Referral patterns in a global store-and-forward telemedicine system

We examined the nature of the referral patterns in the email telemedicine network operated by the Swinfen Charitable Trust with a view to informing long-term resource planning. Over the first six years of operation, 62 hospitals from 19 countries registered with the Trust in order to be able to refer cases for specialist advice; 55 of these hospitals (89%) actually referred cases during this period. During the first six years of operation, nearly 1000 referrals were submitted and answered, from a wide range of specialty areas. Between July 2002 and March 2005 the referral rate rose from 127 to 318 cases per year. The median length of time required to provide a specialist's response was 2.3 days during the first 12 months and 1.8 days during the last 12 months. Five hospitals submitted cases for more than four years (together sending a total of 493 cases). Their activity data showed a trend to declining referral rates over the four-year period, which may represent successful knowledge transfer. There is some evidence that over the last three years the growth in demand has been exponential, while the growth in resources available (i.e. specialists) has been linear, a situation which cannot continue for very long before demand outstrips supply.

Knowledge about a Species' Conservation Status and Funding for its Preservation: Analysis

Using a species' population to measure its conservation status, this paper explores how increased knowledge about a species' status changes the public's willingness to donate funds for its conservation. This is based on the behavioral relationship between the level of donations and a species' conservation status satisfying general mathematical properties. This level of donation increases, on average, with greater knowledge of a species' conservation status if it is endangered, but falls if it is secure. Modelling enables individuals' demand for extra information about the conservation status of species to be specified. While this model may suggest that conservation bodies could boost funds for conservation of species by exaggerating species' endangerment, such a strategy is shown to be potentially counterproductive. (c) 2006 Elsevier B.V. All rights reserved.

TRALI in 2 cases of leukemia

We describe transfusion-related acute lung injury (TRALI) in 2 acute leukemia cases to increase awareness of this under reported serious transfusion complication syndrome in multitransfused patients. There are a number of reports in multitransfused patients with nonmalignant disorders. However, reports of pediatric oncology patients are few, suggesting a lack of recognition or misdiagnosis of the syndrome. A disproportionately high number of fatalities in children is recorded in the literature. This highlights the need for increased awareness and appropriate treatment of this serious complication of transfusion. Although TRALI is initially a clinical diagnosis, the laboratory investigation is vital as it contributes to defining the pathogenesis of the syndrome and importantly facilitates the effective management of implicated donations and donors. An investigational strategy for suspected cases is presented and the results are discussed in the context of current proposed mechanisms for TRALI. As each transfused blood product is associated with a potential risk of TRALI, more frequent reports in patients receiving large volume or recurrent transfusion would be expected.

An analysis of the images attached to referral messages in an e-mail based telemedicine system for developing countries

Little is known about the quality of the images transmitted in email telemedicine systems. The present study was designed to survey the quality of images transmitted in the Swinfen Charitable Trust email referral system. Telemedicine cases were examined for a 3 month period in 2002 and a 3 month period in 2006. The number of cases with images attached increased from 8 (38%) to 37 (53%). There were four types of images (clinical photographs, microscope pictures, notes and X-ray images) and the proportion of radiology images increased from 27 to 48%. The cases in 2002 came from four different hospitals and were associated with seven different clinical specialties. In 2006, the cases came from 19 different hospitals and 20 different specialties. The 46 cases (from both study periods) had a total of 159 attached images. The quality of the images was assessed by awarding each image a score in four categories: focus, anatomical perspective, composition and lighting. The images were scored on a five-point scale (1 = very poor to 5 =very good) by a qualified medical photographer. In comparing image quality between the two study periods, there was some evidence that the quality had reduced, although the average size of the attached images had increased. The median score for all images in 2002 was 16 (interquartile range 14-19) and the median score in 2006 was 15 (13-16). The difference was significant (P < 0.001, Mann-Whitney test).

CRIANÇA ESPERANÇA: comunicação e marketing da Rede Globo

Este estudo teve como objetivo analisar o Projeto Criança Esperança, da Rede Globo de Televisão, buscando identificar se ele é uma atividade de filantropia pela qual a empresa busca ajudar a sociedade brasileira, prestando-lhe contas sobre os resultados e direcionamento das doações por meio de seu veículo de comunicação ou se é uma Estratégia de Comunicação do Marketing de Causas Sociais da organização, que além de ajudar a comunidade com as ações propostas, utiliza os instrumentos de Relações Públicas para auxiliar na consolidação da imagem institucional da empresa, por meio da articulação dos seus vários públicos. A pesquisa embasou suas conclusões na análise dos valores das doações dos telespectadores no show/programa, dos índices de audiência e de participação de parceiros e de patrocinadores. Esses itens mostraram ser indicadores confiáveis de uma estratégia de comunicação de sucesso ou, até então, de insucesso do projeto. A metodologia empregada foi o Estudo de Caso do Programa/Show Criança Esperança, pesquisa bibliográfica embasada em documentos e entrevistas.

Diabetes service provision:a qualitative study of newly diagnosed Type 2 diabetes patients' experiences and views

Aims: To explore newly diagnosed Type 2 diabetes patients' views about Scottish diabetes services at a time when these services are undergoing a major reorganization. To provide recommendations to maximize opportunities brought by the devolvement of services from secondary to primary healthcare settings. Methods: Qualitative panel study with 40 patients newly diagnosed with Type 2 diabetes, recruited from hospital clinics and general practices in Lothian, Scotland. Patients were interviewed three times over 1 year. The study was informed by grounded theory, which involves concurrent data collection and analysis. Results: Patients were generally satisfied with diabetes services irrespective of the types of care received. Most wanted their future care/review to be based in general practice for reasons of convenience and accessibility, although they dis-liked it when appointments were scheduled for different days. Many said they lacked the knowledge/confidence to know how to manage their diabetes in particular situations, and needed access to healthcare professionals who could answer their questions promptly. Patients expressed a need for primary care professionals who had diabetes expertise, but who had more time and were more accessible than general practitioners. Patients who had encountered practice lead nurses for diabetes spoke particularly positively of these professionals. Conclusions: Nurses with diabetes training are particularly well placed to provide information and support to patients in primary care. Ideally, practices should run 'one-stop' diabetes clinics to provide structured care, with easily accessible dietetics, podiatry and retinopathy screening. Newly diagnosed patients may benefit from being made more aware of specific services provided by charitable organizations such as Diabetes UK. © 2005 Diabetes UK.

The public benefit requirement for charities in England and Wales:a qualitative study of its impact

The Charities Act 2006 introduced at least three changes leading to renewed emphasis on the public benefit requirement for charities in England and Wales: changes which have the potential to alter substantially society’s understanding of what it means for a body to be a charity. There has been a great deal of technical discussion of the changes, but against that background, this article presents a qualitative assessment of perceptions of the practical impact. The changes made by the 2006 Act took effect in 2008, and by 2012 four years had elapsed for the impact to settle down. We assessed the perceived impact of the renewed public benefit emphasis, using in depth interviews with a number of major stakeholders and open workshops with charity staff, trustees and advisers. We found that most study participants valued public benefit as a central concept distinguishing charitable and non-charitable organisations, although for many charities the impact is experienced mainly at the time of registration and when producing their annual reports.

Enjoying the third age! Discourse, identity and liminality in extra-care communities

Extra-care housing has been an important and growing element of housing and care for older people in the United Kingdom since the 1990s. Previous studies have examined specific features and programmes within extra-care locations, but few have studied how residents negotiate social life and identity. Those that have, have noted that while extra care brings many health-related and social benefits, extra-care communities can also be difficult affective terrain. Given that many residents are now ‘ageing in place’ in extra care, it is timely to revisit these questions of identity and affect. Here we draw on the qualitative element of a three-year, mixed-method study of 14 extra-care villages and schemes run by the ExtraCare Charitable Trust. We follow Alemàn in regarding residents' ambivalent accounts of life in ExtraCare as important windows on the way in which liminal residents negotiate the dialectics of dependence and independence. However, we suggest that the dialectic of interest here is that of the third and fourth age, as described by Gilleard and Higgs. We set that dialectic within a post-structuralist/Lacanian framework in order to examine the different modes of enjoyment that liminal residents procure in ExtraCare's third age public spaces and ideals, and suggest that their complaints can be read in three ways: as statements about altered material conditions; as inter-subjective bolstering of group identity; and as fantasmatic support for liminal identities. Finally, we examine the implications that this latter psycho-social reading of residents' complaints has for enhancing and supporting residents' wellbeing.

Determinants of resource development strategies in nonprofit organizations: An analysis of children, youth and family services

This study is an exploratory analysis of an operational measure for resource development strategies, and an exploratory analysis of internal organizational contingencies influencing choices of these strategies in charitable nonprofit organizations. The study provides conceptual guidance for advancing understanding about resource development in the nonprofit sector. The statistical findings are, however, inconclusive without further rigorous examination. A three category typology based on organization technology is initially presented to define the strategies. Three dimensions of internal organizational contingencies explored represent organization identity, professional staff, and boards of directors. Based on relevant literature and key informant interviews, an original survey was administered by mail to a national sample of nonprofit organizations. The survey collected data on indicators of the proposed strategy types and selected contingencies. Factor analysis extracted two of the initial categories in the typology. The Building Resource Development Infrastructure Strategy encompasses information technology, personnel, legal structures, and policies facilitating fund development. The Building Resource Development Infrastructure Strategy encompasses the mission, service niche, and type of service delivery forming the basis for seeking financial support. Linear regressions with each strategy type as the dependent variable identified distinct and common contingencies which may partly explain choices of strategies. Discriminant analysis suggests the potential predictive accuracy of the contingencies. Follow-up case studies with survey respondents provide additional criteria for operationalizing future measures of resource development strategies, and support and expand the analysis on contingencies. The typology offers a beginning framework for defining alternative approaches to resource development, and for exploring organization capacity specific to each approach. Contingencies that may be integral components of organization capacity are funding, leadership frame, background and experience, staff and volunteer effort, board member support, and relationships in the external environment. Based on these findings, management questions are offered for nonprofit organization stakeholders to consider in planning for resource development. Lessons learned in designing and conducting this study are also provided to enhance future related research. ^

Intercollegiate athletics and college rankings: An analysis of the relationship between athletic success and the U.S. News and World Report college rankings

The purpose of this study was to gain a greater understanding of the relationship between athletic success of football and men's basketball and the U.S. News and World Report (USNWR) college rankings. There has been consistent debate among researchers who study institutional quality about whether intercollegiate athletics enhances reputation. This study is similar to other studies attempting to measure the relationship between athletic success and possible indirect benefits to the university from athletics, such as increased admissions applications and increased alumni donations and giving. This study offered a more nuanced model for measuring athletic success, a concept that has been difficult to measure quantitatively. The method used here also measured change over time (in this case, from year-to-year over an eleven year period). The research questions for this study were (a) is there a correlation between athletic success and the USNWR college ranking; and (b) is there a correlation in the change from year-to-year in athletic success with the change from year-to-year in the USNWR college rankings? Spearman Rho correlation and ANOVA tests were used to answer these research questions. The results from the statistical tests demonstrated little correlation between athletic success, whether in football or men's basketball, with the USNWR college rankings. Although the relationships were weak, men's basketball success consistently demonstrated a stronger relationship than football success. This finding differed from what is most often found in the literature, which often favors football success. The ANOVA test results did reveal some results that suggest athletic participation is a factor in the USNWR college rankings. As the debate continues about whether intercollegiate athletics enhances reputation, and as colleges and universities continue spending enormously on athletics, a keener understanding about the possible indirect benefits to the university from athletic programs is needed. The "advertising" provided by spectator sports such as football and men's basketball is often assumed by university leaders to present substantial indirect benefits for the university. However, the existing research along with this study provides little evidence of such opportunities.

A influência da relevância social no viés de grupo

Behaviors found in every culture, general human tendencies, are knew in Evolutionary Psychology as evolved psychological mechanisms. Those behaviors date back the Environment of Evolutionary Adaptedness, and a well know example of such behavior is the group bias (or intergroup bias). This bias consists of recognizing members of your own group and favor them, while disregarding or even harming outsiders. This behavior was and still is extensively studies, among the most important conclusions about this phenomenon is the Minimal Groups Paradigm, in which it was discovered that the group bias could trigger even when the groupings were done in following very arbitrary criteria. In the current study, our goal was to test if the participants, when playing an economic game, would behave in a similar fashion under a minimal group situation and real groups, with social meaning. With this in mind we made two experimental conditions, a Low Social Meaning one (LSM) where the groups were represented by letters (H, B, O and Y) in which participants would be ramdomly assorted to each group; and the High Social Meaning condition (HSM) in which religion was used as a group marker, containing the two most dominating religious groups in Brazil, catholic and evangelic, another group containing all the other affiliations e the fourth and last group representing atheists and agnostics. The ratio of donations in-group/out-group was roughly the same across both conditions. However, the amount of wafers donated to ingroup was significantly bigger in the HSM condition. By verifying which aspects of the individual best predicted the observed group bias, we discovered that the in-group Entitativity perception as well as the Group Identification were the most relevant variables, however, only in the HSM condition. Simultaneously, by verifying the generosity, biased or not, we observed that the agreeableness personality factor was the only variable able to predict it, and only in the LSM condition. We conclude that our generosity, or the lack of it, is for most part defined by our personality, the Agreeableness factor in particular. But this very generosity can be biased by the social meaning of the involved groups and that, if the social meaning is big enough, even people who, thanks to their personality, normally wouldn’t show generosity, are able to do so when the receiver is an in-group member.

A randomized trial of specialized versus standard neck physiotherapy in cervical dystonia

We thank: the patients who took part; Monsieur John-Pierre Bleton for training the physiotherapists; Gladys McPherson (Senior IT Manager), Adesoji Adeyemi (programmer) and Diana Collins (data entry) from the Centre for Healthcare Randomised Trials, University of Aberdeen who provided the randomisation and database service; and the funders including The Dystonia Society, the RS Macdonald Charitable Trust, The Sir Halley Stewart Trust, The Foyle Foundation and The Garfield Weston Foundation. The Dystonia Society and other funders had no role in the design, conduct, analysis or writing of the report or the decision to submit the manuscript.

Prior Antithrombotic Use is Associated with Favorable Mortality and Functional Outcomes in Acute Ischemic Stroke

Sources of Funding The GWTG-Stroke program is currently supported in part by a charitable contribution from Bristol-Myers Squibb/Sanofi Pharmaceutical Partnership and the American Heart Association Pharmaceutical Roundtable. GWTG-Stroke has been funded in the past through support from Boehringer-Ingelheim and Merck. These funding agencies did not participate in design or analysis, manuscript preparation, or approval of this study.

Whole-brain patterns of 1H-magnetic resonance spectroscopy imaging in Alzheimer's disease and dementia with Lewy bodies

Acknowledgments We thank Craig Lambert for his help in processing the MRS data. The study was funded by the Sir Jules Thorn Charitable Trust (grant ref: 05/JTA) and was supported by the National Institute for Health Research (NIHR) Newcastle Biomedical Research Centre and the Biomedical Research Unit in Lewy Body Dementia based at Newcastle upon Tyne Hospitals National Health Service (NHS) Foundation Trust and Newcastle University and the NIHR Biomedical Research Centre and Biomedical Research Unit in Dementia based at Cambridge University Hospitals NHS Foundation Trust and the University of Cambridge. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.