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Do you dream of using a document image management system at your facility? This article balances the reasons why healthcare facilities are slow to invest in such technology against the benefits offered by electronic document image management systems. The author also provides a list of vendors.
J Am Med Rec Assoc 1990 Dec
PMID:Document image management systems: promise versus reality. 1010 86

The Pennsylvania Trauma Systems Foundation has existed for five years. A concept that in 1984 seemed like a futuristic dream has been accomplished. Standards for trauma center accreditation have been developed, and trauma centers are accredited in a fair, unbiased, and systematic manner. Pennsylvania's voluntary system could not have succeeded without the full support of the hospital, medical, and nursing communities. Trauma centers are not edifices alone; the commitment of the institutions and their personnel was phenomenal. Pennsylvania has the largest and most comprehensive trauma registry in terms of complete data compliance in the United States. Data collected have been used for quality assurance, the accreditation process, and trauma prevention and research. The commitment by medical record professionals to develop and maintain individual hospital trauma registries as well as the PTSF trauma registry has been enormous. The future of trauma system development in Pennsylvania lies in the data collection system and the research in trauma systems and trauma care that is generated from the database.
Top Health Rec Manage 1990 Dec
PMID:Anatomy of a statewide trauma registry. 1010 96

The transactions between physicians and medical record practitioners have rarely been stress-free, and the advent of the prospective payment system (PPS) has put additional pressure on both groups. However, a smooth working relationship is not an impossible dream. This article offers advice on how to find common ground with the majority of physicians and a few suggestions on way to relate more effectively to those few who cause persistent problems.
J Am Med Rec Assoc 1986 Aug
PMID:Physicians and medical record practitioners--maximizing cooperation, minimizing conflict. 1027 56

Kv4 pore-forming subunits are the principal constituents of the voltage-gated K+ channel underlying somatodendritic subthreshold A-type currents (I(SA)) in neurones. Two structurally distinct types of Kv4 channel modulators, Kv channel-interacting proteins (KChIPs) and dipeptidyl-peptidase-like proteins (DPLs: DPP6 or DPPX, DPP10 or DPPY), enhance surface expression and modify functional properties. Since KChIP and DPL distributions overlap in the brain, we investigated the potential coassembly of Kv4.2, KChIP3 and DPL proteins, and the contribution of DPLs to ternary complex properties. Immunoprecipitation results show that KChIP3 and DPP10 associate simultaneously with Kv4.2 proteins in rat brain as well as heterologously expressing Xenopus oocytes, indicating Kv4.2 + KChIP3 + DPP10 multiprotein complexes. Consistent with ternary complex formation, coexpression of Kv4.2, KChIP3 and DPP10 in oocytes and CHO cells results in current waveforms distinct from the arithmetic sum of Kv4.2 + KChIP3 and Kv4.2 + DPP10 currents. Furthermore, the Kv4.2 + KChIP3 + DPP10 channels recover from inactivation very rapidly (tau(rec) approximately 18-26 ms), closely matching that of native I(SA) and significantly faster than the recovery of Kv4.2 + KChIP3 or Kv4.2 + DPP10 channels. For comparison, identical triple coexpression experiments were performed using DPP6 variants. While most results are similar, the Kv4.2 + KChIP3 + DPP6 channels exhibit inactivation that slows with increasing membrane potential, resulting in inactivation slower than that of Kv4.2 + KChIP3 + DPP10 channels at positive voltages. In conclusion, the native neuronal subthreshold A-type channel is probably a macromolecular complex formed from Kv4 and a combination of both KChIP and DPL proteins, with the precise composition of channel alpha and auxiliary subunits underlying tissue and regional variability in I(SA) properties.
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PMID:Multiprotein assembly of Kv4.2, KChIP3 and DPP10 produces ternary channel complexes with ISA-like properties. 1612 12

In 1965, the psychoanalyst and social scientist Elliott Jaques introduced a term, the 'midlife crisis', that continues to structure Western understandings and experiences of middle age. Following Jaques's work, the midlife crisis became a popular means of describing how-and why-men and women around the age of 40 became disillusioned with work, disenchanted with relationships and detached from family responsibilities. Post-war sociological and psychological studies of middle age regarded the midlife crisis as a manifestation of either biological or psychological change, as a moment in the life course when-perhaps for the first time-people felt themselves to be declining towards death. Although the midlife crisis has often been dismissed as a myth or satirized in novels and films, the concept has persisted not only in stereotypical depictions of rebellion and infidelity at midlife, but also in research that has sought to explain the particular social, physical and emotional challenges of middle age. In the spirit of the pioneering research of John Wilkins, John Bernal and Peter Medawar, each of whom in different ways emphasized the complex interrelations between science and society, I want to argue that the emergence of the midlife crisis-as concept and experience-during the middle decades of the twentieth century was not coincidental. Rather it was the product of historically specific demographic changes and political aspirations-at least in the Western world-to keep alive the American dream of economic progress and material prosperity.
Notes Rec R Soc Lond 2020 Sep 20
PMID:2019 Wilkins-Bernal-Medawar lectureLife begins at 40: the demographic and cultural roots of the midlife crisis. 3283 9