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PubMed1990

Prison mental health services: results of a national survey of standards, resources, administrative structure, and litigation.

The formation of adequate mental health systems within prisons has accelerated as a result of successful class action lawsuits. Our recent national survey questioned all state correctional departments about the existence of standards in each system, compliance with such standards, prevalence of class action lawsuits involving the issue of providing adequate mental health services for inmates, issues related to consent decrees, available mental health resources within the correctional system, and the administrative structure of the mental health system. Our purpose was to identify those factors correlated with certified class action lawsuits involving issues related to mental health services. Twenty-one states were involved in such litigation. Only the presence of psychiatric hospitals operated by the department of corrections correlated with the presence of certified class action lawsuits involving mental health services. Prison systems larger than 15,000 inmates were at higher risk for such litigation. Smaller systems having psychiatric hospitals run by the state mental health agency appeared to be at less risk for such litigation.

Jurisprudence↗
PubMed2003

The CATH database: an extended protein family resource for structural and functional genomics.

The CATH database of protein domain structures (http://www.biochem.ucl.ac.uk/bsm/cath_new) currently contains 34 287 domain structures classified into 1383 superfamilies and 3285 sequence families. Each structural family is expanded with domain sequence relatives recruited from GenBank using a variety of efficient sequence search protocols and reliable thresholds. This extended resource, known as the CATH-protein family database (CATH-PFDB) contains a total of 310 000 domain sequences classified into 26 812 sequence families. New sequence search protocols have been designed, based on these intermediate sequence libraries, to allow more regular updating of the classification. Further developments include the adaptation of a recently developed method for rapid structure comparison, based on secondary structure matching, for domain boundary assignment. The philosophy behind CATHEDRAL is the recognition of recurrent folds already classified in CATH. Benchmarking of CATHEDRAL, using manually validated domain assignments, demonstrated that 43% of domains boundaries could be completely automatically assigned. This is an improvement on a previous consensus approach for which only 10-20% of domains could be reliably processed in a completely automated fashion. Since domain boundary assignment is a significant bottleneck in the classification of new structures, CATHEDRAL will also help to increase the frequency of CATH updates.

Animals↗
PubMed2002

The CATH protein family database: a resource for structural and functional annotation of genomes.

Over the last decade, there have been huge increases in the numbers of protein sequences and structures determined. In parallel, many methods have been developed for recognising similarities between these proteins, arising from their common evolutionary background, and for clustering such relatives into protein families. Here we review some of the protein family resources available to the biologist and describe how these can be used to provide structural and functional annotations for newly determined sequences. In particular we describe recent developments to the CATH domain database of protein structural families which have facilitated genome annotation and which have also revealed important caveats that must be considered when transferring functional data between homologous proteins.

Databases, Protein↗
PubMed2006

Rules and resources: a structuration approach to understanding the coordination of children's inpatient health care.

AIM: This paper presents findings from a multi-method study exploring the process of care coordination in children's inpatient health care. BACKGROUND: Existing work on care coordination is typified by "black-box" type studies that measure inputs to and outcomes of care coordination roles and practices, without addressing the process of coordination. METHOD: Using questionnaires, interviews and observation to collect data in multiple sites in the United Kingdom and Denmark between 1999 and 2005, the study gathered the perceptions of staff and compared these with observed practice. Giddens' structuration theory was used to provide an analytical and explanatory framework. FINDINGS: Current care coordination practice is diverse and inconsistent. It involves a wide range of clinical and non-clinical staff, many of whom perceive a lack of clarity about who should perform specific coordination activities. Staff draw upon a wide range of different material and non-material resources in coordinating care, the use of which is governed by largely tacit and informal rules. CONCLUSIONS: Care coordination can be usefully conceptualized as a "structurated" process--one that is continually produced and reproduced by staff using rules and resources to "instantiate" or bring about care coordination through action. Potentially negative implications of this are manifested in diversity and inconsistency in care coordination practice. However, positive aspects such as the opportunity this provides to tailor care to the needs of the individual patient can be realized.

Attitude of Health Personnel↗
PubMed2004

Targeting and structuring information resource use: a path toward informed clinical decisions.

A core skill for all physicians to master is that of information manager. Despite a rapidly expanding set of electronic and print-based information resources, clinicians continue to answer their clinical queries predominantly through informal or formal consultation. Even as new tools are brought to market, the majority of them present information in a rigid fashion, presenting cumbersome user interfaces and inflexible data presentation. The need to rethink the structure of electronic information is paramount to improving the use of evidence at the bedside. As new tools are developed and educators teach clinicians to use them, the context for use of information resources must be considered, with special attention to physician work-flow, following the three paths outlined in this article. The process will be facilitated greatly by promoting evidence-based practice for the care of patients in the hospital and clinic setting.

Decision Making↗
PubMed1999

The treatment of chronic cancer pain in a cancer hospital in The Netherlands.

In a prospective study of 313 Dutch cancer patients with chronic pain, the practice of pain treatment was evaluated by means of Donabedian's structure-process-outcome framework. The practice of pain treatment was assessed by: (1) structural resources, describing the setting in which pain treatment is provided; (2) process components, which describe the clinical practice; and (3) outcome measures, which refer to patients' pain intensity, patient satisfaction, or composite pain management index scores. Results showed that 31.4-59.8% of the cancer pain patients received less than optimal pain treatment. Although pain education and refresher courses for health care providers are scarce, structural resources were not the major cause of the suboptimal level of pain treatment. Rather, the major cause was the process components. Only 36.4% of the patients received strong opioids; 23.1% received analgesics "as needed." Patients' pain knowledge was far from optimal (54.8 on a 0-100 scale), and written pain information was given to only 15.8% of the patients. After discharge, only 36.8% of the district nurses were informed about patients' pain. These results emphasize that continuing efforts to improve the practice of pain treatment are needed.

Chronic Disease↗
PubMed1999

[Management of human resources, materials, and organization processes in radioprotection].

INTRODUCTION: The radiologist must learn to face daily management responsibilities and therefore he/she needs the relevant knowledge. Aside from the mechanisms of management accounting, which differ only slightly from similar analysis methods used in other centers, the managing radiologist (the person in charge) is directly responsible for planning, organizing, coordinating and controlling radiation protection, a major discipline characterizing diagnostic imaging. We will provide some practical management hints, keeping in mind that radiation protection must not be considered a simple (or annoying) technical task, but rather an extraordinary positive element for the radiologist's cultural differentiation and professional identity. MATERIAL AND METHODS: The managing radiologist can use the theory and practice of management techniques successfully applied in business, customizing them to the ethics and economics of health care. Meeting the users' needs must obviously prevail on balancing the budget from both a logical and an accounting viewpoints, since non-profit organizations are involved. In radiological practice, distinguishing the management of human from structural resources (direct funding is not presently available) permits to use internal benchmarking for the former and controlled acquisition and planned replacement of technologies in the latter, obviously after evaluation of specific indicators and according to the relevant laws and technical guidelines. RESULTS AND DISCUSSION: Managing human resources means safeguarding the patient, the operator and the population, which can be achieved or improved using benchmarking in a diagnostic imaging department. The references for best practice will be set per tabulas based on the relevant laws and (inter)national guidelines. The physical-technical and bureaucratic-administrative factors involved will be considered as process indices to evaluate the gap from normal standards. Among the different elements involved in managing structural resources, the appropriate acquisition of a piece of radiological equipment is important from both a radiation protection and an economic viewpoints. In the acquisition process, the first and the last steps (technology assessment and planned replacement, respectively) are specifically important for the radiologist and play a major role in global management. In both cases the radiologist must be able to lay out autonomous and objective working projects, also using evaluation algorithms.

Costs and Cost Analysis↗
PubMed1999

The genexpress IMAGE knowledge base of the human muscle transcriptome: a resource of structural, functional, and positional candidate genes for muscle physiology and pathologies.

Sequence, gene mapping, and expression data corresponding to 910 genes transcribed in human skeletal muscle have been integrated to form the muscle module of the Genexpress IMAGE Knowledge Base. Based on cDNA array hybridization, a set of 14 transcripts preferentially or specifically expressed in muscle have been selected and characterized in more detail: Their pattern of expression was confirmed by Northern blot analysis; their structure was further characterized by full-insert cDNA sequencing and cDNA extension; the map location of the corresponding genes was refined by radiation hybrid mapping. Five of the 14 selected genes appear as interesting positional and functional candidate genes to study in relation with muscle physiology and/or specific orphan muscular pathologies. One example is discussed in more detail. The expression profiling data and the associated Genexpress Index2 entries for the 910 genes and the detailed characterization of the 14 selected transcripts are available from a dedicated Web server at. The database has been organized to provide the users with a working space where they can find curated, annotated, integrated data for their genes of interest. Different navigation routes to exploit the resource are discussed.

Base Sequence↗
PubMed1984

A strategy, structure, human resource database: OASIS.

Traditionally, strategic planners and human resource professionals have taken separate approaches in their attempts to improve organization functioning. As a result, strategic planners lack important information that affects the implementation of their plans and human resource managers have little impact on the strategic direction of their organizations. The University of Michigan, Hay Associates, and The Strategic Planning Institute have come together in a new venture to build a multicompany database that links organization characteristics and human resource and strategic planning practices with data on company financial performance. The database will be used to make intercompany comparisons on significant organization variables and to identify those practices that lead to improved financial performance.

Data Collection↗
PubMed1994

Families of chronically mentally ill patients: their structure, coping resources, and tolerance for deviant behavior.

The attitudes of families toward caring for a mentally ill member in the home are explored through in-depth interviews with 105 families of chronically ill psychiatric patients from a public and a private hospital. Family readiness, defined as having the ability and the willingness to supervise the patient, was measured by the St. Paul Scale of Family Functioning and the Tolerance of Deviant Behavior Scale. Findings revealed a significant relationship between the respondent's belief in his or her ability to manage the behavior of the patient and willingness to accept the patient into the home as measured by tolerance for deviant behavior. No significant relationships were found between family resources, level of functioning, income, or community connectedness. Implications for practice and study limitations are discussed.

Adaptation, Psychological↗
PubMed2004

The Genomic Threading Database: a comprehensive resource for structural annotations of the genomes from key organisms.

Currently, the Genomic Threading Database (GTD) contains structural assignments for the proteins encoded within the genomes of nine eukaryotes and 101 prokaryotes. Structural annotations are carried out using a modified version of GenTHREADER, a reliable fold recognition method. The Gen THREADER annotation jobs are distributed across multiple clusters of processors using grid technology and the predictions are deposited in a relational database accessible via a web interface at http://bioinf.cs.ucl.ac.uk/GTD. Using this system, up to 84% of proteins encoded within a genome can be confidently assigned to known folds with 72% of the residues aligned. On average in the GTD, 64% of proteins encoded within a genome are confidently assigned to known folds and 58% of the residues are aligned to structures.

Animals↗
PubMed1984

Requirements of structure and resource for an adequate audiology service in the post-Griffiths Health Service.

Planning the development of services in audiology has been hampered by lack of an explicit set of recommendations concerning the range of services to be offered and their detailed procedural content. We provide this and bracket each service component with its resource requirements, indicating roughly what it should cost to introduce or appropriately deliver each component. We provide such a list, distinguishing between routine services requiring to be organised at health district level and those more specialised (low-patient-volume) services that are more appropriately centralised. This framework encourages explicit decisions as to what services are made available at each site, in the light of economic and other factors, and allows of contracting between districts to meet the needs of the population, rather than assuming a fixed model for a district service.

Aged↗
PubMed2000

CISMeF: a structured health resource guide.

In 1999, the Internet has become a major source of health information. The objective of CISMeF is to catalogue and index the main French-speaking health resources. In September 1999, the number of indexed resources totaled over 7,100 with a mean of 75 new sites per week. CISMeF uses two standard tools for organizing information: the Medline bibliographic database MeSH thesaurus and the Dublin Core metadata format. Resources included in CISMeF are described by the following: title, author or creator, subject and keywords, description, publisher, date, resource type, format, identifier, and language. To index resources, CISMeF uses five levels of hierarchy: "meta-term", category, keyword, subheading, and resource type. CISMeF contains a thematic index, including medical specialities and an alphabetic index. CISMeF respects the Net Scoring, criteria to assess the quality of health information on the Internet. The CISMeF project offers a valuable tool for the French-speaking health community: 2,500 computer users visit the Web site each working day.

Abstracting and Indexing↗