Summary (text)
Abstract (text)
A comparison of two hospitalist models with traditional care in a community teaching hospital.
Many studies have documented significant length of stay reduction and cost savings when hospitalist care is compared with traditional care. However, less is known about the concurrent performance of more than one hospitalist model in a single site.
This retrospective cohort study of 10595 patients was conducted between July 2001 and June 2002 in a tertiary care community-based teaching hospital. Risk-adjusted length of stay, variable costs, 30-day readmission rates, and in-hospital and 30-day mortality were measured for patients treated by Community Physicians, Private Hospitalists and Academic Hospitalists.
There was a 20% reduction in length of stay on the Academic Hospitalist service (p <.0001) and 8% on the Private Hospitalist service (P = .049) compared with Community Physicians. Similarly, total costs were 10% less on the Academic (P <.0001) and 6% less on the Private Hospitalist (P = .02) services compared with Community Physicians. The length of stay of Academic Hospitalists was 13% shorter than that of Private Hospitalists (P = .002); differences in costs between hospitalist groups were not statistically significant. Differences in in-hospital and 30-day mortality and 30-day readmission rates among the 3 physician groups were also not statistically significant.
The impact on patient outcomes and resource utilization may vary with the hospitalist model used. Future studies should examine the specific organizational characteristics of hospitalists that contribute to improved patient care and resource utilization.
[Pubmed - MEDLINE]
Full Text Sources
检索记录[]
丁香园旗下网站Summary (text)
Abstract (text)
2010 Jan-Feb
Determination of total dietary fiber (CODEX definition) by enzymatic-gravimetric method and liquid chromatography: collaborative study.
A method for the determination of total dietary fiber (TDF), as defined by the CODEX Alimentarius, was validated in foods. Based upon the principles of AOAC Official Methods 985.29, 991.43, 2001.03, and 2002.02, the method quantitates high- and low-molecular-weight dietary fiber (HMWDF and LMWDF, respectively). In 2007, McCleary described a method of extended enzymatic digestion at 37 degrees C to simulate human intestinal digestion followed by gravimetric isolation and quantitation of HMWDF and the use of LC to quantitate low-molecular-weight soluble dietary fiber (LMWSDF). The method thus quantitates the complete range of dietary fiber components from resistant starch (by utilizing the digestion conditions of AOAC Method 2002.02) to digestion resistant oligosaccharides (by incorporating the deionization and LC procedures of AOAC Method 2001.03). The method was evaluated through an AOAC collaborative study. Eighteen laboratories participated with 16 laboratories returning valid assay data for 16 test portions (eight blind duplicates) consisting of samples with a range of traditional dietary fiber, resistant starch, and nondigestible oligosaccharides. The dietary fiber content of the eight test pairs ranged from 11.57 to 47.83%. Digestion of samples under the conditions of AOAC Method 2002.02 followed by the isolation and gravimetric procedures of AOAC Methods 985.29 and 991.43 results in quantitation of HMWDF. The filtrate from the quantitation of HMWDF is concentrated, deionized, concentrated again, and analyzed by LC to determine the LMWSDF, i.e., all nondigestible oligosaccharides of degree of polymerization & or =3. TDF is calculated as the sum of HMWDF and LMWSDF. Repeatability standard deviations (Sr) ranged from 0.41 to 1.43, and reproducibility standard deviations (S(R)) ranged from 1.18 to 5.44. These results are comparable to other official dietary fiber methods, and the method is recommended for adoption as Official First Action.
[Pubmed - MEDLINE]
Full Text Sources
检索记录[]
丁香园旗下网站Causes, forms and consequences of the professionalization of international sport federa-tions in Switzerland: Conceptual framework and first results
Clausen, Josephine; Giauque, David; Ruoranen, Kaisa; Klenk, Christoffer; Schlesinger, Torsten; Bayle, Emmanuel; Nagel, Siegfried
Causes, forms and consequences of the professionalization of international sport federa-tions in Switzerland: Conceptual framework and first results.
23rd EASM Conference. Abstracts.
Dublin, Ireland:
CLAUSEN_EASM_Dublin_120915.pdf
- Presentation
Available under License .
easm2EASM-.pdf
- Published Version
Available under License Publisher holds Copyright.
Official URL:
Synopsis:&#13;
Sport organisations are facing multiple challenges originating from an&#13;
increasingly complex and dynamic environment in general, and from internal&#13;
changes in particular. Our study seeks to reveal and analyse the causes for&#13;
professionalization processes in international sport federations, the forms&#13;
resulting from it, as well as related consequences.&#13;
Abstract:&#13;
AIM OF ABSTRACT/PAPER - RESEARCH QUESTION&#13;
Sport organisations are facing multiple challenges originating from an&#13;
increasingly complex and dynamic environment in general, and from internal&#13;
changes in particular. In this context, professionalization seems to have been&#13;
adopted by sport organisations as an appropriate strategy to respond to&#13;
pressures such as becoming more “business-like”. The ongoing study seeks to&#13;
reveal and analyse the internal and external causes for professionalization&#13;
processes in international sport federations, the forms resulting from it (e.g.&#13;
organisational, managerial, economic) as well as related consequences on&#13;
objectives, values, governance methods, performance management or again&#13;
rationalisation.&#13;
THEORETICAL BACKGROUND/LITERATURE REVIEW &#13;
Studies on sport as specific non-profit sector mainly focus on the prospect of&#13;
the “professionalization of individuals” (Thibault, Slack & Hinings, 1991), often&#13;
within sport clubs (Thiel, Meier & Cachay, 2006) and national sport federations&#13;
(Seippel, 2002) or on organisational change (Griginov & Sandanski, 2008;&#13;
Slack & Hinings, ; Slack, ), thus leaving broader analysis&#13;
on governance, management and professionalization in sport organisations an unaccomplished task.&#13;
In order to further current research on above-mentioned topics, our intention is&#13;
to analyse causes, forms and consequences of professionalisation processes&#13;
in international sport federations. The social theory of action (Coleman, 1986;&#13;
Esser, 1993) has been defined as appropriate theoretical framework, deriving&#13;
in the following a multi-level framework for the analysis of sport organisations&#13;
(Nagel, 2007). In light of the multi-level framework, sport federations are&#13;
conceptualised as corporative actors whose objectives are defined and&#13;
implemented with regard to the interests of member organisations (Heinemann,&#13;
2004) and/or other pressure groups. In order to understand social acting and&#13;
social structures (Giddens 1984) of sport federations, two levels are in the&#13;
focus of our analysis: the macro level examining the environment at large&#13;
(political, social, economic systems etc.) and the meso level (Esser, 1999)&#13;
examining organisational structures, actions and decisions of the federation’s&#13;
headquarter as well as member organisations. &#13;
METHODOLOGY, RESEARCH DESIGN AND DATA ANALYSIS &#13;
The multi-level framework mentioned seeks to gather and analyse information&#13;
on causes, forms and consequences of professionalization processes in sport&#13;
federations. It is applied in a twofold approach: first an exploratory study based&#13;
on nine semi-structured interviews with experts from umbrella sport&#13;
organisations (IOC, WADA, ASOIF, AIOWF, etc.) as well as the analysis of&#13;
related documents, relevant reports (IOC report 2000 on governance reform,&#13;
Agenda 2020, etc.) and important moments of change in the Olympic&#13;
Movement (Olympic revenue share, IOC evaluation criteria, etc.); and secondly&#13;
several case studies. &#13;
Whereas the exploratory study seeks more the causes for professionalization&#13;
on an external, internal and headquarter level as depicted in the literature, the&#13;
case studies rather focus on forms and consequences. Applying our&#13;
conceptual framework, the analysis of forms is built around three dimensions: &#13;
1) Individuals (persons and positions), &#13;
2) Processes, structures (formalisation, specialisation),&#13;
3) Activities (strategic planning). &#13;
With regard to consequences, we centre our attention on expectations of and&#13;
relationships with stakeholders (e.g. cooperation with business partners),&#13;
structure, culture and processes (e.g. governance models, performance), and&#13;
expectations of and relationships with member organisations (e.g.&#13;
centralisation vs. regionalisation).&#13;
For the case studies, a mixed-method approach is applied to collect relevant&#13;
data: questionnaires for rather quantitative data, interviews for rather qualitative&#13;
data, as well as document and observatory analysis. &#13;
RESULTS, DISCUSSION AND IMPLICATIONS/CONCLUSIONS&#13;
With regard to causes of professionalization processes, we analyse the content&#13;
of three different levels:&#13;
1. the external level, where the main pressure derives from financial resources&#13;
(stakeholders, benefactors) and important turning points (scandals, media&#13;
pressure, IOC requirements for Olympic sports);&#13;
2. the internal level, where pressure from member organisations turned out to&#13;
be less decisive than assumed (little involvement of member organisations in decision-making); &#13;
3. the headquarter level, where specific economic models (World Cups, other&#13;
international circuits, World Championships), and organisational structures&#13;
(decision-making procedures, values, leadership) trigger or hinder a&#13;
federation’s professionalization process. &#13;
Based on our first analysis, an outline for an economic model is suggested,&#13;
distinguishing four categories of IFs: “money-generating IFs” being rather based&#13;
on commercialisation and “classical Olympic IFs” being rather&#13;
reactive and dependent on O “classical non-Olympic IFs” being&#13;
rather independent of the Olympic M and “money-receiving IFs” being&#13;
dependent on benefactors and having strong traditions and values.&#13;
The results regarding forms and consequences will be outlined in the&#13;
presentation.&#13;
The first results from the two pilot studies will allow us to refine our conceptual&#13;
framework for subsequent case studies, thus extending our data collection and&#13;
developing fundamental conclusions.&#13;
References:&#13;
Bayle, E., & Robinson, L. (2007). A framework for understanding the&#13;
performance of national governing bodies of sport. European Sport&#13;
Management Quarterly, 7, 249–268 &#13;
Chantelat, P. (2001). La professionnalisation des organisations sportives:&#13;
Nouveaux débats, nouveaux enjeux [Professionalisation of sport&#13;
organisations]. Paris: L’Harmattan.&#13;
Dowling, M., Edwards, J., & Washington, M. (2014). Understanding the concept&#13;
of professionalization in sport management research. Sport Management&#13;
Review. Advance online publication. doi: 10.1016/j.smr.&#13;
Ferkins, L. & Shilbury, D. (2012). Good Boards Are Strategic: What Does That&#13;
Mean for Sport Governance? Journal of Sport Management, 26, 67-80.&#13;
Thibault, L., Slack, T., & Hinings, B. (1991). Professionalism, structures and&#13;
systems: The impact of professional staff on voluntary sport organizations.&#13;
International Review for the Sociology of Sport, 26, 83–97.
Interest & Impact
182 since deposited on 15 Mar 2016
105 in the past 12 months
5 Citations in Web of Science (R)
6 Citations in Scopus
in Google Scholar(TM)
Actions (login required)
Conference or Workshop Item
(Abstract)
Kaisa Reetta Ruoranen
Actions (login required)Summary (text)
Abstract (text)
Effect of Lobesia botrana damages on black aspergilli rot and ochratoxin A content in grapes.
Sixty-nine wine grape samples of two varieties (Bombino Nero and Uva di Troia) were collected from four vineyards in a high ochratoxin A (OTA) incidence grape-growing area in Apulia, southern Italy, during the 2001 and 2002 crop harvests. The levels of toxin, measured in the two year harvests, ranged from 0.02 to 681 ng/g of fresh berries. In both surveys, higher levels of contamination by black aspergilli and OTA were found in both intact and rotten berries originating from bunches damaged by Lobesia botrana larvae as compared to bunches without L. botrana attacks. All berry samples with an OTA level &1 ng/g were contaminated by black aspergilli with a CFU&10(6), and all but one of these samples belonged to the Lobesia damaged berries group. This is the first evidence of an interaction between L. botrana damaged berries and OTA contamination, in field.
[Pubmed - MEDLINE]
Full Text Sources
检索记录[]
丁香园旗下网站Summary (text)
Abstract (text)
Use of continuous quality improvement to increase use of process measures in patients undergoing coronary artery bypass graft surgery: a randomized controlled trial.
A rigorous evaluation of continuous quality improvement (CQI) in medical practice has not been carried out on a national scale.
To test whether low-intensity CQI interventions can be used to speed the national adoption of 2 coronary artery bypass graft (CABG) surgery process-of-care measures: preoperative beta-blockade therapy and internal mammary artery (IMA) grafting in patients 75 years or older.
Three hundred fifty-nine academic and nonacademic hospitals (treating 267 917 patients using CABG surgery) participating in the Society of Thoracic Surgeons National Cardiac Database between January 2000 and July 2002 were randomized to a control arm or to 1 of 2 groups that used CQI interventions designed to increase use of the process-of-care measures.
Each intervention group received measure-specific information, including a call to action t
and periodic longitudinal, nationally benchmarked, site-specific feedback.
Differential incorporation of the targeted care processes into practice at the intervention sites vs the control sites, assessed by measuring preintervention (January-December 2000)/postintervention (January 2001-July 2002) site differences and by using a hierarchical patient-level analysis.
From January 2000 to July 2002, use of both process measures increased nationally (beta-blockade, 60.0%-65.6%; IMA grafting, 76.2%-82.8%). Use of beta-blockade increased significantly more at beta-blockade intervention sites (7.3% [SD, 12.8%]) vs control sites (3.6% [SD, 11.5%]) in the preintervention/postintervention (P =.04) and hierarchical analyses (P<.001). Use of IMA grafting also tended to increase at IMA intervention sites (8.7% [SD, 17.5%]) vs control sites (5.4% [SD,15.8%]) (P =.20 and P =.11 for preintervention/postintervention and hierarchical analyses, respectively). Both interventions tended to have more impact at lower-volume CABG sites (for interaction: P =.04 for beta- P =.02 for IMA grafting).
A multifaceted, physician-led, low-intensity CQI effort can improve the adoption of care processes into national practice within the context of a medical specialty society infrastructure.
[Pubmed - MEDLINE]
Full Text Sources
检索记录[]
丁香园旗下网站}