918 resultados para economic evaluation


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Background: Palliative care should be provided according to the individual needs of the patient, caregiver and family, so that the type and level of care provided, as well as the setting in which it is delivered, are dependent on the complexity and severity of individual needs, rather than prognosis or diagnosis. This paper presents a study designed to assess the feasibility and efficacy of an intervention to assist in the allocation of palliative care resources according to need, within the context of a population of people with advanced cancer. ---------- Methods/design: People with advanced cancer and their caregivers completed bi-monthly telephone interviews over a period of up to 18 months to assess unmet needs, anxiety and depression, quality of life, satisfaction with care and service utilisation. The intervention, introduced after at least two baseline phone interviews, involved a) training medical, nursing and allied health professionals at each recruitment site on the use of the Palliative Care Needs Assessment Guidelines and the Needs Assessment Tool: Progressive Disease - Cancer (NAT: PD-C); b) health professionals completing the NAT: PD-C with participating patients approximately monthly for the rest of the study period. Changes in outcomes will be compared pre-and post-intervention.---------- Discussion: The study will determine whether the routine, systematic and regular use of the Guidelines and NAT: PD-C in a range of clinical settings is a feasible and effective strategy for facilitating the timely provision of needs based care.

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This study reports on the impact of a "drink driving education program" taught to grade ten high school students. The program which involves twelve lessons uses strategies based on the Ajzen and Madden theory of planned behavior. Students were trained to use alternatives to drink driving and passenger behaviors. One thousand seven hundred and seventy-four students who had been taught the program in randomly assigned control and intervention schools were followed up three years later. There had been a major reduction in drink driving behaviors in both intervention and control students. In addition to this cohort change there was a trend toward reduced drink driving in the intervention group and a significant reduction in passenger behavior in this group. Readiness to use alternatives suggested that the major impact of the program was on students who were experimenting with the behavior at the time the program was taught. The program seems to have optimized concurrent social attitude and behavior change.

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The use of appropriate features to characterize an output class or object is critical for all classification problems. This paper evaluates the capability of several spectral and texture features for object-based vegetation classification at the species level using airborne high resolution multispectral imagery. Image-objects as the basic classification unit were generated through image segmentation. Statistical moments extracted from original spectral bands and vegetation index image are used as feature descriptors for image objects (i.e. tree crowns). Several state-of-art texture descriptors such as Gray-Level Co-Occurrence Matrix (GLCM), Local Binary Patterns (LBP) and its extensions are also extracted for comparison purpose. Support Vector Machine (SVM) is employed for classification in the object-feature space. The experimental results showed that incorporating spectral vegetation indices can improve the classification accuracy and obtained better results than in original spectral bands, and using moments of Ratio Vegetation Index obtained the highest average classification accuracy in our experiment. The experiments also indicate that the spectral moment features also outperform or can at least compare with the state-of-art texture descriptors in terms of classification accuracy.