Gaining strategic advantages through partnerships with public health departments.

Public health officials have advocated in public health and public policy journals for collaboration with private sector health care organizations for nearly a decade. There has been little written in the management literature on this topic, however. There are several important areas in which public health departments have expertise that could be valuable to private sector health care organizations, including health maintenance organizations (HMOs). These include the delivery of services in some geographic areas and to some special populations, provision of preventive and health promotion services to HMO members, performance of epidemiology services, assistance in accreditation, and repair of the damaged image of HMOs. HMOs and local health departments in many parts of the country are already entering into contracts for these purposes. Such partnerships between HMOs and local health departments can improve the health of the members of HMO plans and contribute to improving the health of the community.

Prostate cancer screening.

Prostate cancer is a common cancer and a leading cause of cancer death in men. It is potentially detectable at early, possibly curative stages through various combinations of testing, including DRE, PSA, and TRUS of the prostate. Still unproven is the effectiveness of prostate cancer treatment, and because of that lack of proof, the optimal screening strategies are also elusive. It is possible that what is known as prostate cancer today may be, in fact, multiple entities with different natural histories, different treatment needs, and, consequently, different screening strategies. The role of informed consent has been suggested as a means to involve patients in the decision process, especially because the literature presents an environment of intense controversy. It is hoped that the PIVOT trial or similar efforts and further research into the basic mechanisms of the disease will provide clearer answers in the future.

Flash P2 delay in primary degenerative dementia of the Alzheimer type.

1. Flash visual evoked responses of 31 patients meeting DSM-III-R criteria for primary degenerative dementia of the Alzheimer type were compared with 31 healthy controls. 2. P1 latency was normal (75 +/- 6 msec Alzheimer's; 75 +/- 6 msec controls). 3. P2 was significantly delayed (162 +/- 32 msec, 147 +/- 20 msec, p < 0.03) among patients. 4. P1-P2 interpeak latency was significantly increased (87 +/- 32 msec, 71 +/- 21 msec, p < 0.03) among patients.

EEG-based, neural-net predictive classification of Alzheimer's disease versus control subjects is augmented by non-linear EEG measures.

Attempts to classify Alzheimer's disease (AD) subjects versus controls using spectral-band measures of electroencephalographic (EEG) data typically achieve around 80% success. This study assessed the ability of adding non-linear EEG measures and using a neural-net classification procedure to improve this performance level. The non-linear EEG measures were estimated correlation dimension ("dimensional complexity," or DCx) and saturation (degree of leveling-off of DCx with increasing embedding dimension). In a sample of 39 subjects (14 ADs, 25 controls), it was found that (a) the addition of non-linear EEG measures improved the classification accuracy of the AD/control status of subjects, and (b) a back-percolation neural net predictively classified the subjects much better than the standard linear techniques of multivariate discriminant analysis or nearest-neighbor discriminant analysis.

Model to study long-term effects of propoxyphene napsylate (darvon-N) on narcotic-dependent mice.

Five different strains of mice were investigated for their suitability to serve as models for the study of long-term effects of propoxyphene napsylate (PN) on narcotic-dependent mice. The NIH/Swiss outbred strain proved to be most suitable because of its high liability to manifest physical dependence on morphine. Following removal of subcutaneously-implanted morphine pellets from the mice, the incidence of spontaneous withdrawal jumping was used as a quantifiable criterion of physical dependence. An orally administered suspension of PN suppressed the withdrawal jumping in a dose-dependent manner. However, chronic (daily) administration of PN at doses high enough to prevent withdrawal jumping was characterized by a high degree of toxicity.