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Biomedical subjects

K Yates

Publications and source records attributed to K Yates.

16 recordsLinked to original sources
PubMed2000

A managed behavioral health organization operated by an academic psychiatry department.

As a means of adapting to managed care, the psychiatry department at Wake Forest University developed a managed behavioral health organization (MBHO) to manage the care of enrollees in QualChoice, the health maintenance organization of the Wake Forest University Baptist Medical Center. Before the academic MBHO was created, care was managed by a for-profit MBHO. In this case study, financial and utilization data were obtained from both MBHOs and from QualChoice. The data confirm that the academic MBHO was able to offer competitive rates for its services. It also was able to increase enrollees' use of the medical center's own providers and facilities by making more referrals than were made by the for-profit MBHO. Developing a managed behavioral health organization can allow academic psychiatry departments, either individually or as consortia, to preserve the patient base they require for teaching, research, and financial stability.

Academic Medical Centers↗
PubMed1999

Glycerol hyperhydration improves cycle time trial performance in hot humid conditions.

Eight competitive cyclists [mean peak oxygen consumption, (VO2(peak)) = 65 ml x min(-1) x kg(-1)] undertook two 60-min cycle ergometer time trials at 32 degrees C and 60% relative humidity. The time trials were split into two 30-min phases: a fixed-workload phase and a variable-workload phase. Each trial was preceded by ingestion of either a glycerol solution [1 g x kg(-1) body mass (BM) in a diluted carbohydrate (CHO)-electrolyte drink] or a placebo of equal volume (the diluted CHO-electrolyte drink). The total fluid intake in each trial was 22 ml x kg(-1) BM. A repeated-measures, double blind, cross over design with respect to glycerol was employed. Glycerol ingestion expanded body water by approximately 600 ml over the placebo treatment. Glycerol treatment significantly increased performance by 5% compared with the placebo group, as assessed by total work in the variable-workload phase (P < 0.04). There were no significant differences in rectal temperature, sweat rate or cardiac frequency between trials. Data indicate that the glycerol-induced performance increase did not result from plasma volume expansion and subsequently lower core temperature or lower cardiac frequencies at a given power output as previously proposed. However, during the glycerol trial, subjects maintained a higher power output without increased perception of effort or thermal strain.

Adult↗
PubMed1999

Service use and financial performance in a replication program on adult day centers.

The authors describe results from Partners in Caregiving: The Dementia Services Program, and present information on service utilization and financial performance among a group of 48 adult day centers across the United States from 1992 to 1996. Centers, with nonrandom assignment, received either grant support (average value: $93,000) or intensive technical assistance (average value: $39,000). Sites reported baseline data and submitted utilization information (enrollment and census) and financial data (revenue and expenses) quarterly. Overall, there were significant increases in enrollment, census, and financial performance (percent of cash expenses met through operating revenue) over the 4-year period. The grant-supported and technical-assistance sites had similar rates of improvement. Results provide data on service utilization and financial performance and demonstrate gains that can be achieved in these areas through improved marketing and financial management.

Adult↗
PubMed1995

Cardiovascular and respiratory effects of endothelin in the ventrolateral medulla of the normotensive rat.

We studied the relevance of the ventrolateral medulla for the cardiovascular and respiratory effects of endothelin-1 in urethane-anesthetized rats. Microinjection of endothelin-1 into the rostral ventrolateral medulla (RVLM) evoked pressor and bradycardic effects followed by sustained decreases in blood pressure, bradycardia, and respiratory depression. These effects were inhibited by endothelin-A receptor antagonists (BQ-123 and BQ-610) but not by endothelin-B antagonists. In the caudal ventrolateral medulla (CVLM) endothelin-1 decreased blood pressure, renal sympathetic nerve activity, respiratory frequency, and phrenic nerve activity, whereas heart rate increased. Pretreatment with BQ-123 in the CVLM increased respiratory frequency by 15 +/- 6 breaths per minute and prevented the effects of intra-CVLM administration of endothelin-1. In separate experiments, the intracisternal administration of endothelin-1 (20 pmol) to rats pretreated with saline in both RVLM and CVLM resulted in a hypotensive and bradycardic phase that was followed by hypertension (50 +/- 15 mm Hg), bradycardia, and 100% mortality. In a separate group, pretreatment with BQ-123 in the RVLM and CVLM completely inhibited the hypotensive phase and reduced by 83% the subsequent rise in blood pressure evoked by endothelin-1. Cardiorespiratory arrest was prevented in all the rats in this group. Selective endothelin receptor blockade in the RVLM attenuated the hypertensive period of intracisternal administration of endothelin-1 and prevented mortality by 33%, whereas in the CVLM the endothelin receptor antagonist inhibited the initial hypotension and reduced mortality by 25%. Our results support the concept that in the ventral medulla, endothelin-1 can modulate cardiovascular and respiratory function.

Animals↗
PubMed1994

Effects of two caregiver-training programs on burden and attitude toward help.

The purpose of this research was to determine which caregiver-training program (CTP) was most beneficial to caregivers. Two types of CTPs, a behavior management program and a social skills program, were implemented. The effects of the CTPs on attitude toward asking for help, attitude about using adult day care, are caregiving burden were explored. Thirty-three caregivers volunteered to participate. Of the caregivers, the majority were female spouses (n = 22), 76% were over age 60, and 68% had some college education. Subjects were randomly assigned to one of two CTPs or a control group. Pretest was completed during the first phase of the training program. Both CTPs met for six sessions. The control group received no training. The posttest was conducted 1 month after completion of the CTPs. Differences between the three groups were analyzed by using ANOVA. No differences were observed between groups. Six of the subjects chose the alternate training program when given the opportunity for further training. Caregivers who participated in both CTPs experienced a decrease in objective burden and a more positive attitude toward asking for help and using adult day care.

Adult↗
PubMed1991

Massive transfusion: outcome in blunt trauma patients.

Over a 54-month period 6,142 patients were consecutively admitted to our Level I trauma center. Ninety-two blunt trauma patients required massive transfusion (MT) of 20 or more units of packed red blood cells (range, 20-126). Eighty-two per cent of all transfused blood was given within 24 hours of admission. Forty-eight patients (52%) were long-term survivors. Twenty-six patients died (28%) within 24 hours and 21 of these exsanguinated. Eighteen patients died greater than 24 hours: nine (50%) died from multiple organ failure, and nine (50%) died from severe closed head injury (CHI). Clinical predictors of increased mortality were: shock on admission, closed head injury, and age. Forty-three survivors were followed for a mean of 2.5 years (range, 1-5 years). No patient died during followup. All patients were home at 1 year; only four patients required continued medical assistance. Thirty-two patients (74%) returned to work. We conclude that: 1) blunt and penetrating trauma patients receiving MT have similar survival rates of 50%; 2) shock, closed head injury, and age predict increased mortality but do not preclude survival; 3) long-term outcome in blunt patients requiring MT is excellent. Post-discharge death is rare and 3/4 of the survivors return to work, justifying the high cost of acute care.

Blood Transfusion↗
PubMed1989

A cascading development model for amphibian embryos.

The mesodermal tissue of some amphibian gastrula develops into a dorsal-to-ventral sequence of notochord, somite, pronephros, and lateral plate cell types. The cellular proportions regulate with respect to embryo size. The dorsal blastoporal lip appears to function as an organizer for the embryo. The transplantation of a donor lip to the ventral side of a host causes a second, opposed embryo to form and the system commits similar total proportions of cells as do normally developing embryos. Transplantation of donor somite to the ventral side of a host causes a reduction in the proportion of host somite developed. A modified reaction-diffusion system governing embryo development is proposed. Developmental simulations consistent with experimental observations are presented and analyzed. The results suggest that the degree of somite inhibition is positively correlated with the size of the somite transplant. Further predictions are that sufficiently large somite transplants would induce ectopic, ventral pronephros to form and ventral pronephros transplants would inhibit host pronephros development.

Amphibians↗
PubMed1988

Serum cholesterol and coronary heart disease: Auckland general practitioners' attitudes and practices in 1986.

The relationship between elevated serum cholesterol and coronary heart disease, is now generally accepted as being causal. To examine current attitudes and practices regarding the treatment of high serum cholesterol, questionnaires were sent to a randomly selected sample of general practitioners in the Takapuna health district during 1986. The response rate among the 92 doctors in general practice at the time of the study was 80%. The majority of general practitioners (82.5%) believed that there was a casual relationship between high serum cholesterol and coronary heart disease and that reducing levels would help prevent coronary heart disease. Almost all general practitioners (96%) were screening some groups of patients for high serum cholesterol, with most screening those with symptomatic coronary heart disease or associated risk factors, and 15% screening all patients. Although almost 90% of general practitioners had patients on diet therapy and one third had patients on drug treatment, there was wide variation in attitudes regarding the serum cholesterol levels meriting dietary or drug treatment. This suggests that there is still considerable confusion as to when and how to treat high cholesterol levels and that specific national guidelines for the detection and management of high serum cholesterol are required as part of a comprehensive programme to prevent coronary heart disease.

Adult↗
PubMed1978

The kallikrein-kinin system in the kidney.

To understand the role of the kallikrein-kinin system in the kidney all components of the system and their localization need to be considered. About half the kallikrein in urine occurs as the proenzyme which arises in the distal tubule. Kinins are formed in the distal tubule and collecting duct from urokinnogen which is found throughout the tubule. Urine contains about twice as much lysyl-brandykinin as bradykinin. A third kinin, methionyl-lysyl-bradykinin, also can occur in urine. It is probably produced by uropepsin as the kinin is largely formed in acidified urine and its formation is inhibited by pepstatin. The significance of the three kinins is unknown. Kinins are normally slowly (few hours) destroyed in urine. The importance of kallikrein, urokinogen and kininases in regulating the level of kinins needs to be determined.

Adult↗