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Biomedical subjects

R Kellerman

Publications and source records attributed to R Kellerman.

10 recordsLinked to original sources
PubMed2001

Itinerant surgical and medical specialist care in Kansas: report of a survey of rural hospital administrators.

In most rural areas, specialist nonprimary care, when available, is provided by "itinerant" physicians and surgeons who periodically visit from a distant home base. Little is known about current usage and acceptability of itinerant specialists in rural communities. Administrators of hospitals in rural and frontier Kansas counties were asked to report the frequency of itinerant care in their facilities, the home base of each specialist and a listing of procedures performed during specialist visits. Administrators were also asked to respond on a Likert scale to six questions inviting their assessment of itinerant care. Responses were received from 53 of 56 hospitals. All offered at least one monthly session of itinerant medical or surgical care. The most common specialties represented were cardiology (in 87 percent of hospitals), urology (68 percent), orthopedics (68 percent) and radiology (60 percent). General surgeons consulted in over 80 percent of responding hospitals. Psychiatrists, dermatologists and neurologists were rarely available in the hospitals surveyed. Administrators generally rated itinerant care highly, though some expressed concern about revenue lost when specialists performed procedures in their home-base office or hospital. No associations were found between amount of care offered and potential explanatory variables such as hospital size, distance from subregional centers, or percentage of patients hospitalized locally. Further study is needed to better understand differences in itinerant specialist utilization and acceptance among rural Kansas hospitals. Because Kansas demographics are similar to those of many other American rural areas, such study may offer insights applicable to other regions.

Hospitals, Rural↗
PubMed1990

Manufactured housing plant injuries in a rural family practice.

The manufacture of mobile homes and prefabricated houses results in the second highest occupational injury and illness rate of any industry. The types of worker injuries sustained have never previously been characterized. This series of 138 injuries from a rural family practice categorizes the injuries sustained by workers in a manufactured housing plant. Most injuries were not judged to be serious, but did result in lost work time and morbidity. Forty-nine percent of all injuries involved lacerations or puncture wounds. Seventy-six percent of puncture wounds involved staple gun use. Two thirds of lacerations were from pieces of metal, siding, and other sharp objects; one third were from knives. Fingers, hands, and wrists were the most commonly injured anatomic sites. Nine cases of overuse injury were seen; two required carpal tunnel surgical release. Twelve injuries were serious enough to require hospitalization or consultation. There were no fatalities. Several suggestions for improved worker safety are presented.

Accidents, Occupational↗
PubMed1983

Practice management training in family practice residencies.

Recent surveys have suggested that practice management instruction in family practice residency programs is inadequate. The majority of third-year family practice residents graduating in 1980 felt inadequately trained in nearly all aspects of practice management. Thirty-five percent of these residents noted that their residency programs offered no regularly scheduled time for practice management training. Results of four family practice residency graduate follow-up surveys showed that no fewer than 25 percent and, often, 60 to 80 percent of graduates felt underprepared in most areas of practice management.

Administrative Personnel↗
PubMed1981

Reactions to radiographic contrast media.

Patients with a history of an anaphylactoid reaction to radiographic contrast media are at increased risk for a subsequent reaction, but reactions cannot be predicted. Because contrast studies are often essential for optimal management, it may be necessary to take the risk of reexposing the patient to the contrast media. Prednisone-diphenhydramine pretreatment significantly decreases the likelihood of another reaction. Treatment of an anaphylactoid reaction requires knowledge of basic and advanced cardiopulmonary resuscitation.

Anaphylaxis↗
PubMed1975

Water sorption in a dextran gel.

The state of adsorbed water in a dextran gel has been investigated by near-infrared gravimetric-adsoprtion techniques. Water-vapor adsorption (desorption) isotherms at three temperatures are reported. The calculated sorption heats are found to be markedly temperature-dependent as well as dependent on the coverage. The near-infrared spectrum (4650-9000 cm-minus 1) is reported, together with tentative assignments. The H2O combination (v+delta) band at 5184 cm-minus 1 has been examined as a function of relative humidity. The line-shapes of this band have been analyzed by a recently established, Fourier-inversion technique, and information on the microdynamics of the absorbed water molecules has been resolved on the picosecond time-scale. At low and intermediate degrees of hydration, reorientational jumps take place with periods from four to six times longer than those for free water. The onset of saturation is then accompanied by the sudden removal of the reorientational jumps. A comparison of microdynamical and thermodynamic data indicates the hydration mechanism to be highly cooperative at all relative humidities.

Binding Sites↗