Front-office/back-office configurations and operational performance in complex health services

Background: Acquired brain injury (ABI) occurs from various causes at different ages and leads to many different types of healthcare needs. Several Dutch ABI-networks installed a local co-ordination and contact point (CCP) which functions as a central and easily accessible service for people to consult when they have questions related to ABI. Goals: To explore the relationship between front/back office design and operational performance by investigating the particular enquiry service provided by different CCPs for people affected by an ABI. Methods: In-depth interviews with 14 FO/BO employees from three case organizations, complemented with information from desk research and three one-day field visits. Results: The CCPs applied different FO/BO configurations in terms of customer contact and in terms of grouping of front and/or back office activities into tasks for one employee. Discussion: It is the complexity of the enquiry that determines which approach is more appropriate. For complex enquiries, the level of decoupling is high in all CCPs. This allows multiple experts to be involved in the process. For regular enquiries, CCPs have a choice: either working in the same way as in the complex enquiries or coupling FO/BO activities to be able to serve clients faster and without handovers

A comparison of an enzyme-linked immunosorbent assay and counter current electrophoresis for the detection of bovine serum albumin in virus vaccines.

A monoclonal antibody directed against bovine serum albumin (BSA) has been developed and used in an enzyme-linked immunosorbent assay (ELISA) system for the detection of BSA in virus vaccines. The results correlated well with those obtained with a counter current electrophoresis system which has been employed routinely for this purpose. The ELISA was slightly more sensitive and more readily applicable to the screening of large numbers of samples but could not be used in the presence of certain stabilizers

Using Plant Functional Attributes to Quantify Site Productivity and Growth Patterns in Mixed Forests

Forest growth models are one of several important prerequisites for sustainable management. The complexity of tropical moist forest means that there is often little objective information to classify sites and species for growth modelling and yield prediction. Classification based on observable morphological characteristics may be a useful surrogate for, or supplement to other alternatives. This study investigated the utility of plant functional attributes (PFAs) for site and species classification. PFAs describe a plant in terms of its photosynthetic and vascular support system, and the sum of individual PFAs for all species on a plot provides an efficient summary of vegetation features at the site. Preliminary observations suggested that the PFA summary may also indicate site productivity, and that specific PFAs may be used to group species for modelling growth and yield. Data from 17 permanent plots in the tropical rainforests of North Queensland were used to test these preliminary observations. Standard PFA proformas were completed for each plot in January 1995, and the relationships between the PFAs, site productivity and specific growth patterns were examined using discriminant analysis, linear regression and standard statistical tests. Results indicate that mean leaf size, and the incidence of species with vertical leaf inclination (>30° above horizontal) are significantly correlated with site productivity. Of the PFAs assessed, five elements appear to offer a useful basis for grouping species for modelling: leaf size and inclination, a furcation index (i.e., relative height to first fork or break in the main stem), and the presence of lenticels and chlorophyllous tissue on the main stem. The restricted nature of our database limits comment on the general utility of the method, but results suggest that further work on PFAs is warranted

Dose-dependent effects of intravenous lorazepam on cardiovascular activity, plasma catecholamines and psychological function during rest and mental stress

Dose-dependent effects of intravenously administered lorazepam on psychophysiological activity during rest and mental stress were studied in order to examine differential responses to doses which may induce anxiolysis or sedation. In a double-blind randomized cross-over study, nine male volunteers participated in a placebo and a lorazepam session, during which the subjects repeatedly performed a 10-min version of the Stroop Color Word Test (CWT), with 10 min of rest between the CWTs. Lorazepam was administered before each rest period in increasing doses of 0.0, 0.06, 0.13, 0.25 and 0.5 mg (total cumulative dose: 0.94 mg). Heart rate showed a dose-dependent decrease during rest with an ED50 of 0.13 mg lorazepam, while lorazepam had no effect on the cardiovascular and plasma catecholamine response magnitudes to the CWT. Subjective fatigue and reaction time increased significantly after 0.94 mg lorazepam, while at the same dose vigor decreased; state anxiety after the CWT was not influenced by lorazepam. These data show differential effects of lorazepam on cardiovascular, biochemical and psychological function. While heart rate was suppressed at low doses during rest and reaction time and subjective fatigue increased at doses which induced sedation, state anxiety and physiological response patterns to the CWT were not influenced by lorazepam