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Biomedical subjects

S Jones

Publications and source records attributed to S Jones.

At least 685 records · Page 38Linked to original sources
PubMedDate not supplied

The risks of ignoring insurance risk management.

Health insurers face financial risks when they assume liability for the difference between difference between premium revenues and their estimates of future claims costs for a group. Market reform proposals vastly increase the amount of risk health plans of all types will face. A case study is used to show how insurers bidding in an alliance environment must either commit contingency reserves to cover these risks, increase premiums to reduce them, or forgo the business. Unless legislation includes measures that reduce these risks or enable health plans to carry them, premiums are likely to increase greatly.

Actuarial Analysis↗
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Knowledge, perceptions, and practice of nurses toward HIV+/AIDS patients diagnosed with tuberculosis.

BACKGROUND: Tuberculosis (TB) continues to be a major health problem in the United States. Nurses may be exposed to TB and not realize their risks for becoming infected. The presentation of HIV-associated TB is somewhat different from "standard TB." PURPOSE: The purpose of this study was to determine if an educational program could improve nurses' attitudes, level of knowledge, and compliance with infection control standards for HIV/AIDS patients diagnosed with TB. METHOD: Participants included 50 staff nurses. The experimental group (35) and control group (15) completed a knowledge test and an attitude survey. Researchers observed participants for compliance with infection control standards pretest and posttest. RESULTS: Following an educational program, the experimental group demonstrated a greater knowledge of TB than the control group who did not participate in the educational program (F [1.47] = 14.43, p = .000). In addition, the experimental group had a greater improvement in their Nursing Intervention Observation Tool adherence to respiratory isolation and universal precaution protocols scores as compared to the control group (F [1.47] = 8.95, p = .004). However, there was not a tangible increase in knowledge level of AIDS, attitudes or concerns about caring for these patients. CONCLUSION: This nursing research study supports the need for an ongoing educational program with continual monitoring of infection control practices to positively affect client and caregiver outcomes.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

Results of a prospective randomized trial of botulinum toxin therapy in acute unilateral sixth nerve palsy.

Forty-seven patients entered a prospective randomized trial to assess the effect of early botulinum neurotoxin A treatment to the ipsilateral antagonist medial rectus on the ultimate recovery rate of acute unilateral sixth nerve palsy. Twenty-two patients received injections and 25 acted as controls. The overall etiologies were microvascular (72.3%), unknown (17%), multiple sclerosis (6%), and one case each of central nervous system (CNS) sarcoidosis and basilar artery ectasia. Eighty-three percent of the patients entered the trial within 2 weeks of the onset of symptoms and 95.7% within 3 weeks. The controls had a final recovery rate of 20/25 (80%), and the injected group had a final recovery rate of 19/22 (86%). No serious side effects were encountered. We conclude that there is no evidence for a prophylactic effect of botulinum toxin in the group that we have studied.

Abducens Nerve↗
PubMedDate not supplied

Diplopia following subcutaneous injections of botulinum A toxin for facial spasms.

PURPOSE: To study the incidence, cause, recovery time, and prevention of diplopia following subcutaneous injection of botulinum A toxin for the treatment of facial spasms. METHODS: Patients who experienced diplopia after botulinum A toxin injections had their deviations examined in detail. When the muscle that caused diplopia was identifiable, the injection closest to that muscle was omitted in the next treatment in an attempt to prevent diplopia. RESULTS: Of 250 patients receiving about 1500 sets of injections, 25 (1.7%) incidents of diplopia occurred in 10 patients. Excluding two patients who declined further treatment after having diplopia on their first botulinum A toxin treatment, seven of the remaining eight patients had multiple incidents of diplopia. The most common pattern of diplopia was "uncertain diagnosis." The most common identifiable cause of diplopia was paresis of the inferior oblique muscle. Omission of the injection into the central portion of the lower eyelids in the next treatment prevented recurrence of diplopia in only one of the four patients. No significant correlation between botulinum A toxin doses injected and times to recovery was noted. CONCLUSIONS: Diplopia following botulinum A toxin treatment is uncommon. Seven patients (3% of patients studied) had 22 episodes of diplopia (88% of episodes). When diplopia occurs, it tends to recur on reinjection, sometimes with a prolonged recovery time. This response may not be dose dependent. The extraocular muscles of some patients may be more susceptible to chemodenervation than others, or botulinum A toxin may diffuse to extraocular muscles more easily in some patients than in others.

Aged↗
PubMedDate not supplied

Funding the future.

Explore the source record for details and available documents.

Education, Nursing↗
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Fluoride: spanning the health divide.

This article describes the causes and prevention of tooth decay, with particular emphasis on the role of fluoride. Focusing on the North West of England, social class differences in the prevalence of tooth decay, and hence the need for water fluoridation, are discussed. Finally, the role of non-dental health professionals in dental health promotion is outlined.

Child, Preschool↗
PubMedDate not supplied

Impact of genotypic resistance testing on physician selection of antiretroviral therapy.

OBJECTIVES: To determine the impact of genotypic resistance testing on physician selection of antiretroviral therapy. STUDY DESIGN/METHODS: This was a prospective, observational study. A single genotypic resistance test was done when patients failed highly active antiretroviral therapy. The antiretroviral regimen predicted at the time the genotypic resistance assay was done was compared with the regimen that was ultimately selected after review of resistance testing results. RESULTS: In the vast majority of cases (83%), the regimen that the physician selected after resistance testing was different from the predicted regimen. In 54% of cases, these changes involved changing more than two antiretroviral agents, and in 22%, one agent was changed. In 1% of cases, all medications were discontinued, and in 6%, the physician ultimately decided not to change the baseline regimen. Although patients were screened for nonadherence to their medication regimen, 11% had no detectable resistance mutations. CONCLUSIONS: Access to genotypic resistance testing has a significant impact on physician selection of antiretroviral therapy.

Adult↗
PubMedDate not supplied

Utilization of an elastomeric continuous infusion device to maintain catheter patency.

The frequency of vascular access device (VAD) complications increases with the complexity of therapy or poor catheter maintenance. Catheter occlusions are most frequently caused by inadequate catheter flushing or technique. The study group of 25 patients was placed on an elastomeric continuous infusion device with patient costs and occlusion rates compared with historic data. The use of the elastomeric continuous infusion device saved an average of $123 per week when compared with traditional flushing devices, which cost from $216 to $248 per week. The incidence of catheter patency loss was reduced by 50%. The nurses also reported considerable timesaving in catheter maintenance and patient education and an overwhelmingly positive response from staff and patients.

Catheterization, Peripheral↗