Damage to the cell wall, cell membrane, and cytoplasmic components by HHP treatments was observed on scanning and transmission electron microscopy
images. The SDS-PAGE results showed that the protein bands differed between HHP-untreated and HHP-treated S. enterica, in that HHP decreased the protein content and caused partial protein degradation. Therefore, our results indicate that HHP can be used to inactivate S. enterica, via morphological changes in the internal and external cellular structures, as well as through membrane damage, cell wall rupture, and membrane protein degradation. (C) 2013 Published by Elsevier Ltd.”
“Aims.\n\nThis article provides insight into the potential
economic viability of nurse practitioner employment in Dutch general practices.\n\nBackground.\n\nGeneral practitioners face the challenging task of finding the most Linsitinib supplier efficient and effective mix of professionals in general practice to accommodate future care demands VE-821 in vitro within scarce health care budgets. To enable informed decision-making about skill mix issues, economic information is needed.\n\nDesign.\n\nDiscursive paper.\n\nMethod.\n\nA descriptive and explorative design was chosen to study the economic viability of nurse practitioner employment in general practice. The conditions under which the nurse practitioner is able to earn back his/her own cost of employment were identified. Preferences and expectations of general practitioners and health insurers about nurse practitioner reimbursement were made transparent.\n\nResults.\n\nAlthough general practitioners and health insurers acknowledge the importance of the nurse practitioner in accommodating primary care demands, they have polarised CH5183284 nmr views about reimbursement.
The employment of nurse practitioners is seldom economically viable in current practices. It requires a reallocation of (80% of) the general practitioner’s freed up time towards practice growth (12% number of patients).\n\nConclusion.\n\nThe economic viability of the nurse practitioner has proven difficult to achieve in every day health care practice. This study provided insight into the complex interaction of the (cost) parameters that result in economic viability and feeds a further discussion about the content of the nurse practitioner role in general practice based on optimal quality of care vs. efficiency.\n\nRelevance to clinical practice.\n\nEffective and efficient health care can only be provided if the actual care needs of a population provide the basis for deciding which mix of professionals is best equipped to deal with the changing and increasing demand of care. A macro-level intervention is needed to help a broad-scale introduction of the nurse practitioner in general practice.