The 1974 National Acceptors Survey.
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Age Factors↗
Biomedical subjects
J Phillips
Publications and source records attributed to J Phillips.
Breaking down the barriers!
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Communication Barriers↗
Beyond the rhetoric: what do we mean by a 'model of care'?
BACKGROUND: Contemporary health care systems are constantly challenged to revise traditional methods of health care delivery. These challenges are multifaceted and stem from: (1) novel pharmacological and non-pharmacological treatments; (2) changes in consumer demands and expectations; (3) fiscal and resource constraints; (4) changes in societal demographics in particular the ageing of society; (5) an increasing burden of chronic disease; (6) documentation of limitations in traditional health care delivery; (7) increased emphasis on transparency, accountability, evidence-based practice (EBP) and clinical governance structures; and (8) the increasing cultural diversity of the community. These challenges provoke discussion of potential alternative models of care, with scant reference to defining what constitutes a model of care. AIM: This paper aims to define what is meant by the term 'model of care' and document the pragmatic systems and processes necessary to develop, plan, implement and evaluate novel models of care delivery. METHODS: Searches of electronic databases, the reference lists of published materials, policy documents and the Internet were conducted using key words including 'model*', 'framework*', 'models, theoretical' and 'nursing models, theoretical'. The collated material was then analysed and synthesised into this review. RESULTS: This review determined that in addition to key conceptual and theoretical perspectives, quality improvement theory (eg. collaborative methodology), project management methods and change management theory inform both pragmatic and conceptual elements of a model of care. Crucial elements in changing health care delivery through the development of innovative models of care include the planning, development, implementation, evaluation and assessment of the sustainability of the new model. Regardless of whether change in health care delivery is attempted on a micro basis (eg. ward level) or macro basis (eg. national or state system) in order to achieve sustainable, effective and efficient changes a well-planned, systematic process is essential.
Delivery of Health Care↗
The impact of antithrombotic therapy on neurosurgical emergency referral load.
The authors sought to determine the impact of antithrombotic therapy on emergency referrals at one neurosurgical centre. All emergency telephone referrals over a 90 day period were carefully documented with particular attention paid to current antithrombotic medications and their indication. Details regarding age, gender, diagnosis, radiological findings and treatment were also recorded. 713 emergency referrals were documented in the data collection period. 174 (24.4%) patients presented with intracranial or spinal haemorrhage and 75 (43.1%) of these were on antithrombotic therapy, ranging in age from 46-94 years (mean 71.1 years) with 29 (31.8%) on warfarin, 43 (47.2%) on aspirin and 15 (16.4%) on clopidogrel alone or in combination with another antithrombotic agent. 17 (22.6%) had no documented indication for antithrombotic therapy (all of these were on aspirin therapy) and 9 (31%) of those on warfarin had an INR in excess of 3.5 on presentation. Almost one quarter of those on antithrombotic therapy who presented with a haemorrhagic complication had no obvious indication for such therapy. One third of those on warfarin were over anticoagulated.
Aged↗
Cancer control by the year 2000: implications for action.
This article presents an overview of the overall cancer incidence and mortality rates within the United States. More specifically, it addresses the high cancer incidence and mortality rate within the Black community. Included are the guidelines for the National Cancer Institute for cancer control to be achieved by the year 2000. In order to achieve these goals, Black nurses must actively participate in developing, implementing, and evaluating primary and secondary cancer prevention initiatives that will assist in reducing the disproportionate impact of cancer upon Black Americans.
Black or African American↗
Relationships between self-reported physical activity and physical fitness in active men.
We examined relationships between self-reported physical activity and physical fitness in a group of 202 male military officers, 36 to 51 years of age. Physical activity was estimated from the Minnesota Leisure Time Physical Activity Questionnaire and classified as heavy, moderate, or light depending on the intensity of individual activities. Directly measured components of physical fitness included aerobic capacity (treadmill walking peak VO2), body composition (densitometry), muscle strength (isokinetic mode), and flexibility (bend-and-reach test). Both total and heavy activity were significantly (P < .05) related to aerobic capacity, body fat, fat-free mass, upper body strength, and flexibility. Moderate and light activity were not related to the fitness measures. We divided subjects into quartiles of physical activity and corrected the fitness measures for age and cigarette smoking status. Subjects with more total and heavy activity had higher aerobic capacity and lower body fat; subjects with more heavy activity also had greater upper body strength. Again, moderate and low activity were not related to any fitness measure. These data indicate that heavy physical activity is related to various components of physical fitness even after correction for age and smoking status in a group of men who are healthy, generally very active, and fit.
Adult↗
Kasabach-Merritt syndrome-associated kaposiform hemangioendothelioma successfully treated with cyclophosphamide, vincristine, and actinomycin D.
PURPOSE: The authors introduced a successful trial of a chemotherapy regimen to treat refractory thrombocytopenia and pain caused by a rare kaposiform hemangioendothelioma that had been refractory to corticosteroids. PATIENT AND METHOD: A 6-year-old Latina girl with diffuse petechiae, constant pain and edema in her right lower extremity, and severe thrombocytopenia was brought for treatment. Physical examination revealed a large mass in the right lower extremity. The surgical specimen resected earlier in Mexico showed kaposiform hemangioendothelioma, an extremely rare vascular tumor that is frequently associated with consumptive coagulopathy and lymphangiomatosis. Corticosteroid therapy in Mexico had been ineffective in controlling the tumor size, pain, or thrombocytopenia. The patient was brought to the United States because of a rapidly enlarging tumor and intractable leg pain, causing inability to ambulate. Laboratory examinations revealed profound thrombocytopenia and evidence of consumptive coagulopathy. Because of the rapidly enlarging lesion, it was decided to give six cycles of a chemotherapy regimen consisting of vincristine, cyclophosphamide, and actinomycin D (VAC). RESULT: The patient responded to the first cycle of chemotherapy with partial reversal of the thrombocytopenia. The additional five cycles of the same chemotherapy regimen resulted in complete resolution of thrombocytopenia and significant improvement of the pain and edema in the right lower extremity. A follow-up imaging study 9 months later revealed a marked decrease in size of the vascular tumor. CONCLUSION: Inoperable kaposiform hemangioendothelioma unresponsive to corticosteroids can be successfully treated with chemotherapy.
Antineoplastic Combined Chemotherapy Protocols↗