Hospital office leasing is on the rise.
Eighty percent of medical office buildings currently under construction are being built by hospitals.
Ambulatory Care↗
SEARCH · PubMed Health
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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Ambulatory center finished in 14 months.
'Fast track' construction and a team approach enabled a hospital and its outside experts to plan and build an ambulatory care center within 14 months and within a tight budget.
Ambulatory Care↗
Design team simplifies interior to aid patient recuperation.
Vanderbilt University Medical Center's architect and interior designer coordinated efforts to minimize medical components by painting them a neutral color and sought a unified approach throughout the building to make it more personal without a substantial cost increase.
Color↗
The desirability and feasibility of scaling up community health insurance in low-income settings--lessons from Armenia.
There is growing evidence that community financing mechanisms can raise additional revenue, increase equitable access to primary health care (PHC), and improve social protection. More recently there has been interest in scaling up community financing as a step towards universal coverage either via tax-based systems or social health insurance. Using key informant interviews and focus group discussions, this study sought to assess the desirability and feasibility of scaling-up community health insurance in Armenia. The results suggest that there is broad-based political support for scaling up the schemes and that community financing is synergistic with major health sector reforms. High levels of social capital within the rural communities should facilitate scaling up. Existing schemes have increased access and quality of care, but expansion of coverage is constrained by affordability, poor infrastructure, and weak linkages with the broader health system. Long-term subsidies and system-building will be essential if the expanded schemes are to be financially viable and pro-poor. Overall, successfully scaling up community financing in Armenia would depend on addressing a range of obstacles related to legislation, institutional capacity, human resources and resistance to change among certain stakeholders.
Armenia↗
Virtual models of the HLA class I antigen processing pathway.
Antigen recognition by cytotoxic CD8 T cells is dependent upon a number of critical steps in MHC class I antigen processing including proteosomal cleavage, TAP transport into the endoplasmic reticulum, and MHC class I binding. Based on extensive experimental data relating to each of these steps there is now the capacity to model individual antigen processing steps with a high degree of accuracy. This paper demonstrates the potential to bring together models of individual antigen processing steps, for example proteosome cleavage, TAP transport, and MHC binding, to build highly informative models of functional pathways. In particular, we demonstrate how an artificial neural network model of TAP transport was used to mine a HLA-binding database so as to identify HLA-binding peptides transported by TAP. This integrated model of antigen processing provided the unique insight that HLA class I alleles apparently constitute two separate classes: those that are TAP-efficient for peptide loading (HLA-B27, -A3, and -A24) and those that are TAP-inefficient (HLA-A2, -B7, and -B8). Hence, using this integrated model we were able to generate novel hypotheses regarding antigen processing, and these hypotheses are now capable of being tested experimentally. This model confirms the feasibility of constructing a virtual immune system, whereby each additional step in antigen processing is incorporated into a single modular model. Accurate models of antigen processing have implications for the study of basic immunology as well as for the design of peptide-based vaccines and other immunotherapies.
Animals↗
Microporous manganese formate: a simple metal-organic porous material with high framework stability and highly selective gas sorption properties.
Novel microporous metal-organic framework material composed of Mn(II) and formate ions displays permanent porosity, high thermal stability, and size-selective gas sorption behavior. The framework is stable enough to maintain single crystallinity after the complete guest removal at 150 degrees C under a reduced pressure. Most importantly, it selectively adsorbs H2 and CO2 but not N2 and other gases with larger kinetic diameters, which appears to be due to the small aperture of the channels. Despite a moderate H2 storage capacity, which is however still higher than that of any zeolite, its H2 surface coverage is one of the highest among the known microporous materials. Thus this new zeolite-like material made of a simple organic building block may find useful applications in gas separation and sensor.
Journal Article↗
Vision, leadership and partnership: how to enhance the nursing and midwifery contribution to research and development.
AIM: This paper reports an evaluation of nursing and midwifery research and development activity in Northern Ireland. BACKGROUND: Research and development is integral to the quality of patient care. Nurses and midwives have an important contribution to make and, whilst the professional landscape has changed significantly, with improved funding and productivity, there remains much room for improvement. To advance this agenda it is necessary to evaluate progress across the spectrum of research and development activity. The policy literature gives examples of the methods by which this can be achieved, but there is less evidence about evaluation criteria, or the methods by which research and development progress is assessed at organizational, national and international levels. METHOD: A comprehensive analysis of the literature was undertaken to develop a 'Research and Development Best Practice Framework'. This was then used as the basis for structured interviews with 32 organizational leads for three main stakeholder groups: health and care providers (n = 20), education providers (n = 7) and funders of research and development (n = 5). Data collection was from March to November 2004. FINDINGS: Despite general recognition of its value, only a minority of organizations had an up-to-date corporate strategy that included nursing and midwifery research and development. There was considerable variability in the systems, support structures, capacity and productivity of nurses and midwives throughout these organizations. In most, no-one had sole responsibility for leading the professional research and development agenda but, where such leadership was in place, improved outcomes were apparent. Building effective partnerships for research and development and forward planning through developing an organizational strategy were also key indicators of success. CONCLUSION: Our findings confirm progress, but also reinforce the need to develop a clear vision, enhance leadership potential and forge effective partnerships to advance the research and development agenda in nursing and midwifery.
Attitude of Health Personnel↗
Sump bay fever: inhalational fever associated with a biologically contaminated water aerosol.
OBJECTIVE: To investigate the clinical, serological, and environmental features of a work related inhalational fever associated with exposure to an aerosol generated from a biologically contaminated 130,000 gallon water pool in a building used for testing scientific equipment. METHOD: Cross sectional survey of all exposed subjects (n = 83) by symptom questionnaire, clinical examination, spirometry, and serology for antibody to Pseudomonads, pool water extract, and endotoxin. In symptomatic patients diffusion capacity was measured, and chest radiology was performed if this was abnormal. Serial peak flow was recorded in those subjects with wheeze. Bacterial and fungal air sampling was performed before and during operation of the water pool pump mechanism. Endotoxin was measured in the trapped waters and in the pumps. Serum cotinine was measured as an objective indicator of smoking. RESULTS: Of the 20 symptomatic subjects, fever was most common in those with the highest exposure (chi 2 42.7, P < 0.001) in the sump bay when the water was (torrentially) recirculated by the water pumps. Symptoms occurred late in the working day only on days when the water pumps were used, and were independent of the serum cotinine. Pulmonary function was normal in most subjects (spirometry was normal in 79/83, diffusion capacity was low in five subjects, chest radiology was normal). Peak flow recording did not suggest a work relation. The bacterial content of the aerosol rose from 6 to > 10,000 colony forming units per cubic metre (cfu/m3) (predominantly environmental Pseudomonads) when the pumps were operating. High endotoxin concentrations were measured in the waters and oil sumps in the pumps. Low concentrations of antibody to the organisms isolated were detected (apart from two subjects with high antibody) but there was no relation to exposure or the presence of symptoms and similar antibody was found in the serum samples from a non-exposed population. The fever symptoms settled completely with the simple expedient of changing the water and cleaning the pumps. CONCLUSION: Given the results of our study, the development of inhalational fever in this unique environment and clearly restricted cohort was closely related to the degree of exposure to contaminated aerosol and mainly occurred in the absence of distinct serological abnormality and independent of cigarette smoking.
Adult↗
Building a foundation for universal access.
Specific strategies outlined by the Blue Cross and Blue Shield Association call for a restructuring of health care financing that builds on a competitive, employer-based health insurance system. Universal access can be achieved through better management of the cost of care and more affordable health care premiums. Restructuring of the financing system must restore its capacity to manage risk and establish accountability for managing cost. Business practices and public policies that have encouraged market fragmentation should be reformed and incentives to create affordable insurance options for all buyers be established.
Blue Cross Blue Shield Insurance Plans↗
[Effect of naoling decoction on the behavior and the mRNA expression of beta-amyloid precursor protein in the hippocampus in rats with Alzheimer's disease].
OBJECTIVE: To observe the effect of naoling decoction (NLD) on the behavior and the mRNA expression of beta-amyloid precursor protein (APP) in the hippocampus in rat model with Alzheimer's disease (AD). METHODS: D-galactose was intra-abdominally injected and AlCl3was hypodermically injected to build the AD models. The behavior of rats was measured by gamma-electric maze and the level of APP mRNA in the model rat hippocampus was observed by RT-PCR. RESULTS: The learning and memory capacity in the NLD group was improved and the APP mRNA expression level was significantly lower in the NLD group compared with the untreated model and the control group (All P < 0.05). CONCLUSION: NLD can lower the expression of APP mRNA to reduce beta-amyloid protein deposition of rat hippocampus, which may be one of the mechanisms of improving the learning and memory capacity of AD model rats.
Alzheimer Disease↗
Developing local public health capacity in cultural competency: a case study with Haitians in a rural community.
With the increase in cultural diversity in all regions of the United States, public health employees and other health care providers are more challenged than ever before to provide culturally sensitive care to citizens from an increasing range of cultures. Building on their existing experience and skill, health care staff must expand their competencies to address this changing diversity in their communities. This project serves as a case study of how 1 small rural health department in Delaware created a Web site using Purnell's model for cultural competence (Purnell & Paulanka, 2003) as the organizational framework and rose to the challenge of assisting public health staff to provide culturally sensitive health services to a rapidly increasing population of Haitian immigrants.
Adult↗
Building donor ownership. Direct mail pulls more than eight percent response, increasing number of first-time givers. Good Samaritan Hospital Foundation, Corvallis, OR.
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Correspondence as Topic↗
Planning and building health care facilities under conditions of limited resources: organization of the pre-design phase, operational policies--methodical programming.
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Facility Design and Construction↗
[Physiological-hygienic evaluation of the work of the youth in the student's building brigades].
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Adolescent↗
Chemical or biological terrorist attacks: an analysis of the preparedness of hospitals for managing victims affected by chemical or biological weapons of mass destruction.
The possibility of a terrorist attack employing the use of chemical or biological weapons of mass destruction (WMD) on American soil is no longer an empty threat, it has become a reality. A WMD is defined as any weapon with the capacity to inflict death and destruction on such a massive scale that its very presence in the hands of hostile forces is a grievous threat. Events of the past few years including the bombing of the World Trade Center in 1993, the Murrah Federal Building in Oklahoma City in 1995 and the use of planes as guided missiles directed into the Pentagon and New York's Twin Towers in 2001 (9/11) and the tragic incidents involving twentythree people who were infected and five who died as a result of contact with anthrax-laced mail in the Fall of 2001, have well established that the United States can be attacked by both domestic and international terrorists without warning or provocation. In light of these actions, hospitals have been working vigorously to ensure that they would be "ready" in the event of another terrorist attack to provide appropriate medical care to victims. However, according to a recent United States General Accounting Office (GAO) nationwide survey, our nation's hospitals still are not prepared to manage mass causalities resulting from chemical or biological WMD. Therefore, there is a clear need for information about current hospital preparedness in order to provide a foundation for systematic planning and broader discussions about relative cost, probable effectiveness, environmental impact and overall societal priorities. Hence, the aim of this research was to examine the current preparedness of hospitals in the State of Mississippi to manage victims of terrorist attacks involving chemical or biological WMD. All acute care hospitals in the State were selected for inclusion in this study. Both quantitative and qualitative methods were utilized for data collection and analysis. Six hypotheses were tested. Using a questionnaire survey, the availability of functional preparedness plans, specific preparedness education/training, decontamination facilities, surge capacity, pharmaceutical supplies, and laboratory diagnostic capabilities of hospitals were examined. The findings revealed that a majority (89.2%) of hospitals in the State of Mississippi have documented preparedness plans, provided specific preparedness education/training (89.2%), have dedicated facilities for decontamination (75.7%), and pharmaceutical plans and supplies (56.8%) for the treatment of victims in the event of a disaster involving chemical or biological WMD. However, over half (59.5%) of the hospitals could not increase surge capacity (supplies, equipment, staff, patient beds, etc.) and lack appropriate laboratory diagnostic services (91.9%) capable of analyzing and identifying WMD. In general, hospitals in the State of Mississippi, like a number of hospitals throughout the United States, are still not adequately prepared to manage victims of terrorist attacks involving chemical or biological WMD which consequently may result in the loss of hundreds or even thousands of lives. Therefore, hospitals continue to require substantial resources at the local, State, and national levels in order to be "truly" prepared.
Biological Warfare↗
Recreation areas and skylights bring outdoors into psychiatric unit.
Staff involvement in the design and planning phase of this mental health center resulted in a building of unusual shape that is open to the outdoors and that has soaring roofs and skylights.
California↗
Limbic/mesolimbic connections and the pathogenesis of schizophrenia.
The development of models of the pathogenesis of neuropsychiatric diseases that build on recent advances in chemical neuroanatomy will help to guide future research. The interconnections among limbic, basal ganglia, and cortical structures are used to form the basis of a hypothesis of the pathogenesis of schizophrenia. The adaptive capacity of subcortical dopamine systems is advanced as an explanation of the many states of the disease.
Humans↗
A method for 3D reconstruction of neuronal processes using semithin serial sections displayed as a cinematographic sequence.
In order to study the organization and distribution of dendrites and axons in the cerebral cortex, we have developed a computer-assisted method for 3D reconstruction of neuronal processes based on serial light microscopic images displayed as a continuous sequence. A series of tangential sections (0.65 micron thick) through rat parietal cortex was aligned, digitized into the computer and then used to build a sequence (stack) of images which was stored to a digital real-time video disk. Apical dendrites located in dendritic bundles in laminae III and IV were traced through the sequence. Two tracing modes were tested: (1) cinematographic mode, in which the image stack was displayed continuously and automatically by the computer at various preset speeds (max. speed: 25 images/s) and (2) stepping mode, in which the interval between each image was varied manually according to the choice of the operator. Coordinates were stored in a database and used to build a 3D reconstruction where apical dendrites were displayed as wires or tubes. Tracing in cinematographic mode was about 3 times faster than tracing in stepping mode. We believe that the former mode exploits the built in 'filtering' capacity of the visual system to perform temporal averaging.
Animals↗