Small hospitals are 'key to front door' for systems trying to build networks.
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California↗
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Results for “Capacity Building”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
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The precautionary principle and international conflict over domestic regulation: mitigating uncertainty and improving adaptive capacity.
Disputes over invocation of precaution in the presence of uncertainty are building. This essay finds: (1) analysis of past WTO panel decisions and current EU-US regulatory conflicts suggests that appeals to scientific risk assessment will not resolve emerging conflicts; (2) Bayesian updating strategies, with commitments to modify policies as information emerges, may ameliorate conflicts over precaution in environmental and security affairs.
Commerce↗
New dialysis unit in older building meets codes, expands department.
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Hospital Bed Capacity, 500 and over↗
Hospital board sells top of building to pave way for expansion project.
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California↗
Building an academic-community partnered network for clinical services research: the Community Health Improvement Collaborative (CHIC).
OBJECTIVE: Community-based participatory research is recommended for research on health disparities and to improve uptake of clinical research findings. We describe the development of a multicenter consortium designed to support a community agency-academic partner infrastructure to support community-based, health-services research on multiple sources of health and healthcare disparities in local communities. DESIGN: We describe the development of the Los Angeles Community Health Improvement Collaborative (CHIC). RESULTS: The CHIC partners examined the research capacity and health priorities of its partners and developed a research agenda focused on four tracer conditions (depression, violence, diabetes, and obesity) and four areas for development of research capacity: public participation in all phases of research; understanding community and organizational context for clinical services interventions; practical clinical services trial methods; and advancing health information technology for clinical services research. The partners pooled resources to develop these areas for the tracer conditions. CONCLUSIONS: The challenges of a participatory approach to community-based clinical services research go beyond the significant methodologic and operational issues for specific projects and include building a sustainable capacity for research, community programs, and partnership across diverse communities and stakeholder organizations even when funding sources are not fully aligned with these goals.
Community Participation↗
Architectural elements in nucleoprotein complexes: interchangeability of specific and non-specific DNA binding proteins.
Integration host factor (IHF) is required in lambda site-specific recombination to deform the DNA substrates into conformations active for recombination. HU, a homolog of IHF, can also deform DNA but binds without any apparent sequence specificity. We demonstrate that HU can replace IHF by cooperating with the recombinase protein, integrase, to generate a stable and specific complex with electrophoretic mobility and biochemical activity very close to the complex formed by IHF and integrase. The eukaryotic HMG1 and HMG2 proteins differ entirely in structure from HU but they also bind DNA non-specifically and induce or stabilize deformed DNA. We show that the eukaryotic HMG1 and HMG2 proteins cooperate with integrase at least as well as does HU to make a defined structure. We also find that the eukaryotic core histone dimer H2A-H2B can replace IHF, suggesting that the histone dimer is functional outside the context of a nucleosome. HU and the HMG proteins not only contribute to the formation of stable complexes, but they can at least partially replace IHF for the integrative and excisive recombination reactions. These results, together with our analysis of nucleoprotein complexes made with damaged recombination sites, lead us to conclude that the cooperation between HU and integrase does not depend on protein-protein contacts. Rather, cooperation is manifested through building of higher order structures and depends on the capacity of the non-specific DNA binding proteins to bend DNA. While all these non-specific binding proteins appear to fulfil the same bending function, they do so with different efficiencies. This probably reflects subtle structural differences between the assembled complexes.
Allosteric Regulation↗
The neurology of syntax: language use without Broca's area.
A new view of the functional role of the left anterior cortex in language use is proposed. The experimental record indicates that most human linguistic abilities are not localized in this region. In particular, most of syntax (long thought to be there) is not located in Broca's area and its vicinity (operculum, insula, and subjacent white matter). This cerebral region, implicated in Broca's aphasia, does have a role in syntactic processing, but a highly specific one: It is the neural home to receptive mechanisms involved in the computation of the relation between transformationally moved phrasal constituents and their extraction sites (in line with the Trace-Deletion Hypothesis). It is also involved in the construction of higher parts of the syntactic tree in speech production. By contrast, basic combinatorial capacities necessary for language processing--for example, structure-building operations, lexical insertion--are not supported by the neural tissue of this cerebral region, nor is lexical or combinatorial semantics. The dense body of empirical evidence supporting this restrictive view comes mainly from several angles on lesion studies of syntax in agrammatic Broca's aphasia. Five empirical arguments are presented: experiments in sentence comprehension, cross-linguistic considerations (where aphasia findings from several language types are pooled and scrutinized comparatively), grammaticality and plausibility judgments, real-time processing of complex sentences, and rehabilitation. Also discussed are recent results from functional neuroimaging and from structured observations on speech production of Broca's aphasics. Syntactic abilities are nonetheless distinct from other cognitive skills and are represented entirely and exclusively in the left cerebral hemisphere. Although more widespread in the left hemisphere than previously thought, they are clearly distinct from other human combinatorial and intellectual abilities. The neurological record (based on functional imaging, split-brain and right-hemisphere-damaged patients, as well as patients suffering from a breakdown of mathematical skills) indicates that language is a distinct, modularly organized neurological entity. Combinatorial aspects of the language faculty reside in the human left cerebral hemisphere, but only the transformational component (or algorithms that implement it in use) is located in and around Broca's area.
Aphasia, Broca↗
Bacterial load of cockroaches in relation to urban environment.
Sanitation is an important problem in relation to the control of pests in urban environments. This investigation analysed the potential risk related to the presence of cockroaches and their capacity for disseminating bacteria in six different types of buildings: hospital nursing area and out-patient area, swimming-pool pool-side and toilet area, low-income flats and food-handling places. Fifty-six species of bacteria were identified from 157 samples, 14 of these have previously been reported as potentially pathogenic for man and vertebrates. Similarities were found between samples collected in (a) the hospital out-patient area and food-handling establishments and (b) the hospital nursing area and flats. Pool-sides possessed a poorer bacterial flora. There was a greater bacterial specific diversity in food-handling establishments, flats and swimming-bath toilet area. Enterobacter cloacae. Klebsiella pneumoniae and Klebsiella oxytoca were dominant species in flats and the hospital nursing area. Therefore, cockroaches can play a role in disseminating bacteria, which they can carry passively on their cuticle.
Animals↗
Number sense in human infants.
Four experiments used a preferential looking method to investigate 6-month-old infants' capacity to represent numerosity in visual-spatial displays. Building on previous findings that such infants discriminate between arrays of eight versus 16 discs, but not eight versus 12 discs (Xu & Spelke, 2000), Experiments 1 and 2 investigated whether infants' numerosity discrimination depends on the ratio of the two set sizes with even larger numerosities. Infants successfully discriminated between arrays of 16 versus 32 discs, but not 16 versus 24 discs, providing evidence that their discrimination shows the set-size ratio signature of numerosity discrimination in human adults, children and many non-human animals. Experiments 3 and 4 addressed a controversy concerning infants' ability to discriminate large numerosities (observed under conditions that control for total filled area, array size and density, item size and correlated properties such as brightness: Brannon, 2002; Xu, 2003b; Xu & Spelke, 2000) versus small numerosities (not observed under conditions that control for total contour length: Clearfield & Mix, 1999). To investigate the sources of these differing findings, Experiment 3 tested infants' large-number discrimination with controls for contour length, and Experiment 4 tested small-number discrimination with controls for total filled area. Infants successfully discriminated the large-number displays but showed no evidence of discriminating the small-number displays. These findings provide evidence that infants have robust abilities to represent large numerosities. In contrast, infants may fail to represent small numerosities in visual-spatial arrays with continuous quantity controls, consistent with the thesis that separate systems serve to represent large versus small numerosities.
Child Development↗
Successful public/private donation programs: a review of the Diflucan Partnership Program in South Africa.
A review of the partnership between Pfizer Inc. and the South African Ministry of Health to distribute free Diflucan (fluconazole) in the Diflucan Partnership Program (DPP) demonstrates that product donations may be a useful response to AIDS if they are coupled with efforts to build means of drug distribution and enhance professional healthcare capacity to treat patients. Equally important is the creation of a new set of productive working relationships between stakeholders who came to the project with different backgrounds and perspectives, as well as a frankly disparate set of objectives. A decision tree illustrates how these relationships were built into the DPP. This review concludes with a few lessons learned in providing medicines not only to South Africa, but also to the 77 other African countries now participating in the DPP. As the search for new treatments and vaccines continues, increasing access to existing medicines through targeted donations--including training and infrastructure support--is the most practical way for the health community to address the problem of ill health among the poor. In addition to a detailed analysis of the DPP, there is also a discussion of the benefits of a donation program that addresses the AIDS crises on a global scale. This review may serve as a blueprint for establishing programs that are successful in fighting AIDS and improving the lives of millions of people.
AIDS-Related Opportunistic Infections↗
Mentoring new social work faculty:a gerontological perspective.
The John A. Hartford Foundation, in collaboration with the Gerontological Society of America, has developed new models to create geriatric faculty capacity within social work. The Faculty Scholars Program is building faculty leadership in academic geriatric social work through a strategic approach that includes long-distance national and institution- based mentoring. While mentoring models have proven to be effective means of career development, this is relatively new in academic social work and little is known about the impact of long-distance mentoring in association with sponsorship from a mentor at the scholar's home institution. This paper describes the mentoring model and its conceptual underpinnings. Evaluation data from an ongoing evaluation is presented in discussion of the strengths and limitations of the mentoring model.
Aged↗
Cottage hospitals: the charm has gone but the loyalties remain.
'You can't have a resort like this without a hospital,' argued a consultant at Tenby Cottage Hospital when Nick Davidson visited recently. But some staff members hold ambiguous attitudes to the building itself. Indeed, one would like to pull it down and replace it with a modern, purpose-built building.
England↗
Strategic facility planning improves capital decision making.
A large, Midwestern IDS undertook a strategic facility-planning process to evaluate its facility portfolio and determine how best to allocate future investments in facility development. The IDS assembled a facility-planning team, which initiated the planning process with a market analysis to determine future market demands and identify service areas that warranted facility expansion. The team then analyzed each of the IDS's facilities from the perspective of uniform capacity measurements, highest and best use compared with needs, building condition and investment-worthiness, and facility growth and site development opportunities. Based on results of the analysis, the strategy adopted entailed, in part, shifting some space from inpatient care to ambulatory care services and demolishing and replacing the 11 percent of facilities deemed to be in the worst condition.
Capital Expenditures↗
Self-healing and self-organized gold nanoparticle films at a water/organic solvent interface.
Gold nanoparticles (5 nm and 20 nm) have been synthesized and stabilized with mercaptoundecanol. These particles, although insoluble in water or common organic solvents, spread as a thin film at the liquid-liquid interface between a water phase and an organic phase. Films of these gold nanoparticles have been observed both by conventional transmission electron microscopy of deposited samples and by cryo-transmission electron microscopy of plunge-frozen samples. The film can be monolayered and extend over centimeter-sized areas. The particle films spontaneously re-assemble and self-organize at the interface when disrupted. This self-healing capacity of the film should make it possible to build a device for continuous production and deposition of the film.
Cryoelectron Microscopy↗
Opinion of medical students regarding problem based learning.
OBJECTIVE: To assess the process of problem-based learning (PBL) as perceived by the medical students and their opinions regarding the process. METHODS: A cross-sectional study was conducted at Karachi Medical and Dental College. One hundred and four medical students of fourth year MBBS (52 each of batch 2004 and 2005) were selected for their responses and feedback on problem-based learning in small groups. Data was collected through a closed-ended questionnaire. RESULTS: Seventy nine percent (82 out of 104) of medical students liked the PBL sessions. Overall 85% of students were motivated towards self learning while liking for PBL was 82%. Activation of prior knowledge was observed by 83% students. CONCLUSION: Students supported problem-based learning (PBL) as an effective method of learning. Majority of students were motivated towards self- learning. They were convinced that PBL helped them in building up communication skills, interpersonal relationship and problem solving capacity.
Adult↗
Writing all prescriptions by computer.
The information needed for safe prescribing is voluminous, complex and subject to continuous change. The computer makes an ideal instrument on which to store, access, and update general practice prescribing information. By using a desktop computer to check and write all prescriptions, it is possible for the general practitioner to build up a medication data base which has the capacity to record response to treatment and to supply information which can be reported to a remote central drug authority on a regular basis.
Computers↗
Two tools for well-being: health systems and communities.
Medical systems and associative communities are two distinctive social tools. To promote health, tools of community are more significant than system tools. Medical systems were created to serve many needs efficiently and to produce standardized procedures and outcome. Clients are a necessary component of a medical system. Associative communities are formed with the active consent of the people they serve and require citizens rather than clients. If the promotion of health is the goal, the medical system is limited in what it can achieve by the nature of its design. Only when systems recognize the need for community building and work together with associations, focusing on citizens' capacities rather than clients' deficiencies, can health promotion be successful.
Awareness↗
Evaluation of phase transition errors in heat capacity calorimeters using SPICE simulated RC models.
A technique is presented which allows the development of extremely complex (> 5000 components) RC models of calorimeters and provides simulation under a wide variety of inputs. A commercially available circuit simulation program (SPICE) is used to 'build' RC models of relaxation and scanning calorimeter designs used to measure heat capacity. The instrument models are constructed using subcircuits to represent small elements of the materials used in the designs. Only simple linear equations are needed to evaluate the RC values in the subcircuit. The subcircuits also use voltage controlled switches to simulate phase transitions where lambda, C, and delta h can change value instantaneously at predetermined temperatures. The resulting simulations of the two designs provide an ability to predict instrument sensitivity to lambda and C independently. Simulated outputs agree with measured outputs within 10%. Model simulations show serious errors in the heat capacity determinations from both designs during phase transitions. Interactions between lambda, C, and delta h are shown for both designs. The technique provides a means to construct, evaluate, and optimize a calorimeter design completely in software.
Calorimetry, Differential Scanning↗