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Biomedical subjects

D Welch

Publications and source records attributed to D Welch.

46 records · Page 3Linked to original sources
PubMedDate not supplied

Emergency service in Costa Rica.

Visitors to Costa Rica found a country with high priority for health care, community volunteerism, and a low incidence of motor vehicle trauma. They were also able to observe the impact of socialized medicine, public intoxication, and sanctioned social events on the needs of the community.

Costa Rica↗
PubMedDate not supplied

Nutritional compromise in radiation therapy patients experiencing treatment-related emesis.

This article reviews the findings of a research study which investigated the phenomenon of nausea and vomiting in cancer patients receiving radiation therapy. One of the variables studied was nutritional status and how it was related to nausea and vomiting. The relationship between treatment-related emesis and nutritional status is described in two ways: how the patient's nutritional status may have affected the incidence of nausea and vomiting, and how the clinical occurrence of emesis affected the patient's nutritional status. Significant findings included the following. A decrease in appetite was experienced more frequently in patients undergoing therapy of either short (less than 12 days) or long duration (greater than 20 days), in comparison with those patients undergoing therapy of a moderate duration (between 14-20 days) (p = 0.05). A significant relationship was also documented between poor nutritional intake during treatment and a higher incidence of nausea and vomiting (p = 0.01). Another important finding included the fact that those patients who lost more than 5% of their total body weight prior to starting radiotherapy, went on to experience further weight loss during therapy. Recommendations for further research and implications for clinical practice are outlined.

Adolescent↗
PubMedDate not supplied

Influence of acquisition parameters on the measurement of click evoked otoacoustic emissions in neonates in a hospital environment.

There is much interest in the introduction of a universal neonatal hearing screening programme. Screening programmes using high-risk criteria have been used for some time, but 50 per cent of deaf and hearing-impaired neonates are not identified because they are not classified as high risk for hearing impairment at birth. Otoacoustic emission (OAE) measurement is widely regarded as a technique likely to be suitable for universal hearing screening. To examine this, otoacoustic emissions were measured from 351 neonate ears at a large maternity hospital. Of particular interest were the practicalities of recording OAE in a hospital environment, the establishment of an appropriate age at which screening should be performed on neonates and investigation of the relative advantages of different recording techniques. Main findings were: (1) low OAE levels relative to noise during the first 24 to 48 hours post partum; (2) lower OAE signal to noise levels in low frequencies irrespective of age; (3) increase of overall signal to noise ratio in frequencies above 1 kHz through the use of a shortened response window; and (4) OAE recording could be performed easily in mothers' hospital rooms prior to discharge.

Acoustic Stimulation↗
PubMedDate not supplied

Radiology integration in a multi-hospital system.

In 1989, Salt Lake City's Intermountain Health Care (IHC) began a process to reduce costs and streamline processes. Divided into four geographic regions, IHC consists of 24 hospitals and 100 clinics, a 400-member practitioner-physician group, and a staff of 23,000. IHC determined that three Salt Lake Valley hospitals, part of its Urban Central Region, must become one entity with shared management and a reduced staff to cover operations at all three hospitals. Management of the three radiology departments were charged with creating an integration process for the three hospitals. Two directors were selected to manage radiology and meet the outlined goals. Difficulty arose when one director needed to make changes in a facility managed by the other. The directors found that structuring by modality allowed them to plan for all three facilities, standardize equipment purchases and create integrated rather than departmental programs. As consolidation was taking place in top management, employees worried what the resulting changes meant for their jobs. Many were unfamiliar with the concepts of team structure and continuous quality improvement. Various courses and meetings were held to educate staff members and bring them up to new standards. Most successful were the meetings that allowed staff from different facilities to come together and share ideas. Although travel was an issue, these meetings quickly helped move the integration processes forward as peer relationships were developed. Employees were recruited for cross-training and new staff worked wherever needed. As they began to share data, the three hospitals identified best-practice and internal benchmarks. IHC is now ready to hire a single director to manage the radiology departments at the three Salt Lake Valley hospitals.

Budgets↗