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PubMed1991

Implementing the Medical Desktop: tools for the integration of independent information resources.

The increasing availability of medical information resources has moved the "Medical Desktop" from a theoretical construct to a practical necessity. Many micro-computers are becoming available in clinical and academic settings that can access several medical information applications. These computers are usually not powerful workstations that are part of a clinically oriented information support system, but are personal computers with varied capabilities. The applications on these computers come from different sources, are accessed through different user interfaces and do not share data well. The de facto "Medical Desktop" this situation presents will discourage most end-users because the combination of applications is complex, the applications are poorly integrated, and individual applications are inconsistent. At the State University of New York at Buffalo School of Medicine and Biomedical Sciences we have developed several Microsoft Windows-based tools that accept a systems level diversity of resources, but work toward the construction of a coherent "Medical Desktop." These tools include a lexical term linker, a resource database, and a context sensitive help system that is tailored to locally available resources.

Databases, Factual↗
PubMedDate not supplied

Creating a resource database for nursing service administration.

In response to the current information explosion in nursing service administration (NSA), the authors felt a need to collect and organize available resources for use by their faculty and graduate students. An electronic database was developed to facilitate the use of the collected print and software resources. This article describes the creation of the NSA Resource Database from the time the need for it was realized to its completion. There is discussion regarding the criteria used for writing the database, what the database screens look like and why and what the database contains. The article also discusses the use and users of the NSA Resource Database to date.

Databases, Bibliographic↗
PubMedDate not supplied

Academic outcomes for students with learning disabilities in consultation and resource programs.

In this study, pretest and posttest achievement test data were collected for 67 children with learning disabilities assigned to one of four conditions: one period of resource room instruction per day; two periods of resource room instruction per day; consultative services combined with in-class instruction; and consultative services to classroom teachers. Analysis of pretest achievement measures indicated that students assigned to two periods of resource room per day differed significantly from the other groups and results from this group were analyzed separately. Students in the remaining three conditions made gains in standing relative to same-age peers from pretest to posttest. Students receiving a combination of consultation and direct services showed small, but significantly greater overall gains in achievement than did students placed in the resource room.

Achievement↗
PubMed1989

[INCAP'S policies and strategies for training and capacitation of human resources in food and nutrition].

The activities of the Institute of Nutrition of Central America and Panama (INCAP), are focused according to the present food and nutrition situation of the Central American and Panamanian population, their conditioning factors and the prevailing political, economical and social context. According to the mandate of its Directing Council, INCAP has developed teaching activities in the field of food and nutrition at the subregional level, as a priority function. This function falls within the initiative of the plan of priority needs in health, promoted by the countries that integrate the Contadora group, the Central American area Governments and PAHO/WHO. The INCAP's human resources policy is centered on formation and training, which are closely linked to aspects such as holistic planning, recruiting, utilization and evaluation of human resources according to guidelines set up by the Central American countries and PAHO/WHO, in regard to the development of human resources in health and allied fields. The document herein discussed responds to the institutional objective of possessing an explicit guide to orient INCAP's technical cooperation in the programmatic area of human resources, pointing out priorities and fundamental aspects really effective in supporting the institutional development of the countries, thus contributing to the improvement of their food and nutrition situation. The experience accumulated by the Institute and the countries, in formation and training activities oriented to benefit the communities have also been considered in the present document. Likewise, strategies that guide the present and future actions according to the reality of the subregion have also been considered.

Academies and Institutes↗
PubMed1989

Hospital costs, resource characteristics, and the dynamics of death for patients with a primary diagnosis of congestive heart failure.

Although substantial changes have been recommended in the diagnosis related group (DRG) prospective hospital payment system related to very expensive care for some patients, no major change in payment for these patients has been implemented by the US Congress. Both the Health Care Financing Administration and the Prospective Payment Assessment Commission continue to study issues related to DRG stratification along the lines of severity of illness, outcome (lived or died), or complications and/or comorbidities. We analyzed hospital resource consumption for 599 patients with a primary diagnosis of congestive heart failure (CHF) by outcome (ie, survivors vs mortalities). The 68 mortalities had a much greater intensity of hospital resource utilization, and a substantial financial risk under DRG pricing schemes, compared to the 531 survivors. Only mortalities within one week of admission to the hospital were profitable under DRGs. A long hospital length of stay (LOS) for mortalities was very unprofitable (mortalities with a greater than 60-day LOS generated a +42,028 loss per patient). Emergency patients who died tended to have a shorter hospital LOS and less financial risk under DRGs, compared to patients who died who were not admitted as emergencies. These data suggest significant inequities in the DRG prospective payment system vis-a-vis CHF mortality. Variables predictive of greater hospital resource utilization for mortalities included longer hospital lengths of stay and urgent admission. Health policy leaders should be encouraged to further stratify DRG hospital resource consumption for appropriate variance in hospital costs.

Aged↗
PubMedDate not supplied

Appraisals of bereavement, coping, resources, and psychosocial health dysfunction in widows and widowers.

The purpose of the study was to test a model, based on Lazarus and Folkman's (1984) stress-coping framework, on widowed persons' psychosocial health dysfunction after conjugal bereavement. Older widows (n = 100) and widowers (n = 59) were identified through church burial records and interviewed using the Ways of Coping Checklist, Sickness Impact Profile, and questionnaires to assess appraisal of bereavement and resources. Path analysis indicated that lower threat appraisal, more problem-focused and less emotion-focused coping, greater resource strength, and younger age had direct effects on reducing psychosocial health dysfunction, explaining 30% of the variance. Higher threat appraisal influenced the use of more problem- and emotion-focused coping strategies. Greater resource strength directly influenced lower threat appraisal. Sex and type of death affected psychosocial health dysfunction through their effect on resource strength.

Adaptation, Psychological↗
PubMed1988

Resource-based relative values for invasive procedures performed by eight surgical specialties.

We surveyed approximately 850 physicians in eight surgical specialties to investigate physicians' work in performing invasive services. Building on our analysis of physician work, we developed a relative value scale of physicians' services based on resource costs. First, we found that physician charges are not set in proportion to the resources required to perform a given procedure: there is a threefold variation, across hospital-based invasive procedures, in the ratio of charges to resource-based relative values. Second, for most procedures, the preoperative and postoperative periods represent 60% to 75% of a physician's total service time, but only 35% to 50% of the total service work. Lastly, intraoperative work per unit of time varies greatly. Work per minute for invasive procedures is two to three times that of medical office visits and is strikingly greater for some specialties. The Resource-Based Relative Value Scale, at a minimum, represents a useful tool for payers to identify procedures with potentially aberrant charges and also offers unique insights into the nature of physicians' work.

Ambulatory Surgical Procedures↗
PubMed1987

Social support in improving perinatal outcome: the Resource Mothers Program.

This report studies the Resource Mothers Program, an organization that improves perinatal outcome through social support. Resource Mothers are nonprofessional women who combine warmth, parenting experience, and knowledge of their local community services to reduce the hazards associated with rural adolescent pregnancy. Each Resource Mother is assigned to a pregnant teenage primigravida and serves as part of her support system throughout pregnancy and until the infant's first birthday. We studied 565 matched pairs (case/control) of rural teenage primigravidas with single pregnancies with and without the social support of the Resource Mother. There were significantly more patients with adequate prenatal care in the program group (P less than .000001). The frequency of low birth weight infants was significantly less (P = .006), as was the small-for-gestational-age rate (P = .002).

Adolescent↗
PubMedDate not supplied

Developmental resources and depression in the elderly.

A longitudinal study was carried out with 28 clinically depressed and 28 mentally healthy older adults, matched on age, sex, and years of education. Developmental resources and depression were measured on three occasions using the Developmental Resources of Later Adulthood and the Center for Epidemiological Studies Depression scales. A 2 X (3) repeated measures factorial analysis of variance indicated that the depressed group had significantly lower developmental scores across all three time periods. Results of cross-lagged panel correlation analyses suggested that the direction of the relationship between developmental resources and depressive symptoms differed markedly between the two groups. The mentally healthy group showed a significant causal tendency for developmental resources to influence level of depression; a reverse trend was noted in the depressed group.

Aged↗
PubMed1985

Coping resources and parenting mentally retarded children.

Four broad dimensions of coping resources (utilitarian resources, energy/morale, general and specific beliefs, and social support) were assessed with a sample of 140 mothers of mentally retarded children. The dimensions were related to a measure of the adequacy of parental coping, i.e., Questionnaire on Resources and Stress-Friedrich Factor 1, Parent and Family Problems. Three of the four categories of coping resources were significant contributors in a regression analysis and contributed additional variance beyond that of behavioral and physical problems of the child. For validational purposes, 104 of these mothers were reexamined 10 months later. The original analysis was supported, and changes in marital satisfaction were related to an increase in parent and family problems over the elapsed time span.

Adolescent↗
PubMed1979

[Development of human resources for working in environmental health].

This paper was presented as a reference document in the First Meeting of the PAHO/WHO Textbook Program Committee for the Teaching of Sanitary Engineering and Environmental Sciences, held in Santo Domingo, Dominican Republic, from 24 to 26 November 1977. It analyzes the human resource development process in terms of the basic components: planning, development itself, and utilization. Its principal objectives are: to encourage the performance of studies and research on human resources in environmental health as sources of information for taking decisions, making policy, and drawing up training plans; to suggest ways of improving the quality of education and training services; to encourage the development of suitable techniques and methods for determining human resource needs; and to highlight some recent studies and publications on human resources in relation to environmental problems.

Allied Health Personnel↗
PubMedDate not supplied

[Resources in old age].

General results of the psychological research on aging lead to the hypothesis that demands during the life cycle are accomplished the better, the more general and the more specific resources the individual disposes of. The analysis of four surveys on elder people shows that health, income, social integration, knowledge about aging, plans for retirement, good ecological conditions, life satisfaction, and a low age seem to be general resources. In addition there are some specific resources. The relevance and the necessary differentiation of the resource-perspective in gerontology are discussed.

Aged↗
PubMedDate not supplied

Development and evaluation of a community cancer resource directory.

The Frederick Cancer-Related Resource Directory was developed in response to the community's need to be informed about available services for cancer patients. A 1-year followup and evaluation was conducted to determine what changes or corrections were needed in the text of the directory and if the objectives of the project had been met. The evaluation survey of the listed resources revealed that a large number of changes in the directory were required. Seventy-eight percent of the respondents replied that at least one change was required in their entry. The followup also revealed that 16 percent of the listed resources knew of at least one referral that they received as a result of the directory listing. The survey of directory recipients indicated that 27 percent of the private practice physicians and 61 percent of the other health-related service providers who have a directory have used it or read through it. Approximately 64 percent of the users have provided clients or patients with information from the directory. Almost half of all respondents replied that, as a result of the directory listing, they had developed closer working relationships with at least one other cancer-related service organization, although the percentage was considerably higher for health-related service providers (51.2 percent) than for private physicians (27.3 percent). More than half of the respondents (58 percent) believed that a simpler directory should be made available to patients instead of or in addition to the providers' directory. Members of the project's multi agency committee became much more aware of the wide variety of cancer patients' needs and available resources. The most beneficial aspect of the project for them was the opportunity to work with persons from other agencies and to develop closer, long-term relationships.

Cancer Care Facilities↗
PubMed1981

[Co-ordination of the resources on health information. A study of 4 sources].

During the 1979 Health Year a programme was undertaken in the Cape Province to co-ordinate the resources of two well-known national health information centres with the resources of two relatively unknown provincial health information resource centres. Evaluation of this scheme after 1 year indicated that co-ordination of the services of health information resource centres at provincial level can improve this service to remarkable extent.

Information Centers↗
PubMed1995

Cataloging Internet resources.

The number of resources available on the Internet continues to expand exponentially, but finding appropriate resources is still a fragmented, hit-or-miss operation. Traditional library expertise in bibliographic description and access should be applied to the management of this emerging body of material. In the process, catalogers will be able to assess the adequacy of current tools (e.g., cataloging codes, machine-readable cataloging formats, integrated library systems) for providing access to Internet resources and will contribute credibly to design or redesign of access tools. This paper outlines the major issues that must be considered in cataloging electronic resources.

Cataloging↗
PubMed1994

HUBNET: Wide Area Network utilization of Local Area Network medical reference and communication resources.

The State University of New York at Buffalo School of Medicine and Biomedical Sciences and its associated teaching sites have developed and partially implemented a regional Wide Area Network (WAN) in Buffalo and Western New York. The school wishes to use this WAN to deliver reference and communication resources to students, residents and faculty. The richest pool of easy to use reference and communication resources are PC software programs that are intended for individual workstations or at best, client-server, Local Area Network (LAN) implementation. HUBNET (Hospitals and University at Buffalo Library Resource Network), a project of the School of Medicine and the Library Consortium of Health Institutions in Buffalo offers integrated presentation of many such LAN resources over this regional WAN. The system crosses many institutional boundaries and reaches physically remote sites in a complex mix of information systems environments with few issues related to performance. The system design provides a level of ease of use that has brought many new users into active computer use while addressing integration into diverse information systems settings and networking environments.

Computer Communication Networks↗
PubMed1994

Linking resource use to consumer level of need: field test of the level of need-care assessment (LONCA) method.

A team of service system planners in King County, Washington, field-tested the feasibility of the LONCA (level of need-care assessment) method as a strategy to match resources to consumer level of need. LONCA links resources to need by first measuring the incidence and intensity of consumer needs in specific functioning domains. It then preliminarily specifies the type and intensity of services required to minimally but appropriately address specific consumer needs, calculates service costs, and identifies clusters of consumers with similar need and cost profiles. The field test supported the feasibility of performing LONCA tasks. The resulting scheme for clustering consumers appeared to have face validity and was modestly associated with at least 3 independent indicators of resource need: program status, residential status, and hospitalizations. Despite its limitations, the article supports further development of LONCA for use as a resource allocation tool for local service systems.

Community Mental Health Services↗
PubMed1994

[Efficiency of utilization of resources used at a polyvalent intensive care and resuscitation center].

Along the lunes of a survey by GIRTI of 2,710 patients hospitalized in the 14 costituing CRTI, a parallel research has been carried out 350 patients in a polyvalent CRTI in order to compare the results. Omega score has been calculated to evaluate the intensity of the supplied treatment and consequently to settle efficiency of the resources. The results show a greater number of treated patients compared to those only monitored for intensive examination and a majority of patients from medical and surgical departments, compared to those from traumatological dpts. This proves that the intensity of treatment depends significantly and progressively on the diagnosis, seriousness and, above all, duration of hospitalization, with the only difference that more resources were needed for those patients who died than for those survived. Despite the coincidence of the quality of the results, this survey diverges from that of GIRTI as far as the quantity of utilized resources, which were about a half of those reported in their survey. This is probably due to the lack of medical and particularly nursing personnel as well as instruments especially monitoring ones, which prevented CRTI from working at its maximum. Then it has been pointed out that some pathologies (extrahospital cardiac arrest and pulmonary embolism) which caused losses of the utilized resources, could improve by creating Emergency and Urgency Departments.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗