The changing face of cancer epidemiology

This paper is concerned with discussing various methodological components of cancer epidemiology. Developments in measuring disease frequency are acknowledged as well as the high level of sophistication of statistical methodology. Several examples are given to illustrate that methods for measuring exposure to factors which cause or protect against cancer have developed considerably over the last few years and allow new approaches in cancer epidemiology. The potential links with clinical research are highlighted.     

The changing face of healthcare

There seems to be a theme in many publications, books, and media channels lately, and that theme is change. There are changes in global markets, economic factors, and healthcare reform, to name a few, and change.gov is a government Web site. Much discussion has taken place in the past year or so about embracing change, leading change, and overcoming change through resilience. As I look forward into 2012, I am indeed thinking about change.     

The consistency of neuropsychological assessments performed via telecommunication and face to face

Previous studies have suggested that cognitive assessments of adult psychiatric patients can be carried out as reliably via teleconsultation as they can face to face. However, the designs of these studies have often been less than satisfactory. The present study used videoconferencing at 128 kbit/s for the cognitive assessment of individuals with a history of alcohol abuse. Twenty-seven participants were given a range of assessments with two equivalent forms. One of the forms was given via videoconferencing and the other face to face. All participants were assessed using both media and the order of presentation was balanced across participants. Aspects of participant satisfaction with teleconsultations were also assessed, on 10-point scales. The teleconsultations were significantly longer (mean 40.7 min, SD 6.4) than the face-to-face sessions (mean 33.0 min, SD 5.3). For most of the outcome measures, cognitive assessment via teleconsultation produced similar results to face-to-face assessment. Most participants expressed high overall satisfaction with the teleconsultation (mean rating 8.2). The average ratings for the sound quality (mean 7.6) and visual quality of the equipment (mean 7.9) were also high. The findings imply that it is not necessary for patients and neuropsychologists to be present at the same location for cognitive assessments to be carried out.     

The changing face of long-term care

In this article, we present population estimates of individuals with disabilities and discuss the manner in which the composition of this population is changing. We then highlight aspects of service delivery systems that are evolving in response to the changing long-term care (LTC) population. Following a summary of financing issues, we discuss several cross-cutting issues related to the organization of service delivery, quality assurance (QA), and financing. Current and future Health Care Financing Administration (HCFA) research and demonstrations emerging from these issues are then described.