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Biomedical subjects

J Fisher

Publications and source records attributed to J Fisher.

602 records · Page 34Linked to original sources
PubMedDate not supplied

Alaska nursing home takes national role in addressing urinary incontinence.

Urinary incontinence affects over half of all residents in the nation's 25,000 nursing homes. While incontinence assessment, treatment and management techniques have been validated under "laboratory" conditions, the practicality of maintaining the systems pose difficulties for most nursing homes. An evaluation of a new automated system for managing urinary incontinence indicates that a nursing home in Anchorage, Alaska, has successfully implemented and maintained the new system for over ten (10) months. Researchers found that The Mary Conrad Center quickly reduced wetness rates in the target group from 25 percent prior to implementation of the program, to about eight percent and have been able to reduce wetness rates to even lower levels in subsequent months. The evaluation provides critical evidence that nursing homes can implement and maintain the comprehensive system. If further testing in other facilities result in similar findings, the system stands to impact the quality of care for over one million nursing home residents affected by urinary incontinence.

Alaska↗
PubMedDate not supplied

Cancer screening in women: a study of house staff behavior.

To explore physician, patient, and provider factors associated with house staff performance of cancer screening in women, we reviewed 565 randomly selected charts of 58 medical residents in two San Francisco teaching hospitals, H1 and H2. We assessed performance of Pap smear, breast exam, mammography, rectal exam, and stool occult blood testing, and administered questionnaires to all residents to ascertain screening beliefs and attitudes and individual screening criteria. The main finding was a significant difference in screening between the two hospitals. Four of five tests (Pap smear, breast exam, mammography, rectal exam) were performed more frequently at H2. Neither provider nor patient factors could explain this. Organizational differences between the sites included more frequent flow sheet recommendations for mammography and rectal exams at H2. Increased gynecological referral at H2 was also associated with more frequent Pap smears, breast exams, and rectal exams. White women did receive more frequent rectal exams, and mammography was increased among those who agreed with American Cancer Society screening recommendations, but no other provider or patient characteristics were associated with difference in screening. Results of further study of the effect of the learning environment and referral strategies on cancer screening, including assessment of patient acceptability and cost, can be used to improve cancer screening behaviors of medical house staff.

Adult↗
PubMedDate not supplied

Examination of fixative penetration in glutaraldehyde-treated bovine pericardium by stratigraphic analysis of shrinkage temperature measurements using differential scanning calorimetry.

Glutaraldehyde stabilizes pericardial tissue in prosthetic heart valves by forming covalent cross-links between collagen molecules. If the cross-linking is nonuniform owing to variable penetration of the glutaraldehyde, areas of the tissue may become sites for enzymatic attack or become potentially antigenic. Cross-linking can be easily assessed by measuring the shrinkage (thermal denaturation) temperature of the tissue. We used differential scanning calorimetry to perform a stratigraphic analysis of the shrinkage temperature of glutaraldehyde-treated pericardium. In the fixation conditions used (0.25 per cent glutaraldehyde for 28, seven and two days and for 2 hours), no variation was found in the shrinkage temperature measurement throughout the thickness of the tissue. This indicates uniform penetration of fixative and cross-linking throughout the tissue.

Aldehydes↗