High blood pressure control : information and education strategies for messages to public and patient audiences.

Cover title.

The Kress library of business and economics. Catalog, covering material published through 1776, with data upon cognate items in other Harvard libraries.

Arranged chronologically, with alphabetical index of authors and anonymous titles.

Wartime health and education : hearings before a subcommittee of the Committee on Education and Labor, United States Senate, Seventy-eighth Congress, first session, pursuant to S. Res. 74, a resolution authorizing an investigation of the educational and physical fitness of the civilian population as related to national defense.

Claude Pepper, chairman of subcommittee.

Applying ontologies to business and systems modelling techniques and perspectives: Lessons learned

For many years in the area of business systems analysis and design, practitioners and researchers alike have been searching for some comprehensive basis on which to evaluate, compare, and engineer techniques that are promoted for use in the modelling of systems' requirements. To date, while many frameworks, factors, and facets have been forthcoming, none appear to be based on a sound theory. In light of this dilemma, over the last 10 years, attention has been devoted by researchers to the use of ontology to provide some theoretical basis for the advancement of the business systems modelling discipline. This paper outlines how we have used a particular ontology for this purpose over the last five years. In particular we have learned that the understandability and the applicability of the selected ontology must be clear for IS professionals, the results of any ontological evaluation must be tempered by economic efficiency considerations of the stakeholders involved, and ontologies may have to be focused for the business purpose and type of user involved in the modelling situation.

Using a clinical pathway and education to reduce inappropriate prescribing of enoxaparin in patients with acute coronary syndromes: a controlled study

Aims: To evaluate efficacy of a pathway-based quality improvement intervention on appropriate prescribing of the low molecular weight heparin, enoxaparin, in patients with varying risk categories of acute coronary syndrome (ACS). Methods: Rates of enoxaparin use retrospectively evaluated before and after pathway implementation at an intervention hospital were compared to concurrent control patients at a control hospital; both were community hospitals in south-east Queensland. The study population was a group of randomly selected patients (n = 439) admitted to study hospitals with a discharge diagnosis of chest pain, angina, or myocardial infarction, and stratified into high, intermediate, low-risk ACS or non-cardiac chest pain: 146 intervention patients (September-November 2003), 147 historical controls (August-December 2001) at the intervention hospital; 146 concurrent controls (September-November 2003) at the control hospital. Interventions were active implementation of a user-modified clinical pathway coupled with an iterative education programme to medical staff versus passive distribution of a similar pathway without user modification or targeted education. Outcome measures were rates of appropriate enoxaparin use in high-risk ACS patients and rates of inappropriate use in intermediate and low-risk patients. Results: Appropriate use of enoxaparin in high-risk ACS patients was above 90% in all patient groups. Inappropriate use of enoxaparin was significantly reduced as a result of pathway use in intermediate risk (9% intervention patients vs 75% historical controls vs 45% concurrent controls) and low-risk patients (9% vs 62% vs 41%; P < 0.001 for all comparisons). Pathway use was associated with a 3.5-fold (95% CI: 1.3-9.1; P = 0.012) increase in appropriate use of enoxaparin across all patient groups. Conclusion: Active implementation of an acute chest pain pathway combined with continuous education reduced inappropriate use of enoxaparin in patients presenting with intermediate or low-risk ACS.