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Biomedical subjects

N J Baker

Publications and source records attributed to N J Baker.

At least 19 recordsLinked to original sources
PubMed1995

A 13 year review of childhood lead poisoning in Christchurch and Nelson.

AIMS: To find the sources of lead currently poisoning people in Christchurch and Nelson and to review the presentation, epidemiology and symptoms of children with lead poisoning. METHODS: Forty seven people were admitted to hospital in Christchurch and Nelson during the 13 year period January 1981-March 1994 a retrospective case note review was performed. RESULTS: Thirty four children and 13 adults had elevated lead levels. Lead based paint was the main source of lead for children requiring treatment. Most children were asymptomatic or had no specific signs and symptoms. In most cases the diagnosis was not made on clinical grounds. CONCLUSIONS: Excessive lead absorption requiring hospital treatment is now most commonly seen in children. It is likely that many cases of significant lead poisoning are currently being overlooked. Medical practitioners and parents need to be made more aware of the problem. Targeted screening or population screening may be needed. Governmental efforts need to be focused on protecting children from lead exposure in the home.

Child↗
PubMed1995

Strategic footholds for medical education about domestic violence.

The author describes in detail the successful education initiatives on domestic violence, especially violence against adult women, that have been implemented for family medicine residents at the St. Paul-Ramsey Medical Center in St. Paul, Minnesota, and for medical students at each of the three Minnesota medical schools. For example, in 1990 the residency program adopted a community-oriented primary care approach to teaching and clinical activities, including the area of domestic violence. This approach stresses partnerships with community organizations that deal with domestic abuse. Also developed was a curriculum to help residents deal with their apprehension about domestic violence and acquire the knowledge, attitudes, and skills they need to confront this problem effectively. At the three medical schools, teaching about domestic violence takes place in preclinical courses, during clinical rotations (where students work with abuse victims), and through extracurricular activities. The author describes some important types of resistance to having instruction about domestic violence in the medical curriculum. To move forward, faculty must overcome their discomfort with the topic yet acknowledge that teaching about it is difficult and requires personal stamina and empathy with colleagues. Faculty must also agree to collaborate with those who have sensitivity and expertise in the area, and must make a long-term commitment to prepare physicians to recognize problems of domestic violence and work effectively with its victims and perpetrators.

Adult↗
PubMed1992

Reorganization of a private psychiatric unit to promote collaboration with managed care.

Managed care organizations have become significantly involved in health care in the Denver metropolitan area. Their presence has challenged psychiatric hospitals to reduce costs and length of stay. In 1990, a locked private psychiatric unit was reorganized into locked, open, and partial care services through which patients progress at individualized rates. One treatment team manages patients in all settings, allowing a reduction in staffing costs and flexibility in treatment design. The hospital administration takes an active role in facilitating collaborative decision making between hospital clinicians and managed care representatives. In the first year after reorganization, length of stay was significantly reduced; 90 percent of patients were discharged from 24-hour care within ten days or less, whereas only 40 percent were discharged within that time in the original program. Staffing costs were reduced by 15 percent. No increase in recidivism was noted.

Adjustment Disorders↗
PubMed1992

Maternity leave for practicing family physicians.

BACKGROUND: Approximately 37% of all medical students and 36% of family medicine residents in training in the United States are women. The American Academy of Family Physicians (AAFP) has developed a recommended parental leave policy for residents in training but has not established a similar policy for physicians in practice. The purpose of this study was to assess the prevalence of maternity leave policies for practicing family physicians. METHODS: A 14-item self-administered survey questionnaire was designed and mailed to 940 AAFP members randomly selected from the total active female membership. RESULTS: A 52% response rate was obtained. The mean age of respondents was 35 years. Only one third of the physicians not in solo practice reported having a stated maternity leave policy in their current place of practice. Academic programs, when compared with single specialty family practice groups, multispecialty groups and health maintenance organization (HMO) or preferred provider organization (PPO) groups, were more likely to have maternity leave policies and to provide salary on leave. Practice groups with eight or more partners were more likely to have policies that provided salary and benefits while on leave. Ninety percent of respondents requested maternity leave guidelines for practicing family physicians. CONCLUSIONS: Women family physicians expressed strong interest in the development of maternity leave guidelines for their specialty. Guideline components are outlined.

Adult↗
PubMed1990

Sensory gating deficits in psychiatric inpatients: relation to catecholamine metabolites in different diagnostic groups.

Acutely ill psychiatric inpatients were examined for a deficit in sensory gating, measured as failure to suppress the P50 wave of the auditory-evoked response to the second of paired stimuli. Previously, we had found that in mania, this sensory gating deficit is correlated with increased plasma-free levels of the noradrenergic metabolite 3-methoxy, 4-hydroxyphenylglycol (pMHPG), whereas in schizophrenia, there is no correlation with catecholamine metabolism. To assess the generalizability of these findings, we examined inpatients with a broader range of diagnoses, including those with multiple DSM III-R Axis I, II, and III diagnoses. The patients were grouped into three diagnostic spectra for analysis: schizophrenic, manic, and depressive. In the schizophrenic patients, there was no relationship between pMHPG or other catecholamine metabolites and the sensory gating deficit. In manic patients, however, a positive correlation between pMHPG level and the sensory gating deficit was again observed. This relationship did not extend to the depressive patients, who uniquely showed sensory gating deficits that correlated negatively with the severity of their illness. The data suggest that sensory gating deficits are common to these three diagnostic spectra, but the deficits in each group have different relationships to catecholamine metabolism and symptom severity that may reflect differences in the underlying neuronal pathophysiology of these illnesses.

Adult↗
PubMed1990

Literary medicine.

Explore the source record for details and available documents.

Human Development↗
PubMed1988

Reproducibility of the measurement of plasma noradrenergic and dopaminergic metabolites in normal subjects.

The object of this study was to determine the reproducibility of the measurement of plasma catecholamine metabolites in normal control subjects and to assess the influence of factors such as time of day, diet, activity, blood pressure, and mood on the variance of these measures. Plasma free homovanillic acid (HVA), 3-methoxy-4-hydroxyphenylglycol (MHPG), and vanillylmandelic acid (VMA) were simultaneously measured by high performance liquid chromatography with electrochemical detection. Samples were collected from 15 doctors and nurses at 8 a.m. and at noon on 2 separate days. After the fasting 8 a.m. sample, the subjects ate a regular hospital breakfast. Activity in their usual tasks on an inpatient psychiatric unit was monitored electronically by an activity meter. Levels of each metabolite were not significantly different between days at the respective assay times and were highly correlated for individuals. MHPG showed a significant increase from morning to noon, while HVA showed a significant decrease. Activity, dietary intake of tyrosine and tyramine, blood pressure, pulse, scores on the Profile of Mood States, age, and sex were not related to plasma levels. The results demonstrate that measures of dopamine and norepinephrine metabolites have significant reliability in normal subjects in a setting used for research studies with psychiatric patients.

Adult↗
PubMed1987

Family diagnoses missed on a clinical inpatient service.

Methods for taking family psychiatric histories have been developed primarily for research rather than clinical settings. The authors compared family histories obtained independently by a research team and by PGY-3 residents on 52 consecutively admitted adult psychiatric inpatients. In contrast to the residents, the research team used a family tree, screening questions, and a structured interview based on diagnostic criteria and identified more than four times as many diagnoses in relatives as did the residents. The results demonstrate that a family history strategy derived from research methodology significantly enhances the gathering of important diagnostic information in a clinical inpatient setting.

Data Collection↗
PubMed1985

The Mezzich MMPI regression formula revisited.

In a sample of depressed psychiatric inpatients, the Mezzich regression formula, based on five MMPI scales, correlated moderately with clinicians' judgments and yielded few false negative diagnoses in identifying patients with unipolar Major Depressive Disorder, but was less effective in eliminating false positives.

Adult↗
PubMed1982

Lamellar bodies in activated platelets as revealed by the use of tannic acid and a comparison with the concentric laminar organelles of type II pneumocytes.

Transmission electron micrographs of unactivated platelets, adenosine diphosphate-induced platelet aggregates and thrombin-induced platelet clots, prepared using a tannic acid fixative/stain, reveal characteristic lamellar bodies. These lamellar bodies are seen more frequently in the clots. The lower limit of the dark band periodicity in the lamellar bodies is between 4 . 4 and 5 . 0 nm, and the layers are thought to be composed of phospholipid, probably phosphatidyl choline. Analogies are drawn between the lamellar bodies of platelets and the concentric laminar organelles present in Type II pneumocytes (dust cells) which show similar ultrastructural characteristics when treated with the tannic acid fixative/stain.

Adenosine Diphosphate↗