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Robert M. Palmer Steven R. Counsell Seth C. Landefeld 《Disease Management & Health Outcomes》2003,11(8):507-517
Older patients often experience a loss of independent physical functioning during the course of an acute illness that requires hospitalization. Although functional outcomes are not usually the focus of care in the hospital, they may be critical determinants of the quality of life, physical independence, cost of care, and prognosis among older patients.Based on a conceptual model of the dysfunctional syndrome (functional decline associated with hospitalization) we developed, implemented and evaluated a multi-component intervention termed Acute Care for Elders (ACE), in hospital medical units of two urban hospitals. ACE is a model of care that combines the principles of geriatric assessment and quality improvement. The ACE intervention includes a prepared environment (environmental modification), patient-centered care (interdisciplinary assessment), interdisciplinary team rounds and planning for home, and medical care review. Results of randomized clinical trials support the effectiveness of ACE to improve outcomes of hospitalization for older patients. Improved functional status, lower risk of nursing home placement and higher levels of patient and professional satisfaction with care are achievable with ACE.The challenges of establishing an ACE unit in community hospitals can be met through a systematic process of implementation and evaluation.ACE is a multi-component intervention that is potentially transportable to other hospital units, with benefits for patients, health professionals and hospital administrators. 相似文献
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Kevin L. Billups 《Current Sexual Health Reports》2004,1(4):137-141
Erectile dysfunction (ED) is often not considered in the same context as such traditional cardiovascular conditions as hypertension,
dyslipidemia, diabetes, or ischemic heart disease. The detection of ED might be one of the most powerful tools to help manage
cardiovascular disease in men. Clinical research suggests that the penile vascular bed is a sensitive indicator of early systemic
endothelial cell or smooth muscle dysfunction. ED could be one of the initial signs of oxidative stress that occurs before
the development of the structural, occlusive cardiovascular disease. ED is becoming a barometer of overall global cardiovascular
risk and should be viewed in this context rather than as “just a problem with the penis.” Asking men about ED as part of the
review of systems is an effective means of practicing preventive vascular medicine. 相似文献
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Itiswell knownthatimmune inflammatorymechanism playsanimportantroleinpsoriasis .Therelationshipbetweenchemokine ,receptorsandpsori asishasbeenconfirmed[1] .CCchemokineligand 2 0(CCL2 0 )isanewmemberinthefamilyof β chemokineandalsotheonlyligandofCCchemoki… 相似文献
198.
Background
Many studies have found socioeconomic differentials in cancer survival. Previous studies have generally demonstrated poorer cancer survival with decreasing socioeconomic status but mostly used only ecological measures of status and analytical methods estimating simple survival. This study investigate socio-economic differentials in cancer survival using four indicators of socioeconomic status; three individual and one ecological. It uses a relative survival method which gives a measure of excess mortality due to cancer. 相似文献199.
Background
Late stage cancer malignancies may result in severe skeletal muscle wasting, fatigue and reduced quality of life. Resistance training may attenuate these derangements in cancer patients, but how this hypertrophic response relates to normal muscle adaptations in healthy subjects is unknown. Here, we determined the effect of resistance training on muscle mass and myosin heavy chain (MHC) isoform composition in plantaris muscles from tumor-bearing (TB) rats. 相似文献200.