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Biomedical subjects

R Nisbet

Publications and source records attributed to R Nisbet.

3 recordsLinked to original sources

Medical services use by patients before and after detoxification from benzodiazepine dependence.

OBJECTIVE: The authors examined use of medical and mental health services before and after detoxification among a group of patients detoxified from benzodiazepines to see if the data suggested a reduction in service use and costs after detoxification, the so-called offset effect observed for treatment of alcohol and mental disorders. METHODS: Through a medical record review, information was collected about medical service use for patients aged 40 and older who were detoxified from benzodiazepines at Scott and White Clinic and Hospital between 1987 and 1991. RESULTS: Among the 76 patients, medical and mental health outpatient visits fell from an average rate of 25.4 visits per year before detoxification to 4.4 per year after detoxification. For the 44 patients with at least one inpatient stay besides the admission for detoxification, the mean number of inpatient days remained constant at three days per year before and after detoxification. CONCLUSIONS: Although a retrospective record review suffers from a range of limitations, the findings suggest that detoxification from benzodiazepines may be effective in reducing use of outpatient medical and mental health services and presumably in reducing costs of care.

Adult↗

Modelling survivorship kinetics: a two-parameter model.

A mathematical model of survivorship kinetics is presented. It takes into account both deterministic and stochastic aspects of survival curves. Earlier reports [Piantanelli: Arch Gerontol Geriatr 1986;5:107-118; Piantanelli: Ann NY Acad Sci 1988; 521:99-109] described a model capable of making distinct predictions on the mean and standard deviation of an index of physiological function, fitting data even in the tail of survivorship curves, and accounting for the selection of the cohort at advanced ages. However, it contains four parameters whose biological interpretation is unclear. In the present paper we propose a modification of the model which maintains the main characteristics of the previous one and, in addition, results in two significant improvements. First, the number of free parameters is reduced to only two, making much easier both their estimation and interpretation, particularly when the model is applied to data from various animal groups manipulated in different ways. Second, it is possible to relate the parameters to well-defined deterministic and stochastic factors: specifically, a deterministic component describing the environmental and genetic influence on physiological functions, and a stochastic component representing the fluctuating interactions of the living organism and its environment.

Aging↗