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PubMed1992

[A rapid method for the determination of the anti-interferon activity of bacteria].

Methods for the rapid and immediate determination of the anti-interferon activity of bacteria have been developed. The use of these methods makes it possible to reduce the time of determination from 48 hours to 24 and 7 hours. The proposed methods require no additional production costs, while their sensitivity and specificity are not inferior to those ensured by the classical method. These methods are recommended for the etiological diagnosis of diseases caused by opportunistic enterobacteria.

Bacteria↗
PubMedDate not supplied

[Supply of medical equipment in Mexico].

This article covers the report on Supply of Medical Equipment in Mexico, presented during the Second National Congress of Public Health. The results are part of an investigation that dealt with the general conditions that currently prevail in the production and distribution of medical equipment. The information was obtained by means of a survey applied to 208 companies that comprised the sample study. The facts indicate that of the companies that correspond to this industrial sector in Mexico, 3.8 per cent are manufacturers, 69.7 per cent distributors, 19.2 per cent manufacturer-distributors, and the remaining 7.2 per cent correspond to corrective and preventive maintenance. Also, these companies pose serious problems of external dependence with regard to production costs and the commercialization of products. Furthermore, it became evident that there is a substantial need for financial support to optimally satisfy the demands of various institutions in the country's health sector.

Equipment and Supplies↗
PubMed1991

The use of intravenous immune globulin in organ transplantation.

There are no comparative clinical data to differentiate the available IVIG products. Cost, pharmaceutical considerations, and CMV titers are criteria for selecting these products. CMV-IGIV has higher titers of CMV antibodies but is more costly. The potential for CMV infection in transplant patients is great, but the clinical significance may vary. Likewise CMV morbidity and mortality is variable and dependent on the type of transplant, the donor, and immunosuppressive regimens used. IVIG has a role in decreasing CMV infections in transplant patients, but further study and cost-benefit analysis is necessary to determine optimal regimens.

Cytomegalovirus Infections↗
PubMed1991

[Preliminary study on soilless cultivation techniques of Panax quinquefolium L].

Our experiment has shown 1. Vermiculite with sand (volume 1:1) is a good substrate of soil for American Ginseng. The yield and contents of ginsenoside of American ginseng in this soilless substrate are a little higher than those in ordinary soil. 2. This kind of substrate can be used continuously with fewer occurrences of insect pest and plant diseases and contributes significantly to the reduction of production cost.

Ginsenosides↗
PubMed1991

Utilizing findings from the APACHE III research to develop operational information system for the ICU--the APACHE III ICU Management System.

The APACHE III data base reflects the disease, physiologic status, and outcome data from 17,400 ICU patients at 40 hospitals, 26 of which were randomly selected from representative geographic regions, bed size, and teaching status. This provides a nationally representative standard for measuring several important aspects of ICU performance. Results from the study have now been used to develop an automated information system to provide real time information about expected ICU patient outcome, length of stay, production cost, and ICU performance. The information system provides several new capabilities to ICU clinicians, clinic, and hospital administrators. Among the system's capabilities are: the ability to compare local ICU performance against predetermined criteria; the ability to forecast nursing requirements; and, the ability to make both individual and group patient outcome predictions. The system also provides improved administrative support by tracking ICU charges at the point of origin and reduces staff workload eliminating the requirement for several manually maintained logs and patient lists. APACHE III has the capability to electronically interface with and utilize data already captured in existing hospital information systems, automated laboratory information systems, and patient monitoring systems. APACHE III will also be completely integrated with several CIS vendors' products.

Databases, Factual↗
PubMed1990

Organizational determinants of efficiency and effectiveness in mental health partial care programs.

The use of partial care as a treatment modality for mentally ill patients, particularly the chronically mentally ill, has greatly increased. However, research into what constitutes a "good" program has been scant. This article reports on an evaluation study of staff productivity, cost efficiency, and service effectiveness of adult partial care programs carried out in New Jersey in fiscal year 1984/1985. Five program performance indexes are developed based on comparisons of multiple measures of resources, service activities, and client outcomes. These are used to test various hypotheses regarding the effect of organizational and fiscal variables on partial care program efficiency and effectiveness. The four issues explored are: auspices, organizational complexity, service mix, and fiscal control by the state. These were found to explain about half of the variance in program performance. In addition, partial care programs demonstrating midlevel performance with regard to productivity and efficiency were observed to be the most effective, implying a possible optimal level of efficiency at which effectiveness is maximized.

Adolescent↗
PubMed1990

Development of a new inflow valve for a 20cc semisoft ventricle: preliminary results.

We remodeled and tested our semisoft 20cc ventricle and made a new bileaflet flap inflow valve. Housings, bases, outflow valve, and a newly designed diaphragm were all made by vacuum forming and put together by radiofrequency welding or glue. In vitro, the ventricle produced a cardiac output of 2.5 to 3.0 L/min and showed reliable durability results. Hematological testing showed no important thrombogenicity of the new valve. Cardiac output was higher than expected for the volume of the ventricle, perhaps because of stretching or flow through. Animal experiments with the left ventricular assist device (LVAD) version was done at Ohio State University. Earlier in Utah, we did 20 cc total artificial heart (TAH) implantations and LVAD experiments in lambs and recently in calves with the 60cc TAH version. A soft ventricle is easy to implant and low in production costs.

Animals↗
PubMedDate not supplied

Feasibility of home treatment of diarrhoea with packaged rice--ORS.

Feasibility of home treatment of diarrhoea with packaged rice-based oral rehydration salts (R-ORS) was compared, in terms of cost, with that for glucose-based oral rehydration salts (G-ORS). Packets of G-ORS (World Health Organization-recommended composition) were distributed in two Bangladeshi villages (G-ORS area). Packets of R-ORS with similar composition, except that glucose was replaced with rice flour (50 g/l), were distributed in other two villages (R-ORS area). During the 7-month study period, 1061 and 1348 diarrhoeal episodes were detected among 409 under-five children in each of the study areas. R-ORS was used, either alone or in combination with drugs, to treat 662 (62%) episodes in the R-ORS area, compared to 1101 (82%) episodes in the G-ORS area. The treatment cost per episode was more with R-ORS than with G-ORS, though fewer R-ORS packets were used per episode. Among others, the main factor for the higher cost was found to be the higher production cost of R-ORS packets. Expected early recovery from diarrhoea with use of R-ORS was not observed in this study. Under the study situation, the feasibility of home treatment of diarrhoea with packaged R-ORS was not apparent.

Bangladesh↗
PubMed1990

Health-insurance products and plan options.

Trends in health insurance are discussed, with emphasis on insurers' efforts to offer an array of cost-effective plans tailored to the needs of employers and subscribers. Health-insurance companies, responding to employers' demands to curtail the rising costs of premiums, now offer a variety of insurance products. While indemnity plans, health maintenance organizations (HMOs), and preferred-provider organizations (PPOs) remain as the three basic types of plans, insurers are combining these elements in different ways, creating dual- and triple-option plans that consist of indemnity insurance and an HMO, a PPO and an HMO, or other variations. Insurers offering multiple options may effect internal cost savings through shared personnel and administrative expenses. Four factors influence the development and marketing of insurance products: cost and volume of healthcare services, adverse selection, competition, and the profit incentive. Many of the insurance products have been developed in response to requests for maximum freedom of choice of provider; as an example, the fastest-growing HMO product in 1989 was the point-of-service HMO, which allows the subscriber to seek care from a provider who is not part of the HMO network. PPOs and exclusive-provider organizations (EPOs) are growing; these are often organized by hospitals or physician networks. Among the new trends in product-line development are "riders" for specialty services such as vision care and prescription drugs. As competition intensifies, marketing efforts are focusing on previously overlooked groups such as the small employer and certain ethnic communities. Cost and freedom of choice will remain important criteria in the selection of insurance products.(ABSTRACT TRUNCATED AT 250 WORDS)

Economic Competition↗
PubMed1990

Assessing the damage from cigarette smoking in New York State.

Although there is clear evidence that smoking is the leading preventable cause of death in the United States today, almost one third of American adults continue to smoke. To promote public awareness of smoking's adverse effects, we applied a previously established methodology to estimate the impact of cigarette smoking in New York State. Using New York State-specific mortality data, cigarette smoking prevalence rates, and total health care costs, we found that cigarette smoking caused almost 27,000 deaths in 1985, resulting in 335,000 years of potential life lost (mean, 12 years per person). The estimated annual cost of smoking totaled +4.7 billion, including direct (health care) and indirect (lost income and productivity) costs from smoking-attributable deaths and illness. The New York State Department of Health publicized these findings to gain support for a statewide regulation for smoking control in public places. This methodology can easily be applied elsewhere to assess the adverse impact of smoking and to support smoking control activities.

Adult↗
PubMed1989

[Maximization of economic yield, minimum cost optimal diets and cultivation diversification for small scale farmers of the highland region of Guatemala].

The present study was conducted as part of an evaluation of the economic and nutritional effects of a crop diversification program for small-scale farmers in the Western highlands of Guatemala. Linear programming models are employed in order to obtain optimal combinations of traditional and non-traditional food crops under different ecological conditions that: a) provide minimum cost diets for auto-consumption, and b) maximize net income and market availability of dietary energy. Data used were generated by means of an agroeconomic survey conducted in 1983 among 726 farming households. Food prices were obtained from the Institute of Agrarian Marketing; data on production costs, from the National Bank of Agricultural Development in Guatemala. The gestation periods for each crop were obtained from three different sources, and then averaged. The results indicated that the optimal cropping pattern for the minimum-cost diets for auto consumption include traditional foods (corn, beans, broad bean, wheat, potato), non-traditional foods (carrots, broccoli, beets) and foods of animal origin (milk, eggs). A significant number of farmers included in the sample did not have sufficient land availability to produce all foods included in the minimum-cost diet. Cropping patterns which maximize net incomes include only non-traditional foods: onions, carrots, broccoli and beets for farmers in the low highland areas, and raddish, broccoli, cauliflower and carrots for farmers in the higher parts. Optimal cropping patterns which maximize market availability of dietary energy include traditional and non-traditional foods; for farmers in the lower areas: wheat, corn, beets, carrots and onions; for farmers in the higher areas: potato, wheat, raddish, carrots and cabbage.

Agriculture↗
PubMed1977

A new parallel plate dialyser. II. Description of design and in vitro performance.

Using a high efficiency membrane support pattern, described in the previous paper, a prototype of a new parallel plate dialyser has been developed. The new dialyser is designed in such a way that the number of components is reduced to one item per blood layer and the membrane is folded as a continuum. This permits a semiautomatic assembly of the unit, which reduces production costs. Furthermore this technique facilitates aseptic handling of the item. The in vitro performance has been tested and it compares favorably with commercially available disposable parallel plate dialysers.

Biomedical Engineering↗
PubMed1977

Educating patients with Osteoarthritis.

An education program was developed for geriatric patients with osteoarthritis utilizing adult learner methods. The format used was slide/tape with accompanying booklets. Sixty-seven patients were tested before, immediately after, and three weeks after viewing the programs. A change in knowledge was noted for all objectives and was statistically significant (P .05) in five of six objectives. Although initial production costs are substantial, duplication costs are minimal. These results suggest that geriatric patients with osteoarthritis are able to learn and the method used is a cost-effective one.

Cost-Benefit Analysis↗
PubMed1979

Helping staff to manage conflict well.

A hospital that trains its staff to deal assertively with conflict can become more effective in terms of productivity, cost effectiveness, and patient satisfaction. A training model for handling conflict in the work setting is described.

Aggression↗
PubMed1979

Developing drug-use profiles from drug-charge records.

The potential for developing a drug-use profile from drug-charge records was studied at an 830-bed community hospital. Patient drug charges were reviewed retrospectively for one year (1975) to identify: (1) which key drugs accounted for a high percentage of cost and usage; (2) where key drugs were used within the hospital; (3) how they were used; and (4) who were the chief prescribers. Of the drugs used, 8% accounted for 80% of total drug product costs. Seven drug groups (10% of the total drug groups) appeared in the top 10 of both drug cost and quantity categories. Six individual drugs also appeared in the top 10 of both categories. According to cost, cephalosporin antibiotics were ranked first among drug groups but were sixth according to quantity. Analgesics-antipyretics were ranked first among drug groups by quantity and second by cost. Cephalothin was ranked first among individual drugs by cost and was not in the top 10 in quantity. Diazepam was ranked first among individual drugs by quantity and third by cost. Patients' drug-charge records can be used effectively to generate drug-use profiles for ongoing drug use review, quality assurance and cost containment programs.

California↗
PubMed1979

The need for integrated control programs for zoonoses affecting livestock.

Prior to recognition of etiologic agents of zoonoses (infections transmitted between animals and man), physicians encountered these illnesses in man and veterinarians observed them in animals. As the agents were identified, interspecies relationships (and spread) became evident and control programs evolved without consideration of cost-effectiveness. Today, the public demands efficient use of financial resources. Human health as well as economic losses are concerns of animal health agencies. Zoonoses affecting livestock, though not major priorities among public health agencies, cannot be ignored. It seems economical, therefore, to combine the efforts of these agencies in zoonoses control. This would benefit human health by reducing the animal reservoirs and the livestock industry will benefit by lowered production costs.

Animals↗
PubMed1978

[Combined vaccines in veterinary medicine in the developing countries].

It is in the interest of developing countries to have combined vaccines in veterinary medicine, not so much because they reduce production costs, but rather because they increase convenience and efficacy concerning the logistics of prophylactic projects in the field, thus lowering the cost of these projects. Their drawbacks are basically due to the biological compatibility of immunogens (possible immunosuppression by some viruses) and to the interaction of the various components when mixed, or when lyophilization is carried out. Some examples of such associations of vaccines are: (1) cattle plague + pleuropneumonia and possibly anthrax, (2) anthrax + blackleg, (3) sheeppox + anthrax, (4) pleuropneumonia + blackleg, (5) Newcastle disease + fowlpox + fowl typhoid, (6) fowl typhoid + chicken pasteurellosis. Practical results have been most positive and include the eradication of cattle plague - a major scourge of almost all of the African continent - and control over peripneumonia as a first step towards its eradication.

Africa↗
PubMedDate not supplied

Karyology: vaccine manufacturers' views.

Chromosomal analyses and life span studies of WI-38 cell cultures used for vaccine production at the Connaught Laboratories Ltd will be described. Twenty cultures derived from the same seed lot and 25 cultures derived from different starter cultures were analyzed. Karyology tests at population doublings 31 and higher were within acceptable limits. The WI-38 cells reached a finite lifespan of approximately 65 population doublings. Normal growth characteristics were observed within 2/3 of the finite lifespan, i.e. until population doubling 40. The finite lifespan of MRC-5 was found to be 75 population doublings, with normal growth pattern until passage 50. The karyology test results, cell yields and the finite lifespans indicated that these cells could be used as substrates for vaccine production at higher passage levels than previously suggested. Using serially subcultivated cells at higher passage levels would make possible an increase in the volume of vaccine from existing cell seed and would also result in significant reduction in production costs.

Cell Survival↗