992 resultados para 162-984


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116 hojas : ilustraciones, fotográficas a color.

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Objective: To evaluate the impact of a provider initiated primary care outreach intervention compared with usual care among older adults at risk of functional decline. Design: Randomised controlled trial. Setting: Patients enrolled with 35 family physicians in five primary care networks in Hamilton, Ontario, Canada. Participants Patients: were eligible if they were 75 years of age or older and were not receiving home care services. Of 3166 potentially eligible patients, 2662 (84%) completed the validated postal questionnaire used to determine risk of functional decline. Of 1724 patients who met the risk criteria, 769 (45%) agreed to participate and 719 were randomised. Intervention: The 12 month intervention, provided by experienced home care nurses in 2004-6, consisted of a comprehensive initial assessment using the resident assessment instrument for home care; collaborative care planning with patients, their families, and family physicians; health promotion; and referral to community health and social support services. Main outcome measures: Quality adjusted life years (QALYs), use and costs of health and social services, functional status, self rated health, and mortality. Results: The mean difference in QALYs between intervention and control patients during the study period was not statistically significant (0.017, 95% confidence interval -0.022 to 0.056; P=0.388). The mean difference in overall cost of prescription drugs and services between the intervention and control groups was not statistically significant, (-$C165 (£107; €118; $162), 95% confidence interval -$C16 545 to $C16 214; P=0.984). Changes over 12 months in functional status and self rated health were not significantly different between the intervention and control groups. Ten patients died in each group. Conclusions: The results of this study do not support adoption of this preventive primary care intervention for this target population of high risk older adults. Trial registration: Clinical trials NCT00134836.

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Saisi avec 6 autres mss en janvier 1797 dans la bibliothèque de l'abbaye bénédictine de San Benedetto in Polirone près de Mantoue, cf. cote du XVIIIe s. "MS n° 49" (f. de garde); Laffitte, Bulletin du Bibliophile, 1989/2, 300; Delisle, Cab. des mss., II, 414; — ex-libris du XVe s. "Iste liber est mei mag. Johannis Martini de Ferariis de Parma artium ac medicine doctoris" (292v)

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Pós-graduação em Agronomia (Produção Vegetal) - FCAV