PubMed Health⌕ Search

Biomedical subjects

J S Pliskin

Publications and source records attributed to J S Pliskin.

16 recordsLinked to original sources
PubMed1992

Computerized algorithms and pediatricians' management of common problems in a community clinic.

In 1987, a microcomputer clinical algorithm (CA) system for constructing and using CAs for patient care was designed and implemented for six common primary care pediatrics problems. Six community clinic pediatricians agreed to use the system for several months. Length of patient's visit, completeness of data collection, antibiotic use, and appropriateness of clinical plan were measured before the computers were introduced (without CAs) and after the computers were introduced (both with and without CAs). All performance measures improved after the introduction of CAs. However, CA implementation had to be discontinued after five weeks because the CAs were too tedious for the physicians to follow during routine care. The authors conclude that CAs cannot be successfully sustained with physicians for common problems, even though their design and use can significantly improve the process of care.

Adolescent↗
PubMed1991

The impact of a health education course on maternal knowledge: a comparative study in a low socioeconomic rural region.

A comprehensive health education course was designed for mothers in West Bank villages, a relatively low socioeconomic population. The course focused on nutrition, hygiene, child development, and first aid. It was taught by specially trained local instructors in small classes characterized by an individualized teaching method. To evaluate the contribution of the course, the level of knowledge in topics taught in the course was tested. The test was personally administered by trained interviewers to 241 course participants and to a comparison group of 284 mothers who had not participated. As expected, participants demonstrated higher level of knowledge than nonparticipants, regardless of the time since having taken the course. The course seems to have contributed to all participants, but mostly to women of lower education. In a multiple linear regression the two most significant predictors of knowledge were course participation and level of maternal formal education.

Educational Status↗
PubMed1990

Infant feeding practices: an evaluation of the impact of a health education course.

We assessed the impact of a health education course on infant feeding practices in the West Bank territories by comparing mothers who had attended the course (n = 102) with mothers not exposed to the course (n = 133). After adjustment for child's age, maternal age and education, parity, and birth site, course participants were more likely than non-participants to breastfeed, as well as to start supplementation by semi-solid foods at the recommended time.

Breast Feeding↗
PubMed1986

The frequency of bitewing radiographs.

A model for use in analyzing the implications of different rates of caries incidence and progression for the timing of bitewing radiographs was developed. Estimates of progression rates and incidence patterns were derived from an analysis of serial bitewing radiographs. A time schedule for taking the next radiographs was determined so that carious lesions would be detected before radiolucencies reach the inner half of the dentin. For asymptomatic persons with extensive exposure to fluorides and no unrestored enamel lesions on the last radiographs, bitewing films could be scheduled every 2.5 to 3 years. For persons with little exposure to fluorides or with many early enamel lesions or at least one deep enamel lesion that has not been restored, radiographs should be performed every 6 months to 1 year.

Adolescent↗
PubMed1986

The expected benefits from alternative frequencies of bitewing radiograms.

From an analysis of serial bitewing radiograms, we have developed a mathematical model of the initiation and progression of approximal carious lesions in the permanent teeth. The model is used to estimate the expected number of lesions, per individual, not detected until they reach the inner half of the dentin, as a function of the frequency with which radiograms are taken between the ages of 8 and 20 years. If radiograms are performed every 6 months and lesions not restored until radiolucencies appear in the dentin, under 5% of all lesions developing over the 12-year period will reach the inner half of the dentin before detection. If radiograms are taken every 2 years, about 18% of all lesions will have reached the inner half of the dentin before detection. The sensitivity of these conclusions to different assumptions is examined.

Adolescent↗
PubMed1985

Comparative study of costs and quality of life of chronic ambulatory peritoneal dialysis and hemodialysis patients in Israel.

The more widespread use of chronic ambulatory peritoneal dialysis (CAPD) as an alternative to hemodialysis (HD) has focused attention on costs and quality of life aspects of different dialysis modalities. Costs for hospital HD exceed $23,000 annually, while CAPD annual costs are near $10,500 and home HD about $9,000. There are additional initial costs incurred during the first year of treatment, which range from under $2,000 for hospital-based HD and CAPD to over $11,000 for home HD. Quality of life aspects were compared for CAPD and hospital HD patients. Forty-six CAPD patients and 208 hospital HD patients were interviewed regarding ability to work, performance of physical activity, quality of sleep and sexual activity. The two patient groups were similar demographically (age, sex, origin and level of education). There were no statistically significant differences between the two patient groups for each of the quality of life variables, although CAPD patients showed slightly better results.

Adolescent↗
PubMed1976

Cadaveric kidneys for transplantation: is there a need for more?

The paper questions the need for more cadaveric kidneys for transplantation. After establishing such need, it points out the inability of current supply to meet demand. Theoretically, enough kidneys should be available to meet all demand, so the various reasons for discrepancies between theoretical supply and the lesser actual one are discussed. The medical profession is aware of the insufficient supply of kidneys, and several avenues are currently being pursued to increase procurement. The paper reviews these activities and looks into possible future ones, mainly along the line of creating incentives, not necessarily financial, for more donations and procurement. Some experimentation may be necessary to identify more promising activities and to eliminate inefficient ones. Finally, the paper looks into the somewhat controversial problem of allowing living donors to participate in kidney banks. It argues that sometimes it may be immoral to prohibit a living donor from selling a kidney if this kidney has the prospect of offering excellent prognosis to a needy patient.

Automobile Driving↗
PubMed1975

On the probability of finding an HL-A- and ABO-compatible cadaver organ for transplantation.

This paper extends earlier work by Barnes and Miettinen regarding the probabilities of finding an HL-A and ABO-compatible cadaver organ for transplantation to incorporate the dependency of this probability on the continuous time scale. Graphs are derived which enable determination of the length of time required to achieve a certain probability of finding a compatible organ and the probability of finding a compatible organ within any time period. The proposed approach enables the immediate determination of the mean and variance of the required waiting time. The paper provides a practical setting for daily decision-making and enables the physician to more clearly convey information to the patient regarding his chances of finding a compatible donor within any given time period.

ABO Blood-Group System↗
PubMedDate not supplied

A deep model of the incidence of dental caries on proximal surfaces.

As a component of an analysis of the benefits of alternative frequencies of bitewing radiographs to detect dental caries, the authors developed and validated a model to generate an individual's probability distribution for new carious lesions in a year. The model postulates two sources of variability in caries incidence--differences in individuals' underlying caries susceptibilities and a random component. The model is used to examine the nature of caries risk over time. The large random fluctuations in an individual's caries susceptibility from year to year, combined with the random nature of caries attack, makes it difficult to predict future caries experience from the individual's caries experience in the recent past. By modeling the process giving rise to observed incidence data rather than focusing directly on the observed data, i.e., by developing a deep rather than a surface model, the authors have elucidated underlying disease dynamics and provided a basis for generalizing from the particular data used to develop the model.

Adolescent↗
PubMedDate not supplied

Incorporating patient travel times in decisions about size and location of dialysis facilities.

This report demonstrates the power and usefulness of mathematical optimization as a decision support tool in the medical services industry by presenting an application to dialysis service planning. Models to predict the number of dialysis beds in a given region are usually population-based. Dialysis planners and providers have found a need to accommodate sparsely populated regions by making some allowance for patient travel times. A formal approach to incorporating travel times into dialysis planning, based on the formulation and solution of a mixed-integer programming model, is presented. The development of a method for dialysis planning serves as a platform to demonstrate the use of integer programming to support decision making. Major modeling principles are presented; output interpretation and sensitivity analysis are illustrated by examples; and computational requirements are discussed.

Ambulatory Care Facilities↗