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Biomedical subjects

J Mackowiak

Publications and source records attributed to J Mackowiak.

12 recordsLinked to original sources
PubMed2000

Optimizing quality of care and cost effectiveness in treating allergic rhinitis in a managed care setting.

Allergic rhinitis is a common condition in managed care populations. The direct medical cost of rhinitis exceeded $3 billion in 1996, and an additional cost of $4 billion resulted from the exacerbation of other concomitant conditions, such as asthma or otitis media. Costs continued to increase in 1999; sales of prescription antihistamines and nasal steroids exceeded $3 billion and $1 billion, respectively. The indirect costs of allergic rhinitis include lost work productivity, reduced performance and learning, and increased workplace and traffic accidents. Rhinitis treatments include allergen avoidance, over-the-counter (OTC) sedating antihistamines, nonsedating antihistamines, nasal steroids, and immunotherapy. Allergen avoidance strategies for patients with asthma and rhinitis are ineffective or are of very limited benefit. Allergists criticize the use of OTC sedating antihistamines, which are associated with reduced learning and performance even when sedation does not occur. Evidence-based literature reviews of clinical trials have shown that nasal steroids are more effective than nonsedating antihistamines in the treatment of rhinitis. The most commonly prescribed nasal steroid, fluticasone, has been shown to be effective in treating rhinitis and in improving patients' quality of life. It is also more cost effective than the most commonly prescribed antihistamine, loratadine. Clinical trials have indicated that immunotherapy is expensive and of limited benefit. As these evidence-based findings are used to develop managed care treatment guidelines, nasal steroids are likely to be recommended as the first-line treatment for rhinitis, which should result in lower treatment costs and improved outcomes for patients with rhinitis.

Cost of Illness↗
PubMed1998

Cost of heart failure to the healthcare system.

From an economic, mortality, and functional standpoint, heart failure is clearly a disease that needs to be targeted. We can develop a model for heart failure to determine the impact that specific management strategies will have on the overall cost to the system, which by itself can tell us some interesting things because we're currently spending twice as much on transplantation as on digoxin therapy. We can then use this model to assess the impact of different strategies, such as greater use of angiotensin-converting enzyme (ACE) inhibitors or digoxin therapy.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1997

Point-of-service outcomes data and its effect on asthma treatment: a salmeterol pilot investigation.

Outcomes data have enabled physicians to have a much more complete overview of the patient's quality of life and health than their predecessors. One medical center has sought to develop a comprehensive point-of-service outcomes measurement tool for the assessment of patients with asthma. This information may provide a real-time overview on a desktop computer system of the patient's progress. A pilot project involving a therapeutic intervention in patients with asthma was conducted to test the utility of this outcomes tool in a practice setting.

Albuterol↗
PubMed1985

Methods of inventory control.

Various methods for controlling inventory are described, and the advantages and disadvantages of each are discussed. The open-to-buy (OTB) budget method limits purchases to a specific amount of funds available for purchasing pharmaceuticals during a specified period. The emphasis of the OTB method is financial control of the pharmacy inventory. Although it is useful in monitoring and adjusting the dollar value of the inventory, it should be combined with other methods for a total inventory control system. The primary emphasis of the short-list method is to provide accurate and timely inventory information to the person responsible for order placement. The short list identifies the items that are in short supply. It is the most common feedback and control mechanism in use, but it is best suited for settings where duplicate or reserve stock is maintained and monitored by more rigorous methods. The main objective of the minimum and maximum method is to determine when and how much to order of each item. It also provides limited dollar control. The major disadvantage of this method is the time it requires to establish the minimum and maximum levels and to update them regularly to reflect changes in demand. The stock record card method is used to record information on the movement of goods in and out of the storage area. Stock cards can also be used to monitor inventory levels and facilitate order initiation. It is probably the optimum method to be used alone. The most effective system of inventory control is one employing a combination of these methods tailored to meet the institution's needs and available resources.

Budgets↗
PubMed1985

Career management: understanding the process.

This article is the first of a three-part series on career management for hospital pharmacists. Work attitudes, life cycles, needs, and career trends are discussed. Three basic work attitudes exist. Some see work as punishment. Others believe work in itself is good, i.e., they have a strong work ethic. Some view work as a means to satisfy, at least partially, a range of needs. Attitudinal transition points are likely to occur at specific times in the adult life cycle. The stages of the life cycle can be labeled as leaving, reaching out, questioning, midlife crisis, settling down, and mellowing. A progression through each of these stages is required for normal adult psychological development. Every individual exhibits a blend of needs that changes throughout life. Jobs can fulfill existence, relatedness, and growth needs. Relatedness needs include the need for love, affiliation, social esteem, and power, and growth needs include the need for self-esteem, competence, achievement, and autonomy. Three important career trends are the changing opportunities for advancement, women in careers, and dual-career couples. The number of women pharmacists is increasing as is the number of two-career couples. Tips for managing two-career relationships are presented. Pharmacists can manage their careers more effectively by understanding their needs, identifying their basic attitude toward work, and being aware of the trends occurring in pharmacy.

Attitude of Health Personnel↗
PubMed1985

Career management: an active process.

The self-assessment, goal-setting, and career-planning techniques of career management are discussed, and the organization's role in career management is discussed. Career management is a planned process, initiated and carried out by an individual with the assistance of others. Because work and nonwork activities are so interrelated, career and life management planning can maximize a pharmacist's personal success. The career- and life-management process begins with the development of a personal definition of success. A self-assessment must be made of one's values, needs, interests, and activities. The next step of the process involves setting goals and establishing a plan or strategy to achieve them. Establishing a career path requires researching alternate career goals. Career competencies are identified that can increase an employee's chances of success. The employer shares the responsibility for career development through coaching, job structuring, and keeping the employee aware of constraints. Through the integration of the roles of the individual and the organization in the career-management process, employees can optimize their contribution to an organization. Pharmacists can successfully manage their careers by applying the techniques of self-assessment, goal setting, and career planning.

Career Choice↗
PubMed1985

Career management: an ongoing process.

This article is the last in a three-part series on career management. Reasons to pursue and ways to choose a suitable second career are discussed. A stalled career, a lack of achievement, or a wrong job choice are three reasons why people pursue new jobs or careers. To ensure satisfaction in a second career, individuals must examine an ego ideal--an idealized image of what they would like to be in the future. When a pharmacist's career stalls, introspection can help reveal behavior that interferes with career success. Periodic introspection and self-assessment can help an individual adapt to changes in a career and in the profession throughout the various life stages. For the pharmacist who chooses the wrong job, self-assessment and research of alternative opportunities will increase the likelihood that a second career will be satisfactory. The traditional hospital pharmacy career is linear; the pharmacist starts at the bottom of the organization and rises to the top. A nonlinear career strategy is now suggested because of limited positions at the top and an abundance of well-trained individuals. The nonlinear strategy moves a person indirectly in a career; short-term career moves are designed to meet long-term goals. Pharmacists can grow in a current or second career by using introspection and self-assessment and by adapting to changes that occur in the profession.

Career Choice↗
PubMed1979

The effect of dianabol on certain cell energy processes in postirradiation disease. III. The effect of chronic administration of dianabol and irradiation on oxidative phosphorylation in rat liver mitochondria.

Chronic administration of Dianabol did not prevent the radiation-induced changes of oxidative phosphorylation in rat liver mitochondria. Irradiation of rats with X-rays, in a dose of 600 R for the whole body, causes damage of oxidative phosphorylation in rat liver mitochondria. Progressive reducation of oxygen consumption, decrease of high-energy bond formation and a drop of the P/O coefficient were observed in irradiated animals. The presumable role of the postirradiation damage of oxidative phosphorylation and the effects of radioprotective compounds on this process are discussed.

Animals↗