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This paper compares two approaches to the estimation of costs in dental care programs: a conventional approach and an approach based on theoretical expectations. The conventional approach typically uses a linear extrapolation of an average figure - e.g., cost per visit - over various program sizes and thus predicts constant costs. Constant costs are, however, theoretically implausible, and it should be anticipated that their use in program planning or analysis would generate biased estimates. This hypothesis is examined using annual costs and visits from a group of uniform clinics over a five-year period. Results show that costs calculated by the conventional method are underestimated at low volumes and increasingly overestimated at higher volumes. The findings, which illustrate how inefficiency can inadvertently be incorporated into program design, have implications for cost-effectiveness of dental care delivery in the public sector. © 1985, SAGE Publications. All rights reserved.
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This paper analyzes the sources of strain between the professions of medicine and social work. The two professions are compared in relation to (1) the organization and socialization process of professional training; (2) perspectives on patient care, illness and role of the health care professional; (3) attitudes toward knowledge and data; (4) attitudes toward and preparation for teamwork; (5) perspectives on the role of the patient; (6) perceptions of social work’s function. © 1985 Taylor & Francis Group, LLC.
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Age at first hospitalization, premorbid social competence, and developmental categorizations of symptomatology were examined in 228 male and 220 female patients in three diagnostic categories: Major affective disorder, neuroses, and personality disorder. High social competence patients were older at first hospitalization than low competence individuals. Younger first admission patients showed more symptoms in the action category and in the role orientation of turning against others. Older patients more frequently displayed symptoms of the thought variety and of turning against the self. Gender differences in age at first hospitalization were not found. With respect to all developmental variables examined, the results suggest that a broader view of prognosis proposed in research with schizophrenic patients is applicable to nonschizophrenic groups. © 1985 by The Williams & Wilkins Co.
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The third of 5 paradigm periods posited for the history of American geography extends from the establishment of the Committee of Ten in 1892, to the publication of Carl Sauer's 'The Morphology of Landscape' in 1925. This period witnessed the emergence of discipline and profession - an inert physiography, energized by the discipline-forming Davisian cycle of erosion, preceded the causal notion. Determinisms that gave way to studies of control, adjustment, and the geographic factor, provided a framework for the geographic philosophies of such scholars as Albert Perry Brigham, Ellsworth Huntington, and Ellen Semple. Regional delimitations of physiographic provinces and variant forms of economic geography emerged as alternatives to causality. The geography of France, Germany, and Britain afforded little support for varieties of determinism in America, and was further questioned during the 1914-1918 war years. Meanwhile, Wellington D. Jones and Carl O. Sauer developed another viewpoint, adumbrated by Sauer in a series of papers culminating in 'The Morphology of Landscape'. The locus of American geography had been moved.-Author
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A knowledge of normal articulation is needed before the prosthodontist can assess the compensatory articulation used by glossectomy patients. The amount and portion of tongue resected is directly correlated with speech intelligibility. The loss of the tip of the tongue is more critical to intelligibility than a hemiglossectomy. Partial glossectomy speakers can often use the residual tongue stump to perform adaptive movements that approximate normal movements and should be treated as an articulation problem. The compensatory articulation used by the total glossectomy patient was reviewed. The prosthodontic management of patients with partial tongue resection often includes lowering the palatal vault, while the management of the total glossectomy patient usually requires a mandibular tongue prosthesis. These prostheses can be refined with the use of multiview videofluoroscopy, videotaping, and spectrographic analysis. © 1985.