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Own Risk (own + risk)
Selected AbstractsEnter at your own risk: HMO participation and enrollment in the Medicare risk marketECONOMIC INQUIRY, Issue 3 2000J Abraham We examine HMO participation and enrollment in the Medicare risk market for the years 1990 to 1995. We develop a profit-maximization model of HMO behavior, which explicitly considers potential linkages between an HMO's production decision in the commercial enrollee market and its participation and production decisions in the Medicare risk market. Our results suggest that the payment rate is a primary determinant of HMO participation, while the price of a supplemental Medicare insurance policy positively affects HMO Medicare enrollment. We also find empirical support for the existence of complementarities in the joint production of an HMO's commercial and Medicare products. [source] Alarm Calls Affect Foraging Behavior in Eastern Chipmunks (Tamias striatus, Rodentia: Sciuridae)ETHOLOGY, Issue 12 2000Jessica K. Baack We used playback experiments to test whether alarm calls affected the foraging behavior of eastern chipmunks (Tamias striatus). We subjected chipmunks, foraging at artificial feeding stations, to three playback treatments (silent, control noise, and alarm call) and examined changes in vigilant and foraging behavior. Chipmunks responded to alarm calls with a greater degree and duration of vigilant behavior, such as look-ups and alert postures. Chipmunks also ran a shorter distance to cover and took longer to re-emerge from the burrow after hearing an alarm call. Alarm calls caused individuals to spend more time exposed at the feeding stations; however, individuals also took significantly fewer seeds after hearing an alarm call. This was not due to a difference in the time spent handling food, but rather to a slower rate of loading. Chipmunks appear to sacrifice energy gain by increasing vigilance after hearing an alarm call. This study suggests that to avoid the costs of unnecessary escape behavior, individuals directly assess their own risk rather than relying only on indirect cues such as alarm calls. [source] Type 2 diabetes in families and diabetes preventionEUROPEAN DIABETES NURSING, Issue 2 2008FRCP Professor of Diabetic Molecular Medicine, M Walker MD Abstract Type 2 diabetes frequently clusters in families. Non-diabetic first-degree relatives (offspring and siblings) of patients with type 2 diabetes have a three-fold increased lifetime risk of developing diabetes compared with the background population. This increased diabetes risk results from the combined effects of shared genetic and lifestyle factors. Extensive studies of non-diabetic relatives of type 2 diabetic families show that impaired insulin secretion, insulin resistance and an adverse cardiovascular risk factor profile exist well before the development of frank diabetes. Despite this well-documented adverse metabolic predisposition, patients with type 2 diabetes and their non-diabetic relatives generally have a limited understanding of the risks. Several large-scale studies, such as the Finnish Diabetes Prevention and Diabetes Prevention Program studies, indicate unequivocally that lifestyle modification through dietary change and exercise can dramatically decrease risk of progression to diabetes in high-risk subjects. However, such individuals pursue lifestyle changes only if they understand their own risk of developing diabetes. Further work is therefore needed to investigate and develop optimal ways of improving knowledge of diabetes risk in families of patients with type 2 diabetes, so that they can appreciate the potential benefits of diabetes prevention strategies. Copyright © 2008 FEND [source] Using disease risk estimates to guide risk factor interventions: field test of a patient workbook for self-assessing coronary riskHEALTH EXPECTATIONS, Issue 1 2002J. Michael Paterson MSc Objective,To assess the feasibility and acceptability of a patient workbook for self-assessing coronary risk. Design,Pilot study, with post-study physician and patient interviews. Setting and subjects,Twenty southern Ontario family doctors and 40 patients for whom they would have used the workbook under normal practice conditions. Interventions,The study involved convening two sequential groups of family physicians: the first (n=10) attended focus group meetings to help develop the workbook (using algorithms from the Framingham Heart Study); the second (n=20) used the workbook in practice with 40 patients. Follow-up interviews were by interviewer-administered questionnaire. Main outcome measures,Physicians' and patients' opinions of the workbook's format, content, helpfulness, feasibility, and potential for broad application, as well as patients' perceived 10-year risk of a coronary event measured before and after using the workbook. Results,It took an average of 18 minutes of physician time to use the workbook: roughly 7 minutes to introduce it to patients, and about 11 minutes to discuss the results. Assessments of the workbook were generally favourable. Most patients were able to complete it on their own (78%), felt they had learned something (80%) and were willing to recommend it to someone else (98%). Similarly, 19 of 20 physicians found it helpful and would use it in practice with an average of 18% of their patients (range: 1,80%). The workbook helped to correct misperceptions patients had about their personal risk of a coronary event over the next 10 years (pre-workbook (mean (SD) %): 35.2 (16.9) vs. post-workbook: 17.3 (13.5), P < 0.0001; estimate according to algorithm: 10.6 (7.6)). Conclusions,Given a simple tool, patients can and will assess their own risk of CHD. Such tools could help inform otherwise healthy individuals that their risk is increased, allowing them to make more informed decisions about their behaviours and treatment. [source] An update on familial pancreatic cancer and the management of asymptomatic relativesHPB, Issue 1 2007John A. Windsor Families of patients with pancreatic adenocarcinoma (PC) often ask about their own risk of developing this disease. There is now a sufficient body of evidence to inform relatives of their relative risk of developing PC. The purpose of this review is to provide practical advice for the clinician when confronted with questions about the risk of PC in relatives, and the role of genetic testing and screening in high-risk individuals. [source] Patient responses to an integrated service, initiated by community pharmacists, for the prevention of osteoporosisINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 2 2008Dr. Judith A. Crockett project officer Objective This study aimed to develop, implement and evaluate an integrated service provided by pharmacists to consumers based on the results of a risk-assessment survey carried out by the pharmacist and testing of bone mineral density (BMD) by a radiographer. It also investigated whether measurement of BMD in the pharmacy increased the effectiveness of the service and pharmacist referral in terms of adherence to advice and uptake of referral compared with the same service offered without BMD testing. Setting Community pharmacists in urban and rural settings in New South Wales, Australia, delivered the service. Method The adherence to advice or referral given by 12 community pharmacists during 2003 to 217 participants about the prevention of osteoporosis following screening with either a BMD test plus risk-assessment questionnaire or a risk-assessment questionnaire only was compared. Key findings No significant between-group differences in adherence to advice or referral were found. However, participants valued the BMD service significantly more highly than the non-BMD service as measured by satisfaction scores. Conclusions Consumers were interested in receiving information about osteoporosis and their own risk of it and even greater interest in BMD testing in the pharmacy. There was no difference in uptake of referral or advice following either questionnaire only or questionnaire plus BMD testing. Low uptake of referral and advice overall by those deemed to be at high risk is of concern. Far greater education and encouragement for consumers to follow through is required. [source] Overcoming M&A environmental problemsJOURNAL OF CORPORATE ACCOUNTING & FINANCE, Issue 2 2002Peter A. Stanwick Companies contemplating mergers ignore environmental problems at their own risk, warn the authors. Environmental issues can damage the merger's value, or even torpedo the deal. But through proper research and handling, you can avoid that. The authors show you how. © 2002 John Wiley & Sons, Inc. [source] Treatment of non-alcoholic fatty liver disease in children: swim at your own riskPEDIATRIC DIABETES, Issue 1 2009Ryan Fischer First page of article [source] Haemophilia 2002: emerging risks of treatmentHAEMOPHILIA, Issue 3 2002B. L. EVATT Haemophilia care and treatment products have greatly improved over the past 2 decades. Transitions in treatment produced by these changes were accompanied by the emergence of unexpected risks and new complications. In order to provide the best comprehensive care to patients with haemophilia, healthcare providers periodically need to re-evaluate and adjust their management and therapeutic products to prevent or minimize the effects produced by the emerging issues. For example, reducing the effects of infectious agents remains the highest priority for the haemophilia community because of the high level of morbidity and mortality that has resulted from earlier therapeutic agents. In many countries, the goal has been to achieve absolute zero risk for infectious agents. In some instances, the screening procedures to achieve these goals reduced the availability of plasma needed for manufactured derivatives and produced another emerging risk, shortages of clotting factor preparations. Similarly, better diagnostic methods identified other potential agents that were not inactivated by current technology. Likewise, immune tolerance regimens and the prophylactic management of haemophilia introduced different therapeutic delivery systems with their own risks. The drugs used to manage diseases such as human immunodeficiency virus (HIV), which were transmitted by products manufactured before mid-1980, create their own set of risks for this community. Topical emerging risks of treatment, including variant Creutzfeldt,Jakob disease, an assessment of its risks and impact, the complications of using indwelling catheters, and the role of protease inhibitors used to treat HIV may have on bleeding complications of haemophilia are discussed. [source] | |||||||||||||