Instant, trackable remittance processing.
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Cost-conscious health care organizations are demanding that their investments in information technology generate a measurable return. For some applications, predicting a quick payoff is relatively easy. But for complex clinical systems, proving a tangible return can be difficult.
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OBJECTIVE: To determine whether MEDLINE searches based on an existing automated faculty research interest index or on author name entities can be used to automate construction of accurate online lists of faculty publications. METHODS: Curricula vitae (CVs) for 36 faculty members were selected at random. Their lists of journal publications were used to determine recall and precision of two MEDLINE search strategies. OUTCOME: Most faculty publications in the CVs (86%) were indexed in MEDLINE. The research-interest-enhanced MEDLINE searches retrieved citations in the CVs that were also in MEDLINE with a recall of 0.53 and precision of 0.85. For every 10 citations in the research interest-enhanced search, on average 8.5 were in the CVs. The name entity searches retrieved a higher proportion of citations in the CVs (recall 0.94, precision 0.59) with a higher rate of citations not in the CVs: For every 10 citations in the faculty name searches, 7.3 citations were in the CVs. Name commonness or clinical or basic sciences appointment did not change these results. CONCLUSION: MEDLINE searches, especially those based on research interests, can be used to populate faculty publication lists with high rates of accuracy. Author based searches can also be used, but they retrieve a higher proportion of irrelevant citations. This study confirms a successful instance of data reusability and integration at a large health academic sciences institution.
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As a result of a revolution in globalization over the last 10 years, few pharmaceutical companies conduct their non-clinical studies within a single region and virtually none conduct all non-clinical studies in house. The increased activity of product in-licensing at all stages of development results in further segmentation of toxicological source information. Juxtaposed to this segmental collection of toxicology information is the nature of toxicological testing for pharmaceuticals, an iterative process, carefully building subsequent testing designs and analyses upon the foundation of previously identified outcomes and associated safety issues. As a consequence of the segmentation of global product development, today's analyses of toxicological outcomes for single pharmaceutical projects often involve a conglomeration of results from studies conducted in several world regions using a variety of sources of animals. Such practices can lead to discordant study results and difficulty in understanding or rationalizing a compound's toxicological and pharmacological profile, and eventually how this relates to human risk. Despite the variety in source information, an integration of the total toxicology/pharmacology data must be made by industry, and/or by health authorities. To improve this integration, the development and use of better standardized genetics for rodent species used in pharmaceutical testing is more imperative today than in the past, as a result of a constellation of changes in industry policies.
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Six cases of cocaine-related deaths of infants have covered the spectrum of potentially devastating effects. They include an intrauterine death of a 35-week-old fetus following acute maternal cocaine abuse; anoxic encephalopathy at birth with 3 months' vegetative survival from a similar episode; traumatic compression asphyxia in a 4-month-old; infectious cardiomyopathy with heart failure in a twin at age 21 months following maternal cocaine abuse at birth; malnutrition and dehydration in a 7-week-old during continuing cocaine abuse by the parents; and a teenage sibling's cocaine lacing of a baby milk bottle ingested by his 6-week-old brother. All the cases had positive toxicological screening for cocaine or metabolites or both in the mother at delivery or in the infant at birth, or both. There were no instances of sudden infant death syndrome (SIDS, or "crib death"). Pathologic and toxicologic, as well as birth, developmental, and social data are presented. An integrated medical, public health, law enforcement, and educational policy to prevent or at least ameliorate these tragic cases, now approaching epidemic proportions, has yet to be developed. A careful obstetrical history and examination of the mother, indication on the birth certificate of maternal drug abuse, and notification of health authorities (by birth certificate checking, among other ways) may send an early warning message to providers for intercession. Active ingestion/injection and passive inhalation by older children and teenagers require more intensive monitoring and aggressive interaction by pediatricians, social workers, school authorities, and employers.(ABSTRACT TRUNCATED AT 250 WORDS)
The 1992 metaanalysis of adjuvant therapies after surgery in early breast cancer summarizes the most extensively studied of all cancer treatments via randomized controlled trials. This study found overall benefits with use of adjuvant therapies, and their expanded use outside the clinical trial setting was assumed to be effective and implied to be cost effective. Thus, the primary remaining questions are which form of adjuvant therapy to use and how to identify which patients are unlikely to benefit. In British Columbia, the effectiveness of adjuvant therapy outside the clinical trial setting was reassuringly similar to the metaanalysis efficacy. Our decision analysis model of hypothetical cohorts of women with early breast cancer confirmed that the efficacy of adjuvant treatment is the primary determinate of its incremental cost effectiveness. Future cost-effectiveness and quality of life assessments should move from hypothetical cohorts assessed via models to prospective data collected within clinical trials or integrated health delivery system.
Fast efficient access to patient information is an essential management tool in the current healthcare environment. The clinical case management computer module at Stanford Health Services provides and integrates essential patient data elements to facilitate clinical case coordination and assist the nurse case managers with documentation of clinical data for discharge planning and utilization review. Information systems such as this one are critical to the provision of comprehensive, cost-effective patient care management.
The concept of reproductive health has changed throughout the years until it has come to be understood as a constant that goes beyond biological concerns and is related to the values, culture, and personal fulfillment of each human being. It encompasses, therefore, a wide range of action in individual and family life as well as in the collective development of populations. Promoting and maintaining reproductive health requires quality services with equitable access. PAHO has cooperated in this field with Member States for over 30 years, during which maternal and child mortality has diminished, the notion of integral adolescent health has been disseminated, the subject has been added to professional health curriculums, pertinent activities have been integrated into the health services, and new data have been gathered to inform policies and activities on reproductive health. The present situation of national health sector reforms presents a unique opportunity for approaching anew old problems related to reproductive health, to examine policies and strategies, and to implement changes that reaffirm the commitments made in international forums.
Delivery of health care at Scott and White, a large integrated health care delivery system, is supported by an Electronic Medical Record (EMR) system repository of six million SGML-based documents. Control of document access is currently based on standard commercial security and confidentiality methodologies. Given the planned release in Fall 1999 of new federal security and confidentiality requirements, we have developed a web-based security process model that "wraps" existing EMR documents with HTML-compliant security attributes. Resulting logical documents are filtered regarding user queries by mapping the security attributes of the data to specific user role characteristics. A key virtue of our approach is that source EMR data do not undergo alteration by the imposition of the security process. It also places no additional work load or query pressure on the existing EMR system.
It is the position of the American Dietetic Association (ADA) that nutrition is an integral component of oral health. The ADA supports the integration of oral health with nutrition services, education, and research. Collaboration between dietetics and dental professionals is recommended for oral health promotion and disease prevention and intervention. Scientific and epidemiological data suggest a lifelong synergy between nutrition and the integrity of the oral cavity in health and disease. Oral health is an integral part of systemic and nutritional health. Two primary oral infectious diseases are directly influenced by diet and nutrition. Dental caries or tooth decay is modulated by numerous factors, including diet composition and frequency. Periodontal or gum disease is associated with malnutrition. Chronic diseases such as diabetes and cardiovascular disease that are modulated by diet and nutrition intervention have oral sequelae. As we advance in our discoveries of the links between oral and nutrition health, practitioners of both disciplines must learn to provide screening, baseline education, and referral to each other as part of comprehensive client/patient care. The future of dietetics practice requires dietetics professionals to provide medical nutrition therapy (MNT) that incorporates a person's total health needs, including oral health. Inclusion of both didactic and clinical practice concepts that illustrate the role of nutrition in oral health is essential in both dental and dietetic education programs. Collaborative endeavors between dietetics and dentistry in research, education, and delineation of health provider practice roles are needed to ensure comprehensive health care to persons with oral infectious disease and/or oral manifestations of systemic diseases.