Functional value analysis: a technique for reducing hospital overhead costs

Many administrators feel that the methodology suggested for functional value analysis could beneficially be applied to many aspects of hospital administration beyond overhead functions. Some base their comments on their own experience in applying approaches similar to FVA to non-overhead activities. Others--who have not yet used a similar technique--believe that FVA's discipline in methodology and in-depth participation of hospital personnel could produce results in areas such as radiology, laboratory, and nursing.     

Competition in the NHS internal market: an overview of its effects on hospital prices and costs

Two-year stability coefficients were computed for several measures of borderline personality disorder within a nonclinical sample (n = 65) that included individuals with significant borderline features. Overall, the stability coefficients were modest (r ranging from .28 to .62; intraclass correlations ranging from .26 to .62). Stability values for each of the self-report measures under study were higher than those for the interview-based measure of BPD features, and, in some cases, these values varied as a function of the prototypicality of the subsamples examined. Analyses conducted to identify moderator effects provided no evidence that the stability of BPD scores was moderated by change in personal distress level; however, changes in BPD self-report scores were related to changes in level of negative affectivity.     

Acupuncture in a university hospital: implications for an inpatient consulting service

The novel phospholipid 2, which bears a tert-butyl moiety in place of the natural trimethyl ammonium group of phosphatidylcholine, has been enzymatically synthesized via a transphosphatidylation reaction mediated by phospholipase D. The change from the choline headgroup in 1 to the tert-butyl group in 2 reduced the efficiency of hydrolysis by the phosphatidylcholine-preferring phospholipase C from Bacillus cereus by a factor of greater than 10(3).     

The experimental psychologist in a depressed academic market: Learning about applied psychology.

In an increasingly difficult academic job market, graduates of traditional experimental psychology programs must begin to consider careers in nonacademic settings. Since many of these postgraduates have little information about career possibilities in applied fields and have had few opportunities for contact with successful applied psychologists, the prospect of a nonacademic job is frequently viewed with frustration or apprehension. An approach to this problem is described that has informed experimental psychology students about specific jobs in applied psychology and provided a significant means of communication among academic-based psychologists, students, and psychologists employed in nonacademic settings. (1 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

New directions for hospital strategic management: the market for efficient care

An analysis of current trends in the health care industry points to buyers seeking high quality, yet efficient, care as an emerging market segment. To target this market segment, hospitals must be prepared to market the efficient physicians. In the coming years, hospitals that can identify and market their best practicing providers will achieve a competitive advantage.     

Enteral glutamine supplementation for very-low-birth-weight infants decreases hospital costs

Vertebrate Pax-6 and its Drosophila homolog eyeless play central roles in eye specification, although it is not clear if this represents the ancestral role of this gene class. As the most "primitive" animals with true nervous systems, the Cnidaria may be informative in terms of the evolution of the Pax gene family. For this reason we surveyed the Pax gene complement of a representative of the basal cnidarian class (the Anthozoa), the coral Acropora millepora. cDNAs encoding two coral Pax proteins were isolated. Pax-Aam encoded a protein containing only a paired domain, whereas Pax-Cam also contained a homeodomain clearly related to those in the Pax-6 family. The paired domains in both proteins most resembled the vertebrate Pax-2/5/8 class, but shared several distinctive substitutions. As in most Pax-6 homologs and orthologs, an intron was present in the Pax-Cam locus at a position corresponding to residues 46/47 in the homeodomain. We propose a model for evolution of the Pax family, in which the ancestor of all of the vertebrate Pax genes most resembled Pax-6, and arose via fusion of a Pax-Aam-like gene (encoding only a paired domain) with an anteriorly-expressed homeobox gene resembling the paired-like class.     

The academic job search: The experiences of a new PhD in the job market.

Describes the experiences of a new PhD seeking an academic job. The author's observations are drawn from job interviews with 12 psychology departments in Canada and the US. Topics discussed include where to apply, who is invited for an interview, the importance of publications, alternatives to a tenure track position, rejections, and how to make a decision about an offer. (French abstract) (9 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

General hospital psychiatry: implications for occupational therapy--one case study

The hospitalization policy in general hospital psychiatric wards is for crisis intervention. The high cost in such a ward in Israel (in comparison with the cost in psychiatric hospitals) is justified since the patient is treated both physically and mentally. Some cases include patients who suffer from chronic diseases and aggravation of their physical condition causes severe mental reactions. In these cases, the short-term psychiatric admission is often in conflict with the condition of the patient and the desired treatment programme. The occupational therapist whose professional values are founded on the quality of life and his or her holistic approach to the patient, often has to deal with a serious dilemma: hospital policy on one hand and the patient's needs on the other. This dilemma is presented in its most acute form in the case study discussed in this article.     

Developing an economic model to reduce costs in a reengineered hospital environment

In its recent reengineering efforts, the Mount Sinai Hospital developed economic tools to assure that this major restructuring project would reach its predetermined financial objectives. We discuss how these tools were designed and implemented and what impact they had.     

Household and labour market change: implications for the growth of inequality in Britain

The paper examines the relationships between population and household change, on the one hand, and labour market/employment change, on the other, and considers how these relationships have contributed to the growth of inequality. The perspective of the paper is sociological, although much of the work done in these areas has been carried out by demographers and economists. Areas where sociological research remains to be done are highlighted. Developments in patterns of fertility and in households are linked to the growth of individualism and to changes in the labour market, and shown to be implicated jointly in the marked growth of inequality in Britain. The paper argues that future research must link households and labour markets, and work towards understanding emerging new relationships between working and private lives, between living arrangements and labour supply, and between individual freedom and social integration.     

Effect of a stroke protocol on hospital costs of stroke patients

OBJECTIVE: To determine the impact of a protocol on hospitalization costs for patients admitted with stroke. DESIGN AND SETTING: Nonrandomized control trial in an urban community hospital with 376 beds. PATIENTS: All patients admitted with a diagnosis-related group code of 014 (cerebrovascular disease) were included (N = 390). Patients with subdural hematoma (N = 2) or subarachnoid hemorrhage (N = 2) were excluded. INTERVENTION: A protocol for treatment of acute stroke was developed that included a critical path for nursing care, an algorithm for emergency department care, and suggested admission orders for physicians. MAIN OUTCOME MEASURES: The hospital information system computer database was searched for hospitalization charges, length of stay, tests performed, and treatments provided. RESULTS: Patients treated with the protocol had lower charges compared with historical (p = 0.026) and concurrent (p = 0.02) control groups. Lower charges were accounted for by a decreased length of stay in the protocol group compared with historical (p = 0.001) and concurrent (p = 0.13) controls. Tests and treatments provided were similar except that carotid Doppler studies and deep venous thrombosis prophylaxis were more frequently done in those treated with the protocol (p = 0.001 for carotid Doppler and p = 0.026 for deep venous thrombosis prophylaxis). There were no differences in outcome measures such as death or discharge disposition. Medical complications were similar in all groups. CONCLUSIONS: There were significant savings in hospitalization cost for patients with acute stroke after introduction of a treatment protocol. These savings were almost entirely related to decreased length of stay. The protocol led to modest differences in tests ordered and treatments provided.     

Psychological climate changes for women in academic psychology: Forecasts, sources, and implications.

Reflecting on the past, and observing the present, what kinds of psychological changes might be in the forecast for women in psychology, for women affected by our discipline, and for the discipline itself? Using metaphors borrowed from meteorology and climatology, a psychological almanac is constructed for feminist psychology in Canada, warming trends are examined on both the academic and applied fronts, and weather advisories are issued. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Striving for social dominance over peers: The implications for academic adjustment during early adolescence.

This study investigated the proposal that social dominance goals are an important, but overlooked, aspect of social goals for young adolescents' academic adjustment. Self-reports of social goals (dominance, intimacy, and popularity goals) early in the school year were used to predict subsequent engagement (self-reports and peer nominations of effort toward school work and disruptive behavior) and achievement (i.e., grades) when students were in 6th grade (N = 718) and again after the transition to middle school when students were in 7th grade (N = 656; 52% African American and 48% White; 52% female and 48% male). In line with hypotheses, social dominance goals were associated with maladaptive forms of engagement and low achievement in 6th and 7th grades. For intimacy goals, relations were more limited, but when found, these goals were associated with adaptive forms of engagement in 6th and 7th grades. Popularity goals were not generally associated with engagement or achievement. The exception was 6th-grade African American girls, for whom popularity goals were associated with maladaptive engagement, (i.e., low effort, high disruptive behavior, and low peer nominations for trying hard and getting good grades). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Teaching psychotherapy in an academic setting.

Describes a psychotherapy training program that includes 4 sequentially arranged courses: individual, group, marital, and family therapy. The sequence exposes students to a wide range of therapeutic modalities and interventions. Groups, led by an advanced graduate student, learn through written assignments, oral and written critiques of practice sessions, conferences with leaders and/or the instructor, individual assessment, and corrective feedback during practice sessions. Although it is not a substitute for supervised practicum or internship, the sequence bridges the gap between classroom study and the later performance of psychotherapy in a supervised setting. (13 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adverse reactions associated with autologous blood transfusion: evaluation and incidence at a large academic hospital

Malignant fibrous histiocytoma (MFH) in the stomach is very rare, and only four cases have been reported. As a result, there is still little understanding of its clinical and pathological features. We recently experienced two cases of gastric MFH. The first case was a 78-year-old man with epigastralgia and a loss of body weight. Endoscopy revealed an ulcerated submucosal tumor. A gastrectomy was performed and the diagnosis of MFH was made histopathologically. The second case was a 77-year-old man with pulmonary symptoms. An image diagnosis indicated a strong suspicion of lung cancer, and a right middle and lower lobectomy was thus performed. One month after the operation, a bleeding gastric tumor was found and therefore a gastrectomy was performed. Both tumors were diagnosed as MFH. From the analysis of six reported cases including ours, a preoperative correct diagnosis is found to be difficult although the lesion has grown to a considerable size at the time of operation. Since a metastatic lung lesion was first detected in two out of six cases, it is thus recommended that the stomach should be examined when lung MFH is found. Considering the high mortality and the short survival in the six cases, the prognosis for gastric MFH seems to be poorer than that in the extremities. However, lymph node metastasis is uncommon, and a curative resection is possible in some cases such as in our second case.     

The intergenerational costs of parental social stressors: academic and social difficulties in early adolescence for children of young mothers

Social stressors embedded in parents' occupational and family roles have been shown to have effects on family interaction and the cognitive and emotional development of young children. Here we consider whether these patterns also hold for children in early adolescence. We study 1,158 10 to 14-year-old children born to the early childbearers among the female respondents of the National Longitudinal Survey of Youth cohort. We find that both poor quality of parental employment and low quality of mothers' relationships with their partners have adverse effects on the cognitive stimulation and maternal warmth children receive; living in informal unions is also associated with poorer parent-child interaction. These family interaction patterns in turn both buffer the effects of stressful family conditions and shape academic and behavior outcomes directly. Some work and family conditions interact in their effects: In particular, single mothering has less adverse effects on cognitive stimulation and behavior problems when mothers are employed in occupations providing higher complexity. The effects of current conditions are diminished but seldom eliminated when we control for possible selection effects by using data from earlier waves to control for earlier levels of child problems. These findings suggest that current parental social stressors continue to have consequences for both academic and behavioral outcomes during early adolescence.