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Qualitative Interpretation (qualitative + interpretation)
Selected AbstractsQualitative Analysis of Medicare Claims in the Last 3 Years of Life: A Pilot StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2005Amber E. Barnato MD Objectives: To study end-of-life care of a representative sample of older people using qualitative interpretation of administrative claims by clinicians and to explore whether this method yields insights into patient care, including continuity, errors, and cause of death. Design: Random, stratified sampling of decedents and all their Medicare-covered healthcare claims in the 3 years before death from a 5% sample of elderly fee-for-service beneficiaries, condensation of all claims into a chronological clinical summary, and abstraction by two independent clinicians using a standardized form. Setting: United States. Participants: One hundred Medicare fee-for-service older people without disability or end-stage renal disease entitlement who died in 1996 to 1999 and had at least 36 months of continuous Part A and Part B enrollment before death. Measurements: Qualitative narrative of the patient's medical course; clinician assessment of care continuity and apparent medical errors; cause, trajectory, and place of death. Results: The qualitative narratives developed by the independent abstracters were highly concordant. Clinicians felt that 75% of cases lacked continuity of care that could have improved the quality of life and the way the person died, and 13% of cases had a medical error identified by both abstracters. Abstracters disagreed about assignment of a single cause of death in 28% of cases, and abstracters and the computer algorithm disagreed in 43% of cases. Conclusion: Qualitative claims analysis illuminated many problems in the care of chronically ill older people at the end of life and suggested that traditional vital statistics assignation of a single cause of death may distort policy priorities. This novel approach to claims review is feasible and deserves further study. [source] Unusual atmospheric pressure chemical ionization conditions for detection of organic peroxidesJOURNAL OF MASS SPECTROMETRY (INCORP BIOLOGICAL MASS SPECTROMETRY), Issue 9 2003David Rondeau Abstract Organic peroxides such as the cumene hydroperoxide I (Mr = 152 u), the di- tert -butyl peroxide II (Mr = 146 u) and the tert -butyl peroxybenzoate III (Mr = 194 u) were analyzed by atmospheric pressure chemical ionization mass spectrometry using a water,methanol mixture as solvent with a low flow-rate of mobile phase and unusual conditions of the source temperature (,50 °C) and probe temperature (70,200 °C). The mass spectra of these compounds show the formation of (i) an [M + H]+ ion (m/z 153) for the hydroperoxide I, (ii) a stable adduct [M + CH3OH2]+ ion (m/z 179) for the dialkyl peroxide II and (iii) several protonated adduct species such as protonated molecules (m/z 195) and different protonated adduct ions (m/z 227, 389 and 421) for the peroxyester III. Tandem mass spectrometric experiments, exact mass measurements and theoretical calculations were performed for characterize these gas-phase ionic species. Using the double-well energy potential model illustrating a gas-phase bimolecular reaction, three important factors are taken into account to propose a qualitative interpretation of peroxide behavior toward the CH3OH2+, i.e. thermochemical parameters () and two kinetic factors such as the capture constant of the initial stable ion,dipole and the magnitude of the rate constant of proton transfer reaction into the loose proton bond cluster. Copyright © 2003 John Wiley & Sons, Ltd. [source] Susceptibility of oral obligate anaerobes to telithromycin, moxifloxacin and a number of commonly used antibacterialsMOLECULAR ORAL MICROBIOLOGY, Issue 5 2007I. Tomás Introduction:, Obligate anaerobes are closely involved in the pathogenesis of oral and focal infections. The objective of this study was to evaluate the susceptibility profiles of obligate anaerobes of oral origin to telithromycin (TLM), moxifloxacin (MXF), and other antibiotics that are commonly used in dentistry. Methods:, The study sample comprised 172 obligate anaerobes isolated from the saliva of 43 adult volunteers. The minimum inhibitory concentrations (MICs) were determined by the agar dilution technique in Brucella agar medium supplemented with vitamin K, haemin and 5% (volume/volume) laked sheep blood, and incubated under anaerobic conditions. The Clinical and Laboratory Standards Institute methodology was followed and its criteria were used for the qualitative interpretation of the results. The antibiotics evaluated were: amoxicillin (AMX), amoxicillin-clavulanic acid (AMX-CLA), clindamycin (CM), metronidazole (MTZ), azithromycin (AZM), TLM and MXF. Results:, Resistance to AMX (MIC90 16 mg/l) was observed in 45.3% of the obligate anaerobes and resistance to CM (MIC90 16 mg/l) was found in 18.6%. All the isolates were sensitive to MTZ (MIC90 = 1 mg/l) and 98.8% were sensitive to AMX-CLA (MIC90 = 2 mg/l). The MIC90 values for AZM, TLM and MXF were 16, 8 and 2 mg/l, respectively. Conclusion:, Pathogenic, opportunistic and non-pathogenic obligate anaerobes showed high percentages of resistance to AMX and CM, and high MIC values for AZM in the absence of recently administered antibiotics. MXF showed a higher activity than TLM, similar to that detected for AMX-CLA and MTZ. In consequence, MXF could represent a possible alternative antimicrobial against obligate anaerobes of oral origin, particularly in those patients with allergy, intolerance or lack of response to AMX-CLA or MTZ. [source] A Theoretical Study of the Exchange Coupling in Hydroxo- and Alkoxo-Bridged Dinuclear Oxovanadium(IV) CompoundsEUROPEAN JOURNAL OF INORGANIC CHEMISTRY, Issue 1 2004Antonio Rodríguez-Fortea Abstract A density functional study of exchange coupling in hydroxo- and alkoxo-bridged dinuclear oxovanadium(IV) compounds is presented. Coupling constants calculated for full unmodeled structures are in good agreement with experimentally reported values, confirming the ability of the computational strategy used in this work to predict the exchange coupling in dinuclear VIV compounds. The influence of the configuration of the [VO(,-OR)2VO]2+ core in compounds with two edge-sharing octahedrally coordinated oxovanadium(IV) centers, of the nature of the terminal ligands and of structural distortions on the coupling constant have been analyzed through model calculations. The results indicate that the coupling constant is less affected by these factors than for hydroxo- and alkoxo-bridged CuII compounds. The calculations support the orbital models usually employed in qualitative interpretations of magneto-structural correlations, showing good correlations between the calculated coupling constants and the overlap between the two magnetic orbitals or the square of the orbital gap. (© Wiley-VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2004) [source] | |||||||||||||