RESUMEN
The SceneScore is a simple mechanism of injury scoring system designed to facilitate the appropriate triage of crash victims. It comprises 7 variables including age, collision type, impact location, airbag deployment, steering wheel deformity, intrusion, and restraint use. A cutoff value of 7 or 8 provides the maximum balance between sensitivity and specificity, with sensitivities of 75% to 83% and specificities of 29% to 46%. For cases triaged to the trauma center based only on high suspicion of injury, the SceneScore reduces the overtriage rate by almost half. Proper application of the SceneScore may lead to improved triage and enhanced communication of mechanism of injury criteria.
Asunto(s)
Accidentes de Tránsito/estadística & datos numéricos , Vehículos a Motor/estadística & datos numéricos , Triaje/métodos , Heridas y Lesiones/terapia , Anciano , Bases de Datos como Asunto , Servicios Médicos de Urgencia/métodos , Femenino , Florida , Escala de Coma de Glasgow , Indicadores de Salud , Humanos , Puntaje de Gravedad del Traumatismo , Masculino , Persona de Mediana Edad , Proyectos PilotoAsunto(s)
Necesidades y Demandas de Servicios de Salud/tendencias , Servicios de Salud para Ancianos/tendencias , Dinámica Poblacional , Anciano , Comportamiento del Consumidor , Atención a la Salud/tendencias , Fuerza Laboral en Salud/tendencias , Humanos , Esperanza de Vida , Mercadotecnía , Estados UnidosAsunto(s)
Enfermedad Crónica/economía , Política de Salud/legislación & jurisprudencia , Medicaid/legislación & jurisprudencia , Medicare/legislación & jurisprudencia , Anciano , Benchmarking , Presupuestos/legislación & jurisprudencia , Capitación , Enfermedad Crónica/terapia , Prestación Integrada de Atención de Salud/economía , Prestación Integrada de Atención de Salud/organización & administración , Política de Salud/economía , Humanos , Política , Estados UnidosRESUMEN
According to a study, ALFs (assisted living facilities) can offer a cost-effective model of care for the disabled due to the environment's flexible staffing patterns and a slower rate of spend-down to Medicaid.
Asunto(s)
Personas con Discapacidad , Viviendas para Ancianos , Anciano , Anciano Frágil , Humanos , Estados UnidosRESUMEN
Male guinea pigs fed a vitamin C-deficient diet for 3 weeks had lower concentrations of cholesteryl esters in their adrenals than did control animals fed the recommended intake of the vitamin. Not all esters were affected to the same degree, and the fatty acid profiles of the esters from control and deficient guinea pigs differed; there was proportionately more palmitic and linoleic acids and less docosatetraenoic acid [22:4 (n-6)] in the deficient guinea pig adrenal esters. [Fatty acids are designated as X:Y (n-Z), where X and Y are the numbers of carbon atoms and olefinic bonds in the acid and Z is the number of carbon atoms after the terminal olefinic bond.] A 100-fold excess of vitamin C in the diet also resulted in lower concentrations of adrenal cholesteryl esters than did the control diet, but they were not as low as in the deficient animals. Fatty acid profiles were similar for esters from control and excessively supplemented guinea pigs. Vitamin C deficiency apparently imposes a long term stress which results in a depletion of adrenal cholesteryl esters, possibly specific esters, to meet the requirements for glucocorticoid synthesis.
