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At least 217 records · Page 12Linked to original sources
PubMed2004

Medical students' use of information resources: is the digital age dawning?

PURPOSE: One of the many challenges clinicians face is applying growing medical knowledge to specific patients; however, there is an information gap between information needs and delivery. Digital information resources could potentially bridge this gap. Because most medical students are exposed to personal computers throughout their education, this study postulated that students may be more comfortable using computer-based information resources within clinical interactions. METHOD: In 2001, the authors monitored second-year medical students' use of a unique digital textbook, UpToDate, as they transitioned from preclinical to clinical years at the University of Iowa Roy J. and Lucille A. Carver College of Medicine. In 2002, at the end of their third year, students were surveyed about their preferred clinical information resources. RESULTS: Medical students rapidly adopted UpToDate as a clinical resource during their clinical clerkship as evidenced by a rapid growth in the electronic textbook's use. One hundred sixteen of a possible 154 students (75%) responded to the survey. More than 85% of respondents identified electronic sources as their primary resource (UpToDate 53%, MDConsult 33%; p <.001 when compared to paper resources). They also reported using the information resources on a daily basis and requiring less than 15 minutes to answer most of their clinical questions. CONCLUSIONS: This study clearly demonstrates that medical students embrace and use electronic information resources much more than has been reported among practicing clinicians. The current generation of students may be the leaders in a medical culture shift from paper to electronic resources.

Attitude of Health Personnel↗
PubMed1996

The relationship between resource constraints and physician problem solving. Implications for improving the process of care.

OBJECTIVES: Research suggests that physicians will engage in more vigilant problem-solving under conditions of resource constraints than under conditions of resource slack. Increased vigilance related to physicians' clinical strategies enhances care by disposing physicians toward more optimal care choices. The authors examine whether pressures for clinical resource constraints encourage increased and sustained vigilance in problem-solving among cardiologists treating acute myocardial infarction. METHODS: The physician problem-solving process is reconstructed from the medical records of all eligible cases of acute myocardial infarction treated by the physician sample set over a 6-year period. The sample period encompasses phases of both resource slack and resource constraints. The Herfindahl index is used to measure the relative amount of vigilant problem-solving activity exhibited in each of five major tactical areas of the physician care strategies in each year of the study. RESULTS: The results support the hypothesis that resource constraints initially promote a shift to increased vigilance in physician problem-solving. Only one of the five major tactical areas, however, is characterized by sustained vigilance over time. The other areas are, instead, associated with a substantial reduction in vigilant activity after the initial peak period. CONCLUSIONS: The results suggest that resource constraints do set the stage for improved clinical decision-making. Sustained vigilance, however, appears to apply only to those portions of the care strategy for which the physician can draw a clear link between optimizing clinical activity and reducing resource consumption. For those portions of the care strategy for which the physician cannot establish a clear link, ongoing pressures to conserve resources results in reduced vigilance and a potential reduction in quality of clinical decision-making.

Cardiology↗
PubMedDate not supplied

Mothers' potential for child abuse: the roles of childhood abuse and social resources.

BACKGROUND: The mechanism by which some victims of childhood abuse become abusive parents, whereas others do not, is not well understood. Previous empirical evidence indicates that social resources may modify the cycle of abuse or maladaptive parenting; however, the effects of different dimensions of social resources have not been compared. OBJECTIVES: To determine whether a measure of mothers' potential for physical child abuse was related to their retrospective reports of physical and sexual abuse before 18 years of age and to investigate the potential buffering effects of multiple dimensions of social resources on the relationship between childhood abuse and mothers' potential for physical child abuse. METHODS: The potential role of social resources as a moderator of the relationship between a history of childhood abuse and potential for physical child abuse was investigated in 206 low-income single mothers of young children. RESULTS: The levels of physical and sexual abuse in childhood were positively associated with the mothers' child abuse potential; sexual abuse displayed the strongest association. Compared with mothers who were not sexually abused in childhood, those reporting violent sexual abuse as children were almost six times more likely to have high potential for physically abusing their children. There was no evidence that any of the social resources modified the relationship of either type of childhood abuse with the mothers' potential for abuse. However, all four dimensions of social resources demonstrated significant main effects on child abuse potential. CONCLUSIONS: Low-income mothers face many stressors because of their lack of economic resources. This, coupled with a lack of social resources and a history of childhood abuse, makes low-income, single mothers particularly at risk for abusive parenting. The lives of these women and their children may be enhanced by assisting the women to improve their social resources which, ultimately, may reduce their potential for child abuse. Future research should focus on identifying factors that predict and/or modify the potential for abusive parenting as well as actual abuse.

Adult↗
PubMedDate not supplied

Multimedia messages in genetics: design, development, and evaluation of a computer-based instructional resource for secondary school students in a Tay Sachs disease carrier screening program.

PURPOSE: Tay Sachs disease is a recessively inherited neurodegenerative disorder, for which carrier screening programs exist worldwide. Education for those offered a screening test is essential in facilitating informed decision-making. In Melbourne, Australia, we have designed, developed, and evaluated a computer-based instructional resource for use in the Tay Sachs disease carrier screening program for secondary school students attending Jewish schools. The resource entitled "Genetics in the Community: Tay Sachs disease" was designed on a platform of educational learning theory. METHODS: The development of the resource included formative evaluation using qualitative data analysis supported by descriptive quantitative data. The final resource was evaluated within the screening program and compared with the standard oral presentation using a questionnaire. Knowledge outcomes were measured both before and after either of the educational formats. RESULTS: Data from the formative evaluation were used to refine the content and functionality of the final resource. The questionnaire evaluation of 302 students over two years showed the multimedia resource to be equally effective as an oral educational presentation in facilitating participants' knowledge construction. CONCLUSION: The resource offers a large number of potential benefits, which are not limited to the Tay Sachs disease carrier screening program setting, such as delivery of a consistent educational message, short delivery time, and minimum financial and resource commitment. This article outlines the value of considering educational theory and describes the process of multimedia development providing a framework that may be of value when designing genetics multimedia resources in general.

Adolescent↗
PubMed2002

OILing the way to machine understandable bioinformatics resources.

The complex questions and analyses posed by biologists, as well as the diverse data resources they develop, require the fusion of evidence from different, independently developed, and heterogeneous resources. The web, as an enabler for interoperability, has been an excellent mechanism for data publication and transportation. Successful exchange and integration of information, however, depends on a shared language for communication (a terminology) and a shared understanding of what the data means (an ontology). Without this kind of understanding, semantic heterogeneity remains a problem for both humans and machines. One means of dealing with heterogeneity in bioinformatics resources is through terminology founded upon an ontology. Bioinformatics resources tend to be rich in human readable and understandable annotation, with each resource using its own terminology. These resources are machine readable, but not machine understandable. Ontologies have a role in increasing this machine understanding, reducing the semantic heterogeneity between resources and thus promoting the flexible and reliable interoperation of bioinformatics resources. This paper describes a solution derived from the semantic web [a machine understandable world-wide web (WWW)], the ontology inference layer (OIL), as a solution for semantic bioinformatics resources. The nature of the heterogeneity problems are presented along with a description of how metadata from domain ontologies can be used to alleviate this problem. A companion paper in this issue gives an example of the development of a bio-ontology using OIL.

Algorithms↗
PubMed2000

An analysis of resources for indigenous women in NSW about cervical screening.

OBJECTIVE: To examine resources about cervical screening made available to Indigenous women in NSW. METHOD: An Aboriginal woman, on behalf of another Aboriginal woman, telephoned 47 NSW based organisations in May 1998 for information about cervical screening. Received materials were analysed for format, content and readability and then submitted to a panel of Indigenous women for their feedback. RESULTS: Of those 34 organisations agreeing to send resources, only 20 (59%) did so. After removing duplicates, 12 cervical screening resources were available for review of which six were designed and printed in NSW and the other six originated outside NSW. Of the six resources developed in NSW, two (33%) were for Aboriginal women. Of the six resources originating from outside of NSW, another two (33%) also were for Aboriginal women. The Flesch readability scores for resources ranged from 58.6 to 87.27. Those developed in NSW had a significantly lower readability score than those from outside of NSW (p = 0.025). Despite lower education levels among the target group, there was no difference in the readability scores of resources designed for Indigenous women (p = 1). CONCLUSIONS: Most resources obtained by us were not tailored for Indigenous women. IMPLICATIONS: This study has set a base line for resources available for Indigenous women. Our method could be replicated in the future to evaluate and monitor improvement.

Adolescent↗
PubMed2003

Human resources for health policies: a critical component in health policies.

In the last few years, increasing attention has been paid to the development of health policies. But side by side with the presumed benefits of policy, many analysts share the opinion that a major drawback of health policies is their failure to make room for issues of human resources. Current approaches in human resources suggest a number of weaknesses: a reactive, ad hoc attitude towards problems of human resources; dispersal of accountability within human resources management (HRM); a limited notion of personnel administration that fails to encompass all aspects of HRM; and finally the short-term perspective of HRM.There are three broad arguments for modernizing the ways in which human resources for health are managed:bullet; the central role of the workforce in the health sector;bullet; the various challenges thrown up by health system reforms;bullet; the need to anticipate the effect on the health workforce (and consequently on service provision) arising from various macroscopic social trends impinging on health systems.The absence of appropriate human resources policies is responsible, in many countries, for a chronic imbalance with multifaceted effects on the health workforce: quantitative mismatch, qualitative disparity, unequal distribution and a lack of coordination between HRM actions and health policy needs.Four proposals have been put forward to modernize how the policy process is conducted in the development of human resources for health (HRH):bullet; to move beyond the traditional approach of personnel administration to a more global concept of HRM;bullet; to give more weight to the integrated, interdependent and systemic nature of the different components of HRM when preparing and implementing policy;bullet; to foster a more proactive attitude among human resources (HR) policy-makers and managers;bullet; to promote the full commitment of all professionals and sectors in all phases of the process.The development of explicit human resources policies is a crucial link in health policies and is needed both to address the imbalances of the health workforce and to foster implementation of the health services reforms.

Editorial↗
PubMed2006

Improving the use of research evidence in guideline development: 11. Incorporating considerations of cost-effectiveness, affordability and resource implications.

BACKGROUND: The World Health Organization (WHO), like many other organisations around the world, has recognised the need to use more rigorous processes to ensure that health care recommendations are informed by the best available research evidence. This is the 11th of a series of 16 reviews that have been prepared as background for advice from the WHO Advisory Committee on Health Research to WHO on how to achieve this. OBJECTIVES: We reviewed the literature on incorporating considerations of cost-effectiveness, affordability and resource implications in guidelines and recommendations. METHODS: We searched PubMed and three databases of methodological studies for existing systematic reviews and relevant methodological research. We did not conduct systematic reviews ourselves. Our conclusions are based on the available evidence, consideration of what WHO and other organisations are doing and logical arguments. KEY QUESTIONS AND ANSWERS: When is it important to incorporate cost-effectiveness, resource implications and affordability considerations in WHO guidelines (which topics)? For cost-effectiveness:The need for cost/effectiveness information should be dictated by the specific question, of which several may be addressed in a single guideline. It is proposed that the indications for undertaking a cost-effectiveness analysis (CEA) could be a starting point for determining which recommendation(s) in the guideline would benefit from such analysis. For resource implications/affordability:The resource implications of each individual recommendation need to be considered when implementation issues are being discussed. How can cost-effectiveness, resource implications and affordability be explicitly taken into account in WHO guidelines? For cost-effectiveness: composite function If data are available, the ideal time to consider cost-effectiveness is during the evidence gathering and synthesizing stage. However, because of the inconsistent availability of CEAs and the procedural difficulty associated with adjusting results from different CEAs to make them comparable, it is also possible for cost-effectiveness to be considered during the stage of developing recommendations. composite function Depending on the quantity and quality and relevance of the data available, such data can be considered in a qualitative way or in a quantitative way, ranging from a listing of the costs to a modelling exercise. At the very least, a qualitative approach like a commentary outlining the economic issues that need to be considered is necessary. If a quantitative approach is to be used, the full model should be transparent and comprehensive. For resource implications/affordability: composite function Resource implications, including health system changes, for each recommendation in a WHO guideline should be explored. At the minimum, a qualitative description that can serve as a gross indicator of the amount of resources needed, relative to current practice, should be provided. How does one provide guidance in contextualizing guideline recommendations at the country level based on considerations of cost-effectiveness, resource implications and affordability? All models should be made available and ideally are designed to allow for analysts to make changes in key parameters and reapply results in their own country. In the global guidelines, scenarios and extensive sensitivity/uncertainty analysis can be applied.Resource implications for WHO. From the above, it is clear that guidelines development groups will need a health economist. There is need to ensure that this is included in the budget for guidelines and that there is in-house support for this as well.

Journal Article↗
PubMed2006

Effectiveness of clinician-selected electronic information resources for answering primary care physicians' information needs.

OBJECTIVE: To determine if clinician-selected electronic information resources improve primary care physicians' abilities to answer simulated clinical questions. DESIGN: Observational study using hour-long interviews in physician offices and think-aloud protocols. PARTICIPANTS: answered 23 multiple-choice questions and chose 2 to obtain further information using their own information resources. We established which resources physicians chose, processes used, and results obtained when looking for information to support their answers. MEASUREMENTS: Correctness of answers before and after searching, resources used, and searching techniques. RESULTS: 23 physicians sought answers to 46 questions using their own information resources. They spent a mean of 13.0 (SD 5.5) minutes searching for information for the two questions using an average of 1.8 resources per question and a wide variety of searching techniques. On average 43.5% of the answers to the original 23 questions were correct. For the questions that were searched, 18 (39.1%) of the 46 answers were correct before searching. After searching, the number of correct answers was 19 (42.1%). This difference of 1 correct answer was attributed to 6 questions (13.0%) going from an incorrect to correct answer and 5 (10.9%) questions going from a correct to incorrect answer. We found differences in the ability of various resources to provide correct answers. CONCLUSION: For the primary care physicians studied, electronic information resources of choice did not always provide support for finding correct answers to simulated clinical questions and in some instances, individual resources may have contributed to an initially correct answer becoming incorrect.

Databases, Bibliographic↗
PubMed2005

Foraging on some nonfloral resources by stingless bees (Hymenoptera, Meliponini) in a Caatinga region.

In a caatinga region the flowers and nonfloral resources visited by highly eusocial bees, stingless beess and Apis mellifera (Africanized honey bee) were studied. During one year, monthly sampling took place in two sites at Serra da Capivara National Park (Piauf State, Brazil), one of them, including the local village, outside the park, and the other inside, using already existing park trails. With the help of entomological nets, all bees were caught while visiting floral and nonfloral resources. At the study sites we observed more stingless bees in nonfloral resources, made possible by human presence. Twelve stingless bee species used the nonfloral resources in different proportions, showing no preference for time of day, season of the year, or sites. During the rainy season, more water sources and abundant flowering plants were observed, which attract stingless bees, even though many worker bees were found foraging in the aqueous substrates while few were observed at water sources. This relationship was higher for stingless bee species than for Africanized honey bees. Paratrigona lineata was represented by few specimens in floral and nonfloral resources and is perhaps rare in this region. Frieseomelitta silvestrii could be considered rare in the floral resources, but they were abundant in nonfloral resources. The variety and intriguing abundance of bees in nonfloral resources suggests that these are an important part of the stingless bee niches, even if these resources are used for nest construction and defense.

Animals↗
PubMedDate not supplied

Development and testing of the Resourcefulness Scale for Older Adults.

Resourcefulness is the ability to independently perform daily tasks (personal resourcefulness) and to seek help from others when unable to function independently (social resourcefulness). The 2 forms of resourcefulness are theoretically related, yet no current measure captures both simultaneously. This 2-phase study involved development and testing of a Resourcefulness Scale for elders from existing measures of personal and social resourcefulness. Data from 2 studies of 451 chronically ill elders were randomly split: the measure was developed in phase 1 and validated in phase 2. The new Resourcefulness Scale has acceptable internal consistency (a = .85). Two correlated subscales reflecting personal and social resourcefulness (r = .41) were confirmed. The Resourcefulness Scale has potential usefulness for older adults as well as younger and middle-aged adults.

Activities of Daily Living↗
PubMed1995

[The differences between individualists and cooperators: interpersonal cognition of resource allocation].

The purpose of this article is to study interpersonal cognition of resource allocation and individual differences in the cognition. Sixty subjects participated in an experimental game, and 18 individualists and 16 cooperators were selected according to their tendency in resource allocation, which is called social values. Then, they rated resource allocating behavior. Major findings were as follows: (1) Both groups rated "allocating more resource to the partner" as more socially desirable and friendly. (2) Individualists rated "allocating more resource to self," which was consistent with their social values, as more socially desirable. They also rated "equal allocation with own resource adjusted" as more socially desirable but less dynamic. (3) Cooperators rated "equal allocation with own resource adjusted," which was consistent with their social values, as more socially desirable and friendly. (4) Both groups rated "more resource to self" and "less resource to the partner" as dynamic (active and assertive). The relation between interpersonal cognition and social values is discussed.

Adult↗
PubMed1999

The contribution of personal resources to physical and mental health: looking into age and gender effects.

In this study, a model that specified the effects of socioeconomic and psychological resources on physical and mental health was investigated. It was hypothesized that (a) both kinds of resources would affect physical and mental health more strongly in older than in younger adults, and that (b) socioeconomic resources would exert stronger effects in men, whereas psychological resources would exert stronger effects in women. Data were collected in an Israeli national sample. Structural modeling analyses indicated that the model fit the data. A comparison of 4 groups of participants (2 age groups--18-39 and 40-84--and both genders) showed that, for men, the respective effects of socioeconomic and psychological resources on physical and mental health were strong in the older, but not in the younger, group. For women, socioeconomic resources had nonsignificant effects, whereas psychological resources had strong effects on mental health in both age groups; psychological resources also had a moderate effect on physical health in the older group. The results suggest that the contribution of personal resources to health is regulated by the joint impact of age and gender, presumably involving shifting roles and vulnerabilities of men and women across the life span.

Adaptation, Psychological↗
PubMed1990

Achieving competitive advantage through strategic human resource management.

The framework presented here challenges health care executives to manage human resources strategically as an integral part of the strategic planning process. Health care executives should consciously formulate human resource strategies and practices that are linked to and reinforce the broader strategic posture of the organization. This article provides a framework for (1) determining and focusing on desired strategic outcomes, (2) identifying and implementing essential human resource management actions, and (3) maintaining or enhancing competitive advantage. The strategic approach to human resource management includes assessing the organization's environment and mission; formulating the organization's business strategy; assessing the human resources requirements based on the intended strategy; comparing the current inventory of human resources in terms of numbers, characteristics, and human resource management practices with respect to the strategic requirements of the organization and its services or product lines; formulating the human resource strategy based on the differences between the assessed requirements and the current inventory; and implementing the appropriate human resource practices to reinforce the strategy and attain competitive advantage.

Economic Competition↗
PubMed1999

Consequences of preformation for dynamic resource allocation by a carnivorous herb, Pinguicula vulgaris (Lentibulariaceae).

When resource availability changes frequently and unpredictably, natural selection favors flexible resource allocation; however, such versatility may be compromised in perennial plants that differentiate leaves or flowers a year in advance of their development (preformation). We investigated resource allocation by the carnivorous perennial Pinguicula vulgaris to determine whether increased resource availability changes within-season allocation to growth, vegetative propagation, and reproduction. In response to resource supplementation (feeding with fruit flies), plants attained a mass 60% greater than that of unfed plants after a single growing season. Feeding also enhanced vegetative propagation, which is closely associated with growth, without modifying relations between these two vegetative functions. In contrast, feeding did not alter the size of vegetative rosettes or the within-season incidence of either flowering or fruiting. This lack of immediate responses occurred because floral and leaf primordia differentiated up to 10 mo before resource supplementation and flower development. However, enhanced resource status likely affected future reproduction indirectly through resource effects on plant size. Large plants produced more floral primordia and between-year changes in fruiting status corresponded to changes in plant size. These results illustrate that preformation can delay responses to enhanced resources by perennial plants.

Journal Article↗
PubMed2000

The effectiveness of resource allocation methods used by RWCA Title II Consortia in Virginia.

The authors sought to determine the following: (1) How rigorous are the current resource allocation methods used by Virginia's five regional Ryan White CARE (Comprehensive AIDS Resources Emergency) Act Title II consortia? (2) How useful are existing databases in allocating resources? (3) Is it feasible to introduce a standardized performance measurement approach for state-level assessment of consortia effectiveness? The authors reviewed proposals and progress reports from each of the consortia to the Virginia public health agency; they then visited each of the consortia to solicit information to refine the study questions and to review the consortia's databases. The authors reviewed the literature on existing models used to allocate resources, and surveyed members of the Virginia consortia about how they used various resource allocation tools, how effective these tools were, and how ready the consortia were to be evaluated regarding resource allocation. The authors found no uniform process for the allocation of Title II funds in Virginia. Consortia members who felt connected and involved with their consortium were significantly more knowledgeable about its operations and more likely to consider it effective. A consortium's use of a continuous quality improvement (CQI) approach to allocating resources was strongly associated with its members' perception that the consortium was effective. Statewide performance and/or outcome measures cannot be set without some standardized expectations for performance. To do this, some expectations for basic resource allocation procedures must be established. Three of Virginia's five consortia will make use of this study's instrumentation in their next resource allocation processes, and, if their experiences are useful, a statewide process may be established. If a statewide process is established, regional consortia must continue to be able to determine local needs and to respond with locally appropriate service planning.

Adult↗
PubMed2001

[A study on the resources coping with occupational stress in teachers].

OBJECTIVE: To explore the status of the resources coping with occupational stress in teachers. METHODS: Occupational stress inventory revised edition (OSI-R) was used to measure their occupational stress, strain and psychological coping resources for 1,460 teachers in primary and secondary schools and 319 non-teacher intellectuals. Analyses were focused on coping resources of teachers. RESULTS: The higher the level of coping resource of teachers, the lower the personal strain in them, with an inverse correlationship. Coping resource in the teacher group was significantly higher than that in the non-teacher group, with scores of (130.4 +/- 18.2) and (126.9 +/- 19.1), respectively. Coping resource in teachers decreased with the increase of age, with the scores from (134.1 +/- 18.1) in the group aged less than 30 to (128.5 +/- 17.5) in the group aged 50. Coping resource in the female teachers was significantly higher than that in the male teachers, with scores of (131.4 +/- 18.3) and (129.4 +/- 18.1), respectively. Coping resource in the primary school teachers was significantly higher than that in the secondary school teachers, with scores of (132.7 +/- 18.1) and (128.5 +/- 18.1), respectively. CONCLUSION: It is important to enhance teacher's coping resource, especially for the male teachers in the secondary schools, for improving their teaching efficiency.

Adaptation, Psychological↗
PubMed2002

A resource server for medical training.

OBJECTIVES: We have developed a RESOURCE SERVER to collect and store various elements used by a professor during his lecture. METHODS: The server manages four types of objects: ELEMENTS, RESOURCES (set of elements referring to a given topic), INDEXES (to organize the resources for further search and use), and USERS (to identify providers, users, and access rights). If an ELEMENT s modified, the RESOURCE is automatically updated. RESULTS: An example (preparation of an anatomy lecture) explains how the RESOURCE SERVER works in three steps: organization of the training material, indexing, and retrieval. CONCLUSIONS: The RESOURCE SERVER will help instructors develop, update and share pedagogic resources for supporting their training courses, lessons and conferences. Moreover, these techniques, based on Internet technologies for easy handling of and access to these resources, allow local and distant access. Within the general framework of the French-speaking Virtual Medical University, the RESOURCE SERVER will represent an important link between data collection and its use in intelligent pedagogic training.

Computer Storage Devices↗