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Biomedical subjects

R Glenn

Publications and source records attributed to R Glenn.

10 recordsLinked to original sources
PubMed2006

Models of total and presumed wildlife sources of fecal coliform bacteria in coastal ponds.

Models that accurately predict fecal coliform bacteria (FCB) concentrations, one of the most widely used measures of estuarine water quality, are needed to improve land use decision-making. Rapidly occurring changes in coastal land uses and the influence on water quality increases the urgency of having improved decision tools. For this study, samples were collected monthly from six coastal ponds, two tidal creeks and four shallow water wells for up to 212 years. These data were used along with other measures of environmental conditions and land classes within each watershed to construct quantitative relationships between combinations of variables and both total and presumed wildlife sources of FCB. Linear regression, bootstrapping and generalized additive modeling that incorporates both linear and nonlinear terms were used. Results of repeated simultaneous sampling on the same tide stage of ponds and downstream estuarine creeks suggest that most FCB come from wildlife and that the ponds effectively remove these bacteria except immediately following heavy rainfall. Predictive models for concentrations of total and presumed wildlife bacteria are provided along with simple measures to estimate watershed boundaries. It is proposed that these tools can be used to minimize impacts on receiving water body quality. The models can be used to test alternative development approaches within coastal watersheds similar to that found in the southeastern USA coastal zone as well as to evaluate specific proposed landscape alterations.

Animals↗
PubMed2001

Condylomata acuminata (genital warts): patient demographics and treating physicians.

BACKGROUND: Condylomata acuminata (genital warts), caused by the human papillomavirus, are common and sexually transmitted. However, the use of healthcare services for condylomata has never been characterized from a national probability sample study. GOAL: To understand better the demographics of patients seen by physicians for this disorder. STUDY DESIGN: Data from office visits for warts, both condylomata and noncondylomatous types, were obtained from the 1994 to 1998 National Ambulatory Medical Care Survey. RESULTS: The age distribution of those treated for condylomata peaked in 20- to 39-year-olds, with more than 70% of patients in this age category. A younger and wider age distribution was seen in patients with noncondylomatous warts. Women accounted for 67% of the population seen for condylomata, whereas a more equal number of women and men were seen for noncondylomatous warts. Per capita healthcare use for condylomata was equal between blacks and whites, and whites had almost five times more per capita healthcare use than blacks for noncondylomatous warts. Obstetrician/gynecologists were the most commonly consulted physicians for condylomata. Per capita condylomata visits per physician were highest for obstetrician/gynecologists, dermatologists, and urologists, and lower for all other physicians. CONCLUSIONS: The difference in age distribution between condylomata and noncondylomatous visits likely results from differing modes of transmission and age at first sexual contact. Females are more likely than males to use health care for condylomata, which may be attributable to increased prevalence, differences in treatment efficacy, differences in the gender frequency of genital health screenings, or psychosocial causes. Healthcare use for condylomata appears equal between blacks and whites. Patients with condylomata acuminata were most often seen by obstetrician/gynecologists, whereas patients with noncondylomatous warts most often consulted dermatologists. The fact that per capita condylomata visits per physician were highest for obstetrician/gynecologists, dermatologists, and urologists may imply that specialists in these fields have expertise in treating these patients.

Adolescent↗
PubMed1996

Planning and assessing a cross-training initiative with multi-skilled employees.

BACKGROUND: An improvement initiative begun by nurses at Parkview Episcopal Medical Center (Pueblo, Colo) to develop patient-focused care delivered by multiskilled workers followed a quality improvement methodology. Implementation of the new care delivery system on a model unit--2 South--provided the opportunity to plan, analyze data, and make changes as appropriate. Parkview's indoctrination of the teachings of W. Edwards Deming has helped leaders and staff realize the integral role of training in improvement activities. In his 14 points, Deming emphasizes the importance of employee education and of the employee having a clear understanding of his or her job. The time and money put into up-front education should help ensure the long-term success of this initiative. DEFINING THE CAREPARTNER: Three new multi-skilled positions were developed on 2 South--a Personal CarePartner, a Business CarePartner, and a Clinical CarePartner. By cross-training each of these roles to perform duties formerly done by centralized departments, 2 South was able to cut costs and time while ensuring quality care. TRAINING THE CAREPARTNER: An internally developed training program provided the new CarePartners with up-front education to prepare them to deliver patient-centered care. RESULTS: 2 South has experienced drops in patient falls and medication errors--areas that are often negatively affected when multi-skilled programs are instituted. Patient and physician surveys have shown increased satisfaction with care provided on the unit. The increased efficiency of the model unit has produced these outcomes while cutting costs substantially. LESSONS LEARNED: The interdisciplinary team coordinating the improvement project learned many lessons in the process, including the importance of communication, education, and a sense of humor.

Clinical Competence↗
PubMed1993

Left-handedness as a risk factor for unintentional injury in children.

OBJECTIVE: To determine whether left-handedness is a risk factor for unintentional injury among children and adolescents. DESIGN: Case-control study. SETTING: Pediatric emergency department of Arkansas Children's Hospital. PATIENTS: 265 patients sustaining unintentional trauma aged 6 to 18 years and 494 control patients who did not have trauma were given a questionnaire to determine handedness, past unintentional injury, and parental perception of injury proneness. RESULTS: The frequency of left-handedness in the trauma group (18.1%) was significantly greater than frequency of 10.5% in the control group (P < .003, odds ratio = 1.80, 95% confidence interval 1.20 to 2.72). Multivariate analysis revealed handedness as the only significant variable between trauma and control (P < .04). The proportion of left-handers who had been hospitalized previously for injury treatment (20.0%) was larger than the proportion of right-handers, (12.0%) (P < .026, odds ratio = 1.84, 95% confidence interval 1.03 to 3.27). More parents of left-handers rated their child as "more clumsy than average" than parents of right-handers (26.0% vs 15.2%, P < .007). CONCLUSIONS: Left-handedness appears to be a risk factor for unintentional injury in children and adolescents in a pediatric emergency department population.

Accident Proneness↗
PubMed1984

The incidence and progression of pneumoconiosis over nine years in U.S. coal miners: I. Principal findings.

Chest radiographs, taken at a 9-year interval for 1,261 U.S. coal miners, were read for pneumoconiosis side-by-side by six readers in a controlled trial. Incidence and progression of small, rounded opacities were consistent with levels predicted from dose-response curves developed by the British Pneumoconiosis Field Research interpolated at a concentration derived from U.S. compliance levels mandated over the last 9 years. The results imply that the level of pneumoconiosis in U.S. miners is being reduced through application of the current 2 mg/m3 standard. The long developmental period for pneumoconiosis necessitates that further study be undertaken to verify this finding and to determine whether 2 mg/m3 is an appropriate regulatory dust level for the prevention of category 2 or greater simple pneumoconiosis over a 35-year period.

Adult↗
PubMed1984

The incidence and progression of pneumoconiosis over nine years in U.S. coal miners: II. Relationship with dust exposure and other potential causative factors.

Examination of the incidence and progression of pneumoconiosis over 9 years in 1,261 nationally distributed U.S. coal miners has been undertaken in relationship to potential causative factors. Use has been made of a large body of data on dust levels collected by the Mine Safety and Health Administration principally for compliance purposes. Reported dust levels were low and generally under the current 2 mg/m3 standard. No link between dust level and disease progression could be detected. Some evidence was seen that radiological change was related to dust exposures prior to the study in both coal and noncoal mines, and thus experienced before the current dust standards were mandated. Neither migration of miners nor mining method appeared to be associated with disease incidence or progression. None of these findings can be taken as final, as the period of study is short and the number of cases of pneumoconiosis few. Further study is under way to obtain more reliable information over a longer period of follow-up.

Adult↗