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Biomedical subjects

R M Grimes

Publications and source records attributed to R M Grimes.

At least 37 records · Page 2Linked to original sources
PubMed1994

Evidence of intraprison spread of HIV infection.

BACKGROUND: Individuals entering prison are known to have high rates of human immunodeficiency virus (HIV) infection, and inmates are known to engage in high-risk behavior. This suggests the potential for intraprison spread of HIV infection, but this has not been documented. METHODS: All prisoners (N = 556) in the Florida Department of Corrections who had been continuously incarcerated since 1977 were identified. The medical records of these prisoners were reviewed to determine whether they had been tested for HIV infection and, if tested, whether the results were positive. Results were considered positive if there were reactions to two enzyme-linked immunosorbent assays confirmed by Western blot assay. If an individual tested positive, the medical record was reviewed to determine whether the patient had been treated for conditions consistent with HIV infection. RESULTS: Eighty-seven of the 556 prisoners had undergone testing for HIV infection. Of the tested inmates, 18 (21%) were found to be positive for HIV infection. Eight of these individuals had no HIV-related conditions, and 10 had HIV-related symptoms. CONCLUSIONS: The results present strong evidence for intraprison transmission of HIV infection. Given that most inmates serve relatively short sentences, there is a strong possibility that prison-acquired HIV infection will be carried into the "free world." Preventive programs in prisons may be very important in controlling HIV infection in our society.

Adult↗
PubMed1993

Potential bias in teacher referrals to the school nurse.

Education literature suggests gender, race, and socioeconomic status of students influence the quality and quantity of interactions with their teachers. Studies show that teachers favor White, male, and upper-income children. This preliminary study was conducted to determine if bias was evident in teacher referrals to the school nurse. Referrals from seven elementary schools were studied. The 117 children referred for nonroutine nursing intervention during the nine-week period were compared with 3,787 children not referred. Results showed no differences by gender, but significant differences occurred by socioeconomic status and race (p < .001). When controlling for gender and race, no differences existed between White males and African American males. However, significantly (p < .001) more African American females were referred than White females.

Adolescent↗
PubMed1993

HIV infection and AIDS in Texas. A Special Report.

Human Immunodeficiency Virus (HIV) infection and the Acquired Immune Deficiency Syndrome (AIDS) are significant public health problems in Texas. This paper summarizes the most recent information on HIV infection and AIDS from global, national, and state perspectives. Current information on the manifestations of HIV infection and AIDS which are important to dentistry, ramifications for dental health care workers, and initiatives for HIV/AIDS education for dental health care workers in Texas are presented.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Management of HIV infection: a summary of summaries (I).

Often the hardest task in managing HIV-infected patients is keeping up-to-date on the latest in HIV care. Presented here is a summary of 32 current, accessible articles for the primary care physician.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Case-mix groups for VA hospital-based home care.

The purpose of this study is to group hospital-based home care (HBHC) patients homogeneously by their characteristics with respect to cost of care to develop alternative case mix methods for management and reimbursement (allocation) purposes. Six Veterans Affairs (VA) HBHC programs in Fiscal Year (FY) 1986 that maximized patient, program, and regional variation were selected, all of which agreed to participate. All HBHC patients active in each program on October 1, 1987, in addition to all new admissions through September 30, 1988 (FY88), comprised the sample of 874 unique patients. Statistical methods include the use of classification and regression trees (CART software: Statistical Software; Lafayette, CA), analysis of variance, and multiple linear regression techniques. The resulting algorithm is a three-factor model that explains 20% of the cost variance (R2 = 20%, with a cross validation R2 of 12%). Similar classifications such as the RUG-II, which is utilized for VA nursing home and intermediate care, the VA outpatient resource allocation model, and the RUG-HHC, utilized in some states for reimbursing home health care in the private sector, explained less of the cost variance and, therefore, are less adequate for VA home care resource allocation.

Aftercare↗
PubMed1992

Agenda on AIDS.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Agenda on AIDS.

Explore the source record for details and available documents.

AIDS Serodiagnosis↗
PubMed1990

Total and differential leukocyte counts in clinically well children. Information or misinformation?

To determine whether the total and differential leukocyte count is of value as a case-finding test, we applied the evaluation criteria developed by the US Preventive Services Task Force. The criteria comprise review of the current burden of suffering of the disease to be prevented, the attributes of the intervention to be used, and the quality of the evidence available. A literature search revealed no evidence in the form of data from patients, so a chart review of all complete blood cell counts ordered during a 1-year period by one group of pediatricians was undertaken. At least one value outside of published normal ranges was found on 74.7% of the tests performed on clinically well children. No unsuspected illness was discovered as a result of an abnormal total and differential leukocyte count.

Adolescent↗
PubMed1990

Occupational physical activity and other risk factors for preterm birth among US Army primigravidas.

We examined the relation of occupational physical activity to the risk of preterm birth among US Army active-duty primigravidas between 1981 and 1984 using 604 cases (preterm deliveries; less than or equal to 37 weeks gestation) and 6,070 controls (term and post-term deliveries). Women employed in the highest physical activity levels had increased odds of preterm delivery ranging from 1.69 to 1.75. The relation was not changed by adjustment for the effects of age, marital status, socioeconomic status, or education. Missing data suggest cautious interpretation.

Adult↗
PubMed1986

Inflation and health care costs in metropolitan areas.

This paper reports on an examination of the relationship between increases in health care costs in 23 Standard Metropolitan Statistical areas and various other changes in these communities over the period 1969-1977. The other changes examined consisted of 145 variables divided into 7 categories. The categories were termed demographic, economic, community illness, prices of other goods and services, hospital, physician, and technology factors. The results show that there was little relationship between rates of medical and hospital inflation and the examined variables. Total hospital costs could be related to several of the factors, the most important of which were demographic, economic, and hospital factors.

Adolescent↗
PubMed1984

Assessing the influence of non-treatment variables in a study of outcome from severe head injuries.

An evaluation was made of the impact of non-treatment variables on severely injured head trauma patients. The principal findings were: 1) severity of injury was the best predictor of outcome; 2) patient's age had a statistically significant but marginally useful impact on outcome; 3) a regression analysis showed that duration of transport, up to 4 hours, had no impact on outcome; 4) time from accident to intubation had a marginal impact on outcome; and 5) one-way analysis of variance showed that mode of transportation, whether helicopter, ambulance, or other means had no impact on outcome.

Adolescent↗
PubMed1984

The health planners dilemma and the problem of aggregation bias--an irresolvable conflict.

This study examines the potential biases that may exist when data which are collected at one level of aggregation (e.g., the United States) are extrapolated to a smaller area of aggregation (e.g., a census region consisting of several states). Theory would predict that there would be inaccuracies resulting from such extrapolation but does not suggest whether the error would be of sufficient size as to have practical significance for a planner. This study clearly shows that attempting to predict smaller area hospitalizations with large area data is highly inaccurate. It is not only consistent with theory but also shows that the theory has practical value in assessing approaches to estimating hospitalization data.

Catchment Area, Health↗
PubMed1984

Development of indices of effectiveness: a quantification of the accrediting process.

Two indices of effectiveness are described, one of instructional effectiveness and one of administrative effectiveness. Originally, 97 effectiveness measures were obtained from criteria published by national health professional organizations and other accrediting bodies. The Delphi survey process was used to analyze, refine, weight, and select 19 measures of instructional effectiveness and 15 measures of administrative effectiveness. A second article (May 1984) describes the operationalization and quantification of the selected measures and their application to 25 allied health departments in Texas junior and community colleges.

Accreditation↗
PubMed1984

A research approach to simplifying the accrediting process of allied health programs.

The operationalization and quantification of selected measures of effectiveness and their application to 25 allied health departments in junior and community colleges is described. Principal results are that the 34 measures of effectiveness suggested by experts' opinions could be reduced to 14 criteria. These could be combined into two indices of effectiveness, one of instructional effectiveness and one of administrative effectiveness. The results hold promise for simplification of the accrediting process. Part I of this article appeared in the February 1984 issue of JAH.

Accreditation↗