98 research outputs found
Coresponding Author: Nikos Polyzos, Associate Professor of Health Service Management, Former Secretary General of Ministry of Health
Get PDFAbstract Purpose: The purpose of this study was to access the performance of 117 Greek National Health System (NHS) hospitals for the year 2011, to compare the findings with the results from similar studies of the previous years (2009 and 2010) and to investigate the changes during the last three years of financial crisis. Method: An input-oriented Data Envelopment Analysis was used to measure three indicators, technical, pure technical and scale efficiency indicators. Data was collected from the reports of the web-based facility (ESY.net) which was developed by the General Secretary of Ministry of Health and Social Solidarity. The input variables were the number of physicians, the number of nurses and other personnel, the number of beds and expenditures of every hospital. The output variables were the number of inpatient and outpatient visits. Hospitals were categorized into three size groups. Results: Between the years 2009-2011, all hospitals, especially middle-sized hospitals showed performance improvement on all three indicators. Specific problems were noticed mainly in large-sized hospitals. The technical efficiency of Large-sized hospitals was estimated at 80%, of Middle-sized hospitals at 82% and of Small hospitals-Health Care Centres at 89%. Pure technical and scale efficiency varied between satisfactory levels throughout the study period. Conclusion: Comparing the 2009-2011 data, an improvement of technical efficiency in NHS hospitals has been achieved up to 100%, mainly in the middle-sized hospitals. Specifically, an increase of best practice hospitals has been noted, especially in the middle and small-sized hospitals, when certain units were added the technical efficiency reached over 80%. The consequences of the spending-cuts and the constant reforms appear to have a positive effect on hospitals' efficiency. Hippokratia 2012, 16, 4: 350-35
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DIFFERENTIAL SENSITIVITY OF MALE GERM CELLS TO MAINSTREAM AND SIDESTREAM TOBACCO SMOKE IN THE MOUSE
Get PDFCigarette smoking in men has been associated with increased chromosomal abnormalities in sperm and with increased risks for spontaneous abortions, birth defects and neonatal death. Little is known, however, about the reproductive consequences of paternal exposure to second-hand smoke. We used a mouse model to investigate the effects of paternal exposure to sidestream (SS) smoke, the main constituent of second-hand smoke, on the genetic integrity and function of sperm, and to determine whether male germ cells were equally sensitive to mainstream (MS) and SS smoke. A series of sperm DNA quality and reproductive endpoints were investigated after exposing male mice for two weeks to MS or SS smoke. Our results indicated that: (i) only SS smoke significantly affected sperm motility; (ii) only MS smoke induced DNA strand breaks in sperm; (iii) both MS and SS smoke increased sperm chromatin structure abnormalities; and (iv) MS smoke affected both fertilization and the rate of early embryonic development, while SS smoke affected fertilization only. These results show that MS and SS smoke have differential effects on the genetic integrity and function of sperm and provide further evidence that male exposure to second-hand smoke, as well as direct cigarette smoke, may diminish a couple's chance for a successful pregnancy and the birth of a healthy baby
Close encounters: Moving along bumps, breaks, and bubbles on expanded trinucleotide tracts
No full textExpansion of simple triplet repeats (TNR) underlies more than 30 severe degenerative diseases. There is a good understanding of the major pathways generating an expansion, and the associated polymerases that operate during gap filling synthesis at these "difficult to copy" sequences. However, the mechanism by which a TNR is repaired depends on the type of lesion, the structural features imposed by the lesion, the assembled replication/repair complex, and the polymerase that encounters it. The relationships among these parameters are exceptionally complex and how they direct pathway choice is poorly understood. In this review, we consider the properties of polymerases, and how encounters with GC-rich or abnormal structures might influence polymerase choice and the success of replication and repair. Insights over the last three years have highlighted new mechanisms that provide interesting choices to consider in protecting genome stability
A Double-Pronged Sword: XJB-5-131 Is a Suppressor of Somatic Instability and Toxicity in Huntington’s Disease
Get PDFDue to large increases in the elderly populations across the world, age-related diseases are expected to expand dramatically in the coming years. Among these, neurodegenerative diseases will be among the most devastating in terms of their emotional and economic impact on patients, their families, and associated subsidized health costs. There is no currently available cure or rescue for dying brain cells. Viable therapeutics for any of these disorders would be a breakthrough and provide relief for the large number of affected patients and their families. Neurodegeneration is accompanied by elevated oxidative damage and inflammation. While natural antioxidants have largely failed in clinical trials, preclinical phenotyping of the unnatural, mitochondrial targeted nitroxide, XJB-5-131, bodes well for further translational development in advanced animal models or in humans. Here we consider the usefulness of synthetic antioxidants for the treatment of Huntington’s disease. The mitochondrial targeting properties of XJB-5-131 have great promise. It is both an electron scavenger and an antioxidant, reducing both somatic expansion and toxicity simultaneously through the same redox mechanism. By quenching reactive oxygen species, XJB-5-131 breaks the cycle between the rise in oxidative damage during disease progression and the somatic growth of the CAG repeat which depends on oxidation
Close encounters: Moving along bumps, breaks, and bubbles on expanded trinucleotide tracts
No full textThe chicken or the egg: mitochondrial dysfunction as a cause or consequence of toxicity in Huntington’s disease
No full textMitochondrial dysfunction and ensuing oxidative damage is typically thought to be a primary cause of Huntington's disease, Alzheimer's disease, and Parkinson disease. There is little doubt that mitochondria (MT) become defective as neurons die, yet whether MT defects are the primary cause or a detrimental consequence of toxicity remains unanswered. Oxygen consumption rate (OCR) and glycolysis provide sensitive and informative measures of the functional status MT and the cells metabolic regulation, yet these measures differ depending on the sample source; species, tissue type, age at measurement, and whether MT are measured in purified form or in a cell. The effects of these various parameters are difficult to quantify and not fully understood, but clearly have an impact on interpreting the bioenergetics of MT or their failure in disease states. A major goal of the review is to discuss issues and coalesce detailed information into a reference table to help in assessing mitochondrial dysfunction as a cause or consequence of Huntington's disease
The chicken or the egg: mitochondrial dysfunction as a cause or consequence of toxicity in Huntington’s disease
No full textExploiting Caching, Proxy Re-encryption, Incentives, and Wi–Fi Direct for Authorized Content Distribution
No full textAbstractUbiquitous access to the Internet is becoming critical. Direct cellular network connectivity of mobile devices is not always possible or desirable, for various reasons. We design and discuss a scheme that can be used to distribute authorized content to devices through Wi-Fi Direct and discuss how to provide incentives to the devices connected to the Internet to securely relay traffic, taking into consideration their available energy and bandwidth
Striving towards efficiency in the Greek hospitals by reviewing case mix classifications
No full textIn order to verify the efficiency level of Greek public hospitals, this paper evaluates the most recent indicators. Relevant data were collected from the two following databases: (a) hospitals’ utilisation data generally and per clinical speciality [Ministry of Health, Athens, (Data based) 1995]; (b) Patients’ and hospitals’ characteristics per diagnosis [National Statistical Office, Athens, (Data based) 1993]. As explanatory variables, the study examines supply and demand factors following case mix classifications. Firstly, average length of stay (ALOS) and secondly, cost per case were regressed as dependent variables. The study highlights the extent of variability across hospitals for different groups of patients with the same condition. The results specify the most important factors that affect ALOS and cost pertaining to efficiency. Per speciality analysis shows occupancy, size-type of the hospital, beds and doctors per speciality, access and use of outpatient services, and surgical operations, etc. as the most significant factors. Per disease-diagnosis analysis shows age of over 65 years, gender, residence, marital status, surgical operation and insurance as the most important factors. General cost analysis in all National Health Systems (NHS) hospitals shows that economies of scale appear in: (a) district and/or specialised hospitals of 250-400 beds; (b) regional and/or teaching hospitals of over but near to 400 beds. Consequently, the author determines the ‘Greek’ Diagnostic Related Groups (DRGs), based on the cost per clinical speciality in the nine basic specialities and on the cost per diagnosis of the top 15 diagnoses. Further to the scientific results, such studies will enhance much necessary discussions oil the organisation of service delivery and financing, by following case mix classification. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved
A Double-Pronged Sword: XJB-5-131 Is a Suppressor of Somatic Instability and Toxicity in Huntington’s Disease
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