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J J Baker

Publications and source records attributed to J J Baker.

48 records · Page 3Linked to original sources
PubMedDate not supplied

Transbronchial fine needle aspiration of the mediastinum. Importance of lymphocytes as an indicator of specimen adequacy.

To determine the effectiveness and accuracy of transbronchial fine needle aspiration of mediastinal masses for the staging of bronchogenic carcinoma, the results and histologic correlations of 97 transbronchial aspirates submitted from 78 patients over a two-year period were reviewed. Malignant cells were present in 25 of 97 aspirates. Of the remaining 75 nonmalignant aspirates, 34 had corresponding mediastinal tissue sections. Review of these 34 aspirates disclosed respiratory epithelial cells without lymphocytes in 20, lymphocytes without respiratory cells in 1 and both cell types in 8. Neither cell type was present in five aspirates. The predictive value of a negative result was 78% for nonmalignant aspirates containing lymphocytes and 36% for nonmalignant aspirates not containing lymphocytes (P less than .05). The presence of lymphocytes in transbronchial needle aspirates of the mediastinum is an essential criterion of specimen adequacy. Negative specimens lacking lymphocytes should be considered unsatisfactory, regardless of the numbers of respiratory epithelial cells present.

Adenocarcinoma↗
PubMedDate not supplied

Costs of interdisciplinary practice in a school-based health center.

In the context of market-driven health care reform, interest in cost and quality outcomes has increased. Quality, as defined by Donabedian, includes assessment of structure, process, and outcomes. However, the definition of quality in health care must be expanded to include the expectations and opinions of patients, their representatives, and society. The purpose of this article is to examine the outcome variable of costs in a specific nursing practice setting. Cost is frequently defined as the judicious use of resources consumed by structures and processes of care. This article presents activity-based costing methodology and results of a cost study of primary care and mental health services provided by advanced practice nurses (APNs) in a school-based health center. The application of the methods and outcomes of this pilot study has significant implications for the delivery of health care by APNs in a variety of settings, including community nursing centers, freestanding birthing centers, and rural and urban neighborhood centers. Because much of the health care delivered by APNs in these community-based settings includes health promotion, screening, counseling, and anticipatory guidance, it is important to explore methods such as activity-based costing to identify actual costs of care (versus charges) in emerging community-based practices where primary care is delivered by APNs.

Adolescent↗