Foundations of pharmacokinetics.
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Animals↗
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Results for “foundation model”
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Probabilistic foundations for coefficients of generalizability.
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Models, Psychological↗
[Cognitive therapy for posttraumatic stress disorder].
The authors describe the clinical presentation of Posttraumatic Stress Disorder (PTSD) according to the cognitive-behavioral model. The vulnerability factors for the development of PTSD are discussed. The foundations of the cognitive approach to PTSD are presented and guidelines on the contends and duration of the psychotherapy is proposed.
Behavior↗
To make a difference: the founding of the Crohn's and Colitis Foundation of America.
In 1965, with the help of Dr. Henry D. Janowitz, Irwin M. Rosenthal established the Foundation for Research in Ileitis, Inc., now known as the Crohn's and Colitis Foundation of America, Inc. He was joined shortly thereafter by William D. Modell. At that time, the entire annual NIH budget for research on inflammatory bowel disease was only $25,000. Successful fund raising made it possible to recruit a research fellow at The Mount Sinai Hospital in the Division of Gastroenterology to study ileitis. Thereafter, the efforts of the foundation expanded nationwide. It supported a nationally coordinated research program and sponsored education for physicians, patients and the public. In addition, it established support groups to help patients and their families cope with Crohn's disease and ulcerative colitis. With the energy and philanthropy of the foundation's many lay leaders, tens of millions of dollars have been raised for research and education in inflammatory bowel disease.
Colitis↗
Engraftment of human chronic lymphocytic leukemia cells in SCID mice: in vivo and in vitro studies.
Chronic lymphocytic leukemia (CLL) is a heterogeneous disease of the elderly which can present in one of three stages; benign, intermediate or advanced. The molecular events governing the progression of CLL are poorly understood. In order to develop model systems for predicting the aggressiveness of leukemic clones in CLL, in vivo transplantation of SCID mice with CLL cells, and the in vitro growth of CLL cells on mouse and human stromal layers, were investigated. Bone marrow or peripheral blood cells from 40 patients at different stages of CLL were transplanted into 172 immune-deficient SCID mice. Thirty-five percent of SCID mice injected with CLL cells were positive for the presence of human DNA by Southern blot or PCR analysis. The most frequently involved sites were the spleen, lung, kidney and bone marrow, at levels corresponding from 0.1 to 10 percent human DNA. Thrice-weekly intraperitoneal injections of IL-2, alone or in combination with IL-7, did not increase the level of human cell engraftment. SCID mice developed endogenous thymic lymphomas at an incidence of 10-33 percent, a rate that was not increased by CLL cell transplantation. In vitro, CLL cells were able to proliferate for 9 weeks on human stromal layers supplemented with CM (conditioned media from a culture of the human bladder carcinoma cell line 5637), but failed to thrive on the murine stromal cell line MTE cultured either in CM or autologous serum. FACS analysis revealed that 81 percent of proliferating cells on human stromal layers carried the CD5 cell surface marker, identifying them as CLL cells. Previously EBV-negative CLL cells became EBV-positive after 9 to 12 weeks in culture. The results of this study provide a firm foundation for the development of in vivo and in vitro model systems for the study of human CLL.
Animals↗
Psychooncological provision in a general hospital: the Herford model.
Since October 1995 a Department of Psychooncology exists at the Herford Community Hospital. It was founded by a private foundation with the aim of supporting patients who suffer from cancer. The psychooncological section is an independent unit. This state of independence proved to be very useful and functional. The Herford Model is based on four compartments: psychosocial support for the patients; support for the patients' relations; the education of doctors and nurses; the evaluation of the activities of the team members, one music therapist and three psychologists. During the past 2.5 years 846 patients have had contact with the Department of Psychooncology. The mean age was about 62 years within a range from 15 to 92 years. Of the patients, 48% were men and 52% were women. The maximum number of meetings was 49: 29% of the patients had between four and eight therapeutical meetings, 12% had more than nine sessions. It is the aim of this report to show how the section is organized. The daily work and the rate of provision is shown and an outlook of the team's work in the future is given.
Adolescent↗
National Hospital Information Resource Center: a model.
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American Hospital Association↗
Evaluating the sale of a nonprofit health system to a for-profit hospital management company: the Legacy Experience.
OBJECTIVE: To introduce and develop a decision model that can be used by the leadership of nonprofit healthcare organizations to assist them in evaluating whether selling to a for-profit organization is in their community's best interest. STUDY SETTING/DATA SOURCES: A case study of the planning process and decision model that Legacy Health System used to evaluate whether to sell to a for-profit hospital management company and use the proceeds of the sale to establish a community health foundation. Data sources included financial statements of benchmark organizations, internal company records, and numerous existing studies. STUDY DESIGN: The development of the multivariate model was based on insight gathered through a review of the current literature regarding the conversion of nonprofit healthcare organizations. DATA COLLECTION/EXTRACTION METHODS: The effect that conversion from nonprofit to for-profit status would have on each variable was estimated based on assumptions drawn from the current literature and on an analysis of Legacy and for-profit hospital company data. PRINCIPAL FINDINGS: The results of the decision model calculations indicate that the sale of Legacy to a for-profit firm and the subsequent creation of a community foundation would have a negative effect on the local community. CONCLUSIONS: The use of the decision model enabled senior management and trustees to systematically address the conversion question and to conclude that continuing to operate as a nonprofit organization would provide the most benefit to the local community. The model will prove useful to organizations that decide to sell to a for-profit organization as well as those that choose to continue nonprofit operations. For those that decide to sell, the model will assist in minimizing any potential negative effect that conversion may have on the community. The model will help those who choose not to sell to develop a better understanding of the organization's value to the community.
Contract Services↗
[Does population ecology have general laws?].
There is a widespread opinion among ecologists that ecology lacks general laws. In this paper the author argues that this opinion is mistaken. Taking the case of population dynamics, the author points out that there are several very general law-like propositions that provide the theoretical basis for most population dynamics models that were developed to address specific issues. Some of these foundational principles, like the law of exponential growth, are logically very similar to certain law of physics (Newton's law of intertia, for example, is almost a direct analogue of exponential growth). The author discusses two other principles (population self-limitation and resource-consumer oscillations), as well as the more elementary postulates that underlie them. None of the "laws" that the author proposes for population ecology are new. Collectively ecologists have been using these general principles in guiding development of their models and experiments since the days of Lotka, Volterra, and Gause.
Animals↗
Identification and review of sensitivity analysis methods.
Identification and qualitative comparison of sensitivity analysis methods that have been used across various disciplines, and that merit consideration for application to food-safety risk assessment models, are presented in this article. Sensitivity analysis can help in identifying critical control points, prioritizing additional data collection or research, and verifying and validating a model. Ten sensitivity analysis methods, including four mathematical methods, five statistical methods, and one graphical method, are identified. The selected methods are compared on the basis of their applicability to different types of models, computational issues such as initial data requirement and complexity of their application, representation of the sensitivity, and the specific uses of these methods. Applications of these methods are illustrated with examples from various fields. No one method is clearly best for food-safety risk models. In general, use of two or more methods, preferably with dissimilar theoretical foundations, may be needed to increase confidence in the ranking of key inputs.
Analysis of Variance↗
Developments in professional quality assurance towards quality improvement: some examples of peer review in the Netherlands and the United Kingdom.
This study will explore new developments in three clinical peer review programmes in the UK and the visitatie programme in The Netherlands and how these programmes can be linked, in the future, with other quality systems. The information about the English peer review programmes was gathered by conducting four structured interviews with the programme coordinators (see Acknowledgements). Information about the Dutch visitatie programme was gathered by the author working with different visitatie programmes at the Dutch National Institute for Quality Improvement. Comparing new developments in the models of the Institute for Standardization of Organizations and the European Foundation for Quality Management, common changes are identified which seem to reflect elements viewed internationally as necessary in quality improvement. This study will examine if and how these elements are or will be included in the clinical peer review programmes in the UK and in visitatie in The Netherlands.
Forecasting↗
A model of psychological dependence in adolescent substance abusers.
Adolescent substance abuse appears to have its foundations in a distortion of perceived events at an age prior to involvement with substances. Substances are used as a compromise in an attempt to establish a lifestyle which has meaning to the individual. Because the individual's involvement with a substance has taken place during the crucial developmental phase of adolescence, and because the use of drugs alters one's perception of one's social, emotional and cognitive state, any experience during this time must, by necessity, be distorted. At the same time, other experiences, necessary for natural development into adulthood, are forsaken . Thus, certain learned skills are replaced by those learned whilst under the influence of substances or as a reaction to the substance abusing lifestyle. The latter two often being inappropriate in drug-free situations. As the abuse of substances severely hampers the individual's natural development, a model of Developmental Habilitation is the essence of change.
Adolescent↗
The complementary interaction of epidemiological and experimental animal studies: a key foundation of the preventive effort.
This overview will examine the contributions made by animal models of atherosclerosis to our understanding of its pathogenesis and will describe the principles for prevention of this disease process. In addition, some of the recent biochemical and cell biological discoveries, many utilizing animal cells and animal lipoproteins, will be discussed. Further, the increasing knowledge brought to worldwide efforts for the prevention and regression of atherosclerosis by the aforementioned research approaches will be reviewed. The results of some of the most promising animal studies of advanced atherosclerotic plaque regression will be briefly summarized, emphasizing the quantitation of changes. The prospects for verifying some of these findings in quantitative studies of human atherosclerosis will be presented along with some of the obstacles to be overcome.
Animals↗
The AMPPA network as a successful model for public-private or private-private partnership.
In 1997, the Rockefeller Foundation and the Ernst Schering Research Foundation (a subsidiary of Schering AG, Germany, on a non-profit basis) mounted a multi-year global collaborative effort, involving a network of top-level research institutions to intensify research on the regulation of the male reproductive system with special emphasis on post-testicular activity, utilizing new approaches in molecular pharmacology (application of molecular pharmacology for post-testicular activity (AMPPA) network). The new venture proved a success as a public-private sector partnership, as a collaborative scientific program, and as an approach to identify new targets applicable and suitable for drug finding for male fertility regulation.
Aged↗
Theoretical foundations for noninvasive measurement of variations in the width of the subarachnoid space.
Numerical modeling was used for the theoretical analysis of the propagation of optical radiation in the tissues of the human head, generated by a single source placed on the surface of the scalp. Of special interest and importance is the propagation of radiation within the layer of cerebrospinal fluid contained in the subarachnoid space (SAS), which is the only low absorption/high transmittance medium whose width can vary rapidly. Qualitative and quantitative assessment of changes in propagation of radiation within the SAS could become a source of information on changes in the geometry of this anatomical compartment playing a crucial role in cranio-spinal physiology and pathology. Essential for the idea of the possible noninvasive assessment of changes in width of the SAS by an optical method is the dependence of intensity of radiation reaching a photodetector located at a certain distance from the source on changes in the width of this fluid layer, which acts like a biological optical waveguide. Monte Carlo modeling and numerical analysis confirmed the feasibility of assessing changes in the width of the subarachnoid space optically. Presented here are details of the Monte Carlo simulation of light propagation in the tissues of human head and the results of such simulation as a function of the width of the subarachnoid space, calculated for different distances between the source and detector and for a few selected values of bone thickness. Results of numerical modeling were then compared with those of experiments on a mechanical-optical model.
Adolescent↗
A privately financed fellowship model for management training of physicians.
This paper describes the ongoing need for physician executives and reviews current opportunities for training physicians in management. The authors discuss existing sources of funding and highlight one management training program that uses various mechanisms of a new funding model that can increase the number and diversity of learning opportunities, not only in management but also in all disciplines where training traditionally has been underfunded. The basic mechanism of this new model is as follows: a privately funded program uses a locum tenens arrangement whereby a physician fellow works in a community-based private practice in order to produce both compensation for work done and funding for training at an academic institution. Finally, the authors suggest that academic institutions and managed care organizations might consider such a model as one means of using clinical income to expand management training within the contexts of their existing academic missions and patient care commitments.
Fellowships and Scholarships↗
Difference equation model of ventricular parasystole as an interaction between cardiac pacemakers based on the phase response curve.
A model of extended ventricular parasystole proposed by Moe et al. (1977) was formulated as a system of nonlinear difference equations by using the phase response curve of myocardial pacemakers. A number of ECG patterns of ventricular arrhythmia such as bigeminy, trigeminy etc. were explained from the property of periodic solutions of the equation. Characteristic properties of special kinds of arrhythmia called "concealed bigeminy" and "concealed trigeminy" were derived mathematically by assuming the model, in relation to the equation of the analog neuron model. The present study was considered to be of clinical significance as a theoretical foundation for the study of genesis of cardiac arrhythmias.
Arrhythmias, Cardiac↗
Inaccuracy of four coronary surgery risk-adjusted models to predict mortality in individual patients.
OBJECTIVES: This study was undertaken to evaluate the accuracy of four different risk-adjusted models in predicting mortality in individual patients who are undergoing coronary artery by-pass graft surgery. In the last decade several models to stratify patients before open heart surgery, according to factors affecting mortality, were developed with the aim of retrospectively comparing outcomes of open heart surgery, based on reliable stratification of case-mix, and of prospectively identifying high risk patients as a basis for a meaningful informed consent for patients counseling. METHODS: The pre-operative risk of death was calculated with four different models in 418 consecutive patients who underwent coronary artery by-pass surgery and then compared with the actual outcome. To discriminate patients with favorable and unfavorable outcome, the logistic regression analysis and the areas under the receiver-operating-characteristic curves were applied. The accuracy score was used to evaluate the reliability of each score to predict the individual outcome. RESULTS: Seven deaths (1.7%) were observed within 30 days from the operation, and the overall incidence was similar to that predicted by all models. Only the NBI score was not able to discriminate survivors from patients who will die, and the areas under the curves were 0.596 for the Parsonnet score, 0.861 for the Cleveland Clinic Foundation score, 0.823 for the French score, and 0.806 for the EuroSCORE. The four models were highly accurate (between 0.97 and 0.98) to predict the overall mortality. In seven patients who died the mean predictive scores were very low and ranged between 2.1 and 4.6, but were significantly higher than those of patients who survived (between 1.1 and 2.2). CONCLUSIONS: The four pre-surgical predictive models were similarly able to discriminate favorable vs. unfavorable outcomes and highly accurate to predict overall mortality, but very inaccurate to predict mortality in individual patients.
Adult↗