Zertifizierte multidisziplinäre Brustzentren: Ein Implementierungsprojekt der Deutschen Krebsgesellschaft und der Deutschen Gesellschaft für Senologie in Partnerschaft mit der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe

Wallwiener, D.; Brucker, S. Y.

doi:10.1055/s-0031-1271511

Cited by 2 publications

(1 citation statement)

References 4 publications

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“…It is important to note that in the case of breast cancer care it is not only the breast surgeon's ‘case load' which is relevant for the increase in quality and outcome but rather the ‘case load' of all specialized experts involved in the diagnosis and treatment of breast cancer patients [27]. Porter and Guth [28] describe the existing German healthcare providers - divided into functions, specialization, and sites - as a fragmented health providing system.…”

Section: Business Competition - the Driving Force For Improvement? Inmentioning

confidence: 99%

Economic Constraints - the Growing Challenge for Western Breast Cancer Centers

et al. 2013

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Breast cancer care in Western countries has reached a considerable level of quality and standardization, which has contributed to the decline in breast cancer mortality. Certified Breast Cancer Centers (BCC) represent an important element of this development. Related to changes in reimbursement and growing costs, BCC face economic constraints which ultimately could endanger the achievements of the past. Thus, BCC have to optimize their care strategies from an economic perspective, particularly by increasing efficiency but also by adapting their service portfolio. This could result in competitive advantages and additional revenue by increasing case numbers and extra charges to patients. Furthermore, an intensification of collaboration with the outpatient sector resulting in an integrated and managed ‘trans-sectoral' care approach which could allow to shift unprofitable procedures to the outpatient sector - in the sense of a win-win situation for both sectors and without loss of care quality - seems reasonable. Structured and specialized consulting approaches can further be a lever to fulfill economic requirements in order to avoid cuts in medical care quality for the sake of a balanced budget. In this review, economic constraints of BCC with a focus on the German healthcare system and potential approaches to ameliorate these financial burdens are being discussed.

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Section: Business Competition - the Driving Force For Improvement? Inmentioning

confidence: 99%

Economic Constraints - the Growing Challenge for Western Breast Cancer Centers

et al. 2013

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Biofilm-Defective Mutants of <i>Bacillus subtilis</i>

Chagneau

Saier²

2004

Microb Physiol

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Many bacteria can adopt organized, sessile, communal lifestyles. The gram-positive bacterium, Bacillus subtilis,forms biofilms on solid surfaces and at air-liquid interfaces, and biofilm development is dependent on environmental conditions. We demonstrate that biofilm formation by B. subtilis strain JH642 can be either activated or repressed by glucose, depending on the growth medium used, and that these glucose effects are at least in part mediated by the catabolite control protein, CcpA. Starting with a chromosomal Tn917-LTV3 insertional library, we isolated mutants that are defective for biofilm formation. The biofilm defects of these mutants were observable in both rich and minimal media, and both on polyvinylchloride abiotic surfaces and in borosilicate tubes. Two mutants were defective in flagellar synthesis. Chemotaxis was shown to be less important for biofilm formation than was flagellar-driven motility. Although motility is known to be required for biofilm formation in other bacteria, this had not previously been demonstrated for B. subtilis. In addition, our study suggests roles for glutamate synthase, GltAB, and an aminopeptidase, AmpS. The loss of these enzymes did not decrease growth or cellular motility but had dramatic effects on biofilm formation under all conditions assayed. The effect of the gltAB defect on biofilm formation could not be due to a decrease in poly-γ-glutamate synthesis since this polymer proved to be nonessential for robust biofilm formation. High exogenous concentrations of glutamate, aspartate, glutamine or proline did not override the glutamate synthase requirement. This is the first report showing that glutamate synthase and a cytoplasmic aminopeptidase play roles in bacterial biofilm formation. Possible mechanistic implications and potential roles of biofilm formation in other developmental processes are discussed.

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Zertifizierte multidisziplinäre Brustzentren: Ein Implementierungsprojekt der Deutschen Krebsgesellschaft und der Deutschen Gesellschaft für Senologie in Partnerschaft mit der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe

Cited by 2 publications

References 4 publications

Economic Constraints - the Growing Challenge for Western Breast Cancer Centers

Economic Constraints - the Growing Challenge for Western Breast Cancer Centers

Biofilm-Defective Mutants of <i>Bacillus subtilis</i>

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