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W J Crump

Publications and source records attributed to W J Crump.

At least 37 records · Page 2Linked to original sources
PubMed1987

Bishop score and labor duration: a new look.

The Bishop score determined on admission was correlated with labor duration in this group of 770 patients delivered of infants in community hospitals. The total score correlated well with duration of latent-phase labor in primiparas and multiparas, but not with active phase in either parity group. We recommended the Bishop score as a useful predictor of latent-phase duration to facilitate decisions in management of labor.

Female↗
PubMed1987

The Alabama Perinatal Outcome Project: some methodological issues.

As practice networks are built to facilitate the study of unselected patient populations, special advantages and problems of these systems are emerging. The Alabama Perinatal Outcome Project is an example of such a network which has been functioning for over three years. Key methodological questions of sample selection, completeness and reliability of data, and research definitions have been addressed in the initial phase of the project. The evolution of an approach to these methodological issues and some preliminary data are presented for consideration by those designing practice networks.

Adult↗
PubMed1986

The postdate pregnancy. When to wait, when to induce labor.

The postdate pregnancy is a common and difficult problem for the physician, who must decide between risking premature delivery by inducing labor and waiting so long that post-maturity complications may be present. A normal contraction stress test with a postdate pregnancy is reassuring, and artificial labor promoted by an inducible cervix or an abnormal contraction stress test should attain the best result for both mother and baby.

Female↗
PubMedDate not supplied

The department without walls. Acceptability, cost, and utilization of interactive video technology.

As groups of physicians continue to provide more of their activities in sites remote from the central office, communication among providers and staff and the provision of common educational activities are important priorities. An analysis of a 12-month period of the use of full-motion interactive video technology to accomplish these goals in a decentralized academic department shows this method to be acceptable and cost-effective. Careful attention to room environment and staff support were found to be important. Practical recommendations are provided for those considering the use of this technology.

Academic Medical Centers↗
PubMedDate not supplied

A field trial of 2 telemedicine camera systems in a family practice.

Previous reports of telemedicine consultations have demonstrated that the technology is effective but inefficient. Little attention has been directed to the use of telemedicine in a primary care practice, especially the use of the medical peripheral devices. We used a functioning primary care practice as a telemedicine test bed, providing unselected patients in the study group. The goal was to study the performance of a new generation of a compact set of medical peripheral devices specifically designed for telemedicine examinations. In a 3-week field trial, 2 second-generation camera systems were used by physician faculty and residents in family practice to examine the skin, ears, and pharynx of 34 patients, ranging in age from 10 months to 78 years. Evaluations by the clinicians and patients were obtained. The average duration of an examination using these systems was 2 minutes. Patients' response was uniformly positive. A "pistol grip" video otoscope obtained an acceptable image, unless canal debris obscured the view. The system that provided pneumatic otoscopy was preferred, with some modifications necessary to obtain an airtight seal. The preferred skin camera was one that provided an image of a size that clinicians were most accustomed to viewing, although stability of this handheld camera was a problem. This camera also worked well to visualize the pharynx, especially in children with symptoms of pharyngitis. Color was deemed important in all 3 anatomical areas, and using auto-white balance and excluding fluorescent lights were preferred. Thus, the second-generation telemedicine peripheral devices were effective for use in a group of unselected primary care patients. These camera systems can be used by nursing personnel and require a minimum of time per examination.

Adolescent↗
PubMedDate not supplied

The decision to suggest screening lower gastrointestinal endoscopy: the effect of training.

Primary care residency directors in the Southeastern US were surveyed to obtain information on training in lower gastrointestinal endoscopy (LGIE). All residents in a sample of programs were asked to complete a similar questionnaire. Response was 77% for family practice residencies and 60% for internal medicine residencies. Significantly fewer (43%) internal medicine residents reported receiving training in either 35 cm or 60 cm LGIE than family practice residents (77%). When asked if they would suggest LGIE to screen an asymptomatic patient, 67% of family practice and 84% of internal medicine residents replied affirmatively. Those residents who had received training were significantly more likely to suggest screening LGIE. The screening decision was not influenced by the specialty of the physician who supervised the resident training. Out-of-pocket cost to the patient was expected to be a major consideration in the screening decision, but this was not supported statistically. Greater availability of residency training in LGIE will likely increase its use in screening.

Aged↗
PubMedDate not supplied

Teaching lower gastrointestinal endoscopy: a comparison of family medicine and internal medicine residencies.

Lower gastrointestinal endoscopy (LGIE) is an important procedure in primary care for detecting colorectal cancer. This survey of family practice (FP) and internal medicine (IM) residency directors in the southeastern United States shows that 100 percent of FP and 92 percent of IM programs provide training in LGIE. Less than half of all programs had certification criteria, and both disciplines showed a clear preference for the 60-cm flexible sigmoidoscope. LGIE procedures in IM programs were more frequently supervised by gastroenterologists, and in FP programs they were more frequently supervised by FP faculty. Only 55 percent of FP and 56 percent of IM residents were predicted to suggest screening LGIE to their patients, and 80 percent of FP and 63 percent of IM residents were predicted to include sigmoidoscopy in the evaluation of hematochezia.

Certification↗
PubMedDate not supplied

Grateful Med: getting started.

When a local medical library is not available, it is often necessary for physicians to discover alternate ways to receive medical information. Rural physicians, particularly, can make use of a computer program called Grateful Med that provides access to the same literature available to physicians in large cities. This program permits the user to perform database searches on the National Library of Medicine database (MEDLINE), corresponding to the primary index to medical literature, Index Medicus. In this article, we give the procedure for procuring a National Library of Medicine password and for making efficient use of the Grateful Med program.

Computer User Training↗
PubMedDate not supplied

A primer for users of medical bibliographic databases.

A database is electronic information. Perhaps one of the most important information sources in medicine is that which is accessed electronically through a database named MEDLINE, the core medical literature published since 1966. MEDLINE is sold by three major vendors (BRS, Dialog, and the National Library of Medicine) to information experts and to medical experts. Information experts (librarians) and medical experts (physicians) can access MEDLINE by two different methods. This article discusses both and emphasizes use by the medical practitioner. An annotated guide to database vendors is provided, and guidelines are offered that will assist the physician in selecting equipment and assessing services.

MEDLARS↗
PubMedDate not supplied

Oxytocin and the induction of labor: use in a network of community hospitals.

This study uses a matched cohort design to compare the process and outcome of patients whose labor was induced using oxytocin with those entering labor spontaneously in a network of small community hospitals. The patients with induced labor more frequently had an arrest of dilatation and had infants who showed more abnormalities of fetal heart rate. There were no differences in infant APGAR scores. The previously reported increases in epidural anesthesia, episiotomy, and assisted deliveries in patients with induced labor were not found, suggesting a significantly different style of care provided by family physicians in small community hospitals.

Alabama↗
PubMedDate not supplied

Outpatient consultations from a family practice residency program: nine years' experience.

Previous reports of consultation rates from family practice physicians have included small sample sizes and have suggested higher rates in residency training programs. This report summarizes 9 years of data involving 161 family practice physicians in a residency training program and shows an overall rate of 1.4 percent for outpatient consultations. Otolaryngology, orthopedics, obstetrics/gynecology, and general surgery were the most frequent disciplines consulted. These data are helpful in designing health care systems that include family practice residency programs.

Family Practice↗