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At least 775 records · Page 43Linked to original sources
PubMed2005

Cochlear implant complications: utility of federal database in systematic analysis.

OBJECTIVES: To explore the suitability of the Manufacturer User Facility and Distributor Experience (MAUDE) database (which is maintained by the Food and Drug Administration and has a mandatory reporting requirement) for systemic analysis of cochlear implant complications and treatments and, in so doing, analyze trends in cochlear implant complications for 2 periods, 2002 and pre-1998. DATA SOURCES: All events from 2002 and from before 1998 were considered. Events and action taken were categorized and tabulated. DATA SYNTHESIS: Because there was no null hypothesis, statistical analysis (chi2) was only used in comparing the 2 time frames. CONCLUSIONS: Structural limitations of the database, in addition to disparate reporting quality, made systematic analysis difficult. It was noted that spontaneous device failure accounted for the greatest single number of adverse events for both 2002 and the pre-1998 period (267/654 [41%] and 74/129 [57%], respectively), confirming earlier studies. A statistically significant decrease in spontaneous device failure and a significant increase in infections from the pre-1998 period to 2002 was observed. Flap problems ranging from extrusion to infection that required explantation were less frequently reimplanted than other problems requiring explantation, such as device failure or trauma. We considered new directions, including close collaboration with the new MedSun reporting system and conclude that while a valuable resource for narrative data, the current structure of the MAUDE database is only modestly useful for analyzing trends in complications and cannot answer several crucial questions, including device type comparisons. We suggest changing the current report format to include patient age, duration of implant, presence of anatomical abnormalities, and details on spontaneous device failures.

Cochlear Implantation↗
PubMed2004

A study of acute rehabilitation after head injury.

In 1999 a report from the Royal College of Surgeons of England drew attention to the fact that, in the UK, there is little structured acute inpatient rehabilitation for patients admitted after traumatic brain injury (TBI). This paper reports the results of a retrospective study of acute inpatient rehabilitation (AR) after TBI, comparing aspects of resource use in 92 patients who received structured unit-based multidisciplinary AR with 97 patients who received usual practice. About 10% of patients admitted via casualty after TBI required AR after neurosurgical consultation or care. These patients remained in AR for a mean of 20.5 days; length of stay in an acute bed was not prolonged compared with patients in usual practice. Sixty per cent of patients discharged home from unit-based care were referred to community-based rehabilitation on discharge compared with no patients discharged home from neurosurgical care. There is an urgent need to discuss and plan at national level the structured secondary provision of acute rehabilitation after acquired brain injury.

Adult↗
PubMedDate not supplied

[Development of ambulatory surgery. An irreversible perspective].

Whatever the social security system, the burden of health care costs is rising at an intolerable rate. It is however unacceptable to complain about a lack of resoures as long as the resources which are available are not used responsibly. Thanks to new technologies and drugs, ambulatory surgery, with its own adapted structures, can help to ensure responsible use of resources and satisfy patients, surgeons and allied health workers. Ambulatory surgery is currently expanding, especially in the U.S. (1990), where over 17 million operations are performed in an ambulatory mode, i.e. over 50% of all surgery. Hospitalization is avoided or shortened to a few hours whenever possible. Many uncomplicated surgical procedures, which are traditionally performed on an impatient basis under general anesthesia, are just as effectively and safely performed without admission to hospital.

Ambulatory Surgical Procedures↗
PubMed1999

[Impact of various strategies on the rates of flu vaccination in the elderly].

OBJECTIVE: To calculate the impact of different interventions on the rates of anti-flu vaccination in people aged 65 and over. DESIGN: Ecological study with analytical components. SETTING: Health centres and clinics in two health areas in the Community of Valencia. PATIENTS AND OTHER PARTICIPANTS: Care units, characterised by their coverage of stable nuclei of 500 or more people, total population of 415,172 inhabitants. INTERVENTIONS: Use of the communication media, personal invitations by post and telephone; follow-up of activity, discussion of results, external evaluations; registration of people to be vaccinated and prior order to nursing staff to vaccinate. MEASUREMENTS AND MAIN RESULTS: The coverage in quartiles of the previous season and the human resources per thousand inhabitants were the structural factors which best explained the vaccination rates. In the multivariate analysis, invitation by letter had relative risk (RR) of 1.062 (95% CI, 1.036-1.088); telephone call, RR 1.075 (95% CI, 1.021-1.132); discussion of external evaluations, RR 1.046 (95% CI, 1.024-1.068); and the order of vaccination to nursing staff, RR 1.056 (95% CI, 1.025-1.088). All these were associated with greater coverage. The absolute difference in coverage achieved between the care units which invited people to be vaccinated by letter and phone, at which nurses vaccinated directly, and which discussed external evaluations, and the units which did not perform these above activities, was 14 points (95% CI, 13.3-14.5), independently of the other factors. CONCLUSIONS: The previous year's coverage, human resources, invitation by letter or phone, the order to nursing to vaccinate and the discussion of external evaluations, were all associated, independently, with higher rates of vaccination.

Aged↗
PubMed2002

A framework for institutionalizing quality assurance.

OBJECTIVE: To develop a framework to support the institutionalization of quality assurance (QA). DESIGN: The framework for institutionalizing QA consists of a model of eight essential elements and a 'roadmap' for the process of institutionalization. The essential elements are the building blocks required for implementing and sustaining QA activities. Core QA activities include defining, measuring and improving quality. The essential elements are grouped under three categories: the internal enabling environment (internal to the organization or system), organizing for quality, and support functions. The enabling environment contains the essential elements of leadership, policy, core values, and resources. Organizing for quality includes the structure for implementing QA. Three essential elements are primarily support functions: capacity building, communication and information, and rewarding quality. The model can be applied at the level of an organization or a system. The paper also describes the process of institutionalizing QA, starting from a state of preawareness, passing through four phases (awareness, experiential, expansion, and consolidation), and culminating in a state of maturity. The process is not linear; an organization may regress, vacillate between phases, or even remain stagnant. Some phases (e.g. awareness and experiential) may occur simultaneously. CONCLUSION: The framework has been introduced in nearly a dozen countries in Latin America and Africa. The conceptual model has been used to support strategic planning and directing Ministry of Health work plans, and also as a resource for determining the elements necessary to strengthen and sustain QA. The next step will be the development and evaluation of an assessment tool to monitor developmental progress in the institutionalization of QA.

Decision Making, Organizational↗
PubMed2004

Chronic diseases and depression: the modifying role of psychosocial resources.

Psychosocial coping resources have been found to protect against depressive symptoms in people with and without chronic diseases. It has not been established, however, whether these resources have the same effects across patients with different diseases. Therefore, the aim of the study was to estimate the direct and buffer effects of psychosocial resources on depression, and to examine whether these effects are different for various chronic diseases. Data were obtained from the Longitudinal Aging Study Amsterdam. In all, 2288 community-dwelling respondents (age 55-85) were included and followed for a maximum of 6 years. Depressive symptoms (using the Center for Epidemiologic Studies-Depression scale), the presence of seven frequently occurring chronic diseases, social support and personal coping resources, physical functioning and sociodemographic variables were assessed by structured interviews. Generalized estimating equation models were estimated for each disease, social support and personal coping resources. All resources, except social network size, showed a direct effect on depressive symptoms regardless of the presence of chronic diseases. Having a partner, high self-esteem, mastery, self-efficacy and feeling less lonely additionally buffered the negative effect of some, but not all, specific chronic diseases. Unexpectedly, in patients with cardiac disease, none of the psychosocial resources exerted a buffer effect on depressive symptoms. For instrumental and emotional support only direct (unfavorable) effects and no buffer effects could be observed. In conclusion, our study provides evidence that buffer effects of psychosocial resources are different across various chronic diseases. This suggests that interventions to enhance specific resources may ameliorate depressive symptoms in specific chronic patients groups.

Adaptation, Psychological↗
PubMed1997

Water Resource Protection in Taiwan: An Evaluation of the Taipei Water Management Commission

/ This study evaluates the institutional capacity and performance of the Taipei Water Management Commission. The commission, which manages the Taipei Water Special Area-one of 95 such areas in Taiwan and the only one managed by a supervisory agency-has established a record of water conservation that suggests its utility as a model for managing other protected water resources areas in Taiwan. However, its present institutional structure limits its ability deliver on its mandate. The study identifies a number of problems related to the commission's current institutional structure that need to be addressed if the commission is to serve as a viable model for managing other protected water resource areas in Taiwan.KEY WORDS: Water resources management; Commissions; Institutional capacity; Taiwan

Journal Article↗
PubMed1999

Resource loss, resource gain, and depressive symptoms: a 10-year model.

This study examined a broadened conceptualization of the stress and coping process that incorporated a more dynamic approach to understanding the role of psychosocial resources in 326 adults studied over a 10-year period. Resource loss across 10 years was significantly associated with an increase in depressive symptoms, whereas resource gain across 10 years was significantly associated with a decrease in depressive symptoms. In addition, change in the preponderance of negative over positive events across 10 years was inversely associated with change in resources during the period. Finally, in an integrative structural equation model, the association between change in life events and depressive symptoms at follow-up was completely mediated through resource change.

Adaptation, Psychological↗
PubMed2002

[Using network planning techniques for work flow analysis in a clinical environment].

In the face of increasing financial pressure on our health care system, one way to reduce costs while maintaining or even improving outcome quality is to improve work flow efficiency. Network Planning Technique (NPT) is a tool for mapping and analyzing work flows. Designing a network plan requires four steps. Step 1 is concerned with the determination of the work flow structure. Step 2 deals with data acquisition. Based on the data retrieved a network plan is created in Step 3. Step 4 includes the calculation of the critical path and slack times under optimistic, realistic and pessimistic conditions. Applied to the ultrasound division in our department a total examination time of 34:14 minutes was calculated with 23:09 minutes total slack time for the technician under realistic conditions. Using NPT creates transparency in work flows and allows us to estimate resource demands. A comparison between two different divisions with a similar work flow structure but different resource allocation demonstrates this method's potential for improving work flows. Limitations of the NPT can be noted when considering cycle overlap in repetitive work flows and modeling non-regular activities.

Diagnosis-Related Groups↗
PubMed2026

Programmatic access to ICTV virus taxonomy through a public ontology API.

The International Committee on Taxonomy of Viruses (ICTV) is responsible for developing and maintaining a universal virus taxonomy. As the reference framework for organising the viral world, it is essential for virology and related fields. Despite its widespread use in research and public health, programmatic access to ICTV taxonomy has remained limited, posing challenges for integration, versioning, and interoperability across databases and bioinformatics resources requiring up-to-date virus taxonomy. To address this, we developed a public and sustainable solution leveraging ontology-based APIs. Successive ICTV Master Species List (MSL) releases were transformed into a structured ontology and deployed as a unified representation through the Ontology Lookup Service (OLS). The framework also provides ICTV-NCBI mappings and helper libraries for integration into downstream systems. This enables, for the first time, public programmatic retrieval of current and historical virological taxon names, taxonomic relationships, metadata, and persistent identifiers through stable endpoints. More broadly, this work illustrates a general strategy for transforming structured biological datasets into semantically enriched graph resources exposed through scalable public APIs. These developments enhance interoperability, reduce manual curation, and support FAIR-aligned taxonomic data management in virology and pandemic preparedness.

API↗
PubMed2006

The Histone Database: a comprehensive resource for histones and histone fold-containing proteins.

The Histone Database is a curated and searchable collection of full-length sequences and structures of histones and nonhistone proteins containing histone-like folds, compiled from major public databases. Several new histone fold-containing proteins have been identified, including the huntingtin-interacting protein HYPM. Additionally, based on the recent crystal structure of the Son of Sevenless protein, an interpretation of the sequence analysis of the histone fold domain is presented. The database contains an updated collection of multiple sequence alignments for the four core histones (H2A, H2B, H3, and H4) and the linker histones (H1/H5) from a total of 975 organisms. The database also contains information on the human histone gene complement and provides links to three-dimensional structures of histone and histone fold-containing proteins. The Histone Database is a comprehensive bioinformatics resource for the study of structure and function of histones and histone fold-containing proteins. The database is available at http://research.nhgri.nih.gov/histones/.

Amino Acid Sequence↗
PubMed2024

Chromosome-scale assembly with improved annotation provides insights into breed-wide genomic structure and diversity in domestic cats.

INTRODUCTION: Comprehensive genomic resources offer insights into biological features, including traits/disease-related genetic loci. The current reference genome assembly for the domestic cat (Felis catus), Felis_Catus_9.0 (felCat9), derived from sequences of the Abyssinian cat, may inadequately represent the general cat population, limiting the extent of deducible genetic variations. OBJECTIVES: The goal was to develop Anicom American Shorthair 1.0 (AnAms1.0), a reference-grade chromosome-scale cat genome assembly. METHODS: In contrast to prior assemblies relying on Abyssinian cat sequences, AnAms1.0 was constructed from the sequences of more popular American Shorthair breed, which is related to more breeds than the Abyssinian cat. By combining advanced genomics technologies, including PacBio long-read sequencing and Hi-C- and optical mapping data-based sequence scaffolding, we compared AnAms1.0 to existing Felidae genome assemblies (20 scaffolds, scaffolds N50 > 150 Mbp). Homology-based and ab initio gene annotation through Iso-Seq and RNA-Seq was used to identify new coding genes and splice variants. RESULTS: AnAms1.0 demonstrated superior contiguity and accuracy than existing Felidae genome assemblies. Using AnAms1.0, we identified over 1.5 thousand structural variants and 29 million repetitions compared to felCat9. Additionally, we identified > 1,600 novel protein-coding genes. Notably, olfactory receptor structural variants and cardiomyopathy-related variants were identified. CONCLUSION: AnAms1.0 facilitates the discovery of novel genes related to normal and disease phenotypes in domestic cats. The analyzed data are publicly accessible on Cats-I (https://cat.annotation.jp/), which we established as a platform for accumulating and sharing genomic resources to discover novel genetic traits and advance veterinary medicine.

Animals↗
PubMed1984

Social networks and social support of primigravida mothers and fathers.

Most researchers have examined the effects of stress and social support on pregnancy outcomes without identifying the relationship between social support and social network factors. While the type and amount of support have been shown to be related to pregnancy outcomes, the sources of that support and the influence of network structure on a person's supportive resources have not been defined. Network factors, in fact, may predict perceived support or may explain more of the variance in pregnancy outcomes than social support does alone. The objectives of this study were to describe the social networks of primigravida women and their husbands; to determine if there are any differences in social networks based on gender, education, or income; and to examine the relationships among network characteristics, demographic characteristics, and perceived availability of support from network members. The 54 couples who composed the sample for this study were recruited through local physicians who provided the names of all clients who were primigravidas, living with the father of the child, and residing within 25 miles of Ann Arbor, Michigan. During the third trimester of pregnancy, couples were interviewed in their homes, and each parent completed a Social Network Inventory (SNI). The SNI obtained information about the size of the network, role relationships, frequency of contact, percent of uniplex relationships, and degree of overlap with spouse's social network. In addition, parents were provided with definitions of each of House's (1981) four types of social support and asked to indicate which forms of support they received from each network member. Both individual variables (age and educational level) and network structure variables (size, percent kin, percent females, frequency, and density) were significantly associated with the amount of perceived social support. For each type of support, the independent variables associated with support were different for men and women.

Adult↗
PubMed1999

Pattern of mutations that results in loss of reduced folate carrier function under antifolate selective pressure augmented by chemical mutagenesis.

Chemical mutagenesis with N-methyl-N-nitrosourea was employed to study the pattern of mutations in the reduced folate carrier (RFC1) that results in transport-related methotrexate resistance and to identify amino acid residues that are critical to carrier structure and/or function. Thirty-four methotrexate transport-defective L1210 leukemia cell lines were isolated with folic acid as the sole folate source under antifolate selective pressure. The RFC1 mRNA levels were comparable with, or not substantially decreased, in most of these cell lines relative to wild-type L1210 cells. The molecular basis for the transport defects was investigated by sequencing multiple RFC1 cDNA clones isolated from these mutants by reverse transcription-polymerase chain reaction, which encompassed the entire coding region. The mutations identified were further confirmed either by direct sequencing or, when applicable, by restriction analysis of total reverse transcription-polymerase chain reaction products. The majority of mutations (21) led to single amino acid substitutions that were in, or near, 9 of 12 predicted transmembrane domains, with the highest frequencies in the first, fifth, and eighth. There were no mutations in the sixth, ninth, and twelfth transmembrane domains. Glycine, serine, and arginine were the most frequently mutated residues. These data suggest that several transmembrane domains, rather than the amino- and carboxyl-termini, and the large intracellular loop between the sixth and seventh transmembrane domains play key roles as sites for RFC1 inactivation because of single point mutations. This panel of mutated cell lines offers an important resource for studies on RFC1 structure-function and for the evaluation of transport-related cross-resistance patterns with new-generation antifolate inhibitors of tetrahydrofolate cofactor-dependent enzymes.

Animals↗
PubMed1992

The untold story: how the health care systems in developing countries contribute to maternal mortality.

This article attempts to put together evidence from maternal mortality studies in developing countries of how an inadequate health care system characterized by misplaced priorities contributes to high maternal mortality rates. Inaccessibility of essential health information to the women most affected, and the physical as well as economic and sociocultural distance separating health services from the vast majority of women, are only part of the problem. Even when the woman reaches a health facility, there are a number of obstacles to her receiving adequate and appropriate care. These are a result of failures in the health services delivery system: the lack of minimal life-saving equipment at the first referral level; the lack of equipment, personnel, and know-how even in referral hospitals; and worst of all, faulty patient management. Prevention of maternal deaths requires fundamental changes not only in resource allocation, but in the very structures of health services delivery. These will have to be fought for as part of a wider struggle for equity and social justice.

Abortion, Legal↗
PubMed1983

The evolution of Japanese management: lessons for U.S. managers.

To find the key to the success of Japanese economic performance since World War II, Marsland and Beer explore five main "environmental" factors used by Japanese firms to build a successful human resources management approach: Japanese social values, the structure of private enterprise, the structure of labor markets, the historic development of the Japanese employment system, and the structure of Japanese management. This discussion shows that post-war Japanese management, faced with rapid change, introduced new concepts and techniques that reinforced and maintained certain social values and traditions that fit well with human resources management objectives. This skillful blend of new ideas with traditional values enabled the Japanese to achieve superior economic performance.

Japan↗
PubMed2000

The CATH Dictionary of Homologous Superfamilies (DHS): a consensus approach for identifying distant structural homologues.

A consensus approach has been developed for identifying distant structural homologues. This is based on the CATH Dictionary of Homologous Superfamilies (DHS), a database of validated multiple structural alignments annotated with consensus functional information for evolutionary protein superfamilies (URL: http://www. biochem.ucl.ac.uk/bsm/dhs). Multiple structural alignments have been generated for 362 well-populated superfamilies in the CATH structural domain database and annotated with secondary structure, physicochemical properties, functional sequence patterns and protein-ligand interaction data. Consensus functional information for each superfamily includes descriptions and keywords extracted from SWISS-PROT and the ENZYME database. The Dictionary provides a powerful resource to validate, examine and visualize key structural and functional features of each homologous superfamily. The value of the DHS, for assessing functional variability and identifying distant evolutionary relationships, is illustrated using the pyridoxal-5'-phosphate (PLP) binding aspartate aminotransferase superfamily. The DHS also provides a tool for examining sequence-structure relationships for proteins within each fold group.

Amino Acid Sequence↗
PubMedDate not supplied

Home health care in the continuum: a review.

An aging population, financial and technical changes, and consumer preference will drive the increase in the types and volume of service clients receive at home. Financial and technical changes will influence the structure of home care services, but home health agencies will continue to partner with primary, acute, and long-term institutional care to provide a continuum of services. However, the health care system will need to allocate sufficient resources to home health if it is to serve an increasing number of more frail and unstable clients. Lacking such resources, home care may not able to contribute appropriately to the continuum of care, and the effectiveness of the overall health care system may be compromised. Challenges to home health agencies' successful operations include decreased resources, changing payment methods, staff shortages, and structural changes in health care systems that fragment care of decrease attention to home health. Home health care's traditional goals of serving clients and caregivers directly and educating them toward health and independence can continue if these problems are resolved.

Aged↗