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Biomedical subjects

S H Shaha

Publications and source records attributed to S H Shaha.

7 recordsLinked to original sources
PubMed2001

Effectiveness of adenoidectomy and laser tympanic membrane fenestration.

OBJECTIVE: Adenoidectomy alone or with tonsillectomy (A+/-T) is an effective surgical intervention in the management of otitis media in children, especially when it is performed in conjunction with insertion of pressure equalization tubes (PETs). Otorrhea and persistent tympanic membrane (TM) perforation are frequent complications. This study evaluates the effectiveness of intermediate duration middle ear ventilation using laser tympanic membrane fenestration (LTMF) without tube insertion and as an adjunct to adenoidectomy in resolving middle ear disease within the first 90 days after surgery. STUDY DESIGN: This pilot study was a multicenter, prospective clinical cohort trial. Institutional review board approval and informed consent were obtained. The study involved four tertiary care pediatric otolaryngology departments. Fifty children (96 ears) were treated with LTMF in conjunction with A+/-T from June 1, 1998, through March 30, 1999. Ages ranged from 9 months to 12 years. Patients undergoing A+/-T who would have been recommended for PET insertion instead underwent middle ear ventilation with LTMF using the Oto-LAM device (ESC/Sharplan, Yokneam, Israel). Patients were seen at 30, 60, and 90 days postoperatively. Resolution of otitis media with effusion was determined by clinical examination, which included pneumatic otoscopy, audiometry, and tympanometry. RESULTS: Of the treated ears, 88%, 86%, and 83% had clinical resolution of middle ear disease at 30, 60, and 90 days, respectively. Preoperatively, 45% (n = 85) of ears had normal hearing; 92% (n = 49) had normal hearing at 90 days. Eighty-nine percent (n = 92) had type C2 or B tympanograms preoperatively, and 12% (n = 60) had type C2 or B at 90 days. CONCLUSION: Laser tympanic membrane fenestration in conjunction with adenoidectomy was effective in restoring normal middle ear function at 90 days post-treatment in greater than 80% of children who otherwise may have had placement of PETs.

Adenoids↗
PubMed1999

The negative psychosocial impact of strabismus in adults.

INTRODUCTION: The goal in the treatment of strabismus is to realign the visual axes to eliminate diplopia, produce or restore binocular vision, expand the binocular visual field, and/or provide a normal appearance. The treatment of strabismus in adults who do not experience diplopia or who do not have binocular potential has sometimes been regarded as "cosmetic." Many adults with strabismus have stated that it has had a negative effect on their lives. This study was designed to ascertain whether there is a negative social bias against adult patients with strabismus that could affect interpersonal relationships and limit employment opportunities. METHODS: An orthotropic person was photographed in primary, right, and left gaze. These photographs were then digitally altered to produce an esotropia and exotropia of similar magnitude. Subjects were then asked to evaluate a single photograph with reference to personality characteristics that are important for social interaction and employment capability. RESULTS: Overall, the strabismic faces were judged significantly more negatively, across 11 descriptive characteristics, than the nonstrabismic face. The effect of esotropia was worse than exotropia. CONCLUSION: Strabismus creates a significant negative social prejudice. These biases can have a detrimental impact on socialization and employability. Treatment of strabismus may positively alter perceived characteristics of individuals and improve their ability to socialize normally and obtain employment. Therefore, the treatment of strabismus should not be considered cosmetic even when there is no hope of improving binocular vision.

Adolescent↗
PubMed1998

Integrated outcomes: where CIOs need to be thinking.

Financial data have been the mainstay in health care organization business decision making. CIOs can lead efforts to add clinical and satisfaction data and create more customer-focused integrated outcomes systems.

Data Collection↗
PubMed1995

Acuity systems and control charting.

The strengths of control charting and other statistical process control (SPC) tools have not previously been applied to acuity systems. Intermountain Health Care, Salt Lake City, Utah, developed a new acuity system that relies heavily upon control charting for an array of purposes, including immediate feedback to caregivers regarding decisions, ongoing feedback to managers regarding decision patterns, and longer-term feedback regarding trends and budget-relevant information. The use of control charts has eliminated the need for auditing acuity-based staffing and has maintained the reliability of classifications at levels above 95 percent. Implications for other novel applications are offered.

Data Interpretation, Statistical↗
PubMed1983

Spatial representation of maps.

Two experiments tested the hypothesis that the cognitive representation of spatial relations on a map is primarily a visually keyed process. In Experiment 1, undergraduates studied a labeled map where features were presented either as words alone, as mimetic drawings of the referent, or as geometric symbols. Cued recall data showed that discrete features are best located when they are semantically congruent with the label referent, a fact providing considerable support for the image position. Recognition testing required a set of introspective judgements ordinally related to the interfeature metric on the map. The judgment X distance estimates were highly correlated for all groups, intimating that a high correspondence exists between image distances and the original stimulus metric. Experiment 2 had undergraduates view either a full-scale or a three-quarter reduction of a reference map. Subjects in the reduced version were able to recognize significantly more interfeature comparisons, suggesting a predictable relation between visual and imaginal acuity. The judgement X distance results were essentially the same as in Experiment 1, and the two groups failed to differ in terms of cued recall. Data from both experiments imply that spatial relations are cognitively represented in at least a partially isomorphic fashion, which seems to possess quasi-pictorial qualities.

Cognition↗
PubMedDate not supplied

Fixing acuity: a professional approach to patient classification and staffing.

Traditional acuity systems have met with limited success in hospitals. The requirements and high costs of installation, auditing, maintenance, and updating have been problematic criticisms. Intermountain Health Care developed an innovative system which focuses on and refines the professional judgment and decision making of nurses and caregivers as the basis for patient classification and staffing. Results have been favorable for: (a) increasing the usefulness and accuracy of the information, (b) enabling delivery-level innovation in staffing models and successfully considering and testing alternative care delivery models to reduce the costs of care, (c) reducing the expenses associated with maintaining, auditing, and updating the systems, and (d) fostering delivery-level ownership and enhancing the professionalism and satisfaction of the caregiver users.

Clinical Competence↗