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PubMed2003

[Resource use of the elderly in long-term care hospital using RUG-III].

PURPOSE: This study was to classify elderly in long-term care hospitals for using Resource Utilization Group(RUG-III) and to consider feasibility of payment method based on RUG-III classification system in Korea. METHOD: This study designed by measuring resident characteristics using the Resident Assessment Instrument-Minimum Data Set(RAI-MDS) and staff time. The data were collected from 382 elderly over sixty-year old, inpatient in the five long-term care hospitals. Staff time was converted into standard time based on the average wage of nurse and aids. RESULT: The subjects were classified into 4 groups. The group of Clinically Complex was the largest(46.3%), Reduced Physical Function(27.2%), Behavior Problem(17.0%), and Impaired Cognition(9.4%). The average resource use for one resident in terms of care time(nurses, aids) was 183.7 minutes a day. Relative resource use was expressed as a case mix index(CMI) calculated as a proportion of mean resource use. The CMI of Clinically Complex group was the largest(1.10), and then Reduced Physical Function(0.93), Behavior Problem(0.93), and Impaired Cognition(0.83) followed. The difference of the resource use showed statistical significance between major groups(p<0.0001). CONCLUSION: The results of this study showed that the RUG-III classification system differentiates resources provided to elderly in long-term care hospitals in Korea.

English Abstract↗
PubMedDate not supplied

Measuring worksite resources for employee heart health.

PURPOSE: Intervention at the organizational rather than the individual level is gaining greater attention in worksite health promotion efforts. However, little research has been done on instruments to measure this domain. Therefore, the purpose of this study was to further test the utility of an existing organizational heart health support instrument by examining relationships among worksite structural characteristics and comparing these results to other survey findings. DESIGN: One-time cross-sectional. SETTING: New York State. SUBJECTS: One hundred fifteen volunteer worksites in the New York State Healthy Heart Program, representing manufacturing, government, education, health care, and other industries. MEASURES: A survey was conducted using HeartCheck, an organizational assessment of employee support for heart health. HeartCheck contains 175 items measuring organizational support for tobacco control, nutrition, physical activity, stress, screening, and administrative support structure. RESULTS: On average, only 22% of all worksite resources assessed were present in the sample. Having a workforce greater than 250 provided a 12% increase in predicted overall worksite resources. A predominantly female workforce (> 75%) provided 10% higher levels of worksite stress resources. Worksites with unions had higher levels of resources for physical activity (10%), screening (13%), and general supportive structures (10%). The presence of manual labor diminished support for tobacco control resources (-13%). Finally, manufacturing worksites demonstrated a clear advantage for all types of worksite resources, except for stress. CONCLUSION: A number of trends found in this study are consistent with earlier work. Industry type and size both predict worksite supports similar to previous studies. Other findings that appear to contradict previous work, including the relatively low level of support observed in this sample, can be explained by the comprehensive nature of the instrument. Overall, these findings demonstrate the utility of HeartCheck.

Cardiovascular Diseases↗
PubMed1976

Conservation in hospital resource use: treatment of pneumonias. An investigation of care in four hospitals over the past decade.

An investigation of patient care in four hospitals compared levels of resource use between 1964 and 1974 for patients with a primary diagnosis of pneumonia. Results showed a decreased length of stay in all hospitals. Unique patterns of increases and decreases existed in each hospital for the changing use of diagnostic and therapeutic resources. Reduction in dollar value of length of stay was larger in all cases than increases in dollar value of diagnostic and therapeutic resource use. This resulted in an overall reduction in hospital resource charges over the decade, when 1974 dollar values were used. Large increases in diagnostic or therapeutic resources (up to 217%) were reflected as only minor increases in the partial hospital bill over the decade ( less than 11%). Increased intensity of resource use has contributed to increasing per-day charges of up to 27%, in the face of recent average cost rises of more than 10 times that size for daily hospital expenses.

Costs and Cost Analysis↗
PubMedDate not supplied

The effects of medical group practice organizational factors on physicians' use of resources.

Few studies have systematically examined the influence of physician, patient, and practice characteristics on physician-directed use of resources within the overall environment of medical group practices and none have included the practice culture in the analysis. This study analyzes the effects of the structure and culture of medical group practices on the amount of resources used to manage uncomplicated hypertension episodes of care for enrollees in a Minneapolis/St. Paul HMO during 1990. Three findings emerged from this study: (1) resource use for a well-defined episode of care varies much more than one would expect in this highly competitive managed care environment; (2) the culture of the group practice appears to be more important than organizational structure in determining resource use for the treatment of hypertension; and (3) together the culture and structural variables only explain 8 percent of the variance in resource use. The study indicated that medical group practice organizations have less influence on physicians' practice styles than expected. The group practices studied are all located in a highly competitive managed care environment and these conditions should be causing them to create more standardized practice styles among their physicians. However, wide variations in individual physician practice styles account for most of the differences observed. Either much of the unexplained variance in resource use for this episode of care results from unobserved patient and illness characteristics, or managed healthcare is not yet causing medical group practices in Minnesota to challenge physicians' individualistic practice styles.

Cost-Benefit Analysis↗
PubMedDate not supplied

Biotechnologies and genetic resources for food and agriculture.

The article stresses the complimentarity of genetic resources and biotechnologies in ensuring food security. Genetic resources are being lost at an increasing and alarming rate. A small number of crops and farm animals contribute an ever increasing percentage of human food. The conservation and sustainable use of genetic resources have many socio-economic, political, cultural and legal implications. Genetic resources are the raw material to which biotechnology is applied. Biotechnologies are increasingly protected by intellectual property rights, no such incentive for the conservation and sustainable use currently exists. The article discusses the role of the International Undertaking on Plant Genetic Resources, currently being negociated in FAO countries, and of the Code of Conduct on Biotechnology being developed by the FAO Commission on Genetic Resources for Food and Agriculture.

Agriculture↗
PubMed2000

CISMeF: a structured health resource guide.

In 1999, the Internet has become a major source of health information. The objective of CISMeF is to catalogue and index the main French-speaking health resources. In September 1999, the number of indexed resources totaled over 7,100 with a mean of 75 new sites per week. CISMeF uses two standard tools for organizing information: the Medline bibliographic database MeSH thesaurus and the Dublin Core metadata format. Resources included in CISMeF are described by the following: title, author or creator, subject and keywords, description, publisher, date, resource type, format, identifier, and language. To index resources, CISMeF uses five levels of hierarchy: "meta-term", category, keyword, subheading, and resource type. CISMeF contains a thematic index, including medical specialities and an alphabetic index. CISMeF respects the Net Scoring, criteria to assess the quality of health information on the Internet. The CISMeF project offers a valuable tool for the French-speaking health community: 2,500 computer users visit the Web site each working day.

Abstracting and Indexing↗
PubMed2001

Changes in learning-resource use across physicians' learning episodes.

INTRODUCTION: This study explores the numbers of learning resources physicians use at each stage in self-directed learning episodes addressing general problems. MATERIALS AND METHODS: A survey of a statewide random sample of doctors estimated the number of resources used at each stage in solving various general problems. RESULTS: The 50% response rate for faculty allowed generalization of findings to the population of these physicians; the rate for nonfaculty physicians was too low to allow generalization. Faculty findings showed (1) broader resource use in learning about diseases than diagnosis or therapeutics (2) comparable numbers of resources used in deciding whether to take on the learning problem and learning the required skills and knowledge, (3) greater numbers of resources selected to evaluate the problem and to learn the required skills and knowledge than to gain experience with the newly learned skills and knowledge, and (4) support for assertions that doctors value learning resources that are accessible, applicable, familiar, and time effective. DISCUSSION: The findings were interpreted in light of theory describing physicians' self-directed learning episodes, and implications are presented for physicians-in-training, physicians, and medical librarians.

Analysis of Variance↗
PubMed2000

A brief introductory guide to chronic pain resources on the Internet.

The expanding Internet has become an increasingly valuable tool for world wide sharing of information. Health care professionals, patients, lay persons, family members and others are afforded instant access to masses of information and almost unlimited resources on virtually any topic, as well as an almost seamless vehicle for communication. This new medium offers tremendous implications for health care. However, the absence of a single clearinghouse, a single search procedure or guarantee of accuracy often make information access efforts challenging, confusing and frustrating. The present paper provides a brief introduction aimed at increasing appreciation of the Internet and enhancing its utility with regard to chronic pain and its management and offers rudimentary guidelines for efficient accessing of information. Finally, it presents the results of a comprehensive search including nearly 200 useful Internet web links for professionals, patients, family members and other interested persons who assess, treat or cope with chronic pain. Identified resources include numerous organizations, medical, psychological assessment and practical treatment strategies, assessment and treatment reviews, support groups, list serve groups for patients and professionals, advocacy resources, news and assistive technology resources. Special emphasis is given to useful resources to assist professionals treating persons with chronic pain, as well as resources that can assist persons challenged by chronic pain.

Journal Article↗
PubMed2001

Population structure inhibits evolutionary diversification under competition for resources.

A model is presented that explores how population structure affects the evolutionary outcome of ecological competition for resources. The model assumes that competition for resources occurs within groups of a finite number of individuals (interaction groups), and that limited dispersal of individuals between groups (according to Wright's island model of population structure) results in genetic structuring of the population. It is found that both finite-sized interaction groups and limited dispersal can have substantial effects on the evolution of resource exploitation strategies as compared to models with a single, infinitely large, well-mixed interaction group. Both effects, in general, tend to select for less aggressive competitive strategies. Moreover, both effects also tend to reduce the likelihood of the evolutionary diversification of resource exploitation strategies that often occurs in models of resource competition with infinite populations. The results are discussed in the context of theories of the evolutionary diversification of resource exploitation strategies and speciation.

Biological Evolution↗
PubMed2002

[On eco-ethics and sustainable development of natural resources].

In this paper, definition of natural resources was discussed at first, and chief characteristics of natural resources were concluded and summarized systematically. Then, in point of eco-ethics, relationship between natural resources and human was discussed. Human in the contemporary era should hold the responsibilities and commitments to remain abundant resources for survival and development of the offspring, and it is the same important to meet the requirement of human in the contemporary era and the offspring. Bringing eco-ethics into the practice of protection, exploitation, and sustainable development of natural resources has very important theoretic and practical significance undoubtedly. Therefore, approaches and main measures to sustainable development of natural resources were also discussed in this paper.

Ecology↗
PubMed2003

Level of evidence as a future gold standard for the content quality of health resources on the internet.

OBJECTIVE: An assessment of the quality of health information on the Internet is an absolute necessity. In this study 'sensitive' information was defined as information found in documents published on the Internet, which could be used in a medical decision. For sensitive information, the main criterion chosen for the quality of the information was an indication of the level of evidence. A survey was conducted using the CISMeF health catalogue to assess how often a score of the level of evidence is mentioned in the information accessible on the Internet in French-language health resources. METHODS: Since 1999, members of the CISMeF team have systematically been searching for all documents containing 'sensitive' information and verifying whether the level of evidence was explicitly indicated as a score at least once in the document. RESULTS: As of June 2001, 10,190 resources were included in CISMeF; including 2964 textual 'sensitive' resources (29.1%). Out of all these resources, only 4.7% (95% confidence interval: 4.0 - 5.5%) indicated the level of evidence. A statistically significant difference in the prevalence of indicating the level of evidence according to resource types (e.g., 18.1% for guidelines compared to 0.0% for teaching material), year of publication (almost three times greater in 1997-2001 compared with 1990-1996) and publishers was observed. CONCLUSION: As the number of people accessing the growing amount of information on the Internet is increasing daily, publishers have an ethical obligation to inform their readers about the validity of 'sensitive' information their sites contain. However, the vast majority of the French language Internet resources that were surveyed do not mention a score of the level of evidence for their sensitive information.

Consensus↗
PubMed2005

Utilization of evidence-based informational resources for clinical decisions related to posterior composite restorations.

The purpose of this study was to characterize evidence-based informational resources utilization patterns of a sample of general dentists with respect to clinical decisions regarding posterior composite restorations. A stratified random sample of general practitioners belonging to the Academy of General Dentistry (n = 2880) was mailed a questionnaire that elicited information about practice characteristics and informational resources used for clinical decision making related to posterior composite restorations. Six hundred ninety-nine dentists responded (24 percent response rate). Use of evidence-based (EB) resources (journals and online data bases) was low for all respondents (14 percent) for all levels of experience; however, more experienced clinicians were more likely to use EB resources than recent graduates. AGD Master-level members were significantly more likely to use EB resources than their counterparts (p < .05). Within the limitation of this study, current patterns suggest a low reliance on evidence-based informational resources in the practice of clinical dentistry.

Bicuspid↗
PubMed2006

[Description and integration of biomedical information resources by metadata].

With the development and utilization of computer techniques, Internet is playing an important role in information dissemination. There are abundant biomedical resources on the Internet. Accessing biomedical information is more dependent on the Internet than ever. It is important to explore new methods to describe and manage information resources. We have analyzed biomedical databases, search engines, web sites, and the metadata adopted by biomedical databases. The results show that biomedical information resources are characterized by electronic format, networking, dynamia, and dispersion. Describing a resource with metadata allows it to be understood by both humans and machines in ways that promote interoperability. Metadata interoperability has to be the underlying principle for networked information management. It directly impinges on information sharing, interchange, and accessibility across the boundaries of systems, languages, and geographic locations. We can use metadata to describe biomedical information and to integrate resources. It will benefit the people to access, select, and utilize biomedical information resources.

Computer Communication Networks↗
PubMed2006

An automated approach to studying health resource and infobutton use.

Many studies have found that clinicians require access to medical knowledge sources while viewing data in their patients' health records. To address this need, we have been developing links to various on-line health information resources from our Web-based clinical information system (WebCIS). Clinicians can access these resources through a "Health Resources" Web page or use context-sensitive "infobuttons" that automatically link to specific resources. To assist in understanding how clinicians interact with these two mechanisms, we have been exploring the use of an automated approach to answer questions about usage for guiding the further development of links to resources. In this paper, we discuss the use of a knowledge discovery technique (CIS Usage Mining) to obtain usage statistics from log files that record interactions with health resources and infobuttons in WebCIS, describe a Web-based interface developed to present the results, and summarize how the results could be applied. The availability of effective links to on-line medical knowledge sources from the patient health record can assist in resolving information needs, potentially improving patient care and decision-making.

Access to Information↗
PubMedDate not supplied

The influence of family resources and family demands on the strains and well-being of caregiving families.

The purpose of this study was to test a theoretical model developed to explain strains and well-being in families providing care to an elderly parent. The influences of family resources and demands on the well-being of caregiving families and the strains they experienced were examined in a sample of 65 families recruited through a variety of agencies serving older adults and their families. Two types of resources were examined: social support and internal system resources. Demands examined included family life events, the amount of care provided to the elderly parent, and the caregiver's appraisal of caregiving. Socioeconomic status (SES) was included in tests of the model since it was related to both family internal system resources and well-being. Resource variables, demand variables, and SES together accounted for 26% of the variance in family strains. Resource variables, strains, and SES together accounted for 65% of the variance in family well-being.

Adaptation, Psychological↗
PubMed1977

Effective use of patient resources: a training guide for family physicians.

Effective use of resources available to patients in their homes, in their neighborhoods, and in their communities can give the family physician much assistance in the provision of total health care to his patients and their families. Patients' resources can be divided into two broad categories--"Personal" and "Institutional". Examples of the former are family, church, neighbors, unions, etc. Institutional resources can be public or private, and they cover a broad spectrum of services. Patients' needs for dignity and independence are best served by Personal resources. Institutional resources should be used only for those services that cannot be met any other way. Success in using any resource requires an orderly five-step process which is presented and discussed in this paper.

Community Health Services↗
PubMed1996

Global physician budgets as common-property resources: some implications for physicians and medical associations.

Since 1990 payment for physician services in the fee-for-service sector has shifted from an open-ended system to fixed global budgets. This shift has created a new economic context for practising medicine in Canada. A global cap creates a conflict between physicians' individual economic self-interest and their collective interest in constraining total billings within the capped budget. These types of incentive problems occur in managing what are known in economics as "common-property resources." Analysts studying common-property resources have documented several management principles associated with successful, long-run use of such resources in the face of these conflicting incentives. These management principles include early defining the boundaries of the common-property resource, explicitly specifying rules for using the resource, developing collective decision-making arrangements and monitoring mechanisms, and creating low-cost conflict-resolution mechanisms. The authors argue that global physician budgets can usefully be viewed as common-property-resources. They describe some of the key management principles and note some implications for physicians and the provincial and territorial medical associations as they adapt to global budgets.

Budgets↗
PubMed1997

Do nurses have the information resources and skills for research utilization?

While access to information resources and the skills to use them do not ensure that nurses will use nursing research in their practice, they are important facilitators. Mailed questionnaires to assess existing information resources, the information management skills of nurses, and what additional resources and training are required were returned by 67 of the 71 vice-presidents or directors of nursing in hospitals in two regions of Ontario. The two regions have similar information resources, nursing staff with research expertise, and opportunities for training in research and information management but there is variation among hospitals. Most vice-presidents agreed that nurses need better information resources and skills to access and evaluate professional literature. The rapidly developing field of information technology, including the Internet, provides potential for sharing resources and expertise. Nursing administrators can minimize barriers and help staff nurses recognize that information management skills enhance professional development and improve patient care.

Computer User Training↗