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At least 217 records · Page 12Linked to original sources

PubMed1994

Comments on the AAMC policy statement recommending strategies for increasing the production of generalist physicians.

The United States has a physician specialty imbalance, primarily a shortage of generalists (defined as family physicians, general internists, and general pediatricians) relative to other specialists. In recent years, the rising costs of health care, the expansion of managed care, and problems of access to care have accentuated the critical role that generalists must play in a cost-effective, accessible health care system. Despite numerous public and private initiatives designed to address the supply of generalist physicians, the ratio of generalists to specialists has been decreasing. Although the factors contributing to the shrinking proportion of generalists are many and are often outside the control of educators, there is evidence that medical schools can play a major role in influencing specialty choice. Recognizing the need to address the specialty imbalance in this country, the Association of American Medical Colleges (AAMC) appointed the Generalist Physician Task Force to develop a statement suggesting actions that the AAMC and its constituents could take to foster a greater representation of generalist physicians in the United States. The task force produced an Executive Summary, published as an AAMC policy statement in early 1993, that contained recommended strategies for medical schools, graduate medical education, and the practice environment. The authors of the present article critique these recommendations, provide a background and rationale for each of them, and give suggestions about how some of the recommendations might be implemented. While they are in general agreement with the AAMC policy statement, they feel the recommended strategies fall short of the need. They maintain that the AAMC statement represents an admirable but cautious approach to a daunting problem, and that the time is past when cautious approaches will suffice. The authors conclude with the hope that bolder initiatives will emerge from the new AAMC Office of Generalist Physician Programs.

Academic Medical Centers↗

PubMed1998

Mission statement rationales and organizational alignment in the not-for-profit health care sector.

This article presents the findings from a research study conducted on the use of mission statements in not-for-profit health care organizations. In particular, the study sought to determine if a relationship exists between the initial "rationales" that led to the creation of a mission statement and hospital performance. The findings suggest that some of the rationales for developing mission statements are indeed more important than others and that organizational alignment with the mission statement is of key importance to both the mission's and the hospital's success.

Canada↗

PubMed2006

RACP's policy statement on infant male circumcision is ill-conceived.

OBJECTIVE: To conduct a critical peer-review of the 2004 Policy Statement on routine male circumcision produced by the Royal Australasian College of Physicians (RACP). METHOD: Comprehensive evaluation in the context of the research field. RESULTS: We find that the current Statement downplays the wide-ranging life-long benefits of circumcision in prevention of urinary tract infections (UTIs), penile and cervical cancer, genital herpes and chlamydia in women, HIV infection, phimosis, and various penile dermatoses, and at the same time overstates the complication rate. We highlight the many errors in the RACP Statement and note that it sidesteps making a conclusion based on circumcision's well-documented prophylactic health benefits by instead referring to the status of the foreskin at birth. In the era of preventative medicine we view this as irresponsible. CONCLUSION: The RACP's Statement on routine male circumcision is not evidence-based and should be retracted. IMPLICATIONS: In the interests of public health and individual well-being an extensive, comprehensive, evidence-based revision should be conducted so as to provide scientifically accurate, balanced information on the advantages, and also the low rate of mostly minor complications, associated with this simple procedure, which for maximum benefits and minimal risk should ideally be performed in the neonatal period.

Australia↗

PubMed1964

ATTITUDE STATEMENTS AS POSITIVE AND NEGATIVE REINFORCEMENTS.

The finding that attraction is a function of attitude similarity has been interpreted as a special case of the effect of positive and negative reinforcements on attraction. A simple discrimination learning task was employed in which the reinforcements were attitude statements similar and dissimilar to the opinions of the subject. The presentation of similar attitude statements after each correct response and dissimilar attitude statements after each incorrect response significantly changed response probability. The hypothesis that such statements could be used as reinforcers in a learning situation was thus confirmed.

Attitude↗

PubMed2003

Perceiving prosody from the face and voice: distinguishing statements from echoic questions in English.

We examined the processing of potential auditory and visual cues that differentiate statements from echoic questions. In Experiment 1, four natural speech statement-question pairs were identified by participants, and then analyzed to determine which characteristics were ecologically valid. These characteristics were tested in subsequent experiments to determine if they were also functionally valid. In Experiment 2, the characteristics of the most discriminable utterance pair were successfully extended to the other utterance pairs. For Experiment 3, an auditory continuum (varying in F0, amplitude, duration) was crossed with a visual continuum (varying in eyebrow raise, head tilt), using synthetic speech and a computer-animated head. Participants judged five levels along each of these two speech continua between a prototypical statement and prototypical question, in an expanded factorial design. Experiments 4 and 5 were unable to appreciably enhance the weak visual effect relative to the strong auditory effect (from Experiment 3). Overall, we found that both auditory and visual cues reliably conveyed statement and question intonation, were successfully synthesized, and generalized to other utterances. However, the weak visual effect relative to the robustly strong auditory effect precluded optimal integration and conclusive examination of information processing through model-fitting.

Adolescent↗

PubMed1994

The role of negative self-statements during exposure in vivo. A process study of eight panic disorder patients with agoraphobia.

The purpose of this study was to evaluate the pattern of cognitive change, and in particular the role of negative self-statements, in relation to improvement during an in vivo exposure treatment. Eight panic disordered patients with agoraphobia, of whom 4 were most and 4 were least improved on a composite measure, were exposed to standardized agoraphobic situations. During the exposure, heart rate, self-statements, and subjective anxiety were registered throughout the sessions. Fixed criteria were set for habituation of heart rate and reduction of subjective anxiety within a session. Results showed that the total frequency of negative self-statements at the start, during, as well as at the end of treatment differentiated best between the most and least improved patients. These results suggest that it may be therapeutically wise to continue exposure therapy not only until habituation of anxiety (subjectively and physiologically) is achieved, but also until the frequency of negative self-statements is reduced until zero.

Adult↗

PubMed1997

Guidelines for the pediatric cancer center and role of such centers in diagnosis and treatment. American Academy of Pediatrics Section Statement Section on Hematology/Oncology.

The intent of this statement is to delineate those personnel and facilities that are essential to provide state-of-the-art care for children and adolescents with cancer. This statement emphasizes the importance of a board-eligible or board-certified pediatric hematologist-oncologist and pediatric subspecialty consultants overseeing the care of all pediatric and adolescent cancer patients, and the need for facilities available only at a tertiary center as essential for the initial management and much of the follow-up for pediatric and adolescent cancer patients. In 1986, the Section on Oncology/Hematology of the American Academy of Pediatrics outlined the "Guidelines for the Pediatric Cancer Center and Role of Such Centers in Diagnosis and Treatment." Since that statement was published, significant changes in medical care reimbursement have prompted a review of the role of tertiary medical centers in the care of pediatric patients. The potential impact of these developments on the treatment of children with cancer led to a revision of the previous statement with the goal of delineating those elements that are necessary to ensure that current childhood cancer survival rates are not adversely impacted by requirements for care to be given at sites lacking essential personnel or equipment.

Child↗

PubMed1987

The roles of alcohol-related self-statements in social drinking.

Recent literature showed that expectancies or cognitions have been proposed as a major factor in influencing the amount of alcohol an individual consumes and the behavioral consequences following consumption. However, how alcohol expectancies influence alcohol consumption is unclear; this paper reports two studies of the relationship. Study I examined the relationship between alcohol consumption and alcohol-related positive and negative self-statements in 110 social drinkers. The results showed that, in a nondrinking situation, the alcohol expectancies and variables measuring consumption and alcohol-related problems were correlated. Also, subjects who perceived their "alcoholic sets" as negative consumed more than those who perceived theirs as positive. Study II investigated changes in self-statement responding in 8 light and 8 heavy drinkers in a "normal" pub drinking situation. The results showed that alcohol-dependent self-statements in the light drinkers were relatively stable across time and between drinking and nondrinking environments. However, the alcohol-dependent self-statements of heavy drinkers became more negative during the drinking session. Furthermore, the degree and nature of such changes appeared to be related to alcohol-associated problems and consumption.

Adolescent↗

PubMed2006

Valence of self-cognitions: the positivity of individual self-statements.

Based on D. Trafimow, H. C. Triandis, and S. Goto's (1991) research on the distinction between the private, collective, and relational selves, the present authors explored the valence of each self. The authors administered to participants either a private self-prime, a collective self-prime, or a relational self-prime and then asked them to write 20 self-statements. The authors coded the statements for valence (positive, neutral, or negative) and self-statement type (individual, collective, or relational). The results indicated that the valence of individual self-statements were most positive when the collective self or the relational self was primed, indicating the possibility that positive illusions were exaggerated most in the context of other people.

Adult↗

PubMed2004

Screening for thyroid disease: recommendation statement.

This statement summarizes the current U.S. Preventive Services Task Force (USPSTF) recommendations on screening for thyroid disease and updates the 1996 recommendations on this topic. The complete USPSTF recommendation statement on this topic, which includes a brief review of the supporting evidence, is available through the USPSTF Web site (http://www.preventiveservices.ahrq.gov), the National Guideline Clearinghouse (http://www.guideline.gov), and in print through the Agency for Healthcare Research and Quality Publications Clearinghouse (telephone, 800-358-9295; e-mail, ahrqpubs.gov). The complete information on which this statement is based, including evidence tables and references, is available in the accompanying article in this issue and in the summary of the evidence and systematic evidence review on the Web sites already mentioned. The recommendation statement and article are also available in print through the Agency for Healthcare Research and Quality Publications Clearinghouse.

Adult↗

PubMed2004

Screening and behavioral counseling interventions in primary care to reduce alcohol misuse: recommendation statement.

This statement summarizes the U.S. Preventive Services Task Force (USPSTF) recommendations on behavioral counseling interventions to reduce alcohol misuse in primary care patients and updates the 1996 recommendations on this topic. The complete information on which this statement is based, including evidence tables and references, is available in the accompanying article in this issue and in the systematic evidence review on this topic. The complete USPSTF recommendation statement (which includes a brief review of the supporting evidence), the accompanying journal article, and the complete systematic evidence review are available through the USPSTF Web site (http://www.preventiveservices.ahrq.gov). The journal article and the USPSTF recommendation statement are available in print through the Agency for Healthcare Research and Quality Publications Clearinghouse (telephone, 800-358-9295; e-mail, ahrqpubs@ahrq.gov).

Adult↗

PubMed2001

The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomized trials.

To comprehend the results of a randomized, controlled trial (RCT), readers must understand its design, conduct, analysis, and interpretation. That goal can be achieved only through complete transparency from authors. Despite several decades of educational efforts, the reporting of RCTs needs improvement. Investigators and editors developed the original CONSORT (Consolidated Standards of Reporting Trials) statement to help authors improve reporting by using a checklist and flow diagram. The revised CONSORT statement presented in this paper incorporates new evidence and addresses some criticisms of the original statement. The checklist items pertain to the content of the Title, Abstract, Introduction, Methods, Results, and Discussion. The revised checklist includes 22 items selected because empirical evidence indicates that not reporting the information is associated with biased estimates of treatment effect or because the information is essential to judge the reliability or relevance of the findings. We intended the flow diagram to depict the passage of participants through an RCT. The revised flow diagram depicts information from four stages of trial (enrollment, intervention allocation, follow-up, and analysis). The diagram explicitly includes the number of participants, for each intervention group, that are included in the primary data analysis. Inclusion of these numbers allows the reader to judge whether the authors have performed an intention-to-treat analysis. In sum, the CONSORT statement is intended to improve the reporting of an RCT, enabling readers to understand a trial's conduct and to assess the validity of its results.

Humans↗

PubMed1993

Healthcare Financial Management Association, Principles and Practices Board. Statement No. 16. Classifying, valuing, and analyzing accounts receivable related to patient services.

This Principles and Practices Board project was undertaken in response to the frequent requests from HFMA members for a standard calculation of "days of revenue in receivables." The board's work on this project indicated that every element of the calculation required standards, which is what this statement provides. Since there have been few standards for accounts receivable related to patient services, the industry follows a variety of practices, which often differ from each other. This statement is intended to provide a framework for enhanced external comparison of accounts receivable related to patient services, and thereby improve management information related to this very important asset. Thus, the standards described in this statement represent long-term goals for gradual transition of recordkeeping practices and not a sudden or revolutionary change. The standards described in this statement will provide the necessary framework for the most meaningful external comparisons. Furthermore, management's understanding of deviations from these standards will immediately assist in analysis of differences in data between providers.

Accounts Payable and Receivable↗

PubMedDate not supplied

Nursing assessment and care plan statements.

Scope, specificity, and interrelatedness of patient problem and nursing intervention statements on nursing care plans were studied in relation to the introduction into the nursing assessment process of an objective observation checklist and a nursing history form. Ninety nursing care plans from six inpatient units in a Veterans Administration hospital were studied over an 11-month period. Results indicated that significant increases in the numbers of both types of care plan statements occurred only following the introduction of the nursing history, as did the numbers of nursing interventions related to the identified patient problems. The degree of specificity among the problem statements increased, but nursing interventions tended to become less explicit. The scope of focus of both types of statements continued to be primarily physical in orientation. The findings also suggested that, since the care plans reflected less than half the patient problems identified on the nursing histories, care plan studies alone might not be appropriate for evaluating the breadth of nursing care planning.

California↗

PubMed1999

FASB Statement No. 132 simplifies benefits disclosures.

In February 1998, the FASB issued Statement of Financial Accounting Standards No. 132, Employers' Disclosures about Pensions and Other Postretirement Benefits. The new standard is designed to streamline pension and other postretirement benefits disclosures in public and nonpublic entities' financial statements. For nonpublic entities, the statement eliminates separate disclosures of the components of net periodic benefit cost, eliminates the disclosure of the components of benefit obligations and of alternative obligation measures, eliminates the disclosure of plan provisions, adds the disclosure of comprehensive income, eliminates the disclosure of sensitivity to changes in healthcare trend rates, and standardizes the disclosures for pension and other postretirement benefits. Financial managers and their organizations' actuaries and auditors should work together to determine which disclosures their organizations should make to be in compliance with FASB Statement No. 132.

Accounting↗

PubMed2001

The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomised trials.

To comprehend the results of a randomised controlled trial (RCT), readers must understand its design, conduct, analysis, and interpretation. That goal can be achieved only through total transparency from authors. Despite several decades of educational efforts, the reporting of RCTs needs improvement. Investigators and editors developed the original CONSORT (Consolidated Standards of Reporting Trials) statement to help authors improve reporting by use of a checklist and flow diagram. The revised CONSORT statement presented here incorporates new evidence and addresses some criticisms of the original statement. The checklist items pertain to the content of the Title, Abstract, Introduction, Methods, Results, and Discussion. The revised checklist includes 22 items selected because empirical evidence indicates that not reporting this information is associated with biased estimates of treatment effect, or because the information is essential to judge the reliability or relevance of the findings. We intended the flow diagram to depict the passage of participants through an RCT. The revised flow diagram depicts information from four stages of a trial (enrollment, intervention allocation, follow-up, and analysis). The diagram explicitly shows the number of participants, for each intervention group, included in the primary data analysis. Inclusion of these numbers allows the reader to judge whether the authors have done an intention-to-treat analysis. In sum, the CONSORT statement is intended to improve the reporting of an RCT, enabling readers to understand a trial's conduct and to assess the validity of its results.

Humans↗

PubMed1992

Pertussis vaccination: acellular pertussis vaccine for the fourth and fifth doses of the DTP series update to supplementary ACIP statement. Recommendations of the Advisory Committee on Immunization Practices (ACIP).

General recommendations on pertussis prevention were issued August 8, 1991, in the ACIP statement on diphtheria, tetanus, and pertussis (1). A supplementary statement on the use of diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP) was issued February 7, 1992 (2) after the licensure of ACEL-IMUNE, prepared by Lederle Laboratories. With the recent licensure of a second DTaP product, Tripedia, this statement updates the supplement. Tripedia has a formulation that differs from that of ACEL-IMUNE. Both DTaP vaccines are licensed for use only as the fourth and/or fifth doses of diphtheria, tetanus, and pertussis vaccination; they are not licensed for the initial three-dose series for infants and children, regardless of age. Whole-cell DTP should continue to be used for the initial three-dose series and remains an acceptable alternative for the fourth and fifth doses. For details on the background, indications, use, and precautions and contraindications of DTaP, refer to the earlier supplementary statement (2).

Antibodies, Bacterial↗

PubMed2004

Reading and understanding employee benefit plan financial statements.

If your employee benefit plan has more than 100 participants, chances are you've had to work your way through the audited financial statements you're required to include with your Form 5500 filing. These statements contain a wealth of information about the financial health of your plan, and understanding them is an important fiduciary responsibility. To strengthen your grasp of financial statements, this article gives an overview that will make a plan's financial statements more informative, explains their basic structure and provides information on some of the more arcane aspects (such as actuarial tables). While this article focuses on Taft-Hartley (multiemployer) plans, much of it applies to other types of employee benefit plans.

Accounting↗