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Biomedical subjects

R McNeil

Publications and source records attributed to R McNeil.

23 records · Page 2Linked to original sources
PubMed1975

HMOs, competition, and government.

This article considers the role of three sets of forces affecting the development of health maintenance organizations (HMOs) during the early 1970s: legal restrictions, market conditions, and the federal government's policy stance. Our review of the evidence suggests that the rapid increase in the number of HMOs during this period was primarily due to favorable market conditions in certain areas of the country combined with a highly encouraging federal policy toward HMOs. Legal restrictions do not appear to have been as serious a barrier to HMO development as was earlier believed. In 1973-74, major new legislation was enacted at both the federal and state levels, ostensibly to encourage HMO development. Our review of this legislation suggests that, while it removes many of the old legal requirements which apparently were not serious barriers to HMO development, the new legislation imposes a host of new conditions and requirements on HMO participation in the health care marketplace. Ironically, some of these new features may impede the operation of the very market forces which encouraged the earlier HMO growth.

Consumer Behavior↗
PubMedDate not supplied

The use of Glasgow Coma Scale in poisoning.

A 12-month prospective study was undertaken to observe current practice and to determine if a Glasgow Coma Scale (GCS) of 8 or less on admission is a useful parameter to predict the need for airway protection in poisoning. For the period of September 1988 to August 1989, there were 414 admissions for poisoning with 3 fatalities (0.7%). A total of 41 patients (10%) were assessed by attending physicians as requiring airway protection. An initial GCS of 8 or less had a sensitivity of 90% and specificity of 95% for predicting the need for intubation. Logistic regression analysis showed an odds ratio of 0.48 for the relationship between GCS and intubation, significant at P < 0.001. In addition, the absence of a gag reflex on admission gave a sensitivity of 70% and specificity of 100% for predicting the need for airway protection. Further analysis showed that the presence or absence of a gag reflex added nothing to the GCS for the prediction of probability for intubation. In conclusion, an initial GCS of 8 or less was found to be a useful guideline for intubation. However, it should be used in conjunction with the clinical context.

Adolescent↗
PubMedDate not supplied

Behavioral, morphological and physiological correlates of diurnal and nocturnal vision in selected wading bird species.

We examined in selected wading bird species if diurnal or nocturnal foraging and the use of visual or tactile feeding strategies could be correlated with retinal structure and function. The selected species were the Yellow-crowned Night Heron (Nycticorax violaceus), a crepuscular and nocturnal forager, the Great Blue Heron (Ardea herodias), a mainly crepuscular, but also diurnal and nocturnal feeder, the Roseate Spoonbill (Ajaia ajaja), a mainly crepuscular feeder which forages more at night than during the day, the Cattle (Bubulcus ibis) and Tricolored (Egretta tricolor) egrets and the American White Ibis (Eudocimus ruber) which forage only during daytime. Herons and egrets are visual foragers; ibises and spoonbills are tactile feeders. Electroretinograms were obtained from anesthetized birds in photopic and scotopic conditions to a wide range of light intensities, following which the retinae were processed for histological analysis. Based on rod densities and rods:cones ratios, nocturnal vision capability is greater in the Yellow-crowned Night Heron, followed by the Great Blue Heron and the spoonbill, then by the egrets and the ibis. Visual feeders that forage near dawn or dusk or at night have a higher rods:cones ratio, and consequently a greater night vision capability, than visual feeding species which forage only during daytime. Visual nocturnal feeders have a night vision capability greater than tactile diurnal as well as tactile nocturnal feeders. However, based on maximum scotopic b-wave amplitudes, all species studied have roughly comparable night vision capability. The factor that best discriminates between wading bird species appears to be the daytime visual capabilities. Indeed, the diurnal ibis and egrets have similar cone densities, cones:rods ratios, and photopic a-wave amplitudes, values which are greater than those measured in the two nocturnally active heron species.

Animals↗