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PubMed1986

Resource allocation under poor growth conditions. A major role for growth substances in developmental plasticity.

This article argues that the basic function for growth substance is resource allocation under poor growth conditions. The following scheme is suggested. Plants in the wild frequently suffer a paucity of resources which result from interplant competition and ecological and local environmental variation. The strategy adopted by many plants particularly ruderals (from which crops may have evolved) to help mitigate these problems is phenotypic plasticity; the growth of the plant body is adjusted to best exploit the scarce resources and help achieve desirable growth and reproductive goals. Phenotypic plasticity requires decisions to be made concerning the diversion of scarce growth resources to one facet of development rather than another; for example, to height or leaf area rather than thickness; or, between tissues, stem rather than leaves. Growth substances are coupled to these individual facets of development. They represent a simple way in which the extent of resource diversion can be controlled. Cells in specific tissues acquire sensitivity to particular growth substances at a stage in their development when environmental variability often necessitates choices to be made. This acquisition of ontogenetic sensitivity may be all or none. It may reflect acquisition of receptor proteins coupled to specific metabolic events. However in well-nourished plants these phases of development are relatively insensitive to changes in the level of the growth substance/receptor complex. Cells become more sensitive under certain well-defined but specific circumstances, characterized by the general term, poor growth conditions. These are produced by imbalances in one or more of the major environmental (nutritional) requirements for growth, light, nitrogen, water and oxygen. Imbalance in one or more of these produces characteristic and far-reaching metabolic and protein synthesis changes which normally constrain the synthetic processes for growth but amplify metabolic events coupled to growth substances. It is the function of growth substances to circumvent some of these metabolically constraining steps and by applying a constant stimulus to one specific aspect of growth or metabolism permit continued development. The additional input of growth substances into particular facets of development ensures the better maintenance (protection) of that character when competition for resources inside the plant is severe. However competition for scarce resources ensures that continuation of one growth aspect generally leads to relative depletion of others.(ABSTRACT TRUNCATED AT 400 WORDS)

Adaptation, Physiological↗
PubMed1989

Resources and dual-task performance; resource allocation versus task integration.

This study aims at contributing to the explanation of dual-task performance in terms of either resource allocation or of task interference and integration. Twenty-four subjects carried out, single and in combination, a motor interval production task and a perceptual target detection task on the basis of combined memory and display search. The demands of the target detection task were varied by increasing or decreasing the presentation rate of successive search displays. Furthermore, the presentation rate was either constant or variable. The dual-task condition had a negative effect on interval production, the extent of which was unaffected by either rate or variability of display presentation. This means that there was no evidence for synchronizing interval production with display presentation, so that the major opportunity for task integration did not substantiate. It is suggested that the two tasks use different resource pools in addition to a common mechanism, the limited capacity of which causes a general interference in dual-task conditions.

Adolescent↗
PubMed2000

The role of outcomes data in health-care resource allocation.

The purpose of this article was to provide information about the importance of outcome measures in the health-care resource allocation scenario. The increasing focus on outcome measures as a more suitable way to demonstrate the value of services is discussed. Health-care trends toward the use of data from patient outcomes to justify treatment needs and reimbursement are described. Important outcomes including patient satisfaction, functional status, and quality of life are presented. Outcome assessment strategies and requirements are considered in the wider context of evidence-based practice, clinical practice guidelines, and performance measures. An outcomes management approach using the World Health Organization's classification system is suggested. Examples of audiological rehabilitation with hearing aids are provided to illustrate the application of outcome measures to hearing health care.

Correction of Hearing Impairment↗
PubMed2002

Trends in rehabilitation after amputation for geriatric patients with vascular disease: implications for future health resource allocation.

OBJECTIVE: To assess the effect of demographic changes on rehabilitation of geriatric patients after amputation and the implications for future health resource allocation. DESIGN: Population-based study. SETTING: Olmsted County, MN. PARTICIPANTS: Residents over the age of 65 years who had a major lower-extremity amputation because of peripheral arterial disease between 1956 and 1995. Patients who had amputations between 1956 and 1973 (earlier cohort) were compared with those who had amputations between 1974 and 1995 (later cohort). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Demographic and clinical features, total number of amputations, amputation rates, and rate of successful prosthetic fitting over time. RESULTS: Of 292 patients, 93 had amputations between 1956 and 1973 and 199 between 1974 and 1995. Amputation rates declined after 1985, but the total number of amputations was unchanged. Patients in the later cohort were more likely to have a below-knee amputation (P<.001) and cerebrovascular disease (P=.008) and to be discharged to a nursing home (P<.001). There was no significant difference in median age at amputation, survival, or rates of successful prosthetic fitting over time. CONCLUSION: Although amputation rates have declined, the total number of amputations has increased. The rate of successful prosthetic fitting in the geriatric population has not changed significantly over 40 years. Amputations in the geriatric population in the United States will probably double from 28,000 to 58,000 per year by 2030, requiring considerable resources.

Aged↗
PubMed2000

The effect of feeding or starvation on resource allocation to body components during the reproductive cycle of the sea urchin Sphaerechinus granularis (Lamarck).

To determine the effects of feeding or starvation on resource allocation to body components during the reproductive cycle of Sphaerechinus granularis, sea urchins were placed in laboratory tanks and either fed ad libitum or starved during two different periods of their biological cycle, i.e. the mature stage and the recovery stage. The urchin growth was monitored over the whole experimental period, the gonad, gut, lantern indices and organic matter levels of different organs were determined at the end of the experiment. During the mature stage sea urchins in good nutritional conditions did not increase in size, but allotted energy to gonad production and stored reserves in body wall. Limiting food stopped the gonadal growth without complete regression. During the recovery period food allowed somatic growth, i.e. test growth and the storage of reserves in gonad somatic cells. This somatic production did not occur under food-limited conditions and the resources allotted for survival and maintenance were taken from different body components.

Journal Article↗
PubMed1997

[Limits of optimizing resource allocation by debiting the public health service].

Based on the Dornier consulting opinion on the public health service system of Berlin, the limits of optimising the resource allocation process are discussed with respect to austerity budgets. The discussion focuses firstly on problems of finding a consensus of opinion about public tasks and purposes in the German settings of pluralistic impact on health policy, and secondly on methodical, functional and practical limits. Methodical arguments are supported by a comparison of personal density with regard to the twelve largest cities of Western Germany, and supplemented by a factor analysis of sociodemographic characteristics in order to quantify the need of social work in an urban context. Functional and practical limits are demonstrated with respect to the realisation of the principle of subsidiary and concerning the practice of wholesale cut-downs of public health services budget.

Budgets↗
PubMed2000

Complex-valued minimal resource allocation network for nonlinear signal processing.

This paper presents a sequential learning algorithm and evaluates its performance on complex valued signal processing problems. The algorithm is referred to as Complex Minimal Resource Allocation Network (CMRAN) algorithm and it is an extension of the MRAN algorithm originally developed for online learning in real valued RBF networks. CMRAN has the ability to grow and prune the (complex) RBF network's hidden neurons to ensure a parsimonious network structure. The performance of the learning algorithm is illustrated using two applications from signal processing of communication systems. The first application considers identification of a nonlinear complex channel. The second application considers the use of CMRAN to QAM digital channel equalization problems. Simulation results presented clearly show that CMRAN is very effective in modeling and equalization with performance achieved often being superior to that of some of the well known methods.

Algorithms↗
PubMed2002

Resource allocation, social values and the QALY: a review of the debate and empirical evidence.

Most health economists agree that public preferences should play a major role in setting criteria for distributing scarce resources. The quality-adjusted life year (QALY) is used as a preference-based measure for the outcome of health-care activities in health economic evaluative studies. Traditionally, health economists proposed maximizing the additional health gain in terms of QALYs so as to maximize social welfare. Evidence has grown however, that neither potential health gain as a single relevant determinant of value, nor the rule of maximizing this health gain are sufficient. Concerns about fairness and equity are also important to the public in distributional decisions. This paper reviews the debate on the role and limitations of the QALY in health-care priority setting and the empirical evidence surrounding it. A framework is used to systematically explore the available data on factors considered to be important to the public in health-care resource allocation, and to investigate how these fit with the implicit value judgements inherent in the original QALY formulation. Potential sources of social value are classified into (1) factors that relate to the characteristics of patients and (2) factors related to the characteristics of the intervention's effect on patients' health. As well as these main categories, the article considers preferences for distributional rules. Recent approaches that aim to capture public preferences more comprehensively and to better reflect the value attributed to different health-care programmes in economic evaluation methods are outlined briefly.

Health Care Rationing↗
PubMed1980

Applying resource allocation formulae to constituent parts of the U.K.

If the health care budgets of the constituent nations of the United Kingdom in 1977-78 are added together and then redistributed on the RAWP formula there would be a significant movement of resources from Scotland and Northern Ireland and to England and Wales. The differential geographical allocation of resources within the U.K. is critically appraised, and it is argued that the higher resource allocations of the Thames regions and of Scotland and Northern Ireland have been examined imperfectly with polemics rather than analysis. However, the political costs are such that RAWP-type goals for the U.K. would be difficult to achieve.

England↗
PubMed1996

Patient outcome and intensive care resource allocation using APACHE II.

A prospective study of seventy consecutive admissions to the Medical Intensive Care Unit (MICU) of a local hospital over a five-month period was conducted with the aim of developing objective criteria for critical care resource allocation. Patients gaining admission were subjected to APACHE II scoring and their progress followed till they recovered from their illness or perished. The mean APACHE II score of patients who recovered from their illness or perished were 12.96 and 28.52 respectively (p < 0.001). 91.5% of all patients who recovered had an APACHE II score of below 21 whereas 82.6% of those who died had an APACHE II score of more than 23. Males generally had poorer outcome than females [47% mortality vs 8% (p < 0.001)] although their mean ages were comparable [47.6 years vs 46.6 years respectively (p = 0.85)]. The mean APACHE II scores of male and female patients were significantly different [male = 20.6 vs female = 13.6 (p < 0.005)] and this partly accounted for the poorer outcome of males. The APACHE II score has considerable predictive value on the final outcome of patients admitted to the MICU. When ICU beds are short, the allocation of such beds may be made with consideration of the APACHE II Score which identifies the patient who is most likely to benefit from ICU care.

APACHE↗
PubMed2001

Managing time: the effects of personal goal setting on resource allocation strategy and task performance.

One key to understanding motivated behavior is examining the behavior of individuals as they work on multiple tasks under a time constraint. This article is an exploration of the influence of self-set goals on subsequent resource allocation to different tasks. Participants were given a variety of tasks from which they were to choose how to allocate their time and effort. Results indicated that the use of self-set goals structured the work pattern, with less switching between tasks relative to the work pattern of a group of participants who did not set goals. In addition, those who set goals reported less task-related cognitive interference, indicating that they were not as distracted while they worked. Participants who did not set goals, however, performed at a higher level on some of the tasks. It is suggested that self-set goals may often be chosen at an easily attainable level, creating a structured and focused work environment but not necessarily eliciting the motivational properties typically associated with goal setting.

Female↗
PubMed1995

Ethical cautions in the use of outcomes for resource allocation in the managed care environment of mental health.

Increasingly, resources are being allocated through competitive contracting based on outcome data. This context for outcome research renews ethical concern about the nature of outcome data in the field of mental health. The epistemology of mental illness creates special concerns regarding outcome measurement. Ethical cautions specific to six types of outcome measurement are reviewed: utilization, clinician reports, patient reports, objective measures of diagnostic entities, objective measures of functioning and multifactor research. Brief guidelines are offered for addressing ethical cautions. Also discussed are the difficulty in defining good outcomes and a social obligation to future generations that may be better addressed through process measurements.

Contract Services↗
PubMed1994

Health planning and resource allocation in a changing Vietnam.

Vietnam is rapidly changing from a centrally planned to a market economic system. Explores the existing constraints and the degree of flexibility for management in the Government health system. Analyses the potential influence of the recent changes in health sector resource allocation with budgets becoming less under the direct control of the local authority, and based on population rather than the current number of beds. These changes create new possibilities, and responsibilities, for managers actively to manage health services and preventive programmes. Health managers are ill-prepared for this challenge.

Administrative Personnel↗
PubMed1990

Depressive deficits in memory: processing initiative and resource allocation.

Hertel and Hardin investigated the effects of depressed mood states on recognition memory in three experiments. They report that mood effects on memory depend on the subjects' awareness of the task. Four issues are considered in this article: natural and induced moods, processing initiative, initiative versus resource allocation, and strategies.

Adult↗
PubMed2000

Resource allocation modelling for home-based health and social care services in areas having differential population density levels: a case study in Northern Ireland.

This project arose from deliberations within the Department of Health and Social Services (DHSS) in Northern Ireland concerning the acceptability of the revenue resource allocation methodology they were using. One problem with the method being used had been the absence of a component that adequately reflected the relative costs associated with the differential population densities of the four health boards into which the Province is divided. This study investigates a particular element of this issue, viz differences in the travelling distances and times of those health and social service professionals who provide visiting services to patients in their own homes. A modelling approach has been developed and used in conjunction with a comprehensive spatial and geographical information system for Northern Ireland. An important outcome of the study has been estimates of the targets that should be set for the annual health and social care travelling distances and times per head of population in the boards, for a range of home-based services. Also, the project has contributed to decisions made by the DHSS in Northern Ireland concerning the annual financial compensations required by boards for costs associated with their relative population densities.

Catchment Area, Health↗