PubMed Health⌕ Search

Biomedical subjects

K Parrish

Publications and source records attributed to K Parrish.

7 recordsLinked to original sources

A comparison of multimedia and standard advanced cardiac life support learning.

OBJECTIVES: To compare student performance after Multimedia ACLS Learning System (MM) education compared with that after standard (ST) ACLS education. METHODS: Final-year medical students were divided into 2 groups based on convenience scheduling and given ACLS instruction either in a standard format or with the MM course. The sizes of the small groups and the times in small-group instruction were identical. All students were evaluated with the same 50-item multiple-choice written examination, a structured evaluation immediately after the management of a mock cardiac arrest, and a second structured evaluation of the same mock arrest (videotaped) by an instructor blinded to the education method. Students were assigned a mark from 1 to 5 in each of 4 domains: assessment, immediate priorities, continual assessment, and leadership. RESULTS: 75 students took the MM and 38 took the ST course. The mean +/- SD mark for the multiple-choice test was 89.3 +/- 4.9% (MM) vs 89.3 +/- 4.8% (ST); the on-site mock arrest evaluation mark (20 maximum) was 14.1 +/- 2.5 (MM) vs 14.1 +/- 2.0 (ST); and the blinded mock arrest evaluation was 13.1 +/- 2.9 (MM) vs 14.4 +/- 2.9 (ST) (p = 0.024). 1/75 (MM) vs 0/38 (ST) did not successfully complete the on-site mock arrest evaluation. More students in the MM group (46% vs 25%) required multiple attempts to successfully complete the mock arrest evaluation (p < 0.02). CONCLUSION: In medical students with no previous ACLS training, structured access to the multimedia ACLS Learning System provides immediate educational outcomes similar to those of a standard ACLS course. Multimedia computer-interactive learning should be enhanced with a short period of hands-on practice.

British Columbia↗

StORQS: Washington's Statewide Obstetrical Review and Quality System: overview and provider evaluation.

The Foundation for Health Care Quality (Washington) used three administrative public databases and indicators recommended by the Joint Commission and the American College of Obstetrics and Gynecology to build algorithms to measure quality of obstetric care in the state of Washington. Analyses demonstrated a high degree of variability across hospitals for major processes of care such as cesarean section, vaginal birth after cesarean section, and forceps deliveries. Eighty-five percent of the participating hospitals concluded that important aspects of care were being measured. Ninety-four percent found the information useful in describing their performance compared with other hospitals. Sixty-two percent believed the information was useful for initiating quality improvement projects. Of the 25 indicators tested in the project, indicators rated as most useful were the same 10 obstetric indicators chosen by the Joint Commission after alpha testing.

Cesarean Section↗

Alcoholics with eating disorders: prevalence and clinical course. A study from Japan.

Investigation of the prevalence of eating disorders among a large sample of Japanese alcoholics admitted for hospital treatment revealed a strong association between eating disorders and alcohol abuse and alcohol dependence among young women. That association was not apparent in young men. The results of this study of the clinical courses of eating disorders and alcohol abuse and alcohol dependence suggest that women with eating disorders, especially bulimia nervosa, are at high risk of becoming alcoholic.

Adult↗

Effect of active management of labor on the incidence of cesarean section for dystocia in nulliparas.

The hypothesis that introduction of a defined policy of managing labor in nulliparas, active management of labor, would reduce the incidence of cesarean section (CS) for dystocia was examined by the introduction of active management at Hermann Hospital, the University of Texas affiliated hospital in Houston. The study was conducted over four consecutive 6-month periods. Observational data were accumulated for the year preceding introduction of active management, which served as the control period. The overall incidence of CS in nulliparas in the two control periods was 23 and 25%, and declined significantly to 20 and 17.7% in the intervention periods. The incidence of CS for dystocia fell significantly from 13 and 15% to 10 and 8.1%, whereas the incidence for other indications was unchanged. There were no significant differences in perinatal outcome judged by incidence of fetal death in labor, neonatal death associated with asphyxia, rate of admission to neonatal care with a diagnosis of asphyxia, or incidence of neonatal seizure. The data suggest that active management of labor reduces the incidence of cesarean section significantly and that these results can be achieved without detriment to mother or child.

Adolescent↗

Glucan-binding factor in saliva.

High-molecular-weight polymers of alpha-1,6-linked D-glucans are insoluble in alcohol solutions. Whole, but not parotid, saliva prevented the precipitation of D-glucans by 80% (vol/vol) ethanol, showing that the whole saliva contained a factor which complexed with the glucan to render it alcohol soluble. The glucan-binding factor was retained on a column of Sephacryl S-200 which had been preequilibrated with 80% ethanol. The factor was then eluted with water. Passive hemagglutination assays revealed that the glucan-binding factor could sensitize erythrocytes to agglutination with anti-poly(glycerolphosphate), suggesting that the active glucan-binding component with lipoteichoic acid. The glucan-solubilizing factor was resistant to heat (100 degrees C), proteases, sialidase, lysozyme, lactoperoxidase, trichloroacetic acid, and Triton X-100. When sucrose was added to saliva, a suspension of Streptococcus cricetus AHT, or a suspension of Streptococcus sanguis 10556, relatively large amounts of glucan-binding factor were released in a soluble form. In addition, penicillin G caused the release of the glucan-solubilizing component from a suspension of S. cricetus AHT. It is suggested that whole saliva contains a component, tentatively identified as lipoteichoic acid, which can complex with glucans in a relatively hydrophobic solvent. This type of complex formation may be important in the adhesion of oral streptococci to saliva-coated surfaces.

Glucans↗

Psychotic syndromes in epilepsy.

Claims have been made that epilepsy is associated with both brief psychotic episodes and persistent psychotic states. The existence of brief, nonconfusional psychotic episodes in epilepsy has received some formal support; these may be a function of temporal lobe subictal activity. Persistent psychosis is found in about 7% of patients with epilepsy; independent evidence indicates this to be a significant association. Temporal lobe seizure activity, again probably acting subictally, may be involved in the pathogenesis of these states, perhaps in interaction with other factors. Occurrence of psychotic syndromes in epilepsy may be relevant to kindling, atypical psychoses unrelated to epilepsy, and the psychotropic effect of carbamazepine.

Brain↗

Epileptic discharges produced in monkeys by injection of spleen cells from rabbits immunised with monkey brain.

Cell suspension from the spleen of rabbits immunised with monkey brain gave rise to epileptic discharges in the monkey when injected intracortically, except in the case of one injection from a rabbit not recently given a booster treatment. In contrast, cell suspensions from the spleen of unimmunised rabbits, or of a rabbit immunised with a non-brain material, in all cases failed to be effective. The epileptic discharges began about 2 weeks after injection, were variable in frequency, and lasted throughout the period of recording.

Animals↗