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Biomedical subjects

S P Chen

Publications and source records attributed to S P Chen.

At least 19 recordsLinked to original sources
PubMed1992

An overview of the development and refinement of the Resource-Based Relative Value Scale. The foundation for reform of U.S. physician payment.

Responding to distortions in payment rates between services, policymakers in the United States have sought a systematic and rational foundation for determining physician fees. One such approach to paying physicians, the Resource-Based Relative Value Scale (RBRVS), determines fees by measuring the relative resource costs required to produce them. On January 1, 1992, the Medicare program implemented a new payment system for physician services based on the RBRVS. This article provides a brief history of the RBRVS and a summary of the methods and data used to derive it. This overview represents the culmination of 6 years of research by the Harvard RBRVS study team and provides a road map to the study's concepts and definitions. The overview also provides a context for the articles in this issue that describe five major studies undertaken since 1988. The study's overall results are presented in the last article of the series.

Data Collection↗
PubMed1991

Effects of a school nurse prenatal counseling program.

To determine the effects of a school-based, nurse-run prenatal counseling program, records of prenatal care visits of students and their infants' birth weights (i.e., cases) were obtained from the state live birth certificate tape for 1985-1987. From the same tape, a mother residing in the same community but not enrolled in the program was matched with each case on eight criteria to serve as a control. A total of 288 matched case-control pairs were obtained. Using McNemar's test, a significantly higher percentage of the cases received adequate prenatal care than did the controls.

Adolescent↗
PubMed1990

Bulimia nervosa and associated alcohol abuse among secondary school students.

Four adolescent student populations (totalling 686 girls and 705 boys) completed confidential questionnaires (98.6% response rate) concerning bulimia nervosa and alcohol abuse. All of the DSM-III-R criteria for bulimia nervosa were met by 2.0% of the girls and 0.1% of the boys. On the basis of score greater than or equal to 42 on the Adolescent Alcohol Involvement Scale, 12.5% of all girls and 9.2% of all boys were alcohol abusers. Our results suggest a significant association between bulimic behavior and alcohol abuse in this female population. Other factors associated with bulimic behavior included high maternal vocational status, high socioeconomic class (girls only), high weight for age and height, and low personal ideal weight. Other factors associated with alcohol abuse included high maternal vocational status, low paternal vocational status and education, low socioeconomic class (boys only), low grade point average, high age, and high birth order.

Adolescent↗
PubMed1990

[Protective effect of colloidal bismuth subcitrate on gastric mucosal lesion induced by aspirin].

This study was designed to investigate the protective effect of colloidal bismuth subcitrate (CBS) on aspirin-induced gastric mucosal lesion 20 patients with arthralgia were allocated into this study. All of them were free of gastrointestinal symptom and their gastric mucosa were nearly normal under gastroendoscopic observation. The first group of 10 patients received orally aspirin 1.5 qid for 4 days. The second group also of 10 patients was treated with CBS 120 mg qid and after 2 days they received aspirin and CBS simultaneously in the dosage mentioned above for another 4 days. Before and after treatment, the patients of both groups were examined endoscopically. After treatment, the mucosal inflammation was much less in the second group than that in the first group. The prostaglandin E2 concentration of antral mucosa in the first group was reduced significantly after administration of aspirin alone, while that in the second group was slightly increased after a combined treatment of aspirin and CBS. The results demonstrate that CBS is an effective agent in prevention of gastric lesion induced by aspirin and prostaglandin E may be involved in this mucosal protective effect.

Adolescent↗
PubMed1989

Development of a public health nursing quality assessment measure.

The Ervin Quality Assessment Measure (EQAM) is a newly developed instrument that assesses the quality of in-home public health nursing care based on experts' reviews of client/family records. The 14 criteria for quality care included in the EQAM instrument were established based on the input of five nurse experts. A generalizability study of data from EQAM evaluations of 52 client/family records found that the instrument demonstrated a high degree of dependability and a modest degree of interrater agreement. Future studies will examine the usefulness of the EQAM in home health care agencies and possible practical applications of this research instrument.

Nursing Audit↗
PubMed1989

The effectiveness of public health nursing services to prenatal clients: an integrated review.

The effectiveness of public health nursing interventions with prenatal clients was summarized from 17 studies, conducted between 1963 and 1988, that were identified through a comprehensive reference search. The review indicated that public health nursing interventions can increase birthweight, and the use of prenatal medical services, nutritional services, and childbirth classes. Because of methodological problems, however, it is difficult to conclude with certainty that such interventions make a significant difference in client outcomes. These problems included lack of construct validity, lack of specification of interventions, small convenience samples, lack of power to detect small treatment effects, nonexperimental research designs, lack of reliability information, and self-selection and history biases. To overcome these problems, the authors suggest the use of conceptual frameworks, power calculations prior to initiation of research, experimental or quasiexperimental designs, replication of research with different populations, and the calculation and reporting of reliability information.

Evaluation Studies as Topic↗
PubMed1989

[Omeprazole in peptic ulceration: acid inhibition and endoscopic healing].

Basal and pentagastrin stimulated gastric acid secretions were measured in 20 patients with duodenal ulcer before and after one week of treatment with oral omeprazole 20 mg daily. Omeprazole markedly inhibited gastric acid secretion in all the patients. The mean basal intragastric pH rose from 1.6 to 6.3, and the BAO and MAO were reduced by 86.9% and 83.9% respectively on day 7 of the study. We also conducted a clinical trial in 63 duodenal and 12 gastric ulcer patients. Each patient received 20 mg omeprazole. 98% of the patients were free of pain within first week of the treatment. After 2, 4 and 6 weeks of treatment, the healing rates of duodenal ulcer were 81.3%, 96.8% and 100% respectively, and those of gastric ulcer were 50%, 91.7% and 100% respectively. The drug was well tolerated and no side effect was observed.

Duodenal Ulcer↗
PubMed1989

Effect of electro-acupuncture of "Neiguan" on spontaneous discharges of single unit in amygdaloid nucleus in rabbits.

In this paper, the regularity on spontaneous discharges of the single unit in amygdaloid nucleus (AMYG) in rabbits were analyzed and whether the signal of Electro-acupuncture (EA) at Neiguan (P 6) can reach the AMYG was further observed with the technique of glass microelectrode. It was found that the signals of EA at Neiguan can reach AMYG and activate or inhibit the electrical activity of some neurons, manifesting two response patterns: frequency-increasing and frequency-decreasing. Additionally, the same neuron had a different response to the signals of EA at Neiguan and Zusanli (St 36), suggesting that a relative specificity of acupoints is present.

Acupuncture Therapy↗
PubMed1989

Management of retroperitoneal sarcomas.

The records of 116 adult patients who underwent operative treatment for retroperitoneal sarcomas at the Mayo Clinic during the years 1963 to 1982 were reviewed. Clinical, pathologic, and treatment variables were analyzed for their influence on recurrence and death from disease. Leiomyosarcomas, liposarcomas, and malignant fibrous histiocytomas represented 93% of the tumors. The primary tumor was completely excised in 54% of patients. Recurrent tumor developed in 68% of patients (median time to recurrence, 1.3 years). Tumor fixation to adjacent structures (T3 tumor) or a high-grade tumor (G2-4) identified patients at increased risk for recurrent disease. Five-year and 10-year survival rates were 40% and 22%, respectively. Survival was significantly better for patients who had (1) complete surgical excision of their tumors, (2) low-grade tumors (G1), (3) tumors not fixed to adjacent retroperitoneal structures (T1 and T2 sarcomas), and (4) tumors without metastases when initially seen. Complete surgical excision offers patients with retroperitoneal sarcomas the best chance for long-term survival, but recurrent disease remains a vexing problem. The therapeutic challenges in the treatment of retroperitoneal sarcomas continue to be the development of therapy that will increase the rate of complete resection, decrease the rate of local recurrence, and enhance patient survival.

Adult↗