Depression and Schizophrenia

Depression and schizophrenia dragged down psychiatry's scientific status in the twenty-first century due to psychiatry’s inability to get beyond these two big diseases. Depression and schizophrenia formed the backbone of psychiatry since therapeutics are divided mainly into “antidepressants” and “antischizophrenics.” All forms of depression were accompanied by anxiety, and most forms of anxiety, except the psychotic variety, were accompanied by depression. The problem of psychopharmacology today was caused by the invention of new diagnoses that soon became profit centers for the pharmaceutical industry. The great river of diagnosis that flowed from nineteenth-century German psychiatry dominated the global picture of diagnosis and was considered heavily biological because it saw mental illness as brain disease.

Cocoa (Theobroma cacao L.) harvest and postharvest in Tabasco, Mexico

Objective: To characterize the harvest and postharvest of the cocoa managementsystem at La Chontalpa, Tabasco, Mexico.Design / methodology / approach: The study took place in the towns ofFrancisco Trujillo Gurría and Ernesto Aguirre Colorado de Huimanguillo, Tabasco,Mexico. The study was descriptive and accounted for 51 producers and thoseresponsible for the cocoa profit centers. Producers were chosen through targetedsampling. A survey on their harvest and postharvest was applied, in addition todirect assessment in plantations and profit centers.Results: The cocoa harvesting is manual. The producers cut the ripe and almostripe fruits, do not store and 58.8% of them do not break the fruit. With a “machete”cut the fruit in half and manually extract the grains. The fresh grains are sold at aprofit. The cocoa is then fermented in wooden boxes, dried artificially, natural, or ina combined way, and packed in “yute” bags for sale. Profit centers do not keeptrack of their grain origin and make no selection or determine product quality. Study limitations / implications: All producers harvest in the same way, but theprocesses during post-harvest could differ at different collection centers.Findings / conclusions: The harvest of cocoa fruits at different maturity and thelack of storage causes a heterogeneous fermentation. The humidity level duringthe drying process is empirically determined.

Patients' perceptions of quality in Swedish primary care – a study of differences between private and public ownership

PurposeThe purpose of the paper is to describe and analyze differences in patients' quality perceptions of private and public primary care centers in Sweden.Design/methodology/approachThe article explores the differences in quality perceptions between patients of public and private primary care centers based on data from a large patient survey in Sweden. The survey covers seven dimensions, and in this paper the measure Overall impression was used for the comparison. With more than 80,000 valid responses, the survey covers all primary care centers in Sweden which allowed for a detailed analysis of differences in quality perceptions among patients from the different categories of owners.FindingsThe article contributes with a detailed description of different types of private owners: not-for-profit and for profit, as well as corporate groups and independent care centers. The results show a higher quality perception for independent centers compared to both public and corporate groups.Research limitations/implicationsThe small number of not-for-profit centers (21 out of 1,117 centers) does not allow for clear conclusions for this group. The results, however, indicate an even higher patient quality perception for not-for-profit centers. The study focus on describing differences in quality perceptions between the owner categories. Future research can contribute with explanations to why independent care centers receive higher patient satisfaction.Social implicationsThe results from the study have policy implications both in a Swedish as well as international perspective. The differentiation between different types of private owners made in this paper opens up for interesting discussions on privatization of healthcare and how it affects patient satisfaction.Originality/valueThe main contribution of the paper is the detailed comparison of different categories of private owners and the public owners.

Methods in Green Computing to Protect Environment

The introduction of semi conductors changed the world which made our electronic devices and personal computers simple and complex this impact made many companies to introduce lot of computer organized devices which are available to commoners and every individual due to this within a years the usage of these items increased that means the material demand increased in a fast forward the pollutants from it also increased which is harming environment. So, in order to save environment green computing must be followed this topic is very important as how recycling, non-biodegradable components, eco friendly products, hazardous CFCs all comes under this including energy saving, efficiency providing things, sustainable resources. This presentation gives a general overview on the current state of opportunities which are seeing it as a way to create new profit centers while trying to help the environment cause and several formations that we can explore in it in coming future. The new electronic products and services with optimum efficiency and all possible options towards energy saving.

Association of for-profit hospital ownership status with intracranial hemorrhage outcomes and cost of care

OBJECTIVEMuch of the current discourse surrounding healthcare reform in the United States revolves around the role of the profit motive in medical care. However, there currently exists a paucity of literature evaluating the effect of for-profit hospital ownership status on neurological and neurosurgical care. The purpose of this study was to compare inpatient mortality, operation rates, length of stay, and hospital charges between private nonprofit and for-profit hospitals in the treatment of intracranial hemorrhage.METHODSThis retrospective cohort study utilized data from the National Inpatient Sample (NIS) database. Primary outcomes, including all-cause inpatient mortality, operative status, patient disposition, hospital length of stay, total hospital charges, and per-day hospital charges, were assessed for patients discharged with a primary diagnosis of intracranial (epidural, subdural, subarachnoid, or intraparenchymal) hemorrhage, while controlling for baseline demographics, comorbidities, and interhospital differences via propensity score matching. Subgroup analyses by hemorrhage type were then performed, using the same methodology.RESULTSOf 155,977 unique hospital discharges included in this study, 133,518 originated from private nonprofit hospitals while the remaining 22,459 were from for-profit hospitals. After propensity score matching, mortality rates were higher in for-profit centers, at 14.50%, compared with 13.31% at nonprofit hospitals (RR 1.09, 95% CI 1.00–1.18; p = 0.040). Surgical operation rates were also similar (25.38% vs 24.42%; RR 0.96, 95% CI 0.91–1.02; p = 0.181). Of note, nonprofit hospitals appeared to be more intensive, with intracranial pressure monitor placement occurring in 2.13% of patients compared with 1.47% in for-profit centers (RR 0.69, 95% CI 0.54–0.88; p < 0.001). Discharge disposition was also similar, except for higher rates of absconding at for-profit hospitals (RR 1.59, 95% CI 1.12–2.27; p = 0.018). Length of stay was greater among for-profit hospitals (mean ± SD: 7.46 ± 11.91 vs 6.50 ± 8.74 days, p < 0.001), as were total hospital charges ($141,141.40 ± $218,364.40 vs $84,863.54 ± $136,874.71 [USD], p < 0.001). These findings remained similar even after segregating patients by subgroup analysis by hemorrhage type.CONCLUSIONSFor-profit hospitals are associated with higher inpatient mortality, lengths of stay, and hospital charges compared with their nonprofit counterparts.

Improving the Strategic Sustainability Management of large, Medium, and Small Businesses in the Depressed Regions of Russia

This study1 presents a methodology for assessing the strategic sustainability of enterprises in Russian regions at the micro level as a part of assessing the strategic sustainability of the complex of enterprises in a region. The authors suggest directions for fostering the economy of the depressed regions ofRussiaby improving the management of strategic sustainability of the complex of large, medium, and small enterprises in a region. The recommendations developed for federal and regional authorities on how to improve the management of the complex of enterprises in the regions are based on the hypothesis proved in the study about the dependence of economic development indicators of a region on the strategic sustainability of the complex of enterprises operating in its territory.Aim. The study aims to suggest directions for improving the management of the strategic sustainability of large, medium, and small enterprises in the depressed regions of Russia based on the formation of regional profit centers.Tasks. The authors identify the peculiarities in the development of large enterprises in the depressed regions of Russia by calculating an integrated index of economic and financial sustainability of enterprises; conduct a comparative analysis of the activities of large enterprises in depressed and developed regions to prove the hypothesis about the dependence of the economic and financial sustainability of large enterprises on the region’s level of socio-economic development; develop recommendations for federal and regional authorities on how to improve the management of the complex of large, medium, and small enterprises, including a proposal on the formation of regional profit centers.Methods. The theoretical and methodological basis of this study includes theories and concepts on the role of enterprises and entrepreneurship in the economic development of a region. The study uses general scientific methods: analysis and synthesis, comparative and statistical analysis, systematization, calculation of an integrated index, financial ratio analysis.Results. The economic and financial indicators of large businesses in depressed regions are comparable to those of large businesses in developed regions (including the development indicators of the largest enterprises included in the Expert 600 rating), with some indicators showing values that are even higher than in developed regions. This confirms the hypothesis that the level of socio-economic development of a region does not have a dominant effect on the sustainability of development of large enterprises. The level of development of regional economies depends on the regional business structure. The revealed patterns make it possible to propose directions for improving the management of strategic sustainability of enterprises in depressed regions to federal and regional authorities.Conclusions. The improvement of development management in depressed regions should be aimed at developing government support tools that facilitate the development of the complex of enterprises in the regions. It is necessary to integrate the sustainability management of the complex of enterprises in a region into the strategic management system at the federal and regional levels. Along with the implementation of national projects aimed at developing small businesses, increasing labor productivity, supporting innovation and development institutions, in depressed regions it is also necessary to implement projects aimed at developing large businesses and integrating them with medium and small enterprises based on cooperation roadmaps. A new approach to the development of depressed regions based on the formation of regional profit centers would facilitate the formation of the sustainability of the complex of enterprises in depressed regions, allowing rational use of national project funds. This study is a continuation of the article “Approaches to assessing the strategic sustainability of large, medium, and small businesses in the depressed regions of Russia” published in Ekonomika i upravlenie No. 10, 2019.

Does Hospital For-Profit Status Affect Intracranial Hemorrhage Outcomes and Cost of Care?

INTRODUCTION Health care spending in the United States continues to draw national attention, accounting for 17.9 percent of total gross domestic product (GDP) or $3.5 trillion dollars in 2017, expected to rise to nearly 20 percent of GDP by 2026. In order to address these expenditures, further examination of rising hospital costs is required. Evidence suggests that for-profit hospitals may be established in areas with well-insured patient populations, while disproportionately offering high-cost, profit-driven interventions over less profitable services. The objective of this study is to compare inpatient mortality, operation rates, length of stay (LOS), and cost of care between private non-profit and for-profit hospitals in the treatment of intracranial hemorrhage. METHODS This retrospective cohort study used data from the National Inpatient Sample (NIS) database. Primary outcomes including all-cause inpatient mortality, operative status, patient disposition, hospital LOS, total hospital charges, and per-day hospital charges were assessed for patients discharged with a primary diagnosis of intracranial (epidural, subdural, subarachnoid, or intraparenchymal) hemorrhage, while controlling for baseline demographic and comorbidity differences via propensity-score matching. RESULTS Out of 155 977 unique hospital discharges included in this study, 133 518 originated from private non-profit hospitals and 22 459 from for-profit hospitals. Mortality rates were similar, at 13.80% for non-profit centers and 14.50% at for-profit hospitals. Non-profit hospitals appeared to be more intensive with ICP monitor placement, occurring in 5.50% of patients compared to 4.24% in for-profit centers. Although overall discharge disposition and rate of surgical intervention was similar, LOS was greater among for-profit hospitals at 7.46 d, compared to 6.71 d at non-profit centers. Care at for-profit hospitals was more expensive with total charges amounting to $136,845 versus $85,093 at non-profit institutions. CONCLUSION Despite similar mortality and discharge disposition, hospital stays for ICH tend to be costlier and longer at for-profit hospitals compared to their non-profit counterparts.