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PubMed2002

The historical development of human resources policies in the health sector of four Caribbean territories: imitated or created?

Health systems are labour intensive, dependent on a mix of professionals to provide health care in both public and private sectors. In this paper, we explore the historical development of human resources, focusing on doctors and nurses, in four Caribbean territories-the Bahamas, Martinique, Suriname and Trinidad and Tobago. All these territories have faced issues around the out-migration of doctors and nurses and tensions between public health, hospital services and private sector policies. Early policies to increase the number of nurses and doctors were costly, because they were implemented against a tide of increasing outward migration. Both push and pull factors were evident. Human resources policies focused on ways to counter pull factors-such as introducing regional medical training-but neglected push factors. These began to be addressed from the 1980s on, although tensions between public health, hospital services and private sector policies led to resistance and conflicts in attitudes to reform among health professionals. Policy responses were the product of many influences, and it is too simple to conclude they were either imported from abroad or internally generated. However, it is clear that in all four territories the medical profession played a dominant role in human resources policy development either directly or indirectly.

Bahamas↗
PubMed2000

Design and implementation of an Internet-based health information resource.

In support of its institutional mission of community service, the Medical College of Wisconsin created a digital library of health information. This Internet-based resource, named MCW HealthLink, provides health news and information geared to patients, their family members, and the community at large. Information is delivered through a World Wide Web site and an e-mail newsletter. The web and e-mail components are integrated to maximize their utility to readers. This article describes the philosophy, design and implementation of the resource. Ongoing efforts include development of a health information resource tailored to the needs of individual readers.

Community Health Services↗
PubMed2000

Pulsed resources and community dynamics of consumers in terrestrial ecosystems.

Many terrestrial ecosystems are characterized by intermittent production of abundant resources for consumers, such as mast seeding and pulses of primary production following unusually heavy rains. Recent research is revealing patterns in the ways that consumer communities respond to these pulsed resources. Studies of the ramifying effects of pulsed resources on consumer communities integrate 'top-down' and 'bottom-up' approaches to community dynamics, and illustrate how the strength of species interactions can change dramatically through time.

Journal Article↗
PubMedDate not supplied

The FLEXGene repository: exploiting the fruits of the genome projects by creating a needed resource to face the challenges of the post-genomic era.

Thanks to the results of the multiple completed and ongoing genome sequencing projects and to the newly available recombination-based cloning techniques, it is now possible to build gene repositories with no precedent in their composition, formatting, and potential. This new type of gene repository is necessary to address the challenges imposed by the post-genomic era, i.e., experimentation on a genome-wide scale. We are building the FLEXGene (Full Length EXpression-ready) repository. This unique resource will contain clones representing the complete ORFeome of different organisms, including Homo sapiens as well as several pathogens and model organisms. It will consist of a comprehensive, characterized (sequence-verified), and arrayed gene repository. This resource will allow full exploitation of the genomic information by enabling genome-wide scale experimentation at the level of functional/phenotypic assays as well as at the level of protein expression, purification, and analysis. Here we describe the rationale and construction of this resource and focus on the data obtained from the Saccharomyces cerevisiae project.

Animals↗
PubMed1997

A model of educational resource use by children with cochlear implants.

We have tracked patterns of use of educational and rehabilitative resources as part of an initial assessment of cost-benefit ratios of cochlear implants in children. Forty-two children with cochlear implants in the Listening Center at Johns Hopkins program of aural rehabilitation have served as our study cohort to develop the measures to be assessed. An educational resource matrix stratifies school setting (residential vs special education vs non-specialized "mainstream" setting) and levels of rehabilitative support (speech and language therapy and interpreter use) to map past and current use of these services. Initial cost-benefit projections based on observed advancement toward educational independence in the educational resource matrix indicate an extremely favorable net present value of the implant (cost savings minus cost). These cost-benefit projections will need to be supplemented with measures of the impact on quality of life and future educational and vocational options to determine the overall cost-effectiveness of cochlear implants in children.

Baltimore↗
PubMed1999

Effects of an emergency department-based advocacy program for battered women on community resource utilization.

STUDY OBJECTIVE: The emergency department is often accessed by battered women. Although it is recommended that information about community resources be given to women, there is little information regarding how often women use these resources. The objective of this study was to determine whether an ED-based advocacy program resulted in increased community resource utilization by battered women. METHODS: The study used a before-after trial design at an urban county hospital ED. Before the program, a consecutive sample of 117 women was identified in the ED as having sustained injuries by domestic violence. After the program, a consecutive sample of 105 (57% of the 183 asked) who agreed to meet with an advocate in the ED was identified. Participants in both groups lived in Kansas City, Missouri, and were 18 years of age or older. The outcome measures were the proportion of women with shelter use, shelter-based counseling, police calls, full orders of protection, and repeat ED visits for domestic violence after the index ED visit. RESULTS: After the initiation of the program, shelter use increased from 11% to 28% (P =.003) and shelter-based counseling increased from 1% to 15% (P <.001). There was no change in repeat police calls (25% versus 35%, P =.14), full orders of protection (9% versus 6%, P =. 58), or repeat ED visits for domestic violence (11% versus 8%, P =. 63). CONCLUSION: ED-based advocacy for domestic violence resulted in increased use of shelters and shelter-based counseling.

Adolescent↗
PubMed1996

CDC and ATSDR electronic information resources for health officers.

This article catalogs some of the Centers for Disease Control and Prevention's (CDC) more important information resource offerings, which make public health information accessible via computer and automated telephone systems and on electronic media (diskette and CD-ROM). We review mechanisms for (1) finding and retrieving CDC reports, (2) querying CDC's numeric data files, (3) transmitting surveillance and other data files to CDC, (4) exchanging electronic mail with CDC staff, and (5) disseminating state and local public health information and data by using CDC tools. Each resource is followed with a section on how to obtain access to these resources.

CD-ROM↗
PubMed2004

[Quality analysis of the statistical used resources (material and methods section) in thesis projects of a university department].

INTRODUCTION AND OBJECTIVES: Studies about quality in thesis and investigation projects in biomedical sciences are unusual, but very important in university teaching because is necessary to improve the quality elaboration of the thesis. The objectives the study were to determine the project's quality of thesis in our department, according to the fulfillment of the scientific methodology and to establish, if it exists, a relation between the global quality of the project and the statistical used resources. MATERIAL AND METHODS: Descriptive study of 273 thesis projects performed between 1995-2002 in surgery department of the Zaragoza University. The review realized for 15 observers that they analyzed 28 indicators of every project. Giving a value to each of the indicators, the projects qualified in a scale from 1 to 10 according to the quality in the fulfillment of the scientific methodology. RESULTS: The mean of the project's quality was 5.53 (D.E: 1.77). In 13.9% the thesis projects was concluded with the reading of the work. The three indicators of statistical used resources had a significant difference with the value of the quality projects. DISCUSSION: The quality of the statistical resources is very important when a project of thesis wants to be realized by good methodology, because it assures to come to certain conclusions. In our study we have thought that more of the third part of the variability in the quality of the project of thesis explains for three statistical above-mentioned articles.

Academic Dissertations as Topic↗
PubMed1998

Effect of nutritional status on use of health care resources by patients with chronic disease living in the community.

The prevalence of malnutrition in patients with chronic disease living in the community in the UK is around 8%. Whether such patients experience greater morbidity and mortality or make increased use of health care resources is unknown. The aim of this study was to investigate how the use of health care resources by patients with chronic disorders of the respiratory, gastrointestinal and neurological systems varied by nutritional status. We used longitudinal data, collected since 1987, which formed part of the General Practice Research Database in the UK. Subjects were 11 357 men and women aged 18 years or over. Main outcomes were consultation rates in general practice, prescription rates, hospital referral rates, hospital admission rates and mortality. Consultation and prescription rates were lowest amongst patients whose body mass index (BMI) was between 20 and 25. Rates were higher in patients whose BMI was below 20, or 25 and above. There was no statistically significant relation between rate of hospital outpatient referral and nutritional status, but both hospital admission rate and mortality were greatest in those people whose BMIs were below 20 and declined as BMIs increased. In patients with differential use of health care resources in both primary care and hospital practice, and with differences in mortality.

Adolescent↗
PubMed2000

Can incineration technology convert CELSS wastes to resources for crop production? A working hypothesis and some preliminary findings.

Considerable evidence exists to support the hypothesis that human-generated wastes can be utilized as resources in crop production. In the waste mix from a Closed Ecological Life Support System (CELSS), the elemental resources are found mainly in the solid fraction. In order to make these resources available for crop growth, it is necessary to convert the solid wastes to either an aqueous or a gaseous phase. Incineration is one method for processing solid wastes to produce a gaseous fraction and a small solid fraction of ash. Evidence from literature provides a compelling case for a working hypothesis that plants can utilize the gases of incineration. Although uptake and utilization of inorganic elements in the aqueous phase is well established, the uptake and utilization of inorganic elements in the gaseous phase, with the exception of CO2 and O2, is not fully understood. This paper attempts to (a) summarize existing literature on uptake/metabolism of inorganic elements in the gaseous fraction, with the exception of CO2 and O2 and (b) develop a working hypothesis to predict the use of incineration flue gases by plants. Preliminary experimental findings on effects of carbon monoxide, a component of the flue gas, are also presented.

Agriculture↗
PubMed2002

The influence of work, household structure, and social, personal and material resources on gender differences in health: an analysis of the 1994 Canadian National Population Health Survey.

Data from the 1994 Canadian National Population Health Survey (NPHS) do not confirm the widespread assumption that women experience considerably more ill health than men. The patterns vary by condition and age and at many ages, the health of women and men is more similar than is often assumed. However, we should not minimize the gender differences that do exist and in this paper we focus on three health problems which are more common among women: distress, migraine and arthritis/rheumatism. We consider to what extent work, household structure and social, personal and material resources explain these gender differences in health. Analysis of the distributions of paid work conditions, household circumstances and resources reveal mostly minor differences by gender and differences in exposure to these circumstances contribute little to understanding gender differences in health. There is also little evidence that greater vulnerability is a generalized health response of women to paid and household circumstances. We find limited evidence that social, personal and material resources are involved in pathways linking work and home circumstances to health in ways that differ between the sexes. In conclusion, we consider some reasons for the lack of support for our explanatory model: the measures available in the NPHS data set which contains little information on the household itself; the difficulty of separating 'gender' from the social and material conditions of men's and women's lives; and changes in women's and men's roles which may have led to a narrowing of differences in health.

Adolescent↗
PubMed1998

"Communitarian claims" as an ethical basis for allocating health care resources.

This paper presents the case for re-examining the most commonly adopted basis of resource allocation in health care, i.e. need. The key problems identified with most needs approaches are (a) defining its precise meaning, (b) that the community is seldom consulted as to first what constitute needs for health care or second what relative weights are to be attached to health gains aimed at addressing different needs and (c) more generally, proceeding without knowing what the community wants the objectives of health care to be. It is suggested that John Broome's notion of "claims", especially what this paper calls "communitarian claims", may be helpful in providing a better basis for allocating health care resources. Such "communitarian claims" allow inter alia for the community to be involved in setting the social choice rules with respect to the governance of health care and for determining what it is that it (the community) wants from its health service. The links to rights are also identified and the advantages of communitarian claims over both a simple concept of need and rights are set out, without arguing that either needs (or rights) ought necessarily to be abandoned as bases for resource allocation in health care.

Australia↗
PubMed2003

Semantic processing of words, cognitive resources and N400: an event-related potentials study.

The specificity of the right hemisphere (RH) contribution to the semantic processing of words is still debated. Indeed, the semantic impairments of right hemisphere damaged (RHD) subjects may be the expression of limited general cognitive resources rather than a specific impairment of semantic processing ([Monetta et al., 2001]; [Murray, 2000]). The purpose of this study was to evaluate the possibility that the N400 reflect the availability of cognitive resources through an analysis of its different amplitudes according to different semantic complexity level. Ten young adults without any history of neurological damage participated in a semantic categorization task with two different levels of difficulty based on prototypicality. Event related potential (ERP) signals from 64 electrodes were recorded. An N400 was observed during the processing of difficult words and distractors. The results show that the greatest N400 activation was observed during the processing of difficult words, thus reflecting a possible increase in the amount of required cognitive resources.

Adult↗
PubMed2001

Subnational sources of toxicology information: state, territorial, tribal, county, municipal, and community resources online.

The rapid assimilation data and information on the Internet and the World Wide Web (WWW) is reflected in the development of these electronic services by state, county, local, and other subnational agencies, departments, offices, bureaus, and intergovernmental bodies. The content of state and territorial, tribal, county, and local government Web pages varies considerably. However, information about health and the environment are among the most frequently posted resources by subnational government bodies. This article describes the environmental health and toxicology-related data and information resources provided by government agencies and representative associations for subnational government bodies. Standard reference sources for identifying subnational government bodies are described with particular reference to those in electronic and digital formats. Means for identifying and locating electronic resources are described for appropriate subnational environmental quality, environmental (public) health agencies, occupational health and safety, toxicology-related agencies and departments, emergency response, fish consumption advisories, and cancer registries are provided. Professional organizations of state, county, municipal (local) governments and intergovernmental bodies are also described.

Environmental Health↗
PubMed2002

Web resources for drug toxicity.

Information on drug toxicity is used primarily by three segments of the health care industry: the consumer or patient, healthcare practitioners, and research and development (R&D) scientists in the pharmaceutical industry. The major focus of both consumers and health care practitioners is the provision of suitable information for the safe use of drugs for both individuals and specific patient populations. Therefore, accurate information on potential side effects and drug-drug and food-drug interactions is critical. For pharmaceutical scientists, the use of toxicity information is more complex and has become an essential part of the R&D process. The high rate of failures in drug development has precipitated the utilization of all available resources to gather relevant information that may improve the process of drug development. The web is a growing source of information and services for the pharmaceutical industry. Web-based resources for non-clinical drug development include tools for virtual discovery such as silico ADME/Toxicity programs, access to information regarding in vitro and in vivo testing, new data management options, and the latest regulatory guidelines and industry news. These resources are reviewed from the perspective of a toxicologist.

Animals↗
PubMed2002

WEB resources for pesticide toxicology, environmental chemistry, and policy: a utilitarian perspective.

Information about pesticides has grown exponentially over the last four decades and is marked by a diversity of sources including government, universities, environmental advocates, and industry. The internet has made access to this unprecedented amount of information faster than ever, but judging the validity and usefulness of the information is problematic. To avoid turning this discussion of web resources for pesticide information into a narrative about a personal 'top ten' list, a utilitarian perspective of resources useful to a research, educator, and risk communicator is elucidated. Useful web sites are fit into the context of information needed for risk assessment, which includes hazard identification, dose-response relationships, exposure assessment, and risk characterization. In addition resources for pesticide policy and regulations are considered. Specific ways in which the sites are useful are discussed along with information about site updating and validation of information.

Animals↗
PubMed1997

Imaging resources.

The concept of resources has been used in cognitive psychology to refer to computations specific to a given cognitive domain (e.g. orthographic code for words) and those general to many domains (arousal and attention). In this chapter we examine efforts to provide a picture of both kinds of resources with methods designed to explore the anatomy and circuitry of cognitive operations. We conclude that the two types of resources have separable if rather complex anatomical loci and that their common circuitry leads to interactions in which attention and arousal can influence the priority of the task specific cognitive operations. Many situations such as priming, mix the role of automatic activation of specific computations and attention to those same computations. We review some evidence from anatomical and circuit studies that indicate that the anatomy of priming relates closely to the computation involved in the task and suggest methods for separating automatic and attended influences on priming.

Brain↗
PubMedDate not supplied

Resource utilization in the emergency department: the duty of stewardship.

As the pool of available health care resources continues to evaporate, emergency physicians will be increasingly required to guard against the provision of expensive, unnecessary, and marginally beneficial care. This article proposes that emergency physicians embrace the ethic of prudent resource stewardship to ensure the continued availability of emergency services to all who need them. When making resource allocation decisions, emergency physicians must consider the likelihood, magnitude, and duration of benefits to patients, the urgency of the condition, and the cost and burdens of treatment to patients, payers, and society. These considerations go beyond professional duties to individual patients and suggest that ignoring the burdens of emergency department microallocation decisions is socially and morally irresponsible.

Emergency Service, Hospital↗