OBJECTIVE To determine the clinical predictors and rate of relapse for major depression in primary care. DESIGN A cohort study of subjects in 2 randomized trials of depressed patients diagnosed and prescribed antidepressant medicine by primary care physicians. Baseline, 7-month, and 19-month assessments were conducted. SETTING A large primary care clinic of a staff-model health maintenance ...

CONTEXT In recent years, smoking among adolescents has increased and the decline of adult smoking has slowed to nearly a halt; new insights into tobacco dependency are needed to correct this situation. Long-term use of nicotine has been linked with self-medicating efforts to cope with negative emotional, neurobiological, and social effects of adverse childhood experiences. OBJECTIVE To assess...

OBJECTIVE There is no proven primary care treatment for patients with medically unexplained symptoms (MUS). We hypothesized that a long-term, multidimensional intervention by primary care providers would improve MUS patients' mental health. DESIGN Clinical trial. SETTING HMO in Lansing, MI. PARTICIPANTS Patients from 18 to 65 years old with 2 consecutive years of high utilization were ide...

In this paper we introduce the notion of classical quasi-primary submodules that generalizes the concept of classical primary submodules. Then, we investigate decomposition and minimal decomposition into classical quasi-primary submodules. In particular, existence and uniqueness of classical quasi-primary decompositions in finitely generated modules over Noetherian rings are proved. More...

Since the US Surgeon General's conference on health care transitions in 1989, transition from pediatric to adult-oriented health care for youth with chronic conditions continues to develop as an important issue among youth, parents, and health professionals. Key professional organizations, public agencies, and disease-specific organizations have promoted research on transition and the developme...

The Joint Commission on Accreditation of Healthcare Organizations was founded in 1951 as a private, not-for-profit organization that evaluates and accredits hospitals and other healthcare organizations. In 1987, the JCAHO launched its Agenda for Change to create a more modern and sophisticated accreditation process to place primary emphasis on actual performance. Coincident with this new emphas...

Joint Commission–accredited ambulatory care organizations now have the option of expanding their accreditation to include the Primary Care Medical Home designation beginning July 1, 2011. The Joint Commission’s Board of Commissioners recently approved the Primary Care Medical Home option, which will help ambulatory care organizations improve care coordination, increase patient satisfaction, and...

Leaders play crucial roles in their enterprises. Most modern organizations today, such as corporations and government departments, have no leaders. About 80% of all top structures, are run by inertia leaderless organizations. These pretense-pseudo structures filled roles, CEO, Department Head/Secretary, EVP, VP, others, but this non-accountable system mostly harms than benefits the organization...