domingo 31 de julio de 2011
SALUD EQUITATIVA: DIRECTORIO DE DOCUMENTOS EDITADOS EN JULIO 2011 [*]
SALUD EQUITATIVA - GESTIÓN EN SALUD PÚBLICA
SALUD EQUITATIVA
GESTIÓN EN SALUD PÚBLICA
GRUPO DE BLOGS SALUD EQUITATIVA
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▲CIENCIAS DE LA HERENCIA
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▲CIENCIAS MÉDICAS NEWS
Consultas acumuladas desde enero 2009 a la fecha: 214.437
Consultas totales conjuntas (todos los blogs: 3): 1.861.791
Páginas consultadas desde el inicio de los blogs (3): >18,1 millones
Discriminadas como sigue:
1. ESPAÑA: 64.285 [30,0%]
2. ARGENTINA: 46.308 [21,6%]
3. MÉXICO: 23.639 [11,0%]
4. COLOMBIA: 13.773 [ 6,4%]
5. ESTADOS UNIDOS DE NORTEAMÉRICA: 12.967 [ 6,0%]
6. PERÚ: 11.632 [ 5,4%]
7. VENEZUELA: 8.198 [ 3,8%]
8. CHILE: 7.002 [ 3,3%]
9. ECUADOR: 3.868 [ 1,8%]
10. BOLIVIA: 2.450 [ 1,1%]
11. LOS DEMÁS: 20.315 [ 9,3%]
Total de consultas: 214.437 [100%]
Documentos del mes de JULIO 2011: 646
Documentos acumulados en 2011: 4.624
Documentos editados desde el inicio del blog (2008): 11.083
MUESTRA ESTADÍSTICA de un día: (al 31 de JULIO de 2011)
Páginas vistas por países (según estadísticas Google):
España 1.085
Alemania 833
Estados Unidos 519
Argentina 436
Eslovenia 272
Colombia 250
México 244
Francia 111
Suiza 110
Chile 106
▲ Google indica que, en un tercio del lapso monitoreado por Motigo, registran ►
Páginas vistas en el último mes: 20.819
Páginas vistas (historial completo): 239.038
Archivo del blog
▼ 2011 (4624)
▼ julio (646)
1.- Research Activities, August 2011: Announcements: E...
2.- Research Activities, August 2011: Announcements: N...
3.- Research Activities, August 2011: Announcements: A...
4.- Research Activities, August 2011: Announcements: N...
5.- Research Activities, August 2011: Announcements: S...
6.- Research Activities, August 2011: Health Care Work...
7.- Research Activities, August 2011: Child/Adolescent...
8.- Research Activities, August 2011: Child/Adolescent...
9.- Research Activities, August 2011: Child/Adolescent...
10.- Research Activities, August 2011: Child/Adolescent...
11.- Research Activities, August 2011: Agency News and ...
12.- Research Activities, August 2011: Agency News and ...
13.- Research Activities, August 2011: Agency News and ...
14.- Research Activities, August 2011: Agency News and ...
15.- Research Activities, August 2011: Outcomes/Effecti...
16.- Research Activities, August 2011: Women's Health: ...
17.- Research Activities, August 2011: Disparities/Mino...
18.- Research Activities, August 2011: Disparities/Mino...
19.- Más información, menos conocimiento · ELPAÍS.com
20.- ¿Quiere saber cuánto le queda? · ELPAÍS.com
21.- Research Activities, August 2011: Chronic Disease:...
22.- Research Activities, August 2011: Chronic Disease:...
23.- Research Activities, August 2011: Chronic Disease:...
24.- Research Activities, August 2011: Chronic Disease:...
25.- Research Activities, August 2011: Patient Safety a...
26.- Research Activities, August 2011: Patient Safety a...
27.- Research Activities, August 2011: Patient Safety a...
28.- Research Activities, August 2011: Patient Safety a...
29.- Research Activities, August 2011: Patient Safety a...
30.- Research Activities, August 2011: Feature Story: A...
31.- Se disparan los ictus entre las embarazadas | Muje...
32.- :: REVISTA MEDICOS | Medicina Global | La Revista ...
33.- Curso de Lectura Crítica
34.- Science Report - www.cedepap.tv | TEMARIO COMPLETO...
35.- Nuevas Cirugías para Glaucoma / Tin Aung, Ph.D. ...
36.- Nuevas Técnicas Quirúrgicas en Diverticulosis ► CE...
37.- Lecciones Aprendidas en 2009 - 2010 sobre la Influ...
38.- Esquizofrenia ► Nuevos insights en Esquizofrenia /...
39.- RABIA HUMANA, CANINA, EPIDEMIA - BOLIVIA > ISID | ...
40.- KPC, BROTE, INFECCIONES EN UCI - PANAMÁ (CIUDAD DE...
41.- N. GONORRHOEAE, MULTIRESISTENTE: RECOMENDACIONES -...
42.- Freno a las infecciones intrahospitalarias con RFI...
43.- Regenerando la medicina · ELPAÍS.com
44.- El nuevo código ético enfrenta a los médicos sobre...
45.- "Las transferencias fueron una alocada carrera" · ...
46.- Sanidad inicia el trámite de audiencia de los real...
47.- Consejo Interterritorial del Sistema Nacional de S...
48.- Grupo Nacional de Diabetes de la Sociedad Española...
49.- informe ENVIN-HELICS :: El Médico Interactivo, Dia...
50.- Asociación Española de Laboratorios de Medicamento...
51.- Agencia europea de seguridad alimentaria (EFSA) ::...
52.- hepatitis vírica :: El Médico Interactivo, Diario ...
53.- Anuario de la Sanidad y del Medicamento en España ...
54.- Proyecto del Decreto por el que se crean nuevos tí...
55.- Texto íntegro del Real Decreto por el que se regul...
56.- AGREGAR VALOR :: El Médico Interactivo, Diario Ele...
57.- Boi Ruiz: "En urgencias seguimos el criterio técni...
58.- Una de cada cuatro recetas es de genéricos - Diari...
59.- Estadounidenses consumen menos gaseosas dulces: in...
60.- Aumentan las tasas de hepatitis entre usuarios de ...
61.- Simulación confirma pacientes EPOC necesitan oxíge...
62.- Un informe de la cátedra Grünenthal aboga por la l...
63.- Zapatero asegura que la Sanidad va a seguir transf...
64.- El 10% de la población española presenta enfermeda...
65.- Many Doctors Ignore Cancer Genetic Testing Guideli...
66.- Rare paralyzing infection sickens 24 on U.S.-Mexic...
67.- La UE rechaza el 80% de los reclamos sanitarios de...
68.- 'Una vez que conoces la realidad africana es difíc...
69.- La hepatitis, una enfermedad infradiagnosticada | ...
70.- Out-of-Hospital Cardiac Arrest Surveillance --- Ca...
71.- Los fabricantes de medicamentos ultra-huérfanos se...
72.- Médicos de familia piden al Gobierno que deje de f...
73.- El 23 % de las peticiones de cambio de médico está...
74.- trasplante renal :: El Médico Interactivo, Diario ...
75.- Consejería de Sanidad de Galicia :: El Médico Inte...
76.- Un nuevo tratamiento psicológico puede ayudar a la...
77.- La tecnología actual no es eficaz en la detección ...
78.- SEMG, SEMERGEN y SAMFYC :: El Médico Interactivo, ...
79.- estudio EPISER de la Sociedad Española de Reumatol...
80.- CiU :: El Médico Interactivo, Diario Electrónico d...
81.- Medicina low cost :: El Médico Interactivo, Diario...
82.- Una política que vele por la familia médica - Diar...
83.- Cambiar tres TC por dos: un caso de ingeniería fin...
84.- Menos dolor, menos coste, menos tiempo - DiarioMed...
85.- Ideas imaginativas para necesidades reales - Diari...
86.- "Al ciudadano lo que le importa no es quién gestio...
87.- Una transferencia genética horizontal reciente dio...
88.- La personalización obliga a más estudios de poblac...
89.- La definición de eutanasia en la ley de paliativos...
90.- Hepatitis Rates Soar Among IV Drug Users, Study Fi...
91.- Gene Study Sheds Light on Deadly German E. Coli St...
92.- Enfermeras a patadas | Profesión Sanitaria | Blogs...
93.- El reto de la hepatitis en el mundo | Sida y Hepat...
94.- Red de Investigación Cooperativa de Enfermedades T...
95.- gasto farmacéutico :: El Médico Interactivo, Diari...
96.- El Congreso aprueba el dictamen de la Ley de Salud...
97.- Confirman que la angioplastia primaria mejora la s...
98.- Una política que vele por la familia médica - Diar...
99.- El 80 por ciento de los médicos han sido agredidos...
100.- Un fallo reitera que el informe del especialista t...
101.- Amy Winehouse - DiarioMedico.com
102.- La Generalitat participará en el proyecto europeo ...
103.- La deuda en farmacia "no será para siempre", dice ...
104.- Fabra anuncia un plan de contención del gasto en f...
105.- Juan Oliva: "El presupuesto sanitario y el social ...
106.- Autonomías dicen a Pajín que no acordaron el recor...
107.- More Kids Eating Calorie-Packed Take-out Food: Med...
108.- Depression Higher in Wealthier Nations: MedlinePlu...
109.- Study Finds Savings From Medicare's Drug Plan Exte...
110.- Heart Disease Prevention May Save Billions Annuall...
111.- Un tercio de población mundial infectada con hepat...
112.- Cambios en instrucciones de resucitación mejoran s...
113.- La sangre almacenada durante demasiado tiempo podr...
114.- REVISTA MÉDICOS, edición 2011 - Nº 65
115.- Hepatitis A: los casos bajaron más de 95% con la v...
116.- Japón subirá los impuestos para indemnizar a los i...
117.- El paisaje mundial de la depresión | Neurociencia ...
118.- Fin de la epidemia de 'E.coli' | Nutrición | elmun...
119.- "Las decisiones del médico son clave en la eficien...
120.- La proliferación del mosquito tigre se reduce a la...
121.- Podando el gasto farmacéutico para seguir creciend...
122.- "En sanidad no basta con esperar; hay que saber to...
123.- Piden revisar las leyes que regulan los ensayos cl...
124.- Admitido el CI de la anestesia como prueba de la i...
125.- "Un médico no puede negar ningún tipo de informaci...
126.- Condena de un año de prisión a una paciente por la...
127.- Sociedad Española de Médicos Generales y de Famili...
128.- Sociedad Española de Farmacia Comunitaria (SEFAC) ...
129.- Federación de Asociaciones Científico Médicas Espa...
130.- Análisis de los factores socioeconómicos y sanitar...
131.- USO INAPROPIADO :: El Médico Interactivo, Diario E...
132.- La Generalitat de Cataluña cerrará de forma perman...
133.- RECURSOS :: El Médico Interactivo, Diario Electrón...
134.- Atención Familiar y Comunitaria :: El Médico Inter...
135.- Mesa Sectorial Nacional :: El Médico Interactivo, ...
136.- CDC - NIOSH Update - First World Trade Center scie...
137.- La preparación es clave cuando los niños con asma ...
138.- La vacuna contra la varicela podría eliminar las m...
139.- Los empleados manuales con artritis trabajan despu...
140.- Many Doctors Ignore Cancer Genetic Testing Guideli...
141.- Muchos médicos ignoran las directrices para las pr...
142.- Sociedades e industria piden matices a la receta o...
143.- PNV, rafael Bengoa, sanidad
144.- Los médicos piden estabilidad y pactos en Sanidad ...
145.- La quimioterapia pierde eficacia como tratamiento ...
146.- El beneficio de los fármacos para la esclerosis es...
147.- Transparency rules a tangle at cancer journals: Me...
148.- ASEBIO - Asociación Española de Bioempresas
149.- "El sueldo debe ser por productividad" · ELPAÍS.co...
150.- Humanidades médicas - Carlos Pose - ¿Cómo decidiré...
151.- Primaria, hospital y paciente, unidos en pos de lo...
152.- La gratuidad provoca un uso excesivo de la vía pen...
153.- La HCE no hará que muchos de los hospitales de Est...
154.- El abordaje de la infección en mujeres es específi...
155.- "¿Detener la infección? Las perspectivas no son na...
156.- Los modelos sanitarios de seguro social y de servi...
157.- Sociedades e industria piden matices a la receta o...
158.- El Hospital: Anestesia regional en niños
159.- “No existe un hospital con cero infecciones intrah...
160.- Physical Activity Statistics: Introduction | DNPA ...
161.- A National Agenda for Research in Collaborative Ca...
162.- AHRQ Innovations Exchange | Referring Physicians S...
163.- Data Points #5: Prevalence and Medicare Reimbursem...
164.- Consumer Health Information Technology in the Home...
165.- MONAHRQ Version 2.0 || Medicare Hospital Compare ...
166.- HANTAVIRUS, PRIMER CASO HUMANO CONFIRMADO - PERÚ (...
167.- SARAMPIÓN, CASOS SOSPECHOSOS, CERCO SANITARIO - MÉ...
168.- CIGA Hematologia - Curso Intensivo de Geriatria Am...
169.- Cursos organizados por la Sociedad Argentina de Me...
170.- AHRQ News and Numbers: Heart Disease, Cancer and M...
171.- Conference Registration | Children and Family Futu...
172.- Actualidad Entrevistas - Oscar Giménez - Los cient...
173.- Varicela: incorporan la vacuna al calendario - lan...
174.- Pajín replica que el ahorro con genéricos se desti...
175.- La crisis por la ternera radiactiva en Japón se ex...
176.- La Fiscalía de Asturias investiga los casos de dos...
177.- "La discriminación jamás ha creado prosperidad o r...
178.- "Aquí ya es raro que te pidan una marca" · ELPAÍS....
179.- "No puede ser que los fondos no vayan de verdad a ...
180.- La industria farmacéutica calcula que le recortan ...
181.- KRAS and Colorectal Cancer: Ethical and Pragmatic ...
182.- Discovery of genetic susceptibility factors for hu...
183.- Biobanking and public health: is a human rights ap...
184.- CDC - Blogs - Genomics and Health Impact Blog – Me...
185.- ASEBIO :: El Médico Interactivo, Diario Electrónic...
186.- Departamentos de Seguridad :: El Médico Interactiv...
187.- bolsas de ineficiencia :: El Médico Interactivo, D...
188.- SABES QUIÉN FUE MARÍA SKLODOWSKA? :: El Médico Int...
189.- LOS MEDICAMENTOS QUITADOS NO SERÁN REGRESADOS :: E...
190.- Sindicato Médico de Euskadi y la Federación de Méd...
191.- INADMISIBLE :: El Médico Interactivo, Diario Elect...
192.- Are Newer MS Drugs Worth Their High Price Tag?: Me...
193.- Informed-Consent Forms for HIV Research Too Long: ...
194.- IDIBELL ► glioblastoma multiforme - El Idibell po...
195.- Consejo General de Colegios Oficiales de Farmacéut...
196.- Carla Nieto Madrid - La fatiga es la cuarta causa ...
197.- Una encuesta internacional muestra que muchos teme...
198.- Reportan menos errores quirúrgicos en los centros ...
199.- OMS | La OMS previene contra el uso de las pruebas...
200.- Las farmacias se rebelan contra los impagos en tre...
201.- Descubierto un adulterante en la cocaína que debil...
202.- European Medicines Agency - News and press release...
203.- Europa restringe el uso de una vacuna contra la gr...
204.- Acudir al hospital, más peligroso que viajar en av...
205.- La industria considera 'inadmisible' obligar al mé...
206.- Use of the Internet for Health Information: United...
207.- Consejería de Salud, Familia y Bienestar Social de...
208.- Ley de Dependencia :: El Médico Interactivo, Diari...
209.- MEDICAMENTOS :: El Médico Interactivo, Diario Elec...
210.- Asociación Española de Bioempresas (ASEBIO) :: El ...
211.- ÁFRICA - SOMALIA :: El Médico Interactivo, Diario ...
212.- Sociedad Balear de Medicina Familiar y Comunitaria...
213.- La nube entra poco a poco en la vida del profesion...
214.- Tribuna: Preventiva debe quedar fuera del tronco m...
215.- Acceder a antirretrovirales asequibles peligra en ...
216.- El CI decreta la prescripción obligatoria por prin...
217.- La nueva ley podría reducir el sobrepeso en niños ...
218.- La mayoría de las condenas por responsabilidad méd...
219.- La publicidad no permitida conlleva una sanción le...
220.- La amenaza de muerte se pena con un año y medio de...
221.- Fewer Surgical Errors Reported at VA Medical Facil...
222.- Rude Surgeons Hurt Patients, Increase Costs: Medli...
223.- Cambios en instrucciones de resucitación mejoran s...
224.- Los conteos de calorías de los restaurantes podría...
225.- Los médicos deberán recetar por principio activo y...
226.- ENFERMEDAD DE CHAGAS, RIESGO TRANSFUSIONAL - ARGE...
227.- E. COLI O104:H04, FENOGRECO, SEMILLAS IMPORTADAS -...
228.- Announcement: Epidemic Intelligence Service Applic...
229.- IntraMed - Puntos de vista - De Honores y Honorari...
230.- ÉTICA || IntraMed - Arte y Cultura - Ética posmode...
231.- La circuncisión masculina, opción eficaz para redu...
232.- Instituto para el Desarrollo e Integración de la S...
233.- Dragon Medical :: El Médico Interactivo, Diario El...
234.- proyectos de investigación e innovación :: El Médi...
235.- Fertility Counts :: El Médico Interactivo, Diario ...
236.- aspectos destacados del sistema sanitario británic...
237.- Sociedad Española de Cardiología (SEC) :: El Médic...
238.- Rafael Bengoa asegura que Euskadi no tendrá copago...
239.- Metges de Cataluña (MC) :: El Médico Interactivo, ...
240.- Consejería de Sanidad de Galicia :: El Médico Int...
241.- COPAGO INSOLIDARIO :: El Médico Interactivo, Diari...
242.- La interoperabilidad como prioridad del sistema sa...
243.- Adaptar la demanda urgente a la social - DiarioMed...
244.- El tratamiento normaliza la supervivencia en los p...
245.- Un código nuevo ante una medicina cambiante - Diar...
246.- El deber de informar sobre el aborto en atención p...
247.- La prevención está fallando porque la población no...
248.- Low "health literacy" may mean worse health: Medli...
249.- Lifestyle Changes Might Prevent Millions of Cases ...
250.- C-Section Rate in U.S. Climbs to All-Time High: Re...
251.- Las órdenes de no reanimación son más difíciles cu...
252.- Muchos fármacos para psicosis del Parkinson no est...
253.- ¿A los pacientes les va peor con los médicos más e...
254.- Adolescentes con sobrepeso necesitan hablar más co...
255.- OMS pide detener uso test sanguíneos de tuberculos...
256.- WHO | Managing water in the home: accelerated heal...
257.- Estimados: Con el objetivo de tratar la proble...
258.- AHRQ National Advisory Council To Meet on July 22
259.- "La medicina defensiva es una de las causas de que...
260.- Comisión Nacional de Seguimiento y Control de la D...
261.- Centro de Investigación Príncipe Felipe ► MUERTE S...
262.- Coordinadora Nacional de Artritis (ConArtritis) :...
263.- Sociedad Española de Bioquímica Clínica y Patologí...
264.- Federación Española de Empresas de Tecnología Sani...
265.- Comunidad de Madrid ► ER :: El Médico Interactivo,...
266.- nuevo centro de excelencia internacional para inve...
267.- Setenta de cada cien recetas dispensadas en Canari...
268.- Consejo General de Colegios de Enfermería :: El Mé...
269.- registro de objetores sanitarios :: El Médico Inte...
270.- Ley de Protección de la Infancia :: El Médico Inte...
271.- 31 Congreso Nacional de la SEGO :: El Médico Inter...
272.- Rechazar que las comunidades autónomas participen ...
273.- Las mallas pélvicas para la incontinencia conlleva...
274.- Las deficiencias en la cobertura vacunal de los pa...
275.- Sociedad Española de Cardiología: profesionales sa...
276.- Bernat Soria suspende al SNS en prevención de la d...
277.- La SEOM prepara un plan integral de atención a lar...
278.- La crisis mete a la investigación biomédica en un ...
279.- International Collaboration in Clinical Trials - N...
280.- Curso intensivo de imaginología para investigadore...
281.- el uso de teléfonos celulares y el riesgo de cánce...
282.- Servicio de gestión de pacientes redujo el incumpl...
283.- Estudios científicos respaldan nuevas advertencias...
284.- Japón prohíbe la carne de Fukushima cuatro meses d...
285.- Consumer Health Information Technology in the Home...
286.- AESEG muestra su rechazo a la licitación de medica...
287.- irradiación craneal profiláctica :: El Médico Inte...
288.- SARAMPIÓN :: El Médico Interactivo, Diario Electró...
289.- Federación de Asociaciones para la Defensa de la S...
290.- Bruselas pide a los gobiernos que coordinen la inv...
291.- La Sociedad Española de Oncología Médica está elab...
292.- PRECIOS DE REFERENCIA :: El Médico Interactivo, Di...
293.- Medicina Interna :: El Médico Interactivo, Diario ...
294.- Los 14 días del 'preembrión' sólo son una mera con...
295.- Medicina complementaria: experiencias vitales - Di...
296.- La ONT selecciona a 80 líderes para implantar su m...
297.- El COMB reivindica el liderazgo médico para afront...
298.- Sanidad pacta con Enfermería 'un proyecto de futur...
299.- "Es el momento de rediseñar la formación del médic...
300.- CDC - Grand Rounds ► Electronic Health Records: Wh...
301.- Adverse Events Reporting System (AERS) > Adverse E...
302.- Conducir bajo la influencia de las drogas - InfoFa...
303.- "El copago es castigar a los enfermos" · ELPAÍS.co...
304.- IntraMed - Artículos - Sensacionalismo médico
305.- National Quality Measures Clearinghouse | Well-chi...
306.- National Quality Measures Clearinghouse | Well-chi...
307.- National Quality Measures Clearinghouse | Frequenc...
308.- National Quality Measures Clearinghouse | Frequenc...
309.- National Quality Measures Clearinghouse | Adolesce...
310.- QuickStats: Percentage of Office-Based Physicians ...
311.- MEDICAMENTOS MANIPULADOS, MUERTES HOSPITALARIAS - ...
312.- STREPTOCOCCUS GUPO A, BROTE EXTENSO, CARCEL - ESPA...
313.- HANTAVIRUS, BROTE - PARAGUAY (CHACO) - Main ProMED...
314.- Las operaciones de corazón no esperarán más de 180...
315.- Antes de viajar al extrajero, revise si está vacun...
316.- Prevención del VIH: 'se acabaron las mentiras. Hay...
317.- Semfyc defiende Genética Clínica como especialidad...
318.- "El médico es clave para el control del gasto" - D...
319.- Las predicciones de dianas en patologías tropicale...
320.- La calidad asistencial debe introducirse en la ges...
321.- En las intervenciones programadas el consentimient...
322.- Condena a pesar de dudar de la relación entre erro...
323.- El coste del envejecimiento varía según el territo...
324.- Acuerdo por un centro estatal de Salud Pública - D...
325.- El Plan Clínico de Investigación del Caiber se des...
326.- Death in the United States, 2009 || Products - Dat...
327.- Chronic Obstructive Pulmonary Disease Among Adults...
328.- Inpatient Care for Septicemia or Sepsis: A Challen...
329.- Las cuotas de las prepagas aumentarán 9,5% en agos...
330.- Con frecuencia, los trabajadores rurales carecen d...
331.- AHRQ 2011 Annual Conference
332.- Biomar Microbial Technologies :: El Médico Interac...
333.- REDES DE CONSULTA :: El Médico Interactivo, Diario...
334.- Sociedad Española de Hipertensión y Liga para la L...
335.- Sociedad Española de Geriatría y Gerontología :: E...
336.- COPAGOS :: El Médico Interactivo, Diario Electróni...
337.- ¿Sostenibilidad y progreso de la Sanidad catalana?...
338.- tiempo máximo de espera en las prestaciones del SN...
339.- prestación farmacéutica del SNS :: El Médico Inter...
340.- TRIBUNA: Seguridad del paciente: de la estrategia ...
341.- unidades de gestión clínica :: El Médico Interacti...
342.- Un plan pionero para impulsar la investigación ind...
343.- Hospital Borda: cómo vivir sin gas durante tres me...
344.- inmunoglobulina polivalente humana enriquecida en ...
345.- DESABASTECIMIENTO DE MEDICAMENTOS :: El Médico Int...
346.- I Foro de Gestión Clínica :: El Médico Interactivo...
347.- control multifactorial en el abordaje de la diabet...
348.- Federación Española de Cáncer de Mama (FECMA) :: E...
349.- Plan Clínico de Investigación en Ensayos clínicos ...
350.- medidas de farmacia para contener el gasto :: El M...
351.- Real Farmacopea Española :: El Médico Interactivo,...
352.- ENFERMEDADES PROFESIONALES :: El Médico Interactiv...
353.- estrategia nacional para la integración de las adi...
354.- LEY DEL MEDICAMENTO :: El Médico Interactivo, Diar...
355.- GRD - DRG :: El Médico Interactivo, Diario Electró...
356.- Recetas para salvar el SNS - DiarioMedico.com
357.- Mucha información, pero no siempre llega donde se ...
358.- El fallo organizativo no es indemnizable si no est...
359.- La valoración en euros del daño corporal la hace e...
360.- I+D de cápsulas farmacológicas inteligentes - Diar...
361.- La implicación de los pacientes es fundamental par...
362.- ENVEJECIMIENTO - Carla Nieto Madrid - El envejecim...
363.- La utilización de genéricos para el VIH pone en ri...
364.- Control de infecciones 2011 ► IntraMed - Artículos...
365.- Los planes de emergencia nuclear no garantizan la ...
366.- Responsabilidad política | Videoblogs | elmundo.es...
367.- U.S. Colorectal Cancer Death Rates Continue to Dro...
368.- esquizofrenia :: El Médico Interactivo, Diario Ele...
369.- TRIBUNA 2 : La Ley General de Sanidad 2:: El Médic...
370.- TRIBUNA: Ley General de Sanidad :: El Médico Inter...
371.- ENVEJECIMIENTO Y SOSTENIBILIDAD :: El Médico Inter...
372.- OMC :: El Médico Interactivo, Diario Electrónico d...
373.- Martínez Olmos propone un impuesto específico para...
374.- e- Boletín DROGAS Y MEDICAMENTOS || Sistema de Inf...
375.- Administration launches “Apps Against Abuse” techn...
376.- En julio, en los hospitales universitarios aumenta...
377.- El cumplimiento de las directrices para la angiopl...
378.- S.O.S., Hundimos el sistema sanitario | Profesión ...
379.- Acuerdo pionero para las patentes de los antirretr...
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domingo, 31 de julio de 2011
Research Activities, August 2011: Announcements: Emergency Preparedness Resource Inventory updated
Research Activities, August 2011: Announcements: Emergency Preparedness Resource Inventory updated: "Announcements
Emergency Preparedness Resource Inventory updated
The Agency for Healthcare Research and quality (AHRQ) has released a newly updated version of the Emergency Preparedness Resource Inventory (EPRI), a Web-based software tool to help local, regional, and State planners prepare for and respond to emergency situations. Prior to an event, emergency officials can download and use EPRI to develop an inventory of resources necessary to respond to different types of events. During an emergency, EPRI can help determine what resources are available for response.
EPRI is now pre-loaded with resources used in the AHRQ Hospital Surge Model, which allows users to better allocate health care resources during emergency-response operations. It also provides more flexibility for local users to develop inventory reports and emergency request functions that meet their needs. The new version�is also now compatible with current releases of Microsoft database and Web server software. It features an easier installation process with an improved configuration and set up. Other improvements include:
* A more user-friendly interface.
* An updated Administrator's Guide and User Manual.
* Better data-quality monitoring tools.
For more information or to download the new version of EPRI, go to http://www.ahrq.gov/research/epri.
- Enviado mediante la barra Google"
Emergency Preparedness Resource Inventory updated
EPRI is now pre-loaded with resources used in the AHRQ Hospital Surge Model, which allows users to better allocate health care resources during emergency-response operations. It also provides more flexibility for local users to develop inventory reports and emergency request functions that meet their needs. The new version�is also now compatible with current releases of Microsoft database and Web server software. It features an easier installation process with an improved configuration and set up. Other improvements include:
* A more user-friendly interface.
* An updated Administrator's Guide and User Manual.
* Better data-quality monitoring tools.
For more information or to download the new version of EPRI, go to http://www.ahrq.gov/research/epri.
- Enviado mediante la barra Google"
Research Activities, August 2011: Announcements: New resources to care for community-dwelling patients during emergency events
Research Activities, August 2011: Announcements: New resources to care for community-dwelling patients during emergency events: "Announcements
New resources to care for community-dwelling patients during emergency events
AHRQ has released two new resources that can help emergency planners and responders ensure that community-dwelling patients receive appropriate care during a mass casualty event (MCE). Community-dwelling patients with daily health care needs may not be directly affected by a mass casualty event, but if that event disrupts their usual care routine, they may still be at risk. Lacking a usual source of care, these patients are more likely to seek care at hospitals already overburdened with mass casualties.
The Home Health Patient Assessment Tool: Preparing for Emergency Triage (http://www.ahrq.gov/prep/homehealth) reviews existing patient categorization tools and presents a new model patient risk-assessment tool. The new tool will allow home care agencies, hospitals, and emergency planners to anticipate the needs of community-dwelling patients and assess who might be most at risk of hospitalization if their traditional home support services are disrupted during an emergency.
The compendium of resources available in Data Sources for the At-Risk Community-Dwelling Patient Population (http://www.ahrq.gov/prep/atrisk) provides a summary of each data resource, including its strengths and limitations for estimating the numbers of community-dwelling patients at risk during an MCE, as well as any areas of overlap with other data resources.
- Enviado mediante la barra Google"
New resources to care for community-dwelling patients during emergency events
AHRQ has released two new resources that can help emergency planners and responders ensure that community-dwelling patients receive appropriate care during a mass casualty event (MCE). Community-dwelling patients with daily health care needs may not be directly affected by a mass casualty event, but if that event disrupts their usual care routine, they may still be at risk. Lacking a usual source of care, these patients are more likely to seek care at hospitals already overburdened with mass casualties.
The Home Health Patient Assessment Tool: Preparing for Emergency Triage (http://www.ahrq.gov/prep/homehealth) reviews existing patient categorization tools and presents a new model patient risk-assessment tool. The new tool will allow home care agencies, hospitals, and emergency planners to anticipate the needs of community-dwelling patients and assess who might be most at risk of hospitalization if their traditional home support services are disrupted during an emergency.
The compendium of resources available in Data Sources for the At-Risk Community-Dwelling Patient Population (http://www.ahrq.gov/prep/atrisk) provides a summary of each data resource, including its strengths and limitations for estimating the numbers of community-dwelling patients at risk during an MCE, as well as any areas of overlap with other data resources.
- Enviado mediante la barra Google"
Research Activities, August 2011: Announcements: AHRQ offers interactive tool to analyze national and State health care data
Research Activities, August 2011: Announcements: AHRQ offers interactive tool to analyze national and State health care data: "Announcements
AHRQ offers interactive tool to analyze national and State health care data
Mining for specific data on health care quality and disparities in the United States? It's an easy process with the NHQRDRnet online query system by the Agency for Healthcare Research and Quality, which features data from the 2010 National Healthcare Quality Report and National Healthcare Disparities Report.
At the State and national level, you'll find quality-of-care data on clinical conditions ranging from asthma and diabetes to heart disease and cancer. You can review data by specific age groups as well as by race, ethnicity, income, and education. Using NHQRDRnet's search tool, you can locate data tables based on selected words, chapters, or type of table.
To get started on AHRQ's NHQRDRnet system, go to: http://nhqrnet.ahrq.gov.
- Enviado mediante la barra Google"
AHRQ offers interactive tool to analyze national and State health care data
Mining for specific data on health care quality and disparities in the United States? It's an easy process with the NHQRDRnet online query system by the Agency for Healthcare Research and Quality, which features data from the 2010 National Healthcare Quality Report and National Healthcare Disparities Report.
At the State and national level, you'll find quality-of-care data on clinical conditions ranging from asthma and diabetes to heart disease and cancer. You can review data by specific age groups as well as by race, ethnicity, income, and education. Using NHQRDRnet's search tool, you can locate data tables based on selected words, chapters, or type of table.
To get started on AHRQ's NHQRDRnet system, go to: http://nhqrnet.ahrq.gov.
- Enviado mediante la barra Google"
Research Activities, August 2011: Announcements: New brief outlines strategies to put patients at the center of primary care
Research Activities, August 2011: Announcements: New brief outlines strategies to put patients at the center of primary care: "Announcements
New brief outlines strategies to put patients at the center of primary care
A new brief from the Agency for Healthcare Research and Quality (AHRQ), The Patient-Centered Medical Home: Strategies to Put Patients at the Center of Primary Care, highlights opportunities to improve patient engagement in primary care. The brief focuses on involvement at three levels: the engagement of patients and families in their own care, quality improvement activities in the primary care practice, and the development and implementation of policy and research related to the patient-centered medical home (PCMH).
Strategies to Put Patients at the Center of Primary Care provides a clear and concise definition of the PCMH and outlines six strategies that can be used to support primary care practices in their efforts to engage patients and families.
This brief and other resources, including white papers and a searchable database of PCMH-related articles, is available from AHRQ's online PCMH Resource Center at http://www.pcmh.ahrq.gov.
- Enviado mediante la barra Google"
New brief outlines strategies to put patients at the center of primary care
A new brief from the Agency for Healthcare Research and Quality (AHRQ), The Patient-Centered Medical Home: Strategies to Put Patients at the Center of Primary Care, highlights opportunities to improve patient engagement in primary care. The brief focuses on involvement at three levels: the engagement of patients and families in their own care, quality improvement activities in the primary care practice, and the development and implementation of policy and research related to the patient-centered medical home (PCMH).
Strategies to Put Patients at the Center of Primary Care provides a clear and concise definition of the PCMH and outlines six strategies that can be used to support primary care practices in their efforts to engage patients and families.
This brief and other resources, including white papers and a searchable database of PCMH-related articles, is available from AHRQ's online PCMH Resource Center at http://www.pcmh.ahrq.gov.
- Enviado mediante la barra Google"
Research Activities, August 2011: Announcements: Signups soar for AHRQ's popular CME courses
Research Activities, August 2011: Announcements: Signups soar for AHRQ's popular CME courses: "Announcements
Signups soar for AHRQ's popular CME courses
One hundred years ago, students could enter dozens of medical schools after completing less than 4 years of high school. Even Harvard Medical School admitted some students without an undergraduate degree. With a few notable exceptions, most medical training was considered mediocre. And if you wanted to continue your formal studies after medical school, you were on your own.
For today's health professionals, getting into college is competitive. But education doesn't stop—and can't stop—with a degree. Continuing education isn't an extra. It's a requirement.
In 2010, the Agency for Healthcare Research and Quality (AHRQ) began offering Continuing Medical Education/Continuing Education (CME/CE) credits through its Effective Health Care Program. Free credit classes are available to physicians, nurses, nurse practitioners, physician assistants, pharmacists, and other health professionals. Content for the courses comes from comparative effectiveness reviews, which provide systematic appraisals of scientific evidence on common conditions such as arthritis, high cholesterol, and diabetes. The reviews are part of the growing field of patient-centered outcomes research, also called comparative effectiveness research, which evaluates the benefits and harms of treatment options.
The Program's first CME/CE modules were created by the John M. Eisenberg Center for Clinical Decisions and Communications Science at Baylor College of Medicine. In 2011, with funding from the American Recovery and Reinvestment Act, the Agency expanded online courses through a contract with PRIME Education, Inc., a medical education provider. In addition, Total Therapeutic Management provides in-person accredited CME/CE to clinicians in their offices.
'We didn't know what to expect when we first started,' said Kathleen Moreo, R.N., president of PRIME. 'We found that clinicians seek this type of unbiased education.' Indeed, within 60 days of its first CME/CE modules being released, PRIME issued more than 1,000 CME/CE certificates.
Every person who receives a certificate also participates in a post-test. Michael Fordis, M.D., director of the Eisenberg Center, said 'We found that 95 percent of clinicians who complete the CME find them relevant to their practice and about 55 percent find them very relevant.'
This isn't surprising to Frank Urbano, M.D., medical director of care coordination at Cooper University Hospital in Camden, NJ. He recently completed a course comparing treatments for patients with type 2 diabetes. 'A lot of CME courses come from commercial interests,' said Dr. Urbano. 'They tend to be focused on one particular disease or treatment. The AHRQ classes give you a chance to look at what's out there to treat a condition and how the treatments compare. It gives you an objective measure.'
AHRQ's free CME/CE classes give clinicians another choice to keep current. For more information, go to http://www.ce.effectivehealthcare.ahrq.gov�or the AHRQ main site: http://www.effectivehealthcare.ahrq.gov, and select the link to CME/CE courses.
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Signups soar for AHRQ's popular CME courses
One hundred years ago, students could enter dozens of medical schools after completing less than 4 years of high school. Even Harvard Medical School admitted some students without an undergraduate degree. With a few notable exceptions, most medical training was considered mediocre. And if you wanted to continue your formal studies after medical school, you were on your own.
For today's health professionals, getting into college is competitive. But education doesn't stop—and can't stop—with a degree. Continuing education isn't an extra. It's a requirement.
In 2010, the Agency for Healthcare Research and Quality (AHRQ) began offering Continuing Medical Education/Continuing Education (CME/CE) credits through its Effective Health Care Program. Free credit classes are available to physicians, nurses, nurse practitioners, physician assistants, pharmacists, and other health professionals. Content for the courses comes from comparative effectiveness reviews, which provide systematic appraisals of scientific evidence on common conditions such as arthritis, high cholesterol, and diabetes. The reviews are part of the growing field of patient-centered outcomes research, also called comparative effectiveness research, which evaluates the benefits and harms of treatment options.
The Program's first CME/CE modules were created by the John M. Eisenberg Center for Clinical Decisions and Communications Science at Baylor College of Medicine. In 2011, with funding from the American Recovery and Reinvestment Act, the Agency expanded online courses through a contract with PRIME Education, Inc., a medical education provider. In addition, Total Therapeutic Management provides in-person accredited CME/CE to clinicians in their offices.
'We didn't know what to expect when we first started,' said Kathleen Moreo, R.N., president of PRIME. 'We found that clinicians seek this type of unbiased education.' Indeed, within 60 days of its first CME/CE modules being released, PRIME issued more than 1,000 CME/CE certificates.
Every person who receives a certificate also participates in a post-test. Michael Fordis, M.D., director of the Eisenberg Center, said 'We found that 95 percent of clinicians who complete the CME find them relevant to their practice and about 55 percent find them very relevant.'
This isn't surprising to Frank Urbano, M.D., medical director of care coordination at Cooper University Hospital in Camden, NJ. He recently completed a course comparing treatments for patients with type 2 diabetes. 'A lot of CME courses come from commercial interests,' said Dr. Urbano. 'They tend to be focused on one particular disease or treatment. The AHRQ classes give you a chance to look at what's out there to treat a condition and how the treatments compare. It gives you an objective measure.'
AHRQ's free CME/CE classes give clinicians another choice to keep current. For more information, go to http://www.ce.effectivehealthcare.ahrq.gov�or the AHRQ main site: http://www.effectivehealthcare.ahrq.gov, and select the link to CME/CE courses.
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Research Activities, August 2011: Health Care Workforce: Unionized hospital RNs slightly less satisfied with work than non-unionized RNs
Research Activities, August 2011: Health Care Workforce: Unionized hospital RNs slightly less satisfied with work than non-unionized RNs: "Health Care Workforce
Unionized hospital RNs slightly less satisfied with work than non-unionized RNs
Unions are becoming increasingly important among registered nurses (RNs) in the United States. Yet, RNs who are union members are less likely to report job satisfaction than RNs not in unions, found two national surveys. Over 10,000 hospital-employed direct-care RNs were included in the surveys. In 2004, 18.9 percent of RNs were represented by a union and in 2008, 19.6 percent were represented.
Hospital-employed RNs who reported either being 'satisfied' or 'very satisfied' increased between 2004 and 2008 from 74.2 percent to 78.1 percent. In 2004, on average, 73.3 percent of unionized nurses reported being satisfied with work compared with 75.5 percent of non-unionized nurses; by 2008, the comparable figures were 77.1 percent compared with 78.3 percent. Unionized nurses reported higher average income from their principal nursing position in both 2004 and 2008.
There are several possible explanations for the results. Because these findings indicate associations rather than causal relationships, it is possible that lower levels of job satisfaction are not the result of unionization, but rather its cause. Nurses who are dissatisfied may seek union representation, and thus, during some transitional period, overall job satisfaction may be lower. It is also possible that unionized nurses are more inclined to voice dissatisfaction, suggest Joanne Spetz, Ph.D., of the University of California, San Francisco and coinvestigators. Their study was supported by the Agency for Healthcare Research and Quality (HS14207).
See 'Hospital RN job satisfaction and nurse unions,' by Jean Ann Seago, Ph.D., Dr. Spetz, Michael Ash Ph.D., and others in the March 2011 Journal of Nursing Administration 41(3), pp. 109-114.
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Unionized hospital RNs slightly less satisfied with work than non-unionized RNs
Hospital-employed RNs who reported either being 'satisfied' or 'very satisfied' increased between 2004 and 2008 from 74.2 percent to 78.1 percent. In 2004, on average, 73.3 percent of unionized nurses reported being satisfied with work compared with 75.5 percent of non-unionized nurses; by 2008, the comparable figures were 77.1 percent compared with 78.3 percent. Unionized nurses reported higher average income from their principal nursing position in both 2004 and 2008.
There are several possible explanations for the results. Because these findings indicate associations rather than causal relationships, it is possible that lower levels of job satisfaction are not the result of unionization, but rather its cause. Nurses who are dissatisfied may seek union representation, and thus, during some transitional period, overall job satisfaction may be lower. It is also possible that unionized nurses are more inclined to voice dissatisfaction, suggest Joanne Spetz, Ph.D., of the University of California, San Francisco and coinvestigators. Their study was supported by the Agency for Healthcare Research and Quality (HS14207).
See 'Hospital RN job satisfaction and nurse unions,' by Jean Ann Seago, Ph.D., Dr. Spetz, Michael Ash Ph.D., and others in the March 2011 Journal of Nursing Administration 41(3), pp. 109-114.
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Research Activities, August 2011: Child/Adolescent Health: A usual source of care may be more important than insurance on children's receipt of preventive health counseling
Research Activities, August 2011: Child/Adolescent Health: A usual source of care may be more important than insurance on children's receipt of preventive health counseling: "Child/Adolescent Health
A usual source of care may be more important than insurance on children's receipt of preventive health counseling
Although insurance coverage is necessary to access care, it may not be sufficient. In fact, a new study suggests that a usual source of care may play an equally or more important role than health insurance in ensuring that a child receives preventive health counseling.It found that children with neither health insurance nor a usual source of care (USC) had the highest rates of missed counseling, while children with both insurance and a USC had the lowest rates of missed counseling. Children with only insurance were more likely than those with only a USC to have never received preventive health counseling from a health care provider regarding healthy eating, regular exercise, use of car safety devices, use of bicycle helmets, and risk of second-hand smoke exposure.
The researchers examined 2002-2006 data on children 17 years or younger from the nationally representative Medical Expenditure Panel Survey. Parents answered whether they had received anticipatory guidance from a health care provider regarding these five areas of preventive health counseling. Preventive health counseling was estimated to be received by less than half of all children.
The results suggest that expanding eligibility of the Children's Health Insurance Program or mandating health insurance coverage for everyone will not achieve optimal delivery of preventive health counseling without a mechanism to ensure adequate provider capacity. Although a higher percentage of insured children had a USC, it cannot be assumed that gaining stable health insurance will automatically lead to finding a USC, note the researchers. Their study was supported by the Agency for Healthcare Research and Quality (HS16181).
See 'Is health insurance enough? A usual source of care may be more important to ensure a child receives preventive health counseling,' by Jennifer E. DeVoe, M.D., Carrie J. Tillotson, M.P.H., Lorraine S. Wallace, Ph.D., and others in the March 4, 2011, Maternal Child Health Journal [Epub ahead of print].
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A usual source of care may be more important than insurance on children's receipt of preventive health counseling
The researchers examined 2002-2006 data on children 17 years or younger from the nationally representative Medical Expenditure Panel Survey. Parents answered whether they had received anticipatory guidance from a health care provider regarding these five areas of preventive health counseling. Preventive health counseling was estimated to be received by less than half of all children.
The results suggest that expanding eligibility of the Children's Health Insurance Program or mandating health insurance coverage for everyone will not achieve optimal delivery of preventive health counseling without a mechanism to ensure adequate provider capacity. Although a higher percentage of insured children had a USC, it cannot be assumed that gaining stable health insurance will automatically lead to finding a USC, note the researchers. Their study was supported by the Agency for Healthcare Research and Quality (HS16181).
See 'Is health insurance enough? A usual source of care may be more important to ensure a child receives preventive health counseling,' by Jennifer E. DeVoe, M.D., Carrie J. Tillotson, M.P.H., Lorraine S. Wallace, Ph.D., and others in the March 4, 2011, Maternal Child Health Journal [Epub ahead of print].
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Research Activities, August 2011: Child/Adolescent Health: Parents and primary care physicians are satisfied with children's use of nonurgent emergency department services
Research Activities, August 2011: Child/Adolescent Health: Parents and primary care physicians are satisfied with children's use of nonurgent emergency department services: "Child/Adolescent Health
Parents and primary care physicians are satisfied with children's use of nonurgent emergency department services
Nonurgent emergency department (ED) use is considered a problem because of the higher cost to society and the loss of continuity of care. However, a new study found that both parents and primary care physicians (PCPs) generally considered these visits appropriate. Also, neither parents nor physicians saw these visits as a significant enough breach of continuity of care to warrant concern. The researchers interviewed 26 parents of children who had received nonurgent emergency care and 20 of their PCPs.
The interviews also revealed that the need for immediate reassurance that their children are safe from harm is critical to parents' decisions; PCP offices lack specific tests and treatments that parents and physicians believe may be necessary, regardless of whether they are actually needed; and discrepancies exist between PCP and parent perceptions of adequate communication and care access.
The children seen in an academic pediatric ED were treated for fever, pain (oral, ear), breathing problems (wheezing, coughing), rash, laceration, bump on the head, nosebleed, minor trauma, and swollen eye. Parents in this study did not express significant concern about costs. Either they did not have to pay, or they believed the quality of care justified higher charges. The researchers concluded that nonurgent ED use serves as an effective care resource for families, and parents have little motivation to change their current care-seeking behaviors. This study was supported by the Agency for Healthcare Research and Quality (HS15482).
See 'Nonurgent emergency-department care: Analysis of parent and primary physician perspectives,' by David C. Brousseau, M.D., Mark R. Nimmer, B.A., Nichole L. Yunk, M.S., and others in the February 2011 Pediatrics 127, pp. e375-3381.
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Parents and primary care physicians are satisfied with children's use of nonurgent emergency department services
The interviews also revealed that the need for immediate reassurance that their children are safe from harm is critical to parents' decisions; PCP offices lack specific tests and treatments that parents and physicians believe may be necessary, regardless of whether they are actually needed; and discrepancies exist between PCP and parent perceptions of adequate communication and care access.
The children seen in an academic pediatric ED were treated for fever, pain (oral, ear), breathing problems (wheezing, coughing), rash, laceration, bump on the head, nosebleed, minor trauma, and swollen eye. Parents in this study did not express significant concern about costs. Either they did not have to pay, or they believed the quality of care justified higher charges. The researchers concluded that nonurgent ED use serves as an effective care resource for families, and parents have little motivation to change their current care-seeking behaviors. This study was supported by the Agency for Healthcare Research and Quality (HS15482).
See 'Nonurgent emergency-department care: Analysis of parent and primary physician perspectives,' by David C. Brousseau, M.D., Mark R. Nimmer, B.A., Nichole L. Yunk, M.S., and others in the February 2011 Pediatrics 127, pp. e375-3381.
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Research Activities, August 2011: Child/Adolescent Health: When primary care providers apply fluoride varnish, young Medicaid-insured children have fewer cavities
Research Activities, August 2011: Child/Adolescent Health: When primary care providers apply fluoride varnish, young Medicaid-insured children have fewer cavities: "Child/Adolescent Health
When primary care providers apply fluoride varnish, young Medicaid-insured children have fewer cavities
Tooth decay among children younger than 5 years, referred to as early childhood caries (ECC), is preventable. Yet as many as 11 percent of 2-year-olds and 44 percent of 5-year-olds develop ECC, with children from low-income families bearing a disproportionate burden of the disease. According to a new study, application of topical fluoride varnish by non-dental pediatric primary care providers can reduce dental caries-related treatments among children. A North Carolina Medicaid program called 'Into the Mouths of Babes' (IMB), initiated in 2000, had primary care providers apply fluoride varnish to children's teeth during office visits. Analysis of the State's Medicaid enrollment and claims data from 2000 to 2006 showed that the program reduced dental caries-related treatments among children with 4 or more IMB visits by 17 percent up to 6 years of age compared with children with no IMB visits.
When Bhavna T. Pahel, Ph.D., and her University of North Carolina colleagues simulated data for initial IMB visits at 12 and 15 months of age, there was a cumulative 49 percent reduction in dental caries-related treatments at 17 months of age. However, there was an increase in treatments for children from 24 to 42 months of age. The authors hypothesize that this increase in dental caries-related treatments likely occurred due to greater detection of disease in teeth of children who received and benefitted from the program, longer time since fluoride application, and emergence of teeth not initially treated with fluoride. Therefore, the authors concluded that multiple applications of fluoride at the time of primary tooth emergence seem to be most beneficial. In total, the reduction in caries-related treatments from the IMB preventive dental services represents a substantial improvement in the oral health of Medicaid-enrolled children, who historically have had high rates of dental caries but poor access to care from dentists, comment the researchers.
The IMB Program was based on the perception that, although very young children are unlikely to get checkups at the dentist, they frequently make well-child visits to their pediatricians or other primary care providers. The study was supported in part by the Agency for Healthcare Research and Quality (T32 HS00032).
See 'Effectiveness of preventive dental treatments by physicians for young Medicaid enrollees,' by Dr. Pahel, R. Gary Rozier, D.D.S., Sally C. Stearns, Ph.D., and Rocio B. Qunonez, D.M.D., in Pediatrics 127, pp. e682-3689, 2011.
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When primary care providers apply fluoride varnish, young Medicaid-insured children have fewer cavities
Tooth decay among children younger than 5 years, referred to as early childhood caries (ECC), is preventable. Yet as many as 11 percent of 2-year-olds and 44 percent of 5-year-olds develop ECC, with children from low-income families bearing a disproportionate burden of the disease. According to a new study, application of topical fluoride varnish by non-dental pediatric primary care providers can reduce dental caries-related treatments among children. A North Carolina Medicaid program called 'Into the Mouths of Babes' (IMB), initiated in 2000, had primary care providers apply fluoride varnish to children's teeth during office visits. Analysis of the State's Medicaid enrollment and claims data from 2000 to 2006 showed that the program reduced dental caries-related treatments among children with 4 or more IMB visits by 17 percent up to 6 years of age compared with children with no IMB visits.
When Bhavna T. Pahel, Ph.D., and her University of North Carolina colleagues simulated data for initial IMB visits at 12 and 15 months of age, there was a cumulative 49 percent reduction in dental caries-related treatments at 17 months of age. However, there was an increase in treatments for children from 24 to 42 months of age. The authors hypothesize that this increase in dental caries-related treatments likely occurred due to greater detection of disease in teeth of children who received and benefitted from the program, longer time since fluoride application, and emergence of teeth not initially treated with fluoride. Therefore, the authors concluded that multiple applications of fluoride at the time of primary tooth emergence seem to be most beneficial. In total, the reduction in caries-related treatments from the IMB preventive dental services represents a substantial improvement in the oral health of Medicaid-enrolled children, who historically have had high rates of dental caries but poor access to care from dentists, comment the researchers.
The IMB Program was based on the perception that, although very young children are unlikely to get checkups at the dentist, they frequently make well-child visits to their pediatricians or other primary care providers. The study was supported in part by the Agency for Healthcare Research and Quality (T32 HS00032).
See 'Effectiveness of preventive dental treatments by physicians for young Medicaid enrollees,' by Dr. Pahel, R. Gary Rozier, D.D.S., Sally C. Stearns, Ph.D., and Rocio B. Qunonez, D.M.D., in Pediatrics 127, pp. e682-3689, 2011.
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Research Activities, August 2011: Child/Adolescent Health: Impact of self-esteem and academic achievement on substance use and sexual initiation differs among boys and girls
Research Activities, August 2011: Child/Adolescent Health: Impact of self-esteem and academic achievement on substance use and sexual initiation differs among boys and girls: "Child/Adolescent Health
Impact of self-esteem and academic achievement on substance use and sexual initiation differs among boys and girls
A new study focused on adolescent risk-taking shows that high self-esteem, measured during an initial survey of 1,670 students enrolled in grades 7 through 12, was associated with lower odds of substance abuse in the following year among girls, but not among boys. Self-esteem was not significantly correlated with first sexual intercourse (sexual debut) 1 year later among girls or boys, according to Stephanie B. Wheeler, Ph.D., of the University of North Carolina. In addition, higher academic performance in school was associated with less risky activities among young girls. Female students with 'A' averages had significantly lower odds of sexual debut 1 year later compared with students with 'C' averages and below.
In addition, female students with 'A' or 'B' averages at baseline had lower odds of illegal substance abuse in the following year, but neither self-esteem nor grades had a significant effect on substance abuse after 1 year for male students. Neither self-esteem nor academic performance at baseline had significant effects on adolescent risk-taking 6 to 7 years later.
Using the National Longitudinal Study of Adolescent Health (Add Health), the study first surveyed students in 1994-1995 and subsequently in 1995-1996 and 2001-2002. The finding that early sexual intercourse was strongly associated with subsequent substance use, and vice-versa, suggests that these activities are mutually reinforcing. As such, a behavioral intervention targeting multiple types of risky behaviors youths encounter may be warranted, suggests Dr. Wheeler. She adds that since results varied sharply by gender, thoughtfully designed, gender-specific interventions to prevent early sexual debut and substance use in adolescence may be appropriate. This research was supported by the Agency for Healthcare Research and Quality (T32 HS00032).
See 'Effects of self-esteem and academic performance on adolescent decision-making: An examination of early sexual intercourse and illegal substance use,' by Dr. Wheeler, in the Journal of Adolescent Health 47, pp. 582-590, 2010.
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Impact of self-esteem and academic achievement on substance use and sexual initiation differs among boys and girls
A new study focused on adolescent risk-taking shows that high self-esteem, measured during an initial survey of 1,670 students enrolled in grades 7 through 12, was associated with lower odds of substance abuse in the following year among girls, but not among boys. Self-esteem was not significantly correlated with first sexual intercourse (sexual debut) 1 year later among girls or boys, according to Stephanie B. Wheeler, Ph.D., of the University of North Carolina. In addition, higher academic performance in school was associated with less risky activities among young girls. Female students with 'A' averages had significantly lower odds of sexual debut 1 year later compared with students with 'C' averages and below.
In addition, female students with 'A' or 'B' averages at baseline had lower odds of illegal substance abuse in the following year, but neither self-esteem nor grades had a significant effect on substance abuse after 1 year for male students. Neither self-esteem nor academic performance at baseline had significant effects on adolescent risk-taking 6 to 7 years later.
Using the National Longitudinal Study of Adolescent Health (Add Health), the study first surveyed students in 1994-1995 and subsequently in 1995-1996 and 2001-2002. The finding that early sexual intercourse was strongly associated with subsequent substance use, and vice-versa, suggests that these activities are mutually reinforcing. As such, a behavioral intervention targeting multiple types of risky behaviors youths encounter may be warranted, suggests Dr. Wheeler. She adds that since results varied sharply by gender, thoughtfully designed, gender-specific interventions to prevent early sexual debut and substance use in adolescence may be appropriate. This research was supported by the Agency for Healthcare Research and Quality (T32 HS00032).
See 'Effects of self-esteem and academic performance on adolescent decision-making: An examination of early sexual intercourse and illegal substance use,' by Dr. Wheeler, in the Journal of Adolescent Health 47, pp. 582-590, 2010.
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Research Activities, August 2011: Agency News and Notes: Six of every 10 rural emergency departments visits made by poor patients
Research Activities, August 2011: Agency News and Notes: Six of every 10 rural emergency departments visits made by poor patients: "Agency News and Notes
Six of every 10 rural emergency departments visits made by poor patients
Low-income adults aged 18 to 64 accounted for 56 percent of the 8 million visits made to rural hospital emergency departments in 2008, according to the latest News and Numbers from the Agency for Healthcare Research and Quality. The Federal agency's analysis also found that:
* About 44 percent of the adult visits to rural emergency departments were either paid for by Medicaid (28 percent) or were uncompensated or billed to uninsured patients (nearly 16.5 percent).
* Only 31 percent of the visits were paid for by private health plans and 25 percent were covered by Medicare.
* The top 10 reasons for rural emergency department visits included abdominal pain (233,064), back pain (223,248), chest pain from unknown cause (220,647), open wounds (211,587), and chronic obstructive pulmonary disease and bronchiectasis (159,002) that can make breathing difficult.
* Of the emergency departments in rural areas, only about 2 percent were trauma centers and less than 2 percent were located in teaching hospitals. Some 51 percent were located in designated critical access hospitals, which receive cost-based reimbursement for treating Medicare patients to help improve their financial performance and reduce the danger of hospital closure.
This AHRQ News and Numbers summary is based on data from Emergency Department Visits in Rural and Non-Rural Community Hospitals, 2008 (http://www.hcup-us.ahrq.gov/reports/statbriefs/sb116.jsp).
The report uses data from the Agency's 2008 Nationwide Emergency Department Sample (NEDS) and data from supplemental sources from the U.S. Census Bureau. For information about NEDS, go to http://www.ahrq.gov/data/hcup/datahcup.htm.
For other information, or to speak with an AHRQ data expert, please contact Bob Isquith at Bob.Isquith@ahrq.hhs.gov or call (301) 427-1539.
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Six of every 10 rural emergency departments visits made by poor patients
* About 44 percent of the adult visits to rural emergency departments were either paid for by Medicaid (28 percent) or were uncompensated or billed to uninsured patients (nearly 16.5 percent).
* Only 31 percent of the visits were paid for by private health plans and 25 percent were covered by Medicare.
* The top 10 reasons for rural emergency department visits included abdominal pain (233,064), back pain (223,248), chest pain from unknown cause (220,647), open wounds (211,587), and chronic obstructive pulmonary disease and bronchiectasis (159,002) that can make breathing difficult.
* Of the emergency departments in rural areas, only about 2 percent were trauma centers and less than 2 percent were located in teaching hospitals. Some 51 percent were located in designated critical access hospitals, which receive cost-based reimbursement for treating Medicare patients to help improve their financial performance and reduce the danger of hospital closure.
This AHRQ News and Numbers summary is based on data from Emergency Department Visits in Rural and Non-Rural Community Hospitals, 2008 (http://www.hcup-us.ahrq.gov/reports/statbriefs/sb116.jsp).
The report uses data from the Agency's 2008 Nationwide Emergency Department Sample (NEDS) and data from supplemental sources from the U.S. Census Bureau. For information about NEDS, go to http://www.ahrq.gov/data/hcup/datahcup.htm.
For other information, or to speak with an AHRQ data expert, please contact Bob Isquith at Bob.Isquith@ahrq.hhs.gov or call (301) 427-1539.
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Research Activities, August 2011: Agency News and Notes: Employees' share of health plan premium costs up dramatically
Research Activities, August 2011: Agency News and Notes: Employees' share of health plan premium costs up dramatically: "Agency News and Notes
Employees' share of health plan premium costs up dramatically
Employees of private-sector companies contributed up to 121 percent more in 2009 for their yearly share of their employer-sponsored health insurance coverage than they did in 2001, according to the latest News and Numbers from the Agency for Healthcare Research and Quality. By comparison, the total average annual premium for employer-sponsored health plans, which includes both the cost to the worker and to his or her employer, rose at a slower pace during the same period.
Data from the Federal agency found that the average annual premium share for workers with employee-plus-one coverage�soared 121 percent—from $1,070 to $2,363, while the average annual contribution for workers with family coverage went up nearly 100 percent—from $1,741 to $3,474. Workers with single coverage experienced an increase of 92 percent in their average annual share—from $498 to $957. Specifically, the total premium increases for the different categories of coverage were:
* For an employee-plus-one plan—$5,463 to $9,053 (66 percent).
* For a family plan—$7,509 to $13,027 (73.5 percent).
* For a single plan—$2,889 to $4,669 (62 percent).
The data in this AHRQ News and Numbers summary are taken from�the 2001 to 2009 Medical Expenditure Panel Survey,�a detailed source of information on the health services used by Americans, the frequency with which they are used, the cost of those services, and how they are paid. The data in this report are not adjusted for inflation.
For more information, go to Changes in Premiums and Employee Contributions for Employer-Sponsored Health Insurance, Private Industry, 2001-2009, at http://www.meps.ahrq.gov/mepsweb/data_files/publications/st325/stat325.shtml.
For other information, or to speak with an AHRQ data expert, please contact Bob Isquith at Bob.Isquith@ahrq.hhs.gov or call (301) 427-1539.
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Employees' share of health plan premium costs up dramatically
Data from the Federal agency found that the average annual premium share for workers with employee-plus-one coverage�soared 121 percent—from $1,070 to $2,363, while the average annual contribution for workers with family coverage went up nearly 100 percent—from $1,741 to $3,474. Workers with single coverage experienced an increase of 92 percent in their average annual share—from $498 to $957. Specifically, the total premium increases for the different categories of coverage were:
* For an employee-plus-one plan—$5,463 to $9,053 (66 percent).
* For a family plan—$7,509 to $13,027 (73.5 percent).
* For a single plan—$2,889 to $4,669 (62 percent).
The data in this AHRQ News and Numbers summary are taken from�the 2001 to 2009 Medical Expenditure Panel Survey,�a detailed source of information on the health services used by Americans, the frequency with which they are used, the cost of those services, and how they are paid. The data in this report are not adjusted for inflation.
For more information, go to Changes in Premiums and Employee Contributions for Employer-Sponsored Health Insurance, Private Industry, 2001-2009, at http://www.meps.ahrq.gov/mepsweb/data_files/publications/st325/stat325.shtml.
For other information, or to speak with an AHRQ data expert, please contact Bob Isquith at Bob.Isquith@ahrq.hhs.gov or call (301) 427-1539.
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Research Activities, August 2011: Agency News and Notes: Certain Americans pay more than 10 percent of their family income to pay for medical expenses
Research Activities, August 2011: Agency News and Notes: Certain Americans pay more than 10 percent of their family income to pay for medical expenses: "Agency News and Notes
Certain Americans pay more than 10 percent of their family income to pay for medical expenses
Roughly 1 of every 6 Americans aged 18 to 64 reported using more than 10 percent of their total family income to pay for health insurance premiums and out-of-pocket medical expenses in 2007, according to the latest News and Numbers from the Agency for Healthcare Research and Quality. According to the data from the Federal agency, this included:
* People who pay for their own health coverage (47 percent) and those who have employer-sponsored insurance (16 percent) or public insurance, such as Medicaid (also 16 percent).
* The poor (30 percent) and middle-income (19 percent) and high-income (7 percent) persons.
* Unemployed adults (29 percent) and 13 percent of working adults.
* Rural residents (21 percent) and 15 percent of people living in metropolitan areas.
* Adults with disabilities who have complex or basic activity limitations (35 percent and 32 percent) and 15 percent of those with no activity limitations.
This AHRQ News and Numbers is based on information in the 2010 National Healthcare Disparities Report, which examines the disparities in Americans' access to and quality of health care, with breakdowns by race, ethnicity, income, and education.
For other information, or to speak with an AHRQ data expert, please contact Bob Isquith at Bob.Isquith@ahrq.hhs.gov or call (301) 427-1539.
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Certain Americans pay more than 10 percent of their family income to pay for medical expenses
* People who pay for their own health coverage (47 percent) and those who have employer-sponsored insurance (16 percent) or public insurance, such as Medicaid (also 16 percent).
* The poor (30 percent) and middle-income (19 percent) and high-income (7 percent) persons.
* Unemployed adults (29 percent) and 13 percent of working adults.
* Rural residents (21 percent) and 15 percent of people living in metropolitan areas.
* Adults with disabilities who have complex or basic activity limitations (35 percent and 32 percent) and 15 percent of those with no activity limitations.
This AHRQ News and Numbers is based on information in the 2010 National Healthcare Disparities Report, which examines the disparities in Americans' access to and quality of health care, with breakdowns by race, ethnicity, income, and education.
For other information, or to speak with an AHRQ data expert, please contact Bob Isquith at Bob.Isquith@ahrq.hhs.gov or call (301) 427-1539.
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Research Activities, August 2011: Agency News and Notes: New ad campaign urges patients to consider medical treatment options
Research Activities, August 2011: Agency News and Notes: New ad campaign urges patients to consider medical treatment options: "Agency News and Notes
New ad campaign urges patients to consider medical treatment options
'Explore Your Treatment Options,' a new multimedia ad campaign initiated by the Agency for Healthcare Research and Quality (AHRQ) and the Ad Council, encourages patients to become more informed about their options before choosing a treatment for a health condition or illness.
The goal of this campaign is to increase consumers' involvement in their care by providing easy access to unbiased information about treatment options and tools to encourage patients to work with their doctors, nurses, pharmacists, and other clinicians to make health care decisions. It features television, radio, print, Web, and outdoor ads that encourage consumers to visit AHRQ's Effective Health Care Program Web site to find plain-language guides that summarize the scientific evidence on treatments for numerous medical conditions, including diabetes, osteoarthritis, high blood pressure, high cholesterol, and more.
'We see the best outcomes when doctors and patients work together to come up with a treatment plan that takes into account the patient's quality-of-life concerns,' said AHRQ Director Carolyn M. Clancy, M.D. 'Information is power in health care, and this campaign will provide patients with the information they need to become partners with their doctors in their health and health care.'
Since 2005, AHRQ's Effective Health Care Program has compared the outcomes and�effectiveness�of different treatments and communicated findings to providers and consumers to help them make informed decisions about health care. For example, Treating High Cholesterol: A Guide for Adults, provides easy-to-understand information about different kinds of cholesterol medicines, including how they work and their side effects. The guide also includes a list of questions that patients can ask their doctors to help them choose their best treatment option.
As part of the campaign, AHRQ's Effective Health Care Program Web site features personal stories from patients with chronic conditions who achieved better health results by exploring their treatment options. In addition, a new Health Priorities Snapshot tool features questions about common daily activities and allows users to rate the importance of quality-of-life concerns. Patients can print out a list of their own health priorities and share it with their clinicians during medical appointments.�These features are available at http://www.effectivehealthcare.ahrq.gov/options.
Created pro bono for the Ad Council by Grey New York, the new television, radio, print, outdoor, and Web ads highlight the fact that consumers have options when buying clothing, dining out, watching a movie, or buying a car and should expect options when it comes to their health care.
'This new campaign is a wonderful extension of our ongoing efforts with AHRQ to encourage Americans to take a more active role in their health care,' said Peggy Conlon, president and CEO of the Ad Council. 'These ads speak to a compelling insight—we look for options in nearly every aspect of our lives, but we're not always exploring all treatment options available when it comes to our health care. It's a very important message, as these decisions can affect the length and quality of our lives.'
The new public service advertisements (PSAs) are being distributed to approximately 33,000 media stations nationwide. Per the Ad Council's donated media model, all of the new PSAs will air and run in advertising time and space donated by the media.
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New ad campaign urges patients to consider medical treatment options
'Explore Your Treatment Options,' a new multimedia ad campaign initiated by the Agency for Healthcare Research and Quality (AHRQ) and the Ad Council, encourages patients to become more informed about their options before choosing a treatment for a health condition or illness.
The goal of this campaign is to increase consumers' involvement in their care by providing easy access to unbiased information about treatment options and tools to encourage patients to work with their doctors, nurses, pharmacists, and other clinicians to make health care decisions. It features television, radio, print, Web, and outdoor ads that encourage consumers to visit AHRQ's Effective Health Care Program Web site to find plain-language guides that summarize the scientific evidence on treatments for numerous medical conditions, including diabetes, osteoarthritis, high blood pressure, high cholesterol, and more.
'We see the best outcomes when doctors and patients work together to come up with a treatment plan that takes into account the patient's quality-of-life concerns,' said AHRQ Director Carolyn M. Clancy, M.D. 'Information is power in health care, and this campaign will provide patients with the information they need to become partners with their doctors in their health and health care.'
Since 2005, AHRQ's Effective Health Care Program has compared the outcomes and�effectiveness�of different treatments and communicated findings to providers and consumers to help them make informed decisions about health care. For example, Treating High Cholesterol: A Guide for Adults, provides easy-to-understand information about different kinds of cholesterol medicines, including how they work and their side effects. The guide also includes a list of questions that patients can ask their doctors to help them choose their best treatment option.
As part of the campaign, AHRQ's Effective Health Care Program Web site features personal stories from patients with chronic conditions who achieved better health results by exploring their treatment options. In addition, a new Health Priorities Snapshot tool features questions about common daily activities and allows users to rate the importance of quality-of-life concerns. Patients can print out a list of their own health priorities and share it with their clinicians during medical appointments.�These features are available at http://www.effectivehealthcare.ahrq.gov/options.
Created pro bono for the Ad Council by Grey New York, the new television, radio, print, outdoor, and Web ads highlight the fact that consumers have options when buying clothing, dining out, watching a movie, or buying a car and should expect options when it comes to their health care.
'This new campaign is a wonderful extension of our ongoing efforts with AHRQ to encourage Americans to take a more active role in their health care,' said Peggy Conlon, president and CEO of the Ad Council. 'These ads speak to a compelling insight—we look for options in nearly every aspect of our lives, but we're not always exploring all treatment options available when it comes to our health care. It's a very important message, as these decisions can affect the length and quality of our lives.'
The new public service advertisements (PSAs) are being distributed to approximately 33,000 media stations nationwide. Per the Ad Council's donated media model, all of the new PSAs will air and run in advertising time and space donated by the media.
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Research Activities, August 2011: Outcomes/Effectiveness Research: Primary anterior cervical fusion has lower in-hospital complication rates and deaths than posterior cervical fusion
Research Activities, August 2011: Outcomes/Effectiveness Research: Primary anterior cervical fusion has lower in-hospital complication rates and deaths than posterior cervical fusion: "Outcomes/Effectiveness Research
Primary anterior cervical fusion has lower in-hospital complication rates and deaths than posterior cervical fusion
If both approaches are reasonable beforehand, patients undergoing operations to fuse the cervical spine do better after anterior cervical spine fusion (ACDF) than posterior cervical spine fusion (PCDF), according to a new study. Fusion of the cervical spine has become more common in the past 3 decades for the treatment of trauma-fractured cervical vertebrae or degenerative disease that do not respond to other stabilization techniques.
Researchers at Weill Medical College of Cornell University found in their study of 228,113 hospital admissions that involved primary cervical spine fusion, that the hospital length of stay (LOS) was significantly longer for PCDF patients than ACDF patients (7.8 days vs. 2.4 days). Patients undergoing ACDF had a fourth the incidence of procedure-related complications (4.14 percent) than did PCDF patients (15.35 percent), and lower in-hospital mortality (0.26 vs. 1.44 percent).
When the researchers controlled for coexisting medical conditions and other demographic variables, PCDF patients were at twice the risk of perioperative mortality than ACDF patients. Other mortality risk factors for cervical spine fusion found by the study were age 65 years or older or being male. A number of coexisting conditions (particularly kidney disease and pulmonary circulatory disease) were associated with at least a threefold increased risk of perioperative mortality for patients who underwent cervical spine fusion. The authors caution, however, that higher risk associated with PCDF may be influenced by the fact that patients undergoing this procedure compared with ACDF often require more extensive fusion. This is a factor not accounted for in the study due to the lack of such information in the database.
Data on patients who underwent spinal surgery for cervical fusion came from the National Inpatient Samples for 1998 through 2006 of AHRQ's Healthcare Cost and Utilization Project. The study was funded in part by the Agency for Healthcare Research and Quality (HS16075) to Cornell University's Center for Education and Research on Therapeutics (CERT).
For more information on the CERTs program, visit http://www.certs.hhs.gov.
More details are in 'Increased in-hospital complications after primary posterior versus primary anterior cervical fusion,' by Stavros G. Memtsoudis, M.D., Ph.D., Alexander Hughes, M.D., Yan Ma, Ph.D., and others in the March 2011 Clinical Orthopaedics and Related Research 469(3), pp. 649-657. An Erratum was published in the May 2011 Clinical Orthopaedics and Related Research 469(5), pp. 1502-1504.
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Primary anterior cervical fusion has lower in-hospital complication rates and deaths than posterior cervical fusion
If both approaches are reasonable beforehand, patients undergoing operations to fuse the cervical spine do better after anterior cervical spine fusion (ACDF) than posterior cervical spine fusion (PCDF), according to a new study. Fusion of the cervical spine has become more common in the past 3 decades for the treatment of trauma-fractured cervical vertebrae or degenerative disease that do not respond to other stabilization techniques.
Researchers at Weill Medical College of Cornell University found in their study of 228,113 hospital admissions that involved primary cervical spine fusion, that the hospital length of stay (LOS) was significantly longer for PCDF patients than ACDF patients (7.8 days vs. 2.4 days). Patients undergoing ACDF had a fourth the incidence of procedure-related complications (4.14 percent) than did PCDF patients (15.35 percent), and lower in-hospital mortality (0.26 vs. 1.44 percent).
When the researchers controlled for coexisting medical conditions and other demographic variables, PCDF patients were at twice the risk of perioperative mortality than ACDF patients. Other mortality risk factors for cervical spine fusion found by the study were age 65 years or older or being male. A number of coexisting conditions (particularly kidney disease and pulmonary circulatory disease) were associated with at least a threefold increased risk of perioperative mortality for patients who underwent cervical spine fusion. The authors caution, however, that higher risk associated with PCDF may be influenced by the fact that patients undergoing this procedure compared with ACDF often require more extensive fusion. This is a factor not accounted for in the study due to the lack of such information in the database.
Data on patients who underwent spinal surgery for cervical fusion came from the National Inpatient Samples for 1998 through 2006 of AHRQ's Healthcare Cost and Utilization Project. The study was funded in part by the Agency for Healthcare Research and Quality (HS16075) to Cornell University's Center for Education and Research on Therapeutics (CERT).
For more information on the CERTs program, visit http://www.certs.hhs.gov.
More details are in 'Increased in-hospital complications after primary posterior versus primary anterior cervical fusion,' by Stavros G. Memtsoudis, M.D., Ph.D., Alexander Hughes, M.D., Yan Ma, Ph.D., and others in the March 2011 Clinical Orthopaedics and Related Research 469(3), pp. 649-657. An Erratum was published in the May 2011 Clinical Orthopaedics and Related Research 469(5), pp. 1502-1504.
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Research Activities, August 2011: Women's Health: Providers miss opportunities to prevent depression in and discuss birth control with women with unplanned pregnancies
Research Activities, August 2011: Women's Health: Providers miss opportunities to prevent depression in and discuss birth control with women with unplanned pregnancies: "Women's Health
Providers miss opportunities to prevent depression in and discuss birth control with women with unplanned pregnancies
The American College of Obstetricians and Gynecologists recommends that clinicians screen pregnant women during the first prenatal visit for depression, stress, support, and whether the pregnancy was planned. This screening allows providers to pinpoint women who may be at risk for post-partum depression or who may need social support once the baby arrives. A new study finds that this counseling is inconsistent, and clinicians miss opportunities to discuss future birth control and social support with women whose pregnancies were unplanned.
Judy C. Chang, M.D., M.P.H., of Magee-Women's Hospital, and colleagues recorded conversations during 48 prenatal visits with 16 providers in an academic medical center in Pittsburgh. Thirty-five of the women indicated that their pregnancies were unplanned. Most of the visits included discussion about how the women felt about their unplanned pregnancies (29 of 35 visits), but only 8 women's visits included discussion about pregnancy options. What's more, providers referred just six women to counselors or social services, despite evidence showing that an unplanned pregnancy is a risk factor for depression during and after pregnancy. Finally, future birth control plans were addressed in the visits of just 4 of the 35 women whose pregnancies were unplanned.
Because one unplanned pregnancy is a red flag for future unplanned pregnancies, the authors suggest that providers are missing opportunities to help women prevent future unplanned pregnancies. This study was funded in part by the Agency for Healthcare Research and Quality (HS13913).
See 'Now is the chance: Patient-provider communication about unplanned pregnancy during the first prenatal visit,' by Rebecca Meiksin, M.P.H., Dr. Chang, Tina Bhargava, M.A., and others in the December 2010 Patient Education and Counseling 81(3), pp. 462-467.
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Providers miss opportunities to prevent depression in and discuss birth control with women with unplanned pregnancies
Judy C. Chang, M.D., M.P.H., of Magee-Women's Hospital, and colleagues recorded conversations during 48 prenatal visits with 16 providers in an academic medical center in Pittsburgh. Thirty-five of the women indicated that their pregnancies were unplanned. Most of the visits included discussion about how the women felt about their unplanned pregnancies (29 of 35 visits), but only 8 women's visits included discussion about pregnancy options. What's more, providers referred just six women to counselors or social services, despite evidence showing that an unplanned pregnancy is a risk factor for depression during and after pregnancy. Finally, future birth control plans were addressed in the visits of just 4 of the 35 women whose pregnancies were unplanned.
Because one unplanned pregnancy is a red flag for future unplanned pregnancies, the authors suggest that providers are missing opportunities to help women prevent future unplanned pregnancies. This study was funded in part by the Agency for Healthcare Research and Quality (HS13913).
See 'Now is the chance: Patient-provider communication about unplanned pregnancy during the first prenatal visit,' by Rebecca Meiksin, M.P.H., Dr. Chang, Tina Bhargava, M.A., and others in the December 2010 Patient Education and Counseling 81(3), pp. 462-467.
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Research Activities, August 2011: Disparities/Minority Health: Having a usual source of care as well as insurance reduces unmet health needs
Research Activities, August 2011: Disparities/Minority Health: Having a usual source of care as well as insurance reduces unmet health needs: "Disparities/Minority Health
Having a usual source of care as well as insurance reduces unmet health needs
The lowest percentage of unmet medical needs among adults, who visited a doctor in the past year and reported need for additional care, was among those having both health insurance and a usual source of care (USC), according to a new study. In contrast, unmet needs were highest for those persons lacking both insurance and a USC.
Jennifer E. DeVoe, M.D., of Oregon Health & Science University, and colleagues analyzed 2002-2007 data from the Medical Expenditure Panel Survey. They estimated that 77 percent of United States adults had a USC and 81 percent had health insurance. However, only 68 percent of U.S. adults had both a USC and insurance, while 10 percent had neither. Compared with persons with a USC and insurance, persons with insurance, but no USC were 27 percent more likely to have problems getting care, tests, or treatment; those with no insurance, but a USC were 63 percent more likely to report these problems; and adults lacking both USC and insurance were twice as likely to report these problems.
Data for the study came from AHRQ's Medical Expenditure Panel Survey�Household Component, which uses a stratified and clustered random sample from National Health Interview Survey households. The sample of 134,714 people (weighted to represent the United States population) was used for analysis of unmet health care needs among those in the sample who reported having at least one medical appointment in the past 12 months and who reported the need for additional care. The need for care represented: unmet medical needs; unmet prescription needs; problems getting care, tests, or treatment; and delayed urgent care. The study was funded in part by the Agency for Healthcare Research and Quality (HS16181 and HS18569).
More details are in 'The case for synergy between a usual source of care and health insurance coverage,' by Dr. DeVoe, Carrie J. Tillotson, M.P.H., Sarah E. Lesko, M.D., M.P.H., and others in the March 16, 2011, Journal of General Internal Medicine 26 [Epub ahead of print].
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Having a usual source of care as well as insurance reduces unmet health needs
The lowest percentage of unmet medical needs among adults, who visited a doctor in the past year and reported need for additional care, was among those having both health insurance and a usual source of care (USC), according to a new study. In contrast, unmet needs were highest for those persons lacking both insurance and a USC.
Jennifer E. DeVoe, M.D., of Oregon Health & Science University, and colleagues analyzed 2002-2007 data from the Medical Expenditure Panel Survey. They estimated that 77 percent of United States adults had a USC and 81 percent had health insurance. However, only 68 percent of U.S. adults had both a USC and insurance, while 10 percent had neither. Compared with persons with a USC and insurance, persons with insurance, but no USC were 27 percent more likely to have problems getting care, tests, or treatment; those with no insurance, but a USC were 63 percent more likely to report these problems; and adults lacking both USC and insurance were twice as likely to report these problems.
Data for the study came from AHRQ's Medical Expenditure Panel Survey�Household Component, which uses a stratified and clustered random sample from National Health Interview Survey households. The sample of 134,714 people (weighted to represent the United States population) was used for analysis of unmet health care needs among those in the sample who reported having at least one medical appointment in the past 12 months and who reported the need for additional care. The need for care represented: unmet medical needs; unmet prescription needs; problems getting care, tests, or treatment; and delayed urgent care. The study was funded in part by the Agency for Healthcare Research and Quality (HS16181 and HS18569).
More details are in 'The case for synergy between a usual source of care and health insurance coverage,' by Dr. DeVoe, Carrie J. Tillotson, M.P.H., Sarah E. Lesko, M.D., M.P.H., and others in the March 16, 2011, Journal of General Internal Medicine 26 [Epub ahead of print].
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Research Activities, August 2011: Disparities/Minority Health: Studies examine possible disparities surrounding implantable cardioverter defibrillators
Research Activities, August 2011: Disparities/Minority Health: Studies examine possible disparities surrounding implantable cardioverter defibrillators: "Disparities/Minority Health
Studies examine possible disparities surrounding implantable cardioverter defibrillators
A patient who has some types of life-threatening irregular heart rhythms or a patient at high risk of developing a life-threatening irregular heart rhythm can undergo a procedure to receive an implantable cardioverter defibrillator (ICD). This electronic device monitors the heart's rhythm, and when it detects an abnormal rhythm, it delivers energy to the heart to put it back into a normal rhythm. Two new studies from the Duke Center for Education and Research on Therapeutics (CERT), funded by a grant from the Agency for Healthcare Research and Quality (HS16964) to the Duke CERT, examined different aspects of underuse of ICDs in eligible patients. They are summarized here.
LaPointe, N.M., Al-Khatib, S.M., Piccini, J.P., and others (2011, March). 'Extent of and reasons for nonuse of implantable cardioverter defibrillator devices in clinical practice among eligible patients with left ventricular systolic dysfunction.' Circulation Cardiovascular Quality and Outcomes 4(2), pp. 146-51.
Using claims data and the Duke Databank for Cardiovascular Disease, the authors of this study found that 224 of 542 patients (41%) who were potentially eligible to receive an ICD did not receive the device. Being a woman and older age were associated with a lower likelihood of receiving an ICD. This rate of underuse and the factors associated with underuse have been seen in other studies. However, when the medical records of patients were reviewed, many of the 224 patients without an ICD were found to have a contraindi-cation (117 patients) to the ICD or had refused the ICD (38 patients). Therefore, after taking into consideration contraindications and refusals, the rate of underuse was much lower—69 of 542 patients or 13%. Being a woman and being older were no longer associated with not having an ICD. Using the more detailed information available from the medical record, information that is not available from claims data, allowed for a more complete assessment of underuse of ICDs in clinical practice.
Al-Khatib, S.M., Sanders, G.D., O'Brien, S.M., and others (2011). 'Do physicians' attitudes toward implantable cardioverter defibrillation therapy vary by patient age, gender, or race?' Annals of Noninvasive Electrocardiology 16(1), pp. 77-84.
To determine if physicians' attitudes play a factor in the low rates of ICD use, researchers posed four clinical scenarios to 1,127 members of the American College of Cardiology. When an ICD was definitely indicated by guidelines, 84 percent of the physicians said they would recommend the device. When an ICD was not recommended, 98 percent of the physicians indicated they would not offer it. When an ICD was a reasonable option but not clearly indicated, just 61 percent of clinicians said they would offer one, and when an ICD was indicated but the patient had not complied with medical therapy in the past, 65 percent of the clinicians said they would offer an ICD. When gender and race were added to the scenario mix, recommendations for ICD implantation were unaffected, suggesting that if disparities in who receives ICDs exist, they are not prompted by physician bias. Physicians were, however, more likely to recommend ICDs for eligible patients who were 60 years old than patients who were 80 years old. For example, 98 percent of the clinicians indicated they would recommend a 60-year-old receive an ICD when guidelines clearly indicated them, but when the patient's age was changed to 80, 63 percent of the clinicians were less likely to recommend ICDs. The authors suggest that this reluctance may be due in part to the lack of data on ICDs' safety and effectiveness in older patients. Finally, electrophysiologists were much more likely to recommend an ICD when guidelines called for one compared with non-electrophysio-logists (92 percent vs. 81 percent). A possible explanation is that electrophysiologists may be more familiar with the ICD guidelines.
For more information on the CERTs program, visit http://certs.hhs.gov.
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Studies examine possible disparities surrounding implantable cardioverter defibrillators
A patient who has some types of life-threatening irregular heart rhythms or a patient at high risk of developing a life-threatening irregular heart rhythm can undergo a procedure to receive an implantable cardioverter defibrillator (ICD). This electronic device monitors the heart's rhythm, and when it detects an abnormal rhythm, it delivers energy to the heart to put it back into a normal rhythm. Two new studies from the Duke Center for Education and Research on Therapeutics (CERT), funded by a grant from the Agency for Healthcare Research and Quality (HS16964) to the Duke CERT, examined different aspects of underuse of ICDs in eligible patients. They are summarized here.
LaPointe, N.M., Al-Khatib, S.M., Piccini, J.P., and others (2011, March). 'Extent of and reasons for nonuse of implantable cardioverter defibrillator devices in clinical practice among eligible patients with left ventricular systolic dysfunction.' Circulation Cardiovascular Quality and Outcomes 4(2), pp. 146-51.
Using claims data and the Duke Databank for Cardiovascular Disease, the authors of this study found that 224 of 542 patients (41%) who were potentially eligible to receive an ICD did not receive the device. Being a woman and older age were associated with a lower likelihood of receiving an ICD. This rate of underuse and the factors associated with underuse have been seen in other studies. However, when the medical records of patients were reviewed, many of the 224 patients without an ICD were found to have a contraindi-cation (117 patients) to the ICD or had refused the ICD (38 patients). Therefore, after taking into consideration contraindications and refusals, the rate of underuse was much lower—69 of 542 patients or 13%. Being a woman and being older were no longer associated with not having an ICD. Using the more detailed information available from the medical record, information that is not available from claims data, allowed for a more complete assessment of underuse of ICDs in clinical practice.
Al-Khatib, S.M., Sanders, G.D., O'Brien, S.M., and others (2011). 'Do physicians' attitudes toward implantable cardioverter defibrillation therapy vary by patient age, gender, or race?' Annals of Noninvasive Electrocardiology 16(1), pp. 77-84.
To determine if physicians' attitudes play a factor in the low rates of ICD use, researchers posed four clinical scenarios to 1,127 members of the American College of Cardiology. When an ICD was definitely indicated by guidelines, 84 percent of the physicians said they would recommend the device. When an ICD was not recommended, 98 percent of the physicians indicated they would not offer it. When an ICD was a reasonable option but not clearly indicated, just 61 percent of clinicians said they would offer one, and when an ICD was indicated but the patient had not complied with medical therapy in the past, 65 percent of the clinicians said they would offer an ICD. When gender and race were added to the scenario mix, recommendations for ICD implantation were unaffected, suggesting that if disparities in who receives ICDs exist, they are not prompted by physician bias. Physicians were, however, more likely to recommend ICDs for eligible patients who were 60 years old than patients who were 80 years old. For example, 98 percent of the clinicians indicated they would recommend a 60-year-old receive an ICD when guidelines clearly indicated them, but when the patient's age was changed to 80, 63 percent of the clinicians were less likely to recommend ICDs. The authors suggest that this reluctance may be due in part to the lack of data on ICDs' safety and effectiveness in older patients. Finally, electrophysiologists were much more likely to recommend an ICD when guidelines called for one compared with non-electrophysio-logists (92 percent vs. 81 percent). A possible explanation is that electrophysiologists may be more familiar with the ICD guidelines.
For more information on the CERTs program, visit http://certs.hhs.gov.
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