Biomedical subjects

T Hadley

Publications and source records attributed to T Hadley.

23 records · Page 2Linked to original sources

PubMed1990

Improving the physical health-mental health interface for the chronically mentally ill: could nurse case managers make a difference?

Although the increased incidence and prevalence of medical illnesses among the chronically mentally ill has been well documented, access and use of general health care services by this population remains problematic despite the implementation of case management. This article describes the problems experienced in meeting physical health care needs through the five core case-management components of client identification and outreach, assessment, service planning, monitoring of service delivery, and advocacy. A model of case management is proposed that uses psychiatric nurse clinical specialists in supervisory and consultative rôles, and nurse practitioners to deliver primary care.

Health Services Accessibility↗

PubMed1989

A new algorithm for diagnosis of anemia.

Studies of the cognitive processes of diagnosis have shown that use of heuristics (eg, shortcuts, rules of thumb) dominates clinical problem solving. Thus, an algorithmic approach to diagnosis can be particularly useful. Because the sensitivity and specificity of many tests are not known, however, this approach is not perfect. Therefore, algorithms should be taken as a general guide to diagnosis but should not be applied too rigidly. In the past, algorithms for anemia did not apply any principles of decision analysis. The algorithm presented in this article is based on test operating characteristics reported in the literature. Disease is excluded by highly sensitive tests (screening tests) and confirmed by highly specific tests (pathognomonic findings). This algorithm can reduce the need for expensive, complex procedures, including radioisotope studies (eg, chromium 51 red blood cell study, ferrokinetics). It provides a rational and semiquantitative estimation of diagnostic possibilities. Alternate pathways to diagnosis may arise in individual cases. Also, the algorithm is difficult to apply to multifactorial anemias.

Algorithms↗

PubMed1983

Plasmodium knowlesi: studies on invasion of rhesus erythrocytes by merozoites in the presence of protease inhibitors.

The effect of protease inhibitors on invasion of rhesus erythrocytes by Plasmodium knowlesi merozoites was evaluated. Chymostatin, N-alpha-p-tosyl-L-lysine chloromethyl ketone (TLCK), and L-1-tosylamide-2-phenylethylchloromethyl ketone (TPCK) inhibited invasion. Leupeptin, antipain, pepstatin, and phenylmethylsulfonyl fluoride (PMSF) had no effect. TLCK and TPCK inhibited attachment of merozoites to host erythrocytes. Chymostatin had no adverse effect on attachment, and in its presence junction formation between the merozoite and host erythrocyte occurred. Both chymostatin and leupeptin inhibited normal rupture of schizont-infected erythrocytes. It is suggested that proteolytic activity may be important both in the rupture of schizont-infected erythrocytes and in the invasion of erythrocytes by malaria parasites.

Animals↗

PubMed1983

Resistance of Melanesian elliptocytes (ovalocytes) to invasion by Plasmodium knowlesi and Plasmodium falciparum malaria parasites in vitro.

Erythrocytes from humans with Melanesian elliptocytosis are resistant to invasion by Plasmodium falciparum in vitro and epidemiological evidence suggests they may be resistant to P. vivax and P. malariae. We have examined the ability of P. knowlesi merozoites to invade Melanesian elliptocytes in vitro as a definitive means of examining these cells for resistance to invasion by malarial species with different receptor requirements. The Melanesian elliptocytes were highly resistant to invasion by P. knowlesi merozoites showing that the resistance associated with this erythrocyte variant lies at a level common to the invasion pathway(s) of P. falciparum and P. knowlesi. This makes Melanesian elliptocytosis unique as no other human erythrocyte variant has been shown to be resistant to invasion by both species.

Elliptocytosis, Hereditary↗

PubMed1980

Understanding purposes of regulation: a case example in mental health.

This paper reviews the purposes of governmental regulation and how an exploration of purpose can contribute to our understanding of specific regulations. The primary regulatory purpose is defined as the achievement of quality control of a subject system, its process or its product. Quality control via regulation is achieved through one or a combination of approaches: (1) accountability, (2) organizational development, (3) protectionism. Regulatory purpose and approach is illustrated by a case example of the development of regulations for partial hospitalization mental health services.

Community Mental Health Services↗