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Biomedical subjects

J J Baker

Publications and source records attributed to J J Baker.

At least 19 recordsLinked to original sources
PubMed2001

Using an integrated measurement system as a common language: lessons from the U.S. Army medical department.

The Process of developing an integrated measurement system for the U.S. Army Medical Department (AMEDD) is examined in this study. A fundamental issue is whether the measures of performance accumulated by any information system are the correct ones and whether these measures appropriately reflect managers' decision making. Measurement is proposed as a solution to performance barriers. The four steps involved in building the AMEDD integrated measurement system (IMS) model are set out. Strategy is explored as the key input to the IMS model. An activity-based management (ABM) model that can support the required IMS cost-based measures is also described and the interrelationship between the two models is illustrated. The key test for application of the IMS model will be whether linking strategy and measurement results in information that improves decision making.

Benchmarking↗
PubMed2000

Managing the cost of care: a predictive study to identify critical care patients at risk for nosocomial pneumonia.

Nosocomial infections represent a major health problem and can have a significant impact on the cost of treating a patient. Hospital-acquired pneumonia (HAP) is the second most common nosocomial infection in the United States and the leading cause of death due to a nosocomial infection. The high prevalence of HAP and its significant impact on increased length of stay and incremental treatment costs identify nosocomial pneumonia (NP) as a key component in managing the total cost of care. The study's objective was to develop a predictive tool for identifying those adult patients in critical care (CC) who are at greatest risk of developing NP to better manage the costs of care. The authors also expected to determine the expected probability of a patient developing NP in CC. A prospective study of longer stay critical care unit (CCU) patients was performed in nine U.S. CCUs. There were no interventions in the study. Development was based on variables common to CC and specific patient profile risk factors. Twelve statistically significant and clinically meaningful risk factors were identified and placed in a sequential cascade fashion. The positive predictive value of the sequential decision process and corresponding tool was 87.03 percent.

Adult↗
PubMed1998

Identifying costs for capitation in psychiatric case management.

This article presents an example of how one hospital identified costs for capitation in psychiatric case management. An 18-month postacute case management pilot project collected data on a nurse-specific and patient-specific basis. Costs were identified using activity-based costing methodology.

Accounting↗
PubMed1997

Activity-based costing in the operating room at Valley View Hospital.

This article presents an example of how one hospital reports the results of activity-based costing (ABC). It examines the composition and supporting assumptions of an ABC report for a particular procedure in the operating room (OR). It describes management uses of the information generated. It comments upon how the continuous quality improvement (CQI) is synchronized with the ABC reporting.

Accounting↗
PubMed1995

They may want to take charge, but can physicians really organize?

Current managed care network models include physician organizations (POs) and fully integrated regional groups (FIRGs). Proper organization of such networks requires a sequence of essential organizational decisions. If physicians are to organize properly, they must avoid three major pitfalls. Of these, the loss of autonomy is the greatest threat. The proper fit of organizational structure with the founders can assist the entire process significantly.

Decision Making, Organizational↗
PubMed1995

Activity-based costing for integrated delivery systems.

The paradigm shift toward managed care is fueling new cost-finding demands. More sophisticated methods are emerging to meet these demands. Foremost among the new methods is activity-based costing (ABC). ABC is designed to eliminate cross-subsidies between products or services. Because costs are traced by activities across departments and cost centers, costs can also be traced by activities across integrated delivery systems (IDSs). The methodology makes ABC very applicable to combinations of providers including chains, affiliated groups, and IDS participants.

Cost Allocation↗
PubMed1994

Lipoteichoic acid from Streptococcus sanguis is a natural glucosyl acceptor for glucosyltransferases.

The synthesis of methanol insoluble-[14C]labeled-polymers from [14C]sucrose by S. mutans glucosyltransferases was stimulated up to four-fold by the presence of highly purified, lipoteichoic acid (LTA) from S. sanguis. Gel filtration chromatography (Sepharose 4B) and ion exchange chromatography (DEAE-Bio-Gel A) of the [14C]labeled-polymers formed in the presence of [3H]glycerol-labeled-LTA showed that high molecular weight, negatively charged [14C]labeled-[3H]glycerol-labeled-LTA complexes were being formed. The [14C]component was identified as glucose by acid hydrolysis and paper chromatography. A similar high molecular weight, negatively charged [14C]glucosyl-[3H]glycerol-labeled-polymer was extracted from S. mutans cells grown in the presence of [3H]glycerol and [14C]sucrose, suggesting that LTA is a glucosyl-acceptor for glucosyltransferases in vivo as well as in vitro.

Chromatography, Gel↗
PubMed1993

Biosynthesis and characterization of phosphatidylglycerophosphoglycerol, a possible intermediate in lipoteichoic acid biosynthesis in Streptococcus sanguis.

A membrane enzyme preparation from Streptococcus sanguis was shown to convert sn-[14C]glycerol 3-phosphate and CDP-diacylglycerol (or deoxyCDP-diacylglycerol) into a series of progressively higher-molecular-weight [14C]oligophosphoglycerophospholipids in vitro. The first oligophosphoglycerophospholipid to accumulate (termed lipid-1) was purified to homogeneity; chemical analysis, gas-liquid chromatography and chemical degradation studies indicated the most likely structure to be phosphatidylglycerophosphoglycerol (PGpG). PGpG is formed directly from two molecules of phosphatidylglycerol (PG), one molecule of PG serving as a sn-glycerol 1-phosphate (pG) donor and the second serving as the pG acceptor, with co-production of diacylglycerol. These oligophosphoglycerophospholipids may be intermediates in the biosynthesis of lipoteichoic acids.

Carbon Radioisotopes↗
PubMed1992

Antemortem diagnosis of cholangiocellular carcinoma in a horse.

A 10-year-old Tennessee Walking Horse gelding was admitted to the veterinary teaching hospital for evaluation of intermittent fever, lethargy, and anorexia. Initial laboratory analyses revealed anemia and hyperfibrinogenemia. Abdominocentesis and thoracentesis yielded fluid samples with high nucleated cell counts and total protein concentrations. The tentative diagnosis was nonseptic peritonitis. The horse did not improve after 4 days of antimicrobial treatment, and pitting edema of the ventral midline developed. Thoracic radiography and ultrasonography revealed consolidation of the ventral aspect of the lung fields and pleural effusion. Pleuroscopy of the right hemithorax revealed pleural effusion and a soft-tissue mass in the caudal portion of the mediastinum. Findings on biopsy of the liver and mediastinal mass led to a presumptive diagnosis of metastatic cholangiocellular carcinoma. The horse was euthanatized, and the diagnosis was confirmed at necropsy.

Animals↗
PubMed1992

Natural medicine.

Explore the source record for details and available documents.

Complementary Therapies↗
PubMed1989

Prostatic carcinoma presenting with neck metastasis.

Prostatic carcinoma is the second leading cause of cancer mortality in American men. Twenty-seven thousand deaths from this aggressive neoplasm were predicted for 1987. Although this malignancy has metastasized to almost all of the structures in the head and neck, it demonstrates a pathophysiologic proclivity for the supraclavicular lymph nodes. Combining fine-needle aspiration with immunohistochemical techniques produces a cost-effective method to expedite the diagnosis of this hormone-responsive tumor. Four patients presenting with prostatic carcinoma and neck metastasis in a three-year period are reported and discussed.

Acid Phosphatase↗
PubMed1985

Peptidoglycan from the potentially pathogenic oral bacterium Actinomyces viscosus is a B-cell mitogen.

Cell walls and peptidoglycan from Actinomyces viscosus, strain M-100 were compared for their ability to act as mitogens with spleen cells from germ-free Fischer rats. The cell walls were prepared from trypticase soy broth grown whole cells using a French press, followed by two consecutive washes with 0.1 M tris-HCl buffer, pH 8.0, 1 M NaCl and distilled water. Peptidoglycan was prepared from cell walls by three consecutive formamide extractions at 165 degrees C. On a dry-weight basis, the peptidoglycan was a significantly-better mitogen than cell walls, suggesting that the peptidoglycan is the major mitogenic component of A. viscosus cell walls. Mononuclear spleen cells were separated on a Nylon-wool column into a non-adherent subpopulation enriched for T lymphocytes and a weakly-adherent, plunger-removable subpopulation enriched for B lymphocytes. The non-adherent T-cell subpopulation responded strongly to the T-cell mitogen PHA, but was unresponsive to both the peptidoglycan and cell walls from A. viscosus. In contrast, the weakly-adherent enriched B-cell subpopulation was less responsive to PHA, but was strongly stimulated by A. viscosus peptidoglycan and cell walls. These results indicate that peptidoglycan and cell walls from A. viscosus are B-cell mitogens.

Actinomyces↗
PubMed1985

The stimulation of human peripheral blood lymphocytes by oral bacteria: macrophage and T-cell dependence.

Human peripheral blood mononuclear lymphocytes from individuals with moderate periodontitis were separated into purified subpopulations of T lymphocytes and B lymphocytes by rosetting with sheep red blood cells (E). All three lymphocyte subpopulations were compared for proliferative responses to cell walls from seven oral bacteria, phytohemagglutinin (PHA), pokeweed mitogen (PWM), lipopolysaccharide (LPS), and streptolysin-O (SLO). Mononuclear cells and a re-combined subpopulation consisting of four parts purified T lymphocytes and one part B lymphocytes responded significantly to all of the stimulants. Purified T lymphocytes by themselves responded significantly to PHA and PWM, but were unresponsive to oral bacteria and SLO; however, T lymphocytes cultured with 2% autologous macrophages responded significantly to all seven oral bacterial cell walls and to SLO, which indicates that T-cell responses to oral bacteria are macrophage-dependent. T-cell-depleted non-E-rosette-forming B cells by themselves were poorly responsive to all of the tested stimulants; however, the responses of these cells to oral bacteria, PWM, LPS, and SLO increased significantly in the presence of 10% mitomycin-C-treated T cells, demonstrating that B cell proliferation to these stimulants is T-cell-dependent.

B-Lymphocytes↗