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At least 865 records · Page 48Linked to original sources
PubMed2002

The comparability of resource utilisation for Europeans and non-Europeans following stroke in New Zealand.

AIMS: We sought to explore resource use both in hospital and the community twelve months after hospital discharge for patients of different ethnicity admitted to hospital with acute stroke. METHODS: Resource utilisation data were collected for consecutive patients admitted to each of three general hospitals in the Wellington region over a nine month period. Patients were interviewed, where possible, at three, six and twelve months after hospital discharge. Ethnicity was determined by self report. RESULTS: Non-Europeans had longer hospital stays than Europeans (median 36 days vs 18 days, p = 0.01). Contact with rehabilitation professionals in the community was low for all groups with no significant differences between Europeans and non-Europeans. For the entire cohort, spending on institutional care was around ten times higher than spending on community rehabilitation in the first twelve months following stroke. CONCLUSIONS: Differences in hospital stay after stroke may reflect problems of access to inpatient rehabilitation services for younger people and not relate directly to the ethnicity of the patient. With the projected increasing proportion of Maori and Pacific people in the population, combined with the aging of that population, health policy-makers need to consider the implications of differences in resource utilisation for different ethnic groups in New Zealand. How to manage all the available resources for people with stroke to maximise outcome remains an important issue for health funders.

Cohort Studies↗
PubMed2002

Using technology to reduce maternal mortality in low-resource settings: challenges and opportunities.

Technology--consisting of equipment, supplies, procedures, and techniques--can play a central role in the management of pregnancy-related complications. Implementing proven interventions in developing countries and low-resource settings has been difficult, however, because skilled human and financial resources are constrained, and the physical and epidemiological environments are challenging. This article examines the limitations and challenges affecting health technologies in low-resource settings and suggests a framework for characterizing specific technology-based solutions. It also provides examples of pregnancy-related problems in which the introduction of new or modified technologies (drugs for prevention and management of postpartum hemorrhage, infection treatment, manual vacuum aspiration, preeclampsia detection and eclampsia management, partograms, and vacuum extraction) could help save women's lives. The authors call for a more complete assessment of the technology needs associated with pregnancy-related problems in low-resource settings, including evaluating alternative technology-based possibilities, carefully synthesizing and disseminating existing information, and characterizing the nature of current challenges. When accompanied by appropriate provider knowledge and skills, practice guidelines, financing and distribution systems, and community support, technology-based solutions can contribute to a significant reduction in maternal morbidity and mortality around the world.

Developing Countries↗
PubMed2002

[Dialogues on risks and health resources in general practice].

The healing and preventive forces related to individuals' health resources and self-assessed knowledge have hitherto been underestimated in medicine. In this article, we draw attention to ethical and epistemological challenges in relation to values, communication, knowledge, and autonomy that are embedded in the prevailing risk-oriented epidemiology. We have developed a theoretical model for a patient-centered, salutogenetic approach with the aim of a better balance between health resources and risk factors. We briefly present results of dialogues in the general practice consultation based on key questions about self-assessed health resources. We discuss pitfalls related to causality, group-based probabilities, medicalization, and informed consent, focusing on the clinical encounter with the individual patient. By introducing a salutogenetic perspective, we hope to shift attention towards the patient's resources and strengths. Communication can mediate oppression as well as empowerment.

Communication↗
PubMed2001

[Studies on investigation and utilization of medicinal plant resources for sustainable development in Guizhou, China].

OBJECTIVE: To gain a clear idea of the resources of medicinal plants and their pharmaceutical identification in Guizhou, China, and to conserve, develop, and uilize them effectively. METHOD: Investigation on the spot with a statistical analysis. The technical route is "Investigation and identification-->Conservation and development-->Method, technology and ways for protection, propagation and utilization-->GAP cultivated pilot and assessment of medicinal materials and their products-->Comprehensive evaluation and results". RESULT: According to the incomplete statistics, there are 3924 varieties of medicinal materials from plants, accounting for 91.47% of the total in Guizhou. Among them there are 275 families, 1384 genera and 2987 species of vascular bundle plants, accounting for 43.1% of all species. There are 200 species of pteridophyta and 2802 spermatophyta. CONCLUSION: Investigation of wild medicine species has been proceeded, as well as introduction and research of their propagation techniques and production. Guizhou is rich in medicinal plant resources. However, their species and population are reducing progressively. Effective measures must be taken to protect the germ plasma resources and put them into rational uses for the utilization and sustainable development. Rare and endemic medicine species must be introduced for conservation, propagation and realization of GAP pilot cultivation. Resources must be used in an economical way and products must be made with a high technological content.

China↗
PubMed2003

Internet health resources: from quality to trust.

OBJECTIVES: Quality of online health resources remains a much debated topic, despite considerable international efforts. The lack of a systematic and comprehensive conceptual analysis is hindering further progress. Therefore we aim at clarifying the origins, nature and interrelations of pertinent concepts. Further, we claim that quality is neither a necessary nor a sufficient condition for Internet health resources to produce an effect offline. As users' trust is also required, we examine the relation of quality aspects to trust building online. METHODS: We reviewed and analyzed the key documentation and deliverables of quality initiatives, as well as relevant scientific publications. Using the insights of philosophy, we identified the elementary dimensions which underlie the key concepts and theories presented so far in the context of online health information quality. We examined the interrelations of various perspectives and explored how trust as a phenomenon relates to these dimensions of quality. RESULTS: Various aspects associated with the quality of online health resources originate from four conceptual dimensions: epistemic, ethical, economic and technological. We propose a conceptual framework that incorporates all these perspectives. We argue that total quality exists only if all four dimensions have been addressed adequately and that high total quality is conducive to warranted trust. CONCLUSIONS: Quality and trust are intertwined, but distinct concepts, and their relation is not always straightforward. Ideally, trust should track quality. Apprehending the composition of these concepts will help to understand and guide the behavior of both users and providers of online information, as well as to foster warranted trust in online resources. The framework we propose provides a conceptual starting point for further deliberations and empirical work.

Europe↗
PubMed2002

Dynamic resource allocation for epidemic control in multiple populations.

We develop a dynamic resource allocation model in which a limited budget for epidemic control is allocated over multiple time periods to interventions that affect multiple populations. For certain special cases with two time periods, multiple independent populations, and a linear relationship between investment in a prevention programme and the resulting change in risky behaviour, we demonstrate that the optimal solution involves investing in each period as much as possible in some of the populations and nothing in all the other populations. We present heuristic algorithms for solving the general problem, and present numerical results. Our computational analyses suggest that good allocations can be made based on some fairly simple heuristics. Our analyses also suggest that allowing for some reallocation of resources over the time horizon of the problem, rather than allocating resources just once at the beginning of the time horizon, can lead to significant increases in health benefits. Allowing for reallocation of funds may generate more health benefits than use of a sophisticated model for one-time allocation of resources.

Communicable Disease Control↗
PubMedDate not supplied

[Resource-oriented child therapy].

In relation to current American approaches on the development of a positive psychology, positive psychological assessment and positive therapy different strategies of a resource-oriented child therapy are introduced, which are based on multimodal resource assessment, and which shall effectively complement treatments of disorders. It is distinguished between a therapeutical focussing on personal or environmental client resources, although these forms of treatment are often combined in practice. By examples from child therapeutic practice different possible applications of resource-centered treatments are presented.

Adolescent↗
PubMed2003

[Present utilization situation of main fishery resources in Zhoushan fishing ground].

Based on principal component analysis, the present utilization situation of main fishery resources in Zhoushan fishing ground were studied. The results showed that the nine main fishery resources in Zhoushan Fishing Ground could be divided into four categories, i.e., Pseudosciaena crocea and Sepiella maindroni rochebrune were at the degenerating stage; Trichiurus haumela, Pneumatophorus japonicus and Decapterus maruadsi at the fully-utilized stage; Muraenesox cinereus, Pseudosciaena polyactis and Pampus at the partly-used stage and shrimps and crabs were at the initially-used stage. Therefore, it will be of key importance for the sustainability of fishery resources to utilize the current fishery resources at a reasonable way.

Animals↗
PubMed2003

[Construction and evaluation of indicator system for sustainable use of fishery resources in Zhoushan fishing ground].

In order to assess the sustainable use level of fisheries resources, Zhoushan Fishing Ground was selected as a demonstration. Based on 24 indicators related to the resource-environment subsystem and economic subsystem, principal component analysis was employed to analyze the indicator system in each subsystem, and grey relative relationship analysis was computed as a indicator to evaluate the sustainable use level of fisheries resources. The results indicated that the sustainable use of fisheries resources was at a lower level before 1962, and gradually rose to the top in 1974. It has sharply declined since 1978, and dropped to almost the lowest level in 1983, being 51.72% of 1974.

Animals↗
PubMed2003

Challenges for the management of hypertension in low-resource settings.

Cardiovascular diseases (CVD) account for one third of the global mortality and one tenth of the global disease burden; however, if rates of hypertension, a cardiovascular risk factor, were controlled, the reduction of the CVD burden would follow. One of the major constraints for controlling hypertension is the limitation of resources for health care, particularly in low- and middle-income countries, which contribute to 80% of the global CVD burden. Hence, it is vital to use the scarce resources with maximum efficiency. In this context, it is important to note that the benefits and cost-effectiveness of managing hypertension are determined by the overall risk of CVD and not by blood pressure level alone. Using this concept demands a paradigm shift from a "single risk" factor to an "absolute risk" approach. Unfortunately, the weak infrastructure of low-resource settings does not allow cardiovascular risk assessment using such variables as blood lipid measurements for risk stratification. Feasible risk assessment methods are needed and should use simple variables such as age, sex, smoking habits, history of premature cardiovascular disease in the family, and rates of diabetes and hypertension. To meet this need, a pragmatic CVD-Risk Management package has been developed by the World Health Organization (WHO) to facilitate cardiovascular risk assessment and management in low-resource settings. Cost-effective healthcare interventions to reduce the cardiovascular burden can only be implemented if the health services policy environment and financing enable implementation. The success of this approach will also depend on the capacity of primary heathcare systems to deliver these interventions and serve the long-term needs of high-risk CVD patients. For many countries, the individual management of large numbers of patients with low CVD risk will not be affordable. Yet, individuals at low risk, and not those at high risk, account for a greater share of the overall disease burden. Therefore, we must shift the distribution of CVD through population-wide strategies that address all major CVD risk factors, including hypertension.

Adult↗
PubMed2004

Distribution of NHS resources for children's dental care in general dental practice in England.

OBJECTIVE: To determine the relationship between the distribution of NHS resources in general dental practice and dental need and access to services for the population in England under the age of 18 in different socio-economic areas. BASIC RESEARCH DESIGN: A proxy for the oral health of under 18 year olds was made from prevalence surveys undertaken on five year old children in each health authority area in 1999/2000. The level of spending per head of the population was ascertained from Dental Practice Board data. Health authorities were grouped according to the eleven United Kingdom Office of National Statistics socio-economic groups. Access was measured by using registration levels of children. SETTING: General dental practices providing National Health Service treatment for children aged 0-18 in England. RESULTS: There was no correlation (r = -0.03) between increasing need for dental care using mean dmft as a proxy and increasing spending per head of the population for each health authority. There was a correlation (r = 0.38) between increasing registration rates and increased spending per head. The populations under 18 had more spent on their oral health care living in areas classified as Mixed Economies, Services and Education and Most Prosperous. Those in Inner London, Manufacturing, Ports and Industry had proportionately the least. The difference between the highest and lowest group was 33%. The groups of Authorities were not homogenous in their level of resources with variations between Authorities in the same groups. CONCLUSIONS: The distribution of NHS resources to general dental practice for people under 18 does not reflect population need. The higher the registration rate for children the greater the amount resources deployed in an area.

Adolescent↗
PubMed2005

[Resources utilization of main tree populations in Pinus armandii mixed forest after controlled burning and aerial-sowing afforestation].

In Hongchiba region of Wuxi County, the controlled burning and aerial sowing in 1972 rehabilitated degraded forest vegetations, and various types of Pinus armandii mixed communities were formed. By employing Petraitis' general and specific overlap indices, this paper analyzed the resources utilization of 10 main tree populations in Pinus armandii mixed forest. The results showed that Pinus armandii and most native trees had a wide niche breadth, and the interspecies general overlap value was 0.728, indicating that there was a fully and effective habitat resources utilization in the communities. The interspecies specific overlap value of Pinus armandii overlapping other native trees was very low, while that of native trees overlapping Pinus armandii was quite high, which demonstrated that the resources utilization and competition capability of Pinus armandii were weaker than those of native trees, and Pinus armandii population was at its inferior state during the process of their competitions. The interspecies specific overlap value between native trees was very low, generally because of their sound niche differentiation on resources utilization. As a result, the niche characteristics of native trees should be regarded as a favorable sample for the application of ecological rehabilitation and reconstruction. The advantages and disadvantages of Petraitis' overlap indices were discussed in this paper preliminarily.

Conservation of Natural Resources↗
PubMed2005

Advances in the prevention of mother-to-child transmission of HIV-1 infection in resource-limited settings.

Ten years after the first trials demonstrating the efficacy of zidovudine (ZDV) for the prevention of mother-to-child transmission (pMTCT) of HIV, different antiretroviral approaches have been validated in resource-limited settings. Remarkable progress has been made in the last 4 years, with trials demonstrating the efficacy of postexposure antiretroviral prophylaxis in Malawi, as well as studies in Thailand and Côte d'Ivoire assessing the efficacy and viral resistance patterns of short-course regimens combining ZDV plus single-dose nevirapine (sdNVP). The field efficacy of a short course of ZDV plus lamivudine (3TC), together with sdNVP, has also been recently reported, with 6-week transmission rates below 5% for the first time in Africa in a population in which 40% breast-feed. The introduction of HAART for pregnant women has begun on a small scale in resource-limited settings and will hopefully further reduce transmission. What remains is the crucial issue of viral resistance after antiretroviral therapy for pMTCT, especially in the context of the growing availability and use of sdNVP in national pMTCT programs. Preliminary data from South Africa and Côte d'Ivoire suggest that the maternal use of ZDV plus 3TC for at least 3 days postpartum may reduce the occurrence of resistance mutations after maternal exposure to sdNVP. In the context of increasing controversy surrounding the use of sdNVP for pMTCT, the World Health Organization has recently reiterate its recommendations for its use for pMTCT in resource-constrained settings within a wide panel of antiretroviral regimens, in order to allow greater and quicker population coverage. The field application of pMTCT study results is a real challenge, and innovative approaches need to be designed an evaluated ot increase uptake of pMTCT programs in resource-poor settings. Research must continue to identify new interventions and new antiretroviral drugs for pMTCT.

Developing Countries↗
PubMed2005

[The sustainable development framework of national Chinese medicine resources].

The sustainable development of Chinese medicines resources is a key point for the modernization of traditional Chinese medicine. This paper put forward the concept, main tasks and characteristics on the sustainable development of Chinese medicine resources, and analyses the current situation and problems in China. It has explained the basic principle and the sustainable development framework of Chinese medicines resources. The framework consisted of 4 parts: the research system, protection and control system, evaluation index system and development system. It provided external scientific standard for the research of the sustainable development on Chinese medicine resources.

China↗
PubMed2006

A systematic review of culturally sensitive cancer prevention resources for ethnic minorities.

BACKGROUND: Cancer prevention educational resources intended for members of ethnically diverse populations should be tailored to the specific cancer knowledge and beliefs of individual ethnic groups. Culturally sensitive printed materials on cancer prevention have been proposed in the literature. OBJECTIVES: 1) To explore definitions of the term cultural sensitivity (CS) and their application to the development and testing of cancer prevention education materials for ethnic minority groups; and 2) to assess the use of instruments or scales used to measure the CS of cancer information resources. DESIGN: A list of articles explicitly on the CS of cancer prevention education materials was assembled by searching the databases of PubMed, CancerLit, PsycINFO, and Sociological Abstracts for articles published between 1994-2004. RESULTS: Ten studies that met inclusion criteria were included in this review. Most articles included breast cancer resources (90%) and targeted African American populations (70%). Few studies defined the term CS (n=4). Only three studies employed instruments to evaluate the CS of printed cancer information resources, and none of them explicitly listed standard measures of validity or reliability. CONCLUSIONS: Best practice definitions and guidelines for culturally sensitive cancer prevention education need to be established. Ethnic minority individuals' cancer-related knowledge and beliefs must be incorporated into all printed cancer education efforts.

Clinical Trials as Topic↗
PubMed1989

Hospital costs, resource characteristics, and the dynamics of death for hospitalized patients in cardiology Diagnosis-Related Groups.

A number of complex health policy questions face the nation regarding the Diagnosis-Related Group (DRG) prospective hospital payment system. An ongoing debate ensues at the federal level of the utility of improving the DRG system, given the "budget neutrality" provision of the DRG law. We analyzed hospital resource consumption for 5809 cardiology inpatients by outcome (i.e., survival vs death). Hospital resource use was greater and financial risk under DRG pricing schemes was substantial for the 312 deaths compared with the 5497 survivors. Only cases in which the patient died within 1 week of admission to the hospital were profitable under DRGs. A long hospital length of stay for patients who eventually died was very unprofitable (those who died after more than a 60-day hospital length of stay generated a $24,688 loss per patient). Patients who died after emergency admission tended to have a similar hospital length of stay and to be similar financial risk under DRGs, compared with nonemergency patients who died. Those patients who had been referred from other clinical services and who died caused greater resource use and financial risk under DRGs, compared with patients who were not referred and who died. These data suggest significant inequities in the current DRG prospective payment system for patients in cardiology DRGs who die. Variables predictive of greater hospital resource use for cardiology patients who die include longer hospital lengths of stay and referral from another clinical service. Health policy leaders should attempt to improve the equity of cardiology DRGs regarding outcome in the future.

Aged↗
PubMed1989

Differences in inpatient resource use by type of health plan.

Approximately 50% of the annual increase in hospital costs comes from increased resource use per hospital admission. Health maintenance organizations (HMOs), given their fixed financial resources for patient care, have an incentive to constrain their enrollees' use of hospital resources. Our analysis investigates differences in length of stay, total charges, and the ancillary to total charge ratio for hospitalized patients in network HMOs, independent practice associations (IPAs), and fee-for-service (FFS) health plans in the Twin Cities from 1982 to 1984. Network HMO patients in several diagnostic categories are found to use significantly fewer resources, once hospitalized, than patients in either IPA or FFS plans. This difference may give network HMOs a competitive advantage in the market for health plans.

Group Practice↗
PubMed1985

[Various problems in the utilization of resources of occupational health services].

A theoretical starting point of the analysis is a hypothesis of the decreased use of OIHS's resources. This hypothesis is being verified in relation to 39 OIHCSes. The data specyifying the magnitude of resources-confined to the paid time of physicians' work--and their use comes from Lp-8 cards collected and processed at the Institute of Occupational Medicine, Lódź. The results confirmed the hypothesis in relation to all forms of services except those rendered by specialist physicians and--preventive examinations rendered by physicians of gynaecological dispensaries and industrial physicians of local out-patient departments. The least effective use of resources is that of the dental care and--of therapeutic activities carried on by other physicians. The conclusions emphasize the tentative nature of analysis, resulting from the confinement of the notion of effective use of resources to that related to the physicians' working time.

Health Resources↗