International Journal of Integrated Care 

Abstract: Integrated care is a burgeoning field. As is often the case in new areas of inquiry and action, conceptual clarification is demanded. Without such attention, it would be difficult to advance theory and practice in this increasingly important professional arena. In the following discussion paper, the authors explore the intellectual territory of integrated care, and underscore the need for a patient-centric imperative and meaning. They also examine the practical applications and implications arising from their views. The intention is to stimulate fruitful dialogue and debate about what ‘integrated care’ could and should be.

Abstract: From an historical and sociological perspective, ‘integrated care’ has emerged as part of institutional efforts to break up professional fiefdoms, especially of subspecialists entrenched in hospitals, and to reorganise services around clinically integrated pathways and services for the patients. It was the more enlightened part of what I have called the ‘buyers’ revolt’, which occurred in the 1980s when those who had long paid the bills (insurers, governments, employers) became so fed up by the waste, excesses, and variability of services delivered under professional dominance that they started to take forceful action w1x. This book is a masterpiece of historical work and organisational analysis of that revolt at its centre, the San Francisco Bay area.

Abstract: Introduction: Primary care has a central role in integrating care within a health system. However, conceptual ambiguity regarding integrated care hampers a systematic understanding. This paper proposes a conceptual framework that combines the concepts of primary care and integrated care, in order to understand the complexity of integrated care. Methods: The search method involved a combination of electronic database searches, hand searches of reference lists (snowball method) and contacting researchers in the field. The process of synthesizing the literature was iterative, to relate the concepts of primary care and integrated care. First, we identified the general principles of primary care and integrated care. Second, we connected the dimensions of integrated care and the principles of primary care. Finally, to improve content validity we held several meetings with researchers in the field to develop and refine our conceptual framework. Results: The conceptual framework combines the functions of primary care with the dimensions of integrated care. Person-focused and population-based care serve as guiding principles for achieving integration across the care continuum. Integration plays complementary roles on the micro (clinical integration), meso (professional and organisational integration) and macro (system integration) level. Functional and normative integration ensure connectivity between the levels. Discussion: The presented conceptual framework is a first step to achieve a better understanding of the inter-relationships among the dimensions of integrated care from a primary care perspective.

Abstract: Since L-dopa (L-3,4-dihydroxyphenylalanine) has been shown to possess a selective toxicity for melanoma cells both in vitro and in vivo, we have examined the combined effect of L-dopa and radiation on human melanoma cells. It was found that the combined use of L-dopa potentiated the radiation cytotoxicity to HMV-I human melanoma cells, compared with the response seen in non-melanoma HeLa S3 cells. In HMV-I cells during their exponential phase, L-dopa decreased the shoulder width of the radiation survival curve significantly. In addition, L-dopa significantly inhibited the repair of potentially lethal damage (PLD) in HMV-I cells during their plateau phase. When the distributions of the G,, S, and G2-M cells were measured 24 h after combined L-dopa and radiation treatment, there was significant increase in the accumulation of cells in the G2-M phase of the cell cycle, compared to cells that received either L-dopa or radiation treatment only.

Abstract: The WHO European Office for Integrated Health Care Services in Barcelona is an integral part of the World Health Organizations' Regional Office for Europe. The main purpose of the Barcelona office is within the integration of services to encourage and facilitate changes in health care services in order to promote health and improve management and patient satisfaction by working for quality, accessibility, cost-effectiveness and participation. This position paper outlines the need for Integrated Care from a European perspective, provides a theoretical framework for the meaning of Integrated Care and its strategies and summarizes the programmes of the office that will support countries in the WHO European Region to improve health services.