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PubMed1994

A profile of ICD-9-CM coding staff in NSW and ACT hospitals.

The ICD-9-CM coder workforce is on the brink of major changes given impetus by increasing commitments to casemix-based funding and management strategies within the public and private hospital sectors. A study of the ICD-9-CM coding process in NSW and ACT hospitals was undertaken by the School of Health Information Management, Faculty of Health Sciences, The University of Sydney during 1991. This article profiles the composition of the ICD-9-CM coder workforce in NSW and the ACT based on the findings of this study. Recent developments pertaining to national coder workforce issues are also discussed.

Abstracting and Indexing↗
PubMedDate not supplied

Lifting the veil of secrecy from industry funding of nonprofit health organizations.

Those who provide information about scientific issues and science policy normally present themselves as being objective and "scientific." This article describes a range of health charities, professional associations, nonprofit advocacy organizations, and industry-created organizations that receive significant funding from industry. In some cases, industry appears either to influence an organization's positions or to limit an organization's freedom to speak out on matters of interest to the funders. Nonprofit organizations need to consider the potential influence on their independence if they accept funding from interested companies and trade associations.

Conflict of Interest↗
PubMed2004

Lead editorial: The need for greater perspective and innovation in epidemiology.

This editorial introduces the new online, open-access, peer-reviewed journal, Epidemiologic Perspectives & Innovations. Epidemiology (which we define broadly, to include clinical research and various approaches to studying the health of populations) is a critically important field in informing decisions about the health of individuals and populations. But the desire for new information means that the health science literature is overwhelmingly devoted to reporting new findings, leaving little opportunity to improve the quality of the science. By creating a journal dedicated to all topics of and about epidemiology, except standard research reports, we hope to encourage authors to write more on the neglected aspects of the field. The journal will publish articles that analyze policy implications of health research, present new research methods and better communicate existing methods, reassess previous results and dogma, and provide other innovations in and perspectives on the field. Online publishing will permit articles of whatever length is required for the work, speed the time to publication and allow free access to the full content.

Journal Article↗
PubMed1997

[New drug development by innovative drug administration--"change" in pharmaceutical field].

New drug development can be made by providing products of higher "selectivity for the drug" for medical treatment. There are two ways for the approach to get higher "selectivity of drug": 1) discovery of new compounds with high selectivity of drug; 2) innovation of new drug administration, that is new formulation and/or method with high selectivity of drug by integration and harmonization of various hard/soft technologies. An extensive increase of biological information and advancement of surrounding science and technology may modify the situation as the latter overcomes the former in the 21 century. As the science and technology in the 21 century is said to be formed on "3H", that is, 1. hybrid; 2. hi-quality; 3. husbandry, the new drug development by innovative drug administration is exactly based on the science and technology of 3H. Its characteristic points are interdisciplinary/interfusion, international, of philosophy/ethics, and systems of hard/hard/heart. From these points of view, not only the advance of unit technology but also a revolution in thinking way should be "must" subjects. To organize this type of research well, a total research activity such as ROR (research on research) might take an important and efficient role. Here the key words are the "Optimization technology" and "Change in Pharmaceutical Fields." As some examples of new drug innovation, our trials on several topical mucosal adhesive dosage forms and parenteral administration of peptide drugs such as insulin and erythropoietin will be described.

Administration, Oral↗
PubMed2006

Book citations: influence of epidemiologic thought in the academic community.

Whilst their 'death' has often been certified, books remain highly important to most professions and academic disciplines. Analyses of citations received by epidemiologic texts may complement other views on epidemiology. The objective was to assess the number of citations received by some books of epidemiology and public health, as a first step towards studying the influence of epidemiological thought and thinking in academia. For this purpose, Institute for Scientific Information/ Thomson Scientific - Web of Science/ Web of Knowledgedatabase was consulted, in May 2006. The book by Rothman & Greenland appeared to have received the highest number of citations overall (over 8,000) and per year. The books by Kleinbaum et al, and by Breslow & Day received around 5,000 citations. In terms of citations per year the book by Sackett et al ranks 3rd, and the one by Rose, 4th of those included in this preliminary study. Other books which were influential in the classrooms collected comparatively less citations. Results offer a rich picture of the academic influences and trends of epidemiologic methods and reasoning on public health, clinical medicine and the other health, life and social sciences. They may contribute to assess epidemiologists' efforts to demarcate epidemiology and to assert epistemic authority, and to analyze some historical influences of economic, social and political forces on epidemiological research.

Bibliometrics↗
PubMed2002

Telepsychiatry: an overview for psychiatrists.

Telepsychiatry, in the form of videoconferencing and other modalities, brings enormous opportunities for clinical care, education, research and administration to the field of medicine. A comprehensive review of the literature related to telepsychiatry - specifically videoconferencing - was conducted using the MEDLINE, Embase, Science Citation Index, Social Sciences Citation Index and Telemedicine Information Exchange databases (1965 to June 2001). The keywords used were telepsychiatry, telemedicine, videoconferencing, Internet, primary care, education, personal digital assistant and handheld computers. Studies were selected for review if they discussed videoconferencing for patient care, satisfaction, outcomes, education and costs, and provided models of facilitating clinical service delivery. Literature on other technologies was also assessed and compared with telepsychiatry to provide an idea of future applications of technology. Published data indicate that telepsychiatry is successfully used for a variety of clinical services and educational initiatives. Telepsychiatry is generally feasible, offers a number of models of care and consultation, in general satisfies patients and providers, and has positive and negative effects on interpersonal behaviour. More quantitative and qualitative research is warranted with regard to the use of telepsychiatry in clinical and educational programmes and interventions.

Communication↗
PubMed2005

The neurobiology of PTSD: implications for nurses.

Posttraumatic stress disorder (PTSD) is a disabling and prevalent psychiatric disorder. Researchers and scientists have developed a neurobiological basis, which provides a framework for understanding the complexities of PTSD, for many symtoms of the disorder. The estimated lifetime prevalence of PTSD among adult Americans is 7.8%, with women twice as likely as men to have PTSD. Onset of symptoms can occur years after exposure to trauma, and the duration of the illness can last a lifetime. Patients with PTSD often encounter multiple psychosocial problems that result from the symptoms they experience, and their distorted perceptions can affect relationships within the family and the workplace. Nurses in various roles (e.g., educator, therapist, prescriber, case manager, staff nurse) may encounter individuals with PTSD. The nursing profession has traditionally sought to explain sophisticated language to patients in understandable terms, and nurses serve in encouraging, supporting, and evaluating roles, all of which will be increasingly important as science and technology discover more information about the neurobiological basis for mental illnesses.

Attitude to Health↗
PubMed2004

[On doctor-patient communication from an anthropological and social point of view].

This paper attempts to perform a historical anthropological analysis of the factors that currently either favor or obstruct the doctor-patient relationship. For this purpose, the main works of reference are the sociologist Gilles Lipovetsky and the Spanish author Pedro Laín Entralgo. The former, identified with the concept of Postmodernity and individual Hedonism, is crucial in understanding what are the main determinants in the most recent developments affecting the doctor-patient relationship. Since the technological revolution, advances in science have surpassed all imagination, information technology has worked its way into all types of relationship, and thus medical practice has been particularly affected. On the other hand, the work of Laín Entralgo enables us to perform a review of the history of the doctor-patient relationship in the Western world, which affords a more accurate view of the origins and evolution of the current situation.

Anthropology↗
PubMed2004

Moving diabetes care from science to practice: the evolution of the National Diabetes Prevention and Control Program.

The National Diabetes Prevention and Control Program has a dynamic and evolving scientific foundation. This article describes this program and how seminal research studies provide an impetus for its public health policy and programs. The charge and challenges of integrating science into past, current, and future program designs are detailed, as are the program's accomplishments. Areas requiring new science are explored, including better research to translate new findings into clinical and public health practice and models to evaluate the effect of public health on improved outcomes. The epidemic of diabetes and its increasing burden on public health demands a better understanding of existing science and its limitations and informed public dialogue and policy responses.

Diabetes Mellitus↗
PubMed1999

Cultural and personal behavioral factors and women's reproductive tract infections.

OBJECTIVE: To review the relationship between personal behavior and cultural factors and reproductive tract infections (RTIs). METHODS: An English-language literature search using MEDLINE (1994-1998), Social Science Index (1994-1998), and informal discovery. Any original researches and reviews related to RTIs' epidemiology, behavior and culture were selected. RESULTS: RTIs have become a silent epidemic that is devastating women's lives each year. CONCLUSION: The influencing factors include sexual behavior, health related behavior (preventive health behavior, health-seeking behavior, reproductive behavior etc.) and culture, belief, etc. A holistic point of view should be taken.

Bacterial Infections↗
PubMed2002

The promotion of mental health and the prevention of mental and behavioral disorders: surely the time is right.

This article provides an overview of key issues related to promotion and prevention. It examines the increasing role mental disorders play in the global burden of disease, controversies surrounding constructs such as mental health and prevention, and the links among promotion, prevention, treatment and recovery. After discussing disorders often targeted for prevention, it enumerates principles for effective programs and examples of findings from evidence-based programs. It presents recommendations for the prevention science field and concludes with information about the worldwide response to the need for promotion and prevention services.

Cross-Cultural Comparison↗
PubMed1988

Regulations on measures to promote the qualification of women in universities, colleges, and technical schools, 31 August 1988.

These Regulations of the German Democratic Republic, introduced on 1 October 1988, are intended to make it easier for certain categories of women--particularly those with heavy family responsibilities--to study at universities and technical colleges in the German Democratic Republic. The regulations apply to women who have either several children under age 16; a severely handicapped child under age 18; or a family member requiring continual care, supervision, or support. To benefit from the new scheme, women must be selected to sign a "training agreement" by an enterprise, which must have formal plans for promoting its female workforce. Once courses are completed, trainees must be integrated into jobs corresponding to their new skills. The new regulations make it easier to follow correspondence courses by allowing up to 100 days of paid time off each year for study and examination purposes. In following a full-time course, women will receive an allowance equalling 80% of the difference between a basic student allowance and her actual or average earnings prior to enrolling in the course. This will be paid by the employing enterprise. In addition to time off from work, enterprises must provide a support network which includes welfare services, reduced workload, use of the enterprise's training equipment and facilities, and the provision of work assignments linked to training. Steps must be taken to assist women to acquire the qualifications for access to executive and managerial functions. At the core of the new scheme is a whole new range of "specially tailored" correspondence and evening courses which have been introduced into universities and technical colleges. With an average course duration of four and half to five years, course participants will all be nominated by their employing enterprise. The scheme as a whole will be progressively extended to cover all branches of engineering, economic, and agrarian sciences, with special emphasis on information technologies.

Education↗
PubMed1992

Evidence for the effectiveness of CME. A review of 50 randomized controlled trials.

OBJECTIVE: To assess the impact of diverse continuing medical education (CME) interventions on physician performance and health care outcomes. DATA SOURCES: Using continuing medical education and related phrases, we performed regular searches of the indexed literature (MEDLINE, Social Science Index, the National Technical Information Service, and Educational Research Information Clearinghouse) from 1975 through 1991. In addition, for these years, we used manual searches, key informants, and requests to authors to locate other indexed articles and the nonindexed literature of adult and continuing professional education. STUDY SELECTION: From the resulting database we selected studies that met the following criteria: randomized controlled trials; educational programs, activities, or other interventions; studies that included 50% or more physicians; follow-up assessments of at least 75% of study subjects; and objective assessments of either physician performance or health care outcomes. DATA EXTRACTION: Studies were reviewed for data related to physician specialty and setting. Continuing medical education interventions were classified by their mode(s) of activity as being predisposing, enabling, or facilitating. Using the statistical tests supplied by the original investigators, physician performance outcomes and patient outcomes were classified as positive, negative, or inconclusive. DATA SYNTHESIS: We located 777 CME studies, of which 50 met all criteria. Thirty-two of these analyzed physician performance; seven evaluated patient outcomes; 11 examined both measures. The majority of the 43 studies of physician performance showed positive results in some important measures of resource utilization, counseling strategies, and preventive medicine. Of the 18 studies of health care outcomes, eight demonstrated positive changes in patients' health care outcomes. CONCLUSION: Broadly defined CME interventions using practice-enabling or reinforcing strategies consistently improve physician performance and, in some instances, health care outcomes.

Clinical Competence↗
PubMed2005

[LASER applications in endodontics].

Since the development of the ruby laser by Maiman in 1960 and the application of the laser for endodontics by Weichman in 1971, a variety of lasers with a wide range of characteristics are now being used in endodontic therapy. In the past two decades much experience and knowledge has been gained The first purpose of the present paper is to provide an understanding of the essential physical science behind laser technology and information on the effects of laser beams on tissue (tissue interaction). A second purpose is to summarize laser applications in endodontics, including their use in pulp diagnosis, dentinal hypersensitivity, pulp capping and pulpotomy, modification of the root canal walls, sterilization of the root canal system, cleaning--shaping--obturation of the root canal, and endodontic surgery. It will be clear that a number of endodontic procedures with conventional treatments cannot provide comparable results or are less effective.

Dental Instruments↗
PubMed1991

Intravascular contrast media. Ionic versus nonionic: current status.

The development of LOCM is one of the most important medical discoveries made at the end of this century. In developing nonionic compounds, Almén showed that it was possible to decrease the osmolality by a factor of 2 and also thereby reduce the chemotoxicity by as much as a factor of 20. Serious adverse side effects after the intravascular administration of contrast material are caused by a combination of osmotoxic and chemotoxic properties of an individual contrast media molecule as well as the ionic composition of the agent when in solution. Worldwide clinical experience with the use of LOCM, ionic and nonionic, consistently has shown the new material to be safer and more comfortable in clinical practice. Some form of limited use of LOCM is now part of virtually every radiologist's daily practice, and the focus is turning to the low-risk-no-risk group. There are gray areas between risk categories, with some evidence even suggesting that the 20- to 40-year-old age group may be at risk to the same or even a greater degree than other commonly accepted risk groups such as the elderly. The future promises even better and safer but, in all likelihood, expensive, contrast agents for intravascular use. The ultimate decision on choice of contrast or the fate of LOCM rests with public policy makers, organized medicine, and the individual physician and patient. Based on penetration of the marketplace (nearly 50%) in terms of LOCM sales in 1990, there is a growing awareness within our specialty as well as the public sector of the improvements offered by LOCM. It is unlikely that a major conversion back to the universal use of HOCM will ever occur. As long as cost remains the major focus of the debate over the choice, however, physicians need to be informed advocates, familiar with the science, yet sensitive to the economic implications of the decisions they make to best serve the interests of their patients.

Angiography↗
PubMed1991

Perception of linear acceleration in weightlessness.

Tests of the perception and use of linear acceleration sensory information were performed on the science crews of the Spacelab 1 (SL-1) and D-1 missions using linear "sleds" in-flight (D-1) and pre-post flight. The time delay between the acceleration step stimulus and the subjective response was consistently reduced during weightlessness, but was neither statistically significant nor of functional importance. Increased variability of responses when going from one environment to the other was apparent from measurements on the first day of the mission and in the first days post-flight. Subjective report of perceived motion during sinusoidal oscillation in weightlessness were qualitatively similar to reports on earth. In a closed-loop motion nulling task, enhanced performance was observed post-flight in all crewmembers tested in the Y or Z axes.

Acceleration↗
PubMed1990

Perception of linear acceleration in weightlessness.

Tests of the perception and use of linear acceleration sensory information were performed on the science crews of the Spacelab 1 (SL-1) and D-1 missions using linear "sleds" in-flight (D-1) and pre-post flight. The time delay between the acceleration step stimulus and the subjective response was consistently reduced during weightlessness, but was neither statistically significant nor of functional importance. Increased variability of responses when going from one environment to the other was apparent from measurements on the first day of the mission and in the first days post-flight. Subjective reports of perceived motion during sinusoidal oscillation in weightlessness were qualitatively similar to reports on earth. In a closed-loop motion nulling task, enhanced performance was observed post-flight in all crewmembers tested in the Y or Z axes.

Acceleration↗
PubMed1989

Preservation activities and needs in U.S. biomedical libraries: a status report.

A national sample of health sciences and other types of libraries having significant holdings of biomedical literature was studied to determine the status of library preservation programs. Findings pertaining to 134 basic health sciences libraries and to ninety-seven resource libraries in the Regional Medical Library Program network are reported and discussed. Basic health sciences libraries participating in the study were primarily hospital libraries; resource libraries were primarily academic health sciences center libraries. Findings include information on topics perceived to be of greatest need for staff training and for informational or educational materials; on levels of preservation activity, staffing, and funding; and on capabilities for participating in a national cooperative preservation program. Efforts to identify general and special biomedical collections of potential importance to a national preservation program met with limited success.

Corrosion↗