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Biomedical subjects

C A Rice

Publications and source records attributed to C A Rice.

15 recordsLinked to original sources
PubMed1996

Premature termination of group therapy: a clinical perspective.

Premature terminations are an inevitable if complex aspect of any therapy group, as they are of life. They can be destructive to the life of a group, and damaging to its members. It is possible, however, given proper preparation and thoughtful reflection, to make such premature endings effective. And sometimes, understanding the wish to leave may change potentially premature endings into turning points in a continuing therapy. I use two clinical events to illustrate these processes. Premature terminations are described as part of a continuum of endings that include dropouts, early endings, and good-enough terminations.

Adult↗
PubMed1995

Using an encounter form to develop a clinical database for documenting nurse practitioner primary care.

A clinical database will enable nurse practitioners to document and improve characteristics of their practices. This information is vital if nurse practitioners expect to achieve success in the changing U.S. health care system. This article describes the process of creating an encounter form and a related clinical database. Changes made in a family practice clinic that were derived from using a clinical database are presented. Additional uses for a clinical database, such as quality assurance, clinical evaluation, and clinical research, are discussed.

Database Management Systems↗
PubMed1982

The regressed inpatient group in a graded group treatment program.

This article describes the progress of severely regressed inpatients as part of a graded group treatment program. Leaders must actively initiate structure, formulate goals, and emphasize the eventual "graduation" of patients to higher-level groups. Essential qualities of the group leaders and countertransference issues are discussed.

Countertransference↗
PubMed1981

Relationship of physician continuity to type of health problems in primary care.

The objective of this study was to determine if the level of continuity of medical care was related to the type of health problems (chronic or acute) presented by patients at four family health centers during a one-year period. Patients with chronic diagnoses encountered significantly fewer physicians and had a higher mean Continuity Index than patients with acute illness diagnoses, even though these two groups made the same number of health center visits for their respective problems during this period. These findings indicate that the prioritizing of clinical problems (whether planned or fortuitous) with respect to the importance of providing continuous care may already be taking place at these health centers. These activities are appropriate if one accepts the premise that, other things being equal, longer illnesses are treated more effectively if there is a consistent knowledge base about a patient and his/her illness, and that this consistency of knowledge is related to the number of providers encountered by that patient.

Acute Disease↗
PubMed1980

Family practice in Massachusetts: a comparison of residency trained family physicians with the general practitioner experience of 1967-1968.

An analysis of data collected from a one-year survey of the activities of seven residency trained family physicians practicing in Massachusetts was carried out. These data were compared to a study of activities of Massachusetts general practitioners done in 1967-1968, and to the Virginia Study of 1976. Both hospital and health center encounters were analyzed. The age distribution of the practices paralleled that of the general practitioners, particularly the younger general practitioners. The sex distribution was also comparable. However, over one third of all health problems recorded during the study were for preventive or non-illness visits. This represented a significant percentage increase over the general practitioners as well as the family physicians in the Virginia Study. The site of activity was also different in showing a ten percent increase in office visits over 1967-1968. Women's health issues, which include maternity and family planning care, represented a larger percentage of the practices of the residency graduates than was the case in the Virginia Study. Educational and health manpower implications of the study are discussed.

Adolescent↗
PubMed1980

Methodological, technical, and ethical issues of a computerized data system.

This report examines some methodological, technical, and ethical issues which need to be addressed in designing and implementing a valid and reliable computerized clinical data base. The report focuses on the data collection system used by four residency based family health centers, affiliated with the University of Massachusetts Medical Center. It is suggested that data reliability and validity can be maximized by: (1) standardizing encounter forms at affiliated health centers to eliminate recording biases and ensure data comparability; (2) using forms with a diagnosis checklist to reduce coding errors and increase the number of diagnoses recorded per encounter; (3) developing uniform diagnostic criteria; (4) identifying sources of error, including discrepancies of clinical data as recorded in medical records, encounter forms, and the computer; and (5) improving provider cooperation in recording data by distributing data summaries which reinforce the data's applicability to service provision. Potential applications of the data for research purposes are restricted by personnel and computer costs, confidentiality considerations, programming related issues, and, most importantly, health center priorities, largely focused on patient care, not research.

Computers↗
PubMed1979

Correlations in mortality data involving cancers of the colorectum and esophagus.

Massachusetts vital event data for 1969--1972 were used to develop correlations between mortality rates for malignant diseases and other causes of death over the 34 health planning subdivisions of the state. A significant correlation was found between the mortality rates for cancer of the colon and rectum and ischemic heart disease. The association between the mortality figures for cancer of the esophagus and cancer of the lung and cirrhosis of the liver was also investigated. The objective was not only to learn more about the etiology of these conditions, but also to investigate the socioeconomic and other factors which are of importance in developing preventive programs. The need for neighboring states to use their data to confirm or refute findings is stressed.

Colonic Neoplasms↗
PubMed1979

Laboratory prediction of the carrier state in hemophilia B: role of replication of assays.

The authors studied the effect of averaging replicated assays of Factor IX coagulation activity and Factor IX antigen on each plasma specimen in improving the ability to detect carriers of hemophilia B. The improvement resulting from this procedure is particularly marked in tests depending on the linear regression of one characteristic on another to diagnose the carrier state. The effects of averaging assays on the ratio of Factor IX coagulation activity to Factor IX antigen were also explored. The benefits of averaging replications were not greatly increased by use of more than four replications.

Blood Coagulation Tests↗
PubMedDate not supplied

Computed tomography and ultrasonography of carcinoma in duplication cysts.

The CT and ultrasound findings of malignancy arising in walls of alimentary tract duplication cysts are previously unreported. We describe two cases where identification of both cyst and tumor nodule and separation of the mass from other visceral organs was achieved. We review the English literature reporting this unusual condition and suggest that CT and ultrasound are of great value in accurate preoperative diagnosis.

Adenocarcinoma↗