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Biomedical subjects

W M Reid

Publications and source records attributed to W M Reid.

At least 37 records · Page 2Linked to original sources

Health care utilization by the elderly in HMOs: comparing risk and cost contracts.

Data are utilized collected from the American Association of Health Plans, a trade association representing HMOs, to study differences in utilization patterns between medicare beneficiaries enrolled in Medicare risk and cost contracts with health plans. Utilization is measured by the number of ambulatory procedures performed, outpatient and emergency room visits, and acute and nonacute discharges. Compared to elders enrolled in risk plans, those in cost arrangements appear to exhibit higher inpatient and outpatient use. Members of for-profit plans experienced greater outpatient visits, accreditation did not appear to influence utilization, and IPA arrangements resulted in a decrease in outpatient utilization. Financial and policy issues are discussed.

Aged↗

Managerial responses to Medicaid prospective payment in the nursing home sector.

The United States must soon address long-term care policy. Policymakers have sought cost containment through reimbursement policies that contain incentives for efficiency. Nursing facility administrators were surveyed twice following a significant change in Maine's Medicaid reimbursement policy to determine the effects of the change on their managerial practices. The administrators responded to some of the policy changes as profit maximizers, including instituting cost controls and benefiting from incentives. In other areas, such as staffing, staff pay, and accepting heavy care patients, the administrators did not seem to behave entirely as expected. Insights from organizational theory are useful for explaining some of the other behaviors. As long-term care reform is undertaken, a policy framework should include aspects of the internal environment of nursing facilities, such as administrator goals and organizational structure and mission.

Cost Control↗

A study of home care quality management data-collection systems.

A recent study reveals that home care agencies have inconsistent standards for quality management and inefficient data-collection systems. Are currently available data-collection systems suited for home care needs, or should they be redesigned?

Data Collection↗

Elements of a comprehensive absenteeism control program: role of the occupational health nurse.

Absence from work costs American companies more than $40 billion annually. Absenteeism control programs can be cost effective, but relatively few companies in the U.S. seem to have comprehensive programs. Key elements in a comprehensive program include return to work opportunities, careful job design, standards for expected times off, clear administrative responsibility for communicating with absent employees and health care providers, and an effective information system. Perhaps the most important factor in a successful program is employee centered management and a corporate philosophy that views employees as assets. The occupational health nurse is ideally suited by education, knowledge, and job function to lead the design and management of a comprehensive absenteeism control program.

Absenteeism↗

Absenteeism control programs. Results of a national survey of certified occupational health nurses.

An absenteeism control program can reduce employee absenteeism, thereby reducing company expenses, improving productivity, and bringing workers back to work sooner. A survey of Cohn's suggests that many companies in the United States lack absenteeism control programs, and those firms that have such programs are unlikely to have all the elements of a good program in place. Placing the occupational health nurse in charge of a comprehensive program will provide needed leadership, responsibility, expertise, and control.

Absenteeism↗

Anticoccidial efficacy of narasin in floor pen trials.

Narasin is effective against all species of chicken coccidia when tested in short-term battery cage experiments. The efficacy of narasin at concentrations of 20, 40, 60, 80, and 100 ppm was evaluated in ten floor pen trials in which commercial broiler production conditions were simulated. To provide intentional exposure to different levels of coccidia challenge, the litter of some pens was seeded with oocysts of each of the pathogenic species of chicken coccidia, whereas some pens were left nonseeded. Weight gain, feed efficiency, and lesion score data from the ten trials were analyzed as one randomized block experiment. Medication with narasin resulted in a significant reduction in lesion scores and significant improvement in weight gain and feed:gain ratios when compared with scores and gain of nonmedicated controls for both seeded and nonseeded pens. Each increase in narasin concentration up to 100 ppm for the seeded pens and up to 80 ppm for the nonseeded pens resulted in a significant reduction in cecal lesion scores. Although maximum weight gain in the seeded pens was obtained with 40 ppm narasin, concentrations greater than or equal to 60 ppm narasin were significantly better than the 40 ppm concentration in improving feed:gain ratios. These results confirm the effectiveness of narasin in controlling coccidiosis in broilers exposed to oocysts in the litter of floor pens. Furthermore, a clear relationship between the response to narasin and the level of oocyst challenge was demonstrated.

Animals↗

Anticoccidial activity of narasin in broiler chickens reared in floor pens.

The anticoccidial activity of the ionophore narasin was tested in 3 floor-pen experiments. Narasin was tested at levels of 40, 60, 80, 100, or 120 ppm and compared against feeding ration containing 80, 100, or 121 ppm monensin or no medication. Feeding at all levels of narasin significantly prevented coccidiosis-induced mortality and improved weight gains and feed conversion ratios compared with the same parameters in groups given unmedicated feed. Protection with narasin was equal to or slightly greater than the protection obtained with monensin. The reduction in intestinal lesion scores was greater with narasin medication than with monensin. Analysis of pooled data from these trials indicated that a level between 48 and 96 ppm narasin would provide the optimum, depending on whether maximum weight gain or optimum feed conversion ratio was desired. Testing for coccidial immunity using the immunity challenge technique indicated that, based on the parameters of weight gain and lesion scores, even levels as low as 40 ppm narasin had enough efficacy to significantly reduce the amount of immunity which developed in medicated birds compared with the level of immunity developed in birds receiving unmedicated feed.

Animals↗

Practical immunization of chickens against coccidiosis using an attenuated strain of Eimeria tenella.

Three floor-pen trials were conducted to compare two attenuated strains of Eimeria tenella (Wis-F-96 and Wis-F-125) with the strain of E. tenella used in a commercial planned immunization program (Coccivac). Broiler cockerels were started in floor pens on new pine shavings litter. Immunizing oocysts were administered in the drinking water during the first week with total dose per bird of 175 oocysts of the control strain (Coccivac); 175, 350, or 700 oocysts of the Wis-F-125; 350 oocysts of Wis-F-96; or no oocysts (non-seeded control). The control strain was more pathogenic than the Wis-F-125 or the Wis-F-96 strains as indicated by significantly higher lesion scores 17 days after initial exposure and by loss of two birds in the control strain exposed groups. Low lesion scores and no deaths due to coccidiosis characterized the use of the Wis-F-125 strain. Flock immunity, as determined by immunity challenge, was equivalent between the control strain and the higher dosages of Wis-F-125. The Wis-F-96 strain did not adequately immunize chickens in these experiments.

Animals↗

Anticoccidial activity of narasin in battery raised broiler chickens.

The anticoccidial activity of the ionophorus antibiotic narasin was tested against six species of coccidia (Eimeria acervulina, Eimeria mivati, Eimeria maxima, Eimeria necatrix, Eimeria brunetti, and Eimeria tenella) in battery-raised broilers. Feeding ration medicated with 60, 80, or 100 ppm narasin significantly improved weight gains during the periods of D 0 to D7 and D 0 to D 14 (D 0 = day of inoculation with sporulated oocysts), compared with the weight gains in corresponding inoculated groups fed unmedicated feed. A similar protective effect of the medication was seen with feed conversion ratios (feed consumed/bird weight) and coccidiosis-induced mortality. With most species studied, 40 and 60 ppm narasin was not as efficacious as 80 or 100 ppm. The maximum numerial improvement in weight gain and feed conversion ratio was with 80 ppm narasin. Gross intestinal lesion scores were reduced by medication compared with the scores in birds fed unmedicated feed. The overall trend was for a larger reduction in lesion score with higher drug levels. Narasin at 80 or 100 ppm was generally more effective in controlling individual or mixed species infections of coccidia than 99 ppm monensin.

Animals↗

Effects of anaerobic bacteria on Eimeria tenella infection in bacteria-free, monofloral, and conventional chickens.

Bacteria-free, monofloral, and conventional chicks were infected with Eimeria tenella. Monofloral chicks were established by inoculating birds in several gnotobiotic isolators with a single species of Escherichia coli or with one of three Bacteroides sp. isolates (No. 157, No. 202, or No. 366). Daily weights of individual birds were recorded for six days post-infection (PI). On Day 6 PI all birds were sacrificed and cecal lesions were scored. Conventional, infected birds lost weight on days 5 and 6 PI and showed severe lesions. Birds maintained as monofloral groups with isolates of Bacteroides sp. No. 157, No. 202 or E. coli showed equally severe lesions, but lost weight only on day 6 PI. Conventional, uninfected birds with no lesions, birds infected with Bacteroides sp. isolate No. 366 with mild lesions, and bacteria-free birds with mild to severe coccidial lesions all continued to gain weight on each day post-infection.

Animals↗

Monensin, Eimeria tenella infection, and effects on the bacterial populations in the ceca of gnotobiotic chickens.

Bacteria-free chicks in separate plastic film isolators were inoculated orally with single species of bacteria. Within an isolator, half the birds were fed unmedicated feed and half received feed containing 100 ppm monensin. With clostridium perfringens as the established species of monoflora, bacterial counts from the duodenum were 10(4) times lower and counts from the ceca were three times lower in monensin-fed birds compared to unmedicated birds. Infection with Eimeria tenella stimulated an eight-fold increase in the numbers of C. perfringens in the ceca of unmedicated birds but no increase in monensin-fed birds. With Bacteroides sp. or Streptococcus faecalis as monoflora, there was no difference in the cecal or duodenal populations between medicated and unmedicated birds uninfected with coccidia. In contrast to C. perfringens, populations of Bacteroides sp. and S. faecalis in the ceca decreased five to 100-fold in both medicated and unmedicated chicks after infection with E. tenella. Duodenal populations of C. perfringens, Bacteroides sp., and S. faecalis were unaffected by the coccidial infection.

Animals↗

Effect of the anticoccidial arprinocid on production, sporulation, and infectivity of Eimeria oocysts.

Medication of broilers with arprinocid [MK-302, 9-(2-chloro-6-fluorbenzyl adenine)] had 3 distinct effects on oocysts; (1) the number of oocysts produced was decreased, (2) fewer of the oocysts sporulated, and (3) those oocysts which did sporulate were less infective than those from unmedicated birds. The drug level necessary to prevent passage of oocysts depended on the species and strain of coccidia. To essentially eliminate oocyst production (less than 5% of controls) required medication with the following levels of arprinocid: 70 ppm with Eimeria maxima; 60 ppm with E. mivati, E. E. necatrix, and E. brunetti; and 50 ppm with E. tenella. With E. acervulina, oocysts were completely eliminated by 60 ppm of arprinocid with one field strain but were still numerous at 70 ppm with a second field strain. Oocysts recovered from birds on medication often failed to sporulate. No sporulation was seen at drug levels of 30 ppm or above with E. maxima and E. mivati. The level of arpinocid required to prevent sporulation with other species depended on the strain being studied, but varied from 30 ppm to 70 ppm. The oocysts of E. acervulina, E. mivati, E. tenella, and E. brunetti recovered from medicated birds that subsequently sporulated, were less infective when inoculated into susceptible birds, than oocysts from unmedicated birds. Oocysts from low medication level with E. necatrix (30 ppm) and E. maxima (10 ppm), once sporulated, were as infective as oocysts from unmedicated control birds, even though the numbers produced were less. No differences were detected in the time oocysts were produced between medicated and unmedicated birds infected with E. acervulina, E. maxima, E. brunetti, and E. tenella.

Adenine↗

Prevalence of Eimeria acervulina, Eimeria necatrix, Eimeria brunetti and Eimeria tenella in Georgia (USA) as demonstrated by immunity challenge techniques.

Eimeria acervulina, E. necatrix, E. brunetti and E. tenella were found to be widely distributed in north-east Georgia. 2. Using immunity challenge techniques 17 flocks from 12 to 72 weeks of age showed significantly lower lesion scores for the first three species compared with susceptible control flocks similarly challenged. Only one flock was found to be susceptible to E. tenella. No mortality occurred in the field flocks after challenge while 20 to 60% mortality occurred in the susceptible controls. 3. Partial immunity occurred more frequently in field flocks aged 28 weeks of age or less (62%) than in older flocks (30%). Lesion scores ranged from 0-1 to 2-2 with the former and 0-1 to 0-6 with the latter group. 4. A modification of the immunity challenge method was developed using lesion scores as the major criterion determining immunity. The method permits testing of four species infecting different parts of the digestive tract in one group of birds.

Animals↗