For better or worse: Governing healthcare organisations in times of financial distress.

Due to processes of financialisation, financial parties increasingly penetrate the healthcare domain and determine under which conditions care is delivered. Their influence becomes especially visible when healthcare organisations face financial distress. By zooming-in on two of such cases, we come to know more about the considerations, motives and actions of financial parties in healthcare.

Organizational attributes that contribute to the learning & improvement capabilities of healthcare organizations: a scoping review.

Background: This study aims to explore and identify the organizational attributes that contribute to learning and improvement capabilities (L&IC) in healthcare organizations. The authors define learning as a structured update of system properties based on new information, and improvement as a closer correspondence between actual and desired standards. They highlight the importance of learning and improvement capabilities in maintaining high-quality care, and emphasize the need for empirical research on organizational attributes that contribute to these capabilities.

Health care reform and financial crisis in the Netherlands: consequences for the financial arena of health care organizations.

Over the past decade, many health care systems across the Global North have implemented elements of market mechanisms while also dealing with the consequences of the financial crisis. Although effects of these two developments have been researched separately, their combined impact on the governance of health care organizations has received less attention. The aim of this study is to understand how health care reforms and the financial crisis together shaped new roles and interactions within health care.

Bedtime negotiations: Unravelling normative complexity in hospital-based prevention.

This study explores how actors deal with normative complexity in the design and implementation of practices of preventative care. Previous studies have identified conflicting (e)valuations of prevention within health care at large, but little empirical research describes how these conflicts are resolved in day-to-day interactions. Zooming in on the work of a single actor, our ethnographic study describes a Dutch psychiatrist developing a novel type of hospital bed that provides preventative psychiatric care for women in the post-partum period.

Power, legitimacy and urgency: Unravelling the relationship between Dutch healthcare organisations and their financial stakeholders.

Healthcare organisations rely on their financial stakeholders for capital to invest in state-of-the-art buildings, equipment, innovation and the delivery of healthcare services. Nevertheless, relations between healthcare organisations and their financial stakeholders have not been well studied. Here, we studied the relations between Dutch healthcare organisations and two of their main financial stakeholders (banks and health insurers) against the backdrop of system reforms and the financial crisis.

From context to contexting: professional identity un/doing in a medical leadership development programme.

Physicians are known for safeguarding their professional identities against organisational influences. However, this study shows how a medical leadership programme enables the reconstruction of professional identities that work with rather than against organisational and institutional contexts to improve quality and efficiency of care. Based on an ethnographic study, the results illustrate how physicians initially construct conflicting leadership narratives - heroic (pioneer), clinical (patient's guardian) and collaborative (linking pin) leader - in reaction to changing organisational and clinical demands.

Integration of a statewide public hospital laboratory system.

Louisiana operates one of the largest public hospital and clinic systems in the nation, consisting of nine geographically dispersed hospitals, providing a full range of medical care to approximately 1 million low-income and indigent citizens. For many years, these hospitals were under the auspices of the State Department of Hospitals. In 1997, just at the end of a multi-million-dollar procurement project to install laboratory information systems at several of the sites, governance of the nine hospitals was transferred formally to Louisiana State University (LSU) under a new branch, the LSU Health Care Services Division.

Comparison of a new recirculation thrombectomy catheter with other devices of the same type: in vitro and in vivo evaluations.

Rationale And Objectives: To compare a new 7 Fr. Helix thrombectomy catheter with Amplatz thrombectomy devices (ATD) with respect to clot fragmentation efficiency, hemolytic potential, and risk for vascular trauma.

Materials And Methods: Particle size was evaluated following the maceration of 8-to-10-day-old clots, each weighing 6 +/- 0.

Hodgkin lymphoma in a renal transplant recipient associated with low peripheral blood Epstein-Barr virus genome copies.

Posttransplant lymphoproliferative disorders are often accompanied by >500 Epstein-Barr virus (EBV) genome copies/10(5) lymphocytes, and they occur shortly after transplantation. Hodgkin lymphoma occurs rarely after transplantation, appearing a mean of 4.2 years posttransplant, and although Hodgkin lymphoma has strong associations with EBV, no quantitative analysis of peripheral blood EBV genome copies has been reported.

Apolipoprotein E and atherosclerosis in Greenland Inuit.

Arterial, liver, and serum specimens were collected from Greenland Inuit at autopsy and apolipoprotein E genotyping was done on 42 females (mean age = 61.3 years) and 56 males (mean age = 56.8 years).

Diabetes and obesity in the Louisiana Coushatta Indians.

Objective: In order to assist their community in planning intervention and prevention programs, prevalence rates for diabetes and obesity were examined among the Louisiana Coushatta.

Research Design And Methods: Coushatta individuals participated in a health survey (questionnaires and physical examinations). Those without known diabetes underwent oral glucose tolerance testing and were classified as having normal glucose tolerance (NGT), impaired glucose tolerance (IGT), or diabetes mellitus (DM).

Genetic studies suggest a multicentric origin for Hb G-Coushatta [beta22(B4)Glu-->Ala].

Hb G-Coushatta [beta22(B4)Glu-->Ala] is found in geographically separated ethnic groups. Commonest along the Silk Road region of China but also present in the North American Coushatta, we sought to determine whether this variant had a unicentric or multicentric origin. We examined the haplotype of the beta-globin gene cluster in two Chinese families and in five Louisiana Coushatta heterozygous for this mutation.

Lipid and apolipoprotein predictors of atherosclerosis in youth: apolipoprotein concentrations do not materially improve prediction of arterial lesions in PDAY subjects. The PDAY Research Group.

We compared serum lipid and apolipoprotein predictors of atherosclerosis in cases from the multicenter study, Pathobiological Determinants of Atherosclerosis in Youth (PDAY). The lipid measures included HDL cholesterol (HDL-C) and non-HDL-C, and the apolipoprotein measures included concentrations of apoA1, apoB, and Lp(a), and sizes of the apo(a) proteins. We tested whether the apolipoprotein measures predicted atherosclerotic lesions as well as the more traditional lipid measures.

Quantification of human cytomegalovirus by competitive PCR and capillary electrophoresis.

Human cytomegalovirus (CMV) is a ubiquitous pathogen found in 40-100% of adults, and in about 1% of live births in the United States (1). It is the most common fetal and perinatal infectious organism; approx 10% of infected neonates are born with symptomatic congenital CMV disease, which is the most common cause of mental retardation and childhood deafness. CMV is a significant pathogen in immunocompromised individuals, including organ transplant recipients (2-4), and in acquired immune deficiency syndrome (AIDS) patients (5,6).

Comparison of four commercial urinary albumin (microalbumin) methods: implications for detecting diabetic nephropathy using random urine specimens.

The results of four urinary albumin methods used to identify patients with early diabetic renal disease were compared using random urine samples from healthy and diabetic patients. These methods were the Beckman Array and Behring BNAI immunonephelometric methods, the Dade aca particle-enhanced turbidimetric inhibition immunoassay method, and the INCSTAR SPQ immunoturbidimetric method. The albumin/creatinine ratio reference interval was found to be 2-20 mg albumin/g creatinine (mg/g) for the Array and 3.

Polymorphic Alu insertions and the Asian origin of Native American populations.

A rapid PCR-based assay was used to study the distribution of 5 polymorphic Alu insertions in 895 unrelated individuals from 30 populations, 24 from North, Central, and South America. Although a significant level of interpopulation variability was detected, the variability was less than that observed in a worldwide population survey. This is consistent with the bottleneck effect and genetic drift forces that may have acted on the migrating founder groups.

Lipoprotein (a) levels in African-Americans with NIDDM.

Objective: The purpose of this study was to investigate possible relationships between lipoprotein (a) [Lp(a)] levels and NIDDM in African-Americans. The objectives were to identify associations between Lp(a) levels of subjects with and without NIDDM and to determine the influence of glycemic control, determined by GHb, and of mode of therapy on Lp(a) levels.

Research Design And Methods: We studied [4] African-American subjects, 103 with NIDDM and 38 without NIDDM.

Identification of cryptic peanut agglutinin-reactive sites in human lipoprotein(a).

After treatment of human lipoprotein(a) (Lp(a)) with neuraminidase, formerly cryptic sites became available for binding to peanut agglutinin (PNA) lectin and a Thomsen-Friedenreich antigen (T-antigen)-specific monoclonal antibody. The PNA-reactive sites were localized to the apo(a) moiety of Lp(a) and O-specific carbohydrate side chains. Lp(a) with larger isoforms of apo(a) contained more potential PNA reactivity per molecule of Lp(a) apoB than did smaller isoforms.

DNA sequences of Alu elements indicate a recent replacement of the human autosomal genetic complement.

DNA sequences of neutral nuclear autosomal loci, compared across diverse human populations, provide a previously untapped perspective into the mode and tempo of the emergence of modern humans and a critical comparison with published clonally inherited mitochondrial DNA and Y chromosome measurements of human diversity. We obtained over 55 kilobases of sequence from three autosomal loci encompassing Alu repeats for representatives of diverse human populations as well as orthologous sequences for other hominoid species at one of these loci. Nucleotide diversity was exceedingly low.

Detection of tyrosinase mRNA from the blood of melanoma patients.

Surgical therapy for localized melanoma is highly successful. However, if melanoma spreads beyond its primary site, the results of treatment are poor. Therefore, early detection of circulating melanoma cells in the blood may be important.

Racial comparison of p53 alterations in breast cancer: difference in prognostic value.

A significant difference in breast cancer survival between blacks and whites has been observed in the United States. Biological variation between races has been suggested to explain the difference. We investigated the difference by comparing the prognostic value of p53 alterations (mutations and protein accumulation) between black and white breast cancer patients.