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Biomedical subjects

J M Cairns

Publications and source records attributed to J M Cairns.

8 recordsLinked to original sources
PubMed1998

How to involve staff in developing an outcomes-oriented organization.

Outcomes management requires the active participation of clinical staff and/or network providers to succeed. They form the bedrock of the system, since they are the ones who most typically administer the outcomes assessment questionnaires to consumers, encourage them to complete them, and respond to questions and complaints about them. Resistance from clinicians can cause even the most well-designed outcomes management system to fail. Yet with the application of several basic principles, organizations can maximize active participation from its clinicians to operate a dynamic outcomes management system. The authors of this article describe the principles involved, and the action steps necessary to implement them. These principles include: articulate the value of the outcomes management system, involve clinical staff in its design, make it relevant to treatment goals, assure clinicians the system will not be used punitively, show them how it will be used to improve treatment, obtain staff feedback routinely on how the system is working, and demonstrate how the organizational culture from top management down uses the outcomes information to make decisions.

Attitude of Health Personnel↗
PubMed1984

The treatment of rupture of the pregnant uterus. Analysis of 93 cases treated in a rural hospital in Zambia.

In this study 93 cases of uterine rupture, treated in a rural hospital in Zambia have been analyzed. Clinical characteristics and mortality rate were found to be comparable to those reported in other series from developing countries. An attempt was made to compare the outcome of various surgical procedures. No statistically significant differences were found between the mortality rates after repair, subtotal and total hysterectomy (12%, 13% and 28%, respectively). A survey of recent literature on the treatment of uterine rupture in developing countries revealed a wide divergence of opinions and criteria of selection, precluding reliable comparisons. A proposition for individualized treatment is outlined, concluding that repair should be performed when suitable but that hysterectomy is preferable when the tear is extensive, bruised and contaminated.

Developing Countries↗
PubMed1975

The function of the ectodermal apical ridge and distinctive characteristics of adjacent distal mesoderm in the avian wing-bud.

Blocks of mesoderm about 0-1 mm in diameter were isolated from various regions of chick wing-buds of stages 17 through 22 and cultured individually, or sometimes in pairs, in microtest plate wells. Cell deaths had occurred after 10 h of culture in those explants that had come from the region associated with the thickest part of the ectodermal ridge, and after 11-12 h in all other mesoderm. When the adjacent ectodermal ridge was left attached to the mesodermal block there were almost no cell deaths for up to 24 h of culture. When the dorsal ectoderm immediately proximal to the apical ridge was left attached, but no ridge was present, cell deaths occurred just as they did in mesoderm with no ectoderm. When a number (usually six) of complete ridges were suspended in a wire basket at the top of a well, cell deaths did not occur in a test mesodermal block at the bottom of the well (six of eight cases). These experiments support previous evivence for a special function of the ectodermal apical ridge in limb morphogenesis, and indicate that there is a chemical messenger. The cells that migrated from distal mesodermal explants (the band up to 0-15 mm from the apical ridge) differed sharply in morphology and behavior from those coming from explants from any more proximal region. Within the proximal mesoderm there was a less striking variation alons the antero-posterior axis. These observations reveal that there is present even at early stages a detailed pattern within the mesoderm of the limb-bud. The particularly striking and distinctive characteristics of that mesoderm closest to the apical ectodermal ridge provide new possibilities for the understanding of the function of the ridge in limb morphogenesis.

Animals↗
PubMedDate not supplied

Splenectomy in chronic myeloid leukaemia. A case report and review.

We report the case of a man with chronic myeloid leukaemia, whose disease had undergone transformation and whose life was threatened. Splenectomy was performed, and two years later he is alive and well, taking no anti-leukaemic therapy. Since splenectomy he has had one severe attack of malaria, and one episode of jaundice thought to be due to viral hepatitis. He discontinued his malaria prophylaxis one year ago and has not been ill since. Splenectomy as a last resort will benefit some patients with chronic myeloid leukaemia after transformation, and elective splenectomy should be considered in the management of patients with this disease. However, final unequivocal proof of the value of elective splenectomy is still awaited.

Adult↗