Home About us Contact
|
Home About us Contact | ||
|
|
||
One Size (one + size)
Selected AbstractsRelationship Between Patient Age and Duration of Physician Visit in Ambulatory Setting: Does One Size Fit All?JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 7 2005Agnes Lo BSP, PharmD Objectives: To determine whether patient age, the presence of comorbid illness, and the number of prescribed medications influence the duration of a physician visit in an ambulatory care setting. Design: A cross-sectional study of ambulatory care visits made by adults aged 45 and older to primary care physicians. Setting: A probability sample of outpatient follow-up visits in the United States using the National Ambulatory Medical Care Survey (NAMCS) 2002 database. Participants: Of 28,738 physician visits in the 2002 NAMCS data set, there were 3,819 visits by adults aged 45 and older included in this study for analysis. Measurements: The primary endpoint was the time that a physician spent with a patient at each visit. Covariates included for analyses were patient characteristics, physician characteristics, visit characteristics, and source of payment. Visit characteristics, including the number of diagnoses and the number of prescribed medications, the major diagnoses, and the therapeutic class of prescribed medications, were compared for different age groups (45,64, 65,74, and ,75) to determine the complexity of the patient's medical conditions. Endpoint estimates were computed by age group and were also estimated based on study covariates using univariate and multivariate linear regression. Results: The mean time±standard deviation spent with a physician was 17.9±8.5 minutes. There were no differences in the duration of visits between the age groups before or after adjustment for patient covariates. Patients aged 75 and older had more comorbid illness and were prescribed more medications than patients aged 45 to 64 and 65 to 74 (P<.001). Patients aged 75 and older were also prescribed more medications that require specific monitoring and counseling (warfarin, digoxin, angiotensin-converting enzyme inhibitors, diuretics, and levothyroxine) than were patients in other age groups (P<.001). Hypertension, coronary artery disease, atrial fibrillation, congestive heart failure, cerebrovascular disease, and transient ischemic attack were more common in patients aged 75 and older than in other age groups (P<.001). Despite these differences, there were no differences in unadjusted or adjusted duration of physician visit between the age groups. Conclusion: Although patients aged 75 and older had more medical conditions and were at higher risk for drug-related problems than younger patients, the duration of physician visits was similar across the age groups. These findings suggest that elderly patients may require a multidisciplinary approach to optimize patient care in the ambulatory setting. [source] Comorbidity and Psychological Science: Does One Size Fit All?CLINICAL PSYCHOLOGY: SCIENCE AND PRACTICE, Issue 1 2007Nancy A. Piotrowski Psychologists need a thorough understanding of comorbidity involving physical health, substance use, and other mental health problems for clinical research, practice, and training. Comorbidity affects case management from treatment entry through follow-up, touching the work of psychologists in all related settings and at varying levels of training. Conceptualizations of comorbidity, however, are heterogeneous and may vary by training and employment experiences and settings. As such, there is a need to examine the concept of comorbidity more methodically. This article argues that current knowledge and developing language challenges a one-size-fits-all approach to comorbidity. The article outlines and discusses relevant considerations for research, treatment, and training regarding comorbidity. [source] Oriented crystallization and mechanical properties of polypropylene nucleated on fibrillated polytetrafluoroethylene scaffoldsPOLYMER ENGINEERING & SCIENCE, Issue 4 2005Douwe W. van der Meer It is known that friction deposited polytetrafluoroethylene (PTFE) layers are able to nucleate crystallization of thin films of isotactic polypropylene (iPP). In order to investigate the influence of PTFE on the crystallization behavior and morphology of iPP in bulk, PTFE-particles of two different sizes in various concentrations were melt-blended with iPP and subsequently processed by injection molding. For one size of particles, high resolution scanning electron microscopy (HR-SEM) showed the presence of a PTFE scaffold consisting of highly fibrillated PTFE particles. With X-ray diffraction (WAXD) pole-figures, it was evidenced that, after melting and recrystallization of the iPP matrix, a strongly oriented crystallization of iPP on this PTFE scaffold takes place (quiescent crystallization conditions). With WAXD it was also shown that under processing conditions, PTFE acts as a nucleating agent for iPP and that PTFE strongly enhances the formation of processing induced morphologies. Impact and tensile performance of the mixtures were measured. Both the strain energy release rate (GI) and the E-modulus were found to increase upon introducing PTFE in iPP. POLYM. ENG. SCI., 45:458,468, 2005. © 2005 Society of Plastics Engineers. [source] What's So Magical about Five Percent?PUBLIC BUDGETING AND FINANCE, Issue 2 2001A Nationwide Look at Factors That Influence the Optimal Size of State Rainy Day Funds State rainy day funds have increased in popularity as countercyclical planning devices over the past 15 years. The view is widely held that all states need a rainy day fund balance of five percent in order to guard themselves against the threat of budgetary dislocation. This article compares the actual balances in state rainy day funds in 1997 to several factors affecting budgetary volatility. Little relationship is found between rainy day fund balances and the actual level of volatility in a given state. The article finds no justification for a "one size fits all" approach; each state should design policies based on its own peculiar needs. [source] Small Things Remembered: Origins of Early Microlithic Industries in Sub-Saharan AfricaARCHEOLOGICAL PAPERS OF THE AMERICAN ANTHROPOLOGICAL ASSOCIATION, Issue 1 2002Stanley H. Ambrose Backed microliths made on small flakes and blades are considered the hallmark of Later Stone Age (LSA) industries of sub-Saharan Africa. However, some early LSA microlithic industries lack backed tools, others have extremely large ones, and some Middle Stone Age (MSA) industries also have high frequencies of blades and large backed "microliths." The invention of blades, backed microliths, and microlithization were thus separate phenomena in sub-Saharan Africa. Given this diversity and complexity, a "one size fits all" model may neither satisfactorily characterize nor explain the origin of blade-based technologies, large backed tools in the MSA, and microlithic industries in the LSA. This chapter will briefly summarize the evidence for early backed tool and microlithic industries and then evaluate several hypotheses for microlithization and backed tool production, including the invention of composite hafted tools, punch blade technology, hunting with bow and arrow in closed habitats, invention of poisons for projectiles, increased access to fine-grained raw materials, increased mobility, conservation of scarce materials, giving gifts of backed microliths made on fine-grained exotic raw materials, and manufacture of more effective specialized toolkits when increased information sharing permitted reliable anticipation of tasks. If microlithic and backed blade,based industries were invented in Africa, then understanding their origin may provide insight into the evolution of modern human behavior and the dispersal of modern humans and modern human technology out of Africa. [source] 3335: New modalities for the treatment of corneal dystrophiesACTA OPHTHALMOLOGICA, Issue 2010I CLAERHOUT Purpose To give an overview of current treatment modalities of corneal dystrophies. Results New transplant techniques have changed the way that corneal dystrophies are being treated in the last few years. Phototherapeutic keratectomy is still a very valuable tool for superficial dystrophies. Depending on the layers involved the laser will be set to a depth of 5 to 100µm. DALK is now the preferred method of treatment of most stromal dystrophies, although macular dystrophy is an exception to this rule since there is evidence of endothelial involvement in this dystrophy. Endothelial dystrophies are now almost exclusively being treated by different types of endothelial grafts (DSAEK or DMEK). Conclusion Current treatment of corneal dystrophies has evolved from one size fits all to a more customised treatment schedule, still dependent on the layers involved in the disease. [source] | ||||||||||