PubMed Health⌕ Search
Home/Archive/PubMed

PubMed · 7757326

Clinical indicators: a methodological approach.

L Scott·K Grimmer
View original source ↗Export metadata ↓

Abstract

Clinical indicators offer physiotherapists a tool by which quality of care can be flagged and evaluated. Such a flag requires a measure of the cost of treatment as well as the outcome achieved for that cost. Traditionally, the number of treatments to discharge has been used as a proxy measure of cost as well as outcome of physiotherapy care. However, physiotherapists recognize that the cost of treatment is an inappropriate reflection of the outcome of care in many instances. The challenge for physiotherapists in developing clinical indicators is to set appropriate flags of quality of care. This paper presents a methodological approach to the development of a flag of performance for acute lower back pain.

Explore related subjects

Acute DiseaseCosts and Cost AnalysisHumansLow Back PainMethodsOutcome and Process Assessment, Health CarePhysical Therapy ModalitiesProspective StudiesQuality of Health CareTasmaniaJournal Article

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

L Scott, K Grimmer. 1995. Clinical indicators: a methodological approach.. https://pubmed.ncbi.nlm.nih.gov/7757326/

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2001

The role of T cell help for anti-viral CTL responses.

Cytotoxic T lymphocyte (CTL or CD8) responses are a major branch of the immune system involved in controlling viral infections. Murine models have shown that the development of effective and sustained CD8 cell responses requires CD4 T cell help. However, the precise mechanism in which CD4 cells provide help for CD8 cell responses is still controversial. In the literature, mainly two mechanisms are discussed. According to the "classical" pathway, CD4 cells secrete cytokines, such as IL-2, which promote the responsiveness of the CD8 cells. According to the "CD4-APC-CD8" pathway, CD4 cells specifically activate antigen presenting cells (APCs), and APCs specifically interact with CD8 cells, thereby delivering help. Here, we derive kinetic models in order to describe and compare both pathways of help. We find that the two pathways might have different roles in different situations. The classical pathway is more efficient at inducing CD8 cell expansion at high virus loads, while the CD4-APC-CD8 pathway is more efficient at inducing CD8 cell proliferation at low virus loads. From this, it follows that the classical pathway might be needed in order to kick-start a CD8 cell response in the acute phase of the infection, while the CD4-APC-CD8 pathway is needed in order to ensure virus clearance when virus load is reduced by the immune system. These findings have implications for the interpretation of experimental data from virus infection in helper-deficient hosts. In particular, the models offer further suggestions for the development of treatment regimes aimed at achieving immunological control of HIV infection which has been shown to crucially depend on the availability of helper cell responses.

Acute Disease↗
PubMed2001

Acute neuronal apoptosis in a rat model of multiple sclerosis.

Demyelination caused by inflammation of the CNS has been considered to be a major hallmark of multiple sclerosis (MS). Using experimental autoimmune encephalomyelitis, a model of MS, we demonstrate that an immune-mediated attack of the optic nerve is accompanied by an early degeneration of retinal ganglion cells (RGCs). The decrease of neuronal cell density was correlated with functional disabilities as assessed by visual evoked cortical potentials and electroretinogram. Visual acuity was significantly reduced. DNA degradation and activation of caspase-3 in RGCs indicate that cell death of RGCs is apoptotic. These findings show for the first time that an inflammatory attack against myelin components can lead to acute neuronal cell loss by apoptosis.

Acute Disease↗