L-Deprenyl (selegiline) was chronically administered to male Fischer 344 rats via their drinking water beginning at 54 weeks of age (estimated daily dose: 0.5 mg/kg/day). Beginning at 84 weeks of age, the rats were behaviorally evaluated using a sensorimotor battery, a motor-learning task, and the Morris water maze. At 118 weeks of age, cerebellar noradrenergic function was evaluated in the surviving rats using in vivo electrochemistry. The rats were then sacrificed to measure brain monoamine oxidase activity and perform quantitative autoradiography to evaluate the effect of chronic deprenyl treatment on beta-adrenergic receptors in the cerebellum, alpha 2-adrenergic receptors several brain regions, and D1 and D2 dopamine receptors in the striatum. Deprenyl treatment reduced brain monoamine oxidase B activity by 85%, but had no effect on brain monoamine oxidase A. A clear effect of chronic deprenyl treatment upon longevity was not observed. Several measures of CNS function were altered in the deprenyl-treated animals: 1) spatial learning in the Morris water maze was improved; 2) electrochemical signals recorded following local application of NE were reduced, and the responsiveness to the reuptake blocker nomifensine was enhanced, in the cerebellum; 3) beta-adrenergic receptor binding affinity was increased in the cerebellum; 4) alpha 2-adrenergic receptor density was increased in the inferior colliculus; and 5) striatal D1 dopamine receptor density was reduced but binding affinity was enhanced. In contrast, chronic deprenyl treatment did not cause changes in: 1) sensorimotor function, as evaluated by balance beam, inclined screen, or wire hang tasks; 2) motor learning; 3) alpha 2-adrenergic receptor density in any region examined except for the inferior colliculus, or binding affinity in any region examined; or 4) striatal D2 dopamine receptor number or affinity. Thus, long-term oral administration of deprenyl extended the functional life span of rats with respect to cognitive, but not motor, performance.

Animals↗

PubMedDate not supplied

The impact of a diabetes nurse educator on nurses' knowledge of diabetes and nursing interventions in a home care setting.

The purpose of this study was to compare nurses' knowledge of diabetes and nursing interventions in a home health care agency (HHCA) that employed a diabetes nurse educator (DNE) and an agency that did not employ a DNE. Nurse knowledge of diabetes mellitus was measured using the Diabetes: Basic Knowledge Test (DBKT). Nursing care interventions for patients with diabetes were measured using a researcher-developed tool, the Nursing Care Intervention Tool (NCIT). The data analysis showed that the nurses in the agency with the diabetes nurse educator were significantly more knowledgeable about diabetes. The data also showed that the nurses in the HHCA with a diabetes nurse educator provided a significantly higher standard of patient care than the nurses in the agency without a diabetes nurse educator.

Diabetes Mellitus↗

PubMedDate not supplied

Incentivized digital outcomes collection.

The objective of this study was to assess the feasibility of digital patient satisfaction outcomes collection using the Internet and interactive voice response technology. Patients, health care providers, and industry sponsors were provided with incentives to participate. The participants included the practitioners and patients in medical and surgical practices who used Project Quality Card (patent pending) and the Practice Improvement Program. The study subjects were convenience samples of new and established patients seen between September 1999 and December 2000. There were 3 different pilot projects: QC1, QC2, and QC3. Patients were provided with a 20-minute prepaid phone card as an incentive for completing an interactive voice response call. Patients answered the 9-item visit rating questionnaire used to measure patient satisfaction. Patients responded on a 5-point scale, with 5 being excellent, and responses were totaled in the categories of patient access and physician attributes and in an overall score for the visit. A total of 998 patients from 77 physician offices participated. The activation responses, or percentage of patients using the Quality Cards, ranged from 12.8% in group 2 (QC2) to 26.6% in group 1 (QC1) to 34.8% in group 3 (QC3). This study demonstrates that incentivized digital outcomes collection can be successfully implemented in multisite community-based medical and surgical offices. The use of Project Quality Card (interactive voice response technology) and the Practice Improvement Program provides opportunities for user-friendly, benchmarked, real-time data collection. The percentage of patient activations is linked to provider participation in quality improvement programs. Patient participation is improved as the frequency of contact with a peer-directed database increases.

Data Collection↗

PubMedDate not supplied

Service utilization and outcomes in rural home health agencies.

As home health reimbursement moves from fee-for-service to prospective payment, data describing the relationship between service utilization and patient outcomes will be the basis for planning services. The investigators measured the relationship between service utilization and generic patient outcomes for 1,704 home health episodes of care. Few significant relationships were found. The average study patient received 17 visits, well below the average number for the state and nation. Investigators suggested the possibility that visit numbers were too low to stimulate improvement in outcomes and that when services are curtailed, home health staff may do well to focus quality improvement efforts on condition-specific patient outcomes rather than generic outcomes.

Aged↗