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Biomedical subjects

J G Anderson

Publications and source records attributed to J G Anderson.

At least 73 records · Page 4Linked to original sources
PubMed1986

Campylobacter pyloridis is associated with acid-peptic disease in Toronto.

Campylobacter pyloridis has been associated with acid-peptic disease in centres outside Canada. The authors conducted a pilot study to see if this association existed in Toronto. Patients in whom esophagogastroscopy was indicated on clinical grounds were arbitrarily selected for determination of the presence of C. pyloridis. Included in the study were 100 patients who underwent 105 endoscopies. In 75 patients (80 endoscopies) there was some form of acid-peptic disease (inflammation or ulceration of stomach or duodenum). Of those with acid-peptic disease, 34% had C. pyloridis compared with 4% among patients without acid-peptic disease (p less than 0.01). Men with acid-peptic disease were more likely to harbour C. pyloridis than women (48% versus 16%, p less than 0.01). The organisms were curved gram-negative rods that appeared as small colonies after 4 days of incubation under microaerobic conditions. They were strongly urease positive. There was considerable heterogeneity of endoscopic diagnoses. Future clinical studies of C. pyloridis need careful endoscopic and histologic classification.

Adolescent↗
PubMed1985

Computers and clinical judgment: the role of physician networks.

In order to study the relationship between physician networks and utilization of a computer-based hospital information system (HIS), blockmodel analysis and multidimensional scaling were used to analyze and spatially represent the network of professional relations among 24 physicians in a private group practice. A blockmodel analysis of patient referrals, consultations, discussions, and on-call coverage identified four groups of physicians who share common locations and perform similar roles within the network. Investigation of the shared attributes of these groups supports this relational structure. The results suggest that the center-periphery model of diffusion of new ideas among professionals may be too simplistic. Instead, the communication network may involve multiple central cohesive subgroups of physicians who differentially initiate patient referrals and consultations with physicians in other subgroups. Network location was found to have a significant effect on the adoption and utilization of the HIS independently of background and practice characteristics of physicians. The results also suggest that adoption of an innovation and its implementation or utilization may involve separate processes that need to be differentiated in future research.

Computers↗
PubMed1985

Toward an empirical classification of hospitals in multihospital systems.

Inconsistency and lack of utility in multihospital systems research is often attributable to misspecification of the unit of analysis and lack of generalizability of research findings. The typical, system-level focus takes an "organizations are all alike" approach that masks potentially important variation among constituent hospitals in systems. This article develops and validates a multivariate, empirical typology of hospitals affiliated with multihospital systems. The objective of the typology is to identify prevalent types of system hospitals that share similar organizational and operational characteristics. Three hundred and sixty-six hospitals affiliated with secular, not-for-profit multihospital systems were subjected to cluster analysis within and across affiliation categories (owned, leased, and contract managed). Findings indicate that the population of hospitals in not-for-profit systems is organizationally heterogeneous but that distinct groupings of hospitals, based largely on size and affiliation status, occur within this population. Homogeneous groupings of hospitals were tested for differences in governance and performance characteristics. Although these clusters differ only slightly in their governance characteristics, they do manifest several differences in performance characteristics. Implications and applications of these findings are discussed.

Contract Services↗
PubMed1985

The MeSH model for hospital-physician joint ventures.

The MeSH (Medical Staff-Hospital Joint Venture Company) concept has arisen to meet the perceived need for hospital-physician cooperation in a modern age of prospective payment systems, increased supply of health-care providers, cost conscious consumers, corporate health care organizations, and a general trend toward industrialization of health care. Supply and demand economics have created a situation which threatens the autonomy and financial integrity of both hospitals ans physicians, forcing cooperation or mutual destruction. MeSH seeks to preserve the autonomy and financial integrity of both parties through the creation of a free-standing business entity jointly owned by a hospital and those members of its medical staff who choose to participate. This article presents reasons for the need for cooperation, the objectives of MeSH, a description of its structure and operation, and a list of potential projects the program could include.

Hospital Administration↗
PubMed1985

Organizational stress in the hospital: development of a model for diagnosis and prediction.

A model of organizational stress in the hospital was developed and tested. The model utilized measures of organizational climate, supervisory practices, and work group relations as predictors of the amount of role conflict and ambiguity that nurses perceived in providing patient care. Role conflict and ambiguity were treated as variables that intervene between organizational variables and the level of stress that the nursing staff experienced. Nursing stress was viewed as a direct cause of job dissatisfaction and as an indirect cause of absenteeism among the nursing staff. Data from 158 registered nurses, licensed practical nurses, and nursing assistants on seven nursing units in a 1,160-bed private teaching hospital were used to estimate the parameters of a structural equation model. The model was used to predict the results of a survey feedback project designed to change the supervisory style used on the units. Pre- and posttest data from four surgical units were used to validate the model. The findings suggest that, as predicted, supervisory practices that led to more open expression of views and joint problem solving resulted in reduced role conflict, ambiguity, and stress; increased job satisfaction; and lower levels of absenteeism among the nursing staff.

Absenteeism↗
PubMed1984

An informal approach to board evaluation.

This article provides a brief description of the informal board evaluation process that Rochester (MN) Methodist Hospital recently initiated. The evaluation process consisted of informal interviews between individual board members and an ad hoc committee that included the hospital administrator and the chairman of the board.

Evaluation Studies as Topic↗
PubMed1983

The role of physician networks in the diffusion of clinical applications of computers.

This study utilizes network analysis to examine the process by which physicians adopt and utilize computers in providing patient care. It also demonstrates how network techniques can be used to determine the role and position of individual physicians in their professional network and to develop educational programs designed to increase the clinical use of computers.

Communication↗
PubMed1983

A hospital staff support program: design and evaluation.

The literature indicates that nurses on special care units experience stress resulting from the role conflict and ambiguity to which they are exposed. Role theory predicts that such individuals will become dissatisfied with their work and will decrease their confidence in supervisors and co-workers. Consequently, it was hypothesized that a staff support program designed to assist nurses to cope with role conflict and ambiguity would result in reduced stress; increased satisfaction with work, supervision, and co-workers; and decreased staff turnover. A nine week staff support program was implemented on a hospice unit in a large, private, general hospital. The program utilized an insight-oriented approach focused on specific sources of stress combined with structured exercises designed to facilitate nurses' ability to cope with stress resulting from a role conflict and ambiguity. Data were collected from two groups to hospice nurses using a Nursing Stress Scale developed for this study, the Job Description Index, and personnel records. A quasi-experimental research design was used to assess the validity and generalizability of the results of the program. Data were analyzed in four stages: (i) pre-program levels of stress and job satisfaction were analyzed using a multivariate profile analysis; (ii) correlated t-tests were used to test for significant differences between pre- and post-program levels of stress; (iii) a repeated measures ANOVA was used to examine the effect of the program on job satisfaction; (iv) turnover among the nursing staff on four other hospital units was compared to the hospice unit. Results of the evaluation indicated that the support program was effective in reducing nursing stress, increasing job satisfaction, and decreasing staff turnover. The implications of the study for the design and evaluation of hospital staff support programs are discussed.

Conflict, Psychological↗
PubMed1983

Utilization of computers in clinical practice--role of physician networks: preliminary communication.

This study examines the influence of physician networks on the utilization of computers in clinical practice. Data on patient referrals, consultations, professional discussions, and on-call coverage were collected from 24 physicians who comprise a private group practice. Their utilization of a computerized hospital medical information system (HIS) in caring for patients admitted to a 1160-bed private, university affiliated, teaching hospital was determined. A matrix representing the professional relations among these physicians was subjected to smallest space analysis, a form of multidimensional scaling. Also, a number of indices that describe structural and interactional properties of the network and individual physicians were computed. The three-dimensional representation of the network that resulted from the analysis suggests a two-step process of adoption and utilization of medical technology. Physicians who were engaged in outside professional activities and in the training of medical students and house staff were more likely to utilize the system in caring for patients. These physicians, who were more centrally located and dominant in the referral and consultation process, were more likely to influence the practice patterns of their colleagues. The use of network analysis to identify influential physicians whose involvement is essential to the success of efforts aimed at introducing computers into clinical practice is discussed.

Computers↗
PubMed1980

Variability in gas production by Escherichia coli in enrichment media and its relationship to pH.

Variability in gas production in multiple subcultures of Escherichia coli was assessed in two selective enrichment media and in lactose peptone water. Considerable variability occurred with all media at 37 and 44 degrees C. Addition of buffer increased gas production and decreased variability. The relationships between pH, growth, and gas production were complex. In buffered media, viable counts increased by 269 x 10(6) to 382 x 10(6)/U of pH fall, whereas in unbuffered media, they increased by 9.45 x 10(6) to 30.37 x 10(6)/U of pH fall. In buffered and unbuffered media, pH fell as gas production rose. However, variability in gas production among individual subcultures was not associated with changes in pH.

Bacteriological Techniques↗