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[OECD pushes antiquated animal test for endocrine disrupting activity]

The OECD (Organisation for Economic Co-operation and Development) plans to set up a guideline for chemical testing (the "Immature Rat Utereotrophic Bioassay Screening Test") on the basis of an obsolete animal assay to standardise routine testing for endocrine disrupting activity. The proposed method will not do justice to the protection of consumers and the environment. On the other hand a number of promising in vitro methods exist that can be used to study the (also mechanics) effects of substances on the endocrine system. Therefore, from the animal point of view, too, the OECD proposal is unacceptable.

Journal Article↗

Mapping international challenges for managed care.

The author in this presentation discusses the factors which he believes constitute the 5 mega-challenges confronting the global managed care industry; namely: Challenge One: Contest the bogus falsehoods and factual errors about managed care. Challenge Two: Engage the debate on the rightful place of private health care in the global economy. Challenge Three: Make the healthcare industry an integral part of every nation's economic development plan. Challenge Four: Lead the public policy debate on the side of safe, health, peaceful, caring communities. Challenge Five: Join with colleagues from pharmaceutical, medical device and information technology companies to promote a robust private health sector.

Global Health↗

General practice. Hit and miss.

A survey of practices in a primary care group in outer London found many were poorly prepared for implementing clinical governance. More than half consisted of one doctor, and a quarter of practices were not computerised. Only a third had a staff development plan. Only a minority had sought patients' views about new services. Although three-quarters of practices were using guidelines, few had been trained in the use of protocols and guidelines.

Clinical Audit↗

[Waiting lists for transplantation in Italy].

To plan health services it is essential to gauge the needs. In transplant field in Italy, the first suitable data for waiting lists were collected in 1998. The data collected by Istituto Superiore di Sanità gave us a shot of patients field in waiting list at that time. We here analyse more significant data about heart, liver and kidney waiting lists. The situation is very different among north, centre and south of Italy: in South, where transplant activity is low, we found rare transplant centres, and most of patients prefer north centres. In kidney waiting list we found 1100 patients living in southern regions but registered in the waiting list of a different region. These data can help in planning development lines in Italy.

Humans↗

Soretolide (Laboratoires Biocodex).

Laboratoires Biocodex is developing soretolide (D-2916) as a potential treatment for epilepsy. It is currently in phase II trials [299344]. In animal models, soretolide shows an anticonvulsant profile similar to carbamazepine, being active in the maximal electroshock test and poorly active against pentylenetetrazole-induced seizures [299344]. The company is currently discussing future development plans for this drug [410625].

Animals↗

NCLEX-RN strategies for success: a private university's experience.

Our university is committed to teaching excellence and effective student learning. To demonstrate this effectiveness, our school of nursing conducted a pilot study to assess the status of student learning through documented success on the National Council Licensure Examination for Registered Nurses (NCLEX-RN). Recognizing that recommendations on NCLEX-RN test plan development and revisions are based on results of the triennial RN job analysis study, it became apparent to faculty for the need to identify and enhance nursing skills a student should be able to perform at the entry level of a newly licensed registered nurse. Predictive variables were identified and correlated with outcomes on the NCLEX-RN. Recommendations for research, education, and practice were developed and implemented leading to 1999 quarterly increases of 5-10% in NCLEX-RN scores.

Adult↗

Oman Family Health Survey 1995.

Rapid improvements have been occurring in public health and in individual health status in the Sultanate of Oman as a result of the 5-year health development plans that have been implemented since 1976, and also because of accelerated socioeconomic progress. A nationwide health survey was conducted in 1995 as part of the Gulf Family Health Project of the Council of Health Ministers of GCC States. This paper describes the survey methodology used and the results. In the process of rapid epidemiologic transition currently occurring in the country the survey results provide a perspective of public health in the Sultanate of Oman.

Acute Disease↗

Implementation of a change process to improve outcomes of patients admitted to epilepsy monitoring unit.

A continuous quality improvement in health care, combined with measurement of patient and organizational outcomes, is an international trend that promises improvement in meeting the needs of health care consumers in a cost-effective manner. A clinical improvement workshop was conducted in our institution to study the practical methods that can be used by clinical teams to improve the quality and value of health care. This workshop enabled the Epilepsy Team to identify change strategies that potentially could accelerate clinical improvement efforts in the epilepsy monitoring unit (EMU). The Team was able to develop, plan, and test improvements and link these improvements to patient outcomes.

Adult↗

Decontamination upgrading progresses.

Standards of decontamination of surgical instruments in the NHS in England have come under close scrutiny, and some significant improvements have been achieved. Action plans, developed to ensure the rate of improvement is maintained, are described in this article which is derived from the Department of Health/NHS Estate document 'A review of the decontamination of surgical instruments in the NHS in England'. The Institute of Healthcare Engineering and Estate Management is one of the organisations involved in the programme of work on decontamination.

Central Supply, Hospital↗

Design and operation of the National Survey of Early Childhood Health, 2000.

OBJECTIVES: This report presents the development, plan, and operation of the National Survey of Early Childhood Health, a module of the State and Local Area Integrated Telephone Survey, conducted by the National Center for Health Statistics, Centers for Disease Control and Prevention. This survey was designed to assess parents' perceptions of their children's pediatric care. In addition, data were collected that can be used to examine relationships between the promotion of health in the pediatric office and promotion of health in the home. Funding for the survey was provided by The Gerber Foundation, the American Academy of Pediatrics, and the Maternal and Child Health Bureau, Health Resources and Services Administration. The UCLA Center for Healthier Children, Families, and Communities contributed to the design of the study and the questionnaire. METHODS: A national random-digit-dialed (RDD) sample of households with children 4-35 months of age was selected. The study included an oversample of households having an eligible black non-Hispanic or Hispanic child. In households with more than one eligible child, one was randomly selected to be the subject of the interview. The respondent was the parent or guardian who was most responsible for the child's health care. A computer-assisted telephone interviewing (CATI) system was used to collect the data. RESULTS: A total of 2,068 interviews were completed during the first half of 2000. The response rate was 65.6%. A data file has been released that contains demographic information on the focal child and respondent, substantive health and health-related data, and sampling weights. Estimates based on the sampling weights generalize to the entire U.S. population of children 4-35 months of age.

Child↗

Cancer services. Appraising grace.

A system of assessing cancer care in general practice has been well received by practice teams. The most common problems concern development of a cancer register, communication with hospitals and lack of written information for patients. Greatest progress has been made when the primary care organisation has produced a development plan.

Communication↗

[Impact of the positive appraisal of care on quality of life, purpose in life, and will to continue care among Japanese family caregivers of older adults: analysis by kinship type].

PURPOSE: The impact of positive appraisal of care (PAC) on the caregiver's quality of life (QL), sense of purpose in life (sense of ikigai) and will to continue care was examined. METHODS: Data were collected from 322 Japanese family caregivers of older adults who were using visiting nursing services through 21 facilities in the Tokyo metropolitan area, and the prefectures of Shizuoka, Mie and Okinawa. RESULTS: The data were grouped by kinship type (husband or son, wife, daughter or daughter-in-law) and analyzed separately. From the multiple regression and logistic regression analyses, the following results were derived: 1) The PAC was not related to the physical QL regardless of the relationship type; 2) The relationship depended upon the relationship type: only the PAC was related to the mental QL among husband and son caregivers, both the PAC and the negative appraisal of care (NAC) were important among wives, only the NAC among daughters, and none of them among daughters-in-law; 3) Both the PAC and NAC were related to the sense of ikigai in all caregiver types except among husband and son caregivers, which showed no relationship between the NAC and sense of ikigai; 4) Both the PAC and NAC were related to will to continue care among son and husband caregivers, whereas only the PAC was among wives and daughters-in-law. Only the NAC was related among daughters. However, the difference across kinship type seems minimal for will to continue care. CONCLUSIONS: Understanding the PAC among family caregivers may be important in order to better assist them to improve their mental QL or sense of ikigai as well as to predict their continuation of caregiving at home. The impact of PAC varies depending on the kinship type, and it should be assessed separately with reference to this pariable to develop plans for appropriate assistance.

Aged↗

[Analytic management in ophthalmology: towards a cost per hospital out- and in-patient].

PURPOSE: To determine the total annual cost of the activities in the Ophthalmology Department at the Hospital La Mancha-Centro, Homogeneous functional group (HFG) of the INSALUD, and to estimate the cost per patient/process of both ambulatory patients and hospital in-patients. METHODS: The study was designed over 1 year period, from January to December 1997, and applied by using analytic accounting in 17,857 patients seen at the out-patient ophthalmology clinic and 973 hospital in-patients who were classified by diagnosis-related groups (DRG) and sorted out by analysis of Case Mix index. RESULTS: We have determined the annual cost of our activity in both the ambulatory patient group and the hospital in-patient group classified by DRG and obtained the cost per process. CONCLUSIONS: To know systematically the annual cost of our medical and surgical activity is nowadays a necessary tool in the framework of the Total Quality Plan developed by the INSALUD's SIGNO Group since 1991. This leads us to the analytic management area and places us in the never ending search for the ideal model of cost per process determination.

Ambulatory Care↗

[Utilization of semantic-documentary analytical techniques in the study and interpretation of diagnostic expressions of causes of death].

The authors report on a plan developed in Spain to compile a standard terminology of causes of death for use in historical demographic studies. "In the first phase a thesaurus will be created from the data available in the records. The second stage includes the creation of a terminological glossary. Finally...the change of information to standard nomenclatures [is proposed]." (SUMMARY IN ENG AND FRE)

Cause of Death↗

The Hague Forum.

Explore the source record for details and available documents.

Congresses as Topic↗

[Methodology and long-term follow-up of drug induced side effects in children (cancer, leukemia, AIDS, growth hormone)].

Long-term follow up for medicines used in children is necessary in some therapeutic areas. Long-term effects (e.g. in cancer) may be detected many years after the treatment period. Growth, development and maturation specific to children can make these effects particularly harmful. The development plan of a paediatric drug should include, long term follow up on the basis of pharmacological-toxicological and safety data. These aspects should be taken into account when modifying the protocol (lower dosage, withdrawal of some associations etc). The follow up period may be very long, as in cancer (e.g. second tumour after treatment for cancer). A cohort is the best choice for this follow up, but other alternatives may be useful, including a specific follow-up Unit. Long-term follow-up is nevertheless difficult and expensive, manpower-dependent and the risk of failure is great especially in the teenage years.

Acquired Immunodeficiency Syndrome↗