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Biomedical subjects

J Churchill

Publications and source records attributed to J Churchill.

12 recordsLinked to original sources
PubMed1999

Organizational culture in the changing workplace: an employee assistance program perspective.

The rapid change experienced in the work world today results in an often dramatic change in the organizational culture. In the process of culture change, employees experience loss of identity and loss of meaning in their work. These losses will manifest themselves in the workplace in the form of withdrawal, isolation, the failure of teamwork, and a high conflict milieu. It is helpful to the effective navigation of the change process to facilitate the grieving of these losses. Only when these losses have been successfully mitigated will employees experience a resurgence of energy and commitment.

Burnout, Professional↗
PubMed1997

Long-term outcome of inpatients with tuberculosis assigned to outpatient therapy at a local clinic in New Orleans.

BACKGROUND: To characterize the New Orleans tuberculosis (TB) patient population and determine what factors might influence outcome, we followed inpatients with active disease at a large, public hospital who then received outpatient treatment at a public clinic. METHODS: A total of 61 patients were enrolled from January 1, 1993 through July 1994 and followed until no patients were actively receiving treatment. Demographic and psychosocial data were collected and associated with the number of months of treatment received and final outcome. RESULTS: Of the 61 patients, 26 (43%) completed treatment, 15 (25%) were lost to follow-up, 11 (18%) died, and 9 (14%) were referred out of the area during treatment. Among those lost to follow-up, 60% received only one month of treatment. Homelessness was the only factor significantly related to whether or not a patient completed outpatient therapy (p = .02) with almost 60% of all homeless patients becoming lost to follow-up. Assignment to directly observed therapy (DOT) did not significantly raise compliance rates. HIV status did not significantly alter the duration of treatment, but these patients had a mortality rate 3 times that of the other patients. CONCLUSIONS: Efforts to improve TB control should focus on increasing compliance, particularly among the homeless. Although expansion of DOT is essential, raising therapy completion rates to acceptable levels may require additional social services, financial incentives and enforceable legal remedies for noncompliance. More rigorous treatment guidelines are needed to assure consistent management of patients who receive interrupted treatment.

Adult↗
PubMed1992

Trichomonas vaginalis (TV) and human papillomavirus (HPV) infection and the incidence of cervical intraepithelial neoplasia (CIN) grade III.

The temporal relationship between cervical infection with Trichomonas vaginalis (TV) or human papillomavirus (HPV) and the incidence rate of cervical intraepithelial neoplasia grade three (CIN III) was examined in a cohort of 43,016 Norwegian women. From 1980 to 1989, a cervico-vaginal infection from TV and HPV was diagnosed cytologically in 988 and 678 women, respectively. During the 181,240 person-years of observation, 440 cases of CIN III/cervical cancer developed. The age-adjusted incidence rates (IR) of CIN III were 225 per 100,000 person-years among women with no cytologic evidence of infection, 459 among women with TV infection, and 729 among women with HPV infection. A multiple regression model yielded a relative rate (RR) of CIN III of 2.1 (95 percent confidence interval [CI] = 1.3-3.4) among women with TV infection and 3.5 (CI = 1.9-6.6) among women with HPV infection, compared with women with neither infection. As CIN can be misclassified as HPV infection, the entry Pap-smears of 10 women with HPV infection who later developed CIN III were re-examined. Excluding the four discordant cases with the corresponding person-years decreased the RR of CIN III to 2.1 (CI = 0.9-4.8). Our report demonstrates the limitations of studies that rely only on cytologic detection of HPV infection. Nevertheless, the results support the hypothesis that HPV is a causal factor for CIN III lesions, and also display an association between TV infection and cervical neoplasia.

Adult↗
PubMed1992

A psychoeducational model of management consultation: evaluation and follow-up.

Evaluation and follow-up are an integral part of business today. For the creative management consultant, it presents the challenge of incorporating as many feedback mechanisms as possible into the consultation process itself. The management consultation then becomes a continuously evolving, self-correcting service designed to better meet the needs of the consumer.

Consultants↗
PubMedDate not supplied

Limited approach to the right flank for placement of a duodenostomy tube.

A new enterostomy tube placement technique is described for provision of nutrients into the duodenum. Placement of the duodenostomy tube (d-tube) is performed through a limited right flank approach under sedation and local anesthesia. Seven client-owned animals (three dogs and four cats) requiring enteral nutritional support were selected for d-tube placement. Patients were fed via the d-tube for two to 28 days. Complications included discomfort when manipulating and exteriorizing the duodenum, discomfort with bolus feedings, local cellulitis, and tube site infection. All complications resolved without further incident. This technique should be considered in patients that are not good candidates for prolonged general anesthesia or esophageal or gastric feeding, or patients being mechanically ventilated.

Animals↗