellulase-producing cellulolytic organism, when cultivated on Solka-floc (a purified, predominantly amorphorous form of cellulose) or partially delignified sawdust (consisting of a mixture of hardwoods) as the sole-carbon source in the fermentation media. However, in both cases, T, viride produced much higher quantities of free cellulases at faster rates and also degraded more substrate than C. cellulolyticum. It is concluded that the synthesis mechanisms and/or the nature of the cellulase complexes of the two types of organisms are quite different such taht C. cellulolyticum is more optimal for single-cell protein (SCP) production, while T. viride is more optimal for the production of extracellular cellulase. It was also found that the amino acid composition of C. cellulolyticum is generally better than that of T. viride and compares favorably with those of the FAO reference protein, alfalfa, and soya meal. In addition, preliminary feeding trials on rats have shown no adverse effects of the SCP produced by C. cellulolyticum fermentations.