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PubMed1992

Process and structure: resource management and the development of sub-unit organisational structure.

Resource Management (RM) requires hospital units to manage their work in new ways, and the new management processes affect, and are affected by, organisation structure. This paper is concerned with these effects, reporting on the basis of a three-year evaluation of the national RM experiment that was commissioned by the DH. After briefly indicating some of the major characteristics of the RM process, the two main types of unit structures existing in the pilot sites at the beginning of the experiment, unit disciplinary structure and clinical directorates, are analysed. At the end of the experiment, while clinical directorates had become more popular, another variant, clinical grouping, had replaced the unit disciplinary structure. Both types of structure represent a movement towards sub-unit organisation, bringing the work and interests of the service providers and unit managers closer together. Their properties are likewise analysed and their implications, particularly in terms of training and organisational development (OD), are then considered. The paper concludes by considering the causes for these structural changes, which, in the immediate time-scale, appear to owe as much to the NHS Review as to RM.

Decision Making, Organizational↗

PubMed2000

Evolutionarily Stable Strategies for Consuming a Structured Resource.

A general consumer-resource model assuming discrete consumers and a continuously structured resource is examined. We study two foraging behaviors, which lead to fixed and flexible patch residence times, in conjunction with a simple consumer energetics model linking resource consumption, foraging behavior, and metabolic costs. Results indicate a single, evolutionarily stable foraging strategy for fixed and flexible foraging in a nonspatial environment, but flexible foraging in a spatial environment leads to consumer grouping, which affects the resource distribution such that no single foraging strategy can exclude all other strategies. This evolutionarily stable coexistence of multiple foraging strategies may help explain a dichotomous pattern observed in a wide variety of natural systems.

competitive coexistence↗

PubMed2002

Protein structure resources.

The Protein Data Bank (PDB) is the primary source of macromolecular structure data for a worldwide community of users. A subset of those users then process these data to derive secondary information which is also available on the WWW. This process includes validation, some form of reductionism, via sequence or structure, or visualization. The result, a set of further web-accessible resources on protein structure and functional classification, links to primary genomic information, protein-protein and protein-ligand interactions, protein dynamics and protein-modeling resources. This paper reports on these processes and a subset of the web resources that result.

Crystallography, X-Ray↗

PubMedDate not supplied

The peptaibol database: a sequence and structure resource.

The peptaibols are a large family of membrane-active peptides with considerable sequence homology, but with different biological properties and three-dimensional structures. They constitute a rich resource of naturally occurring 'mutants' which are potentially valuable for structure/function studies of ion channels. A searchable on-line database of sequences and structures of the peptaibols has been created at http://www.cryst.bbk.ac.uk/peptaibol, as a resource for the biological and structural community. In this paper, the contents and organization of the website are discussed as well as procedures for submission of new entries to the database. At present, more than 300 peptaibol sequences are stored in the database. Each sequence entry contains its full literature reference and information about its biological source. Tools are provided for searching for specific peptaibol sequences or groupings of sequences, and for locating peptaibols containing specified sequence motifs. In addition the website acts as a database for structural information. The coordinates of all currently available peptaibol x-ray and NMR structures are included and complemented, where appropriate. with molecular graphics illustrations. These include figures of model channel structures and comparisons between different peptaibol structures. The peptaibol database thus provides a tool for ready access to information and a means of investigating the sequences and structures of this class of polypeptides.

Amino Acid Sequence↗

PubMed2005

Teaching resources. Structure of G-protein-coupled receptors and G proteins.

This Teaching Resource provides lecture notes and slides for a class covering the structure and function of G protein-coupled receptors and is part of the course "Cell Signaling Systems: A Course for Graduate Students." The lecture begins with a discussion of the crystal structure of rhodopsin and G protein subunits and then proceeds to describe the molecular mechanisms of receptor activation and the subsequent release of G proteins.

Animals↗

PubMed1993

Optimum use of limited resources. Structured teaching in the clinical area.

1. Structured teaching requires written teaching plans. 2. A teaching plan should describe objectives, teaching methods and methods of assessment. 3. Explanation, demonstration and practice are key stages in teaching skills in the clinical area. 4. NVQs can be adapted to form practical teaching plans.

Clinical Competence↗

PubMed1999

The Homeodomain Resource: sequences, structures and genomic information.

The Homeodomain Resource is a comprehensive collection of sequence, structure and genomic information on the homeodomain protein family. Available through the Resource are both full-length and domain-only sequence data, as well as X-ray and NMR structural data for proteins and protein-DNA complexes. Also available is information on human genetic diseases and disorders in which proteins from the homeodomain family play an important role; genomic information includes relevant gene symbols, cytogenetic map locations, and specific mutation data. Search engines are provided to allow users to easily query the component databases and assemble specialized data sets. The Homeodomain Resource is available through the World Wide Web at http://genome.nhgri.nih.gov/homeodomain

Animals↗

PubMed2002

A variable structure, less resource intensive modification of problem-based learning for pharmacology instruction to health science students.

A less resource intensive but more structured modification of problem-based learning was developed to teach pharmacology to pharmacy students in classes of 90 students. The method utilizes an active learning tool developed from cognitive science and cognitive learning theory. This case-based approach was developed to address the need to teach problem-solving skills to relatively large classes while conserving faculty and other resources. The method involves students working through cases in small groups according to a prescribed format. Groups are chosen at random to present the case to the whole class followed by open but structured discussion. Students bring recommended texts to class and groups are asked to answer questions relating to the material in the case, or to determine how the way their approach to the case would differ if patient parameters or medications in the case were altered utilizing the required texts. Each class begins with a short 1-min quiz on the fact-based material to be discussed that day and ends with a wrap-up of critical issues or principles learned. Continual probing of "what" and "why" characterizes each class meeting. Examinations are predominately open book and follow the same format as the in class cases. Learning outcomes for each general topic are provided at the beginning of the semester. Although the method does require students to learn pharmacology "facts", it places the facts within the context of application to practice. Rather than memorizing lists of side effects, for example, the format requires utilizing the side effects list and information about them to appropriately counsel the patient on how to deal with each and/or to suggest modifications in the therapy. Since implementing this method in an endocrine pharmacology course, student performance on problem-solving examinations has improved. Additionally, student evaluation of the method is extremely positive.

Adult↗

PubMed2004

Which organizational characteristics are associated with increased management of depression using antidepressants in US nursing homes?

BACKGROUND: There is universal agreement that organizational characteristics of nursing facilities can and do influence the quality of care and resident outcomes. OBJECTIVE: This study evaluated the relation between organizational characteristics and management of depression using antidepressants. RESEARCH DESIGN: This was a cross-sectional study of Medicare/Medicaid certified nursing homes in 6 states in 2000. SUBJECTS: We studied 87,907 residents with depression in 2,128 facilities. MEASURES: Minimum Data Set (MDS) provided information regarding use of antidepressants and resident factors. On-line Survey and Certification of Automated Records (OSCAR) provided facility characteristics information including structural, resource, and staffing levels. Adjusted estimates of organizational effects on antidepressant drug use were derived from generalized estimating equations. RESULTS: Increased treatment of depression with antidepressants was associated with facilities with a higher percentage of residents from payer sources other than Medicare/Medicaid (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.02-1.06) and more professional nursing staff (OR, 1.15; 95% CI, 1.05-1.26). Decreased treatment tended to be related to larger homes (OR, 0.76; 95% CI, 0.68-0.84) or if the home employed full-time physicians (OR, 0.87; 95% CI, 0.78-0.96). Once the decision to treat was made, treatment with tricyclics tended to be inversely related to larger homes, for-profit facilities, and homes with more Medicare residents. CONCLUSIONS: Facilities that are required to be more fiscally conservative, be it larger facilities with fewer private pay patients or for profit facilities, have lower rates of pharmacologic treatment. Resource and structural characteristics influence the type of antidepressant being prescribed; resident characteristics may not be the over-riding factor in prescribing.

Activities of Daily Living↗

PubMed1994

Aye-ayes: specialists on structurally defended resources.

During the course of a 2-year field study on aye-ayes (Daubentonia madagascariensis), data were collected on dietary composition, food acquisition and structural properties of food resources. Aye-ayes in this study sampled remarkably few species from a variety of food types. A majority of these resources were heavily structurally defended and therefore difficult of access for other mammals. Aye-ayes used their modified finger and anterior teeth to harvest most of these resources.

Animals↗

PubMed2005

RPBS: a web resource for structural bioinformatics.

RPBS (Ressource Parisienne en Bioinformatique Structurale) is a resource dedicated primarily to structural bioinformatics. It is the result of a joint effort by several teams to set up an interface that offers original and powerful methods in the field. As an illustration, we focus here on three such methods uniquely available at RPBS: AUTOMAT for sequence databank scanning, YAKUSA for structure databank scanning and WLOOP for homology loop modelling. The RPBS server can be accessed at http://bioserv.rpbs.jussieu.fr/ and the specific services at http://bioserv.rpbs.jussieu.fr/SpecificServices.html.

Computational Biology↗

PubMed1989

The structure of resource preferences.

This paper outlines the development and testing of the PW questionnaire (Persönliche Wunschvorstellungen-Resource Preferences)--a German version of the IWIR (Inventory of Wishes for Interpersonal Resources; Foa & Bosman, 1979). The PW is based on a taxonomy of resource classes (love, services, goods, money, information, status) proposed by resource theory (Foa & Foa, 1974). The questionnaire was administered to a stratified sample (447 subjects) for the testing of various structural propositions of resource theory. In general, the results support the predicted theoretical order of resource preferences, but the expected two-dimensional hyperstructure (concreteness, particularism) found in American studies must be eked out with an evaluative dimension. The hypothesized circumplex structure of resource classes is dominated by a general component, partly contradicting some theoretical propositions of resource theory.

Adolescent↗

PubMed2001

The Homeodomain Resource: sequences, structures, DNA binding sites and genomic information.

The Homeodomain Resource is an annotated collection of non-redundant protein sequences, three-dimensional structures and genomic information for the homeodomain protein family. Release 3.0 contains 795 full-length homeodomain-containing sequences, 32 experimentally-derived structures and 143 homeo-box loci implicated in human genetic disorders. Entries are fully hyperlinked to facilitate easy retrieval of the original records from source databases. A simple search engine with a graphical user interface is provided to query the component databases and assemble customized data sets. A new feature for this release is the addition of DNA recognition sites for all human homeodomain proteins described in the literature. The Homeodomain Resource is freely available through the World Wide Web at http://genome.nhgri.nih.gov/homeodomain.

Animals↗

PubMedDate not supplied

Effects of medical practice structure on resource use.

The drive to national health care reform has made a central issue of variations among physicians in the use of resources to treat similar cases. While much research exists on this issue, little of it concentrates on the impact of practice structure on resource use. In this column, the author comments on that research. This column is intended as a point of ongoing analysis of health services research of importance to physician executives. The column is edited by John Kralewski, PhD, who heads the Institute for Health Services Research at the University of Minnesota.

Group Practice↗

PubMed2006

sgTarget: a target selection resource for structural genomics.

sgTarget (http://www.ysbl.york.ac.uk/sgTarget) is a web-based resource to aid the selection and prioritization of candidate proteins for structure determination. The system annotates user submitted gene or protein sequences, identifying sequence families with no homologues of known structure, and characterizing each protein according to a range of physicochemical properties that may affect its expression, solubility and likelihood to crystallize. Summaries of these analyses are available for individual sequences, as well as whole datasets. This type of analysis enables structural biologists to iteratively select targets from their genomic sequences of interest and according to their research needs. All sequence datasets submitted to sgTarget are available for users to select and rank using their choice of criteria. sgTarget was developed to support individual laboratories collaborating in structural and functional genomics projects and should be valuable to structural biologists wishing to employ the wealth of available genome sequences in their structural quests.

Animals↗

PubMed2007

The family medicine curriculum resource project structural framework.

BACKGROUND: In the original contract for the Family Medicine Curricular Resource Project (FMCRP), the Health Resources and Services Administration (HRSA), Division of Medicine and Dentistry, charged the FMCRP executive committee with reviewing recent medical education reform proposals and relevant recent curricula to develop an analytical framework for the project. METHODS: The FMCRP executive and advisory committees engaged in a review and analysis of a variety of curricular reform proposals generated during the last decade of the 20th century. At the same time, in a separate and parallel process, representative individuals from all the family medicine organizations, all levels of learners, internal medicine and pediatric faculty, and the national associations of medical and osteopathic colleges (Association of American Medical Colleges and the American Association of Colleges of Osteopathic Medicine) were involved in group discussions to identify educational needs for physicians practicing in the 21st century. RESULTS: After deliberation, a theoretical framework was chosen for this undergraduate medical education resource that mirrors the Accreditation Council for Graduate Medical Education (ACGME) competencies, a conceptual design originated for graduate medical education. DISCUSSION: In addition to reflecting the current environment calling for change and greater accountability in medical education, use of the ACGME competencies as the theoretical framework for the FMCR provides a continuum of focus between the two major segments of physician education: medical school and residency.

Clinical Competence↗

PubMed1990

Memory deficit in clinical depression: processing resources and the structure of materials.

Resource theory predicts that the relative memory deficit shown by depressed patients should be greater with unstructured than structured material. Previous data using semantic categories word lists supports this, but lists approximating to text have produced the opposite result. Both types of structure were studied in this experiment. The prediction from resource theory was found to hold only when comparing medium and high levels of structure, and to hold more clearly for word lists approximating to text than for semantic categories lists. When word lists of low and medium levels of structure were compared, depressed patients showed relatively greater deficit with the more structured material. Ways in which this could be accommodated in a revised version of resource theory are discussed.

Adult↗

PubMed1993

Quality of care from a patient perspective--a grounded theory study.

The aim of the present study was to develop a theoretical understanding of quality of care from a patient perspective, using a grounded theory approach. Thirty-five interviews were conducted with a sample of 20 adult hospitalized patients (mean age: 60 years) in a clinic for infectious diseases. Data were analysed according to the constant comparative method. A model was formulated according to which quality of care can be understood in the light of two conditions, the resource structure of the care organization and the patient's preferences. The resource structure of the care organization consists of person-related and physical- and administrative environmental qualities. The patient's preferences have a rational and a human aspect. Within this framework, patients' perceptions of quality of care may be considered from four dimensions: the medical-technical competence of the caregivers; the physical-technical conditions of the care organization; the degree of identity-orientation in the attitudes and actions of the caregivers and the socio-cultural atmosphere of the care organization. The model is discussed in relation to existing theories in the field.

Adult↗