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91.
The article explores the relationship between the cost and the quality of hospital care by elaborating a conceptual model of hospital performance. The model relates the financial health status of an organization (financial integrity) to the quality of care provided by that organization (clinical integrity) within an environment that is characterized by various forms of risk. The model suggests that both concepts determine the corporate destiny (success, bankruptcy, or merger) of the organization. If this model proves valid empirically, the results could be used as an early warning system to identify hospitals that might experience financial or clinical distress. 相似文献
92.
CD Holyoak M Stratford Z McMullin MB Cole K Crimmins AJ Brown PJ Coote 《Canadian Metallurgical Quarterly》1996,62(9):3158-3164
The weak acid sorbic acid transiently inhibited the growth of Saccharomyces cerevisiae in media at low pH. During a lag period, the length of which depended on the severity of this weak-acid stress, yeast cells appeared to adapt to this stress, eventually recovering and growing normally. This adaptation to weak-acid stress was not due to metabolism and removal of the sorbic acid. A pma1-205 mutant, with about half the normal membrane H+-ATPase activity, was shown to be more sensitive to sorbic acid than its parent. Sorbic acid appeared to stimulate plasma membrane H+-ATPase activity in both PMA1 and pma1-205. Consistent with this, cellular ATP levels showed drastic reductions, the extent of which depended on the severity of weak-acid stress. The weak acid did not appear to affect the synthesis of ATP because CO2 production and O2 consumption were not affected significantly in PMA1 and pma1-205 cells. However, a glycolytic mutant, with about one-third the normal pyruvate kinase and phosphofructokinase activity and hence a reduced capacity to generate ATP, was more sensitive to sorbic acid than its isogenic parent. These data are consistent with the idea that adaptation by yeast cells to sorbic acid is dependent on (i) the restoration of internal pH via the export of protons by the membrane H+-ATPase in an energy-demanding process and (ii) the generation of sufficient ATP to drive this process and still allow growth. 相似文献
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94.
BACKGROUND: Australia has a high rate of cardiovascular disease mortality and also a significant proportion of migrants. Little is known about the morbidity experience or cardiovascular risk factors among the larger migrant groups, and this is especially true of the Arabic-speaking population. OBJECTIVES: The objectives of the study were to identify the health profile of Arabic-speaking people in Sydney, Australia, to explore the relationship between level of acculturation and health indicators and to identify the morbidity profile of patients presenting to Arabic-speaking general practitioners (GPs). DESIGN: Adult Arabic-speaking patients aged 18-70 years attending 20 Arabic-speaking GPs in Canterbury, Sydney, during the 2-week study period were asked to complete a self-administered questionnaire in Arabic or English while waiting to see the GP. Data on cardiovascular risk factors, level of acculturation and reasons for seeing the GP were collected. RESULTS: Data were collected from 851 patients (62% response rate). Almost three-quarters (73%) of males and 36% of females were considered overweight or obese (body mass index > 25). Of concern, 37% of males and 28% of females were smokers. Females were significantly less likely to have been tested for diabetes (p < .05) or raised blood pressure (p < 0.05) compared with females in NSW. Respondents consumed less bread per day and more fruits than in NSW overall. Respiratory complaints (flu and colds) were the most frequently reported reasons for patient encounters. Except for the youngest age group, males gave more reasons for encounters than females. CONCLUSIONS: Consecutive sampling of ethnic patients attending a GP who speaks their language holds promise as a method of needs assessment with migrant populations. Further, our results suggest that smoking and weight reduction programs are priorities in the Arabic-speaking community. These risk factors are ideal for intervention by GPs speaking the same language. 相似文献
95.
The enantiomers of 5-dimethylamino-1-naphthalene sulfonyl (DNS)-derivatives of selected amino acids were successfully separated using capillary electrophoresis (CE) employing cyclodextrins (CD) as enantio-selective running buffer additives. A previously described model for retention and chiral recognition in CD-modified CE is shown to adapt well in this application. Resolution of the isomers is strongly influenced by the type and concentration of cyclodextrin employed, as predicted by the model. Although data indicates differences in the electrophoretic mobilities for some of the completely complexed enantiomer pairs, selectivity generally requires exploiting differences in the amino acid-CD complexation constants for enantiomer pairs. In this work, the D-enantiomers exhibit larger formation constants and are complexed to a greater degree (elute first) at moderate CD concentration. When mixtures of amino acids are analyzed, the effects of separation conditions on general elution behavior must be considered or separated enantiomer pairs will co-elute with other enantiomers. Preliminary results aimed at predicting the strength of DNS-amino acid enantiomer-CD interactions based on molecular modeling studies are presented. A statistical mechanical approach to treating computationally derived enantiomer-CD interaction energies is shown to provide reasonable correlation with separation performance. 相似文献
96.
AA Schreiber K Frei W Lichtensteiger M Schlumpf 《Canadian Metallurgical Quarterly》1993,38(3-4):265-272
Prenatal exposure to diazepam and other benzodiazepines (BDZ) has been found to result in a marked reduction of T-lymphocyte proliferation during postnatal development of rats. In search for pathogenic changes underlying this effect, we investigated the mitogen lipopolysaccharide (LPS) and concanavalin A (ConA) stimulated release of tumour necrosis factor (TNF)-alpha by mixed splenocytes of male offspring from Long Evans rats treated with 1.25 mg/kg per day diazepam from gestational day 14 to 20. In response to LPS, TNF-alpha release was found to be significantly lower in mixed splenocytes of two- and four-week-old treated than in control offspring. However, at eight weeks of age, prenatally diazepam-treated animals showed a significantly higher LPS-induced TNF-alpha release than control rats. Since monocytes/macrophages represent a major source of TNF-alpha, additional experiments were performed on purified spleen macrophages and lymphocytes stimulated with LPS. TNF-alpha release was only detectable in supernatants of adherent spleen macrophages and not in supernatants of lymphocytes. Thus, our data indicate that a disturbance in TNF-alpha release from macrophages is involved in the deficient immune response of prenatally diazepam-exposed rats. 相似文献
97.
98.
99.
30 patients were exposed to interference currents (IC) alone (group 1) versus 34 patients treated with IC plus iodobromine baths (group 2). After IC action on the region of the kidney projection patients of group 1 experienced positive changes in cellular and humoral immunity providing an antiinflammatory effect. In group 2, the improvement was seen in renal and urinary functions, 24-h urinary excretion of oxalates and calcium diminished. Interference current proved beneficial in chronic pyelonephritis patients with latent inflammation. The combined therapy was effective in patients at high risk of lithogenesis. 相似文献
100.
LV Osadchuk VV Gul'tiaeva AA Filimonenko L Jalkanen 《Canadian Metallurgical Quarterly》1996,82(5-6):102-108
15.7% of spermatozoa were found to be abnormal in silver fox males during their first reproductive season. The total number of spermatozoa and the abnormal spermatogenesis remained unchanged during mating season. Sexual stimulation increased the testosterone level only at the beginning of the mating season. 相似文献