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Biomedical subjects

N Cunningham

Publications and source records attributed to N Cunningham.

At least 37 records · Page 2Linked to original sources
PubMed1988

Selective termination of multiple gestations.

Twenty-two selective terminations in multiple gestations were performed by a number of different methods. In 17 dichorionic pregnancies there was a successful delivery in surviving singletons or twins. In five monochorionic pregnancies undergoing selective termination there was a successful delivery in only one and a pregnancy loss in the other four. Six of the 18 delivered pregnancies were complicated by premature labor and delivery. Among the several methods used for selective termination, intracardiac potassium chloride injection appears to be the procedure of choice in dichorionic pregnancies.

Abortion, Induced↗
PubMed1978

Telemedicine in pediatric primary care. Favorable experience in nurse-staffed inner-city clinic.

Off-site pediatric consultation via bidirectional cable television (TV) was instituted to provide backup for nurse practitioners treating sick and well children in a small primary-care clinic. During a year of study of the system, there were 2,161 clinic visits and 285 TV consultations. When both TV and telephone consultation were available, TV was used for 10.8% of the visits, and telephone was used for 9.6% of visits. Staff reactions, though initially skeptical, were ultimately favorable. The system allowed pediatric nurse practitioners to function without on-site physician coverage 40% of the time. The main disadvantages were technical. Further work is needed to assess the reliability and validity of TV consultation and its acceptability in other settings.

Attitude of Health Personnel↗
PubMed1977

Cost factors in urban telemedicine.

This paper reports on the cost effectiveness of a pediatric primary care system utilizing nurse practitioners (NPs) linked to a physician consultant through bidirectional interactive cable television. In addition, it discusses ways in which multiple uses enhance the economic feasibility of a telemedicine consultation link in a given geographic area. The overall consultation rate during periods of remote physician coverage was 21 per cent, compared with 24 per cent during on-site coverage. The telephone became a partial substitute for the TV for some uses but could not replace it in diagnostic decisions. As telemedicine is obviously underutilized in a one-satellite system, we compare a five-satellite network with other ways of delivering service. The resulting estimated cost of $18.50 an hour, or 2/3 of the cost of a physician providing direct care, includes a TV component of $5.30 an hour of use in a 1,750-hour year. The critical factor is that the NP can be a physician substitute if there is TV backup. The TV appears to prevent unnecessary referrals compared to a physician on site. Whether TV increases the length of the consult compared to the phone for conditions of equal severity is not entirely clear. If TV is compared to transporting a patient to a central place, the implicit value of transport time and disutility required to justify using TV is $7.55 per consult in a five-clinic network. Geographic and other barriers to physician availability enhance the potential for application fo telemedicine.

Child↗