Search PubMed⌕ Search

Biomedical subjects

R H Chapman

Publications and source records attributed to R H Chapman.

At least 37 records · Page 2Linked to original sources
PubMed1979

Failure of severe maternal stress or ACTH during pregnancy to affect emotionality of male rat offspring: implications of litter effects for prenatal studies.

Daily maternal neck restraint, whole body restraint, hyperthermia, and ACTH treatment during the last 3rd of gestation had no reliable effect on open-field and cage-emergence behavior in male Sprague-Dawley offspring. Many of these treatments, however, produced considerable maternal pathology and evidence for maternal adrenocorticoid release. Significant litter effects were found for almost every morphological and behavioral measure. Failure to control for the litter variable may account for many previously reported effects of prenatal stress on emotionality in rats. Female rats showed greater activity and less defecation than males on postpubertal open-field and cage emergence tests.

Adrenalectomy↗
PubMed1978

Maternal stress and pituitary-adrenal manipulations during pregnancy in rats: effects on morphology and sexual behavior of male offspring.

The purpose of the present study was to determine whether the demasculinizing and feminizing effects of prenatal stress (i.e., stress applied to the mother during pregnancy) in rats reported previously are mediated by activation of the maternal pituitary-adrenal axis. Neither whole-body restraint, with or without hyperthermia, nor ACTH treatment during the last third of gestation had any reliable effect on masculine or feminine sexual behavior in male Sprague-Dawley offspring, although these treatments produced maternal pathology and evidence of maternal adrenocorticoid release. Significant littermate similarity was found for almost every morphological and behavioral measure. Failure to control for the litter variable may account for many previously reported effects of prenatal stress on sexual behavior in rats. The discrepancy between the present and earlier findings is discussed in terms of methodological and theoretical considerations.

Adrenal Glands↗
PubMed1976

The effects of prenatal psychological stress on the sexual behavior and reactivity of male rats.

Male offspring of prenatally stressed rats showed low levels of copulatory behavior during a series of brief tests with estrous females but successfully impregnated female cagemates during long term tests of breeding effectiveness. Sexual performance on the short term tests was inversely related to open field activity with the offspring of prenatally handled mothers exhibiting more sexual behavior and less open field activity. The results support the notion that prenatal stress influences both the sexual behavior and emotional reactivity of male offspring. Deficits observed during short term tests of breeding effectiveness appear to be reversible under optimal conditions.

Animals↗
PubMed1975

The development of children's understanding of proportions.

To determine whether the understanding of proportions develops before formal operations, children in grades 1, 3, and 5 and college students were given a variety of judgment tasks contrasting the comparison of quantity with the comparison of proportions. Results for the most difficult tasks indicated that a majority of fifth graders still lacked a full understanding of proportion. Results were interpreted as consistent with Inhelder and Piaget's contention that the comprehension of abstract relations requires formal operations. In grades 3 and 5, boys scored significantly higher than girls.

Adult↗
PubMed1972

Torsion of the testis and its appendages.

In a survey of 101 cases with an index diagnosis of torsion of the testis or its appendage, there were 86 instances of torsion of the testis and 14 of torsion of the hydatid of Morgagni. In 38 of the patients with testicular torsion there were one or more "warning" attacks of pain and swelling, due to torsion which became spontaneously untwisted. In 19 cases operative fixation was performed because of this warning history, and all the testes were preserved. In the other 19 the testes were not explored until the patient came in with a severe "classical" episode of torsion: seven of these testicles were lost from gangrene or delayed atrophy.In 31 cases torsion resulted in failure to save the testis. Of these, 20 were misdiagnosed and treated initially as epididymo-orchitis, despite there being no evidence of a urinary tract infection. There is no excuse for not exploring any actuely inflammed testicle which is unaccompanied by definite evidence of urinary or urethral infection.

Adolescent↗
PubMedDate not supplied

Red cell transfusions in total knee and total hip replacement surgery.

To explore how red cell transfusions were used to support patients who underwent primary and revision hip and knee replacements classified within diagnosis-related group (DRG) 209 (major joint and limb reattachment procedures), we studied abstracted patient discharge records from 151 United States hospitals in 1986. A total of 9684 units of whole blood and/or separated red cells was used to support 6472 patients. The transfusion use varied by surgical procedure, with patient gender as an influencing factor. Large proportions of patients underwent surgery without requiring transfusion. Among transfused patients, the majority received 1 to 3 units of red cells; however, a minority of patients required multiple transfusions, thereby utilizing a disproportionate share of the blood resource. Comparison of transfusion practice within the seven most active hospitals revealed significant differences (p less than or equal to 0.01) in the percentage of patients actually transfused, but not in the mean number of units of red cell components transfused per transfused patient. Similar findings emerged from comparison of transfusion practice when all hospitals were segregated into five hospital classes on the basis of orthopedic surgical service activity. These effects were seen for both total knee and total hip replacement procedures. It can be concluded that the lack of clearly defined criteria for transfusion contributed to the variations observed.

Blood Transfusion↗
PubMedDate not supplied

A comprehensive league table of cost-utility ratios and a sub-table of "panel-worthy" studies.

OBJECTIVES: The authors compiled a comprehensive league table of cost/QALY ratios, and a standardized table of analyses satisfying selected Reference Case criteria from the USPHS Panel on Cost-Effectiveness in Health and Medicine. METHODS: They identified 228 cost-utility analyses (CUAs) through literature searches, and abstracted data on methods and cost-utility ratios. The subset of "Panel-worthy" analyses used: a societal or broad health-care perspective, community or patient preference weights, net costs, incremental comparisons, and discounting of costs and QALYs. RESULTS: The 228 CUAs included ratios for 647 interventions, ranging from cost-saving to $52,000,000/QALY (median = $12,000/QALY). The standardized table presents 112 ratios that met the "Panel-worthy" criteria, with articles published in recent years more likely to meet all of the criteria. CONCLUSIONS: The comprehensive league table (available on the Web) provides a useful reference, but ratios may not be comparable because of methodologic variations. The standardized table focuses on studies meeting basic methodologic criteria, potentially allowing for better comparison with future Reference Case analyses. Future studies should investigate the quality of analyses' underlying assumptions in addition to whether certain key procedural protocols were met.

Adolescent↗
PubMedDate not supplied

An off-the-shelf help list: a comprehensive catalog of preference scores from published cost-utility analyses.

PURPOSE: The Panel on Cost-Effectiveness in Health and Medicine recommends an organized collection of preference measure values for health states that can be used in costutility analyses (CUAs). The authors sought to construct a catalog of preference scores from published CUAs, organize the catalog by clinical categories, and identify methods of preference score assessment. METHOD: The authors systematically searched Medline and other databases to identify original CUAs published through 1997. Information was abstracted on the health state descriptions, corresponding preference scores, method of preference score elicitation, and the source of the estimate. RESULTS: Two hundred twenty-eight CUAs were appraised. The authors found 949 health states and corresponding preference scores. Most frequently, health states pertained to the circulatory system (21.7%), health states were valued by experts (35.8%), and values were derived through community-based preference scores (23.5%). CONCLUSION: A catalog of preference scores for health states can be constructed. The catalog (http://www.hsph.harvard.edu/organizations/hcra/cuadatabase/ intro.html) may provide a useful reference tool for producers and consumers of CUAs but also underscores the methodologic variation and inconsistencies present in the field.

Consumer Behavior↗
PubMedDate not supplied

Are pharmaceuticals cost-effective? A review of the evidence.

The argument that prescription drugs are cost-effective has been made both by the pharmaceutical industry to support rising drug prices and expenditures, and by advocates of expanded drug coverage for elderly and low-income persons. A new database of 228 published cost-utility analyses sheds light on the issue. According to published data, some drugs do save money or are cost-effective, but the issue depends critically on the context in which the drug is used and the intervention with which it is compared. Cost-utility analyses funded by the drug industry tend to report more favorable results than do those funded by nonindustry sources. Cost-effectiveness analysis can help policymakers to determine whether drugs and other interventions offer value for money.

Bias↗
PubMedDate not supplied

Implementing a local area network for nursing in a large teaching hospital.

The authors describe the assessment, planning, implementation, and benefits of a local area network (LAN) for the nursing service of a 504-bed urban teaching hospital. The major goals of the network were to increase the efficiency and effectiveness of the nursing administrative areas and improve communication systems. A network of more than 90 workstations, spanning 12 buildings, was installed. The network provides access to multiple programs that support clinical, managerial, and research activities. Gateways provide access to the hospital's two mainframe computers. Network benefits identified by nursing management include: improved communication and access to information; increased accuracy, efficiency and timeliness of data; and improved computer literacy.

Boston↗