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Biomedical subjects

J A Marr

Publications and source records attributed to J A Marr.

7 recordsLinked to original sources
PubMed1997

Work redesign: a case study.

This paper details the implementation experience of a work redesign process in a neurosurgical setting in a large community hospital, from conception to "live" demonstration. First, the concept of work redesign is explored, in relation to its underpinnings and its application in the health care setting. Work redesign has two elements: first, it involves the reconfiguration in the job or work role itself and second, a change in the way work is actually performed. Next, the model as it was conceived by the organization, is described. While the "high level" or organizational-wide design was constructed by a central steering team, we recognized the need to customize the model to the unique needs of each clinical service area. Finally, implementation is discussed, including structure, process, evaluation and critical success factors.

Canada↗
PubMed1994

Patient restraint: choosing the proper equipment.

In response to the Ontario Hospital Association's position paper describing the use of restraints, the Toronto Hospital responded by developing a "least restraint" policy and procedure. In the developmental stages, various types of equipment were evaluated. This paper describes the equipment selected by the safety task force and the rationale for its use.

Humans↗
PubMed1993

Bacterial and human cell mutagenicity study of some C18H10 cyclopenta-fused polycyclic aromatic hydrocarbons associated with fossil fuels combustion.

A number of isomeric C18H10 polycyclic aromatic hydrocarbons (PAHs), thought to be primarily cyclopenta-fused PAHs, are produced during the combustion and pyrolysis of fossil fuels. To determine the importance of their contributions to the total mutagenic activity of combustion and pyrolysis samples in which they are found, we characterized reference quantities of four C18H10 CP-PAHs: benzo[ghi]fluoranthene (BF), cyclopenta[cd]pyrene (CPP), cyclopent[hi]acephenanthrylene (CPAP), and cyclopent[hi]aceanthrylene (CPAA). Synthesis of CPAA and CPAP is described. The availability of reference samples of these isomers also proved to be an essential aid in the identification of the C18H10 species often found in combustion and pyrolysis samples. Chemical analysis of selected combustion and pyrolysis samples showed that CPP was generally the most abundant C18H10 isomer, followed by CPAP and BF. CPAA was detected only in pyrolysis products from pure PAHs. We tested the four C18H10 PAHs for mutagenicity in a forward mutation assay using S. typhimurium. CPP, BF, and CPAA were roughly twice as mutagenic as benzo[a]pyrene (BaP), whereas CPAP was only slightly active. These PAHs were also tested for mutagenic activity in human cells. In this assay, CPP and CPAA were strongly mutagenic but less active than BaP, whereas CPAP and BF were inactive at the dose levels tested. Also, the bacterial and human cell mutagenicity of CPAA and CPAP were compared with the mutagenicity of their monocyclopenta-fused analogs, aceanthrylene and acephenanthyrlene. Although the mutagenicities of CPAP and acephenanthrylene are similar, the mutagenic activity of CPAA is an order of magnitude greater than that of aceanthyrlene.

Cell Line↗
PubMed1992

Implementing managed care and case management: the neuroscience experience.

The case management model for patient care in the neuroscience area was recently implemented in the neurosciences area at a tertiary care hospital. Understanding of the concepts of case management and managed care were essential to the implementation process. Clustering of case types and appointment of group leaders made the development of individual care maps a manageable task. Case management of 2 case types, Parkinson's disease and Guillain Barré syndrome are described, including the rationale for selection, care map development and education. The process of continuing education focused on operational issues regarding utilization of the map and professional issues such as health teaching responsibilities.

Cost Control↗
PubMed1991

Spinal cord testing: auditing for quality assurance.

A quality assurance audit of spinal cord testing as documented by staff nurses was carried out. Twenty-five patient records were examined for accuracy of documented testing and compared to assessments performed by three investigators. A pilot study established interrater reliability of a tool that was designed especially for this study. Results indicated staff nurses failed to meet pre-established 100% standard in all categories of testing when compared with investigator's findings. Possible reasons for this disparity are discussed as well as indications for modifications in the spinal testing record, teaching program and preset standards.

Autonomic Nervous System↗
PubMed1991

The experience of living with Parkinson's disease.

This phenomenological study examined the experience of living with Parkinson's disease. Data were collected from six individuals during open-ended interviews conducted in subjects' homes. Interviews were tape recorded, transcribed verbatim and then subjected to content analysis. Four themes emerged from data analysis. The experience of living with Parkinson's disease involved impact of the disease, dealing with the disease, maintaining independence and normality, and effort. Impact of the disease involved personal losses of mobility and social activity. The perceived loss of independence and normality resulted in a changed self-concept. Dealing with the disease involved specific strategies and resources such as health and social support. The goal which kept subjects going was to maintain independence and normality. The overriding theme was effort; effort was involved in every aspect of life with Parkinson's disease. Implications for nursing practice and research are discussed.

Activities of Daily Living↗