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At least 1,027 records · Page 57Linked to original sources
PubMed2004

Study of hormone refractory prostate cancer: hospital care and palliative care resource use at a VA medical center.

Palliative care plays a central role in the management of hormone refractory prostate cancer patients (HRPC), yet little is known about palliative care resource use. Computerized medical records of a retrospective cohort of 89 consecutive HRPC patients seen at a VA medical center from 1994 to 1999 were reviewed for hospital and palliative care resource use in the last 6 months of life. There were 51 Caucasian and 38 African American patients; 95% of patients were admitted to the hospital for symptom management (median of 2 admissions); 98% visited clinics (median 19 visits); 35% went to the emergency room (median of 1 visit); 60% died in the hospital (median length of last hospitalization of 22 days); 49% received palliative radiation; 52% used rehabilitation; 57% received blood transfusion (median 2 units). Thirty-five patients (40%) received hospice care (median stay 35 days). The most frequently prescribed medications included opioids (90%), laxatives (89%), H2-blockers (57%), antiemetics (55%), diuretics (49%), and corticosteroids (43%). The prevalence of patients receiving opioids, as well as the dose of opioids increased over time. There was no difference in categories of palliative care resource use or survival by race. The median survival for all patients was 13 months. The results begin to highlight the extent of care and resources needed by patients with end-stage HRPC. This information will be of importance in planning palliative care for patients with HRPC and in designing future prospective studies.

Black or African American↗
PubMed2005

A mechanistic approach for modeling temperature-dependent consumer-resource dynamics.

Paramount to our ability to manage and protect biological communities from impending changes in the environment is an understanding of how communities will respond. General mathematical models of community dynamics are often too simplistic to accurately describe this response, partly to retain mathematical tractability and partly for the lack of biologically pleasing functions representing the model/environment interface. We address these problems of tractability and plausibility in community/environment models by incorporating the Boltzmann factor (temperature dependence) in a bioenergetic consumer-resource framework. Our analysis leads to three predictions for the response of consumer-resource systems to increasing mean temperature (warming). First, mathematical extinctions do not occur with warming; however, stable systems may transition into an unstable (cycling) state. Second, there is a decrease in the biomass density of resources with warming. The biomass density of consumers may increase or decrease depending on their proximity to the feasibility (extinction) boundary. Third, consumer biomass density is more sensitive to warming than resource biomass density (with some exceptions). These predictions are in line with many current observations and experiments. The model presented and analyzed here provides an advancement in the testing framework for global change scenarios and hypotheses of latitudinal and elevational species distributions.

Animals↗
PubMed2005

Impact of an outbreak of norovirus infection on hospital resources.

OBJECTIVE: To describe a nosocomial norovirus outbreak, its management, and its financial impact on hospital resources. DESIGN: A matched case-control study and microbiological investigation. METHODS: We compared 16 patients with norovirus infection with control-patients matched by age, gender, disease category, and length of stay. Bed occupancy-days during the peak incidence period of the outbreak were compared with the corresponding periods in 2001 and 2002. Expenses due to increased workload were calculated based on a measuring system that records time spent for nursing care per patient per day. RESULTS: The attack rates were 13.9% among patients and 29.5% among healthcare workers. The median number of occupied beds was significantly lower due to bed closure during the peak incidence in 2003 (29) compared with the median number of occupied beds in 2001 and 2002 combined (42.5). Based on this difference and a daily charge of 562.50 dollars per patient, we calculated a revenue loss of 37,968 dollars. Additional expenses totaled 10,300 dollars for increased nursing care. Extra costs for microbiological diagnosis totaled 2707 dollars. Lost productivity costs due to healthcare workers on sick leave totaled 12,807 dollars. The expenses for work by the infection control team totaled 1408 dollars. The financial impact of this outbreak on hospital resources comprising loss of revenue and extra costs for microbiological diagnosis but without lost productivity costs, increased nursing care, and expenses for the infection control team totaled 40,675 dollars. CONCLUSIONS: Nosocomial norovirus outbreaks result in significant loss of revenue and increased use of resources. Bed closures had a greater impact on hospital resources than increased need for nursing care

Caliciviridae Infections↗
PubMed2006

Caregivers and professionals partnership caregiver resource center: assessing a hospital support program for family caregivers.

BACKGROUND: Given that 71% of caregivers nationally report that they are caring for someone with a long-term or chronic illness, providing support to families-from diagnosis to the bereavement phase--is essential. PURPOSE: This paper describes an exploratory assessment of a hospital-based support program for family caregivers, the Caregivers and Professionals Partnership (CAPP) Caregiver Resource Center. The goal of the program evaluation was to understand the challenges facing caregivers who used the Center, how social workers intervened and the results of their interventions. Authors suggest that caregivers benefit from social work interventions that focus both on the emotional impact of caregiving and the multiple resource issues caregivers face. METHODS: Social workers assisted more than half of participating caregivers with emotional coping issues as well as referrals to community resources. In approximately 75% of cases, social workers followed up with caregivers to engage them in services and ensure that they received ongoing support. FINDINGS: From the perspective of Resource Center social workers, their interventions enhanced caregivers' abilities to cope with their responsibilities. CONCLUSIONS: Supporting caregivers over time and following up to ensure that they access needed services are critical ways to help them cope with care of a loved one. Future research can focus on how to engage caregivers who are isolated or too overwhelmed to ask for help in order to increase their use of caregiver assistance programs.

Adaptation, Psychological↗
PubMed1999

Costing for long-term care: the development of Scottish health service resource utilization groups as a casemix instrument.

OBJECTIVE: to create a casemix measure with a limited number of categories which discriminate in terms of resource use and will assist in the development of a currency for contracting for the provision of health care. DESIGN: nursing staff completed a questionnaire providing clinical data and also gave estimates of relative patient resource use; ward-based costs were collected from appropriate unit managers. SETTING: National Health Service continuing-care wards in 50 Scottish hospitals. SUBJECTS: 2783 long-stay patients aged 65 years and over. RESULTS: inter-rater reliability was assessed using 1402 patients; percentage agreement between raters for individual variables varied from 68% for feeding to 97% for clinically complex treatments. Nursing costs gave 62% agreement given categories of high, medium and low. The Scottish health service resource utilization groups (SHRUG) measure was developed using 606 cases, and 67% consistency was achieved for the five categories. The relative weights for the SHRUG categories ranged from 0.56 to 1.41. The five categories explain 35% of variance in costs. CONCLUSIONS: the five SHRUG casemix categories show good discrimination in terms of costs. The SHRUG measure compares favourably with diagnosis-related groups in the acute sector and with other casemix instruments for long-term care previously piloted in the UK. SHRUG is a useful measurement instrument in assessing the resource needs of elderly people in long-term care.

Aged↗
PubMed2002

Ectomycorrhizal symbiosis can enhance plant nutrition through improved access to discrete organic nutrient patches of high resource quality.

It is known that roots can respond to patches of fertility; however, root proliferation is often too slow to exploit resources fully, and organic nutrient patches may be broken down and leached, immobilized or chemically fixed before they are invaded by the root system. The ability of fungal hyphae to exploit resource patches is far greater than that of roots due to their innate physiological and morphological plasticity, which allows comprehensive exploration and rapid colonization of resource patches in soils. The fungal symbionts of ectomycorrhizal plants excrete significant quantities of enzymes such as chitinases, phosphatases and proteases. These might allow the organic residue to be tapped directly for nutrients such as N and P. Pot experiments conducted with nutrient-stressed ectomycorrhizal and control willow plants showed that when high quality organic nutrient patches were added, they were colonized rapidly by the ectomycorrhizal mycelium. These established willows (0.5 m tall) were colonized by Hebeloma syrjense P. Karst. for 1 year prior to nutrient patch addition. Within days after patch addition, colour changes in the leaves of the mycorrhizal plants (reflecting improved nutrition) were apparent, and after I month the concentration of N and P in the foliage of mycorrhizal plants was significantly greater than that in non-mycorrhizal plants subject to the same nutrient addition. It seems likely that the mycorrhizal plants were able to compete effectively with the wider soil microbiota and tap directly into the high quality organic resource patch via their extra-radical mycelium. We hypothesize that ectomycorrhizal plants may reclaim some of the N and P invested in seed production by direct recycling from failed seeds in the soil. The rapid exploitation of similar discrete, transient, high-quality nutrient patches may have led to underestimations when determining the nutritional benefits of ectomycorrhizal colonization.

Chlorophyll↗
PubMed2004

Species-specific variation in the importance of the spectral quality gradient in canopies as a signal for photosynthetic resource partitioning.

BACKGROUND AND AIMS: Plants adjust the distribution of photosynthetic capacity and chlorophyll to canopy density. The importance of the gradient in the red : far-red ratio (R : FR) relative to the irradiance gradient was studied for its perception with respect to this partitioning of photosynthetic resources. Whether the relative importance of these two signals varied between six species of different growth habit (Phaseolus vulgaris, Lysimachia vulgaris, Hedera helix, Ficus benjamina, Carex acutiformis and Brachypodium pinnatum) was investigated further. METHODS: Single leaves of plants were shaded in daylight by a spectrally neutral filter or a leaf. In another experiment, leaves were treated with supplemental FR. In most cases, treatment effects were evaluated after 2 weeks. KEY RESULTS: Nitrogen and photosynthetic capacity (Amax) per leaf area, parameters pertaining to between-leaf resource partitioning, were strongly reduced in neutral shade but not additionally by spectral leaf shade. Supplemental FR reduced these parameters also, except in Carex. Acceleration of induction of senescence was observed in spectral leaf shade in primary bean leaves. Amax per unit chlorophyll, a parameter pertaining to within-leaf resource partitioning, was reduced in neutral shade, but not in spectral leaf shade or supplemental FR. CONCLUSIONS: Signalling mechanisms associated with perception of the R : FR gradient in canopies were less important than those associated with the irradiance gradient for between-leaf and within-leaf partitioning of photosynthetic resources. The relative importance of the signals differed between species because Carex was the only species for which no indications were found for an involvement of the spectral gradient in perception of canopy density.

Carex Plant↗
PubMed2006

When, how and how much: Gender-specific resource-use strategies in the dioecious tree Juniperus thurifera.

BACKGROUND AND AIMS: In dioecious species male and female plants experience different selective pressures and often incur different reproductive costs. An increase in reproductive investment habitually results in a reduction of the resources available to other demands, such as vegetative growth. Tree-ring growth is an integrative measure that tracks vegetative investment through the plant's entire life span. This allows the study of gender-specific vegetative allocation strategies in dioecious tree species thoughout their life stages. METHODS: Standard dendrochronological procedures were used to measure tree-ring width. Analyses of time-series were made by means of General Mixed Models with correction of autocorrelated values by the use of an autoregressive covariance structure of order one. Bootstrapped correlation functions were used to study the relationship between climate and tree-ring width. KEY RESULTS: Male and female trees invest a similar amount of resources to ring growth during the early life stages of Juniperus thurifera. However, after reaching sexual maturity, tree-ring growth is reduced for both sexes. Furthermore, females experience a significantly stronger reduction in growth than males, which indicates a lower vegetative allocation in females. In addition, growth was positively correlated with precipitation from the current winter and spring in male trees but only to current spring precipitation in females. CONCLUSIONS: Once sexual maturity is achieved, tree rings grow proportionally more in males than in females. Differences in tree-ring growth between the genders could be a strategy to respond to different reproductive demands. Therefore, and responding to the questions of when, how and how much asked in the title, it is shown that male trees invest more resources to growth than female trees only after reaching sexual maturity, and they use these resources in a different temporal way.

Climate↗
PubMed2026

Nurse-led titration models of care for heart failure reduced ejection fraction: a systematic narrative review of characteristics, patient outcomes, and healthcare resource utilization.

AIMS: Nurse-led titration (NLT) models of care assist with delivery of guideline directed medical therapy for patients with heart failure with reduced ejection fraction (HFrEF). Effectiveness of NLT is established but there is limited information of characteristics of models, patient outcomes and healthcare resource utilization. To build upon the existing evidence by providing a systematic narrative review of the literature of NLT of medications for patients with HFrEF. This review syntheses characteristics of NLT models of care, patient outcomes and healthcare resource utilization. METHODS AND RESULTS: A systematic narrative literature review with systematic search strategy, identification of results, thematic analysis and narrative synthesis. A search was conducted from 2012 to 2025 in Medline, Cinahl complete, Embase and Cochrane. Sixteen studies of NLT models of care were identified from 1944 screened records. Characteristics of models of care were participation of nurses, multidisciplinary teams, follow-up and common features of service delivery. Patient outcomes of mortality were favourable for those that received NLT. There is some evidence of changes in healthcare resource utilization; studies in which the NLT groups received more HF nurse visits and greater HF medication use also reported reduced rehospitalizations. CONCLUSION: Findings reinforce the published benefits of NLT. Additional studies examining adverse events and quality-of-life outcomes are needed to strengthen the evidence base. Several studies suggest a shift in resource use with NLT, highlighting the need for an economic evaluation to inform a cost-effective model of care.

Humans↗
PubMed1992

Effects of age-related reductions in processing resources on text recall.

Available processing resources are presumed to determine the amount of deep, elaborative processing people can carry out, with reduced resources resulting in poor integration of details from texts, but preserved selection of main points. Two experiments examined whether experimentally reducing resources and levels of processing eventually results in a failure of selection and also whether it produces in younger people the pattern of recall normally observed in elderly people. Experiment 1 examined the effect of the added demand of selecting for preferential recall of a primary theme from a two-theme text. Subjects who putatively had greater processing resources ("younger" elderly in their 60s and those with high intelligence test scores) began to behave like older and lower intelligence test score individuals in that they recalled well main points from both themes but showed reduced recall of details from the secondary theme. In a sentence recognition task, subjects in their 70s more often accepted distractor sentences that did not preserve the meaning of the original text. In Experiment 2, encouraging subjects to process text more elaborately improved recall, especially the recall of the elderly, who began to produce recall protocols resembling those of younger and higher intelligence test score individuals. However, discouraging depth of processing did not have the converse effect of reducing quality of recall by younger and high intelligence test score individuals to resemble that of the old and less able. Instead, recall was generally depressed, with recall of main points being especially affected, suggesting that the oldest, lowest ability subjects were beginning to show a failure of selection here.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1994

Physical, psychological, and social resources as moderators of the relationship of stress to mental health of the very old.

The purpose of this pilot study was to assess the attenuating effects of physical, psychological, and social resources on the relationship between stress and mental health among the oldest old. Physical resources include perceived health and independence in functional and instrumental activities of daily living, while psychological resources include mastery, self-esteem, and coping. Social resources are measured by frequency of social interaction and size of the social network. Among the 124 women and 31 men (M = 89 years), greater independence in IADLs and greater perceived control of events significantly attenuated the adverse effects of strain on psychological well-being.

Activities of Daily Living↗
PubMed2005

KEGG as a glycome informatics resource.

Bioinformatics approaches to carbohydrate research have recently begun using large amounts of protein and carbohydrate data. In this field called glycome informatics, the foremost necessity is a comprehensive resource for genome-scale bioinformatics analysis of glycan data. Although the accumulation of experimental data may be useful as a reference of biological and biochemical information on carbohydrates, this is insufficient for bioinformatics analysis. Thus, we have developed a glycome informatics resource (http://www.genome.jp/kegg/glycan/) in KEGG (Kyoto Encyclopedia of Genes and Genomes), an integrated knowledge base of protein networks, genomic information, and chemical information. This review describes three noteworthy features: (1) GLYCAN, a database of carbohydrate structures; (2) glycan-related pathways; and (3) Composite Structure Map (CSM), a map illustrating all possible variations of carbohydrate structures within organisms. GLYCAN includes two useful tools: an intuitive drawing tool called KegDraw, and an efficient glycan search and alignment tool called KEGG Carbohydrate Matcher (KCaM). KEGG's glycan biosynthesis and metabolism pathways, integrating carbohydrate structures, proteins, and reactions, are also a pivotal resource. CSM is constructed as a bridge between carbohydrate functions and structures. CSM is able to display, for example, expression data of glycosyltransferases in a compact manner. In all the KEGG resources, various objects including KEGG pathways, chemical compounds, as well as carbohydrate structures are commonly represented as graphs, which are widely studied and utilized in the computer science field.

Carbohydrates↗
PubMed2004

The Chronic Illness Resources Survey: cross-validation and sensitivity to intervention.

There is great interest in, but few instruments to assess, multiple levels of support and community resources from a social-ecological perspective. This study evaluated the psychometric characteristics of the Chronic Illness Resources Survey (CIRS) and its sensitivity to a multifaceted social-ecological intervention to enhance personally relevant community resources supportive of healthful lifestyles. Participants were 293 post-menopausal women having type 2 diabetes who were part of a multiple-behavior lifestyle change program. Key measures included the CIRS, a validated Food Frequency Questionnaire, the Kristal Fat and Fiber Behavior Questionnaire, the CHAMPS Activities Questionnaire for Older Adults, and other measures of social support. Results revealed that the CIRS displayed good psychometric characteristics in this new sample, was significantly correlated as predicted with established measures of social support, was sensitive to intervention, and partially mediated the effects of intervention on both dietary and physical activity outcomes. The 22-item CIRS scale appears useful for assessing multilevel support resources, predicting successful behavior change and detecting social-ecological intervention effects.

Chronic Disease↗
PubMed2002

A prospective study of prolonged stay in the intensive care unit: predictors and impact on resource utilization.

OBJECTIVE: To evaluate the predictors of prolonged Intensive Care Unit (ICU) stay and the impact on resource utilization. DESIGN: Prospective study. SETTING: Adult medical/surgical ICU in a tertiary-care teaching hospital. STUDY PARTICIPANTS: All admissions to the ICU (numbering 947) over a 20-month period were enrolled. Data on demographic and clinical profile, length of stay, and outcome were collected prospectively. The ICU length of stay and mechanical ventilation days were used as surrogate parameters for resource utilization. Potential predictors were analyzed for possible association with prolonged ICU stay (length of stay > 14 days). RESULTS: Patients with prolonged ICU stay formed only 11% of patients, but utilized 45.1% of ICU days and 55.5% of mechanical ventilation days. Non-elective admissions, readmissions, respiratory or trauma-related reasons for admission, and first 24-hour evidence of infection, oliguria, coagulopathy, and the need for mechanical ventilation or vasopressor therapy had significant association with prolonged ICU stay. Mean APACHE II and SAPS II were slightly higher in patients with prolonged stay. ICU outcome was comparable to patients with < or = 14 days ICU stay. CONCLUSIONS: Patients with prolonged ICU stay form a small proportion of ICU patients, yet they consume a significant share of the ICU resources. The outcome of this group of patients is comparable to that of shorter stay patients. The predictors identified in the study can be used in targeting this group to improve resource utilization and efficiency of ICU care.

Adolescent↗
PubMed1995

Adult German cockroach (Dictyoptera: Blattellidae) movement patterns and resource consumption in a laboratory arena.

Computerized moving-image analysis was used to determine movement behavior of adult German cockroaches among food, water, and harborage resource sites. Adults at different stages in the female reproductive cycle (nonmated females, mated nongravid females, and gravid females) and males were examined continually for 5 d under a photoperiod of 12:12 (L:D) h. Corresponding food and water consumption rates for these adult classes were also determined. Differences were evident among the female reproductive classes and males. Mated nongravid females were the most active overall, and consumed the most resources. Nonmated females were second to the mated nongravid females in consumption and were less active. Gravid females were the most inactive, spending the greatest time in the harborage and consuming the fewest resources. Males were second to females in the mated nongravid class regarding activity, but consumed significantly fewer resources than females in both the mated nongravid and nongravid females. Implications of these findings relating to the biology of these adult classes are discussed.

Animals↗
PubMed1999

Caregiver behaviors and resources influence child height-for-age in rural Chad.

The purpose of this study was to identify caregiver characteristics that influence child nutritional status in rural Chad, when controlling for socioeconomic factors. Variables were classified according to the categories of a UNICEF model of care: caregiving behaviors, household food security, food and economic resources and resources for care and health resources. Sixty-four households with 98 children from ages 12 to 71 mo were part of this study. Caregivers were interviewed to collect information on number of pregnancies, child feeding and health practices, influence on decisions regarding child health and feeding, overall satisfaction with life, social support, workload, income, use of income, and household food expenditures and consumption. Household heads were questioned about household food production and other economic resources. Caregiver and household variables were classified as two sets of variables, and separate regression models were run for each of the two sets. Significant predictors of height-for-age were then combined in the same regression model. Caregiver influence on child-feeding decisions, level of satisfaction with life, willingness to seek advice during child illnesses, and the number of individuals available to assist with domestic tasks were the caregiver factors associated with children's height-for-age. Socioeconomic factors associated with children's height-for-age were the amount of harvested cereals, the sources of household income and the household being monogamous. When the caregiver and household socioeconomic factors were combined in the same model, they explained 54% of the variance in children's height-for-age, and their regression coefficients did not change or only slightly increased, except for caregiver's propensity to seek advice during child illnesses, which was no longer significant. These results indicate that caregiver characteristics influence children's nutritional status, even while controlling for the socioeconomic status of the household.

Aging↗
PubMed1986

BIONET: national computer resource for molecular biology.

This paper describes briefly the BIONET National Computer Resource for Molecular Biology. This presentation is intended as information for scientists in molecular biology and related disciplines who require access to computational methods for sequence analysis. We describe the goals, and the service and research opportunities offered to the community by BIONET, the relationship of BIONET to other national and regional resources, our recent efforts toward distribution of the resource to BIONET Satellites, and procedures for investigators to gain access to the Resource.

Amino Acid Sequence↗
PubMed1998

The Nuclear Receptor Resource: a growing family.

Last year, the original Glucocorticoid Receptor Resource was expanded into a comprehensive project: the Nuclear Receptor Resource (NRR, http:// nrr.georgetown.edu/nrr/nrr.html ). The NRR has since been offering comprehensive information on nuclear receptor structure and function, as well as general facts of interest to the scientific community on meetings, funding and employment opportunities. The project now includes individual resources as part of a network which integrates information on glucocorticoid, androgen, mineralocorticoid, thyroid hormone, Vitamin D and peroxisome-proliferator activated receptors. Many investigators have joined the NRR network by filling the Who is who? form available in the NRR home page. This has facilitated communication among scientists in the field and dissemination of data nor otherwise published. Because several investigators have contacted NRR authors over the past few months asking for advice and materials for educational purposes, we have recently decided to include in our project an educational resource on nuclear receptors termed the 'Graphics Library'. The input and suggestions of NRR users do shape the future direction of the project, so we encourage user to give us feedback.

Computer Communication Networks↗