Spirituality "importance for care"

The causes of red eye range from trivial to life-threatening, and many general practitioners are uncertain of their ability to diagnose them with the aid of an ophthalmoscope. We tested the hypothesis that, in the assessment of a patient with red eye, a doctor using a slit lamp biomicroscope would not differ in diagnostic accuracy from a doctor using a direct ophthalmoscope. A cross-over study was conducted in 98 patients newly attending an eye casualty department. 71% of diagnoses agreed exactly, and all potentially sight-threatening lesions were either diagnosed correctly or managed appropriately by doctors using an ophthalmoscope. We conclude that the initial diagnosis and management of patients with an acute red eye is not prejudiced by the lack of a slit lamp biomicroscope.     

The importance of "legalese" in biotechnology patents

If your patent claims do not use established patent terminology, their scope may turn out to be narrower than you think.     

The predictors of quality care

Patients' perceptions of quality are important to the performance ratings, financial viability, and operational options afforded to purchasers of health care. Through TRICARE, the Department of Defense provides care for the more than 1.5 million active duty service members charged with the defense of the nation. As patients, these service members are typically incapable of assessing the technical quality of the care they receive. This study examines the attributes of health care delivery that define military patients' perceptions of quality and discusses the implications of these assessments.     

The policy implications of using hospital and physician volumes as "indicators" of quality of care in a changing health care environment

There is growing interest in the quality of health care and in using quality measures to direct patients to hospitals and providers offering high quality, low cost health care. The dilemma is that, while there is an increasing need for quality indicators as a result of a changing health care environment, this changing environment has important implications for the use of some of these measures. Since the 1970s, a growing body of research in the U.S. has addressed the empirical relationship between the number of patients with a specific diagnosis of surgical procedure and their outcomes after treatment in a particular hospital or by a particular physician ("volume-outcome" studies). In this paper, we examine the policy implications of using hospital and physician volume information as an "indicator" of quality in a rapidly changing health care environment with new players and new incentives. We begin by describing the evolution of the use of volumes within both regulatory and market-oriented contexts in the U.S. We then discuss policy considerations and cautions in using volumes, along with suggestions for future research. Our purpose is to point out potential problems and clarify confusions about the use of volumes, so that policymakers and practitioners can be sensitive to the potential minefields they are traversing.     

检测原始记录在质量管理体系中的重要性

根据质量管理体系对检测原始记录的要求,结合济钢实验室检测原始记录的运行状况,对检测原始记录的重要性、检测原始记录的基本要求、检测原始记录的管理知识、填写检测原始记录时容易出现的错误等进行描述,纠正检测人员对检测原始记录的模糊认识,使检测原始记录进行规范化管理,符合质量管理体系的要求。     

The perceived quality of hospital care

For the functional psychoses of late life, epidemiological information comes from two sources: studies of persons who have reached psychiatric services; and surveys of elderly persons sampled from the general population. A conspectus of published data from both sources leads to the following conclusions: States phenomenologically similar to those found in clinics do occur in the community in non-trivial numbers. There is no notable divergence in the information obtained from clinical series and from population-based surveys. These states are more common in women, they become more common with increasing age and are sometimes associated with decline in cognitive performance or with degenerative changes in the brain revealed by neuroimaging. Genetic factors appear to be less important than in early-onset psychoses but remain ill-defined, and the roles of social isolation and disorders of personality have not yet been sufficiently elucidated. Both clinical and community-based studies have found an association with sensory impairment. The community-based data suggest that paranoid symptoms may be detectable at subclinical level, and an association between them and cognitive impairment is demonstrable in individuals who are not diagnosable cases either of psychosis or of dementia. Differences exist between late-onset paranoid psychoses and affective psychoses in symptomatology and response to treatment. These observations confirm the importance of the late-onset psychoses for research directed towards uncovering the origins of psychotic symptoms in any age group.     

The importance of quality of life research for health care reform in the USA and the future of public health

Quality of life research data have significant implications for the social and public policy in the USA as it can be used to evaluate the cost-effectiveness of various permutations of treatment as well as the 'human effectiveness' of health care system restructuring. The USA spends more on health care per capita than any other industrialized nation, yet on major health indicators, such as infant mortality rate, this expenditure is not related to beneficial effects on the community. When epidemiological and quality of life data drive national health care planning, improved approaches to the management of health service delivery may become apparent. Ultimately only the patient or consumer can determine if a particular treatment is successful; the same may be true for health care reform.     

The relationship between quality of care and financial performance in dialysis: "doing well by doing good"

Reconstruction of posterior lamellar eyelid defects requires a tissue substitute that is either identical to the tissue lost (ex. surrounding or nearby tarsus) or donor tissue from another site that serves the same supportive role. Irradiated homologous tarsal plate and irradiated homologous aorta are potential posterior lamellar substitutes. Each provides a structural framework for the surrounding lid tissues to grow upon and are incorporated into the normal eyelid anatomy. Both the tarsal plate and aorta can be harvested, irradiated and stored in a refrigerator, ready to be utilized in those selected cases with severe tissue loss. They may also be utilized as a donor material in more routine lid reconstruction as an alternative. We discuss our experience with these materials.     

The quality circle of hip fracture care

Elderly patients with hip fractures have many medical, physical, and psychosocial challenges. Their care can become complex and require the integration of various disciplines. In this article, the author describes and explains the hip fracture preoperative assessment tool that contains various "red flag" indicators and tools used for data collection. The case manager can use this tool to assess patients before surgery and appropriately plan for discharge. Outcome results are discussed, including functional status, length of stay, and costs.     

The importance of professional psychology: A view from managed care.

Over the past 15 years, the development of managed health care has led to changes in the way that psychology is practiced and in the ways that quality is measured in the health care system. In this article, the current status of population-based Health Plan Employer Data and Information Set quality metrics are reviewed. Many medical measures of quality have improved in the past 5 years, whereas behavioral health measures have shown only modest improvement. Reasons for this finding are discussed, and it is suggested that quality of care for individuals and populations could improve as psychology adopts evidenced-based practice and clinical practice guidelines. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The importance of the risk factor "obesity" during gravidy (author''s transl)

The subacute toxicity of sodium saccharin and 2 hydrolytic derivatives, o-sulfamoylbenzoic acid (Compound I) and ammonium o-carboxybenzene sulfonate (Compound II) was evaluated by feeding each of the compounds alone at a dietary level of 20 000 ppm to both beagle dogs and albino rats. Additionally, groups of dogs and rats were fed combinations of the 3 materials at levels up to 20 000 ppm (2000 ppm sodium saccharin, 9000 ppm of both Compound I and II). Dogs were maintained on the test diets for 16 weeks, rats for 13 weeks. No signs of a pharmacotoxic response to the test materials were observed. Parameters determined for treated animals, including growth, food consumption, hematologic profiles, clinical blood chemistry studies, urinalyses, organ weight and ratio data, and both gross and microscopic pathologic evaluation, were not significantly different from control values. From these findings, it is suggested that there is little toxicologic hazard associated with ingestion of the 2 hydrolytic derivatives of sodium saccharin.     

The malpractice controversy and the quality of patient care

The widespread doctor strikes of 1975 stimulated belated attention to a crisis in malpractice insurance. Most state legislatures responded only to a shadow crisis in insurance as they rallied to the defense of health care providers. The smouldering substantive crisis--the reality of malpractice--is now galvanizing institutions and professions into aggressive activities for quality assurance and renewal of trust between patient and doctor. New procedural experiments offer prospects for preserving economy and equity by containing the causes of malpractice suits within the health care system itself.     

The Polish experience of quality improvement in primary care

THE POLISH HEALTH CARE SYSTEM: The health care system in Poland is based on a model typical of east-central European countries, with features such as state-owned health care organizations, centralized management and administration, and primacy of access to care over quality. Poorly planned and uncoordinated reforms have been undertaken to transfer some of the authority for health service management to local governments. PRIMARY HEALTH CARE IN POLAND: The reform of the health care system entails substitution of family physician-based for medical specialist-based primary care. Newly trained family physicians, as the first to start private surgery clinics financed from public sources, are the forerunners of the comprehensive reform and property structure transformation. MAKING THE TRANSITION FROM QUALITY ASSURANCE TO QUALITY IMPROVEMENT: Since the early 1990s, more and more organizations, individuals, and professional groups have begun to perceive health care regulations and other external control mechanisms as ineffective. Attempts have been made to replace periodic, restrictive activities with systematic continuous quality improvement efforts. Systems of voluntary accreditation are being developed and fostered. Groups have started meeting to develop medical practice guidelines and conduct peer review. Concern about quality of health care services is now reflected in the Polish legislation for the first time, as well as in numerous local and nationwide projects and publications. CONCLUSION: Despite some successes, the pioneers of quality improvement (QI) still have a long way to go. Continuation of educational activities and creation of a system of motivation for the development, of QI in primary care should be prioritized and encouraged.     

The importance of public health for twenty-first-century health care: lessons from tuberculosis

Once epidemic, tuberculosis has re-emerged, often in newly drug-resistant forms. This public health threat calls for strong public action as well as improved private care. Action has been hampered by failures in public health infrastructure and legal-philosophical support for government intervention. Josephine Gittler's accompanying article usefully suggests rebuilding public-health agencies and adapting traditional authority and controls from the age of epidemics to take account of today's circumstances and sensibilities.     

Psychology's role in the new health care systems: The importance of psychological interventions in primary health care.

Discusses the new health policies of the World Health Organization. It is suggested that these policies are particularly concerned with prevention and health-enhancing life-styles and, therefore, with the role of psychology in primary health care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)