Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Mail Distribution”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,189 records · Page 66Linked to original sources
PubMed2005

Nationwide antibiogram analysis using NCCLS M39-A guidelines.

Lack of standardization in antibiogram (ABGM) preparation (the overall profile of antimicrobial susceptibility results of a microbial species to a battery of antimicrobial agents) has not been addressed until recently. The objective of this study was to analyze current antibiograms using the recently published NCCLS M39-A guidelines for preparation of antibiograms to identify areas for improvement in the reporting of antibiogram susceptibility data. Antibiograms from across the United States were obtained by various methods, including direct mailings, Internet searches, and professional contacts. Each ABGM collected was analyzed using prospectively defined elements from the M39-A guidelines. Additionally, seven quality indicators were also evaluated to look for the reporting of any atypical or inappropriate susceptibility data. The 209 antibiograms collected from 149 institutions showed at least 85% compliance to 5 of the 10 M39-A elements analyzed. Clinically relevant elements not met included annual analysis, duplicate isolate notation, and the exclusion of organisms with fewer than 10 isolates. As for the quality indicators evaluated, unexpected results included the 7% of antibiograms that reported <100% vancomycin susceptibility for Staphylococcus aureus, 24% that had inconsistent beta-lactam susceptibility for Staphylococcus aureus, 20% that reported <100% imipenem susceptibility for Escherichia coli, and 37% that reported >0% ampicillin susceptibility for Klebsiella pneumoniae. These findings suggest that antibiograms should be reviewed thoroughly by infectious disease specialists (physicians and pharmacists), clinical microbiologists, and infection control personnel for identification of abnormal findings prior to distribution.

Anti-Bacterial Agents↗
PubMedDate not supplied

Dentists' attitudes towards mouthguard protection.

PURPOSE: This study analyzed the attitudes of Virginia general dentists, orthodontists, and pediatric dentists towards mouthguard protection. METHODS: Questionnaires were constructed and mailed to 2500 dentists in Virginia. RESULTS: In this survey, 97% of orthodontists, 84% of pediatric dentists, and 67% of general dentists recommended mouthguard protection for their athletically active patients. The two main reasons for not recommending mouthguards were that the patient could obtain one from a less expensive source than the dental office and the dentist had not received formal training on fabrication or use of mouthguards. More recent graduates were more likely to have been taught mouthguard use and fabrication during their dental training. General dentists (59%) and pediatric dentists (56%) recommended the custom mouthguard while orthodontists recommended the prefabricated stock type (77%) as their primary choice of mouthguard. A majority of general dentists (58%), orthodontists (81%), and pediatric dentists (76%) recommended mouthguard protection for the contact sport of basketball which presently is a non-mandated mouthguard sport. CONCLUSION: Most dentists agree that athletically active patients require mouthguard protection. Many dentists, however, question whether they were the ones responsible for distributing and fabricating the mouthguards.

Athletic Injuries↗
PubMed1999

Non-responders to a postal questionnaire on respiratory symptoms and diseases.

Only few data have been published about non-responders in epidemiological studies on respiratory diseases. The aim of this study was to examine the characteristics of the non-responders and the reasons for non-response in a survey of respiratory health. All 9132 subjects, born 1925-1926, 1940-1941, 1955-1956 and 1970-1971 and living in eight representative areas in Norrbotten, Sweden, were invited to a prevalence study on asthma, chronic bronchitis and respiratory symptoms. The response rate was 85%. A sample of the non-responders from the cross-sectional postal questionnaire study was contacted by telephone and interviewed using the same questionnaire as had been used in the postal survey. Of the 1397 non-responders a stratified sample of 182 subjects were selected for this study and 144 agreed to participate. The response rate was increasing by increasing age. The main reason for non-response was that the subjects had forgotten to mail the questionnaire, lack of interest or lack of time. There were significantly higher proportions of current smokers and manual workers among the non-responders. The prevalence rates of wheezing, long-standing cough, sputum production, attacks of breathlessness, asthma and use of asthma medicines were significantly higher among the non-responders compared with the responders according both univariate and multivariate logistic regression analyses, in which the influences of age, sex, smoking habits, socioeconomic group and area of domicile were taken into account. The prevalence of respiratory symptoms and diseases was slightly underestimated in the postal survey.

Adult↗
PubMed2001

Gender and alcohol use: the roles of social support, chronic illness, and psychological well-being.

Men and women differ in their use of alcohol, in their rates of chronic illnesses and psychological symptoms, and in the social support they receive. In this paper, we assess how the latter three factors are associated with alcohol use, and how these associations differ by gender. Respondents were 3,074 male and 3,947 female randomly selected Health Maintenance Organization members who responded to a mail survey in 1990. Hierarchical multiple regression analyses indicate that social support is associated with alcohol consumption in similar ways for both genders, yet the associations between some demographic, physical health/functioning, and psychological well-being measures are different for men and women. Men with fewer role limits due to physical health drank more, while women with better psychological well-being drank less. Poor psychological well-being may be a modifiable risk factor for increased alcohol use among women; practitioners should be alert for greater consumption among men with few functional limitations and good health.

Adolescent↗
PubMed1994

Impact of direct mail intervention on knowledge, attitudes, and behavioral intentions regarding use of emergency medical services for symptoms of acute myocardial infarction.

This study evaluated a direct mail intervention called the "Call Fast, Call 911" campaign designed to increase use of emergency medical services for symptoms of acute myocardial infarction. The campaign was targeted at individuals over the age of 50. Persons over 50 years of age (N = 130,000) in King County, Washington, were randomly assigned to intervention or control groups. Individuals in the intervention groups received six direct mail pieces over a 1-year period encouraging them to call 911 quickly in response to chest pain. A postintervention telephone survey of a random sample of households (N = 434) assessed the impact of the campaign on knowledge, attitudes, and behavioral intentions regarding use of emergency medical services for symptoms of acute myocardial infarction. The results showed no significant differences between intervention and control groups in terms of knowledge of AMI. However, there were significant differences in beliefs and behavioral intentions to call 911 in a cardiac emergency.

Aged↗
PubMed2003

Research use of the AIDA www.2aida.org diabetes software simulation program: a review--part 2. Generating simulated blood glucose data for prototype validation.

The purpose of this review is to describe research applications of the AIDA diabetes software simulator. AIDA is a computer program that permits the interactive simulation of insulin and glucose profiles for teaching, demonstration, and self-learning purposes. Since March/April 1996 it has been made freely available on the Internet as a noncommercial contribution to continuing diabetes education. Up to May 2003 well over 320,000 visits have been logged at the main AIDA Website--www.2aida.org--and over 65,000 copies of the AIDA program have been downloaded free-of-charge. This review (the second of two parts) overviews research projects and ventures, undertaken for the most part by other research workers in the diabetes computing field, that have made use of the freeware AIDA program. As with Part 1 of the review (Diabetes Technol Ther 2003;5:425-438) relevant research work was identified in three main ways: (i) by personal (e-mail/written) communications from researchers, (ii) via the ISI Web of Science citation database to identify published articles which referred to AIDA-related papers, and (iii) via searches on the Internet. Also, in a number of cases research students who had sought advice about AIDA, and diabetes computing in general, provided copies of their research dissertations/theses upon the completion of their projects. Part 2 of this review highlights some more of the research projects that have made use of the AIDA diabetes simulation program to date. A wide variety of diabetes computing topics are addressed. These range from learning about parameter interactions using simulated blood glucose data, to considerations of dietary assessments, developing new diabetes models, and performance monitoring of closed-loop insulin delivery devices. Other topics include evaluation/validation research usage of such software, applying simulated blood glucose data for prototype training/validation, and other research uses of placing technical information on the Web. This review confirms an unexpected but useful benefit of distributing a medical program, like AIDA, for free via the Internet--demonstrating how it is possible to have a synergistic benefit with other researchers--facilitating their own research projects in related medical fields. A common theme that emerges from the research ventures that have been reviewed is the use of simulated blood glucose data from the AIDA software for preliminary computer lab-based testing of other decision support prototypes. Issues surrounding such use of simulated data for separate computer prototype testing are considered further.

Blood Glucose↗
PubMed2002

Risk factors for breast cancer at young ages in twins: an international population-based study.

BACKGROUND: Breast cancer etiology in women may relate to exposures early in life as well as in adulthood, but it has been difficult to gain information on childhood variables, and evidence on their effects is very limited. Comparison of risk factor levels between affected probands and unaffected twins in twin pairs can provide a unique method to investigate risk factors that act in early life. METHODS: We conducted four population-based case-control studies of breast cancer risk in twins in Denmark, England and Wales, Finland, and Sweden and pooled the data from these studies. The case patients were 400 women with incident breast cancer before the age of 50 years, and the control subjects were their twin sisters who had not had breast cancer by that time. Data on risk factors (e.g., demographic and anthropomorphic variables, reproductive history, and family history) were collected by interview and by a mailed questionnaire and were analyzed by calculating matched odds ratios [ORs]. All statistical tests were two-sided. RESULTS: The risk of breast cancer was increased for women who were less obese (OR = 1.44, 95% confidence interval [CI] = 1.08 to 1.91) or taller (OR = 1.27, 95% CI = 0.95 to 1.70) than their co-twin at age 10 years, for women who developed breasts earlier than their co-twin (OR = 1.53, 95% CI = 1.14 to 2.06), and for women who had a smaller waist-to-hip ratio at age 20 years than their co-twin (OR = 1.79, 95% CI = 1.00 to 3.21). Analysis according to family history of breast cancer showed that the associations of childhood height and weight with risk of breast cancer were only apparent in women without a family history of breast cancer. CONCLUSIONS: Childhood growth before puberty may affect the risk of premenopausal breast cancer, at least in women without a family history of breast cancer. The distribution of body fat in young adulthood may also be related to breast cancer risk.

Adolescent↗
PubMed2004

Experience and attitudes towards information technology among first-year medical students in Denmark: longitudinal questionnaire survey.

BACKGROUND: As more and more information technology (IT) resources become available both for support of campus- based medical education and for Web-based learning, it becomes increasingly interesting to map the information technology resources available to medical students and the attitudes students have towards their use. OBJECTIVE: To determine how extensively and effectively information handling skills are being taught in the medical curriculum, the study investigated Internet and computer availability and usage, and attitudes towards information technology among first-year medical students in Aarhus, Denmark, during a five-year period. METHODS: In the period from 1998 to 2002, students beginning the first semester of medical school were given courses on effective use of IT in their studies. As a part of the tutorials, the students were asked to complete a web-based questionnaire which included questions related to IT readiness and attitudes towards using IT in studies. RESULTS: A total of 1159 students (78%) responded. Overall, 71.7% of the respondents indicating they had access to a computer at home, a number that did not change significantly during the study period. Over time, the power of students' computers and the use of e-mail and Internet did increase significantly. By fall 2002, approximately 90% of students used e-mail regularly, 80 % used the Internet regularly, and 60 % had access to the Internet from home. Significantly more males than females had access to a computer at home, and males had a more positive attitude towards the use of computers in their medical studies. A fairly constant number of students (3-7 %) stated that they would prefer not to have to use computers in their studies. CONCLUSIONS: Taken together with our experience from classroom teaching, these results indicate optional teaching of basic information technology still needs to be integrated into medical studies, and that this need does not seem likely to disappear in the near future.

Adult↗
PubMed1997

Randomization to surgery or observation in patients with symptomatic gallbladder stone disease. The problem of evidence-based medicine in clinical practice.

BACKGROUND: The description and understanding of gallbladder stone disease in the medical literature are difficult because an assessment of the natural course of this symptomatic disease, with separation of patients in strictly defined groups, is generally lacking. METHOD: A multicenter study was carried out with patients randomized to either surgery or conservative, expectant treatment to examine optimal treatment and natural history in well-defined groups of symptomatic gallbladder stone disease with pain, episodes only (study group 1) or acute cholecystitis (study group 2). The patients were between 18 and 80 years of age and had right upper quadrant or midline epigastric pain and ultrasonographic evidence of gallbladder stone, with or without acute cholecystitis. Medical treatment was ordinated on the basis of signs and symptom severity. Patients randomized to surgery were placed on the hospital's waiting list and electively operated on with cholecystectomy as soon as conveniently possible. Preliminary results of follow-up are based on questionnaires mailed at regular intervals and consultations if required by the patients' symptoms. Quality of life and freedom from pain are study end points for evaluation. RESULTS: Five hundred and one patients were considered for the study, 318 patients (63.5%) belonging to group 1 and 183 (36.5%) to group 2. One hundred and eighty-four patients (36.7%) were randomized, 120 (24%) in group 1 and 64 (12.7%) in group 2. Three hundred and seventeen patients (63.3%), with an equal proportion from each study group, were excluded, the largest number of patients because of incapacitating pain or serious presenting symptoms (26%). More women (81%) than men (19%) had pain alone (group 1), but the sex ratio was reduced, 56% women and 44% men, in patients with acute cholecystitis (group 2), with a highly significant difference (P = < 0.001) between the two groups. A significant difference in patient withdrawal from randomized treatment was registered, with 24% from observation and 12% from surgery (P = 0.032), but with an equal distribution in the two study groups. CONCLUSIONS: A randomized trial of this nature is feasible but extremely difficult to perform because of the heterogeneous nature of gallbladder stone disease, leading to exclusion of many patients and difficulties in measuring and evaluating outcome variables.

Acute Disease↗
PubMed2002

Anthrax attack at the United States Capitol. Front line thoughts.

One great fear was realized on October 15, 2001 when United States citizens witnessed firsthand the unprecedented release of anthrax into a community. Although the office of the Attending Physician to Congress had been preparing for such an unthinkable act, lessons were learned as the events unfolded. The following is a summary of the findings: Preparation, planning, and frequent review of bioterrorism response procedures are essential. Effective communication remains the key to successful team performance. Briefings conducted daily and on an as needed basis shape the progress and performance of the team members. Electronic mail may not necessarily be the most effective way to disseminate critical information because not everyone can access the Internet outside of the work environment. Setting up a call center for answering client's questions is crucial. Clients potentially exposed to anthrax should be evacuated from the immediate area. Testing is not indicated for everyone, only those in the immediate areas. Allow health care personnel to decide whom should be tested. Such health care decisions must not be made based on anxiety or expediency. A data collection template should be set up in advance. This template should include, at least, the following: name, date of birth, social security number, the physical location of where the client might have been exposed, antibiotics administered and dosage, test results, and home and work phone number. This should be networked so a group can access and update data in real time. If the occupational health clinic has its own pharmacy, have a pill counter available to help with antibiotic distribution. The team should meet several times daily to ensure dissemination of a reliable and consistent message to the clients. Team members should be prepared to review the medical aspects of anthrax with clients on a frequent basis. A website with updated information might prove helpful for those with Internet access. This experience provided a unique opportunity for the Office of the Attending Physician to Congress to put its bioterrorism plan into action. Nothing substitutes for preparedness. Communication was the most important tool because it kept the team informed and focused on the mission at hand. It behooves all occupational health nurses to begin preparing for future acts as extraordinary as the anthrax attack that occurred on October 15, 2001.

Allied Health Personnel↗
PubMedDate not supplied

Are North American nephrologists biased against peritoneal dialysis?

OBJECTIVE: To examine possible bias against peritoneal dialysis (PD) by nephrologists less familiar with it. DESIGN: Secondary analysis of a previously reported survey. PARTICIPANTS: All practicing Canadian nephrologists (n = 290, response rate 66.2%) and a subgroup of American nephrologists who were members of the National Kidney Foundation Council on Dialysis (n = 507, response rate 47.3%). Responses were then subdivided by type of dialysis practice: mainly or only hemodialysis (HD, n = 117), mainly or only PD (n = 16), or both HD and PD (n = 232). INTERVENTION: Self-administered mailed questionnaire. MAIN OUTCOME MEASURES: Opinions and attitudes of nephrologists concerning patient characteristics favoring one dialysis modality over the other, as well as the relative utilization of HD and PD currently and in a hypothetical ideal situation. RESULTS: The main differences were present between physicians practicing mainly HD and physicians practicing mainly PD, with those practicing both giving answers usually intermediate to the others. The maximum weight suitable for PD was 10 kg less according to HD-oriented nephrologists compared with PD-oriented nephrologists (97.8 kg vs 108.5 kg). All nephrologists agreed that, ideally, 40% of prevalent end-stage renal disease patients should be on PD to optimize cost-effectiveness, whereas the proportion should be between 32% and 45% when one optimizes survival, wellness, and quality of life. In general, differences between groups were small. CONCLUSIONS: Most nephrologists favored a proportion of PD higher than the current prevalence seen in either Canada or the U.S.A. If physicians' biases are contributing to the distribution of dialysis modalities, they are not likely to be major factors. Unknown but important factors, external to the physician, may shape modality distribution more than the opinions and attitudes of physicians. If a more balanced and cost-effective dialysis delivery system is desired, more understanding and manipulation of these non physician-related factors will be required.

Attitude of Health Personnel↗
PubMed1992

Informational influences on physician referrals.

Today's health care marketers are devoting significant resources to increase physician referrals, an area vital to their continued survival. The goal of this investigation was to integrate the findings of previous research on physician referrals, and to provide an up-to-date assessment of those influences underlying physician referral behavior. A questionnaire was mailed to 1,800 physicians differing in specialty and years in practice. Three informational influences were found to affect physician referrals: Program Information, Patient Input, and Location. The results suggest a need for specialists and other organizations interested in managing physician referrals to (a) establish and maintain a network of relationships among those physicians referring patients and specialists being referred to through personal communication, (b) maintain a pool of knowledgeable professionals willing to supply relevant and current information to physicians, and (c) provide complete and prompt feedback information to the referring physician. Managerial implications and directions for future research are also discussed.

Chi-Square Distribution↗
PubMed1999

Women in general practice in New Zealand.

AIM: To investigate the role of women general practitioners (GPs) in New Zealand. METHOD: A five-page questionnaire was posted to 200 randomly selected women GPs from throughout New Zealand. One follow-up mailing was sent. RESULTS: A response rate of 79% was achieved. Twenty-four percent of women GPs work less than 5/10 but 46% earn less than $40000. Forty-eight percent of women GPs' partners also earn less than $40000. The most common reason for working part-time was parenting responsibilities. Eighty-seven percent are married or live with a partner, 77% have children, 48% have preschool-aged children. Only 15% have Membership of the RNZCGP and 57% are owner or partner in their practice. CONCLUSION: Women GPs suffer both professional and financial difficulties because of their dual motherhood/professional roles.

Age Distribution↗
PubMed1998

Attitude and self-reported practice regarding hospice referral in a national sample of internists.

Systematic, nationally representative information about physicians' attitudes and behavior with respect to hospice care is not available. We sought to describe these previously unexamined attitudes and practices. We conducted a mail survey of a random national sample of 1311 internists, of whom 697 responded (an unadjusted response rate of 53%). We elicited physician's attitudes and self-reported practice with respect to hospice. Most internists (89%) felt that hospice care was a good form of terminal care. Physicians with longer definitions of what constitutes "terminal" illness and those whose patients were more accepting of their prognoses were more likely to hold this opinion. Over the course of a year, the median internist referred five patients to hospice. Specialists and those with longer definitions of "terminal" were more likely to have done so. When asked "If you knew exactly how long a patient had to live, how long before death would you refer them to hospice?" the average response was 12.1 +/- 8.5 weeks, but responses varied from 1 to 52 weeks, and the pattern of responses was bimodal, with one peak at about 13 weeks (73% of internists) and one at about 25 weeks (27%). Moreover, the distribution of hospice enrollment times implied by physician reports about ideal practice is significantly more compact than the distribution of survival that is actually observed; physicians support far fewer very short (<2 weeks) and very long (>6 months) stays in hospice than are observed. We conclude that internists show significant support for, and utilization of, hospice and they endorse a length of stay that is longer than currently observed. These findings suggest that it may be possible to increase both the number of patients using hospice and their duration of use of hospice.

Journal Article↗
PubMedDate not supplied

Borderless teleradiology with CHILI.

Teleradiology is one of the most evolved areas of telemedicine, but one of the basic problems which remains unsolved concerns system compatibility. The DICOM (Digital Imaging and Communications in Medicine) standard is a prerequisite, but it is not sufficient in all aspects. Examples of other currently open issues are security and cooperative work in synchronous teleconferences. Users without a DICOM radiological workstation would benefit from the ability to join a teleradiology network without any special tools. Drawbacks of many teleradiology systems are that they are monolithic in their software design and cannot be adapted to the actual user's environment. Existing radiological systems currently cannot be extended with additional software components. Consequently, every new application usually needs a new workstation with a different look and feel, which must be connected and integrated into the existing infrastructure. This paper introduces the second generation teleradiology system CHILI. The system has been designed to match both the teleradiology requirements of the American College of Radiology (ACR), and the functionality and usability needs of the users. The experiences of software developers and teleradiology users who participated in the first years of the clinical use of CHILI's predecessor MEDICUS have been integrated into a new design. The system has been designed as a component-based architecture. The most powerful communication protocol for data exchange and teleconferencing is the CHILI protocol, which includes a strong data security concept. The system offers, in addition to its own secure protocol, several different communication Methods: DICOM, classic e-mail, Remote Copy functions (RCP), File Transfer Protocol (FTP), the internet protocols HTTP (HyperText Transfer Protocol) and HTTPS (HyperText Transfer Protocol Secure),and CD-ROMs for off-line communication. These transfer METHODS allow the user to send images to nearly anyone with a computer and a network. The drawbacks of the non-CHILI protocols are that teleconferences are not possible, and that the user must take reasonable precautions for data privacy and security. The CHILI PlugIn mechanism enables the users or third parties to extend the system capabilities by adding powerful image postprocessing functions or interfaces to other information systems. Suitable PlugIns can be either existing programs, or dedicated applications programmed with interfaces to the CHILI components. The developer may freely choose programming languages and interface toolkits. The CHILI architecture is a powerful and flexible environment for Picture Archiving and Communications Systems (PACS)and teleradiology. More than 40 systems are currently running in clinical routine in Germany. More than 300,000 images have been distributed among the communication partners in the last two years. Feedback and suggestions from the users influenced the system architecture by a great extent. The proposed and implemented system has been optimized to be as platform independent, open, and secure as possible.

Radiology Information Systems↗
PubMed2003

Benchmarking information needs and use in the Tennessee public health community.

OBJECTIVE: The objective is to provide insight to understanding public health officials' needs and promote access to data repositories and communication tools. METHODS: Survey questions were identified by a focus group with members drawn from the fields of librarianship, public health, and informatics. The resulting comprehensive information needs survey, organized in five distinct broad categories, was distributed to 775 Tennessee public health workers from ninety-five counties in 1999 as part of the National Library of Medicine-funded Partners in Information Access contract. RESULTS: The assessment pooled responses from 571 public health workers (73% return rate) representing seventy-two of ninety-five counties (53.4% urban and 46.6% rural) about their information-seeking behaviors, frequency of resources used, computer skills, and level of Internet access. Sixty-four percent of urban and 43% of rural respondents had email access at work and more than 50% of both urban and rural respondents had email at home (N = 289). Approximately 70% of urban and 78% of rural public health officials never or seldom used or needed the Centers for Disease Control (CDC) Website. Frequency data pooled from eleven job categories representing a subgroup of 232 health care professionals showed 72% never or seldom used or needed MEDLINE. Electronic resources used daily or weekly were email, Internet search engines, internal databases and mailing lists, and the Tennessee Department of Health Website. CONCLUSIONS: While, due to the small sample size, data cannot be generalized to the larger population, a clear trend of significant barriers to computer and Internet access can be identified across the public health community. This contributes to an overall limited use of existing electronic resources that inhibits evidence-based practice.

Attitude to Computers↗
PubMed2005

[Descriptive analysis of chronic pain clinics operating in Spain in 2001].

OBJECTIVES: To describe the characteristics and care approaches to care of chronic pain clinics operating in Spain in 2001. DESIGN: Cross-sectional mail survey of pain clinics in Spain. SETTING: Chronic pain clinics in Spain. STATISTICAL ANALYSIS: Descriptive statistics of pain clinics responding to the questionnaire. RESULTS: Fifty-six of the 79 pain clinics (70.8%) responded; 57.1% were in public facilities, 55.4% were affiliated with medical schools, and 53.6% were interdisciplinary units. Both acute and chronic pain were treated by 72.4% of the respondents. Anesthesiology departments supervised 89.3% of the clinics. Only 57.1% had staff permanently assigned to the pain clinic. A mean 2194 (SD 2041) visits by patients were received annually. The most commonly applied treatments were drugs, blocks, spinal techniques, and transcutaneous electrical nerve stimulation. Implantable systems were more frequently used in chronic pain clinics than in mixed pain clinics, and in university-affiliated clinics than in non-teaching facilities (P=0.03 in both comparisons). A psychological approach was used more often in interdisciplinary clinics than in units operated by staff from a single specialty (P<0.01). CONCLUSIONS: Chronic pain clinics were not evenly distributed throughout Spain. The number of patients treated at pain clinics was high. The various characteristics of pain clinics--such as funding source, interdisciplinarity, university affiliation, and specialization in chronic pain--a were factors that affected the use of certain treatments.

Acute Disease↗
PubMed2006

Urban-rural differences in the availability of hospital information technology applications: a survey of Georgia hospitals.

CONTEXT: Information technology (IT) has been identified as a potential tool for improving the safety of health care delivery. PURPOSE: To determine if there are significant differences between urban and rural community hospitals in the availability of selected IT functional applications and technological devices. METHODS: A mailed survey of community hospitals in Georgia assessing the current availability of IT applications (54.6% response rate). FINDINGS: Georgia hospitals reported having 63.6% of 56 possible functional applications computerized but only 52.9% of 41 technological devices. Compared to rural hospitals, urban hospitals had significantly more functional applications computerized (38.0 vs 31.8, P = .031) and technological devices available (23.9 vs 18.2, P = .016). Urban hospitals had significantly (P < .05) more IT applications available in 4 areas: emergency room services (7 of 10), surgical/operating room (8 of 12), laboratory (7 of 12), and radiology (5 of 11). Overall, the availability of IT applications was bimodal in rural hospitals: over 40% of rural hospitals had adopted over 70% of all applications, while approximately 26% of rural hospitals had adopted less than 30%. CONCLUSIONS: Some of the observed urban/rural differences in availability of IT applications may be due to differences in the scope of services provided by rural hospitals, in particular laboratories, radiology departments, emergency rooms, and surgery/operating rooms. Nevertheless, the bimodal distribution of IT applications adopted in rural hospitals raises concerns about the ability of selected rural hospitals to take advantage of regional data-sharing initiatives and maintain quality of patient care in the future.

Georgia↗