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Biomedical subjects

J M Perrin

Publications and source records attributed to J M Perrin.

72 records · Page 4Linked to original sources
PubMed1985

Measurement of xylanase activity with insoluble xylan substrate.

Insoluble xylan was prepared from ground birch (Betula pubescens) pulp by alkali extraction and precipitation with ethanol. The only sugar detected after acid hydrolysis of the preparation was xylose. The insoluble xylan was used as substrate in a nephelometric assay to determine the xylanase (EC 3.2.1.8, 1,4-beta-D-xylan xylanohydrolase and EC 3.2.1.37, 1,4-beta-D-xylan xylohydrolase) activities of Aspergillus and Trichoderma enzymes. The nephelometric method is reliable in evaluating xylanase hydrolysis of insoluble xylan.

Aspergillus↗
PubMed1985

Variability among state Crippled Children's Service programs: pluralism thrives.

The authors review the history of the Crippled Children's Service (CCS) program and report results of a survey of state CCS programs conducted in 1981. The results of the survey document extensive variability among state programs in respect to several indices, including numbers of children served, conditions covered, and services provided. With few exceptions, selected organizational, economic and demographic variables fail to correlate significantly with the variation of these indices. The strongest correlation, .40 (p less than .02) is between percentage of children served and program per capita expenditures, suggesting that relatively wealthier programs tend to serve more children. Furthermore, analyses of the survey results show that mean coverage by CCS programs of surgical disorders is significantly greater than mean coverage of medical disorders or behavioral disorders (p less than .001). The findings of this study underscore the considerable influence of historical and leadership variables on the functioning of state CCS programs.

Asthma↗
PubMed1984

The organization of services for chronically ill children and their families.

Despite a political climate that deters optimism for rapid growth in the field of maternal and child health, we believe that there are reasonable steps that can and ought to be taken in the years immediately ahead. These steps would lead to important and lasting changes in the delivery, organization, and financing of services to chronically ill children and their families. Furthermore, pediatricians can play important roles--as they have historically--in reshaping care for children with special needs. First, children with chronic illness and their families require a set of services substantially different from those required by the majority of the nation's children. Just as there is no escaping the presence of a chronic illness for a child and family, the health care system cannot escape its responsibility to provide these services. This nation has been extraordinarily attentive to the medical services that these children need. Advances in the diagnostic and medical treatment procedures for many chronic illnesses have been remarkable, allowing many children to live far longer and in much better health than anyone would have expected two decades ago. This nation has not been so attentive to other services. A child with diabetes may have the finest medical care available in the region, yet her family lacks the money for gas to visit her in the hospital. The cystic fibrosis specialist may develop a comprehensive management strategy for his patient, but it fails to have full effect because the family's local pediatrician remains uninformed. These and many other examples convince us that the first step toward improving the organization of services for these children and their families must involve sustained national attention to their broad and special needs. Pediatricians are in an excellent position for this effort. Though most pediatricians will not have in their practice many children with the same chronic illness, they are likely to be the only medical practitioners who will get to know a broad spectrum of chronically ill children and their families. Because of this perspective they can be a truly informed and effective voice, articulating to their local communities the need for special services for this population of children. Second, services should be organized in such a way as to de-emphasize dependence on expensive tertiary care hospitals and instead to foster the delivery of care closer to the child's and family's own community.(ABSTRACT TRUNCATED AT 400 WORDS)

Canada↗
PubMed1983

Clinicians' assessments of children's understanding of illness.

Optimal communication between providers of child health care and their patients depends on appropriate expectations of what the children can understand. Recently the developmental stages in children's understanding of the mechanisms of cause, prevention, and treatment of illness have been delineated. We studied the accuracy of clinicians' knowledge of these developmental stages. Pediatricians, nurses, and child development students were asked to estimate the age at which children made typical responses to five questions regarding illness mechanisms. Clinicians usually overestimated the age of younger children and underestimated the age of older children; they correctly estimated children's ages less than 40% of the time. Child health care providers might communicate more effectively with their patients if they became more familiar with typical stages in children's understanding of illness concepts.

Adolescent↗
PubMed1977

Foreign medical graduates in rural primary care: the case of western New York State.

To determine whether foreign medical graduates (FMGs) provide a disproportionate and increasing share of primary care in some rural areas, changes in physician distribution in a rural section of upstate New York over a 20-year period (1953-1973) were evaluated by country of medical education and type of practice. A contiguous urban area was examined for comparison. In 1953, FMGs accounted for a higher proportion of primary care physicians in rural areas (11%) than in urban practice (6%) (p less than 0.01). By 1973, this distribution had increased to 26% rural and 14% urban (p less than 0.001). During the two decades, the number of U.S. medical graduates in primary care declined by 15% in the rural areas but increased by 13% in the urban center. The number of primary care FMGs in this same period increased 88% in the rural area. With a 10% decline in (rural) FMGs trained in developed countries, this net increase in FMGs was accounted for by physicians from developing countries. Primary care physicians trained in the U.S. or in developed countries increased more in the urban center, while physicians from developing countries increased more in rural (53%) than urban (47%) practices. Finally, by 1973, rural primary care physicians were more likely than urban primary care physicians to be from developing countries (p less than 0.001).

Developing Countries↗
PubMedDate not supplied

Assessing managed care for children with chronic conditions.

This paper reviews opportunities to monitor managed care for children and adolescents with chronic conditions and considers how well the Health Plan Employer Data and Information Set, version 3.0 (HEDIS 3.0), assesses care for these children. We propose four steps to strengthen the applicability of HEDIS to children with chronic conditions: (1) develop methods of identifying and monitoring groups of children with chronic conditions; (2) report HEDIS indicators for these children separately from those for other children; (3) develop and implement consumer and provider surveys that elicit information specific to these populations; and (4) develop specific structure, process, and outcomes indicators for children with chronic conditions.

Adolescent↗