Journal articles on the topic 'PACE family'

To see the other types of publications on this topic, follow the link: PACE family.

Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles

Select a source type:

Consult the top 50 journal articles for your research on the topic 'PACE family.'

Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.

You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.

Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.

1

DAVID, PATRICIA H. "FAMILY-BUILDING PATTERNS AND CHILDHOOD MORTALITY: A FAMILY-LEVEL ANALYSIS." Journal of Biosocial Science 31, no. 4 (October 1999): 463–85. http://dx.doi.org/10.1017/s0021932099004630.

Full text
Abstract:
It has been suggested that altering the pace of reproduction would improve the health of women and children. For formulating intervention policies, it is important to know whether on its own such a strategy is likely to lead to risk reduction. This paper analyses mortality risk in sibships to explore the relationship between family formation factors and other household characteristics that identify women whose families are at higher risk. The analysis allows for the fact that reproductive behaviour may be modified by the family's prior experience of child death, using simultaneous equations methods to purge the model of the ‘feedback’ effects of death on the endogenous variable, childbearing pace. The strong relationship between reproductive pace and average risk in a family appears to be due to the association of both with other differences between households. Other aspects of family formation patterns are good indicators of which families are likely to experience excess risks to their children. These factors are associated with maternal education, but measure characteristics of the family or mother that educational attainment does not fully capture. They indicate that high-risk mothers are likely to have less control over many aspects of their lives. The pace of family building does not lead to excess average family risk, but may result, at least in part, from the concentration of risk in families with other characteristic patterns of family formation and few resources. The paper argues for a broader conception of household influences on child health and the health-related behaviour of parents.
APA, Harvard, Vancouver, ISO, and other styles
2

Mettetal, Gwendolyn. "The Dual-Career Family in Context: The Pace of Change." Contemporary Psychology: A Journal of Reviews 39, no. 7 (July 1994): 736. http://dx.doi.org/10.1037/034506.

Full text
APA, Harvard, Vancouver, ISO, and other styles
3

Montgomery, Jay A., Janice Y. Sensing, Sandra D. Saunders, Walter K. Clair, Robert L. Abraham, Arvindh N. Kanagasundram, Christopher R. Ellis, George H. Crossley, Moore Benjamin Shoemaker, and Pablo Saavedra. "Premature battery depletion due to compromised low‐voltage capacitor in a family of defibrillators." Pacing and Clinical Electrophysiology 42, no. 7 (May 14, 2019): 965–69. http://dx.doi.org/10.1111/pace.13713.

Full text
APA, Harvard, Vancouver, ISO, and other styles
4

Crossley, George H., and Christopher R. Ellis. "Safe Identification of the ERI State in St. Jude Medical Identity® Family Pacemakers." Pacing and Clinical Electrophysiology 38, no. 4 (January 20, 2015): 415–16. http://dx.doi.org/10.1111/pace.12568.

Full text
APA, Harvard, Vancouver, ISO, and other styles
5

Hassan, Karl A., Varsha Naidu, Jacob R. Edgerton, Karla A. Mettrick, Qi Liu, Leila Fahmy, Liping Li, et al. "Short-chain diamines are the physiological substrates of PACE family efflux pumps." Proceedings of the National Academy of Sciences 116, no. 36 (August 15, 2019): 18015–20. http://dx.doi.org/10.1073/pnas.1901591116.

Full text
Abstract:
Acinetobacter baumannii has rapidly emerged as a major cause of gram-negative hospital infections worldwide. A. baumannii encodes for the transport protein AceI, which confers resistance to chlorhexidine, a widely used antiseptic. AceI is also the prototype for the recently discovered proteobacterial antimicrobial compound efflux (PACE) family of transport proteins that confer resistance to a range of antibiotics and antiseptics in many gram-negative bacteria, including pathogens. The gene encoding AceI is conserved in the core genome of A. baumannii, suggesting that it has an important primordial function. This is incongruous with the sole characterized substrate of AceI, chlorhexidine, an entirely synthetic biocide produced only during the last century. Here we investigated a potential primordial function of AceI and other members of the PACE family in the transport of naturally occurring polyamines. Polyamines are abundant in living cells, where they have physiologically important functions and play multifaceted roles in bacterial infection. Gene expression studies revealed that the aceI gene is induced in A. baumannii by the short-chain diamines cadaverine and putrescine. Membrane transport experiments conducted in whole cells of A. baumannii and Escherichia coli and also in proteoliposomes showed that AceI mediates the efflux of these short-chain diamines when energized by an electrochemical gradient. Assays conducted using 8 additional diverse PACE family proteins identified 3 that also catalyze cadaverine transport. Taken together, these results demonstrate that short-chain diamines are common substrates for the PACE family of transport proteins, adding to their broad significance as a novel family of efflux pumps.
APA, Harvard, Vancouver, ISO, and other styles
6

Blich, Miry, Hodaya Oron, Wisam Darawsha, Mahmoud Suleiman, Lorber Avraham, Kchoury Asaad, Monther Boulos, and Lior Gepstein. "Non‐ischemic sudden cardiac arrest: Role of 12 lead Holter, family screening and genetic testing." Pacing and Clinical Electrophysiology 44, no. 8 (June 27, 2021): 1347–54. http://dx.doi.org/10.1111/pace.14294.

Full text
APA, Harvard, Vancouver, ISO, and other styles
7

Delaney, Brendan. "General practice at the cutting edge of information technology, or failing to keep pace?" British Journal of General Practice 60, no. 573 (April 1, 2010): 239–40. http://dx.doi.org/10.3399/bjgp10x483869.

Full text
APA, Harvard, Vancouver, ISO, and other styles
8

Raghunath, M., E. A. Putnam, T. Ritty, D. Hamstra, E. S. Park, M. Tschodrich-Rotter, R. Peters, A. Rehemtulla, and D. M. Milewicz. "Carboxy-terminal conversion of profibrillin to fibrillin at a basic site by PACE/furin-like activity required for incorporation in the matrix." Journal of Cell Science 112, no. 7 (April 1, 1999): 1093–100. http://dx.doi.org/10.1242/jcs.112.7.1093.

Full text
Abstract:
Fibrillin-1, the main component of 10–12 nm microfibrils of the extracellular matrix, is synthesized as profibrillin and proteolytically processed to fibrillin. The putative cleavage site has been mapped to the carboxy-terminal domain of profibrillin-1, between amino acids arginine 2731 and serine 2732, by a spontaneous mutation in this recognition site that prevents profibrillin conversion. This site contains a basic amino acid recognition sequence (R-G-R-K-R-R) for proprotein convertases of the furin/PACE family. In this study, we use a mini-profibrillin protein to confirm the cleavage in the carboxy-terminal domain by both fibroblasts and recombinantly expressed furin/PACE, PACE4, PC1/3 and PC2. Site-directed mutagenesis of amino acids in the consensus recognition motif prevented conversion, thereby identifying the scissile bond and characterizing the basic amino acids required for cleavage. Using a PACE/furin inhibitor, we show that wild-type profibrillin is not incorporated into the extracellular matrix until it is converted to fibrillin. Therefore, profibrillin-1 is the first extracellular matrix protein to be shown to be a substrate for subtilisin-like proteases, and the conversion of profibrillin to fibrillin controls microfibrillogenesis through exclusion of uncleaved profibrillin.
APA, Harvard, Vancouver, ISO, and other styles
9

Kataryńczuk-Mania, Lidia. "ARTISTIC AND EDUCATIONAL ROLE OF FAMILY MUSIC MAKING." SOCIETY. INTEGRATION. EDUCATION. Proceedings of the International Scientific Conference 4 (May 21, 2019): 400. http://dx.doi.org/10.17770/sie2019vol4.3988.

Full text
Abstract:
Every family is influenced by modernity, transformation, various changes and the fast pace of life. Music can be the ideal basis for a modern family. The article will show scientific reflections on the educational and artistic role of creating family music. Goals and objectives, the specifics of music and building relationships in the environment of music will be emphasized.
APA, Harvard, Vancouver, ISO, and other styles
10

Rich, Michael L. "The PACE Model: Description and Impressions of a Capitated Model of Long-Term Care for the Elderly." Care Management Journals 1, no. 1 (January 1999): 62–70. http://dx.doi.org/10.1891/1521-0987.1.1.62.

Full text
Abstract:
The Program of All-Inclusive Care for the Elderly (PACE) is an innovative model of comprehensive long-term medical and social services. The system receives monthly capitation payments from Medicare and Medicaid for clients who are nursing-home eligible. PACE was developed originally by On Lok Senior Health Services in San Francisco’s Chinatown in the late 1970s. PACE is based upon the concept of maintaining the independence, autonomy and dignity of frail and disabled elders nearing the end of life (Sapir, 1996). The program’s underlying principle is to keep participants (PACE program enrollees) in the community for as long as it remains medically, socially, and economically feasible (Shen and Iverson, 1992). There is also a strong intention to preserve and support the older adult’s family unit.
APA, Harvard, Vancouver, ISO, and other styles
11

Gras, S., B. Fernandez, V. Chaumont, P. Carpentier, J. Armengaud, and D. Housset. "Structure of a PACE protein: PAB0955, first member of new GTPase family." Acta Crystallographica Section A Foundations of Crystallography 61, a1 (August 23, 2005): c498. http://dx.doi.org/10.1107/s0108767305079468.

Full text
APA, Harvard, Vancouver, ISO, and other styles
12

Lin, Wen-Ting. "Family ownership and internationalization processes: Internationalization pace, internationalization scope, and internationalization rhythm." European Management Journal 30, no. 1 (February 2012): 47–56. http://dx.doi.org/10.1016/j.emj.2011.10.003.

Full text
APA, Harvard, Vancouver, ISO, and other styles
13

Niccodemi, Gianmaria, Giorgia Menta, Jonathan Turner, and Conchita D'Ambrosio. "Pace of aging, family environment and cognitive skills in children and adolescents." SSM - Population Health 20 (December 2022): 101280. http://dx.doi.org/10.1016/j.ssmph.2022.101280.

Full text
APA, Harvard, Vancouver, ISO, and other styles
14

Rehemtulla, Alnawaz, Philip J. Barr, Christopher J. Rhodes, and Randal J. Kaufman. "PACE4 is a member of the mammalian propeptidase family that has overlapping but not identical substrate specificity to PACE." Biochemistry 32, no. 43 (January 26, 1993): 11586–90. http://dx.doi.org/10.1021/bi00094a015.

Full text
APA, Harvard, Vancouver, ISO, and other styles
15

Bagan-Kurluta, Katarzyna. "Notions and Concepts in Family Law. Discrepancy Between Polish Family Law and Social Reality." Studies in Logic, Grammar and Rhetoric 49, no. 1 (March 1, 2017): 7–20. http://dx.doi.org/10.1515/slgr-2017-0001.

Full text
Abstract:
Abstract Modern times are an arena for two opposing trends: the liberalization of mores and laws, and the distancing of changes and adoption of a conservative position against those that occur. Polish family law clearly fails to keep pace with the changes taking place and does not perceive new phenomena. Is this an intentional act of the legislator leading to the preservation of traditional values, or the expression of disapproval and belief in the transitoriness of new phenomena? It comes together with the introduction of new terminology or new interpretations of already existing concepts. Hence the meaning of some of the current concepts in everyday language differs significantly from their meaning arising from legal instruments. The article is an attempt to deal with this problem.
APA, Harvard, Vancouver, ISO, and other styles
16

Phillips, Rhiannon, Helen Stanton, Amina Singh-Mehta, David Gillespie, Janine Bates, Micaela Gal, Emma Thomas-Jones, et al. "C-reactive protein-guided antibiotic prescribing for COPD exacerbations: a qualitative evaluation." British Journal of General Practice 70, no. 696 (May 18, 2020): e505-e513. http://dx.doi.org/10.3399/bjgp20x709865.

Full text
Abstract:
BackgroundAntibiotics are prescribed to >70% of patients presenting in primary care with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD). The PACE randomised controlled trial found that a C-reactive protein point-of-care test (CRP-POCT) management strategy for AECOPD in primary care resulted in a 20% reduction in patient-reported antibiotic consumption over 4 weeks.AimTo understand perceptions of the value of CRP-POCT for guiding antibiotic prescribing for AECOPD; explore possible mechanisms, mediators, and pathways to effects; and identify potential barriers and facilitators to implementation from the perspectives of patients and clinicians.Design and settingQualitative process evaluation in UK general practices.MethodSemi-structured telephone interviews with 20 patients presenting with an AECOPD and 20 primary care staff, purposively sampled from the PACE study. Interviews were audio-recorded, transcribed, and analysed using framework analysis.ResultsPatients and clinicians felt that CRP-POCT was useful in guiding clinicians’ antibiotic prescribing decisions for AECOPD, and were positive about introduction of the test in routine care. The CRP-POCT enhanced clinician confidence in antibiotic prescribing decisions, reduced decisional ambiguity, and facilitated communication with patients. Some clinicians thought the CRP-POCT should be routinely used in consultations for AECOPD; others favoured use only when there was decisional uncertainty. CRP-POCT cartridge preparation time and cost were potential barriers to implementation.ConclusionCRP-POCT-guided antibiotic prescribing for AECOPD had high acceptability, but commissioning arrangements and further simplification of the CRP-POCT need attention to facilitate implementation in routine practice.
APA, Harvard, Vancouver, ISO, and other styles
17

Gervais, Diane, and Danielle Gauvreau. "Women, Priests, and Physicians: Family Limitation in Quebec, 1940–1970." Journal of Interdisciplinary History 34, no. 2 (October 2003): 293–314. http://dx.doi.org/10.1162/002219503322649516.

Full text
Abstract:
The fertility transition occurred relatively later, and at a much slower pace, in Quebec than in most industrializing countries. Quantitative data can help to situate the general trends and the contributing factors. Qualitative data reveal the hostile context in which Catholic couples tried to fulfill their aspirations to have smaller families. They also show variability in the practices of clergy members.
APA, Harvard, Vancouver, ISO, and other styles
18

Bolla, Jani Reddy, Anna C. Howes, Francesco Fiorentino, and Carol V. Robinson. "Assembly and regulation of the chlorhexidine-specific efflux pump AceI." Proceedings of the National Academy of Sciences 117, no. 29 (July 7, 2020): 17011–18. http://dx.doi.org/10.1073/pnas.2003271117.

Full text
Abstract:
Few antibiotics are effective againstAcinetobacter baumannii, one of the most successful pathogens responsible for hospital-acquired infections. Resistance to chlorhexidine, an antiseptic widely used to combatA. baumannii, is effected through the proteobacterial antimicrobial compound efflux (PACE) family. The prototype membrane protein of this family, AceI (Acinetobacterchlorhexidine efflux protein I), is encoded for by theaceIgene and is under the transcriptional control of AceR (Acinetobacterchlorhexidine efflux protein regulator), a LysR-type transcriptional regulator (LTTR) protein. Here we use native mass spectrometry to probe the response of AceI and AceR to chlorhexidine assault. Specifically, we show that AceI forms dimers at high pH, and that binding to chlorhexidine facilitates the functional form of the protein. Changes in the oligomerization of AceR to enable interaction between RNA polymerase and promoter DNA were also observed following chlorhexidine assault. Taken together, these results provide insight into the assembly of PACE family transporters and their regulation via LTTR proteins on drug recognition and suggest potential routes for intervention.
APA, Harvard, Vancouver, ISO, and other styles
19

Hems, Sharon, Louise Taylor, Jan Jones, and Eileen Holmes. "OP22 Patient-Based Evidence: Its Role In Decision-Making On New Medicines." International Journal of Technology Assessment in Health Care 35, S1 (2019): 4–5. http://dx.doi.org/10.1017/s0266462319000941.

Full text
Abstract:
IntroductionThe Scottish Medicines Consortium (SMC) advises NHS Scotland on the clinical and cost-effectiveness of new medicines. Since 2014, evidence from patients and carers on end-of-life and orphan medicines has been gathered during Patient and Clinician Engagement (PACE) meetings. The output is a consensus statement which describes the added value of a new medicine from the perspective of the patient/carer and clinician. This study investigates the importance of factors identified through PACE to committee members and how these are used in their decision-making.MethodsSurvey methodology was used to gain an understanding of the factors from the PACE statement that are most likely to influence members (n = 26) in decision-making. The survey instrument was informed by a literature review and observation of PACE and SMC meetings. Likert scale questions were used to determine the relative importance of factors in the PACE statement, including information relating to eight prominent ‘quality of life’ themes (family/carer impact, health benefits, tolerability, psychological benefit, hope, normal life, treatment choice and convenience), that were identified by an earlier thematic analysis of these statements.ResultsAnalysis of survey responses will use mainly descriptive techniques to generate percentages and ranges. Correlation analysis will be considered to investigate relationships between members’ demographics, type of medicine (end-of-life, orphan) and the importance of different factors in the PACE statement. Preliminary results indicate that key quality of life themes highly valued by patients/carers are also important to committee members in their decision making. Challenges in assimilating qualitative patient-based evidence from PACE alongside quantitative clinical and economic data were highlighted.ConclusionsFindings from this survey will provide valuable insight into how PACE evidence is used by SMC decision makers alongside traditional clinical and economic evidence and will help shape future improvements to the PACE methodology.
APA, Harvard, Vancouver, ISO, and other styles
20

Ferenz, Krystyna. "Friends of the Family in the Cofigurative and Prefigurative Culture Behaviours." Pedagogika 112, no. 4 (December 23, 2013): 148–51. http://dx.doi.org/10.15823/p.2013.1788.

Full text
Abstract:
Opening the political borders triggered cultural diffusion in the European countries as the open communicative space accelerated the pace of globalization processes. As a result, changes occurring within a society influence the lives of fundamental social groups, i.e. the families. The last decades in Poland have marked a period of intense changes in the everyday life culture, and the examples of the persons coming from three generations reflect the significance of prefigurative and cofigurative cultures.
APA, Harvard, Vancouver, ISO, and other styles
21

Palmer, Michael. "Transforming Family Law in Post-Deng China: Marriage, Divorce and Reproduction." China Quarterly 191 (September 2007): 675–95. http://dx.doi.org/10.1017/s0305741007001658.

Full text
Abstract:
AbstractThis article considers the principal changes in family law in the People's Republic of China during the post-Deng period. The developments that have occurred during the period of review have been notable for their pace and their contribution to a growing legal sophistication in China's corpus of family law. They expand on a series of major reforms in family law documented in my earlier China Quarterly article. Overall, it is in the area of divorce that the most dramatic changes have taken place in family law over the past decade.
APA, Harvard, Vancouver, ISO, and other styles
22

Paat, Yok-Fong, Monica Chavira, Rosemarie De La Hoya, and Mitsue Yoshimoto. "Immigrant family socialization." Journal of Comparative Social Work 15, no. 1 (September 17, 2020): 60–83. http://dx.doi.org/10.31265/jcsw.v15i1.320.

Full text
Abstract:
Using convenient and purposive sampling augmented with snowball sampling, this study examines the perceptions of family socialization between two cultures, using in-depth interviews of 15 pairs of adult child-parent dyads (n=30) of Mexican origin in the United States. In sum, despite variations in the pace of acculturation, our study shows that both adult children and their parents proactively adopted compromising strategies (e.g. mutual respect, acceptance, openness, and realistic expectations) to bridge the differences in acculturation and reach common ground in family communication. Several core values and family practices, such as respect to family authority, family interdependence, retention/preservation of cultural heritage (e.g. language, customs, and identity), a strong work ethic, patriarchal gender norms, Mexican versus American parenting styles, and adult children striving for more freedom from traditional customs (e.g. conventional gender roles and living arrangements), were emphasized in Mexican immigrant family socialization in our study. Despite their differences in belief systems and ideologies, our study shows that family communication between the adult child-parent dyads was built on a set of implicit expectations that focus on minimizing family conflicts, yet providing a ‘culturally instrumental’ and supportive/caring context. In contrast to the postulation of the acculturation gap-distress model, our study found that discrepancies in acculturation between immigrant parents and their children were not necessarily associated with poorer family functioning and adjustment.
APA, Harvard, Vancouver, ISO, and other styles
23

Baxley, L., J. Borkan, and A. Davis. "How to Manage the Pace of Practice Innovation Information Flow and Change? Introducing the ADFM Patient Centered Medical Home Taskforce." Annals of Family Medicine 8, no. 2 (March 1, 2010): 184–85. http://dx.doi.org/10.1370/afm.1100.

Full text
APA, Harvard, Vancouver, ISO, and other styles
24

Hems, Sharon, Louise Taylor, Jan Jones, and Eileen Holmes. "OP242 Patient-based Evidence: A Comparison Of The Views Of Patient And Clinical Engagement Participants And Committee Members." International Journal of Technology Assessment in Health Care 37, S1 (December 2021): 8. http://dx.doi.org/10.1017/s0266462321000842.

Full text
Abstract:
IntroductionThe Scottish Medicines Consortium (SMC) conducts early health technology assessment (HTA) of new medicines on behalf of NHSScotland. Evidence from patients and carers on end-of-life and orphan medicines is gathered during Patient and Clinician Engagement (PACE) meetings. The output is a consensus statement describing a medicine's added value from the perspective of patients/carers and clinicians, which is used by SMC committee members in decision-making. This study compared the importance of factors in the PACE statement to PACE participants and committee members.MethodsA survey of ninety-eight PACE participants (consisting of forty-two patient group (PG) representatives and fifty-six clinicians) investigated the importance of quality of life (QoL) themes (family/carer impact, health benefits, tolerability, psychological benefit, hope, normal life, treatment choice and convenience) identified from an earlier thematic analysis of PACE statements. The findings from PG representatives and clinicians were compared, and the overall results were further compared with those from a previous survey of committee members (n = 26).ResultsAmong PACE participants who responded (twenty-six PG representatives and fourteen clinicians), 100 percent rated ‘health benefits’ and ‘ability to take part in normal life’ as important / very important. ‘Convenience of administration’ and ‘treatment choice’ received the lowest rating with fifteen percent and nineteen percent respectively of PG representatives versus seven percent of clinicians rating each as very important. ‘Hope for the future’ received the most diverse response with fifty-eight percent of PG representatives and fourteen of clinicians rating this as very important.In general, PACE participants rated importance of QoL themes higher than committee members (n = 21) but the rank order was similar. Differences between the proportion of PACE participants and committee members who rated themes important/very important was greatest for ‘treatment choice’ (sixty-seven percent versus twenty percent respectively) and ‘hope for the future’ (eighty-two percent versus fifty-three percent).ConclusionsThe findings demonstrate some alignment between PACE participants’ and committee members’ responses, supporting the value of the PACE output in decision-making. Areas for further research are highlighted.
APA, Harvard, Vancouver, ISO, and other styles
25

Wu, Hangyao, Zeshui Xu, and Marinko Skare. "How do family businesses adapt to the rapid pace of globalization? a bibliometric analysis." Journal of Business Research 153 (December 2022): 59–74. http://dx.doi.org/10.1016/j.jbusres.2022.08.022.

Full text
APA, Harvard, Vancouver, ISO, and other styles
26

Aarendonk, Diederik. "Comparing effectiveness of palliative care for elderly people in long-term care facilities in Europe (PACE)EFPC: EUROPEAN FORUM FOR PRIMARY CARE." European Journal of General Practice 20, no. 2 (April 22, 2014): 156. http://dx.doi.org/10.3109/13814788.2014.907782.

Full text
APA, Harvard, Vancouver, ISO, and other styles
27

Burton, Frances. "A BRIGHTLY COLOURED PHOENIX." Denning Law Journal 18, no. 1 (November 23, 2012): 261–64. http://dx.doi.org/10.5750/dlj.v18i1.319.

Full text
Abstract:
Welstead and Edwards Family Law: Core Text ISBN 0 199 28235 8 (Oxford: Oxford University Press, 2006) pp 372, price £18.95Considering the pace and volume of legislation and cultural change in Family law over the past 10 years, lecturers everywhere must finally have begun to despair of ever containing family law within a manageable syllabus before this neat compendium of essential principles and supporting authority was published by Oxford University Press in their Core Text Series, at the same time that the long awaited English spring did not arrive to cheer us after the prolonged winter.
APA, Harvard, Vancouver, ISO, and other styles
28

Cobb, P. W., M. Kofstad, and C. Bealer. "Effects of implementing an electronic system for the collection of patient reported symptoms on clinic note transcription length." Journal of Clinical Oncology 25, no. 18_suppl (June 20, 2007): 17035. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.17035.

Full text
Abstract:
17035 Background: Recent advances in information technology have made the goal of incorporating patient-reported symptoms possible. Initial studies have examined the validity of these systems but no systematic work has been done to examine the impact on overall practice efficiency. The PACE (Patient Assessment, Care, and Education) System captures patient-reported symptoms, quality of life, social and family history changes, and other clinical data at every office visit. The PACE System includes the Patient Care Monitor (PCM), a standardized, comprehensive assessment of a patient's condition that allows for a self-reported review of systems (ROS) via a wireless, touch screen computer tablet. The purpose of this study was to determine if implementation of the PCM had an impact on total transcription length. Methods: The study utilized a retrospective within subjects control design comparing transcription length by physicians practicing both with and without the PCM. The PACE System was implemented in October 2004 in a main outpatient oncology site in Billings, MT (PACE site). The analysis compared transcription length by physicians who practice in the Billings office where the PACE system was available, and also in four sites in Montana and Wyoming where the PACE system was not available during the same time period (January to October 2006). All available, consecutive physician notes were analyzed from eligible physicians during the analysis period. Results: Four physicians met inclusion criteria and 8,150 notes were analyzed. The average number of dictation words at PCM sites was 406.7 as compared to 485.5 at non- PCM sites (a 16% reduction). The average number of dictation lines at the PCM sites was 54.0 as compared to 58.5 at non-PCM sites (an 8% reduction). Conclusions: Increases in the use of information technology in outpatient oncology necessitate increased understanding of the validity and utility of these systems. This study of the PACE system suggests that there may be an efficiency benefit by implementing patient self-reporting systems. No significant financial relationships to disclose.
APA, Harvard, Vancouver, ISO, and other styles
29

Fogiel-Bijaoui, Sylvie, and Dafna Halperin. "Does It All Stay in the (Normative) Family? Attitudes About Family Among Female Jewish and Muslim Health-Profession Students in Israel." Journal of Family Nursing 24, no. 3 (June 25, 2018): 345–73. http://dx.doi.org/10.1177/1074840718780699.

Full text
Abstract:
Family individualization occurs, if at all, at a different pace and to a different extent in various societies and in various parts of society. Its impact has led to new scholarship in the social and caring professions, for which the concept of family is central in both professional education and practice. It is assumed that attitudes toward changing marital norms, family forms, and family relationships affect professionals’ performance. This study, conducted in Israel in 2014 with 157 female health-profession students—102 (65%) Jews and 55 (35%) Muslim Arabs—focuses on attitudes about the family. Three patterns of attitudes emerged: individualized traditionalism—a mix of traditional and individualized attitudes, present among both the Jewish and the Muslim students; individualized autonomy, present mostly among the Jewish students; and classic traditionalism, present mostly among the Muslim students. Implications of these findings for the education and practice of health care professionals are also discussed.
APA, Harvard, Vancouver, ISO, and other styles
30

Hadi, Irawan. "PERANAN LINGKUNGAN KELUARGA (ORANG TUA) TERHADAP PERKEMBANGAN KEPRIBADIAN ANAK." Musawa: Journal for Gender Studies 13, no. 2 (December 31, 2021): 293–319. http://dx.doi.org/10.24239/msw.v13i2.873.

Full text
Abstract:
Family is the first environment recognized by children. Children spend most of their time with family. In family environment, parents have important roles in shaping children's personality because their habits can be imitated by the children. In a family, everyone is influential, but the father and mother are the most influential. Educating children is the most important task for parents because it can affect the success of the family. However, the success of the family means nothing if it fails in educating and shaping children’s character and personality in accordance with the parents’ expectations. Family is the most significant institution in shaping children’s personalities. The essence of education is the responsibility of the family, while formal education is only a part of it. Parents have the greatest role to influence children when they are sensitive to external influences by educating them according to their own pace. Parents are the ones who should know best when and how their children learn.
APA, Harvard, Vancouver, ISO, and other styles
31

Innes, Kari-Anne. "Performing Lydia(s)." Departures in Critical Qualitative Research 5, no. 2 (2016): 47–75. http://dx.doi.org/10.1525/dcqr.2016.5.2.47.

Full text
Abstract:
Performing Lydia(s) is a mystory developed at Bowling Green State University and performed at the Patti Pace Performance Festival in 2010. This mystory uses Diana Taylor's response to Joseph Roach's theory of performance genealogy to examine pieces of my family archive—epistles in the form of scripture, blogs, emails, family letters, and memoirs—for how they have imprinted themselves on later generations' perception of gender identity. The vehicle for this exploration is my performance of the New Testament figure of Lydia in an original liturgical drama juxtaposed with the performance of my great aunt Lydia's memoirs.
APA, Harvard, Vancouver, ISO, and other styles
32

Sharma, Pramodita. "An Overview of the Field of Family Business Studies: Current Status and Directions for the Future." Family Business Review 17, no. 1 (March 2004): 1–36. http://dx.doi.org/10.1111/j.1741-6248.2004.00001.x.

Full text
Abstract:
Based on a review of 217 refereed articles on family business studies, the literature is organized according to its focus on individual, interpersonal or group, organizational, and societal levels of analyses. An assessment of the status of our current understanding at each level is provided and directions for future research are suggested. A discussion of definitional issues, bases of distinctiveness, and family firm performance is used to help understand the domain or scope of the field. Methodological issues and strategies aimed to enhance the pace at which the field achieves a distinctive legitimate place in organizational studies are presented.
APA, Harvard, Vancouver, ISO, and other styles
33

Bonti, Mariacristina, and Enrico Cori. "Traditional Governance and Innovative Strategies in Italian Family SMEs: Evidence from Tuscany." International Business Research 11, no. 2 (January 8, 2018): 103. http://dx.doi.org/10.5539/ibr.v11n2p103.

Full text
Abstract:
Governance in family businesses is a relatively recent research topic in the field of management studies. Much research has sought to shed light on the factors that shape the relationship between governance structures and corporate strategies. Nevertheless, very little research has specifically addressed the relationships between the configuration of the Board of Directors and the firm’s willingness to carry out innovative strategies. Our study aims to shed light on the relationship between the corporate governance structures and the pace of innovation within family SMEs. Evidence from three family-owned SMEs located in Tuscany (Italy) highlights that a traditional type of governance structure can co-exist with the search for innovative strategies and that the intensity of the innovation processes may not be tied to the Board’s composition.
APA, Harvard, Vancouver, ISO, and other styles
34

Mahmood, Naushin, and Syed Mubashir Ali. "Population Planning in Pakistan: Issues in Implementation and its Impact." Pakistan Development Review 36, no. 4II (December 1, 1997): 875–88. http://dx.doi.org/10.30541/v36i4iipp.875-888.

Full text
Abstract:
It is over three decades now that we have official family planning programme in Pakistan. However, because of the absence of a coherent approach to overcome the social and cultural obstacles to the use of family planning in conjunction with poor service delivery and outreach activities; ineffective information, education and communication campaign; frequent changes in the organisational set up of the programme; inefficient management and lack of political commitment to family planning, the programme failed to achieve tangible success. Nevertheless, recent demographic and fertility surveys indicated some positive changes in the demographic indicators. This suggest that the population programme may be in the right direction. In order to accelerate the pace of these changes, intensive and concerted efforts are needed.
APA, Harvard, Vancouver, ISO, and other styles
35

Rehemtulla, A., and RJ Kaufman. "Preferred sequence requirements for cleavage of pro-von Willebrand factor by propeptide-processing enzymes." Blood 79, no. 9 (May 1, 1992): 2349–55. http://dx.doi.org/10.1182/blood.v79.9.2349.2349.

Full text
Abstract:
Abstract Maturation of pro-von Willebrand factor (vWF) to its active form requires proteolytic processing after a pair of dibasic amino acids (- LysArg-) at residue 763. By coexpression of vWF and various propeptide processing enzymes in COS-1 cells, we here demonstrate that vWF is preferentially processed by the paired dibasic amino acid-cleaving enzyme PACE (furin). Processing of vWF by the yeast homologue of PACE, Kex2, was inefficient and not specific for the authentic site. Two additional recently identified mammalian propeptide-processing enzymes PC2 and PC3 had no detectable vWF-processing activity. The inability of PC2 and PC3 to cleave vWF was apparently not due to the absence of a transmembrane domain, since deletion of the transmembrane domain from PACE resulted in a secreted form which retained its propeptide processing activity within the secretory apparatus. The inability of PC2 and PC3 to process wild-type vWF or any of the vWF mutants described suggests different members of subtilisin-related propeptide- processing enzyme family have evolved to selectively recognize and cleave specific sets of substrates. In addition to paired dibasic residues at the propeptide cleavage site, many proteins, including vWF, also contain an arginine at the P4 position. We have generated mutant vWFs with substitutions at the P2 lysine and/or the P4 arginine to investigate their significance in substrate specificity. A conservative substitution of the P4 arginine by lysine resulted in a decrease in vWF processing by PACE, as did a nonconservative substitution to alanine. Substitution of the P2 lysine to aspartic acid decreased processing and little or no processing was detected when both the P4 and P2 were mutated to lysine and aspartic acid, respectively. These data indicate that both the P4 arginine and the P2 lysine play an important role in substrate recognition by PACE.
APA, Harvard, Vancouver, ISO, and other styles
36

Rehemtulla, A., and RJ Kaufman. "Preferred sequence requirements for cleavage of pro-von Willebrand factor by propeptide-processing enzymes." Blood 79, no. 9 (May 1, 1992): 2349–55. http://dx.doi.org/10.1182/blood.v79.9.2349.bloodjournal7992349.

Full text
Abstract:
Maturation of pro-von Willebrand factor (vWF) to its active form requires proteolytic processing after a pair of dibasic amino acids (- LysArg-) at residue 763. By coexpression of vWF and various propeptide processing enzymes in COS-1 cells, we here demonstrate that vWF is preferentially processed by the paired dibasic amino acid-cleaving enzyme PACE (furin). Processing of vWF by the yeast homologue of PACE, Kex2, was inefficient and not specific for the authentic site. Two additional recently identified mammalian propeptide-processing enzymes PC2 and PC3 had no detectable vWF-processing activity. The inability of PC2 and PC3 to cleave vWF was apparently not due to the absence of a transmembrane domain, since deletion of the transmembrane domain from PACE resulted in a secreted form which retained its propeptide processing activity within the secretory apparatus. The inability of PC2 and PC3 to process wild-type vWF or any of the vWF mutants described suggests different members of subtilisin-related propeptide- processing enzyme family have evolved to selectively recognize and cleave specific sets of substrates. In addition to paired dibasic residues at the propeptide cleavage site, many proteins, including vWF, also contain an arginine at the P4 position. We have generated mutant vWFs with substitutions at the P2 lysine and/or the P4 arginine to investigate their significance in substrate specificity. A conservative substitution of the P4 arginine by lysine resulted in a decrease in vWF processing by PACE, as did a nonconservative substitution to alanine. Substitution of the P2 lysine to aspartic acid decreased processing and little or no processing was detected when both the P4 and P2 were mutated to lysine and aspartic acid, respectively. These data indicate that both the P4 arginine and the P2 lysine play an important role in substrate recognition by PACE.
APA, Harvard, Vancouver, ISO, and other styles
37

Williams, Christine, Emmanuelle Tognoli, and Christopher Beetle. "Mathematics and Relatedness: Predicting Optimal Social Engagement in Late Life." Innovation in Aging 4, Supplement_1 (December 1, 2020): 396. http://dx.doi.org/10.1093/geroni/igaa057.1275.

Full text
Abstract:
Abstract Multiple causes converge for older adults to shed social relationships. Lost opportunities for social engagement are tied to weakened cognitive reserve and under-optimal aging in health and disease. For example, a woman, 75, regularly strolls with younger friends. At 80, her reduced motor fitness makes it hard to keep pace and she withdraws her participation. With same-age peers, she might continue this healthy physical and social activity a few more years by unobtrusively shortening the outing or by slowing her pace. A man, 85, loves to debate politics with family, but his turn at talks diminish: his hearing loss (sensory) prevents quick grasp of the discussion; his slower verbal fluency (cognitive) hamper quick-witted replies. Both examples illustrate that social aging is not only a ¬¬¬property of the aging individual. Social context plays an important role. Our recently formed interdisciplinary group (geropsychiatric nurse, mathematical physicist and complexity scientist) is studying the systemic complexities of social aging with experiments and mathematical models. Our aim is to present our model and aging-focused hypotheses, as well as empirical validation in younger adults. Four key variables are group size and heterogeneity, and the strength and adaptability of social coordination. Our current results show that people coordinate better with others like them in pace, but they lose the ability to coordinate with people whose pace is different. We anticipate that our program of research will deliver evidence-based recommendations on social-engineering of activities that maximize opportunities for sustained interactions among older adults.
APA, Harvard, Vancouver, ISO, and other styles
38

Hassan, Karl A., Qi Liu, Liam D. H. Elbourne, Irshad Ahmad, David Sharples, Varsha Naidu, Chak Lam Chan, et al. "Pacing across the membrane: the novel PACE family of efflux pumps is widespread in Gram-negative pathogens." Research in Microbiology 169, no. 7-8 (September 2018): 450–54. http://dx.doi.org/10.1016/j.resmic.2018.01.001.

Full text
APA, Harvard, Vancouver, ISO, and other styles
39

Vago, Marta. "Integrated Change Management©: Challenges for Family Business Clients and Consultants." Family Business Review 17, no. 1 (March 2004): 71–80. http://dx.doi.org/10.1111/j.1741-6248.2004.00005.x.

Full text
Abstract:
Global competition, shorter business cycles, and a new and different workforce require a faster pace of change than some business-owning families can or want to accommodate. They need help to decide what course of action would best serve their needs going forward. Should they change their business model? Should they continue what they're doing? Should they sell the business? Each choice brings with it a different set of consequences. All require stakeholders to make emotionally charged, life-changing decisions. Integrated Change Management© engages clients in meaningful and “feelingful” conversations regarding their individual and collective futures. It also provides them with a clear and finite set of options to choose from, together with a mechanism to assess these options' potential to satisfy business, personal, and family objectives. The process offers family business consultants a range of opportunities to assist clients in charting their future.
APA, Harvard, Vancouver, ISO, and other styles
40

Clark, Gracia. "Negotiating Asante family survival in Kumasi, Ghana." Africa 69, no. 1 (January 1999): 66–86. http://dx.doi.org/10.2307/1161077.

Full text
Abstract:
Extreme flexibility in the residential and financial arrangements attached to marriage and matrilineal kinship have remained a consistent characteristic of Asante throughout this century. The constant renegotiation processes that constitute and renew family relations have kept them remarkably strong through a series of radical changes in the enacted content and boundaries of those relations, linked with dramatic fluctuations in the economic and political environment of Ghana. The degree of personal agency sustaining this Asante social framework has challenged and stretched a succession of theoretical models, since this negotiability extends to the principles and limits of negotiation itself. The continuing vitality of Asante matriliny actually requires a high degree of individual autonomy, including the economic autonomy that anchors the negotiating position of each social adult. Recent life history work among Kumasi women traders shows that the elastic framework of family relations can absorb considerable change in the expectations and the balance of power between spouses or between parents and children as long as the pace remains slow enough and individual self-reliance stable enough to preserve the continuity of the renegotiation process. The economic crisis of the final decade of the century has threatened the basis of social reproduction by reducing the opportunities for financial independence. Without basic autonomous subsistence young men and women can no longer function effectively as Asante adults.
APA, Harvard, Vancouver, ISO, and other styles
41

Suraiya, Ratna, and Nashrun Jauhari. "Psikologi Keluarga Islam sebagai Disiplin Ilmu (Telaah Sejarah dan Konsep)." Nizham Journal of Islamic Studies 8, no. 02 (December 3, 2020): 153. http://dx.doi.org/10.32332/nizham.v8i02.2697.

Full text
Abstract:
Islamic family psychology is currently being developed by a number of experts in the country, both in Islamic scientific studies and in handling practical Islamic family therapy. However, from the development efforts made, it often appears that the identity of the study is blurred between as an Islamic study and between a study from a Western perspective. The main asset to uncover the obscure curtain in the concept of this study is through tracing the psychological history of the Islamic family, so that it can provide an insight into the epistemological framework and the purpose of its study. The research succeeded in finding several points of findings: (1) Islamic family psychology emerged as a scientific study in the 1980s, after the development of family psychology studies in the 1960s in the West; (2) the emergence of Islamic family psychology studies was triggered by a mission to respond back to the pace of development of family psychology studies in the West which increasingly hegemony in the Islamic world; (3) the concept of Islamic family psychology is based on Islamic teachings which uphold human values, especially in the character of human creation; (4) the psychological dimension of each family person is always touched by Islamic teachings in order to create a Sakinah family.
APA, Harvard, Vancouver, ISO, and other styles
42

Breidahl, Karen N., and Christian Albrekt Larsen. "The myth of unadaptable gender roles: Attitudes towards women’s paid work among immigrants across 30 European countries." Journal of European Social Policy 26, no. 5 (November 21, 2016): 387–401. http://dx.doi.org/10.1177/0958928716664292.

Full text
Abstract:
It is a predominant assumption in contemporary political and academic debates that gender roles and attitudes supporting women’s paid work among immigrants are deep-rooted and stable over time. However, the actual work–family orientations among immigrants are rarely studied. The purpose of this article is to study to what extent and at what pace immigrants in general adapt to the attitudes towards women’s paid work that prevail in the host countries. A cross-national research strategy is applied using the European Social Survey rounds 2 (2004), 4 (2008) and 5 (2010), allowing us to compare and analyse attitudes towards women’s paid work among 13,535 foreign-born individuals resident in 30 European countries. The results indicate that immigrants’ attitudes towards women’s paid work are highly structured by the institutional and cultural context of the host country. Both male and female immigrants, as well as immigrants with and without children, adapt to host country attitudes at a high pace.
APA, Harvard, Vancouver, ISO, and other styles
43

Singh, Srishti, Meenakshi Kalhan, J. S. Malik, Anuj Jangra, Nitika Sharma, and Srijan Singh. "Socio-demographic correlates of unmet need for family planning among rural women of Haryana, India." International Journal of Advances in Medicine 5, no. 3 (May 22, 2018): 624. http://dx.doi.org/10.18203/2349-3933.ijam20182113.

Full text
Abstract:
Background: The continuously growing population not only hampers the socio-economic development but the health of mothers and newborns. Progress made in improving social development in addition to strengthening the ongoing family planning programme will contribute towards the future pace of fertility and decline in unmet need. Objective of present study to assess the unmet need for family planning and role of socio-demographic factors among rural women.Methods: The present study was community based cross-sectional study conducted in rural area of Haryana from September 2015 to August 2016 among 500 currently married women (18-49 years).Results: The unmet need for family planning was 19.2% (4.8% spacing and 14.4% limiting). Education, occupation and SES were significantly associated with unmet need for family planning. The commonest reason for not using contraception among those with unmet need was fear of side-effects (37.5%) followed by in-laws disapproval (21.9%).Conclusions: The unmet need for family planning was high. Women education and empowerment by protecting their health, wellbeing and rights, including their reproductive rights would prove to be beneficial.
APA, Harvard, Vancouver, ISO, and other styles
44

Mahler, K. "After Sharp Gains in the 1980s, Pace of Effort Devoted to Family Planning Programs Slackens in the 1990s." International Family Planning Perspectives 23, no. 1 (March 1997): 45. http://dx.doi.org/10.2307/2950790.

Full text
APA, Harvard, Vancouver, ISO, and other styles
45

Atkeson, Andrew G., and Magnus Irie. "Rapid Dynamics of Top Wealth Shares and Self-Made Fortunes: What Is the Role of Family Firms?" American Economic Review: Insights 4, no. 4 (December 1, 2022): 409–24. http://dx.doi.org/10.1257/aeri.20210560.

Full text
Abstract:
We derive an analytical link between the fast dynamics of inequality at the top of the wealth distribution and the prevalence of newly created fortunes. Specifically, in the context of a random growth model of wealth accumulation, the shape of the top of the wealth distribution changes rapidly only if the pace with which new fortunes are created is fast. Quantitatively, the decision of a few families to bear a large amount of idiosyncratic risk in the form of family firms is crucial in accounting for both the prevalence of new fortunes and the dynamics of top wealth inequality. (JEL D22, D31, G32, L25)
APA, Harvard, Vancouver, ISO, and other styles
46

Spooner, Sharon, Louise Laverty, and Kath Checkland. "The influence of training experiences on career intentions of the future GP workforce: a qualitative study of new GPs in England." British Journal of General Practice 69, no. 685 (May 20, 2019): e578-e585. http://dx.doi.org/10.3399/bjgp19x703877.

Full text
Abstract:
BackgroundThe capacity of the UK GP workforce has not kept pace with increasing primary care workloads. Although many doctors successfully complete GP specialty training programmes, some do not progress to work in NHS general practice.AimThis article explores the training experiences and perceptions of newly qualified GPs to understand how their education, training, and early experiences of work influence their career plans.Design and settingA qualitative study of doctors in their final year of GP training (ST3) and within 5 years of completion of GP training (F5).MethodParticipants across England were recruited through training programmes, First5 groups, and publicity using social media and networks. Open narrative interviews were conducted with individuals and focus groups. Audiorecorded interviews were transcribed, and a thematic analysis was supported by NVivo and situational analysis mapping techniques.ResultsFifteen participants engaged in individual interviews and 10 focus groups were carried out with a total of 63 participants. Most doctors reported that training programmes had prepared them to deal confidently with most aspects of routine clinical GP work. However, they felt underprepared for the additional roles of running a practice and in their understanding of wider NHS organisational structures. Doctors wished to avoid unacceptably heavy workloads and voiced concerns about the longer-term sustainability of general practice.ConclusionStrategies to attract and retain enough GPs to support delivery of comprehensive primary care should consider how doctors’ early career experiences influence their career intentions. A coherent plan is needed to improve their preparation and increase confidence that they can achieve a professionally satisfying, effective, and sustainable career in NHS general practice.
APA, Harvard, Vancouver, ISO, and other styles
47

Gratton, Brian, and Frances M. Rotondo. "Industrialization, the Family Economy, and the Economic Status of the American Elderly." Social Science History 15, no. 3 (1991): 337–62. http://dx.doi.org/10.1017/s0145553200021167.

Full text
Abstract:
In his 1911 film What Shall We Do with Our Old? D.W. Griffith dramatized the belief that urban, industrial America had no place for the elderly. Fired for being too slow at his work, an impoverished old man cannot buy food or medicine for his wife, who languishes in their drab, one-room apartment. Justice Benjamin Cardozo told a similar tale in upholding the constitutionality of the Social Security Act (Helvering v. Davis, 301 U.S. 619 [1937]): “The number of [aged] unable to take care of themselves is growing at a threatening pace. More and more our population is becoming urban and industrial instead of rural and agricultural.” Cardozo relied on studies by the U.S. Social Security Board (1937: 3), which found that “the major part of the industrial population . . . earns scarcely enough to provide for its existence. Savings are small and generally cover little more than the cost of burial insurance.” As a result, “industrial workers in [urban] areas . . . reach old age with few resources” (ibid.: 33).
APA, Harvard, Vancouver, ISO, and other styles
48

Li, Yu Bing. "Concurrent Engineering Based Vehicle Development Project Management." Advanced Materials Research 403-408 (November 2011): 2829–34. http://dx.doi.org/10.4028/www.scientific.net/amr.403-408.2829.

Full text
Abstract:
Concurrent engineering has been used in many OEMs in order to face up to the fierce competition situation. Modular development teams develop common modules which are applied in the same platform-based variants and its product family in order to save design costs and reduce development time. The R&D department should construct a concurrent engineering team to quicken the pace of new product development and to ensure product quality by means of open-loop and close-loop cycle, and frame a platform to frequent communication and quick decision for the concurrent engineering team.
APA, Harvard, Vancouver, ISO, and other styles
49

Stewart, Katrine. "Use of CD-ROMs for Teaching Systemic Botany and Horticultural Production Courses." HortScience 33, no. 3 (June 1998): 552c—552. http://dx.doi.org/10.21273/hortsci.33.3.552c.

Full text
Abstract:
Systemic botany often requires the students to visually examine plant materials at different stages of growth and development to determine family characteristics. Fresh plant materials used in these demonstrations are often unavailable to allow the student to review for laboratory examinations. The timing of production courses means that students do not have the chance to see field operations for various crops. CD-ROMs have been developed as a adjunct to lectures to allow students to review and examine material at their own pace in order to better prepare them for examinations.
APA, Harvard, Vancouver, ISO, and other styles
50

Gillespie, David, Christopher C. Butler, Janine Bates, Kerenza Hood, Hasse Melbye, Rhiannon Phillips, Helen Stanton, et al. "Associations with antibiotic prescribing for acute exacerbation of COPD in primary care: secondary analysis of a randomised controlled trial." British Journal of General Practice 71, no. 705 (March 2, 2021): e266-e272. http://dx.doi.org/10.3399/bjgp.2020.0823.

Full text
Abstract:
BackgroundC-reactive protein (CRP) point-of-care testing can reduce antibiotic use in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in primary care, without compromising patient care. Further safe reductions may be possible.AimTo investigate the associations between presenting features and antibiotic prescribing in patients with AECOPD in primary care.Design and settingSecondary analysis of a randomised controlled trial of participants presenting with AECOPD in primary care (the PACE trial).MethodClinicians collected participants’ demographic features, comorbid illnesses, clinical signs, and symptoms. Antibiotic prescribing decisions were made after participants were randomised to receive a point-of-care CRP measurement or usual care. Multivariable regression models were fitted to explore the association between patient and clinical features and antibiotic prescribing, and extended to further explore any interactions with CRP measurement category (CRP not measured, CRP <20 mg/l, or CRP ≥20 mg/l).ResultsA total of 649 participants from 86 general practices across England and Wales were included. Odds of antibiotic prescribing were higher in the presence of clinician-recorded crackles (adjusted odds ratio [AOR] = 5.22, 95% confidence interval [CI] = 3.24 to 8.41), wheeze (AOR = 1.64, 95% CI = 1.07 to 2.52), diminished vesicular breathing (AOR = 2.95, 95% CI = 1.70 to 5.10), or clinician-reported evidence of consolidation (AOR = 34.40, 95% CI = 2.84 to 417.27). Increased age was associated with lower odds of antibiotic prescribing (AOR per additional year increase = 0.98, 95% CI = 0.95 to 1.00), as was the presence of heart failure (AOR = 0.32, 95% CI = 0.12 to 0.85).ConclusionSeveral demographic features and clinical signs and symptoms are associated with antibiotic prescribing in AECOPD. Diagnostic and prognostic value of these features may help identify further safe reductions.
APA, Harvard, Vancouver, ISO, and other styles
We offer discounts on all premium plans for authors whose works are included in thematic literature selections. Contact us to get a unique promo code!

To the bibliography