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Biomedical subjects

I Jacoby

Publications and source records attributed to I Jacoby.

At least 19 recordsLinked to original sources
PubMed1996

Disaster preparedness of poison control centers in the United States.

OBJECTIVE: To assess the state of disaster readiness of poison control centers, a survey questionnaire was sent to all 96 institutional poison control center members of the American Association of Poison Control Centers in the US, both certified and noncertified programs. DESIGN: The data reported are the results and responses from 76 of 96 (79.2%) poison control centers. RESULTS: Fifty-four percent of responding centers have written disaster plans, with 25% having drills to practice the plans. Of the centers that do not have a written plan, the majority have policies and procedures in place to address physical plant damage, increased phone traffic, loss of phone systems and malfunction of computers. Eighty-six percent of respondents have a back up generator, and 82% have an uninterruptable power supply in place. Fifty-four percent have a back up phone system and 33% have cellular phone capacity. Forty-six percent of responding centers have arrangements with other agencies in the event of a disaster. Only half of the managing directors of the responding centers believe their center can meet the public's needs in the event of a disaster.

Disaster Planning↗
PubMed1995

Forecasting requirements for physical therapists.

In response to the existing undersupply of physical therapists and the projected changes of the health care reform era, it is prudent for the profession to consider implementing a training strategy that would bring the supply of physical therapists in line with requirements. Before such a training strategy could be developed, however, the physical therapy community would need to produce a requirements forecast. This article compares the uses and limitations of the two major methods for generating health professions requirements--the "need-based" and "demand-based" approaches--and recommends a pragmatic, tailored approach to determining physical therapist requirements that uses easily obtainable data on staffing patterns of managed care plans. The proposed method draws from both need-based and demand-based models to produce complementary data on which to base policy formation.

Forecasting↗
PubMed1993

Predicting the course of disease.

The ability to predict the course of disease and the effect of interventions is critical to effective medical practice and health care management. In this analysis, we sought to test whether available clinical data and analytic methodologies can be used to accurately predict the time course of the probability of death after hospital admission and the probability of readmission following discharge for patients with acute myocardial infarction or pulmonary disease. We grouped patients by selected physiologic characteristics and made time-to-event predictions using multiple regression models. These predictions were compared with observed probabilities calculated using the actuarial or life-table method. Predictions made with the Bailey-Makeham model generally replicated observed experience. They accurately accounted for substantial differences in the patterns of death and readmission and accurately delineated the effects of therapies, after adjustment for patient risk. These results were validated by analyses of resampled populations that differed in case mix from the source population. We believe that using such models to project the course of disease and the effects of treatment on that course in defined classes of patients should facilitate the development of practice guidelines for patient care and the management of health care resources.

Disease↗
PubMed1986

Direct mailing as a means of disseminating NIH consensus statements. A comparison with current techniques.

The Office of Medical Applications of Research of the National Institutes of Health conducted a survey to evaluate the effectiveness of mass mailing of consensus statements as compared with traditional dissemination methods. The consensus statement on osteoporosis, published earlier in JAMA, was selected for study. Physicians (N = 695) within each of five relevant specialties in two comparable metropolitan areas were surveyed. Findings suggest that while a small but significant increase of awareness resulted from direct mailing, this increase should be weighed against costs and effectiveness of other methods.

Information Services↗
PubMed1984

Single-dose amoxicillin therapy of acute uncomplicated urinary tract infections in women.

Of 210 women who were experiencing dysuria, frequent urination, pyuria, and significant bacteriuria and who were treated with a single 3-g dose of amoxicillin, 165 (79%) were cured of their original infections. Patients with infections that were negative by antibody-coated-bacteria assay were cured at a significantly higher rate than those with infections that were positive by antibody-coated-bacteria assay (90 versus 59%; P less than 0.001). Similarly, those with infections caused by amoxicillin-susceptible organisms were cured at a significantly higher rate than those with infections caused by resistant organisms (85 versus 50%; P less than 0.001). Of 27 patients who had infections caused by amoxicillin-susceptible organisms and who had relapses after single-dose therapy, 14 (52%) had relapses again after a conventional 10-day course of therapy, although all responded to a 6-week course. An additional 27 patients experiencing dysuria, frequent urination, and pyuria but who had a lower number of uropathogens in the urine (10(2) to 10(4.5)/ml of urine) were treated with single-dose therapy, with a 100% eradication of organisms and an 89% rate of symptomatic relief.

Acute Disease↗
PubMed1981

Graduate medical education. Its impact on specialty distribution.

A model was developed that describes the flow of residents through the graduate medical education (GME) system (derived from anonymous GME histories of the 160,000 US medical school graduates [1960 to 1977] on the American Medical Association's physician's master file in 1979). The model showed ultimate specialty distribution among practitioners as a function of specialty distribution among residents at entry to GME indicating that an increase in family practice residents will probably yield an increase in primary care practitioners, owing to the lower level of attrition from family practice residencies as opposed to specialists in internal medicine and pediatrics. Increases in first-year family medicine residencies led to decreases in primary care residencies as a whole led to increases in internal medicine subspecialists but to decreases in surgical subspecialists.

Career Choice↗
PubMed1981

Demographic factors associated with physician staffing in rural areas: the experience of the National Health Service Corps.

To determine which demographic factors favor rural communities obtaining physicians, county characteristics of National Health Service Corps sites are analyzed. Through the use of a difference of means test, sites which were staffed at least once are compared with sites which were never able to obtain physicians. Since a major portion of the sites never staffed were located in the Southeast, the effect of "southeast location" as a separate, binary variable is considered. Five factors related to income, employment and education significantly (p less than 0.01) distinguish the staffed from the "never-staffed" sites. A function derived from discriminant analysis correctly classifies more than 70 per cent of the sites as staffed or never-staffed; inclusion of the southeast variable increases the number of correctly classified sites by 6 per cent. Given the presence of both socioeconomic and nondemographic constraints on rural communities, significant improvements in physician distribution may require that programmatic interventions be intensified.

Demography↗
PubMed1980

Successful treatment of cerebral cryptococcoma and meningitis with miconazole.

Cryptococcal meningitis and a cerebral cryptococcoma developed in a patient with pulmonary cryptococcosis ("coin lesion") shortly after infected area of lung was removed. Treatment with amphotericin B and flucytosine failed to clear the organisms and antigen from the spinal fluid or alter the neurologic manifestations related to the cerebral lesion. Therapy with miconazole cured the meningitis and led to disappearance of the lesion in the brain (serial computed tomographic scan). Study of the patient over the next 5 years disclosed no evidence of relapse of infection and completely normal findings on neurologic examination.

Brain Diseases↗