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Resource allocation

Andrew S Hwang, Steven J Atlas, Johan Hong, Jeffrey M Ashburner, Adrian H Zai, Richard W Grant, Clemens S Hong
BACKGROUND: A better understanding of the attributes of patients who require more effort to manage may improve risk adjustment approaches and lead to more efficient resource allocation, improved patient care and health outcomes, and reduced burnout in primary care clinicians. OBJECTIVE: To identify and characterize high-effort patients from the physician's perspective. DESIGN: Cohort study. PARTICIPANTS: Ninety-nine primary care physicians in an academic primary care network...
October 21, 2016: Journal of General Internal Medicine
Camilla Hardeland, Kjetil Sunde, Helge Ramsdal, Susan R Hebbert, Linda Soilammi, Fredrik Westmark, Fredrik Nordum, Andreas E Hansen, Jon E Steen-Hansen, Theresa M Olasveengen
AIM: Explore, understand and address issues that impact upon timely and adequate allocation of prehospital medical assistance and resources to out-of-hospital cardiac arrest (OHCA) patients. METHODS: Mixed-methods: design obtaining data for one year in three emergency medical communication centres (EMCC); Oslo-Akershus (OA), Vestfold-Telemark (VT) and Østfold (Ø). Data collection included quantitative data from analysis of dispatch logs, ambulance records and audio files...
October 18, 2016: Resuscitation
Joseph K Maddry, Alejandra G Mora, Shelia Savell, Lauren K Reeves, Crystal A Perez, Vikhyat S Bebarta
BACKGROUND: Medical evacuation (MEDEVAC) is the movement and en route care of injured and medically compromised patients by medical care providers via helicopter. Military MEDEVAC platforms provide lifesaving interventions that improve survival in combat. There is limited evidence to support decision making related to en route care and allocation of resources. The association between provider type and en route care is not well understood. Our objective was to describe MEDEVAC providers and identify associations between provider type, procedures performed, and outcomes...
November 2016: Journal of Trauma and Acute Care Surgery
Daniel B Schwab, Armin P Moczek
The elaboration of exaggerated, sexually selected weapons and ornaments often comes at a cost to other traits. For instance, by sustaining the growth of an exaggerated weapon during development, shared and limited resources such as morphogens, growth factors, and nutrients may become depleted and limit the size to which other structures can grow. Such interactions are characteristic of resource allocation trade-offs, which can constrain the production of phenotypic variation and bias evolutionary trajectories...
October 21, 2016: Journal of Experimental Zoology. Part A, Ecological Genetics and Physiology
M Li, H E Muñoz, A Schmidt, B Guo, C Lei, K Goda, D Di Carlo
Euglena gracilis (E. gracilis) has recently been attracting attention as a potential renewable source for the production of biofuels, livestock feed, cosmetics, and dietary supplements. Research has focused on strain isolation, productivity improvement, nutrient and resource allocation, and co-product production, key steps that ultimately determine the economic viability and compatibility of the biomass produced. To achieve these characteristics, approaches to select E. gracilis mutants with desirable properties, such as high wax ester content, high growth rate, and high environmental tolerance for biodiesel and biomass production, are needed...
October 21, 2016: Lab on a Chip
Patrycja Podlaszczuk, Maciej Kamiński, Radosław Włodarczyk, Krzysztof Kaczmarek, Tomasz Janiszewski, Piotr Minias
BACKGROUND: Moult is one of the most costly activities in the annual cycle of birds and most avian species separate moult from other energy-demanding activities, such as migration. To this end, young birds tend to undergo the first post-juvenile moult before the onset of migration, but in some species the time window for the pre-migratory feather replacement is too narrow. We hypothesized that in such species an increased investment in the structural quality of juvenile feathers may allow to retain juvenile plumage throughout the entire migratory period and delay moult until arriving at wintering grounds, thus avoiding a moult-migration overlap...
2016: Frontiers in Zoology
Marta R Pereira, Cristian S Dambros, Charles E Zartman
PREMISE OF THE STUDY: Resource allocation is difficult to characterize in plants because of the challenges of quantifying gametes and propagules. We surveyed six sympatric, unisexual species in the family Calymperaceae (Bryophyta) to test for trade-offs in prezygotic sexual and asexual expression and density-dependent survivorship of female gametangia. METHODS: We tallied gametangial and asexual propagule output for 1820 shoots from 17 populations of six species at monthly intervals during one year (2010-2011) in a central Amazonian forest...
October 7, 2016: American Journal of Botany
Sarah E Seaton, Lisa Barker, Elizabeth S Draper, Keith R Abrams, Neena Modi, Bradley N Manktelow
Modelling length of stay in neonatal care is vital to inform service planning and the counselling of parents. Preterm babies, at the highest risk of mortality, can have long stays in neonatal care and require high resource use. Previous work has incorporated babies that die into length of stay estimates, but this still overlooks the levels of care required during their stay. This work incorporates all babies, and the levels of care they require, into length of stay estimates. Data were obtained from the National Neonatal Research Database for singleton babies born at 24-31 weeks gestational age discharged from a neonatal unit in England from 2011 to 2014...
2016: PloS One
Jessica S Waldrop, Kaitlyn R Erb, Matthew J Grawitch
This study investigated the inherent complexities of the work-life interface (WLI) by examining the relationship between resource allocation (i.e., time and energy dedicated to a particular domain) and perceived interference of individual life domains. Much of the research on the WLI is based on the assumption that a linear pattern best describes the relationship between resource allocation and the interference caused by various life domains; however, this study examined the possibility that curvilinear relationships may be a more appropriate representation...
October 20, 2016: Stress and Health: Journal of the International Society for the Investigation of Stress
Behnaz RaheliNamin, Samar Mortazavi, Abdolrassoul Salmanmahiny
The combination of degrading natural conditions and resources, climate change, growing population, urban development, and competition in a global market complicate optimization of land for agricultural products. The use of pesticides and fertilizers for crop production in the agricultural fields has become excessive in the recent years and Golestan Province of Iran is no exception in this regard. For this, effective management with an efficient and cost-effective practice should be undertaken, maintaining public service at a high level and preserving the environment...
November 2016: Environmental Monitoring and Assessment
Dandan Zhang, Yunzhe Liu, Lili Wang, Hui Ai, Yuejia Luo
Appropriately attending to threatening environmental stimuli is evolutionarily adaptive and crucial for survival. This study revealed that nonconscious attentional modulation of disgust has different behavioral and event-related potential (ERP) patterns, as compared to fear and anger. To facilitate its evolutionary purpose of avoidance, disgust first diverts rather than attracts attention. Accordingly, the N1 was smaller in a validly than in an invalidly disgust-cued condition. Furthermore, the frontal P3a for disgust, anger, and fear was found to be larger in the valid than in the invalid condition, which was interpreted as an involuntary switching of attention toward threat-related events to mobilize cognitive resources for action or defense...
October 19, 2016: Cognitive, Affective & Behavioral Neuroscience
Paul E George, Julio Vidal, Patricia J Garcia
BACKGROUND: Peru experienced a crisis in its blood collection and supply system in the mid-2000s, as contaminated blood led to several transfusion-transmitted infections (TTI), occurring in the backdrop of extremely low voluntary donation rates and a national blood supply shortage. Thus, the Peruvian Ministry of Health (MINSA) implemented a national investigation on the safety and quality of the Peruvian blood collection/transfusion network. METHODS: Every Peruvian blood bank was evaluated by MINSA from 2007-2008...
May 2016: J Epidemiol Public Health Rev
Kensuke Fujiwara, Ayako Yagahara, Takumi Tanikawa, Yuji Tani, Hisateru Ohba, Katsuhiko Ogasawara
The aim of this study is to analyze the maldistribution and the trends in the geographic distribution of radiological resources in secondary medical areas of Hokkaido. The distribution was measured by combining the Gini coefficient (GC), which is an indicator of inequality of distribution, and the Herfindahl-Hirschman index (HHI), which is mainly used to assess market concentration. Data concerning the distribution of radiological resources, such as CT, MRI, radiotherapy facilities (RTF), radiological technologists (RT), and medical doctors were obtained from official publications...
2016: Nihon Hoshasen Gijutsu Gakkai Zasshi
Francesco Cavallin, Marco Scarpa, Matteo Cagol, Rita Alfieri, Alberto Ruol, Vanna Chiarion Sileni, Ermanno Ancona, Carlo Castoro
OBJECTIVE: The aim of this study was to investigate trends in patients' characteristics and comorbidities in esophageal cancer (EC) patients. BACKGROUND: Identifying changing pattern is essential to understand and predict further changes and to plan surgical procedures and resource allocation. METHODS: Trends in patients' characteristics and comorbidities were evaluated in 4440 EC patients at the Center for Esophageal Diseases in Padova, Italy, during 1980 to 2011...
October 17, 2016: Annals of Surgery
Martin Vyska, Christopher Gilligan
We analyse the dynamical behaviour of a simple, widely used model that integrates epidemiological dynamics with disease control and economic constraint on the control resources. We consider both the deterministic model and its stochastic counterpart. Despite its simplicity, the model exhibits mathematically rich dynamics, including multiple stable fixed points and stable limit cycles arising from global bifurcations. We show that the existence of the limit cycles in the deterministic model has important consequences in modelling the range of potential effects the control can have...
October 18, 2016: Bulletin of Mathematical Biology
Mohammad Hossein Mehrolhasani, Sajad Khosravi, Mahya Tohidi
INTRODUCTION: In order to improve health, hospital sources such as beds and staffing should be properly allocated and used. The aim of this study is reallocation of Shafa hospital beds in Kerman using a goal-programming model. METHODS: This study was an applied cross-sectional study, which used the goal programming model and software WinQSB to optimize bed allocation. By review of the literature and interviews with experts, the constraints in beds allocation were identified, and using the collected data the desired model was designed...
August 2016: Electronic Physician
Keertan Dheda, Kwok Chiu Chang, Lorenzo Guglielmetti, Jennifer Furin, H Simon Schaaf, Dumitru Chesov, Aliasgar Esmail, Christoph Lange
Globally there is a burgeoning epidemic of drug mono-resistant tuberculosis (TB), multi-drug-resistant TB (MDR-TB), and extensively drug-resistant TB (XDR-TB). Almost 20% of all TB strains worldwide are resistant to at least 1 major TB drug including isoniazid. In several parts of the world there is an increasing incidence of MDR-TB, and alarmingly almost a third of MDR-TB cases globally are resistant to either a fluoroquinolone or aminoglycocide. This trend cannot be ignored because DR-TB is associated with greater morbidity compared to drug-sensitive TB, it accounts for almost 25% of global TB mortality, is extremely costly to treat, consuming substantial portions of budgets allocated to national TB programmes in TB endemic countries, and is a major threat to healthcare workers who are already in short supply in resource-poor settings...
October 15, 2016: Clinical Microbiology and Infection
Frances C Cunningham, Sue Ferguson-Hill, Veronica Matthews, Ross Bailie
BACKGROUND: Assessment of the quality of primary health care health delivery systems is a vital part of continuous quality improvement (CQI) processes. The Systems Assessment Tool (SAT) was designed to support Indigenous PHC services in assessing and improving their health care systems. It was based on the Assessment of Chronic Illness Care scale, and on practical experience with applying systems assessments in quality improvement in Indigenous primary health care. We describe the development and application of the SAT, report on a survey to assess the utility of the SAT and review the use of the SAT in other CQI research programs...
October 18, 2016: BMC Health Services Research
Alison Pearce, Cathy Bradley, Paul Hanly, Ciaran O'Neill, Audrey Alforque Thomas, Michal Molcho, Linda Sharp
BACKGROUND: When individuals stop working due to cancer this represents a loss to society - the loss of productivity. The aim of this analysis was to estimate productivity losses associated with premature mortality from all adult cancers and from the 20 highest mortality adult cancers in Ireland in 2011, and project these losses until 2030. METHODS: An incidence-based method was used to estimate the cost of cancer deaths between 2011 and 2030 using the Human Capital Approach...
October 18, 2016: BMC Cancer
Amy J Davis, Mevin B Hooten, Ryan S Miller, Matthew L Farnsworth, Jesse Lewis, Michael Moxcey, Kim M Pepin
Evaluation of the progress of management programs for invasive species is crucial for demonstrating impacts to stakeholders and strategic planning of resource allocation. Estimates of abundance before and after management activities can serve as a useful metric of population management programs. However, many methods of estimating population size are too labor intensive and costly to implement, posing restrictive levels of burden on operational programs. Removal models are a reliable method for estimating abundance before and after management using data from the removal activities exclusively, thus requiring no work in addition to management...
October 2016: Ecological Applications: a Publication of the Ecological Society of America
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