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PubMed2003

[Ecological risk assessment of forest resource in northeast China].

Based on the theory and methods of regional eco-risk assessment (REA), the eco-risk of forest resources in northeast China is evaluated. The stresses resulting in the eco-risk of forest resources are physical, chemical, biological and social stresses. The weighed coefficient is 0.30, 0.22, 0.11 and 0.37, respectively. In 93 forest bureaus of this area, 64.4% bureaus are in slight risk, 21.2% in mid-risk, 13.3% in high risk and 1.1% in very high risk. This is in corresponding with the skew normal distribution. The eco-risk of forest resources in northeast China is closely related to the locality of the resources. The risk becomes more and more serious from east to west. The risk management and restoration of the forest resource must be strengthened.

Conservation of Natural Resources↗
PubMed1992

Nutrition related resource use in urban areas.

Current social organization of cities is unable to respond to increases in the population fast enough to ensure adequate physical and social functioning of all inhabitants. New social structures in the organization of cities is changing the situation of disadvantaged and malnourished people by changing their access to resources. Resources include a number of non-economic ones that can contribute to improve health and nutritional status. The use of these resources depends on individual choices by people. The nature of basic needs predisposes these choices to include ones that are economically irrational and an inefficient use of resources from economic standpoints. The combination of restricted access to resources and inherent inefficiencies in their use determine the health and nutritional situation of people. Indicators of change in the number of choices and the elasticities of benefits associated with them would recognise both the non-competitive and the market aspects of the new urban social organization. Indicators of the number and type of choices available to people, associated with the nutritional and health benefits derived from those choices may be tools for use in urban planning to support new initiatives for groups in fast growing areas where malnutrition is prevalent.

Asia, Southeastern↗
PubMed2006

[Aesthetics theory and method of landscape resource assessment].

With the destruction of natural environment by human beings, scenic resources are no longer inexhaustible in supply and use. Human beings begin to lay the scenic resources on the same important strategic status as other natural resources, while landscape resources assessment is the prerequisite of their sustainable exploitation and conservation. This paper illustrated the psychological mechanisms of aesthetic and its approaches, compared with the methodologies of traditional and modem landscape aesthetic research, discussed the characteristics of important aesthetic theories (Platonism, Kant paradigm, Empathizing theory, Gestalt paradigm, Marxism aesthetics theory, and Appleton theory) and the landscape assessment theories of 4 paradigms (expert, psychological, cognitive, and empirical) and 2 groups (landscape environment science and landscape architecture culture), and summarized the important practices and successful examples at home and abroad. It was demonstrated that the historical development of landscape assessment had the feature of a contest between expert- and perception-based approaches, with the expert approach dominated in landscape management, while the perception-based approach dominated in landscape research. Both of these approaches generallty accepted that landscape quality was derived from the interaction between the biophysical features of landscape and the percepultual (judgmental) processes of human viewer. In the future, landscape quality assessment will evolve toward a shaky marriage, both expert- and perceptual approaches will be applied in parallel and merged in the final landscape management decision-making process in some but unspecified way, landscape information and complex geo-temporal dynamics representation central to scenic ecosystem management will present major challenges to the traditional landscape aesthetic assessment, and modem science and technology will continue to help meet these challenges. The main trends of landscape resources aesthetic assessment in this century will be the amalgamation and incorporation of diverse paradigms, the cross-disciplinary intersection and quantitative assessment, the emphasis of environment information and landscape ecological value recognition, the universal application of modern science and technology and of the dynamic and intellectual approaches of landscape information, the reality of landscape simulation and its scene technology of human perception, and the more attention to history and landscape culture.

Conservation of Natural Resources↗
PubMed1991

Reimbursement of ICFs/MR program costs based on client resource use.

In this article we have described the impetus, research, and recommendations for a new reimbursement system based on client resource use for ICFs/MR in Minnesota. Research to develop a targeted reimbursement strategy has been completed and a proposal for basing program rates on client resource use developed. Residents (N = 913) in a stratified sample of 65 facilities were assessed and staff resource use determined. Results showed that although predictors in the area of personal interaction, integration, and independence, activities of daily living, special treatment/medical complexity, and behavior accounted for a significant amount of variation in resource use, the unaccounted for variation was sufficiently large to support recommending a system that will base program rates on individual client resource use and the historical costs of individual facilities. Key design issues were also discussed.

Child↗
PubMedDate not supplied

Nursing intensity as a predictor of resource consumption in public health nursing.

The community Health Intensity Rating Scale (CHIRS) has been found to explain variations in resource consumption by home health care clients. The purposes of this study were to determine the amount of variance in nursing resource consumption among public health nursing (PHN) clients explained by CHIRS and to assess whether the four CHIRS domains accurately represent its underlying structure. The sample included 133 PHN clients from three programs: frail older adult, high-risk prenatal, and high-risk infant. CHIRS total score significantly predicted variation in nursing resource consumption in two of the three PHN programs when a composite measure of resource consumption, referred to as nursing effort, was used as the criterion variable. A principal components factor analysis of CHIRS produced a three-factor solution, two of which were reliable enough for use as subscales. A contextual/behavioral subscale and a physiological subscale increased the variance in nursing resource consumption explained in two of the three PHN programs.

Adolescent↗
PubMedDate not supplied

Valuation of medical resource units collected in health economic studies.

This paper reviews the issues that are critical for the valuation of medical resources in the context of health economic studies. There are several points to consider when undertaking the valuation of medical resources. The perspective of the analysis should be established before determining the valuation process. Future costs should be discounted to present values, and time and effort spent in assigning a monetary value to a medical resource should be proportional to its importance in the analysis. Prices vary considerably based on location of the service and the severity of the illness episode. Because of the wide variability in pricing data, sensitivity analysis is an important component of validation of study results. A variety of data sources have been applied to the valuation of medical resources. Several types of data are reviewed in this paper, including claims data, national survey data, administrative data, and marketing research data. Valuation of medical resources collected in clinical trials is complex because of the lack of standardization of the data sources. A national pricing data source for health economic valuation would greatly facilitate study analysis and make comparisons between results more meaningful.

Economics, Medical↗
PubMed1996

A network approach to outpatient service delivery systems: resources flow and system influence.

OBJECTIVE: The study tests a path model for the effects on organizational influence of an organization's centrality in four resource exchange networks in order to gain insight into the network relations that may affect coordination and effectiveness of outpatient health and mental health service systems. DATA SOURCES: Primary data are used from face-to-face interviews with the directors of every organization in the predefined service systems in three urbanized counties in Oregon. Each system consisted of 19 to 20 organizations. Data were collected during 1986 and 1987. STUDY DESIGN: The path model contains five variables: the major dependent variable is attributed organizational influence; the independent variables are three sets of primary resource exchanges: funds allocation, client referrals, and client inflow. An intervening variable of general network contacts, as an informational resource, is modeled as an outcome of the three primary resource exchanges, as well as one of the predictors of influence. DATA COLLECTION: Organizations were identified as system members through a modified snowball sampling procedure. Measures of organizational influence and centrality in each of the exchange networks were derived from interviews with all directors about their interactions with each organization in the system. Multiple regression analysis was used to test the path model. PRINCIPAL FINDINGS: The most important resource in predicting centrality in a general contact network is centrality in a client referral network, while contacts and funds allocation centrality are significant predictors of organizational influence. CONCLUSIONS: The organization with the greatest influence within the system (because of its ability to allocate funds) may not be the organization that takes the largest role in terms of coordinating routine contacts (because of its ability to refer clients). This disjuncture may signal a weakness in the coordination network and system effectiveness, since the more influential organization may not be the most knowledgeable one in terms of the needs of the system.

Ambulatory Care↗
PubMed1996

Orthodontic care provided by general practitioners and specialists in three Swedish counties with different orthodontic specialist resources.

Three counties in Sweden (A, G, and W) with free orthodontic care and different orthodontic resources and geographic structures were studied in 1987. Samples of totally 942 young adults (mean age 18.8 years, SD 0.44) were examined concerning malocclusions and all orthodontic treatment provided by general practitioners or by orthodontic specialists. The care in a rural area (county G) with abundant specialist resources was based on specialist treatments easy assessable to the patients and supplemented by treatments, mainly without appliances and provided by general practitioners. There was a generous attitude of consultation with specialists and of providing treatment. The sparsity of specialist resources had in an urban area (county A) resulted in a greater restriction on providing treatments. The treatments were performed in a higher age and were, to a greater extent, not completed by the age of 19, and a smaller percentage of individuals were treated than in the other two counties. The care in a large rural area (county W) with long distances to the only specialist clinic was based on treatments provided by general practitioners. In spite of the few specialist resources there was a generous attitude of providing treatments. Interceptive methods were used to a great extent, and later completed with appliance therapy. According to a treatment priority index 44% of the untreated individuals in the three counties had malocclusions and an objective treatment need, and there were no significant differences between the counties. Regardless of differences in specialist resources and structure of the free public orthodontic care, a substantial and equal proportion of the untreated individuals in the counties had malocclusions with treatment need, but they had no treatment desire.

Adolescent↗
PubMed1996

Minor surgery and resources at small clinics in rural Kenya.

The output of minor surgery at 36 government and 49 non-government clinics in a rural Kenyan district was recorded over a period of one year and then compared with the surgery-related resources (equipment, supplies and trained staff) at the same clinics. The mean monthly numbers of operations varied between 2.8 and 7.0 at different resource levels, but we found no association between the surgical operation output of each clinic and its total surgery-related resources. When examining the resource components separately, we found a weak positive association between output and the presence of equipment but no association between output and supplies or trained staff. Other factors than resources, such as the quality of basic training or the preferences of individual health workers, may explain the large surgical output variations between clinics. They should be explored through further studies.

Efficiency, Organizational↗
PubMed1996

[Daily survey of procedures as markers of resources utilization].

OBJECTIVE: To assess and to follow along the time-span of ICU stay the process of resources allocation and utilization. DESIGN: Prospective study. PATIENTS: A cohort of 778 patients consecutively admitted to 7 multipurpose general ICU in the Milano area were enrolled in a survey of the daily performed interventions/procedures. MEASUREMENTS AND MAIN RESULTS: The majority of diagnostic procedure/interventions were performed during the first two days. The number and quality of interventions were transferred into points obtaining a score system in non-monetary units. The resource allocation process shows a regular trend in the sub-intensive patients who were only monitorized. On the contrary the 258 patients who were intensively treated and survived show a phase of high resource-consumption (about 30 daily points: roughly twice the score of monitorized patients) then followed by a post-intensive phase with a resource consumption resulting in a daily score absolutely equal to the sub-intensive patients. The intensive patients who die show a significantly higher score than survived patients. Both daily and cumulative scores do not show differences among different type of patients. CONCLUSION: The evaluation of the process of resources allocation, even if in non-monetary units enables the knowledge of the trend of ICU costs and allows the elaboration of the appropriate budget mechanism.

Cohort Studies↗
PubMed1998

An organizational field approach to resource environments in healthcare: comparing entries of hospitals and home health agencies in the San Francisco Bay region.

OBJECTIVE: To draw together insights from three perspectives (health economics, organizational ecology, and institutional theory) in order to clarify the factors that influence entries of providers into healthcare markets. A model centered on the concept of an organizational field is advanced as the level of analysis best suited to examining the assortment and interdependence of organizational populations and the institutional forces that shape this co-evolution. In particular, the model argues that: (1) different populations of healthcare providers partition fiscal, geographic, and demographic resource environments in order to ameliorate competition and introduce service complementarities; and (2) competitive barriers to entry within populations of providers vary systematically with regulatory regimens. DATA SOURCES: County-level entries of hospitals and home health agencies in the San Francisco Bay Area using data from the American Hospital Association (1945-1991) and California's Office of Statewide Health Planning and Development (1976-1991). Characteristics of the resource environment are derived from the Area Resource File (ARF) and selected government censuses. METHODS OF ANALYSIS: A comparative design is applied to contrast influences on hospital and home health agency entries during the post-World War II period. Empirical estimates are obtained using Poisson and negative binomial regression models. RESULTS: Hospital and HHA markets are partitioned primarily by the age and education of consumers and, to a lesser extent, by urbanization levels and public funding expenditures. Such resource partitioning allows independent HHAs to exist comfortably in concentrated hospital markets. For both hospitals and HHAs, the barriers to entry once generated by oligopolistic concentration have declined noticeably with the market-oriented reforms of the past 15 years. CONCLUSION: A field-level perspective demonstrates that characteristics of local resource environments interact with interdependencies of provider populations and broader regulatory regimes to affect significantly the types of provider organizations likely to enter a given healthcare market.

Catchment Area, Health↗
PubMed1997

Cost analysis of the basic package, resource utilisation and financing of health services at Halley Stott Health Centre and Umbumbulu Clinic in KwaZulu-Natal.

OBJECTIVES: A cost analysis study compared the package of health services, costs, resource utilisation (drugs and staff) and financing mechanisms at Halley Stott Health Centre and Umbumbulu Clinic with those of other primary care providers in KwaZulu-Natal. Options identified were used to improve efficiency, resource allocations and financing of health services in KwaZulu-Natal. DESIGN/OUTCOME MEASURES: The direct accounting method was used to calculate unit costs for the following cost centres--paediatrics and adult curative consultations, antenatal/postnatal care, family planning, the under-5s clinic and the mobile services. Staff efficiency was assessed using the Centre for Health Policy method based on workload estimates, while the International Network for the Rational Use of Drugs indicators were used to assess the efficiency of drug usage. RESULTS: There was considerable variation in the package of services provided at all the health facilities; the average costs ranged from R5.94 to R134.76 and the unit costs ranged from R29.30 to R161.92 for curative care. The bulk of the resources (64-73%) were spent on personnel costs, providing mainly curative care. Under-utilisation of antenatal care, the under-5s clinic and paediatric consultations were reflected in reduced time utilisation and lower levels of staff efficiency, while family planning services were over-utilised, which reflected a relative staff shortage. The components of health services provided at the two health facilities exceeded those recommended by the World Bank. CONCLUSIONS: Cost analysis has the potential to quantify staff and drug efficiency, facilitate resource allocation and improve health service efficiency. Defining the package of health services for each province contributes to the development of the nationally agreed basic package of health services, and enables managers and policy-makers to choose different options rationally, control costs, shift resources and achieve equity.

Community Health Centers↗
PubMed1998

[Is severity related to the utilization of resources? An exploration of the Duke Severity of Illness Scale (DUSOI)].

OBJECTIVE: To measure the distribution of the seriousness of illnesses and patients in primary care with the Duke Severity of Illness Scale (DUSOI) and relate it to resource use. DESIGN: Observational prospective study. SETTING: Eight primary care centres from the centre sub-section of the Catalan Health Service. PATIENTS AND OTHER PARTICIPANTS: For the first two months of the study, patients who attended for consultation at 9 general/family doctors' clinics were systematically sampled. 1,868 patients were selected and observed for 6 months. MEASUREMENTS AND MAIN RESULTS: The DUSOI was used to work out the seriousness of the illness and of the patient. The variables used as indicators of the use of resources for an illness were: the number of attendances, the time and costs of care. The same for the patient were: the number of attendances, number of episodes and costs of care. The average score for the seriousness of the episode was 31.4 with a standard deviation (SD) of 16.4. The correlations between use of resources and seriousness were under 0.4. The seriousness of the patient had an average of 44.9 (SD 21.3) and statistically significant correlations above 0.6 with the use of resources. CONCLUSIONS: The seriousness of the illnesses attended in primary care is low and is related moderately to the use of resources. DUSOI could be better employed in research, inasmuch as there are systems for classifying patients which have greater explanatory power and can be constructed from pre-existing data.

Adolescent↗
PubMed2002

The Modular Resource Center: integrated units for the study of the anatomical sciences in a problem-based curriculum.

The Modular Resource Center (MRC) at the College of Veterinary Medicine at Cornell University was created in 1993 as a way to provide visual resources in support of a newly implemented problem-based curriculum in which the anatomical sciences are taught primarily in the first tutorial-based course, The Animal Body. Over two dozen modules have been created specifically in support of this course, whereas additional modules have been created in support of other basic science courses. The basic unit of organization of the MRC is a module presented in a carrel that provides students a way to study, either alone or in groups, a given topic. The topic is presented through a script and an integrated set of anatomical materials including plastinated dissected specimens, vascular casts, skeletal preparations, models, radiographs, histological slides, and photo- and electron micrographs. The key feature of this resource center is that it is not a museum; rather it is more analogous to an interactive library, that can be used for reference, study, and review, not only by veterinary students but also by faculty, interns, residents, and undergraduates. A unique aspect is that all materials have been made by veterinary students working with faculty during the summer. Although started as a resource in support of a tutorial-based curriculum, the MRC has evolved over a decade into an anatomy resource that would be highly valued in any curricular format.

Anatomy↗
PubMed2003

Profile of on-line anatomy information resources: design and instructional implications.

This study is based on a review of 40 on-line anatomy web resources compiled from sites selected from our own searches as well as sites reviewed and published by an external group (Voiglio et al., 1999, Surg. Radiol. Anat. 21:65-68; Frasca et al., 2000, Surg. Radiol. Anat. 22:107-110). The purpose of our survey was to propose criteria by which anatomy educators could judge the characteristics of the currently available web-based resources for incorporation into the courses they teach. Each site was reviewed and scored based on a survey matrix that included four main categories: 1). site background information, 2). content components, 3). interactivity features, and 4). user interface design components. The average score of the reviewed sites was 3.3 of the total possible score of 10, indicating the limited use of computer-based design features by the majority of sites. We found, however, a number of programs in each of the survey categories that could serve as prototypes for designing future on-line anatomy resources. From the survey we conclude that various design features are less important than the comprehensiveness, depth, and logical organization of content. We suggest that the content should be sufficient for supporting explicitly defined educational objectives, which should target specific end-user populations. The majority of anatomy programs currently accessible on-line fall short of these requirements. There is a need for a coordinated and synergistic effort to generate a comprehensive anatomical information resource that is of sufficient quality and depth to support higher levels of learning beyond the memorization of structure names. Such a resource is a prerequisite for meaningful on-line anatomy education.

Anatomy↗
PubMed2004

Use of information resources by patients with cancer and their companions.

BACKGROUND: Use of the Internet is common among patients with cancer and their companions. However, little is known about patterns of use of print or telephone-based resources amidst growing Internet utilization, nor is it known whether different types of information are sought from electronic compared with print media. It is not clear as to whether patients and their companions differ in their patterns of content seeking. METHODS: A survey was developed to evaluate the use of electronic and nonelectronic informational resources by patients and their companions. During a 10-week period, this questionnaire was administered to 443 outpatients and 124 paired companions attending an urban academic cancer center. RESULTS: In this cohort, 64% of patients and 76% of companions were computer owners, with home Internet access indicated by 58% and 68%, respectively. Use of the Internet to obtain cancer-related information was reported by 44% of patients and 60% of companions. Print resources were used by 79% of patients and 83% of companions, with telephone resources used by 22% and 23%, respectively. The majority of Internet users also read print content (85%), whereas one-half of print users did not access data electronically (52%). Topic areas sought via print and the Internet were similar, with the exception of nutrition-related information, which was more commonly sought in print texts. There was a high rate of concordance between patient and companion use of both electronic and nonelectronic resources. CONCLUSIONS: Despite recent publicity and scrutiny focusing on the quality of Internet health care content, print products remain the most common source of information sought by patients with cancer. Future investigation should focus on the quality of print products used by patients.

Adult↗
PubMed2006

El Salvador earthquakes: relationships among acute stress disorder symptoms, depression, traumatic event exposure, and resource loss.

Four and seven weeks after powerful earthquakes in El Salvador, the authors examined the relationships among demographics, traumatic event exposure, social support, resource loss, acute stress disorder (ASD) symptoms, depression, and posttraumatic growth. Participants were 253 college students (Study 1) and 83 people in the community (Study 2). In Study 1, female gender, traumatic event exposure, low social support, and loss of personal characteristic, condition, and energy resources contributed to ASD symptoms and depression. In Study 2, damage to home and loss of personal characteristic and object resources contributed to ASD symptoms and depression. Posttraumatic growth was not associated with ASD symptoms or depression. Findings support the conservation of resources stress theory (Hobfoll, 1998). Resource loss spirals, excessive demands on coping, and exposure to multiple disasters are discussed.

Adult↗
PubMed1997

Psychosocial resources, adolescent risk behaviour and young adult adjustment: is risk taking more dangerous for some than others?

Longitudinal analyses examined the extent to which adolescent alcohol use, illegal drug use, and antisocial behaviour predicted adjustment and risk behaviour during young adulthood, and whether psychosocial resources buffered any impact of risk-taking. American adolescents completed questionnaires in Grade 12 and 2 years later (n = 694). Personal and social resources predicted success in occupational, relational, and health domains. High school risk behaviours predicted decreased success in relational domains, and alcohol use predicted higher educational attainment, independent of the relations with psychosocial resources. Interactions of resources with risk behaviours predicting adjustment were inconsistent, but resources predicted decreased risk behaviours in young adulthood among adolescent risk-takers. Discussion focuses on the value of, and challenges to, research on consequences of adolescent risk taking.

Achievement↗