Heterogeneity of European DRG Systems and Potentials for a Common Eurodrg System; Comment on “Cholecystectomy and Diagnosis-Related Groups (DRGs: Patient Classification and Hospital Reimbursement in 11 European Countries”

Directory of Open Access Journals (Sweden)

Alexander Geissler

2015-05-01

Full Text Available Diagnosis-Related Group (DRG systems across Europe are very heterogeneous, in particular because of different classification variables and algorithms as well as costing methodologies. But, given the challenge of increasing patient mobility within Europe, health systems are forced to incorporate a common patient classification language in order to compare and identify similar patients e.g. for reimbursement purposes. Beside the national adoption of DRGs for a wide range of purposes (measuring hospital activity vs. paying hospitals, a common DRG system can serve as an international communication basis among health administrators and can reduce the national development efforts as it is demonstrated by the NordDRG consortium.

The debate over diagnosis related groups.

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Spiegel, A D; Kavaler, F

1985-01-01

With the advent of the Prospective Payment System (PPS) using Diagnosis Related Groups (DRGs) as a classification method, the pros and cons of that mechanism have been sharply debated. Grouping the comments into categories related to administration/management, DRG system and quality of care, a review of relevant literature highlights the pertinent attitudes and views of professionals and organizations. Points constantly argued include data utilization, meaningful medical classifications, resource use, gaming, profit centers, patient homogeneity, severity of illness, length of stay, technology limitations and the erosion of standards.

Heterogeneity of European DRG systems and potentials for a common EuroDRG system Comment on "Cholecystectomy and Diagnosis-Related Groups (DRGs): patient classification and hospital reimbursement in 11 European countries".

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Geissler, Alexander; Quentin, Wilm; Busse, Reinhard

2015-03-05

Diagnosis-Related Group (DRG) systems across Europe are very heterogeneous, in particular because of different classification variables and algorithms as well as costing methodologies. But, given the challenge of increasing patient mobility within Europe, health systems are forced to incorporate a common patient classification language in order to compare and identify similar patients e.g. for reimbursement purposes. Beside the national adoption of DRGs for a wide range of purposes (measuring hospital activity vs. paying hospitals), a common DRG system can serve as an international communication basis among health administrators and can reduce the national development efforts as it is demonstrated by the NordDRG consortium. © 2015 by Kerman University of Medical Sciences.

From DRGs to deregulation: New Jersey takes the road less traveled.

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Berliner, H S; Delgado, S

1993-01-01

Following a 1992 court ruling that declared New Jersey's system of financing uncompensated care unconstitutional, the state radically changed its 12-year-old hospital payment system that pioneered the use of diagnostic-related groups (DRGs). In its place, New Jersey lawmakers approved a package of reforms that lets hospitals set their own charges and collect bad debts, uses the state's unemployment insurance trust fund to pay for charity care, and reforms the individual and small group insurance markets. Immediate results of the law include new subsidies for inner-city hospitals, lower bond ratings, and hospital layoffs.

Introducing diagnosis-related groups: is the information system ready?

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Jian, Weiyan; Lu, Ming; Han, Wei; Hu, Mu

2016-01-01

Diagnosis-related group (DRG) system is a classification system widely used in health managements, the foundation of which lies in the medical information system. A large effort had been made to improve the quality of discharge data before the introduction of DRGs in Beijing. We extract discharge data from 108 local hospitals spanning 4 years before and after standardization to evaluate the impact of standardization on DRG grouping performance. The data was grouped on an annual basis in accordance with Beijing's local DRG system. Proportion of ungrouped data, coefficient of variation (CV) and reduction in variance (RIV) were used to measure the performance of the DRG system. Both the descriptive and regression analysis indicate a significant reduction in terms of ungrouped data and CV for expenditure, increase of RIV for expenditure and length of stay. However, when there was no intervention, that is, between 2005 and 2006 and between 2008 and 2009, changes in these indicators were all insignificant. Therefore, the standardization of discharge data did improve data quality and consequently enhanced the performance of DRGs. Developing countries with a relatively weak information infrastructure should strengthen their medical information system before the introduction of the DRG system. Copyright © 2014 John Wiley & Sons, Ltd.

Adopting Thai Diagnosis Related Group for Vietnam Universal Health Coverage: A Case of Ba Vi District Hospital

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Pham Le Tuan, M.D., Ph.D.

2015-09-01

Full Text Available Objective: This studyaimedtoclassifyallhospitaldischargescoveredbyhealthinsurancesystem intodiagnosis relatedgroup (DRG to guideproviderpayment reforms of universalhealth coverage roadmap in Vietnam. Methods: Data from Ba Vi hospital from January to December 2012 were grouped into DRGs by Viet-DRG grouperversion1.0developedbasedon Thai-DRG version5methodologies. ThePearsoncorrelation(r wasused to assess the performance of Viet-DRG grouper as against Thai-DRG grouper. A 5-step trimming of individual inpatientdata to achieve thehighest correlations was performed. Results: Dataof12,220inpatientcases wereanalyzedbybothgroupers,84.4% of totalcases wereclassifiedinto 89 DRGs. Thefive mostcommon DRGs werevaginaldelivery withoutcomplicatingdiagnosis (14500; Respira- tory infection/inflammation, no complication and comorbidity (04520; Otitis media and URI, no complication andcomorbidity(03530; Viral illnessexceptdengue,child,nocomplicationandcomorbidity(18610; Bronchitis and asthma, no complication and comorbidity (04590. The performance of Viet-DRG grouper v1.0 compared with Thai-DRG grouper v5.0for 89 DRGs intermsof relative weights as of 0.4 andlength of stay as of 0.5. Conclusion: Validity of thefirst Viet-DRG was at moderate level compared to Thai-DRG due to the limitation ofdata availability andqualityat thehospital.

Acute myocardial infarction and diagnosis-related groups: patient classification and hospital reimbursement in 11 European countries

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Quentin, Wilm; Rätto, Hanna; Peltola, Mikko; Busse, Reinhard; Häkkinen, Unto

2013-01-01

Aims As part of the diagnosis related groups in Europe (EuroDRG) project, researchers from 11 countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Spain, and Sweden) compared how their DRG systems deal with patients admitted to hospital for acute myocardial infarction (AMI). The study aims to assist cardiologists and national authorities to optimize their DRG systems. Methods and results National or regional databases were used to identify hospital cases with a primary diagnosis of AMI. Diagnosis-related group classification algorithms and indicators of resource consumption were compared for those DRGs that individually contained at least 1% of cases. Six standardized case vignettes were defined, and quasi prices according to national DRG-based hospital payment systems were ascertained. European DRG systems vary widely: they classify AMI patients according to different sets of variables into diverging numbers of DRGs (between 4 DRGs in Estonia and 16 DRGs in France). The most complex DRG is valued 11 times more resource intensive than an index case in Estonia but only 1.38 times more resource intensive than an index case in England. Comparisons of quasi prices for the case vignettes show that hypothetical payments for the index case amount to only €420 in Poland but to €7930 in Ireland. Conclusions Large variation exists in the classification of AMI patients across Europe. Cardiologists and national DRG authorities should consider how other countries' DRG systems classify AMI patients in order to identify potential scope for improvement and to ensure fair and appropriate reimbursement. PMID:23364755

Acute myocardial infarction and diagnosis-related groups: patient classification and hospital reimbursement in 11 European countries.

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Quentin, Wilm; Rätto, Hanna; Peltola, Mikko; Busse, Reinhard; Häkkinen, Unto

2013-07-01

As part of the diagnosis related groups in Europe (EuroDRG) project, researchers from 11 countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Spain, and Sweden) compared how their DRG systems deal with patients admitted to hospital for acute myocardial infarction (AMI). The study aims to assist cardiologists and national authorities to optimize their DRG systems. National or regional databases were used to identify hospital cases with a primary diagnosis of AMI. Diagnosis-related group classification algorithms and indicators of resource consumption were compared for those DRGs that individually contained at least 1% of cases. Six standardized case vignettes were defined, and quasi prices according to national DRG-based hospital payment systems were ascertained. European DRG systems vary widely: they classify AMI patients according to different sets of variables into diverging numbers of DRGs (between 4 DRGs in Estonia and 16 DRGs in France). The most complex DRG is valued 11 times more resource intensive than an index case in Estonia but only 1.38 times more resource intensive than an index case in England. Comparisons of quasi prices for the case vignettes show that hypothetical payments for the index case amount to only €420 in Poland but to €7930 in Ireland. Large variation exists in the classification of AMI patients across Europe. Cardiologists and national DRG authorities should consider how other countries' DRG systems classify AMI patients in order to identify potential scope for improvement and to ensure fair and appropriate reimbursement.

Funding intensive care - approaches in systems using diagnosis-related groups.

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Ettelt, S; Nolte, E

2010-01-01

This report reviews approaches to funding intensive care in health systems that use activitybased payment mechanisms based on diagnosis-related groups (DRGs) to reimburse hospital care. The report aims to inform the current debate about options for funding intensive care services for adults, children and newborns in England. Funding mechanisms reviewed here include those in Australia (Victoria), Denmark, France, Germany, Italy, Spain, Sweden and the United States (Medicare). Approaches to org...

Assessing the impact of DRGs on patient care and professional practice in Switzerland (IDoC) - a potential model for monitoring and evaluating healthcare reform.

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Wild, Verina; Carina, Fourie; Frouzakis, Regula; Clarinval, Caroline; Fässler, Margrit; Elger, Bernice; Gächter, Thomas; Leu, Agnes; Spirig, Rebecca; Kleinknecht, Michael; Radovanovic, Dragana; Mouton Dorey, Corine; Burnand, Bernard; Vader, John-Paul; Januel, Jean-Marie; Biller-Andorno, Nikola; The IDoC Group

2015-01-01

The starting point of the interdisciplinary project "Assessing the impact of diagnosis related groups (DRGs) on patient care and professional practice" (IDoC) was the lack of a systematic ethical assessment for the introduction of cost containment measures in healthcare. Our aim was to contribute to the methodological and empirical basis of such an assessment. Five sub-groups conducted separate but related research within the fields of biomedical ethics, law, nursing sciences and health services, applying a number of complementary methodological approaches. The individual research projects were framed within an overall ethical matrix. Workshops and bilateral meetings were held to identify and elaborate joint research themes. Four common, ethically relevant themes emerged in the results of the studies across sub-groups: (1.) the quality and safety of patient care, (2.) the state of professional practice of physicians and nurses, (3.) changes in incentives structure, (4.) vulnerable groups and access to healthcare services. Furthermore, much-needed data for future comparative research has been collected and some early insights into the potential impact of DRGs are outlined. Based on the joint results we developed preliminary recommendations related to conceptual analysis, methodological refinement, monitoring and implementation.

[Innovative culture and diagnosis related groups in a high complexity hospital, Colombia].

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Gorbanev, Iouri; Agudelo-Londoño, Sandra; Cortes, Ariel; Yepes, Francisco J

2016-04-01

Objectives To characterize the perception of Diagnosis-Related Groups (DRGs) as an innovation among physicians, nurses and administrative staff in a hospital in Colombia. Methods A case study of innovative culture in a hospital. Surveys and focus groups were carried out with the medical, nursing and administrative staff. Descriptive statistics were calculated for the perceptions of innovative culture. Comparative analysis was done between professional groups. The results of the focus groups were transcribed and analyzed to deepen the findings of the surveys. Results Significant differences were found in perceptions of the innovative culture. The nursing staff were more enthusiastic than doctors when evaluating the innovative culture and leadership. Physicians felt more autonomy when discussing professional issues. Administrative staff assessed the Hospital's disposition to acquire new medical technologies as higher than that of physicians. The three groups know little about DRG's. Conclusions When implementing a health innovation it is advisable to analyze its effect on the professionals who participate in the implementation. Physicians perceive DRGs as a threat to their professional autonomy, while nurses see it as a pro-innovation force. It is important to involve nursing and administrative staff when implementing this kind of innovation.

Coronary artery bypass grafts and diagnosis related groups: patient classification and hospital reimbursement in 10 European countries

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2014-01-01

Background The prospective reimbursement of hospitals through the grouping of patients into a finite number of categories (Diagnosis Related Groups, DRGs), is common to many European countries. However, the specific categories used vary greatly across countries, using different characteristics to define group boundaries and thus those characteristics which result in different payments for treatment. In order to assist in the construction and modification of national DRG systems, this study analyses the DRG systems of 10 European countries. Aims To compare the characteristics used to categorise patients receiving a coronary artery bypass graft (CABG) surgery into DRGs. Further, to compare the structure into which DRGs are placed and the relative price paid for patients across Europe. Method Patients with a procedure of CABG surgery are analysed from Austria, England, Estonia, Finland, France, Germany, Ireland, Poland, Spain and Sweden. Diagrammatic algorithms of DRG structures are presented for each country. The price in Euros of seven typical case vignettes, each made up of a set of a hypothetical patient’s characteristics, is also analysed for each country. In order to enable comparisons across countries the simplest case (index vignette) is taken as baseline and relative price levels are calculated for the other six vignettes, each representing patients with different combinations of procedures and comorbidities. Results European DRG payment structures for CABG surgery vary in terms of the number of different DRGs used and the types of distinctions which define patient categorisation. Based on the payments given to hospitals in different countries, the most resource intensive patient, relative to the index vignette, ranges in magnitude from 1.37 in Poland to 2.82 in Ireland. There is also considerable variation in how much different systems pay for particular circumstances, such as the occurrence of catheterisation or presence of comorbidity. Conclusion Past

Lifting the weight of a diagnosis-related groups family change: a comparison between refined and non-refined DRG systems for top-down cost accounting and efficiency indicators.

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Zlotnik, Alexander; Cuchi, Miguel Alfaro; Pérez Pérez, Maria Carmen

Public healthcare providers in all Spanish Regions - Autonomous Communities (ACs) use All Patients Diagnosis-Related Groups (AP-DRGs) for billing non-insured patients, cost accounting and inpatient efficiency indicators. A national migration to All Patients Refined Diagnosis-Related Groups (APR-DRGs) has been scheduled for 2016. The analysis was performed on 202,912 inpatient care episodes ranging from 2005 to 2010. All episodes were grouped using AP-DRG v25.0 and APR-DRG v24.0. Normalised DRG weight variations for an AP-DRG to APR-DRG migration scenario were calculated and compared. Major differences exist between normalised weights for inpatient episodes depending on the DRGs family used. The usage of the APR-DRG system in Spain without any adjustments, as it was developed in the United States, should be approached with care. In order to avoid reverse incentives and provider financial risks, coding practices should be reviewed and structural differences between DRG families taken into account.

Development of a claim review and payment model utilizing diagnosis related groups under the Korean health insurance.

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Shin, Y S; Yeom, Y K; Hwang, H

1993-02-01

This paper describes the development of a claim review and payment model utilizing the diagnosis related groups (DRGs) for the fee for service-based payment system of the Korean health insurance. The present review process, which examines all claims manually on a case-by-case basis, has been considered to be inefficient, costly, and time-consuming. Differences in case mix among hospitals are controlled in the proposed model using the Korean DRGs. They were developed by modifying the US-DRG system. An empirical test of the model indicated that it can enhance the efficiency as well as the credibility and objectivity of the claim review. Furthermore, it is expected that it can contribute effectively to medical cost containments and to optimal practice pattern of hospitals by establishing a useful mechanism in monitoring the performance of hospitals. However, the performance of this model needs to be upgraded by refining the Korean DRGs which play a key role in the model.

The political economy of diagnosis-related groups.

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Bertoli, Paola; Grembi, Veronica

2017-10-01

A well-established political economic literature has shown as multi-level governance affects the inefficiency of public expenditures. Yet, this expectation has not been empirically tested on health expenditures. We provide a political economy interpretation of the variation in the prices of 6 obstetric DRGs using Italy as a case study. Italy offers a unique institutional setting since its 21 regional governments can decide whether to adopt the national DRG system or to adjust/waive it. We investigate whether the composition and characteristics of regional governments do matter for the average DRG level and, if so, why. To address both questions, we first use a panel fixed effects model exploiting the results of 66 elections between 2000 and 2013 (i.e., 294 obs) to estimate the link between DRGs and the composition and characteristics of regional governments. Second, we investigate these results exploiting the implementation of a budget constraint policy through a difference-in-differences framework. The incidence of physicians in the regional government explains the variation of DRGs with low technological intensity, such as normal newborn, but not of those with high technological intensity, as severely premature newborn. We also observe a decrease in the average levels of DRGs after the budget constraint implementation, but the magnitude of this decrease depends primarily on the presence of physicians among politicians and the political alignment between the regional and the national government. To understand which kind of role the relevance of the political components plays (i.e., waste vs. better defined DRGs), we check whether any of the considered political economy variables have a positive impact on the quality of regional obstetric systems finding no effect. These results are a first evidence that a system of standardized prices, such as the DRGs, is not immune to political pressures. Copyright © 2017 Elsevier Ltd. All rights reserved.

Do diagnosis-related group-based payments incentivise hospitals to adjust output mix?

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Liang, Li-Lin

2015-04-01

This study investigates whether the diagnosis-related group (DRG)-based payment method motivates hospitals to adjust output mix in order to maximise profits. The hypothesis is that when there is an increase in profitability of a DRG, hospitals will increase the proportion of that DRG (own-price effects) and decrease those of other DRGs (cross-price effects), except in cases where there are scope economies in producing two different DRGs. This conjecture is tested in the context of the case payment scheme (CPS) under Taiwan's National Health Insurance programme over the period of July 1999 to December 2004. To tackle endogeneity of DRG profitability and treatment policy, a fixed-effects three-stage least squares method is applied. The results support the hypothesised own-price and cross-price effects, showing that DRGs which share similar resources appear to be complements rather substitutes. For-profit hospitals do not appear to be more responsive to DRG profitability, possibly because of their institutional characteristics and bonds with local communities. The key conclusion is that DRG-based payments will encourage a type of 'product-range' specialisation, which may improve hospital efficiency in the long run. However, further research is needed on how changes in output mix impact patient access and pay-outs of health insurance. Copyright © 2014 John Wiley & Sons, Ltd.

Diagnosis Related Groups for DOD: Background of a Competitive Strategy.

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1987-12-01

reimbursement and allowable increases in reimbur - sable costs per discharge. Responding to the State’s dilemma in meeting the costs of their Medicaid...Prospective Reimbursement Z-- - 19 ABSTRT (Continue on reverse if necessary and identify by block number) Public Law 99-661 requires that the...Rates of reimbursement for DRGs, are predicated on the isoresource consumption nature of DRGs. The Federal government has established DRGs as the basis

Trialling diagnosis-related groups classification in the Iranian health system: a case study examining the feasibility of introducing casemix.

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Ghaffari, S; Doran, C; Wilson, A; Aisbett, C

2010-05-01

This paper examines the quality of routinely collected information in an Iranian hospital in a trial of casemix classification. Australian Refined Diagnosis Related Groups (AR-DRG) were used to classify patient episodes. There were 327 DRGs identified, of which 20% had only 1 case. The grouper program identified invalid records for 4% of total separations. Approximately 4.5% of cases were classified into error DRGs and 3.4% were ungroupable. No complication and comorbidity effects were identified with 93% of total cases. R2 (variance in length of stay explained) was 44% for untrimmed cases, increasing to 63%, 57% and 58% after trimming by L3H3, IQR and 10th-95th percentile methods respectively.

Diagnosis-related groups for stroke in Europe: patient classification and hospital reimbursement in 11 countries.

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Peltola, Mikko; Quentin, Wilm

2013-01-01

Diagnosis-related groups (DRGs) are increasingly being used for various purposes in many countries. However, there are no studies comparing different DRG systems in the care of stroke. As part of the EuroDRG project, researchers from 11 countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, the Netherlands, Poland, Sweden and Spain) compared how their DRG systems deal with stroke patients. The study aims to assist clinicians and national authorities to optimize their DRG systems. National or regional databases were used to identify hospital cases with a diagnosis of stroke. DRG classification algorithms and indicators of resource consumption were compared for those DRGs that individually represent at least 1% of stroke cases. In addition, standardized case vignettes were defined, and quasi prices according to national DRG-based hospital payment systems were ascertained. European DRG systems vary widely: they classify stroke patients according to different sets of variables (between 1 and 7 classification variables) into diverging numbers of DRGs (between 1 and 10 DRGs). In 6 of the countries more than half of the patients are concentrated within a single DRG. The countries' systems also vary with respect to the evaluation of different kinds of stroke patients. The most complex DRG is considered 3.8 times more resource intensive than an index case in Finland. By contrast, in England, the DRG system does not account for complex cases. Comparisons of quasi prices for the case vignettes show that hypothetical payments for the index case amount to only EUR 907 in Poland but to EUR 7,881 in Ireland. Large variations in the classification of stroke patients raise concerns whether all systems rely on the most appropriate classification variables and whether the DRGs adequately reflect differences in the complexity of treating different groups of patients. Learning from other DRG systems may help in improving the national systems. Clinicians and

All patient refined-diagnostic related group and case mix index in acute care palliative medicine.

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Lagman, Ruth L; Walsh, Declan; Davis, Mellar P; Young, Brett

2007-03-01

The All Patient Refined-Diagnostic Related Group (APR-DRG) is a modification of the traditional DRG that adds four classes of illness severity and four classes of mortality risk. The APR-DRG is a more accurate assessment of the complexity of care. When individuals with advanced illness are admitted to an acute inpatient palliative medicine unit, there may be a perception that they receive less intense acute care. Most of these patients, however, are multisymptomatic, have several comorbidities, and are older. For all patients admitted to the unit, a guide was followed by staff physicians to document clinical information that included the site(s) of malignancy, site(s) of metastases, disease complications, disease-related symptoms, and comorbidities. We then prospectively compared DRGs, APR-DRGs, and case mix index (CMI) from January 1-June 30, 2003, and February 1-July 31,2004, before and after the use of the guide. The overall mean severity of illness (ASOI) increased by 25% (P DRG classifications captured a higher severity of illness and may better reflect resource utilization.

Transfusion practice in Helsinki University Central Hospital: an analysis of diagnosis-related groups (DRG).

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Syrjälä, M T; Kytöniemi, I; Mikkolainen, K; Ranimo, J; Lauharanta, J

2001-12-01

Transfusion data combined with data automatically recorded in hospital databases provides an outstanding tool for blood utilization reporting. When the reporting is performed with an online analytical processing (OLAP) tool, real time reporting can be provided to blood subscribers. When this data is combined with a common patient classification system, Diagnosis-Related Groups (DRG), it is possible to produce statistical results, that are similar in different institutions and may provide a means for international transfusion bench-marking and cost comparison. We use a DRG classification to describe the transfusion practice in Helsinki University Central Hospital. The key indicators include the percentage of transfused patients, the number of transfused units and costs in different DRG groups, as well as transfusion rates per DRG weighted treatment episodes. Ninety-three per cent of all transfusions could be classified into different DRGs. The largest blood-using DRG group was acute adult leukaemia (DRG 473), which accounted for 10.4% of all transfusion costs. The 13 largest blood consuming DRGs accounted for half the total costs in 1998. Currently, there is a lack of an internationally accepted standardized way to report institutional or national transfusion practices. DRG-based transfusion reporting might serve as a means for transfusion benchmarking and thus aid studies of variations in transfusion practice.

Implications of prospective payment under DRGs for hospital marketing.

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Folland, S; Ziegenfuss, J T; Chao, P

1988-12-01

The authors analyze the hospital marketing implications of Medicare's prospective payment system under DRGs. They take an appropriately broad view of marketing and consider related impacts on culture, structure, and management, in addition to the traditional marketing mix. The article serves to present in one place the ideas and discussions on the subject from a wide and disparate literature. The aim throughout is to identify those marketing responses warranting recommendation. The recommendations are assembled in a concluding section. Though many of the ideas are not new, they have yet to be widely adopted by hospitals. Hence they represent untapped marketing opportunities attributable to the advent of the DRG system. The authors conclude with suggestions for future research.

Diagnosis-Related Groups for Stroke in Europe: Patient Classification and Hospital Reimbursement in 11 Countries

OpenAIRE

Peltola, Mikko; Quentin, Wilm

2013-01-01

Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG geförderten) Allianz- bzw. Nationallizenz frei zugänglich. This publication is with permission of the rights owner freely accessible due to an Alliance licence and a national licence (funded by the DFG, German Research Foundation) respectively. Background: Diagnosis-related groups (DRGs) are increasingly being used for various purposes in many countries. However, there are no studies comparing different DRG systems...

Redefining diagnosis-related groups (DRGs) for palliative care - a cross-sectional study in two German centres.

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Vogl, Matthias; Schildmann, Eva; Leidl, Reiner; Hodiamont, Farina; Kalies, Helen; Maier, Bernd Oliver; Schlemmer, Marcus; Roller, Susanne; Bausewein, Claudia

2018-04-05

Hospital costs and cost drivers in palliative care are poorly analysed. It remains unknown whether current German Diagnosis-Related Groups, mainly relying on main diagnosis or procedure, reproduce costs adequately. The aim of this study was therefore to analyse costs and reimbursement for inpatient palliative care and to identify relevant cost drivers. Two-center, standardised micro-costing approach with patient-level cost calculations and analysis of the reimbursement situation for patients receiving palliative care at two German hospitals (7/2012-12/2013). Data were analysed for the total group receiving hospital care covering, but not exclusively, palliative care (group A) and the subgroup receiving palliative care only (group B). Patient and care characteristics predictive of inpatient costs of palliative care were derived by generalised linear models and investigated by classification and regression tree analysis. Between 7/2012 and 12/2013, 2151 patients received care in the two hospitals including, but not exclusively, on the PCUs (group A). In 2013, 784 patients received care on the two PCUs only (group B). Mean total costs per case were € 7392 (SD 7897) (group A) and € 5763 (SD 3664) (group B), mean total reimbursement per case € 5155 (SD 6347) (group A) and € 4278 (SD 2194) (group B). For group A/B on the ward, 58%/67% of the overall costs and 48%/53%, 65%/82% and 64%/72% of costs for nursing, physicians and infrastructure were reimbursed, respectively. Main diagnosis did not significantly influence costs. However, duration of palliative care and total length of stay were (related to the cost calculation method) identified as significant cost drivers. Related to the cost calculation method, total length of stay and duration of palliative care were identified as significant cost drivers. In contrast, main diagnosis did not reflect costs. In addition, results show that reimbursement within the German Diagnosis-Related Groups system does not

Properties of DRGs, LBGs, and BzK Galaxies in the GOODS South Field

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Grazian, A.; Salimbeni, S.; Pentericci, L.; Fontana, A.; Santini, P.; Giallongo, E.; de Santis, C.; Gallozzi, S.; Nonino, M.; Cristiani, S.; Vanzella, E.

2007-12-01

We use the GOODS-MUSIC catalog with multi-wavelength coverage extending from the U band to the Spitzer 8 μm band, and spectroscopic or accurate photometric redshifts to select samples of BM/BX/LBGs, DRGs, and BzK galaxies. We discuss the overlap and the limitations of these selection criteria, which can be overcome with a criterion based on physical parameters (age and star formation timescale). We show that the BzK-PE criterion is not optimal for selecting early type galaxies at the faint end. We also find that LBGs and DRGs contribute almost equally to the global Stellar Mass Density (SMD) at z≥ 2 and in general that star forming galaxies form a substantial fraction of the universal SMD.

The exploration of medical resources utilization among inguinal hernia repair in Taiwan diagnosis-related groups

Directory of Open Access Journals (Sweden)

Yu-Hua Yan

2017-11-01

Full Text Available Abstract Background This study centered on differences in medical costs, using the Taiwan diagnosis-related groups (Tw-DRGs on medical resource utilization in inguinal hernia repair (IHR in hospitals with different ownership to provide suitable reference information for hospital administrators. Methods The 2010–2011 data for three hospitals under different ownership were extracted from the Taiwan National Health Insurance claims database. A retrospective method was applied to analyze the age, sex, length of stay, diagnosis and surgical procedure code, and the change in financial risk of medical costs in IHR cases after introduction of Tw-DRGs. The study calculated the cost using Tw-DRG payment principles, and compared it with estimated inpatient medical costs calculated using the fee-for-service policy. Results There were 723 IHR cases satisfying the Tw-DRGs criteria. Cost control in the medical care corporation hospital (US$764.2/case was more efficient than that in the public hospital (US$902.7/case or nonprofit proprietary hospital (US$817.1/case surveyed in this study. For IHR, anesthesiologists in the public hospital preferred to use general anesthesia (86%, while those in the two other hospitals tended to administer spinal anesthesia. We also discovered the difference in anesthesia cost was high, at US$80.2/case on average. Conclusions Because the Tw-DRG-based reimbursement system produces varying hospital costs, hospital administrators should establish a financial risk assessment system as early as possible to improve healthcare quality and financial management efficiency. This would then benefit the hospital, patient, and Bureau of National Health Insurance.

The exploration of medical resources utilization among inguinal hernia repair in Taiwan diagnosis-related groups.

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Yan, Yu-Hua; Kung, Chih-Ming; Chen, Yi

2017-11-09

This study centered on differences in medical costs, using the Taiwan diagnosis-related groups (Tw-DRGs) on medical resource utilization in inguinal hernia repair (IHR) in hospitals with different ownership to provide suitable reference information for hospital administrators. The 2010-2011 data for three hospitals under different ownership were extracted from the Taiwan National Health Insurance claims database. A retrospective method was applied to analyze the age, sex, length of stay, diagnosis and surgical procedure code, and the change in financial risk of medical costs in IHR cases after introduction of Tw-DRGs. The study calculated the cost using Tw-DRG payment principles, and compared it with estimated inpatient medical costs calculated using the fee-for-service policy. There were 723 IHR cases satisfying the Tw-DRGs criteria. Cost control in the medical care corporation hospital (US$764.2/case) was more efficient than that in the public hospital (US$902.7/case) or nonprofit proprietary hospital (US$817.1/case) surveyed in this study. For IHR, anesthesiologists in the public hospital preferred to use general anesthesia (86%), while those in the two other hospitals tended to administer spinal anesthesia. We also discovered the difference in anesthesia cost was high, at US$80.2/case on average. Because the Tw-DRG-based reimbursement system produces varying hospital costs, hospital administrators should establish a financial risk assessment system as early as possible to improve healthcare quality and financial management efficiency. This would then benefit the hospital, patient, and Bureau of National Health Insurance.

Diagnosis-Related Groups (DRG and Hospital Business Performance Management

Directory of Open Access Journals (Sweden)

Szynkiewicz Piotr

2014-12-01

Full Text Available The goal of this article is to present the possibility of using Diagnosis- Related Groups (DRG in the hospital management process and to analyse the need for business performance management on the part of hospital management staff. The following research methods were used: literature analysis, case studies, and poll analysis. It is not possible to increase the effectiveness of operation of healthcare entities without increasing the importance of IT systems and using DRG more effectively in the management process. Training users in IT and the use of DRGs is important to achieving hospital effectiveness. The increased importance of analyses and planning in a hospital should be reflected in the organisational structure of service providers. Hospital controllers should have a similar role to those present in most companies in other industries.

Cholecystectomy and Diagnosis-Related Groups (DRGs): Patient Classification and Hospital Reimbursement in 11 European Countries

OpenAIRE

Gerli Paat-Ahi; Ain Aaviksoo; Maria Świderek

2014-01-01

Background As part of the EuroDRG project, researchers from eleven countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Sweden, and Spain) compared how their Diagnosis-Related Groups (DRG) systems deal with cholecystectomy patients. The study aims to assist surgeons and national authorities to optimize their DRG systems. Methods National or regional databases were used to identify hospital cases with a procedure of cholecystectom...

The trauma registry compared to All Patient Refined Diagnosis Groups (APR-DRG).

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Hackworth, Jodi; Askegard-Giesmann, Johanna; Rouse, Thomas; Benneyworth, Brian

2017-05-01

Literature has shown there are significant differences between administrative databases and clinical registry data. Our objective was to compare the identification of trauma patients using All Patient Refined Diagnosis Related Groups (APR-DRG) as compared to the Trauma Registry and estimate the effects of those discrepancies on utilization. Admitted pediatric patients from 1/2012-12/2013 were abstracted from the trauma registry. The patients were linked to corresponding administrative data using the Pediatric Health Information System database at a single children's hospital. APR-DRGs referencing trauma were used to identify trauma patients. We compared variables related to utilization and diagnosis to determine the level of agreement between the two datasets. There were 1942 trauma registry patients and 980 administrative records identified with trauma-specific APR-DRG during the study period. Forty-two percent (816/1942) of registry records had an associated trauma-specific APR-DRG; 69% of registry patients requiring ICU care had trauma APR-DRGs; 73% of registry patients with head injuries had trauma APR-DRGs. Only 21% of registry patients requiring surgical management had associated trauma APR-DRGs, and 12.5% of simple fractures had associated trauma APR-DRGs. APR-DRGs appeared to only capture a fraction of the entire trauma population and it tends to be the more severely ill patients. As a result, the administrative data was not able to accurately answer hospital or operating room utilization as well as specific information on diagnosis categories regarding trauma patients. APR-DRG administrative data should not be used as the only data source for evaluating the needs of a trauma program. Copyright © 2016 Elsevier Ltd. All rights reserved.

Appendectomy and diagnosis-related groups (DRGs): patient classification and hospital reimbursement in 11 European countries

OpenAIRE

Quentin, Wilm; Scheller-Kreinsen, David; Geissler, Alexander; Busse, Reinhard

2012-01-01

Background As part of the EuroDRG project, researchers from 11 countries (i.e., Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Sweden, and Spain) compared how their diagnosis-related groups (DRG) systems deal with appendectomy patients. The study aims to assist surgeons and national authorities to optimize their DRG systems. Methods National or regional databases were used to identify hospital cases with a diagnosis of appendicitis treated with a procedure ...

Diagnosis related group grouping study of senile cataract patients based on E-CHAID algorithm

Science.gov (United States)

Luo, Ai-Jing; Chang, Wei-Fu; Xin, Zi-Rui; Ling, Hao; Li, Jun-Jie; Dai, Ping-Ping; Deng, Xuan-Tong; Zhang, Lei; Li, Shao-Gang

2018-01-01

AIM To figure out the contributed factors of the hospitalization expenses of senile cataract patients (HECP) and build up an area-specified senile cataract diagnosis related group (DRG) of Shanghai thereby formulating the reference range of HECP and providing scientific basis for the fair use and supervision of the health care insurance fund. METHODS The data was collected from the first page of the medical records of 22 097 hospitalized patients from tertiary hospitals in Shanghai from 2010 to 2012 whose major diagnosis were senile cataract. Firstly, we analyzed the influence factors of HECP using univariate and multivariate analysis. DRG grouping was conducted according to the exhaustive Chi-squared automatic interaction detector (E-CHAID) model, using HECP as target variable. Finally we evaluated the grouping results using non-parametric test such as Kruskal-Wallis H test, RIV, CV, etc. RESULTS The 6 DRGs were established as well as criterion of HECP, using age, sex, type of surgery and whether complications/comorbidities occurred as the key variables of classification node of senile cataract cases. CONCLUSION The grouping of senile cataract cases based on E-CHAID algorithm is reasonable. And the criterion of HECP based on DRG can provide a feasible way of management in the fair use and supervision of medical insurance fund. PMID:29487824

Diagnosis related group grouping study of senile cataract patients based on E-CHAID algorithm.

Science.gov (United States)

Luo, Ai-Jing; Chang, Wei-Fu; Xin, Zi-Rui; Ling, Hao; Li, Jun-Jie; Dai, Ping-Ping; Deng, Xuan-Tong; Zhang, Lei; Li, Shao-Gang

2018-01-01

To figure out the contributed factors of the hospitalization expenses of senile cataract patients (HECP) and build up an area-specified senile cataract diagnosis related group (DRG) of Shanghai thereby formulating the reference range of HECP and providing scientific basis for the fair use and supervision of the health care insurance fund. The data was collected from the first page of the medical records of 22 097 hospitalized patients from tertiary hospitals in Shanghai from 2010 to 2012 whose major diagnosis were senile cataract. Firstly, we analyzed the influence factors of HECP using univariate and multivariate analysis. DRG grouping was conducted according to the exhaustive Chi-squared automatic interaction detector (E-CHAID) model, using HECP as target variable. Finally we evaluated the grouping results using non-parametric test such as Kruskal-Wallis H test, RIV, CV, etc. The 6 DRGs were established as well as criterion of HECP, using age, sex, type of surgery and whether complications/comorbidities occurred as the key variables of classification node of senile cataract cases. The grouping of senile cataract cases based on E-CHAID algorithm is reasonable. And the criterion of HECP based on DRG can provide a feasible way of management in the fair use and supervision of medical insurance fund.

Diagnosis related group grouping study of senile cataract patients based on E-CHAID algorithm

Directory of Open Access Journals (Sweden)

Ai-Jing Luo

2018-02-01

Full Text Available AIM: To figure out the contributed factors of the hospitalization expenses of senile cataract patients (HECP and build up an area-specified senile cataract diagnosis related group (DRG of Shanghai thereby formulating the reference range of HECP and providing scientific basis for the fair use and supervision of the health care insurance fund. METHODS: The data was collected from the first page of the medical records of 22 097 hospitalized patients from tertiary hospitals in Shanghai from 2010 to 2012 whose major diagnosis were senile cataract. Firstly, we analyzed the influence factors of HECP using univariate and multivariate analysis. DRG grouping was conducted according to the exhaustive Chi-squared automatic interaction detector (E-CHAID model, using HECP as target variable. Finally we evaluated the grouping results using non-parametric test such as Kruskal-Wallis H test, RIV, CV, etc. RESULTS: The 6 DRGs were established as well as criterion of HECP, using age, sex, type of surgery and whether complications/comorbidities occurred as the key variables of classification node of senile cataract cases. CONCLUSION: The grouping of senile cataract cases based on E-CHAID algorithm is reasonable. And the criterion of HECP based on DRG can provide a feasible way of management in the fair use and supervision of medical insurance fund.

[Costs of appendicitis treatment by diagnosis-related groups in a third-level pediatric hospital].

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Tlacuilo-Parra, Alberto; Hernández-Hernández, Araceli; Venegas-Dávalos, Martha; Gutiérrez-Hermosillo, Violeta; Guevara-Gutiérrez, Elizabeth; Ambriz-González, Gabriela

2014-01-01

Diagnosis-related groups (DRGs) are widely used in Europe. They allow performing comparisons in hospitals and incurrent hospital payment systems, defining the payment categories. We undertook this study to classify children who underwent appendectomy according to DRGs. Cross-sectional study. Comorbidities, length of hospitalization, histopathologic classification, and DRG classifications were analyzed. We included 313 patients, 62% males, with an average age of 8 ± 3 years; 91% were referred by another hospital and 67% were treated at night. Average length of hospitalization was 4 ± 3 days. There were comorbidities in 8% and surgical complications in 11%. According to histopathology, appendicitis was edematous (11%), suppurative (36%), gangrenous (22%), perforated (29%), and abscessed (2%). At discharge, 97% of the patients were healthy. Total cost for DRG 343 was $10,470,173.00 (Mexican pesos), DRG 342 was $1,227,592.00 and DRG 340 was $511,521.00. The global amount was $12,209,286.00 (Mexican pesos). The unitary cost for treatment of appendectomy for DRG 343 was $37,935.00, for DRG 342 was $49,103.00 and for DRG 340 was $42,626.00 (Mexican pesos). Because 88% of the cases of appendicitis were uncomplicated, this amount of money could be spent to treat these patients in a second-level hospital, using reimbursement 343 without generating additional expenses.

Health Professionals Information for Diagnostics Related Groups (DRGs) with the Use of a Website.

Science.gov (United States)

Mpizopoulou, Katerina; Mpizopoulou, Zoe; Magita, Andrianna; Mechili, Aggelos E; Diomidous, Marianna; Mantas, John

2015-01-01

In recent years the costs of hospital care in developed countries absorbed a high proportion of total health resources. In Greece, after the establishment of the National Health System (NHS), funding for hospitals comes mainly from the state budget, and social insurance, therefore auditing of hospital cost is imperative to ensure their viability, especially at this time when the country is tested by economic crisis. Overtime many factors for the increase of hospital cost have been mentioned, such as the rapid development of medical technology, the low level of organization of the hospital system and the low productivity of human resources. The problem of rising health expenditure over the past decades is a worldwide phenomenon and it has brought about many changes in traditional retrospective methods for financing in the hospital sector, with prospective financial forms that combine patient composition and needs, and the productive activity of hospital need to the rationalization and contain expenditures. The system of Diagnosis Related Groups was a revolutionary success over the past decades and has now achieved worldwide recognition.

A comparison of LBGs, DRGs, and BzK galaxies: their contribution to the stellar mass density in the GOODS-MUSIC sample

Science.gov (United States)

Grazian, A.; Salimbeni, S.; Pentericci, L.; Fontana, A.; Nonino, M.; Vanzella, E.; Cristiani, S.; de Santis, C.; Gallozzi, S.; Giallongo, E.; Santini, P.

2007-04-01

Context: The classification scheme for high redshift galaxies is complex at the present time, with simple colour-selection criteria (i.e. EROs, IEROs, LBGs, DRGs, BzKs), resulting in ill-defined properties for the stellar mass and star formation rate of these distant galaxies. Aims: The goal of this work is to investigate the properties of different classes of high-z galaxies, focusing in particular on the stellar masses of LBGs, DRGs, and BzKs, in order to derive their contribution to the total mass budget of the distant Universe. Methods: We used the GOODS-MUSIC catalog, containing ~3000 Ks-selected (~10 000 z-selected) galaxies with multi-wavelength coverage extending from the U band to the Spitzer 8~μm band, with spectroscopic or accurate photometric redshifts. We selected samples of BM/BX/LBGs, DRGs, and BzK galaxies to discuss the overlap and the limitations of these criteria, which can be overridden by a selection criterion based on physical parameters. We then measured the stellar masses of these galaxies and computed the stellar mass density (SMD) for the different samples up to redshift ≃4. Results: We show that the BzK-PE criterion is not optimal for selecting early type galaxies at the faint end. On the other hand, BzK-SF is highly contaminated by passively evolving galaxies at red z-Ks colours. We find that LBGs and DRGs contribute almost equally to the global SMD at z≥ 2 and, in general, that star-forming galaxies form a substantial fraction of the universal SMD. Passively evolving galaxies show a strong negative density evolution from redshift 2 to 3, indicating that we are witnessing the epoch of mass assembly of such objects. Finally we have indications that by pushing the selection to deeper magnitudes, the contribution of less massive DRGs could overtake that of LBGs. Deeper surveys, like the HUDF, are required to confirm this suggestion.

Organ transplant AN-DRGs: modifying the exceptions hierarchy in casemix classification.

Science.gov (United States)

Antioch, K; Zhang, X

2000-01-01

The study described in this article sought to develop AN-DRG Version 3 classification revisions for organ transplantation through statistical analyses of recommendations formulated by the Australian Casemix Clinical Committee. Two separate analyses of variance were undertaken for AN-DRG Version 2 and for the proposed Version 3 AN-DRGs, using average length of stay as the dependent variable. The committee made four key recommendations which were accepted and incorporated into AN-DRG Versions 3 and 3.1. This article focuses on the classification revisions for organ transplantation.

Speaking the same language: underestimating financial impact when using diagnosis-related group versus ICD-9-based definitions for trauma inclusion criteria.

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Deppe, Sharon; Truax, Christopher B; Opalek, Judy M; Santanello, Steven A

2009-04-01

Hospital accounting methods use diagnosis-related group (DRG) data to identify patients and derive financial analyses and reports. The National Trauma Data Bank and trauma programs identify patients with trauma by International Classification of Diseases, Ninth Edition (ICD-9)-based definitions for inclusion criteria. These differing methods of identifying patients result in economic reports that vary significantly and fail to accurately identify the financial impact of trauma services. Routine financial data were collected for patients admitted to our Trauma Service from July 1, 2005 to June 30, 2006 using two methods of identifying the cases; by trauma DRGs and by trauma registry database inclusion criteria. The resulting data were compared and stratified to define the financial impact on hospital charges, reimbursement, costs, contribution to margin, downstream revenue, and estimated profit or loss. The results also defined the impact on supporting services, market share and total revenue from trauma admissions, return visits, discharged trauma alerts, and consultations. A total of 3,070 patients were identified by the trauma registry as meeting ICD-9 inclusion criteria. Trauma-associated DRGs accounted for 871 of the 3,070 admissions. The DRG-driven data set demonstrated an estimated profit of $800,000 dollars; the ICD-9 data set revealed an estimated 4.8 million dollar profit, increased our market share, and showed substantial revenue generated for other hospital service lines. Trauma DRGs fail to account for most trauma admissions. Financial data derived from DRG definitions significantly underestimate the trauma service line's financial contribution to hospital economics. Accurately identifying patients with trauma based on trauma database inclusion criteria better defines the business of trauma.

Development of a method for classification of hospitals based on results of the diagnosis-related groups and the principle of case-mix index.

Science.gov (United States)

Shelf, Louay

2016-08-18

This research used DRGs and CMI to adjust medical waste production through the calculation of DRGs and CMI scores. These scores were used to assess the performances of teaching hospitals in Damascus. The linear correlations between these scores and the annual amount of waste and DRGs values were studied. The differences between the daily waste generations before and after the adjustment process were determined. Accordingly, the highest values of DRGs and CMI Scores were for the pediatric and Al Assad hospitals respectively. Among the teaching hospitals in Damascus, Al Assad has achieved the highest performance. Based on the results, the accuracy and homogeneity of medical waste generation rates were improved, which in turn leads to continuous improvement in the management of medical wastes.

Benign thyroid disorders, radioiodine therapy and diagnosis related groups (DRGs): aspects of cost/benefit; Benigne Schilddruesenerkrankungen, Radioiodtherapie und Diagnosis Related Groups (DRGs): Kosten-Nutzen-Aspekte

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Dietlein, M.; Schicha, H. [Klinik und Poliklinik fuer Nuklearmedizin der Univ. zu Koeln (Germany)

2005-06-01

The increasing prevalence of goiter and thyroid nodules in older patients is accompanied by an increasing frequency of treatment and cost. Cost-effectiveness is given for programs of prophylaxis (primary prevention, e.g. alimentary iodine supplementation), for programs of screening (secondary prevention. e.g. TSH-screening), and for therapeutic strategies to avoid complications of thyroid dysfunction (atrial fibrillation, myocardial infarction, death for cardiac reasons) and to minimize iatrogenic complications (tertiary prevention). Examples of tertiary prevention are radioiodine-therapy of Graves' disease in patients who have an increased risk of relapse after antithyroid drugs (ATD), radioiodine therapy of ouvert or subclinical hyperthyroidism, and radioiodine therapy of large goiters in older patients or in patients suffering from a relevant co-morbidity. A cost-effectiveness-analysis for different therapeutic strategies of Graves' disease has been published using a lifelong time-horizon. The ablative radioiodine dose-regime is cost-effective as a first line therapy if the risk of relapse after ATD exceeds 60%. Cost-minimization-analysis, comparing resection of goiter and radioiodine, has shown lower cost of radioiodine therapy for toxic multinodular goiter up to 100 ml and for Graves' disease up to 60 ml goiter volume. Medical aspects (volume of goiter, uptake of nodules, regressive goiter, suspicion on malignancy, patients' age, co-morbidity, patients' decision) remain decisive for the choice of treatment. (orig.)

[Cardiovascular medicine in the German diagnosis-related group--(G-DRG) system 2005].

Science.gov (United States)

Fürstenberg, T; Bunzemeier, H; Roeder, N; Reinecke, H

2005-05-01

The German diagnosis-related Group (G-DRG) System has recently been published in its third version. From 2005 on, this system will be the definite measure for the budgets of nearly all german hospitals. The preliminary phase with no budget reduction or redistribution being made and in which an inappropriate classification system had no negative impact on reimbursement has, thus, come to an end. At present, many hospitals are struggling in an economic competition about the independence or maintenance of the hospital or several sub-departments. The changes in the classification system with regard to a marked increase in the number of G DRGs, a modified grouping-logic, more properly determined reductions and extra charges for low and high outlier as well as the introduction of further additional charges contribute thereby to a better covering of services and treatments of cardiovascular patients. However, while many of the known problems have been eliminated, there are still weaknesses in the G-DRG System even concerning cardiovascular medicine. The G-DRG System has to be adapted continuously with consultation of the clinical expertise of the respective medical societies. The most important new aspects and changes in the G-DRG System 2005 and the accompanied execution regulations are explained with special view on cardiology.

[Main results of the Swiss study on DRGs (Casemix Study)].

Science.gov (United States)

Casemix, E

1989-01-01

Sponsored by the Health Administrations of nine cantons, this study was conducted by the University Institute of Social and Preventive Medicine in Lausanne in order to assess how DRGs could be used within the Swiss context. A data base mainly provided by the Swiss VESKA statistics was used. The first step provided the transformation of Swiss diagnostic and intervention codes into US codes, allowing direct use of the Yale Grouper for DRG. The second step showed that the overall performance of DRG in terms of variability reduction of the length of stay was similar to the one observed in US; there are, however, problems when the homogeneity of medicotechnical procedures for DRG is considered. The third steps showed how DRG could be used as an account unit in hospital, and how costs per DRG could be estimated. Other examples of applications of DRG were examined, for example comparison of Casemix or length of stay between hospitals.

Patient-Centred Multidisciplinary Inpatient Care-Have Diagnosis-Related Groups an Effect on the Doctor-Patient Relationship and Patients' Motivation for Behavioural Change?

Science.gov (United States)

Romeyke, Tobias; Noehammer, Elisabeth; Ch Scheuer, Hans; Stummer, Harald

2016-10-01

The aim of this, the largest survey of patients performed to date, is to analyse the effects of diagnosis related groups (DRGs) on the doctor-patient relationship in the context of interdisciplinary patient-centered care. In addition, it is intended to investigate the possibility of motivating patients to change their behavioural patterns and lifestyle in the context of holistic therapy. Over a period of five years, a continuous survey was performed of hospitalised patients who were exercising their entitlement to interdisciplinary therapy in an acute, inpatient setting. The therapy was evaluated as good to very good both with and without the conditions of the case tariff fee system. Effects of the diagnosis related groups on the quality of the doctor-patient relationship could not be demonstrated (Mann-Whitney U test, p>0,05). A clear trend was evident in the influence on motivation to change behavioural patterns and lifestyle (Fisher's exact test, p=0,000). Studies of the effects of reimbursement systems in the context of interdisciplinary care are still in their infancy, despite the widespread use of diagnosis related groups. The mandatory character implicit in the case tariff fee system, which requires minimum qualitative standards for structural and procedural parameters in the context of providing interdisciplinary patient-centered care, can influence patients' behavioural patterns and lifestyle.

Evaluating performance of local case-mix system by international comparison: a case study in Beijing, China.

Science.gov (United States)

Jian, Wei-Yan; Lu, Ming; Cui, Tao; Hu, Mu

2011-01-01

Case-mix is an important tool for health planning and management in many countries. As a major developing country, China is considering the introduction of the case-mix system in the health reform. Beijing, the capital of China, developed a local case-mix version whose performance needs to be evaluated before utilization. The objective of this study was to evaluate the performance of the case-mix system developed in Beijing by comparing it with those used in Australia and the U.S.A. A total of 1.3 million inpatient records from 154 hospitals in Beijing in 2008 were grouped respectively using three case-mix systems: (i) Beijing Diagnosis Related Groups (BJ-DRGs); (ii) US-based All Patient DRGs; and (iii) Australian Refined DRGs. Coefficient of variation (CV) and reduction in variance (RIV) were used to measure the performance of DRGs system. The BJ-DRGs produced the best CV and RIV results for expenditure. However, at the level of Major Diagnostic Category (MDC), three MDCs of BJ-DRGs gave the poorest RIVs for both expenditure and length of stay. Although the performance of BJ-DRGs was acceptable, further revision and improvement is needed. Comparisons with other mature DRGs versions can assist in identifying the improvement priorities of the local version. Copyright © 2011 John Wiley & Sons, Ltd.

Evaluation of the performance of diagnosis-related groups and similar casemix systems: methodological issues.

Science.gov (United States)

Palmer, G; Reid, B

2001-05-01

With the increasing recognition and application of casemix for managing and financing healthcare resources, the evaluation of alternative versions of systems such as diagnosis-related groups (DRGs) has been afforded high priority by governments and researchers in many countries. Outside the United States, an important issue has been the perceived need to produce local versions, and to establish whether or not these perform more effectively than the US-based classifications. A discussion of casemix evaluation criteria highlights the large number of measures that may be used, the rationale and assumptions underlying each measure, and the problems in interpreting the results. A review of recent evaluation studies from a number of countries indicates that considerable emphasis has been placed on the predictive validity criterion, as measured by the R2 statistic. However, the interpretation of the findings has been affected greatly by the methods used, especially the treatment and definition of outlier cases. Furthermore, the extent to which other evaluation criteria have been addressed has varied widely. In the absence of minimum evaluation standards, it is not possible to draw clear-cut conclusions about the superiority of one version of a casemix system over another, the need for a local adaptation, or the further development of an existing version. Without the evidence provided by properly designed studies, policy-makers and managers may place undue reliance on subjective judgments and the views of the most influential, but not necessarily best informed, healthcare interest groups.

DRGs and Military Medicine: A Look at DRGs and Length of Stay.

Science.gov (United States)

1985-01-01

Medicine I Casemix 3 Diagnosis Related Groups 4 Utilization Review 7 Financial Analysis 7 Productivity 8 Sampling Frame for Quality Studies 9 AUTOGRP 9...posture is enhanced. CASEMIX Casemix is a term used to describe the degree of case complexity (level of care required) of specific diagnoses and the mix of...different diagnoses treated by an institution. The concept of casemix and its effect on resource consumption has been addressed at length

Casemix classification systems.

Science.gov (United States)

Fetter, R B

1999-01-01

The idea of using casemix classification to manage hospital services is not new, but has been limited by available technology. It was not until after the introduction of Medicare in the United States in 1965 that serious attempts were made to measure hospital production in order to contain spiralling costs. This resulted in a system of casemix classification known as diagnosis related groups (DRGs). This paper traces the development of DRGs and their evolution from the initial version to the All Patient Refined DRGs developed in 1991.

Effects of diagnosis-related group payment system on appendectomy outcomes.

Science.gov (United States)

Kim, Tae Hyun; Park, Eun-Cheol; Jang, Sung-In; Jang, Suk-Yong; Lee, Sang Ah; Choi, Jae Woo

2016-12-01

The voluntary diagnosis-related group (DRG) payment system was introduced in 2002. Since July 2013, the Korean government has mandated DRG participation for all hospitals. The main purpose of this study was to examine the effects of mandatory DRG participation on various outcome metrics for appendectomy patients. We collected inpatient DRG data for 280,062 appendectomy patients between 2007 and 2014 using the Health Insurance Review and Assessment database. We examined patient outcome metrics such as length of stay (LOS), total medical cost, spillover, and readmission rate, according to hospital size. As a result of DRG participation, the average LOS for patients decreased (adjusted ratio: 0.83 [large hospitals], 0.83 [small hospitals]; 95% confidence interval [CI]: 0.82-0.84, 0.82-0.84), the total medical costs of patients increased (adjusted ratio: 1.23 [large hospitals], 1.35 [small hospitals]; 95% CI: 1.22-1.24, 1.34-1.36), the spillover of patients increased (adjusted ratio: 2.10 [large hospitals], 2.30 [small hospitals]; 95% CI: 2.03-2.18, 2.16-2.45), and the readmission rates of appendectomy patients decreased (adjusted ratio: 0.85 [large hospitals], 0.49 [small hospitals]; 95% CI: 0.77-0.94, 0.42-0.57). The mandatory implementation of the DRG payment system in South Korea has led to significant reductions in LOS and readmission rates for appendectomy patients. However, any resulting expansion of outpatient services may result in unnecessary resource usage rather than improving medical quality. Policy makers should consider the various implications reflected by these results when considering DRGs for other diseases. Copyright © 2016 Elsevier Inc. All rights reserved.

An evaluation of a model for the systematic documentation of hospital based health promotion activities: results from a multicentre study

DEFF Research Database (Denmark)

Tønnesen, Hanne; Christensen, Mette E; Groene, Oliver

2007-01-01

The first step of handling health promotion (HP) in Diagnosis Related Groups (DRGs) is a systematic documentation and registration of the activities in the medical records. So far the possibility and tradition for systematic registration of clinical HP activities in the medical records and in pat......The first step of handling health promotion (HP) in Diagnosis Related Groups (DRGs) is a systematic documentation and registration of the activities in the medical records. So far the possibility and tradition for systematic registration of clinical HP activities in the medical records...

Effect of electroacupuncture on thermal pain threshold and expression of calcitonin-gene related peptide, substance P and γ-aminobutyric acid in the cervical dorsal root ganglion of rats with incisional neck pain.

Science.gov (United States)

Qiao, Li-Na; Liu, Jun-Ling; Tan, Lian-Hong; Yang, Hai-Long; Zhai, Xu; Yang, Yong-Sheng

2017-08-01

Acupuncture therapy effectively reduces post-surgical pain, but its mechanism of action remains unclear. The aim of this study was to investigate whether expression of γ-aminobutyric acid (GABA) and the neuropeptides substance P (SP) and calcitonin gene-related peptide (CGRP) in the primary sensory neurons of cervical dorsal root ganglia (DRG) are involved in electroacupuncture (EA)-induced analgesia in a rat model of incisional neck pain. The pain model was established by making a longitudinal midline neck incision in 60 rats. Another 15 rats underwent sham surgery (normal group). Post-incision, 15 rats remained untreated (model group) and 45 rats underwent EA (frequency 2/100 Hz, intensity 1 mA) at bilateral LI18, LI4-PC6 or ST36-GB34 (n=15 each) for 30 min at 4 hours, 24 hours, and 48 hours post-surgery, followed by thermal pain threshold (PT) measurement. 30 min later, the rats were euthanased and cervical (C3-6) DRGs removed for measurement of immunoreactivity and mRNA expression of SP/CGRP and the GABAergic neuronal marker glutamic acid decarboxylase 67 (GAD67). Thermal PT was significantly lower in the model group versus the normal group and increased in the LI18 and LI4-PC6 groups but not the ST36-GB34 group compared with the model group. Additionally, EA at LI18 and LI4-PC6 markedly suppressed neck incision-induced upregulation of mRNA/protein expression of SP/CGRP, and upregulated mRNA/protein expression of GAD67 in the DRGs of C3-6 segments. EA at LI18/LI4-PC6 increases PT in rats with incisional neck pain, which is likely related to downregulation of pronociceptive mediators SP/CGRP and upregulation of the inhibitory transmitter GABA in the primary sensory neurons of cervical DRGs. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Accuracy of the all patient refined diagnosis related groups classification system in congenital heart surgery.

Science.gov (United States)

Parnell, Aimee S; Shults, Justine; Gaynor, J William; Leonard, Mary B; Dai, Dingwei; Feudtner, Chris

2014-02-01

Administrative data are increasingly used to evaluate clinical outcomes and quality of care in pediatric congenital heart surgery (CHS) programs. Several published analyses of large pediatric administrative data sets have relied on the All Patient Refined Diagnosis Related Groups (APR-DRG, version 24) diagnostic classification system. The accuracy of this classification system for patients undergoing CHS is unclear. We performed a retrospective cohort study of all 14,098 patients 0 to 5 years of age undergoing any of six selected congenital heart operations, ranging in complexity from isolated closure of a ventricular septal defect to single-ventricle palliation, at 40 tertiary-care pediatric centers in the Pediatric Health Information Systems database between 2007 and 2010. Assigned APR-DRGs (cardiac versus noncardiac) were compared using χ2 or Fisher's exact tests between those patients admitted during the first day of life versus later and between those receiving extracorporeal membrane oxygenation support versus those not. Recursive partitioning was used to assess the greatest determinants of APR-DRG type in the model. Every patient admitted on day 1 of life was assigned to a noncardiac APR-DRG (pDRG (pDRG experienced a significantly increased mortality (pDRG coding has systematic misclassifications, which may result in inaccurate reporting of CHS case volumes and mortality. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Diagnosis-related group (DRG)-based case-mix funding system, a promising alternative for fee for service payment in China.

Science.gov (United States)

Zhao, Cuirong; Wang, Chao; Shen, Chengwu; Wang, Qian

2018-05-13

Fee for services (FFS) is the prevailing method of payment in most Chinese public hospitals. Under this retrospective payment system, medical care providers are paid based on medical services and tend to over-treat to maximize their income, thereby contributing to rising medical costs and uncontrollable health expenditures to a large extent. Payment reform needs to be promptly implemented to move to a prospective payment plan. The diagnosis-related group (DRG)-based case-mix payment system, with its superior efficiency and containment of costs, has garnered increased attention and it represents a promising alternative. This article briefly describes the DRG-based case-mix payment system, it comparatively analyzes differences between FFS and case-mix funding systems, and it describes the implementation of DRGs in China. China's social and economic conditions differ across regions, so establishment of a national payment standard will take time and involve difficulties. No single method of provider payment is perfect. Measures to monitor and minimize the negative ethical implications and unintended effects of a DRG-based case-mix payment system are essential to ensuring the lasting social benefits of payment reform in Chinese public hospitals.

Bilateral Neuropathy of Primary Sensory Neurons by the Chronic Compression of Multiple Unilateral DRGs

Directory of Open Access Journals (Sweden)

Ya-Bin Xie

2016-01-01

Full Text Available To mimic multilevel nerve root compression and intervertebral foramina stenosis in human, we established a new animal model of the chronic compression of unilateral multiple lumbar DRGs (mCCD in the rat. A higher occurrence of signs of spontaneous pain behaviors, such as wet-dog shaking and spontaneous hind paw shrinking behaviors, was firstly observed from day 1 onward. In the meantime, the unilateral mCCD rat exhibited significant bilateral hind paw mechanical and cold allodynia and hyperalgesia, as well as a thermal preference to 30°C plate between 30 and 35°C. The expression of activating transcription factor 3 (ATF3 was significantly increased in the ipsilateral and contralateral all-sized DRG neurons after the mCCD. And the expression of CGRP was significantly increased in the ipsilateral and contralateral large- and medium-sized DRG neurons. ATF3 and CGRP expressions correlated to evoked pain hypersensitivities such as mechanical and cold allodynia on postoperative day 1. The results suggested that bilateral neuropathy of primary sensory neurons might contribute to bilateral hypersensitivity in the mCCD rat.

The risk-adjusted vision beyond casemix (DRG) funding in Australia. International lessons in high complexity and capitation.

Science.gov (United States)

Antioch, Kathryn M; Walsh, Michael K

2004-06-01

Hospitals throughout the world using funding based on diagnosis-related groups (DRG) have incurred substantial budgetary deficits, despite high efficiency. We identify the limitations of DRG funding that lack risk (severity) adjustment for State-wide referral services. Methods to risk adjust DRGs are instructive. The average price in casemix funding in the Australian State of Victoria is policy based, not benchmarked. Average cost weights are too low for high-complexity DRGs relating to State-wide referral services such as heart and lung transplantation and trauma. Risk-adjusted specified grants (RASG) are required for five high-complexity respiratory, cardiology and stroke DRGs incurring annual deficits of $3.6 million due to high casemix complexity and government under-funding despite high efficiency. Five stepwise linear regressions for each DRG excluded non-significant variables and assessed heteroskedasticity and multicollinearlity. Cost per patient was the dependent variable. Significant independent variables were age, length-of-stay outliers, number of disease types, diagnoses, procedures and emergency status. Diagnosis and procedure severity markers were identified. The methodology and the work of the State-wide Risk Adjustment Working Group can facilitate risk adjustment of DRGs State-wide and for Treasury negotiations for expenditure growth. The Alfred Hospital previously negotiated RASG of $14 million over 5 years for three trauma and chronic DRGs. Some chronic diseases require risk-adjusted capitation funding models for Australian Health Maintenance Organizations as an alternative to casemix funding. The use of Diagnostic Cost Groups can facilitate State and Federal government reform via new population-based risk adjusted funding models that measure health need.

Hospital payment systems based on diagnosis-related groups: experiences in low- and middle-income countries

Science.gov (United States)

Wittenbecher, Friedrich

2013-01-01

Abstract Objective This paper provides a comprehensive overview of hospital payment systems based on diagnosis-related groups (DRGs) in low- and middle-income countries. It also explores design and implementation issues and the related challenges countries face. Methods A literature research for papers on DRG-based payment systems in low- and middle-income countries was conducted in English, French and Spanish through Pubmed, the Pan American Health Organization’s Regional Library of Medicine and Google. Findings Twelve low- and middle-income countries have DRG-based payment systems and another 17 are in the piloting or exploratory stage. Countries have chosen from a wide range of imported and self-developed DRG models and most have adapted such models to their specific contexts. All countries have set expenditure ceilings. In general, systems were piloted before being implemented. The need to meet certain requirements in terms of coding standardization, data availability and information technology made implementation difficult. Private sector providers have not been fully integrated, but most countries have managed to delink hospital financing from public finance budgeting. Conclusion Although more evidence on the impact of DRG-based payment systems is needed, our findings suggest that (i) the greater portion of health-care financing should be public rather than private; (ii) it is advisable to pilot systems first and to establish expenditure ceilings; (iii) countries that import an existing variant of a DRG-based system should be mindful of the need for adaptation; and (iv) countries should promote the cooperation of providers for appropriate data generation and claims management. PMID:24115798

Why and how did Israel adopt activity-based hospital payment? The Procedure-Related Group incremental reform.

Science.gov (United States)

Brammli-Greenberg, Shuli; Waitzberg, Ruth; Perman, Vadim; Gamzu, Ronni

2016-10-01

Historically, Israel paid its non-profit hospitals on a perdiem (PD) basis. Recently, like other OECD countries, Israel has moved to activity-based payments. While most countries have adopted a diagnostic related group (DRG) payment system, Israel has chosen a Procedure-Related Group (PRG) system. This differs from the DRG system because it classifies patients by procedure rather than diagnosis. In Israel, the PRG system was found to be more feasible given the lack of data and information needed in the DRG classification system. The Ministry of Health (MoH) chose a payment scheme that depends only on inhouse creation of PRG codes and costing, thus avoiding dependence on hospital data. The PRG tariffs are priced by a joint Health and Finance Ministry commission and updated periodically. Moreover, PRGs are believed to achieve the same main efficiency objectives as DRGs: increasing the volume of activity, shortening unnecessary hospitalization days, and reducing the gaps between the costs and prices of activities. The PRG system is being adopted through an incremental reform that started in 2002 and was accelerated in 2010. The Israeli MoH involved the main players in the hospital market in the consolidation of this potentially controversial reform in order to avoid opposition. The reform was implemented incrementally in order to preserve the balance of resource allocation and overall expenditures of the system, thus becoming budget neutral. Yet, as long as gaps remain between marginal costs and prices of procedures, PRGs will not attain all their objectives. Moreover, it is still crucial to refine PRG rates to reflect the severity of cases, in order to tackle incentives for selection of patients within each procedure. Copyright © 2016 The Author(s). Published by Elsevier Ireland Ltd.. All rights reserved.

Determining the effects of patient casemix on length of hospital stay: a proportional hazards frailty model approach.

Science.gov (United States)

Lee, A H; Yau, K K

2001-01-01

To identify factors associated with hospital length of stay (LOS) and to model variations in LOS within Diagnosis Related Groups (DRGs). A proportional hazards frailty modelling approach is proposed that accounts for patient transfers and the inherent correlation of patients clustered within hospitals. The investigation is based on patient discharge data extracted for a group of obstetrical DRGs. Application of the frailty approach has highlighted several significant factors after adjustment for patient casemix and random hospital effects. In particular, patients admitted for childbirth with private medical insurance coverage have higher risk of prolonged hospitalization compared to public patients. The determination of pertinent factors provides important information to hospital management and clinicians in assessing the risk of prolonged hospitalization. The analysis also enables the comparison of inter-hospital variations across adjacent DRGs.

Explaining resource consumption among non-normal neonates

Science.gov (United States)

Schwartz, Rachel M.; Michelman, Thomas; Pezzullo, John; Phibbs, Ciaran S.

1991-01-01

The adoption by Medicare in 1983 of prospective payment using diagnosis-related groups (DRGs) has stimulated research to develop case-mix grouping schemes that more accurately predict resource consumption by patients. In this article, the authors explore a new method designed to improve case-mix classification for newborns through the use of birth weight in combination with DRGs to adjust the unexplained case-mix severity. Although the findings are developmental in nature, they reveal that the model significantly improves our ability to explain resource use. PMID:10122360

ISSLS PRIZE IN BASIC SCIENCE 2018: Growth differentiation factor-6 attenuated pro-inflammatory molecular changes in the rabbit anular-puncture model and degenerated disc-induced pain generation in the rat xenograft radiculopathy model.

Science.gov (United States)

Miyazaki, Shingo; Diwan, Ashish D; Kato, Kenji; Cheng, Kevin; Bae, Won C; Sun, Yang; Yamada, Junichi; Muehleman, Carol; Lenz, Mary E; Inoue, Nozomu; Sah, Robert L; Kawakami, Mamoru; Masuda, Koichi

2018-04-01

To elucidate the effects of growth differentiation factor-6 (GDF6) on: (i) gene expression of inflammatory/pain-related molecules and structural integrity in the rabbit intervertebral disc (IVD) degeneration model, and (ii) sensory dysfunction and changes in pain-marker expression in dorsal nerve ganglia (DRGs) in the rat xenograft radiculopathy model. Forty-six adolescent rabbits received anular-puncture in two non-consecutive lumbar IVDs. Four weeks later, phosphate-buffered saline (PBS) or GDF6 (1, 10 or 100 µg) was injected into the nucleus pulposus (NP) of punctured discs and followed for 4 weeks for gene expression analysis and 12 weeks for structural analyses. For pain assessment, eight rabbits were sacrificed at 4 weeks post-injection and NP tissues of injected discs were transplanted onto L5 DRGs of 16 nude rats to examine mechanical allodynia. The rat DRGs were analyzed immunohistochemically. In GDF6-treated rabbit NPs, gene expressions of interleukin-6, tumor necrosis factor-α, vascular endothelial growth factor, prostaglandin-endoperoxide synthase 2, and nerve growth factor were significantly lower than those in the PBS group. GDF6 injections resulted in partial restoration of disc height and improvement of MRI disc degeneration grades with statistical significance in rabbit structural analyses. Allodynia induced by xenograft transplantation of rabbit degenerated NPs onto rat DRGs was significantly reduced by GDF6 injection. Staining intensities for ionized calcium-binding adaptor molecule-1 and calcitonin gene-related peptide in rat DRGs of the GDF6 group were significantly lower than those of the PBS group. GDF6 injection may change the pathological status of degenerative discs and attenuate degenerated IVD-induced pain.

Benign thyroid disorders, radioiodine therapy and diagnosis related groups (DRGs): aspects of cost/benefit

International Nuclear Information System (INIS)

Dietlein, M.; Schicha, H.

2005-01-01

The increasing prevalence of goiter and thyroid nodules in older patients is accompanied by an increasing frequency of treatment and cost. Cost-effectiveness is given for programs of prophylaxis (primary prevention, e.g. alimentary iodine supplementation), for programs of screening (secondary prevention. e.g. TSH-screening), and for therapeutic strategies to avoid complications of thyroid dysfunction (atrial fibrillation, myocardial infarction, death for cardiac reasons) and to minimize iatrogenic complications (tertiary prevention). Examples of tertiary prevention are radioiodine-therapy of Graves' disease in patients who have an increased risk of relapse after antithyroid drugs (ATD), radioiodine therapy of ouvert or subclinical hyperthyroidism, and radioiodine therapy of large goiters in older patients or in patients suffering from a relevant co-morbidity. A cost-effectiveness-analysis for different therapeutic strategies of Graves' disease has been published using a lifelong time-horizon. The ablative radioiodine dose-regime is cost-effective as a first line therapy if the risk of relapse after ATD exceeds 60%. Cost-minimization-analysis, comparing resection of goiter and radioiodine, has shown lower cost of radioiodine therapy for toxic multinodular goiter up to 100 ml and for Graves' disease up to 60 ml goiter volume. Medical aspects (volume of goiter, uptake of nodules, regressive goiter, suspicion on malignancy, patients' age, co-morbidity, patients' decision) remain decisive for the choice of treatment. (orig.)

[Diagnosis-related groups as an instrument to develop suitable case-based lump sums in hematology and oncology].

Science.gov (United States)

Thalheimer, Markus

2011-01-01

In 2003 a new reimbursement system was established for German hospitals. The approximately 17 million inpatient cases per year are now reimbursed based on a per-case payment regarding diagnoses and procedures, which was developed from an internationally approved system. The aim was a better conformity of costs and efforts in in-patient cases. In the first 2 years after implementation, the German diagnosis-related group (DRG) system was not able to adequately represent the complex structures of treatment in hematological and oncological in-patients. By creating new diagnoses and procedures (International Classification of Diseases 10 (ICD-10) and Surgical Operations and Procedures Classification System (OPS) catalogues), generating new DRGs and better splitting of existing ones, the hematology and oncology field could be much better described in the following years. The implementation of about 70 'co-payment structures' for new and expensive drugs and procedures in oncology was also crucial. To reimburse innovations, an additional system of co-payments for innovations was established to bridge the time until innovations are represented within the DRG system itself. In summary, hematological and oncological in-patients, including cases with extraordinary costs, are meanwhile well mapped in the German reimbursement system. Any tendencies to rationing could thereby be avoided, as most of the established procedures and costly drugs are adequately represented in the DRG system. Copyright © 2011 S. Karger AG, Basel.

[Changes to diagnosis-related groups in urology in 2007. Urology in the G-DRG-System 2007].

Science.gov (United States)

Wenke, A; Franz, D; Pühse, G; Hertle, L; Roeder, N

2008-02-01

The German DRG (dose-related groups) system is updated each year by the institution dealing with the remuneration in hospitals (InEK). Once again, the German Spcoety for Urology has supported the adjustment process in a constructive manner. Analysis of the changes and their implications is highly significant for urology. This article describes and discusses the main changes in the system for the specialty of urology insofar as they concern the structure of the DRG system and the catalogues of diagnoses (ICD) and of procedures (OPS). The 2007 edition of the DRG system leads to numerous changes for urology. There are new OPS codes for partial resection of the kidney, treatment of urinary incontinence and radical resection in the pelvis minor. Additional payment for implantation of a prosthetic penis is divided with reference to the type of prosthesis. At DRG level, new DRG splits are found depending on the PCCL and patient age. Combination operations on the bladder and bowel and on the male genitalia are assigned to newly established DRGs. The changes described enhance the professional accuracy of the representations of urological care provision. New strategies designed to solve problems in representation have been established (e.g. multi-step interventions). Various problems persist, e.g. those of operations on the penis (DRG M03Z) and the need for more finely defined representation of laser treatment in urology. In the short term practicable solutions to the problem of improving the quality of representation are needed.

Do diagnosis-related groups appropriately explain variations in costs and length of stay of hip replacement? A comparative assessment of DRG systems across 10 European countries.

Science.gov (United States)

Geissler, Alexander; Scheller-Kreinsen, David; Quentin, Wilm

2012-08-01

This paper assesses the variations in costs and length of stay for hip replacement cases in Austria, England, Estonia, Finland, France, Germany, Ireland, Poland, Spain and Sweden and examines the ability of national diagnosis-related group (DRG) systems to explain the variation in resource use against a set of patient characteristic and treatment specific variables. In total, 195,810 cases clustered in 712 hospitals were analyzed using OLS fixed effects models for cost data (n=125,698) and negative binominal models for length-of-stay data (n=70,112). The number of DRGs differs widely across the 10 European countries (range: 2-14). Underlying this wide range is a different use of classification variables, especially secondary diagnoses and treatment options are considered to a different extent. In six countries, a standard set of patient characteristics and treatment variables explain the variation in costs or length of stay better than the DRG variables. This raises questions about the adequacy of the countries' DRG system or the lack of specific criteria, which could be used as classification variables. Copyright © 2012 John Wiley & Sons, Ltd.

Performance evaluation of inpatient service in Beijing: a horizontal comparison with risk adjustment based on Diagnosis Related Groups.

Science.gov (United States)

Jian, Weiyan; Huang, Yinmin; Hu, Mu; Zhang, Xiumei

2009-04-30

The medical performance evaluation, which provides a basis for rational decision-making, is an important part of medical service research. Current progress with health services reform in China is far from satisfactory, without sufficient regulation. To achieve better progress, an effective tool for evaluating medical performance needs to be established. In view of this, this study attempted to develop such a tool appropriate for the Chinese context. Data was collected from the front pages of medical records (FPMR) of all large general public hospitals (21 hospitals) in the third and fourth quarter of 2007. Locally developed Diagnosis Related Groups (DRGs) were introduced as a tool for risk adjustment and performance evaluation indicators were established: Charge Efficiency Index (CEI), Time Efficiency Index (TEI) and inpatient mortality of low-risk group cases (IMLRG), to reflect respectively work efficiency and medical service quality. Using these indicators, the inpatient services' performance was horizontally compared among hospitals. Case-mix Index (CMI) was used to adjust efficiency indices and then produce adjusted CEI (aCEI) and adjusted TEI (aTEI). Poisson distribution analysis was used to test the statistical significance of the IMLRG differences between different hospitals. Using the aCEI, aTEI and IMLRG scores for the 21 hospitals, Hospital A and C had relatively good overall performance because their medical charges were lower, LOS shorter and IMLRG smaller. The performance of Hospital P and Q was the worst due to their relatively high charge level, long LOS and high IMLRG. Various performance problems also existed in the other hospitals. It is possible to develop an accurate and easy to run performance evaluation system using Case-Mix as the tool for risk adjustment, choosing indicators close to consumers and managers, and utilizing routine report forms as the basic information source. To keep such a system running effectively, it is necessary to

32 CFR 199.10 - Appeal and hearing procedures.

Science.gov (United States)

2010-07-01

... diagnosis-related groups (DRGs), or the methodology for the classification of inpatient discharges within... discharges within each DRG, since each of these is established by this part. (iv) Certain other issues on the...

Research of Medical Expenditure among Inpatients with Unstable Angina Pectoris in a Single Center.

Science.gov (United States)

Wu, Suo-Wei; Pan, Qi; Chen, Tong; Wei, Liang-Yu; Xuan, Yong; Wang, Qin; Li, Chao; Song, Jing-Chen

2017-07-05

With the rising incidence as well as the medical expenditure among patients with unstable angina pectoris, the research aimed to investigate the inpatient medical expenditure through the combination of diagnosis-related groups (DRGs) among patients with unstable angina pectoris in a Grade A tertiary hospital to conduct the referential standards of medical costs for the diagnosis. Single-factor analysis and multiple linear stepwise regression method were used to investigate 3933 cases between 2014 and 2016 in Beijing Hospital (China) whose main diagnosis was defined as unstable angina pectoris to determine the main factors influencing the inpatient medical expenditure, and decision tree method was adopted to establish the model of DRGs grouping combinations. The major influential factors of inpatient medical expenditure included age, operative method, therapeutic effects as well as comorbidity and complications (CCs) of the disease, and the 3933 cases were divided into ten DRGs by four factors: age, CCs, therapeutic effects, and the type of surgery with corresponding inpatient medical expenditure standards setup. Data of nonparametric test on medical costs among different groups were all significant (P angina pectoris is conducive in standardizing the diagnosis and treatment behaviors of the hospital and reducing economic burdens among patients.

"Bending the cost curve" in gastroenterology.

Science.gov (United States)

Slattery, E; Harewood, G C; Murray, F; Patchett, S

2013-12-01

Increasing attention is being focused on reigning in escalating costs of healthcare, i.e. trying to 'bend the cost curve'. In gastroenterology (GI), inpatient hospital care represents a major component of overall costs. This study aimed to characterize the trend in cost of care for GI-related hospitalizations in recent years and to identify the most costly diagnostic groups. All hospital inpatients admitted between January 2008 and December 2009 with a primary diagnosis of one of the six most common GI-related Diagnosis Related Groups (DRGs) in this hospital system were identified; all DRGs contained at least 40 patients during the study period. Patient Level Costing (PLC) was used to express the total cost of hospital care for each patient; PLC comprised a weighted daily bed cost plus cost of all medical services provided (e.g., radiology, pathology tests) calculated according to an activity-based costing approach; cost of medications were excluded. All costs were discounted to 2009 values. Mean length of stay (LOS) was also calculated for each DRG. Over 2 years, 470 patients were admitted with one of the six most common GI DRGs. Mean cost of care increased from 2008 to 2009 for all six DRGs with the steepest increases seen in 'GI hemorrhage (non-complex)' (31 % increase) and 'Cirrhosis/Alcoholic hepatitis (non-complex)' (45 % increase). No differences in readmission rates were observed over time. There was a strong correlation between year-to-year change in costs and change in mean LOS, r = 0.93. The cost of GI-related inpatient care appears to be increasing in recent years with the steepest increases observed in non-complex GI hemorrhage and non-complex Cirrhosis/Alcoholic hepatitis. Efforts to control the increasing costs should focus on these diagnostic categories.

Effects of electroacupuncture at 2 and 100 Hz on rat type 2 diabetic neuropathic pain and hyperalgesia-related protein expression in the dorsal root ganglion.

Science.gov (United States)

He, Xiao-Fen; Wei, Jun-Jun; Shou, Sheng-Yun; Fang, Jian-Qiao; Jiang, Yong-Liang

To investigate the analgesic effects of electroacupuncture (EA) at 2 and 100 Hz on type 2 diabetic neuropathic pain (DNP) and on the expressions of the P2X3 receptor and calcitonin gene-related peptide (CGRP) in the dorsal root ganglion (DRG). Rat type 2 DNP was induced by a high calorie and high sugar diet fed for 7 weeks, plus a single intraperitoneal injection of streptozotocin (STZ) after 5 weeks. EA at 2 and 100 Hz was carried out once every day after 7 weeks for 7 consecutive days. Body weight, serum fasting insulin (FINS), fasting blood glucose (FBG), insulin sensitivity index (ISI), and paw withdrawal latency (PWL) were measured. The expressions of L4-L6 DRG P2X3 receptors and CGRP were assessed by immunofluorescence. Type 2 DNP was successfully induced as shown by the increased body weight, FINS, and FBG, as well as the reduced ISI and PWL. Expressions of P2X3 receptors and CGRP in L4-L6 DRGs increased. EA at both 2 and 100 Hz relieved type 2 DNP, but the analgesic effect of EA was stronger at 2 Hz. P2X3 receptor expression decreased in L4-L6 DRGs following EA at 2 Hz and in L5 and L6 DRGs following EA at 100 Hz. EA at both 2 and 100 Hz down-regulated CGRP overexpression in L4-L6 DRGs. These findings indicate that EA at 2 Hz is a good option for the management of type 2 DNP. The EA effect may be related to its down-regulation of the overexpressions of the DRG P2X3 receptors and CGRP in this condition.

[Seasonal distribution of clinical case codes (DOC study)].

Science.gov (United States)

von Dercks, N; Melz, R; Hepp, P; Theopold, J; Marquass, B; Josten, C

2017-02-01

The German diagnosis-related groups remuneration system (G-DRG) was implemented in 2004 and patient-related diagnoses and procedures lead to allocation to specific DRGs. This system includes several codes, such as case mix (CM), case mix index (CMI) and number of cases. Seasonal distribution of these codes as well as distribution of diagnoses and DRGs may lead to logistical consequences for clinical management. From 2004 to 2013 all the main diagnoses and DRGs for inpatients were recorded. Monthly and seasonal distributions were analyzed using ANOVA. The average monthly number of cases was 265 ± 25 cases, the average CM was 388.50 ± 51.75 and the average CMI was 1.46 ± 0.15 with no significant seasonal differences (p > 0.1). Concussion was the most frequently occurring main diagnosis (3739 cases) followed by fractures of the humeral head (699). Significant distribution differences could be shown for humeral head fractures in monthly (p = 0.018) and seasonal comparisons (p = 0.006) with a maximum in winter. Radius (p = 0.01) and ankle fractures (p ≤ 0.001) also occurred most frequently in winter. Non-bony lesions of the shoulder were significantly less in spring (p = 0.04). The DRGs showed no evidence of a monthly or seasonal clustering (p > 0.1). The significant clustering of injuries in specific months and seasons should lead to logistic consequences (e.g. operating room slots, availability of nursing and anesthesia staff). For a needs assessment the analysis of main diagnoses is more appropriate than DRGs.

A Study to Develop a Model for the Allocation of Medical Supply Funds to the Various Clinical Services at Keller Army Community Hospital Based Upon Inpatient Weighted Units and Ambulatory Weighted Units

Science.gov (United States)

1989-05-11

zDiagnosis Related Groups (DRGs), as developed by ther Mz researchers at Yale University in the late 1960s, were a m mmeans of classifying patients by...the group’s recalibration of the Rickard 19 ambulatory portion of the HCU was most important. This was because it resulted in, "an ambulatory

75 FR 60417 - Proposed Collection; Comment Request

Science.gov (United States)

2010-09-30

...-related groups (DRGs). The CHAMPUS DRG-based payment system, except for children's hospitals (whose.../CHAMPUS DRG-based payment system is modeled on the Medicare Prospective Payment System (PPS) and was... instructions for submitting comments. Mail: Federal Docket Management System Office, 1160 Defense Pentagon...

Physical properties of distant red galaxies in the COSMOS/UltraVISTA field

Science.gov (United States)

Ma, Zhongyang; Fang, Guanwen; Kong, Xu; Fan, Lulu

2015-10-01

We present a study on physical properties for a large distant red galaxy (DRG) sample, using the K-selected multi-band photometry catalog of the COSMOS/UltraVISTA field and the CANDELS near-infrared data. Our sample includes 4485 DRGs with (J - K)AB > 1.16 and KAB DRG morphology are consistent with our rest-frame UVJ color classification; quiescent DRGs are generally compact while star-forming DRGs tend to have extended structures. We find the star formation rate (SFR) and the stellar mass of star-forming DRGs present tight "main sequence" relations in all redshift bins. Moreover, the specific SFR (sSFR) of DRGs increases with redshift in all stellar mass bins and DRGs with higher stellar masses generally have lower sSFRs, which indicates that galaxies were much more active on average in the past, and star formation contributes more to the mass growth of low-mass galaxies than to high-mass galaxies. The infrared-derived SFR dominates the total SFR of DRGs which occupy the high-mass range, implying that the J - K color criterion effectively selects massive and dusty galaxies. DRGs with higher M* generally have redder (U - V)rest colors, and the (U - V)rest colors of DRGs become bluer at higher redshifts, suggesting high-mass galaxies have higher internal dust extinctions or older stellar ages and they evolve with time. Finally, we find that DRGs have different overlap among extremely red objects, BzK galaxies, IRAC-selected extremely red objects, and high-z ultraluminous infrared galaxies, indicating that DRGs are not a special population and they can also be selected by other color criteria.

Specialty-specific admission: a cost-effective intervention?

LENUS (Irish Health Repository)

Slattery, E

2012-02-01

INTRODUCTION: Cost effectiveness of healthcare has become an important component in its delivery. Current practices need to be assessed and measured for variations that may lead to financial savings. Speciality specific admission is known not only to lead improved clinical outcomes but also to lead important cost reductions. METHODS: All patients admitted to an Irish teaching hospital via the emergency department over a 2-year period with a gastroenterology (GI) related illness were included in this analysis.GI illness was classified using the Disease related grouping (DRG) system. Mean length of stay (LOS) and patient level costing (PLC) were calculated. Differences between DRGs with respect to speciality (i.e. specialist vs. non-specialist) were calculated for the five commonest DRGs. RESULTS: Significant variations in LOS and PLC were demonstrated in the DRGs. Mean LOS varied with increasing complexity, from 3.2 days for non-complex GI haemorrhage to 14.4 days for complex alcohol related cirrhosis as expected. A substantial difference in LOS within DRG groups was demonstrated by large standard deviations in the mean (up to 8.1 days in some groups) and was independent of complexity of cases. PLC also varied widely in both complex and non-complex cases with standard deviations of up to 17,342 noted. Specialty-specific admission was associated with shorter LOS for most GI admissions. CONCLUSION: Significant disparity exists for both LOS and PLC for most GI diagnoses. Specialty-specific admissions are associated with reduced LOS. Specialty-specific admission would appear to be cost-effective which may also lead to improved clinical outcomes.

[Evaluation of the appropriateness of hospital admissions using the iso-gravity classification systems APR-DRG and Disease Staging and the Italian version of Appropriateness Evaluation Protocol (AEP)].

Science.gov (United States)

D'Andrea, G; Capalbo, G; Volpe, M; Marchetti, M; Vicentini, F; Capelli, G; Cambieri, A; Cicchetti, A; Ricciardi, G; Catananti, C

2006-01-01

Our main purpose was to evaluate the organizational appropriateness of admissions made in a university hospital, by comparing two iso-gravity classification systems, APR-DRG and Disease Staging, with the Italian version of AEP (PRUO). Our analysis focused on admissions made in 2001, related to specific Diagnosis Related Groups (DRGs), which, according an Italian Law, would be considered at high risk of inappropriateness, if treated as ordinary admissions. The results obtained by using the 2 classification systems did not show statistically significant differences with respect to the total number of admissions. On the other hand, some DRGs showed statistically significant differences due to different algorithms of attribution of the severity levels used by the two systems. For almost all of the DRGs studied, the AEP-based analysis of a sample of medical records showed an higher number of inappropriate admissions in comparison with the number expected by iso-gravity classification methods. The difference is possibly due to the percentage limits of tolerability fixed by the Law for each DRG. Therefore, the authors suggest an integrated use of the two methods to evaluate organizational appropriateness of hospital admissions.

Impact of case type, length of stay, institution type, and comorbidities on Medicare diagnosis-related group reimbursement for adult spinal deformity surgery.

Science.gov (United States)

Nunley, Pierce D; Mundis, Gregory M; Fessler, Richard G; Park, Paul; Zavatsky, Joseph M; Uribe, Juan S; Eastlack, Robert K; Chou, Dean; Wang, Michael Y; Anand, Neel; Frank, Kelly A; Stone, Marcus B; Kanter, Adam S; Shaffrey, Christopher I; Mummaneni, Praveen V

2017-12-01

OBJECTIVE The aim of this study was to educate medical professionals about potential financial impacts of improper diagnosis-related group (DRG) coding in adult spinal deformity (ASD) surgery. METHODS Medicare's Inpatient Prospective Payment System PC Pricer database was used to collect 2015 reimbursement data for ASD procedures from 12 hospitals. Case type, hospital type/location, number of operative levels, proper coding, length of stay, and complications/comorbidities (CCs) were analyzed for effects on reimbursement. DRGs were used to categorize cases into 3 types: 1) anterior or posterior only fusion, 2) anterior fusion with posterior percutaneous fixation with no dorsal fusion, and 3) combined anterior and posterior fixation and fusion. RESULTS Pooling institutions, cases were reimbursed the same for single-level and multilevel ASD surgery. Longer stay, from 3 to 8 days, resulted in an additional $1400 per stay. Posterior fusion was an additional $6588, while CCs increased reimbursement by approximately $13,000. Academic institutions received higher reimbursement than private institutions, i.e., approximately $14,000 (Case Types 1 and 2) and approximately $16,000 (Case Type 3). Urban institutions received higher reimbursement than suburban institutions, i.e., approximately $3000 (Case Types 1 and 2) and approximately $3500 (Case Type 3). Longer stay, from 3 to 8 days, increased reimbursement between $208 and $494 for private institutions and between $1397 and $1879 for academic institutions per stay. CONCLUSIONS Reimbursement is based on many factors not controlled by surgeons or hospitals, but proper DRG coding can significantly impact the financial health of hospitals and availability of quality patient care.

Health care information systems and formula-based reimbursement: an empirical study.

Science.gov (United States)

Palley, M A; Conger, S

1995-01-01

Current initiatives in health care administration use formula-based approaches to reimbursement. Examples of such approaches include capitation and diagnosis related groups (DRGs). These approaches seek to contain medical costs and to facilitate managerial control over scarce health care resources. This article considers various characteristics of formula-based reimbursement, their operationalization on hospital information systems, and how these relate to hospital compliance costs.

When are emotions related to group-based appraisals? A comparison between group-based emotions and general group emotions.

Science.gov (United States)

Kuppens, Toon; Yzerbyt, Vincent Y

2014-12-01

In the literature on emotions in intergroup relations, it is not always clear how exactly emotions are group-related. Here, we distinguish between emotions that involve appraisals of immediate group concerns (i.e., group-based emotions) and emotions that do not. Recently, general group emotions, measured by asking people how they feel "as a group member" but without specifying an object for these emotions, have been conceptualized as reflecting appraisals of group concerns. In contrast, we propose that general group emotions are best seen as emotions about belonging to a group. In two studies, general group emotions were closely related to emotions that are explicitly measured as belonging emotions. Two further studies showed that general group emotions were not related to appraisals of immediate group concerns, whereas group-based emotions were. We argue for more specificity regarding the group-level aspects of emotion that are tapped by emotion measures. © 2014 by the Society for Personality and Social Psychology, Inc.

Function-based payment model for inpatient medical rehabilitation: an evaluation.

Science.gov (United States)

Sutton, J P; DeJong, G; Wilkerson, D

1996-07-01

To describe the components of a function-based prospective payment model for inpatient medical rehabilitation that parallels diagnosis-related groups (DRGs), to evaluate this model in relation to stakeholder objectives, and to detail the components of a quality of care incentive program that, when combined with this payment model, creates an incentive for provides to maximize functional outcomes. This article describes a conceptual model, involving no data collection or data synthesis. The basic payment model described parallels DRGs. Information on the potential impact of this model on medical rehabilitation is gleaned from the literature evaluating the impact of DRGs. The conceptual model described is evaluated against the results of a Delphi Survey of rehabilitation providers, consumers, policymakers, and researchers previously conducted by members of the research team. The major shortcoming of a function-based prospective payment model for inpatient medical rehabilitation is that it contains no inherent incentive to maximize functional outcomes. Linkage of reimbursement to outcomes, however, by withholding a fixed proportion of the standard FRG payment amount, placing that amount in a "quality of care" pool, and distributing that pool annually among providers whose predesignated, facility-level, case-mix-adjusted outcomes are attained, may be one strategy for maximizing outcome goals.

What can we learn from international comparisons of costs by DRG?

Science.gov (United States)

Pirson, M; Schenker, L; Martins, D; Dung, Duong; Chalé, J J; Leclercq, P

2013-02-01

The objective of this study was to compare costs data by diagnosis related group (DRG) between Belgium and Switzerland. Our hypotheses were that differences between countries can probably be explained by methodological differences in cost calculations, by differences in medical practices and by differences in cost structures within the two countries. Classifications of DRG used in the two countries differ (AP-DRGs version 1.7 in Switzerland and APR-DRGs version 15.0 in Belgium). The first step of this study was to transform Belgian summaries into Swiss AP-DRGs. Belgian and Swiss data were calculated with a clinical costing methodology (full costing). Belgian and Swiss costs were converted into US$ PPP (purchasing power parity) in order to neutralize differences in purchasing power between countries. The results of this study showed higher costs in Switzerland despite standardization of cost data according to PPP. The difference is not explained by the case-mix index because this was similar for inliers between the two countries. The length of stay (LOS) was also quite similar for inliers between the two countries. The case-mix index was, however, higher for high outliers in Belgium, as reflected in a higher LOS for these patients. Higher costs in Switzerland are thus probably explained mainly by the higher number of agency staff by service in this country or because of differences in medical practices. It is possible to make international comparisons but only if there is standardization of the case-mix between countries and only if comparable accountancy methodologies are used. Harmonization of DRGs groups, nomenclature and accountancy is thus required.

42 CFR 412.503 - Definitions.

Science.gov (United States)

2010-10-01

... through September 30. LTC-DRG stands for the diagnosis-related group used to classify patient discharges... on or after October 1, 2007, are classified by a severity-adjusted patient classification system, the MS-LTC-DRGs. Any reference to the term “LTC-DRG” shall be considered a reference to the term “MS-LTC...

Planning for subacute care: predicting demand using acute activity data.

Science.gov (United States)

Green, Janette P; McNamee, Jennifer P; Kobel, Conrad; Seraji, Md Habibur R; Lawrence, Suanne J

2016-01-01

Objective The aim of the present study was to develop a robust model that uses the concept of 'rehabilitation-sensitive' Diagnosis Related Groups (DRGs) in predicting demand for rehabilitation and geriatric evaluation and management (GEM) care following acute in-patient episodes provided in Australian hospitals. Methods The model was developed using statistical analyses of national datasets, informed by a panel of expert clinicians and jurisdictional advice. Logistic regression analysis was undertaken using acute in-patient data, published national hospital statistics and data from the Australasian Rehabilitation Outcomes Centre. Results The predictive model comprises tables of probabilities that patients will require rehabilitation or GEM care after an acute episode, with columns defined by age group and rows defined by grouped Australian Refined (AR)-DRGs. Conclusions The existing concept of rehabilitation-sensitive DRGs was revised and extended. When applied to national data, the model provided a conservative estimate of 83% of the activity actually provided. An example demonstrates the application of the model for service planning. What is known about the topic? Health service planning is core business for jurisdictions and local areas. With populations ageing and an acknowledgement of the underservicing of subacute care, it is timely to find improved methods of estimating demand for this type of care. Traditionally, age-sex standardised utilisation rates for individual DRGs have been applied to Australian Bureau of Statistics (ABS) population projections to predict the future need for subacute services. Improved predictions became possible when some AR-DRGs were designated 'rehabilitation-sensitive'. This improved methodology has been used in several Australian jurisdictions. What does this paper add? This paper presents a new tool, or model, to predict demand for rehabilitation and GEM services based on in-patient acute activity. In this model, the

When are emotions related to group-based appraisals? : A comparison between group-based emotions and general group emotions

NARCIS (Netherlands)

Kuppens, Toon; Yzerbyt, Vincent Y.

2014-01-01

In the literature on emotions in intergroup relations, it is not always clear how exactly emotions are group-related. Here, we distinguish between emotions that involve appraisals of immediate group concerns (i.e., group-based emotions) and emotions that do not. Recently, general group emotions,

Potential loss of revenue due to errors in clinical coding during the implementation of the Malaysia diagnosis related group (MY-DRG®) Casemix system in a teaching hospital in Malaysia.

Science.gov (United States)

Zafirah, S A; Nur, Amrizal Muhammad; Puteh, Sharifa Ezat Wan; Aljunid, Syed Mohamed

2018-01-25

The accuracy of clinical coding is crucial in the assignment of Diagnosis Related Groups (DRGs) codes, especially if the hospital is using Casemix System as a tool for resource allocations and efficiency monitoring. The aim of this study was to estimate the potential loss of income due to an error in clinical coding during the implementation of the Malaysia Diagnosis Related Group (MY-DRG ® ) Casemix System in a teaching hospital in Malaysia. Four hundred and sixty-four (464) coded medical records were selected, re-examined and re-coded by an independent senior coder (ISC). This ISC re-examined and re-coded the error code that was originally entered by the hospital coders. The pre- and post-coding results were compared, and if there was any disagreement, the codes by the ISC were considered the accurate codes. The cases were then re-grouped using a MY-DRG ® grouper to assess and compare the changes in the DRG assignment and the hospital tariff assignment. The outcomes were then verified by a casemix expert. Coding errors were found in 89.4% (415/424) of the selected patient medical records. Coding errors in secondary diagnoses were the highest, at 81.3% (377/464), followed by secondary procedures at 58.2% (270/464), principal procedures of 50.9% (236/464) and primary diagnoses at 49.8% (231/464), respectively. The coding errors resulted in the assignment of different MY-DRG ® codes in 74.0% (307/415) of the cases. From this result, 52.1% (160/307) of the cases had a lower assigned hospital tariff. In total, the potential loss of income due to changes in the assignment of the MY-DRG ® code was RM654,303.91. The quality of coding is a crucial aspect in implementing casemix systems. Intensive re-training and the close monitoring of coder performance in the hospital should be performed to prevent the potential loss of hospital income.

[Financing of inpatient orthopedics and trauma surgery in the G-DRG system 2010].

Science.gov (United States)

Franz, D; Schemmann, F; Roeder, N; Mahlke, L

2010-08-01

The German DRG (diagnosis-related groups) system forms the basis for billing inpatient hospital services. It includes not only the case groups (G-DRGs), but also additional and innovation payments. This paper analyzes and evaluates the relevant developments of the G-DRG System 2010 for orthopedics and traumatology from the medical and classification perspectives. Analyses of relevant diagnoses, medical procedures and G-DRGs in the versions 2009 and 2010 based on the publications of the German DRG institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI) were carried out. The DRG catalog is has grown from 8 to 1,200 G-DRGs. A number of codes for surgical measures have been newly established or modified. Here, the identification and the correct and performance-based mapping of complex and elaborate scenarios was again the focus of the restructuring of the G-DRG system. The G-DRG structure in orthopedics and traumatology has been changed, especially in the areas of spinal surgery and surgery of the upper and lower extremities. The actual impact of the changes may vary depending on the individual hospital services. For the first time since the introduction of the G-DRG system, the pure numerical changes at the level of DRGs themselves are so marginal that only part of the DRG users in the hospitals will register them. The changes implemented not only a high selectivity between complex and less complex scenarios, but partly also unintended and unjustified revaluation of less complex measures. The G-DRG system has gained complexity again. Especially the G-DRG allocation of spinal surgery and multiple surgical interventions of the upper and/or lower extremities have reached such a complexity that only a few DRG users can follow them.

Investigating DRG cost weights for hospitals in middle income countries.

Science.gov (United States)

Ghaffari, Shahram; Doran, Christopher; Wilson, Andrew; Aisbett, Chris; Jackson, Terri

2009-01-01

Identifying the cost of hospital outputs, particularly acute inpatients measured by Diagnosis Related Groups (DRGs), is an important component of casemix implementation. Measuring the relative costliness of specific DRGs is useful for a wide range of policy and planning applications. Estimating the relative use of resources per DRG can be done through different costing approaches depending on availability of information and time and budget. This study aims to guide costing efforts in Iran and other countries in the region that are pursuing casemix funding, through identifying the main issues facing cost finding approaches and introducing the costing models compatible with their hospitals accounting and management structures. The results show that inadequate financial and utilisation information at the patient's level, poorly computerized 'feeder systems'; and low quality data make it impossible to estimate reliable DRGs costs through clinical costing. A cost modelling approach estimates the average cost of 2.723 million Rials (Iranian Currency) per DRG. Using standard linear regression, a coefficient of 0.14 (CI = 0.12-0.16) suggests that the average cost weight increases by 14% for every one-day increase in average length of stay (LOS).We concluded that calculation of DRG cost weights (CWs) using Australian service weights provides a sensible starting place for DRG-based hospital management; but restructuring hospital accounting systems, designing computerized feeder systems, using appropriate software, and development of national service weights that reflect local practice patterns will enhance the accuracy of DRG CWs.

Morphological evaluation of lumbar dorsal root ganglion on three-dimensional magnetic resonance imaging

International Nuclear Information System (INIS)

Shen Jun; Chen Jianyu; Zhou Cuiping; Liang Biling; Xu Xiaomao

2007-01-01

, the lumbar DRGs locate more proximally and have relatively larger sizes. (authors)

Group & Intergroup Relations in Living Human Systems.

Science.gov (United States)

1980-06-01

organizational diagnosis , the group is itself a living human system. A group may be underbounded, overbounded, or optimally bounded. The state of group...very im- portant to understand and to use in order to conduct organizational diagnosis " using group methods. 2 -43 (Alderfer, 1977b). The group...Boundary Relations and Organizational Diagnosis . In H. Meltzer and F.W. Wickert (eds.) Humanizing Organizational Behavior. Springfield, Illinois: Thomas

The group-as-a-whole-object relations model of group psychotherapy.

Science.gov (United States)

Rosen, D; Stukenberg, K W; Saeks, S

2001-01-01

The authors review the theoretical basis of group psychotherapy performed at The Menninger Clinic and demonstrate how the theory has been put into practice on two different types of inpatient units. The fundamental elements of the theory and practice used can be traced to object relations theory as originally proposed by Melanie Klein. Her work with individuals was directly applied to working with groups by Ezriel and Bion, who focused on interpreting group tension. More modern approaches have reintegrated working with individual concerns while also attending to the group-as-a-whole. Historically, these principles have been applied to long-term group treatment. The authors apply the concepts from the group-as-a-whole literature to short- and medium-length inpatient groups with open membership. They offer clinical examples of the application of these principles in short-term inpatient settings in groups with open membership.

[Comparison of pedicle and free tissue transfers in the German DRG system].

Science.gov (United States)

Lotter, O; Stahl, S; Hohenstein, C; Schaller, H-E; Jaminet, P

2011-12-01

Diagnosis-Related Groups (DRGs) are a patient classification system grouping related types of patients to the resources they have consumed. In this analysis, we compared pedicle and free flaps in plastic and reconstructive surgery in the actual German DRG system. After grouping common flaps while systematically modifying the diagnosis, the operative procedure(s), and the receptor site, reimbursement and thresholds of length of stay were identified. The mean value of the average length of stay was higher in free flaps as compared to pedicle flaps (15 vs. 9 days) and the mean reimbursement in free flaps was almost twice as high as in pedicle flaps (8 936 € vs. 4 582 €). Regarding the diagnosis, third-grade open fractures in pedicle flaps and full-thickness burns in free flaps are in the vanguard of reimbursement. Higher DRG conformity is generally found with free flaps. Different possibilities in coding the procedures and the strong dependence on the underlying diagnosis lead to variations of remuneration and length of stay, which are not explainable and sometimes even seem paradoxical. Furthermore, mixed calculation creates DRGs that lose the ability to describe the real effort. © Georg Thieme Verlag KG Stuttgart · New York.

Casemix reimbursement: a Singapore Children's Hospital perspective.

Science.gov (United States)

Yoong, S L

2001-07-01

Casemix reimbursement was introduced to Singapore in October 1999 using the Australian National Diagnosis Related Groups Version 3.1 (AN-DRGs 3.1). The possible impact of this classification system on a Singapore Children's Hospital is discussed. Data on paediatric patients in KK Women's and Children's Hospital (KKH) were drawn from the inhouse Datamart warehouse system, and reviewed with regards to volume of patients, length of stay and charges. Several high cost categories were selected for a more in-depth review and discussed. The classification system and reimbursement method did not take into account the higher cost of treating children, thus penalising the Children's Hospital. The wide variety of cases treated also gave rise to difficulty in obtaining appropriate reimbursement. The lack of severity of illness measures was a drawback in the Diagnosis Related Group (DRG) for ventilated patients. The lack of outcome measures gave rise to potentially inequitable reimbursement in some high cost neonatal DRGs. While Casemix is an improvement over previous methods of providing Government funding in Singapore, particular aspects need to be reviewed, and reimbursement criteria refined to ensure equitable funding to Children's Hospital.

Absolute and Relative Socioeconomic Health Inequalities across Age Groups.

Science.gov (United States)

van Zon, Sander K R; Bültmann, Ute; Mendes de Leon, Carlos F; Reijneveld, Sijmen A

2015-01-01

The magnitude of socioeconomic health inequalities differs across age groups. It is less clear whether socioeconomic health inequalities differ across age groups by other factors that are known to affect the relation between socioeconomic position and health, like the indicator of socioeconomic position, the health outcome, gender, and as to whether socioeconomic health inequalities are measured in absolute or in relative terms. The aim is to investigate whether absolute and relative socioeconomic health inequalities differ across age groups by indicator of socioeconomic position, health outcome and gender. The study sample was derived from the baseline measurement of the LifeLines Cohort Study and consisted of 95,432 participants. Socioeconomic position was measured as educational level and household income. Physical and mental health were measured with the RAND-36. Age concerned eleven 5-years age groups. Absolute inequalities were examined by comparing means. Relative inequalities were examined by comparing Gini-coefficients. Analyses were performed for both health outcomes by both educational level and household income. Analyses were performed for all age groups, and stratified by gender. Absolute and relative socioeconomic health inequalities differed across age groups by indicator of socioeconomic position, health outcome, and gender. Absolute inequalities were most pronounced for mental health by household income. They were larger in younger than older age groups. Relative inequalities were most pronounced for physical health by educational level. Gini-coefficients were largest in young age groups and smallest in older age groups. Absolute and relative socioeconomic health inequalities differed cross-sectionally across age groups by indicator of socioeconomic position, health outcome and gender. Researchers should critically consider the implications of choosing a specific age group, in addition to the indicator of socioeconomic position and health outcome

The Poincare group as the symmetry group of canonical general relativity

International Nuclear Information System (INIS)

Beig, R.; Murchadha, N. o

1986-01-01

This work reconsiders the formulation, due to Regge and Teitelboim, of the phase space approach to General Relativity in the asymptotically flat context, phrasing it in the language of symplectic geometry. The necessary boundary conditions at spatial infinity are spelled out in detail. Precise meaning is given to the statement that, as a result of these boundary conditions, the Poincare group acts as a symmetry group on the phase space of G.R. This situation is compared with the spi-picture of Ashtekar and Hansen, where a larger asymptotic symmetry group is obtained. (Author)

[Significance of expert-guided groups for relatives in psychiatry].

Science.gov (United States)

Plessen, U; Postzich, M; Wilkmann, M

1985-03-01

Psychiatric interest in relatives of patients was concentrated in the past on their pathogenetic and etiological influence on mental illness. The medical paradigma of mental illness did not account for relatives affliction in psychic disturbance of their family member. Against this a community care oriented approach involves relatives into psychiatric care, particularly under the aspects of coping strategies and rehabilitative sources. Practicability and effects of this approach were explored in expert-guided relative groups at the Psychiatric Hospital Gütersloh (FRG). Results indicated that relatives are concerned with a series of problems. Participating in relative groups facilitates coping with these problems. Expert-guided and relative centered groups were found helpful, discharging and encouraging for relatives.

Quantum group and Manin plane related to a coloured braid group representation

International Nuclear Information System (INIS)

Basu Mallick, B.

1993-07-01

By considering 'coloured' braid group representation we have obtained a quantum group, which reduces to the standards GL q (2) and GL pq (2) cases at some particular limits of the 'colour' parameters. In spite of quite complicated nature, all of these new quantum group relations can be expressed neatly in the Heisenberg-Weyl form, for a nontrivial choice of the basis elements. Furthermore, it is possible to associate invariant Manin planes, parametrized by the 'colour' variables, with such quantum group structure. (author). 26 refs

The implementation of DRG-based hospital reimbursement in Switzerland: A population-based perspective.

Science.gov (United States)

Busato, André; von Below, Georg

2010-10-16

Switzerland introduces a DRG (Diagnosis Related Groups) based system for hospital financing in 2012 in order to increase efficiency and transparency of Swiss health care. DRG-based hospital reimbursement is not simultaneously realized in all Swiss cantons and several cantons already implemented DRG-based financing irrespective of the national agenda, a setting that provides an opportunity to compare the situation in different cantons. Effects of introducing DRGs anticipated for providers and insurers are relatively well known but it remains less clear what effects DRGs will have on served populations. The objective of the study is therefore to analyze differences of volume and major quality indicators of care between areas with or without DRG-based hospital reimbursement from a population based perspective. Small area analysis of all hospitalizations in acute care hospitals and of all consultations reimbursed by mandatory basic health insurance for physicians in own practice during 2003-2007. The results show fewer hospitalizations and a relocation of resources to outpatient care in areas with DRG reimbursement. Overall burden of disease expressed as per capita DRG cost weights was almost identical between the two types of hospital reimbursement and no distinct temporal differences were detected in this respect. But the results show considerably higher 90-day rehospitalization rates in DRG areas. The study provides evidence of both desired and harmful effects related to the implementation of DRGs. Systematic monitoring of outcomes and quality of care are therefore essential elements to maintain in the Swiss health system after DRG's are implemented on a nationwide basis in 2012.

Financial impact of accurate discharge coding in a liaison psychiatry service.

LENUS (Irish Health Repository)

Jordan, Iain

2012-12-01

Previous research has shown that patients seen by liaison psychiatry services are a complex and expensive patient group and that the psychiatric co-morbidities of hospital inpatients are poorly attested at discharge for assignment to diagnosis-related groups (DRGs). The aim of this study was to investigate the accuracy of discharge coding in a neuropsychiatry liaison population. We also aimed to establish whether or not, had the correct diagnosis been assigned, additional funding would have been allocated to the hospital.

The clustering evolution of distant red galaxies in the GOODS-MUSIC sample

Science.gov (United States)

Grazian, A.; Fontana, A.; Moscardini, L.; Salimbeni, S.; Menci, N.; Giallongo, E.; de Santis, C.; Gallozzi, S.; Nonino, M.; Cristiani, S.; Vanzella, E.

2006-07-01

Aims.We study the clustering properties of Distant Red Galaxies (DRGs) to test whether they are the progenitors of local massive galaxies. Methods.We use the GOODS-MUSIC sample, a catalog of ~3000 Ks-selected galaxies based on VLT and HST observation of the GOODS-South field with extended multi-wavelength coverage (from 0.3 to 8~μm) and accurate estimates of the photometric redshifts to select 179 DRGs with J-Ks≥ 1.3 in an area of 135 sq. arcmin.Results.We first show that the J-Ks≥ 1.3 criterion selects a rather heterogeneous sample of galaxies, going from the targeted high-redshift luminous evolved systems, to a significant fraction of lower redshift (1mass, like groups or small galaxy clusters. Low-z DRGs, on the other hand, will likely evolve into slightly less massive field galaxies.

Attachment theory and group processes: the association between attachment style and group-related representations, goals, memories, and functioning.

Science.gov (United States)

Rom, Eldad; Mikulincer, Mario

2003-06-01

Four studies examined attachment-style differences in group-related cognitions and behaviors. In Studies 1-2, participants completed scales on group-related cognitions and emotions. In Studies 3-4, participants were divided into small groups, and their performance in group tasks as well as the cohesion of their group were assessed. Both attachment anxiety and avoidance in close relationships were associated with negative group-related cognitions and emotions. Anxiety was also related to the pursuit of closeness goals and impaired instrumental performance in group tasks. Avoidance was related to the pursuit of distance goals and deficits in socioemotional and instrumental performance. Group cohesion significantly moderated the effects of attachment anxiety. The discussion emphasizes the relevance of attachment theory within group contexts.

[Clinical and economic analysis of an internal medicine-infectious disease department at a university general hospital (2005-2006)].

Science.gov (United States)

Gómez, Joaquín; García-Vázquez, Elisa; Antonio Puertas, José; Ródenas, Julio; Herrero, José Antonio; Albaladejo, Carmen; Baños, Víctor; Canteras, Manuel; Alcaraz, Manolo

2009-02-01

Comparative study in patients with infectious diseases admitted to a specialized Internal Medicine-Infectious Diseases Department (IMID) versus those admitted to other medical departments in a university general hospital, investigating quality and cost-effectiveness. Analysis of patients in 10 principle diagnosis-related groups (DRGs) of infectious diseases admitted to the IMID were compared to those admitted to other medical departments (2005-2006). The DRG were divided in 4 main groups: respiratory infections (DGR 88, 89, 90, 540), urinary infections (DRG 320, 321), sepsis (DRG 416, 584), and skin infections (DRG 277, 278). For each group, quality variables (mortality and readmission rate), efficacy variables (mean hospital stay and mean DRG-based cost per patient) and complexity variables (case mix, relative weight, and functional index) were analyzed. 542 patients included in the 10 main infectious disease DRGs were admitted to IMID and 2404 to other medical departments. After adjusting for DRG case mix (case mix 0.99 for IMID and 0.89 for others), mean hospital stay (5.11 days vs. 7.65 days), mortality (3.5% vs. 7.9%) and mean DRG-based economic cost per patient (1521euro/patient vs. 2952euro/patient) was significantly lower in the group of patients hospitalized in IMID than the group in other medical departments (peconomic cost per patient. Creation and development of IMID departments should be an essential objective to improve healthcare quality and respond to social demands.

Analysis of Ethnic Group Relations in Living Life

Directory of Open Access Journals (Sweden)

Rafael Grady Christianto

2017-08-01

Full Text Available This research uses qualitative method approach. The data is taken through semi structured interviews so that the researcher can get the deepest information from the subject but still use interview and observation guidance. Aims to determine the perspectives between ethnic groups by looking at how the interactions or relationships that occur in everyday activities, the management of conflicts, what activities are usually done together, and the attachment that exists between various ethnic groups in Kelurahan Pengasinan Kota Bekasi to meet Practical needs. The theory used is the group definition theory of Joseph S. Roucek, Major Polak, and Wila Huky, inter-group relations of Kinloch and Stanley Liberson, social interaction theory of Soekanto, Sunarto-majority minority relations theory, Budiman, Suparlan and Edward M Bruner, and the inter-ethnic perspective theory of Setiaman. Social relations itself has a sense of relationship in which there are interactions that occur in society in order to prevent the emergence of conflict. Based on the results of research and discussion that has been done, it can be concluded that, good interaction among ethnic groups is the key in maintaining relationships among ethnic groups. This will affect the survival, social behavior, and perspectives that arise and develop among others.

Using Focus Group Research in Public Relations.

Science.gov (United States)

Grunig, Larissa A.

1990-01-01

Analyzes a recent instance of focus group research applied to a public relations case (rather than a marketing case). Reviews the advantages and disadvantages of this qualitative method, and describes the case of a county department of mental health relying on focus group research to help plan a program aimed at reducing the stigma of mental…

Dokumentation, Kalkulation und Prozessanalyse im DRG-Zeitalter

OpenAIRE

Ingenerf, J; Gerdsen, F; Seik, B; Pöppl, SJ; Schreiber, R; Heinemeier, AK; Köppe, K; Bruch, HP

2005-01-01

The introduction of the G-DRGs (German Diagnosis Related Groups) in the year 2002 and the gradual use as a reimbursement system beginning from 2005 forces hospitals to meet enormous challenges with respect to organizational and IT-issues. The quality of the basic data set in terms of case and data completeness, accuracy and timeliness has to be ensured because with that the DRG case group and hence, the associated revenue is determined. From the economic point of view the costs of providing t...

Neuronal calcium-binding proteins 1/2 localize to dorsal root ganglia and excitatory spinal neurons and are regulated by nerve injury

DEFF Research Database (Denmark)

Zhang, Ming Dong; Tortoriello, Giuseppe; Hsueh, Brian

2014-01-01

, and nerve injury-induced regulation of NECAB1/NECAB2 in mouse dorsal root ganglia (DRGs) and spinal cord. In DRGs, NECAB1/2 are expressed in around 70% of mainly small- and medium-sized neurons. Many colocalize with calcitonin gene-related peptide and isolectin B4, and thus represent nociceptors. NECAB1....../2 neurons are much more abundant in DRGs than the Ca2+-binding proteins (parvalbumin, calbindin, calretinin, and secretagogin) studied to date. In the spinal cord, the NECAB1/2 distribution is mainly complementary. NECAB1 labels interneurons and a plexus of processes in superficial layers of the dorsal horn....... In the dorsal horn, most NECAB1/2 neurons are glutamatergic. Both NECAB1/2 are transported into dorsal roots and peripheral nerves. Peripheral nerve injury reduces NECAB2, but not NECAB1, expression in DRG neurons. Our study identifies NECAB1/2 as abundant Ca2+-binding proteins in pain-related DRG neurons...

Nilpotent groups related to an automorphism 1 Introduction

Indian Academy of Sciences (India)

29

The extension of a nilpotent group has been studied by different authors. .... study absolute normal subgroups of some finite groups. ...... follows from the relations ... To prove H3 is absolute normal we should investigate four following cases.

DSR Theories, Conformal Group and Generalized Commutation Relation

International Nuclear Information System (INIS)

Leiva, Carlos

2006-01-01

In this paper the relationship of DSR theories and Conformal Group is reviewed. On the other hand, the relation between DSR Magueijo Smolin generators and generalized commutation relations is also shown

Electronic patient journey boards a vital piece of the puzzle in patient flow.

Science.gov (United States)

Clark, Kevin W; Moller, Susan; O'Brien, Lauri

2014-06-01

Internationally, there is growing interest in the applicability of visual management in healthcare, although little is known about the extent of its effectiveness. In the past 5 years technical advances have permitted the integration of all relevant data into a singular display that can improve staff efficiency, accelerate decisions, streamline workflow processes and reduce oversights and errors in clinical practice. The aim of the case study is to describe the features and application of electronic patient journey boards (EPJBs) as an enabler to accelerate patient flow that has been demonstrated and evaluated in Queensland Health hospitals. In 2012 and 2013 we collected ward-specific data that was sourced from the Queensland Hospital Admitted Patient Data Collection, determining the top 10 overnight diagnostic-related groups (DRGs) for each ward participating in the pilots. The Statistical Output Unit within Queensland Health then provided data and analysis on the ALOS for each of these DRGs for the period following an EPJB installation, along with the ALOS for the same DRGs for the corresponding period in the previous year. Patient length of stay reduced and display of estimated discharge dates improved with the introduction of EPJBs along with improved communication and information management resulting in time savings from 20 min per staff member per shift to 2.5h per ward a day. Queensland and South Australian Health systems have succeeded in 'making the hospital patient journey visible' through an innovative combination of information management and prominent display of key information related to patient care portrayed on large liquid crystal display (LCD) screens in hospital wards.

What explains DRG upcoding in neonatology? The roles of financial incentives and infant health.

Science.gov (United States)

Jürges, Hendrik; Köberlein, Juliane

2015-09-01

We use the introduction of diagnosis related groups (DRGs) in German neonatology to study the determinants of upcoding. Since 2003, reimbursement is based inter alia on birth weight, with substantial discontinuities at eight thresholds. These discontinuities create incentives to upcode preterm infants into classes of lower birth weight. Using data from the German birth statistics 1996-2010 and German hospital data from 2006 to 2011, we show that (1) since the introduction of DRGs, hospitals have upcoded at least 12,000 preterm infants and gained additional reimbursement in excess of 100 million Euro; (2) upcoding rates are systematically higher at thresholds with larger reimbursement hikes and in hospitals that subsequently treat preterm infants, i.e. where the gains accrue; (3) upcoding is systematically linked with newborn health conditional on birth weight. Doctors and midwives respond to financial incentives by not upcoding newborns with low survival probabilities, and by upcoding infants with higher expected treatment costs. Copyright © 2015 Elsevier B.V. All rights reserved.

Group as social microcosm: Within-group interpersonal style is congruent with outside group relational tendencies.

Science.gov (United States)

Goldberg, Simon B; Hoyt, William T

2015-06-01

The notion that individuals' interpersonal behaviors in the context of therapy reflects their interpersonal behaviors outside of therapy is a fundamental hypothesis underlying numerous systems of psychotherapy. The social microcosm hypothesis, in particular, claims the interpersonal therapy group becomes a reflection of group members' general tendencies, and can thus be used as information about members' interpersonal functioning as well as an opportunity for learning and behavior change. The current study tested this hypothesis using data drawn from 207 individuals participating in 22 interpersonal process groups. Ratings were made on 2 key interpersonal domains (Dominance and Affiliation) at baseline and at Weeks 2, 5, and 8 of the group. Two-level multilevel models (with participants nested within groups) were used to account for the hierarchical structure, and the social relations model (SRM; Kenny, 1994) was used to estimate peer ratings (target effects in SRM) unconfounded with rater bias. Participants showed consensus at all time points during the interpersonal process groups on one another's levels of dominance and affiliation. In addition, self- and peer ratings were stable across time and correlated with one another. Importantly, self-ratings made prior to group significantly predicted ratings (self- and peer) made within the group, with effect sizes within the medium range. Taken together, these results provide robust support for the social microcosm hypothesis and the conjecture that interpersonal style within-group therapy is reflective of broader interpersonal tendencies. (c) 2015 APA, all rights reserved).

Individual and peer group normative beliefs about relational aggression.

Science.gov (United States)

Werner, Nicole E; Hill, Laura G

2010-01-01

Studies show that children who use relational aggression process social information in unique ways; however, findings have been inconsistent and limited by methodological weaknesses. This short-term longitudinal study examined developmental changes in 245 (49% female; ages 8-13) 3rd through 8th graders' normative beliefs about relational aggression and tested the hypothesis that individual and classroom-level norms predict relational aggression 1 year later. Results showed that the transition to middle school was marked by increased approval of relational aggression, and individual norms predicted future relational aggression. Importantly, a contextual model showed that students in peer groups highly supportive of relational aggression became increasingly aggressive. Findings extend social information processing theories of relational aggression to focus on the role of peer group cognitions.

Conjugacy in relatively extra-large Artin groups

Directory of Open Access Journals (Sweden)

Arye Juhasz

2015-09-01

Full Text Available Let A be an Artin group with standard generators X={x 1 ,…,x n } , n≥1 and defining graph Γ A . A \\emph{standard parabolic subgroup} of A is a subgroup generated by a subset of X . For elements u and v of A we say (as usual that u is conjugate to v by an element h of A if h −1 uh=v holds in A . Similarly, if K and L are subsets of A then K is conjugate to L by an element h of A if h −1 Kh=L . In this work we consider the conjugacy of elements and standard parabolic subgroups of a certain type of Artin groups. Results in this direction occur in occur in papers by Duncan, Kazachkov, Remeslennikov, Fenn, Dale, Jun, Godelle, Gonzalez-Meneses, Wiest, Paris, Rolfsen, for example. Of particular interest are centralisers of elements, and of standard parabolic subgroups, normalisers of standard parabolic subgroups and commensurators of parabolic subgroups. In this work we consider similar problems in a new class of Artin groups, introduced in the paper "On relatively extralarge Artin groups and their relative asphericity", by Juhasz, where the word problem is solved, among other things. Also, intersections of parabolic subgroups and their conjugates are considered.

National nostalgia : A group-based emotion that benefits the in-group but hampers intergroup relations

NARCIS (Netherlands)

Smeekes, A.N.

2015-01-01

Social psychological research on nostalgia has mainly considered this emotion at the individual level rather than the group level. The current paper proposes that group-based nostalgia for the nation (i.e., national nostalgia) is likely to be related to a positive in-group orientation and a negative

Paying the Piper, Calling the Tune: Implications of Changes in Reimbursement

OpenAIRE

Victor R. Fuchs

1985-01-01

The United States is in the midst of a revolution in health care finance, the third since the end of World War II. Medicare's prospective payment system (PPS) based on diagnosis-related groups (DRGs), the State of California's hospital-specific contracts for Medi-Cal patients, deductibles and coinsurance, health maintenance organizations (HMOs), and preferred provider organizations (PPOs) are among the best known symbols of the new era in health care finance. This paper analyzes the economic ...

Content-Related Interactions in Self-initiated Study Groups

Science.gov (United States)

Christian, Karen; Talanquer, Vicente

2012-09-01

The central goal of the present exploratory study was to investigate the nature of the content-related interactions in study groups independently organized by college organic chemistry students. We were particularly interested in the identification of the different factors that affected the emergence of opportunities for students to co-construct understanding and engage in higher levels of cognitive processing. Our results are based on the analysis of in situ observations of 34 self-initiated study sessions involving over a 100 students in three academic semesters. The investigation revealed three major types of social regulation processes, teaching, tutoring, and co-construction in the observed study sessions. However, the extent to which students engaged in each of them varied widely from one session to another. This variability was mostly determined by the specific composition of the study groups and the nature of the study tasks in which they were engaged. Decisions about how to organize the study session, the relative content knowledge and conceptual understanding expressed by the participants, as well as the cognitive level of the problems that guided group work had a strong impact on the nature of student interactions. Nevertheless, group talk in the observed study groups was mostly focused on low-level cognitive processes. The results of our work provide insights on how to better support students' productive engagement in study groups.

Group behavioral therapy for adolescents with tic-related and non-tic-related obsessive-compulsive disorder.

Science.gov (United States)

Himle, Joseph A; Fischer, Daniel J; Van Etten, Michelle L; Janeck, Amy S; Hanna, Gregory L

2003-01-01

Prior research supports the distinction between tic-related and non-tic-related obsessive-compulsive disorder (OCD) based on phenomenologic, etiologic, and neurobehavioral data. The present study examines whether response to psychosocial treatment differs in adolescents, depending on the presence of comorbid tics. Nineteen adolescents, 12-17 years of age, participated in 7-week, uncontrolled trial of group cognitive-behavioral treatment (CBT) for OCD. Eight of the patients had tic-related and eleven had non-tic-related OCD. The group CBT program included psycho-education, exposure and response prevention, cognitive strategies, and family involvement. Significant improvement was observed for all subjects on the Yale-Brown Obsessive Compulsive Scale ratings of obsessions, compulsions, and total OCD symptoms. Outcomes were similar for subjects with tic-related and non-tic-related OCD. These preliminary results suggest that the presence of comorbid tic disorders may not attenuate response to behavioral group treatment among adolescents. Copyright 2003 Wiley-Liss, Inc.

Measuring case-mix complexity of tertiary care hospitals using DRGs.

Science.gov (United States)

Park, Hayoung; Shin, Youngsoo

2004-02-01

The objectives of the study were to develop a model that measures and evaluates case-mix complexity of tertiary care hospitals, and to examine the characteristics of such a model. Physician panels defined three classes of case complexity and assigned disease categories represented by Adjacent Diagnosis Related Groups (ADRGs) to one of three case complexity classes. Three types of scores, indicating proportions of inpatients in each case complexity class standardized by the proportions at the national level, were defined to measure the case-mix complexity of a hospital. Discharge information for about 10% of inpatient episodes at 85 hospitals with bed size larger than 400 and their input structure and research and education activity were used to evaluate the case-mix complexity model. Results show its power to predict hospitals with the expected functions of tertiary care hospitals, i.e. resource intensive care, expensive input structure, and high levels of research and education activities.

2017 Military Services Gender Relations Focus Groups: Active Duty

Science.gov (United States)

2018-04-30

Office of People Analytics Office of People Analytics (OPA) Defense Research, Surveys, and Statistics Center 4800 Mark Center Drive, Suite 06E22...Relations (2017 MSGR) Focus Groups among active duty members. This is the third6 administration of gender relations focus groups. This introductory ...Enlisted, Male “It is true statistically , a majority of sexual assaults there is alcohol or drugs. In the military, it’s into the alcohol more than

RELATIONAL GROUP PSYCHOTHERAPY: THE HEALING OF STRESS, NEGLECT AND TRAUMA

Directory of Open Access Journals (Sweden)

Richard G. Erskine

2010-01-01

Full Text Available This article is the Keynote Address given at the 4th International Integrative Psychotherapy Association Conference, April 17, 2009. In speaking to the conference theme of “Acute Trauma, Cumulative Neglect, and Chronic Stress” the article describes some of the principles of Relational Group Psychotherapy. The theory of methods is based on the concept that the healing of trauma, neglect and stress occurs through a contactful therapeutic relationship. Relational group psychotherapy draws from several developments in group therapy, particularly the cybernetic feedback and other-centered models. It emphasizes the healing power of relationships between group members and the importance of phenomenological inquiry, affective attunement, identification, and relational-needs. The leader’s tasks are to stimulate the flow of contactful dialogue and to teach about human needs and healthy relationships.

Committees and groups related to the EURATOM treaty

Energy Technology Data Exchange (ETDEWEB)

Marcus, F.R. [comp.] [Nordic Nuclear Safety Research, Roskilde (Denmark)

1997-09-01

The EURATOM Treaty has not been modified since its creation (Rome, 25 March 1957) but has simply been adapted to take account of the fusion of the executive bodies of the three original European Treaties and the enlargement with new Member States. The EURATOM Treaty is in existence simultaneously with the 1992 Maastricht Treaty. No changes in the EURATOM Treaty that influence the practical working conditions were brought about in the 1997 intergovernmental conference. This edition of the survey of groups related to the EURATOM Treaty is an update of earlier versions issued in Danish language. It is sponsored by the Nordic Committee for Nuclear Safety Research (NKS) in conjunction with the Swedish Nuclear Power Inspectorate (SKI). The main purpose is to informally provide those circles in the Nordic countries who want to get acquainted with the groups involved in work related to EURATOM with a simplified overview. The present edition is not different from earlier issues in that it contains an outline without the intent to go into details, and without the ambition to be complete. It thus does not represent an official picture of the committees and groups. Nor should it be seen as an organisation chart of related Commission services. The information is mostly based on personal contacts with persons having knowledge from work with the groups in question. The author would be grateful for corrections and suggestions in order to improve the picture given. 15 figs.

Committees and groups related to the EURATOM treaty

International Nuclear Information System (INIS)

Marcus, F.R.

1997-09-01

The EURATOM Treaty has not been modified since its creation (Rome, 25 March 1957) but has simply been adapted to take account of the fusion of the executive bodies of the three original European Treaties and the enlargement with new Member States. The EURATOM Treaty is in existence simultaneously with the 1992 Maastricht Treaty. No changes in the EURATOM Treaty that influence the practical working conditions were brought about in the 1997 intergovernmental conference. This edition of the survey of groups related to the EURATOM Treaty is an update of earlier versions issued in Danish language. It is sponsored by the Nordic Committee for Nuclear Safety Research (NKS) in conjunction with the Swedish Nuclear Power Inspectorate (SKI). The main purpose is to informally provide those circles in the Nordic countries who want to get acquainted with the groups involved in work related to EURATOM with a simplified overview. The present edition is not different from earlier issues in that it contains an outline without the intent to go into details, and without the ambition to be complete. It thus does not represent an official picture of the committees and groups. Nor should it be seen as an organisation chart of related Commission services. The information is mostly based on personal contacts with persons having knowledge from work with the groups in question. The author would be grateful for corrections and suggestions in order to improve the picture given

Monitoring the impact of the DRG payment system on nursing service context factors in Swiss acute care hospitals: Study protocol

Science.gov (United States)

Spirig, Rebecca; Spichiger, Elisabeth; Martin, Jacqueline S.; Frei, Irena Anna; Müller, Marianne; Kleinknecht, Michael

2014-01-01

Aims: With this study protocol, a research program is introduced. Its overall aim is to prepare the instruments and to conduct the first monitoring of nursing service context factors at three university and two cantonal hospitals in Switzerland prior to the introduction of the reimbursement system based on Diagnosis Related Groups (DRG) and to further develop a theoretical model as well as a methodology for future monitoring following the introduction of DRGs. Background: DRG was introduced to all acute care hospitals in Switzerland in 2012. In other countries, DRG introduction led to rationing and subsequently to a reduction in nursing care. As result, nursing-sensitive patient outcomes were seriously jeopardised. Switzerland has the opportunity to learn from the consequences experienced by other countries when they introduced DRGs. Their experiences highlight that DRGs influence nursing service context factors such as complexity of nursing care or leadership, which in turn influence nursing-sensitive patient outcomes. For this reason, the monitoring of nursing service context factors needs to be an integral part of the introduction of DRGs. However, most acute care hospitals in Switzerland do not monitor nursing service context data. Nursing managers and hospital executive boards will be in need of this data in the future, in order to distribute resources effectively. Methods/Design: A mixed methods design in the form of a sequential explanatory strategy was chosen. During the preparation phase, starting in spring 2011, instruments were selected and prepared, and the access to patient and nursing data in the hospitals was organized. Following this, online collection of quantitative data was conducted in fall 2011. In summer 2012, qualitative data was gathered using focus group interviews, which helped to describe the processes in more detail. During 2013 and 2014, an integration process is being conducted involving complementing, comparing and contrasting

Monitoring the impact of the DRG payment system on nursing service context factors in Swiss acute care hospitals: Study protocol.

Science.gov (United States)

Spirig, Rebecca; Spichiger, Elisabeth; Martin, Jacqueline S; Frei, Irena Anna; Müller, Marianne; Kleinknecht, Michael

2014-01-01

With this study protocol, a research program is introduced. Its overall aim is to prepare the instruments and to conduct the first monitoring of nursing service context factors at three university and two cantonal hospitals in Switzerland prior to the introduction of the reimbursement system based on Diagnosis Related Groups (DRG) and to further develop a theoretical model as well as a methodology for future monitoring following the introduction of DRGs. DRG was introduced to all acute care hospitals in Switzerland in 2012. In other countries, DRG introduction led to rationing and subsequently to a reduction in nursing care. As result, nursing-sensitive patient outcomes were seriously jeopardised. Switzerland has the opportunity to learn from the consequences experienced by other countries when they introduced DRGs. Their experiences highlight that DRGs influence nursing service context factors such as complexity of nursing care or leadership, which in turn influence nursing-sensitive patient outcomes. For this reason, the monitoring of nursing service context factors needs to be an integral part of the introduction of DRGs. However, most acute care hospitals in Switzerland do not monitor nursing service context data. Nursing managers and hospital executive boards will be in need of this data in the future, in order to distribute resources effectively. A mixed methods design in the form of a sequential explanatory strategy was chosen. During the preparation phase, starting in spring 2011, instruments were selected and prepared, and the access to patient and nursing data in the hospitals was organized. Following this, online collection of quantitative data was conducted in fall 2011. In summer 2012, qualitative data was gathered using focus group interviews, which helped to describe the processes in more detail. During 2013 and 2014, an integration process is being conducted involving complementing, comparing and contrasting quantitative and qualitative findings

'When psychology and economics meet: Relational goods in training groups

Directory of Open Access Journals (Sweden)

Alessandra Di Caccamo

2014-09-01

Full Text Available The development of the concept of relational goods is an innovation in the economy as opposed to the predominant instrumental logic and the ultimate aim of achieving profit. By facilitating the process of remodeling and reconfiguration the modalities of entering into a relationship, and allowing a new connection between different dimension of one's family, relational and cultural experience, median training groups are a place of choice for developing relational good in different contexts.Keywords: Relational good; Median training group; Social well-being

Courtesy stigma--a focus group study of relatives of schizophrenia patients.

Science.gov (United States)

Angermeyer, Matthias C; Schulze, Beate; Dietrich, Sandra

2003-10-01

Stigmatization of people with mental illness has been investigated in numerous studies. Little research, however, has been done to explore how relatives of people with schizophrenia perceive and experience stigmatization and how they can fight such stigmatization. Aiming to explore stigma from the perspective of relatives of people with schizophrenia, focus group interviews were conducted with 122 members of advocacy groups from different parts of Germany. Focus group sessions were tape- and video-recorded and transcribed. Transcripts were coded using an inductive method, generating categories (domains) from the material. The analysis of focus group data shows that, contrary to previous research findings, discrimination and disadvantages encountered by relatives of schizophrenia patients reach far beyond the spheres of direct social interaction and access to social roles. Our study revealed two additional domains in which relatives encounter stigmatization: structural discrimination and public images of mental illness. Furthermore, psychiatry has been identified as one important source of stigma. Relatives also suggested numerous anti-stigma interventions. These can be grouped into five main categories: communication measures, support for the ill and their relatives, changes in mental health care, education and training, and control and supervision. Based on our findings,ways of how relatives of schizophrenia patients and mental health professionals can fight against stigma are discussed.

Absolute and Relative Socioeconomic Health Inequalities across Age Groups

NARCIS (Netherlands)

van Zon, Sander K. R.; Bultmann, Ute; de Leon, Carlos F. Mendes; Reijneveld, Sijmen A.

2015-01-01

Background The magnitude of socioeconomic health inequalities differs across age groups. It is less clear whether socioeconomic health inequalities differ across age groups by other factors that are known to affect the relation between socioeconomic position and health, like the indicator of

Sea-anemone toxin ATX-II elicits A-fiber-dependent pain and enhances resurgent and persistent sodium currents in large sensory neurons

Directory of Open Access Journals (Sweden)

Klinger Alexandra B

2012-09-01

Full Text Available Abstract Background Gain-of-function mutations of the nociceptive voltage-gated sodium channel Nav1.7 lead to inherited pain syndromes, such as paroxysmal extreme pain disorder (PEPD. One characteristic of these mutations is slowed fast-inactivation kinetics, which may give rise to resurgent sodium currents. It is long known that toxins from Anemonia sulcata, such as ATX-II, slow fast inactivation and skin contact for example during diving leads to various symptoms such as pain and itch. Here, we investigated if ATX-II induces resurgent currents in sensory neurons of the dorsal root ganglion (DRGs and how this may translate into human sensations. Results In large A-fiber related DRGs ATX-II (5 nM enhances persistent and resurgent sodium currents, but failed to do so in small C-fiber linked DRGs when investigated using the whole-cell patch-clamp technique. Resurgent currents are thought to depend on the presence of the sodium channel β4-subunit. Using RT-qPCR experiments, we show that small DRGs express significantly less β4 mRNA than large sensory neurons. With the β4-C-terminus peptide in the pipette solution, it was possible to evoke resurgent currents in small DRGs and in Nav1.7 or Nav1.6 expressing HEK293/N1E115 cells, which were enhanced by the presence of extracellular ATX-II. When injected into the skin of healthy volunteers, ATX-II induces painful and itch-like sensations which were abolished by mechanical nerve block. Increase in superficial blood flow of the skin, measured by Laser doppler imaging is limited to the injection site, so no axon reflex erythema as a correlate for C-fiber activation was detected. Conclusion ATX-II enhances persistent and resurgent sodium currents in large diameter DRGs, whereas small DRGs depend on the addition of β4-peptide to the pipette recording solution for ATX-II to affect resurgent currents. Mechanical A-fiber blockade abolishes all ATX-II effects in human skin (e.g. painful and itch

Cultural styles, relational schemas, and prejudice against out-groups.

Science.gov (United States)

Sanchez-Burks, J; Nisbett, R E; Ybarra, O

2000-08-01

Two studies provide evidence that Latins (i.e., Mexicans and Mexican Americans) are guided by a concern with socioemotional aspects of workplace relations to a far greater degree than are Anglo-Americans. The focus on socioemotional considerations results in Latins having a relatively greater preference for workgroups having a strong interpersonal orientation. Preferred relational style had a far greater impact on preferences for workgroups and judgments about their likely success than did the ethnic composition of the workgroups for both Latins and Anglo-Americans. Evidence that the two groups differ markedly in relational schemas comes from examination of suggestions about how group performance could be improved, judgments about whether a focus on socioemotional concerns necessarily entails a reduction in task focus, and recall for socioemotional aspects of workgroup interactions. Implications for the dynamics of intercultural contact are discussed.

[Diagnostic control. Psychiatric comorbidity in patients of technical orthopedic units].

Science.gov (United States)

Lange, C; Heuft, G; Wetz, H H

2001-04-01

Because of the new hospital finance law a DRG (Diagnosis Related Groups) controlled discount liquidation under consideration of the medical impairment becomes necessary. In this paper the importance of a correct and complete description of the psychic comorbidity for the development of German-Refined-DRGs (GR-DRGs) in the orthopedic field is described. Therefore we analysed data of orthopedic in-patients, who are diagnosed by consultation of the clinic for psychosomatics and psychotherapy. A psychic comorbidity (ICD-10 Chapter F (V)) was diagnosed by 95% of the consulted patient. 30% of the patients showed difficulties in coping with their disease. 40% suffered from chronical psychoneurotic patterns and conflicts, which can be explained (a) as consequence of a difficult psychosocial adaptation by chronic disease or after an amputation (b) as basic mental disorders (c) as cause of the orthopaedic complications. Therefore the number of indications for a psychotherapeutic or psychiatric treatment is very high. The knowledge about a psychic comorbidity can--beside financial aspects--help the team on the orthopaedic station in the treatment of difficult patient.

Using simulation to educate hospital staff about casemix.

Science.gov (United States)

Cromwell, D A; Priddis, D; Hindle, D

1998-10-01

When the Australian government funded a casemix development program, few hospital clinicians or staff knew much about casemix classifications like Diagnosis Related Groups (DRGs). Although the concepts behind casemix are essentially simple, it is not a trivial task to explain the logic used to assign patients to classes, or the use of casemix data for management or funding. Therefore, as part of a project to create educational material, a computer-based management game, built around a simulation model of a hospital, was developed. The game was designed for use in a workshop setting, to allow participants to test their understanding of the casemix information presented to them. The simulation mimicked the operation of a hospital, with a player taking the role of a hospital manager. It aimed to demonstrate how AN-DRGs might be used for funding; how patient costs are influenced by hospital activity; and how casemix data can assist in monitoring the use of resources. The game, called Dragon, proved to be very successful, and is now distributed as part of the National Casemix Education series.

On the relative role of different age groups in influenza epidemics.

Science.gov (United States)

Worby, Colin J; Chaves, Sandra S; Wallinga, Jacco; Lipsitch, Marc; Finelli, Lyn; Goldstein, Edward

2015-12-01

The identification of key "driver" groups in influenza epidemics is of much interest for the implementation of effective public health response strategies, including vaccination programs. However, the relative importance of different age groups in propagating epidemics is uncertain. During a communicable disease outbreak, some groups may be disproportionately represented during the outbreak's ascent due to increased susceptibility and/or contact rates. Such groups or subpopulations can be identified by considering the proportion of cases within the subpopulation occurring before (Bp) and after the epidemic peak (Ap) to calculate the subpopulation's relative risk, RR=Bp/Ap. We estimated RR for several subpopulations (age groups) using data on laboratory-confirmed US influenza hospitalizations during epidemics between 2009-2014. Additionally, we simulated various influenza outbreaks in an age-stratified population, relating the RR to the impact of vaccination in each subpopulation on the epidemic's initial effective reproductive number R_e(0). We found that children aged 5-17 had the highest estimates of RR during the five largest influenza A outbreaks, though the relative magnitude of RR in this age group compared to other age groups varied, being highest for the 2009 A/H1N1 pandemic. For the 2010-2011 and 2012-2013 influenza B epidemics, adults aged 18-49, and 0-4 year-olds had the highest estimates of RR respectively. For 83% of simulated epidemics, the group with the highest RR was also the group for which initial distribution of a given quantity of vaccine would result in the largest reduction of R_e(0). In the largest 40% of simulated outbreaks, the group with the highest RR and the largest vaccination impact was children 5-17. While the relative importance of different age groups in propagating influenza outbreaks varies, children aged 5-17 play the leading role during the largest influenza A epidemics. Extra vaccination efforts for this group may contribute

Feature-based morphometry: discovering group-related anatomical patterns.

Science.gov (United States)

Toews, Matthew; Wells, William; Collins, D Louis; Arbel, Tal

2010-02-01

This paper presents feature-based morphometry (FBM), a new fully data-driven technique for discovering patterns of group-related anatomical structure in volumetric imagery. In contrast to most morphometry methods which assume one-to-one correspondence between subjects, FBM explicitly aims to identify distinctive anatomical patterns that may only be present in subsets of subjects, due to disease or anatomical variability. The image is modeled as a collage of generic, localized image features that need not be present in all subjects. Scale-space theory is applied to analyze image features at the characteristic scale of underlying anatomical structures, instead of at arbitrary scales such as global or voxel-level. A probabilistic model describes features in terms of their appearance, geometry, and relationship to subject groups, and is automatically learned from a set of subject images and group labels. Features resulting from learning correspond to group-related anatomical structures that can potentially be used as image biomarkers of disease or as a basis for computer-aided diagnosis. The relationship between features and groups is quantified by the likelihood of feature occurrence within a specific group vs. the rest of the population, and feature significance is quantified in terms of the false discovery rate. Experiments validate FBM clinically in the analysis of normal (NC) and Alzheimer's (AD) brain images using the freely available OASIS database. FBM automatically identifies known structural differences between NC and AD subjects in a fully data-driven fashion, and an equal error classification rate of 0.80 is achieved for subjects aged 60-80 years exhibiting mild AD (CDR=1). Copyright (c) 2009 Elsevier Inc. All rights reserved.

[Differentiation of coding quality in orthopaedics by special, illustration-oriented case group analysis in the G-DRG System 2005].

Science.gov (United States)

Schütz, U; Reichel, H; Dreinhöfer, K

2007-01-01

We introduce a grouping system for clinical practice which allows the separation of DRG coding in specific orthopaedic groups based on anatomic regions, operative procedures, therapeutic interventions and morbidity equivalent diagnosis groups. With this, a differentiated aim-oriented analysis of illustrated internal DRG data becomes possible. The group-specific difference of the coding quality between the DRG groups following primary coding by the orthopaedic surgeon and final coding by the medical controlling is analysed. In a consecutive series of 1600 patients parallel documentation and group-specific comparison of the relevant DRG parameters were carried out in every case after primary and final coding. Analysing the group-specific share in the additional CaseMix coding, the group "spine surgery" dominated, closely followed by the groups "arthroplasty" and "surgery due to infection, tumours, diabetes". Altogether, additional cost-weight-relevant coding was necessary most frequently in the latter group (84%), followed by group "spine surgery" (65%). In DRGs representing conservative orthopaedic treatment documented procedures had nearly no influence on the cost weight. The introduced system of case group analysis in internal DRG documentation can lead to the detection of specific problems in primary coding and cost-weight relevant changes of the case mix. As an instrument for internal process control in the orthopaedic field, it can serve as a communicative interface between an economically oriented classification of the hospital performance and a specific problem solution of the medical staff involved in the department management.

Sudden death and cervical spine: A new contribution to pathogenesis for sudden death in critical care unit from subarachnoid hemorrhage; first report - An experimental study.

Science.gov (United States)

Kazdal, Hizir; Kanat, Ayhan; Aydin, Mehmet Dumlu; Yazar, Ugur; Guvercin, Ali Riza; Calik, Muhammet; Gundogdu, Betul

2017-01-01

Sudden death from subarachnoid hemorrhage (SAH) is not uncommon. The goal of this study is to elucidate the effect of the cervical spinal roots and the related dorsal root ganglions (DRGs) on cardiorespiratory arrest following SAH. This was an experimental study conducted on rabbits. This study was conducted on 22 rabbits which were randomly divided into three groups: control ( n = 5), physiologic serum saline (SS; n = 6), SAH groups ( n = 11). Experimental SAH was performed. Seven of 11 rabbits with SAH died within the first 2 weeks. After 20 days, other animals were sacrificed. The anterior spinal arteries, arteriae nervorum of cervical nerve roots (C6-C8), DRGs, and lungs were histopathologically examined and estimated stereologically. Statistical analysis was performed using the PASW Statistics 18.0 for Windows (SPSS Inc., Chicago, Illinois, USA). Intergroup differences were assessed using a one-way ANOVA. The statistical significance was set at P < 0.05. In the SAH group, histopathologically, severe anterior spinal artery (ASA) and arteriae nervorum vasospasm, axonal and neuronal degeneration, and neuronal apoptosis were observed. Vasospasm of ASA did not occur in the SS and control groups. There was a statistically significant increase in the degenerated neuron density in the SAH group as compared to the control and SS groups ( P < 0.05). Cardiorespiratory disturbances, arrest, and lung edema more commonly developed in animals in the SAH group. We noticed interestingly that C6-C8 DRG degenerations were secondary to the vasospasm of ASA, following SAH. Cardiorespiratory disturbances or arrest can be explained with these mechanisms.

Individual neuropsychological support and group sessions for relatives to TBI patients

DEFF Research Database (Denmark)

Siert, Lars

TITLE: Individual neuropsychological support and group sessions for relatives to TBI patients. OBJECTIVE: To describe how the neuropsychologist work with early and ongoing individual support and group sessions for relatives to adult TBI patients in the acute and sub acute phase and after discharge...

[Quality of case allocation of orthopedics and trauma surgery in the 2004 and 2014 versions of the German DRG system. An interim assessment of the development process].

Science.gov (United States)

Franz, D; Schemmann, F; Selter, D D; Auhuber, T; Gehweiler, D; Roeder, N; Siebert, H; Mahlke, L

2014-10-01

Since 2004 the German diagnosis-related groups (DRG) system has been applied nationwide in all German somatic hospitals. The G-DRG system is updated annually in order to increase the quality of case allocation. What developments have occurred since 2004 from the perspective of orthopedics and trauma surgery? This article takes stock of the developments between 2004 and 2014. Analysis of relevant diagnoses, medical procedures and G-DRGs in the versions 2004 and 2014 based on the publications of the German DRG Institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI). The number of G-DRGs in the whole system increased by 45.1 % between 2004 and 2014. The number of G-DRGs in the major diagnostic category (MDC) 08 that contains the majority of orthopedic and trauma surgery categories increased in the same period by 61.6 %. The reduction of variance of inlier costs in the MDC 08 category, a statistical measure of the performance of the G-DRG system, was below the corresponding value of the total system in 2004 as well in 2014. However, the reduction of variance of inlier costs in MDC 08 (+ 30.0 %) rose more from 2004 to 2014 than the corresponding value of the overall system (+ 21.5 %). Many modifications of the classification systems of diagnoses (ICD-10-GM) and medical procedures (OPS) and the structures of the G-DRG system could significantly improve the quality of case allocation from the perspective of orthopedics and trauma surgery between 2004 and 2014. Th assignment of cases could be differentiated so that complex cases with more utilization of resources were allocated to higher rated G-DRGs and vice versa. However, further improvements of the G-DRG system are necessary. Only correct and complete documentation and coding can provide a high quality of calculation of costs as a basis for a correct case allocation in future G-DRG systems.

Development of MY-DRG casemix pharmacy service weights in UKM Medical Centre in Malaysia.

Science.gov (United States)

Ali Jadoo, Saad Ahmed; Aljunid, Syed Mohamed; Nur, Amrizal Muhammad; Ahmed, Zafar; Van Dort, Dexter

2015-02-10

The service weight is among several issues and challenges in the implementation of case-mix in developing countries, including Malaysia. The aim of this study is to develop the Malaysian Diagnosis Related Group (MY-DRG) case-mix pharmacy service weight in University Kebangsaan Malaysia-Medical Center (UKMMC) by identifying the actual cost of pharmacy services by MY-DRG groups in the hospital. All patients admitted to UKMMC in 2011 were recruited in this study. Combination of Step-down and Bottom-up costing methodology has been used in this study. The drug and supplies cost; the cost of staff; the overhead cost; and the equipment cost make up the four components of pharmacy. Direct costing approach has been employed to calculate Drugs and supplies cost from electronic-prescription system; and the inpatient pharmacy staff cost, while the overhead cost and the pharmacy equipments cost have been calculated indirectly from MY-DRG data base. The total pharmacy cost was obtained by summing the four pharmacy components' cost per each MY-DRG. The Pharmacy service weight of a MY-DRG was estimated by dividing the average pharmacy cost of the investigated MY-DRG on the average of a specified MY-DRG (which usually the average pharmacy cost of all MY-DRGs). Drugs and supplies were the main component (86.0%) of pharmacy cost compared o overhead cost centers (7.3%), staff cost (6.5%) and pharmacy equipments (0.2%) respectively. Out of 789 inpatient MY-DRGs case-mix groups, 450 (57.0%) groups were utilized by the UKMMC. Pharmacy service weight has been calculated for each of these 450 MY-DRGs groups. MY-DRG case-mix group of Lymphoma & Chronic Leukemia group with severity level three (C-4-11-III) has the highest pharmacy service weight of 11.8 equivalents to average pharmacy cost of RM 5383.90. While the MY-DRG case-mix group for Circumcision with severity level one (V-1-15-I) has the lowest pharmacy service weight of 0.04 equivalents to average pharmacy cost of RM 17.83. A mixed

Structure of some relative relation modules of finite p-groups

International Nuclear Information System (INIS)

Yamin, M.

1990-06-01

Let G be a finite p-group generated by (g i , 1 ≤ i ≤ d), G i the cyclic subgroup generated by g i , E the free product of the G i , 1 ≤ i ≤ d, and S the kernel of the natural epimorphism of E onto G. The largest elementary abelian p-quotient S-circumflex = S/S'S p , regarded as an IF p G-module via conjugation in E, is called a relative relation module of G. If d is the minimum number of generaters for G, the author has proved that S-circumflex is nonprojective and indecomposable. The aim of this paper is to give an alternative proof for the indecomposability of S-circumflex; the proof here is more informative as it deals with Loewy structure and generating sets of S-circumflex and other associated modules. (author). 9 refs

Solidarity through shared disadvantage: Highlighting shared experiences of discrimination improves relations between stigmatized groups.

Science.gov (United States)

Cortland, Clarissa I; Craig, Maureen A; Shapiro, Jenessa R; Richeson, Jennifer A; Neel, Rebecca; Goldstein, Noah J

2017-10-01

Intergroup relations research has largely focused on relations between members of dominant groups and members of disadvantaged groups. The small body of work examining intraminority intergroup relations, or relations between members of different disadvantaged groups, reveals that salient experiences of ingroup discrimination promote positive relations between groups that share a dimension of identity (e.g., 2 different racial minority groups) and negative relations between groups that do not share a dimension of identity (e.g., a racial minority group and a sexual minority group). In the present work, we propose that shared experiences of discrimination between groups that do not share an identity dimension can be used as a lever to facilitate positive intraminority intergroup relations. Five experiments examining relations among 4 different disadvantaged groups supported this hypothesis. Both blatant (Experiments 1 and 3) and subtle (Experiments 2, 3, and 4) connections to shared experiences of discrimination, or inducing a similarity-seeking mindset in the context of discrimination faced by one's ingroup (Experiment 5), increased support for policies benefiting the outgroup (Experiments 1, 2, and 4) and reduced intergroup bias (Experiments 3, 4, and 5). Taken together, these experiments provide converging evidence that highlighting shared experiences of discrimination can improve intergroup outcomes between stigmatized groups across dimensions of social identity. Implications of these findings for intraminority intergroup relations are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Australian diagnosis related groups: Drivers of complexity adjustment.

Science.gov (United States)

Jackson, Terri; Dimitropoulos, Vera; Madden, Richard; Gillett, Steve

2015-11-01

In undertaking a major revision to the Australian Refined Diagnosis Related Group (ARDRG) classification, we set out to contrast Australia's approach to using data on additional (not principal) diagnoses with major international approaches in splitting base or Adjacent Diagnosis Related Groups (ADRGs). Comparative policy analysis/narrative review of peer-reviewed and grey literature on international approaches to use of additional (secondary) diagnoses in the development of Australian and international DRG systems. European and US approaches to characterise complexity of inpatient care are well-documented, providing useful points of comparison with Australia's. Australia, with good data sources, has continued to refine its national DRG classification using increasingly sophisticated approaches. Hospital funders in Australia and in other systems are often under pressure from provider groups to expand classifications to reflect clinical complexity. DRG development in most healthcare systems reviewed here reflects four critical factors: these socio-political factors, the quality and depth of the coded data available to characterise the mix of cases in a healthcare system, the size of the underlying population, and the intended scope and use of the classification. Australia's relatively small national population has constrained the size of its DRG classifications, and development has been concentrated on inpatient care in public hospitals. Development of casemix classifications in health care is driven by both technical and socio-political factors. Use of additional diagnoses to adjust for patient complexity and cost needs to respond to these in each casemix application. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Does HIPE data capture the complexity of stroke patients in an acute hospital setting?

LENUS (Irish Health Repository)

Clarke, B

2010-01-01

The Hospital Inpatient Enquiry (HIPE) system is currently used as a principle source of national data on discharges from acute hospitals. The Casemix Programme is used to calculate funding for patient care (HIPE activity and Specialty Costs Returns). Th coding is usually undertaken by clerical personnel. We were concerned that the medical complexity of our stroke patients was not captured by the process. The aims of this study were to compare activity coded by HIPE coding staff and medical staff in consecutive stroke patients discharged from the hospital. One hundred consecutive discharged patients with stroke as primary diagnosis were coded by clerical staff [usual practice] and by medical staff. We compared the coding and any differences. We calculated the financial comparison of subsequent differences in Diagnostic Related Groups (DRGs) and Relative Values (RVs). Clinician coded DRGs resulted in a higher assigned RV in 45 cases. The total RV value for HIPE using clerical coding was 595,268.94 euros and using medical coding was 725,252.16 euros. We conclude that medical input is useful in detailing the complications arising in stroke patients. We suggest that physicians should assist in the HIPE coding process in order to capture clinical complexity, so that funding can be appropriately assigned to manage these complex patients.

Boundaries of American Identity: Relations between Ethnic Group Prototypicality and Policy Attitudes

Science.gov (United States)

Huynh, Que-Lam; Devos, Thierry; Altman, Hannah R.

2014-01-01

We sought to document that the extent to which different ethnic groups are perceived as embodying the American identity is more strongly linked to anti-minority policy attitudes and acculturation ideologies among majority group members (European Americans) than among minority group members (Asian Americans or Latino/as). Participants rated 13 attributes of the American identity as they pertain to different ethnic groups, and reported their endorsement of policy attitudes and acculturation ideologies. We found a relative consensus across ethnic groups regarding defining components of the American identity. However, European Americans were perceived as more prototypical of this American identity than ethnic minorities, especially by European American raters. Moreover, for European Americans but not for ethnic minorities, relative ingroup prototypicality was related to anti-minority policy attitudes and acculturation ideologies. These findings suggest that for European Americans, perceptions of ethnic group prototypicality fulfill an instrumental function linked to preserving their group interests and limiting the rights afforded to ethnic minorities. PMID:26347578

Boundaries of American Identity: Relations between Ethnic Group Prototypicality and Policy Attitudes.

Science.gov (United States)

Huynh, Que-Lam; Devos, Thierry; Altman, Hannah R

2015-08-01

We sought to document that the extent to which different ethnic groups are perceived as embodying the American identity is more strongly linked to anti-minority policy attitudes and acculturation ideologies among majority group members (European Americans) than among minority group members (Asian Americans or Latino/as). Participants rated 13 attributes of the American identity as they pertain to different ethnic groups, and reported their endorsement of policy attitudes and acculturation ideologies. We found a relative consensus across ethnic groups regarding defining components of the American identity. However, European Americans were perceived as more prototypical of this American identity than ethnic minorities, especially by European American raters. Moreover, for European Americans but not for ethnic minorities, relative ingroup prototypicality was related to anti-minority policy attitudes and acculturation ideologies. These findings suggest that for European Americans, perceptions of ethnic group prototypicality fulfill an instrumental function linked to preserving their group interests and limiting the rights afforded to ethnic minorities.

Opportunities knock: Mediation of peer-relations during meal-time in toddler groups

Directory of Open Access Journals (Sweden)

Ellen Os

2013-11-01

Full Text Available According to socio-cultural perspectives, adults are seen as mediators of cultural believes, values and practices. Qualitative analyses of teachers’ mediation of peer relations based on video-recordings in 9 toddler-groups indicate that meal-time represents opportunities for teachers to facilitate togetherness and peer-relations between toddlers. The teachers might facilitate sharing, passing food, routinized practices such as singing, and conversations. The results indicate variations between child- and group-oriented approaches, and accomplishing meals in an effective way. The child- and group-oriented approaches are marked by encouragement of toddlers’ initiatives and teachers supporting peer-interactions. Raising teachers’ consciousness about their contributions to children’s development of peer-relations and togetherness in group settings might contribute to enhance reflected practices in working with toddlers in groups.

Group-by Skyline Query Processing in Relational Engines

DEFF Research Database (Denmark)

Yiu, Man Lung; Luk, Ming-Hay; Lo, Eric

2009-01-01

the missing cost model for the BBS algorithm. Experimental results show that our techniques are able to devise the best query plans for a variety of group-by skyline queries. Our focus is on algorithms that can be directly implemented in today's commercial database systems without the addition of new access......The skyline operator was first proposed in 2001 for retrieving interesting tuples from a dataset. Since then, 100+ skyline-related papers have been published; however, we discovered that one of the most intuitive and practical type of skyline queries, namely, group-by skyline queries remains...

Medicaid prospective payment: Case-mix increase

Science.gov (United States)

Baker, Samuel L.; Kronenfeld, Jennie J.

1990-01-01

South Carolina Medicaid implemented prospective payment by diagnosis-related group (DRG) for inpatient care. The rate of complications among newborns and deliveries doubled immediately. The case-mix index for newborns increased 66.6 percent, which increased the total Medicaid hospital expenditure 5.5 percent. Outlier payments increased total expenditure further. DRG distribution change among newborns has a large impact on spending because newborn complication DRGs have high weights. States adopting a DRG-based payment system for Medicaid should anticipate a greater increase in case mix than Medicare experienced. PMID:10113463

The Social Relations of a Health Walk Group: An Ethnographic Study.

Science.gov (United States)

Grant, Gordon; Pollard, Nick; Allmark, Peter; Machaczek, Kasia; Ramcharan, Paul

2017-09-01

It is already well established that regular walks are conducive to health and well-being. This article considers the production of social relations of regular, organized weekly group walks for older people. It is based on an ethnographic study of a Walking for Health group in a rural area of the United Kingdom. Different types of social relations are identified arising from the walk experience. The social relations generated are seen to be shaped by organizational factors that are constitutive of the walks; the resulting culture having implications for the sustainability of the experience. As there appears to be no single uniting theory linking group walk experiences to the production of social relations at this time, the findings are considered against therapeutic landscape, therapeutic mobility, and social capital theorizing. Finally, implications for the continuance of walking schemes for older people and for further research are considered.

Physicians Mutual Aid Group: A Response to AIDS-Related Burnout.

Science.gov (United States)

Garside, Bruce

1993-01-01

Describes origins and functioning of physician's mutual aid group for physicians providing primary care to people with Acquired Immune Deficiency Syndrome (AIDS). Offers suggestions related to overcoming resistance physicians might have to participating in such a group and reviews modalities that were helpful in facilitating participants' ability…

Sudden death and cervical spine: A new contribution to pathogenesis for sudden death in critical care unit from subarachnoid hemorrhage; first report – An experimental study

Science.gov (United States)

Kazdal, Hizir; Kanat, Ayhan; Aydin, Mehmet Dumlu; Yazar, Ugur; Guvercin, Ali Riza; Calik, Muhammet; Gundogdu, Betul

2017-01-01

Context: Sudden death from subarachnoid hemorrhage (SAH) is not uncommon. Aims: The goal of this study is to elucidate the effect of the cervical spinal roots and the related dorsal root ganglions (DRGs) on cardiorespiratory arrest following SAH. Settings and Design: This was an experimental study conducted on rabbits. Materials and Methods: This study was conducted on 22 rabbits which were randomly divided into three groups: control (n = 5), physiologic serum saline (SS; n = 6), SAH groups (n = 11). Experimental SAH was performed. Seven of 11 rabbits with SAH died within the first 2 weeks. After 20 days, other animals were sacrificed. The anterior spinal arteries, arteriae nervorum of cervical nerve roots (C6–C8), DRGs, and lungs were histopathologically examined and estimated stereologically. Statistical Analysis Used: Statistical analysis was performed using the PASW Statistics 18.0 for Windows (SPSS Inc., Chicago, Illinois, USA). Intergroup differences were assessed using a one-way ANOVA. The statistical significance was set at P < 0.05. Results: In the SAH group, histopathologically, severe anterior spinal artery (ASA) and arteriae nervorum vasospasm, axonal and neuronal degeneration, and neuronal apoptosis were observed. Vasospasm of ASA did not occur in the SS and control groups. There was a statistically significant increase in the degenerated neuron density in the SAH group as compared to the control and SS groups (P < 0.05). Cardiorespiratory disturbances, arrest, and lung edema more commonly developed in animals in the SAH group. Conclusion: We noticed interestingly that C6–C8 DRG degenerations were secondary to the vasospasm of ASA, following SAH. Cardiorespiratory disturbances or arrest can be explained with these mechanisms. PMID:28250634

DIAGNOSTIC-RELATED GROUPS IN PEDIATRICS AND NEONATOLOGY: PERSPECTIVES

Directory of Open Access Journals (Sweden)

M. V. Avksent'eva

2014-01-01

Full Text Available Diagnostic-related groups (DRG are being implemented in Russian Federation since 2012 for hospital and day hospital payment. Unification of provider-payment methods and increase of health care efficiency are considered as the main goal of DRG. Presently the 2d version of Russian DRG model is approved by the Federal Fund of mandatory medical insurance, order from 14.11.2013 № 229. Treatment of children is mostly paid for by the same rules as adults’ treatment just now. There are several separate neonatal groups, as well as separate groups for diabetes and acute leukemia in children. The federal DRG model should be used in all regions of Russia, still it’s not final now and has to be improved. For example, number of pediatric groups will be increased. Each DRG has its own weight coefficient for calculating the tariff. The regions in RF can use correction coefficients to adjust the model. Besides regions can extract subgroups from basic DRG on the basis of standard methodology.

Potenciais usos dos AP-DRG para discriminar o perfil da assistência de unidades hospitalares Potential uses of AP-DRG to describe the health care profile in hospital units

Directory of Open Access Journals (Sweden)

Marina Ferreira de Noronha

2004-01-01

Full Text Available Os All Patient Diagnosis Related Groups (AP-DRG constituem-se em um sistema de classificação de pacientes internados em hospitais gerais, que reúne pacientes em grupos, considerando diversas características com impacto no consumo de recursos hospitalares e critérios clínicos. O AP-DRG tem suas diversas versões utilizadas para a gerência e como unidade de pagamento a hospitais. O objetivo deste artigo foi descrever a classificação, explorando suas potencialidades para gerar informações para a gestão de hospitais. Foi utilizada a base de dados da região de Ribeirão Preto, São Paulo Brasil, de 1997, que inclui unidades hospitalares públicas, privadas e filantrópicas. Foram realizadas comparações entre Ribeirão Preto e Estados Unidos quanto ao tempo médio de permanência hospitalar de AP-DRGs selecionados. Utilizando-se os pesos relacionados ao custo relativo dos DRGs, construídos para o Estado de Nova York, Estados Unidos, foi possível verificar o perfil da atenção prestada por trinta hospitais da região de Ribeirão Preto e também o perfil dos pacientes pagos pelo SUS procedentes de outras localidades. Avalia-se que a classificação fornece informações acerca do perfil de complexidade da atenção hospitalar, tanto no que diz respeito à regionalização e sua organização em níveis de complexidade, como para subsidiar as decisões de composição dessa rede de assistência, auxiliar no seu monitoramento e contribuir para o aprimoramento do pagamento aos hospitais.The All Patient Diagnosis Related Groups (AP-DRG provide a classification system for general hospital inpatients, aggregating hospitalizations based on resource use and clinical criteria. The different versions of the AP-DRG have been applied to inpatient care management and reimbursement. This paper aimed to describe the classification and explore the potential for generating information on inpatient care management based on data from the Ribeirão Preto

Impact of self-financed rotavirus vaccines on hospital stays and costs in Spain after a 3-year introductory period.

Science.gov (United States)

Redondo-González, O; Tenías-Burillo, J M; Ruiz-Gonzalo, J

2017-07-01

Vaccination has reduced rotavirus hospitalizations by 25% in European regions with low-moderate vaccine availability. We aimed to quantify the reduction in hospital costs after the longest period in which Rotarix® and Rotateq® were simultaneously commercially available in Spain. Cases, length of stay (LOS), and diagnosis-related groups (DRGs) were retrieved from the Minimum Basic Data Set. Healthcare expenditure was estimated through the cost accounting system Gescot®. DRGs were clustered: I, non-bacterial gastroenteritis with complications; II, without complications; III, requiring surgical/other procedures or neonatal cases (highest DRG weights). Comparisons between pre (2003-2005)- and post-vaccine (2007-2009) hospital stays and costs by DRG group were made. Rotaviruses were the most common agents of specific-coded gastroenteritis (N = 1657/5012). LOS and extended LOS of rotaviruses fell significantly in 2007-2009 (β-coefficient = -0·43, 95% confidence intervals (95% CI) -0·68 to -0·17; and odds ratio 0·62, 95% CI 0·50-0·76, respectively). Overall, costs attributable to rotavirus hospitalizations fell approximately €244 per patient (95% CI -365 to -123); the decrease in DRG group III was €2269 per patient (95% CI -4098 to -380). We concluded modest savings in hospital costs, largely attributable to cases with higher DRG weights, and a faster recovery. A universal rotavirus vaccination program deserves being re-evaluated, regarding its potential high impact on both at-risk children and societal costs.

Hesitant Probabilistic Multiplicative Preference Relations in Group Decision Making

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Zia Bashir

2018-03-01

Full Text Available The preference of one alternative over another is a useful way to express the opinion of the decision-maker. In the process of group decision-making, preference relations are used in preference modeling of the alternatives under given criteria. The probability is an important tool to deal with uncertainty and, in many scenarios of decision-making problems, the probabilities of different events affect the decision-making process directly. In order to deal with this issue, the hesitant probabilistic multiplicative preference relation (HPMPR is defined in this paper. Furthermore, consistency of the HPMPR and consensus among decision makers are studied here. In this respect, many algorithms are developed to achieve consistency of HPMPRs, reasonable consensus between decision-makers and a final algorithm is proposed comprehending all other algorithms, presenting a complete decision support model for group decision-making. Lastly, we present a case study with complete illustration of the proposed model and discuss the effects of probabilities on decision-making validating the importance of the introduction of probability in hesitant multiplicative preference relations.

Relation Entropy and Transferable Entropy Think of Aggregation on Group Decision Making

Institute of Scientific and Technical Information of China (English)

CHENG Qi-yue; QIU Wan-hua; LIU Xiao-feng

2002-01-01

In this paper, aggregation question based on group decision making and a single decision making is studied. The theory of entropy is applied to the sets pair analysis. The system of relation entropy and the transferable entropy notion are put. The character is studied. An potential by the relation entropy and transferable entropy are defined. It is the consistency measure on the group between a single decision making. We gained a new aggregation effective definition on the group misjudge.

The role of sense of coherence in group relations training

Directory of Open Access Journals (Sweden)

Frans Cilliers

2001-09-01

Full Text Available This research measured the role that sense of coherence (SOC plays on an individual and group level during group relations training, presented to fifty-eight managers, using Antonovsky’s scale and an semi-structured interview. The individual measuring high on SOC showed more understanding of group dynamics,made more use of own existing resources to cope with anxiety and found the experience challenging and meaningful, than the low measuring individual. On the group level, the split between high and lowled to projective identification: the high SOC individuals contain competence and the low, incompetence.Recommendations for future group relations training are formulated. Opsomming Hierdie navorsing meet die rol wat sin vir koherensie (SOC op individuele en groepvlak tydens groepverhoudinge opleiding speel soos aangebied vir agt-en-vyftig bestuurders, en gemeet met Antonovsky se skaal en ’n semi-gestruktureerde onderhoud. Die individuwat hoogmeet op SOC toon’n beter begrip van groepdinamika, maak meer gebruik van eie bestaande hulpbronne om met angs te cope, en vind die ervaringmeer uitdagend en betekenisvol, as die individu wat laag meet. Op groepsvlak lei die verdeling tussen hoog en laag na projektiewe identifikasie: die hoe SOC individue ‘‘behou’’ bevoegdheid en die lae, onbevoegdheid. Aanbevelings vir toekomstige groepsverhoudinge opleiding word geformuleer.

Coherent states related with SU(N) and SU(N,1) groups

International Nuclear Information System (INIS)

Gitman, D.M.; Shelepin, A.L.

1990-01-01

The basis of coherent state (CS) for symmetric presentations of groups SU(N) and SU(N,1) is plotted, its properties being investigated. Evolution of CS is considered. Relation between CS of groups SU(N) and Glauber is ascertained

Nursing dependency, diagnosis-related groups, and length of hospital stay

OpenAIRE

Halloran, Edward J.; Kiley, Marylou

1987-01-01

Most efforts to modify the diagnosis-related group (DRG) case classification system focus on variables related to medical management. In this study, we investigated the separate but related natures of medicine and nursing by examining 1,288 adult medical and surgical patients in an urban teaching hospital. The complexity of medical treatment was measured by use of the DRG relative cost weight. The nursing indicator was derived from a set of nursing diagnoses. We found that the DRG cost weight...

The role of national identity representation in the relation between in-group identification and out-group derogation: Ethnic versus civic representation

OpenAIRE

Meeus, Joke; Duriez, Bart; Vanbeselaere, Norbert; Boen, Filip

2010-01-01

Two studies investigated whether the content of in-group identity affects the relation between in-group identification and ethnic prejudice. The first study among university students, tested whether national identity representations (i.e. ethnic vs. civic) moderate or mediate the relation between Flemish in-group identification and ethnic prejudice. A moderation hypothesis is supported when those higher in identification who subscribe to a more ethnic representation display higher ethnic prej...

How does social essentialism affect the development of inter-group relations?

Science.gov (United States)

Rhodes, Marjorie; Leslie, Sarah-Jane; Saunders, Katya; Dunham, Yarrow; Cimpian, Andrei

2018-01-01

Psychological essentialism is a pervasive conceptual bias to view categories as reflecting something deep, stable, and informative about their members. Scholars from diverse disciplines have long theorized that psychological essentialism has negative ramifications for inter-group relations, yet little previous empirical work has experimentally tested the social implications of essentialist beliefs. Three studies (N = 127, ages 4.5-6) found that experimentally inducing essentialist beliefs about a novel social category led children to share fewer resources with category members, but did not lead to the out-group dislike that defines social prejudice. These findings indicate that essentialism negatively influences some key components of inter-group relations, but does not lead directly to the development of prejudice. © 2017 John Wiley & Sons Ltd.

Social media in communicating health information: an analysis of Facebook groups related to hypertension.

Science.gov (United States)

Al Mamun, Mohammad; Ibrahim, Hamza M; Turin, Tanvir Chowdhury

2015-01-29

We studied Facebook groups related to hypertension to characterize their objectives, subject matter, member sizes, geographical boundaries, level of activity, and user-generated content. We performed a systematic search among open Facebook groups using the keywords "hypertension," "high blood pressure," "raised blood pressure," and "blood pressure." We extracted relevant data from each group's content and developed a coding and categorizing scheme for the whole data set. Stepwise logistic regression was used to explore factors independently associated with each group's level of activity. We found 187 hypertension-related Facebook groups containing 8,966 members. The main objective of most (59.9%) Facebook groups was to create hypertension awareness, and 11.2% were created primarily to support patients and caregivers. Among the top-displayed, most recent posts (n = 164), 21.3% were focused on product or service promotion, whereas one-fifth of posts were related to hypertension-awareness information. Each Facebook group's level of activity was independently associated with group size (adjusted odds ratio [AOR], 1.02; 95% confidence interval [CI], 1.01-1.03), presence of "likes" on the most recent wall post (AOR, 3.55, 95% CI, 1.41-8.92), and presence of attached files on the group wall (AOR, 5.01, 95% CI, 1.25-20.1). The primary objective of most of the hypertension-related Facebook groups observed in this study was awareness creation. Compared with the whole Facebook community, the total number of hypertension-related Facebook groups and their users was small and the groups were less active.

Plasma-related matrix effects in inductively coupled plasma--atomic emission spectrometry by group I and group II matrix-elements

International Nuclear Information System (INIS)

Chan, George C.-Y.; Chan, W.-T.

2003-01-01

The effects of Na, K, Ca and Ba matrices on the plasma excitation conditions in inductively coupled plasma-atomic emission spectrometry (ICP-AES) were studied. Normalized relative intensity was used to indicate the extent of the plasma-related matrix effects. The group I matrices have no effects on the plasma excitation conditions. In contrast, the group II matrices depress the normalized relative intensities of some spectral lines. Specifically, the Group II matrices have no effects on the normalized relative intensity of atomic lines of low upper energy level (soft lines), but reduce the normalized relative intensity of some ionic lines and atomic lines of high energy level (hard lines). The Group II matrices seem to shift the Saha balance of the analytes only; no shift in the Boltzmann balance was observed experimentally. Moreover, for some ionic lines with sum of ionization and excitation potentials close to the ionization potential of argon (15.75 eV), the matrix effect is smaller than other ionic lines of the same element. The reduced matrix effects may be attributed qualitatively to charge transfer excitation mechanism of these ionic lines. Charge transfer reaction renders ionic emission lines from the quasi-resonant levels similar in characteristics of atomic lines. The contribution of charge transfer relative to excitation by other non-specific excitation mechanisms (via Saha balance and Boltzmann balance) determines the degree of atomic behavior of a quasi-resonant level. A significant conclusion of this study is that plasma-related matrix effect depends strongly on the excitation mechanism of a spectral line. Since, in general, more than one excitation mechanism may contribute to the overall excitation of an emission line, the observed matrix effects reflect the sum of the effects due to individual excitation mechanisms. Excitation mechanisms, in addition to the often-used total excitation energy, should be considered in matrix effect studies

Special relativity and quantum theory: a collection of papers on the Poincari Group

International Nuclear Information System (INIS)

Noz, M.E.; Kim, Y.S.

1988-01-01

When the present form of quantum mechanics was formulated in 1927, the most pressing problem was how to make it consistent with special relativity. This still remains a most important and urgent theoretical problem in physics. The underlying language for both disciplines is group theory, and E.P. Wigner's 1939 paper on the Poincari group laid the foundation for unifying the concepts and algorithms of quantum mechanics and special relativity. This volume comprises forty-five papers, including those by P.A.M. Dirac, R.P. Feynman, S. Weinberg, E.P. Wigner and H. Yukawa, covering representations of the Poincari group, time-energy uncertainty relation, covariant pictures of quantum bound states, Lorentz-Dirac deformation in high-enery physics, gauge degrees of freedom for massless particles, group contractions applied to the large-momentum/zero-mass limit, localization problems, and physical applications of the Lorentz group

Perception of radiation related risks among three population groups

International Nuclear Information System (INIS)

Mihai, L.T.; Milu, C.; Voicu, B.; Enachescu, D.

2003-01-01

A questionnaire survey was conducted among three groups that mainly differ in socioeconomic status and professional exposure to ionizing radiations. Seventy-seven (26.3%) of the respondents were professionally exposed to radiation, 35 (11.9%) were medical doctors without professional exposure and 177 (68.4%) belonged to the general population group. The level of anxiety toward radiation, expressed as a concernedness index, is significantly lower in people who are professionally exposed to radiation compared to medical doctors and general population (0.81±0.94, 1.42±1.21 and 1.72±1.34 respectively, p < 0.001). In a similar manner, concernedness index values varied with the education status, with lowest values among medical university graduates and highest among public school graduates (p < 0.001). Both university-graduated groups significantly differ from the non-university groups (p < 0.05). Knowledge about radiation and knowledge about emergency plans in nuclear accident/incident were also checked in relation with concernedness, the results confirming the hypothesis that better knowledge associates lower concernedness. The extent to which people accept the civil utilization of nuclear power is also related to concernedness and knowledge, significant associations having been found. The results suggest that a political decision in radiation matter requires a valid analysis of the public's understanding and acceptance. For that reason, it is important that radiological protection authorities develop new plans and materials for communicating with people, in order to improve knowledge upon ionizing radiation, irradiation risks and safety of nuclear energy application for civil purposes. (author)

A Semiparametric Bayesian Approach for Analyzing Longitudinal Data from Multiple Related Groups.

Science.gov (United States)

Das, Kiranmoy; Afriyie, Prince; Spirko, Lauren

2015-11-01

Often the biological and/or clinical experiments result in longitudinal data from multiple related groups. The analysis of such data is quite challenging due to the fact that groups might have shared information on the mean and/or covariance functions. In this article, we consider a Bayesian semiparametric approach of modeling the mean trajectories for longitudinal response coming from multiple related groups. We consider matrix stick-breaking process priors on the group mean parameters which allows information sharing on the mean trajectories across the groups. Simulation studies are performed to demonstrate the effectiveness of the proposed approach compared to the more traditional approaches. We analyze data from a one-year follow-up of nutrition education for hypercholesterolemic children with three different treatments where the children are from different age-groups. Our analysis provides more clinically useful information than the previous analysis of the same dataset. The proposed approach will be a very powerful tool for analyzing data from clinical trials and other medical experiments.

Uncertainty relations, zero point energy and the linear canonical group

Science.gov (United States)

Sudarshan, E. C. G.

1993-01-01

The close relationship between the zero point energy, the uncertainty relations, coherent states, squeezed states, and correlated states for one mode is investigated. This group-theoretic perspective enables the parametrization and identification of their multimode generalization. In particular the generalized Schroedinger-Robertson uncertainty relations are analyzed. An elementary method of determining the canonical structure of the generalized correlated states is presented.

Adolescents' perception of peer groups: Psychological, behavioral, and relational determinants.

Science.gov (United States)

Lee, Seungyoon; Foote, Jeremy; Wittrock, Zachary; Xu, Siyu; Niu, Li; French, Doran C

2017-07-01

Adolescents' social cognitive understanding of their social world is often inaccurate and biased. Focusing on peer groups, this study examines how adolescents' psychological, behavioral, and relational characteristics influence the extent to which they accurately identify their own and others' peer groups. Analyses were conducted with a sample of 1481 seventh- and tenth-grade Chinese students who are embedded with 346 peer groups. Overall, females and older students had more accurate perceptions. In addition, lower self-esteem, higher indegree centrality, and lower betweenness centrality in the friendship network predicted more accurate perception of one's own groups, whereas higher academic performance and lower betweenness centrality in the friendship network predicted more accurate perception of others' groups. Implications for understanding the connection between adolescents' psychological and behavioral traits, social relationships, and social cognition are discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

The Impact of Merger Status and Relative Representation on Identification with a Merger Group

Directory of Open Access Journals (Sweden)

Filip Boen

2005-12-01

Full Text Available This experiment tested to what extent identification with a new merger group is determined by the status of that merger group and by the relative representation of the pre-merger ingroup. One hundred university students were assigned to a team of 'inductive' thinkers, and were later merged with a team of 'deductive' thinkers to form a team of 'analyst' thinkers. The status of the merger group (low, high and the relative representation of the ingroup into the novel merger group (low, high were manipulated. Participants identified more with the merger group in the high than in the low status condition, and they identified more in the high than in the low representation condition. The predicted interaction between relative representation and merger status was not significant. However, relative representation did interact with participants' pre-merger identification: Pre- and post-merger identification were positively related when the ingroup was highly represented, but 'negatively' when the ingroup was lowly represented.

[25 years of the DRG-based health-financing system in Hungary].

Science.gov (United States)

Babarczy, Balázs; Gyenes, Péter; Imre, László

2015-07-19

After a thourough development phase, a new system of health financing was introduced in Hungary in 1993. One of the cornerstones of the system was the financing of acute hospital care through Diagnosis-Related Groups (DRGs). This method was part of a comprehensive healthcare model, elaborated and published around 1990 by experts of Gyógyinfok, a public institute. The health financing system that was finally introduced reflcted in large part this theoretical model, while the current Hungarian system differs from it in some important respects. The objective of this article is to identify these points of divergence.

Combat-related, chronic posttraumatic stress disorder: implications for group-therapy intervention.

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Makler, S; Sigal, M; Gelkopf, M; Kochba, B B; Horeb, E

1990-07-01

The patient with combat-related chronic Posttraumatic Stress Disorder suffers from a wide spectrum of maladaptive behaviors. This paper delineates the work that has been done with such a population in group therapy. The plan that is proposed takes into account three interrelated sets of factors: factors important for creating an effective working relation; curative factors; and particular themes. Each of these factors is analyzed in the light of the particularities of group work with such a population. Each of the points discussed is based upon the relevant literature, upon the experience of the therapist, and illustrated with examples.

The influence of individual, group, and relative self-esteem on outcome for patients undergoing group cognitive-behavioural therapy treatment.

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Parker, Thomas J; Page, Andrew C; Hooke, Geoff R

2013-11-01

Despite a strong association between individual self-esteem and treatment outcome in group cognitive-behavioural therapy (GCBT), no study has investigated how patient outcomes might be influenced by an individual's self-esteem relative to other group members. The study comprised a retrospective examination of patients' data and used a multiple regression analysis to identify predictors of treatment outcome. Patients' pre-treatment self-esteem scores were assessed on a continuum and assigned to be low, medium, or high. Therapy groups were assigned to be either low, balanced or high self-esteem groups based on averaged self-esteem scores of participants. In this study, 3,878 patients who had completed a 10-day intensive cognitive behavioural group therapy programme at a private psychiatric facility were included in the study. The Rosenberg Self-Esteem measure was chosen to assess self-esteem. The three subscales of the Depression Anxiety Stress Scales were used as the outcome measures. Patient outcomes were influenced by pre-treatment self-esteem scores, such that higher initial self-esteem was associated with better treatment outcomes. Low group self-esteem was predictive of significantly better outcomes for depression, relative to higher self-esteem groups. Additionally, the combined influence of high individual self-esteem and low group self-esteem was associated with significantly enhanced depression improvement. High self-esteem patients perform better on outcome measures following completion of GCBT. Low self-esteem groups show greater improvement in depression symptoms. Similar results for depression are achieved when patients with high self-esteem complete treatment in low self-esteem groups. © 2013 The British Psychological Society.

Age groups related glioblastoma study based on radiomics approach.

Science.gov (United States)

Li, Zeju; Wang, Yuanyuan; Yu, Jinhua; Guo, Yi; Zhang, Qi

2017-12-01

Glioblastoma is the most aggressive malignant brain tumor with poor prognosis. Radiomics is a newly emerging and promising technique to reveal the complex relationships between high-throughput medical image features and deep information of disease including pathology, biomarkers and genomics. An approach was developed to investigate the internal relationship between magnetic resonance imaging (MRI) features and the age-related origins of glioblastomas based on a quantitative radiomics method. A fully automatic image segmentation method was applied to segment the tumor regions from three dimensional MRI images. 555 features were then extracted from the image data. By analyzing large numbers of quantitative image features, some predictive and prognostic information could be obtained by the radiomics approach. 96 patients diagnosed with glioblastoma pathologically have been divided into two age groups (age groups (T test, p age difference (T test, p= .006). In conclusion, glioblastoma in different age groups present different radiomics-feature patterns with statistical significance, which indicates that glioblastoma in different age groups should have different pathologic, protein, or genic origins.

General relation between the group delay and dwell time in multicomponent electron systems

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Zhai, Feng; Lu, Junqiang

2016-10-01

For multicomponent electron scattering states, we derive a general relation between the Wigner group delay and the Bohmian dwell time. It is found that the definition of group delay should account for the phase of the spinor wave functions of propagating modes. The difference between the group delay and dwell time comes from both the interference delay and the decaying modes. For barrier tunneling of helical electrons on a surface of topological insulators, our calculations including the trigonal-warping term show that the decaying modes can contribute greatly to the group delay. The derived relation between the group delay and the dwell time is helpful to unify the two definitions of tunneling time in a quite general situation.

How Does Biological Belief in Race Relate to Our Feelings towards In-Group and Out-Groups?: A Cognitive Dissonance Framework

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Tawa, John; Kim, Grace S.

2011-01-01

This study considered the effect of belief in race as a biological construct (RACEBIO) and inter-group anxiety (IGA) on in-group racial salience (IGRS) and out-group discomfort (OGD). Participants included 66 racially and ethnically diverse high school boarding students. As hypothesized, RACEBIO was positively related to both IGRS and OGD. In…

Review of Diagnosis-Related Group-Based Financing of Hospital Care

Directory of Open Access Journals (Sweden)

Natasa Mihailovic

2016-05-01

Full Text Available Since the 1990s, diagnosis-related group (DRG-based payment systems were gradually introduced in many countries. The main design characteristics of a DRG-based payment system are an exhaustive patient case classification system (ie, the system of diagnosis-related groupings and the payment formula, which is based on the base rate multiplied by a relative cost weight specific for each DRG. Cases within the same DRG code group are expected to undergo similar clinical evolution. Consecutively, they should incur the costs of diagnostics and treatment within a predefined scale. Such predictability was proven in a number of cost-of-illness studies conducted on major prosperity diseases alongside clinical trials on efficiency. This was the case with risky pregnancies, chronic obstructive pulmonary disease, diabetes, depression, alcohol addiction, hepatitis, and cancer. This article presents experience of introduced DRG-based payments in countries of western and eastern Europe, Scandinavia, United States, Canada, and Australia. This article presents the results of few selected reviews and systematic reviews of the following evidence: published reports on health system reforms by World Health Organization, World Bank, Organization for Economic Co-operation and Development, Canadian Institute for Health Information, Canadian Health Services Research Foundation, and Centre for Health Economics University of York. Diverse payment systems have different strengths and weaknesses in relation to the various objectives. The advantages of the DRG payment system are reflected in the increased efficiency and transparency and reduced average length of stay. The disadvantage of DRG is creating financial incentives toward earlier hospital discharges. Occasionally, such polices are not in full accordance with the clinical benefit priorities.

Reductions in Average Lengths of Stays for Surgical Procedures Between the 2008 and 2014 United States National Inpatient Samples Were Not Associated With Greater Incidences of Use of Postacute Care Facilities.

Science.gov (United States)

Dexter, Franklin; Epstein, Richard H

2018-03-01

Diagnosis-related group (DRG) based reimbursement creates incentives for reduction in hospital length of stay (LOS). Such reductions might be accomplished by lesser incidences of discharges to home. However, we previously reported that, while controlling for DRG, each 1-day decrease in hospital median LOS was associated with lesser odds of transfer to a postacute care facility (P = .0008). The result, though, was limited to elective admissions, 15 common surgical DRGs, and the 2013 US National Readmission Database. We studied the same potential relationship between decreased LOS and postacute care using different methodology and over 2 different years. The observational study was performed using summary measures from the 2008 and 2014 US National Inpatient Sample, with 3 types of categories (strata): (1) Clinical Classifications Software's classes of procedures (CCS), (2) DRGs including a major operating room procedure during hospitalization, or (3) CCS limiting patients to those with US Medicare as the primary payer. Greater reductions in the mean LOS were associated with smaller percentages of patients with disposition to postacute care. Analyzed using 72 different CCSs, 174 DRGs, or 70 CCSs limited to Medicare patients, each pairwise reduction in the mean LOS by 1 day was associated with an estimated 2.6% ± 0.4%, 2.3% ± 0.3%, or 2.4% ± 0.3% (absolute) pairwise reduction in the mean incidence of use of postacute care, respectively. These 3 results obtained using bivariate weighted least squares linear regression were all P < .0001, as were the corresponding results obtained using unweighted linear regression or the Spearman rank correlation. In the United States, reductions in hospital LOS, averaged over many surgical procedures, are not accomplished through a greater incidence of use of postacute care.

Factors Related to Women's Childbirth Satisfaction in Physiologic and Routine Childbirth Groups.

Science.gov (United States)

Jafari, Elham; Mohebbi, Parvin; Mazloomzadeh, Saeideh

2017-01-01

Women's satisfaction with childbirth is an important measure of the quality of maternity care services. This study aims to address factors related to women's childbirth satisfaction in physiological and routine childbirth groups. This descriptive-analytical study was conducted among 340 women in physiological and routine childbirth groups in 2012. Women were selected through convenience sampling method in the routine group and by census in the physiological group. Data were collected using a 5-part questionnaire composed of demographic and obstetrics details, Mackey's Childbirth Satisfaction Rating Scale (CSRS), satisfied with birth setting, Labor Agentry Scale (LAS), and Visual Analogue Scale (VAS), which was completed by interview 24 hours after childbirth. Data were analyzed using the Statistical Package for the Social Sciences version 18 software using Pearson correlation test, independent t -test, analysis of variance, and linear, multivariate regression model at the significant level of P toward the recent pregnancy ( P = 0.007), and perceived severity of pain ( P = 0.016). However, in the routine group, satisfaction was related only to intentional pregnancy ( P = 0.002). In neither group, satisfaction was related to demographic characteristics, maternal parity, and participation in pregnancy and childbirth classes or maternal feelings toward the onset of childbirth ( P > 0.05). Improved physical structure and setting of birth room, nonmedical pain relief, mothers' involvement in the process of labor, and sense of being in control are associated with mothers' satisfaction.

ESPEN expert group recommendations for action against cancer-related malnutrition.

Science.gov (United States)

Arends, J; Baracos, V; Bertz, H; Bozzetti, F; Calder, P C; Deutz, N E P; Erickson, N; Laviano, A; Lisanti, M P; Lobo, D N; McMillan, D C; Muscaritoli, M; Ockenga, J; Pirlich, M; Strasser, F; de van der Schueren, M; Van Gossum, A; Vaupel, P; Weimann, A

2017-10-01

Patients with cancer are at particularly high risk for malnutrition because both the disease and its treatments threaten their nutritional status. Yet cancer-related nutritional risk is sometimes overlooked or under-treated by clinicians, patients, and their families. The European Society for Clinical Nutrition and Metabolism (ESPEN) recently published evidence-based guidelines for nutritional care in patients with cancer. In further support of these guidelines, an ESPEN oncology expert group met for a Cancer and Nutrition Workshop in Berlin on October 24 and 25, 2016. The group examined the causes and consequences of cancer-related malnutrition, reviewed treatment approaches currently available, and built the rationale and impetus for clinicians involved with care of patients with cancer to take actions that facilitate nutrition support in practice. The content of this position paper is based on presentations and discussions at the Berlin meeting. The expert group emphasized 3 key steps to update nutritional care for people with cancer: (1) screen all patients with cancer for nutritional risk early in the course of their care, regardless of body mass index and weight history; (2) expand nutrition-related assessment practices to include measures of anorexia, body composition, inflammatory biomarkers, resting energy expenditure, and physical function; (3) use multimodal nutritional interventions with individualized plans, including care focused on increasing nutritional intake, lessening inflammation and hypermetabolic stress, and increasing physical activity. Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Blockage of High-Affinity Choline Transporter Increases Visceral Hypersensitivity in Rats with Chronic Stress

Science.gov (United States)

2018-01-01

Background Visceral hypersensitivity is a common feature of irritable bowel syndrome. Cholinergic system involves in the development of visceral hypersensitivity, and high-affinity choline transporter (CHT1) is of crucial importance in choline uptake system. However, involvement of CHT1 in visceral hypersensitivity remains unknown. The research aimed to study the CHT1 expression in dorsal root ganglions (DRGs) and the role of CHT1 in visceral hypersensitivity. Methods Repetitive water avoidance stress (WAS) was used to induce visceral hypersensitivity in rats. Colorectal distension (CRD) was determined, and the abdominal withdrawal reflex (AWR) and threshold intensity data were recorded to measure the visceral sensitivity. After intraperitoneal injection of hemicholinium-3 (HC-3), the specific inhibitor of CHT1, CRD data were also recorded. The CHT1 expression of DRGs was investigated by Western blotting, immunohistochemistry, and quantitative RT-PCR. Acetylcholine levels in the DRGs were detected by the assay kit. Results Repetitive WAS increased the AWR score of CRD at high distension pressure and decreased the mean threshold of rats. The CHT1 expression and acetylcholine concentration of DRG were significantly increased in WAS rats. After the administration of HC-3, the AWR score in WAS group was significantly increased at higher distension pressure while the threshold intensity was significantly reduced compared to the normal saline group. Acetylcholine concentration was significantly lower than the normal saline rats. Conclusion Our research firstly reports that CHT1 is overexpressed in noninflammatory visceral hypersensitivity, and blockage of CHT1 can enhance the visceral hypersensitivity. CHT1 may play an inhibitory role in visceral hypersensitivity. PMID:29849603

Relations between high and low power groups: the importance of legitimacy.

Science.gov (United States)

Hornsey, Matthew J; Spears, Russell; Cremers, Iris; Hogg, Michael A

2003-02-01

Using a social identity perspective, two experiments examined the effects of power and the legitimacy of power differentials on intergroup bias. In Experiment 1, 125 math-science students were led to believe that they had high or low representation in a university decision-making body relative to social-science students and that this power position was either legitimate or illegitimate. Power did not have an independent effect on bias; rather, members of both high and low power groups showed more bias when the power hierarchy was illegitimate than when it was legitimate. This effect was replicated in Experiment 2 (N = 105). In addition, Experiment 2 showed that groups located within an unfair power hierarchy expected the superordinate power body to be more discriminatory than did those who had legitimately high or low power. The results are discussed in terms of their implications for group relations. Copyright 2003 Society for Personality and Social Psychology, Inc.

The costs of acute readmissions to a different hospital –

DEFF Research Database (Denmark)

Dahl, Christian M.; Kongstad, Line Planck

2017-01-01

Treatment costs are found to vary substantially and systematically within DRGs. Several factors have been shown to contribute to the variation in costs within DRGs. We argue that readmissions might also explain part of the observed variation in costs. A substantial number of all readmissions occu....... If teaching hospitals are not compensated for the additional costs of treating different-hospital readmission patients, they might be unfairly funded under a DRG-based payment scheme.......Treatment costs are found to vary substantially and systematically within DRGs. Several factors have been shown to contribute to the variation in costs within DRGs. We argue that readmissions might also explain part of the observed variation in costs. A substantial number of all readmissions occur...... to a different hospital. The change in hospital indicates that a progression of the illness has occurred since the initial hospitalisation. As a result, different-hospital readmissions might be more costly compared to same-hospital admissions. The aim of this paper is twofold. Firstly, to analyse differences...

Estimation of hospital efficiency--do different definitions and casemix measures for hospital output affect the results?

Science.gov (United States)

Vitikainen, Kirsi; Street, Andrew; Linna, Miika

2009-02-01

Hospital efficiency has been the subject of numerous health economics studies, but there is little evidence on how the chosen output and casemix measures affect the efficiency results. The aim of this study is to examine the robustness of efficiency results due to these factors. Comparison is made between activities and episode output measures, and two different output grouping systems (Classic and FullDRG). Non-parametric data envelopment analysis is used as an analysis technique. The data consist of all public acute care hospitals in Finland in 2005 (n=40). Efficiency estimates were not found to be highly sensitive to the choice between episode and activity descriptions of output, but more so to the choice of DRG grouping system. Estimates are most sensitive to scale assumptions, with evidence of decreasing returns to scale in larger hospitals. Episode measures are generally to be preferred to activity measures because these better capture the patient pathway, while FullDRGs are preferred to Classic DRGs particularly because of the better description of outpatient output in the former grouping system. Attention should be paid to reducing the extent of scale inefficiency in Finland.

Intergroup conflict management strategies as related to perceptions of dual identity and separate groups.

Science.gov (United States)

Bizman, Aharon; Yinon, Yoel

2004-04-01

The authors examined the relations between (a) the perceptions of dual identity and separate groups and (b) intergroup conflict management strategies, in two contexts: the conflict between the secular and religious sectors in Israel and the allocation of resources among organizational subunits. In both contexts, contention (i.e., forcing one's will on the other party) was associated with the perception of separate groups. Only in the organizational context, avoidance (i.e., doing nothing or discontinuing participation in the conflict) was associated with the perception of dual identity. Problem solving (i.e., finding a solution that is acceptable to both parties) was related to the perception of dual identity in the secular-religious context. In the organizational context, this relation appeared only under a low perception of separate groups. Yielding (i.e., satisfying the other party's needs at the expense of one's own) was related to the perception of dual identity in the organizational context. In the secular-religious context, this relation appeared only under a high perception of separate groups. The authors discussed the varying pattern of the associations between (a) the perceptions of dual identity and separate groups and (b) the conflict management strategies in the two contexts in terms of the Dual Concern Model and the perceived feasibility of the strategies.

Genome-Wide Identification and Analysis of Drought-Responsive Genes and MicroRNAs in Tobacco

Directory of Open Access Journals (Sweden)

Fuqiang Yin

2015-03-01

Full Text Available Drought stress response is a complex trait regulated at transcriptional and post-transcriptional levels in tobacco. Since the 1990s, many studies have shown that miRNAs act in many ways to regulate target expression in plant growth, development and stress response. The recent draft genome sequence of Nicotiana benthamiana has provided a framework for Digital Gene Expression (DGE and small RNA sequencing to understand patterns of transcription in the context of plant response to environmental stress. We sequenced and analyzed three Digital Gene Expression (DGE libraries from roots of normal and drought-stressed tobacco plants, and four small RNA populations from roots, stems and leaves of control or drought-treated tobacco plants, respectively. We identified 276 candidate drought responsive genes (DRGs with sequence similarities to 64 known DRGs from other model plant crops, 82 were transcription factors (TFs including WRKY, NAC, ERF and bZIP families. Of these tobacco DRGs, 54 differentially expressed DRGs included 21 TFs, which belonged to 4 TF families such as NAC (6, MYB (4, ERF (10, and bZIP (1. Additionally, we confirmed expression of 39 known miRNA families (122 members and five conserved miRNA families, which showed differential regulation under drought stress. Targets of miRNAs were further surveyed based on a recently published study, of which ten targets were DRGs. An integrated gene regulatory network is proposed for the molecular mechanisms of tobacco root response to drought stress using differentially expressed DRGs, the changed expression profiles of miRNAs and their target transcripts. This network analysis serves as a reference for future studies on tobacco response stresses such as drought, cold and heavy metals.

Two ways related to performance in elite sport: the path of self-confidence and competitive anxiety and the path of group cohesion and group goal-clarity.

Science.gov (United States)

Kjørmo, Odd; Halvari, Hallgeir

2002-06-01

A model tested among 136 Norwegian Olympic-level athletes yielded two paths related to performance. The first path indicated that self-confidence, modeled as an antecedent of competitive anxiety, is negatively correlated with anxiety. Competitive anxiety in turn is negatively correlated with performance. The second path indicated that group cohesion is positively correlated with group goal-clarity, which in turn is positively correlated with performance. Competitive anxiety mediates the relation between self-confidence and performance, whereas group goal-clarity mediates the relation between group cohesion and performance. Results from multiple regression analyses supported the model in the total sample and among individual sport athletes organized in training groups (n = 100). Among team sport athletes (n = 36), personality and group measures are more strongly intercorrelated than among individual sport athletes, and the relation with performance is more complex for the former group. The interaction of self-confidence and competitive anxiety is related to performance among team sport athletes.

Ethnic group variations in alcohol-related hospital admissions in England: does place matter?

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Barry, Eleanor; Laverty, Anthony A; Majeed, Azeem; Millett, Christopher

2015-01-01

The health burden of alcohol use is socially and geographically patterned in many countries. Less is known about variations in this burden between ethnic groups and whether this differs across place of residence. National cross-sectional study using hospital admission data in England. Alcohol-related admission rates, where an alcohol-related condition was either the primary diagnosis (considered as the reason for admission) or a comorbidity, were calculated using ethnic group specific rates for English regions. In 2010/11 there were a total of 264,870 alcohol-related admissions in England. Admission rates were higher in the North of England than elsewhere (e.g. for primary diagnosis 161 per 100,000 population in the North vs. 62 per 100,000 in the South). These patterns were not uniform across ethnic groups however. For example, admission rates for alcohol-related comorbidity were four times higher among White Irish in London compared with those in the South of England (306 to 76 per 100,000) and four times higher in Indians living in the Midlands compared with those in the South of England (128 to 29 per 100,000). These patterns were similar for admissions with a comorbid alcohol-related condition. Geographical location may be an important determinant of within and between ethnic group variations in alcohol-related hospital admissions in England. While a number of factors were not examined here, this descriptive analysis suggests that this heterogeneity should be taken into account when planning interventions and services for the prevention and management of alcohol misuse.

Peer group self-identification as a predictor of relational and physical aggression among high school students.

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Pokhrel, Pallav; Sussman, Steven; Black, David; Sun, Ping

2010-05-01

Adolescent peer group self-identification refers to adolescents' affiliation with reputation-based peer groups such as "Goths" or "Jocks." These groups tend to vary on normative characteristics, including the group members' attitudes and behaviors. This article examined whether adolescents' baseline peer group self-identification predicted their self-reported relational and physical aggression 1 year later. Self-report data were collected from 1614 students from 9 regular and 9 continuation (alternative) high schools in Southern California, at baseline and 1-year follow-up. Subjects' mean baseline age was 15.21 years (SD = 1.18) and 51.6% of the subjects were female. Findings indicated that compared with self-identified "Regular" or "Normal" students, adolescents who identified with high-risk peer groups (eg, "Druggies,"Goths") tended to report higher relational and physical aggression 1 year later, controlling for baseline aggression and demographic variables. In addition, adolescents' self-identification with high-status peer groups (eg, "Jocks,"Populars") was predictive of higher relational aggression 1 year later. Gender and school type (ie, regular vs continuation) were not found to moderate these effects. It appears that peer group self-identification is a salient predictor of physical and relational aggression across gender and school type. Adolescents who identify with high-risk peer groups tend to report higher levels of physical as well as relational aggression in the future. In addition, adolescents who affiliate with elite groups tend to become more relationally aggressive over time. School-based prevention programs targeting aggression may benefit from addressing the impacts of peer group self-identification on adolescents' aggressive behavior.

[Financing of inpatient orthopaedics and trauma surgery in the 2011 G-DRG System].

Science.gov (United States)

Franz, D; Schemmann, F; Roeder, N; Siebert, H; Mahlke, L

2011-09-01

The German DRG system forms the basis for billing inpatient hospital services. It includes not only the case groups (G-DRGs), but also copayments. This paper analyses and evaluates the relevant developments of the 2011 G-DRG system for orthopaedics and traumatology from the medical and classificatory perspective. An analysis was performed of relevant diagnoses, medical procedures and G-DRGs in the 2010 and 2011 versions based on the publications of the German DRG Institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI). A number of codes for surgical measures have been newly established or modified - above all in foot surgery, arthroscopic surgery and wound surgery. Here, the identification and the correct and performance-based mapping of complex and elaborate scenarios was again the focus of the restructuring of the G-DRG system. The G-DRG structure in orthopaedics and traumatology is changed, especially for polytraumata. The allocation of common cases with a standardized treatment pattern appears to be appropriate and the reimbursement adequate. For the less common and more complex cases the 2011 G-DRG system still shows need for further modification (e.g. polytraumata, joint replacement, spine surgery). The proper integration of the modified OPS classification for foot surgery to the appropriate G-DRGs will be essential to maintain the high quality of the reimbursement structure for the future.

Relation of ABO Blood Groups to the Plaque Characteristic of Coronary Atherosclerosis.

Science.gov (United States)

Huang, Xingtao; Zou, Yongpeng; Li, Lulu; Chen, Shuyuan; Hou, Jingbo; Yu, Bo

2017-01-01

The ABO blood types related to morphological characteristics of atherosclerosis plaque are not clear. We aimed to evaluate the relationship between ABO blood groups and the coronary plaque characteristic. We retrospectively identified the target lesions in 392 acute coronary syndrome patients who underwent optical coherence tomography examination before stenting. Subjects were divided into different groups according to different blood types. The fibrous cap thickness was significantly thicker in O type compared with non-O type (0.075 ± 0.033 mm versus 0.061 ± 0.024, p blood type groups even between O type and non-O type group ( p > 0.05). The plaques of O type blood group were exhibited more stably compared with non-O type blood group. Moreover, the non-O type blood group have more serious coronary artery stenosis than O type blood group.

Two experimental tests of relational models of procedural justice: non-instrumental voice and authority group membership.

Science.gov (United States)

Platow, Michael J; Eggins, Rachael A; Chattopadhyay, Rachana; Brewer, Greg; Hardwick, Lisa; Milsom, Laurin; Brocklebank, Jacinta; Lalor, Thérèse; Martin, Rowena; Quee, Michelle; Vassallo, Sara; Welsh, Jenny

2013-06-01

In both a laboratory experiment (in Australia) using university as the basis of group membership, and a scenario experiment (in India) using religion as the basis of group membership, we observe more favourable respect and fairness ratings in response to an in-group authority than an out-group authority who administers non-instrumental voice. Moreover, we observe in our second experiment that reported likelihood of protest (herein called "social-change voice") was relatively high following non-instrumental voice from an out-group authority, but relatively low following non-instrumental voice from an in-group authority. Our findings are consistent with relational models of procedural justice, and extend the work by examining likely use of alternative forms of voice as well as highlighting the relative importance of instrumentality. ©2012 The British Psychological Society.

Hospital billing for blood processing and transfusion for inpatient stays.

Science.gov (United States)

McCue, Michael J; Nayar, Preethy

2009-07-01

Medicare, an important payer for hospitals, reimburses hospitals for inpatient stays using Diagnosis Related Groups (DRGs). Many private insurers also use the DRG methodology to reimburse hospitals for their services. Therefore, those blood service organizations that bill Medicare directly require an understanding of the DRG system of payment to enable them to bill Medicare correctly, and in order to be certain they are adequately reimbursed. Blood centers that do not bill Medicare directly need to understand how hospitals are reimbursed for blood and blood components as this affects a hospital's ability to pay service fees related to these products. This review presents a detailed explanation of how hospitals are reimbursed by the Centers for Medicare and Medicaid Services (CMS) for Medicare inpatient services, including blood services.

Social groups preferences relation to motivations and ability levels of whitewater kayakers

Science.gov (United States)

Seth Turner; Rod Zwick

2002-01-01

Social groups play an important role in many adventure recreation activities. The purpose of this study was to examine the social group preference relation to motives and ability levels of whitewater kayakers. When participants go out on a kayaking trip they are seeking varying degrees of experiences, a major contributor to that experience comes from the members of...

The importance of role distribution in working groups : an evaluation of two different groups working in the same environment based on self-evaluation and observer-reported data by the use of SPGR-Systematizing the Person Group Relation

OpenAIRE

Nyheim, Linda

2007-01-01

ABSTRACT The present thesis examines personal and group relations. Two groups served as the study context: one group of doctors and one group of nurses. SPGR – Systematizing the Person Group Relation – was used as a framework. SPGR is a theory on how behaviour and relations develop in groups and organizations. The purpose of the study was to investigate typical tendencies in groups to identify the prevailing functions based on the formative SPGR dimensions Nurture, Dependency, Contro...

78 FR 59427 - Reasonable Charges for Inpatient MS-DRGs and SNF Medical Services; V3.13, Fiscal Year 2014 Update

Science.gov (United States)

2013-09-26

... medical services, items, and supplies identified by Healthcare Common Procedure Coding System (HCPCS... were based on 2013 Medicare severity diagnosis related groups (MS-DRG). Acute inpatient facility...

Loop space representation of quantum general relativity and the group of loops

International Nuclear Information System (INIS)

Gambini, R.

1991-01-01

The action of the constraints of quantum general relativity on a general state in the loop representation is coded in terms of loop derivatives. These differential operators are related to the infinitesimal generators of the group of loops and generalize the area derivative first considered by Mandelstam. A new sector of solutions of the physical states space of nonperturbative quantum general relativity is found. (orig.)

Dental health economics and diagnosis related groups/casemix in Indonesian dentistry

Directory of Open Access Journals (Sweden)

Ronnie Rivany

2009-12-01

Full Text Available Background: Dental Health Economics is a branch of transdiciplinary science that refers to the Economic and Public Health science. On the other hand, in other developed countries, Diagnosis Related Groups (DRG’s /Casemix has been used as a basic in creating the same perception between providers, patients and insurance companies in many aspects such as health planning, healthcare financing and quality assurance. Purpose: The objective of this review is to propose a new paradigm of economics to be applied in Indonesian Dentistry. Reviews: The Dental Health Economics should be considered as an important aspect in Indonesian Dentistry, which is used to determine the dental treatment fee based on unit cost, cost containment, and cost recovery rate analysis. Referring to Australian Refined Diagnosis Related Group, health care industry in Indonesia has starting to try a more structured way in grouping disease pattern in order to come up with more precise health care services to their patients. The on going development of Indonesian DRG’s is meant to confirm the disease pattern and partition. Conclusion: The development of Indonesian DRG’s concept, especially the Dental & Oral Disorders, needs a new paradigm, so the practitioners and academics could group and calculate the unit cost from each dental treatment according to the Indonesian DRG version (INA-DRG’s.

Blockage of High-Affinity Choline Transporter Increases Visceral Hypersensitivity in Rats with Chronic Stress

Directory of Open Access Journals (Sweden)

Chen Zhao

2018-01-01

Full Text Available Background. Visceral hypersensitivity is a common feature of irritable bowel syndrome. Cholinergic system involves in the development of visceral hypersensitivity, and high-affinity choline transporter (CHT1 is of crucial importance in choline uptake system. However, involvement of CHT1 in visceral hypersensitivity remains unknown. The research aimed to study the CHT1 expression in dorsal root ganglions (DRGs and the role of CHT1 in visceral hypersensitivity. Methods. Repetitive water avoidance stress (WAS was used to induce visceral hypersensitivity in rats. Colorectal distension (CRD was determined, and the abdominal withdrawal reflex (AWR and threshold intensity data were recorded to measure the visceral sensitivity. After intraperitoneal injection of hemicholinium-3 (HC-3, the specific inhibitor of CHT1, CRD data were also recorded. The CHT1 expression of DRGs was investigated by Western blotting, immunohistochemistry, and quantitative RT-PCR. Acetylcholine levels in the DRGs were detected by the assay kit. Results. Repetitive WAS increased the AWR score of CRD at high distension pressure and decreased the mean threshold of rats. The CHT1 expression and acetylcholine concentration of DRG were significantly increased in WAS rats. After the administration of HC-3, the AWR score in WAS group was significantly increased at higher distension pressure while the threshold intensity was significantly reduced compared to the normal saline group. Acetylcholine concentration was significantly lower than the normal saline rats. Conclusion. Our research firstly reports that CHT1 is overexpressed in noninflammatory visceral hypersensitivity, and blockage of CHT1 can enhance the visceral hypersensitivity. CHT1 may play an inhibitory role in visceral hypersensitivity.

Decomposing one-relator products of cyclic groups into free products with amalgamation

International Nuclear Information System (INIS)

Benyash-Krivets, V V

1998-01-01

The problem of the decomposition of one-relator products of cyclics into non-trivial free products with amalgamation is considered. Two theorems are proved, one of which is as follows. Let G= 2n =R m (a,b)=1>, where n≥0, m≥2, and R(a,b) is a cyclically reduced word containing b in the free group on a and b. Then G is a non-trivial free product with amalgamation. One consequence of this theorem is a proof of the conjecture of Fine, Levin, and Rosenberger that each two-generator one-relator group with torsion is a non-trivial free product with amalgamation

Impact of the discovery of crude oil on inter-group relations between ...

African Journals Online (AJOL)

Impact of the discovery of crude oil on inter-group relations between Isoko and her immediate neighbours in the western Niger Delta of Nigeria. ... The article shows that the discovery of crude oil petroleum in the western Niger Delta marked a watershed in the history of intergroup relations in the area. Keywords: Discovery ...

75 FR 66125 - Federal Land Managers' Air Quality Related Values Work Group (FLAG)

Science.gov (United States)

2010-10-27

... pollutants that could affect the health and status of resources in areas managed by the three agencies... Work Group (FLAG) AGENCY: National Park Service, Interior. ACTION: Notice of availability of final... Public Comments document. The Federal Land Managers' Air Quality Related Values Work Group (FLAG) was...

Charting a path forward: policy analysis of China's evolved DRG-based hospital payment system.

Science.gov (United States)

Liu, Rui; Shi, Jianwei; Yang, Beilei; Jin, Chunlin; Sun, Pengfei; Wu, Lingfang; Yu, Dehua; Xiong, Linping; Wang, Zhaoxin

2017-09-01

At present, the diagnosis-related groups-based prospective payment system (DRG-PPS) that has been implemented in China is merely a prototype called the simplified DRG-PPS, which is known as the 'ceiling price for a single disease'. Given that studies on the effects of a simplified DRG-PPS in China have usually been controversial, we aim to synthesize evidence examining whether DRGs can reduce medical costs and length of stay (LOS) in China. Data were searched from both Chinese [Wan Fang and China National Knowledge Infrastructure Database (CNKI)] and international databases (Web of Science and PubMed), as well as the official websites of Chinese health departments in the 2004-2016 period. Only studies with a design that included both experimental (with DRG-PPS implementation) and control groups (without DRG-PPS implementation) were included in the review. The studies were based on inpatient samples from public hospitals distributed in 12 provinces of mainland China. Among them, 80.95% (17/21) revealed that hospitalization costs could be reduced significantly, and 50.00% (8/16) indicated that length of stay could be decreased significantly. In addition, the government reports showed the enormous differences in pricing standards and LOS in various provinces, even for the same disease. We conclude that the simplified DRGs are useful in controlling hospitalization costs, but they fail to reduce LOS. Much work remains to be done in China to improve the simplified DRG-PPS. © The Author 2017. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

Bridges or Barriers? Conceptualization of the Role of Multiple Identity Gateway Groups in Intergroup Relations

Directory of Open Access Journals (Sweden)

Aharon Levy

2017-06-01

Full Text Available The modern era of globalization has been accompanied by a massive growth in interconnections between groups, and has led to the sharing of multiple identities by individuals and groups. Following these developments, research has focused on the issue of multiple identities, and has shed important light on how individuals who hold these complex forms of identity feel and behave, and on the reactions they elicit from members of other groups. However, the potential of groups with such multiple identities (e.g., biracials, immigrants, etc. to affect the intergroup relations between the groups that represent the respective sources of the different identities (e.g., Blacks and Whites, country of origin and country of residence, etc. has not been examined to date. Accordingly, in this paper, we first systematically explore the potential of groups in which people identify with multiple social categories, or groups that are perceived as such by others, to play a role in intergroup dynamics. Next, we offer a theoretical framework outlining what functions groups of people with shared multiple identities may serve (as bridges or barriers by proposing how their presence may facilitate or deteriorate intergroup relations. Finally, we present recent empirical research examining how groups of people with shared multiple identities can act as gateways and bridge the cleft between two separate groups that represent the respective sources of their different identities, and discuss the theoretical and practical implications for the field of intergroup relations.

Religious Groups and Their Influence on Interstate Relations (The Case of U.S.-Israel Relations

Directory of Open Access Journals (Sweden)

Igor Istomin

2014-01-01

Full Text Available The impact of interest groups on foreign policy of the state up until today has not received substantial attention in the theory of international relations. In particular, activities of the entities shaped by the common religious affiliation of their members lack assessment in the academic literature. Meanwhile, their mobilization in the recent decades became significant aspect of political life both in developing and developed countries. The activity of religious groups in the United States forced deep transformation of the national political landscape, as they desire to affect not only internal debate, but external policies as well. Among other issues attention of such social and political bodies is also focused on the situation in the middle East. Their proactive standing facilitated advancement of the partnership between the United States and Israel, including growth of American diplomatic and military aid to Tel-Aviv. The supporters of such policy include not only small, but well organized Jewish community, but also representatives of the conservative Evangelical Protestants, which constitute the most numerous religious group in the U.S. Despite the fact that leaders of both group often use theological reasons to justify their support for Israel, the real motivation of the most regular members is primarily humanitarian and pragmatic. The diversity of the Pro-Israeli groups promotes bipartisan support of cooperation between the two countries, and enabled creation of both Democratic and Republican lobby on this issue. However the growing criticism of the current policy of Tel-Aviv on behalf of some of the adherents of American-Israeli cooperation leads to the erosion of impact of these groups.

School-related risk factors for drunkenness among adolescents: risk factors differ between socio-economic groups

DEFF Research Database (Denmark)

Andersen, Anette; Holstein, Bjørn E; Due, Pernille

2006-01-01

Purpose: To examine, separately for boys and girls, whether socio-economic differences in drunkenness exist in adolescence, whether the level of exposure to school-related risk factors differ between socio-economic groups, and whether the relative contribution of school-related risk factors......) was measured by parental occupation. RESULTS: Among girls, exposures to school-related risk factors were more prevalent in lower socio-economic groups. Poor school satisfaction was associated with drunkenness among girls from high SEP, odds ratio (OR) = 2.98 (0.73-12.16). Among boys from high SEP autonomy...

IPPS Provider Summary for the Top 100 DRGs - FY2011

Data.gov (United States)

U.S. Department of Health & Human Services — A provider level summary of Inpatient Prospective Payment System (IPPS) discharges, average charges and average Medicare payments for the Top 100 Diagnosis-Related...

Healthcare reforms in Cyprus 2013-2017: Does the crisis mark the end of the healthcare sector as we know it?

Science.gov (United States)

Petrou, Panagiotis; Vandoros, Sotiris

2018-02-01

As part of a bailout agreement with the International Monetary Fund, the European Commission and the European Central Bank (known as the Troika), Cyprus had to achieve a fiscal surplus through budget constraints and efficiency enhancement. As a result, a number of policy changes were implemented, including a reform of the healthcare sector, and major healthcare reforms are planned for the upcoming years, mainly via the introduction of a National Health System. This paper presents the healthcare sector, provides an overview of recent reforms, assesses the recently implemented policies and proposes further interventions. Recent reforms targeting the demand and supply side included the introduction of clinical guidelines, user charges, introduction of coding for Diagnosis Related Groups (DRGs) and the revision of public healthcare coverage criteria. The latter led to a reduction in the number of people with public healthcare coverage in a time of financial crises, when this is needed the most, while co-payments must be reassessed to avoid creating barriers to access. However, DRGs and clinical guidelines can help improve performance and efficiency. The changes so far are yet to mark the end of the healthcare sector as we know it. A universal public healthcare system must remain a priority and must be introduced swiftly to address important existing coverage gaps. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

Payment Reform Pilot In Beijing Hospitals Reduced Expenditures And Out-Of-Pocket Payments Per Admission.

Science.gov (United States)

Jian, Weiyan; Lu, Ming; Chan, Kit Yee; Poon, Adrienne N; Han, Wei; Hu, Mu; Yip, Winnie

2015-10-01

In 2009 China announced plans to reform provider payment methods at public hospitals by moving from fee-for-service (FFS) to prospective and aggregated payment methods that included the use of diagnosis-related groups (DRGs) to control health expenditures. In October 2011 health policy makers selected six Beijing hospitals to pioneer the first DRG payment system in China. We used hospital discharge data from the six pilot hospitals and eight other hospitals, which continued to use FFS and served as controls, from the period 2010-12 to evaluate the pilot's impact on cost containment through a difference-in-differences methods design. Our study found that DRG payment led to reductions of 6.2 percent and 10.5 percent, respectively, in health expenditures and out-of-pocket payments by patients per hospital admission. We did not find evidence of any increase in hospital readmission rates or cost shifting from cases eligible for DRG payment to ineligible cases. However, hospitals continued to use FFS payments for patients who were older and had more complications than other patients, which reduced the effectiveness of payment reform. Continuous evidence-based monitoring and evaluation linked with adequate management systems are necessary to enable China and other low- and middle-income countries to broadly implement DRGs and refine payment systems. Project HOPE—The People-to-People Health Foundation, Inc.

The impacts of racial group membership on people's distributive justice: an event-related potential study.

Science.gov (United States)

Wang, Yan; Tang, Yi-Yuan; Deng, Yuqin

2014-04-16

How individuals and societies distribute benefits has long been studied by psychologists and sociologists. Previous work has highlighted the importance of social identity on people's justice concerns. However, it is not entirely clear how racial in-group/out-group relationship affects the brain activity in distributive justice. In this study, event-related potentials were recorded while participants made their decisions about donation allocation. Behavioral results showed that racial in-group factor affected participants' decisions on justice consideration. Participants were more likely to make relatively equity decisions when racial in-group factor was congruent with equity compared with the corresponding incongruent condition. Moreover, this incongruent condition took longer response times than congruent condition. Meanwhile, less equity decisions were made when efficiency was larger in the opposite side to equity than it was equal between the two options. Scalp event-related potential analyses revealed that greater P300 and late positive potential amplitudes were elicited by the incongruent condition compared with the congruent condition. These findings suggest that the decision-making of distributive justice could be modulated by racial group membership, and greater attentional resources or cognitive efforts are required when racial in-group factor and equity conflict with each other.

Intergroup Discrimination in Positive and Negative Outcome Allocations: Impact of Stimulus Valence, Relative Group Status, and Relative Group Size.

Science.gov (United States)

Otten, Sabine; And Others

1996-01-01

Three studies investigated the determination of social discrimination by the valence of stimuli that are allocated between groups. The studies were based on either the minimal group paradigm or a more reality-based laboratory intergroup setting, with stimulus valence, group status, and group size as factors and with pull scores on Tajfel matrices…

Renormalization group and relations between scattering amplitudes in a theory with different mass scales

International Nuclear Information System (INIS)

Gulov, A.V.; Skalozub, V.V.

2000-01-01

In the Yukawa model with two different mass scales the renormalization group equation is used to obtain relations between scattering amplitudes at low energies. Considering fermion-fermion scattering as an example, a basic one-loop renormalization group relation is derived which gives possibility to reduce the problem to the scattering of light particles on the external field substituting a heavy virtual state. Applications of the results to problem of searching new physics beyond the Standard Model are discussed [ru

soil groups relative susceptibility to erosion in parts of south-eastern

African Journals Online (AJOL)

Dr Obe

erosion by water determined based on the amount of soil lost during the various runs. Based on ... knowledge of the many factors of soil erosion .... Table 4: Relative erodibility levels of soil groups in lmo and Abia States under 'wet' conditions. Moderately Erodible. Highly Erodible. Very Highly Erodible. 1. Type Dystropepts.

Oral health-related cultural beliefs for four racial/ethnic groups: Assessment of the literature.

Science.gov (United States)

Butani, Yogita; Weintraub, Jane A; Barker, Judith C

2008-09-15

The purpose of this study was to assess information available in the dental literature on oral health-related cultural beliefs. In the US, as elsewhere, many racial/ethnic minority groups shoulder a disproportionate burden of oral disease. Cultural beliefs, values and practices are often implicated as causes of oral health disparities, yet little is known about the breadth or adequacy of literature about cultural issues that could support these assertions. Hence, this rigorous assessment was conducted of work published in English on cultural beliefs and values in relation to oral health status and dental practice. Four racial/ethnic groups in the US (African-American, Chinese, Filipino and Hispanic/Latino) were chosen as exemplar populations. The dental literature published in English for the period 1980-2006 noted in the electronic database PUBMED was searched, using keywords and MeSH headings in different combinations for each racial/ethnic group to identify eligible articles. To be eligible the title and abstract when available had to describe the oral health-related cultural knowledge or orientation of the populations studied. Overall, the majority of the literature on racial/ethnic groups was epidemiologic in nature, mainly demonstrating disparities in oral health rather than the oral beliefs or practices of these groups. A total of 60 relevant articles were found: 16 for African-American, 30 for Chinese, 2 for Filipino and 12 for Hispanic/Latino populations. Data on beliefs and practices from these studies has been abstracted, compiled and assessed. Few research-based studies were located. Articles lacked adequate identification of groups studied, used limited methods and had poor conceptual base. The scant information available from the published dental and medical literature provides at best a rudimentary framework of oral health related ideas and beliefs for specific populations.

Oral health-related cultural beliefs for four racial/ethnic groups: Assessment of the literature

Directory of Open Access Journals (Sweden)

Barker Judith C

2008-09-01

Full Text Available Abstract Background The purpose of this study was to assess information available in the dental literature on oral health-related cultural beliefs. In the US, as elsewhere, many racial/ethnic minority groups shoulder a disproportionate burden of oral disease. Cultural beliefs, values and practices are often implicated as causes of oral health disparities, yet little is known about the breadth or adequacy of literature about cultural issues that could support these assertions. Hence, this rigorous assessment was conducted of work published in English on cultural beliefs and values in relation to oral health status and dental practice. Four racial/ethnic groups in the US (African-American, Chinese, Filipino and Hispanic/Latino were chosen as exemplar populations. Methods The dental literature published in English for the period 1980–2006 noted in the electronic database PUBMED was searched, using keywords and MeSH headings in different combinations for each racial/ethnic group to identify eligible articles. To be eligible the title and abstract when available had to describe the oral health-related cultural knowledge or orientation of the populations studied. Results Overall, the majority of the literature on racial/ethnic groups was epidemiologic in nature, mainly demonstrating disparities in oral health rather than the oral beliefs or practices of these groups. A total of 60 relevant articles were found: 16 for African-American, 30 for Chinese, 2 for Filipino and 12 for Hispanic/Latino populations. Data on beliefs and practices from these studies has been abstracted, compiled and assessed. Few research-based studies were located. Articles lacked adequate identification of groups studied, used limited methods and had poor conceptual base. Conclusion The scant information available from the published dental and medical literature provides at best a rudimentary framework of oral health related ideas and beliefs for specific populations.

76 FR 44491 - Group Health Plans and Health Insurance Issuers: Rules Relating to Internal Claims and Appeals...

Science.gov (United States)

2011-07-26

... 37208) entitled, ``Group Health Plans and Health Insurance Issuers: Rules Relating to Internal Claims..., ``Group Health Plans and Health Insurance Issuers: Rules Relating to Internal Claims and Appeals and... external review processes for group health plans and health insurance issuers offering coverage in the...

Adolescents' Motivation for Reading: Group Differences and Relation to Standardized Achievement

Science.gov (United States)

Wolters, Christopher A.; Denton, Carolyn A.; York, Mary J.; Francis, David J.

2014-01-01

The purpose of this study was to extend the research on adolescents' motivation for reading by examining important group differences and the relation of motivation to standardized achievement. Adolescents (N = 406) ranging from grade 7 to grade 12 completed a self-report survey that assessed 13 different aspects of their reading motivation…

Group singing and health-related quality of life in Parkinson's disease.

Science.gov (United States)

Abell, Romane V; Baird, Amee D; Chalmers, Kerry A

2017-01-01

Parkinson's disease (PD) has a negative impact on health-related quality of life (HRQoL). Previous studies have shown that participating in group singing activities can improve quality of life in some patient populations (e.g., people with chronic mental health or neurological conditions). The aim of this study was to investigate the effects of group singing on HRQoL for people diagnosed with PD. Eleven participants (mean age 70.6 years) with a formal diagnosis of PD between Hoehn and Yahr Stages I-III were recruited from a community singing group for people with PD, their family and their carers. Participants' perceptions of the effect of group singing on their quality of life were captured in a semistructured interview. Interpretive Phenomenological Analysis (IPA), a qualitative methodology, informed data collection and analysis. The IPA analysis revealed 6 categories that characterized the effects of group singing: physical, mood, cognitive functioning, social connectedness, "flow-on" effects, and sense-of-self. All participants reported positive effects across at least 4 of these categories. Three participants reported a negative effect in 1 category (physical, mood, or sense-of-self). The results suggest that group singing improved HRQoL with all participants reporting positive effects regardless of PD stage or symptom severity. Weekly engagement in group singing resulted in multiple benefits for the participants and counteracted some of the negative effects of PD. These findings suggest that group singing "gives back" some of what PD "takes away." (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The Expenditures for Academic Inpatient Care of Inflammatory Bowel Disease Patients Are Almost Double Compared with Average Academic Gastroenterology and Hepatology Cases and Not Fully Recovered by Diagnosis-Related Group (DRG) Proceeds.

Science.gov (United States)

Baumgart, Daniel C; le Claire, Marie

2016-01-01

Crohn's disease (CD) and ulcerative colitis (UC) challenge economies worldwide. Detailed health economic data of DRG based academic inpatient care for inflammatory bowel disease (IBD) patients in Europe is unavailable. IBD was identified through ICD-10 K50 and K51 code groups. We took an actual costing approach, compared expenditures to G-DRG and non-DRG proceeds and performed detailed cost center and type accounting to identify coverage determinants. Of all 3093 hospitalized cases at our department, 164 were CD and 157 UC inpatients in 2012. On average, they were 44.1 (CD 44.9 UC 43.3 all 58) years old, stayed 10.1 (CD 11.8 UC 8.4 vs. all 8) days, carried 5.8 (CD 6.4 UC 5.2 vs. all 6.8) secondary diagnoses, received 7.4 (CD 7.7 UC 7 vs. all 6.2) procedures, had a higher cost weight (CD 2.8 UC 2.4 vs. all 1.6) and required more intense nursing. Their care was more costly (means: total cost IBD 8477€ CD 9051€ UC 7903€ vs. all 5078€). However, expenditures were not fully recovered by DRG proceeds (means: IBD 7413€, CD 8441€, UC 6384€ vs all 4758€). We discovered substantial disease specific mismatches in cost centers and types and identified the medical ward personnel and materials budgets to be most imbalanced. Non-DRG proceeds were almost double (IBD 16.1% vs. all 8.2%), but did not balance deficits at total coverage analysis, that found medications (antimicrobials, biologics and blood products), medical materials (mostly endoscopy items) to contribute most to the deficit. DRGs challenge sophisticated IBD care.

The effectiveness of therapeutic group and behavior for illogical belief and quality of peoples life related

Directory of Open Access Journals (Sweden)

Akram Dastjani, F

2014-02-01

Full Text Available Objective: This research with purpose of impression of recognition–manner group iatrical is done on change to invertebrate extinct beliefs and person`s life quality related to amphetamine. Method: thus have inspected 127 reference diseased to matters abusing iatrical centers of Arak city with questionnaire help of Jonz invertebrate extinguish (with 0.71 cronbakh alpha of persons to high marks and life quality questionnaire (with 0.7 cronbakh alpha of persons to low marks. Then selected 30 diseased as situations possessing and holding and they reset to random replacing in two groups of examination and control (15 bodies in every group. So the method of recognition–manner group iatrical applied on examination group and the end again both groups have assessment with mentioned questionnaires. Obtained information of questionnaires, have been analysis through multi-parameter covariance analysis test. The obtains shown to difference of marks and scours of recognition–manner group iatrical is meaning in comparison to control group on reducing invertebrate extinct beliefs and increasing of person’s life quality related to amphetamine. The results of the research shown that recognition–manner group iatrical is effective to management to parameters of invertebrate extinct beliefs and person’ life quality related to amphetamine.

Work and diet-related risk factors of cardiovascular diseases: comparison of two occupational groups.

Science.gov (United States)

Hartung, Danielle; Stadeler, Martina; Grieshaber, Romano; Keller, Sylvia; Jahreis, Gerhard

2010-03-22

Although work related risk factors associated with Cardiovascular Diseases (CD) have been well researched, there is no detailed knowledge regarding disparate occupational groups each with a different risk exposition. Therefore, two occupational groups (chefs and office workers) were compared with a focus on nutritional and psychosocial factors. Two groups of subjects were tested for work and diet-related risks of CD (45 chefs and 48 office workers). The groups matched both for gender (male) and age (30 to 45 years). The study included a medical check-up, bioelectrical impedance analysis as well as an evaluation of questionnaires on health, nutritional behaviour and coping capacity. In addition, volunteers were required to compile a 7-day-dietary-record and collect their urine 24 h prior to their check-up. Blood samples drawn were analysed for glucose and lipid metabolism, homocysteine, vitamin B12, folic acid; C-reactive protein, uric acid, red blood cell fatty acids, plant sterols, antioxidative capacity and oxidative stress. On average, the chefs showed one risk factor more compared to the office workers. The most frequent risk factors in both groups included overweight/obesity (chef group [CG]: 62.2%; office group [OG]: 58.3%) and elevated TC (CG: 62.2%; OG: 43.8%]. Moreover, although the chefs often had higher CRP-concentrations (40.0%), more office workers suffered from hypertension (37.5%).Chefs showed significant higher concentrations of saturated fatty acids and oleic acid, whereas docosahexaenoic acid, Omega-6- and trans fatty acids were found more frequently in the red blood cell membranes of office workers. While there were no significant differences in analysed plant sterols between the two occupational groups, 7,8-dihydro-8-oxo-2'-deoxyguanosine was significantly increased in office workers.Concerning the work-related psychosocial factors, the chefs were characterised by a stronger subjective importance of work, a greater degree of professional

The effect of presenteeism-related health conditions on employee work engagement levels: A comparison between groups

Directory of Open Access Journals (Sweden)

Leon T. de Beer

2014-10-01

Research purpose: The primary objective of this study was to determine the differences in work engagement levels based on groups of presenteeism-related conditions in employees. Motivation for the study: Awareness of the impact of presenteeism-related conditions on work engagement levels can aid in the crafting of interventions to assist employees who suffer from these conditions, which in turn can boost work engagement levels. Research design, approach and method: Cross-sectional data was collected from an availability sample of employees in the manufacturing sector (N = 3387. Main findings: The results of the multi-group structural equation modelling revealed significant mean differences in work engagement levels between the groups. Practical significance tests revealed significant differences between all the groups. The largest difference was between the group who suffered from no presenteeism-related conditions and the group who suffered from all three conditions included in this study concurrently. Practical/managerial implications: Organisational stakeholders are encouraged to take note of the effects that presenteeism-related health conditions have on work engagement and to consider relevant strategies and interventions to address and alleviate symptoms in order to tend to employee health and obviate the effect on productivity. Contribution: This study found that there were clear practical differences between employees who suffer from the presenteeism-related conditions and those who suffer from none of the conditions. Furthermore, there was also a clear difference when comparing the ‘no condition’ group to a general random sample in which employees might experience some symptoms but not comorbidity.

Oral health and related factors in a group of children with cystic ...

African Journals Online (AJOL)

Oral health and related factors in a group of children with cystic fibrosis in Istanbul, Turkey. ... presented as a marker of wound healing and bleeding tendency of oral cavity. ... Caries experience, oral hygiene, and dental erosion were assessed.

Constructing a Measurement Method of Differences in Group Preferences Based on Relative Entropy

Directory of Open Access Journals (Sweden)

Shiyu Zhang

2017-01-01

Full Text Available In the research and data analysis of the differences involved in group preferences, conventional statistical methods cannot reflect the integrity and preferences of human minds; in particular, it is difficult to exclude humans’ irrational factors. This paper introduces a preference amount model based on relative entropy theory. A related expansion is made based on the characteristics of the questionnaire data, and we also construct the parameters to measure differences in the data distribution of different groups on the whole. In this paper, this parameter is called the center distance, and it effectively reflects the preferences of human minds. Using the survey data of securities market participants as an example, this paper analyzes differences in market participants’ attitudes toward the effectiveness of securities regulation. Based on this method, differences between groups that were overlooked by analysis of variance are found, and certain aspects obscured by general data characteristics are also found.

Stimulating high impact HIV-related cardiovascular research: recommendations from a multidisciplinary NHLBI Working Group on HIV-related heart, lung, and blood disease.

Science.gov (United States)

Shah, Monica R; Cook, Nakela; Wong, Renee; Hsue, Priscilla; Ridker, Paul; Currier, Judith; Shurin, Susan

2015-02-24

The clinical challenges confronting patients with human immunodeficiency virus (HIV) have shifted from acquired immunodeficiency syndrome (AIDS)-related illnesses to chronic diseases, such as coronary artery disease, chronic lung disease, and chronic anemia. With the growing burden of HIV-related heart, lung, and blood (HLB) disease, the National Heart, Lung, and Blood Institute (NHLBI) recognizes it must stimulate and support HIV-related HLB research. Because HIV offers a natural, accelerated model of common pathological processes, such as inflammation, HIV-related HLB research may yield important breakthroughs for all patients with HLB disease. This paper summarizes the cardiovascular recommendations of an NHLBI Working Group, Advancing HIV/AIDS Research in Heart, Lung, and Blood Diseases, charged with identifying scientific priorities in HIV-related HLB disease and developing recommendations to promote multidisciplinary collaboration among HIV and HLB investigators. The working group included multidisciplinary sessions, as well as HLB breakout sessions for discussion of disease-specific issues, with common themes about scientific priorities and strategies to stimulate HLB research emerging in all 3 groups. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

ABO blood groups and malaria related clinical outcome.

Science.gov (United States)

Deepa; Alwar, Vanamala A; Rameshkumar, Karuna; Ross, Cecil

2011-03-01

The study was undertaken to correlate the blood groups and clinical presentations in malaria patients and to understand the differential host susceptibility in malaria. From October 2007 to September 2008, malaria positive patients' samples were evaluated in this study. Hemoglobin, total leukocyte count, and platelet count of each patient were done on an automated cell counter. After determining the blood groups, malarial species and the severity of clinical course were correlated. A total of 100 patients were included in the study, of which 63 cases were positive for Plasmodium falciparum and 37 cases were positive for P. vivax infection and 11 patients had mixed infection. The results of the blood groups showed 22 - 'A' group, 42 - 'B' group, 35 - 'O' group and 1 was 'AB' group. When the clinical courses between different groups were compared using the following parameters for severe infection--a parasitic load of >10/1000 RBCs, severe anemia with hemoglobin 101°F and other organ involvement, it was observed that 'O' group had an advantage over other the groups. The difference in rosetting ability between red blood cells of different 'ABO' blood groups with a diminished rosetting potential in blood group 'O' red blood cells was due to the differential host susceptibility. 'O' group had an advantage over the other three blood groups. Based on literature and the results of this study, the diminished rosetting potential in blood group 'O' red blood cells is suggested as the basis for the differential host susceptibility.

Control Algorithms Along Relative Equilibria of Underactuated Lagrangian Systems on Lie Groups

DEFF Research Database (Denmark)

Nordkvist, Nikolaj; Bullo, F.

2008-01-01

We present novel algorithms to control underactuated mechanical systems. For a class of invariant systems on Lie groups, we design iterative small-amplitude control forces to accelerate along, decelerate along, and stabilize relative equilibria. The technical approach is based upon a perturbation...

Control algorithms along relative equilibria of underactuated Lagrangian systems on Lie groups

DEFF Research Database (Denmark)

Nordkvist, Nikolaj; Bullo, Francesco

2007-01-01

We present novel algorithms to control underactuated mechanical systems. For a class of invariant systems on Lie groups, we design iterative small-amplitude control forces to accelerate along, decelerate along, and stabilize relative equilibria. The technical approach is based upon a perturbation...

Exploring a Relational Cultural Group Trainee Model for Master's Level Counseling Students

Science.gov (United States)

Hall, Brenda S.; Harper, Irene; Korcuska, James

2018-01-01

We explored students' experiences of a graduate level group course infused with components of the Relational Cultural Theory (RCT). During the didactic and experiential aspects of 2 semester-long group courses, the faculty instructors and students focused on creating an environment of safety, connection, and empowerment. The instructor and…

Abnormal expression of blood group-related antigens in uterine endometrial cancers.

Science.gov (United States)

Tsukazaki, K; Sakayori, M; Arai, H; Yamaoka, K; Kurihara, S; Nozawa, S

1991-08-01

The expression of A, B, and H group antigens, Lewis group antigens (Lewis(a), Lewis(b), Lewis(x), and Lewis(y)), and Lc4 and nLc4 antigens, the precursor antigens of both groups, was examined immunohistochemically with monoclonal antibodies in 9 normal endometria, 6 endometrial hyperplasias, and 31 endometrial cancers. 1) A, B and/or H antigens were detected in endometrial cancers at an incidence of 51.6%, while no distinct localization of these antigens was observed in normal endometria. H antigen, the precursor of A and B antigens, was particularly frequently detected in endometrial cancers. 2) An increased rate of expression of Lewis group antigens, particularly Lewis(b) antigen, was observed in endometrial cancers compared with its expression in normal endometria. 3) Lc4 and nLc4 antigens were detected in endometrial cancers at rates of 41.9% and 38.7%, respectively, these expressions being increased compared with those in normal endometria. 4) These results suggest that a highly abnormal expression of blood group-related antigens in endometrial cancers occurs not only at the level of A, B, and H antigens and Lewis group antigens, but also at the level of their precursor Lc4 and nLc4 antigens. 5) Lewis(a), Lewis(b), and Lc4 antigens, built on the type-1 chain, are more specific to endometrial cancers than their respective positional isomers, Lewis(x), Lewis(y), and nLc4 antigens, built on the type-2 chain.

Assessing stakeholder opinion on relations between cancer patient groups and pharmaceutical companies in Europe.

Science.gov (United States)

Leto di Priolo, Susanna; Fehervary, Andras; Riggins, Phil; Redmond, Kathy

2012-01-01

The relationship between the pharmaceutical industry and cancer patient groups has been the subject of much scrutiny and skepticism, and some high-profile negative media coverage has focused attention on some of the problematic aspects of the relationship. Both the pharmaceutical industry and cancer patient groups have made an effort in recent years to improve the transparency and openness of their relations, specifically with regard to the financial support offered by pharmaceutical companies to patient groups. The objectives of this survey were to benchmark perceptions held by different stakeholder groups about current relationships between cancer patient groups and pharmaceutical companies in Europe, and to explore opinions about ways in which partnerships between patient groups and pharmaceutical companies could evolve to the benefit of cancer patients. The survey was conducted using a structured questionnaire that contained a combination of matrix, scaled, and open-ended questions. The questionnaire was developed based on a literature search and the findings from ten in-depth interviews conducted with policy makers and advocates working at an EU level. Telephone interviews were carried out using a structured questionnaire with a convenience sample of 161 policy makers, cancer healthcare group representatives, and cancer patient group leaders from France, Germany, Hungary, Italy, Latvia, the Netherlands, Poland, Portugal, Romania, Spain, Sweden, and the UK. The interviews took place in the relevant language of the country. The current relationship between the pharmaceutical industry and cancer patient groups in Europe is generally viewed as positive, but it is also viewed as being unequal, not transparent enough, and not sufficiently patient-centric. There is broad agreement that cancer patient groups can help companies identify unmet needs and contribute to the development of innovative medicines; however, there is some concern about cancer patients

Distribution des durées de séjour par Diagnosis Related Group

OpenAIRE

Eggli, Yves; Koehn, Véronique; Paccaud, Fred; Moyard M. (Collab.),

1988-01-01

Ce cahier fournit les principales informations concernant les durées de séjour et le nombre de sorties observées dans 33 hôpitaux suisses pour l'années 1984. La description des clientèles hospitalières est fondée sur les "Diagnosis Related Groups" (DRG), qui forment une classification de 472 groupes de patients hospitalisés. [Auteurs, p. 1

Relation Analysis of Knowledge Management, Research, and Innovation in University Research Groups

Directory of Open Access Journals (Sweden)

Heyder Paez-Logreira

2016-12-01

Full Text Available Knowledge is a competitive advantage for companies. Knowledge Management helps to keep this competitiveness. Universities face with challenges in research, innovation and international competitiveness. The purpose of this paper includes studying Knowledge Management Models, and Innovation Models apply to Research Groups of Universities, through an analysis of relation in inter-organizational level. Some researchers and leaders of research groups participated in a survey about knowledge management and innovation. Here we show the relationship between knowledge management, innovation and research, including processes and operations performed by universities around these. We organize the results in three dimensions: Knowledge Management perception, the relationship between Knowledge Management and Innovation, and Strategic Knowledge organization. Too, we identify a generality of good practices, challenges, and limitations on Research Groups for Knowledge Management.

Reimbursement of care for severe trauma under SwissDRG.

Science.gov (United States)

Moos, Rudolf M; Sprengel, Kai; Jensen, Kai Oliver; Jentzsch, Thorsten; Simmen, Hans-Peter; Seifert, Burkhardt; Ciritsis, Bernhard; Neuhaus, Valentin; Volbracht, Jörk; Mehra, Tarun

2016-01-01

Treatment of patients with severe injuries is costly, with best results achieved in specialised care centres. However, diagnosis-related group (DRG)-based prospective payment systems have difficulties in depicting treatment costs for specialised care. We analysed reimbursement of care for severe trauma in the first 3 years after the introduction of the Swiss DRG reimbursement system (2012-2014). The study included all patients with solely basic insurance, hospital admission after 01.01.2011 and discharge in 2011 or 2012, who were admitted to the resuscitation room of the University Hospital of Zurich, aged ≥16 years and with an injury severity score (ISS) ≥16 (n = 364). Clinical, financial and administrative data were extracted from the electronic medical records. All cases were grouped into DRGs according to different SwissDRG versions. We considered results to be significant if p ≤0.002. The mean deficit decreased from 12 065 CHF under SwissDRG 1.0 (2012) to 2 902 CHF under SwissDRG 3.0 (2014). The main reason for the reduction of average deficits was a refinement of the DRG algorithm with a regrouping of 23 cases with an ISS ≥16 from MDC 01 to DRGs within MDC21A. Predictors of an increased total loss per case could be identified: for example, high total number of surgical interventions, surgeries on multiple anatomical regions or operations on the pelvis (p ≤0.002). Psychiatric diagnoses in general were also significant predictors of deficit per case (p<0.001). The reimbursement for care of severely injured patients needs further improvement. Cost neutral treatment was not possible under the first three versions of SwissDRG.

Alterations in the Anandamide Metabolism in the Development of Neuropathic Pain

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Natalia Malek

2014-01-01

Full Text Available Endocannabinoids (EC, particularly anandamide (AEA, released constitutively in pain pathways might be accountable for the inhibitory effect on nociceptors. Pathogenesis of neuropathic pain may reflect complex remodeling of the dorsal root ganglia (DRGs and spinal cord EC system. Multiple pathways involved both in the biosynthesis and degradation of AEA have been suggested. We investigated the local synthesis and degradation features of AEA in DRGs and spinal cord during the development and maintenance of pain in a model of chronic constriction injury (CCI. All AEA synthesis and degradation enzymes are present on the mRNA level in DRGs and lumbar spinal cord of intact as well as CCI-treated animals. Deregulation of EC system components was consistent with development of pain phenotype at days 3, 7, and 14 after CCI. The expression levels of enzymes involved in AEA degradation was significantly upregulated ipsilateral in DRGs and spinal cord at different time points. Expression of enzymes of the alternative, sPLA2-dependent and PLC-dependent, AEA synthesis pathways was elevated in both of the analyzed structures at all time points. Our data have shown an alteration of alternative AEA synthesis and degradation pathways, which might contribute to the variation of AEA levels and neuropathic pain development.

Dissociating the effects of semantic grouping and rehearsal strategies on event-related brain potentials.

Science.gov (United States)

Schleepen, T M J; Markus, C R; Jonkman, L M

2014-12-01

The application of elaborative encoding strategies during learning, such as grouping items on similar semantic categories, increases the likelihood of later recall. Previous studies have suggested that stimuli that encourage semantic grouping strategies had modulating effects on specific ERP components. However, these studies did not differentiate between ERP activation patterns evoked by elaborative working memory strategies like semantic grouping and more simple strategies like rote rehearsal. Identification of neurocognitive correlates underlying successful use of elaborative strategies is important to understand better why certain populations, like children or elderly people, have problems applying such strategies. To compare ERP activation during the application of elaborative versus more simple strategies subjects had to encode either four semantically related or unrelated pictures by respectively applying a semantic category grouping or a simple rehearsal strategy. Another goal was to investigate if maintenance of semantically grouped vs. ungrouped pictures modulated ERP-slow waves differently. At the behavioral level there was only a semantic grouping benefit in terms of faster responding on correct rejections (i.e. when the memory probe stimulus was not part of the memory set). At the neural level, during encoding semantic grouping only had a modest specific modulatory effect on a fronto-central Late Positive Component (LPC), emerging around 650 ms. Other ERP components (i.e. P200, N400 and a second Late Positive Component) that had been earlier related to semantic grouping encoding processes now showed stronger modulation by rehearsal than by semantic grouping. During maintenance semantic grouping had specific modulatory effects on left and right frontal slow wave activity. These results stress the importance of careful control of strategy use when investigating the neural correlates of elaborative encoding. Copyright © 2014 Elsevier B.V. All rights

Health-related quality of life and self-related health in patients with type 2 diabetes: effects of group-based rehabilitation versus individual counselling.

Science.gov (United States)

Vadstrup, Eva S; Frølich, Anne; Perrild, Hans; Borg, Eva; Røder, Michael

2011-12-07

Type 2 diabetes can seriously affect patients' health-related quality of life and their self-rated health. Most often, evaluation of diabetes interventions assess effects on glycemic control with little consideration of quality of life. The aim of the current study was to study the effectiveness of group-based rehabilitation versus individual counselling on health-related quality of life (HRQOL) and self-rated health in type 2 diabetes patients. We randomised 143 type 2 diabetes patients to either a six-month multidisciplinary group-based rehabilitation programme including patient education, supervised exercise and a cooking-course or a six-month individual counselling programme. HRQOL was measured by Medical Outcomes Study Short Form 36-item Health Survey (SF-36) and self-rated health was measured by Diabetes Symptom Checklist - Revised (DCS-R). In both groups, the lowest estimated mean scores of the SF36 questionnaire at baseline were "vitality" and "general health". There were no significant differences in the change of any item between the two groups after the six-month intervention period. However, vitality-score increased 5.2 points (p = 0.12) within the rehabilitation group and 5.6 points (p = 0.03) points among individual counselling participants.In both groups, the highest estimated mean scores of the DSC-R questionnaire at baseline were "Fatigue" and "Hyperglycaemia". Hyperglycaemic and hypoglycaemic distress decreased significantly after individual counselling than after group-based rehabilitation (difference -0.3 points, p = 0.04). No between-group differences occurred for any other items. However, fatigue distress decreased 0.40 points within the rehabilitation group (p = 0.01) and 0.34 points within the individual counselling group (p group cardiovascular distress decreased 0.25 points (p = 0.01). A group-based rehabilitation programme did not improve health-related quality of life and self-rated health more than an individual counselling programme

Evaluating the perceived effectiveness of pregnancy-related cigarette package health warning labels among different gender/age groups.

Science.gov (United States)

Kollath-Cattano, Christy; Osman, Amira; Thrasher, James F

2017-03-01

The impact of pregnancy-related health warning labels (HWLs) appearing on cigarette packages on women of reproductive age and other socio-demographic groups is not well understood. The current study analyzes how different age/gender groups respond to pregnancy-related HWLs as compared to non-pregnancy HWLs. Data were analyzed from four waves of an online longitudinal study with adult smokers aged 18-64 in Australia, Canada, Mexico, and the US. Participants were classified into four age\\gender groups: women 40 and under; men 40 and under; women over 40; men over 40. Participants rated one pregnancy-related and several non-pregnancy related labels on worry, believability, and motivation to quit. Country-specific adjusted linear GEE were estimated regressing ratings for each of the three key outcomes for 1) pregnancy-related HWLs and 2) a rating difference score that subtracted the average ratings of the non-pregnancy warning from the rating of the pregnancy warning. All models adjusted for socio-demographics and smoking related variables. In Mexico and Australia, where graphic pregnancy-related HWL imagery is used (i.e., premature infant), women of reproductive age reported stronger believability, worry, and quit motivation than all other groups. Results were similar in the US, where text only HWLs are used. In contrast in Canada, where the pregnancy-related HWL imagery features a pregnant woman, ratings were unassociated with gender/age groups. Stronger effects among women of reproductive age were limited to pregnancy HWLs in each country, except Canada. HWLs that depict graphic effects to illustrate smoking-related pregnancy risks appear to be perceived as particularly effective among women of reproductive age. Copyright © 2016 Elsevier Ltd. All rights reserved.

Relating Functional Groups to the Periodic Table

Science.gov (United States)

Struyf, Jef

2009-01-01

An introduction to organic chemistry functional groups and their ionic variants is presented. Functional groups are ordered by the position of their specific (hetero) atom in the periodic table. Lewis structures are compared with their corresponding condensed formulas. (Contains 5 tables.)

Up-regulation of p55 TNF alpha-receptor in dorsal root ganglia neurons following lumbar facet joint injury in rats.

Science.gov (United States)

Sakuma, Yoshihiro; Ohtori, Seiji; Miyagi, Masayuki; Ishikawa, Tetsu; Inoue, Gen; Doya, Hideo; Koshi, Takana; Ito, Toshinori; Yamashita, Masaomi; Yamauchi, Kazuyo; Suzuki, Munetaka; Moriya, Hideshige; Takahashi, Kazuhisa

2007-08-01

The rat L5/6 facet joint is multisegmentally innervated from the L1 to L6 dorsal root ganglia (DRG). Tumor necrosis factor (TNF) is a known mediator of inflammation. It has been reported that satellite cells are activated, produce TNF and surround DRG neurons innervating L5/6 facet joints after facet injury. In the current study, changes in TNF receptor (p55) expression in DRG neurons innervating the L5/6 facet joint following facet joint injury were investigated in rats using a retrograde neurotransport method followed by immunohistochemistry. Twenty rats were used for this study. Two crystals of Fluorogold (FG; neurotracer) were applied into the L5/6 facet joint. Seven days after surgery, the dorsal portion of the capsule was cut in the injured group (injured group n = 10). No injury was performed in the non-injured group (n = 10). Fourteen days after the first application of FG, bilateral DRGs from T13 to L6 levels were resected and sectioned. They were subsequently processed for p55 immunohistochemistry. The number of FG labeled neurons and number of FG labeled p55-immunoreactive (IR) neurons were counted. FG labeled DRG neurons innervating the L5/6 facet joint were distributed from ipsilateral L1 to L6 levels. Of FG labeled neurons, the ratio of DRG neurons immunoreactive for p55 in the injured group (50%) was significantly higher than that in the non-injured group (13%). The ratio of p55-IR neurons of FG labeled DRG neurons was significantly higher in total L1 and L2 DRGs than that in total L3, 4, 5 and 6 DRGs in the injured group (L1 and 2 DRG, 67%; L3, 4, 5 and 6 DRG, 37%, percentages of the total number of p55-IR neurons at L1 and L2 level or L3-6 level/the total number of FG-labeled neurons at L1 and L2 level or L3-6 level). These data suggest that up-regulation of p55 in DRG neurons may be involved in the sensory transmission from facet joint injury. Regulation of p55 in DRG neurons innervating the facet joint was different between upper DRG innervated

[IHE (Integrating the Healthcare Enterprise): a new approach for the improvement of digital communication in healthcare].

Science.gov (United States)

Wein, B B

2003-02-01

Parallel to the introduction of diagnosis related groups (DRGs) for the reimbursement of hospitals, a marked reduction of financial means within the healthcare system is taking place. Healthcare enterprise information systems will play an increasing role to accommodate the new working conditions by developing reliable and efficient workflow solutions. Interfacing the systems currently in use can meet considerable obstacles. By offering high connectivity, IHE (Integrating the Healthcare Enterprise), which was initiated by concerted actions of users and vendors, ensures improved health care delivery and, furthermore, assists in acquiring new information systems in the future. IHE is not a standard but makes extensive use of existing international standards, such as HL7 and DICOM. National IHE demonstrations confirmed the power of this approach and presented its mission to large groups of users and vendors. The concept continues to grow and for the first time provides groups of various interests cooperative solutions to the problems encountered in collecting and distributing information.

IHE (Integrating the Healthcare Enterprise): A new approach for the improvement of digital communication in healthcare

International Nuclear Information System (INIS)

Wein, B.B.

2003-01-01

Parallel to the introduction of diagnosis related groups (DRGs) for the reimbursement of hospitals, a marked reduction of financial means within the healthcare system is taking place. Healthcare enterprise information systems will play an increasing role to accommodate the new working conditions by developing reliable and efficient workflow solutions. Interfacing the systems currently in use can meet considerable obstacles. By offering high connectivity, IHE (Integrating the Healthcare Enterprise), which was initiated by concerted actions of users and vendors, ensures improved health care delivery and, furthermore, assists in acquiring new information systems in the future. IHE is not a standard but makes extensive use of existing international standards, such as HL7 and DICOM. National IHE demonstrations confirmed the power of this approach and presented its mission to large groups of users and vendors. The concept continues to grow and for the first time provides groups of various interests cooperative solutions to the problems encountered in collecting and distributing information. (orig.) [de

76 FR 46677 - Requirements for Group Health Plans and Health Insurance Issuers Relating to Coverage of...

Science.gov (United States)

2011-08-03

... Requirements for Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services... regulations published July 19, 2010 with respect to group health plans and health insurance coverage offered... plans, and health insurance issuers providing group health insurance coverage. The text of those...

Health-related quality of life and self-related health in patients with type 2 diabetes: Effects of group-based rehabilitation versus individual counselling

Directory of Open Access Journals (Sweden)

Vadstrup Eva S

2011-12-01

Full Text Available Abstract Background Type 2 diabetes can seriously affect patients' health-related quality of life and their self-rated health. Most often, evaluation of diabetes interventions assess effects on glycemic control with little consideration of quality of life. The aim of the current study was to study the effectiveness of group-based rehabilitation versus individual counselling on health-related quality of life (HRQOL and self-rated health in type 2 diabetes patients. Methods We randomised 143 type 2 diabetes patients to either a six-month multidisciplinary group-based rehabilitation programme including patient education, supervised exercise and a cooking-course or a six-month individual counselling programme. HRQOL was measured by Medical Outcomes Study Short Form 36-item Health Survey (SF-36 and self-rated health was measured by Diabetes Symptom Checklist - Revised (DCS-R. Results In both groups, the lowest estimated mean scores of the SF36 questionnaire at baseline were "vitality" and "general health". There were no significant differences in the change of any item between the two groups after the six-month intervention period. However, vitality-score increased 5.2 points (p = 0.12 within the rehabilitation group and 5.6 points (p = 0.03 points among individual counselling participants. In both groups, the highest estimated mean scores of the DSC-R questionnaire at baseline were "Fatigue" and "Hyperglycaemia". Hyperglycaemic and hypoglycaemic distress decreased significantly after individual counselling than after group-based rehabilitation (difference -0.3 points, p = 0.04. No between-group differences occurred for any other items. However, fatigue distress decreased 0.40 points within the rehabilitation group (p = 0.01 and 0.34 points within the individual counselling group (p p = 0.01. Conclusions A group-based rehabilitation programme did not improve health-related quality of life and self-rated health more than an individual counselling

75 FR 43329 - Interim Final Rules for Group Health Plans and Health Insurance Issuers Relating to Internal...

Science.gov (United States)

2010-07-23

... 45 CFR Part 147 Interim Final Rules for Group Health Plans and Health Insurance Issuers Relating to... Interim Final Rules for Group Health Plans and Health Insurance Issuers Relating to Internal Claims and... of Labor; Office of Consumer Information and Insurance Oversight, Department of Health and Human...

Group contribution modelling for the prediction of safety-related and environmental properties

DEFF Research Database (Denmark)

Frutiger, Jerome; Abildskov, Jens; Sin, Gürkan

warming potential and ozone depletion potential. Process safety studies and environmental assessments rely on accurate property data. Safety data such as flammability limits, heat of combustion or auto ignition temperature play an important role in quantifying the risk of fire and explosions among others......We present a new set of property prediction models based on group contributions to predict major safety-related and environmental properties for organic compounds. The predicted list of properties includes lower and upper flammability limits, heat of combustion, auto ignition temperature, global...... models like group contribution (GC) models can estimate data. However, the estimation needs to be accurate, reliable and as little time-consuming as possible so that the models can be used on the fly. In this study the Marrero and Gani group contribution (MR GC) method has been used to develop the models...

Using Synchronous Online Peer Response Groups in EFL Writing: Revision-Related Discourse

Directory of Open Access Journals (Sweden)

Mei-Ya Liang

2010-02-01

Full Text Available In recent years, synchronous online peer response groups have been increasingly used in English as a foreign language (EFL writing. This article describes a study of synchronous online interaction among three small peer groups in a Taiwanese undergraduate EFL writing class. An environmental analysis of students’ online discourse in two writing tasks showed that meaning negotiation, error correction, and technical actions seldom occurred and that social talk, task management, and content discussion predominated the chat. Further analysis indicates that relationships among different types of online interaction and their connections with subsequent writing and revision are complex and depend on group makeup and dynamics. Findings suggest that such complex activity may not guarantee revision. Writing instructors may need to proactively model, scaffold and support revision-related online discourse if it is to be of benefit.

Palliative sedation: a focus group study on the experiences of relatives.

Science.gov (United States)

Bruinsma, Sophie; Rietjens, Judith; van der Heide, Agnes

2013-04-01

Most studies that have investigated the practice of palliative sedation have focused on physicians' practices and attitudes. The aim of this study was to explore relatives' experiences with palliative sedation and to gain more insight in positive and negative elements in their evaluation of palliative sedation. Focus groups and individual interviews. Various care settings in the Netherlands. A total of 14 relatives of patients who received palliative sedation until death participated. Most relatives evaluated the provision of palliative sedation of their dying family member positively. Positive experiences were related to: the beneficial impact of palliative sedation on the patient's suffering, the opportunity that was offered to prepare for the patient's death, their involvement in the decision-making and care for the patient, and the pleasant care environment. However, the majority of the relatives were unsatisfied with one or more aspects of how information was being provided for. Some relatives were frustrated about the fact that nurses were not authorized to make decisions about the care for the patient and about the absence of physicians during weekends. None of the relatives mentioned the loss of the ability to communicate with the patient during the sedation and the possibility of "hastening death" as disadvantages of palliative sedation. Relatives tend to evaluate the provision of palliative sedation to their severely suffering family member positively because it contributes to a peaceful dying process. However, relatives indicated discontent with how information was being provided and with the communication in general.

Planning focus group interviews with asylum seekers: Factors related to the researcher, interpreter and asylum seekers.

Science.gov (United States)

Eklöf, Niina; Hupli, Maija; Leino-Kilpi, Helena

2017-10-01

The aim of this article was to discuss factors related to the researcher, interpreter and asylum seekers when planning focus group interviews with asylum seekers. Focus group interview is one of the basic data collection methods in descriptive nursing and health research. It has been used in multicultural research, allowing an opportunity to participate without literacy and to have linguistic and cultural support from other participants. Asylum seekers form a specific, vulnerable group, and the growing number of asylum seekers increases the need for research related to them. A culturally, methodologically and ethically high-quality focus group interview is based on the researcher's special knowledge and skills, acknowledgement of asylum seekers as both individuals and part of cultural and communal groups, and careful planning of the interpreter's role during the interviews. © 2017 John Wiley & Sons Ltd.

Casemix funding in Australia.

Science.gov (United States)

Braithwaite, J; Hindle, D; Phelan, P D; Hanson, R

1998-06-01

Casemix funding for hospitals with the use of diagnosis-related groups (DRGs), which organise patients' conditions into similar clinical categories with similar costs, was introduced in Australia five years ago. It has been applied in different ways and to a greater or lesser extent in different Australian States. Only Victoria and South Australia have implemented casemix funding across all healthcare services. Attempts have been made to formally evaluate its impact, but they have not met the required scientific standards in controlling for confounding factors. Casemix funding remains a much-discussed issue. In this Debate, Braithwaite and Hindle take a contrary position, largely to stimulate policy debate; Phelan defends the casemix concept and advocates retaining its best features; and Hanson adds a plea for consumer input.

Pathways to DRG-based hospital payment systems in Japan, Korea, and Thailand.

Science.gov (United States)

Annear, Peter Leslie; Kwon, Soonman; Lorenzoni, Luca; Duckett, Stephen; Huntington, Dale; Langenbrunner, John C; Murakami, Yuki; Shon, Changwoo; Xu, Ke

2018-05-07

Countries in Asia are working towards achieving universal health coverage while ensuring improved quality of care. One element is controlling hospital costs through payment reforms. In this paper we review experiences in using Diagnosis Related Groups (DRG) based hospital payments in three Asian countries and ask if there is an "Asian way to DRGs". We focus first on technical issues and follow with a discussion of implementation challenges and policy questions. We reviewed the literature and worked as an expert team to investigate existing documentation from Japan, Republic of Korea, and Thailand. We reviewed the design of case-based payment systems, their experience with implementation, evidence about impact on service delivery, and lessons drawn for the Asian region. We found that countries must first establish adequate infrastructure, human resource capacity and information management systems. Capping of volumes and prices is sometimes essential along with a high degree of hospital autonomy. Rather than introduce a complete classification system in one stroke, these countries have phased in DRGs, in some cases with hospitals volunteering to participate as a first step (Korea), and in others using a blend of different units for hospital payment, including length of stay, and fee-for-service (Japan). Case-based payment systems are not a panacea. Their value is dependent on their design and implementation and the capacity of the health system. Copyright © 2018 Elsevier B.V. All rights reserved.

Assessment of Groups Influence on Management Style as Related to University Governance

Science.gov (United States)

Irtwange, S. V.; Orsaah, S.

2010-01-01

The study was undertaken with the objective of assessing groups influence on management style as related to University governance with University of Agriculture, Makurdi as a case study from academic staff perspective. The management style of the Vice Chancellor of the University of Agriculture, Makurdi between the period September 3, 1996 to…

Factors related to women's childbirth satisfaction in physiologic and routine childbirth groups

Directory of Open Access Journals (Sweden)

Elham Jafari

2017-01-01

Full Text Available Background: Women's satisfaction with childbirth is an important measure of the quality of maternity care services. This study aims to address factors related to women's childbirth satisfaction in physiological and routine childbirth groups. Materials and Methods: This descriptive-analytical study was conducted among 340 women in physiological and routine childbirth groups in 2012. Women were selected through convenience sampling method in the routine group and by census in the physiological group. Data were collected using a 5-part questionnaire composed of demographic and obstetrics details, Mackey's Childbirth Satisfaction Rating Scale (CSRS, satisfied with birth setting, Labor Agentry Scale (LAS, and Visual Analogue Scale (VAS, which was completed by interview 24 hours after childbirth. Data were analyzed using the Statistical Package for the Social Sciences version 18 software using Pearson correlation test, independent t-test, analysis of variance, and linear, multivariate regression model at the significant level of P 0.05. Conclusions: Improved physical structure and setting of birth room, nonmedical pain relief, mothers' involvement in the process of labor, and sense of being in control are associated with mothers' satisfaction.

Relation of ABO blood groups to the severity of coronary atherosclerosis: an Gensini score assessment.

Science.gov (United States)

Gong, Ping; Luo, Song-Hui; Li, Xiao-Lin; Guo, Yuan-Lin; Zhu, Cheng-Gang; Xu, Rui-Xia; Li, Sha; Dong, Qian; Liu, Geng; Chen, Juan; Zeng, Rui-Xiang; Li, Jian-Jun

2014-12-01

Although the study on the relationship between ABO blood groups and coronary atherosclerosis has a long history, few data is available regarding ABO to severity of coronary atherosclerosis in a large cohort study. Therefore, the present study aimed to investigate the relation of the ABO blood groups to the severity of coronary atherosclerosis assessed by Gensini score (GS) in a large Chinese cohort undergoing coronary angiography. A total of 2919 consecutive patients undergoing coronary angiography were enrolled, and their baseline characteristics and ABO blood groups were collected. The GS was calculated as 1st tertile (0-10), 2nd tertile (11-36), 3rd tertile (>36) according to angiographic results. The relation of the ABO blood groups to GS was investigated. The frequency of blood group A was significantly higher in the upper GS tertiles (24.4% vs. 28.2% vs. 29.5%, p = 0.032). Multivariable linear regression analysis revealed that blood group A was independently associated with GS (β = 0.043, p = 0.017). Likewise, multivariable logistic regression analysis showed that group A remained significantly associated with mid-high GS (OR = 1.44, 95% CI 1.16-1.80, p = 0.001), and the group O was showed as a protective factor (OR = 0.77, 95% CI = 0.65-0.92, p = 0.004). In this large Chinese cohort study, the data indicated that there was an association between ABO blood groups and the severity of coronary atherosclerosis. Moreover, the blood group A was an independent risk factor for serious coronary atherosclerosis. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Low Frequency Electroacupuncture Alleviated Spinal Nerve Ligation Induced Mechanical Allodynia by Inhibiting TRPV1 Upregulation in Ipsilateral Undamaged Dorsal Root Ganglia in Rats

Directory of Open Access Journals (Sweden)

Yong-Liang Jiang

2013-01-01

Full Text Available Neuropathic pain is an intractable problem in clinical practice. Accumulating evidence shows that electroacupuncture (EA with low frequency can effectively relieve neuropathic pain. Transient receptor potential vanilloid type 1 (TRPV1 plays a key role in neuropathic pain. The study aimed to investigate whether neuropathic pain relieved by EA administration correlates with TRPV1 inhibition. Neuropathic pain was induced by right L5 spinal nerve ligation (SNL in rats. 2 Hz EA stimulation was administered. SNL induced mechanical allodynia in ipsilateral hind paw. SNL caused a significant reduction of TRPV1 expression in ipsilateral L5 dorsal root ganglia (DRG, but a significant up-regulation in ipsilateral L4 and L6 DRGs. Calcitonin gene-related peptide (CGRP change was consistent with that of TRPV1. EA alleviated mechanical allodynia, and inhibited TRPV1 and CGRP overexpressions in ipsilateral L4 and L6 DRGs. SNL did not decrease pain threshold of contralateral hind paw, and TRPV1 expression was not changed in contralateral L5 DRG. 0.001, 0.01 mg/kg TRPV1 agonist 6′-IRTX fully blocked EA analgesia in ipsilateral hind paw. 0.01 mg/kg 6′-IRTX also significantly decreased pain threshold of contralateral paw. These results indicated that inhibition of TRPV1 up-regulation in ipsilateral adjacent undamaged DRGs contributed to low frequency EA analgesia for mechanical allodynia induced by spinal nerve ligation.

76 FR 37037 - Requirements for Group Health Plans and Health Insurance Issuers Relating to Internal Claims and...

Science.gov (United States)

2011-06-24

... Requirements for Group Health Plans and Health Insurance Issuers Relating to Internal Claims and Appeals and... interim final regulations published July 23, 2010 with respect to group health plans and health insurance..., group health plans, and health insurance issuers providing group health insurance coverage. The text of...

Content-related interactions and methods of reasoning within self-initiated organic chemistry study groups

Science.gov (United States)

Christian, Karen Jeanne

2011-12-01

Students often use study groups to prepare for class or exams; yet to date, we know very little about how these groups actually function. This study looked at the ways in which undergraduate organic chemistry students prepared for exams through self-initiated study groups. We sought to characterize the methods of social regulation, levels of content processing, and types of reasoning processes used by students within their groups. Our analysis showed that groups engaged in predominantly three types of interactions when discussing chemistry content: co-construction, teaching, and tutoring. Although each group engaged in each of these types of interactions at some point, their prevalence varied between groups and group members. Our analysis suggests that the types of interactions that were most common depended on the relative content knowledge of the group members as well as on the difficulty of the tasks in which they were engaged. Additionally, we were interested in characterizing the reasoning methods used by students within their study groups. We found that students used a combination of three content-relevant methods of reasoning: model-based reasoning, case-based reasoning, or rule-based reasoning, in conjunction with one chemically-irrelevant method of reasoning: symbol-based reasoning. The most common way for groups to reason was to use rules, whereas the least common way was for students to work from a model. In general, student reasoning correlated strongly to the subject matter to which students were paying attention, and was only weakly related to student interactions. Overall, results from this study may help instructors to construct appropriate tasks to guide what and how students study outside of the classroom. We found that students had a decidedly strategic approach in their study groups, relying heavily on material provided by their instructors, and using the reasoning strategies that resulted in the lowest levels of content processing. We suggest

Testing a diagnosis-related group index for skilled nursing facilities

Science.gov (United States)

Cotterill, Philip G.

1986-01-01

Interest in case-mix measures for use in nursing home payment systems has been stimulated by the Medicare prospective payment system (PPS) for short-term acute-care hospitals. Appropriately matching payment with care needs is important to equitably compensate providers and to encourage them to admit patients who are most in need of nursing home care. The skilled nursing facility (SNF) Medicare benefit covers skilled convalescent or rehabilitative care following a hospital stay. Therefore, it might appear that diagnosis-related groups (DRG's), the basis for patient classification in PPS, could also be used for the Medicare SNF program. In this study, a DRG-based case-mix index (CMI) was developed and tested to determine how well it explains cost differences among SNF's. The results suggest that a DRG-based SNF payment system would be highly problematic. Incentives of this system would appear to discourage placement of patients who require relatively expensive care. PMID:10311674

Health-related quality of life of infants from ethnic minority groups: the Generation R Study.

Science.gov (United States)

Flink, Ilse J E; Beirens, Tinneke M J; Looman, Caspar; Landgraf, Jeanne M; Tiemeier, Henning; Mol, Henriette A; Jaddoe, Vincent W V; Hofman, Albert; Mackenbach, Johan P; Raat, Hein

2013-04-01

To assess whether the health-related quality of life of infants from ethnic minority groups differs from the health-related quality of life of native Dutch infants and to evaluate whether infant health and family characteristics explain the potential differences. We included 4,506 infants participating in the Generation R Study, a longitudinal birth cohort. When the child was 12 months, parents completed the Infant Toddler Quality of Life Questionnaire (ITQOL); ITQOL scale scores in each ethnic subgroup were compared with scores in the Dutch reference population. Influence of infant health and family characteristics on ITQOL scale scores were evaluated using multivariate regression models. Infants from ethnic minority groups presented significantly lower ITQOL scale scores compared to the Dutch subgroup (e.g., Temperament and Moods scale: median score of Turkish subgroup, 70.8 (IQR, 15.3); median score of Dutch subgroup, 80.6 (IQR, 13.9; P ethnic minority status and infant health-related quality of life. However, these factors could not fully explain all the differences in the ITQOL scale scores. Parent-reported health-related quality of life is lower in infants from ethnic minority groups compared to native Dutch infants, which could partly be explained by infant health and by family characteristics.

75 FR 27121 - Interim Final Rules for Group Health Plans and Health Insurance Issuers Relating to Dependent...

Science.gov (United States)

2010-05-13

... 45 CFR Parts 144, 146, and 147 Group Health Plans and Health Insurance Issuers Relating to Dependent... 144, 146, and 147 RIN 0991-AB66 Interim Final Rules for Group Health Plans and Health Insurance... requirements for group health plans and health insurance issuers in the group and individual markets under...

Interagency mechanical operations group numerical systems group

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-09-01

This report consists of the minutes of the May 20-21, 1971 meeting of the Interagency Mechanical Operations Group (IMOG) Numerical Systems Group. This group looks at issues related to numerical control in the machining industry. Items discussed related to the use of CAD and CAM, EIA standards, data links, and numerical control.

We'll never get past the glass ceiling! Meta-stereotyping, world-views and perceived relative group-worth.

Science.gov (United States)

Owuamalam, Chuma; Zagefka, Hanna

2013-11-01

This article examines the implications of perceived negativity from members of a dominant outgroup on the world views and perceived relative group worth of members of disadvantaged groups. We hypothesized that concerns about the negative opinions a dominant outgroup is perceived to hold of the ingroup (i.e., meta-stereotypes) would undermine group members' views about societal fairness. We expected this trend to be mediated by recall of previous personal experiences of discrimination. We further hypothesized that members' views about societal fairness would predict their perception of the ingroup's worth relative to the outgroup - such that undermined views about societal fairness would be associated with lower perceived ingroup worth relative to the outgroup. Taken jointly, results from two studies using two real intergroup contexts support these hypotheses and are discussed in terms of their implications for the social mobility of members of disadvantaged groups. © 2012 The British Psychological Society.

A Group Decision Framework with Intuitionistic Preference Relations and Its Application to Low Carbon Supplier Selection.

Science.gov (United States)

Tong, Xiayu; Wang, Zhou-Jing

2016-09-19

This article develops a group decision framework with intuitionistic preference relations. An approach is first devised to rectify an inconsistent intuitionistic preference relation to derive an additive consistent one. A new aggregation operator, the so-called induced intuitionistic ordered weighted averaging (IIOWA) operator, is proposed to aggregate individual intuitionistic fuzzy judgments. By using the mean absolute deviation between the original and rectified intuitionistic preference relations as an order inducing variable, the rectified consistent intuitionistic preference relations are aggregated into a collective preference relation. This treatment is presumably able to assign different weights to different decision-makers' judgments based on the quality of their inputs (in terms of consistency of their original judgments). A solution procedure is then developed for tackling group decision problems with intuitionistic preference relations. A low carbon supplier selection case study is developed to illustrate how to apply the proposed decision model in practice.

Brightest group galaxies - II: the relative contribution of BGGs to the total baryon content of groups at z < 1.3

Science.gov (United States)

Gozaliasl, Ghassem; Finoguenov, Alexis; Khosroshahi, Habib G.; Henriques, Bruno M. B.; Tanaka, Masayuki; Ilbert, Olivier; Wuyts, Stijn; McCracken, Henry J.; Montanari, Francesco

2018-04-01

We performed a detailed study of the evolution of the star formation rate (SFR) and stellar mass of the brightest group galaxies (BGGs) and their relative contribution to the total baryon budget within R200 (f^{BGG}_{b,200}). The sample comprises 407 BGGs selected from X-ray groups (M200 = 1012.8-1014 M⊙) out to z ˜ 1.3 identified in the Cosmic Evolution Survey (COSMOS), XMM Large-Scale Structure survey (XMM-LSS), and the All-Wavelength Extended Groth strip International Survey (AEGIS) fields. We find that BGGs constitute two distinct populations of quiescent and star-forming galaxies and their mean SFR is ˜2 dex higher than the median SFR at z 2 dex. We take into account the halo mass growth of groups in selecting the sample of BGGs and find that the mean (median) stellar mass of BGGs has grown by 0.3 dex since z = 1.3 to the present day. We show that up to ˜ 45 per cent of the stellar mass growth in a star-forming BGG can be due to its star formation activity. With respect to f^{BGG}_{b,200}, we find it to increase with decreasing redshift by ˜0.35 dex, while decreasing with halo mass in a redshift-dependent manner. We show that the slope of the relation between f^{BGG}_{b,200} and halo mass increases negatively with decreasing redshift. This trend is driven by an insufficient star formation in BGGs, compared to the halo growth rate. We separately show the BGGs with the 20 per cent highest f^{BGG}_{b,200} are generally non-star-forming galaxies and grow in mass by processes not related to star formation (e.g. dry mergers and tidal striping). We present the M⋆-Mh and M⋆/Mh-Mh relations and compare them with semi-analytic model predictions and a number of results from the literature. We quantify the intrinsic scatter in stellar mass of BGGs at fixed halo mass (σ _{log M_{\\star}}) and find that σ _{{log }M_{\\star}} increases from 0.3 dex at z ˜ 0.2-0.5 dex at z ˜ 1.0 due to the bimodal distribution of stellar mass.

Women On-Line: Cultural and Relational Aspects of Women's Communication in On-line Discussion Groups.

Science.gov (United States)

Ferris, Sharmila Pixy

1996-01-01

Women's online communication often mirrors that of face-to-face communication, linguistically and relationally. Women-only online communities, however, provide an opportunity to develop a distinct relational and cultural style. Discusses gender differences in face-to-face language use, and in mixed gender online discussion groups. Describes…

Some reciprocity-like relations in multi-group neutron diffusion and transport theory over bare homogeneous regions

International Nuclear Information System (INIS)

Modak, R.S.; Sahni, D.C.

1996-01-01

Some simple reciprocity-like relations that exist in multi-group neutron diffusion and transport theory over bare homogeneous regions are presented. These relations do not involve the adjoint solutions and are directly related to numerical schemes based on an explicit evaluation of the fission matrix. (author)

75 FR 70159 - Group Health Plans and Health Insurance Coverage Rules Relating to Status as a Grandfathered...

Science.gov (United States)

2010-11-17

... Group Health Plans and Health Insurance Coverage Rules Relating to Status as a Grandfathered Health Plan... contracts of insurance. The temporary regulations provide guidance to employers, group health plans, and health insurance issuers providing group health insurance coverage. The IRS is issuing the temporary...

The Role of Adolescent Friendship Group Integration and Cohesion in Weapon-Related Violent Crime as a Young Adult.

Science.gov (United States)

Mundt, Marlon P; Antonaccio, Olena P; French, Michael T; Zakletskaia, Larissa I

2017-08-01

Weapon-related violent crime is a serious, complex, and multifaceted public health problem. The present study uses data from Waves I and III of Add Health (n = 10,482, 54% female) to examine how friendship group integration and cohesion in adolescence (ages 12-19) is associated with weapon-related criminal activity as a young adult (ages 18-26). Results indicate that greater cohesion in friendship groups is associated with significantly lower weapon-related criminal activity in young adulthood. In addition, for adolescent girls, a greater number of close friendship ties-an indicator of friendship group integration-is associated with less weapon-related criminal activity in young adulthood. These findings suggest that school-based initiatives to facilitate inclusive and cohesive adolescent peer communities may be an effective strategy to curb weapon-related criminal activity in young adulthood.

Cosmological term in general relativity theory and localization of de Sitter and Einstein groups

International Nuclear Information System (INIS)

Tunyak, V.N.

1984-01-01

The theory of gauge gravitational field with the de Sitter group localization is formulated. proceeding from the de Sitter Universe tetrad components the relationship between Riemann metrics and de Sitter gauge field is established. It is shown that General relativity theory (GRT) with a cosmological term is the simplest variant of the de Sitter gauge gravitation theory passing in the limit of infinite curvature radius of the de Sitter Universe into the Poincare - invariant GRT without cosmological term. Similarly the theory of gauge gravitational field at localization of the dynamical group of the Einstein homogeneous static Universe (Einstein group RxSO(4)) is formulated

HERV-W group evolutionary history in non-human primates: characterization of ERV-W orthologs in Catarrhini and related ERV groups in Platyrrhini.

Science.gov (United States)

Grandi, Nicole; Cadeddu, Marta; Blomberg, Jonas; Mayer, Jens; Tramontano, Enzo

2018-01-19

The genomes of all vertebrates harbor remnants of ancient retroviral infections, having affected the germ line cells during the last 100 million years. These sequences, named Endogenous Retroviruses (ERVs), have been transmitted to the offspring in a Mendelian way, being relatively stable components of the host genome even long after their exogenous counterparts went extinct. Among human ERVs (HERVs), the HERV-W group is of particular interest for our physiology and pathology. A HERV-W provirus in locus 7q21.2 has been coopted during evolution to exert an essential role in placenta, and the group expression has been tentatively linked to Multiple Sclerosis and other diseases. Following up on a detailed analysis of 213 HERV-W insertions in the human genome, we now investigated the ERV-W group genomic spread within primate lineages. We analyzed HERV-W orthologous loci in the genome sequences of 12 non-human primate species belonging to Simiiformes (parvorders Catarrhini and Platyrrhini), Tarsiiformes and to the most primitive Prosimians. Analysis of HERV-W orthologous loci in non-human Catarrhini primates revealed species-specific insertions in the genomes of Chimpanzee (3), Gorilla (4), Orangutan (6), Gibbon (2) and especially Rhesus Macaque (66). Such sequences were acquired in a retroviral fashion and, in the majority of cases, by L1-mediated formation of processed pseudogenes. There were also a number of LTR-LTR homologous recombination events that occurred subsequent to separation of Catarrhini sub-lineages. Moreover, we retrieved 130 sequences in Marmoset and Squirrel Monkeys (family Cebidae, Platyrrhini parvorder), identified as ERV1-1_CJa based on RepBase annotations, which appear closely related to the ERV-W group. Such sequences were also identified in Atelidae and Pitheciidae, representative of the other Platyrrhini families. In contrast, no ERV-W-related sequences were found in genome sequence assemblies of Tarsiiformes and Prosimians. Overall, our

What Is a Group? Young Children's Perceptions of Different Types of Groups and Group Entitativity.

Directory of Open Access Journals (Sweden)

Maria Plötner

Full Text Available To date, developmental research on groups has focused mainly on in-group biases and intergroup relations. However, little is known about children's general understanding of social groups and their perceptions of different forms of group. In this study, 5- to 6-year-old children were asked to evaluate prototypes of four key types of groups: an intimacy group (friends, a task group (people who are collaborating, a social category (people who look alike, and a loose association (people who coincidently meet at a tram stop. In line with previous work with adults, the vast majority of children perceived the intimacy group, task group, and social category, but not the loose association, to possess entitativity, that is, to be a 'real group.' In addition, children evaluated group member properties, social relations, and social obligations differently in each type of group, demonstrating that young children are able to distinguish between different types of in-group relations. The origins of the general group typology used by adults thus appear early in development. These findings contribute to our knowledge about children's intuitive understanding of groups and group members' behavior.

The relationship between relational models and individualism and collectivism: evidence from culturally diverse work groups.

Science.gov (United States)

Vodosek, Markus

2009-04-01

Relational models theory (Fiske, 1991 ) proposes that all thinking about social relationships is based on four elementary mental models: communal sharing, authority ranking, equality matching, and market pricing. Triandis and his colleagues (e.g., Triandis, Kurowski, & Gelfand, 1994 ) have suggested a relationship between the constructs of horizontal and vertical individualism and collectivism and Fiske's relational models. However, no previous research has examined this proposed relationship empirically. The objective of the current study was to test the association between the two frameworks in order to further our understanding of why members of culturally diverse groups may prefer different relational models in interactions with other group members. Findings from this study support a relationship between Triandis' constructs and Fiske's four relational models and uphold Fiske's ( 1991 ) claim that the use of the relational models is culturally dependent. As hypothesized, horizontal collectivism was associated with a preference for equality matching and communal sharing, vertical individualism was related to a preference for authority ranking, and vertical collectivism was related to a preference for authority ranking and communal sharing. However, contrary to expectations, horizontal individualism was not related to a preference for equality matching and market pricing, and vertical individualism was not associated with market pricing. By showing that there is a relationship between Triandis' and Fiske's frameworks, this study closes a gap in relational models theory, namely how culture relates to people's preferences for relational models. Thus, the findings from this study will enable future researchers to explain and predict what relational models are likely to be used in a certain cultural context.

Risk-adjusted capitation funding models for chronic disease in Australia: alternatives to casemix funding.

Science.gov (United States)

Antioch, K M; Walsh, M K

2002-01-01

Under Australian casemix funding arrangements that use Diagnosis-Related Groups (DRGs) the average price is policy based, not benchmarked. Cost weights are too low for State-wide chronic disease services. Risk-adjusted Capitation Funding Models (RACFM) are feasible alternatives. A RACFM was developed for public patients with cystic fibrosis treated by an Australian Health Maintenance Organization (AHMO). Adverse selection is of limited concern since patients pay solidarity contributions via Medicare levy with no premium contributions to the AHMO. Sponsors paying premium subsidies are the State of Victoria and the Federal Government. Cost per patient is the dependent variable in the multiple regression. Data on DRG 173 (cystic fibrosis) patients were assessed for heteroskedasticity, multicollinearity, structural stability and functional form. Stepwise linear regression excluded non-significant variables. Significant variables were 'emergency' (1276.9), 'outlier' (6377.1), 'complexity' (3043.5), 'procedures' (317.4) and the constant (4492.7) (R(2)=0.21, SE=3598.3, F=14.39, Probpayment (constant). The model explained 21% of the variance in cost per patient. The payment rate is adjusted by a best practice annual admission rate per patient. The model is a blended RACFM for in-patient, out-patient, Hospital In The Home, Fee-For-Service Federal payments for drugs and medical services; lump sum lung transplant payments and risk sharing through cost (loss) outlier payments. State and Federally funded home and palliative services are 'carved out'. The model, which has national application via Coordinated Care Trials and by Australian States for RACFMs may be instructive for Germany, which plans to use Australian DRGs for casemix funding. The capitation alternative for chronic disease can improve equity, allocative efficiency and distributional justice. The use of Diagnostic Cost Groups (DCGs) is a promising alternative classification system for capitation arrangements.

An evaluation of a model for the systematic documentation of hospital based health promotion activities: results from a multicentre study

DEFF Research Database (Denmark)

Tønnesen, Hanne; Christensen, Mette E; Groene, Oliver

2007-01-01

The first step of handling health promotion (HP) in Diagnosis Related Groups (DRGs) is a systematic documentation and registration of the activities in the medical records. So far the possibility and tradition for systematic registration of clinical HP activities in the medical records...... and in patient administrative systems have been sparse. Therefore, the activities are mostly invisible in the registers of hospital services as well as in budgets and balances.A simple model has been described to structure the registration of the HP procedures performed by the clinical staff. The model consists...... of two parts; first part includes motivational counselling (7 codes) and the second part comprehends intervention, rehabilitation and after treatment (8 codes).The objective was to evaluate in an international study the usefulness, applicability and sufficiency of a simple model for the systematic...

What Is a Group? Young Children’s Perceptions of Different Types of Groups and Group Entitativity

Science.gov (United States)

Plötner, Maria; Over, Harriet; Carpenter, Malinda; Tomasello, Michael

2016-01-01

To date, developmental research on groups has focused mainly on in-group biases and intergroup relations. However, little is known about children’s general understanding of social groups and their perceptions of different forms of group. In this study, 5- to 6-year-old children were asked to evaluate prototypes of four key types of groups: an intimacy group (friends), a task group (people who are collaborating), a social category (people who look alike), and a loose association (people who coincidently meet at a tram stop). In line with previous work with adults, the vast majority of children perceived the intimacy group, task group, and social category, but not the loose association, to possess entitativity, that is, to be a ‘real group.’ In addition, children evaluated group member properties, social relations, and social obligations differently in each type of group, demonstrating that young children are able to distinguish between different types of in-group relations. The origins of the general group typology used by adults thus appear early in development. These findings contribute to our knowledge about children's intuitive understanding of groups and group members' behavior. PMID:27010484

Investigations of safety-related parameters applying a new multi-group diffusion code for HTR transients

International Nuclear Information System (INIS)

Kasselmann, S.; Druska, C.; Lauer, A.

2010-01-01

The energy spectra of fast and thermal neutrons from fission reactions in the FZJ code TINTE are modelled by two broad energy groups. Present demands for increased numerical accuracy led to the question of how precise the 2-group approximation is compared to a multi-group model. Therefore a new simulation program called MGT (Multi Group TINTE) has recently been developed which is able to handle up to 43 energy groups. Furthermore, an internal spectrum calculation for the determination of cross-sections can be performed for each time step and location within the reactor. In this study the multi-group energy models are compared to former calculations with only two energy groups. Different scenarios (normal operation and design-basis accidents) have been defined for a high temperature pebble bed reactor design with annular core. The effect of an increasing number of energy groups on safety-related parameters like the fuel and coolant temperature, the nuclear heat source or the xenon concentration is studied. It has been found that for the studied scenarios the use of up to 8 energy groups is a good trade-off between precision and a tolerable amount of computing time. (orig.)

Singing in groups for Parkinson's disease (SING-PD): a pilot study of group singing therapy for PD-related voice/speech disorders.

Science.gov (United States)

Shih, Ludy C; Piel, Jordan; Warren, Amanda; Kraics, Lauren; Silver, Althea; Vanderhorst, Veronique; Simon, David K; Tarsy, Daniel

2012-06-01

Parkinson's disease related speech and voice impairment have significant impact on quality of life measures. LSVT(®)LOUD voice and speech therapy (Lee Silverman Voice Therapy) has demonstrated scientific efficacy and clinical effectiveness, but musically based voice and speech therapy has been underexplored as a potentially useful method of rehabilitation. We undertook a pilot, open-label study of a group-based singing intervention, consisting of twelve 90-min weekly sessions led by a voice and speech therapist/singing instructor. The primary outcome measure of vocal loudness as measured by sound pressure level (SPL) at 50 cm during connected speech was not significantly different one week after the intervention or at 13 weeks after the intervention. A number of secondary measures reflecting pitch range, phonation time and maximum loudness also were unchanged. Voice related quality of life (VRQOL) and voice handicap index (VHI) also were unchanged. This study suggests that a group singing therapy intervention at this intensity and frequency does not result in significant improvement in objective and subject-rated measures of voice and speech impairment. Copyright © 2012 Elsevier Ltd. All rights reserved.

75 FR 34537 - Interim Final Rules for Group Health Plans and Health Insurance Coverage Relating to Status as a...

Science.gov (United States)

2010-06-17

... 45 CFR Part 147 Group Health Plans and Health Insurance Coverage Relating to Status as a... for Group Health Plans and Health Insurance Coverage Relating to Status as a Grandfathered Health Plan... and Insurance Oversight, Department of Health and Human Services. ACTION: Interim final rules with...

Disease-Specific Trends of Comorbidity Coding and Implications for Risk Adjustment in Hospital Administrative Data.

Science.gov (United States)

Nimptsch, Ulrike

2016-06-01

To investigate changes in comorbidity coding after the introduction of diagnosis related groups (DRGs) based prospective payment and whether trends differ regarding specific comorbidities. Nationwide administrative data (DRG statistics) from German acute care hospitals from 2005 to 2012. Observational study to analyze trends in comorbidity coding in patients hospitalized for common primary diseases and the effects on comorbidity-related risk of in-hospital death. Comorbidity coding was operationalized by Elixhauser diagnosis groups. The analyses focused on adult patients hospitalized for the primary diseases of heart failure, stroke, and pneumonia, as well as hip fracture. When focusing the total frequency of diagnosis groups per record, an increase in depth of coding was observed. Between-hospital variations in depth of coding were present throughout the observation period. Specific comorbidity increases were observed in 15 of the 31 diagnosis groups, and decreases in comorbidity were observed for 11 groups. In patients hospitalized for heart failure, shifts of comorbidity-related risk of in-hospital death occurred in nine diagnosis groups, in which eight groups were directed toward the null. Comorbidity-adjusted outcomes in longitudinal administrative data analyses may be biased by nonconstant risk over time, changes in completeness of coding, and between-hospital variations in coding. Accounting for such issues is important when the respective observation period coincides with changes in the reimbursement system or other conditions that are likely to alter clinical coding practice. © Health Research and Educational Trust.

Dolphin underwater bait-balling behaviors in relation to group and prey ball sizes.

Science.gov (United States)

Vaughn-Hirshorn, Robin L; Muzi, Elisa; Richardson, Jessica L; Fox, Gabriella J; Hansen, Lauren N; Salley, Alyce M; Dudzinski, Kathleen M; Würsig, Bernd

2013-09-01

We characterized dusky dolphin (Lagenorhynchus obscurus) feeding behaviors recorded on underwater video, and related behaviors to variation in prey ball sizes, dolphin group sizes, and study site (Argentina versus New Zealand, NZ). Herding behaviors most often involved dolphins swimming around the side or under prey balls, but dolphins in Argentina more often swam under prey balls (48% of passes) than did dolphins in NZ (34% of passes). This result may have been due to differences in group sizes between sites, since groups are larger in Argentina. Additionally, in NZ, group size was positively correlated with proportion of passes that occurred under prey balls (pdolphins in Argentina more often swam through prey balls (8% of attempts) than did dolphins in NZ (4% of attempts). This result may have been due to differences in prey ball sizes between sites, since dolphins fed on larger prey balls in Argentina (>74m(2)) than in NZ (maximum 33m(2)). Additionally, in NZ, dolphins were more likely to swim through prey balls to capture fish when they fed on larger prey balls (p=0.025). Copyright © 2013 Elsevier B.V. All rights reserved.

Self-categorization, commitment to the group and social self-esteem as related but distinct aspects of social identity.

NARCIS (Netherlands)

Ellemers, N.; Kortekaas, P.; Ouwerkerk, J.W.

1999-01-01

The aim of this study is to show that, when examining social identification, it is both possible and important to distinguish between self-categorisation, commitment to the group, and group self-esteem, as related but separate aspects of group members' social identity. This was demonstrated in an

Affective expressions in groups and inferences about members' relational well-being: The effects of socially engaging and disengaging emotions.

Science.gov (United States)

Rothman, Naomi B; Magee, Joe C

2016-01-01

Our findings draw attention to the interpersonal communication function of a relatively unexplored dimension of emotions-the level of social engagement versus disengagement. In four experiments, regardless of valence and target group gender, observers infer greater relational well-being (more cohesiveness and less conflict) between group members from socially engaging (sadness and appreciation) versus disengaging (anger and pride) emotion expressions. Supporting our argument that social (dis)engagement is a critical dimension communicated by these emotions, we demonstrate (1) that inferences about group members' self-interest mediate the effect of socially engaging emotions on cohesiveness and (2) that the influence of socially disengaging emotion expressions on inferences of conflict is attenuated when groups have collectivistic norms (i.e., members value a high level of social engagement). Furthermore, we show an important downstream consequence of these inferences of relational well-being: Groups that seem less cohesive because of their members' proud (versus appreciative) expressions are also expected to have worse task performance.

Weak Lensing Calibrated M-T Scaling Relation of Galaxy Groups in the COSMOS Field

NARCIS (Netherlands)

Kettula, K.; Finoguenov, A.; Massey, R.; Rhodes, J.; Hoekstra, H.; Taylor, J.; Spinelli, P.; Tanaka, M.; Ilbert, O.; Capak, P.; McCracken, H.; Koekemoer, A.

2013-01-01

The scaling between X-ray observables and mass for galaxy clusters and groups is instrumental for cluster-based cosmology and an important probe for the thermodynamics of the intracluster gas. We calibrate a scaling relation between the weak lensing mass and X-ray spectroscopic temperature for 10

Transient Relative Age Effects across annual age groups in National level Australian Swimming.

Science.gov (United States)

Cobley, Stephen; Abbott, Shaun; Dogramaci, Sera; Kable, Adam; Salter, James; Hintermann, Mirjam; Romann, Michael

2017-12-29

To determine the prevalence, magnitude and transient patterning of Relative Age Effects (RAEs) according to sex and stroke event across all age-groups at the Australian National age swimming Championships. Repeated years of cross-sectional participation data were examined. Participants were 6014 unique male (3185) and female (2829) swimmers (aged 12-18 years) who participated in Freestyle (50, 400m) and/or Breaststroke (100, 200m) at the National age swimming Championships between 2000-2014 (inclusive). RAE prevalence, magnitude and transience were determined using Chi-square tests and Cramer's V estimates for effect size. Odds Ratios (OR) and 95% Confidence Intervals (CI) examined relative age quartile discrepancies. These steps were applied across age-groups and according to sex and each stroke event. Consistent RAEs with large-medium effect sizes were evident for males at 12-15 years of age respectively, and with large-medium effects for females at 12-14 respectively across all four swimming strokes. RAE magnitude then consistently reduced with age across strokes (e.g., Q1 vs. Q4 OR range 16year old males=0.94-1.20; females=0.68-1.41). With few exceptions, by 15-16 years RAEs had typically dissipated; and by 17-18 years, descriptive and significant inverse RAEs emerged, reflecting overrepresentation of relatively younger swimmers. Performance advantages associated with relative age (and thereby likely growth and maturation) are transient. Greater consideration of transient performance and participation in athlete development systems is necessary. This may include revising the emphasis of sport programmes according to developmental stages and delaying forms of athlete selection to improve validity. Copyright © 2018 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Therapeutic Change in Group Therapy For Interpersonal Trauma: A Relational Framework for Research and Clinical Practice.

Science.gov (United States)

Chouliara, Zoë; Karatzias, Thanos; Gullone, Angela; Ferguson, Sandra; Cosgrove, Katie; Burke Draucker, Claire

2017-04-01

Our understanding of therapeutic change processes in group therapy for complex interpersonal trauma has been limited. The present study aimed at addressing this gap by developing a framework of therapeutic change in this field from a survivor and therapist perspective. This is a qualitative study, which utilized semistructured individual interviews. Transcripts were analyzed using interpretative phenomenological analysis (IPA) to identify recurrent themes. A final sample of n = 16 patients and n = 5 facilitators completed the interview. Main change processes identified by survivors were as follows: self versus others, trust versus threat, confrontation versus avoidance, and "patching up" versus true healing. Therapeutic processes identified by therapist facilitators included managing group dynamics, unpredictability and uncertainty, and process versus content. The proposed framework explains therapeutic change in group therapy in relational terms, that is, therapeutic dissonance, the dynamic interaction of self and experience as well as building empathic trusting relations. The importance of managing dissonance to aid personally meaningful recovery was highlighted. These findings have implications for the usefulness of relational and person-centered approaches to clinical practice in the area of interpersonal and complex trauma, especially in the early identification, prevention, and management of dropouts.

The Effect of Group Differences among Church-Related Youth in Indonesia, Malaysia, and Singapore.

Science.gov (United States)

Pedersen, Paul

1983-01-01

Examines the influence of nationality, ethnicity, language, and beliefs on priority concerns among church related college students in Indonesia (N=122), Malaysia and Singapore (N=341). Results confirm the importance of traditional values with less agreement between groups about peers and adults. Implications for counselors are discussed. (JAC)

The relation between fearfulness in young and stress-response in adult laying hens, on individual and group level.

Science.gov (United States)

de Haas, Elske N; Kops, Marjolein S; Bolhuis, J Elizabeth; Groothuis, Ton G G; Ellen, Esther D; Rodenburg, T Bas

2012-10-10

Fearfulness of an individual can affect its sensitivity to stress, while at the same time the social situation in which an animal lives can affect its fear level. It is however unknown what the long-term effects of high fearfulness on sensitivity to stress are, on individual or group level in laying hens. We hypothesize that increased fearfulness at a young age results in increased sensitivity to stress at an adult age, and that this relation can differ between groups, due to differences in group composition. Therefore, we studied the relation between fearfulness in an Open Field (OF) test at six weeks of age and plasma-corticosterone (CORT) levels after a 5-min Manual Restraint test (MR) at 33 weeks of age, and assessed behavior in the home pen. We used birds from a low mortality line, selected for four generations on low mortality due to feather pecking and cannibalism and a control line (n=153 in total, eight pens/line). These lines are known to differ in fearfulness and stress physiology. Chicks from the low mortality line were more active in the OF compared to chicks from the control line. Chicks that showed a fearful response (no walking, no vocalizing) in the OF test had higher CORT at 33 weeks of age than chicks that walked and/or vocalized in the OF test and had higher activity in the home pen as adults. On group level, a passive response in the OF was related to high CORT levels after MR. Presence of at least one fearful bird in a group led to higher CORT in the other group mates compared to birds from groups with no fearful birds present. Birds from groups in which more than 50% of birds had severe comb lesions had higher CORT levels compared to birds from groups with less than 50% of birds affected. High fearfulness of laying hen chicks can on individual level have a long-term effect on stress sensitivity. The presence of fearful birds in a group as well as signs of social instability in a group, indicated by comb lesions, can affect sensitivity to

75 FR 34571 - Group Health Plans and Health Insurance Coverage Rules Relating to Status as a Grandfathered...

Science.gov (United States)

2010-06-17

... Group Health Plans and Health Insurance Coverage Rules Relating to Status as a Grandfathered Health Plan... of Consumer Information and Insurance Oversight of the U.S. Department of Health and Human Services... health insurance coverage offered in connection with a group health plan under the Employee Retirement...

The Effects of Peer-Controlled or Moderated Online Collaboration on Group Problem Solving and Related Attitudes

Directory of Open Access Journals (Sweden)

Ke Zhang

2003-10-01

Full Text Available Abstract. This study investigated the relative benefits of peer-controlled and moderated online collaboration during group problem solving. Thirty-five self-selected groups of four or five students were randomly assigned to the two conditions, which used the same online collaborative tool to solve twelve problem scenarios in an undergraduate statistics course. A score for the correctness of the solutions and a reasoning score were analyzed. A survey was administered to reveal differences in students' related attitudes. Three conclusions were reached: 1. Groups assigned to moderated forums displayed significantly higher reasoning scores than those in the peer-controlled condition, but the moderation did not affect correctness of solutions. 2. Students in the moderated forums reported being more likely to choose to use an optional online forum for future collaborations. 3. Students who reported having no difficulty during collaboration reported being more likely to choose to use an optional online forum in the future.

Relation between ABO blood groups and Helicobacter pylori infection in symptomatic patients

Directory of Open Access Journals (Sweden)

Jaff MS

2011-09-01

Full Text Available Mohamad Salih Jaff Pathology Department, College of Medicine, Hawler Medical University (formerly Salahuddin University, Erbil, Kurdistan Region, Iraq Abstract: Epidemiological studies have demonstrated higher frequencies of the O blood group and the nonsecretor phenotype of ABH antigens among patients suffering from peptic ulcers. Since Helicobacter pylori has been established as the main etiological factor in this disease, controversies about the associations of the ABO and Lewis blood group phenotypes and secretor and nonsecretor phenotypes in relation to susceptibility towards infection by this bacillus have been presented. The aim of this study was to verify the frequencies of ABO and Rhesus (Rh blood groups in H. pylori seropositive symptomatic patients. The study included (n = 1108 patients with dyspepsia symptoms referred from an outpatient clinic in Erbil city for investigation. Age, sex, and residency were recorded as a routine laboratory framework. Patients underwent SD Bioline (Standard Diagnostics Inc, Kyonggi-do, South Korea and enzyme-linked immunosorbent assay serologic tests for H. pylori. ABO blood group phenotypes were determined by a standard hemagglutination test. Results showed that 64.8% of patients (n = 718/1108 were seropositive for H. pylori infection, and (35.2% (n = 390/1108 were seronegative. Of the seropositive patients, 40.8% (n = 293/718 were male and 59.2% (n = 425/718 were female; while of the seronegative patients, 46.7% (n = 182/390 were male and 53.3% (n = 208/390 were female. The mean age for seropositives and seronegatives was (38.0 ± 14.6 years and (37.6 ± 15.7 years respectively. The frequency of the ABO and Rh-positive (Rh+ blood groups among seropositive patients was (A = 32.0%, B = 19.5%, AB = 6.7%, O = 41.8%, and Rh+ = 92.5% and was (A = 32.3%, B = 28.2%, AB = 8.0%, O = 31.5%, and Rh+ = 92.5% in seronegatives. The results of this study suggest that ABO blood groups, age, and gender influence

75 FR 43109 - Requirements for Group Health Plans and Health Insurance Issuers Relating to Internal Claims and...

Science.gov (United States)

2010-07-23

... Requirements for Group Health Plans and Health Insurance Issuers Relating to Internal Claims and Appeals and... the Office of Consumer Information and Insurance Oversight of the U.S. Department of Health and Human... health insurance coverage offered in connection with a group health plan under the Employee Retirement...

Barriers related to physical activity practice in adolescents. A focus-group study

Directory of Open Access Journals (Sweden)

Ciro Romélio Rodriguez Añez

2010-04-01

Full Text Available The aim of study was to identify barriers to physical activity in adolescents. Focus group interviews were conducted with subjects aged 15 to 18 years (n=59, 50.8% girls and divided according to gender. Content analysis was used to classify the reports into specific dimensions. Descriptive statistics employing relative and absolute frequencies of similar reports was performed using the SPSS 11.0 software. The most frequent barriers among adolescents were those associated with “psychological, cognitive and emotional” and “cultural and social” dimensions. For boys, the most frequently reported barriers were “feeling lazy”, “lack of company” and “lack of time”. For girls, “feeling lazy”, “lack of com-pany” and “occupation” were the most common barriers. In conclusion, the perception of barriers by adolescents varies according to gender, a fact requiring specific actions for the promotion of physical activity in this group.

[Evolution of the relative prices of food groups between 1939 and 2010 in the city of Sao Paulo, Southeastern Brazil].

Science.gov (United States)

Yuba, Tania Yuka; Sarti, Flavia Mori; Campino, Antonio Carlos Coelho; Carmo, Heron Carlos Esvael do

2013-06-01

To analyze the evolution of relative prices of food groups and its influence on public healthy eating policies. Data from the municipality of Sao Paulo between 1939 and 2010 were analyzed based on calculating index numbers. Data from the Economic Researches Foundation Institute price database and weight structures (1939 to 1988) and from the Brazilian Institute of Geography and Statistics (1989 to 2010) were used to. The price database was organized, its consistency tested and prices were deflated using the consumer price index. Relative prices were calculated and associated to food categories and groups, according to the food pyramid guide adapted for the Brazilian population. The price indices for each group were calculated according to Laspeyres modified formula. The general food price index was compared with the indices for each food group and respective category: fresh food, processed food, beverages, meat, legumes, milk and eggs, cereals and root vegetables and eating out. Price indices for fat, oil, spices, sugars and sweets and processed food showed relative price reduction. Fresh food, such as fruit and vegetables, showed an increase in relative prices. Other food groups, such as cereals, flour and pasta, meat, milk and egg, showed a steadier long term trend in relative prices. The evolution of relative prices of food in the city of Sao Paulo demonstrates a negative trend towards healthy eating at household level in the long run.

Finding Combination of Features from Promoter Regions for Ovarian Cancer-related Gene Group Classification

KAUST Repository

Olayan, Rawan S.

2012-01-01

In classification problems, it is always important to use the suitable combination of features that will be employed by classifiers. Generating the right combination of features usually results in good classifiers. In the situation when the problem is not well understood, data items are usually described by many features in the hope that some of these may be the relevant or most relevant ones. In this study, we focus on one such problem related to genes implicated in ovarian cancer (OC). We try to recognize two important OC-related gene groups: oncogenes, which support the development and progression of OC, and oncosuppressors, which oppose such tendencies. For this, we use the properties of promoters of these genes. We identified potential “regulatory features” that characterize OC-related oncogenes and oncosuppressors promoters. In our study, we used 211 oncogenes and 39 oncosuppressors. For these, we identified 538 characteristic sequence motifs from their promoters. Promoters are annotated by these motifs and derived feature vectors used to develop classification models. We made a comparison of a number of classification models in their ability to distinguish oncogenes from oncosuppressors. Based on 10-fold cross-validation, the resultant model was able to separate the two classes with sensitivity of 96% and specificity of 100% with the complete set of features. Moreover, we developed another recognition model where we attempted to distinguish oncogenes and oncosuppressors as one group from other OC-related genes. That model achieved accuracy of 82%. We believe that the results of this study will help in discovering other OC-related oncogenes and oncosuppressors not identified as yet.

Finding Combination of Features from Promoter Regions for Ovarian Cancer-related Gene Group Classification

KAUST Repository

Olayan, Rawan S.

2012-12-01

In classification problems, it is always important to use the suitable combination of features that will be employed by classifiers. Generating the right combination of features usually results in good classifiers. In the situation when the problem is not well understood, data items are usually described by many features in the hope that some of these may be the relevant or most relevant ones. In this study, we focus on one such problem related to genes implicated in ovarian cancer (OC). We try to recognize two important OC-related gene groups: oncogenes, which support the development and progression of OC, and oncosuppressors, which oppose such tendencies. For this, we use the properties of promoters of these genes. We identified potential “regulatory features” that characterize OC-related oncogenes and oncosuppressors promoters. In our study, we used 211 oncogenes and 39 oncosuppressors. For these, we identified 538 characteristic sequence motifs from their promoters. Promoters are annotated by these motifs and derived feature vectors used to develop classification models. We made a comparison of a number of classification models in their ability to distinguish oncogenes from oncosuppressors. Based on 10-fold cross-validation, the resultant model was able to separate the two classes with sensitivity of 96% and specificity of 100% with the complete set of features. Moreover, we developed another recognition model where we attempted to distinguish oncogenes and oncosuppressors as one group from other OC-related genes. That model achieved accuracy of 82%. We believe that the results of this study will help in discovering other OC-related oncogenes and oncosuppressors not identified as yet.

Effects of group sports on health-related physical fitness of overweight youth: A systematic review and meta-analysis.

Science.gov (United States)

Oliveira, Ana; Monteiro, Ângela; Jácome, Cristina; Afreixo, Vera; Marques, Alda

2017-06-01

Group sports interventions have been developed to improve health-related physical fitness of overweight/obese youth. However, its benefits are not systematically documented. This study synthesizes the evidence about the effects of group sports on health-related physical fitness of overweight/obese youth. Pubmed, Web of Knowledge, Scopus, Medline, CINAHL, SportDiscus, and Academic Search Complete were searched in February 2016. Studies assessing the effects of group sports on body composition, cardiorespiratory endurance, muscle strength, flexibility, and neuromotor fitness of overweight/obese youth (aged  0.05), maximal power output (ES from 0 to 0.06; P > 0.05), sit-and-reach test (pooled ES = 0.26; 95% CI = -0.16 to 0.68) and agility test (ES = 0; P = 0.48). Group sports improve body composition, cardiorespiratory endurance, and hand grip strength of overweight/obese youth. Flexibility and neuromotor fitness do not seem to change following group sports. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Shp-1 dephosphorylates TRPV1 in dorsal root ganglion neurons and alleviates CFA-induced inflammatory pain in rats.

Science.gov (United States)

Xiao, Xing; Zhao, Xiao-Tao; Xu, Ling-Chi; Yue, Lu-Peng; Liu, Feng-Yu; Cai, Jie; Liao, Fei-Fei; Kong, Jin-Ge; Xing, Guo-Gang; Yi, Ming; Wan, You

2015-04-01

Transient receptor potential vanilloid 1 (TRPV1) receptors are expressed in nociceptive neurons of rat dorsal root ganglions (DRGs) and mediate inflammatory pain. Nonspecific inhibition of protein-tyrosine phosphatases (PTPs) increases the tyrosine phosphorylation of TRPV1 and sensitizes TRPV1. However, less is known about tyrosine phosphorylation's implication in inflammatory pain, compared with that of serine/threonine phosphorylation. Src homology 2 domain-containing tyrosine phosphatase 1 (Shp-1) is a key phosphatase dephosphorylating TRPV1. In this study, we reported that Shp-1 colocalized with and bound to TRPV1 in nociceptive DRG neurons. Shp-1 inhibitors, including sodium stibogluconate and PTP inhibitor III, sensitized TRPV1 in cultured DRG neurons. In naive rats, intrathecal injection of Shp-1 inhibitors increased both TRPV1 and tyrosine-phosphorylated TRPV1 in DRGs and induced thermal hyperalgesia, which was abolished by pretreatment with TRPV1 antagonists capsazepine, BCTC, or AMG9810. Complete Freund's adjuvant (CFA)-induced inflammatory pain in rats significantly increased the expression of Shp-1, TRPV1, and tyrosine-phosphorylated TRPV1, as well as the colocalization of Shp-1 and TRPV1 in DRGs. Intrathecal injection of sodium stibogluconate aggravated CFA-induced inflammatory pain, whereas Shp-1 overexpression in DRG neurons alleviated it. These results suggested that Shp-1 dephosphorylated and inhibited TRPV1 in DRG neurons, contributing to maintain thermal nociceptive thresholds in normal rats, and as a compensatory mechanism, Shp-1 increased in DRGs of rats with CFA-induced inflammatory pain, which was involved in protecting against excessive thermal hyperalgesia.

Human resource assignment and role representation mechanism with the "cascading staff-group authoring" and "relation/situation" model.

Science.gov (United States)

Hirose, Y; Sasaki, Y; Kinoshita, A

2001-01-01

We have previously reported the access control mechanism and audit strategy of the "patient-doctor relation and clinical situation at the point-of-care" model with multi-axial access control matrix (ACM). This mechanism overcomes the deficit of ACM in the aspect of data accessibility but does not resolve the representation of the staff's affiliate and/or plural membership in the complex real world. Care groups inside a department or inter-department clinical team plays significant clinical role but also spend great amount of time and money in the hospital. Therefore the impact of human resource assignment and cost of such stakeholders to the hospital management is huge, so that they should be accurately treated in the hospital information system. However multi-axial ACM has problems with the representation of staff groups due to static parameters such as department/license because staffs belong to a group rather temporarily and/or a medical staff may belong to plural groups. As a solution, we have designed and implemented "cascading staff-group authoring" method with "relation and situation" model and multi-axial ACM. In this mechanism, (i) a system administrator certifies "group chief certifying person" according to the request and authorization by the department director, (ii) the "group chief certifying person" certifies "group chief(s)", (iii) the "group chief" recruits its members from the medical staffs, and at the same time the "group chief" decides the profit distribution policy of this group. This will enable medical staff to access EMR according to the role he/she plays whether it is as a department staff or as a group member. This solution has worked successfully over the past few years. It provides end-users with a flexible and time-to-time staff-group authoring environment using a simple human-interfaced tool without security breach and without system administration cost. In addition, profit and cost distribution is clarified among departments and

8-group relative delayed neutron yields for monoenergetic neutron induced fission of 239Pu

International Nuclear Information System (INIS)

Piksaikin, V.M.; Kazakov, L.E.; Isaev, S.G.; Korolev, G.G.; Roshchenko, V.A.; Tertychnyj, R.G

2002-01-01

The energy dependence of the relative yield of delayed neutrons in an 8-group model representation was obtained for monoenergetic neutron induced fission of 239 Pu. A comparison of this data with the available experimental data by other authors was made in terms of the mean half-life of the delayed neutron precursors. (author)

Women's experience of SLE-related fatigue: a focus group interview study.

Science.gov (United States)

Pettersson, Susanne; Möller, Sonia; Svenungsson, Elisabet; Gunnarsson, Iva; Welin Henriksson, Elisabet

2010-10-01

The aim of this study was to describe women's experience of SLE-related fatigue, how they express the feeling of fatigue, impact on life and strategies developed to manage fatigue in daily living. Seven, semi-structured focus group discussions with 33 women were audio-taped, transcribed verbatim and analysed according to qualitative content analysis. Perceptions of SLE-related fatigue were sorted into four themes. Nature of Fatigue, involved the sensation, occurrence and character. Aspects Affected by Fatigue described emotions that arose together with fatigue as well as aspects of work, family life, social contacts and leisure activities that were affected by fatigue. Striving Towards Power and Control concluded the array of ways used to manage daily life and were categorized into the mental struggle, structure, restrict and provide. Factors Influencing the Perception of Fatigue described understanding from their surroundings and pain as strongly influencing the experience and perception of fatigue. SLE-related fatigue was portrayed as an overwhelming phenomenon with an unpredictable character, resulting in the feeling that fatigue dominates and controls most situations in life. The choice of strategies was described as a balance with implications for how fatigue limited a person's life. Health care professionals are advised to take a more active role to empower people with SLE to find their own balance as a way to achieve a feeling of being in control.

Fee-for-service payment - an evil practice that must be stamped out?

Science.gov (United States)

Ikegami, Naoki

2015-02-01

Co-opting physicians to regulate Fee-for-Service (FFS) payment is more feasible and simpler to administer than capitation, Diagnosis-Related Groups (DRGs) and pay-for-performance. The key lies in designing and revising the fee schedule, which not only defines and sets the fee for each item, but also the conditions of billing. Adherence to these regulations must be strictly audited in order to control volume and costs, and to assure quality. The fee schedule requires periodic revisions on an item-by-item basis in order to maintain balance among the providers, to list new drugs, devices and equipment, and to reflect the lower market prices of existing ones. Implementing the fee schedule will facilitate the control of balance billing and extra billing, and the introduction of more sophisticated methods of payment in the future.

The variance of length of stay and the optimal DRG outlier payments.

Science.gov (United States)

Felder, Stefan

2009-09-01

Prospective payment schemes in health care often include supply-side insurance for cost outliers. In hospital reimbursement, prospective payments for patient discharges, based on their classification into diagnosis related group (DRGs), are complemented by outlier payments for long stay patients. The outlier scheme fixes the length of stay (LOS) threshold, constraining the profit risk of the hospitals. In most DRG systems, this threshold increases with the standard deviation of the LOS distribution. The present paper addresses the adequacy of this DRG outlier threshold rule for risk-averse hospitals with preferences depending on the expected value and the variance of profits. It first shows that the optimal threshold solves the hospital's tradeoff between higher profit risk and lower premium loading payments. It then demonstrates for normally distributed truncated LOS that the optimal outlier threshold indeed decreases with an increase in the standard deviation.

Fee-for-Service Payment – An Evil Practice that Must be Stamped Out?

Directory of Open Access Journals (Sweden)

Naoki Ikegami

2015-02-01

Full Text Available Co-opting physicians to regulate Fee-for-Service (FFS payment is more feasible and simpler to administer than capitation, Diagnosis-Related Groups (DRGs and pay-for-performance. The key lies in designing and revising the fee schedule, which not only defines and sets the fee for each item, but also the conditions of billing. Adherence to these regulations must be strictly audited in order to control volume and costs, and to assure quality. The fee schedule requires periodic revisions on an item-by-item basis in order to maintain balance among the providers, to list new drugs, devices and equipment, and to reflect the lower market prices of existing ones. Implementing the fee schedule will facilitate the control of balance billing and extra billing, and the introduction of more sophisticated methods of payment in the future.

Health-related quality of life and self-related health in patients with type 2 diabetes: effects of group-based rehabilitation versus individual counselling

DEFF Research Database (Denmark)

Vadstrup, Eva S; Frølich, Anne; Perrild, Hans

2011-01-01

Type 2 diabetes can seriously affect patients' health-related quality of life and their self-rated health. Most often, evaluation of diabetes interventions assess effects on glycemic control with little consideration of quality of life. The aim of the current study was to study the effectiveness ...... of group-based rehabilitation versus individual counselling on health-related quality of life (HRQOL) and self-rated health in type 2 diabetes patients....

Outpatient psychodynamic group psychotherapy - outcomes related to personality disorder, severity, age and gender.

Science.gov (United States)

Kvarstein, Elfrida Hartveit; Nordviste, Ola; Dragland, Lone; Wilberg, Theresa

2017-02-01

Outpatient group psychotherapy is frequent within specialist services, recruits a mixed population, but effects are poorly documented. This study investigates long-term outcomes for patients with personality disorder (PD) treated in outpatient, psychodynamic groups within secondary mental health service. A naturalistic study (N = 103) with repeated assessments of process and clinical outcomes. Longitudinal statistics are linear mixed models. The main PDs were avoidant, borderline and NOS PD, mean number of PDs 1.4(SD0.7), 60% females and mean initial age 38(SD10) years. Mean treatment duration was 1.5(SD 0.9) years. Therapist alliance and experienced group climate was satisfactory and stable. Improvements were significant (symptom distress, interpersonal problems, occupational functioning and additional mental health services), irrespective of general PD-severity, but not of PD-type, age or gender. The study demonstrates PD NOS benefits across all outcomes, occupational improvements for avoidant PD, despite prevailing symptoms, but generally poorer outcomes for males and age >38 years. For borderline PD, experienced conflict was stronger, treatment duration shorter and outcomes poor for early drop-outs (28%). Psychodynamic group psychotherapy is a recommendable treatment for moderate PDs, which may address avoidant strategies, but may not meet clinical challenges of borderline PD. The outcome differences related to gender and age are noteworthy. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Demographic, health-related, and work-related factors associated with body mass index and body fat percentage among workers at six Connecticut manufacturing companies across different age groups: a cohort study.

Science.gov (United States)

Garza, Jennifer L; Dugan, Alicia G; Faghri, Pouran D; Gorin, Amy A; Huedo-Medina, Tania B; Kenny, Anne M; Cherniack, Martin G; Cavallari, Jennifer M

2015-01-01

Effective workplace interventions that consider the multifactorial nature of obesity are needed to reduce and prevent obesity among adults. Furthermore, the factors associated with obesity may differ for workers across age groups. Therefore, the objective of this study was to identify demographic, health-related, and work-related factors associated with baseline and changes in body mass index (BMI) and body fat percentage (BFP) and among Connecticut manufacturing workers acrossage groups. BMI and BFPof 758 workers from six Connecticut manufacturing companies were objectively measuredat two time points approximately 36 months apart. Demographic, health-related, and work-related factors wereassessed via questionnaire. All variables were included in linear regression models to identify factors associated with baseline and changes in BMI and BFP for workers in 3 age groups: 55 years (28 %). There were differences in baseline and changes in BMI and BFP among manufacturing workers across age groups. Being interested in changing weight was significantly (p gender (BMI p = 0.04), female gender (BFP p gender (BMI p = 0.02), female gender (BFP p gender (BFP p 55 year age category. Few factors were associated with change in BMI or BFP across any age category. Among manufacturing workers, we identified associations between individual, health-related, and work-related factors and baseline BMIand BFP that differed by age. Such results support the use of strategies tailored to the challenges faced by workers in specific age groups rather than adopting a one size fits all approach. Effective interventions should consider a full range of individual, health-related, and work-related factors. More work must be done to identify factors or strategies associated with changes in obesity over time.

Epidemiology of drinking, alcohol use disorders, and related problems in US ethnic minority groups.

Science.gov (United States)

Caetano, Raul; Vaeth, Patrice A C; Chartier, Karen G; Mills, Britain A

2014-01-01

This chapter reviews selected epidemiologic studies on drinking and associated problems among US ethnic minorities. Ethnic minorities and the White majority group exhibit important differences in alcohol use and related problems, including alcohol use disorders. Studies show a higher rate of binge drinking, drinking above guidelines, alcohol abuse, and dependence for major ethnic and racial groups, notably, Blacks, Hispanics, and American Indians/Alaskan Natives. Other problems with a higher prevalence in certain minority groups are, for example, cancer (Blacks), cirrhosis (Hispanics), fetal alcohol syndrome (Blacks and American Indians/Alaskan Natives), drinking and driving (Hispanics, American Indians/Alaskan Natives). There are also considerable differences in rates of drinking and problems within certain ethnic groups such as Hispanics, Asian Americans, and American Indians/Alaskan Natives. For instance, among Hispanics, Puerto Ricans and Mexican Americans drink more and have higher rates of disorders such as alcohol abuse and dependence than Cuban Americans. Disparities also affect the trajectory of heavy drinking and the course of alcohol dependence among minorities. Theoretic accounts of these disparities generally attribute them to the historic experience of discrimination and to minority socioeconomic disadvantages at individual and environmental levels. © 2014 Elsevier B.V. All rights reserved.

TOPSIS-based consensus model for group decision-making with incomplete interval fuzzy preference relations.

Science.gov (United States)

Liu, Fang; Zhang, Wei-Guo

2014-08-01

Due to the vagueness of real-world environments and the subjective nature of human judgments, it is natural for experts to estimate their judgements by using incomplete interval fuzzy preference relations. In this paper, based on the technique for order preference by similarity to ideal solution method, we present a consensus model for group decision-making (GDM) with incomplete interval fuzzy preference relations. To do this, we first define a new consistency measure for incomplete interval fuzzy preference relations. Second, a goal programming model is proposed to estimate the missing interval preference values and it is guided by the consistency property. Third, an ideal interval fuzzy preference relation is constructed by using the induced ordered weighted averaging operator, where the associated weights of characterizing the operator are based on the defined consistency measure. Fourth, a similarity degree between complete interval fuzzy preference relations and the ideal one is defined. The similarity degree is related to the associated weights, and used to aggregate the experts' preference relations in such a way that more importance is given to ones with the higher similarity degree. Finally, a new algorithm is given to solve the GDM problem with incomplete interval fuzzy preference relations, which is further applied to partnership selection in formation of virtual enterprises.

75 FR 41726 - Interim Final Rules for Group Health Plans and Health Insurance Issuers Relating to Coverage of...

Science.gov (United States)

2010-07-19

... Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services Under the Patient... and health insurance coverage in the group and individual markets under provisions of the Patient... plans and group health insurance issuers for plan years beginning on or after September 23, 2010. These...

The readmission rates in patients with versus those without diabetes mellitus at an urban teaching hospital.

Science.gov (United States)

Sonmez, Halis; Kambo, Varinder; Avtanski, Dimiter; Lutsky, Larry; Poretsky, Leonid

2017-12-01

We examined the 30-day hospital readmission rates and their association with the admission diagnosis and the length of stay (LOS) in patients with diabetes versus those without diabetes mellitus (DM) in an urban teaching hospital. In this retrospective study, we compared the 30-day readmission rates in patients with DM (n=16,266) versus those without DM (n=86,428) at an urban teaching hospital between January 1, 2013, and September 30, 2015. In individuals with a secondary diagnosis of DM, we analyzed the relationship between readmission rates and the ten most common Medicare Severity Diagnosis Related Groups (MS-DRGs). Additionally, we examined the relationship between the LOS and readmission rates in patients with diabetes and those without DM. The 30-day readmission rates adjusted for age and gender were higher in patients with DM compared to those without DM (15.3% vs. 8.4%, respectively, readmissions was present both in patients with a primary or a secondary diagnosis of DM. For the secondary diagnosis of DM, statistically significant difference was present for two out of the ten most common DRGs (DRG # 313 [chest pain], and # 392 [esophagitis, gastroenteritis, and miscellaneous digestive disorders], p=0.045 and 0.009, respectively). There was a direct correlation between LOS and readmission rates in both patients with diabetes and those without DM (preadmission rates are higher in patients with DM compared to patients without DM. DM is an independent risk factor for hospital readmissions. The readmission rates correlate directly with LOS in both patients with diabetes and those without DM. Copyright © 2017 Elsevier Inc. All rights reserved.

Reliability of the minimum basic dataset for diagnoses of cerebrovascular disease.

Science.gov (United States)

Hernández Medrano, I; Guillán, M; Masjuan, J; Alonso Cánovas, A; Gogorcena, M A

2017-03-01

The minimum basic dataset is the largest available hospital care administrative database that is used in clinical studies and hospital management in association with diagnosis-related groups (DRGs). In 2011, the quality of the national MBDS in hospital discharges was audited, in order to assess its reliability. This paper presents a sub-analysis of the results from that analysis which are referred to cerebrovascular disease (CVD). Using all discharge reports from the Spanish MBDS in 2009, a representative sample was obtained by stratified sampling and 11 209 records were evaluated. Outcome indicators were obtained to measure any differences observed between the national MBDS being evaluated and the hospital's original MBDS. Analysis of codes for CVD as a primary diagnosis was performed for ICD-9-CM diagnostic categories 430 through 438. We evaluated error rates in the selection and classification of main diagnoses, as well as in DRG assignment. There were 397 discharges of cases of CVD which included 21 different DRGs. Diagnostic coding showed a concordance rate of 81.87%; the selection error rate was 2.26% and the classification error rate was 15.87%. The error rate in the DRG was 16.12% and associated with the greatest impact on the mortality risk level. While the errors we observed must be taken into account, data suggest that the quality of the MBDS for CVD is sufficient to ensure delivery of valid information. The hospital discharge registry serves as a valuable tool for use in studies of this disease. Copyright © 2014 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

MiR-210 disturbs mitotic progression through regulating a group of mitosis-related genes.

Science.gov (United States)

He, Jie; Wu, Jiangbin; Xu, Naihan; Xie, Weidong; Li, Mengnan; Li, Jianna; Jiang, Yuyang; Yang, Burton B; Zhang, Yaou

2013-01-07

MiR-210 is up-regulated in multiple cancer types but its function is disputable and further investigation is necessary. Using a bioinformatics approach, we identified the putative target genes of miR-210 in hypoxia-induced CNE cells from genome-wide scale. Two functional gene groups related to cell cycle and RNA processing were recognized as the major targets of miR-210. Here, we investigated the molecular mechanism and biological consequence of miR-210 in cell cycle regulation, particularly mitosis. Hypoxia-induced up-regulation of miR-210 was highly correlated with the down-regulation of a group of mitosis-related genes, including Plk1, Cdc25B, Cyclin F, Bub1B and Fam83D. MiR-210 suppressed the expression of these genes by directly targeting their 3'-UTRs. Over-expression of exogenous miR-210 disturbed mitotic progression and caused aberrant mitosis. Furthermore, miR-210 mimic with pharmacological doses reduced tumor formation in a mouse metastatic tumor model. Taken together, these results implicate that miR-210 disturbs mitosis through targeting multi-genes involved in mitotic progression, which may contribute to its inhibitory role on tumor formation.

Evaluation of Banana Hypersensitivity Among a Group of Atopic Egyptian Children: Relation to Parental/Self Reports

OpenAIRE

El-Sayed, Zeinab A.; El-Ghoneimy, Dalia H.; El-Shennawy, Dina; Nasser, Manar W.

2013-01-01

Purpose To evaluate the frequency of banana sensitization and allergy among a group of atopic Egyptian children in relation to parental/self reports. Methods This is a case-control study included 2 groups of allergic children with and without history of banana allergy, each included 40 patients. They were subjected to skin prick test (SPT) using commercial banana allergen extract and prick-prick test (PPT) using raw banana, in addition to measuring the serum banana-specific IgE. Oral banana c...

Identity and Belonging in Social Learning Groups: The Importance of Distinguishing Social, Operational and Knowledge-Related Identity Congruence

Science.gov (United States)

Hughes, Gwyneth

2010-01-01

Collaborative learning has much to offer but not all learners participate fully and peer groups can be exclusive. The article examines how belonging or "congruence" in learning groups is related to identities of gender, age, ethnicity and socio-economic status. A study of student experiences of collaborative learning on three different…

Expression profile of vesicular nucleotide transporter (VNUT, SLC17A9) in subpopulations of rat dorsal root ganglion neurons.

Science.gov (United States)

Nishida, Kentaro; Nomura, Yuka; Kawamori, Kanako; Moriyama, Yoshinori; Nagasawa, Kazuki

2014-09-05

ATP plays an important role in the signal transduction between sensory neurons and satellite cells in dorsal root ganglia (DRGs). In primary cultured DRG neurons, ATP is known to be stored in lysosomes via a vesicular nucleotide transporter (VNUT), and to be released into the intercellular space through exocytosis. DRGs consist of large-, medium- and small-sized neurons, which play different roles in sensory transmission, but there is no information on the expression profiles of VNUT in DRG subpopulations. Here, we obtained detailed expression profiles of VNUT in isolated rat DRG tissues. On immunohistochemical analysis, VNUT was found in DRG neurons, and was predominantly expressed by the small- and medium-sized DRG ones, as judged upon visual inspection, and this was compatible with the finding that the number of VNUT-positive DRG neurons in IB4-positive cells was greater than that in NF200-positive ones. These results suggest that VNUT play a role in ATP accumulation in DRG neurons, especially in small- and medium-sized ones, and might be involved in ATP-mediated nociceptive signaling in DRGs. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

What young people want from health-related online resources: a focus group study.

Science.gov (United States)

Fergie, Gillian; Hunt, Kate; Hilton, Shona

2013-08-01

The growth of the Internet as an information source about health, particularly amongst young people, is well established. The aim of this study was to explore young people's perceptions and experiences of engaging with health-related online content, particularly through social media websites. Between February and July 2011 nine focus groups were facilitated across Scotland with young people aged between 14 and 18 years. Health-related user-generated content seems to be appreciated by young people as a useful, if not always trustworthy, source of accounts of other people's experiences. The reliability and quality of both user-generated content and official factual content about health appear to be concerns for young people, and they employ specialised strategies for negotiating both areas of the online environment. Young people's engagement with health online is a dynamic area for research. Their perceptions and experiences of health-related content seem based on their wider familiarity with the online environment and, as the online environment develops, so too do young people's strategies and conventions for accessing it.

"Understanding my ALS". Experiences and reflections of persons with amyotrophic lateral sclerosis and relatives on participation in peer group rehabilitation.

Science.gov (United States)

Madsen, Louise Sofia; Jeppesen, Jørgen; Handberg, Charlotte

2018-01-26

The aim of this study was to gain insight into experiences and reflections of persons with amyotrophic lateral sclerosis and relatives concerning the peer group rehabilitation programme "More Life - Less Illness". This qualitative study used the Interpretive Description methodology with Symbolic Interactionism as the analytical framework. Eighteen programme participants representing persons with amyotrophic lateral sclerosis (n = 8) and relatives (n = 10) were included. Data consisted of individual interviews and participant observation. The analysis revealed two categorical themes, "Sense of Community Building" and "Understanding my ALS", which represented the participants' experiences and reflections on peer group rehabilitation. Through the analysis, it became apparent that "Sense of Community Building" gave rise to an increased and personalised understanding of amyotrophic lateral sclerosis among the participants. As a part of the continuous processing of the knowledge gained, "Facing Facts" and "Retaining Normality" appeared as subthemes regarding the participants' ability to live a less dependent and more meaningful life. This study of peer group rehabilitation for persons with amyotrophic lateral sclerosis and relatives indicates that programme participation leads to positive experiences in terms of living a shared meaningful life despite severe disability. The findings may guide practice to develop longitudinal peer group rehabilitation programmes with joint inclusion of persons with amyotrophic lateral sclerosis and relatives. Implications for Rehabilitation Peer group rehabilitation may facilitate an increased and personalised understanding of what it means to live with amyotrophic lateral sclerosis. A programme design with six months of sequential sessions enables a continuous processing of shared experiences and gained knowledge. Joint participation of persons with amyotrophic lateral sclerosis and their relatives supports both their internal

Calcium signaling in closely related protozoan groups (Alveolata): non-parasitic ciliates (Paramecium, Tetrahymena) vs. parasitic Apicomplexa (Plasmodium, Toxoplasma).

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Plattner, H; Sehring, I M; Mohamed, I K; Miranda, K; De Souza, W; Billington, R; Genazzani, A; Ladenburger, E-M

2012-05-01

The importance of Ca2+-signaling for many subcellular processes is well established in higher eukaryotes, whereas information about protozoa is restricted. Recent genome analyses have stimulated such work also with Alveolates, such as ciliates (Paramecium, Tetrahymena) and their pathogenic close relatives, the Apicomplexa (Plasmodium, Toxoplasma). Here we compare Ca2+ signaling in the two closely related groups. Acidic Ca2+ stores have been characterized in detail in Apicomplexa, but hardly in ciliates. Two-pore channels engaged in Ca2+-release from acidic stores in higher eukaryotes have not been stingently characterized in either group. Both groups are endowed with plasma membrane- and endoplasmic reticulum-type Ca2+-ATPases (PMCA, SERCA), respectively. Only recently was it possible to identify in Paramecium a number of homologs of ryanodine and inositol 1,3,4-trisphosphate receptors (RyR, IP3R) and to localize them to widely different organelles participating in vesicle trafficking. For Apicomplexa, physiological experiments suggest the presence of related channels although their identity remains elusive. In Paramecium, IP3Rs are constitutively active in the contractile vacuole complex; RyR-related channels in alveolar sacs are activated during exocytosis stimulation, whereas in the parasites the homologous structure (inner membrane complex) may no longer function as a Ca2+ store. Scrutinized comparison of the two closely related protozoan phyla may stimulate further work and elucidate adaptation to parasitic life. See also "Conclusions" section. Copyright © 2012 Elsevier Ltd. All rights reserved.

A framework for health-related nanomaterial grouping.

Science.gov (United States)

Gkika, D A; Nolan, J W; Vansant, E F; Vordos, N; Kontogoulidou, C; Mitropoulos, A Ch; Cool, P; Braet, J

2017-06-01

Nanotechnology has been in the limelight since its emergence and its products affect everyday lives. Nanomaterials are characterized by features such as size and shape, thus rendering their possible number essentially unlimited, which in turn makes them difficult to study and categorize regarding possible dangers. This work suggests that grouping could allow studying them with limited testing efforts without endangering safety. Initially, the materials are identified and grouped according to their applications in health/medicine, as well as on their environmentally-friendly potential. The materials are then categorized using various toxicity classification methods to identify those with highest risks and group them with others that demonstrate similar behavior. The materials studied show promising uses in diagnostics, drug delivery, biosensors, water purification, oil spill cleaning, emission control and other fields. The toxicity risk assessment shows that the majority pose little to moderate risk, however there are certain materials that can be extremely hazardous or even cause death under specific circumstances. A risk mitigation plan was also developed. Nanomaterials applications, including drug delivery, cancer treatment, waste treatment, solar energy generation etc. can be very beneficiary, but at the same time, these materials can be extremely harmful or even cause death, thus making the need to prioritize research on high risk materials crucial. A clear regulatory framework that addresses both benefits and risks and communicates that information effectively should play an important part in European and worldwide efforts. The risk analysis validated the impression that there is limited research on nanomaterial toxicity risks, which calls for a more organized approach. The framework outlined in this work can be utilized by researchers as well as government bodies, in order to form regulatory policies and adopt a universally accepted labeling system. This

Viral Richness is Positively Related to Group Size, but Not Mating System, in Bats.

Science.gov (United States)

Webber, Quinn M R; Fletcher, Quinn E; Willis, Craig K R

2017-12-01

Characterizing host traits that influence viral richness and diversification is important for understanding wildlife pathogens affecting conservation and/or human health. Behaviors that affect contact rates among hosts could be important for viral diversification because more frequent intra- and inter-specific contacts among hosts should increase the potential for viral diversification within host populations. We used published data on bats to test the contact-rate hypothesis. We predicted that species forming large conspecific groups, that share their range with more heterospecifics (i.e., sympatry), and with mating systems characterized by high contact rates (polygynandry: multi-male/multi-female), would host higher viral richness than species with small group sizes, lower sympatry, or low contact-rate mating systems (polygyny: single male/multi-female). Consistent with our hypothesis and previous research, viral richness was positively correlated with conspecific group size although the relationship plateaued at group sizes of approximately several hundred thousand bats. This pattern supports epidemiological theory that, up to a point, larger groups have higher contact rates, greater likelihood of acquiring and transmitting viruses, and ultimately greater potential for viral diversification. However, contrary to our hypothesis, there was no effect of sympatry on viral richness and no difference in viral richness between mating systems. We also found no residual effect of host phylogeny on viral richness, suggesting that closely related species do not necessarily host similar numbers of viruses. Our results support the contact-rate hypothesis that intra-specific viral transmission can enhance viral diversification within species and highlight the influence of host group size on the potential of viruses to propagate within host populations.

Safety assessment of dangerous goods transport enterprise based on the relative entropy aggregation in group decision making model.

Science.gov (United States)

Wu, Jun; Li, Chengbing; Huo, Yueying

2014-01-01

Safety of dangerous goods transport is directly related to the operation safety of dangerous goods transport enterprise. Aiming at the problem of the high accident rate and large harm in dangerous goods logistics transportation, this paper took the group decision making problem based on integration and coordination thought into a multiagent multiobjective group decision making problem; a secondary decision model was established and applied to the safety assessment of dangerous goods transport enterprise. First of all, we used dynamic multivalue background and entropy theory building the first level multiobjective decision model. Secondly, experts were to empower according to the principle of clustering analysis, and combining with the relative entropy theory to establish a secondary rally optimization model based on relative entropy in group decision making, and discuss the solution of the model. Then, after investigation and analysis, we establish the dangerous goods transport enterprise safety evaluation index system. Finally, case analysis to five dangerous goods transport enterprises in the Inner Mongolia Autonomous Region validates the feasibility and effectiveness of this model for dangerous goods transport enterprise recognition, which provides vital decision making basis for recognizing the dangerous goods transport enterprises.

Randomized controlled pilot of a group antenatal care model and the sociodemographic factors associated with pregnancy-related empowerment in sub-Saharan Africa.

Science.gov (United States)

Patil, Crystal L; Klima, Carrie S; Leshabari, Sebalda C; Steffen, Alana D; Pauls, Heather; McGown, Molly; Norr, Kathleen F

2017-11-08

The links between empowerment and a number of health-related outcomes in sub-Saharan Africa have been documented, but empowerment related to pregnancy is under-investigated. Antenatal care (ANC) is the entry point into the healthcare system for most women, so it is important to understand how ANC affects aspects of women's sense of control over their pregnancy. We compare pregnancy-related empowerment for women randomly assigned to the standard of care versus CenteringPregnancy-based group ANC (intervention) in two sub-Saharan countries, Malawi and Tanzania. Pregnant women in Malawi (n = 112) and Tanzania (n = 110) were recruited into a pilot study and randomized to individual ANC or group ANC. Retention at late pregnancy was 81% in Malawi and 95% in Tanzania. In both countries, individual ANC, termed focused antenatal care (FANC), is the standard of care. FANC recommends four ANC visits plus a 6-week post-birth visit and is implemented following the country's standard of care. In group ANC, each contact included self- and midwife-assessments in group space and 90 minutes of interactive health promotion. The number of contacts was the same for both study conditions. We measured pregnancy-related empowerment in late pregnancy using the Pregnancy-Related Empowerment Scale (PRES). Independent samples t-tests and multiple linear regressions were employed to assess whether group ANC led to higher PRES scores than individual ANC and to investigate other sociodemographic factors related to pregnancy-related empowerment. In Malawi, women in group ANC had higher PRES scores than those in individual ANC. Type of care was a significant predictor of PRES and explained 67% of the variation. This was not so in Tanzania; PRES scores were similar for both types of care. Predictive models including sociodemographic variables showed religion as a potential moderator of treatment effect in Tanzania. Muslim women in group ANC had a higher mean PRES score than those in

Health professionals perceive teamwork with relatives as an obstacle in their daily work - a focus group interview.

Science.gov (United States)

Laursen, Jannie; Broholm, Malene; Rosenberg, Jacob

2017-09-01

Health professionals must often balance between different rationalities within the hospital organisation. Having adequate time with patients, shorter waiting time and the ability to greater professional autonomy have been shown to help provide a higher quality of care. Empathy and sympathy appear to be crucial components for the health professionals and their relationship to patients. The aim of this study was to explore health professionals' experiences of relatives to critically ill patients in order to identify aspects that may facilitate a better understanding of this teamwork. The study was descriptive and exploratory and had a qualitative design with a phenomenological/hermeneutic orientation for the interviews. Focus group was the chosen methodology. The study comprised 19 health professionals in four focus groups. Two themes emerged from the interviews: the hospital culture does not integrate relatives, and health professionals felt that relatives took their resources and saw them as an obstacle in their daily work. Health professionals felt divided between the system and the individual sphere, which makes it difficult for them to integrate relatives more and see them as participants in a natural teamwork for the benefit of the patient. © 2016 Nordic College of Caring Science.

Casemix funding for a specialist paediatrics hospital: a hedonic regression approach.

Science.gov (United States)

Bridges, J F; Hanson, R M

2000-01-01

This paper inquires into the effects that Diagnosis Related Groups (DRGs) have had on the ability to explain patient-level costs in a specialist paediatrics hospital. Two hedonic models are estimated using 1996/97 New Children's Hospital (NCH) patient level cost data, one with and one without a casemix index (CMI). The results show that the inclusion of a casemix index as an explanatory variable leads to a better accounting of cost. The full hedonic model is then used to simulate a funding model for the 1997/98 NCH cost data. These costs are highly correlated with the actual costs reported for that year. In addition, univariate regression indicates that there has been inflation in costs in the order of 4.8% between the two years. In conclusion, hedonic analysis can provide valuable evidence for the design of funding models that account for casemix.

Self-help groups for former patients: relations with mental health professionals.

Science.gov (United States)

Emerick, R E

1990-04-01

Data from a national survey of 104 self-help groups for former mental patients were examined to assess actual and potential partnerships between these groups and mental health professionals. The groups' level of interaction with and attitudes toward professionals varied with the structure, affiliation, and service model of the groups. The majority were moderate "supportive" groups in which partnerships with professionals could occur but were problematic. Less common were radical "separatist" groups, with which professional partnerships were almost guaranteed to fail, and conservative "partnership" groups, with which partnerships were likely to succeed. Strong antipsychiatric attitudes throughout the mental patient movement suggest that mental health professionals who approach former-patient groups with narrow clinical conceptions of mental illness are likely to fail in establishing partnerships.

Behaviors Related to Mosquito-Borne Diseases among Different Ethnic Minority Groups along the China-Laos Border Areas.

Science.gov (United States)

Wu, Chao; Guo, Xiaofang; Zhao, Jun; Lv, Quan; Li, Hongbin; McNeil, Edward B; Chongsuvivatwong, Virasakdi; Zhou, Hongning

2017-10-15

Background : In China, mosquito-borne diseases are most common in the sub-tropical area of Yunnan province. The objective of this study was to examine behaviors related to mosquito-borne diseases in different ethnic minority groups and different socioeconomic groups of people living in this region. Methods : A stratified two-stage cluster sampling technique with probability proportional to size was used in Mengla County, Xishuangbanna Prefecture, Yunnan. Twelve villages were used to recruit adult (≥18 years old) and eight schools were used for children (related to mosquito-borne diseases was devised. Results : Multiple correspondence analysis (MCA) grouped 20 behaviors into three domains, namely, environmental condition, bed net use behaviors, and repellent use behaviors, respectively. The Han ethnicity had the lowest odds of rearing pigs, their odds being significantly lower than those of Yi and Yao. For bed net use, Dai and other ethnic minority groups were less likely to use bed nets compared to Yi and Yao. The odds of repellent use in the Han ethnicity was lower than in Yi, but higher than in Dai. The Dai group was the most likely ethnicity to use repellents. Farmers were at a higher risk for pig rearing and not using repellents. Education of less than primary school held the lowest odds of pig rearing. Those with low income were at a higher risk for not using bed nets and repellent except in pig rearing. Those with a small family size were at a lower risk for pig rearing. Conclusion : Different ethnic and socioeconomic groups in the study areas require different specific emphases for the prevention of mosquito-borne diseases.

Progress on study of nuclear data theory and related fields at the Theory Group of CNDC

Energy Technology Data Exchange (ETDEWEB)

Zhigang, Ge [China Nuclear Data Center, CIAE (China)

1996-06-01

The Theory Group of CNDC (China Nuclear Data Center) has made a lot of progress in nuclear reaction theory and its application as well as many other related fields in 1995. The recent progress in nuclear reaction theory study and its applications, the recent progress in the nuclear data calculation and related code development are introduced. The production rate of radioactive nuclear beam induced by 70 MeV protons on {sup 72}Ge target were calculated. The calculated results are presented.

Evaluating the efficacy of the current diagnosis-related group reimbursement system for laparoscopic appendectomy at a single institute in Korea

OpenAIRE

Yoo, Ri Na; Chung, Chul-Woon; Kim, Jong-Woo

2014-01-01

Purpose The diagnosis-related group (DRG) system has been adapted to reduce overall medical costs by grouping and classifying relatively homogenous patients based on similar resource consumption patterns in the treatment. However, despite its wide range of disease manifestation from early inflammation to severe peritonitis, acute appendicitis is included in the DRG system. Responding to a need to assess the DRG system for patients diagnosed with appendicitis, this study evaluates the efficacy...

Humanness and (im)morality in group relations

OpenAIRE

Henriques, Ana Patrícia Matos

2017-01-01

Tese de Doutoramento em Psicologia na área de especialidade - Psicologia Social Morality is a valued dimension within and between groups (Ellemers, Pagliaro, & Barreto, 2013; Leach, Bilali, & Pagliaro, 2015), that has been consistently pointed out as part of what makes us uniquely human (Demoulin et al., 2004; Leyens et al., 2000; Haslam, 2006). On the other hand, the extent to which we see others as fully human also impacts on other’s moral status (Bastian, Laham, Wilson, Haslam, & Koval,...

Small Group Research

Science.gov (United States)

McGrath, Joseph E.

1978-01-01

Summarizes research on small group processes by giving a comprehensive account of the types of variables primarily studied in the laboratory. These include group structure, group composition, group size, and group relations. Considers effects of power, leadership, conformity to social norms, and role relationships. (Author/AV)

Authentic leadership, group cohesion and group identification in security and emergency teams.

Science.gov (United States)

García-Guiu López, Carlos; Molero Alonso, Fernando; Moya Morales, Miguel; Moriano León, Juan Antonio

2015-01-01

Authentic leadership (AL) is a kind of leadership that inspires and promotes positive psychological capacities, underlining the moral and ethical component of behavior. The proposed investigation studies the relations among AL, cohesion, and group identification in security and emergency teams. A cross-sectional research design was conducted in which participated 221 members from 26 fire departments and operative teams from the local police of three Spanish provinces. The following questionnaires were administered: Authentic Leadership (ALQ), Group Cohesion (GEQ), and Mael and Ashford's Group Identification Questionnaire. A direct and positive relation was found between AL, cohesion, and group identification. An indirect relation was also found between AL and group cohesion through group identification, indicating the existence of partial mediation. The utility of the proposed model based on AL is considered; this model can be employed by those in charge of the fire departments and operative groups in organizations to improve workteams' cohesion. Both AL and group identification help to explain group cohesion in organizations committed to security and emergencies.

Peptidomics and Secretomics of the Mammalian Peripheral Sensory-Motor System

Science.gov (United States)

Tillmaand, Emily G.; Yang, Ning; Kindt, Callie A. C.; Romanova, Elena V.; Rubakhin, Stanislav S.; Sweedler, Jonathan V.

2015-12-01

The dorsal root ganglion (DRG) and its anatomically and functionally associated spinal nerve and ventral and dorsal roots are important components of the peripheral sensory-motor system in mammals. The cells within these structures use a number of peptides as intercellular signaling molecules. We performed a variety of mass spectrometry (MS)-based characterizations of peptides contained within and secreted from these structures, and from isolated and cultured DRG cells. Liquid chromatography-Fourier transform MS was utilized in DRG and nerve peptidome analysis. In total, 2724 peptides from 296 proteins were identified in tissue extracts. Neuropeptides are among those detected, including calcitonin gene-related peptide I, little SAAS, and known hemoglobin-derived peptides. Solid phase extraction combined with direct matrix-assisted laser desorption/ionization time-of-flight MS was employed to investigate the secretome of these structures. A number of peptides were detected in the releasate from semi-intact preparations of DRGs and associated nerves, including neurofilament- and myelin basic protein-related peptides. A smaller set of analytes was observed in releasates from cultured DRG neurons. The peptide signals observed in the releasates have been mass-matched to those characterized and identified in homogenates of entire DRGs and associated nerves. This data aids our understanding of the chemical composition of the mammalian peripheral sensory-motor system, which is involved in key physiological functions such as nociception, thermoreception, itch sensation, and proprioception.

Alteration of the cell adhesion molecule L1 expression in a specific subset of primary afferent neurons contributes to neuropathic pain.

Science.gov (United States)

Yamanaka, Hiroki; Obata, Koichi; Kobayashi, Kimiko; Dai, Yi; Fukuoka, Tetsuo; Noguchi, Koichi

2007-02-01

The cell adhesion molecule L1 (L1-CAM) plays important functional roles in the developing and adult nervous systems. Here we show that peripheral nerve injury induced dynamic post-transcriptional alteration of L1-CAM in the rat dorsal root ganglia (DRGs) and spinal cord. Sciatic nerve transection (SCNT) changed the expression of L1-CAM protein but not L1-CAM mRNA. In DRGs, SCNT induced accumulation of the L1-CAM into the surface of somata, which resulted in the formation of immunoreactive ring structures in a number of unmyelinated C-fiber neurons. These neurons with L1-CAM-immunoreactive ring structures were heavily colocalized with phosphorylated p38 MAPK. Western blot analysis revealed the increase of full-length L1-CAM and decrease of fragments of L1-CAM after SCNT in DRGs. Following SCNT, L1-CAM-immunoreactive profiles in the dorsal horn showed an increase mainly in pre-synaptic areas of laminae I-II with a delayed onset and colocalized with growth-associated protein 43. In contrast to DRGs, SCNT increased the proteolytic 80-kDa fragment of L1-CAM and decreased full-length L1-CAM in the spinal cord. The intrathecal injection of L1-CAM antibody for the extracellular domain of L1-CAM inhibited activation of p38 MAPK and emergence of ring structures of L1-CAM immunoreactivity in injured DRG neurons. Moreover, inhibition of extracellular L1-CAM binding by intrathecal administration of antibody suppressed the mechanical allodynia and thermal hyperalgesia induced by partial SCNT. Collectively, these data suggest that the modification of L1-CAM in nociceptive pathways might be an important pathomechanism of neuropathic pain.

Acute morphine activates satellite glial cells and up-regulates IL-1β in dorsal root ganglia in mice via matrix metalloprotease-9

Directory of Open Access Journals (Sweden)

Berta Temugin

2012-03-01

Full Text Available Abstract Background Activation of spinal cord glial cells such as microglia and astrocytes has been shown to regulate chronic opioid-induced antinociceptive tolerance and hyperalgesia, due to spinal up-regulation of the proinflammatory cytokines such as interleukin-1 beta (IL-1β. Matrix metalloprotease-9 (MMP-9 has been implicated in IL-1β activation in neuropathic pain. However, it is unclear whether acute opioid treatment can activate glial cells in the peripheral nervous system. We examined acute morphine-induced activation of satellite glial cells (SGCs and up-regulation of IL-1β in dorsal root ganglia (DRGs, and further investigated the involvement of MMP-9 in these opioid-induced peripheral changes. Results Subcutaneous morphine injection (10 mg/kg induced robust peripheral glial responses, as evidenced by increased GFAP expression in DRGs but not in spinal cords. The acute morphine-induced GFAP expression is transient, peaking at 2 h and declining after 3 h. Acute morphine treatment also increased IL-1β immunoreactivity in SGCs and IL-1β activation in DRGs. MMP-9 and GFAP are expressed in DRG neurons and SGCs, respectively. Confocal analysis revealed a close proximity of MMP-9 and GFAP immunostaining. Importantly, morphine-induced DRG up-regulation of GFAP expression and IL-1β activation was abolished after Mmp9 deletion or naloxone pre-treatment. Finally, intrathecal injections of IL-1β-selective siRNA not only reduced DRG IL-1β expression but also prolonged acute morphine-induced analgesia. Conclusions Acute morphine induces opioid receptors- and MMP-9-dependent up-regulation of GFAP expression and IL-1β activation in SGCs of DRGs. MMP-9 could mask and shorten morphine analgesia via peripheral neuron-glial interactions. Targeting peripheral glial activation might prolong acute opioid analgesia.

RiceMetaSys for salt and drought stress responsive genes in rice: a web interface for crop improvement.

Science.gov (United States)

Sandhu, Maninder; Sureshkumar, V; Prakash, Chandra; Dixit, Rekha; Solanke, Amolkumar U; Sharma, Tilak Raj; Mohapatra, Trilochan; S V, Amitha Mithra

2017-09-30

Genome-wide microarray has enabled development of robust databases for functional genomics studies in rice. However, such databases do not directly cater to the needs of breeders. Here, we have attempted to develop a web interface which combines the information from functional genomic studies across different genetic backgrounds with DNA markers so that they can be readily deployed in crop improvement. In the current version of the database, we have included drought and salinity stress studies since these two are the major abiotic stresses in rice. RiceMetaSys, a user-friendly and freely available web interface provides comprehensive information on salt responsive genes (SRGs) and drought responsive genes (DRGs) across genotypes, crop development stages and tissues, identified from multiple microarray datasets. 'Physical position search' is an attractive tool for those using QTL based approach for dissecting tolerance to salt and drought stress since it can provide the list of SRGs and DRGs in any physical interval. To identify robust candidate genes for use in crop improvement, the 'common genes across varieties' search tool is useful. Graphical visualization of expression profiles across genes and rice genotypes has been enabled to facilitate the user and to make the comparisons more impactful. Simple Sequence Repeat (SSR) search in the SRGs and DRGs is a valuable tool for fine mapping and marker assisted selection since it provides primers for survey of polymorphism. An external link to intron specific markers is also provided for this purpose. Bulk retrieval of data without any limit has been enabled in case of locus and SSR search. The aim of this database is to facilitate users with a simple and straight-forward search options for identification of robust candidate genes from among thousands of SRGs and DRGs so as to facilitate linking variation in expression profiles to variation in phenotype. Database URL: http://14.139.229.201.

Chronic stress and peripheral pain: Evidence for distinct, region-specific changes in visceral and somatosensory pain regulatory pathways.

Science.gov (United States)

Zheng, Gen; Hong, Shuangsong; Hayes, John M; Wiley, John W

2015-11-01

Chronic stress alters the hypothalamic-pituitary-adrenal (HPA) axis and enhances visceral and somatosensory pain perception. It is unresolved whether chronic stress has distinct effects on visceral and somatosensory pain regulatory pathways. Previous studies reported that stress-induced visceral hyperalgesia is associated with reciprocal alterations of endovanilloid and endocannabinoid pain pathways in DRG neurons innervating the pelvic viscera. In this study, we compared somatosensory and visceral hyperalgesia with respect to differential responses of peripheral pain regulatory pathways in a rat model of chronic, intermittent stress. We found that chronic stress induced reciprocal changes in the endocannabinoid 2-AG (increased) and endocannabinoid degradation enzymes COX-2 and FAAH (decreased), associated with down-regulation of CB1 and up-regulation of TRPV1 receptors in L6-S2 DRG but not L4-L5 DRG neurons. In contrast, sodium channels Nav1.7 and Nav1.8 were up-regulated in L4-L5 but not L6-S2 DRGs in stressed rats, which was reproduced in control DRGs treated with corticosterone in vitro. The reciprocal changes of CB1, TRPV1 and sodium channels were cell-specific and observed in the sub-population of nociceptive neurons. Behavioral assessment showed that visceral hyperalgesia persisted, whereas somatosensory hyperalgesia and enhanced expression of Nav1.7 and Nav1.8 sodium channels in L4-L5 DRGs normalized 3 days after completion of the stress phase. These data indicate that chronic stress induces visceral and somatosensory hyperalgesia that involves differential changes in endovanilloid and endocannabinoid pathways, and sodium channels in DRGs innervating the pelvic viscera and lower extremities. These results suggest that chronic stress-induced visceral and lower extremity somatosensory hyperalgesia can be treated selectively at different levels of the spinal cord. Copyright © 2015 Elsevier Inc. All rights reserved.

Cervical cancer prevention-related knowledge and attitudes among female undergraduate students from different ethnic groups within China, a survey-based study.

Science.gov (United States)

Wu, Enqi; Tiggelaar, Sarah M; Jiang, Tao; Zhao, Huanhu; Wu, Ritu; Wu, Rilige; Xu, Fangmei

2017-05-22

The purpose of this study was to understand cervical cancer prevention-related knowledge and attitudes among female undergraduate students from different ethnic groups within China. We conducted a survey among ethnically diverse female students from the Minzu University of China, in Beijing in October, 2014. Questionnaires from 493 participants aged from 16 to 26 years were included in the final database. The seven ethnic groups included in the final analysis were Han, Korean, Mongolian, Uyghur, Tibetan, Hui, and Tujia. Compared to the Han Chinese, the members of the other six ethnic groups had lower cervical cancer knowledge levels. The knowledge scores of Mongolian and Korean students were significantly lower than those of the Han Chinese. The willingness to accept cervical cancer prevention efforts also differed across different ethnic groups. After adjusting for age and place of residence, the acceptance of cervical cancer screening among the Tibetan, Uyghur, and Korean groups was significantly lower than among the Han Chinese, with different related decision-making factors in each group. Cervical cancer prevention-related public education is an urgent need in China. Extra consideration of ethnic differences should be taken into account when designing and improving new current cervical cancer prevention programs.

Emotional reactions to deviance in groups: the relation between number of angry reactions, felt rejection, and conformity.

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Heerdink, Marc W; van Kleef, Gerben A; Homan, Astrid C; Fischer, Agneta H

2015-01-01

How many members of a group need to express their anger in order to influence a deviant group member's behavior? In two studies, we examine whether an increase in number of angry group members affects the extent to which a deviant individual feels rejected, and we investigate downstream effects on conformity. We show that each additional angry reaction linearly increases the extent to which a deviant individual feels rejected, and that this relation is independent of the total number of majority members (Study 1). This felt rejection is then shown to lead to anti-conformity unless two conditions are met: (1) the deviant is motivated to seek reacceptance in the group, and (2) conformity is instrumental in gaining reacceptance because it is observable by the majority (Study 2). These findings show that angry reactions are likely to trigger anti-conformity in a deviant, but they are also consistent with a motivational account of conformity, in which conformity is strategic behavior aimed at gaining reacceptance from the group.

Importance of hemodialysis-related outcomes: comparison of ratings by a self-help group, clinicians, and health technology assessment authors with those by a large reference group of patients

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Janssen IM

2016-12-01

Full Text Available Inger M Janssen,1 Fueloep Scheibler,2 Ansgar Gerhardus3,4 1Department of Epidemiology and International Public Health, University of Bielefeld, Bielefeld, 2Department of Non-Drug Interventions, Institute for Quality and Efficiency in Health Care, Cologne, 3Department for Health Services Research, Institute for Public Health and Nursing Research, University of Bremen, 4Health Sciences Bremen, University of Bremen, Bremen, Germany Background: The selection of important outcomes is a crucial decision for clinical research and health technology assessment (HTA, and there is ongoing debate about which stakeholders should be involved. Hemodialysis is a complex treatment for chronic kidney disease (CKD and affects many outcomes. Apart from obvious outcomes, such as mortality, morbidity and health-related quality of life (HRQoL, others such as, concerning daily living or health care provision, may also be important. The aim of our study was to analyze to what extent the preferences for patient-relevant outcomes differed between various stakeholders. We compared preferences of stakeholders normally or occasionally involved in outcome prioritization (patients from a self-help group, clinicians and HTA authors with those of a large reference group of patients. Participants and methods: The reference group consisted of 4,518 CKD patients investigated previously. We additionally recruited CKD patients via a regional self-help group, nephrologists via an online search and HTA authors via an expert database or personal contacts. All groups assessed the relative importance of the 23 outcomes by means of a discrete visual analog scale. We used descriptive statistics to rank outcomes and compare the results between groups. Results: We received completed questionnaires from 49 self-help group patients, 19 nephrologists and 18 HTA authors. Only the following 3 outcomes were ranked within the top 7 outcomes by all 4 groups: safety, HRQoL and emotional state. The

Adding an alcohol-related risk score to an existing categorical risk classification for older adults: sensitivity to group differences.

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Wilson, Sandra R; Fink, Arlene; Verghese, Shinu; Beck, John C; Nguyen, Khue; Lavori, Philip

2007-03-01

To evaluate a new alcohol-related risk score for research use. Using data from a previously reported trial of a screening and education system for older adults (Computerized Alcohol-Related Problems Survey), secondary analyses were conducted comparing the ability of two different measures of risk to detect post-intervention group differences: the original categorical outcome measure and a new, finely grained quantitative risk score based on the same research-based risk factors. Three primary care group practices in southern California. Six hundred sixty-five patients aged 65 and older. A previously calculated, three-level categorical classification of alcohol-related risk and a newly developed quantitative risk score. Mean post-intervention risk scores differed between the three experimental conditions: usual care, patient report, and combined report (Ptrinary risk classification. The additional clinical value of the risk score relative to the categorical measure needs to be determined.

[Cases and duration of mechanical ventilation in German hospitals : An analysis of DRG incentives and developments in respiratory medicine].

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Biermann, A; Geissler, A

2016-09-01

Diagnosis-related groups (DRGs) have been used to reimburse hospitals services in Germany since 2003/04. Like any other reimbursement system, DRGs offer specific incentives for hospitals that may lead to unintended consequences for patients. In the German context, specific procedures and their documentation are suspected to be primarily performed to increase hospital revenues. Mechanical ventilation of patients and particularly the duration of ventilation, which is an important variable for the DRG-classification, are often discussed to be among these procedures. The aim of this study was to examine incentives created by the German DRG-based payment system with regard to mechanical ventilation and to identify factors that explain the considerable increase of mechanically ventilated patients in recent years. Moreover, the assumption that hospitals perform mechanical ventilation in order to gain economic benefits was examined. In order to gain insights on the development of the number of mechanically ventilated patients, patient-level data provided by the German Federal Statistical Office and the German Institute for the Hospital Remuneration System were analyzed. The type of performed ventilation, the total number of ventilation hours, the age distribution, mortality and the DRG distribution for mechanical ventilation were calculated, using methods of descriptive and inferential statistics. Furthermore, changes in DRG-definitions and changes in respiratory medicine were compared for the years 2005-2012. Since the introduction of the DRG-based payment system in Germany, the hours of ventilation and the number of mechanically ventilated patients have substantially increased, while mortality has decreased. During the same period there has been a switch to less invasive ventilation methods. The age distribution has shifted to higher age-groups. A ventilation duration determined by DRG definitions could not be found. Due to advances in respiratory medicine, new

Behaviors Related to Mosquito-Borne Diseases among Different Ethnic Minority Groups along the China-Laos Border Areas

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Chao Wu

2017-10-01

Full Text Available Background: In China, mosquito-borne diseases are most common in the sub-tropical area of Yunnan province. The objective of this study was to examine behaviors related to mosquito-borne diseases in different ethnic minority groups and different socioeconomic groups of people living in this region. Methods: A stratified two-stage cluster sampling technique with probability proportional to size was used in Mengla County, Xishuangbanna Prefecture, Yunnan. Twelve villages were used to recruit adult (≥18 years old and eight schools were used for children (<18 years old. A questionnaire on behaviors and environment variables related to mosquito-borne diseases was devised. Results: Multiple correspondence analysis (MCA grouped 20 behaviors into three domains, namely, environmental condition, bed net use behaviors, and repellent use behaviors, respectively. The Han ethnicity had the lowest odds of rearing pigs, their odds being significantly lower than those of Yi and Yao. For bed net use, Dai and other ethnic minority groups were less likely to use bed nets compared to Yi and Yao. The odds of repellent use in the Han ethnicity was lower than in Yi, but higher than in Dai. The Dai group was the most likely ethnicity to use repellents. Farmers were at a higher risk for pig rearing and not using repellents. Education of less than primary school held the lowest odds of pig rearing. Those with low income were at a higher risk for not using bed nets and repellent except in pig rearing. Those with a small family size were at a lower risk for pig rearing. Conclusion: Different ethnic and socioeconomic groups in the study areas require different specific emphases for the prevention of mosquito-borne diseases.

Creating social spaces to tackle AIDS-related stigma: reviewing the role of church groups in Sub-Saharan Africa.

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Campbell, C; Skovdal, M; Gibbs, A

2011-08-01

An expanding body of literature explores the role of African church groups in facilitating or hindering the support of people living with AIDS and challenging or contributing to HIV/AIDS-related stigma. Treating church groups as social spaces in which HIV/AIDS-related stigma may potentially be challenged, we systematically review this literature, identifying five themes that highlight the complex and contradictory role of the church as a potential agent of health-enhancing social change. In many ways the church perpetuates HIV/AIDS-related stigma through (i) moralistic attitudes and (ii) its reinforcement of conservative gender ideologies. However some churches have managed move towards action that makes a more positive contribution to HIV/AIDS management through (iii) promoting various forms of social control for HIV prevention, (iv) contributing to the care and support of the AIDS-affected and (v) providing social spaces for challenging stigmatising ideas and practices. We conclude that church groups, including church leadership, can play a key role in facilitating or hindering the creation of supportive social spaces to challenge stigma. Much work remains to be done in developing deeper understandings of the multi-layered factors that enable some churches, but not others, to respond effectively to HIV/AIDS.

Reciprocal Relations between Student-Teacher Relationship and Children's Behavioral Problems: Moderation by Child-Care Group Size

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Skalická, Vera; Belsky, Jay; Stenseng, Frode; Wichstrøm, Lars

2015-01-01

In this Norwegian study, bidirectional relations between children's behavior problems and child-teacher conflict and closeness were examined, and the possibility of moderation of these associations by child-care group size was tested. Eight hundred and nineteen 4-year-old children were followed up in first grade. Results revealed reciprocal…

MiR-210 disturbs mitotic progression through regulating a group of mitosis-related genes

OpenAIRE

He, Jie; Wu, Jiangbin; Xu, Naihan; Xie, Weidong; Li, Mengnan; Li, Jianna; Jiang, Yuyang; Yang, Burton B.; Zhang, Yaou

2012-01-01

MiR-210 is up-regulated in multiple cancer types but its function is disputable and further investigation is necessary. Using a bioinformatics approach, we identified the putative target genes of miR-210 in hypoxia-induced CNE cells from genome-wide scale. Two functional gene groups related to cell cycle and RNA processing were recognized as the major targets of miR-210. Here, we investigated the molecular mechanism and biological consequence of miR-210 in cell cycle regulation, particularly ...

ALIGNMENTS OF GROUP GALAXIES WITH NEIGHBORING GROUPS

International Nuclear Information System (INIS)

Wang Yougang; Chen Xuelei; Park, Changbom; Yang Xiaohu; Choi, Yun-Young

2009-01-01

Using a sample of galaxy groups found in the Sloan Digital Sky Survey Data Release 4, we measure the following four types of alignment signals: (1) the alignment between the distributions of the satellites of each group relative to the direction of the nearest neighbor group (NNG); (2) the alignment between the major axis direction of the central galaxy of the host group (HG) and the direction of the NNG; (3) the alignment between the major axes of the central galaxies of the HG and the NNG; and (4) the alignment between the major axes of the satellites of the HG and the direction of the NNG. We find strong signal of alignment between the satellite distribution and the orientation of central galaxy relative to the direction of the NNG, even when the NNG is located beyond 3r vir of the host group. The major axis of the central galaxy of the HG is aligned with the direction of the NNG. The alignment signals are more prominent for groups that are more massive and with early-type central galaxies. We also find that there is a preference for the two major axes of the central galaxies of the HG and NNG to be parallel for the system with both early central galaxies, however, not for the systems with both late-type central galaxies. For the orientation of satellite galaxies, we do not find any significant alignment signals relative to the direction of the NNG. From these four types of alignment measurements, we conclude that the large-scale environment traced by the nearby group affects primarily the shape of the host dark matter halo, and hence also affects the distribution of satellite galaxies and the orientation of central galaxies. In addition, the NNG directly affects the distribution of the satellite galaxies by inducing asymmetric alignment signals, and the NNG at very small separation may also contribute a second-order impact on the orientation of the central galaxy in the HG.

Great Expectations: How Role Expectations and Role Experiences Relate to Perceptions of Group Cohesion.

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Benson, Alex J; Eys, Mark A; Irving, P Gregory

2016-04-01

Many athletes experience a discrepancy between the roles they expect to fulfill and the roles they eventually occupy. Drawing from met expectations theory, we applied response surface methodology to examine how role expectations, in relation to role experiences, influence perceptions of group cohesion among Canadian Interuniversity Sport athletes (N = 153). On the basis of data from two time points, as athletes approached and exceeded their role contribution expectations, they reported higher perceptions of task cohesion. Furthermore, as athletes approached and exceeded their social involvement expectations, they reported higher perceptions of social cohesion. These response surface patterns-pertaining to task and social cohesion-were driven by the positive influence of role experiences. On the basis of the interplay between athletes' role experiences and their perception of the group environment, efforts to improve team dynamics may benefit from focusing on improving the quality of role experiences, in conjunction with developing realistic role expectations.

Perceptual grouping and attention: not all groupings are equal.

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Kimchi, Ruth; Razpurker-Apfeld, Irene

2004-08-01

We examined grouping under inattention using Driver, Davis, Russell, Turatto, & Freeman's (2001) method. On each trial, two successive displays were briefly presented, each comprising a central target square surrounded by elements. The task was to judge whether the two targets were the same or different. The organization of the background elements stayed the same or changed, independently of the targets. In different conditions, background elements grouped into columns/rows by color similarity, a shape (a triangle/arrow, a square/cross, or a vertical/horizontal line) by color similarity, and a shape with no other elements in the background. We measured the influence of the background on the target same-different judgments. The results imply that background elements grouped into columns/rows by color similarity and into a shape when no segregation from other elements was involved and the shape was relatively "good." In contrast, no background grouping was observed when resolving figure-ground relations for segregated units was required, as in grouping into a shape by color similarity. These results suggest that grouping is a multiplicity of processes that vary in their attentional demands. Regardless of attentional demands, the products of grouping are not available to awareness without attention.

Relative Risk of Various Head and Neck Cancers among Different Blood Groups: An Analytical Study

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Kote, Sunder; Patthi, Basavaraj; Singla, Ashish; Singh, Shilpi; Kundu, Hansa; Jain, Swati

2014-01-01

Background: Cancer is a unique disease characterized by abnormal growth of cells which have the ability to invade the adjacent tissues and sometimes even distant organs. The limited and contrasting evidence regarding the association of ABO blood groups with the different types of head and neck cancers in the Indian population warrants the need for the present study. Aim and Objective: To assess the relative risk of various Head & Neck cancers among different blood groups. Materials and Method: Three hundred sixty two diagnosed cases of different type of head and neck cancers and 400 controls were selected from four hospitals of New Delhi, India. The information regarding the type of head and neck cancer was obtained from the case sheets of the patients regarding their socio demographic profile, dietary history using a structured performa. The information regarding type of cancer (cases only), ABO blood group was collected. Statistical Tests: The data was analysed using the SPSS 19 version. Chi square test and odd ratios were calculated. The level of significance was fixed at 5%. Results: The O blood group was found to be most prevalent followed by B, A and AB among the cases as well as the controls. Oral cancer patients showed maximum number in blood group O followed by B, A and AB. Significant pattern of distribution was seen among the patients of esophageal cancer, laryngeal cancer and salivary gland cancer as well (p= 0.003, p=0.000 p=0.112 respectively. Conclusion: The present study reveals that there is an inherited element in the susceptibility or protection against different types of head and neck cancers. Blood group A was found to be a potential risk factor for the development of oral cancers, esophageal cancers and salivary gland cancers while blood group B was found to be a potential risk factor for laryngeal cancers. PMID:24959511

Relative Risk of Various Head and Neck Cancers among Different Blood Groups: An Analytical Study.

Science.gov (United States)

Singh, Khushboo; Kote, Sunder; Patthi, Basavaraj; Singla, Ashish; Singh, Shilpi; Kundu, Hansa; Jain, Swati

2014-04-01

Cancer is a unique disease characterized by abnormal growth of cells which have the ability to invade the adjacent tissues and sometimes even distant organs. The limited and contrasting evidence regarding the association of ABO blood groups with the different types of head and neck cancers in the Indian population warrants the need for the present study. To assess the relative risk of various Head & Neck cancers among different blood groups. Three hundred sixty two diagnosed cases of different type of head and neck cancers and 400 controls were selected from four hospitals of New Delhi, India. The information regarding the type of head and neck cancer was obtained from the case sheets of the patients regarding their socio demographic profile, dietary history using a structured performa. The information regarding type of cancer (cases only), ABO blood group was collected. Statistical Tests: The data was analysed using the SPSS 19 version. Chi square test and odd ratios were calculated. The level of significance was fixed at 5%. The O blood group was found to be most prevalent followed by B, A and AB among the cases as well as the controls. Oral cancer patients showed maximum number in blood group O followed by B, A and AB. Significant pattern of distribution was seen among the patients of esophageal cancer, laryngeal cancer and salivary gland cancer as well (p= 0.003, p=0.000 p=0.112 respectively. The present study reveals that there is an inherited element in the susceptibility or protection against different types of head and neck cancers. Blood group A was found to be a potential risk factor for the development of oral cancers, esophageal cancers and salivary gland cancers while blood group B was found to be a potential risk factor for laryngeal cancers.

Feasibility and validity of International Classification of Diseases based case mix indices.

Science.gov (United States)

Yang, Che-Ming; Reinke, William

2006-10-06

Severity of illness is an omnipresent confounder in health services research. Resource consumption can be applied as a proxy of severity. The most commonly cited hospital resource consumption measure is the case mix index (CMI) and the best-known illustration of the CMI is the Diagnosis Related Group (DRG) CMI used by Medicare in the U.S. For countries that do not have DRG type CMIs, the adjustment for severity has been troublesome for either reimbursement or research purposes. The research objective of this study is to ascertain the construct validity of CMIs derived from International Classification of Diseases (ICD) in comparison with DRG CMI. The study population included 551 acute care hospitals in Taiwan and 2,462,006 inpatient reimbursement claims. The 18th version of GROUPER, the Medicare DRG classification software, was applied to Taiwan's 1998 National Health Insurance (NHI) inpatient claim data to derive the Medicare DRG CMI. The same weighting principles were then applied to determine the ICD principal diagnoses and procedures based costliness and length of stay (LOS) CMIs. Further analyses were conducted based on stratifications according to teaching status, accreditation levels, and ownership categories. The best ICD-based substitute for the DRG costliness CMI (DRGCMI) is the ICD principal diagnosis costliness CMI (ICDCMI-DC) in general and in most categories with Spearman's correlation coefficients ranging from 0.938-0.462. The highest correlation appeared in the non-profit sector. ICD procedure costliness CMI (ICDCMI-PC) outperformed ICDCMI-DC only at the medical center level, which consists of tertiary care hospitals and is more procedure intensive. The results of our study indicate that an ICD-based CMI can quite fairly approximate the DRGCMI, especially ICDCMI-DC. Therefore, substituting ICDs for DRGs in computing the CMI ought to be feasible and valid in countries that have not implemented DRGs.

A Prognostic Indicator for Patients Hospitalized with Heart Failure.

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Snow, Richard; Vogel, Karen; Vanderhoff, Bruce; Kelch, Benjamin P; Ferris, Frank D

2016-12-01

Current methods for identifying patients at risk of dying within six months suffer from clinician biases resulting in underestimation of this risk. As a result, patients who are potentially eligible for hospice and palliative care services frequently do not benefit from these services until they are very close to the end of their lives. To develop a prospective prognostic indicator based on actual survival within Centers for Medicare and Medicaid Services (CMS) claims data that identifies patients with congestive heart failure (CHF) who are at risk of six-month mortality. CMS claims data from January 1, 2008 to June 30, 2009 were reviewed to find the first hospitalization for CHF patients with episode of care diagnosis-related groups (DRGs) 291, 292, and 293. Univariate and multivariable analyses were used to determine the associations between demographic and clinical factors and six-month mortality. The resulting model was evaluated for discrimination and calibration. The resulting prospective prognostic model demonstrated fair discrimination with an ROC of 0.71 and good calibration with a Hosmer-Lemshow statistic of 0.98. Across all DRGs, 5% of discharged patients had a six-month mortality risk of greater than 50%. This prospective approach appears to provide a method to identify patients with CHF who would potentially benefit from a clinical evaluation for referral to hospice care or for a palliative care consult due to high predicted risk of dying within 180 days after discharge from a hospital. This approach can provide a model to match at-risk patients with evidenced-based care in a more consistent manner. This method of identifying patients at risk needs further prospective evaluation to see if it has value for clinicians, increases referrals to hospice and palliative care services, and benefits patients and families.

Feasibility and validity of International Classification of Diseases based case mix indices

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Reinke William

2006-10-01

Full Text Available Abstract Background Severity of illness is an omnipresent confounder in health services research. Resource consumption can be applied as a proxy of severity. The most commonly cited hospital resource consumption measure is the case mix index (CMI and the best-known illustration of the CMI is the Diagnosis Related Group (DRG CMI used by Medicare in the U.S. For countries that do not have DRG type CMIs, the adjustment for severity has been troublesome for either reimbursement or research purposes. The research objective of this study is to ascertain the construct validity of CMIs derived from International Classification of Diseases (ICD in comparison with DRG CMI. Methods The study population included 551 acute care hospitals in Taiwan and 2,462,006 inpatient reimbursement claims. The 18th version of GROUPER, the Medicare DRG classification software, was applied to Taiwan's 1998 National Health Insurance (NHI inpatient claim data to derive the Medicare DRG CMI. The same weighting principles were then applied to determine the ICD principal diagnoses and procedures based costliness and length of stay (LOS CMIs. Further analyses were conducted based on stratifications according to teaching status, accreditation levels, and ownership categories. Results The best ICD-based substitute for the DRG costliness CMI (DRGCMI is the ICD principal diagnosis costliness CMI (ICDCMI-DC in general and in most categories with Spearman's correlation coefficients ranging from 0.938-0.462. The highest correlation appeared in the non-profit sector. ICD procedure costliness CMI (ICDCMI-PC outperformed ICDCMI-DC only at the medical center level, which consists of tertiary care hospitals and is more procedure intensive. Conclusion The results of our study indicate that an ICD-based CMI can quite fairly approximate the DRGCMI, especially ICDCMI-DC. Therefore, substituting ICDs for DRGs in computing the CMI ought to be feasible and valid in countries that have not

Death certificates underestimate infections as proximal causes of death in the U.S.

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Sushant Govindan

Full Text Available Death certificates are a primary data source for assessing the population burden of diseases; however, there are concerns regarding their accuracy. Diagnosis-Related Group (DRG coding of a terminal hospitalization may provide an alternative view. We analyzed the rate and patterns of disagreement between death certificate data and hospital claims for patients who died during an inpatient hospitalization.We studied respondents from the Health and Retirement Study (a nationally representative sample of older Americans who had an inpatient death documented in the linked Medicare claims from 1993-2007. Causes of death abstracted from death certificates were aggregated to the standard National Center for Health Statistics List of 50 Rankable Causes of Death. Centers for Medicare and Medicaid Services (CMS-DRGs were manually aggregated into a parallel classification. We then compared the two systems via 2×2, focusing on concordance. Our primary analysis was agreement between the two data sources, assessed with percentages and Cohen's kappa statistic.2074 inpatient deaths were included in our analysis. 36.6% of death certificate cause-of-death codes agreed with the reason for the terminal hospitalization in the Medicare claims at the broad category level; when re-classifying DRGs without clear alignment as agreements, the concordance only increased to 61%. Overall Kappa was 0.21, or "fair." Death certificates in this cohort redemonstrated the conventional top 3 causes of death as diseases of the heart, malignancy, and cerebrovascular disease. However, hospitalization claims data showed infections, diseases of the heart, and cerebrovascular disease as the most common diagnoses for the same terminal hospitalizations.There are significant differences between Medicare claims and death certificate data in assigning cause of death for inpatients. The importance of infections as proximal causes of death is underestimated by current death certificate

Early results of pediatric appendicitis after adoption of diagnosis-related group-based payment system in South Korea

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Moon SB

2015-11-01

Full Text Available Suk-Bae MoonDepartment of Surgery, Kangwon National University Hospital, Kangwon National School of Medicine, Kangwon National University, Chuncheon, South KoreaPurpose: As an alternative to the existing fee-for-service (FFS system, a diagnosis-related group (DRG-based payment system has been suggested. The aim of this study was to investigate the early results of pediatric appendicitis treatment under the DRG system, focusing on health care expenditure and quality of health care services.Patients and methods: The medical records of 60 patients, 30 patients before (FFS group, and 30 patients after adoption of the DRG system (DRG, were reviewed retrospectively.Results: Mean hospital stay was shortened, but the complication and readmission rates did not worsen in the DRG. Overall health care expenditure and self-payment decreased from Korean Won (KRW 2,499,935 and KRW 985,540, respectively, in the FFS group to KRW 2,386,552 and KRW 492,920, respectively, in the DRG. The insurer’s payment increased from KRW 1,514,395 in the FFS group to KRW 1,893,632 in the DRG. For patients in the DRG, calculation by the DRG system yielded greater overall expenditure (KRW 2,020,209 vs KRW 2,386,552 but lower self-payment (KRW 577,803 vs KRW 492,920 than calculation by the FFS system.Conclusion: The DRG system worked well in pediatric patients with acute appendicitis in terms of cost-effectiveness over the short term. The gradual burden on the national health insurance fund should be taken into consideration.Keywords: appendicitis, child, fee-for-service plans, diagnosis-related groups, quality of health care, health care expenditures

Becoming the denigrated other: Group relations perspectives on initial reactions to a bipolar disorder diagnosis

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Susan G. Goldberg

2012-09-01

Full Text Available The initial reactions to a bipolar disorder diagnosis of research participants in a small, qualitative study consisted of astonishment, dread of being mad, and extremely negative associations. All had prior mental health diagnoses, including episodes of severe depression (all but one and alcoholism (one. All participants reported mental health histories prediagnosis and most had spent years contending with mental health labels, medications, symptoms, and hospitalizations. In addition, most participants were highly educated health professionals, quite familiar with the behaviors that the medical system considered to comprise bipolar disorder. Their negative associations to the initial bipolar disorder diagnosis, therefore, appeared inconsistent with their mental health histories and professional knowledge. This article contextualizes these initial reactions of shock and distress and proposes interpretations of these findings from societal and psychodynamic group relations perspectives. The participants’ initial negative reactions are conceptualized as involving the terror of being transported from the group of normal people into the group of mad or crazy people, i.e., people with mental illnesses, who may constitute a societal denigrated other.

Smoking and Adolescence: Exploring Tobacco Consumption and Related Attitudes in Three Different Adolescent Groups in Switzerland

Science.gov (United States)

Bosson, Marlene; Maggiori, Christian; Gygax, Pascal Mark; Gay, Christelle

2012-01-01

The present study constitutes an investigation of tobacco consumption, related attitudes and individual differences in smoking or non-smoking behaviors in a sample of adolescents of different ages in the French-speaking part of Switzerland. We investigated three school-age groups (7th-grade, 9th-grade, and the second-year of high school) for…

Introduction to Sporadic Groups

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Luis J. Boya

2011-01-01

Full Text Available This is an introduction to finite simple groups, in particular sporadic groups, intended for physicists. After a short review of group theory, we enumerate the 1+1+16=18 families of finite simple groups, as an introduction to the sporadic groups. These are described next, in three levels of increasing complexity, plus the six isolated ''pariah'' groups. The (old five Mathieu groups make up the first, smallest order level. The seven groups related to the Leech lattice, including the three Conway groups, constitute the second level. The third and highest level contains the Monster group M, plus seven other related groups. Next a brief mention is made of the remaining six pariah groups, thus completing the 5+7+8+6=26 sporadic groups. The review ends up with a brief discussion of a few of physical applications of finite groups in physics, including a couple of recent examples which use sporadic groups.

32 CFR 705.22 - Relations with community groups.

Science.gov (United States)

2010-07-01

... seminar is of principal importance and the use of mess facilities is incidental thereto. (2) Because of... unclear, pending advice from the Chief of Information. (d) Commands may make facilities, less housing and... of the Navy to do so. Mess facilities may not be used for meetings of civic groups or other...

Emotional Reactions to Deviance in Groups: The Relation between Number of Angry Reactions, Felt Rejection, and Conformity

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Marc W. Heerdink

2015-06-01

Full Text Available How many members of a group need to express their anger in order to influence a deviant group member's behavior? In two studies, we examine whether an increase in number of angry group members affects the extent to which a deviant individual feels rejected, and we investigate downstream effects on conformity. We show that each additional angry reaction linearly increases the extent to which a deviant individual feels rejected, and that this relation is independent of the total number of majority members (Study 1. This felt rejection is then shown to lead to anti-conformity unless two conditions are met: (1 the deviant is motivated to seek reacceptance in the group, and (2 conformity is instrumental in gaining reacceptance because it is observable by the majority (Study 2. These findings show that angry reactions are likely to trigger anti-conformity in a deviant, but they are also consistent with a motivational account of conformity, in which conformity is strategic behavior aimed at gaining reacceptance from the group.

Predictors of Strength of In-Group Identity in Northern Ireland: Impact of Past Sectarian Conflict, Relative Deprivation, and Church Attendance.

Science.gov (United States)

Goeke-Morey, Marcie C; Taylor, Laura K; Merrilees, Christine E; Cummings, E Mark

2015-07-01

Social identity in Northern Ireland is multifaceted, with historical, religious, political, social, economic, and psychological underpinnings. Understanding the factors that influence the strength of identity with the Protestant or Catholic community, the two predominate social groups in Northern Ireland, has implications for individual well-being as well as for the continuation of tension and violence in this setting of protracted intergroup conflict. This study examined predictors of the strength of in-group identity in 692 women (mean age 37 years) in post-accord Northern Ireland. For Catholics, strength of in-group identity was positively linked to past negative impact of sectarian conflict and more frequent current church attendance, whereas for Protestants, strength of in-group identity was related to greater status satisfaction regarding access to jobs, standard of living, and political power compared to Catholics; that is, those who felt less relative deprivation. The discussion considers the differences in the factors underlying stronger identity for Protestants and Catholics in this context.

Risk factors for treatment related clinical fluctuations in Guillain-Barré syndrome. Dutch Guillain-Barré study group

NARCIS (Netherlands)

L.H. Visser (Leendert); F.G.A. van der Meché (Frans); J. Meulstee (Jan); P.A. van Doorn (Pieter)

1998-01-01

textabstractThe risk factors for treatment related clinical fluctuations, relapses occurring after initial therapeutic induced stabilisation or improvement, were evaluated in a group of 172 patients with Guillain-Barre syndrome. Clinical, laboratory, and electrodiagnostic features

Assessment of nuclear data needs for broad-group SCALE library related to WWER spent fuel applications

International Nuclear Information System (INIS)

Zalesky, K.; Markova, L.

1999-12-01

A preliminary study aimed at the issue of feasibility to generate a broad-group SCALE library related to WWER spent fuel applications was made. The SCALE code system has been installed and is being used in many countries operating WWER-type reactors for criticality and shielding analyses as well as spent fuel isotopic inventory calculations but still without an extensive validation and verification for the WWER environment. This study should be a contribution to QA connected with the SCALE code system application for the WWER calculations as a basis on which the generation of the specific WWER SCALE library can be prepared. Possible ways of the broad-group library development are described. (author)

Dutch Adolescents' Motives, Perceptions, and Reflections Toward Sex-Related Internet Use: Results of a Web-Based Focus-Group Study.

Science.gov (United States)

Doornwaard, Suzan M; den Boer, Fedde; Vanwesenbeeck, Ine; van Nijnatten, Carol H C J; Ter Bogt, Tom F M; van den Eijnden, Regina J J M

2017-10-01

The Internet offers adolescents unique opportunities to actively shape their own sexual media environment. The aim of this study was to gain in-depth insight into Dutch adolescents' motives, perceptions, and reflections toward Internet use for (a) finding information or advice related to romance and sexuality; (b) searching for and viewing pornographic or erotic material; and (c) romantic and sexual communication (i.e., cybersex/sexting). Data were collected through 12 Web-based focus groups (36 adolescents aged 16 to 19 years, 72.2% girls) and analyzed through three stages of open, axial, and selective coding. The themes that emerged from the focus-group discussions suggest that sex-related Internet use is a complex and ambivalent experience for adolescents. Sex-related Internet use seems an increasingly normalized and common phenomenon. Participants perceived the Internet as a useful source of sexual information, stimulation, inspiration, and communication. Yet they discussed a range of negative consequences and risks related to sex-related online behaviors, particularly concerning pornography's potential to create unrealistic expectations about sex and sexual attractiveness. Participants generally believed they had the necessary skills to navigate through the online sexual landscape in a responsible way, although they believed other young people could be influenced inadvertently and adversely by sex-related online content.

Understanding Mathematic Concept in Relation and Function Method through Active Learning Type Group to Group Distributed LKS

Science.gov (United States)

Kudri, F.; Rahmi, R.; Haryono, Y.

2018-04-01

This research is motivated by the lack of understanding of mathematical concepts students and teachers have not familiarize students discussed in groups. This researchaims to determine whether an understanding of mathematical concepts junior class VIII SMPN 2 in Ranah Batahan Kabupaten Pasaman Barat by applying active learning strategy group to group types with LKS better than conventional learning. The type of research is experimental the design of randomized trials on the subject. The population in the study were all students VIII SMPN 2 Ranah Batahan Kabupaten Pasaman Barat in year 2012/2013 which consists of our class room experiment to determine the grade and control class with do nerandomly, so that classes VIII1 elected as a experiment class and class VIII4 as a control class. The instruments used in the test empirically understanding mathematical concepts are shaped by the essay with rt=0,82 greater than rt=0,468 means reliable tests used. The data analysis technique used is the test with the help of MINITAB. Based on the results of the data analisis known that both of the sample are normal and homogenity in real rate α = 0,05, so the hypothesis of this research is received. So, it can be concluded students’ understanding mathematical concept applied the active Group to Group learning strategy with LKS is better than the students’ understanding mathematical concept with Conventional Learning.

Risk adjustment policy options for casemix funding: international lessons in financing reform.

Science.gov (United States)

Antioch, Kathryn M; Ellis, Randall P; Gillett, Steve; Borovnicar, Daniel; Marshall, Ric P

2007-09-01

This paper explores modified hospital casemix payment formulae that would refine the diagnosis-related group (DRG) system in Victoria, Australia, which already makes adjustments for teaching, severity and demographics. We estimate alternative casemix funding methods using multiple regressions for individual hospital episodes from 2001 to 2003 on 70 high-deficit DRGs, focussing on teaching hospitals where the largest deficits have occurred. Our casemix variables are diagnosis- and procedure-based severity markers, counts of diagnoses and procedures, disease types, complexity, day outliers, emergency admission and "transfers in." The results are presented for four policy options that vary according to whether all of the dollars or only some are reallocated, whether all or some hospitals are used and whether the alternatives augment or replace existing payments. While our approach identifies variables that help explain patient cost variations, hospital-level simulations suggest that the approaches explored would only reduce teaching hospital underpayment by about 10%. The implications of various policy options are discussed.

Development of a relational database for nuclear material (NM) accounting in RC and I Group

International Nuclear Information System (INIS)

Yadav, M.B.; Ramakumar, K.L.; Venugopal, V.

2011-01-01

A relational database for the nuclear material accounting in RC and I Group has been developed with MYSQL for Back-End and JAVA for Front-End development. Back-End has been developed to avoid any data redundancy, to provide random access of the data and to retrieve the required information from database easily. JAVA Applet and Java Swing components of JAVA programming have been used in the Front-End development. Front-End has been developed to provide data security, data integrity, to generate inventory status report at the end of accounting period, and also to have a quick look of some required information on computer screen. The database has been tested for the data of three quarters of the year 2009. It has been implemented from 1st January, 2010 for the accounting of nuclear material in RC and I Group. (author)

Development of a relational database for nuclear material (NM) accounting in RC and I Group

Energy Technology Data Exchange (ETDEWEB)

Yadav, M B; Ramakumar, K L; Venugopal, V [Radioanalytical Chemistry Division, Radiochemistry and Isotope Group, Bhabha Atomic Research Centre, Mumbai (India)

2011-07-01

A relational database for the nuclear material accounting in RC and I Group has been developed with MYSQL for Back-End and JAVA for Front-End development. Back-End has been developed to avoid any data redundancy, to provide random access of the data and to retrieve the required information from database easily. JAVA Applet and Java Swing components of JAVA programming have been used in the Front-End development. Front-End has been developed to provide data security, data integrity, to generate inventory status report at the end of accounting period, and also to have a quick look of some required information on computer screen. The database has been tested for the data of three quarters of the year 2009. It has been implemented from 1st January, 2010 for the accounting of nuclear material in RC and I Group. (author)

Assemblage patterns of fish functional groups relative to habitat connectivity and conditions in floodplain lakes

Science.gov (United States)

Miyazono, S.; Aycock, J.N.; Miranda, L.E.; Tietjen, T.E.

2010-01-01

We evaluated the influences of habitat connectivity and local environmental factors on the distribution and abundance patterns of fish functional groups in 17 floodplain lakes in the Yazoo River Basin, USA. The results of univariate and multivariate analyses showed that species-environmental relationships varied with the functional groups. Species richness and assemblage structure of periodic strategists showed strong and positive correlations with habitat connectivity. Densities of most equilibrium and opportunistic strategists decreased with habitat connectivity. Densities of certain equilibrium and opportunistic strategists increased with turbidity. Forested wetlands around the lakes were positively related to the densities of periodic and equilibrium strategists. These results suggest that decreases in habitat connectivity, forested wetland buffers and water quality resulting from environmental manipulations may cause local extinction of certain fish taxa and accelerate the dominance of tolerant fishes in floodplain lakes. ?? 2010 John Wiley & Sons A/S.

Is There a Relation between ABO Blood Groups and Clinical Outcome in Patients with Pemphigoid? A Case-Control Study.

Science.gov (United States)

Bakhtiari, Sedigheh; Toosi, Parviz; Azimi, Somayyeh; Esmaili, Nafiseh; Montazami, Ali; Rafieian, Nasrin

2016-01-01

Background. Relationship between blood groups and dermatologic diseases remains controversial and was not yet fully elucidated nor explained clearly. The aim of this study was to examine if any relation exists between different types of pemphigoid diseases and ABO blood group. Methods. In this case-control study, 159 pemphigoid patients and 152 healthy matched-controls were evaluated. All blood group (including Rh status) data for the study was obtained from the hospital medical records. Statistical comparisons were completed with chi-square test and logistic regression. Results. Blood group "O" was found in 32.9% of patients and 38.2% of control group. Blood group "A" was found among 30.8% of patients and 34.2% of control group, while group "B" was reported in 27.4% of cases and 21.1% of controls and "AB" was identified among 8.9% of patients and 6.6% of control group. 84.9% of patients were Rh positive, while in the control group 86.2% of patients were Rh positive. No significant differences were found regarding ABO blood groups (P = 0.46) or Rh (P = 0.76) between pemphigoid patients and control group. Also, older females had the higher risk of developing bullous pemphigoid. Conclusion. We found no relationship between ABO blood groups and pemphigoid disease.

Relative Susceptibilities of ABO Blood Groups to Plasmodium falciparum Malaria in Ghana.

Science.gov (United States)

Afoakwah, Richmond; Aubyn, Edmond; Prah, James; Nwaefuna, Ekene Kwabena; Boampong, Johnson N

2016-01-01

The clinical outcome of falciparum malaria in endemic areas is influenced by erythrocyte polymorphisms including the ABO blood groups. Studies have reported association of ABO blood group to resistance, susceptibility, and severity of P. falciparum malaria infection. Individuals with blood group "A" have been found to be highly susceptible to falciparum malaria whereas blood group "O" is said to confer protection against complicated cases. We analyzed samples from 293 young children less than six years old with malaria in the Korle-Bu Teaching Hospital in Accra, Ghana. It was observed that group O was present in about 16.1% of complicated cases weighed against 40.9% of uncomplicated controls. Individuals with complicated malaria were about twice likely to be of blood groups A and B compared to group O (A versus O, OR = 1.90, 95% CI = 1.59-2.26, P Blood group O participants with complicated diseases had low parasitaemia compared to the other blood groups (P blood group O individuals a survival advantage over the other groups in complicated malaria as suggested. Participants with complicated falciparum malaria were generally anaemic and younger than those with uncomplicated disease.

Group and Topic Discovery from Relations and Their Attributes

National Research Council Canada - National Science Library

Wang, Xuerui; Mohanty, Natasha; McCallum, Andrew

2006-01-01

The authors present a probabilistic generative model of entity relationships and their attributes that simultaneously discovers groups among the entities and topics among the corresponding textual attributes...

The ties that bind: Group membership shapes the neural correlates of in-group favoritism.

Science.gov (United States)

Telzer, Eva H; Ichien, Nicolas; Qu, Yang

2015-07-15

Across species, including non-human primates, rodents, and humans, prosocial behavior, the act of helping others, is preferentially provided to members of one's own group. Whereas a particularly ubiquitous example of this is kinship, whereby humans and animals expend greater resources and take more risks for their own kin, in-group prosocial behavior has been demonstrated among diverse shared social groups, including race and culture. In the current study, we made group membership salient by recruiting Chinese and American participants to engage in a prosocial decision-making task during fMRI with an American and Chinese confederate. We found across all participants that donations to the in-group relative to out-group was associated with increased activation in the ventral striatum. Moreover, participants with a greater sense of group identity and Chinese participants relative to American participants, showed heightened activation in self-control (VLPFC, ACC) and mentalizing (TPJ, DMPFC) regions when contributing to the out-group relative to in-group. Our findings provide novel evidence about the neural mechanisms involved in intergroup prosocial behavior. Copyright © 2015 Elsevier Inc. All rights reserved.

Disk and dwarf spheroidal galaxies kinematics from general relativity with infrared renormalization group effects

International Nuclear Information System (INIS)

Rodrigues, Davi C.; Oliveira, Paulo L.C. de; Fabris, Julio C.; Shapiro, Ilya L.

2011-01-01

Full text: The running of coupling constants is a well known phenomenon within Quantum Field Theory. It is also known that the renormalization group method can be extended to quantum field theory on curved space time. Nonetheless, although we know that the beta function of QED go to zero in the infrared limit fast enough to lead to constant charge at the classical level (in conformity with both the Appelquist-Carazzone theorem and experimental data), no analogous proof exists for General Relativity. Some authors have proposed that the infrared beta function of General Relativity is not trivial, and as such certain small running of the gravitational coupling might take place at astrophysical scales, leading in particular to changes on the role of dark matter in galaxies. We review and extend our contribution to infrared Renormalization Group (RG) effects to General Relativity in the context of galaxies, an approach we call RGGR. We extend our previous results by analyzing a larger sample of galaxies, now also including elliptical and dwarf spheroidal galaxies, besides disk galaxies (both LSB and HSB). We compare our RGGR results to both standard dark matter profiles (NFW, Isothermal, Burkert) and alternative models of gravity (MOND, MSTG), showing that the RGGR results are similar in quality to the best dark matter profiles (the cored ones, e.g., Isothermal and Burkert), while displaying a better fitting to the data than NFW, MOND or MSTG. To the latter, we evaluated both the shape of the rotation curve and the expected stellar mass-to-light ratios. Dwarf spheroidal (dSph) galaxies are small galaxies believed to be dominated by dark matter, with the highest fraction do dark matter per baryonic matter. These galaxies provide a strong test to any theory that mimics either all or part of the dark matter behavior. In particular, this is the only type of galaxy that MOND seems incapable of fitting the data. (author)

An Evaluation of the Lower Rio Grande Valley Contracts with Non-VA Providers

National Research Council Canada - National Science Library

Piihl, Janet

1999-01-01

... (DRGs with a HCFA average length of stay of three days or less). Surprisingly, four months after the contracts were implemented actual utilization of the contracts was significantly lower than projected...

Relative Susceptibilities of ABO Blood Groups to Plasmodium falciparum Malaria in Ghana

Directory of Open Access Journals (Sweden)

Richmond Afoakwah

2016-01-01

Full Text Available The clinical outcome of falciparum malaria in endemic areas is influenced by erythrocyte polymorphisms including the ABO blood groups. Studies have reported association of ABO blood group to resistance, susceptibility, and severity of P. falciparum malaria infection. Individuals with blood group “A” have been found to be highly susceptible to falciparum malaria whereas blood group “O” is said to confer protection against complicated cases. We analyzed samples from 293 young children less than six years old with malaria in the Korle-Bu Teaching Hospital in Accra, Ghana. It was observed that group O was present in about 16.1% of complicated cases weighed against 40.9% of uncomplicated controls. Individuals with complicated malaria were about twice likely to be of blood groups A and B compared to group O (A versus O, OR = 1.90, 95% CI = 1.59–2.26, P<0.0001; B versus O, OR = 1.82. 95% CI = 1.57–2.23, P<0.0001. Blood group O participants with complicated diseases had low parasitaemia compared to the other blood groups (P<0.0001. This may give blood group O individuals a survival advantage over the other groups in complicated malaria as suggested. Participants with complicated falciparum malaria were generally anaemic and younger than those with uncomplicated disease.

Changes in energy metabolism in relation to physical activity due to fermentable carbohydrates in group housed, growing pigs

NARCIS (Netherlands)

Schrama, J.W.; Bakker, G.C.M.

1999-01-01

Fermentable nonstarch polysaccharides (dietary fiber) affect energy retention in group-housed growing pigs by reducing physical activity. This study assessed the effects of fermentation and bulkiness of dietary carbohydrates on physical activity in relation to energy metabolism. Eight clusters of 14

Changes in energy metabolism in relation to physical activity due to fermentable carbohydrates in group-housed growing pigs

NARCIS (Netherlands)

Schrama, J.W.; Bakker, G.C.M.

1999-01-01

Fermentable nonstarch polysaccharides (dietary fiber) affect energy retention in group-housed growing pigs by reducing physical activity. This study assessed the effects of fermentation and bulkiness of dietary carbohydrates on physical activity in relation to energy metabolism. Eight clusters of 14

Relative stability of core groups in pollination networks in a biodiversity hotspot over four years.

Science.gov (United States)

Fang, Qiang; Huang, Shuang-Quan

2012-01-01

Plants and their pollinators form pollination networks integral to the evolution and persistence of species in communities. Previous studies suggest that pollination network structure remains nested while network composition is highly dynamic. However, little is known about temporal variation in the structure and function of plant-pollinator networks, especially in species-rich communities where the strength of pollinator competition is predicted to be high. Here we quantify temporal variation of pollination networks over four consecutive years in an alpine meadow in the Hengduan Mountains biodiversity hotspot in China. We found that ranked positions and idiosyncratic temperatures of both plants and pollinators were more conservative between consecutive years than in non-consecutive years. Although network compositions exhibited high turnover, generalized core groups--decomposed by a k-core algorithm--were much more stable than peripheral groups. Given the high rate of turnover observed, we suggest that identical plants and pollinators that persist for at least two successive years sustain pollination services at the community level. Our data do not support theoretical predictions of a high proportion of specialized links within species-rich communities. Plants were relatively specialized, exhibiting less variability in pollinator composition at pollinator functional group level than at the species level. Both specialized and generalized plants experienced narrow variation in functional pollinator groups. The dynamic nature of pollination networks in the alpine meadow demonstrates the potential for networks to mitigate the effects of fluctuations in species composition in a high biodiversity area.

Advisory group meeting on safeguards related to final disposal of nuclear material in waste and spent fuel (AGM-660)

International Nuclear Information System (INIS)

1988-12-01

The Advisory Group was asked to advise the Agency on the circumstances under which the Agency might logically implement Section 11 of INFCIRC/153, or the comparable Section 26c of INFCIRC/66/rev2, which provides for a determination that nuclear material is 'practicably irrecoverable', and that therefore safeguards could be terminated. This advice was sought, and in the paragraphs that follow is given, in two areas. One relates to 'waste', which the Group understands as referring to material which contains nuclear material that the State/facility operator believes has no economically recoverable value and for which no further use is foreseen. The other relates to spent fuel, which in some cases may be placed in geological 'permanent repositories'

Blocking the benefit of group-based HIV-prevention efforts during adolescence: the problem of HIV-related stigma.

Science.gov (United States)

Barker, David H; Swenson, Rebecca R; Brown, Larry K; Stanton, Bonita F; Vanable, Peter A; Carey, Michael P; Valois, Robert F; Diclemente, Ralph J; Salazar, Laura F; Romer, Daniel

2012-04-01

HIV-related stigma has been shown to impede HIV-antibody testing and safer sexual practices in adults. Less is known about its effects on prevention programs among at-risk youth. This study examined the longitudinal relationships between HIV-stigma and HIV-knowledge following completion of a validated group-based intervention. Data were provided by 1,654 African-American adolescents who participated in a large multi-city prevention trial (Project iMPACCS). Participants were randomly assigned to an empirically-validated skill-based intervention or a general health promotion control group. Both stigma and knowledge were assessed at baseline and post-intervention. Results suggested that adolescents participating in the intervention showed improvements in knowledge and decreases in stigma when compared to controls. Improvements in stigma appeared to be partly driven by improvements in knowledge. Higher baseline stigma was shown to reduce gains in knowledge in both the treatment and control groups. Results suggest that HIV-stigma can interfere with how youth identify with and internalize messages from group-based prevention trials.

[Cost recovery for the treatment of retinal and vitreal diseases by pars plana vitrectomy under the German DRG system].

Science.gov (United States)

Framme, C; Franz, D; Mrosek, S; Helbig, H

2007-10-01

Since 2004 inpatient health care in Germany is paid according to calculated DRGs. Only a few university hospitals participated in distinct cost calculations of clinical treatment. It was the aim of this study to check the cost recovery at a University Eye Hospital for the surgical treatment of retinal and vitreal diseases by pars plana vitrectomy (ppV), which are included in DRGs C03Z and C17Z. The performance data for both DRGs were collected for the years 2005 and 2006 using the E1 sheets according to section 21 KHEntG. The mean duration of all procedures was collected by data from the internal controlling. Costs for single operations were calculated from fixed and variable costs for the operation theatre and the ward including costs for personnel and material. In the 2-year period of 4,721 inpatient procedures 1,307 ppVs were performed. Each ppV had fixed surgical costs of 130.60 EUR; personnel costs varied between 575 EUR (C03Z; including cataract surgery; mean OP duration: 85 min) and 510 EUR (C17Z; no cataract surgery; mean OP duration: 73 min) at a proportion between general anaesthesia and local anaesthesia of 80/20. For a pure ppV material costs were 255 EUR. Additional adjuncts such as an encircling band, perfluorcarbon, ICG, tPA, gas and silicon oil or cataract surgery led to extra costs between 51 EUR and 250 EUR per adjunct und were used in 56% (C03Z) and 74.5% (C17Z) of all procedures. Costs for hospitalisation were about 1765 EUR at a mean residence time of 6.5 days. Thus, the overall costs of a pure basic ppV amounted to 2975 EUR (C03Z) and 2661 EUR (C17Z). In consideration of the current relative DRG weights of 1.08 and 0.957 and a current base rate of 2787.19 EUR in Bavaria, cost recovery is only given for basic ppV but not for complex ppVs having higher material and personnel costs. Additionally, the costs for multiple surgeries as occur in 5.9% of cases are not compensated by the DRG system. The reimbursement for inpatient ppVs in a University

'Group value foresight' - Treating the nuclear interest in IVO Group Communications

International Nuclear Information System (INIS)

Heininen-Ojanpera, Marke

1999-01-01

Fortum is a new international energy group formed through the combination of the IVO Group and the Neste Group, two Finnish industrial groups with extensive operations in the energy sector in the Nordic countries and certain other countries throughout the world. IVO Group uses almost all fuels to generate electricity: nuclear, hydro, gas, oil, coal, peat, biomass, municipal waste, wind and solar. The main capacity is generated by nuclear, coal and water but gas, particularly in cogeneration, has been expected to grow. The major challenge in communicating is to find a balanced way of dealing with this variety so that the messages will be open and objective and, at the same time, not harming unnecessarily any of the generation forms in business terms. Moreover, new business procedures are welcome. The majority of the communicating issues deal with either competition or environmental questions under the threat of bad publicity and more strict regulatory controls. From the beginning, one of the working groups was responsible for defining the issues and sorting out the weak signals related to nuclear energy. In terms of corporate communications, special nuclear policies and messages have been worked out each year. For many reasons, the earlier nuclear policies and communication agendas have been unnecessarily strongly emphasising the nuclear option only. Today, the Group Value Foresight process, among others, has helped IVO to find the correct weighting of any nuclear issue and option in relation to other major forms of generation and related issues. The policies and messages have become more reasonable and more sensitive to changing situations in the market and in relation to public perception. There is less and less need for presenting the nuclear option in public with a quivering voice of offended authority

A Randomized Control Study on Psycho-Education Group on Improving Health-Related Quality of Life of Chinese Persons with Major Neurocognitive Disorder.

Science.gov (United States)

Young, Kim-Wan

2016-01-01

People with a major neurocognitive disorder (PwND) are found to have a lower health related quality of life (HRQoL) than those without neurocognitive disorder. This research study aims to evaluate the effectiveness of a psycho-education group in improving the HRQoL of Chinese PwND. By adopting randomized control trial (RCT), Chinese PwND were randomly assigned to either a 10-session psycho-education group or the control group. Family caregivers of treatment group were encouraged to take part in two sessions focusing on the caring and communication skills. Control group and their family caregivers received standardized educational materials on basic information on neurocognitive disorder for them to read at home. Standardized assessment was conducted both with PwND and their caregivers independently to give the self-rated and caregiver-rated HRQoL of PwND in the pre- and post- treatment periods by a research assistant who was blind to the group assignment of the participants. Moreover, qualitative interviews were also conducted for ten participants and five family caregivers of the treatment group to identify those group elements relating to its effectiveness. 2 × 2 repeated measures ANCOVA demonstrated that the treatment group (n = 32) was significantly more effective than the control group (n = 32) in improving the caregiver-rated HRQoL (F[1, 61] = 4.35, p = .04 psycho-education group significantly improves caregiver-rated HRQoL of PwND, supporting the feasibility and effectiveness of the psycho-education group.

Age-related differences in functional nodes of the brain cortex - a high model order group ICA study

Directory of Open Access Journals (Sweden)

Harri Littow

2010-08-01

Full Text Available Functional MRI measured with blood oxygen dependent (BOLD contrast in the absence of intermittent tasks reflects spontaneous activity of so called resting state networks (RSN of the brain. Group level independent component analysis (ICA of BOLD data can separate the human brain cortex into 42 independent RSNs. In this study we evaluated age related effects from primary motor and sensory, and, higher level control RSNs. 168 healthy subjects were scanned and divided into three groups: 55 adolescents (ADO, 13.2 ± 2.4 yrs, 59 young adults (YA, 22.2 ± 0.6yrs , and 54 older adults (OA, 42.7 ± 0.5 yrs, all with normal IQ. High model order group probabilistic ICA components (70 were calculated and dual regression analysis was used to compare 21 RSN’s spatial differences between groups. The power spectra were derived from individual ICA mixing matrix time series of the group analyses for frequency domain analysis. We show that primary sensory and motor networks tend to alter more in younger age groups, whereas associative and higher level cognitive networks consolidate and re-arrange until older adulthood. The change has a common trend: both spatial extent and the low frequency power of the RSN’s reduce with increasing age. We interpret these result as a sign of normal pruning via focusing of activity to less distributed local hubs.

Migratory bird habitat in relation to tile drainage and poorly drained hydrologic soil groups

Science.gov (United States)

Kastner, Brandi; Christensen, Victoria G.; Williamson, Tanja N.; Sanocki, Chris A.

2016-01-01

The Prairie Pothole Region (PPR) is home to more than 50% of the migratory waterfowl in North America. Although the PPR provides an abundance of temporary and permanent wetlands for nesting and feeding, increases in commodity prices and agricultural drainage practices have led to a trend of wetland drainage. The Northern Shoveler is a migratory dabbling duck species that uses wetland habitats and cultivated croplands in the PPR. Richland County in North Dakota and Roberts County in South Dakota have an abundance of wetlands and croplands and were chosen as the study areas for this research to assess the wetland size and cultivated cropland in relation to hydrologic soil groups for the Northern Shoveler habitat. This study used geographic information system data to analyze Northern Shoveler habitats in association with Natural Resource Conservation Service soil data. Habitats, which are spatially associated with certain hydrologic soil groups, may be at risk of artificial drainage installations because of their proximity to cultivated croplands and soil lacking in natural drainage that may become wet or inundated. Findings indicate that most wetlands that are part of Northern Shoveler habitats were within or adjacent to cultivated croplands. The results also revealed soil hydrologic groups with high runoff potential and low water transmission rates account for most of the soil within the Northern Shoveler‘s wetland and cropland habitats. Habitats near agriculture with high runoff potential are likely to be drained and this has the potential of reducing Northern Shoveler habitat.

Characterizing Rat PNS Electrophysiological Response to Electrical Stimulation Using in vitro Chip-Based Human Investigational Platform (iCHIP)

Energy Technology Data Exchange (ETDEWEB)

Khani, Joshua [Georgetown Univ., Washington, DC (United States); Prescod, Lindsay [Georgetown Univ., Washington, DC (United States); Enright, Heather [Georgetown Univ., Washington, DC (United States); Felix, Sarah [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Osburn, Joanne [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Wheeler, Elizabeth [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Kulp, Kris [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

2015-08-18

Ex vivo systems and organ-on-a-chip technology offer an unprecedented approach to modeling the inner workings of the human body. The ultimate goal of LLNL’s in vitro Chip-based Human Investigational Platform (iCHIP) is to integrate multiple organ tissue cultures using microfluidic channels, multi-electrode arrays (MEA), and other biosensors in order to effectively simulate and study the responses and interactions of the major organs to chemical and physical stimulation. In this study, we focused on the peripheral nervous system (PNS) component of the iCHIP system. Specifically we sought to expound on prior research investigating the electrophysiological response of rat dorsal root ganglion cells (rDRGs) to chemical exposures, such as capsaicin. Our aim was to establish a protocol for electrical stimulation using the iCHIP device that would reliably elicit a characteristic response in rDRGs. By varying the parameters for both the stimulation properties – amplitude, phase width, phase shape, and stimulation/ return configuration – and the culture conditions – day in vitro and neural cell types - we were able to make several key observations and uncover a potential convention with a minimal number of devices tested. Future work will seek to establish a standard protocol for human DRGs in the iCHIP which will afford a portable, rapid method for determining the effects of toxins and novel therapeutics on the PNS.

["Vocational perspective"--short-term efficacy of a group treatment for patients with extensive work-related problems during medical rehabilitation].

Science.gov (United States)

Bönisch, A; Dorn, M; Ehlebracht-König, I

2012-01-01

To analyze the short-term efficacy of the Vocational Perspective programme for patients identified as having extensive work-related problems during rheumatology or orthopaedic inpatient rehabilitation. The primary objectives of the programme on patient level are to convey information about the legal provisions regarding earning incapacity and occupational reintegration, to suggest strategies for dealing with one's own occupational situation, and to strengthen the motivation to stay employed. The programme is explicitly designed for patients who wish to retire or have applied for a pension. On the systemic level, the main goals are to facilitate doctor-patient communication and to increase rehabilitation teams' awareness of occupational problems. In a controlled quasi-experimental design, 359 subjects were consecutively assigned to either the control group (CG, n=177) or the intervention group (IG, n=182). The control group received standard care only, whereas the intervention group additionally participated in the 5-part Vocational Perspective programme. Evaluation criteria were assessed by questionnaire at the beginning (t1) and at end of rehabilitation (t2). Survey participation was 92.2% at t2. The socio-medically relevant knowledge status was objectively documented using a specially designed knowledge questionnaire. Aspects of treatment satisfaction were evaluated using individual items, and the subjective prognosis of gainful employment was assessed using the Subjective Prognosis of Gainful Employment (SPE) scale. Facilitation of communication between doctor and patient was operationalized at patient level in terms of patient satisfaction with medical care, and increased awareness of the rehabilitation team was operationalized in terms of the rate of recommendations to apply for vocational reintegration (LTA) services at discharge. Emotional and functional parameters were exploratively analyzed (anxiety and depression using the IRES 3.1 scales, and

Applying the nominal group technique in an employment relations conflict situation: A case study of a university maintenance section in South Africa

Directory of Open Access Journals (Sweden)

Cornelis (Kees S. van der Waal

2009-09-01

Full Text Available After a breakdown in employment relations in the maintenance section of a higher education institution, the authors were asked to intervene in order to try and solve the employment relations conflict situation. It was decided to employ the Nominal Group Technique (NGT as a tool in problem identification during conflict in the workplace. An initial investigation of documentation and interviews with prominent individuals in the organisation was carried out. The NGT was then used in four focus group discussions to determine the important issues as seen by staff members. The NGT facilitates the determination of shared perceptions and the ranking of ideas. The NGT was used in diverse groups, necessitating adaptations to the technique. The perceived causes of the conflict were established. The NGT can be used in a conflict situation in the workplace in order to establish the perceived causes of employment relations conflict.

Group Psychotherapy in Italy.

Science.gov (United States)

Giannone, Francesca; Giordano, Cecilia; Di Blasi, Maria

2015-10-01

This article describes the history and the prevailing orientations of group psychotherapy in Italy (psychoanalytically oriented, psychodrama, CBT groups) and particularly group analysis. Provided free of charge by the Italian health system, group psychotherapy is growing, but its expansion is patchy. The main pathways of Italian training in the different group psychotherapy orientations are also presented. Clinical-theoretical elaboration on self development, psychopathology related to group experiences, and the methodological attention paid to objectives and methods in different clinical groups are issues related to group therapy in Italy. Difficulties in the relationship between research and clinical practice are discussed, as well as the empirical research network that tries to bridge the gap between research and clinical work in group psychotherapy. The economic crisis in Italy has led to massive cuts in health care and to an increasing demand for some forms of psychological treatment. For these reasons, and because of its positive cost-benefit ratio, group psychotherapy is now considered an important tool in the national health care system to expand the clinical response to different forms of psychological distress.

8-group relative delayed neutron yields for epithermal neutron induced fission of 235U and 239Pu

International Nuclear Information System (INIS)

Piksaikin, V.M.; Kazakov, L.E.; Isaev, S.G.; Korolev, G.G.; Roshchenko, V.A.; Tertychnyj, R.G

2002-01-01

An 8-group representation of relative delayed neutron yields was obtained for epithermal neutron induced fission of 235 U and 239 Pu. These data were compared with ENDF/B-VI data in terms of the average half- life of the delayed neutron precursors and on the basis of the dependence of reactivity on the asymptotic period. (author)

Understanding Medical Students' Experience with Stress and Its Related Constructs: A Focus Group Study from Singapore.

Science.gov (United States)

Farquhar, Julia; Lie, Desiree; Chan, Angelique; Ow, Mandy; Vidyarthi, Arpana

2018-02-01

In order to protect medical students from burnout and its untoward psychiatric effects, it is imperative to understand their stress, burnout, coping, and resilience experiences. This study aimed to derive collective definitions from the medical student perspective, to identify common themes of students' experiences, and to distinguish pre-clinical and clinical year students' experiences relating to these four constructs. The authors conducted focus groups of medical students in Singapore across 4 years using a semi-structured question guide. Participants shared their understanding, experiences, and the relationships between stress, burnout, coping, and resilience. Coders independently evaluated construct definitions and derived common themes through an iterative process, and compared transcripts of pre-clinical and clinical year students to determine differences in experience over time. Nine focus groups (54 students, 28 females, mean age 24.3) were conducted. Students identified common definitions for each construct. Nine themes emerged within three domains: (1) relating constructs to personal experience, (2) interrelating stress, burnout, coping, and resilience, and (3) understanding the necessity of stress. Compared to clinical students, pre-clinical students reported theory-based rather than reality-based experiences and exam-induced stress, defined constructs using present rather than future situations, and described constructs as independent rather than interrelated. This sample of medical students in Singapore shares a common understanding of stress, burnout, coping, and resilience, but experiences these uniquely. They perceive a positive role for stress. These findings build upon prior literature, suggesting an interrelationship between stress and its related constructs and adding the novel perspective of students from an Asian country.

7 CFR 29.1026 - Group.

Science.gov (United States)

2010-01-01

... 7 Agriculture 2 2010-01-01 2010-01-01 false Group. 29.1026 Section 29.1026 Agriculture Regulations... Type 92) § 29.1026 Group. A division of a type covering closely related grades based on certain characteristics which are related to stalk position, body, or the general quality of the tobacco. Groups in Flue...

7 CFR 29.3523 - Group.

Science.gov (United States)

2010-01-01

... 7 Agriculture 2 2010-01-01 2010-01-01 false Group. 29.3523 Section 29.3523 Agriculture Regulations... Type 95) § 29.3523 Group. A division of a type covering closely related grades based on certain characteristics which are related to stalk position, body, or the general quality of the tobacco. Groups in Dark...

7 CFR 29.3031 - Group.

Science.gov (United States)

2010-01-01

... 7 Agriculture 2 2010-01-01 2010-01-01 false Group. 29.3031 Section 29.3031 Agriculture Regulations... Group. A division of a type covering closely related grades based on certain characteristics which are related to stalk position or the general quality of the tobacco. Groups in Burley, Types 31 and 93, are as...

Individuality and social influence in groups : Inductive and deductive routes to group identity

NARCIS (Netherlands)

Postmes, T; Spears, R; Lee, AT; Novak, RJ

2005-01-01

A distinction between forms of social identity formation in small interactive groups is investigated. In groups in which a common identity is available or given, norms for individual behavior may be deduced; from group properties (deductive identity). In groups in which interpersonal relations are

Using risk analysis in Health Impact Assessment: the impact of different relative risks for men and women in different socio-economic groups

DEFF Research Database (Denmark)

Nilunger, Louise; Diderichsen, Finn; Burström, Bo

2004-01-01

The aim of this study is to contribute to the emerging field of quantification of Health Impact Assessment (HIA), by analysing how different relative risks affect the burden of disease for various socio-economic groups (SES). Risk analysis, utilising attributable and impact fraction, raises several...... methodological considerations. The present study illustrates this by measuring the impact of changed distribution levels of smoking on lung cancer, ischemic heart disease (IHD), chronic obstructive lung disorder (COLD) and stroke for the highest and lowest socio-economic groups measured in disability adjusted...... the highest and lowest socio-economic groups may decrease by 75% or increase by 21% depending on the size of the relative risk. Assuming the same smoking prevalence for the lowest socio-economic group as for the highest (impact fraction), then the inequality may decrease by 7-26%. Consequently, the size...

Asymmetry within social groups

DEFF Research Database (Denmark)

Barker, Jessie; Loope, Kevin J.; Reeve, H. Kern

2016-01-01

Social animals vary in their ability to compete with group members over shared resources and also vary in their cooperative efforts to produce these resources. Competition among groups can promote within-group cooperation, but many existing models of intergroup cooperation do not explicitly account...... of two roles, with relative competitive efficiency and the number of individuals varying between roles. Players in each role make simultaneous, coevolving decisions. The model predicts that although intergroup competition increases cooperative contributions to group resources by both roles, contributions...... are predominantly from individuals in the less competitively efficient role, whereas individuals in the more competitively efficient role generally gain the larger share of these resources. When asymmetry in relative competitive efficiency is greater, a group's per capita cooperation (averaged across both roles...

Estimation of Environment-Related Properties of Chemicals for Design of Sustainable Processes: Development of Group-Contribution+ (GC+) Property Models and Uncertainty Analysis

Science.gov (United States)

The aim of this work is to develop group-contribution+ (GC+) method (combined group-contribution (GC) method and atom connectivity index (CI) method) based property models to provide reliable estimations of environment-related properties of organic chemicals together with uncert...

From individual preference construction to group decisions: framing effects and group processes

NARCIS (Netherlands)

Milch, K.F.; Weber, E.U.; Appelt, K.C.; Handgraaf, M.J.J.; Krantz, D.H.

2009-01-01

Two choice tasks known to produce framing effects in individual decisions were used to test group sensitivity to framing, relative to that of individuals, and to examine the effect of prior, individual consideration of a decision on group choice. Written post-decision reasons and pre-decision group

Andrographolide Inhibits Mechanical and Thermal Hyperalgesia in a Rat Model of HIV-Induced Neuropathic Pain

Directory of Open Access Journals (Sweden)

Zhihua Yi

2018-06-01

Full Text Available Aim: In this study, we investigated whether andrographolide (Andro can alleviate neuropathic pain induced by HIV gp120 plus ddC treatment and the mechanism of its action.Methods: The paw withdrawal threshold and the paw withdrawal latency were observed to assess pain behaviors in all groups of the rats, including control group, control combined with Andro treatment group, sham group, gp120 combined with ddC treatment group, gp120 plus ddC combined with A438079 treatment group, and gp120 plus ddC combined with Andro treatment by intrathecally injecting at a dose of 25 μg/20 μl group. The protein expression levels of the P2X7 receptor, tumor necrosis factor-α-receptor (TNFα-R, interleukin-1β (IL-1β, IL-10, phospho-extracellular regulated protein kinases (ERK (p-ERK in the L4–L6 dorsal root ganglia (DRG were measured by western blotting. Real-time quantitative polymerase chain reaction was used to test the mRNA expression level of the P2X7 receptor. Double-labeling immunofluorescence was used to identify the co-localization of the P2X7 receptor with glial fibrillary acidic protein (GFAP in DRG. Molecular docking was performed to identify whether the Andro interacted perfectly with the rat P2X7 (rP2X7 receptor.Results: Andro attenuated the mechanical and thermal hyperalgesia in gp120+ddC-treated rats and down-regulated the P2X7 receptor mRNA and protein expression in the L4–L6 DRGs of gp120+ddC-treated rats. Additionally, Andro simultaneously decreased the expression of TNFα-R and IL-1β protein, increased the expression of IL-10 protein in L4–L6 DRGs, and inhibited the activation of ERK signaling pathways. Moreover, Andro decreased the co-expression of GFAP and the P2X7 receptor in the SGCs of L4–L6 DRG on 14th day after surgery.Conclusion: Andro decreased the hyperalgesia induced by gp120 plus ddC.

24 CFR 982.610 - Group home: Who may reside in a group home.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Group home: Who may reside in a group home. 982.610 Section 982.610 Housing and Urban Development Regulations Relating to Housing and... Housing Types Group Home § 982.610 Group home: Who may reside in a group home. (a) An elderly person or a...

THE STELLAR MASS–HALO MASS RELATION FOR LOW-MASS X-RAY GROUPS AT 0.5< z< 1 IN THE CDFS WITH CSI

International Nuclear Information System (INIS)

Patel, Shannon G.; Kelson, Daniel D.; Williams, Rik J.; Mulchaey, John S.; Dressler, Alan; McCarthy, Patrick J.; Shectman, Stephen A.

2015-01-01

Since z∼1, the stellar mass density locked in low-mass groups and clusters has grown by a factor of ∼8. Here, we make the first statistical measurements of the stellar mass content of low-mass X-ray groups at 0.5Groups are selected from combined Chandra and XMM-Newton X-ray observations in the Chandra Deep Field South. These ultra-deep observations allow us to identify bona fide low-mass groups at high redshift and enable measurements of their total halo masses. We compute aggregate stellar masses for these halos using galaxies from the Carnegie-Spitzer-IMACS (CSI) spectroscopic redshift survey. Stars comprise ∼3%–4% of the total mass of group halos with masses 10 12.8 relation is σ∼0.25 dex, which is relatively small and suggests that total group stellar mass can serve as a rough proxy for halo mass. We find no evidence for any significant evolution in the stellar–halo mass relation since z≲1. Quantifying the stellar content in groups since this epoch is critical given that hierarchical assembly leads to such halos growing in number density and hosting increasing shares of quiescent galaxies

Gender differences in computer-mediated communication: a systematic literature review of online health-related support groups.

Science.gov (United States)

Mo, Phoenix K H; Malik, Sumaira H; Coulson, Neil S

2009-04-01

Previous research has contended that the unique characteristics of the Internet might remove some of the gender differences that exist in face-to-face healthcare. The aims of the present study were to systematically review studies that have examined gender differences in communication within online health communities. A literature search was conducted to identify studies addressing gender differences in messages posted to online health-related support groups. Out of the 1186 articles identified, twelve were retrieved for review. Half of the studies examined gender differences by comparing male and female cancer discussion boards. The literature review revealed that some gender differences were observed in these studies. However, for studies that analysed mixed-gender communities, gender differences were less evident. Results seemed to reveal gender differences in communications in single-sex online health support groups, and similarities in communication patterns in mixed-sex online health support groups. However, findings should be treated with caution due to the diversity in studies and methodological issues highlighted in the present review. There is a need for health care professionals to take into account a range of situational and contextual factors that may affect how men and women use online health support groups. However, more robust research is needed before concrete guidelines can be developed to help health care professionals develop effective online support interventions.

Reinterpreting between-group inequality

NARCIS (Netherlands)

Elbers, C.T.M.; Lanjouw, P.F.; Mistiaen, J.; Özler, B

2008-01-01

We evaluate observed inequality between population groups against a benchmark of the maximum between-group inequality attainable given the number and relative sizes of those groups under examination. Because our measure is normalized by these parameters, drawing comparisons across different settings

Zinc concentrations in marine macroalgae and a lichen from western Ireland in relation to phylogenetic grouping, habitat and morphology

International Nuclear Information System (INIS)

Stengel, Dagmar B.; Macken, Ailbhe; Morrison, Liam; Morley, Nicholas

2004-01-01

Zinc concentrations in 19 species of marine macroalgae and a lichen from western Ireland (Spiddal, Co. Galway) were analysed by atomic absorption spectrophotometry. Algae were collected from a single site but occupied different shore levels and belonged to distinct phylogenetic groupings and to different (previously recognised) morphological groups. Concentrations ranged from 15-115 μg g -1 dry weight. The greatest variation in concentration occurred amongst the red algal species, containing both maximum and minimum concentrations. Zn concentrations in brown and green algae were generally lower than those in red algae. When grouped according to thallus morphology, thin, branched sheets (which consisted mainly of red algae) contained the highest Zn concentrations. In filamentous algae, Zn levels were higher than in thick-leathery or coarsely branched algae. However, all green algal species examined had similar Zn concentrations, despite their different morphologies. In brown algae, the highest Zn levels were detected in mid-shore fucoids (Fucus vesiculosus and Fucus serratus), while thicker, subtidal and low-shore brown algae (Laminaria digitata, Halydris siliquosa) exhibited lower Zn concentrations. The lowest Zn concentrations were detected in high-intertidal species (Fucus spiralis, Pelvetia canaliculata), the only marine lichen examined (Ramalina siliquosa) and a red crustose alga (Corallina officinalis). In all morphological groups, red algal representatives contained relatively higher levels of Zn, the exception being Corallina officinalis. Zn levels in 4 species from a second, estuarine site in Galway Bay exhibited the same relative differences amongst species, but were all consistently higher than in algae from Spiddal. It is concluded that Zn accumulation in macroalgae is closely related to ecological growth strategies, following a functional-form model. However, the phylogenetic origin of species which determines carbohydrate and phenol composition, and

Zinc concentrations in marine macroalgae and a lichen from western Ireland in relation to phylogenetic grouping, habitat and morphology

Energy Technology Data Exchange (ETDEWEB)

Stengel, Dagmar B.; Macken, Ailbhe; Morrison, Liam; Morley, Nicholas

2004-05-01

Zinc concentrations in 19 species of marine macroalgae and a lichen from western Ireland (Spiddal, Co. Galway) were analysed by atomic absorption spectrophotometry. Algae were collected from a single site but occupied different shore levels and belonged to distinct phylogenetic groupings and to different (previously recognised) morphological groups. Concentrations ranged from 15-115 {mu}g g{sup -1} dry weight. The greatest variation in concentration occurred amongst the red algal species, containing both maximum and minimum concentrations. Zn concentrations in brown and green algae were generally lower than those in red algae. When grouped according to thallus morphology, thin, branched sheets (which consisted mainly of red algae) contained the highest Zn concentrations. In filamentous algae, Zn levels were higher than in thick-leathery or coarsely branched algae. However, all green algal species examined had similar Zn concentrations, despite their different morphologies. In brown algae, the highest Zn levels were detected in mid-shore fucoids (Fucus vesiculosus and Fucus serratus), while thicker, subtidal and low-shore brown algae (Laminaria digitata, Halydris siliquosa) exhibited lower Zn concentrations. The lowest Zn concentrations were detected in high-intertidal species (Fucus spiralis, Pelvetia canaliculata), the only marine lichen examined (Ramalina siliquosa) and a red crustose alga (Corallina officinalis). In all morphological groups, red algal representatives contained relatively higher levels of Zn, the exception being Corallina officinalis. Zn levels in 4 species from a second, estuarine site in Galway Bay exhibited the same relative differences amongst species, but were all consistently higher than in algae from Spiddal. It is concluded that Zn accumulation in macroalgae is closely related to ecological growth strategies, following a functional-form model. However, the phylogenetic origin of species which determines carbohydrate and phenol composition

Separation and Relating in a Parent-Toddler Group Setting

Science.gov (United States)

Navridi, Evanthia; Navridis, Klimis; Midgley, Nick

2012-01-01

Parent-toddler groups constitute a primary intervention programme whose target is to support and encourage the parent-toddler relationship. Toddlerhood is a developmental period when major, crucial changes take place regarding how children function, as well as their relationship to their parents (especially to their mother). The present paper…

Impact of the Korean Diagnosis-Related Groups payment system on the outcomes of adenotonsillectomy: A single center experience.

Science.gov (United States)

Kwak, Sang Hyun; Kim, Ji Hoon; Kim, Da Hee; Kim, Jung Min; Byeon, Hyung Kwon; Kim, Won Shik; Koh, Yoon Woo; Kim, Se-Heon; Choi, Eun Chang

2018-06-01

To report outcomes with regard to clinical aspects and medical costs of adenotonsillectomy and tonsillectomy at a single institution before and after implementation of the Diagnosis-Related Groups (DRG) payment system in Korea. We retrospectively reviewed the records of patients treated with adenotonsillectomy or tonsillectomy between July 2012 and June 2014. The Korean DRG payment system was applied to seven groups of specific diseases and surgeries including adenotonsillectomy and tonsillectomy from July 2013 at all hospitals in Korea. We divided patients into four groups according whether the fee-for-service (FFS) or DRG payment system was implemented and operation type (FFS-adenotonsillectomy (AT), DRG-AT, FFS-tonsillectomy (T), and DRG-T). A total of 1402 patients were included (485 FFS-AT, 490 DRG-AT, 203 FFS-T, and 223 DRG-T). The total medical cost of the DRG-AT group was significantly lower than that of the FFS-AT group (1191±404 vs. 1110±279 USD, PDRG system for adenotonsillectomy and tonsillectomy reduced medical costs and clinical outcomes were not significantly altered by the adoption of the DRG system. 4. Copyright © 2017 Elsevier B.V. All rights reserved.

Structural features and electronic properties of group-III-, group-IV-, and group-V-doped Si nanocrystallites

International Nuclear Information System (INIS)

Ramos, L E; Degoli, Elena; Cantele, G; Ossicini, Stefano; Ninno, D; Furthmueller, J; Bechstedt, F

2007-01-01

We investigate the incorporation of group-III (B and Al), group-IV (C and Ge), and group-V (N and P) impurities in Si nanocrystallites. The structural features and electronic properties of doped Si nanocrystallites, which are faceted or spherical-like, are studied by means of an ab initio pseudopotential method including spin polarization. Jahn-Teller distortions occur in the neighborhood of the impurity sites and the bond lengths show a dependence on size and shape of the nanocrystallites. We find that the acceptor (group-III) and donor (group-V) levels become deep as the nanocrystallites become small. The energy difference between the spin-up and spin-down levels of group-III and group-V impurities decreases as the size of the Si nanocrystallite increases and tends to the value calculated for Si bulk. Doping with carbon introduces an impurity-related level in the energy gap of the Si nanocrystallites

Multivariate analysis of chromatographic retention data as a supplementary means for grouping structurally related compounds.

Science.gov (United States)

Fasoula, S; Zisi, Ch; Sampsonidis, I; Virgiliou, Ch; Theodoridis, G; Gika, H; Nikitas, P; Pappa-Louisi, A

2015-03-27

In the present study a series of 45 metabolite standards belonging to four chemically similar metabolite classes (sugars, amino acids, nucleosides and nucleobases, and amines) was subjected to LC analysis on three HILIC columns under 21 different gradient conditions with the aim to explore whether the retention properties of these analytes are determined from the chemical group they belong. Two multivariate techniques, principal component analysis (PCA) and discriminant analysis (DA), were used for statistical evaluation of the chromatographic data and extraction similarities between chemically related compounds. The total variance explained by the first two principal components of PCA was found to be about 98%, whereas both statistical analyses indicated that all analytes are successfully grouped in four clusters of chemical structure based on the retention obtained in four or at least three chromatographic runs, which, however should be performed on two different HILIC columns. Moreover, leave-one-out cross-validation of the above retention data set showed that the chemical group in which an analyte belongs can be 95.6% correctly predicted when the analyte is subjected to LC analysis under the same four or three experimental conditions as the all set of analytes was run beforehand. That, in turn, may assist with disambiguation of analyte identification in complex biological extracts. Copyright © 2015 Elsevier B.V. All rights reserved.

Transactive memory in organizational groups: the effects of content, consensus, specialization, and accuracy on group performance.