Search

Interviews with 102 family CGs of patients with mild to severe AD (MMSE 0 to 29) identified whether they would want their relative to take a medicine that slowed dementia progression and had no risk. Only 17 (17%) did not want their relative to take this medicine. Univariate logistic regression analyses showed that CGs who were older (OR= 1.04, p=0.05), depressed (OR=3.66, p=0.03), who cared for patients who lived in a nursing home (OR=3.60, p=0.02) or had more severe dementia (MMSE OR=0.91, p=0.006) were less likely to want to slow their relative's dementia. The lower a CG rated their relatives' quality of life on a single item global rating (OR=0.25, p=0.001) and the QOL-AD scale (OR=0.33, p=0.002), the less willing they were to slow the dementia. Most CGs are willing to slow their relatives' dementia even far into AD severity. However, a sizable minority prefer not to. This choice may reflect not only disease stage but also caregiver characteristics, including depression, age and their assessment of their relative's QOL.

The structure of health care has been rapidly evolving in response to financial pressures and demands to improve quality. Little work has documented the structure of care and its impact in the context of breast cancer care. We conducted a survey to characterize Los Angeles physicians caring for breast cancer patients and the structural landscape of the healthcare system in which they practice. Cross-sectional survey of physicians who treated a population-based cohort of breast cancer patients. We surveyed 477 physicians, targeting all Los Angeles County medical oncologists, radiation oncologists, and surgeons reported by patients participating in the Los Angeles Women's Health Study (77% response rate). Specialty-specific questionnaires were developed. Items were based on the structure and quality of care literature, cognitive interviews with cancer care specialists, and existing physician survey instruments. Breast cancer care providers in Los Angeles are diverse, with one-third non-white and 46% speaking a non-English language. Group practice is most common, (37% single specialty, 16% group-model HMO, 8% multi-specialty group). Minimal teaching involvement predominates. Mean new breast cancer patient volumes are relatively high (8 per month overall; six for surgeons), representing 46% of new cancer patients. Physicians reported high career satisfaction levels (83-92%). Physicians were least satisfied with the amount of time spent with patients (82%). Data from this study represent important building blocks for further analyses to determine the impact of structural characteristics on the quality of care that breast cancer patient's experience. [ABSTRACT FROM AUTHOR]

Since destination image is accepted as an important element of destination management, destination management organizations (DMOs) commonly engage in destination image studies. The majority of published image studies have focused on measuring the image of a particular destination at a point in time. Destination image is prone to change but this aspect received little attention due to lack of studies measuring image change over time. Therefore, the purpose of this study is to assess the change in the image of a destination over a period of time using the same instrument on the same sampling destinations. A large scale and longitudinal market survey data gathered by the Michigan Regional Travel Market Survey were analyzed for the purposes of this study. The findings indicated that Michigan had an image change between 1996 and 2002 since the image of the most image dimensions recorded significant improvement in these markets. Potential reasons, managerial implications as well as limitations and future research suggestions are provided. [ABSTRACT FROM AUTHOR]

This paper presents a case for the equilibrium between authentic features of a tourist destination and familiar elements provided for tourists. Support for this proposal is offered and the variables influential in defining this equilibrium point are identified. Implications for research and the hospitality industry are presented. [ABSTRACT FROM AUTHOR]

Spinal cord injury (SCI) is associated with increased risk of pressure ulcers, but there are few published data about this in the United Kingdom (UK). This article represents a quantitative exploration of the occurrence of pressure ulcers in a UK spinal injuries unit (SIU). The technique used is a retrospective review of records: details of 144 completed first admissions for SCI between 1998 and 2000 were entered on to a database (SPSS) for analysis. Thirty-two per cent of patients already had pressure ulcers on admission to the SIU, while a total of 56% experienced an ulcer at some stage between injury and discharge from the SIU. Four pressure ulcer risk assessment scales were used (Waterlow, Braden, Norton and SCIPUS-A). These appeared to have moderate predictive power in this population. Pressure ulcers were found to be associated with increased length of hospital stay, density of lesion, surgical stabilization of neck injury before transfer to the SIU, tracheostomy on admission to the SIU and delayed transfer to the SIU after injury. Implications for practice are discussed. [ABSTRACT FROM AUTHOR]

Discusses the development of the New South Wales sentencing information system. Analysis of technology used; Provision of judges with legal, factual and statistical data; System's purpose of better informing discretion; Achievement of consistency of approach throughout the jurisdiction.

An account is given of measurements of amplitude fluctuations for sound transmitted over a fixed off-shore multiple-transducer range from projectors radiating in turn at the two frequencies: 35 and 65 kHz. The observed fluctuations are found to saturate with range even though their values are small for all of the ranges employed. This effect is explained in terms of a truncation concept which is found to apply not only to the results reported here but also to the previously published measurements of other workers. [ABSTRACT FROM AUTHOR]