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Improved Rate (improved + rate)
Selected AbstractsA framework for describing the impact of antidepressant medications on population health statusPHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 7 2002Scott B. Patten MD Abstract Background In the absence of strategies for primary prevention, public health initiatives for major depression have generally focused on secondary and tertiary strategies such as case-finding, public and professional education and disease management. Much emphasis has been placed on low reported rates of antidepressant utilization. In principle, increased rates of treatment utilization should lead to improved mental health status at the population level. However, methods for relating antidepressant utilization to population health status have not been described. Methods An incidence,prevalence model was developed using data from a Canadian national survey, supplemented by parameter estimates from literature reviews. The lifetime sick-day proportion (LSP) was used to approximate point prevalence. Results Mathematical simulations using this model produced reasonable approximations of point prevalence for major depression. The model suggests that an improved rate of treatment utilization may not, in itself, lead to substantially reduced prevalence. Reducing the rate of relapse in those with highly recurrent disorders, which can be accomplished by long-term antidepressant treatment, is predicted to have a more substantial impact on population health status. Conclusions The model presented here offers a framework for describing the impact of antidepressant treatment on population health status. Mathematical models may assist with decision-making and priority setting in the public health sphere, as illustrated by the model presented here, which challenges some commonly held assumptions. Copyright © 2002 John Wiley & Sons, Ltd. [source] Identification of genetic markers associated with fatness and leg weakness traits in the pigANIMAL GENETICS, Issue 6 2009B. Fan Summary Pigs have undergone long-term selection in commercial conditions for improved rate and efficiency of lean gain. Interestingly, it has been observed in both experimental and field conditions that leg weakness has increased over time, concurrent with the selection for improved rate of lean gain, while fatter animals tend to have better leg action, and foot and leg (FL) structure. The exact molecular mechanisms or individual genes responsible for this apparent genetic correlation between fatness and leg weakness and other physical adaptability traits have been less well reported. Based on our recent studies involving candidate genes and leg weakness traits, the present investigation has identified 30 SNPs from 26 genes that were found to be associated with 10th rib backfat in a sow population consisting of 2066 animals. The specific alleles associated with increased backfat tended to be associated with better overall leg action, as shown for the genes including MTHFR, WNT2, APOE, BMP8, GNRHR and OXTR, while inconsistent associations with the single FL structure trait and backfat were observed for other genes. This study suggests that in some cases there may be a common genetic mechanism or linked genes regulating fatness and leg weakness. Such relationships are clearly complex, and the utilization of genetic markers associated with both traits should be treated cautiously. [source] Follow-up to a Federally Qualified Health Center and Subsequent Emergency Department UtilizationACADEMIC EMERGENCY MEDICINE, Issue 1 2010Tara M. Scherer MD Abstract Objectives:, Determine if 1) proximity of referral to a federally qualified health center (FQHC) improves initial follow-up rates for discharged emergency patients, 2) improved initial follow-up rates are associated with improved rates for an "ongoing relationship" with the FQHC, and 3) an ongoing relationship with an FQHC is associated with decreased subsequent emergency department (ED) utilization over a 2-year follow-up period. Methods:, An expedited referral system was initiated just prior to January 2004 for discharged ED patients referred to an FQHC. Referral categories were as follows: R1 = next-day; R2 = 2 to 7 days; R3 = 2 to 3 weeks; and R4 = follow-up as needed. The FQHC database for 2004,2006 was merged with the ED database from 2004 through 2006. The FQHC database contained all ED referrals, the referral category, whether the patient kept his or her initial ED referral appointment, all subsequent scheduled clinic appointments, and whether the patient kept any of the subsequent scheduled appointments. We compared initial referral follow-up rates and subsequent scheduled visits to the FQHC for each referral category, over a 2-year follow-up period. We evaluated the effects of age, sex, marital status, insurance status, initial triage score, race, comorbidities, and number of prescription medications on initial follow-up, and subsequent kept appointments with the FQHC. We defined an "ongoing relationship" as one or more kept scheduled appointments annually. Finally, we compared the number of subsequent ED visits over the follow-up period between patients who maintained an ongoing relationship with the FQHC and those who did not, before and after correcting for the demographic and clinical factors. Results:, There were 520 referrals over the study period. Follow-up rates ranged from 37.5% (95% confidence interval [CI] = 13.5% to 69.6%) for R1 to 9.0% (95% CI = 4.4% to 17.0%) for R4. The overall ongoing relationship rate was 7.1% (95% CI = 5.2% to 9.7%) and had weak association with temporal proximity of referral. On bivariate analysis, older age, female sex, white race, one or more comorbidities, and three or more medications were associated with increased rates of initial follow-up. These factors (with the exception of race) were also associated with increased rates of developing an ongoing relationship. Patients with an ongoing relationship with the FQHC had more repeat ED visits over the study period than did patients without (3.6 vs. 1.7, p = 0.003). However, this difference was no longer evident after adjusting for age, race, comorbidities, and medication usage. Conclusions:, Overall patient follow-up to an FQHC was low, but increased with next-day or same-week referral. The ongoing relationship rate was low, but increased with temporal proximity of ED referral. Increased comorbidities and medication usage were significantly associated with increased initial follow-up rates, development of an ongoing relationship, and subsequent ED utilization. Patients with an ongoing relationship with the FQHC had higher ED utilization over the 2-year follow-up period, likely due to a higher rate of comorbidities. ACADEMIC EMERGENCY MEDICINE 2010; 17:55,62 © 2010 by the Society for Academic Emergency Medicine [source] Natural Diversity to Guide Focused Directed EvolutionCHEMBIOCHEM, Issue 13 2010Helge Jochens Dr. Abstract Simultaneous multiple site-saturation mutagenesis was performed at four active-site positions of an esterase from Pseudomonas fluorescens to improve its ability to convert 3-phenylbutyric acid esters (3-PBA) in an enantioselective manner. Based on an appropriate codon choice derived from a structural alignment of 1751 sequences of ,/,-hydrolase fold enzymes, only those amino acids were considered for library creation that appeared frequently in structurally equivalent positions. Thus, the number of mutants to be screened could be substantially reduced while the number of functionally intact variants was increased. Whereas the wild-type esterase showed only marginal activity and poor enantioselectivity (Etrue=3.2) towards 3-PBA-ethyl ester, a significant number of hits with improved rates (up to 240-fold) and enantioselectivities (up to Etrue=80) were identified in these "smart" libraries. [source] | ||||||||||