Long-term alliance for pathology equipment and technology acquisition: a paradigm shift for improved quality and efficiency.

Objective: Personnel costs are the largest single budget item in the clinical laboratory, other major expenses being equipment, analyzers, blood and blood components, and cost of day-to-day consumables. This report describes our experience with developing a long-term relationship with a single major vendor as a paradigm shift from the traditional multiple vendors, multiple contracts, and recurrent extended negotiations. Our objective was to develop a long-term approach for replacement of effete equipment and upgrades to operations in a pathology and laboratory medicine department in collaboration with vendors providing equipment and services.

Timing of Referrals to a Down Syndrome Parent Group by Race.

Unlabelled: The Down Syndrome Association of Central Ohio (DSACO) is a nonprofit organization that supports families, promotes community involvement, and encourages lifetime opportunities for people with Down syndrome.

Methods: At DSACO, ongoing efforts for quality improvement included: a Medical Advisory Committee in 2016, the creation of resources groups for Latino families in 2017, for Somali families from 2018 to 2019, and for African American families in fall 2018, presentations at birth hospitals, and close tracking of referrals from hospitals when an infant with Down syndrome is born. In addition, the timing of referrals, either "early" (on the day of birth or the first day after birth) or "late" (2 or more days after birth), were tracked and plotted in p charts.

Searching for the "Active Ingredients" in Physical Rehabilitation Programs Across Europe, Necessary to Improve Mobility in People With Multiple Sclerosis: A Multicenter Study.

Background: Physical rehabilitation programs can lead to improvements in mobility in people with multiple sclerosis (PwMS).

Objective: To identify which rehabilitation program elements are employed in real life and how they might affect mobility improvement in PwMS.

Methods: Participants were divided into improved and nonimproved mobility groups based on changes observed in the Multiple Sclerosis Walking Scale-12 following multimodal physical rehabilitation programs.

Rheological and sensory behaviors of parboiled pasta cooked using a microwave pasteurization process.

Unlabelled: Pasta hydration and cooking requirements make in-package microwave pasteurization of pasta a processing challenge. The objective of this study was to assess instrumental and sensory attributes of microwave-treated pasta in comparison to conventionally cooked pasta. Fettuccine pasta was parboiled for 0, 3, 6, 9, or 12 min, pasteurized by microwaves at 915 MHz, then stored under refrigeration for 1 week.

A School-Based Dental Program Evaluation: Comparison to the Massachusetts Statewide Survey.

Background: School-based dental programs target high-risk communities and reduce barriers to obtaining dental services by delivering care to students in their schools. We describe the evaluation of a school-based dental program operating in Chelsea, a city north of Boston, with a low-income and largely minority population, by comparing participants' oral health to a Massachusetts oral health assessment.

Methods: Standardized dental screenings were conducted for students in kindergarten, third, and sixth grades.

Effect of Antidepressant Switching vs Augmentation on Remission Among Patients With Major Depressive Disorder Unresponsive to Antidepressant Treatment: The VAST-D Randomized Clinical Trial.

Importance: Less than one-third of patients with major depressive disorder (MDD) achieve remission with their first antidepressant.

Objective: To determine the relative effectiveness and safety of 3 common alternate treatments for MDD.

Design, Setting, And Participants: From December 2012 to May 2015, 1522 patients at 35 US Veterans Health Administration medical centers who were diagnosed with nonpsychotic MDD, unresponsive to at least 1 antidepressant course meeting minimal standards for treatment dose and duration, participated in the study.

Estimating the cost of school sealant programs with minimal data.

Objective: Develop methodology to estimate the annual cost of resources used by school sealant programs (SSPs) and demonstrate its use.

Methods: We used existing literature and expert opinion to identify SSP cost components and the most appropriate units for their measurement (e.g.

Microwave Pasteurization of Cooked Pasta: Effect of Process Parameters on Texture and Quality for Heat-and-Eat and Ready-to-Eat Meals.

Pasta presents a challenge to microwave processing due to its unique cooking requirements. The objective of this study was to determine the effects of microwave processing on pasta physicochemical and mechanical properties. Fettuccine pasta was parboiled for selected times, then pasteurized using a Microwave Assisted Pasteurization System and stored under refrigeration for 1 wk.

Responsiveness and clinically meaningful improvement, according to disability level, of five walking measures after rehabilitation in multiple sclerosis: a European multicenter study.

Background: Evaluation of treatment effects on walking requires appropriate and responsive outcome measures.

Objectives: To determine responsiveness of 5 walking measures and provide reference values for clinically meaningful improvements, according to disability level, in persons with multiple sclerosis (pwMS).

Methods: Walking tests were measured pre- and postrehabilitation in 290 pwMS from 17 European centers.

Calculating averted caries attributable to school-based sealant programs with a minimal data set.

Objectives: We describe a methodology for school-based sealant programs (SBSP) to estimate averted cavities, (i.e., difference in cavities without and with SBSP) over 9 years using a minimal data set.

Quality of reporting in economic evaluations of interventions to prevent dental caries needs improvement.

Article Title And Bibliographic Information: Systematic review of publications on economic evaluations of caries prevention programs. Marino RJ, Khan AR, Morgan M. Caries Res 2013;47(4):265-72.

An analysis of the New York University Emergency Department Algorithm's suitability for use in gauging changes in ED usage patterns.

Background: The Emergency Department Algorithm (EDA) developed at New York University uses administrative discharge data to distill hundreds of International Classification of Diseases-9 codes for emergency department (ED) visits into 4 categories, making it attractive to researchers and policy makers. The EDA has been used to analyze patterns of ED visits in a wide variety of locations and populations. However, there are concerns regarding the validity and use of the EDA for research and policy.

Association of health information technology and teleintensivist coverage with decreased mortality and ventilator use in critically ill patients.

Background: Little evidence exists to support implementing various health information technologies, such as telemedicine, in intensive care units.

Methods: A coordinated health information technology bundle (HITB) was implemented along with remote intensivist coverage (RIC) at a 727-bed academic community hospital. Critical care specialists provided bedside coverage during the day and RIC at night to achieve intensivist coverage 24 hours per day, 7 days per week.

Exploring four-handed delivery and retention of resin-based sealants.

Background: To date, no trials have been published that examine whether four-handed delivery of dental sealants increases their retention and effectiveness. In the absence of comparative studies, the authors used available data to explore the likelihood that four-handed delivery increased sealant retention.

Methods: The authors examined data regarding the retention of autopolymerized resin-based sealants from studies included in systematic reviews of sealant effectiveness.

Perceived disability, fatigue, pain and measured isometric muscle strength in patients with post-polio symptoms.

Background And Purpose: Several years after the acute polio illness, patients may develop new post-polio symptoms. The purpose of the present study was to evaluate patients with post-polio symptoms with regard to perceived fatigue, functional ability, muscle strength, pain and with regard to measured physical fitness and isometric muscle strength. In addition, the relationship between the results of these subjective and objective measurements was investigated.

Impact of increasing Medicaid dental reimbursement and implementing school sealant programs on sealant prevalence.

Unlabelled: We examined the impact of two financing strategies--increasing Medicaid dental reimbursements and providing school sealant programs--on dental sealant? prevalence (number of children with at least one sealant) among 7- to 9-year-olds in Alabama and Mississippi counties from 1999 to 2003.

Methods: We used Medicaid claims data in a linear regression model. We regressed number of children sealed per county onto eligible children, median family income, dentist-to-population ratio, and indicator variables for reimbursement increase, presence of community health center (CHC) or school sealant program, and interaction between reimbursement increase and presence of school program or CHC.

Estimated impact of competing policy recommendations for age of first dental visit.

Objective: To compare levels of dental utilization and untreated dental decay among children aged 1 to 3 years that are likely to occur under 2 potential guidance policies: (1) pediatricians refer all toddlers to dentists for screening (consistent with American Academy of Pediatric Dentistry and the American Dental Association recommendations; DENT), and (2) pediatricians receive training in caries risk assessment, screen toddlers, and refer at-risk children to dentists (consistent with American Academy of Pediatrics recommendations; PED).

Methods: Using decision analysis, we estimated the impact of PED and DENT assuming alternately unlimited dental capacity for Medicaid-insured patients and fixed Medicaid dental capacity. Results With unlimited capacity, if DENT were implemented, then dental utilization is estimated to increase from 27% under the status quo to 65% and untreated decay to decrease from a mean of 0.

[Spasticity treated with selective posterior rhizotomy].

Background: Spasticity is often seen in patients with central nervous lesions. Some patients with severe spasticity are not optimally treated with physiotherapy and medication.

Material And Methods: We present a case history of a 41-year-old woman with multiple sclerosis and severe painful spasticity in her lower limbs.