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Biomedical subjects

H L Smith

Publications and source records attributed to H L Smith.

At least 19 recordsLinked to original sources
PubMed1992

Strategic planning in rural health care organizations.

Is strategic planning associated with higher levels of performance in health care organizations? Is strategic planning effective? This article examines strategic planning's impact on rural hospital and rural nursing facility performance, organizational characteristics, and strategy. The findings suggest that strategic planning in rural hospitals is strongly associated with higher profits, operating margins and planning effectiveness, and associated to a lesser extent with lower costs and higher revenues per patient day. However, strategic planning does not appear to be associated with higher performance in nursing facilities. The implications for strategic planning in rural health care organizations are discussed.

Financial Management↗
PubMed1991

The role of structural symmetry in linearizing ocular reflexes.

This work presents a simulation study using an anatomically relevant model of the vestibulo-ocular reflex (VOR). The aim is to explore the functional properties of a bilateral structure in the premotor circuits of the oculomotor system. The major conclusions using sinusoidal inputs are: A bilateral structure in a sensory-motor system improves its linear range beyond expected central limits, if provided with symmetric interconnections. Given a bilateral (push-pull) sensory arrangement, non-linear sensor characteristics are actually advantageous. The greatest improvement in linear range of the reflex (here VOR) relies on intact sensors on both sides. In the case of a single sensor (unilateral head velocity input), or unmatched bilateral sensors, this study predicts a decrease in the linear range and the appearance of a variable bias. These implications are compatible with available data and can be tested in a clinical environment.

Animals↗
PubMed1991

Assessing neck extension-flexion as a basis for temporomandibular joint dysfunction.

In the August 1987 issue of the Journal of Oral and Maxillofacial Surgery, Weinberg and LaPointe published an article entitled "Cervical Extension-Flexion Injury (Whiplash) and Internal Derangement of the Temporomandibular Joint" in which they proposed an explantation for injury to the temporomandibular joint resulting from certain motor vehicle accidents. In this article, the previous mechanism is assessed and the authors conclude that it is inaccurate.

Acceleration↗
PubMed1991

Responses to prospective payment by rural New Mexico hospitals.

A cross-sectional study is used to determine how rural New Mexico hospitals altered service diversification, inpatient service emphasis, and service promotion during Medicare's prospective payment system (PPS) transition and posttransition phases. Results suggest that the hospitals implemented distinct strategies in response to PPS. The posttransition strategies were examined for their association with improved revenue and utilization indicators. Few of the service diversification and promotional strategies were consistent predictors of performance. Emphasis on fine-tuning inpatient services was the most promising predictor of higher utilization and revenue measures. The implications for other rural hospitals are discussed.

Cross-Sectional Studies↗
PubMed1990

Managing hospital-physician relations: a strategy scorecard.

Since the initiation of prospective payment, hospitals have been struggling to develop strategies that improve their prospects for long-run viability. Foremost among these strategy formulations have been efforts to build hospital-physician relations. This article reviews several popular strategies designed to achieve mutually satisfying hospital-physician relations.

Hospital Administration↗
PubMed1990

The effects of a pectin-supplemented elemental diet in a boy with short gut syndrome.

The effect of a pectin-supplemented diet in short gut syndrome was investigated in a 3-year-old boy. Nitrogen absorption was higher and stomach-to-anus transit time was prolonged during pectin supplementation of the enteral feed. Pectin supplementation had no adverse effects on electrolyte balance or glucose absorption. These data indicate that pectin supplementation of enteral feed may enhance nitrogen absorption and seems not to adversely affect absorption in short gut syndrome.

Child, Preschool↗
PubMed1990

Gastric emptying of liquids in cystic fibrosis.

Epigastric impedance recording was used to measure the rate of gastric emptying (GE) of a liquid test meal in 45 control children and 28 CF patients. Epigastric impedance was recorded in the fasting state and following ingestion of orange squash. In 8 controls and 8 CF patients the test was repeated with the addition of 1.25% fat to the test meal. Mean time to half-emptying (t1/2) was 13.5 min in controls and 15.6 min in CF patients (NS). The addition of fat to the test meal prolonged t1/2 in all controls and most CF patients. In those CF patients in whom GE of orange + fat was more rapid than orange alone, repetition of the test with added pancreatic enzymes reversed this effect. We concluded that GE of clear liquids in CF patients does not differ significantly from normal controls, and that most CF patients behave like controls in their response to fat in the test meal.

Adolescent↗
PubMed1979

Serotyping of non-cholera vibrios.

The serotyping system for non-cholera vibrios reported by us in 1965 has been re-evaluated and extended. Results from serotyping 2,624 cultures are presented. These isolates were accumulated over a period of 20 years and came from clinical and environmental samples in many parts of the world. Included is a discussion of the use of terms "Vibrio cholerae" and "non-cholera vibrios" for clinical reports.

Agglutination Tests↗
PubMed1977

On periodic solutions of a delay integral equation modelling epidemics.

A delay-integral equation, proposed by Cooke and Kaplan in [1] as a model of epidemics, is studied. The focus of this work is on the qualitative behavor of solutions as a certain parameter is allowed to vary. It is shown that if a certain threshold is not exceeded then solutions tend to zero exponentially while if this threshold is exceeded, periodic solutions exist. Many features or the numerical studies in [1] are explained.

Disease Outbreaks↗
PubMed1977

Antibacterial structure-activity relationships obtained with resistant microorganisms I: Inhibition of R-factor resistant Escherichia coli by tetracyclines.

Aparent partition coefficients and inhibitory activities against sensitive and resistant Escherichia coli were determined for 14 tetracyclines. The difference in the kinetics of inhibition of the two organisms is discussed in terms of their permeabilities. The partition coefficients were determined in an octanol-buffer system. Values for eight compounds were in general agreement with the literature; values for the remaining six compounds had not been reported previously. Growth of the organisms was determined by a single-point turbidimetric method in the presence and absence of tetracyclines. Inhibitory activities were obtained by a kinetic treatment. Derived rate constants for the sensitive organism were linearly related to antibiotic concentration. For the resistant organism and 12 compounds, the derived rate constants and antibiotic concentration were related in a manner typical of saturation kinetics. These inhibitory activities were related to the partition coefficients, while activities against the sensitive strain were not. These findings suggest that activity against the resistant strain is permeability controlled but that activity against the sensitive strain has a different rate-determining step.

Depression, Chemical↗
PubMed1977

The effect of anaerobiosis and bile salts on the growth and toxin production by Vibrio cholerae.

Environemntal conditions which might be present in the human intestinal lumen, such as anaerobiosis, a temperature of 37 degrees C and the presence of bile salts, were examined for their effects on the growth and toxin production by Vibrio cholerae strains 569B and B1307 in Syncase and in peptone water media. Using aerobic conditions at 30 degrees C, which are commonly used for enterotoxin production, toxin (5 mug ml(-1)) and pleomorphic cells were detected during the exponential phase of the growth cycle. When the incubation temperature was raised to 37 degrees C, no toxin ( less than 0-1 mug ml(-1)) and no pleomorphic forms were found. In cultures incubated anaerobically at 30 or 37 degrees C, the organisms grew poorly, forming pleomorphic cells which lysed after the cultures reached a maximum turbidity at 640 nm of 1-45 at 12 h. Toxin (2-5 mug ml(-1)) was present at 12, 24 and 48 h. When 0-1% sodium deoxycholate was incorporated into the culture medium, growth was inhibited under aerobic conditions at 30 and 37 degrees C. At 30 degrees C under aerobic conditions and at 37 degrees C under anaerobic conditions, the toxin yield was not significantly affected by the presence of sodium deoxycholate; but at 37 degrees C under aerobic conditions, sodium deoxycholate caused an increase in the toxin yield (5 mug ml(-1)) due to the release of cell-bound toxin.

Aerobiosis↗
PubMed1976

Naturally occurring Tyzzer's disease as a complication of distemper and mycotic pneumonia in a dog.

Tyzzer's disease, distemper, and mycotic pneumonia were diagnosed at necropsy of a 6-week-old mixed breed pup. The illness was characterized by lethargy, poor appetite, dysentery, and convulsions, the latter developing just prior to death. The necropsy findings included pale, dilated large intestine and swollen, dark liver. Histologically, multifocal hepatic necrosis, similar to that of Tyzzer's disease in other species of animals, was observed. Bacillus piliformis was found in hepatocytes and necrotic areas of the liver.

Animals↗