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PubMedDate not supplied

Resources for the care of arthritics in a nonmetropolitan community. Redding, California.

All professional, institutional, and administrative resources available to persons with musculoskeletal disabilities, including arthritis, were surveyed in a large nonmetropolitan community. Access to such resources and their residual capacity to serve local arthritics was determined. The resources appeared adequate as was the access, but the referral pattern was poorly developed. Most of the physicians in the community did not perceive a need for a trained rheumatologist practicing in the community.

Arthritis, Rheumatoid↗
PubMed2006

The impact of a diagnosis of fibromyalgia on health care resource use by primary care patients in the UK: an observational study based on clinical practice.

OBJECTIVE: To investigate the impact of a diagnosis of fibromyalgia (FM) in clinical practice on health care resource use in the UK. METHODS: Rates of visits, prescriptions, referral, and diagnostic testing were estimated in patients who had been diagnosed as having FM between 1998 and March 2003 in UK primary care and compared with those in matched controls. Rates were calculated in 6-month intervals from 10 years before until 4 years after the FM diagnosis. RESULTS: Patients (2260) were newly diagnosed as having FM; 81.3% were women. Their mean age was 49 years. FM patients had considerably higher rates of visits, prescriptions, and testing from at least 10 years prior to diagnosis compared with controls. By the time of diagnosis, FM patients had 25 visits and 11 prescriptions per year compared with 12 visits and 4.5 prescriptions per year in controls. Visit rates were highest for depression, followed by fatigue, chest pain, headache, and sleep disturbance. Following diagnosis, visits for most symptoms and health care use markers declined, but within 2-3 years, most visits rose to levels at or higher than those at diagnosis. CONCLUSION: Primary care patients who had been diagnosed as having FM reported higher rates of illness and health care resource use for at least 10 years prior to their diagnosis, which suggests that illness behavior may play a role. Being diagnosed as having FM may help patients cope with some symptoms, but the diagnosis has a limited impact on health care resource use in the longer term, possibly because there is little effective treatment.

Adolescent↗
PubMed2003

The surgical treatment of cancer: a comparison of resource utilization following procedures performed with a curative and palliative intent.

BACKGROUND: Costs associated with the provision of medical care continue to escalate. Therefore, providers must evaluate the cost-effectiveness and benefit to individual healthcare practices. The authors evaluated the immediate and short-term resource utilization needs of patients undergoing surgical intervention with curative or palliative intent. METHODS: Three hundred two patients undergoing surgery with therapeutic intent were observed from the time of admission for intervention until the time of death or until 6 months from the time of the surgical procedure. Surgeons preoperatively identified each case as either curative or palliative in intent. Demographic information, as well as the nature of all interactions with the cancer center, was recorded. RESULTS: Surgeons identified 58 (19%) procedures as palliative and 244 (81%) as curative in intent. Demographic characteristics between the two groups were similar, although recurrent or metastatic disease was more often present in palliative rather than curative patients (P = 0.0078) and palliative intent patients were more likely to have received previous therapy. During the 6-month period, 4690 encounters occurred with the cancer center. The mean number of encounters per patient in each group was similar, although curative intent patients were more likely to have visits with therapeutic intent including chemotherapy administration (P = 0.01), radiation (P = 0.003), or repeat surgical procedures (P = 0.006). In contrast, palliative patients were more likely to be admitted for management of symptoms (P = 0.0001) and had fewer hospital-free days than did curative patients (P = 0.0069). CONCLUSIONS: The average number of encounters for patients undergoing treatment of disease was not significantly different, suggesting that patients undergoing surgery with palliative intent do not require a greater amount of resources than curative intent patients. The nature of the interactions, however, was different, suggesting that resource needs are different and may need to be anticipated in the assessment of how better quality outcomes can be achieved in the palliative surgery setting.

Adolescent↗
PubMed2007

Maternal behavior, infant development, and the question of developmental resources.

The natural development of maternal and infant behavior occurs in a dyad characterized by synchrony and reciprocal interactions. Major concepts used to describe and analyze this synchrony were reviewed. It was concluded that the dyad undergoes a developmental progression in which each part of the dyad is both a developing organism and a reliably changing milieu forming part of the extended inheritance of the other. The reliability of inherited resources is rooted in interactions essential to life, such as those used to transfer metabolic needs to dependent offspring; to stimulation (incidentally but necessarily) associated with life-supporting mechanisms; and to perceptual, motor, or learning mechanisms used to extract specific resources from the available milieu. The diverse resources in extended inheritance contribute to the construction of new traits through opportunistic shaping or regulating interactions among them that are unrestricted by their function at earlier stages.

Animals↗
PubMed2005

Genomic resources for chicken.

The recent sequencing and draft assembly of a chicken genome has provided biologists with an invaluable research tool that complements a growing list of additional avian genomic resources. For many researchers, finding and using these resources is challenging, because information is presented through an increasing number of Web sites and browser navigation frequently requires specific knowledge and expertise. This primer provides an overview of online genomic resources for the chicken, including the Ensembl, UCSC, and NCBI annotated chicken genome browsers; expressed sequence tag and in situ hybridization databases; and sources for microarrays, cDNAs, and bacterial artificial chromosomes (BACs). Several short tutorials oriented toward the biologist with limited bioinformatics skills outline how to retrieve several types of commonly needed information and reagents.

Animals↗
PubMed1995

Polymerase chain reaction-based assays for the characterisation of plant genetic resources.

Plant genetic resources are an important component of biodiversity and provide the basic genetic variability that allow new and improved cultivars to be developed. Numerous germplasm collections have been established and it is important to established that such collections are representative and accessible to breeders and biotechnologists. Molecular markers provide the best estimate of genetic diversity since they are independent of the confounding effects of environmental factors. Assays based on the polymerase chain reaction (PCR) are considered to meet both the technical and genetical requirements for the characterisation of plant and animal genetic resources. Two main approaches are described, based on anonymous and defined primers. The use of both randomly amplified polymorphic DNA (RAPD) and microsatellites or simple sequence repeats (SSR) for the characterisation of perennial tree species, and distribution of variability within gene pools is reported. The detection of interspecific gene introgression between coffee species with RAPD markers is described together with the use of microsatellites to genotype potato. The use of PCR-based assays will facilitate the evaluation and utilisation of plant genetic resources.

Base Sequence↗
PubMed1992

Management of human resources in health care: the Canadian experience.

Each of Canada's ten provinces has a publicly administered system of health insurance, funded by provincial and federal taxes, that is accessible to all citizens and covers all medically necessary services provided by physicians and hospitals. Canadians spend an estimated 9.2 percent of their gross national product on health care (about 2.8 percentage points below US spending), of which three quarters is public-sector spending. According to the Organization for Economic Cooperation and Development, Canada's health status is equal to or better than that of the United States, despite lower per capita health spending. About seven percent of the Canadian labour force works in health care, and attempts to introduce coordinated planning of human resources in health care have not as yet proceeded far. The predominant policy issue here is the supply and the role of physicians. It has been argued that entrenching within the system the fee-for-service method of paying physicians has created a disincentive to the delegation of responsibility to health personnel other than doctors. It is also argued that introduction of government-run health insurance provided the opportunity for human resource planning, but that the decision by governments to act only as the payer resulted in ad-hoc planning approaches. However, governments' concern over health care costs has led to a more direct role by them in the planning of the human resources in health. They are re-examining the autonomy and jurisdictional rights of the professions that deliver health care to Canadians.

Canada↗
PubMed2005

Using multilevel models for assessing the variability of multinational resource use and cost data.

Multinational economic evaluations often calculate a single measure of cost-effectiveness using cost data pooled across several countries. To assess the validity of pooling international cost data the reasons for cost variation across countries need to be assessed. Previously, ordinary least-squares (OLS) regression models have been used to identify factors associated with variability in resource use and total costs. However, multilevel models (MLMs), which accommodate the hierarchical structure of the data, may be more appropriate. This paper compares these different techniques using a multinational dataset comprising case-mix, resource use and cost data on 1300 stroke admissions from 13 centres in 11 European countries. OLS and MLMs were used to estimate the effect of patient and centre-level covariates on the total length of hospital stay (LOS) and total cost. MLMs with normal and gamma distributions for the data within centres were compared. The results from the OLS model showed that both patient and centre-level covariates were associated with LOS and total cost. The estimates from the MLMs showed that none of the centre-level characteristics were associated with LOS, and the level of spending on health was the centre-level variable most highly associated with total cost. We conclude that using OLS models for assessing international variation can lead to incorrect inferences, and that MLMs are more appropriate for assessing why resource use and costs vary across centres.

Age Factors↗
PubMed1999

Hepatic retransplantation in cholestatic liver disease: impact of the interval to retransplantation on survival and resource utilization.

The aim of our study was to quantitatively assess the impact of hepatic retransplantation on patient and graft survival and resource utilization. We studied patients undergoing hepatic retransplantation among 447 transplant recipients with primary biliary cirrhosis (PBC) and primary sclerosing cholangitis (PSC) at 3 transplantation centers. Cox proportional hazards regression analysis was used for survival analysis. Measures of resource utilization included the duration of hospitalization, length of stay in the intensive care unit, and the duration of transplantation surgery. Forty-six (10.3%) patients received 2 or more grafts during the follow-up period (median, 2.8 years). Patients who underwent retransplantation had a 3.8-fold increase in the risk of death compared with those without retransplantation (P <.01). Retransplantation after an interval of greater than 30 days from the primary graft was associated with a 6.7-fold increase in the risk of death (P <.01). The survival following retransplantations performed 30 days or earlier was similar to primary transplantations. Resource utilization was higher in patients who underwent multiple consecutive transplantations, even after adjustment for the number of grafts during the hospitalization. Among cholestatic liver disease patients, poor survival following hepatic retransplantation is attributed to late retransplantations, namely those performed more than 30 days after the initial transplantation. While efforts must be made to improve the outcome following retransplantation, a more critical evaluation may be warranted for late retransplantation candidates.

Adult↗
PubMedDate not supplied

Health sector reform and STD/AIDS control in resource poor settings--the case of Tanzania.

Integration in health sector reform tends to mean horizontal interaction between vertical programmes. This can result in a larger more complex system than a set of individual vertical programmes. This article looks at the HIV/AIDS programme in Tanzania and the possible impact of system-wide health sector reform involving 'decentralization' and horizontal integration. It implies that the build-up to reform is likely to be costly, at least initially (although eventually the system may become more cost-effective). Integration can thus save resources, but it will also demand additional inputs, and may lead to reduced service output if operations depend on horizontal functions that fail to deliver. The objective of reform must be to create a reasonably sized, well-balanced, system which aims to maximize the output of quality services, both preventive and curative, and to facilitate community efforts to improve health. It is doubtful whether present reform efforts in Tanzania will contribute to more effective services, if not based on a more thorough analysis adapted to the local situation and given considerably more resources, both human and financial. There is also a risk that key preventive programmes, such as those aimed at the control of STD/AIDS, will be further weakened because of both integration with subsequent dependence on poorly functioning horizontal units and reduction in allocated resources.

Acquired Immunodeficiency Syndrome↗
PubMed1984

A strategy, structure, human resource database: OASIS.

Traditionally, strategic planners and human resource professionals have taken separate approaches in their attempts to improve organization functioning. As a result, strategic planners lack important information that affects the implementation of their plans and human resource managers have little impact on the strategic direction of their organizations. The University of Michigan, Hay Associates, and The Strategic Planning Institute have come together in a new venture to build a multicompany database that links organization characteristics and human resource and strategic planning practices with data on company financial performance. The database will be used to make intercompany comparisons on significant organization variables and to identify those practices that lead to improved financial performance.

Data Collection↗
PubMed1980

Genetic variability of alcohol dehydrogenase among Australian Drosophila species: correlation of ADH biochemical phenotype with ethanol resource utilization.

Alcohol dehydrogenase (ADH) activities, electrophoretic phenotypes, and the extent of ethanol resource utilization are compared for three groups of species distinguishable on ecological criteria: 1) the cosmopolitan species D. melanogaster, a frequent inhabitant of wineries; 2) fruit-baited species of the typically Australian subgenus Scaptodrosophila: D. lativittata, D. nitidithorax and D. howensis; and 3) Scaptodrosophila species not attracted to fermented-fruit baits being collected by sweeping in temperate rain forests (D. inornata, D. collessi) or from Hibiscus flowers (D. hibisci). D. melanogaster showed the highest levels of ADH activity and an electrophoretic polymorphism with two active allelic forms, while group 2) species showed intermediate ADH activities and polymorphisms, which were consistent with "high activity" and "low activity" allelic forms in natural populations of these species, and group 3) species showed only "low activity" forms. Ethanol resource utilization follows the same sequence, being 1 greater than 2 greater than 3 (D. howensis and D. collessi were not tested). Therefore the species considered show an association of ADH biochemical phenotype, laboratory ethanol utilization, and resources utilized.

Alcohol Oxidoreductases↗
PubMed2006

The impact of resource loss and traumatic growth on probable PTSD and depression following terrorist attacks.

The authors interviewed by phone 2,752 randomly selected individuals in New York City within 6 to 9 months after the attacks of September 11, 2001 on the World Trade Center, and 1,939 of these were reinterviewed at a 12- to 16-month follow-up. It was hypothesized that resource loss would significantly predict probable posttraumatic stress disorder (PTSD) and probable depression since September 11, and that resource loss's impact would be independent of previously identified predictors relating to individuals' demographic characteristics, history of stressful event exposure, prior trauma history, peritraumatic experience, and social support. Second, it was predicted that reported traumatic growth would be related to greater, not lesser, psychological distress. The authors' findings supported their hypotheses for resource loss, but traumatic growth was unrelated to psychological outcomes when other predictors were controlled.

Adolescent↗
PubMed1987

The health of conjugally bereaved older widows: the role of appraisal, coping and resources.

Relationships between bereavement, coping, resources, and health dysfunction were investigated in 100 older women (M age = 71.3 years) widowed from 1 to 12 months prior to the interview. Differences in coping for those who appraised their bereavement as either (a) harmful loss, but without major accompanying losses, (b) harmful loss with other anticipated threats, or (c) a challenge were hypothesized. Data collection included use of the Ways of Coping Checklist, Sickness Impact Profile, and appraisal of bereavement and resources. The appraisal groups differed significantly in overall problem-focused coping, wishful thinking, help seeking/avoidance, self blame, and growth-oriented coping. There was no difference in use of emotion-focused coping and ways to minimize threat and seek social support. Social support, strong religious beliefs, practice of rituals, belief in control over bereavement, and good prior mental health were related to less psychosocial and/or physical dysfunction. Greater numbers of resources, but not greater numbers of coping strategies, also were related to less psychosocial and/or physical dysfunction.

Adaptation, Psychological↗
PubMed2004

Healthcare resource utilization during 1-year treatment with long-acting, injectable risperidone.

BACKGROUND: Schizophrenia is associated with disproportionately high costs, mainly due to hospitalization rates. This study assessed healthcare resource use in patients with schizophrenia and schizoaffective disorder during treatment with long-acting risperidone. METHODS: Patients (n = 397 [inpatients, 24%; outpatients, 76%]) receiving stable doses of an antipsychotic for >or=4 weeks were eligible to enter this 1-year, open-label study. Following a 2-week run-in period (oral risperidone 1-6 mg/day), patients received intramuscular long-acting risperidone (25 or 50 mg modal dose) every 2 weeks. Healthcare resource use in the previous 12 weeks was assessed at baseline and 12-weekly intervals. RESULTS: Patients needing hospitalization decreased significantly and continuously from 38% during the 12 weeks before study entry to 12% during the last 12 weeks. Mean hospitalization length during the study was 30.5 days (outpatients, 4.9 days; inpatients, 110 days). This included 28 patients (7%) who remained in hospital throughout the study. During treatment, 71% of those hospitalized at baseline were discharged. Partial hospitalization decreased significantly from 7% of patients during the 12 weeks before treatment to 3% during the last 12 weeks. Outpatient consultations also decreased significantly from 70% of patients to 30% in the first 12 weeks of treatment and remained stable thereafter. Only 9% of patients required an emergency room visit; mostly for non-psychiatric conditions. CONCLUSION: Healthcare resource use is significantly reduced in patients with stable schizophrenia or schizoaffective disorder receiving long-acting risperidone. It is highly likely that these reductions will decrease healthcare costs in patients receiving long-acting risperidone.

Adult↗
PubMed2004

PhosphoSite: A bioinformatics resource dedicated to physiological protein phosphorylation.

PhosphoSite is a curated, web-based bioinformatics resource dedicated to physiologic sites of protein phosphorylation in human and mouse. PhosphoSite is populated with information derived from published literature as well as high-throughput discovery programs. PhosphoSite provides information about the phosphorylated residue and its surrounding sequence, orthologous sites in other species, location of the site within known domains and motifs, and relevant literature references. Links are also provided to a number of external resources for protein sequences, structure, post-translational modifications and signaling pathways, as well as sources of phospho-specific antibodies and probes. As the amount of information in the underlying knowledgebase expands, users will be able to systematically search for the kinases, phosphatases, ligands, treatments, and receptors that have been shown to regulate the phosphorylation status of the sites, and pathways in which the phosphorylation sites function. As it develops into a comprehensive resource of known in vivo phosphorylation sites, we expect that PhosphoSite will be a valuable tool for researchers seeking to understand the role of intracellular signaling pathways in a wide variety of biological processes.

Animals↗
PubMed2005

PhosphaBase: an ontology-driven database resource for protein phosphatases.

PhosphaBase is an ontology-driven database resource containing information on the protein phosphatase family. It is the first public resource dedicated to protein phosphatases, which are enzymes that perform dephosphorylation reactions. In conjunction with the phosphorylation action of protein kinases, phosphatases are involved in important control and communication mechanisms in the cell. They have also been implicated in many human diseases, including diabetes and obesity, cancers, and neurodegenerative conditions. PhosphaBase aims to centralize the growing base of knowledge in the phosphatase research domain. The resource is built around a formal, domain-specific DAML+OIL ontology, and the data are collected from heterogeneous biological sources using Gene Ontology terms as a means of data extraction. The overall ontology-driven architecture provides a robust structure with distinct advantages for sustainability and provides the potential for the development of diagnostic tools, as well as a data repository.

Animals↗
PubMed2003

Resource assessment and clutch size in the bean weevil, Acanthoscelides obtectus.

Bean weevil (Acanthoscelides obtectus (Say)) females were found to use seeds (discrete resource patches) differentially when different sizes were offered in multiple-choice tests. Females, either as a group or as individuals, laid significantly (two to six times) more eggs on large seeds than on those of five times smaller mass. In contrast, seed shape (flattened or spherical) did not contribute to clutch-size adjustment. Thus, A obtectus females seem to measure only relative seed size when a comparison is possible. Nevertheless, females overload seeds with eggs and this can result in larval competition, so that, whereas resource size assessment and a robust egg-load adjustment indicate a trade-off between resource use and female fitness, it does not seem to provide much benefit for the progeny in stored dry beans. Several features, eg the use of oviposition markers and its consequences, may counterbalance the possible negative effects. It is assumed that, due to life cycle differences, females in the bean field may realise different fitness gains in comparison with those living in stores.

Animals↗