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Biomedical subjects

S Zweig

Publications and source records attributed to S Zweig.

At least 37 records · Page 2Linked to original sources
PubMed1987

Adverse effects of faculty practice on diagnostic content of residents' outpatient experience.

The outpatient experience of two cohorts of family medicine residents was compared. Those who worked at a site with an existing faculty practice had fewer pregnancy-related patient encounters and proportionately more encounters for acute self-limited care compared with residents at a site without a faculty practice (P less than .001). More important, the faculty-associated residents also cared for fewer patients with a variety of chronic diseases and saw them less frequently. These findings suggest that a coexistent faculty practice may have adverse effects on outpatient training in primary care.

Age Factors↗
PubMed1987

Selection of a physician for prenatal care.

The selection of a physician for prenatal care was studied as a model of the generic process of choosing a physician. The results suggest that factors important in this process are similar to those relating to satisfaction with care: physician competence, cost and convenience, and personal qualities. Women selecting obstetricians for prenatal care placed a higher emphasis on physician competence, whereas those selecting family physicians placed a greater emphasis on cost and convenience.

Adult↗
PubMed1986

Changes in smoking and alcohol consumption during pregnancy: a population-based study in a rural area.

Changes in smoking and drinking behavior during pregnancy and factors influencing these changes were studied in a typical rural county. Using birth certificates and mailed questionnaires, information was obtained from 255 married women residents of Callaway County, Missouri, who gave birth in a one-year period. The women were much more likely to drink alcohol than to smoke before pregnancy (48.6 versus 28.2%, P less than .01). There was a significant decrease in both smoking and drinking during pregnancy, though the women were much more likely to modify drinking behavior than smoking behavior. Of the women who drank alcohol before pregnancy, 53.2% stopped alcohol consumption completely during pregnancy, while only 16.7% of smokers stopped smoking during pregnancy (P less than .001). Women cited fear for the infant's health as an important factor underlying the decision to decrease these behaviors more often than they did advice from doctor, family, friends, or media, or adverse physical effects of tobacco or alcohol. It was very difficult to predict changes in smoking and drinking behavior during pregnancy on the basis of demographic and behavioral characteristics such as age, income, education, attendance of childbirth classes, desirability of pregnancy, and method of infant feeding.

Adult↗
PubMed1986

Patient satisfaction with obstetric care.

Patient satisfaction with obstetric care was studied in a cohort of postpartum women from a rural midwestern county. Birth certificate data defined the population, and satisfaction data were acquired through a mailed questionnaire. An indirect measure (satisfaction scale) was derived with acceptable construct validity and internal consistency. A direct measure (open-ended questions) elicited specific comments about each woman's recent experience with obstetric care. Satisfied women, as described by the scale, were more likely to have had good physician continuity and to have attended childbirth classes. The open-ended responses most frequently described problems relating to the physician-patient relationship. In comparing the indirect and direct measures, women with high satisfaction scores were more likely to make no critical comments about their obstetric care (chi 2 = 9.16, P less than .003). The patient's perception of the physician's attitude of concern emerged as an important issue in both measures. The data demonstrate that perceived physician concern is an important component of patient satisfaction with obstetric care.

Adult↗
PubMed1986

Health effects of relocation at work.

The health effects of a work-related stressor over a six-month period in 355 employees at a university medical center were prospectively measured. Subjects were assigned to cohorts determined by whether they experienced a move from their office or laboratory during a time of building construction and renovation. After controlling for demographic factors, preexisting health status, prior physician utilization, and bed-disability, movers had a higher rate of bed-disability (P = .05). They were also more likely to report a deterioration in their health (P less than .05). Movers with high support at work and high total social support were more likely to report increased physician utilization. The findings suggest that a work-related stressor can adversely affect health, but this study does not support the hypothesis that such effects are moderated by social supports. Family physicians should be sensitive to the potential adverse health effects of work-related stressors on their patients.

Adult↗
PubMed1985

Purification of an 86-70 kDa nuclear DNA-associated protein complex.

In the course of studies on nucleolar antigens, monoclonal antibodies were developed, one of which recognized an 86 kDa antigen as shown by analysis of nuclear extracts from HeLa or Namalwa cells. Immunofluorescence studies on HeLa cells showed a nucleoplasmic and phase-dependent nucleolar localization of the monoclonal antibody was decreased after digestion with DNAase I but not with RNAase A. For purification, the antigen was released from nuclei by digestion with DNAase I and then purified by chromatography on DEAE cellulose, phosphocellulose and antibody-Sepharose affinity chromatography. Interestingly, the immunoaffinity purified product contained two polypeptide chains; the immunoreactive polypeptide had an Mr of 86 000 and a pI of 6.0. The complex also contained a 70 kDa, pI 6.5 nonantigenic polypeptide in a 1:1 ratio. The overall purification of the complex was 5700-fold. Both polypeptides contained approx. 15 mol% glutamic acid and the 70 kDa polypeptide contained approx. 15 mol% serine.

Amino Acids↗
PubMed1979

Concanavalin A-induced endocytosis in rabbit reticulocytes, and its decrease with reticulocyte maturation.

Concanavalin A (Con A) was taken up to a limited extent by endocytosis in rabbit reticulocytes but not in rabbit erythrocytes. This process was observed by the use of ferritin-labeled Con A and transmission electron microscopy of thin sections of plastic-embedded cells. Furthermore, the extent of endocytosis among the reticulocytes decreased with the extent of their maturation, reticulocyte age being measured by ribosome configurations. These results are consistent with the proposal that there are domains in the membranes of reticulocytes in which the Con A receptors are laterally mobile, and can be clustered and endocytosed. These mobile domains exist, or are formed, within a larger framework of immobile membrane. During reticulocyte maturation, these domains are gradually eliminated, eventually disappearing upon formation of the mature erythrocyte. Possible molecular mechanisms for this proposed elimination process are discussed.

Animals↗
PubMed1978

Carbon monoxide and ventricular fibrillation threshold in dogs with acute myocardial injury.

In a blind, randomized study, the effect of breathing 100 p.p.m. of CO versus compressed, purified air for 2 hours on ventricular fibrillation threshold (VFT) was investigated in 21 dogs with acute myocardial injury. The mean arterial carboxyhemoglobin was 1.16 per cent in the air control period, 1.07 per cent after air, 1.08 per cent in the CO control period, and 6.34 per cent after CO. In comparison to air, CO increased the mean arterial carboxyhemoglobin (P less than 0.001). One dog developed spontaneous ventricular fibrillation 100 minutes after CO. Mean VFTs in the other 20 dogs were 12.8 +/- 6.8 milliamperes after CO, 11.2 +/- 6.0 milliamperes in the air control period, and 15.0 +/- 5.1 milliamperes after air. In comparison to air, CO decreased the VFT (P less than 0.001). These data show that breathing 100 p.p.m. of CO for 2 hours reduces the VFT in dogs with acute myocardial injury.

Acute Disease↗
PubMedDate not supplied

Carbon monoxide and ventricular fibrillation threshold in normal dogs.

In a blind, randomized study, the effect of breathing 100 ppm of carbon monoxide versus compressed, purified air for 2 hr on ventricular fibrillation threshold was investigated in twenty anesthetized normal open-chested dogs. The mean arterial carboxyhemoglobin level was 1.12% in the air control period, 0.99% after air, 1.10% in the carbon monoxide control period, and 6.48% after carbon monoxide. Carbon monoxide increased the mean arterial carboxyhemoglobin (P less than .001). Mean ventricular fibrillation thresholds were 19.9 +/- 6.5 mA in the carbon monoxide control period, 15.7 +/- 5.6 mA after carbon monoxide 20.8 +/- 6.3 mA in the air control period, and 24.5 +/- 9.5 mA after air. Carbon monoxide decreased the ventricular fibrillation threshold (P less than .005). These data show that breathing 100 ppm of carbon monoxide for 2 hr reduces the ventricular fibrillation threshold in anesthetized normal open-chested dogs.

Air↗
PubMedDate not supplied

The downstream financial effects of a nursing home practice on an academic medical center.

OBJECTIVE: To determine the financial impact of a nursing home practice on an academic medical center. DESIGN: Retrospective cohort design. SETTING: Middle-sized Midwestern community with fee-for-service Medicare population. SAMPLE: One hundred seventy-six nursing home residents followed by faculty and residents of a medical school department of family and community medicine. MEASUREMENTS: Billings and collections for professional and hospital services delivered by the academic medical center during fiscal year 1998. RESULTS: One hundred forty-four patient-years of service resulted in over 1 million dollars in billed charges. For every 1 dollar billed by family medicine, consulting physicians billed 2 dollars and the hospital billed 10 dollars. This amounted to over 4000 dollars per patient per year in reimbursement. This practice generated a wide variety of clinical problems (37 different diagnosis-related groups (DRGs) for the 61 admissions to the hospital). CONCLUSIONS: There is a significant downstream financial effect of a nursing home practice on an academic health center. For this and other reasons, this practice may be worthy of institutional support.

Journal Article↗
PubMedDate not supplied

Improving the quality of nurse assistants in nursing homes: report of an attending physician survey and an AMDA Symposium.

OBJECTIVES: To describe views of attending physicians regarding nurse assistants as part of a multidisciplinary seminar on nurse assistants at the 1997 American Medical Directors Association (AMDA) Annual Symposium. DESIGN: Mailed survey. PARTICIPANTS: AMDA members. MEASUREMENTS: Attitudes regarding nurse assistants and the role of attending physicians with regard to enhancing the role of nurse assistants. RESULTS: Respondents rated the importance of quality nurse assistants with a mean of 4.85 and a mode of 5 (5 being very important). They also thought it was important for the medical director attending physicians to support, train, or otherwise assist in the professional development of nurse assistants (mean 4.07, mode 5). Respondents recommended enhanced training, reduced workload, increased salary and benefits, and building more effective relationships as strategies for improving the quality of care provided by nurse assistants. CONCLUSION: Physicians can be important in enhancing the role of the nursing assistant. Some activities may include acknowledging the nurse assistant, providing support and feedback, and supporting policy changes that enhance continuity, nonhierarchical management, and creative training programs.

Journal Article↗
PubMedDate not supplied

Future directions in family medicine: results of a Delphi study.

A Delphi study using a panel of 17 experts in family medicine predicted the characteristics of family medicine in the future to anticipate changes needed in residency education. Proposed new competencies included managing the medical care of the patient, skills in geriatrics, emphasis on health maintenance, health promotion and disease screening, and expertise in computers and data management. Competencies to be de-emphasized included major surgical procedures, specific technical and procedural aspects of hospital care, and obstetrics (except in rural areas). In addition, panelists thought the basic principles and values of family medicine will not change, although there will be emphasis on managed health care, increased care of the elderly, and changes in the professional status of the physician. Curricular changes will require help from other disciplines, new educational settings, and additional faculty and financial resources.

Curriculum↗
PubMedDate not supplied

The health belief model and attendance for prenatal care.

Adequate prenatal care as defined by timely initiation and completion of prenatal visits has been frequently associated with good perinatal outcomes. Health beliefs and other psychosocial and demographic variables were explored in a cohort of 255 rural recently delivered women to determine the important correlates with adequate prenatal care. Respondents' health beliefs relating to pregnancy and prenatal care were assessed with an instrument with acceptable construct validity and reliability. A prevention-oriented health belief score, tangible social support, and adequate health insurance were all positively associated with adequacy of care as defined above.

Adult↗