Search PubMed⌕ Search

Biomedical subjects

M A Goodwin

Publications and source records attributed to M A Goodwin.

At least 37 records · Page 2Linked to original sources
PubMed1998

Billing for physician services: a comparison of actual billing with CPT codes assigned by direct observation.

BACKGROUND: Little is known about the accuracy of family physicians' use of the Current procedural Terminology (CPT) coding scheme for office visits, despite increased administrative oversight of Medicare billing practices. In addition, the patient and visit characteristics that are associated with over- and undercoding are not well understood. METHODS: This study compared coding for evaluation and management (E&M) services billed for 3791 visits to 138 family physicians with the codes assigned by trained research nurses using direct observation. We calculated the degree to which the codes for E&M were concordant with the observer-assigned codes. Analysis of variance and logistic regression were used to examine the association of visit and patient characteristics with discordance between billed and observer-assigned CPT codes. RESULTS: Billing codes were concordant for 55% of encounters. Discordance was evenly distributed between under- and overcoding. Concordance of billed and observed codes was greatest for patients with indemnity insurance. Undercoding increased with longer visit length and a smaller percentage of the visit spent planning treatment. Overcoding was more common during visits with a greater percentage of time spent chatting, planning treatment, and delivering preventive services. CONCLUSIONS: Family physicians are generally accurate in their billing procedures. The findings on patient and visit characteristics associated with over- or undercoding may be used by practicing clinicians to enhance the accuracy of their coding and billing procedures.

Adult↗
PubMed1998

Patient and visit characteristics associated with opportunistic preventive services delivery.

BACKGROUND: This study's purpose was to identify patient and visit characteristics associated with the use of illness visits as opportunities for the delivery of preventive services and to determine if time is allocated differently during illness visits that make use of these opportunities. METHODS: Research nurses directly observed the delivery of preventive services during consecutive patient visits on 2 separate days in the offices of 138 family physicians. Data on patient eligibility for preventive services were collected by medical record review. Time use during patient visits was categorized using the Davis Observation Code (DOC). Patient characteristics, visit characteristics, and time use were compared during illness visits in which at least one service recommended by the US Preventive Services Task Force was delivered to eligible patients, compared with illness visits during which no recommended preventive services were delivered. RESULTS: Preventive services were delivered during 32% of 3547 illness visits. Adults, overweight patients, those who smoke or drink alcohol, new patients, and patients with fewer visits in the past year were more likely to receive preventive services. Patient request was also associated with increased delivery of preventive services. The presence of another family member, visits for an acute illness, and the prescription of a drug were associated with a decreased likelihood of a patient's receiving preventive services. When preventive services were delivered during illness visits, less time was spent on chatting, procedures, and physical examination, and more time was spent on history-taking. CONCLUSIONS: Family physicians take greater advantage of opportunities for the delivery of preventive services during the illness visits of high-risk patients. The results of our study suggest strategies that could be used to expand the opportunistic delivery of preventive services to other patients and types of visits.

Adolescent↗
PubMed1994

Active and passive protection against variant and classic infectious bursal disease virus strains induced by baculovirus-expressed structural proteins.

Infectious bursal disease virus (IBDV) is responsible for a highly immunosuppressive disease in young chickens which causes significant economic losses to the poultry industry worldwide. The structural protein genes (VP2, VP3 and VP4) of a variant IBDV strain (GLS) were expressed in insect cells using a baculovirus expression system. Susceptible chickens vaccinated with a single dose of the recombinant IBDV antigens were completely protected against challenge with two variant strains of IBDV (GLS and Delaware), and partially protected against the standard challenge strain (STC). A booster dose of the recombinant antigens induced higher levels of neutralizing antibodies and afforded complete protection against both variant and standard virus challenges. Specific-pathogen-free hens vaccinated with a single dose of the same subunit vaccine produced virus-neutralizing antibodies that were capable of passively protecting the progeny from infection with variant IBDV.

Animals↗
PubMed1994

Medical student experience with AIDS and needle disposal behaviour.

A survey of medical students at Columbia University, College of Physicians and Surgeons, was conducted to investigate needle-handling behaviour with HIV positive patients. Recapping a used needle increases the students' risk of a needle stick. There were 160 responses, yielding a response rate of 27.6%. Students placed used needles in the sharps container without recapping the needle significantly more often if they had experience with a patient with AIDS. There was no correlation between personal exposure to contaminated material (being stuck or exposure to other contaminated material) and correct needle disposal behaviour. Women students (single or married) only used increased precautions during sex about one-third of the time, a figure similar to women psychiatric patients. Single male students used increased precautions 41.5% of the time, while married male students used increased precautions 8.7% of the time.

Female↗
PubMed1994

Experimental toxoplasmosis in Japanese quail.

Twenty-four 5-month-old battery-hatched Japanese quail were inoculated orally with 10(5) (ME 49 strain, group A, 6 birds), 10(3) (ME 49 strain, group B, 6 birds), 10(5) (GT-1 strain, group C, 6 birds), and 10(3) (GT-1 strain, group D, 6 birds) Toxoplasma gondii oocysts. All birds in group C died or were euthanized within 8 days after inoculation (DAI). Five of the 6 birds in group D died or were euthanized 8, 9, 15, 19, and 23 DAI. One of the 6 quail in group A died 9 DAI, and 1 of the 6 birds in group D died 16 DAI. The 11 quail (1 from group D and 10 from groups A and B) were euthanized 63 DAI; T. gondii was isolated by bioassays in mice from the brains of 10, hearts of 10, and skeletal muscles of all 11 quail. Quail that survived marked small intestinal and splenic toxoplasmosis lived long enough to develop severe protozoal pneumonia, myocarditis, or meningoencephalitis. The quail that survived only to be examined at 63 DAI had moderate multifocal nonpurulent encephalitis and myositis and had a hypertrophic spleen that contained hemosiderin-laden macrophages. Toxoplasma gondii antibodies were found in the sera of all quail examined 63 DAI. Antibody titers to T. gondii in the modified agglutination test were higher than in the indirect hemagglutination and latex agglutination tests. Antibodies were not detected in quail sera examined by the Sabin-Feldman dye test.

Agglutination Tests↗
PubMed1989

Antigenic comparisons of selected avian reoviruses by use of the plaque-reduction neutralization assay.

The antigenic interrelatedness of 3 clone-purified turkey reoviruses (NG-Turkey, 82-88, and NC-TEV) to each other and to 4 clone-purified chicken reoviruses (S1133, Co8, Fahey-Crawley, and avian type 2) was determined in reciprocal cross-neutralization tests, using polyclonal antisera and the plaque-reduction technique. The morphologic features of plaques formed under agar were studied for all 7 reoviruses, and size comparisons for turkey vs chicken isolates were made. All 3 turkey reoviruses (with the exception of NG-Turkey vs Fahey-Crawley chicken reovirus) formed plaques significantly (P less than 0.05) smaller than plaques produced by their chicken counterparts. The 3 turkey reoviruses were closely related to each other and to chicken reovirus CO8. The antigenic differences between turkey reoviruses 82-88 and NC-TEV and chicken reovirus S1133 were slight (minor subtype); however, the latter and NG-Turkey were serotypically distinct. The NG-Turkey and 82-88 turkey reoviruses were more related (minor subtype) to the Fahey-Crawley and avian type 2 chicken reoviruses, than was NC-TEV turkey reovirus (major subtype).

Animals↗
PubMed1988

Respiratory cryptosporidiosis in chickens.

In order to better characterize spontaneous respiratory cryptosporidiosis in chickens, a retrospective examination of histopathology reports from the Georgia Poultry Laboratories for an 18-mo period (4/1/86 to 9/30/87) was made; 12 cases were found. Collected data were analyzed and certain epidemiologic and histologic features were identified. Eleven of the 12 cases involved broiler type chickens. The ages of chickens with respiratory cryptosporidiosis were evenly distributed between 17 and 52 days of age. The infected birds were always clinically ill. Viruses or bacteria or both often accompanied respiratory Cryptosporidium sp. infections. Histologic lesions (including those of ciliary-adherent bacteria) are described. As the inflammatory response in infected organs became progressively nonpurulent (lymphocytes and plasma cells predominate), numbers of Cryptosporidium diminished. Cytologic preparations were useful for making diagnoses of respiratory cryptosporidiosis in chickens. Identification of epidemiologic features of respiratory cryptosporidiosis, and improved ability to make accurate and prompt diagnoses of Cryptosporidium sp. infection, are vital for a more complete understanding of the impact of this disease on poultry health.

Animals↗
PubMed1987

Hypomyelination in Weimaraner dogs.

Dogs from two separate litters of Weimaraners developed tremors by 3 weeks of age. Light and electron microscopic findings in one dog from each of the litters were compared to those of two age-matched controls. Many axons in the brain and spinal cord were either thinly myelinated or nonmyelinated in the affected dogs relative to the controls, while the peripheral nervous system was normally myelinated. The degree of hypomyelination seemed particularly severe at the periphery of the lateral and ventral funiculi of the spinal cord. In all areas of white matter evaluated, astrocytes subjectively outnumbered oligodendrocytes in the Weimaraners, while the reverse was true in the controls. This discrepancy in oligodendrocyte and astrocyte numbers was confirmed quantitatively in the spinal cord. These findings suggested that abnormal glial differentiation was responsible for the hypomyelination. Clinical signs in two affected littermates of one of the dogs gradually resolved, suggesting that the underlying lesion was reversible.

Animals↗
PubMed1985

The use of intestinal D-xylose absorption and other parameters to determine the pathogenicity of and immunity to Eimeria acervulina.

The degree of pathogenicity of Eimeria acervulina infection in broiler chickens was evaluated by body weight gain, feed conversion ratio, oocyst production, gross morphologic lesion score, and intestinal D-xylose absorption. The least pathogenic effects, after challenge, occurred in birds immunized with 5 X 10(4) oocysts and challenged on Day 14 with 3 X 10(6) oocysts. Intestinal D-xylose absorption was found to be a sensitive method for evaluating the effects of coccidial infection and correlated well with body weight gain and feed conversion ratio. Oocyst production and morphologic lesion scoring were less sensitive techniques than D-xylose absorption, weight gain, and feed conversion for determination of pathogenic effects between the groups of birds tested.

Animals↗
PubMed1984

Quantitation of intestinal D-xylose absorption in normal turkeys.

Both a standard method and a modified micromethod of quantitating intestinal D-xylose absorption were successfully performed in turkeys. Absorption peaks and curves for both tests closely resembled those observed in humans. The micromethod was preferred because it could be performed in poults as young as 3 days of age, required a smaller sample size, and was more economical and less time-consuming. Both tests were suitable for experimental and clinical determination of small intestinal absorptive function in the turkey.

Animals↗
PubMedDate not supplied

Family history-taking in community family practice: implications for genetic screening.

PURPOSE: To identify characteristics of physicians, patients, and visits associated with obtaining family history information in community family practice. METHODS: Research nurses directly observed 4,454 patient visits to 138 family physicians and reviewed office medical records. RESULTS: Family history was discussed during 51% of visits by new patients and 22% of visits by established patients. Physicians' rates of family history-taking varied from 0% to 81% of visits. Family history was more often discussed at well care rather than illness visits. The average duration of family history discussions was <2.5 minutes. CONCLUSIONS: These data can form the basis for realistic interventions to increase the use of family history in primary care.

Adolescent↗
PubMedDate not supplied

Relationship of common avian pathogen antibody titers in so-called chicken anemia agent (CAA)-antibody-positive chicks to titers in CAA-antibody-negative chicks.

Antibody titers for infectious bursal disease virus (IBDV), infectious bronchitis virus, Newcastle disease virus, and reovirus from chicks with chicken anemia agent (CAA) antibodies were compared with antibody titers from their CAA-antibody-negative counterparts. These comparisons were made in 396 chickens that were 1 day, 2 weeks, 8-9 weeks, 10 weeks, 17 weeks, or 29-32 weeks old. Only one serum sample was collected from any given chick or chicken. There were no significant differences between the antibody titers at any age for any antigen, with one exception: at 29-32 weeks, the IBDV titers were higher (t = 2.62, df = 142, P less than 0.01) in chickens with CAA antibody. Although not at all likely, we believe that the observation of high IBDV antibody titers in CAA-antibody-positive chicks could have been a spurious one.

Anemia↗