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Biomedical subjects

W Burton

Publications and source records attributed to W Burton.

14 recordsLinked to original sources
PubMed1999

Assessing the validity of tuberculin skin test readings by trained professionals and patients.

STUDY OBJECTIVES: To assess the validity of purified protein derivative (PPD) readings by patients and trained health-care professionals as compared with a calibrated model. DESIGN AND PARTICIPANTS: Survey of a group of patients, nurses, medical assistants, and physicians at five neighborhood health centers in the Bronx, NY. INTERVENTIONS: Participants were asked to read a calibrated model with four PPD indurations measuring 0 mm, 3 mm, 7 mm, and 13 mm. Indurations > or = 5 mm were to be considered "positive" reactions. MEASUREMENTS AND RESULTS: Data were obtained from 233 patients and 80 trained professionals. All patients correctly measured the 0-mm induration site and were able to detect the presence of an induration in 99.3% of possible observations. Compared with professionals, patients had more variability in measurements and interpretations of the 3-, 7-, and 13-mm sites. Professionals detected 100% of all indurations. Patients' specificity for the 0- and 3-mm sites was 97.4% and 62.7%, respectively; whereas sensitivity for the 7- and 13-mm sites was 68.2% and 89.3%, respectively. Professionals' specificity for the 0- and 3-mm sites was 98.7% and 65.3%, respectively; their sensitivity for the 7- and 13-mm sites was 86.7% and 97.3%, respectively. Seventy percent of professionals agreed that the model was a realistic representation of PPD indurations. CONCLUSIONS: Patients can reliably distinguish between the presence and absence of an induration at a PPD injection site. They are not as reliable in the measurement and interpretation of test reactions. Professionals had considerable variability in their assessments of PPDs but were more precise overall in their assessments than patients.

Adult↗
PubMed1998

Multi-anode detection in electrospray ionization time-of-flight mass spectrometry.

An electrospray ionization ion source coupled to a time-of-flight mass analyzer incorporating a multi-anode time-to-digital converter is described. High-speed data acquisition (kHz mass spectral acquisition) rates are achieved. The four-anode detector produces a significant increase in detection/counting efficiency over that for a single-anode detector. In this work a 2.5 times increase in detection efficiency is demonstrated. The multi-anode detector is also used as a diagnostic tool to optimize transmission of the ion optics.

Cytochrome c Group↗
PubMed1998

Attitudes and beliefs about organ donation among different racial groups.

Many people on the waiting list for organ donation die each year without receiving organs. The shortage of organs is even more pronounced in minority communities. Despite the fact that minorities are at higher risk, they may be less likely to support or consent to organ donation. This investigation was undertaken to study racial factors in organ donation, by focusing on differences in awareness, attitudes, and behavior. Three family practice centers in the Bronx with racially diverse but socioeconomically homogenous communities were studied. The study population consisted of a convenience sample of 163 patients who were approached for participation while they waited to see a doctor. Respondents filled out a 25-item survey that measured demographic information; their exposure to, awareness of, and attitudes toward organ donation; and whether they had signed an organ donor card. The results demonstrated overwhelming support for organ donation across all racial groups. Racial differences were found on awareness of and attitudes toward organ donation, and in the signing of organ donation cards. In contrast to other studies, racial minorities were not less likely than whites to support organ donation. These results suggest that making it easier for racial minorities to obtain organ donor cards could increase their rates of consenting to donate organs.

Adult↗
PubMed1998

Quality of student learning and preceptor productivity in urban community health centers.

BACKGROUND AND OBJECTIVES: Clinicians in community health centers find it difficult to balance the demands of increased productivity and effective teaching. We hypothesized that precepting third-year students would decrease clinical productivity and that many elements related to the quality of the learning experience (e.g., amount of patient contact, student autonomy) would be adversely affected by pressure to see increasing numbers of patients. METHODS: Students and preceptors in a 6-week family medicine clerkship completed daily surveys that measured the presence of quantifiable elements of the ambulatory teaching experience. They also rated the overall quality of learning during each session. RESULTS: For 62 sessions for which both students and preceptors completed evaluations, students rated the overall quality of learning more highly than preceptors. For students, the elements most positively associated with quality of learning were total teaching time and the frequency with which family issues were raised. For preceptors, the elements that predicted quality of learning were the number of patients that students saw independently and total teaching time. The clinical productivity of preceptors did not differ for sessions with and without a student. CONCLUSIONS: Preceptors can be effective teachers who encourage student autonomy and who model behaviors central to family practice, without decreasing productivity.

Clinical Clerkship↗
PubMed1997

Using and controlling subcontractors.

The use of subcontractors for the provision of goods and services is an increasing fact of life in the medical device industry. Many specialist subcontractor companies do nothing but fulfil the needs of primary manufacturers. This article examines the quality system and compliance aspects of using subcontractors and makes reference to the recent recommendations from the European Notified Bodies Group on Medical Devices.

Contract Services↗
PubMed1995

HIV-related cases among 2,094 admissions to a psychiatric hospital.

OBJECTIVE: Admissions to an acute care psychiatric hospital were studied to determine what proportion of admissions were for HIV-related psychiatric disturbances, what evidence exists that the HIV-related admissions constitute a new population of psychiatric inpatients, and whether any psychiatric variables distinguish patients with HIV-related disorders from patients without such disorders. METHODS: Charts for 2,094 consecutive admissions to the hospital in a three-year period were reviewed. Chi square analyses and t tests were used to compare various groups of HIV-related admissions and non-HIV-related admissions on sociodemographic characteristics, length of stay, history of psychiatric hospitalization, and other clinical measures. RESULTS: One-hundred and sixty-three admissions (7.8 percent of the total admissions) were judged to be HIV related. The largest category of HIV-related admissions, nearly half, were patients experiencing functional or psychological complications of HIV infection or risk. AIDS-phobic patients, who expressed irrational concerns about infection, accounted for 20.2 percent, and patients with organic manifestations for 18.4 percent. If the AIDS-phobic, HIV-bereaved, and factitious HIV-positive admissions were excluded, the rate of HIV-related admissions was 5.2 percent. CONCLUSIONS: Psychiatric hospitals can expect a significant but not overwhelming number of HIV-related admissions.

Adolescent↗
PubMed1992

Undetected HIV infection among acutely ill psychiatric inpatients.

Serological testing of waste bloods revealed that 25 (7%) of 350 acutely ill psychiatric inpatients had HIV infection. Eight of the 10 HIV-positive patients whose serological status was not recorded on admission were discharged with their status still unrecorded and presumably undetected. Thirty-nine (51%) of the 77 inpatients with HIV-related risk behaviors identified on admission were discharged with no record of their having been serologically tested before or during hospitalization.

AIDS Serodiagnosis↗
PubMed1984

EEG time and frequency domain measures of cerebral specialization.

Electroencephalographic (EEG) studies of lateralized cognitive functions have primarily relied upon measures of averaged evoked potentials (AEP) and power spectra (PS) to demonstrate hemispheric differences. The nature of the tasks appropriate to each of these methods of signal analysis generally require different cognitive activities and suggest different assumptions about cerebral specialization. This study investigated whether the tasks associated with either method were more likely to produce EEG asymmetries. Eighteen right-handed subjects participated in a three phase experiment which varied the amount of subject involvement in task performance. Phase I entailed passive listening to speech and nonspeech sounds. Phase II required active attention to speech and nonspeech sounds. Phase III involved a verbal matching task, a spatial rotations task, and a noncognitive control task. Auditory AEPs were measured in Phases I and II, and PS were measured in Phase II and III. EEG recordings were obtained from frontal and parietal areas of both hemispheres (F3, F4, P3, P4) referred to linked ears. Power spectra were derived from the 4-8, 8-13, and 13-20 Hz frequency bands at each lead. Despite statistically significant task and/or stimuli differences found in all three phases of study, essentially no task by lead interactions were obtained. That is, interhemispheric activity did not covary with differing stimuli and tasks. The absence of such interactions calls into question uncritical acceptance of a simple direct relation between task performance, EEG activity, and hemisphere specialization.

Acoustic Stimulation↗
PubMed1980

Changes in the rhesus monkey's EEG responses to ethanol during chronic exposure.

This study was designated to document the changes in the CNS response to ethanol during chronic exposure in 5 male, 3.5--5.0 kg rhesus monkeys. Electrodes were implanted bilaterally into the amygdala, hippocampus and the calvarium over the frontal and temporal cortex. Ethanol or control solutions were administered intragastrically through indwelling cannulae. The 1.25 g/kg ethanol challenge dose was administered during EEG recordings. After one challenge dose, the animals received 60 days of chronic alcohol exposure (3.0 g/kg/day increasing to 8.0 g/kg/day). EEG was recorded every 10 days and analyzed by period analysis. Changes in the effect of the challenge dose were assessed by determining the percentage change of the EEG from pre-dose levels to selected times post-dose throughout the chronic alcohol exposure. The EEG response changed significantly during chronic alcohol treatment. Although each structure exhibited a slightly different pattern of change, the overall change was a shift from an excitatory response in the non-tolerant animal to an EEG slowing during chronic exposure. We suggest that such a change may be useful as a diagnostic marker for alcohol tolerance. In addition, the differential nature of the in vivo expression of alcohol tolerance in each brain area suggests that such analysis may provide a valuable tool for understanding the mechanism and expression of alcohol tolerance in the CNS.

Alcoholism↗
PubMed1969

Radical vulvectomy.

Explore the source record for details and available documents.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

Barriers to follow-up of abnormal Papanicolaou smears in an urban community health center.

OBJECTIVE: To determine factors predictive of failure to return for colposcopy among women with significant abnormalities on Papanicolaou smears in a high-risk clinical population. DESIGN: Telephone survey. SETTING: An urban community health center. PARTICIPANTS: Two hundred seventy-nine women randomly selected from all women seen at the health center with abnormal Papanicolaou smears requiring colposcopy during 1993 to 1994. Six (2%) refused participation, and 19% could not be reached for inclusion. Subjects were mostly minority women receiving Medicaid. MAIN OUTCOME MEASURE: Completion of colposcopy. RESULTS: Of the 279 selected women, 79% were interviewed. The rate of adherence with colposcopy was 75% for the respondents. Women who did not know the results of their smear or who incorrectly understood their results were significantly less likely to return for colposcopy (P = .001). Younger women, especially teenagers, were less likely to return (P = .02). Socioeconomic status, education, primary language, health beliefs, fear of cancer, and clinician's gender or discipline were not associated with rate of follow-up. Barriers involving transportation, child care, and insurance also did not predict follow-up. CONCLUSIONS: Effective communication of results is the most important factor related to follow-up after abnormal Papanicolaou smear in this setting. In other settings, other factors may be of greater importance.

Adolescent↗