SEARCH · PubMed Health

Results for “Mail Distribution”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources

PubMedDate not supplied

Comparison of laboratory performance with blind and mail-distributed proficiency testing samples.

Simulated addict urine samples containing drugs were sent to collaborating hospital administrators and officials of methadone centers, who then forwarded the samples to their supporting laboratories as though they were ordinary specimens from patients. The laboratories, which were already participating in the proficiency testing program of the Center for Disease Control, received the identical test samples in the mail as part of a regular Center for Disease Control proficiency testing program. Most of the laboratories performed acceptably with the mail-distributed samples, but many performed poorly when the identical samples were sent to them as if they were specimens from patients. Because of the limitations of proficiency testing involving mail-distribution samples and the impracticality of extensive testing with blind samples on a national level, the Center for Disease Control proposes to compliment its regular proficiency testing program with a monitored, onsite program of performance evaluation.

Centers for Disease Control and Prevention, U.S.↗

PubMed2000

Response rate comparisons of e-mail- and mail-distributed student evaluations.

BACKGROUND: The proliferation of electronic information delivery systems has led to increasing use of e-mail as a rapid method of gathering information. Little research has been conducted on the use of e-mail for collecting curriculum evaluations. PURPOSE: To compare e-mailed and mailed educational evaluations for 4th-year medical students. METHODS: Curriculum evaluations were sent to 4th-year medical students who were randomly assigned to receive the survey either by mail or e-mail. RESULTS: Mailed evaluations yielded a higher return rate, fewer number of students omitting items, and shorter responses to an open-ended question than evaluations completed via e-mail. CONCLUSIONS: Although the findings have limited generalizability because of low response rates and small sample sizes, the results suggest caution when using e-mail to collect curriculum evaluations from 4th-year medical students.

Clinical Clerkship↗

PubMed1993

Proficiency test performance as a predictor of accuracy of routine patient testing for theophylline.

Proficiency testing (PT) is pivotal in assessing laboratory qualifications for certification and licensure. PT is expected to typify routine assay performance and determine whether the laboratory is producing clinically useful test results. Conventional schemes use mail-distributed test specimens and are often criticized as measuring the best possible laboratory performance, principally because of special practices associated with processing PT specimens. We used on-site proficiency tests and split samples to evaluate the ability of conventional PT schemes to accurately characterize routine laboratory performance. Using 412 assays of theophylline, performed routinely by 200 laboratories and subsequently in a reference laboratory, we found that the predictive value of PT performance in assessing quality of routine testing was high (100% for predicting substandard reliability of routine patient testing and 94% for excluding substandard reliability of patient testing). The imprecision of interlaboratory PT results was equivalent whether testing was observed (hand-carried specimens) or unobserved (mail-distributed specimens). Many methods used for determining theophylline concentration in serum were highly automated, closed, and precise analytical systems. The performance characteristics of these analytical systems are not easily manipulated by the analyst for purposes of improving PT outcome, and PT by use of mail-distributed test specimens is effective for assessing intralaboratory performance.

Chemistry, Clinical↗

PubMed2004

Office preparedness for pediatric emergencies: baseline preparedness and the impact of guideline distribution.

OBJECTIVE: To determine the baseline level of preparedness of Wisconsin primary care physician offices for pediatric emergencies and to assess the impact of mail distribution of guidelines on this level of preparedness. METHOD: Preintervention surveys were mailed to all Wisconsin physicians requesting information about pediatric equipment, medications, training, and policies. Guidelines were distributed by mail to all physicians who returned completed surveys. An identical postintervention survey was mailed to these physicians, and an analysis of the paired surveys for each respondent was performed. RESULTS: Baseline preparedness of 1051 Wisconsin physician offices ranged from 37% with intraosseous needles to 96% with albuterol solution for inhalation. Physician certification in pediatric advanced life support was required in 26% of offices. A total of 568 paired preintervention and postintervention surveys were analyzed. Improvements were identified for the availability of equipment and medications, transport policies, and reference guides. CONCLUSIONS: Mail distribution of guidelines was minimally effective in improving the preparedness of Wisconsin offices for pediatric emergencies.

Data Collection↗

PubMed2004

Population-based stepwise screening for unrecognised Type 2 diabetes is ineffective in general practice despite reliable algorithms.

AIMS/HYPOTHESIS: The yield of screening programmes for Type 2 diabetes in the existing healthcare setting might be lower than anticipated from tests of screening algorithms in data from epidemiological surveys. Our aims were to evaluate the reliability of the algorithms and the effectiveness of a proposed stepwise screening programme for Type 2 diabetes in general practice. METHODS: The screening programme had four steps: (i) mail-distributed self-administered risk-chart; (ii) screening tests: random blood glucose (RBG) and HbA(1)c; (iii) diagnostic procedure 1 for fasting blood glucose (FBG) (if RBG >/=5.5 mmol/l or HbA(1)c >/=6.1%); and (iv) OGTT as diagnostic procedure 2 (if 5.6</=FBG<6.1 mmol/l or HbA(1)c >/=6.1%). Abnormalities of glucose metabolism were classified according to the WHO 1999 criteria, based on capillary whole blood. The subjects were all patients between 40 and 69 years of age ( n=60,926) who were registered in 88 general practices and had not been previously diagnosed with diabetes. RESULTS: A total of 11,263 individuals had a high-risk risk-score and attended the screening consultation (step 1 test-positive). Of these, 30.1% needed diagnostic tests (step 2 test-positive) and 27.2% of these needed an OGTT (step 3 test-positive). The test-positive proportions were equal to the proportions obtained in data from a population-based survey from Step 2 onwards, and the algorithms were thus reliable. The identification rate was only 19% of all prevalent undiagnosed diabetes according to a recently published prevalence estimate. This was due to a large dropout rate among high-risk individuals prior to entry into the programme. CONCLUSIONS/INTERPRETATION: Population-based mail-distributed stepwise screening for Type 2 diabetes in general practice is ineffective, despite reliable screening algorithms, primarily because many high-risk individuals fail to participate.

Adult↗

PubMed1989

[Possibility of using WHO questionnaires, distributed by mail, for detecting stenocardia during mass screening].

In the non-organized population of males and females aged 30 to 50 years who live on the territory served by a Tbilisi district polyclinic, the authors have examined the possibilities of applying the WHO questionnaire sent by mail to the detection of angina pectoris, to the establishment of prevalence of arterial hypertension and smoking and the people's awareness of the presence of coronary heart disease. It has been shown that the questionnaire may assist the physician in detecting patients with exercise-associated angina, establishing the priorities of inviting patients for screening to the polyclinic, forming a follow-up group. The high prevalence of arterial hypertension was found among males (24.2%) and females (31.2%). The low awareness of patients with angina on having coronary heart disease was also ascertained, which was being 30.7%.

Adult↗

PubMed1989

Effective staff communications in a large I.C.U.

A byproduct of the Quality Assurance process is the continual review of individual and group practice. The aim is to eliminate errors and to improve care. For managers and directors to know what issues are currently important to the staff members an upward channel of communication is also needed. In our SICU with over 120 staff there was no documentation of communication in either direction. Casual survey did not reveal a major problem - but the need to document the dissemination of information, particularly new policies - especially to satisfy accrediting agencies - led us to develop MEMOS, an electronic mail system for staff members within the local area network (LAN) in the SICU. The system will run on an individual PC. The network is used because of the physical configuration of the intensive care units. The system is used by nurse managers to keep staff members up to date. Features include: Easy file maintenance. Individual password access. A defined group of system operators with access to all system functions Limited access to all other users. As many as 40 definable sub-groups for the purposes of mail distribution. Easy operator tallying of those delinquent in reading their mail. Hard copy with distribution list for all memos added to system. Browse feature to allow re-reading of old memos. Feedback channel regularly read by system operators. This system has improved the level of staff awareness in the SICU and helped build morale.

Computer Systems↗

PubMed2004

Bacillus anthracis contamination and inhalational anthrax in a mail processing and distribution center.

AIMS: Four inhalational anthrax cases occurred in a large mail processing and distribution center in Washington, DC, after envelopes containing Bacillus anthracis spores were processed. This report describes the results of sampling for B. anthracis spores during investigations conducted in October and December 2001. METHODS AND RESULTS: Wet swabs, wet wipes, vacuum sock, and air-filter samples were collected throughout the facility to characterize the extent of building contamination. The results showed widespread contamination of B. anthracis spores, particularly associated with one delivery bar code sorter (DBCS) machine that had sorted the spore-containing envelopes and an area where the envelopes were handled by postal workers. Spore concentrations decreased as distance from the DBCS machine increased, but spores were widely dispersed into surrounding areas. CONCLUSION: The spatial distribution of culture positive samples was closely related to the work areas of the inhalational anthrax cases and supported epidemiological evidence that the workers became ill from exposure to B. anthracis spores in areas where the contaminated envelopes had travelled. SIGNIFICANCE AND IMPACT OF THE STUDY: The results of this investigation were used to guide decontamination efforts and provided baseline spore concentrations for follow-up measurements after the building had been cleaned. Implementing methods to reduce aerosolization and dispersion of dust within the facility would reduce postal workers' potential exposures to bioterrorism agents.

Air Pollution, Indoor↗

PubMedDate not supplied

[Use of internet and electronic resources among Spanish intensivist physicians. First national survey].

OBJECTIVE: Estimate knowledge and use habits of different electronic resources in a sample of Spanish intensivists: Internet, E-mail, distribution lists, and use of portable electronic devices. DESIGN: Self-applied questionnaire. METHODS: A 50-question questionnaire was distributed among Spanish intensivists through the hospital marketing delegates of a pharmaceutical company and of electronic forums. RESULTS: A total of 682 questionnaires were analyzed (participation: 74%). Ninety six percent of those surveyed used Internet individually: 67% admitted training gap. Internet was the second source of clinical consultations most used (61%), slightly behind consultation to colleagues (65%). The pages consulted most were bibliographic databases (65%) and electronic professional journals (63%), with limited use of Evidence Based Medicine pages (19%). Ninety percent of those surveyed used e-mail regularly in the practice of their profession, although 25% admitted that were not aware of its possibilities. The use of E-mail decreased significantly with increase in age. A total of 62% of the intensivists used distribution lists. Of the rest, 42% were not aware of its existence and 32% admitted they had insufficient training to handle them. Twenty percent of those surveyed had portable electronic devices and 64% considered it useful, basically due to its rapid consultation at bedside. Female gender was a negative predictive factor of its use (OR 0.35; 95% CI 0.2-0.63; p=0.0002). CONCLUSIONS: A large majority of the Spanish intensivists use Internet and E-mail. E-mail lists and use of portable devices are still underused resources. There are important gaps in training and infrequent use of essential pages. There are specific groups that require directed educational policies.

Adult↗

PubMed2005

Pediatric Gastroenterology Workforce Survey, 2003-2004.

BACKGROUND: The North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) performed a workforce survey to determine the number, distribution, and work-related activities of pediatric gastroenterologists in the United States of America (USA) and Canada, and compared these findings with the first workforce survey completed in 1996. METHODS: The survey queried pediatric gastroenterologists in the USA and Canada between November, 2003 and June 2004. To permit the optimal comparison to the 1996 survey data, the original survey was used as a template for development of the current instrument and, when possible, the questions were left unchanged. Additional questions were added to address important contemporary issues not present in the initial survey. Limited income information was also collected. The survey was posted on the NASPGHAN website, and the NASPGHAN membership was notified of the survey by electronic mail via its electronic mail distribution list. This was followed by a three-part postal mail survey to all non-respondents. After the Internet and postal mail requests, all non-respondent physicians were telephoned a minimum of three times. If unsuccessful in contacting the physicians directly, office personnel were queried to facilitate survey completion regarding the provision of pediatric gastroenterology, nutrition or hepatology services in either clinical care or research. RESULTS: The response rate based on the potential contact list for Part I of the survey was 69%. The final phone call or electronic mail contact of an office staff member with questions regarding gender and delivery of pediatric gastroenterology services yielded a total contact rate of 88%. There were 699 pediatric gastroenterologists identified in North America, as compared with 672 in 1996. If known non-respondents are included, there could be as many as 794 pediatric gastroenterologists. Time spent in clinical activities increased from 60% to 66% in the USA and from 43% to 53% in Canada. The use of nurse practitioners and physician assistants has increased considerably over the past 7 years. Fifty-three percent of respondents feel there are too few pediatric gastroenterologists. Fifty percent of section and practice heads report that they are currently recruiting partners. Limited income information is presented. CONCLUSIONS: There is currently a self-perceived shortage of pediatric gastroenterologists as compared with 7 years ago, despite a constant proportion of pediatric gastroenterologists per million children. In the USA, nurse practitioners and physician assistants are being increasingly used to fill this need, and physicians in both Canada and the USA have increased the time they spend in clinical care.

Adult↗

PubMedDate not supplied

The effect of a self-care minimal intervention for colds and flu on the use of medical services.

OBJECTIVE: To determine the impact of mailed distribution of a brief self-care pamphlet on upper respiratory infection (URI)-related-medical care utilization. DESIGN: Randomized controlled clinical trial with randomization by physician panel. SETTING: Health maintenance organization. PATIENTS: 20,127 patients assigned to the panels of 22 primary care physicians randomly divided into an experimental group (n = 12,353) and a control group (n = 7,774), each consisting of 11 physician panels. INTERVENTION: A mailed four-page self-care pamphlet for URI care. MEASUREMENTS AND MAIN RESULTS: The medical records and survey data of a random sample of 790 persons were studied during a baseline period and an intervention period. URI visit rates decreased 14% more in the experimental group versus the control group (p = 0.878). Appropriateness of URI visits during the intervention period in the experimental group (80%) was comparable to that in the control group (76%). URI drug prescriptions during the intervention period for all 20,127 patients showed no significant difference. CONCLUSIONS: A simple mailed self-care pamphlet has little effect on medical care utilization for URI care.

Adult↗

PubMedDate not supplied

[The Socisin Mailing List: assessment at 12 months].

BACKGROUND: This Mailing List (ML) is an automatic e-mail distribution system on a specific topic. The medical world uses MLs to keep specialists in touch, however far apart they may be. The Socisin ML, circulated for discussion among members of the Italian Society of Nephrology (SIN), was one year old on 30th September 2001. This paper reports on its first 12 months in use. METHODS: We analysed all data on the number of messages received, accepted and rejected, their characteristics and authors, as well as the numbers subscribing and unsubscribing to the list. RESULTS: The number of messages were 391, 171 (43.7%) of them related to genuine scientific discussion. The proportional weight of the topics discussed was: peritoneal dialysis 51% (n=88), hemodialysis 40% (n=68), nephropathology 8% (n=13), transplantation 1% (n=2). Twenty-five congresses, symposiums and meetings were presented and one research trial was implemented after its presentation to the members. Compared with the Nephrology international ML, the number of messages were 13.5% (391/2907). Membership increased from 336 to 443 (+32%). There were 124 new subscribers and 17 unsubscribers (+107). During this first year, 146 nephrologists sent at least one message to the ML. DISCUSSION: Our objective is to extend the number of participants, make the discussion increasingly scientific, and cover all aspects of nephrology. The Socisin ML will certainly become very valuable to Italian nephrologists provided it continues to grow and keeps to the rules pertinent to such tools and the spirit of a "common" project.

Electronic Mail↗

PubMed2000

The intersection of race, gender, and primary care: results from the Women Physicians' Health Study.

The Women Physicians' Health Study is a nationally distributed mailed questionnaire survey of a random sample of 4501 female physicians. We examined differences in the professional characteristics and personal health habits of minority women physicians compared to other women physicians, with regard to the choice of primary care specialties, type or location of practice site, and career satisfaction. Most women physicians were self-described as non-Hispanic white (77.4%), with 13% Asians, and few blacks (4.3%) or Hispanics (5.2%). Blacks and Hispanics were more likely to choose primary care specialties (61.6% and 57.9%, respectively, vs. 49.3% of whites, p < 0.05). Black and Hispanic physicians were most likely to practice in urban areas (71.8% and 72.2%, respectively, p < 0.001). Minority physicians were most likely to report spending some time each week on clinical work for which they did not expect compensation. Black physicians were least likely to report high levels of work control and were least likely to be satisfied with their careers. While most physicians were compliant with the examined recommendations of the U.S. Preventive Services Task Force, we did find significant differences by ethnicity in compliance with clinical breast exams, mammograms, and pap smears. In conclusion, there continues to be fewer blacks and Hispanics in the U.S. physician workforce than in the general population. Minority women physicians are more likely to provide primary care services in communities that have been traditionally underserved and may also report higher rates of career dissatisfaction.

Adult↗

PubMed1977

A retrospective study of recurrent herpes labialis (RHL) in a professional population, 1958-1971.

A retrospective 12-year investigation of 1,788 professional school students from the schools of medicine, veterinary medicine, dental medicine, nursing, and dental hygiene was conducted by the mailed distribution of questionnaires requesting information on current and prior disease history of recurrent herpes labialis (RHL). Because of changes in address, death, loss of married names, and unwillingness to participate in the investigation, only 683 proband subjects were available for the follow-up study. The data suggested a trend toward a decrease in the prevalence and severity of RHL during the interval of study: only slightly more than one firth (23.9 per cent) of the proband population of the present study experienced RHL as compared with almost two fifths (39.6 per cent) at the time when they were students.

Adult↗

PubMed2004

Improving anesthesiologist performance through profiling and incentives.

STUDY OBJECTIVE: To determine the influence of profiling and incentives on anesthesiologist behavior in relation to several key indicators of performance. DESIGN: Prospective collection and analysis of operational data before and after implementation of a physician profiling, reporting, and incentive program. SETTING: University hospital. MEASUREMENTS: An intervention consisting of two components was studied with the intent of stimulating a high level of performance in relation to a peer group. The first component, a monthly report of physician performance via an individualized performance report, was provided to each physician for each of 6 months. The second component consisted of a financial incentive. For each month in the study, physicians were eligible to receive a variable financial incentive of between $0 and $500 per month depending on individual performance based scoring in relation to each other. Physician performance was tracked in five areas: 1) percentage of first cases of the day in the room at or before the scheduled in-room time, 2) percentage of cases with an anesthesia prep time less than a target, 3) percentage of cases delayed due to waiting for an anesthesiology patient evaluation, 4) percentage of cases delayed during the anesthesiology controlled time, and, 5) percentage of cases delayed due to waiting for the anesthesiology attending. Results were reported to each physician on a monthly basis, by e-mail distribution, of an individualized perioperative efficiency summary report. A monthly financial incentive was awarded to the top performing physicians in the form of a credit to the physician's personal CME/expense account. Also, all physicians received a rank order list of their performance on each indicator at the end of each month. MAIN RESULTS: 31 anesthesiologists, comprising the multispecialty division, and covering all services with the exception of obstetrics, pediatrics, and cardiothoracic anesthesia were tracked for 6 months. Compared to the first month, the percent of first cases of the day in the room at or before the scheduled start time and the percent of cases with an anesthesiology prep time less than target increased significantly (19 +/- 4.6%, vs. 61 +/- 6.5%, 95% CI, p <0.001; and 57 +/- 5.3%, vs. 73 +/- 5.1%, 95% CI, p <0 .001) during the sixth month. The mean number of cases per physician with a delay during anesthesiology controlled time decreased (14.9 +/- 2.9 vs. 3.3 +/- 1, p <0.001), no change occurred in the number of cases with a delay due to waiting for an anesthesiology patient evaluation or number of cases delayed due to waiting for the anesthesiology attending in the sixth month compared with the first month. CONCLUSION: Tracking and rewarding physician performance with monthly profiling and a financial incentive given to the best in a peer group improves anesthesiologist performance in several key areas.

Anesthesiology↗

PubMed2002

Audiometric findings in workers exposed to low levels of styrene and noise.

Audiometry and exposure measurements were conducted on workers from fiberglass and metal products manufacturing plants and a mail distribution terminal (N = 313). Workers exposed to noise and styrene had significantly worse pure-tone thresholds at 2, 3, 4, and 6 kHz when compared with noise-exposed or nonexposed workers. Age, noise exposure, and urinary mandelic acid (a biologic marker for styrene) were the variables that met the significance level criterion in the multiple logistic regression. The odds ratios for hearing loss were 1.19 for each increment of 1 year of age (95% confidence interval [CI], 1.11-1.28), 1.18 for every decibel >85 dB(A) of noise exposure (95% CI, 1.01-1.34), and 2.44 for each millimole of mandelic acid per gram of creatinine in urine (95% CI, 1.01-5.89). Our findings suggest that exposure to styrene even below recommended values had a toxic effect on the auditory system.

Adult↗

PubMed2003

Benefits of an Outpatient Psychiatric TeleConsultation Unit: Results of a 1-Year Pilot.

BACKGROUND: A Psychiatric TeleConsultation Unit (PTCU) was created at the Massachusetts General Hospital (MGH) in response to critical changes in the health care delivery system. The PTCU's design was based on an understanding of the needs of primary care physicians (PCPs) at MGH, as derived from PCPs' responses to a survey and at focus groups. The PTCU was designed to supply psychiatric expertise to PCPs on a "1 phone call away" basis and to assist the MGH in supporting an increasingly large network of PCPs by expanding access to the MGH's psychiatric staff and services. METHOD: Open Monday through Friday, 9 a.m. to 5 p.m., the PTCU provided PCPs with immediate telephone access to a staff psychiatrist who answered diagnostic- and treatment-related questions, often while the patient was still in the PCP's office. If a referral for mental health services was required, the PTCU facilitated this using an electronic mail (e-mail)-based referral system. Data were gathered from April 1996 to April 1997. RESULTS: During its first year of operation, the PTCU served 107 PCPs and their 46,377 patients; its projected capacity was 470,000 patients. It provided 595 teleconsultations; half were primarily directed toward making a referral, one fourth were primarily directed toward diagnosis or treatment, and one fourth were for both referral- and diagnosis- or treatment-related reasons. 361 patients were referred via e-mail distribution lists to a network of 92 clinicians. In 72 teleconsultations (12%), referral for mental health services was prevented. The estimated savings from these prevented services far exceeded the PTCU's costs of providing all 595 teleconsultations. Projected yearly savings for the PTCU at full capacity were projected at $379,080, from prevented referrals for mental health services. Follow-up semistructured interviews of the first 81 PCP callers revealed that 71% were "extremely satisfied," 18% were "very satisfied," and only 2% were "not at all satisfied" with the PTCU. PCPs reported that the PTCU saved them time in 85% of teleconsultations. Teleconsultations related to diagnosis or treatment changed the PCP's diagnosis 20% of the time and changed the PCP's treatment plan in nearly two thirds of cases. Twenty percent of the teleconsultations were done while the patient was in the PCP's office. Ninety-four percent of the PCPs enthusiastically said they would use the PTCU again. CONCLUSION: Our PTCU increased the efficiency and efficacy of care provided by PCPs. Cost savings associated with a reduced frequency of unnecessary referrals were more than the costs of the PTCU in a capitated health care system.

Journal Article↗

PubMedDate not supplied

Images of children appeal to seniors. Stratis Health lures mature market for blood tests.

The Sandcastle Group appeals to the senior market by using adorable pixie photographs of children through poster and direct mail distribution. To emphasize the critical nature of blood testing, and to help clinics to communicate more effectively with patients, the ad agency created a series of self-mailers featuring conversations initiated by youngsters who have diabetes.

Aged↗