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Biomedical subjects

M W Herman

Publications and source records attributed to M W Herman.

At least 19 recordsLinked to original sources
PubMed1990

Shielding of the patient's gonads during intramedullary interlocking femoral nailing.

Levels of exposure to radiation were recorded at sixty sites in fifteen patients during intramedullary interlocking femoral nailing. Radiation film dosimeters were placed at four gonadal sites on each subject. A standard male-gonad cup or a pelvic drape of 0.5-millimeter-thick lead-equivalent was put in place to shield the gonads. A second set of four dosimeters was placed external to the shield to approximate unprotected exposure. The total duration of the fluoroscopy averaged five minutes (range, thirty seconds to fourteen minutes). The total exposure to radiation external to the shield was 35 +/- 34 millirems at the male gonadal sites and 17 +/- 11 millirems at the female gonadal sites. With use of the gonadal shield, exposure to radiation was not measurable in thirteen of the fifteen patients. The differences between the exposures of the shielded and unshielded sites to radiation were statistically significant (p less than 0.001). The highest level of gonadal exposure was found with the treatment of proximal femoral fractures and with the use of statically locked nails. Regardless of the conditions, and for all types of fractures and locations, our results demonstrated that gonadal shielding is justified.

Adult↗
PubMed1987

Radiation exposure reduction by use of Kevlar cassettes in the neonatal nursery.

A study was performed to determine whether the use of Kevlar cassettes in the neonatal intensive care nursery would reduce radiation exposure to patients. The radiation dose to the neonates was measured by using thermoluminescent dosimeters. In addition, the attenuation of the Kevlar cassettes and the sensitivity of the film-screen combination were compared with the previously used system. The greatest radiation reduction using a mobile X-ray unit was 27%; based on sensitivity measurements, the theoretical reduction averaged 38%. The reduction in radiation exposure resulted from reduced attenuation by the Kevlar cassette.

Body Weight↗
PubMed1985

Adjustment and psychosocial problems of Iranian and Filipino physicians in the U.S.

A questionnaire was mailed to 2,521 Iranian and 2,938 Filipino physicians who were practicing medicine in the U.S. Six hundred ninety-five Iranians and 898 Filipinos responded. Data of a section of the questionnaire on perceived adjustment and psychosocial problems were analyzed in this study. Statistical analyses of the data (bivariate correlations, multiple regression, and factor analysis) indicated that the reported adjustment problem was related closely to psychopathological measures such as loneliness, anxiety, depression, homesickness, and low self-esteem in both nationality groups. Participation in social activities with Americans was inversely related to perceived adjustment problems. In both groups, those who had become naturalized U.S. citizens and those who planned to stay permanently in the U.S. were less likely to report adjustment problems. The relationships between perceived adjustment problems and age and total years in the U.S. were not significant for Iranian physicians; however, they were correlated significantly for the Filipinos, which indicates that older physicians in this group and those who had been in the U.S. for a longer period of time were less likely to report adjustment problems. Other differences and similarities between the two nationality groups also were identified.

Acculturation↗
PubMed1985

Medical students' opinions on economic aspects of the health care system.

Responses of 423 freshmen and 410 seniors at Jefferson Medical College in 1980-81 and 1982-83 to 15 questions on economic aspects of the health care system were compared. A majority of the students considered the cost of medical care, the cost of medical education, malpractice claims, and the failure of individuals to assume responsibility for their health to be major problems. A majority of the seniors also considered excessive government influence on the financing of medical care a major problem. More freshmen than seniors favored national health insurance and health maintenance organizations. More seniors than freshmen supported the professional standards review organization concept and action to discourage increases in the supply of physicians. Concern about the number of physicians entering the profession increased among seniors between 1981 and 1983. The data suggest that at graduation the students were more concerned about the position of physicians but might not be more informed about important aspects of the functioning of the health care system than they were at entry.

Costs and Cost Analysis↗
PubMed1984

Medical students' opinions concerning the health care system.

The opinions of freshman and senior medical students on major health system problems and policies were investigated in 1980-81. Responses of 214 freshmen and 203 seniors are reported in four major areas: (1) physician dominance of the health care system, (2) autonomy in patient care, (3) availability of services, and (4) preventive and social aspects of care. With respect to physician dominance, more seniors (63%) than freshman (44%) agree that physicians should determine health policy and that dominance of other health personnel is necessary (75%) and (61%). Professional review of patient care is generally acceptable to both classes, but more freshmen than seniors agree that evaluation should be a condition for relicensure. Less than a fifth of the students in either class believe that patients should be told as little as possible or that they should accept the authority of doctors without question. More freshmen than seniors consider the availability of medical care a major problem (76%) and (58%), and similar proportions believe it is the responsibility of government to assure access to all. Freshmen and seniors generally agree on the need for greater emphasis on prevention and social aspects of illness. Because of the important role played by physicians in the health care system, it is recommended that serious attention be devoted to education in this area, even though it may have a limited impact on professional attitudes.

Adult↗
PubMed1983

Validity and importance of low ratings given medical graduates in noncognitive areas.

The extent to which recent (1978-1981) graduates of one medical school received low ratings on 10 items concerning noncognitive aspects of professional behavior is presented and related to ratings on items dealing with knowledge, data-gathering skills, and clinical judgment. Overall, only 3 percent of the graduates had low ratings on the noncognitive items. Despite high correlations among ratings in the four areas of professional competence (knowledge, data-gathering, clinical judgment, and professional attitudes), 40 percent of the graduates with low ratings on noncognitive items had high ratings in at least two of the areas. The validity of the ratings is tested by relating them to the willingness of residency supervisors to offer the graduates further postgraduate training and to clinical ratings received in the third year of medical school. Substantial relationships are shown both with the residency offer and medical school ratings for graduates with high and low ratings.

Attitude of Health Personnel↗
PubMed1982

A dose table describing fractions of peripheral volume for 125I volume implants.

A dose table that provides the dose as a function of fractions of peripheral volume for 125I implants is presented. The table is based on seed distributions from 50 actual patient implants. Computer dosimetry was used to determine peripheral doses and dose ranges within implant volumes. The effects of seed distribution were also examined. The patient data and a study of computer-generated randomized seed coordinates within a given volume suggest that matched doses do not depend strongly on the exact position of each seed. The table provides the means for planning an implant to obtain a desired peripheral dose that can be directly compared with the postimplant computer dose calculation.

Brachytherapy↗
PubMed1981

Premedical training, personal characteristics and performance in medical school.

Despite concern over the concentration on science in pre-medical education and the selection of medical students in the United States, no major changes have been made. The present study compares attrition rates and clinical competence levels of medical students who vary in pre-medical training, age, and sex, in order to determine the risk attached to accepting applicants with different background characteristics. No differences were found in levels of clinical competence, although the groups varied in average science scores on the medical college admission tests (MCATs). Students with non-science undergraduate majors had lower scores on this test than science majors. Younger women had relatively high attrition rates, but high performance on the MCAT science sub-test and in medical school science course. It was concluded that all groups had adequate science preparation for medical school, and there was no greater risk of producing doctors with low levels of clinical competence associated with accepting students from groups with lower science performance.

Clinical Competence↗
PubMed1980

Continuity of care.

Continuity of care is of value only to the extent that it has an impact on the outcome of care, the prevention or reduction of physical, mental, or social disabilities, the satisfaction of patients, and the costs of care. It is important that research studies include patients with a broad range of social characteristics and that costs as well as health care benefits be measured. An accountability model describing the contributions of physicians, health care institutions, patients, and the local community to health outcomes is recommended. The following three principles are outlined for the evaluation of health care: (1) determine the patient's health status before and after care, (2) use appropriate measures of health outcomes, and (3) consider potential effects of factors extrinsic to medical care.

Continuity of Patient Care↗