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PubMed2006

Visualizing the demand for various resources as a function of the master surgery schedule: a case study.

This paper presents a software system that visualizes the impact of the master surgery schedule on the demand for various resources throughout the rest of the hospital. The master surgery schedule can be seen as the engine that drives the hospital. Therefore, it is very important for decision makers to have a clear image on how the demand for resources is linked to the surgery schedule. The software presented in this paper enables schedulers to instantaneously view the impact of, e.g., an exchange of two block assignments in the master surgery schedule on the expected resource consumption pattern. A case study entailing a large Belgian surgery unit illustrates how the software can be used to assist in building better surgery schedules.

Belgium↗
PubMed2006

Effects of bio-active ceramic resources in cutaneous wound healing and the role of TGF-beta signaling.

The wound healing process is a highly orchestrated process, which includes inflammation, re-epithelialization, granulation tissue formation, matrix formation and re-modeling. In this paper, we attempt to determine if bio-active ceramic resource powder particles had an effect on cutaneous wound healing. Furthermore, we investigated its related mechanism and the expression of Smads of cutaneous wound healing, which can be accelerated by bio-active ceramic ointment. Topically applied lesions of 5%, 10% and 15% bio-active ceramic ointment (AO) showed accelerated wound closure, re-epithelialization, and the related immediate down stream of TGF-beta (p-Smad2/3 and Smad3) was suppressed. In particular, 10% and 15% AO lesions became closed faster at Days 3 and 4 of post-wound and p-Smad2/3 was also suppressed. All AO lesions showed accelerated mild wound closure at Day 6, but there were no significant difference. Several papers reported that Smad3 may mediate the signaling pathways that is inhibitory to wound healing, as the deletion of Smad3 leads to enhanced re-epithelialization and contraction of the wound area. This study showed that topical, bio-active ceramic ointment applications accelerated wound closure, re-epithelialization and the suppression of Smad proteins (p-Smad2/3, Smad3). The data revealed that the suppression of Smad3, which was induced by bio-active ceramic resources powder particles affected re-epithelialization and cutaneous wound closure. At the end of this paper, we concluded that bio-active ceramic resources affect cutaneous wound healing by accelerating the re-epithelialization of keratinocytes and that is mediated by the suppression of related protein, Smad3.

Animals↗
PubMed2006

Development of a questionnaire to assess dentists' knowledge, opinion, education resources, physician cooperation, and clinical practice regarding obstructive sleep apnea (OSAQ-D).

This report describes the construction of a questionnaire to assess dentists' knowledge, opinion, education resources, clinical practice, and physician cooperation regarding obstructive sleep apnea (OSA) based on the PRECEDE-PROCEED model. The scale development included such steps as generating an item pool, expert review of initial item pool, pilot test, and final test. After the expert review, a total of 78 items made up the pilot test instrument including five demographic (age, year graduated from dental school, gender, years in practice dentistry, and membership of the Academy of Dental Sleep Medicine), 22 knowledge, 15 opinion, 11 education resources, 10 physician cooperation, and 15 clinical practice questions. The pilot test samples were third or fourth year dental school students and dentists from the University of Florida. Nineteen dentists and 26 students returned the survey. Based on the results of item analysis and content review, a total of 70 questions were remained for the final test. The final questionnaire was mailed to 450 dentists who were randomly selected from a list of 10,838 dentists with a Florida license and also delivered to 65 dental school students and postgraduates of the University of Florida. A total of 163 participants including 112 dentists and 51 students and postgraduates responded. The average age was 42.87 years, and most of them are males (77.8%). Only one dentist was a current member of the Academy of Dental Sleep Medicine. The item analysis was performed for five scales. 8 items with poor item difficulty, lower item discrimination, or having big effect on the item consistency were removed from the instrument, and 62 questions were kept for the further evaluation. The reliability coefficient alpha of knowledge, opinion, education resources, physician cooperation, and clinical practice scales was 0.77, 0.86, 0.67, 0.75, and 0.86, respectively. According to the standard from DeVellis (Scale development: theory and applications, Sage, Thousand Oaks, 2003), they were acceptable, or respectable, or even very good.

Adult↗
PubMed2005

HIV-associated tuberculosis and cryptococcosis in resource-limited settings.

Tuberculosis (TB) and cryptococcosis are common infectious complications in HIV in resource-limited settings and contribute substantial morbidity and mortality. The increasing access to highly active antiretroviral treatment (HAART) has invited numerous challenges such as timing of HAART, cotreatment (drug dosages and interaction), immune reconstitution syndromes, and withdrawal of chemoprophylaxis. Numerous small studies propose the feasibility of concomitant TB/HIV treatment that needs to be confirmed in large, randomized trials. Treatment of acute cryptococcocal meningo-encephalitis with amphoterecin B is fraught with logistic problems in resource-limited settings. An effective safe dose of fluconazole as monotherapy needs to be determined in phase II studies. Current management guidelines extrapolated from developed countries may not necessarily apply and need validation in resource-limited settings.

AIDS-Related Opportunistic Infections↗
PubMed2005

HIV antiretroviral therapy in resource-limited settings: experiences from Haiti.

An unprecedented international effort to expand high activity antiretroviral therapy (HAART) to resource-poor nations has been launched. The World Health Organization (WHO) has created antiretroviral (ARV) treatment guidelines adapted to resource-poor settings. The first-line regimen is two nucleoside reverse transcriptase inhibitors (NsRTIs) and one nonnucleoside reverse transcriptase inhibitor (NNRTI). Therapy is initiated by clinical staging and CD4 T-cell counts when available. Adherence is the responsibility of health care workers. The use of ARV therapy in resource-poor settings faces several challenges, including the poverty of patients, political and social upheavals and violence, social stigma associated with HIV/AIDS, unreliable pharmacy systems, tuberculosis, and lack of trained health care workers. Using our experience in Haiti, we describe how we have addressed these challenges with the goal of increasing access to care for the poor with HIV/AIDS.

Adolescent↗
PubMed1996

Critical resources that influence habitat selection decisions by gastrointestinal helminth parasites.

Habitat selection may be the basis of some of the most exciting questions in behavioural ecology today, but parasites are being excluded from this debate. Parasites are not aberrant; they form a large proportion of the diversity of life on earth, and one estimate suggests that parasitism is more common than all other feeding strategies combined. We still do not understand the adaptive value of habitat selection behaviours in these organisms, even though the literature is full of examples of parasites migrating and navigating through hosts to their specific habitats. Parasites must make the same decisions that every animal has to make regarding food acquisition, shelter and reproduction. However, we cannot even make reasonable guesses on the habitat selection strategies and critical resources that influence their decision-making. The purpose of this review is to provide examples of experiments and methods of incorporating critical resources into the ecological analyses of habitat selection by gastrointestinal parasites. Information on parasite resources is simply not available for most parasites, and these ideas might stimulate and guide future research. In addition, parasites are ideal models to test theoretical assumptions of habitat selection. Experimental manipulations of parasites are ideal models to test theoretical assumptions of habitat selection. Experimental manipulations of parasite populations are simple, and habitats of endoparasites can be precisely altered by surgical methods. Few tests of habitat selection theory have been attempted in free-living environments because of the difficulty of assessing the correlations between environmental variations and organismal success in real-world situations, but this is not a problem with parasites because their habitats are replicated exactly in each host.

Animals↗
PubMed1992

Psychopathology and pain in medical in-patients predict resource use during hospitalization but not rehospitalization.

The authors investigated the relationship between psychopathology and resource use in general medical in-patients during hospitalization and rehospitalization. Between 1 July 1987, and 30 April 1989, 1020 in-patients were prospectively screened for depression, anxiety, cognitive dysfunction, and pain. Overall, the screen identified 47% of patients as having high psychopathology or pain, including 25.7% depressed, 21.8% anxious, 17.6% with cognitive dysfunction, and 5.2% with high pain. There were no measured differences in demographics or disease severity between high and low psychopathology groups. High psychopathology patients had longer stays and higher costs during the index hospitalization but there were no differences during subsequent hospitalizations. Length of stay declined overall during the study period, but there were no changes over time in the association between high psychopathology or pain with increased resource use. The measured symptoms of psychopathology and pain we measured are associated with increased short-term utilization of health care resources, but the increase does not extend to subsequent hospitalizations. Outcome studies aiming to reduce psychopathology in medical in-patients should pay particular attention to short term costs.

Anxiety Disorders↗
PubMed1983

Cost/effectiveness analysis of alcoholism and drug abuse treatment programs: the relevance of recidivism and resource absorption.

Cost/effectiveness measures are increasingly being applied to alcoholism and drug abuse treatment programs. Program evaluators usually regard readmissions as inadequate for assessing outcome, and resource absorption is rarely examined; this paper presents the argument that increased attention to recidivism and resource absorption is integral to the program evaluation process. Readmissions formed 53% of admissions to U.S. drug abuse programs, and in alcoholism treatment centers, 4% of the patients accounted for 24% of the detoxications. Problems with assessing cost/effectiveness are associated with duration of treatment, average cost, time span of analyses, quasi-experimental designs, multiple episodes of treatment, "silting up", and extrapolation. Five approaches to dealing with these problems are suggested: analyzing existing program data bases for recidivism and resource absorption, considering recidivism when evaluating programs, tempering clinical enthusiasm with skepticism, matching patients with levels of care appropriate to previous treatment history, and assessing additional benefit derived from increasing amounts of care per patient as part of cost/effectiveness analysis.

Alcoholism↗
PubMed1991

Hospital comparisons using a Euro Health Data Base for resource management and strategic planning.

A European approach for resource management and strategic planning has been implemented in the HOSCOM project of AIM by defining information standards needed across countries, as well as a methodology to measure resources and costs at the institutional and interinstitutional level. A Euro Health Data Base (EHDB) has been obtained in order to test data availability and comparability as well as to validate models through macrocomparisons using case-mix (DRG's, refined grouping, disease staging) and microcomparisons based on three diseases (cardiac valve replacement, diabetes mellitus and hip fracture). The EHDB's presently based on 274 164 medical record summaries sampled from 7 countries allowed us to build prototypes (using Clipper, Prolog and SQL) in order to export uniform aggregates in the different countries, with standard software tools for statistical comparisons. It showed the present feasibility of using case-mix based on the European Minimum Basic Data Set (MBDS) and the difficulty of obtaining uniform data on resources and costs other than length of stay across countries. Medical data confidentiality was assured but not yet population-based representativity. Given the present state of the EHDB, problems have been clearly identified in order to be solved by international research and development projects in the near future.

Abstracting and Indexing↗
PubMed1993

Doctors and resource management: incentives and goodwill.

The increasing pressure on resources available for health care in many countries has led to a re-examination of the way in which resources are allocated and committed. One important and innovative option is for managers and doctors to collaborate formally in decision-making. This paper draws on experience of this approach in the UK National Health Service, in the Resource Management Initiative and suggests that its success or failure depends on the nature and strength of the incentives to the two sides to collaborate.

Decision Making, Organizational↗
PubMed1996

Economic analysis at the global level: a resource requirement model for HIV prevention in developing countries.

Agencies operating at the international level have a need for economic analysis to help develop global health policies and determine resource requirements to support their advocacy efforts. This paper presents work commissioned by the Global Programme on AIDS to estimate the total resource requirements of implementing a package of HIV prevention strategies in developing countries. The modelling approach identified a hypothetical package which should be implemented and developed a set of assumptions relating the size, number and coverage of programmes required for each strategy to a set of demographic and other characteristics of individual countries. Costs were attached to estimate the total costs of the package for individual countries, regions and the developing world. Results are presented for regions and their implications discussed. Conclusions are drawn on the value of this type of modelling approach to estimating resource requirements.

Budgets↗
PubMed1990

Information resources useful in forensic toxicology.

This paper addresses information resources available to forensic toxicologists. The approach taken here is to discuss those resources found useful in problem solving situations. First, attempt to obtain information from someone familiar with the problem. This is generally the most efficient mechanism to use. The next most efficient mechanism is to search the published literature, electronically using bibliographic databases, if possible. The least efficient method of obtaining information is to go into the laboratory and generate the desired information. In many situations, however, the problem must be solved, or the information confirmed, in the laboratory. Suggested sources of information have been listed in the appendices. These are not intended to be exhaustive, but rather to stimulate and direct the access to information resources.

Databases, Bibliographic↗
PubMed1989

The relation of widows' needs and resources to perceived health and depression.

The study investigated the relationship of widowhood-related needs and resources to physical health and to depressed affect. Participants were 246 widowed women of all ages, who were widowed from 1 to 7 years, and who were drawn by stratified-random sampling from widows living in urban areas in Israel, and receiving social insurance payments. The findings show that although there was a significant added contribution by resources, the unique contribution of needs to the health and depression variance was generally maintained. Length of widowhood was not related either to health or depression, while widows' age was significantly related to both. The findings suggest that needs, as well as resources are necessary concepts for a fuller understanding of the coping process of widows.

Adaptation, Psychological↗
PubMed1987

The combining of multiple hemispheric resources in learning-disabled and skilled readers' recall of words: a test of three information-processing models.

Three theoretical models (additive, independence, maximum rule) that characterize and predict the influence of independent hemispheric resources on learning-disabled and skilled readers' simultaneous processing were tested. Predictions related to word recall performance during simultaneous encoding conditions (dichotic listening task) were made from unilateral (dichotic listening task) presentations. The maximum rule model best characterized both ability groups in that simultaneous encoding produced no better recall than unilateral presentations. While the results support the hypothesis that both ability groups use similar processes in the combining of hemispheric resources (i.e., weak/dominant processing), ability group differences do occur in the coordination of such resources.

Cerebral Cortex↗
PubMed1992

Coping resources of women with premenstrual syndrome.

The purpose of this study was to determine what coping resources are used by women who suffer from premenstrual syndrome (PMS), and to compare the coping resources used with those of a normative population. Two hundred forty-four women volunteered to be in the study. After screening and a 3-month lapse time required for diary completion, 54 subjects remained in the study. A history developed by the researchers, menstrual diaries, and the Coping Resources Inventory (CRIS) were used in data collection. The findings indicate a statistically significant relationship between the dependent variable, severity of PMS, and the independent variables, self-disclosure, stress monitoring, social support, and structure. There was a positive relationship between self-disclosure and stress monitoring with severity of PMS, and an inverse relationship between social support and structuring and severity of PMS.

Adaptation, Psychological↗
PubMed2006

Evaluation of a community health promotion resource for primary care practices.

BACKGROUND: Primary care physicians' ability to provide effective health behavior change advice might be leveraged by linking to available community resources. This study evaluates tools to facilitate such a link. DESIGN: A mixed methods longitudinal pre-post-test study was conducted in 2004. SETTING/ PARTICIPANTS: Seven primary care practices in northeast Ohio and two longitudinal cohorts of patients (n=784). INTERVENTION: The practice-tailored intervention included two main components: (1) a web-based health behavior change resource including a database of community programs and patient education materials, and (2) a health behavior prescription pad. MAIN OUTCOME MEASURES: Rates of discussion of diet, exercise, weight management, and smoking cessation; and patient change in motivation to modify behaviors at 8 weeks post-visit. Qualitative field notes about practice routines, culture, and implementation efforts were analyzed to enhance understanding of the practice change process. RESULTS: The post-intervention cohort reported higher rates of discussion of diet (25.7% vs 20.2%), exercise (27.8% vs 16.9%), and weight management (23.2% vs 16.3%), and greater referral to patient education materials (24.2% vs 21.6%) and community programs for health behavior change (16.0% vs 13.6%) (p<0.05). No difference in change in patient motivation to modify behavior was observed between the pre- and post-intervention cohorts. Evaluation of the qualitative field notes suggests that for six of seven practices, the intervention was not appreciably implemented. CONCLUSIONS: The intervention tools show promise for increasing clinician discussion of health behaviors, information referral, and referral to community resources. Additional work to increase practice adoption of the tools is required to understand their potential to affect patient motivation to change behavior.

Adult↗
PubMed2006

Simulating the pattern of right-hemisphere-damaged patients for the processing of the alternative metaphorical meanings of words: evidence in favor of a cognitive resources hypothesis.

Lately, many studies have suggested that communication impairments in brain-damaged individuals might be explained--at least in part--in terms of cognitive resource allocation. Reproducing a clinical pattern in normal subjects by using a dual-task treatment might be a way of evaluating the role of cognitive resources in the right hemisphere's contribution to verbal communication. This study suggests that the RH's presumed specific contribution to the processing of the alternative metaphorical meanings of words is, at least to some extent, the expression of the RH's complementary, and necessary, contribution to the pool of attentional resources needed for the most effortful processing.

Aged↗
PubMed2004

Web resources for the carbohydrate chemist.

Bioinformatics has played a pivotal role in advancing genetics and protein sciences. The large amount of information generated by genomics, and now proteomics, has been a driving force. By comparison, glycobiology still generates small amounts of data. The need to organize our knowledge about carbohydrates is however growing constantly and has given rise to an increasing number of public databases and freely available tools. This review gives an overview of the carbohydrate-oriented resources currently available on the Internet. Many of the resources are seldom referred to in the literature and difficult to find, in part because of the constant flux of the net itself, but also because many efforts have been lead by a single individual. As the World Wide Web has matured the number of 'permanent' resources, maintained by organizations rather than individuals, has increased. In this paper, we present some of the more useful and accessible public tools and databases. There are also a few commercial initiatives but these have not been reviewed.

Biochemical Phenomena↗