20 results on '"Bal R"'
Search Results
2. Building an inter-organizational communication network and challenges for preserving interoperability
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Pirnejad, H., Bal, R., and Berg, M.
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KNOWLEDGE gap theory , *INTERNETWORKING , *PRIMARY health care , *MEDICAL quality control , *MEDICAL records , *HOSPITAL & community - Abstract
Abstract: Background: The ideal scenario for information technology to bridge information gaps between primary and secondary healthcare and to improve the quality of healthcare in the medication process is to build an interoperable communication network. This type of undertaking requires diverse information systems to be integrated, and central to this are the preservation of data integrity and the integration of different pieces of patient data. Objectives and methodology: In this study, we focused on sources of challenges to the integration process and to the building of an interoperable communication network. Interviews, document analysis, and observations were conducted to evaluate the integration process in a project that involved medication data communication between primary healthcare providers (i.e., general practitioners and community pharmacists) and secondary healthcare providers (i.e., hospital pharmacists and specialist physicians). Results: The project encountered numerous integration problems, many of which persisted even after extensive technical intervention. An analysis of the problems revealed that they were mostly rooted either in problematic integration of work processes or in the way the system was used. Despite the project''s ideal technical condition, the integration could be accomplished only by applying human interfaces. Conclusion: The main challenge to building interoperable communication network does not lie in technical integration. The real problem occurs when the technical linkage is implemented without the work processes being aligned and integrated. [Copyright &y& Elsevier]
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- 2008
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3. Rosalind Bal talks to the joint winners of the Nursing Standard Nurse 2003 nursing leadership awards.
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Bal R
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- 2003
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4. Save as you learn.
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Bal R
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IDENTIFICATION cards , *MEMBERSHIP cards , *STUDENT discounts , *INSURANCE - Abstract
Stretch your bursary or loan by capitalising on your student status, writes Rosalind Bal. [ABSTRACT FROM AUTHOR]
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- 2005
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5. Palladium(II) containing hydrotalcite as an efficient heterogeneous catalyst for Heck reaction
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Bennur, T.H., Ramani, A., Bal, R., Chanda, B.M., and Sivasanker, S.
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PALLADIUM catalysts , *AROMATIC compounds , *HALIDES - Abstract
Palladium(II) containing hydrotalcite (Pd-HT) has been found to be an efficient and reusable catalyst in Heck reaction between aryl halides (X = Br, I) and olefins to give carbon–carbon coupled products in good to moderate yields. [Copyright &y& Elsevier]
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- 2002
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6. Emricasan to prevent new decompensation in patients with NASH-related decompensated cirrhosis.
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Frenette, Catherine, Kayali, Zeid, Mena, Edward, Mantry, Parvez S., Lucas, Kathryn J., Neff, Guy, Rodriguez, Miguel, Thuluvath, Paul J., Weinberg, Ethan, Bhandari, Bal R., Robinson, James, Wedick, Nicole, Chan, Jean L., Hagerty, David T., and Kowdley, Kris V.
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LIVER histology , *CIRRHOSIS of the liver , *PARACENTESIS , *FATTY liver , *INTERNATIONAL normalized ratio , *HEPATORENAL syndrome , *LIVER diseases , *DABIGATRAN - Abstract
Non-alcoholic steatohepatitis is a leading cause of end-stage liver disease. Hepatic steatosis and lipotoxicity cause chronic necroinflammation and direct hepatocellular injury resulting in cirrhosis, end-stage liver disease and hepatocellular carcinoma. Emricasan is a pan-caspase inhibitor that inhibits excessive apoptosis and inflammation; it has also been shown to decrease portal pressure and improve synthetic function in mice with carbon tetrachloride-induced cirrhosis. This double-blind, placebo-controlled study randomized 217 individuals with decompensated NASH cirrhosis 1:1:1 to emricasan (5 mg or 25 mg) or placebo. Patients were stratified by decompensation status and baseline model for end-stage liver disease-sodium (MELD-Na) score. The primary endpoint comprised all-cause mortality, a new decompensation event (new or recurrent variceal hemorrhage, new ascites requiring diuretics, new unprecipitated hepatic encephalopathy ≥grade 2, hepatorenal syndrome, spontaneous bacterial peritonitis), or an increase in MELD-Na score ≥4 points. There was no difference in event rates between either of the emricasan treatment groups and placebo, with hazard ratios of 1.02 (95% CI 0.59–1.77; p = 0.94) and 1.28 (95% CI 0.75–2.21; p = 0.37) for 5 mg and 25 mg of emricasan, respectively. MELD-Na score progression was the most common outcome. There was no significant effect of emricasan treatment on MELD-Na score, international normalized ratio, total serum bilirubin, albumin level or Child-Pugh score. Emricasan was generally safe and well-tolerated. Emricasan was safe but ineffective for the treatment of decompensated NASH cirrhosis. However, this study may guide the design and conduct of future clinical trials in decompensated NASH cirrhosis. Patients with decompensated cirrhosis related to non-alcoholic steatohepatitis are at high risk of additional decompensation events and death. Post hoc analyses in previous pilot studies suggested that emricasan might improve portal hypertension and liver function. In this larger randomized study, emricasan did not decrease the number of decompensation events or improve liver function in patients with a history of decompensated cirrhosis related to non-alcoholic steatohepatitis. NCT03205345. • Pan-caspase inhibition with emricasan did not decrease clinical events in patients with decompensated NASH-cirrhosis. • Caspase inhibition did not affect MELD-Na scores, INR, total serum bilirubin or Child-Pugh score. • Emricasan was generally well-tolerated over the duration of treatment. [ABSTRACT FROM AUTHOR]
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- 2021
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7. Time for a change.
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Bal R
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School nurse Melanie Brock set up a baby care course to show teenage girls there is more to life than becoming a mum at 16. [ABSTRACT FROM AUTHOR]
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- 2004
8. Running the show.
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Bal R
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Faced with the closure of a mobile community coronary care unit, Annetta Quigley and Valerie McNiffe decided that nurses could keep it on the road. [ABSTRACT FROM AUTHOR]
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- 2004
9. Path finder.
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Bal R
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Helping men get through the maze of prostate cancer treatment earned specialist nurse Mary Kirkham her first ever award. [ABSTRACT FROM AUTHOR]
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- 2004
10. Targeting test environments and rust-resistant genotypes in lentils (Lens culinaris) by using heritability-adjusted biplot analysis.
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Parihar, A. K., Basandrai, Ashwani K., Kushwaha, K. P. S., Chandra, S., Singh, K. D., Bal, R. S., Saxena, D., Singh, Deepak, and Gupta, Sanjeev
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LENTILS , *RUST diseases , *GENOTYPE-environment interaction - Abstract
Lentil rust incited by the fungus Uromyces viciae-fabae is a major impedance to lentil (Lens culinaris Medik.) production globally. Host-plant resistance is the most reliable, efficient and viable strategy among the various approaches to control this disease. In this study, 26 lentil genotypes comprising advanced breeding lines and released varieties along with a susceptible check were evaluated consecutively for rust resistance under natural incidence for two years and at five test locations in India. A heritability-adjusted genotype main effect plus genotype × environment interaction (HA-GGE) biplot program was used to analyse disease-severity data. The results revealed that, among the interactive factors, the GE interaction had the greatest impact (27.81%), whereas environment and genotype showed lower effects of 17.2% and 20.98%, respectively. The high GE variation made possible the evaluation of the genotypes at different test locations. The HA-GGE biplot method identified two sites (Gurdaspur and Pantnagar) as the ideal test environments in this study, with high efficiency for selection of durable and rust-resistant genotypes, whereas two other sites (Kanpur and Faizabad) were the least desirable test environments. In addition, the HA-GGE biplot analysis identified three distinct mega-environments for rust severity in India. Furthermore, the analysis identified three genotypes, DPL 62, PL 165 and PL 157, as best performing and durable for rust resistance in this study. The HA-GGE biplot analysis recognised the best test environments, restructured the ecological zones for lentil-rust testing, and identified stable sources of resistance for lentil rust disease, under multi-location and multi-year trials. [ABSTRACT FROM AUTHOR]
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- 2018
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11. Ni/CeO2 catalysts for methane partial oxidation: Synthesis driven structural and catalytic effects.
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Pantaleo, G., Parola, V. La, Deganello, F., Singha, R.K., Bal, R., and Venezia, A.M.
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OXIDATION , *METHANE , *PARTIAL oxidation , *CATALYTIC activity , *HYDROTHERMAL deposits , *ATMOSPHERIC pressure , *TEMPERATURE effect - Abstract
Catalytic partial oxidation of methane (CPO) to synthesis gas was performed over differently prepared CeO 2 supported nickel catalysts with 6 wt% Ni content. The samples were synthesized by microwave assisted procedures and by hydrothermal deposition procedure. Differences in the catalyst structural properties of the prepared catalysts were detected by XRD, TPR and XPS measurement. When tested at atmospheric pressure with feed gas mixture containing methane and oxygen in molecular ratio CH 4 /O 2 = 2, all the samples reached 98% conversion with CO selectivity values >95% in the 700–800 °C temperature range. The samples exhibited different behavior towards carbon formation during the tests. Moreover, according to XRD, XPS and TGA results, when the carbon was formed it did not cause catalyst deactivation. TPR profiles confirmed different degree of chemical interaction between NiO and CeO 2 support, depending on the preparation method. The building up or the easy removal of carbon during the CH 4 temperature programmed surface reaction (TPSR), substantiate the role of the CeO 2 lattice oxygen mobility, enhanced by metal-support interaction, in the removal of the deposited carbon through CO evolution. Structure-activity relationship established a close dependence of the CPO performance on the combination of NiO and CeO 2 crystallite sizes and the interaction between the two. [ABSTRACT FROM AUTHOR]
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- 2016
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12. Biofortification of wheat, rice and common bean by applying foliar zinc fertilizer along with pesticides in seven countries.
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Ram, H., Rashid, A., Zhang, W., Duarte, A., Phattarakul, N., Simunji, S., Kalayci, M., Freitas, R., Rerkasem, B., Bal, R., Mahmood, K., Savasli, E., Lungu, O, Wang, Z., Barros, V., Malik, S., Arisoy, R., Guo, J., Sohu, V., and Zou, C.
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FOOD crops , *CALORIC content of foods , *CARBON sequestration in forests , *MOLECULAR structure , *SOIL classification - Abstract
Aims: Rice ( Oryza sativa L.), wheat ( Triticum aestivum L.) and common bean ( Phaseolus vulgaris L.) are major staple food crops consumed worldwide. Zinc (Zn) deficiency represents a common micronutrient deficiency in human populations, especially in regions of the world where staple food crops are the main source of daily calorie intake. Foliar application of Zn fertilizer has been shown to be effective for enriching food crop grains with Zn to desirable amounts for human nutrition. For promoting adoption of this practice by growers, it is important to know whether foliar Zn fertilizers can be applied along with pesticides to wheat, rice and also common bean grown across different soil and environmental conditions. Methods: The feasibility of foliar application of zinc sulphate (ZnSO.7HO) to wheat, rice and common bean in combination with commonly used five fungicides and nine insecticides was investigated under field conditions at the 31 sites-years of seven countries, i.e., China, India, Pakistan, Thailand, Turkey, Brazil and Zambia. Results: Significant increases in grain yields were observed with foliar Zn/foliar Zn + pesticide (5.2-7.7 % of wheat and 1.6-4.2 % of rice) over yields with no Zn treatment. In wheat, as average of all experiments, higher grain Zn concentrations were recorded with foliar Zn alone (41.2 mg kg) and foliar Zn + pesticide (38.4 mg kg) as compared to no Zn treatment (28.0 mg kg). Though the magnitude of grain Zn enrichment was lesser in rice than wheat, grain Zn concentrations in brown rice were significantly higher with foliar Zn (24.1 mg kg) and foliar Zn + pesticide (23.6 mg kg) than with no Zn (19.1 mg kg). In case of common bean, grain Zn concentration increased from 68 to 78 mg kg with foliar Zn alone and to 77 mg kg with foliar Zn applied in combination with pesticides. Thus, grain Zn enrichment with foliar Zn, without or with pesticides, was almost similar in all the tested crops. Conclusions: The results obtained at the 31 experimental site-years of seven countries revealed that foliar Zn fertilization can be realized in combination with commonly-applied pesticides to contribute Zn biofortification of grains in wheat, rice and common bean. This agronomic approach represents a useful practice for the farmers to alleviate Zn deficiency problem in human populations. [ABSTRACT FROM AUTHOR]
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- 2016
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13. Resolution of sub-nanosecond motions in botulinum neurotoxin endopeptidase: An evidence of internal flexibility.
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Kumar, Raj, Cai, Shuowei, Ojadi, Emmanuel, and Singh, Bal. R.
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BOTULINUM toxin , *ENDOPEPTIDASES , *POISONS , *CRYSTAL structure , *FLUORESCENCE anisotropy - Abstract
Botulinum neurotoxins (BoNTs) are the most poisonous substances known to mankind, which act on the peripheral nervous system leading to flaccid paralysis. Although co-crystal structure of BoNT/A light chain (LC) reveals some unique features of the biological function of this molecule, structural characteristics in solution reveal its dynamic features, not available through the published crystal structures. In this study, we have examined internal flexibility of this molecule by measuring rotational correlation time as a function of viscosity, using frequency domain fluorescence anisotropy decay technique. Fluorescence anisotropy decay of BoNT/A LC resolved sub-nanosecond local motion (faster component), interpreted as internal flexibility of the molecule was affected significantly with viscosity. Both local and global movements were affected by viscosity, which indicates the accessibility of protein core and flexibility of overall structure. In conclusion, this work demonstrates the presence of flexibility in the internal peptide segments, which appears to play a significant role in BoNT/A LC biological function. [ABSTRACT FROM AUTHOR]
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- 2015
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14. Differential role of molten globule and protein folding in distinguishing unique features of botulinum neurotoxin.
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Kumar, Raj, Kukreja, Roshan V., Cai, Shuowei, and Singh, Bal R.
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PROTEIN folding , *BOTULINUM toxin , *THERAPEUTICS , *PHOSPHORYLATION , *UBIQUITINATION , *CRYSTAL structure - Abstract
Abstract: Botulinum neurotoxins (BoNTs) are proteins of great interest not only because of their extreme toxicity but also paradoxically for their therapeutic applications. All the known serotypes (A-G) have varying degrees of longevity and potency inside the neuronal cell. Differential chemical modifications such as phosphorylation and ubiquitination have been suggested as possible mechanisms for their longevity, but the molecular basis of the longevity remains unclear. Since the endopeptidase domain (light chain; LC) of toxin apparently survives inside the neuronal cells for months, it is important to examine the structural features of this domain to understand its resistance to intracellular degradation. Published crystal structures (both botulinum neurotoxins and endopeptidase domain) have not provided adequate explanation for the intracellular longevity of the domain. Structural features obtained from spectroscopic analysis of LCA and LCB were similar, and a PRIME (PReImminent Molten Globule Enzyme) conformation appears to be responsible for their optimal enzymatic activity at 37°C. LCE, on the other hand, was although optimally active at 37°C, but its active conformation differed from the PRIME conformation of LCA and LCB. This study establishes and confirms our earlier finding that an optimally active conformation of these proteins in the form of PRIME exists for the most poisonous poison, botulinum neurotoxin. There are substantial variations in the structural and functional characteristics of these active molten globule related structures among the three BoNT endopeptidases examined. These differential conformations of LCs are important in understanding the fundamental structural features of proteins, and their possible connection to intracellular longevity could provide significant clues for devising new countermeasures and effective therapeutics. [Copyright &y& Elsevier]
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- 2014
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15. First Isolation of Dengue Virus from the 2010 Epidemic in Nepal.
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Pandey, Basu D., Nabeshima, Takeshi, Pandey, Kishor, Rajendra, Saroj P., Shah, Yogendra, Adhikari, Bal R., Gupta, Govinda, Gautam, Ishan, Tun, Mya M. N., Uchida, Reo, Shrestha, Mahendra, Kurane, Ichiro, and Morita, Kouichi
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DENGUE , *DENGUE viruses , *RNA analysis , *REVERSE transcriptase polymerase chain reaction , *ENZYME-linked immunosorbent assay , *NUCLEOTIDE sequencing , *BLOOD sampling , *PROGNOSIS - Abstract
Dengue is an emerging disease in eNepal and was first observed as an outbreak in nine lowland districts in 2006. In 2010, however, a large epidemic of dengue occurred with 4,529 suspected and 917 serologicallyconfirmed cases and five deaths reported in government hospitals in Nepal. The collection of demographic information was performed along with an entomological survey and clinical evaluation of the patients. A total of 280 serum samples were collected from suspected dengue patients. These samples were subjected to routine laboratory investigations and IgM-capture ELISA for dengue serological identification, and 160 acute serum samples were used for virus isolation, RT-PCR, sequencing and phylogenetic analysis. The results showed that affected patients were predominately adults, and that 10% of the cases were classified as dengue haemorrhagic fever/ dengue shock syndrome. The genetic characterization of dengue viruses isolated from patients in four major outbreak areas of Nepal suggests that the DENV-1 strain was responsible for the 2010 epidemic. Entomological studies identified Aedes aegypti in all epidemic areas. All viruses belonged to a monophyletic single clade which is phylogenetically close to Indian viruses. The dengue epidemic started in the lowlands and expanded to the highland areas. To our knowledge, this is the first dengue isolation and genetic characterization reported from Nepal. [ABSTRACT FROM AUTHOR]
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- 2013
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16. Quality improvement in long-term mental health: results from four collaboratives.
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STRATING, M. M. H., BROER, T., VAN ROOIJEN, S., BAL, R. A., and NIEBOER, A. P.
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CLINICAL medicine , *CASE studies , *EVALUATION of medical care , *MENTAL health services , *PROBABILITY theory , *PSYCHIATRIC social work , *QUALITY assurance , *RESEARCH funding , *SCALES (Weighing instruments) , *SOCIAL networks , *SOCIAL skills , *T-test (Statistics) , *MULTIPLE regression analysis , *EVALUATION research , *BODY mass index , *ORGANIZATIONAL governance , *DESCRIPTIVE statistics - Abstract
Accessible summary Overall, the four collaboratives lead to significant improvement in most objective outcomes, such as health, loneliness, and clients' problem areas., With respect to perceived effectiveness significant differences between the four collaboratives were found. Team members participating in the Social Psychiatric Care collaborative scored significantly lower than team members in the other three collaboratives. The Recovery-Oriented Care collaborative scored weakly higher., Multilevel regression analyses indicated that innovation attributes, appropriate measures, usable data collection tools, and an innovative team culture could explain variation in perceived effectiveness., The results supported the notion that a layered approach is necessary to achieve improvements in quality of care., Abstract This multiple case study evaluates four quality improvement collaboratives (QICs) in long-term mental health care focusing on social psychiatric care, recovery oriented care, social participation and somatic co-morbidity of psychiatric patients. The aim is to explore (1) effectiveness in terms of objective outcome indicators and impact of changes as perceived by team members; and (2) associations between collaborative-, organizational- and team-level factors and perceived effectiveness. Most objective outcomes, such as health, loneliness and clients' problem areas, showed significant improvement. Because of the diversity in content no single measure for objective effectiveness could be computed across the four collaboratives. Perceived effectiveness of team members was used as an indicator of the overall impact. In all, 55 of the 94 participating team leaders and 117 remaining team members completed a written survey at the end of each quality improvement collaborative. Multilevel regression analyses indicated that innovation attributes, appropriate measures, usable data collection tools and an innovative team culture could explain variation in perceived effectiveness. In conclusion, overall positive changes for clients were realized as demonstrated by objective outcomes and team members' perceptions of improvements in care processes. The results supported the notion that a layered approach is necessary to achieve improvements in quality of care. [ABSTRACT FROM AUTHOR]
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- 2012
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17. Melatonin modulates wireless (2.45GHz)-induced oxidative injury through TRPM2 and voltage gated Ca2+ channels in brain and dorsal root ganglion in rat
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Nazıroğlu, M., Çelik, Ö., Özgül, C., Çiğ, B., Doğan, S., Bal, R., Gümral, N., Rodríguez, A.B., and Pariente, J.A.
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TRP channels , *CALCIUM channels , *MELATONIN , *OXIDATIVE stress , *NEURONS , *LABORATORY rats , *ELECTROENCEPHALOGRAPHY , *ELECTROMAGNETIC fields , *PEROXIDATION , *GLUTATHIONE - Abstract
Abstract: We aimed to investigate the protective effects of melatonin and 2.45GHz electromagnetic radiation (EMR) on brain and dorsal root ganglion (DRG) neuron antioxidant redox system, Ca2+ influx, cell viability and electroencephalography (EEG) records in the rat. Thirty two rats were equally divided into four different groups namely group A1: Cage control, group A2: Sham control, group B: 2.45GHz EMR, group C: 2.45GHz EMR+melatonin. Groups B and C were exposed to 2.45GHz EMR during 60min/day for 30days. End of the experiments, EEG records and the brain cortex and DRG samples were taken. Lipid peroxidation (LP), cell viability and cytosolic Ca2+ values in DRG neurons were higher in group B than in groups A1 and A2 although their concentrations were increased by melatonin, 2-aminoethyldiphenyl borinate (2-APB), diltiazem and verapamil supplementation. Spike numbers of EEG records in group C were lower than in group B. Brain cortex vitamin E concentration was higher in group C than in group B. In conclusion, Melatonin supplementation in DRG neurons and brain seems to have protective effects on the 2.45GHz-induced increase Ca2+ influx, EEG records and cell viability of the hormone through TRPM2 and voltage gated Ca2+ channels. [Copyright &y& Elsevier]
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- 2012
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18. Constructing the social: an evaluation study of the outcomes and processes of a 'social participation' improvement project.
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BROER, T., NIEBOER, A. P., STRATING, M. M. H., MICHON, H. W. C., and BAL, R. A.
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ANALYSIS of variance , *DEVELOPMENTAL disabilities , *INTERVIEWING , *LONELINESS , *RESEARCH methodology , *MEDICAL quality control , *POSTAL service , *PROBABILITY theory , *QUALITY assurance , *INDUSTRIAL research , *SOCIAL networks , *T-test (Statistics) - Abstract
This paper reports on an evaluation of a 'social participation' improvement project in a mental health care and care for the intellectually disabled setting. The main research question is how sociality (i.e. clients' social lives) was constructed and what consequences this had for the project and for the clients. We undertook a dual approach: investigating the predefined outcomes and analysing the improvement processes in terms of how these processes construct sociality. As to the predefined outcomes, clients' social networks were not widened, but clients felt significantly less lonely at the end of the project. In a bottom-up analysis of data gathered on the improvement processes, we articulated two ways of constructing sociality: individualization, in which clients had to verbalize their wishes (verbalization) and to act upon them more actively (enterprising); and normalization, in which a good social life was one embedded in 'normal' community. We argue that this (explorative) way of conceptualizing change corresponds with some of the quantitative findings but also brings to light aspects that would have gone unnoticed by using only the predefined outcomes. Therefore, a mixed methods approach in studying effectiveness is a fruitful addition to the quality improvement literature. [ABSTRACT FROM AUTHOR]
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- 2011
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19. Impact of a computerized physician order entry system on nurse-physician collaboration in the medication process.
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Pirnejad H, Niazkhani Z, van der Sijs H, Berg M, and Bal R
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- 2008
- Full Text
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20. Identifying and explaining the variability in development and implementation costs of disease management programs in the Netherlands.
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Tsiachristas, A., Waters, B. Hipple, Adams, S. A., Bal, R., and Mölken, M. P. M. M. Rutten-van
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DISEASE management , *MEDICAL care , *CHRONIC diseases , *FINANCIAL risk , *MIXED methods research , *MANAGEMENT , *COST effectiveness - Abstract
Background: In the Netherlands, disease management programs (DMPs) are used to treat chronic diseases. Their aim is to improve care and to control the rising expenditures related to chronic diseases. A bundled payment was introduced to facilitate the implementation of DMPs. This payment is an all-inclusive price per patient per year for a pre-specified care package. However, it is unclear to which extent the costs of developing and implementing DMPs are included in this price. Consequently, the organizations providing DMPs bear financial risk because the development and implementation (D&I) costs may be substantial. The aim of this paper is to investigate the variability in and drivers of D&I costs among 22 DMPs and highlight characteristics that impact these. Methods: The data was analyzed using a mixed methods approach. Descriptive statistical analysis explored the variability in D&I costs as measured by a self-developed costing instrument and investigated the drivers. In addition, qualitative research, including document analysis and interviews, was conducted to explain the possible underlying reasons of cost variability. Results: The development costs varied from €5,891 to €274,783 and the implementation costs varied from €7,278 to €387,879 across DMPs. Personnel costs were the main component of development. Development costs were strongly correlated with the implementation costs (p = 0.55), development duration (p = 0.74), and number of FTEs dedicated DMP development. Organizations with large size and high level of care prior to the implementation of a DMP had relatively low development costs. These findings were in line with the cross-case qualitative comparison where programs with a longer history, more experienced project leadership, previously established ICT systems, and less complex patient populations had lower D&I costs. Conclusions: There is wide variation in D&I costs of DMPs, which is driven primarily by the duration of the development phase and the staff needed to develop and implement a DMP. These drivers are influenced by the attributes of the DMP, characteristics of the target population, project leadership, and ICT involved. There are indications of economies of scale and economies of scope, which may reduce D&I costs. Lessons learned for research development: D&I costs of DMPs are substantial and should be incorporated in economic evaluation studies. In addition, the case-mix of patients included in a DMP is associated with the D&I costs. Limitations: The costs that facilitated the DMP development and occurred prior to it were not available. Future research: should investigate whether the D&I costs per patient decrease in the longer term due to the broader inclusion of patients in DMPs. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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