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PubMed2000

Immunonutrition - fact or fad.

Suggestions that modifications to the diet may have a beneficial effect on health are not new. recent work demonstrates that nutritional supplements may effect immune function. This review examines the evidence for the effects of these supplements including arginine, glutamine, nucleotides and omega - 3 fatty acids. In particular, clinical trials with patients in multiple organ failure are discussed. The evidence published thus far suggests that immunonutrition, if absorbed in adequate amounts both pre- and post-operatively, reduces septic complications and improves surrogate measures of ourcome, including length of stay and requirements for mechanical ventilation.

Animals↗
PubMedDate not supplied

Telehealth: passing fad or lasting benefits?

Advocates of telehealth argue that the delivery of health services by means of communications technologies is both feasible and desirable. Nevertheless, the benefits of telehealth, due to the variety of its applications and their uneven development, are not self-evident. The goal of this paper is to reflect on the processes by which telehealth applications do or do not contribute to the delivery of health services. We propose a framework structuring a preliminary analysis of the match between needs and the possibilities offered by telehealth. Four mechanisms of expected benefits are discussed: 1) decreasing patient transfers; 2) decreasing trips by providers and patients; 3) meeting the needs of underserved populations; and 4) building providers' and patients' knowledge and reducing rural isolation. We conclude by stressing that the participation of providers is crucial, both in the research on telehealth and in the steering of its evolution.

Delivery of Health Care↗
PubMed2000

Physician unionization in the United States: fad or phenomenon?

This article explores the current trends and issues surrounding physician unionization in the United States, using data from secondary sources and nine interviews with leaders of organizations at the forefront of physician unionizing efforts. Several key points are supported by these data and prior unionization research. First, unions should become a viable organizing alternative for the almost 50% of doctors who are salaried employees because of fewer legal barriers to collective representation, the involvement of national labor unions with resources to spend on organizing, more physicians belonging to demographic groups less hostile to organized labor. and work-related pressures faced by physician-employee under managed care. A second key point is that unions will find it difficult to represent self-employed physicians because of the influence of organized medicine and legal barriers to gaining collective bargaining rights for this group. This discussion is intended to raise awareness of the physician union issue among health care policy-makers and researchers.

American Medical Association↗
PubMed2001

Integrated learning. Passing fad or foundation for the future?

On the surface, higher education has served the nation well. An increasing percentage of adults have attended college. Information is widely and freely available to most citizens; the economy is steady; and technological developments appear to offer ever-increasing improvements in the quality of life. Looking just beneath the surface, though, one realizes that knowledge is fragmented, access to knowledge is not universal, and there are no guarantees that past successes will sustain the future. Thus, it is worth examining how higher learning has contributed to the general prosperity and how education might evolve to address society's evident problems. This essay discusses the core approach of liberal arts in the context of the value--and obstacles--of integration across the traditional disciplines. Critical to the natural sciences is a firm grounding in the central importance of rigorous evidence, while the humanities keep us rooted in the importance of human values. Seeking linkages and connections between these realms is the lively challenge of this conference. The details of curricular design will be of less interest at this juncture than locating the critical issues and discussing how education might serve the goal of unifying knowledge and learning.

Education↗
PubMed2002

Defined contribution: threat ... or fad?

Sensing an invasion of their territory, MCOs are jumping into a market forged by a group of upstarts. The development renews a fundamental debate about the juxtaposition of consumer involvement, cost containment, cost shifting, and quality of care.

Community Participation↗
PubMedDate not supplied

More than a passing fad.

Explore the source record for details and available documents.

Evidence-Based Medicine↗
PubMed2001

Work hardening: Outdated fad or effective intervention?

OBJECTIVES: The purpose of this outcome measurement study was to determine the effectiveness of a work hardening program as measured by the participants' work status at three months after program completion. Predictors of successful return to work were explored. STUDY DESIGN: The sequential case series design was employed, and data were gathered at three points: the initial work hardening assessment, the discharge assessment, and three months post-discharge from the work hardening program. Seventy-nine participants were included. RESULTS: Eighty-two percent (82%) of the clients who completed a work hardening program reported that they were working in some capacity three months after program completion. They listed their employment status in 5 sub-categories. Significant predictors of employment included "single" marital status, lower perceived disability scores at program entry, reduction in reported pain during program duration, and funding source. CONCLUSION: Work hardening remains an effective treatment strategy which promotes successful return to the workplace. Ongoing analyses of these programs is imperative.

Journal Article↗