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Biomedical subjects

R B Williams

Publications and source records attributed to R B Williams.

At least 163 records · Page 9Linked to original sources
PubMed1986

Type As who think they are type Bs: discrepancies between self-ratings and interview ratings of the type A (coronary-prone) behaviour pattern.

The study described here explored discrepancies between self-ratings and interview ratings of Type A behaviour. A total of 281 patients referred for diagnostic coronary angiography underwent a comprehensive psychological assessment including the Type A structured interview (SI), the Minnesota Multiphasic Personality Inventory (MMPI) and two self-report measures of Type A behaviour, the Jenkins Activity Survey (JAS) and the Type A Self-Rating Inventory (TASRI). Two subgroups of patients were identified--Type A subjects whose Type A self-ratings were consistent with the SI classification, and subjects who obtained low self-rating scores and yet were classified as Type A by the SI. A comparison of the MMPI profiles showed that the discordant Type As scored lower on MMPI scales 9 (Ma) and 4 (Pd), and higher on scales 0 (Si), 2 (D) and F. The personality attributes associated with this MMPI pattern are more consistent with individual self-reports of Type A behaviour than observer ratings during the SI.

Coronary Disease↗
PubMed1986

Multiple-regression hospitalization-cost model for pharmacy cost analysis.

A multiple-regression model that used hospital data for a single diagnosis-related group (DRG) was developed and tested as a tool for measuring the effect of pharmaceutical services on costs. Computer-generated data from one university teaching hospital for fiscal year 1983 were used to develop a model for identifying patient-specific and treatment-specific factors that correlated with total hospital costs and adjusted total costs (total costs minus room and board). Costs were analyzed for patients hospitalized for cardiothoracic procedures (DRG 108). Data for 100 patients were included. The demographic, severity, treatment-intensity, and drug-use factors included in the model accounted for 95.6% of the variation in adjusted total cost. Length of stay, number of secondary surgical procedures, quantity of supplies or drugs used in the operating room, and several drug therapies--tobramycin, i.v. electrolytes, and i.v. fluids--had significant effects on adjusted total cost. This regression model was useful for assessing the effects of the choice of drug therapy or specific services on the costs for one DRG; it should be tested for other DRGs in other institutions. The usefulness of the model for planning cost-effective services is limited by the need for better billing information, cost-estimation techniques, and records of clinical services provided.

Computers↗
PubMed1986

Achieving excellence.

The concept of achieving excellence in pharmacy through development of effective leadership is discussed. The majority of hospital pharmacy directors have had very little education and training in management and effective leadership. Yet, excellent leadership skills will be needed to transform pharmacy more completely into a health profession. The management style most likely to be effective in this era of change is one that encompasses a high regard for both people and production through shared responsibility, high participation, involvement, and commitment. The following recommendations are offered to help achieve excellence through effective leadership: the ethic of self-development must be instilled in aspiring managers; courses in human behavior, leadership, and management should be added to undergraduate pharmacy curricula; pharmacy technicians should be educated in college-based programs that focus on drug distribution; Master of Science programs in hospital pharmacy should be deleted or restructured to focus on leadership and management; regional "centers for excellence" in leadership education should be developed; general residency training should be incorporated in undergraduate education so that more advanced residencies can be offered to graduates; high-level, self-study programs in management and leadership need to be developed, and substantial research funds need to be dedicated to the study of hospital pharmacy management.

Drug Industry↗
PubMed1986

Solving problems through staff participation in focus groups.

Use of a survey and employee focus groups to solve problems in a hospital pharmacy department is described. All pharmacy staff members were asked to identify perceived problems; 33% completed the written questionnaire. Managers clarified the survey comments and ranked problems for priority, using nominal group technique. Focus groups were formed to address appropriate problems; for each focus group supervisors selected two pharmacists and two technicians who volunteered or were nominated by peers. A pharmacy resident was the facilitator for each group. Meeting weekly for one hour, each group defined problems, set priorities, gathered ideas, analyzed possible solutions, and proposed a solution to the pharmacy supervisors. One group proposed guidelines for staff scheduling and seven-days-on, seven-days-off rotations for night pharmacists; the other proposed a structure for technician training in the department and a required orientation and training schedule for all employees. This process required more staff time than unilateral management decisions would have, but the solutions were acceptable to all levels of staff members. The focus group process was effective in identifying and solving problems at this hospital. Routine resurveys will be conducted and new focus groups will be formed to address problems that would benefit from analysis and consensus by employees.

Florida↗
PubMed1985

Development of a brief self-report measure of the type A (coronary prone) behavior pattern.

This study reports the development of a brief self-report measure of the Type A behavior pattern based upon a set of adjectives derived from the Gough Adjective Checklist (ACL). Previous work from our laboratory established a set of adjectives identified by experts as being relevant to the Type A construct that subsequently was found to successfully distinguish Type A individuals from their Type B counterparts. In the present study, a Type A self-rating scale based on these adjectives was found to be significantly related to an established Type A self-report instrument, the Jenkins Activity Survey (JAS), and to an independent behavioral rating based upon a standard structured interview (SI). However, no measure of Type A was related to the severity of coronary artery disease (CAD) as documented by coronary angiography. The advantages and disadvantages of the various Type A measures are discussed in the context of their ability to identify individuals at risk for the development of CAD.

Coronary Disease↗
PubMed1985

The inhibited power motive, type A behavior, and patterns of cardiovascular response during the structured interview and Thematic Apperception Test.

The Type A behavior pattern and the inhibited power motive have been implicated in the development of coronary heart disease (CHD). Since it is widely believed that enhanced cardiovascular responsivity may be one mechanism by which individuals develop CHD, the present study examined the relationship of Type A behavior and the inhibited power motive to different patterns of cardiovascular response during two behavioral tasks. Forty-one (24 Type A's, 17 Type B's) male undergraduates underwent the Type A structured interview (SI) and the Thematic Apperception Test (TAT) while a broad range of cardiovascular functions were simultaneously recorded. Different patterns of cardiovascular response were observed during the SI and TAT, and Type A's showed a greater tendency than Type B's to exhibit increased heart rate (HR), systolic blood pressure (SBP), and forearm blood flow (FBF) during the SI and the preparatory phase (but not the story-telling phase) of the TAT. The inhibited power motive was not related to enhanced cardiovascular responsivity during the SI or TAT. The implications of these findings for the development of CHD are discussed.

Adult↗
PubMed1985

College of pharmacy-teaching hospital relationships: building strength.

Perhaps the most important factor to focus on is that organizations work because of the people in them; also, they don't work because of the people in them. Perhaps some people in some of our organizations need changing. Hospitals and colleges face similar issues that need to be worked on together. The philosophy of collaboration needs adopting because competition will not provide the success desired by the college or the hospital. Without a strong commitment on the part of decision makers, time and effort will be wasted. There must be an active process. It can't be talked about only once a year. There should also be an ongoing, active process at the national level. We must build on our mutual needs. We must use positive approaches rather than developing more negative arguments. The key to success is to concentrate more heavily on communications, visibility, and accountability. F. Scott Fitzgerald put it this way: The test of a first-rate intelligence is the ability to hold two opposed ideas in mind at the same time and still retain the ability to function. We have three ideas that at times are in opposition. Service, education, and research can be integrated by applying the intelligence found in every teaching hospital and college of pharmacy.

Education, Pharmacy↗
PubMed1985

Does Plasmodium gallinaceum induce relapse of Eimeria acervulina infection in chickens?

An experiment was carried out to test the hypothesis that chickens previously infected with Eimeria acervulina, but having ceased producing oocysts, recommence E acervulina oocyst production when infected with Plasmodium gallinaceum. No relapse of coccidiosis was caused by the malarial infection. Subsequent treatment with the immunosuppressant betamethasone of the control chicks infected with E acervulina only did not reveal any occult coccidial infection. The results are critically compared with previously published results which apparently supported the hypothesis.

Animals↗
PubMed1984

Potent and selective hydroxynaphthoquinone inhibitors of mitochondrial electron transport in Eimeria tenella (Apicomplexa: Coccidia).

Novel hydroxynaphthoquinones have been shown to be potent and selective inhibitors of mitochondrial electron transport in the protozoan Eimeria tenella, inhibiting at concentrations of 10(-10) to 10(-11)M. The primary site of electron transport inhibition has been localized to the ubiquinol-cytochrome c reductase span of the respiratory chain, whereas a secondary site of inhibition occurs in the NADH- and succinate-ubiquinone reductase complexes. Inhibition at the primary site is selective for the E. tenella enzyme; inhibition at the secondary sites is comparable in both E. tenella and chick (Gallus gallus) liver mitochondria. Hydroxynaphthoquinone inhibition of chick liver succinate-cyto-chrome c reductase was fully reversible by addition of the exogenous ubiquinone-2 analogue, 6-decyl-2,3-dimethoxy-5-methyl-1,4-benzoquinone; inhibition of the corresponding E. tenella enzyme was not reversed by this ubiquinone. E. tenella lines made resistant to the anticoccidial agents decoquinate or clopidol showed no cross-resistance to the hydroxynaphthoquinones, either at the level of electron transport or in vivo.

Coccidiostats↗
PubMed1984

Evaluation of a mixture of trimethoprim and sulphaquinoxaline for the treatment of poultry: safety and palatability studies.

The safety of a 1:3 mixture of trimethoprim (TMP) and sulphaquinoxaline (SQX) for administration in food or water was assessed in broiler chickens, chicks of an egg laying strain and breeding fowl. The only effects recorded in six-week-old broilers medicated for seven days at levels ranging from 16 to 133 mg TMP plus SQX per kg bodyweight were decreases in water or food consumption, probably caused by unpalatability at overdosage levels, and associated decreases in weight gain and packed cell volume at an achieved overdose level of 4.4 times the recommended use concentration (RUC). Breeding fowl medicated at levels of 1 X or 3 X RUC for 14 days showed slightly reduced reproductive performance reflected by lowered egg production, egg weight and hatchability. These effects were temporary and performance equal to that of unmedicated birds was re-established by 14 days after medication ceased. Week-old chicks medicated for five days at levels from 0.7 to 4.7 X RUC showed normal growth rate over 12 days. Eleven-day-old chicks could not distinguish medicated from unmedicated water.

Animal Feed↗
PubMed1984

Effects of decoquinate and clopidol on electron transport in mitochondria of Eimeria tenella (Apicomplexa: Coccidia).

Resistance of the chicken coccidium Eimeria tenella to the anticoccidial agents decoquinate and clopidol, and the synergistic activity of mixtures of these compounds have been confirmed in vivo. Inhibition of electron transport by decoquinate and clopidol has been studied in mitochondria isolated from unsporulated oocysts of the same lines of E. tenella as those used in the in vivo studies. Electron transport in mitochondria of a drug sensitive line was susceptible to inhibition by both decoquinate and clopidol, and mitochondria isolated from lines made resistant to one or the other of these compounds showed a corresponding resistance at the level of electron transport. Combinations of low concentrations of decoquinate and clopidol caused a greater inhibition of electron transport than expected from summation of their individual actions. Isobolograms showed that decoquinate and clopidol in fact potentiated each other's effect on electron transport. Induced resistance to either decoquinate or clopidol resulted in an increased sensitivity of electron transport to inhibition by the other drug. Cytochrome spectra of E. tenella mitochondria and a biphasic response of NADH-oxidase and terminal oxidase activity to inhibition by cyanide or azide suggest the presence of two functional terminal oxidases. There is a correlation between the resistance of electron transport to inhibition by decoquinate or clopidol and the susceptibility to inhibition by cyanide or azide. Mitochondrial electron transport that is more resistant to inhibition by decoquinate exhibits greater sensitivity to cyanide and azide; electron transport that is more resistant to inhibition by clopidol exhibits a decreased sensitivity to cyanide and azide. Resistance to decoquinate and clopidol is discussed in view of a possibly branched electron transport chain in mitochondria of E. tenella.

Animals↗
PubMed1984

Unimproved chest pain in patients with minimal or no coronary disease: a behavioral phenomenon.

Patients with chest pain and minimal or no coronary disease have a good prognosis for survival, yet many continue to have pain. In our experience with 821 medically treated patients there were three cardiac deaths (0.3%) and two nonfatal myocardial infarctions (0.2%) in the first year after angiography, which had revealed insignificant (less than 75% narrowing of the luminal diameter) or no coronary artery stenosis. In a subset of 548 patients selected with no apparent systematic difference from the inception cohort of 821 patients, there was complete absence of chest pain in 178 (33%) patients but 155 (28%) had similar or worse pain. From an analysis of clinical history and catheterization data entered in a stepwise logistic regression function, unimproved chest pain was significantly associated with female sex (p = 0.01) and an index of five chest pain descriptors (p = 0.0005). After adding selected behavioral variables available for a representative sample of 217 patients, a high hypochondriasis score (scale I from the Minnesota Multiphasic Personality Inventory) became the strongest determinant of continued pain (p less than 0.0001). In our experience, an exaggerated preoccupation with personal health is prospectively associated with continued chest pain in patients with minimal or no coronary disease.

Adolescent↗
PubMed1984

Preparing and justifying the budget for new or improved services.

The process of preparing and justifying the budget for a new or improved hospital pharmacy service is described. Factors that influence the justification process include the rationale for the new service, facts needed for the decision-making process, the political process within the hospital, timing, and salesmanship. Steps preliminary to preparing the proposal include identifying hospital and departmental goals, relating the proposed service to those goals, assessing the odds of new service approval, and establishing priority for development of the proposal. The components of a formal proposal are discussed, including the budget that describes the financial feasibility of the service. A sample proposal is presented. Prospective pricing does not necessarily eliminate the opportunity for development of new hospital pharmaceutical services. However, the need, cost, revenue, and benefits of such services must be thoroughly justified on a hospital-specific basis.

Budgets↗