bluuebunny/crossref_metadata_2025_split huggingface dataset:
Family planning in Egypt. A planning response to an Islamic environment
Authors: Longworthy Nancy , Fierman Harry 
Published: May 2007

AbstractThe problem of choosing the appropriate strategy to increase acceptance and use of modern contraceptives is very complex. Islamic fundamentalism is an increasingly important factor in the environment of Egyptian family planning programs. This article presents Egypt as a case example, illustrating the importance of external environmental analysis in planning for the operational implementation of family planning programs. Within the specifics of the Egyptian case, we additionally illustrate one practical tool for developing a planning response to that environment: Warren's (1977) typology of strategies for implementing social change.
The economic impact of smoking in Canada
Authors: Choi Bernard C. K. , Nethercott James R. 
Published: May 2007

AbstractA cost‐benefit analysis of smoking, using an attributable risk approach, has been carried out for Canada and for three regions within Canada. The total cost of the consequences of tobacco use—in terms of extra deaths, disability, hospitalization, physician services, and fire losses due to tobacco use—in all cases exceeded the total consumer expenditure for tobacco products. The excess was estimated to have a range from $14 to $127 (1983 Canadian dollars) per person per year. This represents the amount that an individual in society would gain, on average, if tobacco use was eliminated from the society for one year. Tobacco use was also found to be responsible for 12 to 17 per cent of all adult deaths, 4 to 5 per cent of all adult disability days, 12 to 14 per cent of all days of hospitalization, and 2 to 3 per cent of all physician visits.
Vitamin a cost‐effectiveness model
Authors: Grosse Robert N. , Tilden Robert L. 
Published: May 2007

AbstractTo assist in the selection of a preferable vitamin A deficiency control policy, a model has been developed to organize information on program costs and program‐related effects. The model was designed to compare three approaches: (1) diet modification; (2) fortification of processed foods; and (3) periodic large doses. Health effects projected are rates of specific eye pathologies associated with vitamin A deficiency (xerophthalmia), and mortalities within age cohorts. Effectiveness is calculated as a function of coverage, biological efficacy, and incidence of vitamin A deficiency. The model was applied to data from the Province of West Java in Indonesia. The results of this application suggest that funding level considerations are an important factor in selecting a preferred control strategy. In addition to determining the relative resource requirements of alternative interventions aimed at reducing the morbidity and mortality effects of vitamin A deficiencies, the model, using marginal cost and marginal effectiveness information, can serve as a guide to the most efficient allocation of resources for each type of intervention.
Effects of different remuneration methods on general medical practice: A comparison of capitation and fee‐for‐service payment
Authors: Shimmura Kazuya 
Published: May 2007

AbstractThere are severe methodological problems to be overcome in comparing the effects of different payment methods on general medical practice, not least because there are many factors which affect the pattern of service delivery. Also, the reliability and comparability of data may be poor. This article emphasises that the effects of capitation and fee‐for‐service payment methods on general medical practice should be carefully compared with factual information, especially numerical data. In so doing, it is shown that there are supporting data for the contention that a fee‐for‐service system encourages more consultations, more diagnostic tests, higher drug use, higher surgical rates and higher costs than a capitation system. On the other hand, a capitation system may lead doctors to hastier and less courteous care than a fee‐for‐service system. The geographical distribution of general practitioners (GPs) may be more even, and continuity of care may be better maintained, under a capitation system; but there may be excessive referrals from GPs to specialists under this system of payment. There is no evidence for the contention that a capitation system encourages preventive medicine, but the financial coverage for preventive procedures does encourage such procedures.
The Kuwaiti national health service: Financial restraints and cost sharing imperatives
Authors: Bustan Mahmoud Al , Batistella Roger M. 
Published: May 2007

AbstractThe post‐World War II oil boom that transformed the country from a Bedouin trading center to a modern society has brought Kuwaiti citizens one of the world's highest living standards, including a tax‐free economy and a lavish array of welfare state services. Enormous wealth has not, however, sheltered Kuwait from the contemporary public policy dilemma generally encountered in other countries—how to reconcile fast‐rising public expectations for more and better government services with slower‐growing budgetary revenues. Following a review of some of the more prominent national economic and social characteristics, the structure of the Kuwaiti National Health Service is described against the backdrop of new economic realities precipitated by a decline in oil export earnings and a slowing of economic expansion. Government plans to alleviate the pressure on public spending are described which center on cost sharing with consumers and employers. Finally, the implications of cost containment for the future of private medical practice are discussed.
Health planning and the closure of a community hospital
Authors: Fontana Leonard 
Published: May 2007

AbstractThe overall purpose of the research reported in this article is two‐fold: firstly, to describe the efforts of a regional health planning agency in the United States to reduce the size of acute care facilities in its planning area; and, secondly, to frame these events into a general theory of structural problems of state interventions in the American health care sector. Specifically, a case study is presented that documents—over time—the process of decision making, in seeking to close a community hospital against strong, and vocal, local interests. This analysis supports the view that, in the real world of health planning, power is exercised through a process of bargaining between health care providers and government, and between health care providers. Overall, the study illustrates the constraints upon the American health planning agencies to steer a relatively autonomous health care sector.
Application of goal programming to improve resource allocation for health services in Papua New Guinea
Authors: Chae Young Moon , Newbrander William C. , Thomason Jane A. 
Published: May 2007

AbstractThis paper describes exploratory work on two allocation models for policy makers in Papua New Guinea using goal programming. The first model allocates national financial resources for health among the 19 provinces. Determinants of the model include health status, population, manpower, and access provisions and previous resource distribution. The second model utilizes the results from the first model to allocate resources among different health activities within each province. Determinants of the model include major health problems of each province and available health resources. The paper concludes with a dicsussion on the use and implications of the model in the Papua New Guinean situation.
A crossectional country group study of three health level outcomes and four potential causes
Authors: Pegels C. Carl 
Published: May 2007

AbstractA crossectional study of four country groups segmented by per capita income of the majority of the world's countries was made to evaluate the relationship between health level outcomes and potential causes which may impact on the health level outcomes. The health level outcomes consist of life expectancy at birth, infant mortality rate and child mortality rate. The potential causes consist of secondary school children per 100 in school age group, daily calory supply per capita, population per physician and population per nurse. For the two lower income country groups the two important determinants of life expectancy were daily calory supply per capita and secondary school children per 100 in school age group. For the upper middle income the country group the important positive determinant of life expectancy was population per nurse and for the upper income country group the important negative determinant of life expectancy was daily calory supply per capita. Infant and child mortality rates were associated with secondary school children per 100 in school age group and population per physician or population per nurse for the two lower income country groups. For the upper middle income country group population per nurse or population per physician was supplemented by daily calory supply per capita for both infant and child mortality. For the upper income country group only infant mortality had statistically significant determinants. They were daily calory supply per capita and secondary school children per 100 in school age groups.
Thailand: Current public health perspectives
Authors: Baum Bernard H. , Strenski Teri 
Published: May 2007

AbstractThailand's public health system is in transition, reflecting the economic status of the country. The decentralized system has made great strides in improving the health of its people. But paradoxes exist. While some urban areas have an oversupply of CT Scanners, rural villages still cope with hygiene‐related illnesses. Malaria and Yellow Fever no longer dominate health resources. Now AIDs, heart disease and accidents top the problem list. Like other countries, Thailand also struggles with health financing to address the unmet needs.
The use of QALYs in health service planning
Authors: Allen D. , Lee R. H. , Lowson K. 
Published: May 2007

AbstractThere has been substantial interest in recent years, among research workers and in health service management, in the potential use of quality‐adjusted life years (QALYs) as an aid to decision‐making about the development of services and use of resources in health services (Gudex, 1986; Drummond, 1986). In 1986 the North Western Regional Health Authority (RHA) initiated the first large‐scale attempt to use QALYs as a practical aid to planning in the National Health Service. This paper draws on the experience of the North Western RHA in examining some methodological and practical issues relating to the future of QALYs as an aid to decision‐making in the Health Service.
‘Tipping the balance towards primary health care’: Managing change at the local level
Authors: Godinho Joana 
Published: May 2007

AbstractThis article addresses the problem of managing change at the local level, by focusing on the experience of the research and action project ‘Tipping the Balance Towards Primary Health Care’. The experience of this project and case studies in other countries is abstracted. It includes some characteristics of the actors and forces under which local services operate, pointing to some opportunities and constraints in managing change and development, as well as organizational relationships in the field of primary health care. In this article it is argued that the ongoing structural reform is a necessary prerequisite, but it is not the unique key, for solving local health services problems. If the mission of the health sector is to satisfy the real and the perceived needs of the population, skilled professionals, appropriate technology, and enough financial resources must be allocated to the local level.
Changing relations between hospitals and primary health care: New challenges for hospital management
Authors: Maarse J. A. M. , Mur‐Veeman I. M. , Tijssen I. M. J. G. 
Published: May 2007

AbstractHospitals in the Netherlands are now operating in a rapidly changing environment. Most changes directly result from government's policy to achieve effective cost containment in health care. Some of them basically affect the existence and functioning of hospitals. These changing environmental conditions inspire hospitals to undertake innovative activities to protect or even strengthen their position. This will be illustrated below by a case in which a small acute hospital attempted to establish a close relationship with primary health care in order to protect its position. Our focus will be upon this innovative initiative and upon some management problems that must then be resolved.
The importance of organizational culture on development activities in a primary health care organization
Authors: Kinnunen Juha 
Published: May 2007

AbstractThe aim of this article is to examine, by means of an empirical study, the: a) relationship between formal and cultural structures; b) similarities and differences between professional subcultures (medical, nursing and managerial); and, c) the effects of the social assumptions of the work teams on development activities in one large primary health care organization. The results show that different professional groups have created quite different sets of social values, norms and assumptions, which have significant consequences, both for patient care and organizational performance.
Motivational patterns of management team members in a large hospital
Authors: Brotherus‐Kettunen Aune , Sinkkonen Sirkka , Miettinen Asko 
Published: May 2007

AbstractManagement teams have been introduced as a means of solving conflicts and providing highly required co‐ordination between professional groups, sub‐units and their individual leaders in large, complex organizations such as hospitals. This study examines the motivational patterns of the three members of management teams of four clinical departments at a large university hospital. A strong professionalism was the dominant motivational orientation of all nurse managers (nursing directors of the clinics) and to a great extent also of the physician managers (head physicians of the clinics). The business managers' dominant motivational pattern was hierarchy in two out of the four teams, and professionalism in two teams. The respective comparison groups had rather similar motivational patterns in common with their leaders: ordinary physicians and nurses had a professional and administrative staff hierarchic orientation. The comparison group of mid‐level managers from private firms was also hierarchically oriented, although task orientation was also often high in their motivational pattern. The results are consistent with the educational background and differences in the tasks of the groups studied. The role of different professional cultures in determining and designing efficiently functioning management teams is an important task for further research.
Implementing public competition in Swedish county councils: A case study
Authors: Saltman Richard B. , Von Otter Casten 
Published: May 2007

AbstractEarlier presentations of the theoretical framework for public competition (Saltman and von Otter, 1987) and of the comparative advantage of public competition as against a mixed market model (Saltman and von Otter, 1989a) suggest the importance of concrete arrangements to introduce a public competition approach at the operating level. This paper explores the administrative infra‐structure required to implement public competition within the Swedish county‐council‐based health care system.
The health planning needs in small pacific Island states
Authors: Singleton Garth 
Published: May 2007

AbstractThe post of health planner is a relative newcomer to the health ministries in the Pacific. The small size of most Pacific Island States necessitates activities for the planner that may be slightly different from those of health planners elsewhere. This paper argues that these activities include the following:

The promotion of communications both within the Ministry of Health and between it and other government departments.
Liaison with donors.
Monitoring activities/expenditures.
Policy development.
Management practices and priorities for mental health system performance: Evidence from England and west Germany
Authors: Schulz Rockwell , Girard Chris , Harrison Stephen 
Published: May 2007

AbstractPerformance priorities for high quality care, multiprofessional team care and deinstitu‐tionalization of patients among mental health services in England and West Germany were found to be significantly influenced by management practices fostering goal congruence, peer review and staff participation in decision making.
Organisational issues and effectiveness of the health sector in the Republic of Slovenia, Yugoslavia
Authors: Bogomil Bergant , Alojz Brus 
Published: May 2007

AbstractThe republic of Slovenia is one of the six republics of the Socialist federal republic of Yugoslavia. The article deals with the health situation over the period from 1975 to 1988. Illness and hospitalisation data are shown in Slovenia for the year 1988, and the movement of common illnesses shown over the period 1980–1988. The health infrastructure is presented for the year 1986, and the stock of cadres of health worker i.e. doctors, dentists, pharmacists, nurses, is shown in tabular and graphic form, together with changes in the composition of that stock over the last fifteen years. These data are then used to develop trends, and a commentary on progress made. Finally, the level of financing of health care is shown, and movements in the share of the social product (GNP) from 1975 to the present time. Over that period, the share has remained constant, though significant fluctuations have taken place from year to year.
Cost recovery in the health‐care sector in Sub‐Saharan Africa
Authors: Vogel Ronald J. 
Published: May 2007

AbstractCost recovery, or the pricing of health‐care services in government‐run health‐care facilities, continues to be a politically delicate subject in Sub‐Saharan Africa. Nevertheless, ministries of health are now beginning to understand that the selective pricing of healthcare services can be a powerful tool for achieving the efficiency and equity goals that their governments have set, and for increasing ministry financial resources that can be used to improve the quality of care offered. This article provides a blue‐print for these nascent cost‐recovery efforts. After a consideration of the rationale for cost recovery within a theoretical context, a set of pricing principles for the whole public health sector is presented and a prototypical systemic price schedule is derived from the principles. Constraints to effective and equitable cost recovery are then discussed, and topics for further empirical research are suggested.
Microrna expression distinguishes between germinal center B cell‐like and activated B cell‐like subtypes of diffuse large B cell lymphoma
Authors: Lawrie Charles H. , Soneji Shamit , Marafioti Teresa , Cooper Christopher D.O. , Palazzo Stefano , Paterson Jennifer C. , Cattan Helen , Enver Tariq , Mager Rachel , Boultwood Jacqueline , Wainscoat James S. , Hatton Christian S.R. 
Published: May 2007

AbstractDiffuse large B cell lymphoma (DLBCL) is an aggressive malignancy that accounts for nearly 40% of all lymphoid tumors. This heterogeneous disease can be divided into germinal center B cell‐like (GCB) and activated B cell‐like (ABC) subtypes by gene expression and immunohistochemical profiling. Using microarray analysis on prototypic cell lines, we identified microRNAs (miR‐155, miR‐21 and miR‐221) that were more highly expressed in ABC‐type than GCB‐type cell lines. These microRNAs were over‐expressed in de novo DLBCL (n = 35), transformed DLBCL (n = 14) and follicular center lymphoma cases (n = 27) compared to normal B cells. Consistent with the cell line model, expression levels were higher in DLBCL cases with an ABC‐type immunophenotype than those that were GCB‐type (p < 0.05). Moreover, using multivariate analysis we found that expression of miR‐21 was an independent prognostic indicator in de novo DLBCL (p < 0.05). Interestingly, expression levels of both miR‐155 and miR‐21 were also higher in nonmalignant ABC than in GCB cells. As we also demonstrate that expression of microRNAs can be measured reliably from routine paraffin‐embedded biopsies of more than 8‐years‐old (p < 0.001), we suggest that microRNAs could be clinically useful molecular markers for DLBCL as well as other cancers. © 2007 Wiley‐Liss, Inc.
Androgen receptor targets NFκB and TSP1 to suppress prostate tumor growth in vivo
Authors: Nelius Thomas , Filleur Stephanie , Yemelyanov Alexander , Budunova Irina , Shroff E. , Mirochnik Yelena , Aurora Arin , Veliceasa Dorina , Xiao Wuhan , Wang Zhou , Volpert Olga V. 
Published: May 2007

AbstractThe androgen role in the maintenance of prostate epithelium is subject to conflicting opinions. While androgen ablation drives the regression of normal and cancerous prostate, testosterone may cause both proliferation and apoptosis. Several investigators note decreased proliferation and stronger response to chemotherapy of the prostate cancer cells stably expressing androgen receptor (AR), however no mechanistic explanation was offered. In this paper we demonstrate in vivo anti‐tumor effect of the AR on prostate cancer growth and identify its molecular mediators. We analyzed the effect of AR on the tumorigenicity of prostate cancer cells. Unexpectedly, the AR‐expressing cells formed tumors in male mice at a much lower rate than the AR‐negative controls. Moreover, the AR‐expressing tumors showed decreased vascularity and massive apoptosis. AR expression lowered the angiogenic potential of cancer cells, by increasing secretion of an anti‐angiogenic protein, thrombospondin‐1. AR activation caused a decrease in RelA, a subunit of the pro‐survival transcription factor NFκB, reduced its nuclear localization and transcriptional activity. This, in turn, diminished the expression of its anti‐apoptotic targets, Bcl‐2 and IL‐6. Increased apoptosis within AR‐expressing tumors was likely due to the NFκB suppression, since it was restricted to the cells lacking nuclear (active) NFκB. Thus we for the first time identified combined decrease of NFκB and increased TSP1 as molecular events underlying the AR anti‐tumor activity in vivo. Our data indicate that intermittent androgen ablation is preferable to continuous withdrawal, a standard treatment for early‐stage prostate cancer. © 2007 Wiley‐Liss, Inc.