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Biomedical subjects

W Best

Publications and source records attributed to W Best.

At least 19 recordsLinked to original sources
PubMed2004

Evaluation of a procedure to assess the adverse effects of illicit drugs.

The assessment procedure of new synthetic illicit drugs that are not documented in the UN treaty on psychotropic drugs was evaluated using a modified Electre model. Drugs were evaluated by an expert panel via the open Delphi approach, where the written score was discussed on 16 items, covering medical, health, legal, and criminalistic issues of the drugs. After this face-to-face discussion the drugs were scored again. Taking the assessment of ketamine as an example, it appeared that each expert used its own scale to score, and that policymakers do not score deviant from experts trained in the medical-biological field. Of the five drugs evaluated by the panel, p-methoxy-metamphetamine (PMMA), gamma-hydroxybutyric acid (GHB), and 4-methylthio-amphetamine (MTA) were assessed as more adverse than ketamine and psilocine and psilocybine-containing mushrooms. Whereas some experts slightly adjusted during the assessment procedure their opinion on ketamine and PMMA, the opinion on mushrooms was not affected by the discussion held between the two scoring rounds. All experts rank the five drugs in a similar way on the adverse effect scale i.e., concordance scale of the Electre model, indicating unanimity in the expert panel with respect to the risk classification of these abused drugs.

Advisory Committees↗
PubMed2001

Finance modeling in the delivery of medical care in tertiary-care hospitals in the Department of Veterans Affairs.

BACKGROUND: In the mid-1990s, the Department of Veterans Affairs (DVA) implemented the Veterans Equitable Resource Allocation (VERA), a new financial model developed to attempt to better distribute the approximately $18 billion annual budget among roughly 170 Veterans Administration Medical Centers (VAMCs). VERA is based on a Health Maintenance Organization (HMO) model. VERA provides reimbursement to each of the 22 regional Veterans Integrated Service Networks (VISNs), and subsequent VISN distribution to individual VAMCs is based on an individual medical center's enrollment of unique social security numbers (uniques). In HMO vocabulary these are individual "covered lives." METHODS: Currently available demographic and staffing information regarding the DVA's 23 tertiary hospital systems (Category 7 hospitals) on the KLF database (DVA Austin Data Base) and published information on the DVA website were reviewed. The following was obtained: (1) staffing information-physician and nurse full-time employment equivalent (FTEE) staffing; (2) patient demographics and hospital workload-facility uniques (u), outpatient facility uniques, average daily census (ADC), discharges, and outpatient clinic visits. The following staffing ratios were calculated for both physician and nursing: FTEE/(u/1000), FTEE/(discharges/1000), FTEE/(clinic visits/1000), FTEE/ADC. For all categories the means +/- SD were calculated and correlation coefficients were calculated on pertinent pairings. RESULTS: Although categorized as similar tertiary care facilities, the 23 "Group 7" VA hospitals are anything but equivalent when reviewed using the VERA financing model with respect to physician staffing, nurse staffing, and facility uniques. Using VERA methodology, average physician FTEE and total nursing FTEE staffing/(u/1000) are 3.67 +/- 0.89 and 15.53 +/- 3.77, respectively. Correlation statistics of staffing versus unique SSNs demonstrated correlation coefficients of 0.46 and 0.59 with respect to physician and nurse staffing, respectively. On the other hand, when physician FTEE and nursing FTEE staffing were compared with VAMC workload parameters (total ADC, discharges, and outpatient visits), correlation coefficients were more consistent, ranging from 0.62 to 0.86. CONCLUSIONS: In the VERA model, the reward of a larger annual budget for an individual VAMC or the regional VISN is realized when staffing of VAMCs is minimized, overall provided medical services (especially costly tertiary services) are limited, and the number of covered lives is maximized. A VAMC staffing system that equates medical services delivered in a tertiary VAMC setting based on an HMO model like VERA (where the user population is skewed toward the sicker, older patient) shows decreased correlation when compared with VAMC workload model parameters.

Delivery of Health Care↗
PubMed2001

Phonological and orthographic approaches to the treatment of word retrieval in aphasia.

We present a preliminary report on a study of the treatment of word finding difficulties in aphasia using phonological and orthographic cues. These techniques although often used to cue word finding in the immediate term have been little evaluated in terms of therapy designed to improve word retrieval in the long term. The first phase using cued word retrieval in a picture naming task was followed by a second phase designed to facilitate use of treated words in real-life contexts. The results from both phases were encouraging with improved word retrieval for three out of the four participants. The implications for clinical practice are discussed.

Aphasia↗
PubMed2001

Treatment of word retrieval in aphasia: generalisation to conversational speech.

The question of whether treatment gains in picture naming generalise to conversation remains relatively unexplored. Several difficulties surround data collection and analysis. A quantitative measure of word retrieval in aphasia is presented along with relevant details relating to the reliability of the measure, and the relationship between word retrieval in picture naming and noun retrieval in conversation. We discuss the clinical application of the measure and its applicability outside the field of aphasia.

Aphasia↗
PubMed2000

Rolling of unsaturated porous materials: evolution of a fully saturated zone

When a roll moves over a partially fluid filled porous layer, the degree of saturation in the porous layer will change in an a priori unknown area which is affected by the roll. In this work, a mathematical model is developed that describes the saturation dynamics in the porous layer for moderate rolling velocities. The model is based on two-phase flow equations in one dimension. It can be expressed as a nonlinear second order convection-diffusion equation that can be solved by standard (upwind) finite volume techniques. The size of the area affected by the roll, and within this area the degree of saturation, fluid pressures, and fluid velocities, can be predicted. An example is studied where a fully saturated zone evolves between the rolls when the rolling velocity is increased beyond some critical value.

Journal Article↗
PubMed1998

Treating word-finding difficulties--beyond picture naming.

This paper presents some preliminary findings from research into the phonological treatment of word-finding difficulties in aphasia focusing on two areas of investigation. Firstly we report on the effects of giving a choice of phonological cues on word-finding. Secondly we describe our findings concerning the reliability of a measure of real-life interaction.

Aphasia↗
PubMed1997

Fractionating the articulatory loop: dissociations and associations in phonological recoding in aphasia.

This paper uses neuropsychological data to differentiate between three models of verbal short-term memory (Baddeley, 1983, 1986; Besner, 1987; Monsell, 1987). The focus is on three tasks: homophone judgments, rhyme judgments and pseudohomophone detection. When lesioned each model predicts characteristic patterns of impairment across these tasks. Thirteen span impaired aphasic subjects were assessed on all three tasks. The patterns of performance unequivocally supported the model proposed by Monsell (1987) which distinguishes input and output phonological buffers. Implications for further research are discussed.

Adult↗
PubMed1995

A reverse length effect in dysphasic naming: when elephant is easier than ant.

When the influence of length on picture naming in dysphasia has been investigated in the past, studies tend to show worse performance with longer items (or no influence of stimulus length). This paper describes a man with dysphasia who is better at labelling pictures with long names than with short names: he demonstrates a reverse length effect. Three models which incorporate an output component are described. The details of the case study are given and discussed in relation to the predictions of these models regarding target length. This leads onto further predictions from one model (Butterworth, 1989) which are tested against the data.

Aged↗
PubMed1993

The effectiveness of communication groups in day nurseries.

This project, run by a speech and language therapist and a clinical psychologist, took place in three inner city day nurseries. A group of children over whose communication there was concern were assessed on both formal (verbal and non-verbal) and informal (observational) measures. At each nursery these children were divided into two matched groups: intervention and control. The intervention consisted of communication groups run jointly with nursery staff. These small groups focused on promoting communication through play. On reassessment the children attending the communication groups had made significantly more improvement than the controls on both formal and informal measures. In particular, the number and quality of children's interactions, their underlying ability to focus on tasks and their knowledge of basic concepts appeared to benefit from the intervention. The study, therefore, provides strong evidence for the efficacy of such interventions in enhancing communication development in a real-life setting.

Child, Preschool↗
PubMed1987

Otolith-organ mechanics: lumped parameter model and dynamic response.

The otolith organs comprise a second-order system whose response is overdamped and whose dynamics can be expressed by two time constants. The long time constant has been experimentally measured at 10 s. The short time constant is approximately 0.0002 s using a maximum mechanical displacement criterion for the otoconial layer. With these two values determined, the system dynamic response indicates that, between the two system corner frequencies, the peripheral sensory cells (primary Type II cells) report skull velocity information to the central nervous system, and striolar cells (primary Type I cells) report skull acceleration information to the central nervous system. Below the lower corner frequency, peripheral sensory cells report skull acceleration information to the central nervous system, and striolar sensory cells report rate of change of acceleration information to the central nervous system.

Acceleration↗
PubMed1985

Barrett's oesophagus and colonic tumours.

Of 65 patients with Barrett's oesophagus, all of whom were white, 29 (44.6%) had colonic tumours; 19 were benign and 10 were malignant. The frequency of colonic cancer was especially high (38%) in patients with Barrett's oesophagus aged 64 years or older. 7 of the 65 patients had had previous colonic resections for cancer and 3 were found prospectively to have malignant tumours. Benign tumours had been removed by colonoscopic polypectomy in 3 of the 19 patients; in 16 patients the tumours were diagnosed prospectively. In comparison with two other high risk groups, malignant tumours were found in 7.7% of 325 symptomatic patients admitted for colonoscopy and in 11.3% of 120 symptom-free patients with occult blood in the stools. The probability of finding this number of malignant tumours in an age-matched random sample of the general population is less than one in a million.

Adenocarcinoma↗
PubMed1983

The influence of androgens on the development of a sex difference in the vasopressinergic innervation of the rat lateral septum.

The vasopressinergic innervation of the lateral septum is much denser in male than in female rats. The present study demonstrates that, under physiological conditions, the development of this sex difference is dependent on the presence of androgens around the seventh postnatal day. It was possible, however, to induce in female or neonatally castrated male rats a fiber density as high as in control males by high doses of testosterone, given in the first, second or even third week of life.

Animals↗
PubMed1978

[Cherry red spot without secure evidence of sphingolipidosis (author's transl)].

The occurence of bilateral cherry red spot without neurological disorders is a rare event. The reported case is a girl aged 14 years, whose only complaint was slight deterioration of vision. No secure enzymatic defects was found on examination of leucocytes. Though the cherry red spot is hardly to be explained in another way than by storage in optic ganglion cells. Static perimetry revealed a paracentral depression of contrast sensitivity.

Adolescent↗
PubMed1977

[Traumatic cyclodialysis and its treatment (author's transl)].

A summary of the literature concerning traumatic cyclodialysis is given. Among 5 cases reports 4 hypotension-syndromes occurred. Traumatic cyclodialysis with persistent hypotension as well as postoperative hypotension resulting from planned cyclodialysis require the same surgical treatment. 3 out of 4 cases with hypotony-syndrome were treated succesfully by surgical closing of the cleft. Another case who had panophthalmitis prior to surgery became phthisic. The surgical procedure used is similar to that described in the literature.

Adult↗
PubMed1975

[Thoughts on phacoemulsification (author's transl)].

It is difficult to have a clear opinion about phacoemulsification since attitudes towards this method are at the moment controversal. The author tries to make judgment easier by discussing the contrary arguments.

Cataract Extraction↗