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PubMed1965

WHY AUTOMATION?

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Automation↗
PubMedDate not supplied

Health care plan decisions regarding preventive services.

BACKGROUND: Medical decisions previously made by physicians and patients are increasingly influenced by health plans. It is important to understand how these decisions are made and who makes them. OBJECTIVES: To determine protocols used by health plans for recommending preventive services and to identify methods used to develop these protocols. METHODS: An interviewer conducted semistructured telephone interviews with medical directors from 6 major types of health plans regarding coverage of certain procedural preventive services. Each medical director was asked: (1) Is this procedure paid for by the health plan? (2) What is the frequency recommended for this procedure? (3) What age groups do you recommend for this procedure? (4) Do you encourage patients to receive this procedure, and if so, how? (5) Who developed these preventive services recommendations? (6) How were these recommendations developed? RESULTS: Ten interviews were completed representing 6 chosen types of health plans. While the different plans varied little regarding the preventive services recommended, there was variation in efforts to promote recommended services to members. There were also differences among the plans in the decision-making process for developing preventive services recommendations. CONCLUSIONS: Managed care organizations promote certain preventive services to members. All health plans had at least 1 preventive medicine task force charged with making coverage decisions about preventive services. However, more could be done to rationalize development of preventive services recommendations, primarily, implementation of evidence-based guidelines.

Adult↗
PubMed1987

Cancer incidence and mortality among workers exposed to acrylonitrile.

A cohort of 1,083 male employees who had potential for exposure to acrylonitrile between 1944 and 1970 at a Du Pont textile fibers plant were followed through 1981 for mortality and through 1983 for cancer incidence. In total, the 21 cancer deaths were fewer than expected based on either Du Pont or U.S. rates. No significant excesses were seen by primary site. In all, 37 cancer cases occurred as compared with 36.5 expected based on company rates. Five lung cancer cases were observed and 6.9 expected. There were 5 prostate cancer cases as compared with 1.9 expected. Of these, 4 occurred among wage employees during the 1975-1983 period, compared to 0.9 expected. This excess was statistically significant.

Acrylonitrile↗
PubMed1993

Further observations on a method for estimating hominoid dental developmental patterns.

Several recent studies have concluded that early hominines resembled apes in patterns of dental ontogeny and have inferred from this conclusion that they were ape-like in other aspects of growth and development as well. Prior to their employment on fossil juveniles, the comparative methods used in these studies were not first tested for their predictive accuracy in distinguishing modern humans from apes on the basis of proposed patterns of dental ontogeny. We find that 92% of a sample of 48 modern children are classified as ape-like or nonhuman by the criteria employed in one of these studies and overlap entirely with fossil juvenile dental patterns. The use of these methods to characterize early hominines as "ape-like" or distinctly divergent from humans is thus shown to be unwarranted.

Animals↗
PubMed2005

Perceived deterrence and outcomes in drug court.

According to perceived-deterrence theory, the likelihood that an offender will engage in drug use or illegal activity is influenced by the perceived certainty of being detected for infractions or recognized for accomplishments, the perceived certainty of receiving sanctions for infractions or rewards for accomplishments, and the anticipated magnitude of the sanctions and rewards. This study evaluated drug court participants' perceived deterrence at monthly intervals during their enrollment in drug court. Exploratory cluster analysis (N=255) on the longitudinal scores yielded five subtypes of drug offenders characterized either by consistently elevated perceived-deterrence scores, consistently moderate scores, consistently low scores, increasing scores, or decreasing scores. The best outcomes were associated with consistently elevated scores, whereas the worst outcomes were associated with scores that declined over time as the participants became accustomed to the program. The clusters also differed in predicted directions on demographic variables. The correlational design does not permit inferences of causality; however, the results lend credence to perceived deterrence as a potential explanatory mechanism for the effects of drug courts.

Adolescent↗
PubMed2002

Eating disorder symptomatology is not associated with pregnancy and perinatal complications in a cohort of adolescents who were born preterm.

OBJECTIVES: We attempt to resolve the question of whether pregnancy complications and perinatal trauma, including brain insults, in premature infants increase the susceptibility to eating disorder symptomatology during the adolescent years. METHOD: This study uses a historical, prospective methodology to investigate the 84 members of a cohort of infants born prematurely (<33 weeks gestation) at Thomas Jefferson University Hospital during a 25-month period, from 1979 to 1981. We extracted the following information from their neonatal intensive care unit (NICU) records: ultrasound examination findings (graded on intraventricular hemorrhage [IVH] and periventricular leukomalacia [PVL]), records of pregnancy complications and perinatal trauma, and medical problems during the NICU stay. This method eliminated recall bias, a problem with previous studies. We followed up the members of this cohort, obtaining data on 53 (63%). We correlated the NICU data with the following outcome measures: physical measurements and psychosocial, psychological, and eating disorder symptomatology data obtained by self-report questionnaires. Pregnancy and perinatal complications were combined into one composite variable. We used the method of multiple discriminant function analysis to determine statistical significance between groups. RESULTS: There were no statistically significant differences between the low (0-2) and high (3-7) composite variable of pregnancy/perinatal complications and outcome variables. CONCLUSIONS: These results indicate that traumatic episodes early in life, including brain insults, do not appear to increase the susceptibility of developing eating disorder symptomatology, depression, deficiency of self-esteem, or distortion of body shape during late adolescence.

Adolescent↗
PubMed2005

Transcriptome profiling of individual larvae of two different developmental modes in the poecilogonous polychaete Streblospio benedicti (Spionidae).

Understanding the range of biochemical and physiological phenotypes in a cohort of embryos or larvae is crucial to understanding the lifespan, dispersal potential, and recruitment success of the early life history stages of a species. In this study, a novel kinetic assay has been employed to profile the transcriptome pool complexity in individual larvae of both planktotrophic and lecithotrophic developmental modes in the poecilogonous polycheate Streblospio benedicti. Using a nano-scale synthesis strategy, the mRNA pool in a single embryo or larva can be amplified into cDNA for quantitative characterization in a high-throughput, kinetic reannealing assay in a 96-well, microtiterplate format. This assay generates transcript-pool complexity estimates at 1 degrees C temperature increments for each sample producing 3,360 quantitative measurements per 96-well plate. Measuring transcriptome complexity on 8 individual planktotrophic and 8 individual lecithotrophic larvae (with 4 duplicate assays for each individual) reveals a more complex gene expression profile in planktotrophic larvae and a lower level of interindividual variation in expression patterns in lecithotrophic larvae. Although differences in these gene expression patterns are more likely due to physiological differences between feeding and non-feeding larval types in these late-stage individuals, this is one of the first assessments of inter-individual variation in gene expression patterns in marine invertebrate larvae and indicates a large potential for developmental variability.

Animal Nutritional Physiological Phenomena↗
PubMed1991

State mental health agency responsibility for outreach.

Historically, state mental health agencies have narrowly defined their responsibility for providing services. Recently, however, many have begun to be more assertive in managing community-based systems of care.

Community Mental Health Services↗