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991.
Vincent Kuraitis 《Disease Management & Health Outcomes》2007,15(3):135-140
For the past decade, US physicians have failed to embrace disease management (DM) approaches offered by private DM companies and health plans. Until recently, physicians have not offered an alternative, systematic approach to caring for patients with chronic illnesses and conditions.The medical home model has become the centerpiece of reforms proposed by associations that represent family medicine physicians (the American Academy of Family Physicians [AAFP]) and general internal medicine physicians (the American College of Physicians [ACP]). In February 2007, the AAFP and the ACP were joined by the American Academy of Pediatrics and the American Osteopathic Association in issuing joint principles for the patient-centered medical home. While the medical home model is promoted primarily as a comprehensive approach to primary care reform, there is one aspect where the medical home and DM overlap: care coordination.Medicare has been exploring alternative mechanisms to manage and reimburse chronic care and care-coordination activities. In 2003, the US Congress passed legislation to require pilot projects for chronic care improvement programs; the program implementing this legislation is Medicare Health Support (MHS). To date, very little information has been available about the progress of MHS projects. The three early announcements about MHS progress have not been encouraging: the expected financial results are not being achieved.In December 2006, Congress passed legislation authorizing the Medicare Medical Home Demonstration (MMHD) project. MHS and MMHD are directed at similar patient populations: high-cost, frail, elderly patients with multiple co-morbid conditions. The medical home concept being advanced by primary care physicians has the potential to be competitive with DM companies. Health plans that have built their own DM programs are more likely to be supportive of the medical home model. Do physicians have the ability to compete at providing care-coordination services? There are strong arguments suggesting ‘no’ and strong arguments suggesting ‘yes’.While the medical home model is focused on primary care reform, its effect could be competitive to DM companies and others. The medical home model could affect the flow of hundreds of billions of dollars — money that over time might flow either to physicians or to private companies. 相似文献
992.
Eva Broberger Carol Tishelman Louise von Essen Eva Doukkali Mirjam A. G. Sprangers 《Quality of life research》2007,16(10):1635-1645
Patients with lung cancer experience considerable distress. Therefore, accurate methods for assessing distress and quality
of life over time may play a key role for managing and evaluating palliative care. Alternatives to commonly used standardized
questionnaires are individual measures. This study prospectively and retrospectively explored the concerns that 46 patients
with inoperable lung cancer spontaneously reported as causing most distress close to diagnosis and 6 months later. Changes
in content individually generated through a structured inductive freelisting were compared with EORTC-QLQ-C30+LC13 ratings.
The results showed that patients perceived a wide variety of concerns as most distressing and that their concerns changed
over time. Between 56 and 62% of these concerns were assessed by items included in the EORTC-QLQ-C30+LC13 questionnaires.
Furthermore, patients’ reports of most distress from fatigue, pain and dyspnea were not always reflected in intensity ratings
of comparable EORTC-QLQ-C30+LC13 items. These results indicate that items included in standardized measures are not always
adequate to assess patients’ concerns, priorities and changes over time. In addition to standardized questionnaires, individualized
measures may be useful in the clinical palliative setting for providing detailed information about the individual’s problems
and prioritizations. 相似文献
993.
以限题检索为手段,以收录期刊所载论文为指标,比较分析了国内常用的4种医学电子文献数据库收录医学期刊的质量。结果表明4种医学电子文献数据库均存在收录“非法医学期刊”之瑕疵,但各数据库的收录量有差异。提示广大读者和电子文献数据库使用者注意,并针对此问题提出了相应的对策和建议。
相似文献994.
讨论了一系列N-酰化壳聚糖膜的抗张强度、透水性、VB_(12)的透过性、透氧性以及血液相容性。N-已酰化壳聚糖膜具有良好的血液相容性。在制膜过程中,加入分子量为1500的聚乙二醇为致孔剂,则可使N-己酰化壳聚糖膜的渗透性有较大提高。同时保持较好的血液相容性和强度。 相似文献
995.
Daniel A Rossignol Lanier W Rossignol S Jill James Stepan Melnyk Elizabeth Mumper 《BMC pediatrics》2007,7(1):36
Background
Recently, hyperbaric oxygen therapy (HBOT) has increased in popularity as a treatment for autism. Numerous studies document oxidative stress and inflammation in individuals with autism; both of these conditions have demonstrated improvement with HBOT, along with enhancement of neurological function and cognitive performance. In this study, children with autism were treated with HBOT at atmospheric pressures and oxygen concentrations in current use for this condition. Changes in markers of oxidative stress and inflammation were measured. The children were evaluated to determine clinical effects and safety. 相似文献996.
Background
Cardiovascular disease remains the leading killer of women in most developed areas of the world. Rates of physical inactivity and poor nutrition, which are two of the most important modifiable risk factors for cardiovascular disease in women, are substantial. This study sought to examine the effectiveness of a community-based lifestyle-modification program on increasing women's physical activity in a randomized trial guided by community-based participatory research (CBPR) methods. 相似文献997.
Ann Lecluyse 《The European journal of health economics》2007,8(3):237-243
This paper provides new evidence on the degree of income-related inequality in self-assessed health in Belgium. First of all,
we combine the time dimension, which has been shown to be very important in the analysis of inequality, and the use of the
recently developed interval regression approach to transform a categorical health variable in a continuous one. Second, we
measure how the long-run inequality differs from the short-run inequality. Finally, we decompose this health-related income
mobility index as well as the long-run concentration index (CI) itself into its contributors. Using data from the panel survey
of Belgian households (1994–2002), we find that health is pro-rich distributed and that its inequality is underestimated by
9.45% when neglecting the dynamics of individuals over time. Income, education, job status and age are the most important
contributors in the CI and the difference between the short-run and long-run inequality.
相似文献
998.
We compared the Acrysoft monofocal intraocular lens (IOL) in the mini monovision formula (n = 20) with the Array multifocal intraocular lens (n = 20) for glasses independence after cataract surgery. The Acrysoft monofocal IOL group showed similar and even slightly
better results than the Array multifocal IOL group. The monofocal Acrysoft IOL using the mini monovision (blended vision)
formula is a good alternative for providing post-cataract surgery glasses independence.
Drs. Chen, Clinical Assistant Professor of Ophthalmology and Neal H. Atebara are at University of Hawaii School of Medicine,
Honolulu, Hawaii, USA.
Dr. Te Tsaw Chen, Past Professor & Director, was at Department of Ophthalmology, Taipei Medical University, Taipei, ROC.
The authors have stated that they do not have a significant financial interest or other relationship with any product manufacturer
or provider of services discussed in this article. The authors also do not discuss the use of off-label products, which includes
unlabeled, unapproved, or investigative products or devices.
The authors compared the Acrysoft monofocal intraocular lens in the mini monovision formula to the Array multifocal intraocular
lens for glasses independence after cataract surgery. 相似文献
999.
Kamran Sardari Ehsan Galedar Kakhki Mehrdad Mohri 《Comparative clinical pathology》2007,16(3):197-200
Ten bulls (age 7 months, weight 302 ± 15 kg) were used in this study. After sterile preparation of skin, a full thickness
wound (20 × 20 mm) was created in each bull. The bulls were randomly assigned into two groups: group 1 received 6 ml Theranekron
subcutaneously and group 2 penicillin banzatine 10,000 IU/kg IM. These doses were repeated 6 days after initial wounding.
At days 0, 3, 6, 10 and 14, digital photographs were taken from the wounds to calculate wound contraction and epithelialization
using geometry. Chi-square test was performed for statistical analysis using SPSS 9 for Windows. There was no significant
differences in wound contraction between trial groups (P > 0.05) but a statistical difference was seen in epithelialization between groups (P < 0.05). Epithelialization is one of the most important factors in wound healing. According to the results of the present
study, Theranekron can significantly stimulate epithelialization in full thickness wounds in cows during the first 14 days
of healing. 相似文献
1000.
目的 观察行为干预对慢性乙型肝炎患者健康行为的影响。方法 将300例慢性乙型肝炎患者作为目标人群进行健康教育,建立目标人群管理档案,进行目标人群健康行为干预,比较教育前后相关行为的改变。结果 慢性乙型肝炎患者8项健康行为和8项危险健康行为有明显改观,差异具有统计学意义(P〈0.01)。结论 通过行为干预,有效地使慢性乙型肝炎患者完全遵从医嘱合理用药,完全依从健康行为,从而减少危险行为的发生。 相似文献