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Biomedical subjects

D Barr

Publications and source records attributed to D Barr.

59 records · Page 4Linked to original sources
PubMedDate not supplied

The diagnostic challenge of postoperative acute appendicitis.

During the period 1979 to 1989, 0.1% of all cases of acute appendicitis at our institution occurred soon after another operative procedure. The interval between primary operation and appendectomy was 5 to 31 days (mean, 14 days). Signs and symptoms did not differ from those of classical acute appendicitis. Duration of symptoms ranged from 12 hours to 8 days (mean, 2.4 days). Perforation was present in 3 patients, suppurative appendicitis in 1 patient, and acute inflammation in 4 patients. Two of the perforations were associated with abscess formation. Morbidity related to the appendiceal condition included hepatic abscesses, septic shock, and prolonged ileus. There was no mortality. Hospitalization ranged from 6 to 80 days (mean, 12.5 days).

Acute Disease↗
PubMedDate not supplied

An organization-based intervention to improve support for employee heart health.

PURPOSE: The purpose of this study was to evaluate the effectiveness of a management training seminar, developed through a partnership among a college, a managed care company, and a state public health department, to increase the level of organizational support for employee heart health in selected companies. DESIGN: Quasiexperimental. SETTING: Worksites, including heavy and light industries, school districts, insurance companies, county health agencies, and health care centers. SUBJECTS: Twenty western New York companies matched on size, industry type, and interest in worksite health promotion. INTERVENTION: Seven training seminars held at a college for 1 year and directed primarily at human resource managers. Training was supplemented by the availability of student interns, faculty consulting, a vendors' fair, and various program planning aids. MEASURES: Groups were assessed using HeartCheck, a measure of organizational support for employee heart health. RESULTS: A fourfold difference in change for HeartCheck was observed by the experimental vs. comparison groups (p < .01), along with significantly greater increases on five of the instrument's six subscales (p < .05). The level of HeartCheck reached in the experimental group matched those seen in highly acclaimed commercially sponsored programs. CONCLUSION: This study represents one of the first attempts to intervene at the organizational level within a worksite health promotion initiative. Positive results were observed that appear to be both meaningful and cost-effective.

Health Education↗
PubMedDate not supplied

Measuring worksite resources for employee heart health.

PURPOSE: Intervention at the organizational rather than the individual level is gaining greater attention in worksite health promotion efforts. However, little research has been done on instruments to measure this domain. Therefore, the purpose of this study was to further test the utility of an existing organizational heart health support instrument by examining relationships among worksite structural characteristics and comparing these results to other survey findings. DESIGN: One-time cross-sectional. SETTING: New York State. SUBJECTS: One hundred fifteen volunteer worksites in the New York State Healthy Heart Program, representing manufacturing, government, education, health care, and other industries. MEASURES: A survey was conducted using HeartCheck, an organizational assessment of employee support for heart health. HeartCheck contains 175 items measuring organizational support for tobacco control, nutrition, physical activity, stress, screening, and administrative support structure. RESULTS: On average, only 22% of all worksite resources assessed were present in the sample. Having a workforce greater than 250 provided a 12% increase in predicted overall worksite resources. A predominantly female workforce (> 75%) provided 10% higher levels of worksite stress resources. Worksites with unions had higher levels of resources for physical activity (10%), screening (13%), and general supportive structures (10%). The presence of manual labor diminished support for tobacco control resources (-13%). Finally, manufacturing worksites demonstrated a clear advantage for all types of worksite resources, except for stress. CONCLUSION: A number of trends found in this study are consistent with earlier work. Industry type and size both predict worksite supports similar to previous studies. Other findings that appear to contradict previous work, including the relatively low level of support observed in this sample, can be explained by the comprehensive nature of the instrument. Overall, these findings demonstrate the utility of HeartCheck.

Cardiovascular Diseases↗
PubMedDate not supplied

Litigation, insurance, and implantable devices: good-bye progress.

Once the concept of strict liability was extended to cover defective product design, negligence was no longer truly an issue in a products liability case. The manufacturer must now design his product so that it will be "safe" when used for its intended purpose and must foresee any possible misuse that may be made of the product. As the doctrine of strict liability became prevalent throughout the United States, the cost of insuring against the potential of huge verdicts associated with products rose dramatically. The resultant increased costs borne by a manufacturer may eventually lead to fewer and fewer implantable devices being developed and placed on the market.

Commerce↗