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Biomedical subjects

D A Gregory

Publications and source records attributed to D A Gregory.

13 recordsLinked to original sources
PubMed2001

Strategic renegotiation of managed care contracts.

Given the myriad revenue and cost pressures faced by today's organizational providers, it behooves healthcare financial managers to identify opportunities to improve the terms of their managed care agreements when renewal time is near. Selection of a contract renegotiation strategy should be preceded by a focused analysis of situational variables and followed by conscientious performance monitoring. Through careful consideration of the compatibility to their goals, core values, and operational capabilities, healthcare providers and managed care organizations can craft agreements with the potential for sustaining meaningful long-term partnerships.

Contract Services↗
PubMed2000

Uniparental mitochondrial transmission in sexual crosses in Cryptococcus neoformans.

Restriction fragment length polymorphism (RFLP) in the large ribosomal RNA region of the mitochondrial DNA (mtDNA) was developed as a genetic marker for investigating mitochondrial transmission in sexual crosses of the human pathogenic basidiomycetous yeast Cryptococcus neoformans. Strain JEC20 of C. neoformans var. neoformans (mat a) was mated with six strains of C. neoformans var. grubii (mat alpha). Successful mating was indicated by the formation of hyphae and basidiospores. These basidiospores were examined for mtDNA RFLP genotypes. All 570 basidiospores examined from the six crosses showed the mtDNA genotype of strain JEC20. The failure to recover the C. neoformans var. grubii mtDNA in any cross indicates that the C. neoformans var. grubii mtDNA is either selectively eliminated in the newly formed dikaryon or selectively excluded in the immediate dikaryotic hyphae of the newly formed dikaryon.

Crosses, Genetic↗
PubMed1992

Suitability for day case cataract surgery.

Areas of concern about day case surgery are highlighted. A group of 442 patients underwent cataract surgery with lens implant. They were randomly allocated to day case or inpatient groups. Questionnaires were used to assess opinions about day case cataract surgery and how patients felt they would manage. None of the areas of concern were actually a problem. Difficulties encountered by patients and clinicians in the postoperative period are discussed. Most patients appear suitable for day case surgery provided they are well informed.

Activities of Daily Living↗
PubMed1991

Patient perceptions and social impact. Preliminary results of the Bristol MRC Study.

One hundred and nine inpatients were compared with 84 day cases by means of specially designed questionnaires presented at set times by staff other than the operating surgeon. The aim was to highlight patient attitudes, expectations and satisfaction with a standard method of endocapsular cataract extraction and posterior chamber lens implant under local anaesthetic as either a day case (DC) or an inpatient (IP). The results showed a high patient acceptance of whichever method of management was chosen. Both groups appeared satisfied with their treatment and the final result. The cost of DC and IP treatment was assessed.

Ambulatory Surgical Procedures↗
PubMed1987

Can rational prescribing be assessed?

The prescribing of a group of young general practitioners was assessed, before and after educational intervention, using five parameters of rational prescribing. The proportion of drugs prescribed by their generic name, and the proportion falling within a basic formulary for general practice increased significantly even though the participating doctors had neither been involved in the compilation of the formulary nor been given a copy of it. Items prescribed bygeneric name rose from 45 to 74% and the proportions of new and repeat items within the formulary rose by 73 to 83% and 68 to 77% respectively. It appears that discussions about rational prescribing lead to similar changes in prescribing as involvement in the compilation of a formulary.The notion of an ;essential drugs list' for general practice is described, and three easily applied measures of rational prescribing are suggested: (1) the proportion of patients not given a prescription, (2) the proportion of drugs written in their generic form and (3) the proportion of drugs falling within a general practice ;essential drugs list'.

Drug Prescriptions↗
PubMed1986

Repeat prescribing: a study prior to the imposition of the limited list.

A diverse group of general practitioners from separate practices kept a record of their repeat prescriptions for a week in March 1985, just prior to the imposition of the Government's limited list of drugs which could be prescribed on the National Health Service. Up to one-fifth of repeat prescriptions needed to be altered to comply with the eventual list. An unexpected finding was the wide differences among the doctors in the proportion of repeat prescriptions that were written as the approved generic names. While the anxieties about generic prescribing have yet to be resolved, the problems of converting repeat prescriptions into generic names requires not only a change in doctors' behaviour, but also clear explanation to reception staff and patients. Such a change could produce considerable financial savings, and might be more effective in this than further imposed restrictions.

Drug Prescriptions↗
PubMed1985

Development of a limited formulary for general practice.

Over a period of 1 year, a diverse group of general practitioners from separate practices constructed a limited formulary for general practice. The formulary contains 137 drugs and is intended to provide adequate and appropriate treatment for 90% of general practice patients. The study provides a model for development of agreed local formularies which do not infringe clinical freedom and offer an alternative to imposed limited lists as a means of reducing the cost of prescriptions. Development of such a list can be an enjoyable and dynamic educational exercise and can lead to more rational and safer prescribing.

Drug Prescriptions↗
PubMed1985

Statistical association of dietary components with Simonsiella species residing in normal human mouths.

Members of the genus Simonsiella, aerobic, multicellular filamentous gliding bacteria, were detected in swabbings from the palates of 32% of 212 human subjects free of gross oral pathologies. Nutritional evaluations for 142 of the subjects showed a significantly greater daily intake among 53 Simonsiella carriers for 13 dietary variables, including four fat components, but there was no significantly greater daily intake for any of the carbohydrate components. Overall, there was a general excess dietary intake by Simonsiella carriers. The mean dietary intake of the carriers was numerically greater than that of the noncarriers for 70 of 74 dietary variables.

Adolescent↗
PubMed1978

Isolation, characterization, and numerical taxonomy of Simonsiella strains from the oral cavities of cats, dogs, sheep, and humans.

Forty-nine strains of the gliding prokaryote Simonsiella were isolated from the oral cavities of cats (8), dogs (19), sheep (4), and humans (18) in Southern California by a direct isolation procedure using a complex serum-enriched medium. The numerical taxonomic analysis (unweighted pair-group method using arithmetric averages) of 57 differential traits for each strain was based on standard bacteriological diagnostic tests and included the molar guanine-plus-cytosine contents of the DNA and the relative percentages of fatty acid contents reported earlier. The resulting phenogram clustered the strains of Simonsiella into groups that correlated with sources of origin. The study included the neotype strain of Simonsiella crassa (ATCC 27504, ICPB 3651, NCTC 10283) of Australian sheep origin. The strains isolated from dogs, sheep, and humans form clusters of organisms that appear to have become adapted to live in and possibly to have evolved with their respective "hosts". In our judgment, these source-of-origin clusters represent different "ecospecies".

Animals↗
PubMed1977

Deoxyribonucleic acid base composition of Simonsiellaceae.

The molar percentages of guanine plus cytosine in the DNA of 51 strains of Simonsiellaceae were determined by buoyant density ultracentrifugation of cell lysates in CsCl. The DNA base ratios ranged from 41-55 mole-% guanine plus cytosine. These values fall within the range known for the Order Cytophagales, the non-fruiting gliding bacteria, and are outside the range of the Order Myxobacterales, the fruiting myxobacteria. Among the strains of the genus Simonsiella, four distinct group can be delineated on the basis of source of origin (sheep, dog, cat, human) and GC content. The neotype of Alysiella filiformis has a GC content of 45.4 mole-%.

Animals↗