bluuebunny/crossref_metadata_2025 huggingface dataset:
Pressure effect of growing with electron beam‐induced deposition with tungsten hexafluoride and tetraethylorthosilicate precursor
Authors: Choi Young R. , Rack Philip D. , Randolph Steven J. , Smith Daryl A. , Joy David C.
Published: July 2010

Electron beam‐induced deposition (EBID) provides a simple way to fabricate submicron‐ or nanometerscale structures from various elements in a scanning electron microscope (SEM). The growth rate and shape of the deposits are influenced by many factors. We have studied the growth rate and morphology of EBID‐deposited nanostructures as a function of the tungsten hexafluoride (WF6) and tetraethylorthosilicate (TEOS) precursor gas pressure and growth time, and we have used Monte Carlo simulations to model the growth of tungsten and silicon oxide to elucidate the mechanisms involved in the EBID growth. The lateral radius of the deposit decreases with increasing pressure because of the enhanced vertical growth rate which limits competing lateral broadening produced by secondary and forward‐scattered electrons. The morphology difference between the conical SiOx and the cylindrical W nanopillars is related to the difference in interaction volume between the two materials. A key parameter is the residence time of the precursor gas molecules. This is an exponential function of the surface temperature; it changes during nanopillar growth and is a function of the nanopillar material and the beam conditions.
Microstructural characterization of degradation in a high‐chromium alloy in the sugar industry
Authors: Zumelzu E. , Parada A. , Goyos L. , Bobadilla C.
Published: July 2010

A new high (24%)‐chromium alloy was experimentally manufactured by combining the particular chemical composition of various materials with the use of thermal treatments to produce pump impellers for the sugar industry. The alloy metal was tested in situ in a sugar medium and then evaluated by electrochemical measurements; the two former procedures were associated with a nontraditional method to assess the susceptibility and resistance to corrosion. Potentiostatic and atomic absorption measurements were carried out to characterize the degradation and damage morphology by scanning electron microscopy (SEM) observations. The trials proved a good performance for the new alloy in the sugar medium in spite of nonsignificant localized damages involving erosion‐corrosion mechanisms and surface microcrackings of the material.
Detection of lip, alveolar ridge and hard palate abnormalities using two‐dimensional ultrasound enhanced with the three‐dimensional reverse‐face view
Authors: Sommerlad M. , Patel N. , Vijayalakshmi B. , Morris P. , Hall P. , Ahmad T. , Campbell S. , Lees C.
Published: July 2010

Objective

The aim of this study was to assess conventional two‐dimensional (2D) ultrasound enhanced with a three‐dimensional (3D) ultrasound technique, the ‘reverse‐face’ view (3D‐RF) in prenatal evaluation of the involvement of the lips, alveolar ridge and secondary palate in suspected isolated orofacial clefting.

Methods

One hundred and twenty‐four cases of suspected orofacial clefting diagnosed by a routine 2D ultrasound scan were referred for specialist ultrasound at 20–34 weeks' gestation for a detailed assessment of the lips and palate using both 2D and 3D ultrasound. For the 3D examination the lips and alveolar ridges were examined both in profile and in the frontal plane. The palate was then assessed in the reverse coronal view by rotating the face through 180° on the vertical axis to produce the 3D‐RF view. Antenatal diagnoses were compared with postnatal findings. Left and right lip and alveolar ridge defects were counted separately according to the Kernohan ‘striped Y’ classification.

Results

Of 124 patients, 110 had isolated facial clefts and were available for follow‐up; in 10, 3D‐RF views were not successfully obtained, leaving 100 cases for assessment. The sensitivity of the 2D enhanced with 3D‐RF technique for the diagnosis of cleft of the lip was 116/122 (95%), false‐positive rate (FPR) 7.7%; for alveolar ridge was 87/103 (84.5%), FPR 7.2%; and for hard palate was 61/68 (89.7%), FPR 15.6%.

Conclusion

The data reported represent the largest series of orofacial abnormalities diagnosed by 2D ultrasound and enhanced with 3D imaging to refine the detection of clefts of the hard palate. The technique is feasible in 90% of patients in whom almost 90% have a correct classification of clefts of the lip, alveolar ridge and palate. Copyright © 2010 ISUOG. Published by John Wiley & Sons, Ltd.
Second‐trimester assessment of gestational age in twins: validation of singleton biometry charts
Authors: Dias T. , Arcangeli T. , Bhide A. , Mahsud‐Dornan S. , Papageorghiou A. , Thilaganathan B.
Published: July 2010

Objective

To determine the accuracy of dating twin pregnancies, of between 16 and 26 weeks' gestation, using singleton head circumference (HC) formulae.

Methods

This was a retrospective study of 269 singleton and 119 twin non‐anomalous pregnancies conceived by in‐vitro fertilization (IVF) with a known embryo transfer date. Fetal ultrasound biometry data for HC, obtained using different formulae, were compared with expected fetal HC size for gestation calculated from the date of conception. Similar comparisons were undertaken for femur length (FL) and for transverse cerebellar diameter.

Results

The mean differences in HC between observed ultrasound measurements and those expected from the IVF history were small (1–4 mm) and within the measurement error for both singletons and twins for all formulae. All measurements from the larger and the smaller twins straddled those of singletons, regardless of biometry and formula used. Negative skewing of FL measurements in the smaller twin suggests that fetal growth restriction may occur at this gestation and supports the practice of dating using the HC of the larger twin.

Conclusions

Singleton pregnancy HC charts can be used to date reliably twin pregnancies. The data of the study also suggest that the HC of the larger twin is the most reliable measurement for use in dating. Copyright © 2010 ISUOG. Published by John Wiley & Sons, Ltd.
Correlation between uteroplacental three‐dimensional power Doppler indices and true uterine blood flow: evaluation in a pregnant sheep model
Authors: Morel O. , Pachy F. , Chavatte‐Palmer P. , Bonneau M. , Gayat E. , Laigre P. , Evain‐Brion D. , Tsatsaris V.
Published: July 2010

Objectives

Three‐dimensional (3D) Doppler quantification within the uteroplacental unit could be of great help in understanding and screening for pre‐eclampsia and intrauterine growth restriction. Yet the correlation between 3D Doppler indices and true blood flow has not been confirmed in vivo. The aim of this study was to evaluate this correlation in a pregnant sheep model.

Methods

A blood flow quantitative sensor and a controllable vascular occlusion system were placed around the common uterine artery in seven sheep in late pregnancy, while all the other arterial supplies were ligated. Several occlusion levels were applied, from 0 to 100%, simultaneously with 3D Doppler acquisitions of several placentomes, using standardized settings. Each placentome was analyzed using VOCAL™ (Virtual Organ Computer‐aided AnaLysis) software. The correlation between true blood flow and Doppler indices (vascularization index (VI), flow index (FI) and vascularization flow index (VFI)) was evaluated, together with measurement reproducibility.

Results

Forty‐eight acquisitions were analyzed. All 3D Doppler indices were significantly correlated with true blood flow. Higher correlations were observed for VI and VFI (r = 0.81 (0.74–0.87), P < 0.0001 and r = 0.75 (0.67–0.82), P < 0.0001) compared with FI (r = 0.53 (0.38–0.64) P < 0.0001). Both intra‐ and interobserver reproducibility were high, with intraclass correlation coefficients of at least 0.799.

Conclusion

This is the first in‐vivo experimental study confirming a significant correlation between true blood perfusion and quantitative 3D Doppler indices measured within the uteroplacental unit. These results confirm the potential usefulness of 3D Doppler ultrasound for the assessment of placental vascular insufficiency both in clinical cases and in a research setting. Copyright © 2010 ISUOG. Published by John Wiley & Sons, Ltd.
Ductus venosus velocimetry in monitoring pregnancy in women with pregestational diabetes mellitus
Authors: Wong S. F. , Petersen S. G. , Idris N. , Thomae M. , McIntyre H. D.
Published: July 2010

Objective

The purpose of this research was to assess the ability of ductus venosus (DV) Doppler velocimetry to predict adverse perinatal outcome in pregnancies complicated by pre‐existing diabetes mellitus.

Methods

This was a prospective study conducted at a tertiary referral obstetric facility in Brisbane, Australia. The study group included women with pregestational diabetes mellitus who delivered in the hospital between 1 January 1995 and 31 December 2006. The DV Doppler index was defined as abnormal if the DV peak velocity index for veins (PVIV) was equal to or greater than the 95th percentile for gestation. Adverse perinatal outcome included one or more of the following criteria: small‐for‐gestational‐age infant; Cesarean section for non‐reassuring fetal status; fetal acidemia at delivery; a 1‐min Apgar score of ⩽ 3; a 5‐min Apgar score of < 7; hypoxic ischemic encephalopathy; and stillbirth or neonatal death. The maternal characteristics and perinatal outcomes of pregnancies with normal or abnormal DV Doppler indices were compared.

Results

Eighty‐two pregestational diabetic pregnancies were studied and an abnormal DV‐PVIV was identified in 25 (30.5%). Adverse perinatal outcome was identified in eight of 25 (32.0%) pregnancies with an abnormal DV‐PVIV compared to seven of 57 (12.3%) pregnancies with a normal DV‐PVIV (P < 0.05). The sensitivity of the DV‐PVIV in predicting adverse perinatal outcomes in pregestational diabetic pregnancies was 53.3%, the specificity was 74.6%, the positive predictive value was 32.0% and the negative predictive value was 87.7%.

Conclusion

It may be useful to include DV‐PVIV in the antenatal screening of pregnancies complicated by pregestational diabetes. Copyright © 2010 ISUOG. Published by John Wiley & Sons, Ltd.
A dynamic population model for tsetse (Diptera: Glossinidae) area‐wide integrated pest management
Authors: Barclay Hugh J. , Vreysen Marc J. B.
Published: July 2010

A spatial model of tsetse (Glossina palpalis ssp. and G. pallidipes) life cycle was created in FORTRAN, and four control measures [aerial spraying of non‐residual insecticides, traps and targets, insecticide‐treated livestock (ITL) and the sterile insect technique] were programmed into the model to assess how much of each of various combinations of these control tactics would be necessary to eradicate the population. The model included density‐independent and ‐dependent mortality rates, temperature‐dependent mortality, an age‐dependent mortality, two mechanisms of dispersal and a component of aggregation. Sensitivity analyses assessed the importance of various life history features and indicated that female fertility and factors affecting survivorship had the greatest impact on the equilibrium of the female population. The female equilibrium was likewise reduced when dispersal and aggregation were acting together. Sensitivity analyses showed that basic female survivorship, age‐dependent and temperature‐dependent survivorship of adults, teneral‐specific survivorship, daily female fertility, and mean temperature had the greatest effect on the four applied control measures. Time to eradication was reduced by initial knockdown of the population and due to the synergism of certain combinations of methods [e.g., traps‐targets and sterile insect technique (SIT); ITL and SIT]. Competitive ability of the sterile males was an important parameter when sterile to wild male overflooding ratios were small. An aggregated wild population reduced the efficiency of the SIT, but increased it with increased dispersal. The model can be used interactively to facilitate decision making during the planning and implementation of operational area‐wide integrated pest management programs against tsetse.
Experimental evidence for density‐dependent reproductive output in a coral reef fish
Authors: Forrester Graham , Harmon Lindsay , Helyer Jason , Holden William , Karis Rebecca
Published: July 2010

We tested for density‐dependent reproduction in a small coral reef fish using field manipulations of density and observational data. Males of the study species, the bridled goby (Coryphopterus glaucofraenum Gill), defend benthic nest sites, within which they spawn with females, and females can spawn repeatedly over an extended breeding season. In small areas, usually only a single male nested at any one time regardless of how many males were present, so the probability of nesting was inversely proportional to density. Nesting males were almost always the largest in the vicinity, suggesting that, for males whose home ranges overlap, social interactions dictate opportunities to nest. Both the per capita rate at which clutches were laid and the number of eggs produced per clutch declined with increasing density, so the per capita rate of egg production was also density dependent. All three measures of fecundity were better predicted by numerical density (numbers per unit area) than biomass (mass of fish per unit area), and were well described as an inverse function of the number of gobies in the vicinity. A simple hypothesis consistent with these results is that a constant number of females spawn, regardless of density. Alternately, the effect of crowding may depend primarily on the number of interacting individuals and affect all females relatively equally. This density dependence could thus contribute to population regulation at the spatial scale over which populations become reproductively closed.
Palm Oil Removal from Fabric Using Microemulsion‐Based Formulations
Authors: Tanthakit Parichat , Ratchatawetchakul Pantipa , Chavadej Sumaeth , Scamehorn John F. , Sabatini David A. , Tongcumpou Chantra
Published: July 2010

Laundry detergency of palm oil on a polyester/cotton blend was measured using an anionic extended surfactant/nonionic secondary alcohol surfactant blend under conditions corresponding to ultralow oil/water interfacial tension microemulsion formation. The oil removal for the surfactant blend could exceed 90%, which was greater than that for either component surfactant alone or for a commercial liquid laundry detergent. Presoaking produced better detergency than increasing the number of wash cycles beyond two due to fabric abrasion (leading to a brightness decrease) with an excessive number of wash cycles. Higher oil contact angles and shorter oil droplet detachment times were found to correspond to higher detergency. High speed photography showed that snap‐off occurred rather than roll‐up for these systems.
An International Perspective on the Moral Maturity of Marketers
Authors: Falkenberg Andreas W.
Published: July 2010

The value chain networks created by international marketers criss-cross cultures and jurisdictions across the globe. Some of these jurisdictions are plagued by inadequate institutions or behavioural traffic rules, which do not promote flourishing lives for affected parties. As marketers facilitate these exchanges, there is a temptation to take a limited view of one's responsibilities for possible adverse consequences of these exchanges. A primitive approach to responsibility would be an individual cost/benefit analysis of the sticks and carrots involved in the transaction and a move as close to the minimum requirement as possible. A more mature marketer may consider her own culture's conventions as well as the conventions of the local culture when considering the nature of the exchange. Finally, one can seek to apply basic ethical principles to the exchange, which would require an analysis that would be relatively free of cultural conventions and a short term sticks and carrot analysis. It is the purpose of this paper to present a framework for analysis that would be useful for international marketers as they seek to facilitate exchanges between jurisdictions with inadequate institutions.
Is Academic Marketing Losing Its Way? Embrace Intermediaries
Authors: Lilien Gary L.
Published: July 2010

I suggest that a solution to Reibstein et al. (2009) diagnosis that Academic Marketing is losing its way is to seek creative connections with marketing intermediaries (consultancies and market research firms) that can provide access both to problems and to data. That access should help the field find its way back to the path that leads to rigorous academic research on real and important problems.
Analysis of HapMap tag-SNPs in dysbindin (DTNBP1) reveals evidence of consistent association with schizophrenia
Authors: Voisey J. , Swagell C.D. , Hughes I.P. , Lawford B.R. , Young R.M. , Morris C.P.
Published: July 2010

Dystrobrevin binding protein 1 (DTNBP1), or dysbindin, is thought to be critical in regulating the glutamatergic system. While the dopamine pathway is known to be important in the aetiology of schizophrenia, it seems likely that glutamatergic dysfunction can lead to the development of schizophrenia.DTNBP1is widely expressed in brain, levels are reduced in brains of schizophrenia patients and aDTNBP1polymorphism has been associated with reduced brain expression. Despite numerous genetic studies noDTNBP1polymorphism has been strongly implicated in schizophrenia aetiology. Using a haplotype block-based gene-tagging approach we genotyped 13 SNPs inDTNBP1to investigate possible associations withDTNBP1and schizophrenia. Four polymorphisms were found to be significantly associated with schizophrenia. The strongest association was found with an A/C SNP in intron 7 (rs9370822). Homozygotes for the C allele of rs9370822 were more than two and a half times as likely to have schizophrenia compared to controls. The other polymorphisms showed much weaker association and are less likely to be biologically significant. These results suggest thatDTNBP1is a good candidate for schizophrenia risk and rs9370822 is either functionally important or in disequilibrium with a functional SNP, although our observations should be viewed with caution until they are independently replicated.
Vaginal pH versus cervical length in the mid‐trimester as screening predictors of preterm labor in a low‐risk population
Authors: Matijevic Ratko , Grgic Ozren , Knezevic Mario
Published: July 2010

Objective

To assess the accuracy of a sign of bacterial vaginosis and a sign of cervical insufficiency in predicting preterm labor (PTL, occurring in the 37th week or earlier) and early PTL (occurring in the 34th week or earlier) in a low‐risk cohort of 316 pregnant women.

Method

Vaginal pH was assessed using test gloves and cervical length (CL) was measured by transvaginal ultrasound. A pH value less than 5.0 (the 95th‐percentile threshold) and a CL greater than 26 mm (the 5th‐percentile threshold) were considered normal.

Results

There were 14 participants (4.4%) with an elevated vaginal pH and 15 (4.7%) with a shortened CL. The incidence of PTL (< 37 weeks) was 7.2%, while incidence of early PTL (≤ 34 weeks) was 2.5%. A shortened CL was significantly correlated with PTL (likelihood ratio [LR] weighted by prevalence; 2.7; 95% CI, 1.1–6.7) but not with early PTL (LR, 0.8; 95% CI, 0.4–1.8). An elevated vaginal pH was a better predictor of PTL (LR, 3.7; 95% CI, 1.3–10.4) and early PTL (LR, 1.7; 95% CI, 1.1–3.1).

Conclusion

An elevated vaginal pH was a better predictor of early PTL than a shortened CL in this cohort of pregnant women at low risk.
Reconciling Two Solitudes: The Example of Physicians and Managers in Ontario's Hospitals
Authors: Shortt S.E.D. , Bukowskyj Meri
Published: July 2010

This paper describes five aspects of the traditional relationship of physicians to hospitals and their administrators which fail to facilitate cost control or quality assurance. Several significant obstacles to changing this relationship are described, including the inertia of tradition, the fallacy of costless care and the chasm between medical and management cultures. It argues that to achieve care which is both cost-efficient and of high quality, physicians and hospital managers must unite to pursue common goals in a well-integrated management structure. Five suggestions for developing an effective new relationship are made, including the adoption of a “social contract” for all hospitals, the integration of physicians into hospital management and quality assurance programs, improved patient-level data collection and obligatory cost-awareness programs for hospital physicians.
La réconciliation de deux solitudes: L'exemple des médecins et des gestionnaires dans les hôpitaux de l'Ontario
Authors: Shortt S.E.D. , Bukowskyj Meri
Published: July 2010

Ce texte décrit cinq caractéristiques des relations que les médecins entretiennent depuis toujours avec les hôpitaux et leur administration et qui font obstacle au contrôle des coûts et de la qualité. On y décrit certains des obstacles importants qui empêchent de modifier ces relations, notamment l'inertie de la tradition, l'illusion de soins gratuits et le gouffre entre les cultures des milieux médical et administratif. Le texte souligne que, pour en arriver à donner des soins à la fois rentables et de qualité, les médecins et les directeurs des hôpitaux doivent unir les efforts afin d'atteindre des buts communs dans une gestion bien intégrée. On y suggère cinq façons d'établir de nouvelles relations plus efficaces, y compris l'adoption d'un « contrat » par tous les hôpitaux, la participation des médecins à la gestion de l'hôpital et aux programmes d'assurance de la qualité, une meilleure cueillette de données sur les patients et un programme obligatoire de sensibilisation aux coûts pour tons les médecins travaillant dans les hôpitaux.
Organizational Renewal and Strategic Planning: A Winning Combination
Authors: Cercone R. , McDonald D. , Tarrant L. , Tremblay K.
Published: July 2010

Several approaches to organizational renewal have been described, but few are reported for health care institutions in Canada. In contrast, approaches to strategic planning in health care facilities have been well documented.

From our experience over the past six years, the theory and practice of organizational renewal complement the focused activities of strategic planning. This combination can be an effective means to enhance organizational performance, employee commitment and a shared vision among the various stakeholders within the hospital and community. This article outlines the process and benefits that can accrue through such efforts. It demonstrates how the investment of organizational renewal strategies can produce sustainable, operational and strategic planning benefits for community hospitals.
Leadership without Bosses: Shared Leadership in the Creation of a Health Network
Authors: Elliott Chris
Published: July 2010

After province X's Minister of Health announced that health administration would be regionalized, administrators from two hospitals, a health unit and a nursing home planned a health network. In planning the network, the participants looked beyond their own facilities as being separately governed and separately funded organizations. This study investigates the exercise of shared leadership in order to increase the understanding of the nature of leadership and the meanings attributed to leadership activity by the various participants.
Préparation et implantation d'un changement: L'expérience d'un centre d'hébergement et de soins de longue durée
Authors: Villeneuve Sylvie , Thivierge Marie-Josée , Collerette Pierre
Published: July 2010

Cet article présente la méthodologie et les approches qui ont été privilégiées pour préparer le milieu, concevoir les contenus de changement et en faciliter la mise en oeuvre. Il a été rédigé à la suite d'observations dans l'établissement, d'une recherche documentaire et d'entrevues réalisées auprès des cadres et du consultant impliqué dans la démarche de changement. Le contenu a été validé par la direction générale de La Pietà.

La première section de l'article, présente la problématique à laquelle l'établissement était confronté. La seconde section est consacrée à la description du cadre de référence ayant inspiré la démarche du Centre. La dernière section, quant à elle, relate l'expérience de La Pietà à la lumière des principes et des éléments du cadre de référence.
Business Process Reengineering: A Remedy for Health Care
Authors: Carmichael B. Donald
Published: July 2010

Health care organizations are facing significant economic constraints that threaten to dismantle core services. The perceived need for reform is great. Business process reengineering may be the strong medicine required to achieve dramatic productivity improvement without jeopardizing the quality and scope of core health care services. Reengineering challenges health care organizations to eliminate functions that do not contribute to a flattened organization structure in which fewer care providers deliver a wider range of health care services. Information technology is used to displace manual checks and controls. Reengineering may facilitate the implementation of contemporary management models, such as patient-focused care, case management and product or program management. The product of reengineering can be enhanced over time by Continuous Quality Improvement.
More Than “Bandaids”: Emotional Support and Education during the Downsizing Process
Authors: Arndt Erika M. , Duchemin Kay F.
Published: July 2010

This paper illustrates the importance of giving emotional support and education to patients, families, staff and managers at The Queen Elizabeth Hospital, Toronto during the spring 1992 downsizing effort.

The Queen Elizabeth Hospital is a 601-bed, two-site facility which provides complex specialized rehabilitative and supportive care, teaching and research, as well as specialty programs in rehabilitation, geriatric service, geriatric psychiatry and long-term care.

Downsizing at The Queen Elizabeth Hospital meant the consolidation and closure of 82 long-term beds, on one nursing unit at each site, to offset a projected budget deficit of $5.4 million. Internal restraint over the past year and during the budget process reduced this deficit to $2.8 million, thus necessitating further downsizing consideration.

Background information includes a review of the recent downsizing literature. This paper describes the informal and formalized support activities that took place during the two-month process and the educational sessions that were provided on a regular basis. It gives specific attention to methodology and rationale.

The authors also make recommendations for the successful implementation of a downsizing process which can be beneficial to any health care setting involved in bed closure.
Resource Utilization Groups (RUGs): Defining Chronic Care, Rehabilitation and Nursing Home Case Mix in Canada
Authors: Botz Chas. K. , Bestard Susan , Demaray Mary , Molloy Gail
Published: July 2010

The two major purposes of this study were: (1) to evaluate Resource Utilization Groups (RUGs III) as a unified method for classifying all residential, chronic care and rehabilitation patients at the St. Joseph's Health Centre, London, and (2) to compare the potential funding implications of RUGs and other patient/resident classification systems. RUGs were used to classify a total of 336 patients/residents in residential, extended care, chronic care and rehabilitation beds at the Health Centre. Patients were also concurrently classified according to the Alberta Long Term Care Classification System and the Medicus Long Term Care System. Results show that RUGs provide relatively more credit for higher acuity patients than do the Alberta or Medicus systems. If used as a basis for funding, chronic care and rehabilitation hospitals would be entitled to more funding (relative to residential/nursing homes) under RUGs than under the other two patient classification mechanisms.
Groupes d'utilisation des ressources: Définir un groupe mixte composant la clientèle des centres d'hébergement, de réadaptation et de soins infirmiers au Canada
Authors: Botz Chas. K. , Bestard Susan , Demaray Mary , Molloy Gail
Published: July 2010

Les deux objectifs principaux de cette étude étaient: (1) d'évaluer les Resource Utilization Groups (RUG-III) en tant que méthode unifiée de classification de la clientèle du Centre de santé St. Joseph's de London qui bénéficie de soins d'hébergement, de soins chroniques ou de soins de réadaptation, et (2) de comparer les implications potentielles des RUG et d'autres systèmes de classification patient/résident sur le plan du financement. Les RUG ont été utilisés pour la classification de 336 patients/résidents dans des lits d'hébergement, de soins prolongés, de soins chroniques et de soins de réadaptation de l'établissement. De façon concomitante, les patients ont été classés selon la Long-Term Care Classification de l'Alberta et le système Medicus. Les résultats montrent que, par rapport au système albertain et à Medicus, les RUG permettent l'obtention de crédits relativement plus importants pour les patients traités pour des maladies plus sévères. En adoptant le système de financement fondé sur les groupes d'utilisation des ressources, les hôpitaux de soins chroniques et de réadaptation auraient droit à un financement supérieur (par rapports aux centres d'hébergement et aux maisons de repos) qu'en vertu des deux autres mécanismes de classification de la clientèle.
Paradigms and Nursing Management, Analysis of the Current Organizational Structure in a Large Hospital
Authors: Wilson Donna
Published: July 2010

Hospitals developed over the period of time when positivism become a predominant world view. Positivism was founded by four Western trends: preponderance of hierarchy and autocracy, popularization of bureaucracy, extensive application of a machine orientation to work and predominance of “scientific” inquiry. Organizational theory developed largely from quantitative research findings arising from a positivistic world view.

A case study, analyzing a current nursing organizational structure at one large hospital, is presented. Nursing management was found to be based upon the positivistic paradigm. The predominance of a machine orientation, and an autocratic and bureaucratic structure are evidence of this. A change to shared governance had been attempted, indicating a shift to a more modern organizational structure based on a different paradigm. The article concludes by emphasizing that managers are largely responsible for facilitating change; change that will meet internal human resource needs and the cost-effectiveness crises of hospitals today through more effective use of human resources.
Planning for Strategic Change? A Participative Planning Approach for Community Hospitals
Authors: MacDonald Susan K. , Beange J. Edna , Blackford Peter C. H.
Published: July 2010

Strategic planning is becoming to hospitals what business case analysis is to private corporations. In fact, this type of planning is becoming essential for the professional management of Ontario hospitals. The participative strategic planning process at Toronto East General Hospital (TEGH) is an example of how a professionally structured and implemented strategic planning process can be successfully developed and implemented in a community hospital.

In this article, the environmental factors driving planning are reviewed and the critical success factors for the development and implementation of a strategic plan are examined in the context of TEGH's experience.
Travailler ensemble: La collaboration administrative et clinique fait noître un programme de soins gériatriques pour l'hôpital
Authors: Wells Donna L. , Saltmarche Anita , Adolphus Patricia , Marshall Kerry
Published: July 2010

À Toronto, le Centre hospitalier Sunnybrook a conçu et rédigé un programme de soins pluridisciplinaires à l'intention des malades âgés en traitement actif. Le programme prévoit des activités particulières d'extension dans la collectivité, en conjonction avec les programmes hospitaliers, qui répondent aux besoins nouveaux d'une population vieillissante. Certains de ces objectifs sont de réussir à mesurer l'évolution de la durée de séjour, de réduire le nombre de patients en attente de transfert à un établissement de soins prolongés (d'où l' expression péjorative «problème de placement») et d'accroître la satisfaction des malades, des familles et du personnel. Une méthode d'évaluation du programme est en cours d'élaboration.

Le programme fait appel à une triple démarche de soins: (1) le malade âgé bien portant, (2) le malade âgé dont le cas est plus complexe et (3) les soins aux patients qui sont en convalescence d'une maladie grave mais qui doivent être hospitalisés dans un établissement de soins prolongés.
Patient Counselling Services: A Multidisciplinary Department
Authors: Klug Leo F.
Published: July 2010

Most contemporary urban hospitals in Canada provide social services, pastoral care and psychological services, usually in separate departments. The similarities in many of the services provided by these three professions has often been noted, along with the observation that organizational restructuring could support such collaboration. The Misericordia Hospital, Edmonton, has amalgamated social services, pastoral care, psychological services and the pastoral institute into the Department of Patient Counselling Services. Its main purpose is to allocate more resources to direct patient care and enhance interdisciplinary collaboration.
Utilization Management: A Literature Review for Canadian Health Care Administrators
Authors: Sheps Sam B. , Anderson Geoff , Cardiff Karen
Published: July 2010

Utilization management (UM), the attempt to measure, understand and reduce inappropriate hospital use, has been in development for over 20 years. It is an outgrowth of two related phenomena: (1) the increasing responsibility of large institutional third party payers for health care costs and the increasing demand of those payers for accountability; and (2) in Canada, particularly, the debate surrounding the adequacy of hospital funding and the perceived inadequacy of cost control using global budgeting. Given the interest in UM, hospital administrators, provincial and federal associations representing hospitals, hospital employees and physicians would find a review of UM programs useful in terms of what is known about their effectiveness, and the specific initiatives in Canada. The authors underscore the critical need for formal evaluation of UM programs; to date there has been little systematic research into issues related to its implementation and impact. This issue is particularly pertinent because UM programs have not been widely implemented in Canada.
Planification de services communs: Leçons tirées des expériences de l'Hôpital Princess Margaret
Authors: Ratz Johanne E. , Chenoy Neville C. , Morrison Mary Jean
Published: July 2010

Le projet de reconstruction de l'Hôpital Princess Margaret (PMH) de l'avenue de l'Université, à Toronto a donné aux institutions de la région plusieurs occasions de mettre en commun des programmes et des services. Le processus de planification de PMH a soulevé des questions quant aux facteurs qui interviennent dans l'élaboration des programmes de services communs et au sujet des difficultés que de tels projets posent en fait d'organisation et de gestion. Cette expérience suggère 13 principes de réalisation de services communs efficaces.
Use of Severity to Evaluate Appropriateness of Admissions and Length of Stay
Authors: MacKenzie Thomas A. , Willan Andrew R. , Wilchesky MacHelle
Published: July 2010

We undertook a case study for a Canadian teaching hospital to see if use of a severity of illness system could facilitate management of utilization practice in the hospital. The two issues selected were low severity emergency room admissions and length of stay on medical services. Use of a severity system allows for comparisons within case mix groups and also should control for large differences in severity within CMGs. The results of the study were consistent with the prior expectation of the hospital with respect to the relative efficiency of the physicians under study.
Economic and Ethical Considerations in the Intensive Care Unit
Authors: Noseworthy Thomas W. , Jacobs Phil
Published: July 2010

Intensive care units (ICUs) sustain life but, in certain cases, this resource becomes a means to prolong dying, with great physical, emotional and financial impact. The cost to care for patients in the ICU is at least three times more than general ward care; thus, ICUs have become one of the largest cost centres in the hospital. Economic pressures require us to be mindful of whom the ICU treats and for how long.

Health professionals working in the ICU must critically appraise the ethical basis for their behaviour and actions. In so doing, many are likely to appeal to the patient's right to self-determination and the physician's reliance on the principles of beneficence and non-maleficence as the underpinnings of morality in medicine.

One approach is to examine the issues and rights pertinent to an individual case using a circular model. Decisions are based on medical facts and prognosis, a patient's right to self-determination, a patient's best interests and external factors. Health personnel would be compelled to consider all of these issues. Within this framework, prevention or resolution of moral dilemma can take place within the clinical rather than the legal forum.
Overview of Provincial Home Care Programs in Canada
Authors: Richardson Blair G.
Published: July 2010

Across Canada, the phenomenal success of home care has led to rapid growth, demand outstripping resources and fragmentation of services. These problems and many others are facing home care managers today. Four controversial issues are discussed and comments are made on how they may be (or should be) resolved: (a) what groups should home care serve? (b) what should the link be between home care and the other components of the health system? (c) co-ordination of the array of services for the elderly population and (d) control of home care.
Les comités de déontologie dans les hôpitaux canadiens: Rapport sur l'enquête de 1989
Authors: Storch Janet L. , Griener Glenn G. , Marshall Deborah A. , Olineck Beverly A.
Published: July 2010

On a effectué en 1989 une enquête auprès des hôpitaux de langue anglaise de plus de 300 lits au Canada afin d'évaluer les comités de déontologie de ces établissements. On a constaté une augmentation spectaculaire du nombre de ces comités, comparativement aux résultats obtenus à la suite d'une enquête semblable effectuée en 1984. Nous analysons la croissance des activités des comités de déontologie dans les établissements de soins de santé et soulignons qu'il faut consacrer davantage d'attention à la recherche sur leur efficacité.
Case Mix Management Education in a Canadian Hospital
Authors: Moffat Malcolm , Prociw Michael
Published: July 2010

The Sunnybrook Health Science Centre's matrix organization model includes a traditional departmental structure, a strategic program-based structure and a case management-based structure — the Clinical Unit structure.

The Clinical Unit structure allows the centre to give responsibility for the management of case mix and volume to decentralized Clinical Unit teams, each of which manages its own budget.

To train physicians and nurses in their respective roles of Medical Unit directors and Nursing Unit directors, Sunnybrook designed unique short courses on financial management and budgeting, and case-costing and case mix management. This paper discusses how these courses were organized, details their contents and explains how they fit into Sunnybrook's program of decentralized management.
The Low Cost of Universal Access to Healthcare in Canada
Authors: Barer Morris L.
Published: July 2010

The significant difference between Canada and the United States in respective share of productive activity consumed by healthcare has emerged only since 1971, This difference, currently about 2.5 percent of GNP, is concentrated in three components — medical care, hospital care and administration. Highlighted are the Canada-U.S. dissimilarities, both in overall healthcare cost and experiences since 1971. The reasons are tracked to greater U.S. hospital daily servicing intensity, higher U.S. physician fees, and the cost of the fragmented public-private U.S. system of administration and regulation.
Multidisciplinary Teams in Health Care: Lessons from Oncology and Renal Teams
Authors: Fried Bruce J. , Leatt Peggy , Deber Raisa , Wilson Elaine
Published: July 2010

An indepth study conducted on units treating renal disease and cancer clinics determined that multidisciplinary teams are relatively commonplace in these areas.

Developing four team organizational structures — sequential, primary, nucleus and dynamic — the authors hypothesize that each varies on a continuum in terms of how highly structured they are. The framework suggests that the ideology of equal participation on the team is the most difficult to sustain, and that difficulties typically arise as organization requirements become more complex.

More research seems to be indicated to develop a comprehensive organizational framework, and the probable effect of organizational form on team performance. One of the key issues addressed is team leadership.
Analysis of Patient Categorization Schemes
Authors: Bardswich Earl , Davenport Marilyn , Hundert Mark , Stewart Diane Y.
Published: July 2010

The subject here is the limited comparison of two potential prototype evaluation systems at University Hospital in London, Ontario. The analysis focuses on the categorization of in-patients within particular subspecialties (general surgery and cardiology) on the basis of total hours of care provided by diagnostic and treatment staff (the resource consumption measure), and average nursing acuity or discharge nursing workload (the category descriptors). A comparison is also made with Case Mix Group (CMG) categories within these subspecialties, taking into account that CMGs are a factor evaluation system and are based on clinical characteristics.
Designing for Psychogeriatric Care
Authors: Rapelje Douglas H.
Published: July 2010

After two years of design research, the near-term goal of the Senior Citizens Department, Regional Niagara, was to build innovative homes to address the issues and programs the studies revealed. The long-term objective was to build homes that would start to change the public perception of long-term care facilities.

Featuringa “Town Square”, the home comprises five houses of 20 beds, each providing a different level of care. Corridors are a unique design, and each house has its own dining room facilities and activity room. A central Day Care lounge features dining room facilities for family and friends.

The Department hopes the overall design will help to break down the stereotype image of long-term care design, an d provide a suitable environment for the mentally and physically frail, as well as ambulatory residents.
The Political Role of the Health Services Executive
Authors: Taylor Belva
Published: July 2010

The “politicization” of health care in Canada means an increasing political role for health service executives. This article focuses on the political activities and skills required for administrators to become effective in this expanded role. In the 1990s, the administrator must become increasingly externally oriented and proactive. Two externally oriented skills, networking and information processing, are discussed in relation to the current health care environment. Practical examples are provided to illustrate how these skills can be used to ensure both the success of the executive and the position of the organization.
The Interaction between Market Orientation, Industry Environment and Business Success: Evidence from an Exporting Context
Authors: Sundqvist Sauna , Puumalainen Kaisu , Salminen Risto T. , Cadogan John W.
Published: July 2010

The present study extends the export market orientation research examining the impact of industry environment on the relationship between export market orientation and export performance using responses of 783 exporters. Our approach yields a better predictive validity for performance than earlier studies, and explains how the environment moderates the relationship.
The Effects of Efficacy, Cognitive Processing and Message Framing on Persuasion
Authors: Lee Christina Kwai-Choi , Brown Richard , Blood Deborah
Published: July 2010

This paper reports the results of a replication of a study by Block and Keller (1995) to investigate the roles of efficacy, cognitive processing and framing in message persuasiveness. A major objective is to resolve an inconsistent result between Block and Keller's (1995) two studies. Two of this study's findings support Block and Keller: first, high efficacy messages (relative certainty that following the recommendation will lead to the desired outcome) lead to greater intentions to comply. Second, under low efficacy conditions, negatively framed messages are more persuasive than positively framed messages. However, two findings were Contrary to Block and Keller's results: under high efficacy conditions, positively framed messages are more persuasive than negatively framed messages; and no effects are found for cognitive processing with either low or high efficacy messages.
Effect of Public Disgrace on Celebrity Endorser Value
Authors: Bednall David H.B. , Collings Anthony
Published: July 2010

While celebrity endorsers are widely used to promote products because of their visibility, attractiveness and expertise, marketers run a risk if they subsequently get involved in a scandal. Previous research indicated that the seriousness of a scandal would depend on the degree of harm to any victim and the extent to which it fell outside society's norms. This study systematically investigated the effect of scandal and product type on a celebrity's suitability to continue endorsing. A hypothetical Sydney Olympics sports celebrity, facing a variety of scandals, was evaluated by samples of undergraduate and graduate students. It was found that the scandals tested (particularly, rape and recreational drug use) had a very strong effect on likeability and through this to trustworthiness and expertise. In turn, trustworthiness and likeability had a moderate influence on suitability to continue endorsing. Product endorsements related to sport contributed directly to rated expertise and this in turn contributed to suitability to continue endorsing, somewhat ameliorating the effects of scandal.
A 7-Point Program for Successful Academic Research in Marketing
Authors: Lilien Gary L.
Published: July 2010

The farther you are from North America, the more challenging it is to pursue a successful academic career in Marketing. Provided are seven concrete recommendations that should help make that task a bit less challenging.
What Areas of Research are Most Likely to be Important/Useful for ANZ Researchers to Pursue?
Authors: Sweeney Jill
Published: July 2010

This paper compares Australia and New Zealand academic marketing publications with those of the two regions that dominate in terms of research productivity - North America and Europe. Comparisons, based on the two-year period 1998-1999, are made in terms of major journals in each region and also the origin of the author. Additionally, ANZMAC conference publications were examined. Important differences are identified. In addition questions are raised as to our future - whether to adopt a “mix it” approach, researching areas that are similarly pursued in North America or Europe or whether to take advantage of unique characteristics of our region and develop expertise on a particular theme.