bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using hospital activity indicators to evaluate performance in Andhra pradesh, India
Authors: Mahapatra Prasanta , Berman Peter 
Published: May 2007

AbstractThe performance of secondary level public hospitals in Andhra Pradesh, India was evaluated with the help of input‐output ratios of hospital activity and service mix. Indicators for emergency, clinical, diagnostic and medico‐legal services have been defined. Wide variability of global hospital activities was observed. Variability of turnover rate and bed occupancy was much more than length of stay. Combined utilization and productivity analysis showed that all outlying hospitals were either in the low turnover, low occupancy group or in the high turnover, high occupancy group. Low productivity or inadequate hospital capacity seem to be the major problems. All low turnover, low occupancy hospitals also had low levels of outpatient consultations, and high turnover, high occupancy hospitals had above‐average outpatient activity. About 40 per cent of hospitals did not provide emergency services. About 10 per cent of hospitals were not performing any diagnostic tests. Strengthening emergency service delivery capacity, as well as diagnostic facilities, could improve productivity and capacity utilization. Extremes of turnover and occupancy were not associated with any particular case‐mix pattern. Thus, neither poor productivity and capacity utilization nor overcrowding can be explained by case‐mix differences. Problems of poor performance and inadequate capacity seem to be real.
Is there a relation between waiting‐list length and surgery rate?
Authors: Nordberg Mai , Keskimǎki Ilmo , Hemminki Elina 
Published: May 2007

AbstractThe aim of this study was to investigate whether the differences in waiting‐list lengths between hospitals can result from differences in demand for surgery. We compared waiting‐list lengths for seven surgical procedures to the rates of these procedures. The numbers of procedures were obtained from the 1987 Finnish Hospital Discharge Register, and the numbers of patients on the waiting lists were obtained from an inquiry made to Finnish hospitals in 1987. Correlation coefficients were calculated between population‐based waiting‐list lengths and procedure ratesSignificant, positive correlations were found between population‐based waiting‐list lengths and rates for operations on hallux valgus, for herniorrhaphy and for hysterectomy. Rates for cholecystectomy and haemorrhoidectomy were also positively correlated with waiting‐list lengths, but these correlations were not statistically significant. There was no correlation for varicose‐vein operations, and a negative correlation for cataract extraction. These results suggest that insufficient resources are not the only reason for long waiting lists; but, both long waiting lists and a high rate of surgery can result from a high demand for surgery, influenced by physicians' decisions. If the waiting list is long because surgical treatment is preferred, the answer is not necessarily to increase resources, but to examine critically the indications for surgery.
The Israeli health care reform: A study of an evolutionary major change
Authors: Shirom Arie 
Published: May 2007

AbstractLike other advanced market economies, Israel has been engaged in a reform of its health care system, more intensely so since 1994. The first two sections describe the key features of the Israeli health care system before the reform, and their strengths and weaknesses. A State Commission of Inquiry, established by the government in 1988, proposed in its 1990 report two different reform strategies, respectively developed by the majority and the minority in it. The Commission diagnoses, recommendations and strategies are assessed and explained in the next sections. Legislators and policy makers opted for the incremental, evolutionary reform strategy, proposed by the minority in the Commission. The essence of the reform strategy being implemented as from 1995 is presented and examined in the penultimate section. In the concluding part, the Israeli experience with the formulation and implementation of a health care reform is discussed.
Incentives and provider payment methods
Authors: Barnum Howard , Kutzin Joseph , Saxenian Helen 
Published: May 2007

AbstractThe mode of payment creates powerful incentives affecting provider behavior and the efficiency, equity and quality outcomes of health finance reforms. This article examines provider incentives as well as administrative costs, and institutional conditions for successful implementation associated with provider payment alternatives. The alternatives considered are budget reforms, capitation, fee‐for‐service, and case‐based reimbursement. We conclude that competition, whether through a regulated private sector or within a public system, has the potential to improve the performance of any payment method. All methods generate both adverse and beneficial incentives. Systems with mixed forms of provider payment can provide tradeoffs to offset the disadvantages of individual modes. Low‐income countries should avoid complex payment systems requiring higher levels of institutional development.
Planning for health: The significance of life style
Authors: Rosengren Bengt , Borgenhammar Edgar 
Published: May 2007

AbstractThe health of a population is related to more than the volume and quality of health services available. Ischaemic heart diseases and cancers are the main causes of death for adults in most developed countries. Partly, these diseases are related to diet and other life style variables. The purpose of this article is to discuss some prevention possibilities related to health practices. Empirical data were collected by means of a questionnaire on health status and ‘life style’ among long‐standing members of a Swedish popular movement for physical culture. The principal question was what could be learned for health planning and management. Genetic factors have lately come more in focus as an explanation of untimely death and disease while, for example, life style has been de‐emphasized. There is a risk, thereby, that a purchaser—provider approach, where short‐sighted returns are in focus, will give too low a priority to health promotion.
Principles of health infrastructure planning in less developed countries
Authors: Unger J.‐P. , Criel Bart 
Published: May 2007

AbstractThis article proposes a number of key principles for health infrastructure planning, based on a literature review on the one hand, and on a process of internal deduction on the other. The principles discussed are the following: an integrated health system; a thrifty planning of tiers within that health system; a specificity of tiers; a homogeneity of the tiers' structures; a minimum package of activities; a territorial responsibility and/or an explicit and discrete responsibility for a well‐defined population; a necessary and sufficient population basis; a partial separation of administrative and public health planning bases; and, finally, rules for a geographical division and integration of nongovernmental organizations. The definition of two strategies, primary health care and district health systems, is also revisited.
Culturally acceptable health care services for saudi's elderly population: The decision‐maker's perception
Authors: Al‐Shammari Sulaiman A. , Felemban Ferial M. , Jarallah Jamal S. , Ali El‐Shabrawy , Al‐Bilali Suleiman A. , Hamad Jaafer M. 
Published: May 2007

AbstractThis article reports on a study carried out in 1993 to elicit the opinions of decision makers (medical and non‐medical) as to the types of facilities, locations and culturally acceptable levels of health care appropriate for the elderly in Saudi Arabia. In addition, the study sought to find out the procedures and likely constraints in the development of future health care services for the elderly.An opinion survey was carried out on a randomly selected sample of decision makers, drawn from: hospitals of 100‐bed capacity or more; and, from directorates of education, agriculture, police, municipalities, commerce, transport and media, in each of the regions of Saudi Arabia. A predesigned Arabic questionnaire was completed by the respondents during February‐April, 1993.Of the 244 respondents, the most important categories of elderly to be cared for were considered to be those with handicaps, the chronically ill, and those without family support. The non‐medical decision makers gave higher scores to these alternatives than did the medical decision makers (P<0.05). Use of the family home for elderly health care was rated as the most appropriate, followed by medical rehabilitation centres, and only then by hospitals. Non‐medical respondents gave more emphasis on rehabilitation centres (P<0.02). Medical respondents thought that primary care doctors (87.2%), physiotherapists (87.2%) and general nurses (78.2%) can adequately fulfil the needs of most elderly patients. In contrast, non‐medical respondents demanded the presence of specialist doctors (72.3%), specialist nurses (78.9%), laboratory and X‐ray facilities to run such services (P<0.05).Medical decision makers were also more concerned than the non‐medical respondents that the availability of such medical facilities might encourage some people to neglect their elderly parents (P<0.04). Equally, medical respondents were seemingly more aware of the high cost of hospital beds than their non‐medical counterparts (P<0.0001).The conclusion to be drawn is that there is a need to provide both acceptable and suitable health care facilities tailored to the needs of the elderly in Saudi Arabia. Any proposed setting should be both cost‐effective and avoid socially adverse outcomes. Above all, the community should be encouraged to participate positively in the development, running and periodic evaluation of such facilities.
International trends in accreditation
Authors: Scrivens Ellie 
Published: May 2007

AbstractAccreditation of hospitals began in the early part of the twentieth century in the USA as a mechanism to ensure an appropriate environment in which clinicians could practise effectively. It was adopted in Canada and Australia, where it conformed to the early design of standards to control the hospital environment. In the past decade, these accreditation systems have been forced to change in response to the decline in the role of the hospital in health care delivery; the demands of governments and the public for greater information about quality of health care. They have also responded to pressure for greater knowledge of clinical effectiveness by introducing indicators of clinical performance. Within the past 5 years, accreditation has been adopted in a number of other countries where governments have extended their role into assuring the quality of health care. Accreditation, originally perceived as a vehicle to enable organizational development, is increasingly an agent of government regulation.
Hospital accreditation in catalunya: An assessment of the performance in quality of hospitals
Authors: Bohigas Lluis , Asenjo Miguel Angel 
Published: May 2007

AbstractInformation about a hospital accreditation program generally goes unpublished, and when published, it is seldom used to analyse the quality performance in a group of hospitals. This article uses the information derived from the Accreditation Program of Hospitals in Catalunya to assess the quality of the performance of hospitals in this region. Catalunya's accreditation program is publicly administered, and the advantages and disadvantages of such a model in comparison to others will also be analysed.
Models for relating performance measurement and accreditation
Authors: Schyve Paul 
Published: May 2007

AbstractThe Joint Commission on Accreditation of Healthcare Organizations has attempted to move away from simple measures of organizational process to measures of organizational performance. As no measures of organizational performance existed, the Joint Commission was forced to embark upon a lengthy search for methodologies and technologies to measure organizational performance. In addition, an approach to the use of performance measures, which would be acceptable to the health service community, and which was compatible with the process of accreditation, had to be found.
Shaping the health future in Turkey: A new role for human resource planning
Authors: Ozcan Serpil , Taranto Yael , Hornby Peter 
Published: May 2007

AbstractThe expanding health needs and expectations of a growing and changing population in Turkey are placing new pressures on a health system that is increasingly financially constrained. These pressures are bringing into sharp focus the need to take radical approaches to the organization, planning and management of the health sector; and, in particular, in the planning and management of health human resources. Issues of effectiveness, efficiency and value for money are increasingly becoming the central issues for the 1990s and beyond. The article examines the development of the Turkish health system. Within a framework of health care reform proposals emerging from a major development project in the Ministry of Health itself, the text explores current initiatives and future needs in developing human resource planning if the health care reforms are to be successful in meeting the health needs of the population.
Rapid dose initiation of quetiapine for the treatment of acute schizophrenia and schizoaffective disorder: a randomised, multicentre, parallel‐group, open study
Authors: Boidi Giuseppina , Ferro Maurizio 
Published: May 2007

AbstractObjectiveRapid resolution of symptoms is a priority for clinicians treating acute psychosis, and rapid initiation of pharmacotherapy may prove beneficial. This study examined rapid dose initiation of quetiapine in acutely ill patients.MethodsA 2‐week, multicentre, randomised, parallel‐group, open study. Inpatients (n = 269) diagnosed with schizophrenia or schizoaffective disorder received rapid (n = 139) or conventional (n = 130) initiation of quetiapine, followed by flexible dosing (maximum 800 mg/day). Primary outcome included proportion of patients experiencing ≥1 episode of selected AEs (somnolence, dizziness, orthostatic hypotension) during Week 1. Secondary outcomes included discontinuations due to AEs, and efficacy assessed by BPRS and CGI‐S scores.ResultsThe proportion of patients with ≥1 selected AE during Week 1 was 5.4% and 10.1% in the conventional and rapid initiation groups, respectively. Most common AEs (>5% patients) were hypotension, tachycardia, somnolence and sedation. Overall, four (3.1%) and three (2.1%) patients from the conventional and rapid initiation group, respectively, withdrew due to AEs. BPRS and CGI‐S scores decreased significantly (p < 0.001) from baseline in both groups.ConclusionA higher proportion of patients experienced AEs with rapid initiation of quetiapine (800 mg/day by Day 4), although withdrawals due to AEs were comparable. Rapid initiation of quetiapine was generally well tolerated and effective in this setting. Copyright © 2007 John Wiley & Sons, Ltd.
Progesterone increases csk homologous kinase in HMC‐1560 human mast cells and reduces cell proliferation
Authors: Belot Marie‐Pierre , Abdennebi‐Najar Latifa , Gaudin Françoise , Emilie Dominique , Machelon Véronique 
Published: May 2007

AbstractMast cells proliferate in vivo in areas of active fibrosis, during parasite infestations, in response to repeated immediate hypersensitivity reactions and in patients with mastocytosis. We investigated how progesterone reduces the proliferation of HMC‐1560 mast cells that proliferate spontaneously in culture. Cells were incubated with 1 µM to 1 nM progesterone for 24–48 h. Progesterone (1 µM) reduced the spontaneous proliferation of HMC‐1560 mast cells to half that of cells cultured without hormone. [3H] thymidine incorporation was only 50% of control; there were fewer cells in G2/M and more cells in G0/G1. The amounts of phospho‐Raf‐1 (Tyr 340–341) and phospho‐p42/p44 MAPK proteins were also reduced. In contrast progesterone had no effect on MAP kinase‐phosphatase‐1. The Raf/MAPK pathway, which depends on Src kinase activity, is implicated in the control of cell proliferation. HMC‐1560 cells incubated with the tyrosine kinase inhibitor PP1 proliferated more slowly than controls and had less phospho‐Raf‐1 (Tyr 340–341) and phospho‐p42/p44 MAPK. The Csk homologous kinase (CHK), an endogenous inhibitor of Src protein tyrosine kinases, was also enhanced in progesterone‐treated cells. In contrast, progesterone had no effect on the growth of cells transfected with siRNA CHK. We conclude that progesterone increases the amount of csk homologous kinase, which in turn reduces HMC‐1560 mast cell proliferation. This effect parallels decreases in the phosphorylated forms of Raf‐1 and p42/44 MAPK, as their production depends on Src kinase activity. J. Cell. Biochem. 102: 1271–1280, 2007. © 2007 Wiley‐Liss, Inc.
Simplifying the extracellular matrix for 3‐D cell culture and tissue engineering: A pragmatic approach
Authors: Prestwich Glenn D. 
Published: May 2007

AbstractThe common technique of growing cells on tissue culture plastic (TCP) is gradually being supplanted by methods for culturing cells in two‐dimensions (2‐D) on matrices with more appropriate physical and biological properties or by encapsulation of cells in three‐dimensions (3‐D). The universal acceptance of the new 3‐D paradigm is currently constrained by the lack of a biocompatible material in the marketplace that offers ease of use, experimental flexibility, and a seamless transition from in vitro to in vivo applications. In this Prospect, I argue that the standard for 3‐D cell culture should be bio‐inspired, biomimetic materials that can be used “as is” in drug discovery, toxicology, cell banking, and ultimately in medicine. Such biomaterials must therefore be highly reproducible, manufacturable, approvable, and affordable. To obtain integrated, functional, multicellular systems that recapitulate tissues and organs, the needs of the true end‐users—physicians and patients—must dictate the key design criteria. Herein I describe the development of one such material that meets these requirements: a covalently crosslinked, biodegradable, simplified mimic of the extracellular matrix (ECM) that permits 3‐D culture of cells in vitro and enables tissue formation in vivo. In contrast to materials that were designed for in vitro cell culture and then found unsuitable for clinical use, these semi‐synthetic hyaluronan‐derived materials were developed for in vivo tissue repair, and are now being re‐engineered for in vitro applications in research. J. Cell. Biochem. 101: 1370–1383, 2007. © 2007 Wiley‐Liss, Inc.
Pillar‐structured microchannels for on‐chip liquid chromatography: Evaluation of the permeability and separation performance
Authors: De Pra Mauro , De Malsche Wim , Desmet Gert , Schoenmakers Peter J. , Kok Wim Th. 
Published: May 2007

AbstractThe chromatographic characteristics were determined for a set of microfabricated separation channels structured with cylindrical and diamond‐shaped pillars with a characteristic size of 5 μm. Channels with different structures and porosities were etched in a silicon wafer using lithographic techniques. The permeability for flow of the channels was shown to increase strongly with the overall porosity. Diamond‐shaped pillars appeared to yield a slightly higher permeability than cylindrical pillars at the same channel porosity. Compared to packed columns, permeabilities were higher by a factor of up to 5. Band dispersion in the channels was measured with an unretained fluorescent probe compound using a fluorescence microscope. A relatively large variation in the observed plate heights between channels was found, which was mainly attributed to the inaccurate geometry of the structure close to the side walls. Reduced plate heights between 0.2 and 1.0 were obtained. The lowest plate heights were found for channels with low porosity. The chromatographic impedances were calculated and compared to the values for the traditional chromatographic systems. For one of the structured microchannels the impedance was found to be more than ten times lower than for a column packed with nonporous spherical particles. With the data collected, predictions are given on the possibilities in terms of efficiency and speed offered by structured microchannels for pressure‐driven separations, taking practical constraints into account.
Automated screening platform with isochronal‐parallel analysis and conditioning for rapid method development of chiral separations
Authors: Wetli Herbert A. , Francotte Eric 
Published: May 2007

AbstractAn automated chiral separation‐screening platform was developed, allowing separation analysis on one column while another column is simultaneously equilibrated with a different mobile phase (MP). The platform can be set up from usual HPLC components at moderate cost and it considerably speeds up the screening process, allowing numerous chromatographic conditions to be tested within a short period of time and leading to a significant gain in time and productivity in preparative separations.
Optimization of extraction chromatography separations of trace levels of actinides with ICP‐MS detection
Authors: Peterson Dominic S. , Plionis Alexander A. , Gonzales Edward R. 
Published: May 2007

AbstractThe separation of trace level actinides has been evaluated on extraction chromatography columns. Detection of the actinides was achieved through the use of an inductively coupled plasma MS (ICP‐MS). The columns that we tested were prepared from a commercial TRU resin. The separation of the actinides was optimized for several parameters including particle size, column length, packing pressure, and eluent flow rate. We also examined the possibility of reducing or eliminating oxalic acid in the eluents in order to improve the performance of the mass spectrometer. We were able to separate a mixture of five actinides (232Th, 238U, 237Np, 239Pu, 243Am) in less than 4 min. This work has application to rapid bioassay as well as for automated separations of actinide materials.
Electrochemical studies on the effect of (2E)‐3‐amino‐2‐phenylazo‐but‐2‐enenitrile and its derivative on the behaviour of copper in nitric acid
Authors: Abd El‐Maksoud S.A. , Hassan H.H. 
Published: May 2007

AbstractThe objective of this work is to provide additional insight on the influence of (2E)‐3‐amino‐2‐phenylazo‐but‐2‐enenitrile and its derivative as corrosion inhibitors for copper in 0.5 M HNO3. Electrochemical techniques (potentiodynamic polarization, polarization resistance and impedance spectroscopy) as well as weight loss measurements have been employed to study the corrosion inhibition. The investigated compounds have shown inhibition efficiency in 0.5 M HNO3. Inhibition efficiency of these compounds has been found to vary with the concentrations of the compounds. The adsorption of these compounds on the copper surface from the acid solution has been found to obey Langmuir adsorption isotherm. The results revealed that the compounds are mixed type inhibitors. The effect of temperature on the inhibition efficiency was studied.