ABSTRACT
OBJECTIVE: An evaluation of the impact of a social work preadmission program on length of stay (LOS) of orthopedic patients undergoing elective total hip or total knee replacement surgeries (under diagnosis-related groups [DRGs]) at the Hadassah Ein-Kerem Hospital in Jerusalem is Israel. INTERVENTION: The social work interventions included preadmission psychosocial evaluation and preliminary discharge planning, coordination of nursing and physiotherapy evaluations, ensuring completion of all medical tests prior to admission, and additional psychosocial follow-up during hospitalization to carry out the original discharge plan or prepare alternatives. PATIENTS: The intervention patients were divided into two groups in order to see changes over time: May through December 1994 (n = 48), and January through December 1995 (n = 81). The comparison groups included patients operated on at the same hospital during 1993 (n = 51) and during January through April 1994 (n = 21) and at the Hadassah Mount Scopus Hospital during the same time periods. Patients in the comparison groups received usual social work intervention, as necessary, only after hospitalization. RESULTS: Mean LOS was reduced significantly in the intervention patient groups, as compared to the preintervention patient groups in the same hospital, from 14.2 days (standard deviation [SD], 4.7) in 1993 and 14.7 (SD, 5.1) in January through April 1994 to 10.9 (SD, 3.0) in May through December 1994 and to 9.1 (SD, 2.8) in 1995 (P < .01). Length of stay also was reduced in the comparison hospital, but by 1995 was longer than in the intervention patients. No differences in LOS by gender, age, or marital status were found. Length of stay was significantly longer for those undergoing total hip replacement as compared to those undergoing total knee replacement in all the groups. CONCLUSIONS: Preadmission screening and case management by a social worker can contribute to the efforts to decrease LOS of orthopedic patients by early multidisciplinary evaluations, discharge planning, and coordination of services.
Subject(s)
Arthroplasty, Replacement, Hip , Arthroplasty, Replacement, Knee , Diagnostic Tests, Routine , Length of Stay/statistics & numerical data , Patient Admission , Social Work Department, Hospital/organization & administration , Aged , Evaluation Studies as Topic , Female , Health Services Research , Humans , Israel , Male , Middle Aged , Patient Discharge , Quality of Health CareSubject(s)
Biomedical Research/standards , Gene Rearrangement , Immunoglobulin Idiotypes/genetics , Records/standards , Animals , History, 20th Century , Hybridomas/immunology , Immunoglobulin Idiotypes/analysis , Immunoglobulin Idiotypes/immunology , Immunoglobulin mu-Chains/genetics , Lymph Nodes/immunology , Mice , Mice, Inbred C57BL , Mice, Transgenic , Scientific MisconductSubject(s)
Biomedical Research , Publishing , Research/standards , Editorial Policies , Federal GovernmentABSTRACT
A case of admitted scientific fraud has shed new light on the system that ensures the integrity of the scientific literature. Certain lapses from generally accepted standards of research may be more frequent than is commonly believed.
KIE: John Darsee was found to have fabricated much of the data that formed the basis of over 100 articles that he coauthored with 47 researchers at the medical schools of Harvard and Emory universities. Stewart and Feder analyzed these publications to investigate the vigilance of scientific referees, journal editors, and Darsee's coauthors in meeting accepted publication standards. They characterize their findings as revealing two types of frequently occurring lapses. Type A lapses--such as the presence of errors or inconsistencies, failure to obtain relevant data, and honorary authorship--may simply reflect carelessness. More serious Type B lapses include misleading statements or citations and failure to acknowledge sources of data or to respond appropriately to charges of fraud. The authors discuss reasons for these lapses and recommend a random study of published papers to ascertain the extent of such poor publishing practices.
Subject(s)
Biomedical Research , Crime , Fraud , Animals , Arterial Occlusive Diseases , Cardiomyopathy, Dilated , Dogs , Editorial Policies , Female , Humans , Male , National Institutes of Health (U.S.) , Pedigree , Publishing , Random Allocation , Statistics as Topic , United StatesABSTRACT
Electron microscopic study of livers from mice fed 167 ppm polybrominated biphenyl (PBB) revealed mitochondrial abnormalities which consisted of both alterations in size and the formation of crystalline-like inclusions within the mitochondrial matrix. These inclusions appeared as parallel arrays of rods and were found in elongated mitochondria which contained few cristae. The findings are briefly described and the possible significance of such inclusions in relation to mitochondrial aberrations are discussed.
Subject(s)
Biphenyl Compounds/toxicity , Inclusion Bodies/ultrastructure , Liver/drug effects , Mitochondria, Liver/ultrastructure , Polybrominated Biphenyls/toxicity , Animals , Crystallization , MiceSubject(s)
Glucuronidase/metabolism , Mosaicism , Animals , Biological Transport , Liver/enzymology , Male , Mice , Seminal Vesicles/enzymology , Thyroid Gland/enzymologySubject(s)
Histological Techniques , Molecular Weight , Peroxidases , Animals , Cerebral Cortex/cytology , Cerebral Cortex/enzymology , Cerebral Ventricles , Chemical Phenomena , Chemistry , Histocytochemistry , Injections, Intravenous , Mice , Microscopy, Electron , Peroxidases/isolation & purification , Peroxidases/metabolism , Staining and Labeling , Time FactorsSubject(s)
Heme , Peptides/blood , Animals , Blood Proteins/analysis , Brain/cytology , Chemical Phenomena , Chemistry , Methods , Mice , Microscopy, Electron , Molecular WeightABSTRACT
In the galea of silkmoths undergoing metamorphosis, generalized epidermal cells, which had previousty secreted pupal cuticle, transform into highly specialized cells producing a new protein, the enzyme cocoonase. These cells first segregate by mitosis and displacement, then grow rapidly through endomitosis and accumulation of RNA-rich cytoplasm, and finally begin rapid synthesis of cocoonase. Replication of DNA continues in fully differentiated cells synthesizing cocoonase.
