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PubMed1982

[Establishment of puberty in the doe rabbit (folliculogenesis and ovulation. Effect of rationing the diet].

We used 307 Californian doe-rabbits divided into 7 experimental groups. The first 4 groups, fed an ad libitum diet, were presented to the male at 11, 14, 17 or 20 weeks of age. The other 3 groups were fed a 75 p. 100 ad libitum diet and were presented to the male at 14, 17 and 20 weeks of age. Three to 5 does per group were killed at 8 postcoitum hours to check the ovarian follicles, and the remaining females, after effective mating, were killed 12 days later to check the ovulation rate. Acceptation of mating was homogeneous (75-80 p. 100) in all the groups, except in the one with the restricted diet presented to the male at 14 weeks of age (55 p. 100). In ad libitum-fed does, the percentage of females mated and ovulating reached one-third at 14 weeks and two-thirds at 17 and 20 weeks. Rationing retarded by 3 weeks live-weight gain and ability to ovulate. Whatever the diet given, the mean weight of does of this breed had to reach 3 kg before the first ovulation occurred and 3.3 kg before the percentage of females ovulating after mating became normal. The number of ova found in ovulating females did not differ statistically in any of the groups, but the rationed does tended to have fewer ova (- 8 p. 100) in direct relation to their live weight. In fact, whatever the diet, the number of ova increased more than 2-units for a weight increase of 1 kg of live weight. In ad-libitum-fed does, the follicle population doubled between 11 and 14 weeks, then decreased to attain at 20 weeks the value found at 11 weeks. Although this population was unimodal at 11 weeks, it became bimodal afterwards and was clearly so at 17-20 weeks. The second mode represented 5 then 8 p. 100 of the total follicles which were large-size (greater than 407000 mu2) and corresponded to preovulatory follicles. The number of atretic follicles followed a similar pattern. Rationing did not change the follicular population of the first mode; on the contrary, it altered the size and number of the large-sized follicle population of the second mode. Rationing also increased the percentage of atretic preovulatory follicles in the two oldest groups.

Aging↗

PubMed1980

Effect of pharmacist consultation on rational antimicrobial therapy.

The incidence of rational decisions concerning antimicorbial therapy before and after the establishment of clinical pharmaceutical services in a hospital was compared. A protocol was designed to determine the rationality of physician orders for antimicrobial therapy. This ptocol was used to analyze retrospectively the medical records for patients admitted to a 30-bed surgical unit and a 30-bed medical unit during two months before and after clinical pharmaceutical services were initiated. The results showed that exposure to routine clinical pharmaceutical services appeared to improve prescribing rationality only of drugs used to treat infectious conditions. Since the study design had no control group, the causal effect of clinical pharmaceutical services on the rationality of antimicrobial therapy could not be determined; however, the use of an organized protocol in monitoring antimicrobial therapy allowed an assessment of the use and misuse of antimicrobials in hospitals.

Anti-Bacterial Agents↗

PubMed1995

Biomechanical basis of choosing the rational mass and its distribution throughout the lower limb prosthesis segments.

A solution for finding a rational distribution of mass in lower limb prostheses has been considered based on the formal premise favoring the identification of the movements of a prosthetic and an intact leg. For the purpose of simplicity, and analysis has been carried out for only the swing phase, the data about the properties of moving segments being determined without integrating differential equations of motion. At the formation of equations of motion, an assumption that body segments are absolutely rigid and have constant moments of inertia and locations of the center of mass was taken into consideration. Based on independent proportions formed of combinations of the coefficients of equations of motion, a system of three equations has been formulated and solved in relation to the mass values sought: a static radius and a radius of inertia of the prosthesis complex link "shin + foot + footwear." From the six unknowns included in the equations, three values are chosen as mean values determined empirically. The solution of obtained equations results in the following conclusions: the parameters of the mass distribution in a "shin + foot + footwear" complex link depend on the amputation level and the patient's mass. These data, reported in appropriate tables, may be used in prosthetics practice. Recommendations have also been presented with regard to a prosthesic mass relative to the age of the person with amputation and a method of a balancing of prostheses aimed at the achievement of a rational distribution of masses. The analysis of obtained equations has also allowed us to make recommendations about the artificial foot mass. It has been concluded that a reasonable desire to reduce the mass of the prosthetic segments is not an end in itself, but is only the means of a rational distribution by means of balancing. It has been proved that rational prosthetic fitting results in decreased energy costs and overloads are decreased and a normalized gait.

Amputation, Surgical↗

PubMed1977

Effect of ruminal lactic acid-utilizing bacteria on adaptation of cattle to high-energy rations.

Heifers, unadapted to a concentrate ration, were intraruminally inoculated (1 dose) with cultures of ruminal lactic acid-utilizing bacteria or with ruminal fluid from a steer adapted to a concentrate ration. Inoculation with cultures (1 L) of Selenomonas ruminantium or Megasphaera elsdenii did not produce better average daily weight gains or feed efficiency of heifers fed a high-energy ration for 21 days, if these values were compared with the performance of noninoculated heifers. Average daily weight gain and feed efficiency of heifers inoculated with 1 L of Peptococcus asaccharolyticus culture or with 1 L of adapted ruminal fluid and fed a high-energy ration for 21 days were better if these values were compared with the performance of noninoculated heifers.

Animal Feed↗

PubMed1996

Can Shneidman's "Ten Commonalities of Suicide" accommodate rational suicide?

Shneidman's (1985) commonly reproduced "Ten Commonalities of Suicide" cannot accommodate rational suicide, as the concept has been defined in recent literature, and therefore are not "commonalities" of all suicides. Quotes from Shneidman describing the "commonalities" are provided and selected items are briefly examined in light of one set of criteria for rational suicide. It is suggested that Shneidman's list, which is inherently biased against allowing for the possibility of rational suicide, be renamed so that its contents will not continue to be inappropriately used as evidence that suicide cannot be rational.

Attitude of Health Personnel↗

PubMedDate not supplied

Determination of monensin in high-moisture cattle rations by liquid chromatography with postcolumn derivatization.

An existing liquid chromatographic method using postcolumn derivatization has been used extensively to quantitate monensin in animal feeds. Because of the relatively high moisture content of many cattle feed rations, some modifications were made to this method. Several sample-processing steps were evaluated to determine optimum sample-processing procedure. The sample weight/sample diluent ratio was modified, and method linearity was validated for the lower monensin concentrations anticipated in high-moisture cattle rations. The accuracy and precision of data generated at these lower concentrations were also determined. Because of the high moisture content of these rations, data analysis for this method required correction of feed potency for loss on drying. With these modifications, monensin can be accurately determined in high-moisture cattle rations.

Animal Feed↗

PubMed1976

[Dynamics of calcium metabolism in lactating cows when the calcium content of the rations is reduced (author's transl)].

From twenty-eight balance trials and supplementary findings on the state of health, milk production, body weight and composition of the bone, blood, saliva, milk, urine and faeces it is concluded that four cows of the Dutch-Friesian breed can conveniently live and produce for seven and, including the preliminary period, for sixteen months on a ration consisting of straw, potatoes and concentrates having an average calcium content (including calcium in drinking water) of 0.22 per cent (varying from 0.17 to 0.25 per cent) in the dry matter. There was found to be an inverse relationship between the calcium content of the ration and the absorption coefficient. The absorption coefficient of calcium ranged from 28.7 to 83.8 per cent when the calcium content of the ration varied from 0.44 to 0.17 per cent. For sixteen months, the calcium-phosphorus ratio of the ration varied from 0.4 to 0.8. Bone biopsy was successfully performed using a universal drill.

Animal Feed↗

PubMed1976

Abomasal displacement in cattle: influence of concentrates in the ration on fatty acid concentrations in ruminal, abomasal, and duodenal contents.

The primary causative factor in abomasal displacement appears to be atony or hypotony of the abomasum. Seemingly, high-concentrate feeding inhibits abomasal motility by increasing the amount of fatty acids which enter the abomasum. In the present study, cows with ruminal, abomasal, and duodenal fistulas were fed a hay ad libitum ration or a hay and concentration ration and were compared. It was shown that a considerable increase in ruminal volatile free fatty acid (VFFA) concentrations was not followed by a subsequent increase in abomasal VFFA concentrations. Differences in abomasal VFFA levels between the 2 rations could not be found. There was a slight, but insignificant, increase in duodenal VFFA concentrations after cows were fed the hay ration. One cow given the hay and concentrate diet had a small, but significant, increase in duodenal VFFA concentrations during the first 2 hours after feeding. The VFFA concentrations in duodenal fluid were too low to support the hypothesis that changes in duodenal VFFA concentrations could be responsible for abomasal hypotony.

Abomasum↗

PubMed1977

The effects of rational stage directed imagery on self-concept and reduction of psychological stress in adolescent delinquent females.

This study examined the effect of four treatment conditions on self-concept and reduction of psychological stress in adolescent delinquent females. The treatments were Rational State Directed Imagery, a cognitive behavioral approach that utilized intensive muscle relaxation and vivid-emotive-imagery, a rational (cognitive) restructuring treatment, a placebo condition, and a no treatment control. Ss were assigned randomly to one of these treatment groups, which met 1 hour per week for 6 consecutive weeks, with in-vivo homework assignments also utilized. Statistically scale were noted for the RSDI group at the posttest and at a 2-month follow-up, which supports the therapeutic efficacy of this treatment. Support was found for the effectiveness of the rational (cognitive) restructuring approach immediately posttreatment; however these effects disappeared at the 2-month follow-up. The placebo and control groups showed no significant effects at either posttreatment or the follow-up. These results suggest that RSDI has potential for use as a short-term psychotherapeutic approach when self-concept modification is a primary goal.

Adolescent↗

PubMed1989

Pain control and rational thinking. Implications for rheumatoid arthritis.

In this study, we examined the factor structure of the Coping Strategies Questionnaire and studied the relevance of the coping process to health status in rheumatoid arthritis patients. The 2 factors of the questionnaire that were analyzed were Coping Attempts and Pain Control and Rational Thinking. The Pain Control and Rational Thinking factor was related to pain and psychological status, even after demographic variables and disease severity were statistically controlled. In addition, increases in Pain Control and Rational Thinking scores were related to improvements in pain, psychological status, and health status. Implications for the psychological care of rheumatoid arthritis patients are discussed.

Adaptation, Psychological↗

PubMedDate not supplied

Should we ration health care?

The paper begins by drawing a distinction between "allocation"--the distribution of resources between different categories, and "rationing"--the distribution of scarce resources within a single category. I argue that the current allocation of funds to health care makes some form of rationing unavoidable. The paper next considers proposals by Daniel Callahan and Norman Daniels supporting age rationing publicly-financed life-extending medical care. I provide reasons for doubting that either argument succeeds. The final section of the paper sets forth an alternative approach which holds that if people have any rights to health care, then they have a right to a decent minimum.

Age Factors↗

PubMed1991

An objective method to evaluate rationing of pediatric intensive care beds.

Rationing of pediatric intensive care beds occurs when the severity of illness of patients admitted to and discharged from the PICU is inversely proportional to the number of available PICU beds. Bed rationing may also increase the proportion of patients using unique PICU therapies, thereby increasing efficiency. Consecutive PICU admissions (n = 283) were evaluated for three months for descriptive data, daily severity of illness, and daily care modalities. PICU and hospital censuses were also recorded. The mean PICU occupancy was 75% (range 37.5%-100%), the hospital occupancy was 79% (range 60%-96%) and the daily PICU efficiency was 78% (range 50%-100%). The PICU census was greater than 90% on 13% of the study days. Neither PICU nor hospital census was associated with the severity of illness of patients admitted to or discharged from the PICU. Severity of illness for patients admitted when only one bed was available or discharged when there were no available beds was not higher than at other times. Therefore, we did not find evidence of rationing of pediatric intensive care by using quantitative methods. As health care funding becomes more limited, quantitative analyses such as this study differentiating the need for more PICU beds from the need for better PICU bed utilization will be beneficial.

Bed Occupancy↗

PubMed2006

Suicide mortality and agricultural rationalization in post-war Europe.

BACKGROUND: The relationship between agricultural rationalization and suicide mortality has been little researched. On the basis of the hypothesis that agricultural rationalization leads to more suicide, this study investigated whether a general relationship could be found between structural change in agriculture and suicide mortality in post-war Europe. METHOD: Due to the expected small size of the effect, the data were deliberately collected so as to maximize the variation in the independent variable. Annual national-level data on suicide mortality, the percentage of the work force in agricultural employment, and the unemployment level were collected from those countries and 10-year periods where the structural changes (reductions in employment) in agriculture between 1950 and 1995 had been most and least pronounced. In order to avoid confounders, the annual changes in the variables' values were correlated with each other, adding a control for the level of unemployment, and allowing for lagged effects. RESULTS: The annual changes in the levels of agricultural employment and those of suicide mortality did not covary at all. Controlling for unemployment levels did not change this, nor could any lagged effects be found. CONCLUSIONS: At the most general level, no causal relation between agricultural rationalization and suicide mortality was detected. This lack of a universal relation does not, however, preclude the possibility of the relationship existing given certain socio-historical circumstances.

Agriculture↗

PubMed1999

Public opinion and rationing in the United Kingdom.

In the United Kingdom and as in all other countries, health care professionals ration access to diagnosis and treatment. Throughout its history there has been a reluctance to acknowledge the existence, let alone the nature of rationing processes and public opinion about them. Several health policy reforms are discussed with reference to their approach to dealing with the scarcity of health care resources. Data taken form the 1998 Eurobarometer Survey are analysed to examine public opinion regarding rationing issues, such as funding for health care, the need to set limits in health coverage, the role of stakeholders in setting priorities, and the use of age, and other factors, as a criteria for setting priorities.

Health Care Rationing↗

PubMed2002

Why is less money spent on health care for the elderly than for the rest of the population? Health care rationing in German hospitals.

The consequences of population ageing for the public health care system and health care costs may be less severe than is commonly assumed. Hospital discharge data from Germany's largest health insurer (AOK) show that the cost of caring for patients during their last year of life makes up a large part of total health expenditures. And this last year of life is less costly if patients die at an advanced age. As a multivariate analysis reveals, oldest old patients as a rule receive less costly treatment than younger patients for the same illness. Moreover, this pattern is more pronounced for elderly women than for elderly men. These findings suggest that health care is informally rationed according to the age and sex of the patient. The data also indicate that there may be more age-related rationing going on in Germany than in the United States. Future research should investigate the national, institutional, and individual factors behind health care rationing. In this paper, I discuss the physician's professional decision as one plausible determinant.

Adult↗

PubMed2001

Rationalizations and defensive attributions for high-risk sex among heterosexuals.

A group of 39 respondents high at risk for HIV and a group of 39 respondents low at risk for HIV were selected from a larger sample to examine their rationalizations and attributions for having unprotected sex. Respondents high at risk for HIV used more often rationalizations and attributions to justify and excuse their risky behavior. At the same time, respondents high at risk were somewhat more fearful of contracting Acquired Immune Deficiency Syndrome (AIDS), and did not deny the riskiness of their behaviors compared with low-risk respondents. It is suggested that interventions should not focus on enhancing risk perceptions, but rather on challenging rationalizations and attributions that foster risky sexual behavior.

Attitude to Health↗

PubMed2002

Evidence-based medicine as an instrument for rational health policy.

This article tries to present a broad view on the values and ethical issues that are at stake in efforts to rationalize health policy on the basis of economic evaluations (like cost-effectiveness analysis) and randomly controlled clinical trials. Though such a rationalization is generally seen as an objective and 'value free' process, moral values often play a hidden role, not only in the production of 'evidence', but also in the way this evidence is used in policy making. For example, the definition of effectiveness of medical treatment or health care service is heavily dependent on dominant individual or social views about the goals of the particular treatment or service. There is also a concern that a reliance on EBM in health policy will occur at the expense of widely shared social values like equity and solidarity. Moreover, there is a concern that when economic considerations and rational procedures become more influential, various 'outside' groups third parties like insurance companies and policy makers will get a stronger influence on medical practice which may lead to a change in the patient-provider relationship. The authors conclude that social values and patient preference should be explicitly addressed when health policy making is based on economic and other scientific evidence.

Cost-Benefit Analysis↗

PubMed2006

The dangers of rationing dialysis treatment: the dilemma facing a developing country.

The increasing burden of chronic kidney disease places enormous strains on resources of all countries, but especially of those with emerging economies. Few developing countries are able to afford dialysis programs and those that do ration this scarce resource. In South Africa, rationing has been practiced since the introduction of dialysis. Our renal unit carefully screened patients with end-stage kidney disease (ESKD) based on certain medical and socioeconomic criteria. The outcome of these decisions taken by the Assessment Committee is reviewed in this study. Details of the 2442 patients with ESKD assessed between 1988 and 2003 for the renal replacement program were captured. Using univariate and multivariate analysis, the odds of being accepted for treatment based on several variables were determined. The majority (52.7%) of patients with ESKD were not offered renal replacement therapy in the period of study. The number of kidney transplants progressively decreased, as did the number of patients accepted. The patients mostly likely to be accepted for renal replacement therapy were aged 20-40 years, white, employed, married, non-diabetic, and lived in proximity to a dialysis center. Almost 60% of patients were denied renal replacement treatment because of social factors related to poverty. In a developing country, where rationing of treatment is unavoidable, it is difficult to ensure equity of treatment and certain groups are advantaged over others. In our experience, socioeconomic factors influenced decision to accept patients more profoundly than medical ones.

Adult↗