Biomedical subjects
Publications and source records attributed to R A Kane.
The commercial availability of double-lumen balloon catheters has added a new tool for the angiographer in controlling gastrointestinal bleeding. Our report describes a situation in which the unique properties of this catheter were quite effective in controlling life-threatening hemorrhage.
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The ultrasonographic appearance of five cases of acute cholecystitis which progressed to either gangrenous necrosis or empyema of the gallbladder is presented with clinical, surgical and pathological correlation. A typical pattern consisted of diffuse, medium-to-coarse intraluminal echoes within the gallbladder which did not show layering or acoustical shadowing. Other findings, including thickening of the gallbladder wall and localized peritoneal fluid collections, are described. It is concluded that cholecystosonography can be of considerable value in the early diagnosis of these serious complications of acute cholecystitis.
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Long-term care for the aged in the United States is overly dependent upon the nursing home. This hospital-like model for long-term care is particularly inappropriate since it imposes a medical solution on a variety of social problems. An adequate long-term care program requires a range of resources in the community as well as in institutions; sheltered housing options seem a desirable alternative to the nursing home. To ensure the quality of nursing home care, the present focus on setting standards for care activities should be abandoned in favor of a focus on care outcomes (physical, mental, and social). In an effort to change our present perverse incentives in the nursing home industry, the proposal is made that nursing homes be reimbursed according to the degree to which patient outcomes meet predicted outcomes.
A review of literature on suicide shows a focus on early detection of those at risk of suicide and on the traits of those who actually commit suicide, but little attention to the therapeutic decisions of those who treat suicidal patients. Through in-depth interviews, 27 therapists from an interdisciplinary mental health center were asked about their theoretical formulations regarding suicide and their therapeutic preferences in working with suicidal clients: Significant differences were found between the nine respondents who had experienced the suicide of a patient in their caseload and the others who had not.
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During a two-month period in 1976, male patients scheduled to be discharged from two Veterans Administration Hospitals, who were aged 55 or older, chronically ill, able to communicate rationally, and had been hospitalized at least a week for the current illness, were interviewed prior to discharge. Information was sought regarding their feelings about admission and discharge, the availability of and their need for 13 related health-related services at home, and the informal support systems available to them in their local communities. Comparisons were made between patients from distinctly rural settings (communities with less than 5,000 population) and those from larger towns or cities. Both urban and rural patients were modest in assessment of their own health-related needs, especially their need for social and ancillary health services. In almost all instances, the perceived availability exceeded perceived needs. Rural dwellers reported somewhat less apprehension about entering the hospital; they also reported more social contact in their home communities despite the fact that in this sample the rural dwellers were more likely to be older, widowed, and living alone. Rural dwellers were slightly more likely to have their own family doctor.
The angiographic findings of cortical nodular hyperplasia, adenolipoma, and intracaval extension of recurrent pheochromocytoma were correlated with the pathological findings. Adenolipoma was angiographically similar to other adrenal neoplasms, adding difficulties to its differential diagnosis. Two cases of cortical nodular hyperplasia showed possibly pathognomonic patterns of discrete vascular cortical accumulations of contrast media which represent capillary malformations within the hyperplastic nodules. Intracaval extension of recurrent pheochromocytoma was found to be similar to other tumors which invade veins.
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Conflicts in interprofessional teamwork may be as much explained by group process considerations as by the interaction of professional roles and statuses. This paper examines the interprofessional team as a small group, using a synthesis of sources from social psychology, social group work, T-group literature, management theory, and health team research. Eight issues are considered in relation to the team as a small group, namely, (a) the individual in the group, (b) team size, (c) group norms, (d) democracy, (e) decision making and conflict resolution, (f) communication and structure, (g) leadership, and (h) group harmony and its relationship to group productivity.
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