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Biomedical subjects

T Carli

Publications and source records attributed to T Carli.

8 recordsLinked to original sources

NCQA requirements: friend or foe?

In this time of intensified cost-containment pressures and low funding for behavioral healthcare services, organizations are particularly sensitive to externally imposed requirements that add expense and administrative burden. As a tradeoff, the contribution of such requirements to the overall quality of behavioral health services is vitally important. The requirements of the National Committee for Quality Assurance (NCQA) have stimulated many intensely felt reactions among a wide range of managed behavioral healthcare stakeholders, undoubtedly because of the substantial impact those requirements are creating. The reactions portrayed in this dialogue section, from representatives of the payor, purchaser, provider and consumer communities and from NCQA itself, indicate the ambivalence stakeholders have toward the quality-assurance movement.

Accreditation↗

Sulphate-reducing bacteria in bovine faeces.

Sulphate-reducing bacteria (SRB) were found in all of 200 bovine faeces examined. The number of SRB in bovine faeces ranged from 5 x 10(2) to 6 x 10(8) bacteria g-1. Of 50 isolates identified, all were assigned to the genus Desulfovibrio.

Animals↗

Tinnitus and ECT.

We report the case of a 69-year-old man with major depressive disorder and occupational tinnitus; both problems were refractory to several different treatment modalities, but were successfully treated with electroconvulsive therapy (ECT). The tinnitus was present for 15-20 years, but had worsened during the 3 years before treatment, causing him significant distress. Extensive organic workup did not identify a treatable etiology for his symptoms. To date, he has been hospitalized four times due to depressive symptoms associated with tinnitus. He has received ECT each time, and has responded well on each occasion.

Aged↗

Pretreatment nausea in cancer chemotherapy: a conditioned response?

Many patients receiving cancer chemotherapy become nauseated as they anticipate their treatments. We studied this phenomenon in eighteen cancer chemotherapy patients. The eight patients who reported pretreatment nausea had more extensive disease than the other patients and had received twice as much chemotherapy. In most cases pretreatment nausea developed only a after a number of months of treatment. Nausea was usually precipitated by the odor of the clinic and similar odors elsewhere also caused nausea. Patients continued to experience nausea during follow-up visits after treatment was completed. This syndrome of pretreatment nausea can be understood as a classically conditioned response. Clinical recommendations can be made on this basis.

Adult↗

Painless referrals.

Referrals, far and away the most burdensome administrative problem created by managed care, can be automated using secure, private intranets. Hundreds of primary care physicians and their offices in the Northwest have begun using this approach to reduce the approval time to get patients to specialists and to cut administrative costs. Combined with intranet delivery of laboratory and imaging test results, the service allows primary care physicians to fulfill their responsibility as overseers of the health care delivery process.

Attitude to Computers↗