bluuebunny/crossref_metadata_2025_split huggingface dataset:
Linking Research, Policy, and Action: Evidence-Based Complementary and Alternative Medicine
Authors: Wong Vivian Taam , Feichau Pang 
Published: July 2010

Complementary and Alternative Medicine (CAM) is highly prevalent worldwide, resulting in legislation to regulate the providers and the products accompanied by enhancement of educational and research programs in many countries. Evidence-based Medicine (EBM), an effective approach for making healthcare decisions, can be equally applied to CAM, using innovative research methodology. When using Chinese Medicine (CM) as a proxy for CAM, the challenge is to develop a scientific model that could create a common platform of dialogue between CM and Western Medicine (WM), based on shared interpretation of CM syndromes, the pluralistic diagnostic logic, and multi-dimensional treatment approach. To facilitate the above, Hong Kong has implemented CM practitioner registration, transitional trade licensing, and control of proprietary CM. The Hospital Authority has created a modern delivery model by introducing an application system in CM pharmacy and clinical management, which could be used as research and audit tools.
Mobilisation En Vue De L'Agrément Régional
Authors: O'Neill Mary Lou 
Published: July 2010

En janvier 1999, le Conseil de santé régional de l'est (Eastern Regional Health Board) commençait à planifier son agrément régional prévu pour novembre 1999. Il s'agirait d'un premier agrément pour nos deux programmes (Services de lutte contre la toxicomanie et Santé publique: Addiction Services et Public Health) et pour deux des neuf établissements de soins de courte durée de la région. Cet article décrit le processus de planification de l'agrément régional. Il énumère les ressources voulues pour un tel projet, propose un calendrier d'exécution raisonnable et suggère une stratégie de communication. Mobiliser plus de 1000 employés et médecins ainsi que les collectivités en vue de l'agrément régional s'est avéré un défi de taille pour le Comité d'orientation. L'élaboration d'un plan d'action prévoyant des échéances précises a été utile; la nomination de présidents d'équipes conciliants et positifs a été essentielle, et consulter les collectivités dans le cours du processus a été enrichissant. L'information du public s'est faite grâce à des stratégies empruntées à nos homologues de Terre-Neuve (une murale d'agrément et un bulletin publié régulièrement), ainsi que par l'adoption de stratégies de notre cru, comme la Journée du partage, et enfin par le biais de la participation des conseils communautaires de santé dans nos équipes d'agrément. La mise sur pied du projet a été confiée à un comité d'orientation et a mené à la création de 21 équipes. Des plans de communication et de sensibilisation ont constitué des outils importants afin d'informer le Conseil d'administration, le personnel, les médecins et les habitants de la région.
Change Readiness for SAP in the Canadian Healthcare System
Authors: O'Neill Mary Lou , Downer Pauline 
Published: July 2010

The study described in this article was designed to assess the change readiness for e-business cost management systems (particularly SAP) within the Canadian healthcare system. Previous studies and experts suggest that change readiness is an important variable in the application of e-business cost management system implementation. One hundred and fifty-four chief executive officers within the Canadian healthcare system were surveyed. The response rate was 25.9 percent. The survey included a demographic sheet, which supported a better understanding of the profile of Canadian healthcare CEOs, their operational budget responsibilities, and their feelings toward e-business cost management systems. A change readiness instrument reviewed CEOs' change readiness scores in relation to four independent variables (implementation of an e-business cost management system, healthcare restructuring, budget size and tenure of the CEO). There was a significant difference between change readiness scores and the implementation of an e-business cost management system. Given the small sample size (n=40), findings are limited. However the study offers more information on this issue than is found in the Canadian healthcare literature to date.
The Efficiency of Acute Care Bed Utilization in Newfoundland and Labrador
Authors: Doyle Michael , Barrett Brendan J. , McDonald Jackie , McGrath Jerry , Parfrey Patrick S. 
Published: July 2010

Hospital efficiency is closely related to utilization levels and length of stay. This study determined whether inappropriate bed utilization in Newfoundland was related to inefficiency or inadequate access to alternative services. It also compared Canadian Institute for Health Information (CIHI) data to our survey to determine whether they provide comparable information for monitoring efficiency. Inappropriate acute care days were identified using a modified Appropriateness Evaluation Protocol. Average length of stay (ALOS) by service for each of the province's acute care institutions was also reviewed from 1993–94 to 1995–96 using the CIHI database. Hospital admissions were inappropriate in 14.2 percent of 2,007 cases. Of the 14,194 days of care, 22.8 percent were inappropriate, with most (16.4 percent) being avoidable with better use of existing resources. Of the inappropriate days, 49.2 percent related to physicians' functions. The provincial ALOS fell from 5.70 days in 1993–94 to 5.39 days in 1995–96, but remains 10.5 percent above the national average. CIHI national data for ALOS by service correlated with the percent of inappropriate days by service (r=0.57). Excess bed utilization remains because of the inappropriate use of existing services, and almost half of the total inappropriate days in hospital could be influenced by physicians. CIHI data on LOS can be used to target services or physicians for focused intervention.
Continuous Quality Improvement: Status of Canadian Health Care Organizations
Authors: Murphy Tracy , Grimes Kelly , Snasdell-Taylor Barbara 
Published: July 2010

The Canadian Council on Health Services Accreditation (CCHSA) surveyed its client groups to determine how involved they had become in continuous quality improvement (CQI) activities. This was a follow up to a 1992 survey. Most of the participating organizations indicated they had adopted a CQI philosophy. A major factor influencing this decision was the use of the CCHSA's client-centred standards. This article outlines the gains organizations have realized by implementing CQI, and the extent to which organizations have implemented CQI principles, methods and tools. The information from this survey has been used to develop the accreditation program for the year 2000 — “The AIM Project: Achieving Improved Measurement.”
UN MODÈLE PRATIQUE DE PRIORISATION AU PASSAGE À L'AN 2000 DES ÉQUIPEMENTS HOSPITALIERS
Authors: Pagé Michel 
Published: July 2010

Cet article fournit un modèle simple qui permettrait de décider de la priorité et de l'ordre des démarches de résolution de problèmes que soulève le passage à l'an 2000 des équipements hospitaliers micro-programmée ou informatisés. Les raisons de la priorisation sont formulées; des niveaux de priorité sont suggérés; et, la distinction entre risques et priorité est rappelée. Ce modèle lie l'influence de paramètres tels l'interactivité et la complexité systémique; les risques pour la sécurité et les opérations; et, les impacts pour l'institution. La priorisation permet ainsi de fournir des critères d'ordonnancement qui permettront de vérifier le plus grand nombre possible d'équipements, et de structurer plus efficacement la phase des actions correctrices (remplacement, modification, acquisition, etc.). Cette manière cohérente d'aborder le problème permet d'anticiper les étapes de la gestion des risques, l'élaboration d'un plan de contingence, et, de s'assurer de la contribution de responsables institutionnels aux compétences multidisciplinaires dont les rôles, les responsabilités et les degrés d'imputabilité seraient ainsi mieux identifiés.
Governing Integrated Health Delivery Systems: Meeting Accountability Requirements
Authors: Leatt Peggy , Leggatt Sandra G. 
Published: July 2010

Many Canadian provincial governments are exploring methods to increase the integration of health services in an effort to improve the care provided, while maintaining or reducing the costs. Integrated health delivery systems are being implemented in the United States, Britain and other European countries. Such systems aim to provide a full continuum of care to a defined target population under a financing system of capitation. This article explores the issues associated with the governance accountabilities of an IDS. A review of potential governance models is completed, and the factors that influence the choice of a governance model for an integrated delivery system are presented. In 1987, Ewell identified governing boards as the weakest link in the integrated health care systems of the United States. It is suggested that early attention to governance in the development of IDS models in Canada may improve the effectiveness of these systems.
The need for routine physical health care in schizophrenia
Authors: Montejo A.-L. 
Published: July 2010

AbstractWhen managing their patients with schizophrenia, psychiatrists are increasingly concerned about physical disorders, including weight gain, obesity, metabolic abnormalities (in particular, diabetes and the metabolic syndrome), prolactin increase, sexual dysfunction and cardiovascular disease. Other common health-related problems in these patients include recreational drug use, sedation/physical inactivity, adverse drug effects and poor self-care. Each of these can have an impact on patient well-being, adherence to therapy and life expectancy. Collectively they can pose substantial barriers to optimal outcomes. However, the widespread acknowledgement of the importance of the physical health of patients with schizophrenia does not always result in consistent monitoring and management of physical health risks in the clinic. Urgent action is needed to ensure that psychiatrists prioritise physical healthcare alongside mental healthcare as a way to improve the longterm outcomes of treatment in all patients with schizophrenia.
Physical health in schizophrenia: a challenge for antipsychotic therapy
Authors: Heald A. 
Published: July 2010

AbstractIn the management of schizophrenia, mental health outcomes are the principal focus of treatment. The objective is to control the psychotic symptoms while minimising negative features of the illness, to achieve an overall improvement in the societal functioning of patients. Physical health is also important because if it is compromised, many of the benefits of improved mental health will be offset. Compared with the general population, schizophrenia patients are at increased risk of weight gain, abdominal obesity, diabetes, metabolic syndrome, and cardiovascular disease. These physical health problems can contribute to the decreased quality of life, lowered self-esteem and reduced life expectancy commonly reported in schizophrenia. For these reasons there is a pressing need to improve both the monitoring and the management of physical health in patients with schizophrenia as a part of their overall care. A consensus for metabolic monitoring of patients receiving treatment with antipsychotic drugs is available. However, the practicing clinician requires guidance about management of physical health in routine clinical practice. This should include recommendations for measurements that have strong predictive value about physical health risks yet are easy to make, and about the use of medications that have the least effect on physical health parameters. This article will review the gravity of the physical health risks facing schizophrenia patients.
Physical health management in psychiatric settings
Authors: De Hert M. , van Winkel R. , Silic A. , Van Eyck D. , Peuskens J. 
Published: July 2010

AbstractSevere mental disorders have a chronic course associated with a high risk for co-morbid somatic illnesses and premature mortality, but despite this increased risk, general health care needs in this population are often neglected. Over recent years, several groups have developed screening and monitoring guidelines for metabolic and cardiovascular risk assessment in patients treated with antipsychotics. The psychiatrist needs to be aware of the potential metabolic side-effects of antipsychotic medication and to include them in the risk/benefit assessment when choosing a specific antipsychotic. He should also be responsible for the implementation of the necessary screening assessments and referral for treatment of any physical illness. Multidisciplinary assessment of psychiatric and medical conditions is needed. The somatic treatments offered to people with severe and enduring mental illness should be at par with general health care in the non-psychiatrically ill population. In our University Centre, a structured and elaborate screening and monitoring protocol was introduced in late 2003. This paper describes the practical aspects of this monitoring protocol and the results obtained 4 years after its implementation.
Development of a Health Screening Clinic
Authors: Millar H.L. 
Published: July 2010

AbstractMedical morbidity and mortality levels remain elevated in people with schizophrenia compared with the general population. Despite the increasing recognition of an excess of physical health problems in this population, health screening remains limited. Medical risk in this population can be related to a variety of sources. The disease process itself as well as poor diet and sedentary lifestyle contribute to the overall physical health problems. In addition antipsychotic medication can contribute to the risk of cardiovascular and metabolic problems. The Dundee Health Screening Clinic was developed to address the needs of this population by monitoring physical health and providing follow-up to ensure that patients received the necessary care. The Clinic demonstrates how a coordinated approach can be used to take simple steps to improve the overall well-being of these patients. It was set up by adapting the manpower resources and procedures of the community mental health team and local resource centre, without specific additional funding. Simple clinical measurements and tests were conducted in the Clinic and patients clearly demonstrated on a satisfaction questionnaire that they considered the health checks important. This Clinic is an example of how a holistic approach can impact on both the physical and mental well-being of patients and offer them improved care and therefore a better quality of life.
Physical Health Concerns of the Patient, the Family and the Carer
Authors: McCrae J. 
Published: July 2010

AbstractPhysical health monitoring is crucial in the light of current knowledge about the risks associated with schizophrenia and its treatment. Cooperation between psychiatrists, patients and informal carers can significantly enhance patient wellbeing in this regard. Moreover, an advocacy approach elevates patients from being passive recipients of care to active participants in an integrated system that has outcome benefits for all stakeholders. Considerable progress is being made in this regard, although there is still a long way to go to maximise the benefits of carer involvement in the global management of schizophrenia.
Analysis of the relationships between climate variability and grapevine phenology in the Nobile di Montepulciano wine production area
Authors: MARTA A. DALLA , GRIFONI D. , MANCINI M. , STORCHI P. , ZIPOLI G. , ORLANDINI S. 
Published: July 2010

SUMMARYClimate represents one of the main inputs necessary for plants to complete their vegetative–productive cycle, having a direct effect on the onset and duration of phenological stages and development of crops. Equally important are its indirect effects, affecting field operations such as the application of fertilizer, pruning and crop protection, finally determining the yield.In the present study, phenological stages of the Sangiovese grapevine for the production of Nobile di Montepulciano wine were analysed and related to historical series of meteorological information (since 1970 in Tuscany, Italy). Weather conditions were described through large-scale meteorological information; in particular geopotential height at the 500 hPa level (500 hPa GPH) and North Atlantic Oscillation (NAO) index were considered. All data were provided by the National Oceanic and Atmospheric Administration-Cooperative Institute for Research in Environmental Sciences (NOAA-CIRES) Climate Diagnostics Center, Boulder, Colorado, USA, available from the NOAA-CIRES website (http://www.cdc.noaa.gov/) and processed by the National Center for Environmental Prediction/National Center for Atmospheric Research (NCEP/NCAR) Reanalysis Project. Conventional meteorological data, such as air temperature and cumulated rainfall, from ground weather stations were also used.The effects of meteorological parameters on crop phenology (bud-break, flowering and harvest time) were investigated by means of regression analysis, while teleconnections between phenological data and large-scale meteo-climatological data were analysed through correlation maps created using the interactive plotting and analysis link from the NOAA-CIRES website (http://www.cdc.noaa.gov). All correlations were calculated on a monthly to a multi-monthly basis, and also in relation to the different physiological stages of the crop, from 1970 to 2006.The climate change and variability impact on the crop was investigated by trend analysis of meteorological information and its effect on the onset of grapevine phenological stages.The results demonstrated that large-scale meteorological information has a significant effect on the onset of the phenological stages of grapevine. In particular, winter NAO was negatively correlated with bud-break and flowering dates, while GPH of February–March, March–May and May–September were negatively correlated with bud-break, flowering and harvest dates, respectively. The trend analysis demonstrated that the change and variability of climate, due to global warming, directly affects the development of grapevine leading to an anticipation of all considered phenophases.
Institutional Racism and Ethnic Inequalities: An Expanded Multilevel Framework
Authors: PHILLIPS CORETTA 
Published: July 2010

AbstractThe concept of institutional racism re-emerged in political discourse in the late 1990s after a long hiatus. Despite it initially seeming pivotal to New Labour's reform of policing and the antecedent of a new race equality agenda, it has remained a contested concept that has been critiqued by multiple constituencies. This paper notes the ambiguities and contradictions of the concept and considers its validity as an explanatory concept for long-observed ethnic inequalities in educational attainment and stop and search. In so doing, it argues for its retention, but only within a multilevel framework that incorporates racialisations operating at the micro, meso and macro levels.
Prevalence of hepatitis C virus and hepatitis B virus infections in HIV-positive Chinese patients
Authors: YAN Y. X. , GAO Y. Q. , SUN X. , WANG W. , HUANG X. J. , ZHANG T. , LI M. , ZANG C. P. , LI Z. C. , WU H. 
Published: July 2010

SUMMARYTo evaluate the prevalence of hepatitis C virus (HCV) and/or hepatitis B virus (HBV) infections in HIV-infected patients in China, an epidemiological serosurvey was conducted from May 2007 to September 2008 using a random cluster sampling design of infectious disease hospitals in seven high HIV-prevalent provinces (municipalities). Univariate analysis and logistic regression were used to study the determinants of HIV and HBV and/or HCV co-infection. The overall prevalence was 41·83% (95% CI 40·36–43·30) for anti-HCV and 12·49% (95% CI 11·50–13·48) for HBsAg, respectively. The prevalence of anti-HCV and HBsAg varied according to the route of HIV transmission. Compared to those with sexually acquired HIV infection, intravenous drug users and blood donors/recipients had the greatest risk of carrying anti-HCV. Needle sharing and unprotected sexual exposures are important modes of transmission for HBV. Further interventions including health education and harm reduction strategies should be implemented in high-risk populations.
Skin and soft-tissue infection caused by non-tuberculous mycobacteria in Taiwan, 1997–2008
Authors: CHEN H.-Y. , CHEN C.-Y. , HUANG C.-T. , RUAN S.-Y. , CHOU C. H. , LAI C. C. , LIAO C. H. , TAN C. K. , HUANG Y. T. , YU C.-J. , HSUEH P. R. 
Published: July 2010

SUMMARYThe aim of this study was to investigate the clinical, microbiological, and pathological characteristics and the outcomes of skin and soft-tissue infection (SSTI) caused by non-tuberculous mycobacteria (NTM). Medical records of 50 patients with SSTI caused by NTM identified from 2005 to 2008 and 63 patients previously reported in a medical centre from 1997 to 2004 were reviewed. The annual incidence (per 100 000 outpatients and in-patients) ranged from 0·57 in 2005, 0·38 in 2007, to 1·1 in 2008, with an average of 0·62/100 000. From 1997 to 2008, the average incidence was 1·39/100 000 patients. The average annual incidence of SSTI caused by NTM was 0·62/100 000 outpatients and in-patients during 2005 and 2008. Of the total of 113 patients identified during the 12-year period, patients infected withMycobacterium fortuitumandM. marinumwere younger than those infected withM. avium-intracellularecomplex (MAC) (36 and 44 yearsvs. 55 years,P=0·004 andP=0·056, respectively), and were more likely to have previous invasive procedures than those infected with MAC andM. abscessus(81·8% and 72·0%vs. 27·8% and 54·8%,P=0·007), and less likely to have associated immunosuppression (9·1% and 24%vs. 66·7% and 45·2%,P=0·006). Granuloma was more often observed in immunocompetent patients (60·1%vs. 40%,P=0·019), and inM. marinum-infected specimens (78·3%). There were significant differences in the demographic and clinical features of patients with NTM SSTI, including immunosuppression, trauma experience, and depth of tissue infections.
Realisability semantics of parametric polymorphism, general references and recursive types
Authors: BIRKEDAL LARS , STØVRING KRISTIAN , THAMSBORG JACOB 
Published: July 2010

We present a realisability model for a call-by-value, higher-order programming language with parametric polymorphism, general first-class references, and recursive types. The main novelty is a relational interpretation of open types that include general reference types. The interpretation uses a new approach to modelling references.The universe of semantic types consists of world-indexed families of logical relations over a universal predomain. In order to model general reference types, worlds are finite maps from locations to semantic types: this introduces a circularity between semantic types and worlds that precludes a direct definition of either. Our solution is to solve a recursive equation in an appropriate category of metric spaces. In effect, types are interpreted using a Kripke logical relation over a recursively defined set of worlds.We illustrate how the model can be used to prove simple equivalences between different implementations of imperative abstract data types.
Zernike Phase Contrast Electron Microscopy with a Spherically Corrected Foil Lens
Authors: Typke Dieter 
Published: July 2010

AbstractA lens system is proposed that not only provides spherical correction of the objective lens by charges that are induced on a thin foil, in the way proposed in a paper by Otto Scherzer [Optik56(2), 133–147, 1980], but also provides Zernike phase contrast by means of an appropriate phase shift of the scattered electrons within the foil. This system has the potential to provide strong phase contrast from very low spatial frequencies to frequencies above 1/(100 pm).