Kooperativer Bibliotheksverbund

Berlin Brandenburg

and
and

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
Filter
Language
Year
  • 1
    In: Journal of Ambulatory Care Management, 1992, Vol.15(1), pp.29-37
    Description: Patients in this study represented an important group for health services research; their postdischarge costs were high, resulted from readmissions (especially for nonelective reasons), and were incurred by a minority of patients. Moreover, intensive interventions delivered by ambulatory care providers has the potential to reduce overall costs if patients at highest risk for readmission could be identified prospectively (Smith et al., 1988; Weinberger et al., 1988). We developed a model to predict post-hospital discharge costs in these patients using strategies to maximize their predictive capability. Although the model appeared to account for more variance in costs than currently available models in the derivation set, its performance in the validation set, albeit statistically significant, was disappointing. Because we considered a broad array of predictors, expanding the number of patient-oriented variables may not be fruitful. Instead, future research may need to consider more homogenous subgroups of patients in whom specific laboratory tests would have clinical significance; variance in providers' behaviors; and studies in health maintenance organizations, where control over resource utilization may make costs more predictable. Finally, empirically derived models must be tested in an independent sample. Without validating predictive models, the models' ability to predict health care costs may be overestimated.
    Keywords: Models, Econometric ; Health Care Costs -- Statistics & Numerical Data ; Hospitals, Teaching -- Statistics & Numerical Data ; Patient Readmission -- Statistics & Numerical Data;
    ISSN: 0148-9917
    E-ISSN: 15503267
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 2
    Language: English
    In: Geochimica et Cosmochimica Acta, 2011, Vol.75(10), pp.2696-2707
    Description: Based on quantum chemistry calculations for normal octane homolytic cracking, a kinetic hydrogen isotope fractionation model for methane, ethane, and propane formation is proposed. The activation energy differences between D-substitute and non-substituted methane, ethane, and propane are 318.6, 281.7, and 280.2 cal/mol, respectively. In order to determine the effect of the entropy contribution for hydrogen isotopic substitution, a transition state for ethane bond rupture was determined based on density function theory (DFT) calculations. The kinetic isotope effect (KIE) associated with bond rupture in D and H substituted ethane results in a frequency factor ratio of 1.07. Based on the proposed mathematical model of hydrogen isotope fractionation, one can potentially quantify natural gas thermal maturity from measured hydrogen isotope values. Calculated gas maturity values determined by the proposed mathematical model using δD values in ethane from several basins in the world are in close agreement with similar predictions based on the δ C composition of ethane. However, gas maturity values calculated from field data of methane and propane using both hydrogen and carbon kinetic isotopic models do not agree as closely. It is possible that δD values in methane may be affected by microbial mixing and that propane values might be more susceptible to hydrogen exchange with water or to analytical errors. Although the model used in this study is quite preliminary, the results demonstrate that kinetic isotope fractionation effects in hydrogen may be useful in quantitative models of natural gas generation, and that δD values in ethane might be more suitable for modeling than comparable values in methane and propane.
    Keywords: Geology
    ISSN: 0016-7037
    E-ISSN: 1872-9533
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 3
    Language: English
    In: Drug and Alcohol Dependence, 2011, Vol.117(1), pp.24-30
    Description: Despite findings that opioid detoxification serves little more than a palliative function, few patients who enter detoxification subsequently transition to long-term treatment. The current study evaluated intensive role induction (IRI), a strategy adapted from a single-session intervention previously shown to facilitate engagement of substance-dependent patients in drug-free treatment. IRI was delivered either alone or combined with case management (IRI + CM) to determine the capacity of each condition to enhance transition and engagement in long-term treatment of detoxification patients. Study participants were 240 individuals admitted to a 30-day buprenorphine detoxification delivered at a publicly funded outpatient drug treatment clinic. Following clinic intake, participants were randomly assigned to IRI, IRI + CM, or standard clinic treatment (ST). Outcomes were assessed in terms of adherence and satisfaction with the detoxification program, detoxification completion, and transition and retention in treatment following detoxification. Participants who received IRI and IRI + CM attended more counseling sessions during detoxification than those who received ST (both s 〈 .001). IRI, but not IRI + CM participants, were more likely to complete detoxification ( = .017), rated their counselors more favorably ( = .01), and were retained in long-term treatment for more days following detoxification ( = .005), than ST participants. The current study demonstrated that an easily administered psychosocial intervention can be effective for enhancing patient involvement in detoxification and for enabling their engagement in long-term treatment following detoxification.
    Keywords: Opioid Addiction ; Detoxification ; Treatment Engagement ; Social Welfare & Social Work
    ISSN: 0376-8716
    E-ISSN: 1879-0046
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 4
    In: Medical Care, 1988, Vol.26(7), pp.699-708
    Description: A multifaceted intervention was hypothesized to increase postdischarge ambulatory contacts and to reduce nonelective readmissions. Patients (N=1,001) discharged from the general medicine service were stratified by risk for nonelective readmission and randomized to the control or intervention group. Intervention patients received phone calls from nurses, mailings of appointment reminders and lists of early warning signs, and prompt rescheduling of visit failures. Patients were followed for 6 months, and the results were computed in units per patient per month. The intervention group had 10.4% more total office contacts (0.53 vs 0.48, P=0.005) than the control group. Although the intervention group had 7.6% fewer nonelective readmission days (0.85 vs 0.92), this was not statistically significant (P=0.5). Patients in the intervention group at high risk (N=181) had 28.1% more office visits (0.73 vs 0.57, P〈0.01) and 31.9% fewer nonelective readmission days (1.13 vs 1.66), but this was also not statistically significant (P=0.06). Thus, the intervention significantly increased postdischarge contacts, primarily in high-risk patients, but failed to reduce the incidence of nonelective readmission days significantly.
    Keywords: Aftercare ; Patient Readmission;
    ISSN: 0025-7079
    E-ISSN: 15371948
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 5
    In: Medical Care, 1988, Vol.26(11), pp.1092-1102
    Description: This study tested the hypothesis that increasing the intensity of outpatient care for patients discharged from the hospital could lower their subsequent inpatient and total health-care costs. At discharge, 1,001 patients were stratified by risk of readmission (low, medium, or high) and randomly assigned to the intervention or control group. Discharge information (summaries, medications, and postdischarge needs) was provided to outpatient nurses who monitored intervention patients closely and attempted to resolve their problems. Intervention patients also received appointment reminders, and missed visits were promptly rescheduled. The cost of the intervention was $5.20 per patient per month. High-risk patients in the intervention group had significantly higher outpatient costs ($131/month vs. $107/month; P=0.02), but lower inpatient costs ($535/month vs. $800/month; P=0.02) than high-risk patients in the control group. Reduced inpatient costs in the high-risk intervention group were attributed to shorter, less intensive hospital stays. In conclusion, increasing ambulatory care resources after hospital discharge for high-risk patients may reduce health-care costs associated with readmission to the hospital.
    Keywords: Medicine ; Public Health;
    ISSN: 0025-7079
    E-ISSN: 15371948
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 6
    Language: English
    In: Journal of Consulting and Clinical Psychology, 2004, Vol.72(2), pp.227-234
    Description: Retention in outpatient drug-free treatment is poor, with many clients terminating prior to receiving therapeutic benefit. This randomized clinical trial compared the impact on retention and drug use of an individual role induction session conducted at intake with the standard group orientation offered at the clinic. Results of interim analyses indicated that participants assigned to role induction ( n = 180) were retained for more days, more likely to attend at least one postorientation session, and more satisfied with the treatment program than were those assigned to standard treatment ( n = 87). Preliminary results suggest that role induction is a brief technique that shows promise for retaining clients through the critical first 3 months of treatment.
    Keywords: Adult ; Female ; Humans ; Male ; Professional Role ; Remission Induction ; Self Efficacy ; Substance-Related Disorders ; Drug Usage ; Outpatients ; Treatment Compliance ; Treatment Termination ; Substance Use Treatment ; Drug & Alcohol Rehabilitation ; Participant Retention ; Outpatient Drug-Free Treatment ; Drug Use ; Intake Role Induction Session ; Empirical Study ; Quantitative Study ; Human ; Male ; Female ; Outpatient ; Adulthood (18 Yrs & Older) ; Us ; Article;
    ISSN: 0022-006X
    E-ISSN: 1939-2117
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 7
    In: Annals of Internal Medicine, Feb 1, 1991, Vol.114(3), p.216(8)
    Description: Chronic obstructive pulmonary disease is a disease process that results in the decreased ability of the lungs to perform their function of ventilation, the oxygenation of the blood. Symptoms include dyspnea (difficulty breathing); chronic cough; and decreased maximal breathing capacity. Chronic obstructive pulmonary disease may result from chronic bronchitis (inflammation of the lower airways); pulmonary emphysema (distention of lung tissue by the collection of air or gas in the lungs); or chronic asthma. The effectiveness of oral corticosteroid agents in treating patients with chronic obstructive pulmonary disease was assessed. Review of the medical literature produced 33 studies of oral corticosteroid use in chronic obstructive pulmonary disease since 1951. The quality of the studies was assessed by comparing the methodology with consideration of nine criteria developed by physicians and investigators. Response to corticosteroid treatment was defined as a 20 percent increase in the forced expiratory volume at one second (FEV1), a measure of lung function. Ten studies fulfilled the criteria for sufficient study quality. The findings of these studies showed that oral corticosteroid treatment resulted in a 20 percent or more improvement in FEV1, about 10 percent more than observed in patients receiving a placebo. When treating patients with chronic obstructive pulmonary disease, the side effects of corticosteroid agents must be weighed against the relatively modest therapeutic benefit provided by these drugs. (Consumer Summary produced by Reliance Medical Information, Inc.)
    Keywords: Pulmonary Function Tests -- Evaluation ; Chronic Obstructive Lung Disease -- Drug Therapy ; Adrenocortical Hormones -- Evaluation
    ISSN: 0003-4819
    E-ISSN: 15393704
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 8
    Language: English
    In: The Journal of infectious diseases, 01 June 2008, Vol.197(11), pp.1531-6
    Description: Haemophilus ducreyi 35000HP contains a cluster of homologues of genes required for the synthesis of enterobacterial common antigen (ECA), suggesting that H. ducreyi may express a putative ECA-like glycoconjugate. WecA initiates the synthesis of ECA by transferring N-acetylglucosamine to undecaprenyl-P, to form lipid I. A wecA mutant (35000HPwecA) was constructed, and 5 volunteers were inoculated at 3 sites with fixed doses of 35000HP on one arm and at 3 sites with varying doses of 35000HPwecA on the other arm. 35000HPwecA caused pustules to form at 3 sites inoculated with a dose 2.5-fold higher than that of 35000HP. However, at sites inoculated with similar doses of 35000HP and 35000HPwecA, pustules developed at 46.7% (95% confidence interval [CI], 23.3%-70.0%) of 15 parent-strain sites and at 8.3% (95% CI, 0.01%-23.6%) of 12 mutant-strain sites (P = .013). Thus, the expression of wecA contributes to the ability of H. ducreyi to cause pustules in humans.
    Keywords: Multigene Family ; Antigens, Bacterial -- Genetics ; Chancroid -- Microbiology ; Haemophilus Ducreyi -- Genetics
    ISSN: 0022-1899
    E-ISSN: 15376613
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 9
    Language: English
    In: Infection and Immunity, 2012, Vol. 80(2), p.679
    Description: Sialylated glycoconjugates on the surfaces of mammalian cells play important roles in intercellular communication and self-recognition. The sialic acid preferentially expressed in human tissues is N-acetylneuraminic acid (Neu5Ac). In a process called molecular mimicry, many bacterial pathogens decorate their cell surface glycolipids with Neu5Ac. Incorporation of Neu5Ac into bacterial glycolipids promotes bacterial interactions with host cell receptors called Siglecs. These interactions affect bacterial adherence, resistance to serum killing and phagocytosis, and innate immune responses. Haemophilus ducreyi, the etiologic agent of chancroid, expresses lipooligosaccharides (LOS) that are highly sialylated. However, an H. ducreyi sialyltransferase (lst) mutant, whose LOS contain reduced levels of Neu5Ac, is fully virulent in human volunteers. Recently, a second sialyltransferase gene (Hd0053) was discovered in H. ducreyi, raising the possibility that Hd0053 compensated for the loss of lst during human infection. CMP-Neu5Ac is the obligate nucleotide sugar donor for all bacterial sialyltransferases; LOS derived from an H. ducreyi CMP-Neu5Ac synthetase (neuA) mutant has no detectable Neu5Ac. Here, we compared an H. ducreyi neuA mutant to its wild-type parent in several models of pathogenesis. In human inoculation experiments, the neuA mutant formed papules and pustules at rates that were no different than those of its parent. When grown in media with and without Neu5Ac supplementation, the neuA mutant and its parent had similar phenotypes in bactericidal, macrophage uptake, and dendritic cell activation assays. Although we cannot preclude a contribution of LOS sialylation to ulcerative disease, these data strongly suggest that sialylation of LOS is dispensable for H. ducreyi pathogenesis in humans.
    Keywords: Bacterial Proteins -- Metabolism ; Chancroid -- Microbiology ; Haemophilus Ducreyi -- Metabolism ; Lipopolysaccharides -- Metabolism ; N-Acetylneuraminic Acid -- Metabolism;
    ISSN: 1098-5522
    ISSN: 10985522
    ISSN: 00199567
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 10
    Language: English
    In: Patient Education and Counseling, October 2012, Vol.89(1), pp.184-190
    Description: To evaluate (PC), a program that employed lay health workers to motivate antiretroviral adherence among persons living with HIV with coverage from Indiana's high-risk insurance pool. Four hundred and forty nine participants living in the greater Indianapolis area were randomly allocated to treatment ( = 91) or control ( = 358) groups and followed for one year. Compared to control subjects, PC subjects were more likely to adhere to HIV medications (medication possession ratio adherence ≥0.95, OR = 1.83, = 0.046), and to achieve undetectable viral load (〈50 copies/mL, OR = 2.01, = 0.011) in the 12 months following introduction of PC. There were no significant differences observed between groups in any of self-reported health status indicators. Estimates suggest that PC clients were 16% more likely to have undetectable viral loads than clients in standard care. The incremental program cost was approximately $10,000 for each additional person who achieved an undetectable viral load. As persons living with HIV experience greater longevity and healthcare reform expands coverage to these high-risk populations, greater demands will be placed on the HIV-care workforce. Results suggest lay health workers may serve as effective adjuncts to professional care providers.
    Keywords: Lay Health Workers ; Medication Adherence ; HIV ; Medicine ; Public Health
    ISSN: 0738-3991
    E-ISSN: 1873-5134
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
Close ⊗
This website uses cookies and the analysis tool Matomo. Further information can be found on the KOBV privacy pages