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1.
Eur J Hybrid Imaging ; 6(1): 29, 2022 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-36517647

RESUMO

BACKGROUND: The postulated benefits of the ketogenic diet in the management of multiple medical conditions have seen more patients who are in therapeutic ketosis attending 18F-FDG PET scans. This study aimed to investigate the effect of ketosis on cerebral glucose metabolism in a clinical PET scanning environment using 18F-FDG uptake as a surrogate marker. METHODS: A retrospective audit was conducted of the brain 18F-FDG uptake in 52 patients who underwent PET scans for possible cardiac sarcoidosis or suspected intracardiac infection, following a ketogenic diet and prolonged fasting. SUVbw for whole brain and separate brain regions was compared with serum glucose and serum ketone body (beta-hydroxybutyrate) levels. RESULTS: The expected negative association between serum glucose levels and whole brain 18F-FDG uptake was confirmed. A reduction in SUVbw due to increasing serum ketones levels was also observed that was independent of and in addition to the effects of glucose. The magnitude of the reduction in SUVbw related to serum glucose level and serum ketone level was found to be greater in the precuneus than in the cerebellum or whole brain. CONCLUSION: In a real-world clinical PET setting, cerebral 18F-FDG uptake appears to be affected by glycaemia and ketonaemia. This means when assessing the brain, both serum glucose and ketone levels need to be considered when SUVs are used to distinguish between pathologic and physiologic states. The magnitude of this effect appears to vary between different brain regions. This regional difference should be taken into consideration when selecting the appropriate brain region for SUV normalisation, particularly when undertaking database comparison in the assessment of dementia.

2.
Med Vet Entomol ; 33(1): 44-55, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30168152

RESUMO

Culex quinquefasciatus Say (Diptera: Culicidae), an important vector of West Nile virus (WNV) in the U.S.A., was first detected on the Galápagos Islands (Ecuador) in the 1980s. However, little is known of its ecology, distribution or capacity for arbovirus transmission in the Galápagos. We characterize details of lifecycle (including gonotrophic period), temporal abundance, spatial distribution, vector competence and host-feeding behaviour. Culex quinquefasciatus was detected on five islands of the Galápagos during 2006-2011. A period of 7-14 days was required for egg-adult emergence; water salinity above 5 ppt was demonstrated to hinder larval development. Blood-meal analysis indicated feeding on reptiles, birds and mammals. Assessment of WNV vector competency of Galápagos C. quinquefasciatus showed a median infectious dose of 7.41 log10 plaque-forming units per millilitre and evidence of vertical transmission (minimal filial infection rate of 3.7 per 1000 progeny). The distribution of C. quinquefasciatus across the archipelago could be limited by salt intolerance, and its abundance constrained by high temperatures. Feeding behaviour indicates potential to act as a bridge vector for transmission of pathogens across multiple taxa. Vertical transmission is a potential persistence mechanism for WNV on Galápagos. Together, our results can be used for epidemiological assessments of WNV and target vector control, should this pathogen reach the Galápagos Islands.


Assuntos
Distribuição Animal , Culex/fisiologia , Características de História de Vida , Mosquitos Vetores/fisiologia , Febre do Nilo Ocidental/epidemiologia , Animais , Culex/crescimento & desenvolvimento , Equador/epidemiologia , Comportamento Alimentar , Feminino , Espécies Introduzidas , Masculino , Mosquitos Vetores/crescimento & desenvolvimento , Risco , Tolerância ao Sal , Febre do Nilo Ocidental/virologia , Vírus do Nilo Ocidental/fisiologia
3.
Genome Announc ; 4(3)2016 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-27198008

RESUMO

A novel avian paramyxovirus was identified during annual viral surveillance of wild bird populations in Kazakhstan in 2013. The virus was isolated from a white fronted goose (Anser albifrons) in northern Kazakhstan. Here, we report the complete genome sequence of the isolate, which we suggest should constitute a novel serotype.

4.
Infect Genet Evol ; 12(3): 577-85, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22342744

RESUMO

This paper presents the first evaluation of the molecular epidemiology of Mycobacterium tuberculosis in Peru. We characterised 323 isolates using spoligotyping and mycobacterial interspersed repetitive units variable number tandem repeats (MIRU-VNTR) typing. We aimed to determine the levels of genetic diversity and genetic differentiation among and within Peruvian isolates and the epidemiological factors which may be driving patterns of population structure and evolution of M. tuberculosis in Peru. Our results compared to the fourth international spoligotyping database (SpolDB4) and MIRU-VNTRplus, show that the main M. tuberculosis families present are Latin American-Mediterranean, Haarlem, T, and Beijing. Bayesian clustering recovered 15 groups in the Peruvian M. tuberculosis isolates, among which two were composed mainly of orphans, implying the presence of native "Peruvian" strains not previously reported. Variable levels of association with drug resistance were observed, with Beijing genotypes not showing any association with multidrug resistance, while in other groups MIRU-VNTR loci 2, 23, 31, and 40 were found to be associated with the multidrug-resistant tuberculosis (MDR-TB) phenotype, suggesting that a linkage disequibrium between these MIRU and drug resistance loci may be present. Genetic differentiation was present among drug resistant and sensitive strains. Ethambutol appeared to be the main driver of differentiation, suggesting that strong selection pressure could have been exerted by drug treatment in Peru over recent years.


Assuntos
Técnicas de Tipagem Bacteriana/métodos , Farmacorresistência Bacteriana Múltipla , Mycobacterium tuberculosis/efeitos dos fármacos , Mycobacterium tuberculosis/genética , Adolescente , Adulto , Alelos , Teorema de Bayes , Bases de Dados Genéticas , Etambutol/farmacologia , Feminino , Variação Genética , Genótipo , Humanos , Desequilíbrio de Ligação , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Repetições Minissatélites , Tipagem Molecular/métodos , Mycobacterium tuberculosis/isolamento & purificação , Mycobacterium tuberculosis/patogenicidade , Peru/epidemiologia , Filogenia , Seleção Genética , Escarro/microbiologia , Tuberculose/epidemiologia , Tuberculose/microbiologia , Adulto Jovem
5.
J Evol Biol ; 25(4): 674-81, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22300495

RESUMO

Determining the mechanisms that generate population structure is essential to the understanding of speciation and the evolution of biodiversity. Here, we investigate a geographical range that transects two habitat gradients, the North Sea to North Atlantic transition, and the temperate to subpolar regions. We studied the harbour porpoise (Phocoena phocoena), a small odontocete inhabiting both subpolar and temperate waters. To assess differentiation among putative populations, we measured morphological variation at cranial traits (N = 462 individuals) and variation at eight microsatellite loci for 338 of the same individuals from Norwegian, British and Danish waters. Significant morphological differentiation reflected the size of the buccal cavity. Porpoises forage in relatively shallow waters preying mainly on benthic species in British and Danish waters, and on mesopelagic and pelagic fish off the coast of Norway. We suggest that the observed differentiation may be explained by resource specialization and either adaptation or developmental responses to different local habitats.


Assuntos
Phocoena/anatomia & histologia , Phocoena/genética , Animais , Ecossistema , Especiação Genética , Genética Populacional , Repetições de Microssatélites , Mar do Norte
6.
Mol Ecol ; 19(5): 910-24, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-20102517

RESUMO

We investigated temporal changes in hybridization and introgression between native red deer (Cervus elaphus) and invasive Japanese sika (Cervus nippon) on the Kintyre Peninsula, Scotland, over 15 years, through analysis of 1513 samples of deer at 20 microsatellite loci and a mtDNA marker. We found no evidence that either the proportion of recent hybrids, or the levels of introgression had changed over the study period. Nevertheless, in one population where the two species have been in contact since approximately 1970, 44% of individuals sampled during the study were hybrids. This suggests that hybridization between these species can proceed fairly rapidly. By analysing the number of alleles that have introgressed from polymorphic red deer into the genetically homogenous sika population, we reconstructed the haplotypes of red deer alleles introduced by backcrossing. Five separate hybridization events could account for all the recently hybridized sika-like individuals found across a large section of the Peninsula. Although we demonstrate that low rates of F1 hybridization can lead to substantial introgression, the progress of hybridization and introgression appears to be unpredictable over the short timescales.


Assuntos
Cervos/genética , Genética Populacional , Hibridização Genética , Animais , DNA Mitocondrial/genética , Cervos/classificação , Fluxo Gênico , Frequência do Gene , Variação Genética , Genótipo , Haplótipos , Repetições de Microssatélites , Modelos Genéticos , Escócia , Análise de Sequência de DNA
7.
Heredity (Edinb) ; 97(6): 427-37, 2006 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-16941019

RESUMO

Major histocompatibility complex (MHC) antigen-presenting genes are the most variable loci in vertebrate genomes. Host-parasite co-evolution is assumed to maintain the excessive polymorphism in the MHC loci. However, the molecular mechanisms underlying the striking diversity in the MHC remain contentious. The extent to which recombination contributes to the diversity at MHC loci in natural populations is still controversial, and there have been only few comparative studies that make quantitative estimates of recombination rates. In this study, we performed a comparative analysis for 15 different ungulates species to estimate the population recombination rate, and to quantify levels of selection. As expected for all species, we observed signatures of strong positive selection, and identified individual residues experiencing selection that were congruent with those constituting the peptide-binding region of the human DRB gene. However, in addition for each species, we also observed recombination rates that were significantly different from zero on the basis of likelihood-permutation tests, and in other non-quantitative analyses. Patterns of synonymous and non-synonymous sequence diversity were consistent with differing demographic histories between species, but recent simulation studies by other authors suggest inference of selection and recombination is likely to be robust to such deviations from standard models. If high rates of recombination are common in MHC genes of other taxa, re-evaluation of many inference-based phylogenetic analyses of MHC loci, such as estimates of the divergence time of alleles and trans-specific polymorphism, may be required.


Assuntos
Animais Selvagens/genética , Evolução Molecular , Variação Genética , Antígenos de Histocompatibilidade Classe II/genética , Recombinação Genética , Seleção Genética , Alelos , Sequência de Aminoácidos , Animais , Cabras/classificação , Cabras/genética , Fígado/metabolismo , Dados de Sequência Molecular , Reação em Cadeia da Polimerase , Ruminantes/genética , Homologia de Sequência de Aminoácidos
8.
J Evol Biol ; 19(4): 1314-26, 2006 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-16780532

RESUMO

Coevolution has been hypothesized as the main driving force for the remarkable diversity of insect-plant associations. Dating of insect and plant phylogenies allows us to test coevolutionary hypotheses and distinguish between the contemporaneous radiation of interacting lineages vs. insect 'host tracking' of previously diversified plants. Here, we used nuclear DNA to reconstruct a molecular phylogeny for 100 species of Phyllonorycter leaf-mining moths and 36 outgroup taxa. Ages for nodes in the moth phylogeny were estimated using a combination of a penalized likelihood method and a Bayesian approach, which takes into account phylogenetic uncertainty. To convert the relative ages of the moths into dates, we used an absolute calibration point from the fossil record. The age estimates of (a selection of) moth clades were then compared with fossil-based age estimates of their host plants. Our results show that the principal radiation of Phyllonorycter leaf-mining moths occurred well after the main radiation of their host plants and may represent the dominant associational mode in the fossil record.


Assuntos
Fósseis , Mariposas/classificação , Filogenia , Plantas , Animais , Calibragem , Mariposas/genética , Mariposas/fisiologia , Incerteza
9.
Appl Opt ; 45(8): 1804-11, 2006 Mar 10.
Artigo em Inglês | MEDLINE | ID: mdl-16572697

RESUMO

What we believe to be a new type of resonant coupling of an incident bulk wave into guided modes of a slab with a thick holographic grating is shown to occur in the presence of strong frequency detunings of the Bragg condition. This happens through the reflection of the strongly noneigen +1 diffracted order with the slab-grating boundaries, the resultant reflected waves forming a guided slab mode. Rigorous coupled-wave analysis is used for the numerical analysis of the predicted resonant effects. Possible applications include enhanced options for the design of multiplexing and demultiplexing systems, optical signal-processing devices, optical sensors, and measurement techniques.

10.
Mol Ecol ; 10(6): 1357-70, 2001 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-11412360

RESUMO

We assessed genetic differentiation and diversity in 14 populations of sika deer (Cervus nippon) from Japan and four populations of sika deer introduced to the UK, using nine microsatellite loci. We observed extreme levels of differentiation and significant differences in diversity between populations. Our results do not support morphological subspecies designations, but are consistent with previous mitochondrial DNA analyses which suggest the existence of two genetically distinct lineages of sika deer in Japan. The source of sika introduced to the UK was identified as Kyushu. The underlying structure of Japanese populations probably derives from drift in separate glacial refugia and male dispersal limited by distance. This structure has been perturbed by bottlenecks and habitat fragmentation, resulting from human activity from the mid-nineteenth century. Most current genetic differentiation and differences in diversity among populations probably result from recent drift. Coalescent model analysis suggests sika on each of the main Japanese islands have experienced different recent population histories. Hokkaido, which has large areas of continuous habitat, has maintained high levels of gene flow. In Honshu the population is highly fragmented and is likely to have been evolving by drift alone. In Kyushu there has been a balance between gene flow and drift but all the populations have experienced high levels of drift. Habitat fragment size was not significantly associated with genetic diversity in populations but there was a significant correlation between habitat fragment size and effective population size.


Assuntos
Cervos/fisiologia , Genética Populacional , Alelos , Animais , Demografia , Heterozigoto , Japão , Repetições de Microssatélites , Modelos Genéticos , Análise de Regressão , Reino Unido
11.
Genetics ; 152(1): 355-71, 1999 May.
Artigo em Inglês | MEDLINE | ID: mdl-10224266

RESUMO

In this article we describe the structure of a hybrid zone in Argyll, Scotland, between native red deer (Cervus elaphus) and introduced Japanese sika deer (Cervus nippon), on the basis of a genetic analysis using 11 microsatellite markers and mitochondrial DNA. In contrast to the findings of a previous study of the same population, we conclude that the deer fall into two distinct genetic classes, corresponding to either a sika-like or red-like phenotype. Introgression is rare at any one locus, but where the taxa overlap up to 40% of deer carry apparently introgressed alleles. While most putative hybrids are heterozygous at only one locus, there are rare multiple heterozygotes, reflecting significant linkage disequilibrium within both sika- and red-like populations. The rate of backcrossing into the sika population is estimated as H = 0.002 per generation and into red, H = 0.001 per generation. On the basis of historical evidence that red deer entered Kintyre only recently, a diffusion model evaluated by maximum likelihood shows that sika have increased at approximately 9.2% yr-1 from low frequency and disperse at a rate of approximately 3.7 km yr-1. Introgression into the red-like population is greater in the south, while introgression into sika varies little along the transect. For both sika- and red-like populations, the degree of introgression is 30-40% of that predicted from the rates of current hybridization inferred from linkage disequilibria; however, in neither case is this statistically significant evidence for selection against introgression.


Assuntos
Cervos/genética , Hibridização Genética , Alelos , Animais , DNA Mitocondrial/metabolismo , Heterozigoto , Desequilíbrio de Ligação , Repetições de Microssatélites , Modelos Estatísticos , Escócia
12.
Anim Genet ; 29(4): 307-15, 1998 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-9745670

RESUMO

We tested 174 bovine microsatellite primer pairs for use in a primitive breed of sheep and two species of deer. Of 173 markers, 127 (73.4%) gave a product in Soay sheep (Ovis aries) of which 54 (42.5%) were polymorphic. One hundred and twenty-nine of 174 (74.1%) markers gave a product in red deer (Cervus elaphus) of which 72 (55.8%) were polymorphic. In sika deer (Cervus nippon) 126 of 171 (73.7%) microsatellite primers gave a product with 47 (37.3%) polymorphic. The proportion of bovine microsatellite loci conserved across artiodactyl species was significantly greater in this study than previously reported. Reasons for this high degree of microsatellite conservation are discussed. We suggest that a high resolution comparative map of the artiodactyls can be constructed using microsatellites.


Assuntos
Bovinos/genética , Mapeamento Cromossômico/veterinária , Cervos/genética , Repetições de Microssatélites , Ovinos/genética , Alelos , Animais , Primers do DNA , Evolução Molecular , Reação em Cadeia da Polimerase/veterinária
13.
Mol Biol Evol ; 15(2): 104-18, 1998 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-9491609

RESUMO

The harbor seal (Phoca vitulina) has the most extensive distribution of any phocid seal species. An analysis of population structure in this species across its European range was made using 7 phocid derived microsatellites in a sample of 1,029 individuals from 12 separate geographic areas. Despite the species potential for long-distance movement, significant genetic differentiation between areas was observed using an unbiased estimator of RST. Six distinct population units were identified: Ireland-Scotland, English east coast, Waddensea, western Scandinavia (Norway-Kattegat-Skagerrak-west Baltic), east Baltic, and Iceland. Little local substructuring is present along coastlines with a continuous distribution of breeding animals, but differentiation does increase with geographic distance. The degree of differentiation is greater over equivalent distances where the distribution is discontinuous, such as along coasts where breeding colonies are separated by large distances or by stretches of open sea. Patterns of population differentiation derived from microsatellites are very similar to those obtained from previous mitochondrial DNA analysis and suggest that philopatry in harbor seals operates over 300-500 km. In Europe, harbor seals have experienced a complex demographic history and patterns of population structure are likely to have been affected by natural environmental influences such as Pleistocene glaciations and epizootics. Comparison of Nm values from an unbiased estimator of RST, GST, and theta are consistent and, in some cases, may indicate populations where conditions deviate from the expectations of the RST model.


Assuntos
Repetições de Microssatélites , Focas Verdadeiras/genética , Animais , Frequência do Gene , Variação Genética , Genética Populacional , Genótipo , Mar do Norte , Reação em Cadeia da Polimerase , Polimorfismo Genético , Dinâmica Populacional , Países Escandinavos e Nórdicos , Focas Verdadeiras/classificação , Reino Unido
15.
J Mol Biol ; 271(3): 349-61, 1997 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-9268664

RESUMO

DNA branch migration is a fundamental process in genetic recombination. A new model system has been developed for studying branch migration in a small synthetic four-arm junction. A mathematical method for describing branch-point movement by discrete steps in such junctions is also presented. The key to our experimental system is the ability to fix the location of the branch point during the assembly of the junction with a reversible block. The block is provided by a short oligonucleotide that forms triplex DNA adjacent to the initial location branch point at low pH. Raising the pH causes the triplex strand to dissociate, making the branch point free to migrate. Once mobile, the branch point can run off the end of the junction. The time-course for this runoff is consistent with a random walk of the branch point. If it is assumed that one migration step moves the branch point one base-pair, the time-course gives a rate constant for one step of 1.4 second-1 at 37 degrees C in 10 mM MgCl2, 50 mM NaCl. These values are consistent with other measurements of non-enzymatic branch migration. We have also monitored the spread of the branch points directly with T4 endonuclease VII. Using EcoRI restriction endonuclease, we have shown that the binding of this protein to the arms of the junction essentially blocks branch migration through the binding site. In these experiments Ca2+ replaces Mg2+, and the enzyme does not cleave the DNA. In vivo there must be a special process to get branch points to migrate past bound proteins.


Assuntos
DNA/química , Conformação de Ácido Nucleico , DNA/metabolismo , Proteínas de Ligação a DNA , Endodesoxirribonucleases/metabolismo , Modelos Químicos , Fatores de Tempo
16.
Mol Ecol ; 6(7): 661-6, 1997 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-9226947

RESUMO

Microsatellites have rapidly become the marker of choice for a wide variety of population genetic studies. Here we describe 20 pinniped microsatellite markers which have been tested across 18 pinniped species. The majority of these markers have broad utility in all pinnipeds and provide a strong base for detailed population genetic studies in the Pinnipedia.


Assuntos
Caniformia/classificação , Caniformia/genética , Repetições de Microssatélites , Animais , Sequência de Bases , Primers do DNA , Dados de Sequência Molecular , Reação em Cadeia da Polimerase , Polimorfismo Genético , Focas Verdadeiras/classificação , Focas Verdadeiras/genética
17.
Nature ; 375(6528): 232-5, 1995 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-7746323

RESUMO

The mechanism for object location in the environment, and the perception of the external world as stable when eyes, head and body are moved, have long been thought to be centred on the posterior parietal cortex. However, head position signals, and their integration with visual and eye position signals to form a representation of space referenced to the body, have never been examined in any area of the cortex. Here we show that the visual and saccadic activities of parietal neurons are strongly affected by head position. The eye and head position effects are equivalent for individual neurons, indicating that the modulation is a function of gaze direction, regardless of whether the eyes or head are used to direct gaze. These data are consistent with the idea that the posterior parietal cortex contains a distributed representation of space in body-centred coordinates.


Assuntos
Cabeça , Neurônios/fisiologia , Lobo Parietal/fisiologia , Movimentos Sacádicos/fisiologia , Animais , Fixação Ocular/fisiologia , Haplorrinos , Lobo Parietal/citologia , Estimulação Luminosa , Postura , Retina/fisiologia
18.
Science ; 264(5163): 1313-6, 1994 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-17780850

RESUMO

Detectors aboard the Compton Gamma Ray Observatory have observed an unexplained terrestrial phenomenon: brief, intense flashes of gamma rays. These flashes must originate in the atmosphere at altitudes above at least 30 kilometers in order to escape atmospheric absorption and reach the orbiting detectors. At least a dozen such events have been detected over the past 2 years. The photon spectra from the events are very hard (peaking in the high-energy portion of the spectrum) and are consistent with bremsstrahlung emission from energetic (million-electron volt) electrons. The most likely origin of these high-energy electrons, although speculative at this time, is a rare type of high-altitude electrical discharge above thunderstorm regions.

19.
Crit Care Med ; 21(6): 851-9, 1993 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-8504652

RESUMO

OBJECTIVES: To describe patterns of critical care services used after cardiac surgery and to evaluate whether variations in the process of care influence outcome. DESIGN: Multicenter, prospective study. SETTING: A convenience sample of four cardiac surgical units: three in university-affiliated (teaching) hospitals and one in a nonteaching regional referral center. PATIENTS: A "consecutive sample" of 335 patients after cardiac surgery in four hospitals. INTERVENTIONS: Data were collected regarding all cardiac surgery patients admitted to the critical care units in the four test hospitals. MEASUREMENTS AND MAIN RESULTS: The critical care unit and hospital lengths of stay and survival were followed. The Therapeutic Intervention Scoring System (TISS) was used to assess the intensive care unit (ICU) interventions used during the first 24 hrs in the ICU and for the final 24 hrs before discharge from the ICU. The severity of illness on admission was assessed using the Acute Physiology and Chronic Health Evaluation (APACHE) scoring system. For patients having similar procedures (e.g., aortocoronary bypass and nonaortocoronary bypass procedures) and with similar outcome (mortality/total hospital length of stay), we found significant differences in the pattern of ICU resource utilization among hospitals. Significant (p < .05) differences in unit length of stay were related to varying factors in different hospitals. In hospital unit A, the type of procedure and preoperative chronic health status influenced unit length of stay (aortocoronary bypass 2.8 +/- 1.7 days; nonaortocoronary bypass 8.7 +/- 8.9 days) because length of stay was different for differing procedure groups. In hospital unit B, the critical care management system and lack of step-down (intermediate care) unit availability resulted in an increased unit length of stay for aortocoronary bypass patients (5.1 +/- 4.5 days) as compared with the other units (mean ICU lengths of stay of 2.8, 2.3, and 3.0 days, respectively). Unit B kept patients for monitoring purposes and had a reduced need for critical care nursing on the day of discharge (TISS = 7.5 +/- 5.5) as compared with the other units (mean TISS scores of 27.4, 23.2, and 21.5). CONCLUSIONS: Significant differences exist among hospitals in the same healthcare system in the utilization of critical care services for cardiac surgery. In spite of these differences, for similar patient "input," the outcome (mortality and hospital lengths of stay) appeared similar. Assessments of utilization of critical care must focus on more detailed specific issues than unit length of stay, and must include factors such as availability of intermediate care areas, the unit management system, chronic health status, and the operative procedures performed, if a utilization management process is to effect improved resource use in critical care.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Cuidados Críticos/estatística & dados numéricos , Unidades de Terapia Intensiva/estatística & dados numéricos , Cuidados Pós-Operatórios/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Canadá , Cuidados Críticos/organização & administração , Pesquisa sobre Serviços de Saúde , Número de Leitos em Hospital , Mortalidade Hospitalar , Hospitais de Ensino/estatística & dados numéricos , Humanos , Unidades de Terapia Intensiva/organização & administração , Tempo de Internação/estatística & dados numéricos , Modelos Lineares , Avaliação de Resultados em Cuidados de Saúde , Admissão do Paciente/estatística & dados numéricos , Alta do Paciente/estatística & dados numéricos , Estudos Prospectivos , Encaminhamento e Consulta , Índice de Gravidade de Doença , Taxa de Sobrevida , Desmame do Respirador/estatística & dados numéricos , Recursos Humanos
20.
Am J Ment Retard ; 96(4): 432-41, 1992 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-1739456

RESUMO

The social support networks of 418 adults with mental retardation who live at home were found to be large, durable, active, and diverse in their composition. Family members predominated as members of these support networks. Differences were found in many network characteristics based on the gender and level of mental retardation of the adults. Males and those with the most severe mental retardation were found to be at risk for social isolation. Contrasts with the social support networks of adults in nonfamily settings were discussed.


Assuntos
Família , Deficiência Intelectual/psicologia , Características de Residência , Apoio Social , Adolescente , Adulto , Idoso , Feminino , Humanos , Deficiência Intelectual/reabilitação , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Isolamento Social
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