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, a clinically based patient classification developed by the Health Care Research Department of Blue Cross of Western Pennsylvania under Grant No. 18-P-97063/3-06 from the Health Care Financing Administration. This article describes the clinical specificity of patient-management categories, how their design and definition incorporates severity of illness, and how comorbid patients are differentiated from single disease patients having multiple related diagnoses.
and other drugs and how widespread the use of these substances is among younger children. Is it rampant and universal, as some press accounts have it, or are the images portrayed by the news media, by popular movies, and by other communication outlets fueling harmful stereotypes? The campaign's market research consisted of in-depth reviews of the literature, of personal communications, conference proceedings, grant and contract reports, monographs, newspaper and magazine articles, and of national survey
(83% v. 65%), and obtainedgrants (51% v. 18%) and personal awards (37% v. 18%). The BScMed graduates also had significantly more publications than the control subjects. Although part of the difference between the two groups may be explained by the tendency of students who were more inclined toward an academic career to enter the BScMed program, it was evident that the program has a substantial effect on promoting the development of clinical investigators.
: This study provides a preliminary look at how participating in supported employment, a form of vocational rehabilitation emphasizing ongoing support in competitive jobs, affects the amount that participants earn from work and the total amount of income they receive from all sources. Further, we examine the extent to which receiving public benefits affects the amount earned from private employment, taking into consideration other factors that might be associated with benefit status. METHODS: Data are from (...) ordinary least-squares regression, we analyzed the effect of benefit status on changes in earnings, taking into account diagnosis, work history, education, program type, site of program, psychiatric symptoms, global functioning and previous earnings. RESULTS: Estimated total income increased by an average of $134 (US) per month after enrolling in supported employment. More than three-quarters of this increase was from government sources, such as Social Security and educational grants. The increase
Program on Surgical Control of the Hyperlipidemias (POSCH): recruitment experience. The Program on Surgical Control of the Hyperlipidemias (POSCH) is an investigator-initiated NHLBI grant-funded secondary coronary heart disease intervention trial using partial ileal bypass (PIB) for lipid reduction. Randomization started in September 1975 and ended in July 1983 with enrollment of 838 participants (421 surgery, 417 controls). The trial is scheduled to reveal the atherosclerosis impact (...) of individuals to be randomized from 1000 to 838 and with extension of the duration of minimum follow-up from 5 to 7 years. Only with the development of a uniform model clinic concept, with specified levels of performance calculated from actual recruitment data, did accrual of patients into the trial become predictable and achievable. Some of the recruitment delays in POSCH were related to problems, in part generic to the existent grantfunding mechanism and associated with decisions made by NHLBI and its
scores becomes problematic. Structural equation modeling programs (e.g., LISREL) may be used to explicity test assumptions of factor stationarity and invariance. As part of a National Institute on Drug Abuse grant-funded, double-blind, placebo-controlled trial to assess effectiveness of treating cocaine-abusing patients with fluoxetine, POMS data were collected at baseline and at 6 weeks (n = 90). Applying a longitudinal factor analysis strategy, factor stationarity and invariance of two POMS factors
Competing HMOs collaborate to improve preventive services. In July 1993, an unusual collaboration developed between competing managed care plans and with competing primary care clinics as part of a federally funded research grant (IMPROVE from the Agency for Health Care Policy and Research). The goal of this collaboration is to scientifically test the ability of an health maintenance organization (HMO) to improve the delivery of eight adult preventive services by training and facilitating (...) the use of continuous quality improvement and prevention systems by contracted private primary clinics.In order to conduct this effectiveness study, it was necessary for two HMOs to come to a structural and functional understanding of how to operate jointly. Investigators recruited 44 private clinics for a randomized controlled trial in which 22 are being assisted in improving the process used to deliver these preventive services and 22 are being left alone as comparison clinics. The intervention
, child care assistance, and education and training opportunities. This article reviews the policy context in which the Teenage Parent Welfare Demonstration was designed and implemented, and describes how participation in the enhanced services group affected the teen mothers as adults and as parents. Results showed that, for the reasonable aggregate annual cost of $2,400 per participant, the program increased the 'teenagers' attendance at school and job training programs, and modestly increased (...) the proportion who were employed to 48%, compared with 43% among those receiving regular welfare services. As the participants' earnings from employment increased, their welfare grants shrank. Because these changes offset each other, the program did not improve the economic well-being of the families, although fewer tax dollars were needed to support them. The program did not discourage further childbearing, however, or affect either the parenting behavior of the young women or the development
TRICC: ICU transfusion threshold TRICC - Wiki Journal Club TRICC From Wiki Journal Club Jump to: , Hebert PC, et al. "A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care". The New England Journal of Medicine . 1999. 340(6):409-417. • • Contents Clinical Question Among critically ill patients, how does a restrictive transfusion strategy (hemoglobin goal of 7-9 g/dL) compare with a liberal transfusion strategy (hemoglobin goal of 10-12 g/dL (...) disease decreases the generalizability of the results May not apply to patients at high altitudes No subgroup analysis in those with brain injury Only 13% of those screened were randomized in the trial, potentially harming external validity Funding Funding from Medical Research Council of Canada and an unrestricted grant from Bayer. Further Reading Cite error: Invalid tag; no text was provided for refs named ssc ↑ Retrieved from " " : Navigation menu Personal tools Namespaces Variants Views More
Leuven Surgical Trial: Intensive glycemic therapy in SICU Leuven Surgical Trial - Wiki Journal Club Leuven Surgical Trial From Wiki Journal Club Jump to: , Van den Berghe G, et al. "Intensive Insulin Therapy in Critically Ill Patients". The New England Journal of Medicine . 2001. 345(19):1359-1367. • • Contents Clinical Question In surgical ICU patients, how does intensive compare to conventional glycemic control in reducing mortality? Bottom Line Among surgical ICU patients, intensive glycemic (...) mortality 1.7% vs. 1.8% (P=0.9) >5-day mortality 10.6% vs. 20.2% (P=0.005) In-hospital death 7.2% vs. 10.9% (P=0.01) In-hospital death among those in ICU for >5 days 16.8% vs. 26.3% (P=0.01) Criticisms Non-blinded design Predominantly surgical rather than medical patients Funding Funded by the University of Leuven, the Belgian Fund for Scientific Research, the Belgian Foundation for Research in Congenital Heart Disease, and an unrestricted grant from Novo Nordisk. Further Reading Retrieved from
Non-compliance in patients with heart failure: how can we manage it? Non-compliance in patients with heart failure: how can we manage it? Non-compliance in patients with heart failure: how can we manage it? van der Wal M H, Jaarsma T, van Veldhuisen D J CRD summary This review investigated the effectiveness of interventions to improve compliance in patients with heart failure. The authors concluded that education and counselling may be beneficial, but existing evidence is scarce and more (...) to 85 years and 27 to 73% were female. No information on co-morbidities or medication use was reported. Outcomes assessed in the review Studies that included any measure of compliance (medication or lifestyle recommendations) as an outcome were eligible for inclusion. The included studies reported on the following outcomes: medication compliance (method of measurement not defined), daily weighing, fluid restriction, dietary compliance and sodium restriction adherence. How were decisions
How to integrate prevention into primary care. Guidelines and Measures | Agency for Healthcare Research & Quality HHS.gov Search ahrq.gov Search ahrq.gov Menu Topics A - Z Healthcare Delivery Latest available findings on quality of and access to health care Searchable database of AHRQ Grants, Working Papers & HHS Recovery Act Projects AHRQ Projects funded by the Patient-Centered Outcomes Research Trust Fund You are here Guidelines and Measures Funding for the National Guideline Clearinghouse (...) (NGC) has ended. Learn more about the status of the site. View the criteria guidelines and measures had to meet to be included in NGC and NQMC, respectively. Learn how measures were classified according to the domain framework. Find information on the legacy National Guideline Clearinghouse (NGC) and National Quality Measures Clearinghouse (NQMC). Status of NGC and NQMC Summaries and information about inclusion criteria and domain framework Updates and announcements on the status of NGC and NQMC
the response rate for, and cost-effectiveness of, this alternative. Source of funding Supported by grants from the Vaccine Safety Datalink Project of the National Immunization Program, Centers for Disease Control, and the Northern California Kaiser Innovation Program. Bibliographic details Lieu T A, Black S B, Ray P, Schwalbe J A, Lewis E M, Lavetter A, Morozumi P, Shinefield H R. Computer-generated recall letters for underimmunized children: how cost-effective? Pediatric Infectious Disease Journal 1997 (...) Computer-generated recall letters for underimmunized children: how cost-effective? Computer-generated recall letters for underimmunized children: how cost-effective? Computer-generated recall letters for underimmunized children: how cost-effective? Lieu T A, Black S B, Ray P, Schwalbe J A, Lewis E M, Lavetter A, Morozumi P, Shinefield H R Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary
provided on the sensitivity analysis of costs and benefits and the methodology used. Source of funding Supported in part by NIMH grant MH41459, by a grant from the Kaiser Family Foundation and by NIDA grant DA09531. Bibliographic details Kahn J G. The cost-effectiveness of HIV prevention targeting: how much more bang for the buck? American Journal of Public Health 1996; 86(12): 1709-1712 PubMedID Indexing Status Subject indexing assigned by NLM MeSH Cost-Benefit Analysis; Epidemiologic Methods; HIV (...) The cost-effectiveness of HIV prevention targeting: how much more bang for the buck? The cost-effectiveness of HIV prevention targeting: how much more bang for the buck? The cost-effectiveness of HIV prevention targeting: how much more bang for the buck? Kahn J G Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical
How cost-effective is it to leave perineal skin unsutured How cost-effective is it to leave perineal skin unsutured How cost-effective is it to leave perineal skin unsutured Petrou S, Gordon B, Mackrodt C, Fern E, Ayers S, Grant A, Truesdale A, McCandlish R Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical (...) of funding None stated. Bibliographic details Petrou S, Gordon B, Mackrodt C, Fern E, Ayers S, Grant A, Truesdale A, McCandlish R. How cost-effective is it to leave perineal skin unsutured. British Journal of Midwifery 2001; 9(4): 209-214 Other publications of related interest Gordon B, Mackrodt C, Fern E, Truesdale A, Ayers S, Grant A. The Ipswich childbirth study: 1. A randomised evaluation of two stage postpartum perineal repair leaving the skin unsutured. British Journal of Obstetrics and Gynaecology
When and how to assess fast-changing technologies: A comparative study of medical applications of four generic technologies When and how to assess fast-changing technologies: A comparative study of medical applications of four generic technologies When and how to assess fast-changing technologies: A comparative study of medical applications of four generic technologies Mowatt G, Bower DJ, Brebner JA, Cairns JA, Grant AM, McKee L Record Status This is a bibliographic record of a published health (...) technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Mowatt G, Bower DJ, Brebner JA, Cairns JA, Grant AM, McKee L. When and how to assess fast-changing technologies: A comparative study of medical applications of four generic technologies. Health Technology Assessment 1997; 1(14): 1-151 Authors' objectives To try to identify the optimal time at which to start assessing new and fast-evolving health technologies
In post-vasectomy patients who still show sperm in their samples, how long should you wait before referring back to the surgeon? In post-vasectomy patients who still show sperm in their samples, how long should you wait before referring back to the surgeon? - Trip Database or use your Google+ account Find evidence fast ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING (...) . As well as research evidence we also allow clinicians to search across other content types including images, videos, patient information leaflets, educational courses and news. For further information on Trip click on any of the questions/sections on the left-hand side of this page. But if you still have questions please contact us via email@example.com In post-vasectomy patients who still show sperm in their samples, how long should you wait before referring back to the surgeon? In 2004
How long should patients with psychotic depression stay on the antipsychotic medication? Patients who have major depression with psychotic features have greater morbidity and mortality than patients with nonpsychotic major depression. In particular, relapse and recurrence have been reported to occur more frequently in patients with psychotic depression than nonpsychotic depression. Despite the frequent relapse and recurrence in major depression with psychotic features, there are few studies (...) of the efficacy of continuation and maintenance treatments.Forty patients with a diagnosis of unipolar DSM-III-R major depression with psychotic features were treated with fluoxetine and perphenazine for 5 weeks after granting written informed consent. The patients who responded to treatment continued to receive the combination for an additional 3 months. If a patient was stable for 4 months on treatment with the combination, the patient was then gradually tapered off perphenazine treatment. For patients who
Surgical teaching: how should neurosurgeons handle the conflict of duty to today's patients with the duty to tomorrow's? The author examines the problem of tension in neurosurgical teaching between the duty to train residents by providing various levels of unsupervised surgery and the duty to patient care. The duty to train the residents also translates into ensuring the provision of good care for patients of tomorrow by producing competent surgeons. The author contends that both duties can (...) be fulfilled simultaneously, but the surgical tension inherent in this situation must not be ignored or taken for granted.
How patients' trust relates to their involvement in medical care. To examine the connection between patients' trust and their attitudes toward seeking care, participating in medical decision making, and adhering to treatment recommendations.Data were collected from a national telephone survey of English-speaking adults (N=553) in 1999. Eligibility requirements were some type of public or private health care coverage and having seen a physician or other health professional at least twice (...) significant in multivariate regression models. Views varied slightly by trust in the specific physician. There were no racial differences.A strong connection exists between patients' preferred involvement in medical care and trust in the medical profession, but only a slight connection with trust in their own physician. Increased trust in physicians generally is associated with greater willingness to seek care, to follow recommendations of physicians, and to grant them decisional authority. Higher trust