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PubMed1991

The expanded role of nurse case managers.

1. Effective nursing practice is responsive to the changing needs of clients. The community, rather than the hospital, has become the primary treatment setting in which the long-term mentally ill manage their daily activities. 2. The professional role of rehabilitative nurse case management can provide an opportunity for nurses to expand their roles and develop new career directions. 3. The primary nursing model provides an excellent foundation for acquiring the attitudes and skills necessary in the delivery of a comprehensive rehabilitative model of case management.

Hospital Departments↗
PubMedDate not supplied

The Heart and Stroke Foundation of Canada's Health Check food information program: modelling program effects on consumer behaviour and dietary practices.

BACKGROUND: A conceptual model was proposed and tested in order to link attitudinal and awareness factors that might explain changes in food purchase behaviours and dietary patterns related to the Heart and Stroke Foundation of Canada's Health Check food information program. METHODS: Two hundred food shoppers completed a survey inquiring about demographics, diet-related health conditions, attitude toward healthy food purchases, use of food package information, and awareness, perceived value and reported use of the Health Check logo. Participants provided their receipt for groceries purchased and completed a dietary fat assessment. Path analysis was used to test the model. RESULTS: Shoppers purchasing a Health Check product had lower fat intakes than shoppers who did not (30.4% vs. 33.9% calories from fat; p<0.05). There was strong association (beta=0.81; p<0.001) between logo awareness and use, and the meaning consumers attributed to the logo moderated this relationship (beta=0.53; p<0.01). Logo awareness was related to general use of food package information (beta=0.14; p<0.05) and attitude toward healthy food purchases (beta=0.15; p<0.05). INTERPRETATION: Persons successfully limiting their fat intake purchase Health Check products, suggesting the program has utility in this regard. Program promotional efforts should aim to increase understanding of the Health Check logo's meaning in helping to make healthier purchase decisions. Promotional efforts surrounding the introduction of new nutrition labels in Canada are also expected to have a positive effect on the program.

Adult↗
PubMed2002

Lessons from the Australian Patient Safety Foundation: setting up a national patient safety surveillance system--is this the right model?

The evolution of the concepts and processes underpinning the Australian Patient Safety Foundation's systems over the last 15 years are traced. An ideal system should have the following attributes: an independent organisation to coordinate patient safety surveillance; agreed frameworks for patient safety and surveillance systems; common, agreed standards and terminology; a single, clinically useful classification for things that go wrong in health care; a national repository for information covering all of health care from all available sources; mechanisms for setting priorities at local, national and international levels; a just system which caters for the rights of patients, society, and healthcare practitioners and facilities; separate processes for accountability and "systems learnings"; the right to anonymity and legal privilege for reporters; systems for rapid feedback and evidence of action; mechanisms for involving and informing all stakeholders. There are powerful reasons for establishing national systems, for aligning terminology, tools and classification systems internationally, and for rapid dissemination of successful strategies.

Australia↗
PubMed2006

ESRD in Guatemala and a model for preventive strategies: outlook of the Guatemalan Foundation for Children with Kidney Diseases.

The rapidly growing burden of chronic renal failure (CRF) is a major public health problem that will stretch the health care system of all countries, especially those that are not yet industrialized. It is estimated that only 35% of Guatemalan patients with end stage renal disease (ESRD) would be diagnosed and treated, and unlike many developed countries, the age of presentation in 60% of the patients is before the forth decade. Therefore, the cost of death and disability due to a CRF in this young population is particularly profound, resulting in reduced productivity and economic growth of the country. It is also estimated that 400 pediatric cases develop progressive kidney disorder (neurogenic bladder, reflux nephropathy, chronic glomerulonephritis) annually, which, if left untreated, could result in ESRD in adulthood. This reality justifies initiatives such as FUNDANIER (Foundation for Children with Kidney Diseases), whose mission is to offer comprehensive nephrological treatment to children and adolescents and enable health care providers to prevent ESRD by early identification, diagnosis, and timely referral of children with risk factors. Efforts should be taken to better involve pediatricians and pediatric nephrologists in the fight against the burden of CRF.

Biomedical Research↗
PubMed2000

Insurance and imperfect financial markets in Grossman's demand for health model--a reply to Tabata and Ohkusa.

In the article by Tabata and Ohkusa, they show that the insurance system set out in Liljas [Liljas, B., 1998a. The demand for health with uncertainty and insurance. Journal of Health Economics 17, 153-170.] does not have an optimal solution, and propose a new formulation. It is argued here that even though the new model works mathematically, it has a less realistic economic foundation. Furthermore, generalizing the Grossman model by making the marginal utility of income variable over time is suggested to be more relevant in the case where there are imperfect financial markets, and a simple example is provided. Overall, there seems to be room for further theoretical extensions in the demand for health literature.

Attitude to Health↗
PubMed2000

Comparison of a reduced explosion model to blast curve and experimental data.

This paper discusses a new reduced model for vapor cloud explosions (VCEs) which incorporates some factors found in more complex models such as three-dimensional effects. The common foundation of all VCE analysis models is discussed and a simplified model based on a set of blast curves is reviewed to highlight the differences in the various model assumptions. Output from the reduced model is compared to experimental data and results from the simplified model. It is shown that the reduced model captures critical factors such as cloud shape and flame dynamics.

Air Movements↗
PubMed2003

A utility-theoretic model for QALYs and willingness to pay.

Despite the widespread use of quality-adjusted life years (QALY) in economic evaluation studies, their utility-theoretic foundation remains unclear. A model for preferences over health, money, and time is presented in this paper. Under the usual assumptions of the original QALY-model, an additive separable presentation of the utilities in different periods exists. In contrast to the usual assumption that QALY-weights do solely depend on aspects of health-related quality of life, wealth-standardized QALY-weights might vary with the wealth level in the presented extension of the original QALY-model resulting in an inconsistent measurement of QALYs. Further assumptions are presented to make the measurement of QALYs consistent with lifetime preferences over health and money. Even under these strict assumptions, QALYs and WTP (which also can be defined in this utility-theoretic model) are not equivalent preference-based measures of the effects of health technologies on an individual level. The results suggest that the individual WTP per QALY can depend on the magnitude of the QALY-gain as well as on the disease burden, when health influences the marginal utility of wealth. Further research seems to be indicated on this structural aspect of preferences over health and wealth and to quantify its impact.

Attitude to Health↗
PubMed2003

Foundations of a query and simulation system for the modeling of biochemical and biological processes.

The analysis of large amounts of data, produced as (numerical) traces of in vivo, in vitro and in silico experiments, has become a central activity for many biologists and biochemists. Recent advances in the mathematical modeling and computation of biochemical systems have moreover increased the prominence of in silico experiments; such experiments typically involve the simulation of sets of Differential Algebraic Equations (DAE), e.g., Generalized Mass Action systems (GMA) and S-systems. In this paper we reason about the necessary theoretical and pragmatic foundations for a query and simulation system capable of analyzing large amounts of such trace data. To this end, we propose to combine in a novel way several well-known tools from numerical analysis (approximation theory), temporal logic and verification, and visualization. The result is a preliminary prototype system: simpathica/xssys. When dealing with simulation data simpathica/xssys exploits the special structure of the underlying DAE, and reduces the search space in an efficient way so as to facilitate any queries about the traces. The proposed system is designed to give the user possibility to systematically analyze and simultaneously query different possible timed evolutions of the modeled system.

Biochemical Phenomena↗
PubMed2006

Performance goals for the laboratory testing of antithrombin, protein C and protein S.

To achieve a reliable analytical quality for both monitoring and diagnostic testing, laboratories need to fulfil the widely accepted analytical performance goals based on the biological variation of the analytes of testing. Not only is the short-term analytical performance, which regularly is assessed by internal quality control procedures, of importance, but also the long-term analytical performance. To assess the long-term analytical performance, data obtained from an external quality assessment programme can be used. In this study we have used the evaluation model designed by the ECAT Foundation for the assessment of the longterm analytical performance, including imprecision, bias and total analytical error. The model was applied to the data from 136 different laboratories for the assay of antithrombin (activity), protein C (activity and antigen) and protein S (activity, total and free antigen). The imprecision (median; range), reflected by the long-term analytical coefficient of variation (LCV (A) ), was the lowest for antithrombin (7.6%; 2.6 - 43.8%) and the highest for protein S activity (17.2%; 4.3 - 88.6%). For bias and total error the same pattern was observed (antithrombin: 3.8%; 0.3 - 17.1% and 9.1%; 3.4 - 34.3%, respectively; protein S activity: 12.8%; 3.1 - 34.8% and 24.5%; 9.9 - 87.0%, respectively). For the majority of the laboratories (70 - 85%) the imprecision contributes considerably more to the total error than the bias. However the effect of the bias on the analytical quality is not negligible. Assays for antithrombin, protein C and protein S are mainly used for diagnostic testing. About 70 - 100% of the laboratories can fulfil the desirable performance goal for imprecision. The desirable performance goal for bias was reached by 50 - 95% of the laboratories. In all cases the highest numbers of laboratories fulfilling performance goals was obtained for the protein C variables. To improve the analytical quality in assays of antithrombin, protein C and protein S it is highly recommended that primarily imprecision (non-systematic failures) be suppressed. However the effect of the bias (systematic failures) on the analytical quality should not be neglected. A useful tool for determining the imprecision (LCV (A) ) and bias is the long-term analytical performance evaluation model as used by the ECAT Foundation.

Antithrombin III↗
PubMed2004

The structure and mechanical properties of the mitral valve leaflet-strut chordae transition zone.

Biaxial testing, histological measurements and theoretical continuum mechanics modeling were employed to investigate the structure and mechanical properties of the mitral valve leaflet-strut chordae transition zone (LCT). The results showed that geometry changes and collagen fiber angle distribution contribute to variations in mechanical properties in the LCT zone. A simple three-coefficient exponential constitutive law was able to simulate the variation in stress-stretch behavior in the LCT zone by spatially varying a single coefficient and incorporating collagen fiber angle and degree of alignment. This quantitative information can greatly improve the predictions from biomechanical valve models by incorporating regional variations of structure and properties in the mitral leaflet-chordae tendineae system. These data provide the foundation for a computational model for studying stress distributions before and following chordal rupture, which may indicate the underlying reasons for the development of valve insufficiency in patients.

Animals↗
PubMed2002

Risk-based modeling of early warning systems for pollution accidents.

An early warning system is a mechanism for detecting, characterizing and providing notification of a source water contamination event (spill event) in order to mitigate the impact of contamination. Spill events are highly probabilistic occurrences with major spills, which can have very significant impacts on raw water sources of drinking water, being relatively rare. A systematic method for designing and operating early warning systems that considers the highly variable, probabilistic nature of many aspects of the system is described. The methodology accounts for the probability of spills, behavior of monitoring equipment, variable hydrology, and the probability of obtaining information about spills independent of a monitoring system. Spill Risk, a risk-based model using Monte Carlo simulation techniques has been developed and its utility has been demonstrated as part of an AWWA Research Foundation sponsored project. The model has been applied to several hypothetical river situations and to an actual section of the Ohio River. Additionally, the model has been systematically applied to a wide range of conditions in order to develop general guidance on design of early warning systems.

Accidents↗
PubMed2026

Artificial Intelligence for Colorectal Surgeons-Part II: Research Applications, Challenges in Adoption, and Practical Resources.

BACKGROUND: This is part II of a 2-part series examining artificial intelligence in colorectal surgery. Part I established foundational concepts and clinical applications. Implementation, however, requires understanding research methodologies, available resources, and the specific challenges currently limiting widespread adoption. These topics are the focus of part II. OBJECTIVE: To examine artificial intelligence's transformation of surgical research, provide practical implementation resources, address adoption challenges, and explore future directions in colorectal surgery. METHODS: Comprehensive literature review focusing on artificial intelligence research methodology, implementation barriers, educational resources, and emerging technologies relevant to colorectal surgeons. RESULTS: Artificial intelligence streamlines clinical trial design through predictive modeling and natural language processing, reducing enrollment challenges that contribute to failed or inadequate trial accrual. Machine learning enables heterogeneity analysis within clinical trials, identifying treatment-responsive subgroups. Foundation models unlock analysis of unstructured electronic health record data at scale. Professional societies and universities offer specialized artificial intelligence education programs, with open-access data sets facilitating research participation. However, implementation faces multifaceted challenges: technical infrastructure demands, with real-time processing requiring dedicated graphics processing unit clusters; regulatory frameworks struggling with continuously evolving algorithms; undefined liability distribution for artificial intelligence-assisted decisions; algorithmic bias risking health care disparities; and the "black box" problem limiting clinical trust. Economic barriers include substantial initial costs without clear reimbursement pathways. Future directions include multimodal artificial intelligence integrating imaging, genomics, and histopathology; cognitive robotic systems with real-time decision support; digital twin technology for patient-specific surgical simulation; and global surgical artificial intelligence networks enabling distributed learning across institutions. CONCLUSIONS: Although artificial intelligence offers transformative potential for colorectal surgery research and practice, successful implementation requires addressing technical, regulatory, ethical, and economic challenges. The surgeon's evolving role demands both traditional expertise and computational fluency. Future advances in multimodal integration, autonomous systems, and global collaboration will fundamentally reshape surgical practice but will require thoughtful implementation prioritizing patient benefit and clinical value.

Humans↗
PubMed2002

Synaptic vesicle endocytosis: the races, places, and molecular faces.

The classical experiments on synaptic vesicle recycling in the 1970s by Heuser and Reese, Ceccarelli, and their colleagues raised opposing theories regarding the speed, mechanisms, and locations of membrane retrieval at the synapse. The Heuser and Reese experiments supported a model in which synaptic vesicle recycling is mediated by the formation of coated vesicles, is relatively slow, and occurs distally from active zones, the sites of neurotransmitter release. Because heavy levels of stimulation were needed to visualize the coated vesicles, Ceccarelli's experiments argued that synaptic vesicle recycling does not require the formation of coated vesicles, is relatively fast, and occurs directly at the active zone in a "kiss-and-run" reversal of exocytosis under more physiological conditions. For the next thirty years, these models have provided the foundation for studies of the rates, locations, and molecular elements involved in synaptic vesicle endocytosis. Here, we describe the evidence supporting each model and argue that the coated vesicle pathway is the most predominant physiological mechanism for recycling synaptic vesicles.

Animals↗
PubMed1976

Drug information for prescribers and dispensers: toward a model system.

Four alternative ways of providing health care professionals with drug information are examined in terms of medical and social values. It is assumed that maximum patient benefit will result when prescribing decisions can be made in an environment of enlightened neutrality. The alternative of maintaining the status quo is discarded because it does little to provide practitioners with complete data. The second alternative notes major reforms that would further regulate promotional efforts and upgrade the qualifications of detailmen. Because this approach yields a suboptimum solution, a third alternative introduces the concept of a National Drug Education Foundation. This countervailing force would disseminate objective drug information to clinicians through 2,000 therapeutic consultants, subsidize professional journals and schools, develop regional drug information centers, and conduct a variety of related functions. Foundation operations are estimated to cost $167 million per year or about one-seventh of current expenditures for drug promotion and information. Since commercial inputs would not only be redundant but also tend to negate Foundation efforts, the fourth model contends that social benefits can be optimized only when such outlays are terminated.

Advertising↗
PubMed2003

It's time to rework the blueprints: building a science for clinical psychology.

The aims in this article are to connect the conceptual structure of clinical psychological science to what the author believes to be the omnipresent principles of evolution, use the evolutionary model to create a deductively derived clinical theory and taxonomy, link the theory and taxonomy to comprehensive and integrated approaches to assessment, and outline a framework for an integrative synergistic model of psychotherapy. These foundations also provide a framework for a systematic approach to the subject realms of personology and psychopathology. Exploring nature's deep principles, the model revives the personologic concept christened by Henry Murray some 65 years ago; it also parallels the interface between human social functioning and evolutionary biology proposed by Edward Wilson in his concept of sociobiology.

Biological Evolution↗
PubMed2004

Invertebrate disease models in neurotherapeutic discovery.

Models that reproduce many of the cellular and molecular aspects of various human neurodegenerative disorders have been developed in the fruit fly Drosophila melanogaster and the nematode Caenorhabditis elegans. An understanding of the underlying molecular and genetic mechanisms of disease pathogenesis is being gained from studies utilizing the wealth of genetic and molecular tools available for these invertebrate model organisms. This review focuses on recent studies that lay a foundation for utilizing these disease models in drug discovery and for continued genetic dissection of disease mechanisms.

Animals↗
PubMed2005

[Effect of qiangyi jiangtang capsules on diabetes mellitus model rats].

OBJECTIVE: To study the pharmacodynamics of qiangyi jiangtang capsules (QJC) to offer the scientific foundation for clinical treatment to model rats of diabetes millitus induced by high lipid forage and streptozotocin. METHODS: The model rats of diabetes mellitus were induced by intraperitoneal injection of 0.6% streptozotocin (30 mg/kg body weight) given to Wistar rats after feeding with high lipid forage for a month and followed by fasting for 18 hours. Rats with level of blood glucose over 10.0 mmol/L 5 days after modelling was regarded as the successful model. Besides, a group of blank control was set up with rats fed with general forage and injected with equal volume of citric acid buffer solution. The successfully modelled rats were randomly divided into the model group, the positive control group and the high (2.0 g/kg), middle (1.2 g/kg) and low (0.4 g/kg) dose QJC treated groups. Meanwhile, the same volume of normal saline was given to rats in the blank control group and the model group, while Matfarmin (0.5 g/kg) was given to the rats in the positive control group. The levels of blood glucose (BG), serum fructose amine (SFA), hemoglobin A1c (HbA1c) were measured after one month of medication, and the amount of water drinking and food intake were measured at the second and the fourth week of the treatment. RESULTS: The levels of BG, SFA, HbA1c, the amount of water drinking and food intake in the 3 QJC treated groups were obviously lower than those in the model group (P < 0.05 or P < 0.01). CONCLUSION: QJC could remarkably lower the levels of BG, HbA1c, SFA and the amount of food intake and water-drinking of DM model rats, it is a Chinese herbal preparation worthy of further development and research.

Animals↗
PubMed2002

Nursing science as human science: the new world and human becoming.

The human science perspective of the theory of human becoming holds intrinsic characteristics conducive to permeating teaching-learning in the 21st century. This column focuses on the challenges involved in the teaching-learning of nursing science as a human science, particularly from a human becoming perspective. Moving from a medical model of studying disease processes as the foundation for nursing education, to a nursing model of understanding the meaning of unitary lived experiences, poses challenges for both faculty and students in today's nursing world. These challenges include: explicating the unitary nature of humankind, living the responsibility of expressing new thought, perceiving teaching-learning as engaging community; and visioning nursing leadership as a transformative presence in change.

Community Health Nursing↗