Integrated Online Media Management Systems For Media Centers: A Model For Selection And Effective Use

The researcher proposed to advice in the selection of an Integrated Online Library System (IOLS) for use in the 103 school media centers in the Palm Beach County Schools, Florida. This was accomplished by evaluating the two finalists of those vendors who answered the district\u27s Request for Proposal (RFP). Of the five vendors who responded to the RFP. CLSI and SIRSI were selected as the systems most likely to meet the needs of the media centers of the school district. An overview and definition of IOLS was first discussed. This overview then related itself to the needs of the school district as presented in the RFP. A selection criteria was then designed from previous research on the subject to help find the ideal system. The history and development of an Integrated Online Library System was important in seeing where the systems have originated in contrast to the systems in the Eighties to the also revealed the present time. Literature IOLS principles of operation. The Request for Proposal reflected the needs assessment discussed over several years of committee meetings of representatives from various schools. The committees explored IOLS automated options and compared these options. The RFP outlined the system requirements. Thoughts on staff attitudes while planning for a system were also considered. Each system was evaluated with the criteria outlined in the RFP. The background and capabilities of both systems were explored. This exploration took place where by the benchmark tests, on-site demonstrations systems were in use daily, conferences with the vendors, systems. And reading literature reviews on both systems. Evaluation guidelines and criteria were found in library resources. The functions required for terminal access requirements, process for data conversion, vendor background and reliability, contained in these library resources. And the cost were contained in these library resources. The results of this study culminated in the official recommendation of the SIRSI to be purchased by the district\u27s school board. It was the expectation of the author of this document to see the purchase of the recommended system by the school board and have it implemented in all the schools in the district within a three year period following the submission of the recommendation

Mind the Gap: Why Closing the Doughnut Hole Is Insufficient for Increasing Medicare Beneficiary Access to Oral Chemotherapy

Orally administered anticancer medications are among the fastest growing components of cancer care. These medications are expensive, and cost-sharing requirements for patients can be a barrier to their use. For Medicare beneficiaries, the Affordable Care Act will close the Part D coverage gap (doughnut hole), which will reduce cost sharing from 100% in 2010 to 25% in 2020 for drug spending above $2,960 until the beneficiary reaches$4,700 in out-of-pocket spending. How much these changes will reduce out-of-pocket costs is unclear

The Influence of Medicare Home Health Payment Incentives: Does Payer Source Matter?

During the late 1990s, an interim payment system (IPS) was instituted to constrain Medicare home health care expenditures. Previous research has largely focused on the implications of the IPS for Medicare patients, but our study broadens the analysis to consider patients with other payer sources. Using the National Home and Hospice Care Survey, we found similar effects of the IPS across payer types. Specifically, the IPS was associated with a decrease in access to care for the sickest patients, less agency assistance with activities of daily living, and shorter length-of-use. However, these changes did not translate into worse discharge outcomes.Medicare, health, incentives

Factors Associated With Tyrosine Kinase Inhibitor Initiation and Adherence Among Medicare Beneficiaries With Chronic Myeloid Leukemia

There is substantial concern surrounding affordability of orally administered anticancer therapies, particularly for Medicare beneficiaries. We examined rates of initiation and adherence to tyrosine kinase inhibitors (TKIs) among Medicare beneficiaries with chronic myeloid leukemia (CML) with and without cost-sharing subsidies. We selected TKIs given their effectiveness and strong indication for use among patients diagnosed with CML

Prostate Cancer Survivorship: Prevention and Treatment of the Adverse Effects of Androgen Deprivation Therapy

BACKGROUND: More than one-third of the estimated 2 million prostate cancer survivors in the United States receive androgen deprivation therapy (ADT). This population of mostly older men is medically vulnerable to a variety of treatment-associated adverse effects. MEASUREMENTS AND RESULTS: Androgen-deprivation therapy (ADT) causes loss of libido, vasomotor flushing, anemia, and fatigue. More recently, ADT has been shown to accelerate bone loss, increase fat mass, increase cholesterol and triglycerides, and decrease insulin sensitivity. Consistent with these adverse metabolic effects, ADT has also recently been associated with greater risks for fractures, diabetes and cardiovascular disease.CONCLUSION: Primary care clinicians and patients should be aware of the potential benefits and harms of ADT. Screening and intervention to prevent treatment-related morbidity should be incorporated into the routine care of prostate cancer survivors. Evidence-based guidelines to prevent fractures, diabetes, and cardiovascular disease in prostate cancer survivors represent an important unmet need. We recommend the adapted use of established practice guidelines designed for the general population

Prostate Cancer Survivorship: Prevention and Treatment of the Adverse Effects of Androgen Deprivation Therapy

BACKGROUND: More than one-third of the estimated 2 million prostate cancer survivors in the United States receive androgen deprivation therapy (ADT). This population of mostly older men is medically vulnerable to a variety of treatment-associated adverse effects. MEASUREMENTS AND RESULTS: Androgen-deprivation therapy (ADT) causes loss of libido, vasomotor flushing, anemia, and fatigue. More recently, ADT has been shown to accelerate bone loss, increase fat mass, increase cholesterol and triglycerides, and decrease insulin sensitivity. Consistent with these adverse metabolic effects, ADT has also recently been associated with greater risks for fractures, diabetes and cardiovascular disease. CONCLUSION: Primary care clinicians and patients should be aware of the potential benefits and harms of ADT. Screening and intervention to prevent treatment-related morbidity should be incorporated into the routine care of prostate cancer survivors. Evidence-based guidelines to prevent fractures, diabetes, and cardiovascular disease in prostate cancer survivors represent an important unmet need. We recommend the adapted use of established practice guidelines designed for the general population

Early Impact of the Affordable Care Act on Uptake of Long-acting Reversible Contraceptive Methods

The Affordable Care Act (ACA) required most private insurance plans to cover contraceptive services without patient cost-sharing as of January 2013 for most plans. Whether the ACA’s mandate has impacted long-acting reversible contraceptives (LARC) use is unknown

Uncertainty in Lung Cancer Stage for Outcome Estimation via Set-Valued Classification

Difficulty in identifying cancer stage in health care claims data has limited oncology quality of care and health outcomes research. We fit prediction algorithms for classifying lung cancer stage into three classes (stages I/II, stage III, and stage IV) using claims data, and then demonstrate a method for incorporating the classification uncertainty in outcomes estimation. Leveraging set-valued classification and split conformal inference, we show how a fixed algorithm developed in one cohort of data may be deployed in another, while rigorously accounting for uncertainty from the initial classification step. We demonstrate this process using SEER cancer registry data linked with Medicare claims data.Comment: Code available at: https://github.com/sl-bergquist/cancer_classificatio

The Association between Fatalistic Beliefs and Late Stage at Diagnosis of Lung and Colorectal Cancer.

BACKGROUND: Fatalistic beliefs may be implicated in longer help-seeking intervals, and consequently, greater risk of advanced stage at cancer diagnosis. METHODS: We examined associations between fatalism and stage at diagnosis in a population-based cohort of 4,319 U.S. patients with newly diagnosed lung or colorectal cancer participating in the Cancer Care Outcomes and Research Surveillance (CanCORS) study. Fatalistic beliefs were assessed with an established measure. A fatalism score (range, 4-16) was created by summing Likert scale responses to four items. Cancer stage at diagnosis was abstracted from medical records by trained staff. Logistic regression was used to assess the association between fatalism score and advanced stage at diagnosis (IV vs. I-III), adjusting for sociodemographic and clinical characteristics. RESULTS: Overall, 917 (21%) patients had stage IV cancers (lung: 28%, colorectal: 16%). The mean fatalism score was 10.7 (median = 11; interquartile range, 9-12). In adjusted analyses, a higher fatalism score was associated with greater odds of stage IV diagnosis (OR per unit increase in fatalism = 1.05; 95% confidence interval 1.02-1.08; P = 0.003). Patients with the highest fatalism score had an adjusted 8.9% higher frequency of stage IV diagnosis compared with patients with the lowest score (25.4% vs. 16.5%). DISCUSSION: In this large and socioeconomically, geographically, and ethnically diverse population of patients with lung and colorectal cancer, fatalistic beliefs were associated with higher risk of advanced stage at diagnosis. Longitudinal studies are needed to confirm causation. IMPACT: These findings support the value of incorporating information about the curability of early-stage cancers in public education campaigns.This work of the Cancer Care Outcomes Research and Surveillance (CanCORS) Consortium was supported by grants from the National Cancer Institute (NCI) to the Statistical Coordinating Center (U01 CA093344) and the NCI-supported Primary Data Collection and Research Centers (Dana Farber Cancer Institute/Cancer Research Network U01 CA093332, Harvard Medical School/Northern California Cancer Center U01 CA093324, RAND/UCLA U01 CA093348, University of Alabama at Birmingham U01 CA093329, University of Iowa U01 CA093339, University of North Carolina U01 CA093326) and by a Department of Veteran’s Affairs grant to the Durham VA Medical Center CRS 02-164. Dr. Keating’s effort was also supported by 1R01CA164021-01A1 and K24CA18151 from the NCI. Professor Wardle’s contribution is supported by Cancer Research UK Programme grant C1418/A14134. Dr. Lyratzopoulos is supported by a Post-Doctoral Fellowship award by the (UK’s) National Institute for Health Research (PDF-2011-04-047) 2012-2014 and a Cancer Research UK Clinician Scientist Fellowship award (A18180) from 2015. The views expressed in this publication are those of the authors and not necessarily those of the National Cancer Institute, the Department of Veterans Affairs, the NHS (National Health Service), the National Institute for Health Research (NIHR), the (UK) Department of Health, or any other funder.This is the accepted manuscript. The final version is available at http://cebp.aacrjournals.org/content/24/4/720.long