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Biomedical subjects

T Field

Publications and source records attributed to T Field.

At least 91 records · Page 5Linked to original sources
PubMed1985

Technology under Medicare diagnosis-related groups prospective payment. Implications for medical intensive care.

Medicare prospective payment by diagnosis-related groups (DRGs) has intensified the debate over the use and costs of medical technology. In this study, we examine the financial impact of DRG payment for medicare patients receiving medical intensive care. During a one-year period, payment for 446 Medicare patients receiving medical intensive care at a large teaching hospital was calculated to be +4.7 million below costs, representing an average loss per discharge of +10,567. Patients stayed an average of 21.6 days including an average of 5.0 days in the medical intensive-care unit--23 percent of the total stay. Twenty-eight percent of the MICU patients died during hospitalization. For this group, the average payment per discharge was projected to be +21,651 below the average per discharge cost. We conclude that the results send strong financial messages to hospitals providing medical intensive care to severely ill, elderly patients. Further exploration and research must occur to ensure hospital responses will be consistent with public policy expectations.

Costs and Cost Analysis↗
PubMed1985

Effects of ultrasound feedback on pregnancy anxiety, fetal activity, and neonatal outcome.

A group of pregnant women received video and verbal feedback during three ultrasound examinations. This group was compared with a no-feedback group on measures of pregnancy anxiety, fetal activity, and neonatal outcome. The feedback appeared to reduce pregnancy anxiety and fetal activity, particularly for the primiparous women. These women also experienced fewer obstetric complications and gave birth to neonates who were greater weight, more appropriate weight-for-length, less active and irritable, and showed better performance on the Brazelton neonatal behavior assessment.

Anxiety↗
PubMed1984

Children's responses to separation from mother during the birth of another child.

Preschool children's behavioral and physiological responses to separation were monitored before, during, and after their mothers' hospitalization for the birth of a sibling. During these 3 periods, play sessions were videotaped simultaneous with activity level and heart rate monitoring, nighttime sleep was time-lapse videotaped, and the parents were administered questionnaires on changes in their child's behaviors. Increases in fantasy play across these periods were interpreted as active coping both with the stress of separation and the altered interactions following the arrival of a new sibling. Increases in negative affect, activity level, heart rate, night wakings, and crying characterized the hospital period as one of agitation. Longer periods of deep sleep at this stage were interpreted as conservation withdrawal. Following the mother's return, decreases were noted in positive affect, activity level, heart rate, and active sleep suggestive of depression. These changes are discussed in the context of parallel data on agitation/depression during young primate separations.

Affect↗
PubMed1984

Pacifying effects of nonnutritive sucking on term and preterm neonates during heelstick procedures.

Behavioral state, heart rate, and respiration were monitored during heelstick procedures in samples of healthy, term neonates (N = 48) and preterm neonates treated in minimal care (N = 48) and intensive care (N = 48) nurseries. The treated infants who were given pacifiers spent significantly less time fussing and crying during and following the heelstick procedures. Physiologic arousal was monitored in both preterm groups but was attenuated only in the preterm infants who received pacifiers (minimal care group). As similar amounts of sucking were observed in both preterm groups, the inconsistency in treatment effects on behavioral and physiologic arousal was interpreted as a lack of cardiac-somatic coupling in the neonate in intensive care. Results suggest that nonnutritive sucking during heelstick procedures may attenuate behavioral distress in all neonates and physiologic arousal in neonates with less severe postnatal complications.

Analysis of Variance↗
PubMed1984

Leave-takings and reunions of infants, toddlers, preschoolers, and their parents.

The leave-taking and reunion behaviors of infants, toddlers, preschoolers, and their parents were observed as the children were "dropped off" and "picked up" at their nursery school each day. On arrival at their classroom, infants and toddlers related primarily to their parents, whereas preschoolers related to their teachers. Girls more frequently engaged in interaction with their teachers, and boys more frequently approached the children's play activities. Distress behaviors during the parents' departures were most frequently shown by toddlers, and the toddlers' parents hovered about them and " sneaked out of the room" more frequently. Children dropped off by mothers versus fathers showed more attention-getting behavior and crying, and mothers versus fathers engaged in more "distracting-the-child" behaviors and showed a longer latency to leave the classroom. During the second semester of observations parents and children spent less time relating to each other during leave-taking, children protested the departures less frequently, and the parents left the classroom more quickly. Regression analyses on distress behaviors during leave- takings and ambivalent behavior during reunions suggested that parent behaviors such as verbal explanation, distracting the child, latency to leave, and " sneaking out of the room" were correlated with children's distress and leave-taking distress was related to ambivalent behavior at reunion.

Attitude↗
PubMed1982

Immediate and long-term outcome of acute arterial occlusion of the extremities. The effect of added vascular reconstruction.

Patients with acute arterial occlusion in immediate danger of limb loss, are frequently high-risk surgical candidates, yet a simple balloon thromboembolectomy often does not suffice for limb salvage. With this in mind, we studied 61 male patients with acute arterial occlusions to assess the effects of added vascular procedures at the time of initial thromboembolectomy. Forty-three patients had only thromboembolectomy, but 18 required additional vascular reconstructive procedures. Immediate limb salvage (83.3%) and long-term limb salvage (67%) in these 18 patients, who had no operative deaths, were similar to those of the other 43 patients. Surgical therapy including needed additional vascular reconstruction of acute arterial occlusions results in not only satisfactory short-term but also good long-term functional outcome.

Acute Disease↗
PubMed1982

Nonnutritive sucking during tube feedings: effects on preterm neonates in an intensive care unit.

Preterm neonates (mean 32 weeks' gestation, 1,300 gm birth weight) were provided a pacifier for nonnutritive sucking during tube feedings in the intensive care nursery. Their clinical course, subsequent bottle feeding behavior, and performance on the Brazelton Neonatal Behavior Assessment scale were compared with those of control group infants. The infants provided with pacifiers averaged 27 fewer tube feedings, started bottle feeding three days earlier, averaged a greater weight gain per day, and were discharged eight days earlier for an average hospital cost savings of approximately $3,500. Formula intake was similar for the two groups, although nurses appeared to provide more feeding stimulation for the control infants. On the Brazelton scale, the infants provided with pacifiers showed weak reflexes more frequently. Increased restfulness and diminished activity level in these infants may have contributed to the appearance of weak reflexes. The consistency between these findings and those of previous investigators suggests that the provision of a pacifier for nonnutritive sucking during tube feedings may be a cost-effective form of intervention.

Body Weight↗
PubMed1982

Effects of parent training on teenage mother and their infants.

Parent training was provided for 80 low-income, black teenage mothers during their infants' first six months. Half of the mothers were visited biweekly in their homes to be instructed in caregiving and in sensorimotor and interaction exercises, and half were trained as CETA (Comprehensive Employment Training ACT)-paid, teacher's aides in a medical school infant nursery that provided care for their infants and infants of medical faculty. Growth and development during the first two years were superior for the infants whose mothers received training, particularly those who received paid parent training as teacher's aides in the infant nursery. Repeat pregnancy rates were lower and return to work/school rates were higher for the infant nursery mothers, most of whom subsequently pursued nurse's aide training.

Adolescent↗
PubMed1980

Squamous cell carcinoma of the proximal bile duct--a case report.

A 56-year-old white male with abdominal pain, vomiting, and jaundice was found on exploration to have squamous cell carcinoma of the hepatic ducts with metastasis to the liver. He was treated with palliative procedure consisting of dilation of tumor and placement of T-tube past the lesion. After recovering from surgery, patient was begun on radiation therapy to the liver and hilum, but his postoperative course was of progressive liver failure. This first necessitated cessation of radiation therapy and finally ended with the death of the patient three months after diagnosis.

Carcinoma, Squamous Cell↗
PubMed1980

Supplemental stimulation of preterm neonates.

Studies on supplemental stimulation of preterm infants treated in intensive care nurseries suggest some benefits for the stimulated infants. The types, degree and duration of benefit, however, vary across studies. The following is a review of these studies, with a discussion of methodological considerations which may explain variability of findings and which may be modified in future investigations.

Acoustic Stimulation↗