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Search Results: 1 - 10 of 8425 matches for " Marie Deom "
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What doctors think about the impact of managed care tools on quality of care, costs, autonomy, and relations with patients
Marie Deom, Thomas Agoritsas, Patrick A Bovier, Thomas V Perneger
BMC Health Services Research , 2010, DOI: 10.1186/1472-6963-10-331
Abstract: Mail survey of doctors (N = 1546) in Geneva, Switzerland. Respondents were asked to rate the impact of 8 managed care tools on 4 aspects of care on a 5-level scale (1 very negative, 2 rather negative, 3 neutral, 4 rather positive, 5 very positive). For each tool, we obtained a mean score from the 4 separate impacts.Doctors had predominantly negative opinions of the impact of managed care tools: use of guidelines (mean score 3.18), gate-keeping (2.76), managed care networks (2.77), second opinion requirement (2.65), pay for performance (1.90), pay by salary (2.24), selective contracting (1.56), and pre-approval of expensive treatments (1.77). Estimated impacts on cost control were positive or neutral for most tools, but impacts on professional autonomy were predominantly negative. Primary care doctors held more positive opinions than doctors in other specialties, and psychiatrists were in general the most critical. Older doctors had more negative opinions, as well as those in private practice.Doctors perceived most managed care tools to have a positive impact on the control of health care costs but a negative impact on medical practice. Tools that are controlled by the profession were better accepted than those that are imposed by payers."Managed care" is a global term for health care systems that integrate the delivery and financing of health care. Managed care contrasts with liberal medical practice, which allows doctors to make clinical decisions and bill for their services without interference from managers or payers. Traditional forms of managed care include the staff-model health maintenance organization (HMO) and the office-based independent provider association [1,2]. However, many variants exist. Luft notes that "in reality, each HMO is a highly complex combination of economic incentives, bureaucratic structures, and personalities" [3]. Another definition characterizes managed care programs by their use of a variety of interventions, including economic incen
Evaluation of peanut genotypes for resistance to Tomato spotted wilt virus by mechanical and thrips inoculation
Nascimento, Luciana Cordeiro do;Pensuk, Viboon;Costa, Nivania Pereira da;Assis Filho, Francisco Miguel de;Pio-Ribeiro, Gilvan;Deom, Carl Michael;Sherwood, John;
Pesquisa Agropecuária Brasileira , 2006, DOI: 10.1590/S0100-204X2006000600006
Abstract: the objective of this work was to evaluate the reactions of three peanut breeding lines (ic-10, ic-34, and icgv 86388) to tomato spotted wilt virus (tswv) by mechanical and thrips inoculation, under greenhouse conditions, and compare them to the reactions of cultivars sunoleic, georgia green, and the breeding line c11-2-39. tswv infection by mechanical inoculation was visually assessed using an index ranging from 0 (no symptoms) to 4 (apical death). enzyme-linked immunosorbent assay was used to confirm tswv infection from both mechanical and thrips inoculations. ic-10, ic-34, icgv 86388, and c11-2-39 were more resistant than the cultivars sunoleic and georgia green based on mechanical inoculation. upon thrips inoculation only ic-34 and icgv-86388 were infected by tswv, as demonstrated by reverse transcription polymerase chain reaction (rt-pcr), although no symptoms of infection were observed. the peanut breeding lines ic-10, ic-34, and icgv 86388 show higher level of resistance to tswv than cultivar georgia green considered a standard for tswv resistance.
Production of human polyclonal antibodies by transgenic animals  [PDF]
Louis-Marie Houdebine
Advances in Bioscience and Biotechnology (ABB) , 2011, DOI: 10.4236/abb.2011.23022
Abstract: Polyclonal antibodies collected from the blood of animals and humans experimentally immunised or spontaneously immunised respectively can be injected into patients to protect them against pathogens, toxins, tumours etc. This approach is severely limited by the availability of human polyclonal antibodies of interest. Moreover, polyclonal antibodies from animals are recognised as antigens by patients and are thus rapidly rejected and inactivated. To circumvent this problem, animals (essentially rabbits, chicken, pigs and cows) are being genetically engineered. Their immunoglobulin genes are being inactivated and the corresponding human immunoglobulin genes are being transferred to them. These animals will be immunized and it is expected that large amounts of pure human polyclonal antibodies will be extracted from their blood to be administered to patients. The possible acceptability problem of this approach is under a case study of the European Union Pegasus project.
Efficacy and tolerability of propolis special extract gh 2002 as a lip balm against herpes labialis: a randomized, double-blind three-arm dose finding study  [PDF]
Simona Holcová, Marie Hladiková
Health (Health) , 2011, DOI: 10.4236/health.2011.31010
Abstract: A dose-finding study was performed with respect to the clinical applicability and tolerability of three different concentrations of propolis special extract GH 2002 in a lip balm (0.1%, 0.5% and 1%). The trial was designed as a double-blind, randomized dermatological study in 150 outpatients with Herpes labialis. The primary parameter was the duration in days until painless incrustation in 50% or 90% of the patients (observable in 121 patients). Secondary parameters were local pain (assessed on a visual analogue scale), itching, burning and tension/ swelling on a verbal rating scale, and tolerability. Visits were performed on days 2/3, 5/6 and 8/9. Best efficacy results with shortest healing time (3.4 and 5.4 days in the 50th and 90th percentile, respectively; p = 0.008 vs. 1% and 0.09 vs. 0.1%) and good tolerability were observed with the 0.5% concentration. All three concentrations achieved highly significant therapeutic results in comparison with baseline values (p < 0.0005) for all secondary parameters as early as day 2/3. Analgesia was the most prominent effect for the patients. Conclusion: The 0.5 % concentration of propolis special extract GH 2002 in a lip balm was found to have the best risk-benefit ratio for the treatment of Herpes labialis.
Classroom Assessment Techniques: An Assessment and Student Evaluation Method  [PDF]
Dawn-Marie Walker
Creative Education (CE) , 2012, DOI: 10.4236/ce.2012.326136
Abstract: Some of the challenges that face Higher Education are how to ensure that assessment is meaningful and that feedback is prompt in order to promote learning. Another issue is how to provide lecturers with feedback regarding their efficacy, in a timely and non-judgmental manner. This paper proposes that Classroom Assessment Techniques (Angelo and Cross, 1993), maybe a good way of answering both of those issues. They are quick and easy tasks set within the lecture, which tests the student’s knowledge, providing an immediate opportunity for further elaboration if needed by the lecturer, therefore providing immediate feedback to the students. It also ensures that the lecturer has delivered the most salient messages, therefore also providing feedback to the lecturer.
Fuzzy Logic Strategy for Solving an Optimal Control Problem of Glucose and Insulin in Diabetic Human  [PDF]
Jean Marie Ntaganda
Open Journal of Applied Sciences (OJAppS) , 2013, DOI: 10.4236/ojapps.2013.37052
Abstract:

This paper aims at the development of an approach integrating the fuzzy logic strategy for a glucose and insulin in diabetic human optimal control problem. To test the efficiency of this strategy, the author proposes a numerical comparison with the indirect method. The results are in good agreement with experimental data.

Hopf Bifurcation of a Two Delay Mathematical Model of Glucose and Insulin during Physical Activity  [PDF]
Jean Marie Ntaganda
Open Journal of Applied Sciences (OJAppS) , 2014, DOI: 10.4236/ojapps.2014.42006
Abstract: In this paper, we are interested in looking for Hopf bifurcation solutions for mathematical model of plasma glucose and insulin during physical activity. The mathematical model is governed by a system of delay differential equations. The algorithm for determining the critical delays that are appropriate for Hopf bifurcation is used. The illustrative example is taken for a 30 years old woman who practices regular three types of physical activity: walking, jogging and running fast.
Bank Characteristics and Procyclicality: A Theoretical Approach  [PDF]
Marie-Sophie Gauvin
Journal of Financial Risk Management (JFRM) , 2014, DOI: 10.4236/jfrm.2014.33007
Abstract:

The 2007-2008 crisis highlighted liquidity management troubles. We witness a real estate asset price boom during the pre-crisis period and a difficulty for banks to raise funding afterwards. Consequently, bank choices in response to the conduct of the monetary policy along the cycle can be studied. Despite usual financial accelerator, the excessive (lack of) confidence of banks in the upward (down) phase explains procyclical balance sheet movements. Moreover, the monetary policy effects on bank behaviors vary according to their initial specifications. From a theoretical point of view, this paper examines the response of the banking sector to monetary authorities impulses, in function of their initial characteristics. So, the paper highlights a theoretical model, based on accounting identities, in which banks are distinguished in different categories according to their level of capitalization and liquidity. The principal result is that the less capitalized and liquid banks have more procyclical behaviors.

Psychological Distress in California: Identifying Those at Greatest Risk  [PDF]
Gina Marie Piane
Open Journal of Preventive Medicine (OJPM) , 2014, DOI: 10.4236/ojpm.2014.48075
Abstract:

In order to address the unmet need for prevention and treatment of psychological distress and mental disorders, program planners and treatment providers need to identify individuals at high risk. The results of the California Health Interview Survey from 2009 (n = 47,614) indicate that there are high relative risks by demographics and smoking status for reports of psychological distress and intermediate measures: feeling nervous, hopeless, worthless, depressed, restless, and that everything is an effort. Specific demographic factors and smoking status can predict a greater need for prevention and treatment of psychological distress and lack of insurance coverage for treatment. Profiles associated with high risk can help in referral for diagnosis or to plan prevention programs.

Maternal Mortality Correlates by Nation  [PDF]
Gina Marie Piane
Open Journal of Preventive Medicine (OJPM) , 2014, DOI: 10.4236/ojpm.2014.410085
Abstract: Background: This study reports the results of a secondary analysis of data provided by the World Health Organization to determine the correlates of maternal mortality among all reporting nations worldwide. Historically, maternal mortality ratios have declined in nations that provided a system for access to skilled care for the majority of its women. Currently, maternal mortality ratios are associated with access to skilled care as well as economic indicators, literacy, education, access to contraceptives, transportation and HIV prevalence. Methods: Descriptive statistics, bi-variate correlations and multiple linear regression analyses are reported using maternal mortality ratios as the dependent variable. In addition, an examination of countries that are exceptions to the regression is also reported. Results: Strong positive Pearson two-tailed correlations were found between MMR and infant mortality rate (0.866), total fertility rate (0.854), poverty rate (0.756), and adolescent fertility rate (0.710). Strong negative correlations were found between MMR and percentage of births attended by a skilled attendant (-0.786), percentage of women using contraceptives (-0.786), and adult literacy rate (-0.710). Eighty-one percent of the variation in MMR can be explained by differences in IMR, percent of births attended by a skilled provider, percent of women using contraceptive, total fertility rate, adolescent fertility rate, adult literacy rate and poverty. Discussion: Examination of the correlates of maternal mortality gives direction to the effort to achieve the WHO’s Millennium Development Goal of reducing maternal mortality by two-thirds from 1995-2015.
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