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Biomedical subjects

P E Jones

Publications and source records attributed to P E Jones.

At least 19 recordsLinked to original sources
PubMed2001

Physician assistants in Texas.

Understanding the health requirements of a state begins with identifying the population at need and the workforce available to meet those needs. A descriptive study was undertaken to examine the physician assistant (PA) workforce in Texas as part of an ongoing effort to meet the health needs of Texas residents. In September 2000, Texas had 2237 licensed PAs practicing in 186 counties. Education for PAs in Texas began in 1970 and currently includes one private, one military, and six public programs. Most practicing PAs in Texas graduate from in-state programs and tend to locate within the state. Preparations are under way to shift the public undergraduate programs to graduate degree programs. Although barriers to health care access in Texas remain a substantial public health issue, PAs have helped reduce these barriers, especially in many rural communities. The supply of and demand for Texas PAs appear to be in equilibrium. Policy implications are discussed.

Delivery of Health Care↗
PubMed2000

The potential for social contextual and group biases in team decision-making: biases, conditions and psychological mechanisms.

This paper provides a critical review of social contextual and group biases that are relevant to team decision-making in command and control situations. Motivated by the insufficient level of attention this area has received, the purpose of the paper is to provide an insight into the potential that these types of biases have to affect the decision-making of such teams. The biases considered are: false consensus, groupthink, group polarization and group escalation of commitment. For each bias the following four questions are addressed. What is the descriptive nature of the bias? What factors induce the bias? What psychological mechanisms underlie the bias? What is the relevance of the bias to command and control teams? The analysis suggests that these biases have a strong potential to affect team decisions. Consistent with the nature of team decision-making in command and control situations, all of the biases considered tend to be associated with those decisions that are important or novel and are promoted by time pressure and high levels of uncertainty. A concept unifying these biases is that of the shared mental model, but whereas false consensus emanates from social projection tendencies, the rest emanate from social influence factors. The authors also discuss the 'tricky' distinction between teams and groups and propose a revised definition for command and control team. Finally, the authors emphasize the need for future empirical research in this area to pay additional attention to the social side of cognition and the potential that social biases have to affect team decision-making.

Decision Making, Organizational↗
PubMed1991

Portable cardiopulmonary bypass for heart-lung donor transplants.

In 1985 a portable cardiopulmonary bypass machine was devised in order that heart-lung donors from hospitals that were some distance away from our own institution could be procured. The distance of these hospitals ranged from the far north of Scotland to the Greek city of Athens. This paper will show how the portable bypass machine was developed and how it is used for the procurement of donor organs. As an offshoot of this, the device has been used for two emergency bypass procedures at noncardiac units where the transfer of the patient was impossible.

Cardiopulmonary Bypass↗
PubMed1989

Oesophageal function in patients with angina pectoris: a comparison of patients with normal coronary angiograms and patients with coronary artery disease.

Oesophageal function was assessed in 52 patients with angina pectoris whose coronary angiograms were completely normal and in 21 patients with angina pectoris who had significant coronary artery disease. During a standard oesophageal manometric study, abnormalities were found in 23 (44%) patients with normal coronary angiograms but in only 2 (10%) patients with coronary artery disease (p less than 0.01). Twenty-four (46%) patients with normal coronary angiograms were found to have gastro-oesophageal reflux disease during 24-hour oesophageal pH monitoring. Of the 52 patients with normal coronary angiograms, 19 (37%) had gastro-oesophageal reflux disease and abnormal oesophageal motility, 5 (10%) had gastro-oesophageal reflux disease alone, and 7 (13%) had oesophageal motility disorder alone. The use of provocation procedures, including intravenous edrophonium during oesophageal manometry and treadmill exercise testing during pH monitoring, enabled the oesophageal abnormality to be demonstrated simultaneously with chest pain in 25 of these 31 patients. Typical angina pectoris, coincident with abnormal oesophageal motility, was precipitated in a subgroup of patients who had been shown to have oesophageal manometric abnormalities and gastro-oesophageal reflux disease by the infusion of hydrochloric acid into the oesophagus; both the chest pain and manometric abnormality resolved following the oral administration of antacid.

Adult↗
PubMed1988

Angina-like chest pain: a joint medical and psychiatric investigation.

Sixty three patients with chest pain typical of angina and who had normal coronary angiograms were investigated for left ventricular, oesophageal and psychiatric abnormalities. An additional 21 patients, age and sex matched, who had angina and significant coronary artery disease were also studied. Eighty six per cent of the 63 patients without evidence of coronary artery disease could be demonstrated to have a physical abnormality (left ventricular dysfunction in 35%, oesophageal disorder 51%). There was, however, a wide variation in the incidence of psychiatric morbidity between the diagnostic subgroups-18% in left ventricular dysfunction, 29% in those with coronary artery disease and 59% in patients with oesophageal disorders (P less than 0.01). Thus failure to identify left ventricular dysfunction and inclusion of such subjects in psychological assessments of 'angiogram-negative' chest pain might give misleading results. This study confirms that patients with angina and normal coronary angiography have a high incidence of oesophageal disorders. However psychiatric illness is also common in this group of subjects and management needs to take both these factors into account.

Angina Pectoris↗
PubMed1987

Manchester air disaster.

On 22 August 1985 a fire occurred on a Boeing 737 jet airliner at take off at Manchester Airport. One hundred and thirty seven passengers and crew were on board. Fifty two passengers died on the aircraft, 85 escaped. Most survivors had minor physical injuries, but 15 required admission to hospital because of smoke inhalation and two of these had severe burns. At presentation only one survivor required ventilation but within 12 hours a further five required ventilation. Although initially patients suffering from smoke inhalation may seem relatively well, lung function may deteriorate rapidly in the first 24 hours. Careful organisation and regular practice of procedures to deal with a major accident are essential to be able to respond adequately to such an event.

Accidents, Aviation↗
PubMed1987

Exertional gastro-oesophageal reflux: a mechanism for symptoms in patients with angina pectoris and normal coronary angiograms.

During 24 hour oesophageal pH monitoring 52 patients who had angina pectoris and normal coronary angiograms underwent exercise testing, as far as their symptoms allowed, on a treadmill to determine whether gastro-oesophageal reflux occurred during exertion. In 11 patients the 24 hour oesophageal pH score was abnormally high; 10 of these showed exertional gastro-oesophageal reflux, and in nine this was associated with their usual chest pain. A further 13 patients had a normal 24 hour pH score but had exertional reflux coincident with chest pain during exercise testing. The mean lower oesophageal sphincter pressure in both of these groups of patients was appreciably lower than that in 28 patients who had a normal 24 hour pH score and no exertional reflux. These findings suggest that exertional gastro-oesophageal reflux accounts for the symptoms of a large proportion of patients who have angina pectoris and normal coronary angiograms and that oesophageal pH monitoring during exercise testing on a treadmill enables this group of patients to be identified.

Adult↗
PubMed1987

Left ventricular function and oesophageal function in patients with angina pectoris and normal coronary angiograms.

Left ventricular function and oesophageal function (including oesophageal manometry and pH monitoring) were investigated and a psychiatric assessment carried out in 63 patients with angina pectoris and normal coronary angiograms. Twenty two (35%) patients had regional abnormalities of left ventricular wall motion (group A). Thirty six (57%) patients had an oesophageal abnormality (group B); 19 patients had gastro-oesophageal reflux and abnormal oesophageal motility, five had gastro-oesophageal reflux alone, and 12 had abnormal oesophageal motility alone. Only four had regional abnormalities of the left ventricular wall and abnormal oesophageal function. In nine (14%) patients left ventricular and oesophageal function were normal (group C). Psychiatric morbidity was significantly less common in group A than in groups B and C and was similar in group B and group C. A definite abnormality of left ventricular function, oesophageal function, or psychiatric morbidity is present in a high proportion of patients with angina pectoris and normal coronary angiograms and in some instances this may lead to specific treatment. If quantitative assessment of left ventricular function is normal, oesophageal investigations should be performed. Endoscopy of the upper gastrointestinal tract may demonstrate oesophageal disease, but, if findings are normal, oesophageal manometry and ambulatory oesophageal pH monitoring (including during treadmill exercise testing) should be carried out.

Adult↗
PubMed1984

Designing organizations to compete.

The ability of corporations to defend or take market share from competitors varies with the corporations' strengths and weaknesses, may of which spring from their own structures. The challenge is not to design organizational structures that are perfect, but to design structures that are better than those of competitors.

Economic Competition↗
PubMed1983

Comparison of cimetidine and tripotassium dicitrato bismuthate in healing and relapse of duodenal ulcers.

A comparison between cimetidine and tripotassium dicitrato bismuthate liquid (TDB) in the treatment of endoscopically diagnosed duodenal ulcer by single-blind randomized trial in 48 patients has shown 18 (75%) out of 24 patients receiving TDB and 13 (54%) out of 24 patients receiving cimetidine healed after 4 weeks' therapy. Symptomatic improvement within 1 month was seen in 19 patients on TDB and 18 patients on cimetidine, but did not only occur in patients whose ulcers healed. On follow-up, endoscopically proven relapse occurred within 1 year in 47% of patients whose ulcers had healed during treatment with TDB in comparison with 60% of those healing on cimetidine.

Adolescent↗
PubMed1982

Alkaline phosphatase synthesis and properties of subcellular organelles during in vitro culture of jejunal biopsies from control subjects and patients with coeliac disease.

Portions of jejunal biopsies from control subjects and from patients with coeliac disease were cultured for 24 hours using an in vitro organ culture technique. Alkaline phosphatase activity was measured in the tissue and medium before and after culture; enzyme activities were expressed per microgram tissue DNA. The increase in enzyme activity during the culture period was taken to represent net enzyme synthesis. Alkaline phosphatase synthesis by mucosa from patients with untreated gluten-sensitive coeliac disease and by mucosa from patients with non-responsive coeliac disease was significantly less than that by normal mucosa. Alkaline phosphatase synthesis by mucosa from patients with treated gluten-sensitive coeliac disease was greater than that by untreated coeliac mucosa but was less than normal mucosa. Sequential studies of alkaline phosphatase synthesis by jejunal mucosa from seven patients with coeliac disease, before and after successful treatment by gluten withdrawal, showed an increase in synthesis in all patients. Study, by analytical subcellular fractionation with sucrose density gradient centrifugation, of the properties of the organelles of cultured control tissue showed good preservation of their integrity. A striking finding, however, was the decrease in malate dehydrogenase with a corresponding marked increase in lactate dehydrogenase. This would be expected to be followed by a shift from aerobic to anaerobic metabolism. Analytical subcellular fractionation of cultured mucosa from patients with coeliac disease gave similar conclusions. There was, however, a marked improvement of the brush border abnormalities, characteristic of coeliac disease, during culture with increased enzyme activities and membrane equilibrium density in the sucrose gradients.

Alkaline Phosphatase↗
PubMed1981

Oral zinc supplements in non-responsive coeliac syndrome: effect on jejunal morphology, enterocyte production, and brush border disaccharidase activities.

Three patients with clinically mild non-responsive adult coeliac syndrome were treated for eight weeks with oral zinc sulphate, and detailed biochemical and morphological studies were performed on the jejunal mucosa before and on treatment. Plasma zinc levels were reduced before treatment and rose to normal levels with therapy; mucosal zinc was normal before treatment and increased after therapy. Oral zinc supplementation did not alter the villous morphology, intraepithelial lymphocyte count or in vitro enterocyte production rate. In addition, there was no improvement in the clinical status of the patients. There was, however, a small increase in the activity of certain of the brush border disaccharidases. This effect may be due to direct stabilisation of the brush border membrane. The clinical value of zinc supplements in coeliac syndrome remains to be determined.

Aged↗
PubMed1981

Protein synthesis by cultured jejunal mucosa from control subjects and patients with coeliac disease.

Jejunal biopsies from patients with coeliac disease and from controls were cultured in vitro for 24 hours with 14C-labelled leucine. The net rate of protein synthesis was found to be linear over 24 hours for mucosa from control subjects and patients with coeliac disease. Protein synthesis by mucosa from untreated coeliac patients was significantly greater than by control mucosa. Protein synthesis by treated gluten-sensitive coeliac mucosa was significantly less than that by untreated coeliac mucosa and did not differ from control mucosa. Protein synthesis by treated non-responsive coeliac mucosa was significantly less than untreated coeliac mucosa but greater than control mucosa. The differences in protein synthesis could not be accounted for by differences in the size of the enterocyte leucine pool. Analytical subcellular fractionation of cultured jejunal mucosa showed that most of the protein synthesised in vitro was found in the cytosol and endoplasmic reticulum-brush border fractions of the enterocyte.

Celiac Disease↗