PubMed Health⌕ Search

Biomedical subjects

M Bates

Publications and source records attributed to M Bates.

At least 37 records · Page 2Linked to original sources
PubMed1998

Diabetes prevalence and hospital and pharmacy use in the Veterans Health Administration (1994). Use of an ambulatory care pharmacy-derived database.

OBJECTIVE: To develop a diabetes registry from an outpatient pharmacy database to systematically analyze the prevalence of diabetes, patterns of glycemic medication and glucose monitoring, pharmacy costs, and hospital use related to diabetes care in the Veterans Health Administration (VHA) in fiscal year (FY) 1994. RESEARCH DESIGN AND METHODS: Veterans with diabetes were identified using a software program that extracted the social security number (SSN) of patients receiving insulin, sulfonylurea agents, or glucose-monitoring supplies. The cumulative FY94 cost for a drug was calculated by multiplying the units dispensed times the unit cost for each fill, using the actual drug cost that was in effect at the time of dispensing. Admission data were obtained by crossmatching the SSN registry with the VHA Austin Mainframe Patient Treatment Files to retrieve associated diagnosis-related groups (DRG), Physicians' Current Procedural Terminology (CPT), and International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) codes. RESULTS: From among 1,180,260 unique patients, 139,646 veterans with diabetes receiving insulin, oral agents, or glucose-monitoring strips were identified, accounting for a prevalence of 11.83% from 62 Veterans Administration medical centers. There were 63,078 individuals (52%) who received oral agents, of whom 26.3% also received blood glucose-monitoring supplies; 46,664 individuals (39%) received insulin, of whom 53.2% received blood glucose-monitoring supplies; and 9,440 individuals (8%) received both oral agents and insulin during FY94, with 64.4% receiving blood glucose-monitoring supplies. Only 1,482 (1.2%) individuals received monitoring supplies alone, and 129 patients (0.1%) were provided with an insulin pump. Using an adjusted data set, 12% of veterans accounted for 24% of all outpatient pharmacy costs, with an average expenditure of $622 for veterans with diabetes compared with $276 for veterans without diabetes. There was $454 (73%) for non-diabetes-specific prescriptions and $168 (27%) for prescriptions related to glycemic control. Of pharmacy expenditures for glycemic control, $101 (60.1%) was attributed to insulin, oral agents, and supplies, while $67 (39.9%) was attributable to glucose monitoring. Veterans with diabetes were admitted 1.6 times as frequently as veterans without diabetes. CONCLUSIONS: This study demonstrates the feasibility of using a pharmacy-based electronic diabetes database in a payor system that can track both claims and individual classes of medication based on a unique identifier number. While the prevalence of diabetes in the VHA is high relative to other health care systems and the general population, patterns of medication usage, pharmacy costs, and relative admission frequency are comparable to results from the private sector.

Ambulatory Care↗
PubMed1998

The need for a thoughtful deployment strategy: evaluating clinicians' perceptions of critical deployment issues.

This paper presents data collected from 899 clinicians across three Department of Veterans Affairs (VA) medical centers where existing terminal-based architecture was being replaced with client-server architecture. Surveys were conducted with physicians (n = 184), nurses (n = 355) and other clinicians (n = 360) gathering user characteristics and their perceptions of five deployment issues (e.g. adequacy of technical and institutional support and perceptions of the soon-to-be-implemented clinical workstation). Mean scores for the five deployment issues for all clinicians indicates perceptions are somewhat neutral. However, when data is analyzed according to job classification, significant (p = 0.05) differences in perceptions were noted among groups of clinicians (e.g., physicians and registered nurses). Results of analyzing data grouped by VA site (n = 3) indicates significant (p = 0.05) differences exist among sites in clinicians' perceptions of the deployment issues. A thoughtful deployment strategy including an in-depth assessment of clinician users by job classification and by location may produce important information, critical to the successful deployment of new technologies, in very large health management institutions.

Attitude to Computers↗
PubMed1997

Campylobacteriosis in New Zealand: results of a case-control study.

STUDY OBJECTIVE: To identify and assess the contributions of major risk factors for campylobacteriosis in New Zealand. DESIGN: Case-control study. Home interviews were conducted over nine months using a standardised questionnaire to assess recent food consumption and other exposures. SETTING: Four centres in New Zealand with high notification rates of campylobacter infections--Auckland, Hamilton, Wellington, and Christchurch. PARTICIPANTS: Case patients were 621 people notified between 1 June 1994 and 28 February 1995 as having campylobacter infection. Control subjects were selected randomly from telephone directories, and were matched 1:1 with case patients in relation to sex, age group, and home telephone prefix. RESULTS: Risk of campylobacteriosis was strongly associated with recent consumption of raw or undercooked chicken (matched odds ratio 4.52, 95% confidence interval 2.88, 7.10). There was also an increased risk with chicken eaten in restaurants (matched odds ratio 3.85; 2.52, 5.88). Recent consumption of baked or roasted chicken seemed to be protective. Campylobacteriosis was also associated with recent overseas travel, rainwater as a source of water at home, consumption of raw dairy products, and contact with puppies and cattle, particularly calves. CONCLUSIONS: Improperly cooked chicken seems to be associated with a large proportion of campylobacteriosis in New Zealand. Thorough cooking of chicken in homes and restaurants could reduce considerably the incidence of this disease.

Campylobacter Infections↗
PubMed1997

Psychometric evaluation of the Organizational Job Satisfaction Scale.

Findings are reported from a replicated evaluation of the psychometric properties of the Organizational Job Satisfaction Scale. Data lend strong support for the scale which assesses four dimensions of organizational job satisfaction. Principal component factor analysis of data from two independent samples of urban staff registered nurses (RNs) (n = 496; n = 532) confirmed four dimensions of pay, interaction, administration, and status. Cronbach's alpha for subscales ranged from .76 to .88. Pearson correlation coefficients for the interrelationships among subscales and an estimate of theta verified internal consistency. The Organizational Job Satisfaction Scale scores correlated significantly with a criterion measure of job enjoyment. Hypothesis testing of theoretically predictable relationships supported construct validity. Scores on the organizational job satisfaction subscales correlated significantly with automony, stress, and commitment. Item revisions and recommendations for future use of the instrument are discussed.

Adult↗
PubMed1996

The effect of methadone prescribing in a clinic setting on the criminal activity of drug users.

The objective was to examine the impact of clinic attendance and methadone prescribing on drug user criminality. Fifty-four consecutive attenders at a Drug Problem Clinic were interviewed by questionnaire. An objective assessment of the criminality on 49(91%) of the above was made by examining their conviction details, before and after clinic attendance. Seventy-seven per cent strongly agreed that fewer criminal charges had been preferred since attendance at the clinic had begun and drugs prescribed. No statistically significant difference was found in the conviction numbers for the group as a whole: mean 3.9 (before) to 3.2 (after): p = 0.24, or for the females in particular: mean 2.8 (before) to 5.9 (after): p = 0.97. There was, however, a significant drop in the number of convictions amongst the males: mean 4.3 (before) to 2.5 (after): p = 0.02. This study confirms an association between methadone maintenance therapy in a clinic setting and a reduction in criminality amongst males.

Adult↗
PubMed1996

Dexrazoxane cardioprotection for patients receiving FAC chemotherapy: a pharmacoeconomic evaluation.

Anthracyclines are among the most effective and commonly-prescribed antitumor agents but have dose-limiting cumulative cardiotoxicity. We performed a pharmacoeconomic evaluation of the ability of dexrazoxane to prevent cardiac-related adverse events in patients with Stage IIIB or IV metastatic breast cancer who were treated with a median of 10 cycles of intravenous FAC (5-fluorouracil, doxorubicin and cyclophosphamide) at doses of 500/50/500 mg/m2 respectively. Dexrazoxane was given at 500 mg/m2 commencing at the seventh cycle of treatment. We determined the cost of each cardiac event prevented and the cost of each additional life-year saved by dexrazoxane use. The cost per cardiac event prevented was CDN $5745 and the cost per additional life-year saved was CDN $2856. With the increasing use of anthracyclines in Stages I and II breast cancer, these favorable clinical and economic results may broaden the range of therapeutic possibilities for anthracyclines in adjuvant and metastatic therapy of breast cancer.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1995

Is New Zealand's recent increase in campylobacteriosis due to changes in laboratory procedures? A survey of 69 medical laboratories.

AIMS: To evaluate the contribution of changing procedures in microbiology laboratories over the previous 5 years to the increase in campylobacteriosis notifications. To assess whether regional differences in notification rates are due to variations in laboratory procedures. METHODS: A questionnaire was sent to 69 New Zealand medical laboratories, requesting data on their identification procedures for enteric pathogens, including campylobacter. RESULTS: Changes over the last 5 years in laboratory techniques were insufficient to account for a marked increase in campylobacter isolations. On the basis of data provided by 12 laboratories, the number of specimens that grew campylobacter increased by 49% between 1992 and 1993. Differences in laboratory methods do not explain regional differences in campylobacter notification rates. CONCLUSION: Changes in laboratory methodologies over the last 5 years do not appear to account for the recent national increase in campylobacteriosis notifications.

Campylobacter↗
PubMed1995

Models of natural language understanding.

This paper surveys some of the fundamental problems in natural language (NL) understanding (syntax, semantics, pragmatics, and discourse) and the current approaches to solving them. Some recent developments in NL processing include increased emphasis on corpus-based rather than example- or intuition-based work, attempts to measure the coverage and effectiveness of NL systems, dealing with discourse and dialogue phenomena, and attempts to use both analytic and stochastic knowledge. Critical areas for the future include grammars that are appropriate to processing large amounts of real language; automatic (or at least semi-automatic) methods for deriving models of syntax, semantics, and pragmatics; self-adapting systems; and integration with speech processing. Of particular importance are techniques that can be tuned to such requirements as full versus partial understanding and spoken language versus text. Portability (the ease with which one can configure an NL system for a particular application) is one of the largest barriers to application of this technology.

Cognition↗
PubMed1995

Lead in children from older housing areas in the Wellington region.

AIMS: To examine blood lead levels in children, aged 12 to 23 months, living in old housing areas of Wellington and Lower Hutt, and to investigate risk factors for high lead levels. METHOD: Children were selected from Plunket Society rolls. Venous blood samples were collected, and care givers were interviewed with a questionnaire. Soil samples were taken from around the children's homes. Both soil and blood samples were analysed for lead content. RESULTS: Blood samples and completed questionnaires were obtained for 143 children. The geometric mean blood lead level for all the children was 0.25 mumol/L (5.1 micrograms/dL) (95% confidence interval [95% CI]: 0.22-0.28 mumol/L). Three children had blood lead levels that exceeded the level for notification in New Zealand 1.45 mumol/L and a further 13 had blood lead levels exceeding 0.48 mumol/L. Children with elevated lead levels were likely to live in a house greater than 50 years old where paint removal had taken place in the last 2 years (risk ratio [RR] = 14.4, 95% CI: 2-107). Eating dirt, particularly for children who usually played outside within 2 metres of the house, was also a risk factor for elevated blood lead levels. Soil lead levels generally increased with the age of the house and were weakly correlated with blood lead levels (r = 0.32). CONCLUSION: Paint removal in old houses is a major risk factor for elevated blood lead levels. However, the number of study children living in houses less than 50 years old was limited. Because of this and possible participant selection bias, the results of this study require confirmation in a separate population-based study. Information about the specific paint removal procedures that cause high lead levels is also needed.

Cross-Sectional Studies↗
PubMed1995

Assessment of the risk of transmission of N meningitidis in a classroom setting.

AIM: To evaluate the risk of colonisation with N meningitidis among university classroom contacts of a student with invasive meningococcal disease. METHODS: Throat cultures were obtained from classmates and faculty exposed to a university student with meningococcal disease. Exposures to the index case were quantified using a questionnaire. RESULTS: None of the 41 students and staff from whom cultures were obtained showed evidence of colonisation with N meningitidis. The contacts had spent an average of 13.5 h in class with the index case during the 2 days prior to the onset of her illness. CONCLUSIONS: The risk of colonisation with N meningitidis among casual university classroom contacts appears to be low. This study lends support to decisions to withhold chemoprophylaxis in most instances of such contact.

Adult↗
PubMed1994

Percutaneous deployment of a polytetrafluoroethylene (PTFE) graft to repair a pseudoaneurysm produced by a graft to graft anastomotic dehiscence.

Arterial injuries, creating a pseudonauerysm or arteriovenous fistula have, in the main, been managed through surgical ligation of the involved segments, arterial reconstruction, embolization of the involved artery, and percutaneous placement of a stented graft [Marin ML, et al: J Vasc Surg 18:299-302, 1993]. This communication describes the percutaneous repair of a large popliteal pseudoaneurysm, created by dehiscence of the anastomotic suture line of a composite polytetrafluoroethylene (PTFE) femoropopliteal and a popliteal-posterior tibial graft using a PTFE graft without stent assistance.

Aged↗
PubMed1989

Movements of the Schwann cell nucleus implicate progression of the inner (axon-related) Schwann cell process during myelination.

Although it has been known for several decades that peripheral myelin is formed from an extended, spiraled, and compacted sheet of Schwann cell (SC) plasma membrane, the mechanism by which this unique spiraling is accomplished remains unknown. We have studied the movements of SC nuclei before, during, and subsequent to myelin formation (over periods of 24-72 h) to determine if this nuclear motion (noted in earlier reports) would provide useful insights into the mechanism of myelinogenesis. We used rodent sensory neuron and SC cultures in which initiation of myelinogenesis is relatively synchronized and bright field conditions that allowed resolution of the axon, compact myelin, and position of the SC nucleus. Observed areas were subsequently examined by electron microscopy (EM); eight myelinating SCs with known nuclear movement history were subjected to detailed EM analysis. We observed that, prefatory to myelination, SCs extended along the length of larger axons, apparently competing with adjacent SCs for axonal surface contact. This lengthening preceded the deposition of compact myelin. SC nuclear circumnavigation of the axon was found to attend early myelin sheath formation. This movement was rarely greater than 0.25 turns per 3 h; on the average, more nuclear motion was seen in relation to internodes that formed during observation (0.8 +/- 0.1 turns/24 h) than in relation to those that had begun to form before observation (0.3 +/- 0.1 turns/24 h). Nuclear circumnavigation generally proceeded in one direction, could be in similar or opposite direction in neighboring myelinating SCs on the same axon, and was not proportional to the number of major dense lines within the myelin sheath. A critical finding was that, in all eight cases examined, the overall direction of nuclear movement was the same as that of the inner end of the spiraling SC process, and thus opposite the direction of the outer end of the spiral. We conclude that the correspondence of the direction of nuclear rotation and inner end of the spiraling cytoplasmic lip implicates active progression of the inner lip over the axonal surface to form the membranous spiral of myelin, the nuclear motion resulting from towing by the advancing adaxonal lip. This interpretation fits with finding basal lamina and macular adhering junctions associated with the external lip of SC cytoplasm; these attributes would imply anchorage rather than movement of this region of the SC.

Animals↗
PubMed1987

Fractionation of plant and animal high mobility group chromosomal proteins by ion-exchange and reversed-phase high-performance liquid chromatography.

A method for purifying wheat high mobility group (HMG) chromosomal proteins using a combination of weak cation-exchange and reversed-phase high-performance liquid chromatography (HPLC) is described. Previously reported HPLC systems devised for fractionating HMG proteins of vertebrate animals are not effective for the plant proteins. The system described here can be used for the fractionation of both plant and animal HMG proteins.

Animals↗
PubMed1987

The effect of acute exercise on high density lipoprotein-cholesterol and the subfractions in females.

The effect of an acute exercise session on high density lipoprotein-cholesterol (HDL-C) and the subfractions HDL2-C and HDL3-C was determined for 9 healthy females (VO2max = 46.62 +/- 4.82 ml X kg-1 min-1). Each subject underwent a continuous 40-min run on a treadmill at a workload corresponding to 70% of VO2max. A venous blood sample was obtained immediately prior to exercise and 5 min, 24, 48 and 96 h after the exercise. Pre-exercise values were: HDL-C (61.7 +/- 3.7 mg X dl-1); HDL2-C (22.4 +/- 2.1 mg X dl-1); HDL3-C (39.3 +/- 2.0 mg X dl-1). At 5 min after exercise, HDL-C (66.2 +/- 4.4 mg X dl-1) and HDL3-C (44.5 +/- 2.8 mg X dl-1) were significantly elevated (P less than 0.01) when compared to pre-exercise values. HDL-C and HDL3-C were not significantly different from pre-exercise at the remaining time points. In comparison with pre-exercise, HDL2-C showed no significant change at any of the post-exercise time points. Results indicated that the rise in HDL-C following acute exercise was due to an increase in the subfraction HDL3-C. The change in total HDL-C and HDL3-C was transient in that pre-exercise values were re-attained within 24 h following acute submaximal exercise.

Adult↗
PubMed1986

Survey: statewide family support programs.

Results of a survey of 23 state conducted family support programs are presented. Sixteen programs are legislatively mandated and the majority have a similar purpose: reduction of out-of-home placements. However, great variability exists on eligibility criteria, methods of program administration, amount of support, and types of services provided. Program evaluation data are reviewed indicating that cost-benefits, decreased rates of out-of-home placement, and effects on family enhancement are primary concerns of these programs. Implications for future program development based upon normalization philosophy and stress/coping theories are presented.

Cost-Benefit Analysis↗
PubMed1985

The association of lipoprotein cholesterol with vitamin A.

Several studies have linked total serum cholesterol concentrations below 200 mg/dl with increased cancer risk, especially among men. Cancer risk appears to be associated primarily with low concentrations of total cholesterol and of low-density lipoprotein cholesterol but not of high-density lipoprotein cholesterol (HDL). It has been suggested that low concentrations of total cholesterol are associated with increased cancer risk indirectly by virtue of their association with low concentrations of carotene and/or retinol. The relationship between serum carotene and cholesterol in a biracial group of 146 first-year college students was investigated. White men and women had similar carotene concentrations. Blacks had higher serum carotene concentrations than whites. There was a significant relationship between carotene concentrations and total cholesterol, which was most evident in men, both black (r = +0.72; P less than 0.01) and white (r = +0.49; P less than 0.01). The correlations for the women were significant, but of lower magnitude than for the men. Significant carotene-HDL relationships were observed among black men (r = 0.31; P less than 0.05) and among women (r = 0.35; P less than 0.05 and r = 0.31; P less than 0.05, black and white, respectively). Furthermore, the women also demonstrated a significant carotene-HDL2 association. The results are consistent with the hypothesis that the association between low serum cholesterol concentrations and cancer may be the result of a relationship between lipoprotein cholesterol concentrations and vitamin A metabolism.

Adolescent↗