bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diffuse noxious inhibitory control evoked by tonic craniofacial pain in humans
Authors: Sowmanl P.F. , Wangl K. , Svenssonl P. , Arendt‐Nielsenl L. 
Published: July 2010

AbstractTonic pain in one body segment can inhibit the perception of pain in another body segment. This phenomenon is mediated by diffuse noxious inhibitory controls (DNIC), and its efficacy in craniofacial regions is investigated in this study. A compressive device that evoked a tonic, moderate/severe, headache‐like, conditioning pain (∼8/10 on a visual analogue scale) was applied for 15 min. Eleven males participated in the study. Pressure pain threshold (PPT) and pressure pain tolerance (PPTol) at multiple heterosegmental body sites (right masseter, splenius capitis, second intermediate phalange, brachioradialis and tibialis anterior) were measured before, during and at multiple time points (5, 20 and 35 min) after the termination of the conditioning pain. PPTs and PPTols were compared within participants across two experimental sessions; one that included painful conditioning stimulation, and a separate control session on a different day. Painful conditioning increased PPT significantly during pain over the masseter (p <0.05) and over the tibialis anterior (p <0.01). PPTol was unchanged. In the period after the painful conditioning stimulation PPT was depressed compared to control. This study shows that pain evoked from the craniofacial region evokes DNIC‐like mechanisms on segmental as well as heterosegmental sites.
Depression in middle-aged and older first generation migrants in Europe: Results from the Survey of Health, Ageing and Retirement in Europe (SHARE)
Authors: Aichberger M.C. , Schouler-Ocak M. , Mundt A. , Busch M.A. , Nickels E. , Heimann H.M. , Ströhle A. , Reischies F.M. , Heinz A. , Rapp M.A. 
Published: July 2010

AbstractObjectiveTo determine the prevalence of depression in migrants aged 50 years or older in comparison to residents without a history of migration in 11 European countries.Methods and subjectsThe Survey of Health, Ageing and Retirement in Europe (SHARE), a cross-national, multidisciplinary, household-based panel survey using nationally representative probability samples (n= 28,517) of 11 European countries of the non-institutionalized population aged 50 years and older. Depression was measured using the EURO-D scale, and odds ratios (OR) were estimated for migration status. Effects of sociodemographic variables, somatic comorbidities, functional impairment, cognitive function, geographic region, and time lived in current country of residence were assessed in multivariate logistic regression analysis.ResultsAdjusting for confounds, the OR for depression in migrants was 1.42 (95% CI, 1.28–1.59). The influence of migration status on the prevalence of depression was significantly greater in Northern (OR, 1.85; 95% CI, 1.39–2.46) and Western Europe (OR, 1.38; 95% CI, 1.22–1.57), compared to Southern Europe (OR, 1.16; 95% CI, 0.79–1.70) (p< 0.05 for the interaction).ConclusionWe found a higher prevalence of depression in first-generation migrants aged 50 years or older, together with relevant geographical variation. This difference was not due to other known predictors of depression in older age.
Characteristic brain hypoperfusion by 99mTc-ECD single photon emission computed tomography (SPECT) in patients with the first-episode schizophrenia
Authors: Wake R. , Miyaoka T. , Kawakami K. , Tsuchie K. , Inagaki T. , Horiguchi J. , Yamamoto Y. , Hayashi T. , Kitagaki H. 
Published: July 2010

AbstractObjectiveIn this study, we evaluated brain perfusion in patients with first-episode medicated schizophrenia using the new analytical method, statistical parametric mapping (SPM) applied to single photon emission computed tomography (SPECT).MethodWe performed SPECT with 99-Tc-ethyl cysteinate dimer (99mTc-ECD) of the brain and magnetic resonance imaging (MRI) in patients with schizophrenia (n = 30) and control subjects matched for age and gender (n = 37). A voxel-by-voxel group analysis was performed using SPM2 (Z > 3.0, P < 0.001, uncorrected for multiple comparisons).ResultIn comparison with control subjects, the volumes of the bilateral frontal areas were found to be decreased on MRI. Blood flow was found to be reduced in the bilateral temporal areas in the patients with schizophrenia on SPECT.ConclusionIn this study, patients with first-episode schizophrenia appeared to have significant bilateral temporal hypoperfusion, although temporal volumes were not significantly decreased in comparison with control subjects. Abnormality of temporal lobe blood flow in schizophrenia may show that functional changes occur earlier than structural changes, and may assist in the diagnosis of schizophrenia.
P2Y2 receptor expression is altered in rats after spinal cord injury
Authors: Rodríguez‐Zayas Ana E. , Torrado Aranza I. , Miranda Jorge D. 
Published: July 2010

AbstractSpinal cord injury increases inhibitory factors that may restrict neurite outgrowth after trauma. The expression of repulsive molecules in reactive astrocytes and the formation of the glial scar at the injury site produce the non‐permissive environment for axonal regeneration. However, the mechanism that triggers this astrogliotic response is unknown. The release of nucleotides has been linked to this hypertrophic state.Our goal is to investigate the temporal profile of P2Y2 nucleotide receptor after spinal cord injury in adult female Sprague–Dawley rats. Molecular biology, immunofluorescence studies, and Western Blots were used to evaluate the temporal profile (2, 4, 7, 14, and 28 days post‐injury) of this receptor in rats injured at the T‐10 level using the NYU impactor device.Real time RT‐PCR showed a significant increase of P2Y2 mRNA after 2 days post‐injury that continues throughout 28 days post‐injury. Double labeling studies localized P2Y2 immunoreactivity in neuronal cell bodies, axons, macrophages, oligodendrocytes and reactive astrocytes. Immunofluorescence studies also demonstrated a low level of P2Y2 receptor in sham samples, which increased after injury in glial fibrillary acidic protein positive cells. Western Blot performed with contused spinal cord protein samples revealed an upregulation in the P2Y2 42 kDa protein band expression after 4 days post‐injury that continues until 28 days post‐injury. However, a downregulation of the 62 kDa receptor protein band after 2 days post‐injury that continues up to 28 days post‐injury was observed.Therefore, the spatio‐temporal pattern of P2Y2 gene expression after spinal cord injury suggests a role in the pathophysiology response generated after trauma.
Resource Intensity Weighing and Case Mix Grouping: Assumptions and Implications for Health Service Performance Evaluation
Authors: Chu Christabel 
Published: July 2010

The use of Resource Intensity Weights (RIWs*) for equity funding and utilization management assumes validity of the cost estimates, reliability of the patient categorization scheme, equivalence of the bases for cost comparison, and equity of the subsequent resource distribution. This paper examines these assumptions, and concludes that caution must be taken when using the current RIWs and Case Mix Groups (CMGs*) for resource allocation and performance evaluation purposes. RIW has represented a milestone in the history of Canadian health care product costing and management. It would be prudent for health care professionals at the operational level to provide structured and continuing feedback that can contribute to the validation and refinement of these valuable management tools.
Re-Engineering: A Prescription for Hospitals
Authors: Bolton Cindy , Gordon John R.M. 
Published: July 2010

Previously applied mostly in large, private sector corporations, “re-engineering” is fast becoming a tool that hospitals can use to break away from the old to find a new and better way of doing things. Re-engineering, however, first requires strong leadership which is committed to employee involvement and re-inventing the process design to meet the needs of the customers. Once the transition has been completed, the processes and the organization must continue to be managed differently. This article reviews the processes involved in re-engineering, and discusses the implementation of the initiative at the Sunnybrook Health Science Centre in Toronto.
The Change Experience of a Long-Term Care Centre
Authors: Villeneuve Sylvie , Thivierge Marie-Josée , Collerette Pierre 
Published: July 2010

This article highlights the methodology and approaches chosen in preparing for a major change in orientation at La Pietà in Hull, Quebec, devising the content for change and facilitating the implementation of new directions. It is based on the observations of the change seen within the organization, research and interviews with management and the hired consultant involved in the change process. The first part of the article establishes the situation confronting the organization. It then describes the frame of reference that was to guide the centre through the change process. The conclusion sums up the La Pietà experience in the light of the guiding principles and elements that together formed the frame of reference for the change.
Program Management and Health Care Informatics: Defining Relationships
Authors: Harber B.W. , Miller SA 
Published: July 2010

The program management (PM) structure is a relatively well-known organizational model for hospitals. A variation of the matrix structure, it allows for an interdisciplinary team of health care providers to facilitate patient care delivery. However, providing such focused care results in a complex, highly information-dependent operational environment. To meet the information needs of such an environment, careful planning in selecting and implementing technology is required. Along with supporting patient care, the technology will also help in managing costs, human resources, quality and utilization, as well as in monitoring performance and outcomes measurement. Focusing specifically on the information technology environment, this article addresses health care in formatics (the diverse categories of information and systems) needed to support clinical program managers, executives and others in a PM organization. Examples from both a university-affiliated and a community-based program managed hospital illustrate their approach to PM and information technology.
La gestion hospitalière au Canada: Une enquête auprès de responsables d'entreprise membres du conseil d'administration d'un hôpital
Authors: Brunelle Francis W.H. 
Published: July 2010

Lors du recrutement de cadres supérieurs, The Caldwell Partners Amrop International a souvent l'occasion d'entrer en contact avec de nombreux responsables canadiens d'entreprise qui sont également membres d'un conseil d'administration hospitalier. En raison des inquiétudes exprimées spontanément par ces gestionnaires, il a été jugé opportun de mener une enquête en bonne et due forme. Le Département d'administration de la santé de l'Université de Toronto a été chargé de mettre au point le questionnaire et de compiler les résultats. Les constatations de l'enquête portent sur de multiples aspects de la gestion: taille du conseil, composition, durée des mandats, représentation, rôles, fusionnements, évaluation, qualité des soins, instituts de recherche, questions financières et rapports avec le gouvernement.
Health Care Managers in British Columbia, Part I: Who Manages Our System?
Authors: Kazanjian Arminée , Pagliccia Nino 
Published: July 2010

Part I of this article provides, for the first time, the supply side overview of middle- and high-level managers in the B.C. health care system. It presents findings from two province-wide surveys and describes the sociodemographic characteristics and the employment experiences of the population of interest. Part II presents a detailed analysis of management tasks and management roles, and of competency requirements for future managerial roles.
Measuring Case Mix and Severity of Illness in Canada: Case Mix Groups versus Refined Diagnosis Related Groups
Authors: Halpine Stuart , Ashworth M.A. 
Published: July 2010

This study compares the effectiveness of Case Mix Groups (CMG*) groups and Refined Diagnosis Related Groups (RDRG) in reducing Canadian length of stay (LOS) variability. The effectiveness of the two case mix grouping methodologies was assessed with a common data base, 282,459 abstracts with ICD-9 CM diagnosis codes reported to the Hospital Medical Records Institute (HMRI) from January to March 1989. Death, signouts, transfers to or from acute care institutions and cases with an outlier LOS (“atypical” cases) were excluded from the analysis. HMRI utilization management reports to acute care hospitals use a data base defined in this way. On the basis of the variance reduction statistic (R2) from ordinary least squares regression analysis, CMG groups were found to be slightly more effective than RDRGs in reducing LOS variability. R2 statistics were 45.7 and 43.8 for CMG groups and RDRGs, respectively. Within subgroups of cases, CMG groups were found to be markedly more effective with the newborn/neonate group and to a lesser extent with non-surgical cases. The severity of illness categories within RDRGs did not, over all “typical” cases in the data base, yield more homogeneous groups of cases than CMG groups, which have half the number of categories. The value of tailoring severity measurement to Canadian medical practice and Canadian diagnosis coding is highlighted.
Alberta's Acute Care Funding Project
Authors: Jacobs Philip , Hall Edward M. , Lave Judith R. , Glendining Murray 
Published: July 2010

Alberta initiated the Acute Care Funding Project (ACFP) in 1988, a new hospital funding system that institutes case mix budgeting adjustments to the global budget so that hospitals can be treated more equitably. The initiative is a significant departure in principle from the former method of funding. The ACFP is summarized and critiqued, and focuses on the inpatient side of the picture. The various elements of the project are discussed, such as the hospital performance index, the hospital performance measure, the Refined Diagnostic Related Group, case weights, typical and outlier cases, and the costing mechanisms. Since its implementation, the ACFP has undergone substantial changes; these are discussed, as well as some of the problems that still need to be addressed. Overall, the system offers incentives to reduce length of stay and to increase the efficiency with which inpatient care is provided.
Issues for Consideration in the Establishment of a Program Management Structure
Authors: Harber Bruce W. , Eni Godwin O. 
Published: July 2010

In a product management structure, the management of separate products is moved down in the organization to achieve greater participatory management as well as greater effectiveness in the identification of factors most relevant to the survival of the product. For the business industry, managing products as separate entitites enables more effective competition in the marketplace. This approach has been used in U.S. hospitals in managing programs and services. Described here are the initial attempts at program management undertaken at the Health Sciences Centre in Winnipeg, a highly specialized, provincial 1, 100-bed teaching and referral hospital. Some issues important in developing and implementing the program management approach are discussed.
Living Wills and Medical Treatment of the Terminally Ill
Authors: Schmeiser Douglas A. 
Published: July 2010

A terminally ill individual may sign a living will, which is a document requesting to be allowed to die a natural death, have it witnessed and address this wish to a relative, physician, lawyer or medical facility. No legislation, however, exists in Canada concerning living wills. Consequently, establishing the legal situation is based on both legislative and non-legislative sources. This article explores implications of the Criminal Code, the application of rules of criminal and civil law, provisions of the Charter, living will legislation in the United States and the power of attorney approach regarding this controversial issue.
Merger and Medical Staff: An Approach to Integration
Authors: Johnson Michael W. , Coombs Geoffrey W. , Wood Victor M. 
Published: July 2010

One of the most important aspects of a hospital merger is the impact on the medical staff. At University Hospital in British Columbia, which was established when two large general teaching hospitals merged, the comprehensive process to reorganize the medical staff structure was designed to account for this impact. Preliminary indications are that the process used was effective in creating a positive atmosphere and that the fundamental arrangements that resulted are conducive to future development. Although a formal evaluation of the overall integration of the medical staff at University Hospital is some time off, general evaluative criteria are proposed for future application.
Managing for Change: A Departmental Quality Improvement Program (QIP)
Authors: Cyr Linda V. 
Published: July 2010

The development and implementation of an integrated Quality Improvement Program (QIP) for the Department of Surgery at The Hospital for Sick Children was approached as a problem-solving process by which departmental managers could bring about change so that actual results would align more closely with desired outcomes. A planned and systematic process was developed, through which managers are able to reach decisions about when and where to make useful changes that result in improved quality of care and services provided. Three useful techniques were employed: team-building, continuing education and quality circles.
La gestion du changement: Un programme d'amélioration de la qualité (PAQ) du service
Authors: Cyr Linda V. 
Published: July 2010

L'élaboration et la mise en oeuvre d'un programme intégré d'amélioration de la qualité (PAQ) au Service de chirurgie du Hospital for Sick Children ont été abordées comme un processus de solution aux problèmes grâce auquel les directeurs de services pourraient apporter des changements de telle sorte que les résultats concrets correspondent davantage aux résultats voulus. Un processus planifié et systématique a été élaboré au moyen duquel les directeurs peuvent prendre des décisions par rapport au moment et au lieu où effectuer des changements utiles qui permettent d'améliorer la qualité des soins et des services offerts. Trois techniques utiles ont été employées: la constitution d'équipes, la formation permanente et les cercles de qualité.
Estimating Replacement Costs for Hospital Equipment
Authors: Jacobs Philip , Hall Edward M. 
Published: July 2010

This paper presents a methodology for predicting future replacement costs of hospital capital equipment. The methodology is applied to the equipment inventory of a large Canadian teaching hospital. The authors used forecasted Producer Price Indexes for several equipment categories, and applied them to the estimated equipment replacement needs. The Canadian Management Information System schedule and the American Hospital Association schedule were used to determine the estimates, which varied considerably between the two schedules. However, the test case demonstrated that such estimates can help hospitals to document capital funding needs in relation to available funds.
Innovative Revenue Generation
Authors: Pink George H. , Deber Raisa B. , Lavoie Joe N. , Aserlind Eric 
Published: July 2010

Innovative revenue generation by Canadian hospitals is drawing increasing attention. After a critical examination of the literature, we classified these into six areas: clinical/diagnostic insured services, clinical/diagnostic non-insured services, hotel services, retail services, administrative services and financial activities. We concluded that many Canadian hospitals are engaging in innovative revenue generation activities, the success of such activities has been mixed, there are many factors to consider when selecting revenue generation activities, many aspects of innovative revenue generation involve sophisticated business and risk management skills not traditionally required in hospital management, and implementation of many such activities requires support from the hospital board, hospital staff and medical staff.
Hospital Reimbursement in Alberta: Outcomes Management is on the Way
Authors: MacKenzie T.A. , Reynolds D. , Greenaway-Coates A. 
Published: July 2010

The Alberta government has initiated a process to alter fundamentally the way it pays hospitals. As with most provinces, Alberta has been paying hospitals for what they spend. The new Alberta model will initially pay hospitals for what they do and ultimately will pay hospitals for what they ought to do; that is, for the outcomes that should be achieved. This article describes the initial step of what is expected to be a lengthy journey. The principles underlying the model are: it should be a prospective case-based system; there should be performance linkages between types of hospitals; severity should be incorporated into the model; and cost or cost proxies should be used where possible in weight development and clinical concerns, both nursing and medical, should be addressed. For the past two years funding adjustments have been made on the basis of the calculation of a Hospital Performance Index (HPI). The HPI is the average predicted cost per case divided by the unweighted average actual cost per case. The HPI is intended as an interim measure only. Ultimately, the system will evolve into a true prospective case-based system with volume controlled via role statements and linked to clinical outcomes.
Executive Briefing
Authors: Shields Charles A. 
Published: July 2010

Although discussion and debate are continuing on the Free Trade Agreement between Canada and the U.S., implementation is expected to take place on January 1, 1989. In April 1988, CCHSE hosted a workshop, attended by senior healthcare executives and policy makers, to explore the effects of the Agreement on the Canadian healthcare system. Participants raised a number of important questions. While some areas might possibly see changes, most views were that, overall, the Free Trade Agreement would not have serious implications. Many also believed that finding ways to market Canada's healthcare expertise in the U.S. and the expected boost in the Canadian economy would be positive aspects of the Agreement.
Sale and Leaseback by Canadian Hospitals: Theory and Practice
Authors: Pink George H. , Hudson Steven K. 
Published: July 2010

Currently in Canada, between $3 and $4 billion of assets are financed annually through various forms of leasing, with the sale and leaseback transaction as the common vehicle for larger value asset financing. Financial theory of sale and leaseback is applied to Canadian hospitals with illustrations of the structure and process of sale and leaseback in practice. The moratorium on sale and leaseback transactions recently imposed by the federal and Ontario governments is also covered.
Psychogeriatric Care: Problems and Challenges
Authors: Rapelje Douglas H. 
Published: July 2010

From the aspect of homes for the aged, understanding the needs of the elderly mentally frail is the initial step to providing more suitable conditions. Many of the traditional features of these long-term care facilities need to be questioned and challenged. Care does not stop at the physical environment, indeed it goes even beyond establishing excellent relationships with the families involved and a caring, well-trained staff. Stress is needed on emphasizing the resident's remaining capacities and skills, not on behavioural problems.