CEO summit. Building the new health care delivery alliance, Part III. Roundtable discussion

In cooperation with McManis Associates, Hospitals & Health Networks recently convened a CEO summit on physician/hospital integration activities. In the third report of a three-part series on the summit, leading health care executives discuss investor capital needs, strategic information management needs, and the management competencies required for capitated managed care success.     

Interactions and Chemical Transformations of Coronene Inside and Outside Carbon Nanotubes

By exposing flat and curved carbon surfaces to coronene, a variety of van der Waals hybrid heterostructures are prepared, including coronene encapsulated in carbon nanotubes, and coronene and dicoronylene adsorbed on nanotubes or graphite via π–π interactions. The structure of the final product is determined by the temperature of the experiment and the curvature of the carbon surface. While at temperatures below and close to the sublimation point of coronene, nanotubes with suitable diameters are filled with single coronene molecules, at higher temperatures additional dimerization and oligomerization of coronene occurs on the surface of carbon nanotubes. The fact that dicoronylene and possible higher oligomers are formed at lower temperatures than expected for vapor‐phase polymerization indicates the active role of the carbon surface used primarily as template. Removal of adsorbed species from the nanotube surface is of utmost importance for reliable characterization of encapsulated molecules: it is demonstrated that the green fluorescence attributed previously to encapsulated coronene is instead caused by dicoronylene adsorbed on the surface which can be solubilized and removed using surfactants. After removing most of the adsorbed layer, a combination of Raman spectroscopy and transmission electron microscopy was employed to follow the transformation dynamics of coronene molecules inside nanotubes.     

The effects of parent training on parenting stress and sense of competence.

Examined the effects of behavioral parent training groups on parenting stress and sense of competence. Ss, parents of 91 clinically diagnosed hyperactive preschoolers (aged 3–6 yrs), were randomly assigned to an immediate treatment group (experimental) or a delayed treatment group (control). Results indicate that group parent training yielded benefits beyond changes in parent and child behavior. Compared with controls, experimental Ss reported less parenting stress and increased sense of competence following treatment and 3 mo later. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Safety Management Assessment System (SMAS): a process for identifying and evaluating human and organization factors in marine system operations with field test results

Eighty percent or more of major marine accidents are caused or influenced by humans and organizations. Research has identified characteristics of high reliability organizations (HRO), organizations which have had few accidents while involved in operations where failure would result in severe consequences. These characteristics have important effects on the safety of marine systems. Assessing systems for these HRO characteristics is the first step in reducing accidents caused by human and organization factors (HOF). The Safety Management Assessment System (SMAS) was developed specifically to assess marine systems (offshore platforms, marine terminals, ships) for HOF. SMAS is a screening method that selects and trains operators of the system to conduct a self-assessment. The assessment process takes five days and has the assessors making comparisons and evaluating HOF by selecting ranges and providing comments to capture the uncertainty. Included in the process is a visit to the system. A computer program was developed to assist in the assessment process. A field test of SMAS was conducted at a marine terminal in California. Two teams, with members from the terminal and the regulatory agency, along with a facilitator, were selected and trained. These two independent teams conducted separate evaluations on the same marine terminal. A comparison of their assessments showed that the use of ranges and comments were very helpful. An analysis of field test data shows that SMAS can produce results more consistent than randomness. SMAS shows promise as an efficient and practical method to assess humans and organizations.     

Carbohydrate–Lectin Interactions: An Unexpected Contribution to Affinity

Uropathogenic E. coli exploit PapG‐II adhesin for infecting host cells of the kidney; the expression of PapG‐II at the tip of bacterial pili correlates with the onset of pyelonephritis in humans, a potentially life‐threatening condition. It was envisaged that blocking PapG‐II (and thus bacterial adhesion) would provide a viable therapeutic alternative to conventional antibiotic treatment. In our search for potent PapG‐II antagonists, we observed an increase in affinity when tetrasaccharide 1 , the natural ligand of PapG‐II in human kidneys, was elongated to hexasaccharide 2 , even though the additional Siaα(2–3)Gal extension is not in direct contact with the lectin. ITC studies suggest that the increased affinity results from partial desolvation of nonbinding regions of the hexasaccharide; this is ultimately responsible for perturbation of the outer hydration layers. Our results are in agreement with previous observations and suggest a general mechanism for modulating carbohydrate–protein interactions based on nonbinding regions of the ligand.