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PubMed2000

Hospital human resource planning in Slovakia.

The study is an attempt to provide empirical evidence, in the context of acute hospital care, of the current human resource practices in the health sector of the Slovak Republic. Using a sample of 72 acute care hospitals the research explored the perceived functions, typical customers and priorities of hospital human resource departments, ownership of a workforce plan, and the relationships between ownership of a workforce plan and type of hospital, as well as the degree to which different human resource activities are given priority. Cross-tabulation procedure revealed statistically significant relationships between ownership of a workforce plan and the degree of priority given to having a quick, efficient and cost-effective recruitment and selection system and, not surprisingly, the degree of priority given to ensuring that the human resource department has a workforce plan. The study evidence also indicates that, although the human resource staff in hospitals seem to be aware of their role in assisting hospital management in decision making, the human resource function in the Slovak hospitals still rather resembles that of a personnel administration than that of an important strategic human resource activity.

Health Services Research↗
PubMed2006

Spatial aggregation and association in different resource-patch distributions: experimental analysis with Drosophila.

1. Laboratory experiments using homogeneous resources were conducted to examine intra- and interspecific spatial egg distribution of D. simulans, D. auraria and D. immigrans in three different resource-patch distribution patterns: patchy, even and clustered. 2. Individuals of each species were introduced separately or simultaneously into the cage, into which artificial substrates were placed and allowed to oviposit for 24 h. Spatial analyses were performed with indices of intraspecific aggregation (J), interspecific association (C) and L-function based on Ripley's K-function. 3. Eggs were always spatially aggregated irrespective of species and the resource-patch distribution patterns. Spatial egg aggregation was influenced significantly by the resource-patch distribution pattern and tended to be weaker in the clustered resource-patch distribution than in the patchy or even resource-patch distribution. 4. Spatial extent of egg aggregation was always beyond the single resource patch scale, indicating aggregation of ovipositing females. 5. Interspecific association of egg distribution was absent or very weak. Thus, these results present experimental evidence of independent egg aggregation among drosophilids.

Adaptation, Physiological↗
PubMed2006

Biodiversity as both a cause and consequence of resource availability: a study of reciprocal causality in a predator-prey system.

1. One of the oldest questions in ecology is how species diversity in any given trophic level is related to the availability of essential resources that limit biomass (e.g. water, nutrients, light or prey). Researchers have tried to understand this relationship by focusing either on how diversity is influenced by the availability of resources, or alternatively, how resource abundance is influenced by species diversity. These contrasting perspectives have led to a seeming paradox '... is species diversity the cause or the consequence of resources that limit community biomass?' 2. Here we present results of an experiment that show it is possible for species diversity and resource density to exhibit reciprocal causal relationships in the same ecological system. Using a guild of ladybeetle predators and their aphid prey, we manipulated the number of predator species in field enclosures to examine how predator diversity impacts prey population size. At the same time, we manipulated the abundance of aphid prey in discrete habitat patches within each enclosure to determine how smaller-scale spatial variation in resource abundance affects the number of co-occurring predator species. 3. We found that the number of ladybeetle species added to enclosures had a significant impact on aphid population dynamics because interference competition among the predators reduced per capita rates of predation and, in turn, the overall efficiency of the predator guild. At the same time, spatial variation in aphid abundance among smaller habitat patches generated variation in the observed richness of ladybeetles because more species occurred in patches where predators aggregated in response to high aphid density. 4. The results of our experiment demonstrate that it is possible for species diversity to simultaneously be a cause and a consequence of resource density in the same ecological system, and they shed light on how this might occur for groups of mobile consumers that exhibit rapid responses to spatial and temporal variation in their prey.

Animals↗
PubMed2006

A critical appraisal of internet resources on colorectal cancer.

OBJECTIVE: The significance of the internet as a source of healthcare information for professionals and public is widely recognized. Access to good quality information is very important for informed decisions making on healthcare issues. This is an introduction to the critical appraisal of clinical information on the internet, discussion of the significance of quality checking of healthcare internet resources and the application of critical appraisal tools to selected internet resources on colorectal cancer care. METHODS: Internet resources were identified on the basis of a general criterion that it provides information on colorectal cancer and selected on the basis of explicit inclusion and exclusion criteria. Each selected website is assessed for quality of information with validated criteria. RESULTS: The search strategy identified 10 well known internet resources on healthcare information (e.g. Cochrane, NICE) and 12 websites which are dedicated to cancer related information (e.g. CancerBacup, cancer.gov). The websites of NHS Direct, cancerBACUP, cancer.gov, NICE and Cancer Survivors Network were qualified as resources providing good quality information. DISCUSSION: The critical appraisal process assures quality of the available information and the tool is applicable to all healthcare related internet resources. The process is discussed with respect to colorectal cancer information resources and will be equally useful to healthcare professional and public. The healthcare professionals can apply the tool in practice and advise the public more confidently on internet information.

Colorectal Neoplasms↗
PubMed2006

Job resources in Dutch dental practice.

AIM: To develop an instrument measuring job resources among dentists, and to assess the relative importance of these resources and relate them to job satisfaction. METHODS: 848 Dutch general dental practitioners (GDPs) received a questionnaire to monitor work experiences, including the Dentists' Experienced Job Resources Scale (DEJRS, 46 items, score range: 1 (not satisfying) to 5 (very satisfying), and the Dentist Job Satisfaction Scale (DJSS, 5 items, Cronbach's alpha = 0.85). RESULTS: A total of 497 (58.6%) dentists responded. Factor analysis (PCA) on the DEJRS resulted in 8 factors (Cronbach's alpha: 0.75 > alpha < 0.89), representing distinguishable categories of job resources. In rank order: Immediate Results / Aesthetics (M = 4.04, sd = 0.5); (Long-term) Patient Results (M = 4.03, sd = 0.6); Patient Care (M = 3.90, sd = 0.6); Craftmanship (M = 3.77, sd = 0.7); Idealism / Pride (M = 3.65, sd= 0.6); Entrepreneurship (M = 3.55, sd = 0.9); Material Benefits (M = 3.05, sd = 0.7); and Professional Contacts (M = 3.03, sd = 0.7). MANOVA indicated gender differences on: (Long-term) Patient Results (F(1,548) = 10.428, p = .001), and Patient Care (F(1,548) = 11.036, p < .001). Subscale correlations with the total DEJRS are: 0.57 > r < 0.88. All subscales show a positive correlation with the DJSS. DISCUSSION: The DEJRS is a valuable and psychometrically sound instrument to monitor job resources as experienced by GDPs. Dentists report immediate results and aesthetics, and long-term results of working with patients to be the most rewarding aspects. All job resources showed a positive correlation with job satisfaction. The discussion includes conjecture that stimulating a greater awareness of job resources serves a major role in burnout prevention.

Adult↗
PubMed1995

Resource islands predict the distribution of heterotrophic bacteria in chihuahuan desert soils.

The resource island hypothesis predicts that soil resources such as nitrogen, phosphorus, and water will be distributed evenly in grasslands but have a patchy distribution focused around plants in shrublands. This hypothesis predicts that microorganism numbers will follow resources and be (i) evenly distributed in grasslands, (ii) concentrated around individual plants in shrublands, and (iii) higher where resources are higher when comparing the same vegetation type. This study enumerated total heterotrophic bacteria and a subset of these, the nitrogen-efficient guild (NEG), in three shrublands (playa fringe mesquite, tar bush, and creosote) and two grasslands (playa and bajada). Both heterotrophs and NEG members followed the distribution pattern predicted by the resource island hypothesis. There were no significant differences in heterotroph or NEG numbers comparing at-plant and interplant samples for both the playa and bajada grasslands. Furthermore, populations were generally higher in nutrient-rich playa grasslands than nutrient-poor bajada grasslands. In contrast, both heterotroph and NEG numbers were higher at shrubs than between shrubs in all three shrub sites. These results suggest that resource abundance in resource islands predicts the distribution of heterotrophic bacterial numbers in desert soils.

Journal Article↗
PubMed2002

Acceptance, cognitions, and resourcefulness in women with diabetes.

The coexistence of diabetes and depression occurs frequently among young and middle-age women. Unless one is resourceful, simultaneous management of the symptoms of both conditions is especially challenging. Skills constituting resourcefulness are learned throughout life and are important for the optimal performance of daily activities. Little is known about specific factors that influence resourcefulness. In this study contextual factors (diabetic and depressive symptoms) and cognitive factors (positive cognitions and acceptance of diabetes) were examined as antecedents of learned resourcefulness in 82 women with type 2 diabetes. Regression analyses showed that depressive symptoms and positive cognitions were significant antecedents of learned resourcefulness: Positive cognitions mediated the effects of depressive symptoms on learned resourcefulness. The findings suggest the need for interventions thatfocus on development of positive cognitions to better promote resourcefulness in women with type 2 diabetes who are at risk for depression.

Adaptation, Psychological↗
PubMed1999

Do market-level hospital and physician resources affect small area variation in hospital use?

This study evaluates the effect of market-level physician and hospital resources on hospital use. It is anticipated that higher hospital discharges are associated with (1) greater hospital and physician resources, (2) more differentiated hospital and physician resources, and (3) higher levels of teaching intensity in the community. Data on 14 modified diagnostically related groups (DRGs) and 58 hospital market communities in Michigan are analyzed during a 7-year period. Findings indicate that physician resources, hospital resources, differentiation of hospital and physician resources, and teaching intensity contribute only modestly to discharges, holding constant the socioeconomic attributes of the community and adjusting for the variation in hospital use over time. With the inclusion of hospital and physician resource variables, socioeconomic factors remain important determinants of the variation across market communities. Findings are discussed in terms of their implications for health care organizations, managed care programs, and cost control efforts in general.

Adult↗
PubMed2001

Effects of microcosm scaling and food resources on growth and survival of larval Culex pipiens.

BACKGROUND: We used a simple experimental design to test for the effects of microcosm scaling on the growth and survival of the mosquito, Culex pipiens. Microcosm and mesocosm studies are commonly used in ecology, and there is often an assumption that scaling doesn't affect experimental outcomes. The assumption is implicit in the design; choice of mesocosms may be arbitrary or based on convenience or cost. We tested the hypothesis that scale would influence larvae due to depth and surface area effects. Larvae were predicted to perform poorly in microcosms that were both deep and had small openings, due to buildup of waste products, less exchange with the environment, and increased competition. To determine if the choice of scale affected responses to other factors, we independently varied leaf litter quantity, whose effects on mosquitoes are well known. RESULTS: We found adverse effects of both a lower wall surface area and lower horizontal surface area, but microcosm scale interacted with resources such that C. pipiens is affected by habitat size only when food resources are scarce. At low resource levels mosquitoes were fewer, but larger, in microcosms with smaller horizontal surface area and greater depth than in microcosms with greater horizontal surface area and shallower depth. Microcosms with more vertical surface area/volume often produced larger mosquitoes; more food may have been available since mosquitoes browse on walls and other substrates for food. CONCLUSIONS: The interaction between habitat size and food abundance is consequential to aquatic animals, and choice of scale in experiments may affect results. Varying surface area and depth causes the scale effect, with small horizontal surface area and large depth decreasing matter exchange with the surrounding environment. In addition, fewer resources leads to less leaf surface area, and the effects of varying surface area will be greater under conditions of limiting resources. This leads to smaller size, which limits fecundity and survival. Choice of container size, either by ovipositing females or researchers, interacts with a major aspect of the ecology of animals; obtaining resources in a resource-limited environment.

Analysis of Variance↗
PubMed2005

A centralised public information resource for randomised trials: a scoping study to explore desirability and feasibility.

BACKGROUND: There are currently several concerns about the ways in which people are recruited to participate in randomised controlled trials, the low acceptance rates among people invited to participate, and the experiences of trial participants. An information resource about on-going clinical trials designed for potential and current participants could help overcome some of these problems. METHODS: We carried out a scoping exercise to explore the desirability and feasibility of establishing such a resource. We sought the views of a range of people including people who were considering taking part in a trial, current trial participants, people who had been asked but refused to participate in a trial, consumer group representatives and researchers who design and conduct trials. RESULTS: There was broad-based support for the concept of a centralised information resource for members of the public about on-going and recently completed clinical trials. Such an information resource could be based on a database containing standardised information for each trial relating to the purpose of the trial; the interventions being compared; the implications of participation for participants; and features indicative of scientific quality and ethical probity. The usefulness of the database could be enhanced if its search facility could allow people to enter criteria such as a disease and geographic area and be presented with all the trials relevant to them, and if optional display formats could allow them to view information in varying levels of detail. Access via the Internet was considered desirable, with complementary supported access via health information services. The development of such a resource is technically feasible, but the collation of the required information would take a significant investment of resources. CONCLUSION: A centralised participant oriented information resource about clinical trials could serve several purposes. A more detailed investigation of its feasibility and exploration of its potential impacts are required.

Databases as Topic↗
PubMed2003

The use of interactive graphical maps for browsing medical/health Internet information resources.

As online information portals accumulate metadata descriptions of Web resources, it becomes necessary to develop effective ways for visualising and navigating the resultant huge metadata repositories as well as the different semantic relationships and attributes of described Web resources. Graphical maps provide a good method to visualise, understand and navigate a world that is too large and complex to be seen directly like the Web. Several examples of maps designed as a navigational aid for Web resources are presented in this review with an emphasis on maps of medical and health-related resources. The latter include HealthCyberMap maps http://healthcybermap.semanticweb.org/, which can be classified as conceptual information space maps, and the very abstract and geometric Visual Net maps of PubMed http://pubmed.antarcti.ca/start. Information resources can be also organised and navigated based on their geographic attributes. Some of the maps presented in this review use a Kohonen Self-Organising Map algorithm, and only HealthCyberMap uses a Geographic Information System to classify Web resource data and render the maps. Maps based on familiar metaphors taken from users' everyday life are much easier to understand. Associative and pictorial map icons that enable instant recognition and comprehension are preferred to geometric ones and are key to successful maps for browsing medical/health Internet information resources.

Journal Article↗
PubMed2005

Iranian staff nurses' views of their productivity and human resource factors improving and impeding it: a qualitative study.

BACKGROUND: Nurses, as the largest human resource element of health care systems, have a major role in providing ongoing, high-quality care to patients. Productivity is a significant indicator of professional development within any professional group, including nurses. The human resource element has been identified as the most important factor affecting productivity. This research aimed to explore nurses' perceptions and experiences of productivity and human resource factors improving or impeding it. METHOD: A qualitative approach was used to obtain rich data; open, semi-structured interviews were also conducted. The sampling was based on the maximum variant approach; data analysis was carried out by content analysis, with the constant comparative method. RESULTS: Participants indicated that human resources issues are the most important factor in promoting or impeding their productivity. They suggested that the factors influencing effectiveness of human resource elements include: systematic evaluation of staff numbers; a sound selection process based on verifiable criteria; provision of an adequate staffing level throughout the year; full involvement of the ward sister in the process of admitting patients; and sound communication within the care team. Paying attention to these factors creates a suitable background for improved productivity and decreases negative impacts of human resource shortages, whereas ignoring or interfering with them would result in lowering of nurses' productivity. CONCLUSION: Participants maintained that satisfactory human resources can improve nurses' productivity and the quality of care they provide; thereby fulfilling the core objective of the health care system.

Journal Article↗
PubMed2005

Precise formulation and evidence-based application of resource-constrained triage.

OBJECTIVES: To develop a precise mathematical formulation of resource-constrained triage, denoted the Sacco triage method (STM), to develop an evidence-based application to blunt trauma, and to compare the STM with the simple triage and rapid treatment (START) method. METHODS: Resource-constrained triage is modeled mathematically as a classic resource allocation problem. The objective is to maximize expected survivors given constraints on the timing and availability of resources. The model incorporates estimates of time-dependent victim survival probabilities based on an initial assessment and expected deterioration. For application to blunt trauma, an "RPM" score, based on respiratory rate, pulse rate, and motor response, was used to predict survivability. Logistic function-generated survival probability estimates for scene values of RPM were determined from 76,459 blunt-injured patients from the Pennsylvania Trauma Outcome Study (PTOS). The Delphi method provided expert consensus on victim deterioration rates, and the model was solved using linear programming. STM was compared with START across various criteria of process and outcome. Outcome was measured by expected number of survivors in simulated resource-constrained casualty incidents. RESULTS: In this mathematical simulation, RPM was a more accurate predictor of survivability from blunt trauma than the Injury Severity Score and the Revised Trauma Score, as measured by calibration and discrimination statistics. STM resulted in greater expected survivorship than START in all simulations. CONCLUSIONS: Resource-constrained triage is modeled precisely as an evidence-based, outcome-driven method that maximizes expected survivors in consideration of resources. The lifesaving potential and operational advantages over current methods warrant scrutiny and further research.

Delphi Technique↗
PubMed2003

Beyond demographic change in human resources planning: an extended framework and application to nursing.

OBJECTIVES: To introduce health care production functions into human resources planning and to apply the approach to analysing the need for registered nurses in Ontario during a period of major reduction in inpatient capacity. METHODS: Measurement of changes in services delivered by acute care hospitals in Ontario between 1994/95 and 1998/99, and comparison with changes in the mix of human resources, non-human resources and patient needs. RESULTS: Inpatient episodes per nurse fell by almost 2%. At the same time the number of beds was cut by over 20%. As a result, the number of patients per bed increased by 12%. Allowing for severity, there was a 20% reduction in beds per episode and a 3.7% reduction in nurses per episode. CONCLUSIONS: The demands on nurses in acute care hospitals have increased as an increasing number of severity-adjusted episodes are served using fewer beds by a reduced number of nurses. Human resources planning traditionally only considers the effects of demographic change on the need for and supply of health care. Failure to recognize the variable and endogenous nature of other health care inputs leads to false impressions about the adequacy of existing supplies of human resources. Consideration of human resources in the context of the production function for health services provides a meaningful way of improving the effectiveness and efficiency of human resources planning.

Demography↗
PubMedDate not supplied

National survey of dietary supplement resources at drug information centers.

OBJECTIVE: To assess the resources drug information centers are currently using to respond to dietary supplement information requests and to determine the frequency with which drug information centers are used as sources of information on dietary supplements. DESIGN: Cross-sectional survey. SETTING: United States. PARTICIPANTS: 116 drug information centers. INTERVENTIONS: Mail survey that collected information on the use of drug information centers for dietary supplement information requests and the dietary supplement-specific resources available at and used in these centers. MAIN OUTCOMES MEASURES: Survey responses, evaluated using descriptive statistics. RESULTS: Drug information centers received a relatively small number of requests for information related to dietary supplements, and most such requests came from consumers. The centers had a number of resources available to assist in responding to those requests, with Facts and Comparisons' The Review of Natural Products and the print version of Natural Medicines Comprehensive Database being the resources most often at hand. The majority of respondents believed their centers were "usually able" to respond to the requests received. CONCLUSION: Drug information centers are often overlooked as sources of information about dietary supplements; however, centers have resources that are, by self-assessment, sufficient to respond to dietary supplement information requests. Great variation exists among centers in the resources available to address requests, with just two resources, the Review of Natural Products and the print version of Natural Medicines Comprehensive Database, available to more than three-fourths of the respondents.

Data Collection↗
PubMed1999

Community care and mental disorder: an analysis of discursive resources.

The number of people with mental disorders living in the community has recently increased with further increases likely. This study provides a post-attitudinal examination of the discursive resources on which ordinary New Zealanders draw when talking about 'community care'. Four common resources were identified: dual community, rights, disorder and patronization. Each of these resources is examined by using a range of analytic concepts which illustrate the rhetorical achievements and social practices found in the data. We argue that the dual community resource works to position the disordered as being outside the community which is contrary to the broad aim of community care. The analysis of talk of rights was cast as an ideological dilemma for participants who endorsed both universality and conditionality of rights for the disordered. The disorder resource was notable for its flexible rhetorical deployment, while patronization contributed to the positioning of the disordered as subordinate. The implications of these resources are discussed in terms of existing notions of stigma and possibilities for change centred around affiliative resources.

Adult↗
PubMed2002

Economic analysis of filgrastim use for patients with acute myeloid leukaemia in the UK: a comparison of collection methods of resource use data.

BACKGROUND: A clinical trial of patients with de novo acute myeloid leukaemia (AML) showed that haematopoietic support with filgrastim (granulocyte colony-stimulating factor, G-CSF) following induction and consolidation chemotherapy accelerated recovery from neutropenia. The clinical benefits included reductions in infections, anti-infective therapy and length of hospital stay. OBJECTIVE: The objective of this economic analysis is 2-fold. First, it aims to determine if the observed clinical benefits from the use of filgrastim would lead to cost savings from the perspective of a healthcare institution in the UK. Second, the analysis compares the results of two methods on collection of resource use data. DESIGN: A retrospective cost-minimisation analysis was undertaken based on the clinical results of all UK patients enrolled in the trial. Two cost models were developed: a model based only on the medical resource use collected in the case report forms (the CRF model); and a model based on all medical resources collected from patient medical files (the PF Model). Treatment costs of AML between filgrastim and the placebo arm were compared for the first induction cycle as well as the first induction and the first consolidation cycles combined. Results from the two models were compared. SETTING AND PATIENTS: The CRF model was applied to two samples of patients: all UK patients (n = 82) and patients enrolled at one centre [the Manchester Royal Infirmary (MRI) (n = 30)], whereas the PF model was applied to the MRI patient sample only. RESULTS: For all UK patients, using the CRF model, the filgrastim-treated arm produced cost savings of 747 pounds sterling (9.0%) and 2135 pounds sterling (14.4%) [1998 values] per patient in the first induction cycle and in the induction and consolidation cycles combined, respectively. For the patients at MRI the CRF model resulted in cost savings with filgrastim of 177 pounds sterling (2.2%) and 414 pounds sterling (3.2%) per patient respectively. Using the PF model the savings at MRI were 910 pounds sterling (8.6%) and 1285 pounds sterling (8.0%) per patient, respectively. CONCLUSION: Use of filgrastim in the treatment of AML in the UK may result in net cost savings. A retrospective analysis using total resources obtained through patient files produced higher cost savings estimates than that obtained by resources noted in the CRFs. The models based on PF resource data may be more reliable because they are more comprehensive. However, the cost estimates in this study may have been impacted by sample size, site characteristics, disease and treatment settings. Therefore, further evaluation on the methods for collecting resource use data in larger, multicentred studies is warranted.

Adult↗
PubMed1998

Resource allocation during the rereading of scientific texts.

Two experiments examined how cognitive resources are allocated to comprehension processes across two readings of the same scientific texts. In Experiment 1, readers read and later reread texts describing scientific topics. The results indicated that across readings, readers decreased resources allocated to proposition assembly, increased resources allocated to text-level integration, and expended a similar amount of resources to lexical access. Subjects who reread the texts after a week delay showed a similar pattern, except that they did not show the increase for text-level integration. Experiment 2 revealed a similar pattern of results with a moving window procedure, except that there was a significant decrease in resources allocated to lexical access across exposures. This experiment also indicated that the rereading speedup was greatest at sentence boundaries, suggesting that the prior exposure enabled readers to immediately process each word. Overall, the results are consistent with the claim that readers allocate proportionally more available resources to text-level integration during rereading because proposition assembly, which enables text-level integration, can be completed with fewer resources.

Adult↗