“Most US Hospitals are Run by Non-Physician Managers” plus 1 more nursing article(s): NursingCrib.com Updates

Most US Hospitals are Run by Non-Physician Managers

Posted: 11 Jul 2011 12:05 AM PDT

The conventional thought is that doctors should manage hospitals and business managers are suited for enterprise. But according to the 2009 study in the Journal Academic Medicine, surprisingly out of 6,500 hospitals in the US, only 235 are led by physicians.

In a recent research by Dr. Amanda Goodall, a senior researcher at the Institute for the Study of Labor in Bonn, Germany about hospital performance and ranking, she found out that physicians leaders can result to improved hospital performance and patient care. The overall hospital quality scores were about 25 percent higher when doctors ran the hospital, compared with other hospitals. For cancer care, doctor-run hospitals posted scores 33 percent higher.

The study doesn't offer any evidence as to why doctor-run hospitals appear to post better results, but Dr. Goodall said it may be because doctors truly understand "the core business of health."
"Hence, they are more likely to better understand the conditions under which their fellow core workers — doctors and nurses — will function best,'' she wrote in an e-mail. "If a leader creates optimal working conditions for the core workers, then that is likely to create a more efficient organization."

Photo Credits: news.eastvillagers.org

Neurotransmitters and How They Work

Posted: 10 Jul 2011 08:18 PM PDT

Definition

Nerve cells arranged in networks communicate information with one another through neurotransmission which is the conduction of electrical messages from neuron to neuron. The electrochemical messages cross the synapses between neural cells by way of special chemical messengers called neurotransmitters. Neurotransmitters are chemicals found and produced in the brain to allow the transmission of impulses from one nerve cell to the next across synapses. They aid in the conduction of information throughout the body. These chemicals fit into specific receptor cells embedded in the membrane of the dendrite that either fuel up or excite action in the cells (excitatory) or stop or inhibit an action (inhibitory). Presence or absence of these neurotransmitters can directly or indirectly have an effect on neurons in a specific portion of the brain. Thus, the levels of these chemicals in the brain have an effect to a person's behavior.

Mechanism of Nerve Impulse

Nerve cell conduction or communication is an extremely rapid process which involves the following:

The impulse moves through the nerve in a long and slender cellular part called the axon.
As the impulse travels through the axon it travels the presynaptic membrane. It is in this area that neurotransmitters are released in the free space called the synaptic cleft.
The receptors located in the postsynaptic membrane of another nearby neuron pick up the free flowing neurotransmitters.
The molecule is adapted in the next nerve cell and the impulse continues to the next nerve cell until the message is relayed throughout the body.

What happens after neurotransmitters sent the information?

After they served their purpose of being released into the synapse and relaying the messages to the receptor cells, they are transported back from the synapse to the axon to be stored for later use which is a process called reuptake. If the neurotransmitters will not undergo reuptake, they will be metabolized and inactivated by enzymes, primarily monoamine oxidase.

Major Neurotransmitters

Acetylcholine

This is the first neurotransmitter discovered which is found in the brain, spinal cord and particularly at the neuromuscular junction of the skeletal muscle of the peripheral nervous system. The mechanism of action of acetylcholine could either be excitatory or inhibitory. Acetylcholine is synthesized from dietary choline found in red meat and vegetables. Research and studies have linked the incidence of Alzheimer's disease with decreased acetylcholine secretion in the neurons.

Physiologic Effects and Functions:

Muscular stimulation – acetylcholine signals muscles to become active including the muscles of the gastrointestinal system.
Controls the sleep and wakefulness cycle of a person. It has a part in scheduling the rapid eye movement (REM) sleep or dream.