Rationale & Objective: Chronic kidney disease (CKD) care is often fragmented across multiple health care providers. It is unclear whether patients rely mostly on their nephrologists or ...non-nephrologist providers for medical care, including CKD treatment and advice. Study Design: Cross-sectional study. Setting & Participants: Adults receiving nephrology care at CKD clinics in Pennsylvania. Predictors: Frequency, duration, and patient-centeredness (range, 1 least to 4 most) of participants’ nephrology care. Outcome: Participants’ reliance on nephrologists, primary care providers, or other specialists for medical care, including CKD treatment and advice. Analytical Approach: Multivariable logistic regression to quantify associations between participants’ reliance on their nephrologists (vs other providers) and their demographics, comorbid conditions, kidney function, and nephrology care. Results: Among 1,412 patients in clinics targeted for the study, 676 (48%) participated. Among these, 453 (67%) were eligible for this analysis. Mean age was 71 (SD, 12) years, 59% were women, 97% were white, and 65% were retired. Participants were in nephrology care for a median of 3.8 (IQR, 2.0-6.6) years and completed a median of 4 (IQR, 3-5) nephrology appointments in the past 2 years. Half (56%) the participants relied primarily on their nephrologists, while 23% relied on primary care providers, 18% relied on all providers equally, and 3% relied on other specialists. Participants’ adjusted odds of relying on their nephrologists were higher for those in nephrology care for longer (OR, 1.08 95% CI, 1.02-1.15; P = 0.02), those who completed more nephrology visits in the previous 2 years (OR, 1.16 95% CI, 1.05-1.29; P = 0.005), and those who perceived their last interaction with their nephrologists as more patient-centered (OR, 2.63 95% CI, 1.70-4.09; P < 0.001). Limitations: Single health system study. Conclusions: Many nephrology patients relied on non-nephrologist providers for medical care. Longitudinal patient-centered nephrology care may encourage more patients to follow nephrologists’ recommendations.
The U.S. medical environment continues to evolve with issues from Privacy to EMR, Insurance regulations, Physician Access and Healthcare Reform, and MACRA (Medicare Access and CHIP Reauthorization ...Act) on the discussion table. Not since the advent of Medicare and Medicaid in the mid 1960’s, have we seen such widespread changes in the medical healthcare environment (Centers for Medicare and Medicaid Services). Physicians, industry, patients and consumers are affected by the changes. These four groups have historically worked as separate entities, but are now key stakeholders in the future of dermatology. As stakeholders collaborating in building a future together, the dermatologists/physicians will help to ensure and preserve the quality of patient care and best patient outcomes. In the Executive Forum, leaders from the Women’s Dermatologic Society and Industry, explored five important areas: 1) A five-year outlook of Dermatology and Medicine; 2) Access of Industry to Dermatologists and Trainees; 3) The New Practice Environment; 4) Doing Things Differently; and 5) Unmet Specialty Needs. The collaborative group explored solutions for our specialty and the patients we serve.
Law and society scholars challenge the common belief that law is simply a neutral tool by which society sets standards and resolves disputes. Decades of research shows how much the nature of ...communities, organizations, and the people inhabiting them affect how law works. Just as much, law shapes beliefs, behaviors, and wider social structures, but the connections are much more nuanced - and surprising - than many expect. Law and Society Reader II provides readers an accessible overview to the breadth of recent developments in this research tradition, bringing to life the developments in this dynamic field. Following up a first Law and Society Reader published in 1995, editors Erik W. Larson and Patrick D. Schmidt have compiled excerpts of 43 illuminating articles published since 1993 in The Law and Society Review, the flagship journal of the Law and Society Association. By its organization and approach, this volume enables readers to join in discussing the key ideas of law and society research. The selections highlight the core insights and developments in this research tradition, making these works indispensable for those exploring the field and ideal for classroom use. Across six concisely-introduced sections, this volume analyzes inequality, lawyering, the relation between law and organizations, and the place of law in relation to other social institutions.
Coccidia of the llama, Lama glama, in Colorado and Wyoming Schrey, C.F. (Colorado State Univ., Fort Collins, CO (USA). Dept. of Biology); Abbott, T.A; Stewart, V.A ...
Veterinary parasitology,
1991, Letnik:
40, Številka:
1
Journal Article
Recenzirano
Fecal samples were collected from 144 llamas, Lama glama, on four premises in northern Colorado and southern Wyoming. Feces were examined for the presence of coccidial oocysts; Eimeria alpacae was ...found in 55.6%, Eimeria lamae in 67.3% and Eimeria macusaniensis in 1.4% of the samples. An adult female llama was found to be infected with Eimeria macusaniensis at necropsy. This is the first report of these species of coccidia in the llama.
Yes
In recent years, the scientific community has called for improvements in the credibility, robustness and reproducibility of research, characterized by increased interest and promotion of open and ...transparent research practices. While progress has been positive, there is a lack of consideration about how this approach can be embedded into undergraduate and postgraduate research training. Specifically, a critical overview of the literature which investigates how integrating open and reproducible science may influence student outcomes is needed. In this paper, we provide the first critical review of literature surrounding the integration of open and reproducible scholarship into teaching and learning and its associated outcomes in students. Our review highlighted how embedding open and reproducible scholarship appears to be associated with (i) students' scientific literacies (i.e. students' understanding of open research, consumption of science and the development of transferable skills); (ii) student engagement (i.e. motivation and engagement with learning, collaboration and engagement in open research) and (iii) students' attitudes towards science (i.e. trust in science and confidence in research findings). However, our review also identified a need for more robust and rigorous methods within pedagogical research, including more interventional and experimental evaluations of teaching practice. We discuss implications for teaching and learning scholarship.
UKRI/ESRC rapid call grant, ealth Research Board Applying Researchinto Policy and Practice Fellowship, John Templeton Foundation (grant ID: 62631), Northern Ireland Department for the Economy Research Studentship
REPORT OF THE COMMITTEE ON NATIONAL BANKS Hatch, Vermont; Sewall, Grenville S.; Baker, James A. ...
The Business lawyer,
07/1956, Letnik:
11, Številka:
4
Journal Article
PDF
