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C Charles

Publications and source records attributed to C Charles.

At least 55 records · Page 3Linked to original sources
PubMed1994

Evaluating physician impact analysis. Methods, results, and uses in Ontario Hospitals.

Physician impact analysis (PIA) is a planning tool intended to bring greater predictability to hospital medical staff resource planning by providing a means to predict the impact of a new or replacement physician's practice profile on a hospital's clinical program priorities, staffing resources, and costs. Two key methods advocated to undertake PIAs are the Department Survey Method and the Hospital Medical Records Institute Case-Mix Groups/Resource Intensity Weights Methods developed by the Hospital Medical Records Institute. This article discusses issues related to the methods, results, and uses of PIA information in Ontario hospitals. Further evaluation of the PIA process is recommended to increase our understanding of both the strengths and limitations of this planning tool.

Diagnosis-Related Groups↗
PubMed1994

Involving stakeholders in health services research: developing Alberta's resident classification system for long-term care facilities.

Little attention has been directed in Canada to identifying stakeholders at the administrative policy level to whom relevant health services research information can be targeted. This article describes a case study in which key stakeholders (long-term care facility owners, operators, and care providers) were explicitly defined not only as targets of original research information to inform administrative public policy but also as collaborators in the research process and dissemination of results. The research involved development of a classification system to measure resident care requirements in the province's nursing homes and auxiliary hospitals. The classification system formed the basis of a new government administrative policy for allocating public funds to these facilities based on levels of care. The authors describe the rationale for involving stakeholders in the research process, the role of stakeholders as collaborators, and lessons learned from the Alberta experience. Examples are presented of how stakeholders can contribute to the health services research process and outcome: by providing experiential knowledge related to the research outcome, anticipating and overcoming potential problems with policy implementation, facilitating policy-oriented learning across stakeholder groups, assisting in the transfer of research information to wider stakeholder audiences, and promoting acceptance for policy change.

Aged↗
PubMed1993

Revisiting physician impact analyses: predicted versus observed hospital resource use.

In order to determine the accuracy of predictions made using Physician Impact Analysis (PIA), a comparison was undertaken of predicted versus actual resource use for 10 new physician specialists at a southern Ontario community hospital. The predictions were done from 1987 to 1989 using methodology recommended by the Ontario Hospital Association (OHA) and available at that time. This included (1) Hospital Medical Records Institute data and (2) a hospital service department survey. A comparison was made between PIA predictions and actual physician resource utilization data gathered in 1991. There was little agreement between the two. The usefulness of PIA rests largely on its ability to generate accurate predictions about a new physician recruit's number of cases and hospital resource use. However, because this research was undertaken in only one community hospital, further evaluation of the PIA process is recommended.

Data Collection↗
PubMed1993

Lay participation in health care decision making: a conceptual framework.

Lay participation in health care decision making has attracted increasing interest in Canada, with numerous provincial government reports advocating this initiative. Interest stems from a number of factors. Among them is a growing recognition that patient preferences ought to be incorporated into decision making that involves individual treatment choices. Another factor is the desire to increase public accountability for decisions on the allocation of health care resources, in order to make providers more accountable to the communities they serve. There is, however, still considerable confusion over what lay participation really means. In addition, little consideration has been given to whether and how lay participation can lead to better decision making and the criteria by which it should be judged. This article presents a framework based on decision-making domains, role perspectives, and levels of participation and is intended as an initial step toward providing greater conceptual clarity regarding the key dimensions and goals of lay participation in health care decision making.

Canada↗
PubMed1992

Bivariate assay for cleaved atrial natriuretic factor (ANF(101-105/106-126)) in sheep plasma.

A bivariate assay has been developed to measure both ANF, and cleaved ANF (ANF(101-105/106-126)) the primary product of endopeptidase-24.11 action on rat ANF(101-126). The assay employed two different antisera directed to the carboxy-terminal and ring regions of ANF to enable discrimination and measurement of intact endogenous ANF(99-126) and infused cleaved ANF (rat ANF(101-105/106-126)) in sheep plasma extracts. The assay which was validated by HPLC analysis of plasma extracts, had sufficient accuracy and precision to measure the metabolic clearance rate and half-life of cleaved ANF when infused in normal sheep.

Analysis of Variance↗
PubMed1992

Assay of endopeptidase-24.11 activity in plasma applied to in vivo studies of endopeptidase inhibitors.

We developed a fluorometric assay for endopeptidase-24.11 (EC 3.4.24.11) in human plasma. Substrate [glutaryl-Ala-Ala-Phe-amidomethylcoumarin(AMC)] was incubated with plasma (20 microL, 30 min, pH 7.6) with (control) or without the endopeptidase-24.11 inhibitor phosphoramidon. Further incubation with aminopeptidase M released free AMC. Within-assay CVs were 4.5% and 8.6%, respectively, at 3.31 and 0.27 nmol of AMC released per milliliter per minute. The between-assay CV was 10.4% at 0.31 nmol/mL per minute and the detection limit was 0.05 nmol/mL per minute. A highly skewed distribution of endopeptidase-24.11 in 41 normal samples was found, ranging from 0.12 to 6.84 nmol/mL per minute (median = 0.44). Mean endopeptidase-24.11 concentrations were significantly higher in hypertensive subjects (0.68 nmol/mL per minute) than in normotensive subjects (0.34 nmol/mL per minute; P less than 0.05). Compared with placebo administration, the oral endopeptidase-24.11 inhibitor UK 79300 significantly inhibited the plasma enzyme at doses of 100 mg (twice daily). Although in normotensive subjects the enzyme was unaffected with doses of 25 mg, the same dose (25 mg) inhibited the plasma enzyme in hypertensive subjects. No activity was detected in sheep plasma, but addition of exogenous endopeptidase-24.11 to sheep plasma in vitro allowed in vivo assessment of the effect of infused endopeptidase-24.11 inhibitor SCH 39370.

Amino Acid Sequence↗
PubMed1990

Regulation and hospital strategic planning in Canada.

Constraints on resources push hospitals into strategic planning. Although this process is accelerating in the United States, Canadian hospitals need to approach planning according to the provincial structure. This study included a literature and policy review as well as interviews of key stakeholders. Decisions toward centralized planning versus hospital-initiated development were found to depend on the availability of planning and policy staff, and the views of the elected representatives. Implications for Canadian health care planners were offered.

Canada↗
PubMed1989

Isolation of rat Schwann cell lines: use of SV40 T antigen gene regulated by synthetic metallothionein promoters.

Synthetic promoter elements from the mouse metallothionein-I promoter controlling the expression of SV40 T antigen have been tested for their efficacy in cloning rat Schwann cell lines that retained the characteristic properties of these cells and could be passed in culture indefinitely. The constructed promoters contained either four (MT4) or five (MT5) copies of a metal regulatory element 5' to the CAAT and TATA elements from the HSV-1 thymidine kinase gene. Characterization of these promoters in transient expression assays and transformation assays showed that both MT5 and MT4 were approximately 10-fold and 15-fold, respectively, weaker than the wild-type MT-I promoter in the presence of heavy metal inducer. However, in the absence of inducer, the basal activity of both MT5 and MT4 was barely detectable and much lower than that of MT-I. Schwann cells were transfected with plasmids containing the SV40 T antigen gene under the control of the different metallothionein promoters and cell lines were established from each. Only with the MT5 and MT4 promoters were lines obtained that resembled secondary Schwann cells in culture in their morphology, generation time, and demonstration of contact inhibition. In the presence of zinc, the expression of T antigen in the lines derived with MT5 and MT4 was about 10-fold lower than that derived with MT-I. On removal of the inducer this level was reduced, and in one cell line T antigen was undetectable. Concomitant with the reduction in T antigen expression there was an increased expression of Po, a protein specific to myelin-forming Schwann cells, and a decreased expression of glial fibrillary acidic protein, a protein expressed only in nonmyelin-forming Schwann cells. These cell lines, therefore, closely resemble untransfected Schwann cells in culture.

Animals↗
PubMed1989

[Not Available].

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France↗
PubMed1987

Pregnancy in chronic active hepatitis with cirrhosis.

Pregnancy in chronic active hepatitis and cirrhosis is rare. There is an appreciable perinatal mortality and the effect of pregnancy on the underlying liver disease remains uncertain. Two patients with autoimmune chronic active hepatitis with cirrhosis who became pregnant during an active stage of their disease while on therapy are described. Both had an uneventful pregnancy with successful deliveries. One of the patients had two other pregnancies but the pregnancy had to be terminated because of clinical deterioration. With close supervision patients with chronic active hepatitis and cirrhosis may have successful pregnancies.

Abortion, Therapeutic↗
PubMed1986

Respiratory effects in two-dimensional Fourier transform MR imaging.

Respiratory and other regular motions during two-dimensional Fourier transform magnetic resonance imaging produce image artifacts consisting of local blurring and more or less regularly spaced "ghost" images propagating along the direction of the phase-encoding magnetic field gradient. The patterns of these ghost artifacts can be understood in terms of the technique of image production and basic properties of the discrete Fourier transform. This understanding permits, without respiratory gating, production of images of improved quality in body regions in which there is significant respiratory motion. In particular, the ghosts can be maximally separated from the primary image by choosing intervals between phase-encoding gradient pulse increments that are equal to one-half the respiratory period; they can be minimally separated by choosing an interval equal to the respiratory period. Increasing the number of signal averages between each phase-encoding increment decreases the intensity of the ghosts.

Abdomen↗
PubMed1984

The pituitary fossa: a correlative anatomic and MR study.

This study characterizes the normal appearance of the pituitary fossa in partial saturation magnetic resonance (MR) images. In sagittal images, the pituitary fossa appears inhomogeneous. Correlation of sagittal MR images in normal subjects with sagittal cryomicrotomic images in cadavers suggests that the highest intensity signal from the posterior-inferior pituitary fossa is due to a fat pad. This conclusion was supported by MR images and postmortem cryotome sections obtained in normal subhuman primates. The cause of the less constant, low intensity signal was less certain. The height of the pituitary gland in sagittal images was usually less than 8 mm, and the upper surface was flat or concave.

Adipose Tissue↗