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Biomedical subjects

S Allcorn

Publications and source records attributed to S Allcorn.

At least 19 recordsLinked to original sources
PubMed2001

Early activation of Ca(2+)-permeable AMPA receptors reduces neurite outgrowth in embryonic chick retinal neurons.

Calcium entry through Ca(2+)-permeable AMPA/kainate receptors may activate signaling cascades controlling neuronal development. Using the fluorescent Ca(2+)-indicator Calcium Green 1-AM we showed that the application of kainate or AMPA produced an increase of intracellular [Ca(2+)] in embryonic chick retina from day 6 (E6) onwards. This Ca(2+) increase is due to entry through AMPA-preferring receptors, because it was blocked by the AMPA receptor antagonist GYKI 52466 but not by the N-methyl-D-aspartic acid (NMDA) receptor antagonist AP5, the voltage-gated Ca(2+) channel blockers diltiazem or nifedipine, or by the substitution of Na+ for choline in the extracellular solution to prevent the depolarizing action of kainate and AMPA. In dissociated E8 retinal cultures, application of glutamate, kainate, or AMPA reduced the number of neurites arising from these cells. The effect of kainate was prevented by the AMPA/kainate receptor antagonist CNQX and by GYKI 52466 but not by AP5, indicating that the reduction in neurite outgrowth resulted from the activation of AMPA receptors. Blocking Ca(2+) influx through L-type voltage-gated Ca(2+) channels with diltiazem and nifedipine prevented the effect of 10-100 microM kainate but not that of 500 microM kainate. In addition, joro spider toxin-3, a blocker of Ca(2+)-conducting AMPA receptors, prevented the effect of all doses of kainate. Neither GABA, which is depolarizing at this age in the retina, nor the activation of metabotropic glutamate receptors with tACPD mimicked the effects of AMPA receptor activation. Calcium entry via AMPA receptor channels themselves may therefore be important in the regulation of neurite outgrowth in developing chick retinal cells.

6-Cyano-7-nitroquinoxaline-2,3-dione↗
PubMed1996

Restructuring medical schools to better manage their three missions in the face of financial scarcity.

The leaders of schools of medicine face a major financial and management challenge as they approach the end of the twentieth century. The new environment for the practice of medicine is diminishing the clinical income that schools have used for so long to supplement their operations. Deans and their staffs must discover new ways to manage their schools and their schools' finances. In particular, schools that continue to rely on subsidies from their health care operations will very likely face the prospect of having to defend themselves as pressures for more cost-effective operations increase and clinical and other subsidies dwindle. In sum, for deans to remain captains of their own ships, preserve their schools' three missions, and balance their books, it is essential that they lead their schools in change toward better administrative, information, and financial management systems. Stritch School of Medicine at Loyola University of Chicago is reinventing itself in response to this challenge. The organizational and management models being used there have been partially guided by the two approaches to redesigning schools of medicine described in detail in this article, the service line management matrix (SLMM) and the fractal management (FM) method. In turn, the experience of implementing the education and research service lines at Loyola has permitted a refinement of the approaches, reflected in the descriptions in this article. These approaches constitute a new model that provides for the development of three administrative service lines-teaching, research, and clinical service (not implemented at Loyola). Each service line has its own leaders and managers, who are responsible for balancing income against expenses. Each service line is a profit-and-loss center, an approach that highlights how effectively the service line is being managed and leads to greater accountability and productivity of faculty and staff. This new approach makes it possible for the school to answer the question, "Can research and teaching pay for themselves?" If they cannot, any subsidies that are needed from clinical income are identified as such. This businesslike approach supplants the traditional one of commingling all income streams to pay for operations, a strategy that worked well enough when research and clinical income constantly increased but now places medical schools in harm's way.

Administrative Personnel↗
PubMed1996

Developmental expression and self-regulation of Ca2+ entry via AMPA/KA receptors in the embryonic chick retina.

Excessive activation of glutamate receptors in the late embryonic and adult retina leads to excitotoxic cell death through an increase in intracellular calcium concentration. Here we use the cobalt-staining technique of Pruss et al. to investigate the developmental expression of Ca(2+)-permeable alpha-amino-3-hydroxy-5-methyl-isoxazole-4-propionic acid/kainate (AMPA/KA) receptors in the embryonic chick retina, and the effects of AMPA/KA receptor activation on cell survival and AMPA/KA receptor expression. Ca(2+)-permeable AMPA/KA receptors are present in the retina as early as embryonic day 6 (E6). While sustained activation of these receptors with KA led to massive cell death in explant and dissociated cultures of the chick retina late in development, continuous application of high doses of KA from early times was not excitotoxic. Cell survival in KA is correlated with both a reduction in cobalt staining and the KA-evoked membrane current, and thus with a reduction in the Ca2+ entry into cells via AMPA/KA receptors. The effects of KA could be blocked by the non-N-methyl-D-aspartic acid (NMDA) receptor antagonist 6-cyano-7-nitro-quinoxaline-2,3-dione (CNQX), but not by the NMDA receptor antagonist D-2-amino-5-phosphonovalerate (AP5) nor the L-type Ca2+ channel blockers diltiazem and nifedipine. The action of AP5 was mimicked by exposure to glutamate but not by the metabotropic receptor agonist 1S,3R-1-aminocyclopentane-1,3-dicarboxylic acid. Thus exposure of retinal neurons to glutamate early in development may protect them from its excitotoxic actions later on.

Animals↗
PubMed1990

The design and development of a satellite medical record center.

This article discusses the successful development of a medical record satellite through the collaboration of the Department of Medicine of the University of Rochester management and the Medical Record Department of Strong Memorial Hospital.

Academic Medical Centers↗
PubMed1990

Using matrix organization to manage health care delivery organizations.

Matrix organization can provide health care organization managers enhanced information processing, faster response times, and more flexibility to cope with greater organization complexity and rapidly changing operating environments. A review of the literature informed by work experience reveals that the use of matrix organization creates hard-to-manage ambiguity and balances of power in addition to providing positive benefits for health care organization managers. Solutions to matrix operating problems generally rely on the use of superior information and decision support systems and extensive staff training to develop attitudes and behavior consistent with the more collegial matrix organization culture. Further improvement in understanding the suitability of matrix organization for managing health care delivery organizations will involve appreciating the impact of partial implementation of matrix organization, temporary versus permanent uses of matrix organization, and the impact of the ambiguity created by dual lines of authority upon the exercise of power and authority.

Communication↗
PubMed1986

Medical group management: a marketing orientation.

This article considers the pragmatic aspects of conducting a situation/marketing audit for group medical practices. This audit is a key component in the formulation of a competitive strategy and the development of a marketing program. Given are a series of questions that may be used by medical groups to guide assessment of the opportunities and threats present in the environment as well as the strengths and weaknesses of the organization in meeting the environmental challenges. Furthermore, the article provides a framework for thinking about strategy and the variables that should be considered and aligned to achieve effective implementation of strategy. Finally, the parameters are outlined for deciding on a marketing program: the mix of marketing tools (service design, distribution channels, pricing and promotion) that should be employed to offensively and/or defensively position the medical group in the competitive marketplace.

Group Practice↗
PubMed1985

A new look at nursing school program development: self- and external evaluation.

Developing and evaluating educational programs in schools of nursing is one of the most critical functions of the faculty. This process can be approached from a variety of perspectives. Historically, most faculty efforts have been directed at development or evaluation; however, a more proactive approach is to incorporate a process which will encompass both. To accomplish this, two models, the Holistic Formative Evaluation Model and the Stakes Countenance Model, have been merged to produce a model which is applicable to the integrated development and evaluation of a nursing curriculum. This model, the Internal Program Development and Self-Evaluation Model, provides faculty, curriculum developers, and administrators with a comprehensive process which focuses on the monitoring program internal consistency and congruence.

Curriculum↗
PubMed1985

Three dimensional strategic marketing analysis for hospitals.

Hospital administrators have no choice, they must become effective marketers. marketing should commence with a careful evaluation of the strategic operating variables that influence directly the success or failure of marketing strategies. Three dimensional strategic marketing analysis can be a valuable technique for hospital administrators to conceptualize better and exploit the nature of their hospital's unique competitive environment. The following discussion provides administrators with an analytical instrument that can help with managing the complexities of health care marketing.

Economic Competition↗
PubMedDate not supplied

Professional fee billing.

Good billing system management information is critical for maximizing income and providing the understanding health care providers need to make their practices profitable.

Economics, Medical↗
PubMedDate not supplied

Managing stress and anxiety in clinical laboratories. Guidelines for psychologically informed interventions.

Pressures to improve the cost effectiveness of the health-care delivery industry promise to make life stressful for those who work within the industry during the 1990s. Employees who work in stressful conditions eventually feel anxious about themselves, their performance, how they are being treated, and others. Employees cope with these anxieties by using psychological defenses that have a major impact on interpersonal relations and work performance. This article shows how stress and anxiety diminish employee effectiveness and illustrates the connection between managing employee defensiveness and performance. Intervention guidelines are provided to help clinical laboratory managers develop insightful, informed, and effective interventions when performance problems occur.

Adaptation, Psychological↗
PubMedDate not supplied

The group dynamics of medical practices.

A medical group by definition is a group of physicians and their support staff who have joined together to practice medicine. However, a medical group is more than that. Medical groups are composed of many different types of subgroups and group dynamics that are in constant flux and which may serve the medical group well or inhibit it from achieving its best performance. Understanding group dynamics is, therefore, one of the paths toward achieving excellence in the practice of low cost but fulfilling medicine. This article describes three types of potentially unsatisfactory group dynamics--homogenized, institutionalized and autocratic. Homogenized dynamics occur when physicians act as though they must all participate in decision making. Managing the group can become deadlocked by one veto. Institutionalized group dynamics lead to an over reliance upon systems and procedures to control work. Flexibility, adaptability and creativity are often lost in the process. Autocratic group dynamics arise when a single individual assumes nearly absolute control of decision making. Each of these group dynamics contain positive and negative outcomes that must be considered when evaluating medical group performance. Case examples and exhibits are provided to operationalize the importance of understanding these potentially dysfunctional group dynamics.

Behavior↗
PubMedDate not supplied

Power and authority: their meaning for group practice administrators.

The word power is filled with meaning. It can't be spoken without creating some type of reaction. Power is a key issue in our lives. Authors Mikel Lynch and Seth Allcorn, Ph.D., look at power and authority through a scenario involving a physician and an administrator to show how it can be used effectively in a group practice setting.

Authoritarianism↗
PubMedDate not supplied

Self-protection from stress. Its meaning for medical groups.

Seth Allcorn, Ph.D., M.B.A., associate dean for fiscal affairs at the Loyola University Chicago Stritch School of Medicine, writes how self-protection can initially reduce stress in the individual but is detrimental to the group. He investigates self-protective behavior from a psychological view and offers his analysis on the nature of self-protection, its impact on others and how to minimize the effects.

Defense Mechanisms↗
PubMedDate not supplied

A look at management roles and operating environments of medical schools.

In order to reach a better understanding of the many complexities involved in the management of schools of medicine, in 1980-81 a survey was taken of deans of medicine and department chairs of medicine, surgery, and family practice at US medical schools. The major attributes of the managerial work environment are identified and provide a foundation for further inquiry into the overall operating effectiveness of schools of medicine.

Academic Medical Centers↗