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Biomedical subjects

J G Baker

Publications and source records attributed to J G Baker.

At least 19 recordsLinked to original sources
PubMed2001

Adolescent girl's coping with an STD. Not enough problem solving and too much self-blame.

STUDY OBJECTIVE: Approximately three million teenagers are infected with an STD each year. The ways in which an adolescent girl copes with an STD may have implications for future risk and for psychological adjustment. The purpose of the current study was to compare whether coping with an STD was similar to coping with other stressors. SETTING: Urban, hospital-based adolescent medicine clinic. DESIGN AND PARTICIPANTS: Sixty-seven girls with a mean age of 15.9 (sexual debut was 13.8) yr completed the KIDCOPE in response to both an STD acquisition and an interpersonal stressor within the previous 6 months. RESULTS: Problem solving was used less often, and self-blame was used more often, in response to an STD acquisition. Frequency of use of self-blame was not correlated with perceived helpfulness. CONCLUSIONS: These findings suggest that clinicians need to help adolescent girls manage STD acquisition from the perspective of problem solving rather than self-blame.

Adaptation, Psychological↗
PubMed2001

Reporter-gene systems for the study of G-protein-coupled receptors.

Reporter-gene assays offer an alternative to biochemical assays for following signal transduction pathways from receptors at the cell surface to nuclear gene transcription in living cells. Specific reporter-gene systems are now available for the study of ligand activity at G alpha(i/o), G alpha(s) and G alpha(q) G-protein-coupled receptors. In recent years reporter genes have been applied in academia and industry to the study of ligand efficacy and affinity in recombinant and primary cell lines using a variety of colour, fluorescent or luminescent read-outs.

Animals↗
PubMed2001

Engaging community mental health stakeholders in pharmacy cost management.

To improve the cost-effectiveness of psychotropic medications, a process was established to involve all stakeholders in a seven-county public-sector behavioral health managed care plan in the development of formulary guidelines. After delineation of the issues and of possible strategies, proposed formulary guidelines were drafted and presented to the stakeholders in a series of meetings. The stakeholders were also educated about pharmacy cost management issues and possible strategies. The guidelines were modified on the basis of the feedback obtained from stakeholders, and the consensus formulary guidelines were adopted. Within ten weeks of implementation of the guidelines, monthly medication costs had declined by 3 percent from baseline, although the number of medication users increased by 3 percent over the same period. There were few complaints about the guidelines. Effective, consensus-driven, medication cost-containment strategies can be implemented through a process of engagement and education of stakeholders in a community mental health plan.

Community Mental Health Services↗
PubMed2000

Prevalence and identification of problems in daily functioning in a primary medicine clinic.

PURPOSE: This pilot study compares scores on a health status/functional assessment measure to clinician identification of problems in functioning and referrals for these problems, based on examination of information in the patient's medical chart. METHOD: A sample of 194 participants at a primary medicine clinic in an urban general hospital completed a measure of health status and functioning, the Medical Outcomes Trust Short Form 36 (SF-36). Chart reviews were conducted to assess whether problems in functioning were addressed by the primary care clinician. RESULTS: Overall, levels of functioning on the scales of the SF-36 were well below norms for the general US population from the Medical Outcomes Study. Older adults showed lower physical functioning and higher emotional functioning than younger adults. Participants with 1, 2, or 3 chronic conditions showed increasingly lower levels of physical functioning. For participants with functional assessment scale scores in the lowest quartile, problems in functioning noted in the chart ranged from 13%-28%. Only 6% 20% of participants with marked problems in functioning were referred for further assessment or treatment. CONCLUSIONS: Functional problems are frequently important indicators of risk of development of secondary complications and need for referral. Questionnaire screening may increase identification and referral for problems in functioning in primary care settings.

Activities of Daily Living↗
PubMed2000

Lime disease?

Explore the source record for details and available documents.

Adolescent↗
PubMed2000

Using quality improvement teams to improve documentation in records at a community mental health center.

OBJECTIVE: A community mental health center sought a system for qualitative review of patients' records to improve the quality of documentation through the engagement of clinical staff in the review process. METHODS: The center developed a quality improvement system in which treatment team clinicians use a scored 30-item protocol to measure the quality of record documentation by peers. Questions address whether the record documents the full range of the psychiatric treatment process, including assessment and diagnosis, treatment planning, and provision of clinical services. Other questions address specific contractual or regulatory requirements, such as whether procedure codes are correct, and evaluate the physician's record of medication management. Each treatment team at the mental health center's six clinics has a quality improvement work group, composed of the team psychiatrist and at least one other team clinician. Each month the work group meets to review two randomly selected medical records from another treatment team at the same clinic and arrive at a consensus score. An administrative oversight team meets regularly with clinician-reviewers to foster uniform scoring of the protocol throughout the center. RESULTS: An analysis of the trend in protocol scores over a 21-month period suggests that the procedure improves the quality of the documentation in patients' records. CONCLUSIONS: A team-based quality review process appears to have a positive impact on the quality of medical record documentation. Improved documentation may improve continuity of care and improve the accuracy of record information used for other quality measurement systems.

Community Mental Health Centers↗
PubMed1999

Relationship between perceived parental monitoring and young adolescent girls' sexual and substance use behaviors.

STUDY OBJECTIVE: The purpose of the study was to examine the independent effects of perceived parental monitoring on sexual experience, contraceptive, and substance use. DESIGN, SETTING, AND PARTICIPANTS: Adolescent females at an urban-based adolescent clinic (N = 174; 41% sexually experienced) rated the extent to which they were directly and indirectly monitored by their parents. MAIN OUTCOME MEASURES: These perceptions were compared with reported contraceptive use as well as substance use. Direct parental monitoring was best described using two dimensions: direct monitoring and direct monitoring when with peers. RESULTS: Direct monitoring was found to be associated with the use of hormonal birth control methods at last intercourse. Direct parental monitoring when with peers was found to be associated with less use of alcohol and cigarettes. CONCLUSIONS: These data suggest that parental monitoring is a relevant factor for primary care physicians to explore during treatment.

Adolescent↗
PubMed1999

Perceived ideological differences, job satisfaction and organizational commitment among psychiatrists in a community mental health center.

Physician turnover has long been a problem in community mental health centers. While explanations for the problem have been offered, there have been no systematic studies of factors associated with the high turnover. In this study, the Minnesota Satisfaction Questionnaire and the Organizational Commitment Questionnaire were given to psychiatrists employed by a community mental health center. Subjects were also asked to identify their treatment ideology, and to rate their perception of the ideology of other clinicians and administrators with whom they work. Psychiatrists perceived significant differences in many ideological areas. Analysis demonstrated a correlation between these differences and the commitment of the psychiatrists to the organization.

Community Mental Health Centers↗
PubMed1998

The development of prejudice towards gays and lesbians by adolescents.

The authors studied the development of gay and lesbian prejudice in white, suburban adolescents in grades 7, 9, and 11. Results parallel several major findings with adults: males were more prejudiced than females; this difference was greater towards gay males than lesbians; and same-sex prejudice was greater than opposite-sex prejudice. For males and females prejudice increased between grades 7 and 9, but from grades 9 to 11 it decreased for females and increased for males. These differences were explained by the increased vulnerability of males to defensive reactions in response to the prospect of intimate relationships. None of the personality measures were significantly correlated with prejudice.

Adolescent↗
PubMed1997

A spreadsheet method for calculating maximum caseload and intake capacity for CMHC psychiatrists.

OBJECTIVE: A method was sought to help administrators of community mental health centers determine a level of psychiatric staffing that is both cost-efficient and ensures high quality of care. METHODS: A survey of staff psychiatrists was conducted at a large community mental health center with seven outpatient clinics. The survey measured variables that can affect staffing requirements, including the number of hours psychiatrists have available for direct care, their preferred intervals between a patient's return visits, and the duration of appointments for an initial psychiatric assessment and for medication maintenance. A computer spreadsheet was developed to calculate the caseload capacity and intake capacity for clinics of the center. RESULTS: The survey indicated that the psychiatrists at the center had an average of 33 hours a week available for direct care. The mean preferred time between a patient's medication maintenance visits was 7.3 weeks. The mean time required for a psychiatric assessment was 80 minutes, and for a medication maintenance visit it was 33 minutes. With these data, the spreadsheet method was used to calculate intake and caseload capacity for psychiatric staff at three of the center's clinics. CONCLUSIONS: The data-based approach to calculating capacity can be modified to meet local needs. It brings objectivity to decision making about staffing, and the methods can improve resource management and enhance relationships between stakeholders and physicians.

Community Mental Health Centers↗
PubMed1996

Memory and emotion processing in cortical and subcortical dementia.

Findings from studies of implicit-memory dissociations, emotion processing, and emotion-memory phenomena were integrated with reference to distinctions between so-called cortical and subcortical dementia. Hemispheric distinctions and implications for normal psychological processes are discussed.

Alzheimer Disease↗
PubMed1995

Monitoring in methadone maintenance treatment.

Weekly preannounced and unannounced urine testing was compared in a counterbalanced design with two random samples of clients (n = 74) from a methadone maintenance program. Results indicated no significant differences in the detected rate of positive specimens for the two types of testing. Clients reported preference for the preannounced testing and indicated that testing was not very helpful in avoiding the use of illicit drugs. The merits of psychosocial procedures in response to the outcome of monitoring are discussed.

Adult↗