951 resultados para patient perspective.


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As defined, the modeling procedure is quite broad. For example, the chosen compartments may contain a single organism, a population of organisms, or an ensemble of populations. A population compartment, in turn, could be homogeneous or possess structure in size or age. Likewise, the mathematical statements may be deterministic or probabilistic in nature, linear or nonlinear, autonomous or able to possess memory. Examples of all types appear in the literature. In practice, however, ecosystem modelers have focused upon particular types of model constructions. Most analyses seem to treat compartments which are nonsegregated (populations or trophic levels) and homogeneous. The accompanying mathematics is, for the most part, deterministic and autonomous. Despite the enormous effort which has gone into such ecosystem modeling, there remains a paucity of models which meets the rigorous &! validation criteria which might be applied to a model of a mechanical system. Most ecosystem models are short on prediction ability. Even some classical examples, such as the Lotka-Volterra predator-prey scheme, have not spawned validated examples.

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Objective: The subjective experience of psychotic patients toward treatment is a key factor in medication adherence, quality of life, and clinical outcome. The aim of this study was to assess the subjective well-being in patients with schizophrenia and to examine its relationship with the presence and severity of depressive symptoms. Methods: A multicenter, cross-sectional study was conducted with clinically stable outpatients diagnosed with schizophrenia. The Subjective Well-Being under Neuroleptic Scale - short version (SWN-K) and the Calgary Depression Scale for Schizophrenia (CDSS) were used to gather information on well-being and the presence and severity of depressive symptoms, respectively. Spearman's rank correlation was used to assess the associations between the SWN-K total score, its five subscales, and the CDSS total score. Discriminative validity was evaluated against that criterion by analysing the area under the curve (AUC). Results: Ninety-seven patients were included in the study. Mean age was 35 years (standard deviation = 10) and 72% were male. Both the total SWN-K scale and its five subscales correlated inversely and significantly with the CDSS total score (P < 0.0001). The highest correlation was observed for the total SWN-K (Spearman's rank order correlation [ rho] = -0.59), being the other correlations: mental functioning (-0.47), social integration (-0.46), emotional regulation (-0.51), physical functioning (-0.48), and self-control (-0.41). A total of 33 patients (34%) were classified as depressed. Total SWN-K showed the highest AUC when discriminating between depressive severity levels (0.84), followed by emotional regulation (0.80), social integration (0.78), physical functioning and self-control (0.77), and mental functioning (0.73). Total SWN-K and its five subscales showed a significant linear trend against CDSS severity levels (P < 0.001). Conclusion: The presence of moderate to severe depressive symptoms was relatively high, and correlated inversely with patients' subjective well-being. Routine assessment of patient-reported measures in patients with schizophrenia might reduce potential discrepancy between patient and physician assessment, increase therapeutic alliance, and improve outcome.

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Unremitting waves and occasional storms bring dynamic forces to bear on the coast. Sediment flux results in various patterns of erosion and accretion, with an overwhelming majority (80 to 90 percent) of coastline in the eastern U.S. exhibiting net erosion in recent decades. Climate change threatens to increase the intensity of storms and raise sea level 18 to 59 centimeters over the next century. Following a lengthy tradition of economic models for natural resource management, this paper provides a dynamic optimization model for managing coastal erosion and explores the types of data necessary to employ the model for normative policy analysis. The model conceptualizes benefits of beach and dune sediments as service flows accruing to nearby residential property owners, local businesses, recreational beach users, and perhaps others. Benefits can also include improvements in habitat for beach- and dune-dependent plant and animal species. The costs of maintaining beach sediment in the presence of coastal erosion include expenditures on dredging, pumping, and placing sand on the beach to maintain width and height. Other costs can include negative impacts on the nearshore environment. Employing these constructs, an optimal control model is specified that provides a framework for identifying the conditions under which beach replenishment enhances economic welfare and an optimal schedule for replenishment can be derived under a constant sea level and erosion rate (short term) as well as an increasing sea level and erosion rate (long term). Under some simplifying assumptions, the conceptual framework can examine the time horizon of management responses under sea level rise, identifying the timing of shift to passive management (shoreline retreat) and exploring factors that influence this potential shift. (PDF contains 4 pages)

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In this paper, we give a geometric interpretation of determinantal forms, both in the case of general matrices and symmetric matrices. We will prove irreducibility of the determinantal singular loci and state its dimension. We also provide detailed description of the singular locus for small dimensions.

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The paper examines the concept of the feminization of poverty and reviews the limited evidence on the extent of poverty among women. It then examines the arguments that poor women can be highly effective change agents for the eradication of poverty. However, all the women may be considered as instruments for eliminating poverty, lack of understanding an appreciation of the impact of their sex roles and of gender roles and stereotypes continue to prevent the realization of this potential. Therefore, the paper moves on to summarize the differences between sex and gender and examines how both women's sexes roles and the imp gender roles and stereotypes lead to the feminization of poverty and exclude women from the participation in development and programmes to eliminate poverty. The paper reviews the major approaches: women in development or WID, gender and development or GAD and extension of GAD known as mainstreaming. Finally, it considers the issue of poverty, women and gender in Nigeria. It also advances a number of recommendations on women and gender poverty and rural development for the consideration of policy-makers in Nigeria