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PubMed2001

Assessing the effectiveness of critical pathways on reducing resource utilization in the surgical intensive care unit.

OBJECTIVES: To evaluate the effectiveness of procedure-specific surgical critical pathways on reducing resource utilization in a university surgical intensive care unit (ICU). DESIGN AND SETTING: Prospective cohort study in a university surgical ICU. PATIENTS: 194 patients, accounting for 255 patient days, sampled on randomly selected days over a 12-month period of time. MEASUREMENTS AND RESULTS: The primary outcomes of this study were pathway eligibility and laboratory utilization. Patients were eligible for a procedure-specific pathway in 34% of patient days identified, and the patient's clinical course was "on" pathway in 22% of patient days. Of those "on" the pathway, 54% had a pathway present in the chart and 32% of these included documentation of the patient's clinical course. Thus in 78% of the patient days the patient was either not eligible for a critical pathway or the patient's clinical course was "off" pathway. In those patients "on" the pathway 46 % did not have a pathway present in the chart. Being on a critical pathway did not reduce laboratory utilization. Laboratory utilization did not vary between patients "on" and "off" the pathway (19.1 +/- 11.3 laboratory tests/patient day versus 20.4 +/- 5.7 laboratory tests/patient day). Predicted laboratory utilization by the pathway was 5.6 laboratory tests/patient day. By reducing actual laboratory utilization to that predicted by the critical pathway we would reduce laboratory utilization at our institution by $1.2 million per year. CONCLUSIONS: Procedure-specific surgical critical pathways are not an effective tool for reducing resource utilization in our ICU. Most of our patients were not eligible for an available pathway, and those who were eligible and were "on" the pathway did not appear to have laboratory utilization guided by the pathway. Future initiatives need to explore other means such as ICU-specific care processes to reduce resource utilization in the ICU.

Aged↗
PubMed2002

Investigation into the significance of task difficulty and divided allocation of resources on the glucose memory facilitation effect.

RATIONALE: Memory for a list of 20 words can be enhanced by preceding learning with consumption of 25 g glucose rather than an equally sweet aspartame solution. In previous studies, participants performed a secondary hand-movement task during the list-learning phase. OBJECTIVE: The present placebo-controlled, double-blind study examined whether the additional cognitive load created by a secondary task is a crucial feature of the glucose memory facilitation effect. METHODS: The effect of glucose administration on word recall performance in healthy young participants was examined under conditions where the primary memory task and a secondary task were competing for cognitive resources (across a range of secondary tasks), and where task difficulty was increased but dual task-mediated competition for cognitive resources did not exist. Measures of non-verbal and working memory performance were also compared under the different glycaemic conditions (glucose versus aspartame drinks). RESULTS: In the present study, a beneficial effect of glucose on memory was detected after participants encoded a 20-word list while performing a secondary task, but not when participants encoded the list without a secondary task, nor when the 20 target words were intermixed with 20 non-target words (distinguished by gender of speaker). In addition, glucose significantly enhanced performance on spatial and working memory tasks. CONCLUSION: The data indicate that possible "depletion" of episodic memory capacity and/or glucose-mediated resources in the brain due to performing a concomitant cognitive task might be crucial to the demonstration of a glucose facilitation effect. Possible implications regarding underlying cognitive and physiological mechanisms are discussed in this article.

Adolescent↗
PubMed1998

Dual task performance after diazepam intake: can resource depletion explain the benzodiazepine-induced amnesia?

It was tested whether a depletion in resources can account for the benzodiazepine-induced memory impairment. In two experiments, it was examined whether dividing attention had a disproportionately detrimental effect on learning semantically related and unrelated word pairs after diazepam intake. Word pairs had to be learned in both a single task condition and while performing a visual discrimination task concurrently (dual task condition). Moreover, the complexity of the visual discrimination task was manipulated systematically. Diazepam (15 mg, orally) or placebo was administered in a double-blind, between-subjects design. Subjects after diazepam intake were clearly impaired in learning unrelated word pairs, but not in learning related word pairs. Dividing attention in the dual task condition was associated with a reduction in learning unrelated word pairs, but this was not disproportionately reduced after diazepam intake. Moreover, the magnitude of resource depletion did not correlate with the severity of the diazepam-induced memory impairment. In general, the pattern of results does not support the hypothesis that a depletion of resources can explain the benzodiazepine-induced memory impairment.

Adult↗
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

PROFILE: Integrating Stressor and Response Monitoring into a Resource-Based Water-Quality Assessment Framework.

/ South African water law as well as the country's water resource management policies are currently under review. The Water Law Principles, which were established as part of this review process, indicate a commitment to sustainable development of water resources and the protection of an ecological "reserve." Such policy goals highlight the limitations of traditional and current water-quality management strategies, which rely on stressor monitoring and associated regulation of pollution. The concept of an assimilative capacity is central to the implementation of the current water-quality management approach. Weaknesses inherent in basing water management on the concept of assimilative capacity are discussed. Response monitoring is proposed as a way of addressing some of the weaknesses. Following a global trend, the new policy goals emphasize the need to protect rather than to use the ability of ecosystems to recover from disturbances. This necessitates the adoption of response measurements to quantify ecological condition and monitor ecological change. Response monitoring focuses on properties that are essential to the sustainability of the ecosystem. These monitoring tools can be used to establish natural ranges of ecological change within ecosystems, as well as to quantify conceptually acceptable and unacceptable ranges of change. Through a framework of biological criteria and biological impairment standards, the results of response monitoring can become an integral part of future water resource management strategies in South Africa. KEY WORDS: Stressor monitoring; Response monitoring; Assimilative capacity; Ecosystem stability; Resilience; Biocriteria

Journal Article↗
PubMed2003

Trophallaxis in forager honeybees (Apis mellifera): resource uncertainty enhances begging contacts?

Trophallaxis among adult worker honeybees is the transfer of liquid food by mouth from one individual to another. Within the colony, nectar foragers perform offering contacts (as food-donors) to transfer the contents of their crops to recipient nest-mates and, in addition, they also perform begging contacts (as food-receivers). The biological relevance of these last interactions remains unknown. Previous evidence suggests that begging may be involved in the exchange of information on food resources that occurs naturally between employed foragers and nest-mates. This work was aimed to reveal possible connections between the information obtained while foraging and the begging behavior displayed inside the nest. Experiments were intended to (1) analyze whether chemosensory information obtained while foraging, i.e., odors and sucrose concentrations, affects begging behavior, and (2) determine whether resource uncertainty enhances begging contacts. Results showed that: (1) most begging contacts lasted less than 1 s, a duration which only allows receiving food samples from nest-mates; (2) the diversity of odors and sucrose concentrations at the feeding place enhances the occurrence of begging contacts; and (3) an increased resource uncertainty enhances the forager begging behavior. In addition, results suggest that foragers may direct their begging contacts frequently to other employed nectar foragers.

Animal Communication↗
PubMed2006

[Age differences in psychosocial resources and psychological well-being of cancer patients at the start of chemotherapy].

It has been suggested that older patients would have fewer resources than younger patients. We assessed psychosocial resources in 361 recently diagnosed cancer patients. Older patients had a stronger internal health-related locus of control but also less hope than younger patients. No age differences were found for self-esteem and perceived social support. In addition, older patients reported lower levels of negative and positive affect. Curative-intended therapy and social support were associated with a more positive affect only in younger patients, whereas hope was only related to older patients' psychological well-being. It is concluded that older cancer patients have similar levels of psychosocial resources compared to younger patients, but that lack of hope is a vulnerability factor for older patients in particular.

Adolescent↗
PubMed2003

Growth or reproduction? Resource allocation by female frogs Rana temporaria.

The decision how to allocate marginal resources to reproduction and growth can have important effects on associated life-history parameters as well as on population dynamics. In addition to showing variation among individuals in a population, such allocation rules may be either condition-dependent or fixed in different individuals. While many studies on anuran amphibians have focused on egg numbers and egg sizes in females of different sizes, virtually no data exist on the relative allocation of marginal resources to growth versus reproduction. In the laboratory, we therefore offered female common frogs ( Rana temporaria) low versus high food rations for a full reproductive cycle, and monitored their growth and later reproductive investment (egg number and egg size the following breeding season). Feeding rates had an effect both on female growth and on egg number and size. There was no trade-off found between the two forms of investment. A flexible allocation rule could not be supported as there was no significant effect of feeding rate on the relative allocation of resources to growth versus reproduction.

Adaptation, Physiological↗
PubMed2004

Spatial aggregation across ephemeral resource patches in insect communities: an adaptive response to natural enemies?

Although an increase in competition is a common cost associated with intraspecific crowding, spatial aggregation across food-limited resource patches is a widespread phenomenon in many insect communities. Because intraspecific aggregation of competing insect larvae across, e.show $132#g. fruits, dung, mushrooms etc., is an important means by which many species can coexist (aggregation model of species coexistence), there is a strong need to explore the mechanisms that contribute to the maintenance of this kind of spatial resource exploitation. In the present study, by using Drosophila-parasitoid interactions as a model system, we tested the hypothesis whether intraspecific aggregation reflects an adaptive response to natural enemies. Most of the studies that have hitherto been carried out on Drosophila-parasitoid interactions used an almost two-dimensional artificial host environment, where host larvae could not escape from parasitoid attacks, and have demonstrated positive density-dependent parasitism risk. To test whether these studies captured the essence of such interactions, we used natural breeding substrates (decaying fruits). In a first step, we analysed the parasitism risk of Drosophila larvae on a three-dimensional substrate in natural fly communities in the field, and found that the risk of parasitism decreased with increasing host larval density (inverse density dependence). In a second step, we analysed the parasitism risk of Drosophila subobscura larvae on three breeding substrate types exposed to the larval parasitoids Asobara tabida and Leptopilina heterotoma. We found direct density-dependent parasitism on decaying sloes, inverse density dependence on plums, and a hump-shaped relationship between fly larval density and parasitism risk on crab apples. On crab apples and plums, fly larvae benefited from a density-dependent refuge against the parasitoids. While the proportion of larvae feeding within the fruit tissues increased with larval density, larvae within the fruit tissues were increasingly less likely to become victims of parasitoids than those exposed at the fruit surface. This suggests a facilitating effect of group-feeding larvae on reaching the spatial refuge. We conclude that spatial aggregation in Drosophila communities can at least in part be explained as a predator avoidance strategy, whereby natural enemies act as selective agents maintaining spatial patterns of resource utilisation in their host communities.

Adaptation, Biological↗
PubMed2004

Impact of resource availability on species composition and diversity in freshwater nematodes.

This study investigates the long-term effects of resource availability in a freshwater nematode community. We carried out a mesocosm experiment where natural nematode communities were exposed to nutrient addition/depletion over 2 years. Compared to the nutrient-addition treatment, species richness and diversity were strongly reduced upon nutrient depletion. The functional group of bacterial feeders particularly suffered severely from nutrient depletion. The decrease in diversity of bacterial feeders was linked to reduced species richness and diversity of large omnivorous species, as predicted by trophic-dynamic models. Tilman's (1976) statement, that under low nutrient levels the best competitor dominates the system, was applicable in our system. Upon nutrient depletion, resource depletion led to a monoculture of 1 small bacterial feeder, but even after 2 years of resource depletion, up to 16 species still coexisted. Our results provide strong evidence that freshwater nematode systems can be regulated by nutrient competition.

Animal Nutritional Physiological Phenomena↗
PubMed2006

Changes in resource concentration and defence during leaf development in a tough-leaved (Nothofagus moorei) and soft-leaved (Toona ciliata) species.

Developing leaves that are soft, with high concentrations of resources, can be particularly vulnerable to herbivore damage. Since a developing leaf cannot be very tough, given the constraints of cell expansion, the major form of protection is likely to be chemical defence. We investigated changes in concentration of herbivore resources (protein, carbohydrates and water) and putative defences (total phenolics, tannin activity, cyanogenic glycosides, alkaloids, cell wall, and leaf mechanics) across five leaf development stages of the soft-leaved Toona ciliata M. Roem. and the tough-leaved Nothofagus moorei (F. Muell.) Krasser. Chemical defences were predicted to be more highly developed in young than expanded leaves of both species, and to decline more in expanded leaves of N. moorei, which become tough and strong at maturity, than in the softer expanded leaves of T. ciliata. Resources and defences were dynamic within the developing leaves. Highest concentrations of protein were recorded in young leaves in both species, and highest levels of non-structural carbohydrate were recorded in young leaves of T. ciliata. Allocation to defence varied in both amount and type across leaf stages. In T. ciliata, there was an increase in chemical defence in expanded leaves (tannin activity, alkaloids). However, in N. moorei, increasing strength and toughness of developing leaves coincided with decreasing chemical defence, consistent with our hypothesis. For phenolics, this decrease was partly due to dilution by cell wall, but cyanogenic glycosides were present in young leaves and absent in fully mature leaves. These results are consistent with leaf toughness acting as an effective anti-herbivore defence, thereby reducing the need for investment in chemical defence.

Chlorophyll↗
PubMed2006

The effects of resource enrichment, dispersal, and predation on local and metacommunity structure.

Community structure is the observable outcome of numerous processes. We conducted a laboratory experiment using a microbial model system to disentangle effects of nutrient enrichment, dispersal, and predation on prey species richness and predator abundance at local and metacommunity scales. Prey species included: Chilomonas sp., Colpidium striatum, Colpoda cucullus, Paramecium tetraurelia, P. caudatum, Philodina sp., Spirostomum sp., Tetrahymena thermophila, and Uronema sp., and Stentor coeruleus was the predator used. We hypothesized that: (1) increased basal resources should maintain greater species richness and higher predator abundance; (2) dispersal should maintain greater species richness; and (3) predation should reduce species richness, especially in the high resource treatments relative to no-predator treatments. Our results support all three hypotheses. Further, we show that dispersal affects richness at the local community scale but not at the metacommunity scale. However, predation seems to have major effects at both the local and metacommunity scale. Overall, our results show that effects of resource enrichment, dispersal, and predation were mostly additive rather than interactive, indicating that it may be sometimes easier to understand their effects than generally thought due to complex interactive effects.

Analysis of Variance↗
PubMed1999

Complete clinical outcomes audit. Resource requirements and validation of the instrument.

BACKGROUND: Clinically relevant surgical outcomes are usually monitored by surgeons only for new and/or high-volume procedures. Prospective outcomes audit studies are rarely done on 100% of procedures performed by a single surgeon, a surgical practice, or an institution. Therefore, we set out to determine the resource utilization and accuracy of a well-validated system at its introduction into a North American university surgical practice. METHODS: The Otago Surgical Audit, which has been validated in a wide spectrum of surgical practices in Australasia, was applied to a university practice in general and laparoscopic surgery. Data were recorded by the surgeon on the day of operation, at discharge, and during any subsequent readmission. Resource utilization was determined by timing the important steps in data acquisition and computer entry. Data accuracy was assessed by an independent chart review of 22% of all records. Case capture was audited by reviewing operating room case logs. RESULTS: Over 1 year, from October 1, 1996 to September 30, 1997, 338 procedures were performed. Data recording and coding by the surgeon required 2 min per form, or a total of 676 min (11.3 h) annually. Data entry required 2.11 min per form, or a total of 713 min (11.9 h) for the year. Eight percent of cases were returned to the surgeon for additional information. In the medical record audit, no additional mortality or readmissions were discovered, and one minor complication was recorded in the hospital record but not the outcomes audit. One complication and three operations recorded in the audit database were omitted from operating room records. Two minor procedures on the operating room log were omitted from the audit database. Operating time reported by the surgeon averaged 19 min less than recorded in the operative log. Data accuracy and coding accuracy improved significantly between the 1st month (month 4) and the 2nd month audited (month 12), (p <.01). CONCLUSIONS: It is possible to perform a 100% clinical outcome audit with the use of minimal resources. When the surgeon is involved with data acquisition and coding, the accuracy and completeness of the log may outstrip the medical record, but a learning curve of 4-6 months may be required to achieve this goal.

Humans↗
PubMed2004

Masting by Betula-species; applying the resource budget model to north European data sets.

Masting, the intermittent production of large crops of flowers by a plant population, is a common feature among trees in boreal and temperate forests. The pollen of many broadleaved trees causes allergic diseases, which are major causes of increasing health-care costs in industrialised countries. As the prevalence and severity of allergic diseases are connected with the concentrations of airborne pollen, an universal model predicting the intensity of the coming flowering would be a valuable tool for pollen information services, and ultimately for allergic people and allergologists. We investigated whether a resource budget model created in Japan explains the fluctuations in the annual pollen sums of Betula-species in north European data sets (10-12 years at 4 sites, 20 years at 10 sites). Using the shorter data sets, the model explained 76-92% of the annual fluctuations at five study sites. Using the 20-year data set, the percentage for southern Finland was much lower, only 48%, compared with the 85% of the 12-year data set. The annual pollen sums have been higher during the 1990s than in the 1980s, which may explain the ineffectiveness of the model, while applied to the 20-year data set. Our results support the resource budget model: the masting of birch species is regulated by weather factors together with the system of resource allocation among years. The model can serve pollen information service. However, only the 10 most recent years should be used to avoid interference from trends in changing vegetation and/or climate.

Betula↗
PubMed2006

The WiscDsLox T-DNA collection: an arabidopsis community resource generated by using an improved high-throughput T-DNA sequencing pipeline.

We have developed a new community resource, called the WiscDsLox collection, for performing reverse-genetic analysis in arabidopsis. This resource is composed of 10,459 T-DNA lines generated using the Arabidopsis thaliana ecotype Columbia. The flanking sequence tag for each T-DNA insertion has been deposited in public databases, and seed for each line is currently available from the Arabidopsis Biological Resource Center. The pDsLox vector used to create this new population contains a Ds transposon and Cre/Lox recombination sites. Each WiscDsLox line therefore has the potential to serve as a launch-pad for performing local saturation mutagenesis by mobilization of the Ds element. In addition, Cre-Lox recombination between the T-DNA and a transposed Ds element should enable targeted deletion of specific genomic regions. We generated the WiscDsLox collection using an improved high-throughput pipeline that streamlines analysis of large numbers of independent Arabidopsis thaliana (L.) Hyenh. lines. In this paper we describe the details of this novel method and also provide potential users of WiscDsLox T-DNA lines with useful background information about this collection. Experiments to characterize the utility of the Ds transposon and Cre/Lox elements present in the WiscDsLox lines are in progress and will be reported in the future.

Arabidopsis↗
PubMed2005

Collaborative filtering to improve navigation of large radiology knowledge resources.

OBJECTIVE: Collaborative filtering is a knowledge-discovery technique that can help guide readers to items of potential interest based on the experience of prior users. This study sought to determine the impact of collaborative filtering on navigation of a large, Web-based radiology knowledge resource. MATERIALS AND METHODS: Collaborative filtering was applied to a collection of 1,168 radiology hypertext documents available via the Internet. An item-based collaborative filtering algorithm identified each document's six most closely related documents based on 248,304 page views in an 18-day period. Documents were amended to include links to their related documents, and use was analyzed over the next 5 days. RESULTS: The mean number of documents viewed per visit increased from 1.57 to 1.74 (P < 0.0001). CONCLUSIONS: Collaborative filtering can increase a radiology information resource's utilization and can improve its usefulness and ease of navigation. The technique holds promise for improving navigation of large Internet-based radiology knowledge resources.

Algorithms↗
PubMedDate not supplied

Curriculum resources for training direct care providers in public sector mental health.

Direct care personnel who do not have graduate-level professional degrees provide a substantial amount of client care in mental health organizations across the nation. Training for them is minimal in many settings. This shortcoming may negatively affect client care, staff recruitment and retention, and the effective use of scarce resources. In this paper, we identify and review curriculum resources available to mental health organizations interested in implementing or enhancing training programs for direct care personnel. These include two relevant competency sets and six portable training curricula, as well as information on how to access these resources.

Behavioral Medicine↗
PubMed2006

Use of the family resource scale in children's mental health: reliability and validity among economically diverse samples.

The adequacy of a family's resources has implications for child and family service processes and outcomes. The field needs tools to assess resources in a manner relevant to children's services research. The purpose of this study was to examine the reliability and validity of the FRS among families caring for children who are receiving mental health services and to compare its measurement quality across samples that differ on economic variables. Exploratory and confirmatory factor analyses supported similar factor structures across samples, and internal consistency was equivalent. Findings from the regression analyses provided evidence of construct validity for the FRS. Overall, findings indicated that the FRS holds promise as a reliable and valid tool for assessing perceived adequacy of concrete resources among economically diverse families of children with emotional and behavioral disorders. However, the FRS could benefit from some refinements; those recommendations are discussed.

Child↗