Organizational change: initial results in a health care setting.

An applied study was conducted in a federal health care facility to assess change in organizational climate variables over a 7-yr. period. Using the Survey of Organizations--2000, preliminary results show improvements on five climate indicators from Time 1 to Time 2 of the survey. Potential explanations for the positive changes are provided.

Identification of managerial behavior dimensions in a federal health-care agency.

Understanding the behavior of managers provides an opportunity to assess congruencies between organizational needs and managerial skills. This assessment is critical in federal health-care wherein the environment is rapidly changing. In the current investigation, dimensions of managerial behavior for 267 managers in a federal health-care agency were identified. Recommendations are provided with respect to the relevance of using these dimensions for organizational training and development activities.

Hearing loss in pediatric meningitis.

Bacterial meningitis is the leading cause of acquired sensorineural hearing loss in children. Acquired hearing loss can have a devastating effect on a child's speech, language and eventual intellectual development, especially when the hearing loss occurs before the child learns to talk. If an immediate referral for audiologic testing is not made, valuable time is lost in obtaining hearing aids and habilitative/rehabilitative services for children during the critical period of language development.

Echelon grating multiplexers for hierarchically multiplexed fiber-optic communication networks.

Echelon gratings have many beneficial properties when used as the dispersing mechanism of a fiber-optic wavelength multiplexer including high optical dispersion, high optical efficiency, greatly reduced sensitivity to polarization, simultaneous utility on many wavelength bands, and a capability for hierarchical multiplexing. The use of echelon multiplexers in a hierarchical environment is discussed, and a prototype echelon multiplexer is constructed and used to demonstrate the unique capabilities of this device for creating wavelength division multiplexing systems.

Do most practices have an age-sex register? Results of the West Midlands age-sex register study.

A cross sectional study based on all (1260) general practices in the West Midlands was conducted in late 1984 and early 1985. Responses to a postal questionnaire were received from 762 (60.5%) practices, and of these, 387 (50.8%) stated that they had an age-sex register; 104 (13.6%) practices replied that they had definite plans to establish an age-sex register within six months, and a random sample of these was later telephoned to see if the plans had come to fruition. A random telephone sample was also made from the 498 (39.5%) non-responders. It was concluded that the current prevalence of age-sex registers in the West Midlands is 52% (+/- 5% for 95% confidence) of all practices. A register has now been established of 422 practices (35.5% of the total number in the West Midlands) that have an age-sex register. This is being used as a database for other research. The most common reason stated for not having an age-sex register was that it would be too time consuming. Most of the practices that had one stated that it was used for research, disease recording, screening, surveillance, or health education, which implies that the registers are being used.

Electroencephalographic abnormalities in children with congenital heart disease.

Ninety-eight consecutive patients with clinically suspected congenital heart disease were prospectively studied with electroencephalographic (EEG) recordings before cardiac catheterization. Twenty-five patients had abnormal EEGs. Fifty-five patients had acyanotic heart disease and normal neurologic examination results, of whom 15 had abnormal EEGs. Thirteen had spikes or spike and wave discharges and two had mildly abnormal EEGs. Twenty-seven patients had cyanotic heart disease and normal neurologic examination results, of whom four had abnormal EEGs. Seven patients (8%) had abnormal neurologic examination results, of whom four had abnormal EEGs. There was a higher incidence of seizures with increasing age. Based on their medical history two children with acyanotic heart disease had had seizures without EEG abnormalities. Five children with normal catheterization findings and four children with Down's syndrome (two with abnormal EEGs) were excluded from the total of 98. These findings suggest that subclinical nervous system involvement may occur in congenital heart disease.

Giardiasis: a common, sexually transmissible parasitic diarrhea with pitfalls in diagnosis.

Giardia lamblia is the number one intestinal parasite in the United States. Symptoms of giardiasis include upper abdominal pain and distress, flatulence, nervousness, and diarrhea. Multiple stool specimens examined for ova and parasites by nonexpert parasitologists will frequently not provide the diagnosis, and special studies must then be done. Antibiotics, antidiarrheals, certain enema preparations, and oily laxatives can cause a temporary disappearance of parasites from the stool. Treatment of choice is a five-day course of quinacrine hydrochloride. Recently, attention has been brought to the fact that oral sex may be responsible for transmission in a significant number of cases of giardiasis.

Pseudolymphoma of colon.

A case of pseudolymphoma of the colon is reported. Radiographically and endoscopically the lesion could not be conclusively distinguished from malignant neoplasm, particularly lymphoma or segmental colitis, thus necessitating right hemicolectomy. Careful histological examination established the diagnosis of pseudolymphoma with pathologic features identical to the focal form of pseudolymphoma more commonly observed in the stomach.

Effects of pregnancy on sarcoidosis.

The effects of pregnancy in patients with sarcoidosis is reviewed in 18 patients. During 35 pregnancies, no clinical or roentgenographic effect upon the disease process was noted in nine patients. Six of these patients demonstrated an improvement, and in three patients, a deleterious effect was noted. A relapse of the disease was not noted after delivery in 15 of the patients. In three patients, a progression of the disease continued after delivery.

Further characterization of Listeria monocytogenes serotype 5.

Fifteen strains of Listeria monocytogenes serotype 5 were characteriized for carbohydrate utilization, enzymic reactions, and other differential criteria. Hemolytic patterns were tested on ovine, bovine, equine, human and lapine blood agars. Results were compared with those of previously reported strains of L. monocytogens serotype 5.