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At least 487 records · Page 27Linked to original sources
PubMed2005

Modelling a regional reorganization of cardiovascular surgery provision.

The Nord-Pas-de-Calais region of France is under-served in terms of access to cardiovascular surgery services, as illustrated by relatively high levels of waiting list mortality. This prompted the decision to create a new surgical unit in the region's densely populated, former industrial heartland called the "Mining Basin". Geographical and epidemiological modelling was used prospectively to estimate the likely future level of activity of the existing public sector cardiovascular surgery units. Information on the regional population distribution and the likely pattern of service use enabled us to estimate the new unit's potential activity. Our simulations produced nine scenarios which describe variations in the existing public units' activity ranging from -54% to +95%. This type of approach should enable policy makers to improve the organization of healthcare provision.

Adolescent↗
PubMed2003

Development and implementation of a multi-centre information system for paediatric and infant critical care.

BACKGROUND: With no UK collective information system, a need existed to establish an integrated information system for public and private sector hospitals providing paediatric and infant critical care services. A lack of information in the past made it difficult for those procuring, providing and monitoring services to make informed, evidence-based decisions using reliable integrated data. OBJECTIVES: To develop and implement a collective multi-purpose information system for paediatric and infant critical care that was easily adaptable to any UK infant or paediatric critical care setting. Information outputs had to fulfil policy requirements and meet the needs of stakeholders. METHOD: Two minimum datasets, corresponding data definitions, survey forms and a user database were developed through a process of consultation by utilising an information partnership. Design, content, development and implementation issues were identified, discussed and resolved through a co-ordinated collaborative process. RESULTS: Data collection was implemented in all London and Brighton National Health Service (NHS) general and cardio-thoracic paediatric intensive care (PIC) units, several private PIC units and one NHS tertiary referral neonatal unit (NNU) 24 months from project start. CONCLUSIONS: The development of universal integrated information systems for defined settings of care is achievable within reasonable timeframes; however, successful development and implementation requires working within an information partnership to maximise co-ordination, co-operation and collaboration. Those collecting and using data must be identified and involved in all aspects of development from project start. Financial and manpower resources must be well planned. Datasets should be as small as possible in order to make the collection of complete and valid data realistically achievable. When considering service-based information needs, considerable thought should be given to a multi-purpose; multi-use approach based on the most refined minimum dataset possible.

Child↗
PubMed2001

Using human rights in maternal mortality programs: from analysis to strategy.

This article describes an approach to maternal mortality reduction that uses human rights not simply to denounce the injustice of death in pregnancy and childbirth, but also to guide the design and implementation of maternal mortality policies and programs. As a first principle, programs and policies need to prioritize measures that promote universal access to high quality emergency obstetric care services, which we know from health research are essential to saving women's lives. With that priority, human rights principles can be integrated into programs at the clinical, facility management, and national policy levels. For example, a human rights 'audit' can help identify ways to encourage respectful, non-discriminatory treatment of patients, providers and staff in the clinical setting. Human rights principles of entitlement and accountability can inform mechanisms of community participation designed to improve responsiveness and functioning of health facilities. Human rights principles can inform analysis of health sector reform and its impact on access to emergency obstetric care. Whether applied to the intricacies of human relationships within a facility or to the impact of international financial institutions on health systems, the ultimate role of human rights is to identify the workings of power that keep unacceptable levels of maternal morality as they are and to use the human rights vision of dignity and social justice to work for the re-arrangements of power necessary for change.

Emergency Medical Services↗
PubMed2003

The Mumbai experience in building field level partnerships for DOTS implementation.

In February 1999, the Revised National Tuberculosis (TB) Control Programme (RNTCP) was implemented in the city of Mumbai after a pilot phase of 5 years. The city has a population of more than 12 million people and an estimated annual TB incidence of 21,000 cases, 8000 of these being infectious. This paper describes a partnership between the TB programme and a Non Governmental Organization (NGO), which began with a methodological analysis of the problems faced by the programme to help identify other key organizations, who might usefully be involved. The work focussed on "networking" to ensure the optimum use of existing resources. The problems encountered affected all levels of TB control from access to drug supply and treatment. The major issues related to an inadequate public health infrastructure resulting in poor technical and administrative support to field staff. There was confusion over roles of the health personnel in the TB programme and the public health facility, as well as poor technical performance. Partnerships were found to be useful in addressing the following areas: (1) the implementation of an external quality assurance scheme for sputum microscopy through involvement of microbiologists from large hospitals and research organizations; (2) training and capacity strengthening of programme and public health facility staff through innovative training and team building exercises organized by the programme, NGOs and the private sector; (3) development of Information, Education and Communication (IEC) material through partnerships with NGOs, and (4) the involvement of local NGOs and private doctors to increase case finding and to improve access to direct observation of treatment (DOT). The paper discusses the lessons learnt in this process and identifies some of the key issues in urban TB control, for consideration by policy makers.

Communicable Disease Control↗
PubMed2001

Reporting sexual function disorders caused by antipsychotic drugs: is there a role for the community pharmacy?

Sexual function disorders are frequent adverse effects of antipsychotic use. These effects can lead to non-compliance to medication, which dramatically worsen the outcome of the psychotic disease. Detecting sexual dysfunction by the carers may be difficult, since feelings of embarrassment may occur in both care-taker as in patient. In order to prevent underreporting, strategies to recognise sexual dysfunction should be developed, based upon collaboration between care providers of the psychotic patient. Community pharmacies in many countries can detect non-compliance to medication in prescription data and report this to psychiatric services of the patient. Exchanging information by cross-sectoral networks may optimise the disease management of the psychotic patient.

Adverse Drug Reaction Reporting Systems↗
PubMed2001

Facilitating interorganizational collaboration: the contributions of interorganizational alliances.

In an attempt to promote service delivery integration and improve interorganizational collaboration, many recent human service delivery initiatives have included the development of interorganizational alliances such as coalitions and coordinating councils. Despite their popularity, little is known about how these alliances influence interorganizational collaboration, specifically the extent to which they alter the interactions among human service delivery organizations. The present study examined the interorganizational interactions, specifically the exchange relationships, within one county that was implementing two interorganizational alliances--a countywide coordinating council and interagency service delivery teams. Membership on both alliances was associated with broader interorganizational exchange networks. Organizations involved in a coordinating council were more likely to be included in client, information, and resource exchanges, and participate in joint ventures with a broader range of organizations. Providers involved in interagency teams also exchanged clients and information with a broader sector of service delivery organizations than nonparticipating providers. Observational data suggested that both alliances created structures and processes intended to facilitate interorganizational exchanges. Together, these results suggest that the development of opportunities for and encouragement of staff and leader involvement in these types of alliances may be an important part of our attempt to create a more integrated social service delivery system. The implications of these findings for researchers and practitioners are discussed.

Cooperative Behavior↗
PubMed2002

Introducing soft systems methodology plus (SSM+): why we need it and what it can contribute.

There are many complicated and seemingly intractable problems in the health care sector. Past ways to address them have involved political responses, economic restructuring, biomedical and scientific studies, and managerialist or business-oriented tools. Few methods have enabled us to develop a systematic response to problems. Our version of soft systems methodology, SSM+, seems to improve problem solving processes by providing an iterative, staged framework that emphasises collaborative learning and systems redesign involving both technical and cultural fixes.

Australia↗
PubMed1997

The orofacial cancer patient's support from the general practitioner, hospital teams, family, and friends.

BACKGROUND: After the diagnosis of cancer, about a third of patients have adjustment disorders. Of recently diagnosed patients, 5 to 15% experience serious psychological disturbances, but their distress is often undetected and untreated. Little attention has been directed to the patients' sources of support and their adequacy. METHODS: This study assessed a defined group (n = 49) of cancer patients' ratings of the support they received from general practitioners, hospital teams, family, and friends. Additional information was collected on the patients' interest in receiving further hospital services and their psychological morbidity (i.e., anxiety and depression). RESULTS: The results show wide variation in patients' perceptions of the helpfulness of the primary and secondary care teams, raising concern about the levels of help and support available to some cancer patients. CONCLUSIONS: Although this sample rated the help received from the hospital very highly, those patients who requested more information from the hospital sector showed little evidence of having had their general anxiety "buffered" by involvement of family members.

Adjustment Disorders↗
PubMed2000

The real and the nominal? Making inflationary adjustments to cost and other economic data.

Given the scarcity of cost data for health interventions, there has been substantial use of a relatively small number of existing studies to underpin policy development formulation. Intervention-specific cost and cost-effectiveness data have been used to plan overall budgets, to assess the relative efficiency of different interventions and to consider the resource requirements for programme implementation at both the local and national levels. Cost and cost-effectiveness comparisons have been made between these studies and general sources such as the World Bank's World Development Report 1993. At the same time, information on key health sector variables, such as annual health expenditures, has been systematically compiled for more than two decades. The question of possible inflationary effects is becoming increasingly important as the original data on which these numbers are based ages. For example, cost figures from the mid-1980s require a 60% inflationary adjustment simply to maintain their real value in current dollars. This paper looks at methods to adjust cost data to account for inflation and discusses the difference between real or constant and nominal or current values. These methods are also used to make inflationary adjustments to other types of economic data such as income.

Cost-Benefit Analysis↗
PubMedDate not supplied

Physical parameters affecting the visibility of small ventricular septal defects using two-dimensional echocardiography.

We report a study showing that two-dimensional echocardiography is capable of visualizing a ventricular septal defect as small as 3 mm. The physical parameters which determine the visibility of an aperture in the myocardium include the presence of anterior refractile tissue, the amount of ultrasound beam focusing and range over which this occurs, the angle of incidence of the ultrasound beam on the septum, and the number of lines of information per degree of sector sweep. These factors are illustrated by in vitro tests. The influence of operator controllable variables in two-dimensional sector scanning echocardiography is discussed.

Child, Preschool↗
PubMed2002

Dalitz plot analysis of the decay D(+)-->K(-)pi(+)pi(+) and indication of a low-mass scalar Kpi resonance.

We study the Dalitz plot of the decay D(+)-->K(-)pi(+)pi(+) with a sample of 15090 events from Fermilab experiment E791. Modeling the decay amplitude as the coherent sum of known Kpi resonances and a uniform nonresonant term, we do not obtain an acceptable fit. If we allow the mass and width of the K(*)(0)(1430) to float, we obtain values consistent with those from PDG but the chi(2) per degree of freedom of the fit is still unsatisfactory. A good fit is found when we allow for the presence of an additional scalar resonance, with mass 797+/-19+/-43 MeV/c(2) and width 410+/-43+/-87 MeV/c(2). The mass and width of the K(*)(0)(1430) become 1459+/-7+/-5 MeV/c(2) and 175+/-12+/-12 MeV/c(2), respectively. Our results provide new information on the scalar sector in hadron spectroscopy.

Journal Article↗
PubMedDate not supplied

Visual exploration of complex time-varying graphs.

Many graph drawing and visualization algorithms, such as force-directed layout and line-dot rendering, work very well on relatively small and sparse graphs. However, they often produce extremely tangled results and exhibit impractical running times for highly non-planar graphs with large edge density. And very few graph layout algorithms support dynamic time-varying graphs; applying them independently to each frame produces distracting temporally incoherent visualizations. We have developed a new visualization technique based on a novel approach to hierarchically structuring dense graphs via stratification. Using this structure, we formulate a hierarchical force-directed layout algorithm that is both efficient and produces quality graph layouts. The stratification of the graph also allows us to present views of the data that abstract away many small details of its structure. Rather than displaying all edges and nodes at once, resulting in a convoluted rendering, we present an interactive tool that filters edges and nodes using the graph hierarchy and allows users to drill down into the graph for details. Our layout algorithm also accommodates time-varying graphs in a natural way, producing a temporally coherent animation that can be used to analyze and extract trends from dynamic graph data. For example, we demonstrate the use of our method to explore financial correlation data for the U.S. stock market in the period from 1990 to 2005. The user can easily analyze the time-varying correlation graph of the market, uncovering information such as market sector trends, representative stocks for portfolio construction, and the interrelationship of stocks over time.

Journal Article↗
PubMed2005

Correct procedures and cutting corners: a qualitative study of women's occupational health and safety in a beauty therapy industry.

OBJECTIVE: To examine the context of occupational health and safety related to blood-borne communicable diseases practice. METHODS: A case study approach using qualitative semi-structured interviews with five key informants who represented different sectors of the beauty therapy industry in South Australia. RESULTS: Four main themes were identified: (i) exposure to blood and blood-borne communicable diseases; (ii) prevention in practice; (iii) OH&S problems; and (iv) industry needs. CONCLUSION: Key OH&S issues in the beauty therapy industry include: power relationships between employers and employees, equipment costs, the need for more continuing education, and monitoring of practitioners. IMPLICATIONS: Economic constraints, continuing education, and government regulation of the beauty therapy industry are highlighted as significant areas for further consideration in addressing the OH&S needs of practitioners and their clients.

Beauty↗
PubMed2005

Mexican immigrants' explanatory model of latent tuberculosis infection.

This article reveals how the multiple and disparate explanations of latent tuberculosis infection (LTBI) from the U.S. and Mexico professional health sectors and the popular sector are used to inform the explanatory model (EM) of LTBI for Mexican immigrants residing in the U.S.-Mexico border region. Fourteen immigrants, nine diagnosed with LTBI (n = 9) and their spouses (n = 5) participated in this critical ethnographic study. Because care seeking and treatment decisions are influenced by EMs, the results indicate that it is imperative that interventions for Mexican immigrants with LTBI are built on an understanding of their illness experience and are contextually meaningful.

Adult↗
PubMed1990

Functional health development model: a tool for planning.

This paper describes a functional model (gross style) taking available information about the health sector e.g. indicators of health status, types of service utilization, source allocations and placing these quantities into a systematic framework as a tool for planning for health services in a developing area. The major advantages of functional models over trial-and-error for planning have been presented. The functional model described could contribute to the sorting out of desirable from less desirable policy alternatives for a specific population. The output from the model is useful for matching resources to program development, taking into consideration costs and effectiveness.

Computer Simulation↗