Letter: Deaths during dentistry.
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Biomedical subjects
Publications and source records attributed to J Bourne.
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Vanderbilt University Medical Center is implementing an Integrated Advanced Information Management System (IAIMS) using a fast-track approach. The elapsed time between start-up and completion of implementation will be 7.5 years. The Start-Up and Planning phases of the project are complete. The Implementation phase asks one question: How does an organization create an environment that redirects and coordinates a variety of individual activities so that they come together to provide an IAIMS? Four answers to this question are being tested. First, design resources to be "scalable"--i.e., capable of supporting enterprise-wide use. Second, provide information technology planning activities as ongoing core functions that direct local efforts. Third, design core infrastructure resources to be both reusable and expandable at the local level. Fourth, use milestones to measure progress toward selected endpoints to permit early refinement of plans and strategies.
Diabetes prevalence and complications rates were examined for the indigenous population of the Commonwealth of the Northern Mariana Islands in the western Pacific. Diabetes is common, with 4% of the population and 11% of adults having diagnosed diabetes. Diabetes is more common among females and islanders of Carolinian descent. End stage renal disease, hospitalizations for pneumonia, non-traumatic lower extremity amputations and retinopathy are more common than expected (with relative risks of 3.9, 3.0, 1.5 and 1.3, respectively, compared with diabetics in US), while diabetes-related mortality and hospitalizations for ischemic heart disease/cerebrovascular disease are less (with relative risks of 0.9 and 0.8). Implications for primary and secondary prevention of diabetes and its complications are discussed.