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Biomedical subjects

W P Moran

Publications and source records attributed to W P Moran.

11 recordsLinked to original sources
PubMed1995

Health-related messages in consumer magazine advertising.

OBJECTIVE: To characterize the patterns of health-related messages in consumer advertising from U.S. magazines. DESIGN: Observational survey of advertisements occupying a third of a page or more from the January 1994 issues of the 11 most popular consumer magazines. MEASUREMENTS AND MAIN RESULTS: Health messages were present in 22.8% (85/372) of all the advertisements reviewed. Of the advertisement categories (prescription medication, over-the-counter medication, exercise-related product, health service, health device, diet/health-related food, and other), over-the-counter medications were the most common among the advertisements that had health messages (32.9%, 28/85) (7.5% of the total advertisements, 28/372). The five advertisements for prescription medications were duplications of two different advertisements, one for a hair promotion product and one for hormone replacement therapy. Products related to diet and exercise together represented 29.4% (25/85) of all advertisements with health messages. Three advertisements (3.5%) were for health devices, and five (5.9%) were for health services. CONCLUSIONS: Health-related messages are frequent in consumer advertising. The effects of health marketing on consumer protection, health care costs, and the physician-patient relationship are discussed.

Advertising↗
PubMed1995

Emergency medical transport of the elderly: a population-based study.

Patterns of utilization of emergency medical services transport (EMS) by the elderly are poorly understood. We determined population-based rates of EMS utilization by the elderly and characterized utilization patterns by age, gender, race, and reason for transport. This observational, population-based study was conducted in Forsyth County, NC, a semi-urban county served by one convalescent ambulance service and one EMS service. Using data on all 1990 EMS transports and the 1990 U.S. census data, age-, gender-, and race-specific transport rates for persons aged 60 or older were calculated. Reasons for transport and frequency of repeat users were established. After exclusion of transports because of an address outside the county, a nonhospital destination, a scheduled transport, or missing data, 4,688 transports (78% of total) remained for analysis. The overall rate of transport was 104/1,000 county residents. Transport rates increased for successively older five-year age groups, demonstrating a 5.7-fold stepwise increase from ages 60-65 to 85+ (51/1,000 to 291/1,000). There was no difference in mean age between patients who were frequent EMS users (more than three transports during the year) (n = 66) and other elderly transportees. Reasons for transport differed little between those 60 to 84 years of age and those 85 years of age and older with the exception of chest pain, cardiac arrest, and seizures, all of which were significantly more prevalent in the younger age group.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1995

Teleform scannable data entry: an efficient method to update a community-based medical record? Community care coordination network Database Group.

Community-based multi-disciplinary care of chronically ill individuals frequently requires the efforts of several agencies and organizations. The Community Care Coordination Network (CCCN) is an effort to establish a community-based clinical database and electronic communication system to facilitate the exchange of pertinent patient data among primary care, community-based and hospital-based providers. In developing a primary care based electronic record, a method is needed to update records from the field or remote sites and agencies and yet maintain data quality. Scannable data entry with fixed fields, optical character recognition and verification was compared to traditional keyboard data entry to determine the relative efficiency of each method in updating the CCCN database.

Chronic Disease↗
PubMed1994

Community surveillance of falls among the elderly using computerized EMS transport data.

Because falls are common among the elderly and are associated with high morbidity and mortality, community surveillance has been recommended. The purpose of this study was to characterize the impact of falls among the elderly on emergency medical transport services (EMS) and to explore the potential for community surveillance of falls through the use of computerized EMS data. Computerized EMS data and United States census data for 1990 for persons aged > or = 65 in Forsyth County, NC, were used to produce EMS transport rates for falls and to make comparisons by age, gender, race, and residence (nursing home vs community). A fall was reported as the cause for EMS summons in 15.1% (613 of 4,058) of cases. Transport rates in 1990 for falls were 7.8 per 1,000, 25.4 per 1,000, and 58.5 per 1,000 for the age groups of 65 to 74 years, 75 to 84 years, and 85 years and older. Rates were higher for females than for males (17.1 per 1,000 v 8.1 per 1,000) and higher for whites than for African-Americans (14.3 per 1,000 v 10.3 per 1,000). Rates for nursing home residents were four times that of community residents (70.6 per 1,000 v 16.0 per 1,000). Over 50% of nursing home fallers were transported between midnight and 0400 compared with 25% of community dwellers. EMS summons for older adults reporting a fall accounts for a significant portion (15%) of all transports in this county. Computerized EMS data demonstrated patterns of falls among the elderly that are consistent with known demographic factors. The potential for using computerized EMS data as a practical means of community surveillance should be further explored.

Accidental Falls↗
PubMed1994

A practice-based information system for multi-disciplinary care of chronically ill patients: what information do we need? The Community Care Coordination Network Database Group.

Primary care physicians provide longitudinal care for chronically ill individuals in concert with many other community-based disciplines. The care management of these individuals requires data not traditionally collected during the care of well, or acutely ill individuals. These data not only concern the patient, in the form of patient functional status, mental status and affect, but also pertain to the caregiver, home environment, and the formal community health and social service system. The goal of the Community Care Coordination Network is to build a primary care-based information system to share patient data and communicate patient related information among the community-based multi-disciplinary teams. One objective of the Community Care Coordination Network is to create a Community Care Database for chronically ill individuals by identifying those data elements necessary for efficient multi-disciplinary care.

Chronic Disease↗
PubMed1993

Clinical presentation of meningioma in the elderly.

OBJECTIVE: To compare presenting manifestations of meningioma in elderly patients with those in younger patients. DESIGN: Retrospective survey. SETTING: Tertiary care center. PATIENTS: All hospitalized adult patients with the primary diagnosis of meningioma over a 5-year period (n = 116). Nine patients with recurrence of a previously resected meningioma were excluded. Fifty-two percent (56/107) of patients were > or = 65 years of age. MEASUREMENTS: Presenting symptoms were classified as asymptomatic, focal, non-specific, or both focal and non-specific. Presenting neurologic signs on physical examination were classified as focal, non-focal, or normal. Duration of symptoms was classified as < or = 1 week, 1 week to 1 month, 1 to 6 months, and > 6 months. RESULTS: Older patients presented more commonly with confusion (32% vs 4%) and dystaxia (28% vs 10%) than younger patients and presented less commonly with headache (23% vs 49%) and visual changes (21% vs 43%). While 2% of patients were asymptomatic at presentation, the remainder had symptoms categorized as focal (38%), non-specific (26%), or both (34%). There was no significant difference between older and younger age groups in the proportions of patients having focal symptoms. Duration of symptoms for all patients was categorized as < or = 1 week (15%), 1 week to 1 month (16%), 1 to 6 months (23%), and > 6 months (44%). In general, older patients were diagnosed earlier than younger patients. The presence of focal neurologic signs was not significantly different between older and younger patients. CONCLUSIONS: Presenting manifestations of meningioma differ between older and younger adult patients, but focality of symptoms and signs is similar. In this case series, the duration of symptoms prior to diagnosis was shorter in older than in younger patients.

Adult↗
PubMed1993

Implementing computerized tracking at a community health center: challenges and solutions.

A computerized tracking system for both preventive care and chronic disease tracking was implemented at a community health center, using a PC based local area network interfaced with a mainframe scheduling and billing system. Initial database construction used downloads of historical billing data, but ongoing database maintenance is accomplished by using an optical mark-sense scanner to construct both billing and clinical tracking files from custom-designed encounter forms. In this way, expanded clinical data is collected with an actual reduction in manually keyed data, reducing the ongoing cost of the system.

Ambulatory Care Information Systems↗
PubMedDate not supplied

Computer-generated mailed reminders for influenza immunization: a clinical trial.

A randomized, single-blind, controlled trial was performed at a community health center to measure the impact of computer-generated reminders mailed to patients on the rate of influenza immunization. High-risk patients were randomized to one of three groups: 1) usual care, 2) one reminder letter, offering free influenza immunization without an appointment, or 3) two sequential reminder letters, offering the same. The reminders did not significantly affect rates of influenza immunization. Analysis of the combined groups indicates that an appointment with a primary care provider remains the most reliable method of immunizing high-risk patients at this health center.

Aged↗