SEARCH · PubMed Health

Results for “Goals”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 73 records · Page 4Linked to original sources

PubMed2004

Roundtable discussion: blood pressure goal attainment: meeting the challenge of the JNC 7's blood pressure goals and the role of renin-angiotensin-aldosterone system blockade.

This roundtable discussion, held in December 2003, was convened to discuss the impact of the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure's (JNC 7) challenging blood pressure goal objectives for the clinical management of hypertensive patients. The discussion was moderated by Michael Weber, MD, of the State University of New York Downstate College of Medicine in New York City. Participants included leading experts in the field Joseph Izzo, Jr., MD, of the School of Medicine and Biomedical Sciences at the State University of New York at Buffalo; Suzanne Oparil, MD, of the Vascular Biology and Hypertension Program, Division of Cardiovascular Disease, University of Alabama at Birmingham; and Jan Basile, MD, of the Ralph H. Johnson VA Medical Center and Department of General Internal Medicine/Geriatrics, Medical University of South Carolina in Charleston. The primary intention of this roundtable is to educate physicians about the importance of achieving the blood pressure goals agreed upon by the JNC 7 Committee and to present practical ways for the attainment of such goals in clinical practice.

Antihypertensive Agents↗

PubMed1998

Model-based, goal-oriented, individualised drug therapy. Linkage of population modelling, new 'multiple model' dosage design, bayesian feedback and individualised target goals.

This article examines the use of population pharmacokinetic models to store experiences about drugs in patients and to apply that experience to the care of new patients. Population models are the Bayesian prior. For truly individualised therapy, it is necessary first to select a specific target goal, such as a desired serum or peripheral compartment concentration, and then to develop the dosage regimen individualised to best hit that target in that patient. One must monitor the behaviour of the drug by measuring serum concentrations or other responses, hopefully obtained at optimally chosen times, not only to see the raw results, but to also make an individualised (Bayesian posterior) model of how the drug is behaving in that patient. Only then can one see the relationship between the dose and the absorption, distribution, effect and elimination of the drug, and the patient's clinical sensitivity to it; one must always look at the patient. Only by looking at both the patient and the model can it be judged whether the target goal was correct or needs to be changed. The adjusted dosage regimen is again developed to hit that target most precisely starting with the very next dose, not just for some future steady state. Nonparametric population models have discrete, not continuous, parameter distributions. These lead naturally into the multiple model method of dosage design, specifically to hit a desired target with the greatest possible precision for whatever past experience and present data are available on that drug--a new feature for this goal-oriented, model-based, individualised drug therapy. As clinical versions of this new approach become available from several centers, it should lead to further improvements in patient care, especially for bacterial and viral infections, cardiovascular therapy, and cancer and transplant situations.

Anti-Arrhythmia Agents↗

PubMed1990

Tenacious goal pursuit and flexible goal adjustment: explication and age-related analysis of assimilative and accommodative strategies of coping.

Crises and critical life transitions activate 2 distinct but complementary modes of coping, (a) transforming developmental circumstances in accordance with personal preferences (assimilative tendency) and (b) adjusting personal preferences to situational constraints (accommodative tendency). Assimilative and accommodative tendencies were measured by a questionnaire comprising 2 independent scales (Tenacious Goal Pursuit and Flexible Goal Adjustment). Both scales predict high life satisfaction and low depression and are positively related to generalized internal control beliefs. The scales evinced an opposite relation to age: Cross-sectional analyses on a sample of 890 Ss in the age range from 34 to 63 years revealed a gradual shift from an assimilative to an accommodative mode of coping. Implications for theories of depression and successful aging are discussed.

Adaptation, Psychological↗

PubMedDate not supplied

Certification: goals set, goals met.

When the American Board of Medical Management was founded by the American College of Physician Executives on January 1, 1989, it was understood that the process for formal recognition of medical management as a specialty of medicine would be rigorous. Understandably, particularly at a time when the medical profession and the health care delivery system are under increasing scrutiny by all third-party payers, the decision to expand medical specialization is made with great caution. But the process of recognition for medical management is now well under way. In an interview with Frank A. Riddick Jr., MD, FACPE, Chairman of the Board of Directors of ABMM, Physician Executive learned more about the specific goals of ABMM and about the degree to which those goals have been achieved.

Certification↗

PubMed1996

[Goal attaining scale. Reliability and practical experiences in 397 psychiatric treatment courses. 2: Practical experiences with a simplified version of Goal Attainment Scaling in clinical practice and intermediate length rehabilitational treatment].

Goal attainment scaling (GAS) measures outcome dependent on the degree, to which patients attain, what was thought to be their potential. Can this method be simplified by giving up to detail in advance, what would be "much more" and "much less" than the expected outcome? In 339 psychiatric treatment courses of inpatients, GAS was compared with a traditional clining rating. The patients did least agree to goals, their therapists wrote down concerning "social contacts" and "coping". The simplified form of GAS turned out to be more vulnerable to wrong prognoses. The influence of the vocational experience of those, who constructed the scales was tested as well. Despite methodological shortcomings GAS has evident therapeutic qualities: how else can we evaluate, how much of their potential our patients realize?

Adaptation, Psychological↗

PubMedDate not supplied

Reconstructive goals for children with burns: are our goals the same?

It is often difficult if not impossible to include a pediatric patient in the planning of burn reconstruction. To give the patient greater input into his or her reconstructive plan, we developed a survey tool to evaluate the different reconstructive goals of the patient, the parent, and the physician. Each patient, parent, and physician were requested to complete a separate goal form. Each form consisted of a simple line drawing of a child that shows both anterior and posterior views. The patient, the parent, and the physician were each asked to circle the desired reconstruction site or sites. The responses were collated and compared by sex, age, size of burn, and evaluator (patient, parent, or physician). Patients indicated fewer and different desired reconstruction sites than the physicians or the parents. Before reconstruction is planned, the patient should be consulted. The desires of the parents and the physician may differ significantly from those of the patient.

Adolescent↗

PubMed1995

Desirable routine analytical goals for quantities assayed in serum. Discussion paper from the members of the external quality assessment (EQA) Working Group A on analytical goals in laboratory medicine.

The aim of the Working Group was to describe guidelines for deriving desirable analytical goals in laboratory medicine. First, a literature review is given of the different approaches used until now, and some of the most important studies are presented in detail. These approaches are then discussed critically, and the analytical goals proposed by the group are outlined with respect to monitoring and diagnostic testing. The group recommends that, most realistically, analytical quality specifications be biologically based. For diagnostic testing, the aim is achievement of accuracy, allowing the use of common reference intervals when populations are homogeneous for a given quantity. For monitoring (within an individual laboratory and performed with the same instrument), analytical performance should aim at stable operation and low imprecision compared with the within-subject biological variation. Method accuracy is also very important for the comparability of results from different laboratories or instruments.

Blood Chemical Analysis↗

PubMed1984

Evaluation of treatment goals: the use of goal attainment scaling.

Several observations are made on certain problems which psychiatric nurses may face during the evaluation phase of the nursing process. It is argued that the key to successful evaluation in this field lies in planning the evaluation itself, thereby strengthening the scientific basis of nursing practice by empirical methods. The use of goal attainment scaling is presented as one approach to this end.

Goals↗

PubMed1979

Analytical goals in clinical chemistry: their relationship to medical care. Proceedings of the Subcommittee on Analytical Goals in Clinical Chemistry. World Association of Societies of Pathology, Ciba Foundation, London, England (U. K.), April 25-28, 1978.

The discipline of clinical chemistry is undergoing dramatic changes. The force for change stems from a worldwide recognition of the importance of chemical analyses in medical practice. In the past, developments in clinical chemistry were initiated from a technical perspective. This report provides an alternative approach, starting from the patient and then defining the role of the clinical chemistry laboratory in patient care. The discussions attempt to define the relationship between patient care and analytic goal development in statistical terms. This approach provides a method for appraising the needs of medical care in quantitative terms from the perspective of the physician and the patient. The approach also provides guidance for identifying areas where further technical advance is required, as well as areas where present laboratory performance is adequate for patient care in terms of analytic quality.

Chemistry, Clinical↗

PubMed1963