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A three-year study was undertaken in the general medical clinic of a private community hospital, to assess the health behavior, health status, and profile of function of stable chronic disease was developed and tested. It was shown that these patients used a disproportionate amount of health care services. Half of the group was treated by a nurse practitioner/physician team and half by a house officer/preceptor team. Patients in both groups behaved similarly. These patients: 1) made frequent demands for outpatient services but did not need more than average hospital care; 2) tended to have problems of socio-economic indigency; 3) were likely to have hypertension, obesity, arthritis, and functional disease; 4) were chiefly women; 5) required special visits 9 percent of the time, usually for exacerbations of illness or intercurrent health problems; 6) made greater demands if they had functional complaints as a primary or secondary health problem; and 7) viewed their health more positively and functioned at a higher level if they were over 65 years of age. It was also found that the nurse practitioner, working in consultation with a physician, was able to provide high-quality health care.  相似文献   
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The dynamics of the ultrastructure of the neurosecretory system in the postburn period is characterized by phasic of organells of neurosecretory cells and synapses on their bodies and processes. Immediately after burn there appear pronounced signs of an increased formation of secretion synchronous to a considerably increased functional activity of synaptic structures. Of the opposite character are fine structures in neurocytes in the subsequent period (1-1,5 hour after burn). Phenomena of disintegration and degeneration of organells are developing in the cells. In the posiologically active neurohormones and degeneration of membrane structures gradually increase at all the observed stages of the burn trauma. All the elements of the supraoptic nucleus and the posterior lobe of the hypophysis early responding to the effect of such a powerful extreme factor are involved in the response of the organism to burn. It should be noted that immediately after burn there appears an increased permeability of capillaries followed by extravasation of formed elements and liquid blood. It steadily increases with the development of the process.  相似文献   
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