The clinical management
of prostate cancer has been outlined, yet is not intended to describe click here quality prostate cancer care. Therefore, RAND researchers developed quality indicators for early stage prostate cancer. The ACoS (American College of Surgeons) used these indicators to perform the first national assessment to our knowledge of the quality of care among men with early stage prostate cancer undergoing expectant management.
Materials and Methods: Information from medical records was abstracted for evidence of compliance with the RAND indicators (structure and process). Weighted and stratified proportions were selleck compound calculated to assess indicator compliance. Logistic regression models were fit and evaluated by hospital type and patient factors.
Results: A weighted and stratified total of 13,876
early stage prostate cancer cases on expectant management in 2000 to 2001 were investigated. Compliance with structural indicators was high (greater than 80%) and compliance with process indicators varied (19% to 87%). Differences in process indicators were observed from models by hospital type and comorbid conditions, but not for age, race or insurance status.
Conclusions: Using the RAND quality indicators this study revealed several process areas for quality improvement among men with early stage prostate cancer on expectant 3-mercaptopyruvate sulfurtransferase management in the United States. Efforts to improve the quality of early stage prostate cancer care need to move beyond the paradigm of age, race and insurance status.”
“The use of weapons in violence increases both the severity of harm to victims and the severity of legal consequences for offenders, but little is known of the characteristics of violent offenders who choose to use weapons. Levels of anger, attitude to risk, time discounting, and antisocial history among a sample of weapon-using violent offenders
(n = 15) were compared to violent offenders who had not used a weapon (n = 10) and nonviolent offenders (n = 15). Results showed that weapon-using violent offenders displayed greater trait aggression and were more risk seeking than other offender types. In addition, weapon-using violent offenders were first convicted at an earlier age and truanted from school more frequently compared to other offender types. The results indicate that weapon users are more aggressive and more risk taking, but no more present focused than other violent and nonviolent offenders. Further research into the cognitive and social factors that influence weapon use is required if this dangerous behavior is to be reduced. (C) 2009 Elsevier Ireland Ltd. All rights reserved.