bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health insurance and private providers: A study of the civil servants' medical benefit scheme in bangkok, Thailand
Authors: Bennett Sara , Tangcharoensathien Viroj 
Published: May 2007

AbstractCompulsory health insurance schemes have received attention recently as a means of creating a reliable extra‐budgetary source of health care funding. Yet, the full implications of such schemes in a developing country context are unclear; in particular, the impact on and relationship with private sector providers has infrequently been explored. This study examines patterns of public and private sector utilization under the Civil Servants' Medical Benefit Scheme (CSMBS) in Bangkok, Thailand. The CSMBS currently provides limited reimbursement for private inpatient care, but recent proposals suggest increasing benefit levels for care sought in the private sector. The study shows that despite high level of cost recovery in the public sector, charges were much lower than those in the private sector. Different patterns of diagnosis in the two sectors were found with private hospitals tending to treat a less complex case mix. Within the private sector, there was a limited tendency to specialize in certain types of care. It is concluded that under the current payment mechanism of fee‐for‐service reimbursement, measures to enhance access to private sector care should be approached with caution. In the long run, the scheme should merge with the recently established social security scheme.
Health system reform in former socialist countries of europe
Authors: Ensor Tim 
Published: May 2007

AbstractThe health systems of all the former socialist countries of Europe are in the midst of far‐reaching reform. The process is still in the early stages but certain patterns of finance and provision are beginning to emerge in a number of countries. All are implementing payroll‐based social insurance while some are beginning to restrict entitlement to those contributing. There is a danger the process of restructuring will leave many without adequate insurance cover. Market solutions are being introduced in many countries to improve the efficiency of provision. Assuming the administrative cost is not too great, this may improve choice and quality of personal care. It is, however, unclear how far these solutions will tackle the fundamental public health problems endemic in these countries today. Those countries that have been slower to implement reform may benefit from learning from the successes and failures of the pioneers.
Rapid assessment of an african district health system. Test of a planning tool
Authors: Nordberg Erik , Oganga Hezron , Kazibwe Sam , Onyango Jared 
Published: May 2007

AbstractOccasional rapid health care system assessments are potentially useful for planning, for monitoring health care systems development over time, and for comparing health systems in different areas. With the decentralization of health sector management, for example in Kenya, there is a growing need of such assessments at district and sub‐district levels. Can rapid assessments be conducted at affordable cost at these levels? What variables and methods are feasible?This paper reports on a rapid health system assessment conducted in rural Kenya during 1991. It required the completion at each health facility of a self‐administered questionnaire which included questions on resources, health care programmes, management, service output, and prominent problems. It also included interviews with officers in charge of each health institution in the sub‐district and an examination of records and reports available at each facilityThe paper presents the range of issues addressed, the indicators used, the methods applied, the problems encountered, the costs of the assessment, and a small selection of the findings. We conclude that the assessment model is manageable at district level with modest planning and analysis support from central level. Field staff need more precise instructions for completion of the questionnaire, and more population‐based estimates need to be calculated. Reassessment taking place every 3–5 years should be adequate for monitoring the process of change in the local health care system.
Quality assurance management methods applied to a local‐level primary health care system in rural Nigeria
Authors: Zeitz Paul S. , Salami Charles G. , Burnham Gilbert , Goings Stella A. J. , Tijani Kyari , Morrow Richard H. 
Published: May 2007

AbstractManagement of primary health care (PHC) systems in less developed countries is often impeded by factors such as poorly trained personnel, limited financial resources, and poor worker morale. This study explored the ability of local‐level PHC supervisors in rural Nigeria to use quality assurance (QA) management methods to improve the quality of the PHC systemPHC supervisors from Bama Local Government Area were trained for 3 days in the use of QA methods and tools. The supervisors targeted the supervisory system and the health information system (HIS) for improvement. Health worker performance in diarrhoea case management was assessed, using a simulated case, to measure the impact of supervision. A HIS audit assessed data collection forms used by 17 PHC facilities. Gaps in quality were monitored over a 2‐month study period and flaws in work processes were modifiedPHC supervisors introduced a checklist during monthly visits to facilities to monitor how workers managed cases of diarrhoea. Performance in history‐taking, physical examination, disease classification, treatment and counselling improved over the evaluation period. The HIS audit found that a variety of reporting forms were used at PHC facilities. After HIS reporting was standardized, the number of health facilities using a daily disease registry significantly improved during the study periodQA management methods were used by PHC supervisors in Nigeria to improve supervision and the HIS. QA management methods are appropriate for improving the quality of the PHC in Nigeria and in other less developed countries where at least a minimal PHC infrastructure exists.
Japanese hospitals—culture and competition: A study of ten hospitals
Authors: Anbäcken Owe 
Published: May 2007

AbstractJapanese health care is characterized by a pluralistic system with a high degree of private producers. Central government regulates the prices and the financing system. All citizens are covered by a mandatory employment‐based health insurance operating on a nonprofit basis. The consumer has a free choice of physician and hospital. A comparison between Japan, Sweden and some other countries shows significant dissimilarities in the length of stay, number of treatments per hospital bed and year and the staffing of hospitals. About 80 per cent of the hospitals and 94 per cent of the clinics are privately owned. The typical private hospital owned by a physician has less than 100 bedsIn this paper, data collected (1992/93) in an empirical study of Japanese hospitals and their leadership is presented. Also discussed are the hospitals' style of management, tools and strategies for competition and competences—personal and formal skills required of the leadership in the hospitalThere follows a study of ten hospitals, among which hospital directors and chief physicians were interviewed. Interviews are also made with key persons in the Ministry of Health and Welfare and other organizations in the health care field. The result is also analysed from a cultural perspective—‘what kind of impact does the Japanese culture have on the health care organization?’ and/or ‘what kind of sub‐culture is developed in the Japanese hospitals’. Some comparisons are made with Sweden, USA, Canada and Germany. The different roles of the professions in the hospital are included in the study as well as the incentives for different kinds of strategies — specialization, growing in size, investments in new equipment, different kind of ownership and hospitals. Another issue discussed is the attempt to uncover whether there is an implicit distribution of specialities—silent agreements between hospitals, etc.
The management of health services in Tanzania: A plea for health sector reform
Authors: Sandiford Peter , Kanga George J. , Ahmed Abdullahi M. 
Published: May 2007

AbstractThere are essentially four main approaches used in attempts to strengthen the management of health services in developing countries. These are: information system development; management training; use of planning and evaluation methodologies; and, health sector reform. As part of a collaborative research project based in Kisarawe District, Tanzania, we tested the hypothesis that a combination of the first three of these approaches would be sufficient to ensure that decisions and actions were taken to bring about major improvements in the management of health services. It was assumed that the decentralization, which took place as part of the 1982 reorganization of local government responsibilities, had provided managers with sufficient decision‐making autonomy to allow them to bring about improvement in health service performance, provided that the other conditions were metIn fact, it was found that despite being presented with clear evidence of serious inefficiencies and inequities in the allocation of health resources, managers were often highly reluctant to decide upon actions which would alleviate the problems in situations where there were potential losers as well as winners, even if the benefits greatly outweighed the costsThis article argues that interventions based solely on training, information systems, or planning and evaluation protocols will make only marginal improvements to health service management, and that changes to the system as a whole are needed in order to provide managers and health professionals with incentives to rectify performance failings. Some ideas for health sector reform, to give managers power and incentives for improving efficiency and quality of care, are put forward. Since it is likely that the systemic problems of the health sector in Tanzania are shared by many other developing countries, the lessons drawn from this study probably have more general applicability.
Voices from the inside: Managing district health services in Nepal
Authors: Aitken Jean‐Marion 
Published: May 2007

AbstractApparent inconsistencies and irrational decisions can be found in all organizations and they often point to underlying attitudes and assumptions among staff, about the organization and the way it works. Concepts such as ‘negotiated order’ and ‘values in use’ have been suggested in recent literature on organization theory to describe the important role of individual, and social, needs and expectations upon the functioning of organizations. This article presents the apparently common assumptions made about government service, as encountered during research into the management of district public health services in Nepal. It argues that, when taken together, these form a wide and coherent system of ‘values in use’, or an ‘implicit theory’ which appears to guide many of the bureaucracy's actionsThe way in which staff are selected and promoted, common attitudes towards work, the shortcomings of the reporting systems, all appear to be part of an ‘implicit’ theory which is based on the fundamental belief that it is the main purpose of the district public health service to provide incomes for its staff. Thus, most posts do not have job descriptions and staff are recruited to them on the basis of factors other than the skills or knowledge required. Training and supervision are seen commonly as means of earning extra allowances, and service quality is not seen as a priority. This contrasts with the ‘official’ theory which is that the organization exists to provide health services to the community and that it is the purpose of the staff to provide those servicesSuch an implicit ‘theory’, recognized and accepted by staff but never acknowledged, and based on very different values and expectations to those assumed in a ‘rational’, task‐oriented bureaucracy, obviously has implications for the success of development programmes. It explains why training so rarely results in improved performance and why the bureaucracy is so resistant to change which does not satisfy the implicit theory. While the implicit theory described here is specific to Nepal, the phenomenon may be widespread. The failure to take account of such ‘theories in use’, guiding the actions of staff and hence organizations, could explain the failure of many attempts to improve government health services.
Implementing health management information systems: Measuring success in Korea's health centers
Authors: Chae Young Moon , Kim Suk Il , Lee Byung Hwa , Choi Sung Hae , Kim In Sook 
Published: May 2007

AbstractThis article analyses the effects that the introduction and adoption of a health management information system (HMIS) can have on both the productivity of health center staff as well as on user‐satisfaction. The focus is upon the service provided by the Kwonsun Health Center located in Suwon City, Korea. Two surveys were conducted to measure the changes in productivity and adoption (knowledge, persuasion, decision, implementation and confirmation) of health center staff over time. In addition, a third survey was conducted to measure the effects of HMIS on the level of satisfaction perceived by the visitors, by comparing the satisfaction level between the study health center and a similar health center identified as a control. The results suggest that HMIS increased the productivity and satisfaction of the staff but did not increase their persuasion and decision levels; and, that it also succeeded in increasing the levels of visitors' satisfaction with the services provided.
Friction and wear behavior of poly(vinyl alcohol)/poly(vinyl pyrrolidone) hydrogels for articular cartilage replacement
Authors: Katta Jayanth K. , Marcolongo Michele , Lowman Anthony , Mansmann Kevin A. 
Published: May 2007

AbstractMany hydrogels have been proposed as articular cartilage replacements as an alternative to partial or total joint replacements. In the current study, poly(vinyl alcohol)/poly(vinyl pyrrolidone) (PVA/PVP) hydrogels were investigated as potential cartilage replacements by investigating their in vitro wear and friction characteristics in a pin‐on‐disk setup. A three‐factor variable‐level experiment was designed to study the wear and friction characteristics of PVA/PVP hydrogels. The three different factors studied were (a) polymer content of PVA/PVP hydrogels, (b) load, and (c) effect of lubricant. Twelve tests were conducted, with each lasting 100,000 cycles against Co–Cr pins. The average coefficient of friction for synovial fluid lubrication was a low 0.035 compared with 0.1 for bovine serum lubrication. Frictional behavior of PVA/PVP hydrogels did not follow Amonton's law of friction. Wear of the hydrogels was quantified by measuring their dry masses before and after the tests. Higher polymer content significantly reduced the wear of hydrogel samples with 15% PVA/PVP samples, showing an average dry polymer loss of 4.74% compared with 6.05% for 10% PVA/PVP samples. A trend change was observed in both the friction and wear characteristics of PVA/PVP hydrogels at 125 N load, suggesting a transition in the lubricating mechanism at the pin‐hydrogel interface at the critical 125 N load. © 2007 Wiley Periodicals, Inc. J Biomed Mater Res 2007
Chiral separation of dansyl amino acids in capillary electrophoresis using mono‐(3‐methyl‐imidazolium)‐β‐cyclodextrin chloride as selector
Authors: Tang Weihua , Ong Teng Teng , Ng Siu‐Choon 
Published: May 2007

AbstractEnantioseparations of fourteen dansyl amino acids were achieved by using a positively‐charged single‐isomer β‐cyclodextrin, mono‐(3‐methyl‐imidazolium)‐β‐cyclodextrin chloride, as a chiral selector. Separation parameters such as buffer pH, selector concentration, separation temperature, and organic modifier were investigated for the enantioseparation in order to achieve the maximum possible resolution. Chiral separation of dansyl amino acids was found to be highly dependent on pH since the degree of protonation of these amino acids can alter the strength of electrostatic interaction and/or inclusion complexation between each enantiomer and chiral selector. In general, the chiral resolution of dansyl amino acids was enhanced at higher pH, which indicates that the carboxylate group on the analytes may interact with the imidazolium group of cationic cyclodextrin. For most analytes, a distinct maximum in enantioresolution was obtained at pH 8.0. Moreover, the chiral separation can be further improved by careful tuning of the separation parameters such as higher selector concentration (e. g. 10 mM), lower temperature, and addition of methanol. Enantioseparation of a standard mixture of these dansyl amino acids was further achieved in a single run within 30 min.
Separation of fifteen quinolones by high performance liquid chromatography: Application to pharmaceuticals and ofloxacin determination in urine
Authors: Cañada‐Cañada Florentina , Espinosa‐Mansilla Anunciación , Muñoz de la Peña Arsenio 
Published: May 2007

AbstractA simple chromatographic method is described for assaying 15 quinolones and fluoroquinolones (pipemidic acid, marbofloxacin, enoxacin, ofloxacin, norfloxacin, ciprofloxacin, danofloxacin, lomefloxacin, enrofloxacin, sarafloxacin, difloxacin, oxolinic acid, nalidixic acid, flumequine and piromidic acid), in urine and pharmaceutical samples. The determination was achieved by LC using an RP C18 analytical column. A mobile phase composed of mixtures of methanol–ACN–10 mM citrate buffer at pH 3.5 and 10 mM citrate buffer at pH 4.5, delivered under an optimum gradient program, at a flow rate of 1.5 mL/min, allows to accomplish the chromatographic separation in 26 min. For detection, diode‐array UV–Vis at 280 nm and fluorescence detection set at excitation wavelength/emission wavelength: 280/450, 280/495, 280/405 and 320/360 nm were used. Detection and quantification limits were between 0.3–18 and 0.8–61 ng/mL, respectively. The method was validated in terms of interday (n = 6) and intraday (n = 6) precision and accuracy. The procedure was successfully applied to the analysis of human and veterinary pharmaceuticals. Also, ofloxacin was determined in human urine samples belonging to a patient undergoing treatment with this active principle, among others.
Characterization of Superfine Wool Powder/Poly(propylene) Blend Film
Authors: Xu Weilin , Wang Xin , Li Wenbin , Peng Xuqiang , Liu Xin , Wang Xun Gai 
Published: May 2007

AbstractSuperfine wool powder was blended and extruded with poly(propylene) (PP) to produce blend pellets, and the extruded pellets were hot‐pressed into a blend film. SEM photographs show that the powder could be uniformly incorporated with PP after extrusion. FT‐IR spectra shows that no substantial changes occurred in the chemical structure of both PP and wool powder in the blend film. X‐Ray diffraction analysis indicates that crystallinity of the blend film was much higher than that of the wool powder and little lower than that of PP. TG‐tested results indicate that the thermal stability of the blend film declined with an increase in the powder content. Endothermic peaks of the wool powder in the blend film become more obvious as the powder content increases. Mechanical properties decline greatly with an increase in the wool powder content in the blend film.magnified image
Heat Equation Asymptotics of Elliptic Operators with Non‐scalar Leading Symbol
Authors: Branson Thomas P. , Gilkey Peter B. , Pierzchalski Antoni 
Published: May 2007

AbstractLet M be a compact smoot Riemannian manifold without boundary and let D = ad0δ0 + bδ1d1 – E on the space of smooth sections of the cotangent bundle where a and b are positive constants and where E is an endomorphism. We use functorial methods and the pseudo‐differential operator calculus to compute the quadratic term a4(D) in the asymptotic expansion of the heat equation trace.
The Riemann Hypothesis for Polynomials Orthogonal on the Unit Circle
Authors: Hamilton Xian‐Jin Li Of 
Published: May 2007

AbstractAn axiomatic treatment is first given of certain Hilbert spaces of polynomials which are implicit in the Szegö theory of polynomials orthogonal on the unit circle [7]. Methods of factorization theory are applied to determine the isometric inclusion of such spaces. Every Szegö space is determined by a polynomial which has no zeros in the unit disk and by an integer r which is greater than or equal to the degree of the polynomial. A positivity condition is formulated for a Szegö space in terms of a quantum q, which is a given number with 0 < q < 1. The quantum can be used to state a functional identity for the defining polynomial. The quantum positivity condition implies that the zeros of the defining polynomial lie on a circle determined by the functional identity. Even when no functional identity is satisfied, the quantum positivity condition denies the existence of twin zeros which are symmetrically placed about the circle. The quantum positivity condition is also applied to weighted Hardy spaces. A characterization is given of those weight functions for which the associated space satisfies the quantum positivity condition. A theorem on the asymptotic behavior of derived Szegö spaces is obtained under a quantum positivity hypothesis for weighted Hardy space. These results are used in an interpretation of the convergence of the Euler product for the zeta‐function of a function field with finite constants field.
A Regularity Result of Nikolskii Type for an Evolution Equation on Compact Homogeneous Spaces
Authors: Bondioli Christiana 
Published: May 2007

AbstractIn the previous paper [2], we proposed a definition of a class of function spaces of Nikolskii type on a special class of riemannian manifolds, namely the manifolds M admitting a transitive compact connected Lie group of isometries. In this paper we continue the subject and we complete the proof that the spaces we have introduced coincide with the classical ones, defined through (finitely many) local charts of M. Moreover, our equivalent definition of these spaces allows us to prove here a regularity result for the solution of a Stefan‐like problem on M, in which the initial datum is assumed to be of Nikolskii type.
Delta‐waves for Semilinear Hyperbolic Cauchy Problems
Authors: Oberguggenberger Michael , Wang Ya‐Guang 
Published: May 2007

AbstractThis paper deals with the propagation of strong singularities for constant coefficient semilinear hyperbolic equations and systems. Limits of regularized solutions are computed as the initial data converge to derivatives of Dirac measures on lower dimensional submanifolds. A general method is given which applies whenever the fundamental solution to the principal part is an integrable measure. Particular cases are semilinear first order systems in one space variable and the semilinear Klein‐Gordon equation in at most three space variables.
On the Pathwise Comparison of Jump Processes Driven by Stochastic Intensities
Authors: Brandt A. , Last G. 
Published: May 2007

AbstractIn this paper we present a pathwise comparison theorem for jump processes governed by stochastic intensities and taking values in an arbitrary partially ordered Polish space. This generalizes recent results for the real‐valued case. The proof given here is based on competing risk arguments rather than on thinning and allows to avoid additional domination conditions. For real valued processes we obtain an almost sure pathwise representation of the comparison result based on an i.i.d. sequence of (0, 1)‐uniformly distributed random variables. For Markov chains our conditions coincide with the classical comparison conditions.