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PubMedDate not supplied

Trend analysis of cigarette smoking by Indiana adolescents, 1991-2000.

OBJECTIVES: To examine the feasibility of using a composite index of smoking behaviors to analyze adolescent smoking. METHODS: A secondary analysis of data from 10 annual surveys (1991-2000), from 566,467 Indiana students in grades 6 through 12. A composite index was calculated, and differences between index scores were analyzed using 1-way ANOVA, Tukey's post hoc tests, and 2-way moving averages. RESULTS: Index scores increased before 1997 and decreased after 1976, with greater change among 7th through 10th graders. CONCLUSIONS: The 2-way moving average comparison of a composite index, used with prevalence-based trend analyses, provides a more complete picture of changes in adolescent cigarette smoking.

Adolescent↗
PubMed1983

A survey of partial hospitalization programs in the state of Indiana.

This article presents normative data on the day-to-day operation of partial hospitalization programs affiliated with mental health centers in the State of Indiana. This network of programs was surveyed with regard to (1) the community settings and locations of their facilities as well as their accessibility to patients, (2) the organizational structure within which the programs operate, (3) their staffing, (4) the characteristics of the patient population they serve, (5) their admission and case management procedures and the nature of their clinical programming, (6) their referral source network, (7) their funding sources, and (8) the extent and nature of their program evaluation and program promotion efforts. Generalizations suggested by the survey data are discussed in an attempt to highlight possible trends in the field at large.

Community Mental Health Centers↗
PubMed1984

PRN drug utilization in Indiana long-term care facilities.

Data collected from a sample of 307 private and Medicaid patients from 20 LTCFs in Indiana showed that patients were prescribed an average of 4.9 PRN medications. Significant differences were found between the types of LTCFs and the average number of PRN medications per patient. In 14 LTCFs classified as both ICF and SNF, patients were prescribed an average of 4.7 PRN medications. In four LTCFs classified ICFs, patients were prescribed an average of 6.2 PRN medications. In two LTCFs classified as SNFs, patients were prescribed an average of 3.9 PRN medications. The average number of PRN medications per Medicaid patient was 5.2 while the average number of PRN medications per private patient was 4.8. Overall, 48.8% of all PRN medication orders were never consumed during the study period. Mean PRN medication utilization per LTCF ranged from 2.5 per cent to 36.4%. It is assumed that if PRN medication not being consumed/used by the patient were to be returned to the pharmacy, a substantial cost savings could be realized by the responsible party.

Analysis of Variance↗
PubMed1982

Indiana application for interim authorization, phase I, hazardous waste management program--Environmental Protection Agency. Notice of public hearing and public comment period.

EPA regulations to protect human health and the environment from the improper management of hazardous waste were published in the Federal Register on May 19, 1980 (45 FR 33063). These regulations include provisions for authorization of State programs to operate in lieu of the Federal program. Today EPA is announcing the availability for public review of the Indiana application for Phase I Interim Authorization, inviting public comment, and giving notice of a public hearing to be held on the application.

Indiana↗
PubMedDate not supplied

Fees for service. A survey of Indiana and selected jurisdictions nationwide.

It is apparent from the economic realities we face today that in order to maintain substantial programs in the environmental health areas, additional sources of income are needed. The uncertainty of the effects of the Gramm-Rudman legislation, the extremely high cost of insurance, and the need for new environmental health programs indicate that the question is no longer whether it is necessary to establish fees for environmental services but rather what those fees should be. A survey was conducted of all 96 local health departments in the State of Indiana from November 15, 1985 to March 15, 1986. It was found that minimal fees or no fees are charged for environmental services. The rationale for the fees charged was based on factors other than the actual cost of the service performed. Further, a study of environmental fees charged for services in a select national survey in 1982, updated by use of the Consumer Price Index for 1986, indicates that Fees for Service and the rationale for the fees vary widely. The philosophy behind a fee for service program, the potential benefits, the potential problems, the techniques for determining fees for service and the use of public funds are discussed. Appropriate recommendations are made concerning the institution of a Fee for Service Program.

Data Collection↗
PubMed1999

Approval of Hospital/Medical/Infectious Waste Incinerator State Plan for designated facilities and pollutants: Indiana. Environmental Protection Agency (EPA). Direct final rule.

EPA is approving Indiana's State Plan for Hospital/Medical/Infectious Waste Incinerators (HMIWI), submitted on September 30, 1999. The State Plan adopts and implements the Emissions Guidelines (EG) applicable to existing HMIWIs. This approval means that EPA finds the State Plan meets Clean Air Act (Act) requirements. Once effective, this approval makes the State Plan federally enforceable.

Hazardous Waste↗
PubMed2000

Adequacy of peritoneal dialysis: a quality improvement project of The Renal Network, Inc (Illinois, Indiana, Kentucky, and Ohio).

The Renal Network, Inc, (end-stage renal disease [ESRD] Networks 9 and 10) from the states of Illinois, Indiana, Kentucky, and Ohio includes approximately 4,250 peritoneal dialysis patients. To better assess the state of peritoneal dialysis in Networks 9 and 10, we undertook a peritoneal dialysis prescription adequacy quality improvement project. Adequacy and facility practice information were obtained from a 100% sample of peritoneal dialysis patients in the Networks. The mean total Kt/V urea for those facilities with a written policy for adequacy measurement was 2.18 +/- 0.66 versus a mean of 2.13 +/- 0.70 for those facilities without a written policy (P = not significant [NS]). The mean total Kt/V urea for those facilities with a written procedure was 2.17 +/- 0.66 versus a mean of 2.12 +/- 0.70 for those facilities without a written procedure (P = NS). There was a significant positive relationship between the observed total Kt/V urea and the frequency of measurement (P <.001). No relationship existed between the value of the D/P creatinine ratio and the weekly dialysis Kt/V. This study supports the recommendation of frequent measurement of peritoneal dialysis adequacy.

Adult↗
PubMed2002

Profile of problem children from a rural county in Indiana.

In order to better identify and understand problems experienced by delinquent children and adolescents in a rural county in Indiana, in-the-trenches professionals working with these children were interviewed. Comparisons are drawn between observations of these professionals and existing research findings regarding Disruptive Behavior Disorders (i.e., ADHD, ODD, CD).

Adolescent↗
PubMed1992

Clinical trials with ifosfamide: the Indiana University experience.

At Indiana University, we began clinical trials with ifosfamide in 1981. Although our initial efforts were in a variety of tumor types, including pancreatic cancer, we have most recently focused our attention on two tumors that have historically exhibited a higher degree of chemosensitivity--testicular cancer and small cell lung cancer (SCLC). In phase II trials, ifosfamide has proven to have single-agent activity in both diseases. Coupling this data with preclinical observations of synergy with cisplatin and etoposide, we began trials of ifosfamide plus cisplatin with either vinblastine (VeIP) or etoposide (VIP) in patients with recurrent germ cell tumors; we also investigated the use of VIP in SCLC. In third-line or greater therapy for recurrent germ cell tumors, a 36% disease-free status was attained, with 16% of patients continuously free of disease for 5 or more years. Currently, ifosfamide is being evaluated as part of initial therapy in patients with advanced disease. In SCLC, VIP has also been investigated as part of initial therapy in patients with extensive disease. The complete response rate of 38% achieved in 37 evaluable patients has spurred the Hoosier Oncology Group to compare the VIP regimen to cisplatin/etoposide in patients with extensive-disease SCLC. Ifosfamide has the broad range of clinical activity, but its ultimate role as part of initial therapy remains to be discerned.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2004

The Indiana network for patient care: an integrated clinical information system informed by over thirty years of experience.

Presented in this article is the Indiana Network for Patient Care, an integrated citywide medical record system that promotes health quality by enabling efficient access to clinical information. It begins with a description of the system's infrastructure, which includes an explanation of how the system accomplishes data integration. This is followed by a series of descriptions and rationales behind the many clinical applications that interface these data. In doing so, some of the factors that we feel contribute to the success of the system are illustrated.

Databases, Factual↗
PubMedDate not supplied

Cultured epidermis: Indiana University Medical Center's experience.

We have treated 11 patients with cultured epidermal autograft (CEA) at the Indiana University Medical Center between April 1989 and January 1991. Seven of these patients had acute burns. We have followed up on five of them for at least 5 months; the remaining two are still hospitalized. Two patients had CEA applied to cover giant hairy nevi, and two were treated for hypertrophic burn scars, one of which was treated too recently to report follow-up. Consequently, we report on our experience with eight patients. At our institution we have broadened the indications for grafting with CEA to include injuries greater than 45% to 50% full-thickness and have found it a useful technique. One patient with a hairy nevus had a "take" of CEA of almost 100%, but a synechia formed along his gluteal crease. In another patient, partial loss of the graft was attributed to scratching. Long-term rubbing of a pressure stocking and splint was believed to be responsible for breakdown in the graft of the patient who had a hypertrophic scar.

Adolescent↗
PubMed1992

Fireworks-related injuries--Marion County, Indiana, 1986-1991.

Based on data from the Consumer Product Safety Commission's (CPSC) National Electronic Injury Surveillance System, fireworks-related injuries accounted for an estimated 12,400 emergency room visits during 1990 in the United States (1); two thirds of fireworks-related injuries occur during the 4-week period surrounding Independence Day. Since 1986, to better characterize fireworks-related injuries and to improve local health education and prevention efforts, the Marion County (Indiana) Health Department (MCHD) has conducted surveillance of fireworks-related injuries. This report summarizes surveillance results for 1986-1991.

Adolescent↗
PubMedDate not supplied

Current computer usage in Indiana dental practices.

A survey of Indiana dentists reveals that increasing numbers of dental practices are computerized. Computer hardware, software, and various functions within dental practices are identified. Furthermore, the survey indicates future anticipated computer usage and the growing need for personnel to be trained in computers.

Humans↗
PubMed1992

Measles at an international gymnastics competition--Indiana, 1991.

On September 7, 1991, the Indiana State Department of Health (ISDH) was notified of three suspected measles cases among athletes from New Zealand (NZ) participating in an international gymnastics competition September 6-15 in Indianapolis (Marion County). Among those potentially at risk for measles were approximately 700 athletes and 1200 coaches, trainers, and managers from 51 countries; an estimated 2500 volunteers and staff; international media, families, and employees; and approximately 60,000 spectators attending the competition. This report summarizes the epidemiologic investigation of these cases.

Adolescent↗
PubMed1991

Antibodies to La Crosse virus in eastern chipmunks in Indiana near an Aedes albopictus population.

Blood samples of 34 Eastern chipmunks trapped in the vicinity of an Aedes albopictus population near New Alsace, IN, were tested for neutralizing antibodies to La Crosse (LAC) virus and other California group viruses. Two samples were positive for LAC antibodies. Analysis of mosquito bloodmeals demonstrated that both Ae. albopictus and Ae. triseriatus from the site fed on chipmunks. This note documents the first record of LAC antibodies in sylvan rodents from Indiana, the presence of LAC virus in the vicinity of Ae. albopictus and that wild Ae. albopictus feed on Eastern chipmunks.

Aedes↗
PubMed1991

Implementing a record-oriented clinical lab interface using HL7 version 2.1 at Indiana University Hospital.

At the Indiana University Hospital (IUH) site on the Indianapolis campus, HL7 version 2.1 is being implemented via a TCP/IP LAN, (using the "Minimal" Lower Layer Protocol). HL7 is currently being used to convey record-oriented lab results from the local clinical laboratory system to a clinical database system via an intelligent router, which also provides store and forward capabilities. The database application displays the lab results in a variety of configurable formats to clinical users.

Clinical Laboratory Information Systems↗
PubMedDate not supplied

Oral squamous cell carcinoma in Indiana.

Oral cancer is expected to occur in 30,800 individuals in the United States in 1991. This article describes the clinical features of 549 cases which were submitted to the Indiana University School of Dentistry Department of Oral Pathology Biopsy Service for the years 1985-1990. Women accounted for 43.8 percent of the cases, and the average age at detection was 62.7. The tongue and floor of the mouth were the sites of origin of 49.6 percent of the cases. The duration of the carcinomas was six months or less in 77.4 percent of the cases. Symptoms were observed in 73.6 percent of the cases and 66 percent were less than 2 cm. in size. Nodes were palpable in 21.4 percent of the cases in which it was specified. This study supports the observation of an increasing incidence of oral cancer in women, as well as in the most common sites of origin, the tongue and floor of the mouth.

Carcinoma, Squamous Cell↗