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Biomedical subjects

M N Hill

Publications and source records attributed to M N Hill.

At least 19 recordsLinked to original sources
PubMed1991

Changes in causes of death after renal transplantation, 1966 to 1987.

This descriptive study was undertaken to examine survival and changes in cause of death after renal transplantation. One fourth (259) of the 1,022 patients who received a renal transplant between 1966 and 1987 at the University of Pennsylvania had died by January 1, 1988. Causes of death for 246 (96%) of the deceased patients were analyzed. Despite an increase in age and number of comorbid diseases before transplantation, posttransplant survival increased significantly over the study period. All-cause mortality rates at 1, 2, and 5 years decreased significantly. Infectious disease cumulative mortality rates at 1, 2, and 5 years also decreased between 1966 and 1985. No trend in the 1-, 2-, or 5-year cardiovascular disease cumulative mortality rates was detected. The decline in the rate of deaths due to infection led to a decrease in the proportion of infection-related deaths and an associated increase in the proportion of cardiovascular disease-related deaths. The reduction in mortality over the past 2 decades is associated with the simultaneous improvement in immunosuppression and treatment of infectious diseases.

Cause of Death↗
PubMed1991

Physicians' perceptions of consensus reports.

In a pretest-posttest panel survey of 595 eligible Maryland physicians practicing family or general medicine, internal medicine, cardiology, or nephrology, perceptions of consensus reports designed to alter medical practice are examined. On a 7-point scale, physicians reported positive or neutral views of descriptors, most favorably rating credible (mean = 2.25) and reliable (mean = 2.41), and least favorably rating biased (mean = 3.79). In a regression analysis of factors influencing changes in practice behavior congruent with consensus recommendations before and 1 year after the release of a consensus report on hypertension (8), these perceptions were not significant determinants. The strongest predictor of congruent practice behavior a year after the report was published was congruent practice behavior just prior to the report's release, and the second strongest predictor was perceived influence of the report's sources/sponsors.

Attitude of Health Personnel↗
PubMed1989

Strategies for patient education.

Patient behavior is a part of the problem of high blood pressure and is also a major part of the solution. As with physical diagnosis and medical care, patient education should be based upon a careful assessment, a correct diagnosis, and an individualized plan of care. Health care providers must be able to identify the specific needs of patients for information, skills, support, and reinforcement. They must meet those needs with a combination of educational strategies, adapting approaches as necessary over time. Providers can determine the quantity and quality of information, interaction, and office procedures that reinforce appropriate behavior. Efforts to increase the number of patients who remain in care, with controlled blood pressures, should include effective educational strategies which increase providers' skills, enhance patient-provider relationships and promote active patient participation.

Humans↗
PubMed1989

Clinical nurse specialist: a facilitator for clinical research.

The role of the clinical nurse specialist is continuing to expand to include participation in clinical research. There is, however, a lack of clinical researchers available to conduct nursing research. A clinical nurse specialist with a joint appointment between a clinical and an academic setting can facilitate clinical research through collaboration. Such collaborative efforts can result in improved patient care and nursing practice. This article describes several major collaborative models used to join the academic and practice settings and discusses their strengths and weaknesses. It also describes in detail a collaborative approach in which the clinical nurse specialist play a more pivotal role by acting as a facilitator for the collaboration. We discuss the formation of the collaborative team, the roles of the participants, and the research plan of the team. Suggestions for implementing this model in other settings are offered.

Clinical Nursing Research↗
PubMed1988

Aortic dissection.

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Aortic Dissection↗
PubMed1988

Awareness, use, and impact of the 1984 Joint National Committee consensus report on high blood pressure.

A random sample of Maryland physicians stratified by practice specialty (family, general, internal medicine, cardiology, and nephrology) was surveyed before and one year after dissemination of the 1984 Report of the Third Joint National Committee on the Detection, Evaluation, and Treatment of High Blood Pressure (The JNC III Report). Fourty-four per cent of the total eligible sample responded to both questionnaires. One year after publication, 62 per cent of physicians participating in both parts of the study were aware of the report. Although availability of a copy (58 per cent), familiarity with the recommendations (81 per cent), and the extent to which care was based on the guidelines (65 per cent) were high, use of the report in practice (17 per cent) and the amount of change in practice behavior required to adhere to the guidelines (18 per cent) were low. Prior to publication of the report, more than two-thirds of responding physicians were found to be practicing in a manner congruent with nine of ten treatment recommendations studied. One year after JNC III's release, they reported practice behavior which was not significantly different. It seems that this consensus report codified, rather than changed, practice behavior in this sample.

Consensus Statements as Topic↗
PubMed1986

Pap testing: opinion and practice among young obstetrician-gynecologists.

Since 1976, contradictory recommendations by a number of groups (including the American Cancer Society, the National Cancer Institute, a National Institutes of Health Consensus Development Conference, the Canadian Task Force on Cervical Cancer Screening Programs, and the American College of Obstetricians and Gynecologists) on the timing of Pap testing--including age to begin testing, appropriate frequency of testing, and age to discontinue testing--have been communicated to both physicians and consumers. The opinions and practices of a U.S. national sample of recently trained obstetrician-gynecologists, whose professional association continues to endorse annual Pap tests, were investigated and compared with key points from the various recommendations. The appropriateness of the recommendations themselves is not addressed. Findings show that respondents are aware of recommendations for less frequent Pap testing, but they believe that women should generally receive annual Pap tests and that regular Pap testing should not be discontinued among the elderly. While the intensity of Pap testing services varies by type of practice arrangement, such variation does not occur for opinions regarding Pap testing, with one exception: Those practicing in multispecialty groups (including health maintenance organizations) are more likely to endorse routine Pap testing for elderly women if they see elderly women in their practices. Thus, the physicians in this study are not adhering to recommendations for Pap testing on a less-than-annual basis or for discontinuance in the elderly.

Adolescent↗
PubMed1985

After the screening.

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Cardiovascular Diseases↗
PubMed1979

Achievement of standards for quality care of hypertension by physicians and nurses.

The quality of care provided by physicians and nurses to a hypertension clinic population was studied using retrospective chart audit to compare control of blood pressure (physiologic outcome) and provider performance (process). Data was collected from 200 records, 36.4% of patients, in the program. Return visits were kept by 173 patients (86.5%) during the 6 month study period. Satisfactory point prevelance BP control (diastolic less than or equal to 90 mmHg) was achieved in 103 (59.5%). Adequate process was documented for 49 of 69 patients with unsatisfactory BP control. The records of 20 patients (11.5%) did not satisfy minumum quality of care criteria. Physicians and nurses saw similar patient groups and did not differ in process documentation or outcome results. The audit methodology was efficient, effective in evaluating management and useful in providing information about staff performance.

Adolescent↗
PubMed1977

Arbovirus isolations from mosquitoes: Kano Plain, Kenya.

Arbovirus isolation attempts on 324,486 mosquitoes captured over a four-year period on the Kano Plain, Kenya, yielded 15 isolates including Pongola (six strains), Ilesha (three strains), Germiston (two strains), Sindbis (one strain), Barur (one strain) and two viruses which could not be characterized. Mansonia uniformis, Anopheles gambiae and Culex antennatus constituted 70% of the total collection and accounted for all of the isolates except one, which came from Anopheles funestus.

Animals↗