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Biomedical subjects

R M Boyle

Publications and source records attributed to R M Boyle.

44 records · Page 3Linked to original sources

An analysis of returning patients in family practice.

Morbidity records from eight practices participating for three years in the Virginia Family Practice Data System are analyzed with respect to two mutually exclusive groups of patients: those who return from one year to the next and those who do not return. Initially, substantial interpractice variation in patient return rates is presented, and age and sex characteristics of these patients are examined. The data indicate that approximately 40 percent of patients visiting the practice in one year return in the next, 25 percent return in each of two subsequent years, and only 12 percent return two years hence. Returning patients are found to be significantly older and more likely to be female than non-returning patients. These two groups of patients are then compared in terms of recorded morbidity and workload rates. Specific categories of problems, such as Diseases of the Circulatory System, are associated with returning patients. This paper thus presents empirical evidence which supports common assumptions concerning patients and problems seen in family practice.

Adult↗

Implementing a multiphased hospice program.

By implementing a hospice program in three phases, each of which can be integrated with existing services in general acute care and long-term care facilities, a health care institution can provide the community with an important new service. And the parent organization incurs only the cost or providing additional inservice and medical education.

Day Care, Medical↗

Family practice in Virginia: a comparative analysis of two years' data.

Data representing Fiscal Years 1975 and 1976 as well as the aggregate 1975--1976 data set are reviewed in this paper. Information on 92,410 discrete patients and the 333,709 transactions they generated is studied. The transactions per patient rate of 3.6 varies greatly among the eight practices under investigation. This interpractice variation is complemented by remarkable year-to-year consistency within each practice. Age and the percent of continuing patients are presented as possible explanations for this variation. These data are useful to the physician in identifying the high-use patients and to the health planner for manpower and funding appropriations.

Adolescent↗

The Age/Sex Register: estimation of the practice population.

Determination of the number of patients served by a family practice is important for health services delivery and research. A sound estimate of the practice population should enhance the patient management responsibilities of the family physician. This methodology uses the Age/Sex Register to provide a series of estimations of a "teaching" unit population. Results of a sample survey indicate that 21.3% of "inactive patients" (those who have not received services from the practice in two years) still consider themselves under the care of the practice. Replication of this approach is suggested for other practices to improve planning and resource allocation.

Age Factors↗

Increased levels of cytosolic phospholipase A2 in dyslexics.

Research findings are increasingly reporting evidence of physiological abnormalities in dyslexia and sites for dyslexia have been identified on three chromosomes. It has been suggested that genetic inheritance may cause phospholipid abnormalities in dyslexia somewhat similar to those found in schizophrenia. A key enzyme in phospholipid metabolism, Type IV, or cytosolic, phospholipase A2 (cPLA2), releases arachidonic acid (AA), a 20-carbon fatty acid, which is the major source of production of prostaglandins and leukotrienes. An entirely new assay, which for the first time has enabled determination of the amount of the enzyme rather than its activity, was used to measure cPLA2 in dyslexic-type adults and controls and the two groups were found to differ significantly, the dyslexic-types having more of the enzyme. A report elsewhere of schizophrenics having even greater amounts of the enzyme suggests that dyslexia may be on a continuum with schizophrenia, as may be other neurodevelopmental disorders - which have also been described as phospholipid spectrum disorders.

Adult↗

Evaluation of the safety of nurse-assisted percutaneous endoscopic gastrostomy.

Percutaneous endoscopic gastrostomy (PEG) procedures have become a common, nonsurgical approach to providing enteral access to patients who are otherwise unable to meet their nutritional needs by mouth. Historically, two physicians have been required to complete this procedure; the first performed the endoscopy while the second helped to position the PEG tube. As a result of constraints on physicians' time and availability, as well as increased medical costs, this process has changed in some settings where the procedure is accomplished by one physician who performs the endoscopy and directly observes a nurse who acts in the role of the second physician. This research study was designed to evaluate the safety of nurse-assisted PEG procedures by comparing the complications of placement (i.e., infection, hemorrhage, perforation, and ileus) with those complications that occur when two physicians perform the procedure. The current standard of care for placing PEG tube was followed. Results in this small sample show that nurse-assisted PEG procedures are as safe as when two physicians perform this procedure.

Adult↗