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PubMedDate not supplied

Hospital-based medical office buildings: report of a national study.

In recent years, many hospitals have developed campus-based medical office buildings (MOBs) as a means of providing physicians with proximal office space and increasing patient days through a more committed medical staff. A nationwide survey was conducted among 1,252 non-government, not-for-profit hospitals with 200 or more beds to understand both the significant factors associated with their development and their overall characteristics. Among the 686 hospitals which responded to the survey, the significant determinants of MOBs were medical school affiliation, religious affiliation/ownership, and location in the western part of the country. Three hundred eleven hospitals reported that they had (or were currently constructing) MOBs; they were most often owned directly by the hospital, housed 30% of the active medical staff, operated at capacity, and made a small profit for the hospital.

Data Collection↗
PubMed1987

[The bone, a complex construction. Thoughts of an architect].

Having a precise knowledge of the construction methods of technical objects is helpful to understand the developing processes in nature, the patterns, the bearing capacity and the investment of energy and material of natural lightweight structures. An engineering framework out of bars and knots can be compared with a framework of bones--keeping in mind, however, that solid and soft components viz. bones, cartilage, sinews, muscles and filling liquids together are building a force guiding system. Such complex systems can most easily be explained by their development and "production". Fibre nets and networks provide flexibility and stiffness to the weak pneu- or hydroskeleton. Outer appearance and internal microstructure prove the bone to be a solidified and prestressed pneu. The load capacity of the bone is determined by the solid materials and the supporting, varying inner pressure in combination with the blood circulation. In contrast to that the pressure of cartilage made of similar materials is constant. All other force guiding networked fibre systems are supposed to have a bone-like structure with all states of solidification. Highly flexible fibre nets are capable of self-alignment, self-remodelling and self-repair. A likewise self-organization can be found in the inner fibre net of the bone. In case of a fracture callus will seal the damaged pneu. The net structure of a strained bone has routings similar to the hypothetical flow of forces within solid bodies. The author evolves the thesis that the bone in the course of its forming process as well as in its final stiffened shape can be looked upon as a pneumatic system with regard to its load-bearing behaviour.

Architecture↗
PubMed2005

Olfactory conditioning experiments in a food-searching passerine bird in semi-natural conditions.

Because passerine birds have a very small relative olfactory bulb size, they have been considered to have weak olfactory capacities for decades. Recent investigations however suggest that breeding female blue tits (Parus caeruleus) are sensitive to lavender odour in the reproductive context of building and maintaining the nest. Here, we present results of an olfactory conditioning experiment in blue tits held in semi-natural conditions during the breeding season. We show that captive male blue tits, trained to associate lavender odour with a food reward, are more attracted to an empty feeder box emitting lavender odour than an odourless empty feeder box. Females did not distinguish significantly between empty feeders with and without lavender odour during the test phase, although they responded positively at the end of the training phase. These results suggest that male blue tits can use olfaction in a context not related to nest building. Additional experiments will be required to better understand the observed sex differences in response to the experimental set up, and in what context free-ranging individuals use olfaction.

Animals↗
PubMed2005

Flow-volumes indices as means to discriminate between intra- and extrapulmonary restrictive disease.

Restrictive lung disease comes in two major categories: (1) intrapulmonary (= parenchymal) disease caused by fibrotic reactions or (2) extrapulmonary (= compression), like in heart failure. In the first category the conducting airways, tethered in stiffened structures, are less likely to be compressed during forceful expiration and expiratory flows hence are expected to remain high. This could serve as a cheap and easy diagnostic, avoiding more complicated measures. A database was build containing 624 patients suffering from either intra- and extrapulmonary disease. The flow-volume curve indices of restrictive patients (with a total lung capacity < -1.96 sd of reference) were compared and it was shown that in primary fibrotic disease and in leukaemia, indeed, the PEF and MEF(75/50/25) were significantly higher compared to the heart failure group (P < or = 0.001). The diabetes mellitus vs. heart failure differences were much less (P > 0.05). The area under the ROC to discriminate extra- from intrapulmonary disease was a low 0.607 and 0.606 for the PEF and MEF75, respectively. For the peakflow an optimal cut-off point was found at 65.8% of the reference value. The positive/negative predictive value of a peakflow < 65.8% to detect extrapulmonary disease was 30.1% and 82.2%, respectively.

Adult↗
PubMed1994

A facilitative role for carbonic anhydrase activity in matrix vesicle mineralization.

Carbonic anhydrase (CA) which catalyzes the reversible hydrolysis of carbon dioxide is known to be important in osteoclastic bone resorption, however, suggested roles in calcium phosphate mineral formation have not been previously demonstrated. Biochemical evidence is provided for the presence of CA in growth plate matrix vesicles (MV) and the level of activity determined by enzyme assay. Inhibition of CA activity with the specific inhibitor acetazolamide resulted in reduced rates of MV mineralization. Other inhibitor studies showed that MV mineralization was also impaired by 4,4-diisothiocyanatostilbene-2, 2-disulfonic acid (DIDS), a blocker of membrane bicarbonate channels. No evidence was found for the presence of any proton pumps or channels. When acetazolamide and DIDS were combined, their inhibitory effects on MV mineralization were additive. These findings suggest that MV possess a pH regulation system composed of carbonic anhydrase and a putative bicarbonate channel. This system may function in the MV by providing intraluminal buffering capacity. The control of intravesicular pH is important for the stabilization of the acid-labile nucleational core complex and in preventing the build-up of protons during calcium phosphate phase transformations.

4,4'-Diisothiocyanostilbene-2,2'-Disulfonic Acid↗
PubMed2005

Revealing metabolic phenotypes in plants: inputs from NMR analysis.

Assessing the performance of the plant metabolic network, with its varied biosynthetic capacity and its characteristic subcellular compartmentation, remains a considerable challenge. The complexity of the network is such that it is not yet possible to build large-scale predictive models of the fluxes it supports, whether on the basis of genomic and gene expression analysis or on the basis of more traditional measurements of metabolites and their interconversions. This limits the agronomic and biotechnological exploitation of plant metabolism, and it undermines the important objective of establishing a rational metabolic engineering strategy. Metabolic analysis is central to removing this obstacle and currently there is particular interest in harnessing high-throughput and/or large-scale analyses to the task of defining metabolic phenotypes. Nuclear magnetic resonance (NMR) spectroscopy contributes to this objective by providing a versatile suite of analytical techniques for the detection of metabolites and the fluxes between them. The principles that underpin the analysis of plant metabolism by NMR are described, including a discussion of the measurement options for the detection of metabolites in vivo and in vitro, and a description of the stable isotope labelling experiments that provide the basis for metabolic flux analysis. Despite a relatively low sensitivity, NMR is suitable for high-throughput system-wide analyses of the metabolome, providing methods for both metabolite fingerprinting and metabolite profiling, and in these areas NMR can contribute to the definition of plant metabolic phenotypes that are based on metabolic composition. NMR can also be used to investigate the operation of plant metabolic networks. Labelling experiments provide information on the operation of specific pathways within the network, and the quantitative analysis of steady-state labelling experiments leads to the definition of large-scale flux maps for heterotrophic carbon metabolism. These maps define multiple unidirectional fluxes between branch-points in the metabolic network, highlighting the existence of substrate cycles and discriminating in favourable cases between fluxes in the cytosol and plastid. Flux maps can be used to define a functionally relevant metabolic phenotype and the extensive application of such maps in microbial systems suggests that they could have important applications in characterising the genotypes produced by plant genetic engineering.

Biotechnology↗
PubMed2002

Developing a public health Web site: the Los Angeles County experience.

The use of the Internet in public health practice is becoming increasingly widespread. The Internet is an important tool for supporting the mission and core functions of local health departments. However, most local health departments have limited resources and technical capacity to develop, deploy, and encourage use of large and complex Web sites. In Los Angeles County, the local health department was able to build and expand public health information systems on the Internet with a limited investment of financial and technical resources. The development process, key functions, and key factors in the success of this effort are described.

Community Health Planning↗
PubMed1997

Collaboration between hospital social work and pastoral care to help families cope with serious illness and grief.

The authors describe an educational program for hospital chaplains based on a partnership between pastoral care and social work in a teaching hospital. The goal of the program is to train chaplains to use social work principles to maximize families' capacity to negotiate a complex health care system, to solve problems in a health crisis, and to participate constructively on the health care team. Building on the two disciplines' shared values in person-centered, process-oriented approaches to care, the program introduces chaplain trainees to social work concepts of crisis intervention and family systems theory that they can apply in their interactions with families in their hospital and congregational practice. The approach taught in the program is illustrated in a case vignette describing a chaplain trainee's work with the family of a child treated for severe burns.

Adaptation, Psychological↗
PubMed1994

Ambulatory care pavilion takes its place out front by solving multiple needs.

In sum, this structure exemplifies the fact that high-tech tertiary care medical centers can be user-friendly to the ambulatory health care consumer by serving their routine needs conveniently and efficiently. Says Gerald Miller, president of Crozer-Chester: "The ambulatory care pavilion has enabled Crozer to successfully and efficiently merge physicians' offices with institutional-based services and inpatient services. We are pleased with how the pavilion positions our medical center for the next century.

Hospital Bed Capacity, 300 to 499↗
PubMedDate not supplied

Buffalo Memorial Hospital. Buffalo, Minnesota.

First owned and managed by a group of local physicians, then operated as a municipal hospital, and now a division of a private, multi-hospital group, Buffalo Memorial Hospital's growth has mirrored that of the rural Minnesota community it serves. From 1918 to 1951, the hospital was located in 12 rooms above the local drugstore . Then, as a city-operated hospital, it occupied a free standing building in the center of town. During the next 25 years, two additions were required to meet the growing demand for health care services in Wright count. In 1977, shortly after the hospital became a division of Health Central, plans were initiated to replace the over-crowded facility with a completely new hospital. In October 1980, Buffalo Memorial Hospital moved into its new home--a sprawling single story, energy efficient building. Now renovated, the old hospital provides housing for senior citizens.

Central Supply, Hospital↗
PubMedDate not supplied

Santa Barbara Cottage Hospital.

The 465-bed Santa Barbara Cottage Hospital is the largest medical facility on the California coast between Los Angeles and the San Francisco bay area. The hospital dates back to 1888, when a group of local citizens began raising funds to build a "cottage-style" hospital for the growing community. Their original plans called for a complex in which each medical specialty would be housed in a separate bungalow. Even then, however, such a decentralized plan was too costly, so work began instead on a single cottage for all hospital departments. The first Cottage Hospital opened in 1891, with 25 beds housed in a two story Victorian building. Now a hugh medical complex employing some 1,500 people, the hospital continues to be called "Cottage" after the original home-like building. Rodney J. Lamb has been Hospital Administrator for the last 30 years.

California↗
PubMed1992

Respiratory symptoms and ventilatory capacity in swine confinement workers.

A group of 59 workers (41 men and 18 women) employed in swine confinement areas was studied to assess the presence of acute and chronic respiratory symptoms and the prevalence of abnormalities in ventilatory function. A control group of 46 (31 men and 15 women) unexposed workers was studied for the prevalence of chronic respiratory symptoms. For both male and female swine confinement workers complaints of chronic cough, dyspnoea, and chest tightness were significantly more frequent than among control workers. Male workers also complained more of chronic phlegm. Male swine confinement workers who were smokers had significantly higher prevalences of chronic cough, chronic phlegm, and chronic bronchitis than male non-smoking swine confinement workers. The frequency of acute symptoms associated with the workshift was high among the swine confinement workers with more than half of the workers complaining of cough and dyspnoea associated with work. Significant acute across shift reductions in lung function occurred in swine confinement workers, being largest for FEF25. All Monday preshift ventilatory capacity measurements in male confinement workers were significantly lower than predicted values; FVC and FEV1 were found to be lower than predicted values for women. The data indicate that exposure in swine confinement buildings is associated with the development of acute and chronic respiratory symptoms and impairment of lung function. Smoking appears to aggravate these changes.

Acute Disease↗