bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enantioselective γ‐Deprotonation of Alkyl‐Substituted O‐1,3‐Butadien‐2‐yl Carbamates and Regioselective Asymmetric Homoaldol Reaction
Authors: Bou Chedid Roland , Fröhlich Roland , Wibbeling Birgit , Hoppe Dieter 
Published: May 2007

AbstractThis work presents a facile method for the construction of geometrically defined 1,3‐dien‐2‐yl carbamates. Their highly stereoselective asymmetric deprotonation with the chiral base pair n‐butyllithium/(–)‐sparteine (2) and substitution reactions allows the flexible synthesis of substituted stereohomogeneous 1,3‐dienes. Diastereo‐ and enantioselective homoaldol reactions with aldehydes are possible after transmetallation of the lithium species with ClTi(NEt2)3. Intensive investigations for the interpretation of the stereochemical outcome of the reactions of each carbamate are also presented. Comparison of all results shows common properties of the allyllithium intermediates as well as surprising differences, which indicate a strong relationship between the structure of these intermediates and their reactivity. (© Wiley‐VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2007)
Synthesis of Methylene‐Bridged Analogues of Biologically Active Pteridine Derivatives
Authors: Ślusarczyk Magdalena , De Borggraeve Wim M. , Toppet Suzanne , Hoornaert Georges J. 
Published: May 2007

AbstractThe hepatitis C virus (HCV) is a major cause of liver disease worldwide. The HCV NS5B RNA‐dependent RNA polymerase, which is a central enzyme in the replication of the virus, has become a potential target for design and synthesis of small molecule inhibitors useful in the treatment of HCV infection by interfering with viral replication. In this publication we describe the synthesis of cyclic analogues of biologically active pteridine derivatives of type B. The key step in the formation of target compounds 1–8, is the condensation reaction of tricyclic diketones 10 and 11 with commercially available 4,5‐diamino‐6‐hydroxypyrimidine (9). Subsequent chlorination and amination reactions led to the formation of the target molecules 1–8, which were further biologically evaluated. (© Wiley‐VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2007)
Eight‐Membered‐Ring Lactams – New Scaffolds for Combinatorial Chemistry Prepared by Ring‐Expansion of 1,4‐Diketones with Primary Amines
Authors: Pflantz Rebekka , Tielmann Patrick , Rössle Michael , Hoenke Christoph , Christoffers Jens 
Published: May 2007

AbstractEight‐membered‐ring lactams were prepared by the Bi‐catalyzed reaction of 1,4‐diketones with primary amines. These lactams define a new type of non‐planar molecular scaffold with three points allowing for diversification, which were evaluated as the basis for combinatorial library synthesis. For this reason, reaction conditions were optimized, and the scope and limitations were investigated. After the Bi‐catalyzed reaction, further diversification was achieved by ester saponification and subsequent amide formation with HATU and another primary amine. Representative examples of a model library showed sufficient stability in DMSO and solubility in aqueous buffer, which are mandatory prerequisites due to our in‐house combinatorial chemistry criteria for library production. (© Wiley‐VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2007)
Analysis of protein/polypeptide interactions in human plasma using nondenaturing micro‐2‐DE followed by 3‐D SDS‐PAGE and MS
Authors: Manabe Takashi , Jin Ya 
Published: May 2007

AbstractPreviously, we have reported on the analysis of human plasma proteins on a nondenaturing micro‐2‐DE (μ2‐DE) gel, using in‐gel digestion followed by MALDI‐MS and PMF [1]. Many of the spots on the μ2‐DE gel showed apparent masses much larger than the calculated masses of their assigned polypeptides, suggesting noncovalent or covalent interactions between the polypeptides. In the present study, we aimed to further analyze the plasma protein spots on a nondenaturing μ2‐DE gel, on which protein/polypeptide interactions have been suggested. The proteins in the spots were extracted under alkaline conditions and subjected to 3‐D separation using SDS‐PAGE in microslab gel format (μSDS gel) with or without the sample treatment of reduction–alkylation. The clear bands in each lane of the μSDS gels demonstrated the successful extraction of proteins from the relevant gel spot and visualized the relative contents of the polypeptides in the spot. Most of the bands were assigned by in‐gel digestion followed by MALDI‐MS and PMF (MASCOT/Swiss‐Prot). The large discrepancy between the apparent mass value of a protein spot and the estimated mass values of the polypeptide bands on a nonreducing μSDS gel strongly suggested noncovalent polypeptide interactions. The differences in the polypeptide separation patterns on the μSDS gels, between with and without the treatment of reduction–alkylation, confirmed polypeptide disulfide bonding. The method employed here, aiming to integrate information on the proteins separated on nondenaturing 2‐DE gels with that on the interactions between polypeptides, would help the comprehensive understanding of complex protein systems.
Nurses making a diagnosis of dementia—a potential change in practice?
Authors: Page S. , Hope K. , Bee P. , Burns A. 
Published: May 2007

AbstractObjectivesTo compare nurse initial diagnoses following domiciliary visits with subsequent formal multidisciplinary formulation based upon the full possession of investigations, neuropsychological tests and brain imaging.DesignRetrospective case note study.SettingHome‐based nurse assessments, secondary care based multidisciplinary memory clinic.ParticipantsFour hundred and four consecutive referrals over an 18‐month period.ResultsOne hundred and seventy‐five patients (43.3%) were diagnosed by the multi‐disciplinary team as having a dementia. Seventy‐three (41.5%) were classified as Alzheimer's disease, 81 (46%) of mixed sub‐type and 20 (11.4%) of vascular origin. Overall nurse‐MDT diagnosis agreement was 0.88 (Kappa = 0.82). Together, two nurses were able to detect dementia with 94% accuracy (Kappa = 0.88) Sensitivity was 92% and specificity 96%. The positive and negative predictive values of their judgements were 94% and 98% respectively. Nurses were able to sub‐diagnose dementia with 86% (kappa = 0.76) accuracy. Multivariate logistic regression modelling showed a MDT dementia diagnosis to be independently and significantly associated with lower scores on the KOLT and total MMSE, and with the absence of biological markers of depression. Nurse dementia diagnoses were associated with lower KOLT scores and the absence of biological depression markers, high past alcohol consumption or a history of hypercholesteraemia.ConclusionsIn this study, structured initial assessment by a specialist nurse was shown to be an accurate method of determining a diagnosis of cognitive impairment, when compared with formal MDT judgement. The principal benefit of this approach was that signposting to subsequent care pathways was expedited. Arguably, such distributed responsibility affords a viable option for the future detection of early dementia. Copyright © 2007 John Wiley & Sons, Ltd.
Behavior‐dependent modulation of hippocampal EEG activity by the selective norepinephrine reuptake inhibitor reboxetine in rats
Authors: Kocsis Bernat , Li Shaomin , Hajos Mihaly 
Published: May 2007

AbstractBoth active wakefulness and rapid eye movement sleep (REM) give rise to rhythmic synchronized hippocampal field oscillations, known as theta activity. Antidepressant drugs, including norepinephrine re‐uptake inhibitors are proven to diminish REM sleep, and REM sleep‐related hippocampal theta oscillation. Since reboxetine, a highly selective norepinephrine re‐uptake inhibitor has been shown to block REM sleep, but induce or facilitate hippocampal theta activity in anesthetized rats, the current study investigated the effects of reboxetine on stage‐ and behavior dependent theta activity. Polysomnographic recordings, which included hippocampal field potentials at the hippocampal fissure, were carried out in rats for 8 h during the light phase of the circadian cycle. Theta rhythm was analyzed during three different behavioral conditions: REM sleep, during motor activity in a familiar environment, and during exploration in a novel environment. We found that, compared with REM sleep, theta power was relatively low during periods of active wakefulness when the animal was in the familiar home cage, but considerably increased during exploration in a novel environment. Reboxetine suppressed sleep and thus abolished REM sleep‐related hippocampal theta rhythm, attenuated theta in the familiar environment, and significantly enhanced theta oscillations associated with exploratory behavior. Our findings demonstrate a state‐ and behavior‐dependent modulation of hippocampal theta activity by reboxetine, providing further evidence for a prominent role of norepinephrine in arousal and focused or selective attention © 2007 Wiley‐Liss, Inc.
Postwar Uganda: A review of health services in Kabarole District
Authors: Kipp Walter , Kielmann Arnfield , Kwered Eric 
Published: May 2007

AbstractThis article summarizes the results of a comprehensive baseline survey of health services, conducted in Kabarole District, Western Uganda, in March 1989. The purpose of this survey was to obtain baseline data in order to facilitate planning, monitoring and evaluation of the Basic Health Services Programme, sponsored by the German Agency for Technical Cooperation, which started in October 1988. The survey was carried out in 12 randomly selected health facilities and in 43 adjacent households, where 435 persons were interviewed. The health service delivery system was characterized by the following score (maximum possible score 100): staff positions filled, 63; presence of staff in health facilities, 59; supervision, 39; management, 17; medical knowledge, 62; skills, 53; drug supply, 80; community participation, 8. The average attendance rate at the health facilities was calculated as 0.8 visits per head per year. The low utilization of health facilities in Kabarole District reflects the quality of government services after a civil war of 15 years, which ended in 1986. The importance of data collection is stressed, as is the methodology employed.
Cost of treatment of congenital dislocation of the hip
Authors: Kernohan George , Trainor Bernadette , Mollan Raymond , Normand Charles 
Published: May 2007

AbstractEarly treatment for congenital dislocation of the hip is usually simple and inexpensive. However, if the disease is not detected by 6 months of age, treatment is often complicated and expensive. We evaluated the potential cost‐saving of screening, by examining the costs in 36 late cases born in 1980 and found an average cost of £6,674 per case for treatment to this date. This amount could justifiably be spent on each case detected in an effective screening programme.
An organizational framework for achieving health for all in developing countries
Authors: Monekosso G. L. 
Published: May 2007

Abstract‘Health for All by the Year 2000’, whether viewed as a goal or a process, is desirable and efforts should be made to ‘achieve’ it. For most developing countries, however, a drive towards it requires an appropriate organizational framework for planning and implementing their health development activities. This article suggests such an organizational framework. One of the attractions of the framework lies in the fact that it would enable those developing countries that adopt it to overcome major constraints at the central, intermediate and local levels.
Constraints on innovatory practice: The case of day surgery in the NHS
Authors: Beech Roger , Morgan Myfanwy 
Published: May 2007

AbstractRates of adoption of new technology or innovatory practices depend upon their inherent managerial and clinical incentives. Rates will be highest where these incentives coincide and lowest where both are weak. Within this framework we examine the current low rate of adoption of day surgery in the National Health Service (NHS) of the United Kingdom (UK). We assess the current managerial incentives for the introduction of day surgery in terms of its potential either to achieve financial savings or to allow expansions in overall hospital caseload. These are both shown to have been low within the context of the traditional method of funding health care in the NHS. Clinical attitudes and their perceptions of the barriers to day surgery are examined based on data from a survey of 240 consultant surgeons. A high proportion of surgeons regard day surgery as clinically acceptable for a wide range of procedures, but the limited clinical appeal of day surgery procedures and the lack of day facilities have further limited its adoption. These findings are considered in the context of the revised methods of funding hospital services in NHS, introduced from April 1991. Priorities may change with managerial incentives playing a greater role in the introduction of new technologies and innovatory practices.
Operating efficiency in inpatient care: An exploratory analysis of teaching hospitals in Rajasthan, India
Authors: Purohit Brijesh C. , Rai Vandana 
Published: May 2007

AbstractThis article reports on the results of an exploratory attempt towards the measurement of operational efficiency within hospitals. This microanalysis focuses attention on the departments of general surgery within four teaching hospitals in the State of Rajasthan in India. The analysis involves devising a costliness index, which then permits a ranking of hospitals according to their relative efficiencies. It is observed, generally, that all the study hospitals exceed their normative cost estimates on inpatient care. This is especially the case for two of the four hospitals, in respect of both fixed and variable costs. In the case of higher fixed costs, the cause seems to be a misallocation of resources resulting from high staffing levels, i.e. on the salaries of teaching or nursing staff. The variable costs are higher either on account of the high expenditure on supplies or on salary costs of common services. A further analysis was conducted to determine the presence or otherwise of inter‐unit efficiencies within the departments of general surgery, it revealed that inter‐unit differentials were mostly insignificant. More significantly, the study does suggest that expenditure efficiency on public health‐care in the hospitals studied could be enhanced through better budgetary management and cost control. This could be achieved, for instance, by enhancing the productivity of (human) resources, by checking wastages and leakages by means of appropriate monitoring, and through adoption as well as experimentation with methods of peer review and quality assurance.
Action‐based learning to improve district management: A case study from Tanzania
Authors: Barnett Elizabeth , Ndeki Sydney 
Published: May 2007

AbstractBetween October 1988 and December 1989, the district health management team (DHMT) of Same District, in Tanzania, tested out an action‐based learning strategy to improve its management capability. The initiative was led by the Centre for Educational Development in Health, Arusha, which was seeking alternatives to institutionbased management training, with support from WHO. The strategy involved the DHMT in an iterative process of problem analysis, action research, problem solving and review. The process combined start‐up and review workshops with on‐going work by the DHMT to tackle problems of primary health care (PHC) implementation. The team monitored its own progress in solving its problems. By December 1989, the team could identify a number of achievements, the most striking being the team spirit it had developed, and its ability to tackle a range of minor problems, and some major problems, facing its PHC work.Following the encouraging results in Same, the Ministry of Health endorsed the strategy, and secured funds to implement it on a wider scale. A further eight districts were introduced to the process. However, whilst there was enthusiasm for the start‐up workshops, the important follow‐up work necessary from regional level failed to take place in time. Insufficient time was given to preparing facilitators, and effective monitoring was not done. Remedial strategies must now be formulated to bring the process back on course. This article demonstrates the importance of ensuring that certain necessary conditions can be met when introducing action‐based learning, as a key continuing education strategy for improving management at district level.
Defining excellence in health service management: Evidence from an international study
Authors: Braithwaite Jeffrey 
Published: May 2007

AbstractHealth service executives are striving to implement the best managerial practices amid the major turbulence and restructuring which is prevalent in many health care systems today. All too often, guidance about what the best practices are needs to be sought from studies contained within the general management literature. It is problematical whether this literature is applicable to health service organizations. This article reports the results of a study which examined the views of 93 executives in 14 hospitals in Britain. Canada and the United States about what constitutes managerial excellence. The hospitals were selected on the basis of their reputed success in health service management. Using grounded theory methodology, eight factors of excellence were derived from the interview data which were supplemented by data made available from hospital documentation supplied by participants. The results of this study are compared with those of Peters and Waterman (1982). This is the most frequently cited study of managerial excellence in the general management literature. The main conclusions drawn are that a current definition of health service management excellence has been identified; there was a high degree of unanimity among participant executives about the constituents of success and excellence in health service management; and, that there are some marked differences between this definition of excellence and that propounded by Peters and Waterman (1982). The implications of this definition of excellence for health service executives are discussed.
Dissecting the patient stay in the UK
Authors: Richardson P. C. , Barwick D. E. , Bagut A. , Young R. J. , Horsley S. D. , Allen D. E. 
Published: May 2007

AbstractA method of analysing the factors which contribute to the length of stay in England as an acute medical in‐patient has been developed, and applied in both real‐time and cross‐sectional studies. The major factors delaying discharge were found to be the time taken to respond to treatment and the actions of agencies other than the acute medical unit of the hospital. Areas where improvement could be made have been identified and some changes implemented. The system can be applied to monitor the effect of such changes.
Health insurance and the bamako initiative in Burundi: Value for money?
Authors: Baza Anaclet , Hakizimana Ali , Hanson Kara , Kwizera Fidele , Geest Sjaak Van Der 
Published: May 2007

AbstractDespite its a priori attractiveness, health insurance schemes are rare in developing countries. A recent external review of the Bamako Initiative in Burundi considered the extent to which the ‘Carte d'Assurance Maladie’ (CAM) has the potential to improve the quality of, and access to, health services. Although utilization of the CAM was found to be low overall, most of those visiting the health centres were in possession of a card, leading the team to conclude that health service utilization for curative care is extremely low. Focus group discussion revealed that users perceive the quality of health services to be poor, and that frequent shortages of basic drugs and supplies create uncertainty as to whether the CAM will provide good value for money, the shortage of basic drugs, the lack of community participation in the management of health services, and the fact that very little of the revenue from sales of the CAM is spent on health service provision provide possible explanations for the weak uptake of health insurance. Closing the link between the payment for health services and the financing of those services would contribute to an improvement in the quality and the confidence of the population in government health services.
Health care reforms in the french hospital system
Authors: Bach Stephen 
Published: May 2007

AbstractThe French health care system, like other health care systems, entered the 1990s in a state of flux. During the 1980s, attempts to curb health care expenditure had a limited impact with the liberal and pluralist values of the health system undermining reform strategies. In 1991 the French government introduced a new hospital reform which had four main strands: rationalizing public and private health care provision; introducing a medical logic into the hospital service; increasing hospital autonomy and strengthening participation and involvement in the hospital system. However, these reforms left untouched the financing of the health service. Consequently there remains a need for a more fundamental reform of the management and financing of the French health care system.
Managing public services in the 1990s president's lecture: 1ST October, 1993 centre for health planning and management, Keele university, MBA (health executive) Alumni association
Authors: Davies Howard 
Published: May 2007

AbstractThe management of public services in the 1990s raises a number of central issues which require to be resolved. On the one hand, efficiency and effectiveness require attention, as in the 1980s or indeed anytime. On the other hand, the distinctive nature of public (and governmental) services needs to be recognized or reasserted. This Keynote Address to the Keele University, Centre for Health Planning and Management MBA (Health Executive) Programme Alumni Association by Howard Davies, Director General of the Confederation of British Industry, sets out some key principles based on the ‘British Debate’ which are nevertheless generalizable in a number of cases to a wholly international audience.
The impact of maternal health improvement on perinatal survival: Cost‐effective alternatives
Authors: Walsh Julia A. , Measham Anthony R. , Feifer Christine N. , Gertler Paul J. 
Published: May 2007

AbstractEach year, an estimated half million women die from complications related to child birth either during pregnancy, delivery or within 42 days afterwards. When pregnant women have complications, their infants are at greater risk of becoming ill, permanently disabled or dying. For every maternal death, there are at least 20 infant deaths: stillbirths, neonatal or postneonatal deaths. Altogether, an estimated 7 million infants each year die perinatally (stillborn or deaths within the first week of life). Low cost, feasible, and effective intervention strategies include: a) improved family planning and abortion services; b) obstetric care at delivery; and, c) prenatal servicesTwo hypothetical populations of one million (a low mortality and a high mortality country) are used to illustrate maternal and perinatal program strategies and priorities. In countries with high fertility, major reductions in maternal and infant deaths result both from reductions in the number of pregnancies through family planning and from improved obstetric care. Where fertility is already low, reductions result almost entirely from improved obstetric and prenatal care. The investments required are relatively low, while the potential gains are great. The cost to avert each death in a high mortality population is estimated between $800 and $1500 or as low as $0.50 per capita per yearThe priorities for programs targeting maternal and perinatal health depend on demographic, ecologic and economic factors, and should include the promotion of good health, not merely the avoidance of death. More operational research is required on various aspects of maternal and perinatal health; in particular, on the cost‐effectiveness of different service components.