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At least 1,189 records · Page 66Linked to original sources
PubMed1998

A descriptive, correlational study of patient satisfaction, provider satisfaction, and provider workload at an army medical center.

Strong national interest in health care delivery systems and a highly competitive marketplace have mandated that military hospital commanders be increasingly aware of organizational performance. Historically, one variable that has been used to assess such performance is patient satisfaction with the care received. The purpose of this study was to measure patient satisfaction at a major military medical center and to assess how patient satisfaction correlated with the variables of provider satisfaction and nurse/patient ratio. One hundred eighty-eight patients completed the LaMonica-Oberst Patient Satisfaction Scale. Data analysis revealed that, although overall patient satisfaction was high, it was significantly higher on the intensive care units and in other areas where the nurse/patient ratio was high. Interestingly, there was no correlation between the staff's perceptions of their work environment and patient satisfaction. Findings from this study serve to highlight the continued need for a low nurse/patient ratio and are suggestive of the need for refinement of patient satisfaction survey tools available at present.

Female↗
PubMed1998

Ease your management workload and develop staff.

A community hospital created a program where staff nurses work as house supervisors. The plan improves house supervisor coverage and provides opportunity for nursing staff development.

Hospitals, Community↗
PubMed1987

Cardiac transfer function relating energy metabolism to workload in different species as studied with 31P NMR.

Cardiac metabolism was studied with 31P NMR in 7 dogs and 4 cats to determine whether animals adapted for different life-styles (stalk and sprint vs endurance running) respond to increased work loads (heart rate X blood pressure product) with different high-energy phosphate kinetics. Hearts were exposed via a left lateral thoracotomy under Nembutal anesthesia (40 mg/kg). Two-turned solenoid surface coils were placed on the left ventricles; pacing wires were sutured into the left ventricular apices. The femoral artery and vein were cannulated for blood pressure and arterial blood gas monitoring and fluid and drug infusion, respectively. Animals were placed in a plexiglass holder into a 2.1-T, 31-cm-bore, superconducting magnet. 31P spectra were obtained from the heart using respiratory and electrocardiogram gating. Cardiac work loads were changed by pacing the heart at 4, 4.5, and 5 Hz. Heart rate X blood pressure product "work" was correlated with Pi/PCr ratios. Dog hearts were more resistant than those of cats to changes in Pi/PCr with increasing work load. It is possible that animals adapted to different life-styles may have cardiovascular systems which are metabolically and mechanically adapted for different forms of stress. These differences may be elicited and effectively delineated using in vivo NMR techniques during various physiological interventions, such as pacing. The basis for these differences may be related to cardiac microvasculature or to intrinsic differences in enzyme kinetics. Delineation of these mechanisms may be helpful in the understanding of the physiological basis of cardiac function in health and disease.

Adaptation, Physiological↗
PubMed1997

Regional workload induced changes in electrophysiology and immediate early gene expression in intact in situ porcine heart.

Cardiac remodelling and hypertrophy induced by chronic haemodynamic overload (stretch) eventually leads to a decrease in cardiac function, an increased incidence of ventricular arrhythmia and mortality. The mechanisms by which myocytes sense haemodynamic stress and activate growth signals are largely unknown. Nuclear immediate early genes may act as third messengers, converting the stretch stimulus into long-term changes of gene expression via cytoplasmic signal transduction. However, previous studies have used cell cultures and isolated hearts, neither of which are ideal models. We have developed a new in situ porcine heart model where local strain (stretch) can be applied, for several hours if required, thus allowing the comparison of changes in electrophysiology and gene expression with unstrained myocardium in the same preparation. A pneumatically controlled stretch-device was attached to a portion of the right ventricle of an anaesthetized animal using suction. Chronic stretch was applied for 30 min or 1 h. Regional loading produced (i) a transient decrease in monophasic action potential duration (3.5+/-0.8%; P<0.05), followed by (ii) an elongation by 15 min, despite maintained stretch (3.4+/-1.5%; P<0.05 compared to the pre-stretch situation). A control segment of the right ventricle did not show these changes. Northern blot analysis showed that both c-fos and c-myc were induced in the areas sampled, but they were 12-fold and three-fold higher, respectively, in stretched compared with control tissue after 30 min. Thus, prolonged regional stretch can produce complex changes in cardiac electrophysiology and increase expression of some immediate early genes. Our model may be useful for studying the cascade of events that lead to remodelling, hypertrophy, and arrhythmia.

Action Potentials↗
PubMed2002

An fMRI study of bilingual sentence comprehension and workload.

To examine the relation between the cortical substrates that support the comprehension of one's native language and those that support a second language, fMRI measures of cortical activation were taken as native Japanese participants, who had acquired moderate fluency in English, listened to auditory sentences in Japanese and English. In addition, to examine the impact of processing difficulty within a language, sentence difficulty was manipulated by including affirmative (easy) and negative (hard) sentences. The volume of activation was greater for English in most of the cortical regions, suggesting that more cognitive effort was required to process English. Also, a high percentage of the voxels that were activated for the Japanese condition were also activated for the English condition, with as much overlap between Japanese and English as between the processing of affirmative and negative sentences within Japanese. Negative sentences elicited greater activation than affirmative sentences primarily for English, indicating that the structural difficulty of negation has a larger impact on cortical activation if it occurs in the context of the second language, which may serve as another source of difficulty. These results suggest that a shared network of cortical regions supports the processing of both a first and a second language, such that the second language requires more computation and activity from the network.

Adult↗
PubMed1982

The use of sinusoidally changing workloads as an aid to identify dynamic properties of physiological systems.

The methodology of using frequency analysis in order to identify types of system(s) is discussed. A number of models with their characteristic Nyquist plots are presented graphically, to facilitate the identification of various types of systems by pattern recognition. A small series of measurements of oxygen consumption and heart rate has been carried out to illustrate the possibilities and limitations of the use of frequency analysis in exercise physiology. With a step function method one can only establish whether a system has multiple components in parallel or not, but with the frequency analysis method one can identify whether a system has multiple components in parallel or in series. It was found that under moderate exercise, the response of oxygen consumption to exercise is a system with multiple components in series, but the response of heart rate to exercise is a system with multiple components in parallel. The data that were obtained are in agreement with those produced by other authors, but the curves to fit the observed data were obtained using second order linear transfer functions.

Adult↗