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Plants have been used throughout history for their medicinal properties. This use has often focused on human health but plants have also been, and still are, applied in ethnoveterinary practice and animal healthmanagement. In recent times, the use of synthetic chemicals has become prevalent. Public awareness of the potential environmental and health risks associated with heavy chemical use has also increased. This has put pressure on regulatory bodies to reduce the use of chemicals in agriculture. The most striking example is the 2006 banning of antibiotics in animal feed by the European Union. Moves such as this have increased the drive to find alternatives to synthetic chemicals and research has again turned to the use of plant bioactives as a means of improving animal health. Current scientific evidence suggests there is significant potential to use plants to enhance animal health in general and that of ruminants (cattle, deer, sheep, etc.) in particular. Active areas of research for plant bioactives (particularly saponin and tannin containing plants) include reproductive efficiency, milk and meat quality improvement, foam production/bloat control and methane production. Nematode control is also a significant area of research and the evidence suggests a much broader range of phytochemicals may be effective. This review presents a summary of the literature and examines international research efforts towards the development of plant bioactives for animal health. PMID:17919666
Rochfort, Simone; Parker, Anthony J; Dunshea, Frank R
Management and care of the nondomestic ruminant neonate are similar in principle to domestic animal practice. Housing of the dam, conditions for birth, preparation for intervention, and plans for treatment and hand-rearing of sick neonates must all be considered carefully before undertaking nondomestic ruminant breeding. Unfortunately, neonatal losses tend to be much higher in nondomestic calves before weaning than in domestic cattle, sheep, and goat herds.1 With continued habitat and population declines in wild species, successful captive breeding of nondomestic herds becomes more important to species sustainability and potential reintroduction programs. The primary challenges contributing to neonatal losses in nondomestic ruminants are often animal temperament and adaptation to captivity. Only through experience can some of these challenges be overcome. However, by understanding some species-specific behavioral tendencies and the fractious nature of nondomestic ruminants in general, we can improve our success in managing and maintaining healthy populations of nondomestic ruminants in captivity. PMID:22640541
Opinion statement \\u000a \\u000a \\u000a \\u000a \\u000a – \\u000a \\u000a Rumination is an unusual gastrointestinal symptom that is characterized by the repetitive regurgitation of gastric contents\\u000a into the oropharynx. The regurgitation occurs very soon after a meal and tends to persist for 1 to 2 hours. Rumination is\\u000a defined by the setting in which it occurs. It is seen in three distinct populations: infants; individuals with psychiatric
The use of anthelmintics is strongly limited in organic farming. This may induce a change in the intensity (no of worms) and diversity (proportions of species) of helminth infection. Helminths remain a major preoccupation in organic sheep farming: high levels of infection have been recorded on several farms and helminth diversity is always higher. The helminth infection in milk cattle of northern Europe is controlled and diversity is higher in organic farms, as recorded in sheep. The role of helminth diversity on intensity is still unclear. Grazing management is one of the means to controlling helminths. The use of safe pastures for calves and sheep after weaning is one of the major components of control. The use of alternate or mixed grazing is common for cattle in northern countries but is uncommon for sheep in France. Grazing management is not sufficient to controlling infection in sheep and conventional anthelmintic treatments are performed. Additionally, alternative treatments are used. The alternative therapies based on phytotherapy or homeopathy are largely recommended in organic farming but do not have any demonstrated efficacy. More research is needed to evaluate such therapies. PMID:12387494
Cabaret, Jacques; Bouilhol, Michel; Mage, Christian
New small ruminant producers in Appalachia have many questions about forage management. Forage management decisions need to be keyed to the specific needs of the small ruminant t species to be grazed. Sheep and goats are different from each other and both are very different from cattle. Important...
Recent work (Muscato, T.V., L.O. Tedeschi, and Russell, J.B. 2002. The effect of ruminal fluid preparations on the growth and health of new-born dairy calves. Journal Dairy Science. In press.) showed that ruminal fluid (RF) supplements (8 ml per d) decreased (P <0.05) the incidence of scours in dair...
Fatty acids of trans configuration in our food come from two different sources – industrially produced partially hydrogenated fat (IP-TFA) used in frying oils, margarines, spreads, and in bakery products, and ruminant fat in dairy and meat products (RP-TFA). The first source may contain up to 60% of the fatty acids in trans form compared to the content in ruminant fat which generally does not exceed 6%. In Western Europe, including Scandinavia, the average daily intake of IP-TFA has decreased during the recent decade due to societal pressure and a legislative ban, whereas the intake of RP-TFA has remained stable. In spite of this decrease we have found that in many countries consumption >20 g of IP-TFA in a one-meal menu consisting of some popular foods is possible, even though the average intake of IP-TFA in these countries is low. Subgroups of the populations may therefore, on average, consume >5 g IP-TFA per day. This level of consumption is generally not possible for RP-TFA. A daily intake of 5 g TFA (primarily IP-TFA) is associated with a 29% increased risk of coronary heart disease. Such an association is not found for RP-TFA up to a daily intake of 4 g. The high amount of IP-TFA in popular foods, the evidence of a more harmful effect on health by IP-TFA than by RP-TFA, and the feasibility of eliminating IP-TFA from foods without side effects for the population, suggest that a selective elimination of IP-TFA from our food is a ‘low hanging fruit’ in the quest for a more healthy diet for subgroups of the population.
Microbial fermentation of carbohydrates in the hindgut of dairy cattle is responsible for 5 to 10% of total-tract carbohydrate digestion. When dietary, animal, or environmental factors contribute to abnormal, excessive flow of fermentable carbohydrates from the small intestine, hindgut acidosis can occur. Hindgut acidosis is characterized by increased rates of production of short-chain fatty acids including lactic acid, decreased digesta pH, and damage to gut epithelium as evidenced by the appearance of mucin casts in feces. Hindgut acidosis is more likely to occur in high-producing animals fed diets with relatively greater proportions of grains and lesser proportions of forage. In these animals, ruminal acidosis and poor selective retention of fermentable carbohydrates by the rumen will increase carbohydrate flow to the hindgut. In more severe situations, hindgut acidosis is characterized by an inflammatory response; the resulting breach of the barrier between animal and digesta may contribute to laminitis and other disorders. In a research setting, effects of increased hindgut fermentation have been evaluated using pulse-dose or continuous abomasal infusions of varying amounts of fermentable carbohydrates. Continuous small-dose abomasal infusions of 1 kg/d of pectin or fructans into lactating cows resulted in decreased diet digestibility and decreased milk fat percentage without affecting fecal pH or VFA concentrations. The decreased diet digestibility likely resulted from increased bulk in the digestive tract or from increased digesta passage rate, reducing exposure of the digesta to intestinal enzymes and epithelial absorptive surfaces. The same mechanism is proposed to explain the decreased milk fat percentage because only milk concentrations of long-chain fatty acids were decreased. Pulse-dose abomasal fructan infusions (1 g/kg of BW) into steers resulted in watery feces, decreased fecal pH, and increased fecal VFA concentrations, without causing an inflammatory response. Daily 12-h abomasal infusions of a large dose of starch (~4 kg/d) have also induced hindgut acidosis as indicated by decreased fecal pH and watery feces. On the farm, watery or foamy feces or presence of mucin casts in feces may indicate hindgut acidosis. In summary, hindgut acidosis occurs because of relatively high rates of large intestinal fermentation, likely due to digestive dysfunction in other parts of the gut. A better understanding of the relationship of this disorder to other animal health disorders is needed. PMID:21415422
|This document contains materials for a college course in healthmanagement developed for the State of Iowa. The course syllabus lists the course title, hours, number, description, prerequisites, learning activities, instructional units, required text, 13 references, evaluation criteria, course objectives, and course competencies. It is followed…
The role of large intestinal or hindgut fermentation in ruminant nutrition has received little research attention in recent decades. Though the contribution of the hindgut to total tract nutrient digestion is substantially less than the contribution from the rumen, hindgut fermentation impacts anima...
Colostrum feeding in small ruminants is crucial during the first hours after birth due to the lack of Ig transfer during pregnancy via the placenta. In addition the immature immune system of the neonate is slow to produce its own Ig during the first weeks of life. Colostrogenesis, i.e. the transfer of Ig from blood into mammary secretions, starts several
N. Castro; J. Capote; R. M. Bruckmaier; A. Argüello
The purpose of this study was to determine baseline knowledge and identify knowledge gaps of farmers on biosecurity, risk of transmission of transboundary diseases and large ruminanthealth and production in three provinces of northern Laos, Hua Phan (HP), Luang Prabang (LPB) and Xieng Khoung (XK). The survey was conducted in six villages that are project sites for an Australian Centre for International Agricultural Research (ACIAR) project, with two villages located in each of the three provinces. A census survey was conducted by interview with all 238 farmers participating in the ACIAR project, using a structured questionnaire. The interviews were conducted in Lao language and took 1-2 h per farmer. The answers were recorded in Lao and the survey data were translated into English and transcribed into Microsoft Excel, and a linear mixed model in the Genstat statistical analysis package was used to compare quantitative traits between the target provinces. The results showed that the prediction mean of farmer knowledge scores on parasitic disorders, infectious disease, reproduction and nutrition management were significantly different between the target provinces. The prediction mean of farmer knowledge scores on infectious disease questions ranged between 5.11 in HP to 8.54 in XK of 24 marks (P < 0.001). The prediction mean of total knowledge scores was 13.48 in LPB and 19.29 in XK of 42 marks (P < 0.001). The results indicate both the need for and scope required to attain improvements in farmer knowledge of large ruminanthealth and production. It was concluded that a participatory research and extension programme to address village-level biosecurity and reduce disease risks, plus enhance large ruminant production capabilities of smallholder producers, is a valid and potentially important strategy to address transboundary disease risk and rural poverty in northern Laos. PMID:21029399
Tissue nutrient supply may be synchronized with endogenous physiological rhythms to optimize animal and human health. Glucose tolerance and insulin sensitivity have endogenous rhythms that are not essentially dependent on food type and eating. Human glucose tolerance declines as day comes into night. Based on such evolutionary findings, large evening meals must be avoided to reduce risks of visceral adiposity, diabetes, hypertension and related cardiovascular complexities. Ruminants as extremely important food-producing livestock have evolved to ruminate mostly overnight when little grazing occurs, and when rumen reaches a larger volume and fermentation capacity. As such, eating time (e.g., evening vs. morning) will alter postprandial and diurnal patterns of food intake, rumen and peripheral metabolites production and supply, and milk and meat production efficiency. Most recent discoveries suggest that eating time modulates postprandial intake and metabolism patterns in non-grazing lactating cows. Eating rate and absolute intake can increase by evening vs. morning feeding in dairy cows. Evening feeding increased postprandial rumen volatile fatty acids (VFA) peak, and surges of blood insulin, lactate and beta-hydroxybutyrate, and induced a peripartal decline in blood glucose. As a result, milk fat and energy production were increased. While being unfavorable to human health, evening and night feeding have proved beneficial to ruminants. These findings establish a differential chronological basis for food intake and nutrient metabolism in man and food-producing animals. Eating time is a major external cue and a feasible life strategy that affects production and health physiology. PMID:23492863
Microbial fuel cell (MFC) systems employ the catalytic activity of microbes to produce electricity from the oxidation of organic, and in some cases inorganic, substrates. MFC systems have been primarily explored for their use in bioremediation and bioenergy applications; however, these systems also offer a unique strategy for the cultivation of synergistic microbial communities. It has been hypothesized that the mechanism(s) of microbial electron transfer that enable electricity production in MFCs may be a cooperative strategy within mixed microbial consortia that is associated with, or is an alternative to, interspecies hydrogen (H2) transfer. Microbial fermentation processes and methanogenesis in ruminant animals are highly dependent on the consumption and production of H2in the rumen. Given the crucial role that H2 plays in ruminant digestion, it is desirable to understand the microbial relationships that control H2 partial pressures within the rumen; MFCs may serve as unique tools for studying this complex ecological system. Further, MFC systems offer a novel approach to studying biofilms that form under different redox conditions and may be applied to achieve a greater understanding of how microbial biofilms impact animal health. Here, we present a brief summary of the efforts made towards understanding rumen microbial ecology, microbial biofilms related to animal health, and how MFCs may be further applied in ruminant research.
Osterstock, Jason B.; Pinchak, William E.; Ishii, Shun'ichi; Nelson, Karen E.
Small farm pastures, hayfields, and woodlots are very productive in terms of forage, animal and wood products. Inherent livestock production capability can be improved through better herbage and animal management. Woodlot management can increase economic return, species diversity, and farm aesthetic...
The Integrated Airplane HealthManagement (IAHM) program is a Navy research activity led by The Boeing Company with support from the University of Hawaii, Referentia Systems Incorporated, and Impact Technologies, LLC. The program focuses on interoperable multi-platform aircraft healthmanagement data handling and analysis methods applicable to military aircraft and commercial air transportation. A primary goal of the program is
Greg J. Clark; John L. Vian; Michael E. West; Vassilis L. Syrmos; William F. Randolph; William J. Hardman
The effect of condensed tannins (CT) on the nutritive value of temperate forages and on the health of grazing ruminant animals is reviewed. The CT bind with proteins and other entities mainly by hydrophobic and hydrogen bonding in a pH-reversible manner, which is influenced by the structure and molecular weights of both the CT and the proteins. These reactions can
Puberty is a gradual process, during which animal reproductive competence is attained with respect to physiology, morphology and behaviour. Onset of puberty in small ruminants differs between sexes, due to early sexual differentiation in the control of steroid feedback systems and, thus, GnRH secretion. A number of puberty determinants have been identified, which include genetic factors, as well as endogenous signals, such as energy balance and environmental cues, whose dynamic interplay is responsible for the timing of puberty onset. Puberty timing affects reproduction through age at first lambing, which impacts on subsequent reproductive life and productivity of small ruminants. Thus, a greater knowledge of the mechanisms underlying puberty process would lead to optimisation of commonly applied strategies for selection of replacement animals. In addition, understanding reproductive responses of animals to exteroceptive factors, such as photoperiod, nutrition and socio-sexual signals, will enable development and improvement of those management tools that that will fulfil the requirements of a 'clean, green and ethical' production. PMID:22326612
Valasi, I; Chadio, S; Fthenakis, G C; Amiridis, G S
This chapter gives an educational overview of: * The actual application of supply chain practice and disciplines required for service delivery improvement within the current health environment. * A rationale for the application of Supply Chain Management (SCM) approaches to the Health sector. * The tools and methods available for supply chain analysis and benchmarking. * Key supply chain success factors. PMID:20407173
High ambient temperatures, high direct and indirect solar radiation, and humidity are environmental stressing factors that impose strain on animals. This review concerns the heat stress–strain response of domestic ruminants from the viewpoint of animal welfare. Despite having well developed mechanisms of thermoregulation, ruminants do not maintain strict homeothermy under heat stress. There is unequivocal evidence that hyperthermia is deleterious
Ruminal fermentation is an exergonic process that converts feedstuffs into short chain volatile fatty acids (VFA), CO2, CH4, NH3, and heat. Some of the free energy is trapped as ATP and this energy is used to drive the growth of anaerobic ruminal microorganisms. The ruminant animals absorb VFA and...
Small ruminant producers in Appalachia have many questions about forage management. Forage management decisions need to be keyed to the specific needs of the small ruminant t species to be grazed. Sheep and goats are different from each other and both are very different from cattle. Important con...
Vehicle healthmanagement (VHM) for space system avionics can ensure system readiness for launch vehicles and space-based dormant vehicles. In a research to evaluate space system avionics VHM for its guidance, navigation, and control systems (GN&C), researchers examined fault tolerance, redundancy, and levels of built-in test coverage needed to meet system performance requirements. They also analyzed ground and on-orbit test
Kathleen Radke; Paul Bursch; Ron Frazzini; Jerry Wald; Don Brown
Hospitals and health-care facilities are among the most complex, costly, and challenging buildings to design, construct and manage. To become a health facilities manager of a hospital or other medical centre in the USA, one requires knowledge not only of how to manage people, but also of how to deal with government agencies and all kinds of regulations and inspections.
Purpose – The purpose of this paper is to reduce ambiguity in diverse approaches to health knowledge management by surfacing key issues, perspectives and philosophical assumptions. Design\\/methodology\\/approach – Knowledge management research in health is critically reviewed. Issues are grouped into research domains, and examined in the light of associated knowledge management perspectives, and philosophical assumptions. Findings – Systemic complexity in
Internal parasitism constitutes one of the greatest disease problems in grazing livestock worldwide. Control of these parasites is now becoming a serious concern, particularly in the small ruminant industries, due to the widespread and rapid development of resistance to chemotherapy. The broad-spectrum drugs (anthelmintics) used in the control of nematode parasites fall into just three classes viz. the benzimidazoles, imidothiazoles
... for at least 1 month to fit the definition of rumination disorder. People do not appear to be ... own, and the child will go back to eating normally without treatment. In other cases, treatment is necessary.
The absence of appropriate financial management competencies has impeded progress in advancing the field of public health finance. It also inhibits the ability to professionalize this sector of the workforce. Financial managers should play a critical role by providing information relevant to decision making. The lack of fundamental financial management knowledge and skills is a barrier to fulfilling this role. A national expert committee was convened to examine this issue. The committee reviewed standards related to financial and business management practices within public health and closely related areas. Alignments were made with national standards such as those established for government chief financial officers. On the basis of this analysis, a comprehensive set of public health financial management competencies was identified and examined further by a review panel. At a minimum, the competencies can be used to define job descriptions, assess job performance, identify critical gaps in financial analysis, create career paths, and design educational programs. PMID:19395980
The future of market-oriented health policy and practice lies in "managed consumerism," a blend of the patient-centric focus of consumer-driven health care and the provider-centric focus of managed competition. The optimal locus of incentives will vary among health services according to the nature of the illness, the clinical technology, and the extent of discretion in utilization. A competitive market will manifest a variety of comprehensive and limited benefit designs, broad and narrow contractual networks, and single-and multispecialty provider organizations. PMID:16284020
A three-year study was conducted to measure the effects of varying levels of dairy slurry application on mineral concentration of forages from three soils types. Slurry was applied to orchardgrass (Dactylis glomerata [L.] cv. Pennlate) growing in 60-cm diameter drainage lysimeters to measure the effect of four levels of slurry (urine and feces) N application (0, 168, 336, and 672 kg of N.ha-1.yr-1) on mineral (P, K, Ca, Mg) concentration of the forage on three soil types (Hagerstown, Hartleton, and Rayne). The results were then related to potential effects on performance and health of grazing ruminants. Forage P was not affected by slurry application (mean = 0.46% of DM). Forage grown on the Hartleton soil had the highest (P < 0.05) P concentration (0.6% of DM). Forage K increased (P < 0.05) with increased slurry (2.50, 2.85, 3.22, and 3.45% of DM, respectively), and was lowest (P < 0.05) for forage grown on the Rayne soil (2.69% of DM). Forage Ca decreased (P < 0.05) with increased slurry (0.59, 0.56, 0.50, and 0.49% of DM, respectively) and was not affected by soil type. Forage Mg also decreased (P < 0.05) with increased slurry (0.25, 0.24, 0.24, and 0.23% of DM, respectively), and was highest (P < 0.05) for the Hartleton soil (0.27% of DM). The variable results in mineral concentration associated with soil type may have, in part, been due to prior soil fertility. The P and Mg concentrations in all treatments were generally adequate for grazing ruminants. The K concentrations were high in relation to NRC recommendations for prepartum dairy cows, which might predispose them to milk fever. The Ca concentrations were inadequate for lactating dairy cows. Comprehensive forage testing and diet formulation based on individual farm situations is the best strategy to ensure proper mineral nutrition of grazing animals. PMID:12817509
|Models of comprehensive Performance Management systems include both employee development and evaluative components. The Organizational Behavior Management discipline focuses almost exclusively on the developmental component, while the Industrial and Organizational Psychology discipline is focused on use of performance appraisals. Performance…
The authors provide an overview of how different approaches to improving public sector management relate to so-called core or essential public health functions, such as disease surveillance, health education, monitoring and evaluation, workforce development, enforcement of public health laws and regulations, public health research, and health policy development. The authors summarize key themes in the public management literature and draw
Ruminal acidosis is a major diet-related health disorder of dairy cattle. Although the main focus of research on ruminal acidosis has been on the rumen, there is ample evidence that the disorder is not strictly centered in the rumen, and that it may involve other gastrointestinal compartments. To ...
The management of biohazard in health care settings entails multidisciplinarity, valuing the interactions among stakeholders (General Manager, Medical Director, health care workers, prevention and protection units, infection control panels, occupational physicians), with the aim of protecting health and safety of workers, third parties and the health care service. The management issue was tackled within SIMLII guidelines on biohazards, as well as by the SIMLII Section on Preventive Medicine for Health Care Workers, followed by editorial initiatives. This contribution focuses on afield example on the management of data stemming from accidents involving biohazards, highlighting the need of information technology enabling management of enormous amount of health data. This work underlines the primacy of individual risk assessment and management, while combining information on working techniques and procedures with modern health surveillance, on the basis of accredited literature and good medical, organizational and technical practices. PMID:23405633
Porru, S; Agresta, A; Cimaglia, C; De Carli, G; Piselli, P; Puro, V; Micheloni, G P
An inventory study into the ethno-veterinary medicine and traditional management practices and the extent of their adoption in the management of small ruminants by farmers in Edo State, Nigeria was carried out. Three hundred and fifty (350) small ruminant farmers randomly chosen from the seven (7) randomly selected local government areas in the state were used for the study. Data pertaining to farmers' background information, small ruminant acquisition and rearing as well as the ethno-veterinary medicines (EVMs) adopted were collected through a scheduled interview where structured questionnaires were administered. Data collected were used in the computation of ethno-veterinary medicine use indices (EVMUIs) and were subjected to simple statistical analysis. Results showed that 60.5% of the farmers interviewed were male while 39.4% were females and 56.9% of them were above 40 years old. About 60% of the farmers had between primary and secondary education, while 33.1% have no formal education and about 86% had little or no exposure to mass media. Thirty-seven (37) different EVMs/Traditional practices were identified. Based on their EVMUIs, 11 or 29.73% were highly used, 9 or 24.32% were moderately used while 17 or 45.95% were poorly used by farmers. Materials identified were noted to be locally available and were fully discussed. It is concluded that EVMs practices are actually adapted to the culture and socio-economic realities of resource poor farmers and means of spreading the knowledge among small scale farmers should be encouraged. PMID:19412741
Employers' past solutions to rising health benefit costs--adopting managed care strategies, cost shifting to employees and reducing benefits-are no longer effectively controlling costs and are depressing the value of health benefits for employee recruitment and retention. An alternative strategy is to implement healthmanagement approaches that improve the health status of employees. These programs reduce medical costs and have a documented positive impact on workers' compensation, disability costs, absenteeism and productivity. Further, this approach is complementary to health care consumerism as a strategy for health improvement and benefit cost reduction and results in improved employee health, outlook and satisfaction. PMID:16792389
Over the last decade, cost-containment pressures, health care reform debates, movement to case-managedhealth care, and reductions\\u000a in health care benefits have required most families to be responsible for selecting specific health care services that keep\\u000a costs to a minimum. As Eddy [17-20] discussed in a series of articles on making decisions in health care, the consensus among\\u000a health care
Carol E. Smith; Susan V. M. Kleinbeck; Karen Fernengel; Linda S. Mayer
An opinion article of health care programmes questioning the effects and benefits of their management. The AA, based on their experience in management/administration, present suggestions to identify, quantify and analyse a problem in health care. After characterising a health care problem, the AA point out the fundamental role of planning (in health care) and invited interdepartmental collaboration between the various levels of health care managers. The eventual mission of health care programmes is stressed, their structural conformity with the external environment (community) and internal environment (health care institutions), the resources affected, their process and the results to be achieved, as well as their co-ordination. The programme manager, with a specific profile and duties, is suggested as an important leadership factor. The conclusion advises health care strategists of the future importance of the programmes. PMID:7484250
Many small- and medium-sized physician practices have developed specific programs and models toward becoming a successful patient-centered medical home. This article reports on a case-control quality improvement study of a multilingual population healthmanagement program for chronic disease management at International Community Health Services. In its first 2.5 years of operation, the International Community Health Services Population HealthManagement program for patients with hypertension and diabetes is associated with significant improvements in key health outcome measures for blood pressure and hemoglobin A1c control. This has significant implications for similar practices. PMID:23448920
Tsui, Edison W; Wang, Grace; Zahler, Abbie; Simoyan, Olapeju M; White, Mark V; Mckee, Michael
The Master of Health Administration program at UNSW was extensively revised in 2006 to ensure that it effectively meets the challenging and dynamic environment of health service managers in local and global health contexts. This paper describes the innovative approach to the redesign of the healthmanagement program within the Faculty of Medicine. It outlines the method and considerations undertaken,
Lois D Meyer; Alan R Hodgkinson; Rosemary Knight; Maria Theresa Ho; Sophie K di Corpo; Sonal Bhalla
The community mental health team is now the established model for mental health service delivery in the community. Managing CMHTs requires a diverse range of managerial skills, role clarity and authority. More research needs to be undertaken on the role and effectiveness of the CMHT manager. PMID:10986955
Recently, operators of complex systems such as aircraft, power plants, and networks, have been emphasizing the need for online health monitoring for purposes of maximizing operational availability and safety. The discipline of prognostics and healthmanagement (PHM) is being formalized to address the information management and prediction requirements for addressing these needs. In this paper, we will explore how standards
John W. Sheppard; Mark A. Kaufman; Timothy J. Wilmering
Recently operators of complex systems such as aircraft, power plants, and networks have been emphasizing the need for on-line health monitoring for purposes of maximizing operational availability and safety. The discipline of prognostics and healthmanagement (PHM) is being formalized to address the information management and prediction requirements for addressing these needs. Herein, we will explore how standards currently under
Managed care has become one of the leading developments in health care financial management, but ignorance and confusion surround its meaning and origins. Managed care seeks to reduced costs and increase profits while maintaining quality, yet the evidence that it is able to achieve these aims is mixed. The following analysis is a review of the events leading to the establishment of managed care and what it has become. Various terms and health care organizations involved in managed care are identified, with emphasis placed on the strengths and weaknesses of managed care programs. This analysis is performed to gain insight and better understanding of the direction health care financial management is headed in the 21st century. PMID:18972972
Discusses strategies for managinghealth and safety within science departments. Emphasizes the importance of risk assessment for both pupil activities and those carried out by technicians. Stresses the role of training and the need for security. (MM)
Current peer review literature clearly documents the economic return and Return-on-Investment (ROI) for employee healthmanagement (EHM) programs. These EHM programs are defined as: health promotion, self-care, disease management, and case management programs. The evaluation literature for the sub-set of health promotion and disease management programs is examined in this article for specific evidence of the level of economic return in medical benefit cost reduction or avoidance. The article identifies the methodological challenges associated with determination of economic return for EHM programs and summarizes the findings from 23 articles that included 120 peer review study results. The article identifies the average ROI and percent health plan cost impact to be expected for both types of EHM programs, the expected time period for its occurrence, and caveats related to its measurement. PMID:19288852
Serxner, Seth; Gold, Daniel; Meraz, Angela; Gray, Ann
Objective: This investigation attempted to determine whether trait and state hostile rumination functioned as risk factors for the relation between acute alcohol intoxication and aggression. Method: Participants were 516 social drinkers (252 men and 264 women). Trait hostile rumination was assessed using Caprara's Dissipation—Rumination Scale. Following the consumption of either an alcohol or a placebo beverage, participants were tested on a laboratory task in which electric shocks were received from and administered to a fictitious opponent under the guise of a competitive reaction-time task. Aggression was operationalized as the combined mean responses for shock intensity and duration across all trials. In a subset of the sample (n = 320), state hostile rumination was assessed following the aggression task using a self-report measure. Results: As expected, both trait and state measures acted as moderators. Specifically, acute alcohol intoxication was more likely to increase aggression in persons with higher trait and state hostile rumination scores compared with their equally intoxicated lower rumination counterparts. Conclusions: This was the first investigation to demonstrate that trait or state rumination significantly heighten the risk of intoxicated aggression. We believe that hostile rumination facilitates intoxicated aggression because ruminators have difficulty diverting their attention away from anger-provoking stimuli and related thoughts, thus making violent reactions more likely. Clinical and public health interventions would benefit by developing strategies to distract ruminative attention away from violence-promoting messages, especially when persons are under the influence of alcohol.
Background This study uses scientometrics methodology to reveal the status quo and emerging issues of collaboration in healthmanagement. Methods We searched all the articles with the keyword “healthmanagement” in the period 1999–2011 in Web of Knowledge, then 3067 articles were found. Methods such as Social network analysis (SNA), co-authorship, co-word analysis were used in this study. Results Analysis of the past 13 years of research in the field of healthmanagement indicates that, whether the production of scientific research, or authors, institutions and scientific research collaboration at the national level, collaboration behavior has been growing steadily across all collaboration types. However, the international scientific research cooperation about healthmanagement study between countries needs to be further encouraged. 17 researchers can be seen as the academic leaders in this field. 37 research institutions play a vital role in the information dissemination and resources control in healthmanagement. The component analysis found that 22 research groups can be regarded as the backbone in this field. The 8 institution groups consisting of 33 institutions form the core of this field. USA, UK and Australia lie in the center by cohesive subgroup analysis; Based on keywords analysis, 44 keywords with high frequency such as care, disease, system and model were involved in the healthmanagement field. Conclusions This study demonstrates that although it is growing steadily, collaboration behavior about healthmanagement study needs to be enhanced, especially between different institutions or countries/regions, which would promote the progress and internationalization of healthmanagement. Besides, researchers should pay attention to the cooperation of representative scholars and institutions, as well as the hot areas of research, because their experience would help us promote the research development of our nation.
Most health care management training programmes and textbooks focus on only one or two models or conceptual frameworks, but the increasing complexity of health care organizations and their environments worldwide means that a broader perspective is needed. This paper reviews five management models developed for business organizations and analyses issues related to their application in health care. Three older, more 'traditional' models are first presented. These include the functional areas model, the tasks model and the roles model. Each is shown to provide a valuable perspective, but to have limitations if used in isolation. Two newer, more 'innovative' models are next discussed. These include total quality management (TQM) and reengineering. They have shown potential for enabling dramatic improvements in quality and cost, but have also been found to be more difficult to implement. A series of 'lessons learned' are presented to illustrate key success factors for applying them in health care organizations. In sum, each of the five models is shown to provide a useful perspective for health care management. Health care managers should gain experience and training with a broader set of business management models. PMID:12476639
Crisis management teams (CMT) are necessary to ensure adequate and appropriate crisis management planning and response to unforeseen, adverse events. This study investigated the existence of CMTs, the membership of CMTs, and the degree of training received by CMTs in Australian health and allied health organisations. This cross-sectional study draws on data provided by executive decision makers in a broad selection of health and allied health organisations. Crisis management teams were found in 44.2 per cent of the health-related organisations surveyed, which is ten per cent lower than the figure for business organisations. Membership of these CMTs was not ideal and did not conform to standard CMT membership profiles. Similarly, the extent of crisis management training in health-related organisations is 20 per cent lower than the figure for business organisations. If organisations do not become pro-active in their crisis management practices, the onus is on government to improve the situation through regulation and the provision of more physical, monetary and skill resources to ensure that the health services of Australia are sufficiently prepared to respond to adverse events. PMID:22576140
... were written or produced by Forest Service personnel and are in the public domain. ... Title: The Applegate Adaptive Management Area ecosystem health assessment ... Forest health through silviculture: proceedings of the 1995 National ... U.S. Government employees on official time, and is therefore in the public domain.
With the number of market-approved biotech drugs approved by the U.S. Food and Drug Administration expected to jump soon, health plans are scrambling to redesign benefit structures, manage utilization, and get a handle on the costs of these new therapies. Here’s how four health plans are addressing these issues.
The financial management of pharmacies and health systems is a combination of the traditional management of personnel and drug and supply costs with the management of the total costs of care. It includes determining the consequences of less than optimal drug therapy, improving drug therapy, and reengineering pharmacy departments and services across all patient care settings to deliver optimal pharmacotherapy. Prevention and reduction of adverse drug events, disease state management, and other methods to improve quality of care are of major importance. Future articles in this series on the financial management of pharmacy practice in health care systems will provide examples of applications of financial management in acute care, ambulatory care, long term care, and across sites of care. They also will include the justification of the development of new types of patient care services. PMID:10164163
We know very little about the development of rumination, the tendency to passively brood about negative feelings. Because rumination is a risk factor for many forms of psychopathology, especially depression, such knowledge could prove important for preventing negative mental health outcomes in youth. This study examined developmental origins of rumination in a longitudinal sample (N=337; 51% girls) studied in preschool
Lori M. Hilt; Jeffrey M. Armstrong; Marilyn J. Essex
We know very little about the development of rumination, the tendency to passively brood about negative feelings. Because rumination is a risk factor for many forms of psychopathology, especially depression, such knowledge could prove important for preventing negative mental health outcomes in youth. This study examined developmental origins of rumination in a longitudinal sample (N=337; 51% girls) studied in preschool
Lori M. Hilt; Jeffrey M. Armstrong; Marilyn J. Essex
Lameness and subacute ruminal acidosis (SARA) both appear to be very prevalent throughout the US dairy industry. Reduced ruminal efficiency, liver and lung abscesses, and laminitis are all thought to be re- lated to SARA. Both the nutritionist and dairy manag- ers are responsible for the delivery and consumption of a ration that is likely to produce a ruminally healthy
Diabetes affects 25.8 million persons in the United States, and these persons make more than 35 million ambulatory care visits annually. Yet, less than half of persons with diabetes meet the recommended levels of A1C, blood pressure and lipid control. One innovative approach is to use mobile health technologies to help patients better manage their diabetes and related conditions, and 85% to 90% of patients have access to mobile health technology. A brief review of the guidelines for diabetes care and mobile health technology that can support the guidelines are reported related to (1) glycemic control and self-monitoring of blood glucose, (2) pharmacological approaches and medication management, (3) medical nutrition therapy, (4) physical activity and resistance training, (5) weight loss, (6) diabetes self-management education and (7) blood pressure control and hypertension. The patient and provider are encouraged to explore possibilities for mobile health technologies that can support behavior change. PMID:23531961
Sieverdes, John C; Treiber, Frank; Jenkins, Carolyn
This article reviews quality of health care initiatives beginning with the quality assessment/quality assurance movement of the 1970s. Conceptually, modern quality of care management is rooted in the intellectual work of Avedis Donabedian who defined quality of care as a combination of structure, process, and outcome. Donabedian's model is presented and some limitations are pointed out. In the late 1980s and 1990s. the health care industry adopted total quality management (TQM). More recently, the pursuit of health care quality has led to substantial performance measurement initiatives such as ORYX by the Joint Commission on Accreditation of Healthcare Organizations and MEDIS by the National Commission of Quality Assurance. The importance of CONQUEST, a freely available performance measurement database developed at the Harvard School of Public Health, is noted and discussed. The article concludes with a list of challenges facing public and private parties interests in health care quality improvement. PMID:15188996
This book brings together the latest research on protein absorption by ruminants and takes a look at the calculation of optimum nutrient requirements, including bacterial digestion, in the calculations. It also describes the parameters of nitrogen conversion in the ruminant and examines the different kinds of protein found in animal feedstuffs.
The recent focus on collaborative relationships in health care means that people and groups must cooperate to accomplish clinical and management tasks. This increasing interdependence may also cause increased organizational conflict. The management of conflicts is critical to the effectiveness of an organization. Negotiating strategies, based on Fisher and Ury's method of "principled negotiation," include establishing superordinate goals, separating the people from the problem, focussing on interests, inventing options, using objective criteria and defining success in terms of gains.
Significance of effectively managing civil infrastructure systems (CIS) throughout CIS life-cycles, and especially during and after natural or man-made disasters is well recognized. Disaster mitigation includes preparedness for hazards to avoid casualties and human suffering, as well as to ensure that critical CIS components can become operational within a short amount of time following a disaster. It follows that mitigating risk due to disasters and CIS managementare intersecting and interacting societal concerns. A coordinated, multi-disciplinary approach that integrates field, theoretical and laboratory research is necessary for innovating both hazard mitigation and infrastructure management. Health monitoring (HM) of CIS is an emerging paradigm for effective management, including emergency response and recovery management. Challenges and opportunities in health monitoring enabled by recent advances in information technology are discussed in this paper. An example of HM research on an actual CIS test-bed is presented.
Aktan, A. Emin; Catbas, Fikret N.; Grimmelsman, Kirk A.; Pervizpour, Mesut; Curtis, Joshua M.; Shen, Kaizhen; Qin, Xiaoli
AH employers are ethically required to provide a safe and healthy workplace for their employees. Health and safety professionals (HSP) may of ten be employed either full-time or part-time to achieve this end. The HSP should be viewed as a non-partisan provider of safety and health services at the workplace. He is equally on the side of management and worker
This study compares community-based managed forests under different purposes of management, namely, state-driven “conservation” or community-designed utilization in two villages located in the Sopsai watershed, Nan Province, northern Thailand. The forest health under different intensity of uses is assessed in association with the collective behaviors and long-term purposes embedded in village social–cultural context. The study found no significant differences in
Nitaya Kijtewachakul; Ganesh P. Shivakoti; Edward L. Webb
Myths impede the effective management of health care, for example that the system is failing (indeed, that is a system), and can be fixed by detached social engineering and heroic leadership, or treating it more like a business. This field needs to reframe its management, as distributed beyond the "top"; its strategy as venturing, not planning; its organizing as collaboration beyond control, and especially itself, as a system beyond its parts. PMID:23342753
Quality management has become one of the most important and most debated topics within the service sector. This is especially true for health care, as the controversy rages on how the existing American system should be restructured. Health care reform aimed at reducing costs and ensuring access to all Americans cannot be allowed to jeopardize the quality of care. As such, total quality management (TQM) has become a vital ingredient to strategic planning within the health care domain. At the heart of any such quality improvement effort is the issue of measurement. TQM cannot be effectively utilized as a competitive weapon unless quality can be accurately defined, measured, evaluated, and monitored over time. Through such analysis a hospital can elect how to expend its limited resources toward those quality improvement projects which will impact customer perceptions of service quality the most. Thus, the purpose of this report is to establish a framework by which to approach the issue of quality measurement, delineate the various components of quality that exist in health care, and explore how these elements affect one another. We propose that the issue of quality measurement in health care be approached as an integration of service quality attributes common to other service organizations and technical quality attributes unique to health care. We hope that this research will serve as a first step toward the synthesis of the various quality attributes inherent in the health care domain and encourage other researchers to address the interactions of the various quality attributes. PMID:8763215
How to offer broad access to services while simultaneously containing costs? These potentially conflicting goals often collide painfully within the individual clinician. We teach an academic seminar, part of a managed mental health care fellowship organized within an HMO. As we describe the guiding principles and methods of this seminar as well as its curriculum and process, we demonstrate how
JAMES M. DONOVAN; SHARON M. STEINBERG; JAMES E. SABIN
OBJECTIVE: We wished to determine the impact of managedhealth care on resident education in obstetrics and gynecology. STUDY DESIGN: A multiquestion survey was mailed to program directors of the 267 obstetrics-gynecology resident training programs in the United States. The questions ascertained departmental philosophy regarding the role of obstetrician-gynecologists as primary care versus specialist physicians, the extent of involvement with
Ira M. Golditch; Ralph J. Anderson; Sterling B. Williams
This paper reviews the occurrence and properties of cyanobacterial toxins, with reference to the recognition and management of the human health risks which they may present. Mass populations of toxin-producing cyanobacteria in natural and controlled waterbodies include blooms and scums of planktonic species, and mats and biofilms of benthic species. Toxic cyanobacterial populations have been reported in freshwaters in over
Geoffrey A. Codd; Louise F. Morrison; James S. Metcalf
This paper describes methodologies and tools to anticipate in real-time, the onset of failures in electronic equipment. Currently developed techniques for prognostics and healthmanagement (PHM), depend on the observation of precursor variables and an imputation from them of impending failure. In electronic systems, such variables are difficult, impossible or expensive to obtain, so we propose a model-based technique utilizing
Chris Wilkinson; Dave Humphrey; Bert Vermeire; J. Houston
Prologue: The term risk contracting has become a familiar part of the vocabulary and the landscape of managed care. Risk contracting refers to an arrangement whereby the cost or claims risk for an insured population is borne by the entity that is desig- nated to bear risk: a prepaid plan or, as is increasingly the case for mental health care,
Richard G. Frank; Thomas G. McGuire; Joseph P. Newhouse
Subacute ruminal acidosis (SARA) is likely to arise when an easily palatable, high-energy diet meets a ruminal environment not adapted to this type of substrate. Increase of short-chained fatty acids (SCFA) will occur. Eventually, this may result in a transient nadir of ruminal pH below 5.5. Two situations are likely to represent the risk of SARA. First, fresh lactating cows are confronted with a diet considerably differing from that in the dry-period. A diet change carried out too rapidly or without proper transition management will put the animals at risk. Secondly, further in lactation, inaccurate calculation of dry-matter-intake (DMI) leading to wrong roughage/concentrate ratio, an inadequate content of structure within the diet or mistakes in preparing of total mixed rations may produce SARA. The consequences of SARA are diverse and complex. Laminitis is regularly connected to SARA and the negative impact of organic acids on the ruminal wall may lead to parakeratosis enabling translocation of pathogens into the bloodstream provoking inflammation and abscessation throughout the ruminant body. Moreover, milk-fat depression (MFD) can be related to SARA. In order to achieve a proper diagnosis, SARA has to be understood as a herd-management problem. A screening of the herd for SARA by means of a rumenocentesis, performed on a sample-group, preferably 12 individuals, may reveal the presence of SARA. The herd screening should include the risk group suspected, preferably. The prevention of SARA applies to the principles of ruminant feeding. Careful transition management from the dry to the lactation period and control of fibre-content and ration quality should be more yielding than the use of buffers or antibiotic drugs. PMID:14633219
Kleen, J L; Hooijer, G A; Rehage, J; Noordhuizen, J P T M
We describe design and prototyping efforts for a Personal HealthManagement Assistant for heart failure patients as part of Project HealthDesign. An assistant is more than simply an application. An assistant understands what its users need to do, interacts naturally with them, reacts to what they say and do, and is proactive in helping them manage their health. In this project, we focused on heart failure, which is not only a prevalent and economically significant disease, but also one that is very amenable to self-care. Working with patients, and building on our prior experience with conversational assistants, we designed and developed a prototype system that helps heart failure patients record objective and subjective observations using spoken natural language conversation. Our experience suggests that it is feasible to build such systems and that patients would use them. The system is designed to support rapid application to other self-care settings. PMID:20937478
Ferguson, G; Quinn, J; Horwitz, C; Swift, M; Allen, J; Galescu, L
The paper argues for a reconceptualization of ruminative coping with the death of a loved one as an avoidant rather than a\\u000a confrontational strategy. Ruminative coping has been characterized within the bereavement field as persistent, repetitive\\u000a and passive focus on negative emotions and symptoms. It has been theoretically described and empirically shown to be a maladaptive\\u000a process, being conceptually related
Margaret Stroebe; Paul A. Boelen; Marcel van den Hout; Wolfgang Stroebe; Elske Salemink; Jan van den Bout
Objectives: The research provides an overview of the health care management literature and the indexing coverage of core journal literature. Method: Citations from five source journals for the years 2002 through 2004 were studied using the protocols of the Mapping the Literature of Allied Health Project and Mapping the Literature of Nursing Project. The productivity of cited journals was analyzed by applying Bradford's Law of Scattering. Results: Journals were the most frequently cited format, followed by books. Only 3.2% of the cited journal titles from all 5 source journals generated two-thirds of the cited titles. When only the health care management practitioner–oriented source journals were considered, two-thirds of the output of cited journal titles came from 10.8% of the titles. Science Citation Index and PubMed provided the best overall coverage of the titles cited by all 5 source journals, while the cited titles from the 2 practitioner-oriented journals were covered most completely by Social Sciences Citation Index and Business Source Complete. Conclusions: Health care management is a multidisciplinary field. Librarians must consider the needs of their users and assist them by providing the necessary materials and combination of indexes to access this field adequately.
Taylor, Mary K.; Gebremichael, Meseret D.; Wagner, Catherine E.
The purpose of the study was to determine prevalent conflict management styles chosen by students in nursing and to contrast these styles with those chosen by students in allied health professions. The associations among the level of professional health care education and the style chosen were also determined. A convenience sample of 126 students in a comprehensive university completed the Thomas-Kilmann Conflict Mode Instrument (TKI), which requires respondents to choose behaviors most characteristic of their response to conflict and classifies these behaviors as one of five styles. There was no significant difference between the prevalent conflict management styles chosen by graduate and undergraduate nursing students and those in allied health. Some of the students were already licensed in their discipline; others had not yet taken a licensing exam. Licensure and educational level were not associated with choice of styles. Women and men had similar preferences. The prevalent style for nursing students was compromise, followed by avoidance. In contrast, avoidance, followed by compromise and accommodation, was the prevalent style for allied health students. When compared to the TKI norms, slightly more than one half of all participants chose two or more conflict management styles, commonly avoidance and accommodation at the 75th percentile or above. Only 9.8% of the participants chose collaboration at that level. Implications for nurse educators, researchers, and administrators are discussed. PMID:17540319
|Managed care organizations (MCOs) and school health programs share some common goals and some competing, conflicting priorities. Partnerships between the two are important for the effective coordination and delivery of comprehensive adolescent health services. This paper discusses adolescent clinical preventive services, school health services,…
Santelli, John; Vernon, Mary; Lowry, Richard; Osorio, Jenny; DuShaw, Martha; Lancaster, Mary Sue; Pham, Ngoc; Song, Elisa; Ginn, Elizabeth; Kolbe, Lloyd J.
Managed care organizations (MCOs) and school health programs share some common goals and some competing, conflicting priorities. Partnerships between the two are important for the effective coordination and delivery of comprehensive adolescent health services. This paper discusses adolescent clinical preventive services, school health services,…
Santelli, John; Vernon, Mary; Lowry, Richard; Osorio, Jenny; DuShaw, Martha; Lancaster, Mary Sue; Pham, Ngoc; Song, Elisa; Ginn, Elizabeth; Kolbe, Lloyd J.
Rangeland health assessment provides qualitative information on ecosystem attributes. Successional management is a conceptual framework that allows managers to link information gathered in rangeland health assessment to ecological processes that need to be repaired to allow vegetation to change in ...
Since 1999 quality care issues have become a primary concern for health care organisational management. During this year, the Institute of Medicine (IOM) released a report that indicated that 98,000 preventable deaths occur each year in the US. Additionally, the report revealed that the individual competence of the practitioner is not the primary source of blame. Rather, it was the
BACKGROUND: The Ministry of Health and Medical Education in the Islamic Republic of Iran has undertaken a reform of its health system, in which-lower level managers are given new roles and responsibilities in a decentralized system. To support these efforts, a United Kingdom-based university was contracted by the World Health Organization to design a series of courses for healthmanagers
Maye Omar; Nancy Gerein; Ehsanullah Tarin; Christopher Butcher; Stephen Pearson; Gholamreza Heidari
Healthmanagement is a philosophy that merges component and system level health monitoring, consisting of anomaly detection, diagnostic and prognostic technologies, with the operations and maintenance arenas. The concepts of healthmanagement, in particular health monitoring system design, have not traditionally been an integral aspect of the overall system design process. This may be partly due to the fact that
Gregory J. Kacprzynski; Michael J. Roemer; Andrew J. Hess; Ken R Bladen
The achievement of national and international health goals requires better-performing health systems. Strengthening leadership and management of health systems thus becomes essential for achieving greater efficiency and responsiveness, ultimately improving health outcomes. Building a global framework of core competencies for leadership and management needs to be approached with systems thinking and methodologies akin to complexity science that takes into account all components and levels of the health system and the possible interactions between them that influence outcomes. The results will have important policy implications for national health authorities seeking to strengthen management capacity and building transformational leadership in health systems. PMID:23342754
|If developing a healthy workforce is critical to reining in the skyrocketing cost of health care, then why have so many attempts at preventive health or disease management fallen short? How can employers connect with employees to engage them in changing unhealthy habits or lifestyles? Duke University has launched an innovative new approach called…
Prognostics and healthmanagement (PHM) is an enabling discipline consisting of technologies and methods to assess the reliability of a product in its actual life cycle conditions to determine the advent of failure and mitigate system risk. Sensor systems are needed for PHM to monitor environmental, operational, and performance-related characteristics. The gathered data can be analyzed to assess product health and predict remaining life. In this paper, the considerations for sensor system selection for PHM applications, including the parameters to be measured, the performance needs, the electrical and physical attributes, reliability, and cost of the sensor system, are discussed. The state-of-the-art sensor systems for PHM and the emerging trends in technologies of sensor systems for PHM are presented.
Cheng, Shunfeng; Azarian, Michael H.; Pecht, Michael G.
The focus of the May-June issue is on outage management and health physics. Major articles/reports in this issue include: A design with experience for the U.S., by Michael J. Wallace, Constellation Generation Group; Hope to be among the first, by Randy Hutchinson, Entergy Nuclear; Plans to file COLs in 2008, by Garry Miller, Progress Energy; Evolution of ICRP's recommendations, by Lars-Erik Holm, ICRP; European network on education and training in radiological protection, by Michele Coeck, SCK-CEN, Belgium; Outage managment: an important tool for improving nuclear power plant performance, by Thomas Mazour and Jiri Mandula, IAEA, Austria; and Plant profile: Exploring new paths to excellence, by Anne Thomas, Exelon Nuclear.
The focus of the May-June issue is on outage management and health physics. Major articles include: Outage optimization initiatives, by George B. Beam, AREVA NP, Inc.; New plant based on excellent track records, by Jim Scarola, Progress Energy; Meeting customer needs and providing environmental benefits, by Peter S. Hastings, Duke Energy; Plants with 3-D design, by Jack A. Bailey, Tennessee Valley Authority; and Highest quality with exceptional planning, by Jason A. Walls, Duke Energy. Industry innovation articles include: Integrated exposure reduction plan, by Ed Wolfe, Exelon; Performance-based radiation worker training, by Joe Giuffre and Timothy Vriezerma, American Electric Power.
Are there additional costs associated with achieving goals of sustainable health care? Will going green enhance or impede financial performance? These are questions that all health care managers should confront, yet there is little evidence to show that health care sustainability is affordable or profitable. This article considers what is presently known and suggests that health care managers use an assessment framework to determine whether they are ready to achieve health care sustainability. PMID:21808179
Rumination has been suggested to mediate the physiological consequences of stress on health. We studied the effects of rumination evoked in the laboratory and subsequent changes over 24 h. Heart rate (HR) and systolic and diastolic blood pressure (SBP, DBP) were monitored in 27 male and 33 female participants during baseline, reading, an anger recall interview, and recovery. Half of the sample was assigned to a distraction condition. The lab session was followed by a 24-hour ambulatory (A)HR and BP recording and self-reports of moods and rumination. Rumination was associated with higher SBP, DBP, and HR and increased negative mood compared to distraction. Rumination during the day was a strong predictor of AHR, ABP, and mood. BP reactivity in the laboratory and increases in ABP during rumination were related. The effects of negative cognition on health go far beyond the recovery periods usually measured in the laboratory, thus playing a pathogenic role. PMID:20846182
Cholesterol was hydrogenated by anaerobic incu- bation with sheep rumen fluid for periods up to 20 hr. The principal product of cholesterol hydrogenation was identified as coprostanol. Cholesterol could be protected against in vitro ruminal hydrogenation by encapsulation in a matrix of formaldehyde-treated casein. Formaldehyde- treated casein-cholesterol preparations were also shown to be protected against hydrogenation in vivo and, when
J. R. Ashes; S. K. Gulati; L. J. Cook; S. C. Mills; T. W. Scott
Presents models suggesting how research evidence can best be operationalised within health care commissioning. Models were derived from data gathered from surveys of Scottish health board managers and GP fundholders regarding the use of information in commissioning from 1995 to 1997. Feedback on the models was obtained subsequently from practitioners in 1998. Two models, one for health board managers and
The implementation of managed care for children with special health care needs is often associ- ated with apprehension regarding new barriers to health care services. At times, these barriers may overshadow opportunities for improvement. This statement discusses such opportunities, identifies challenges, and proposes active roles for pediatricians and families to improve managed care for children with special health care needs.
It has been said that managing change is a synonym for managing people through change. No other industry has experienced more change in the past ten years than the health-care industry. In order to regulate all of this change, managers in health-care organizations must identify new ways to deal with the changes. The issues are as old as time: job
|Curriculum objectives for health care financial management, a bibliography and examples of financial management curricula are presented. The outline of curriculum objectives identifies a core of knowledge and skills in financial management that health administration students might obtain in their academic training. The outline's content is…
Good management, supported by accurate, timely and reliable health information, is vital for increasing the effectiveness of Health Information Systems (HIS). When it comes to managing the under-resourced health systems of developing countries, information-based decision making is particularly important. This paper reports findings of a self-report survey that investigated perceptions of local healthmanagers (HMs) of their own regional HIS in Sri Lanka. Data were collected through a validated, pre-tested postal questionnaire, and distributed among a selected group of HMs to elicit their perceptions of the current HIS in relation to information generation, acquisition and use, required reforms to the information system and application of information and communication technology (ICT). Results based on descriptive statistics indicated that the regional HIS was poorly organised and in need of reform; that management support for the system was unsatisfactory in terms of relevance, accuracy, timeliness and accessibility; that political pressure and community and donor requests took precedence over vital health information when management decisions were made; and use of ICT was unsatisfactory. HIS strengths included user-friendly paper formats, a centralised planning system and an efficient disease notification system; weaknesses were lack of comprehensiveness, inaccuracy, and lack of a feedback system. Responses of participants indicated that HIS would be improved by adopting an internationally accepted framework and introducing ICT applications. Perceived barriers to such improvements were high initial cost of educating staff to improve computer literacy, introduction of ICTs, and HIS restructure. We concluded that the regional HIS of Central Province, Sri Lanka had failed to provide much-needed information support to HMs. These findings are consistent with similar research in other developing countries and reinforce the need for further research to verify causes of poor performance and to design strategic reforms to improve HIS in regional Sri Lanka. PMID:23087080
Home health aides are at the front line of the home health industry, raising quality of care issues and human resource (HR) management challenges. Total quality management (TQM) provides a framework to help meet those challenges. The authors investigated the relationship between TQM and HR effectiveness in home health agencies. Results suggest that TQM practices are related to HR effectiveness. Suggestions are offered to make human resource management consistent with a TQM culture. PMID:8968324
We report on quantitative techniques for managinghealth information as well as for the marketing and the management of health libraries and other health information centres. Important for marketing and management of libraries are the p.r. (public relations) and p.a. (public awareness) activities. We discuss reports (e.g. case studies, annual reports, ...) as important tools in this and pay special
This article uses a pyramid model to illustrate the key components of consumer-directed health care. Consumer-directed health care is considered the essential strategy needed to lower health care costs and is valuable for making significant strides in health care reform. Consumer-directed health care presents new challenges and opportunities for all health care stakeholders and their managers. The viability of the health system depends on the success of managers to respond rapidly and with precision to changes in the system; thus, new and modified roles of managers are necessary to successfully sustain consumerism efforts to control costs while maintaining access and quality. PMID:20436329
The government often uses the Federal Employees Health Benefits (FEHB) Program as a model for both public and private health policy choices. In 2001, the U.S. Office of Personnel Management (OPM) implemented full parity, requiring that FEHB carriers offer mental health and substance abuse benefits equal to general medical benefits. OPM instructed carriers to alter their benefit design but permitted them to determine whether they would manage care and what structures or processes they would use. This article reports on the experience of 156 carriers and the government-wide BlueCross and BlueShield Service Benefit Plan. Carriers dropped cost-restraining benefit limits. A smaller percentage also changed the management of the benefit, but these changes affected the care of many enrollees, making the overall parity effect noteworthy.
Ridgely, M Susan; Burnam, M Audrey; Barry, Colleen L; Goldman, Howard H; Hennessy, Kevin D
Abstract This paper considers how operational research and management science can improve the design of health systems and the delivery of health care, particularly in low-resource settings. It identifies some gaps in the way operational research is typically used in global health and proposes steps to bridge them. It then outlines some analytical tools of operational research and management science and illustrates how their use can inform some typical design and delivery challenges in global health. The paper concludes by considering factors that will increase and improve the contribution of operational research and management science to global health.
Health care waste is considered a major public health hazard. The objective of this study was to assess health care waste management (HCWM) practices currently employed at health care centers (HCCs) in the West Bank – Palestinian Territory. Survey data on solid health care waste (SHCW) were analyzed for generated quantities, collection, separation, treatment, transportation, and final disposal. Estimated 4720.7m3
The focus of the May-June issue is on outage management and health physics. Major articles include the following: Planning and scheduling to minimize refueling outage, by Pat McKenna, AmerenUE; Prioritizing safety, quality and schedule, by Tom Sharkey, Dominion; Benchmarking to high standards, by Margie Jepson, Energy Nuclear; Benchmarking against U.S. standards, by Magnox North, United Kingdom; Enabling suppliers for new build activity, by Marcus Harrington, GE Hitachi Nuclear Energy; Identifying, cultivating and qualifying suppliers, by Thomas E. Silva, AREVA NP; Creating new U.S. jobs, by Francois Martineau, Areva NP. Industry innovation articles include: MSL Acoustic source load reduction, by Amir Shahkarami, Exelon Nuclear; Dual Methodology NDE of CRDM nozzles, by Michael Stark, Dominion Nuclear; and Electronic circuit board testing, by James Amundsen, FirstEnergy Nuclear Operating Company. The plant profile article is titled The future is now, by Julia Milstead, Progress Energy Service Company, LLC.
The poultry industry in the USA is a fully integrated system of animal agriculture. Each company has control over the bird husbandry and healthmanagement aspects of production, including the use of antimicrobial agents. The three segments of the industry-broiler chickens, turkeys, and layer chickens-have few antibiotics available for the therapeutic treatment of bacterial diseases. Prior to approval of the fluoroquinolones, tetracyclines were the major antibiotics approved for the treatment of the most economically important disease in broiler chickens and turkeys, Escherichia coli airsacculitis. This resulted in levels of resistance to the tetracyclines in clinical E. coli isolates in excess of 90%. The integrated nature of the poultry industry lends itself well to preventive medicine utilizing the tools of biosecurity and vaccination. Therefore, very few flocks of birds require antibiotic therapy. When a flock must be treated, the poultry veterinarian will usually base the recommendation of the drug to use on culture and antibiogram results. PMID:23570167
The focus of the May-June issue is on outage management and health physics. Major articles/reports in this issue include: India: a potential commercial opportunity, a U.S. Department of Commerce Report, by Joe Neuhoff and Justin Rathke; The changing climate for nuclear energy, by Skip Bowman, Nuclear Energy Insitute; Selecting protective clothing, by J. Mark Price, Southern California Edison; and Succssful refurbishment outage, by Sudesh K. Gambhir, Omaha Public Power District. Industry innovation articles in this issue are: Containment radiation monitoring spiking, by Michael W. Lantz and Robert Routolo, Arizona Public Service Company; Improved outage performance, by Michael Powell and Troy Wilfong, Arizona Public Service Company, Palo Verde Nuclear Generating Station; Stop repacking valves and achieve leak-free performance, by Kenneth Hart, PPL Susquehanna LLC; and Head assembly upgrade package, by Timothy Petit, Dominion Nuclear.
\\u000a Health informatics has the potential to improve the quality and provision of care while reducing the cost of health care delivery.\\u000a However, health informatics is often falsely regarded as synonymous with information management (IM). This chapter (i) provides\\u000a a clear definition and characteristic benefits of health informatics and information management in the context of health care\\u000a delivery, (ii) identifies and
Regina Gyampoh-Vidogah; Robert Moreton; David Sallah
As their populations age, many countries are facing the increasing economic pressure of providing healthcare to their people. In Taiwan, this problem is exacerbated by an increasing rate of obesity and obesity-related conditions. Encouraging the adoption of personal healthmanagement services is one way to maintain current levels of personal health and to efficiently manage the distribution of healthcare resources. This study introduces Mobile HealthManagement Services (MHMS) and employs the Technology Acceptance Model (TAM) to explore the intention of students in Executive Master of Business Management programs to adopt mobile healthmanagement technology. Partial least squares (PLS) was used to analyze the collected data, and the results revealed that "perceived usefulness" and "attitude" significantly affected the behavioral intention of adopting MHMS. Both "perceived ease of use" and "perceived usefulness," significantly affected "attitude," and "perceived ease of use" significantly affected "perceived usefulness" as well. The results also show that the determinants of intention toward MHMS differed with age; young adults had higher intention to adopt MHMS to manage their personal health. Therefore, relevant governmental agencies may profitably promote the management of personal health among this population. Successful promotion of personal healthmanagement will contribute to increases in both the level of general health and the efficient management of healthcare resources. PMID:20878452
There is a body of evidence, and a group of advocates, supporting the need for integrated system healthmanagement for space exploration systems. The advocates include operators responsible for complex and inherently risky decisions, and the technologists working in the domain of healthmanagement and looking for application for their products. Others in the decision loops take the view that
This article reviews the forces leading to the current emphases on managed mental health systems. Rapidly escalating costs, especially for inpatient care, and associated concerns for quality and patient outcomes, have led third-party payers and employers to demand more eifective cost and quality controls. The article describes and illustrates methodologies for managing mental health costs, and reviews issues related to
|Introduction: For more than 70 years, health care management in the Soviet Union reflected a centralized directive style familiar to the Soviet political system. Market-oriented reform in post-Soviet Russia is pushing practicing physicians and physician-executives to acquire new information and skills regarding health care management. To assist…
The articles in this special section of the Journal of Behavioral Health Services & Research (30:1) present results from evaluations of publicly funded managed care initiatives for substance abuse and mental health treatment in Arizona, Iowa, Maryland, and Nebraska. This overview outlines the four managed care programs and summarizes the results from the studies. The evaluations used administrative data and
The movement towards managed care in the public mental health system has surpassed efforts to develop a systematic literature concerning its theory, practice, and outcome. In particular little has been written about potential challenges and difficulties in translating managed care systems from their origins in the private sector to the delivery of public sector mental health services. This paper provides
Brian J. Cuffel; Lonnie Snowden; Mary Masland; Giorgio Piccagli
Conjugated linoleic acids (CLA) are health-promoting fatty acids found in foods derived from ruminant products that are formed in the rumen during bacterial biohydrogenation of linoleic acid (LA). Although selective antimicrobials might increase CLA production by manipulation of ruminal microflora, feeding of antibiotic growth promoters to livestock is declining due to fears of development of antibiotic resistance in human pathogens.
Z. Durmic; C. S. McSweeney; G. W. Kemp; P. Hutton; R. J. Wallace; P. E. Vercoe
Balancing ruminant diets for appropriate levels and types of dietary carbohydrates (CHO) is necessary to maximize production while assuring the health of the animals. Several feed fractions (i.e., volatile fatty acids (VFA), lactate, sugars, starch) are now being measured in some commercial feed laboratories and this information may assist in better formulating diets. A CHO fractionation scheme based on ruminal
C. Lanzas; C. J. Sniffen; S. Seo; L. O. Tedeschi; D. G. Fox
Rapid change in the health care environment mandates a more comprehensive approach to the education of future health administrators. The area of consideration in this study is that of health care strategic management. A comprehensive literature review suggests microcomputer-based simulation as an appropriate vehicle for addressing the needs of both educators and students. Seven strategic management software packages are reviewed and rated with an instrument adapted from the Infoworld review format. The author concludes that a primary concern is the paucity of health care specific strategic management simulations.
Intensive Health Care at Home Kids can need intensive health care at home after they have been in the hospital ... dolls to help you practice different procedures. Home Health Care Assistance The hospital social worker can help families ...
The sickle cell disease is a genotypic affection, suited to the black race, characterized by the presence of an abnormal haemoglobin S (HbS). The purpose of this survey was to assess the knowledge, the attitudes and the practices of the health professionals on management of children with sickle cells diseases. We carried out a cross-sectional survey in the health centres and involved 140 health professional of Community Health Centres (CSCOM) and 6 health districts in Bamako. The study found that 72% of health professionals had between 24 and 39 year old; 39% were physician; 77% didn't know the name of the drugs used in case of non complicate sickle cells diseas. Among the health professionals, 81% knew that the sickle cells disease was a blood illness. Our findings suggest that management of children with sickle cells diseases was not performed better due to the knowledge insufficiency of health professionals. We recommend training the health staff. PMID:19434959
Large employers are beginning to create much more robust and potentially effective systems of integrated healthmanagement interventions. This organization-wide activity is referred to as a "Population HealthManagement" (PHM) approach. Best practices are also beginning to emerge in this area, and a number of technical developments are helping shape the patterns of response from innovative employers. This initiative is rapidly emerging as a critical part of overall business and health care strategy. PMID:16706008
The purpose of this paper is to describe the development and use of management support measures in two worksite health promotion\\u000a intervention trials. Results from the two intervention trials suggest that management support for health promotion can be\\u000a assessed and tracked over time using both perceptual and observational measures. These results also provide initial evidence\\u000a that an increase in management
David M. Dejoy; Heather M. Bowen; Kristin M. Baker; Bethany H. Bynum; Mark G. Wilson; Ron Z. Goetzel; Rod K. Dishman
This report synthesizes the collective experiences of four managed behavioral health care organizations (MBHOs) that hold public sector managed care carve-out contracts. Four representatives of these MBHOs participated in a daylong focus group meeting, an...
Although the main focus in ruminal acidosis has been on the rumen, it might be more accurate to consider this nutritional disorder as a syndrome that can affect systems beyond the rumen and outside of the gastrointestinal tract. Notwithstanding that ruminal acidosis is by definition related to low r...
|These guidelines are the product of a new Pediatric Asthma Initiative aimed at integrating environmental management of asthma into pediatric health care. This document outlines competencies in environmental health relevant to pediatric asthma that should be mastered by primary health care providers, and outlines the environmental interventions…
Reviews the changes managedhealth care has brought to the delivery and use of medical services and recommends specific steps that will make the existing system more responsive to the needs of children. Systemwide health care reforms must give children stable medical care that emphasizes preventive health and developmental services. (SLD)
Deal, Lisa W.; Shiono, Patricia H.; Behrman, Richard E.
During World War II Mexican and US health professionals and organizations constructed a transnational organizational field to manage the border's public health problems. Despite barriers to inter-organizational cooperation, including disparate administrative structures and North–South stratification, the field's transnational approach to health on the border has continued for 60 years. Using archival data to track changes in the number and types
Rumination syndrome is known to exist in infants and mentally retarded adults since long time. In past few years, some reports appeared that showed its existence in adult patients also. It is frequently confused with the intractable vomiting in adults and misdiagnosis leads to delay in appropriate management. We are here describing the case of a female patient with rumination syndrome where specific points in the history delineated the presence of this illness and helped in appropriate management. The patient became symptom free soon after the diagnosis was reached.
This pilot study assessed occupational health and safety (OHS) management system audit finding reliability using a modified test–retest method. Two industrial hygienists with similar training and education conducted four, 1-day management system audits in four dissimilar organizational environments. The researchers examined four auditable sections (employee participation, training, controls, and communications) contained in a publicly available OHS management system assessment instrument.
Integration of occupational health and safety matters into environmental management systems can bring many benefits to industrial companies. They can avoid duplicated measures and find optimal solutions, because the principles of prevention are similar in environmental protection and safety management. However, the methods currently used in environmental management and engineering such as life-cycle assessments, best available technology reports, and the
Providing care to children with special health care needs within a managed care environment presents special challenges for providers and parents alike. The goal of managed care is to contain costs by encouraging or requiring members to obtain services through a designated network. In managed care programs, children and families may experience limited access to specialized care and services, along
The management of change within a clinical health information technology (HIT) project traditionally focuses on cost, schedule and scope, considered ldquohardrdquo change management (CM). Despite massive funding, clinical HIT projects continue to fail suggesting that the management of risk associated with hard change elements alone, is not effective. The cause of clinical HIT failure is usually attributed to user resistance
This analysis uses in-depth interview data collected from 145 African American, European American and Native American men and women aged 70 and older who reside in two rural North Carolina counties to understand the role of religious faith and prayer in the health self-management of these older adults. The analysis addresses three specific questions: how do these older adults use religion to help them manage their health; are there ethnic and gender differences in the use of religion; and are differences in health status related to differences in the use of religion? The integral role of religion in the lives of these older rural adults is an overarching theme present in the interview texts. Six major themes link religion and health self-management: (1) prayer and faith in health self-management, (2) reading the Bible, (3) church services, (4) mental and spiritual health, (5) stories of physical healing, and (6) ambivalence. Faith and religious activities provide an anchor in the lives of these older adults. There is little variation in the use of religion for health self-management by gender, ethnicity or health status. These results suggest that the strength of religion in rural culture may limit the effectiveness of general religiosity scales to discern the relationship of religion to health and health behavior in rural populations. PMID:14618010
This article explores identity dynamics in public health working at the level of the institutional identity ascribed to public health professionals, and the identity work that public health workers perform. Drawing on focus group research with school nurses and community midwives in England, the article identifies two important but neglected areas for interrogating public health worker's identity work: boundary management
Substantial evidence suggests that rumination is an important vulnerability factor for adolescent depression. Despite this, few studies have examined environmental risk factors that might lead to rumination and, subsequently, depression in adolescence. This study examined the hypothesis that an adverse family environment is a risk factor for rumination, such that the tendency to ruminate mediates the longitudinal association between a negative family environment and adolescent depressive symptoms. It also investigated adolescent gender as a moderator of the relationship between family environment and adolescent rumination. Participants were 163 mother-adolescent dyads. Adolescents provided self-reports of depressive symptoms and rumination across three waves of data collection (approximately at ages 12, 15, and 17 years). Family environment was measured via observational assessment of the frequency of positive and aggressive parenting behaviors during laboratory-based interactions completed by mother-adolescent dyads, collected during the first wave. A bootstrap analysis revealed a significant indirect effect of low levels of positive maternal behavior on adolescent depressive symptoms via adolescent rumination, suggesting that rumination might mediate the relationship between low levels of positive maternal behavior and depressive symptoms for girls. This study highlights the importance of positive parenting behaviors as a possible protective factor against the development of adolescent rumination and, subsequently, depressive symptoms. One effective preventive approach to improving adolescent mental health may be providing parents with psychoeducation concerning the importance of pleasant and affirming interactions with their children. PMID:23323840
Gaté, Michael A; Watkins, Edward R; Simmons, Julian G; Byrne, Michelle L; Schwartz, Orli S; Whittle, Sarah; Sheeber, Lisa B; Allen, Nicholas B
While the challenges of the next pandemic outbreak are overwhelming, either from swine flu, other infectious disease, bioterrorism, timely detection of disease outbreaks is most important for public health surveillance and society safety and stability. In public health surveillance, the objective is to systematically collect, analyze, and interpret public health data (chronic or infectious diseases) in order to understand trends,
In 2009, the City of Toronto, Ontario, Canada, experienced a six-week labor disruption involving 24,000 city workers that included solid waste and public health employees. In an attempt to control illegal dumping and to manage garbage storage across the city during this period, 24 temporary garbage storage sites were established by the city (mostly in local parks) for residents to dispose of their household waste. No other municipality in North America has attempted to operate this many temporary sites for this long a period. Management and nonunion staff from Healthy Environments in Toronto Public Health performed daily inspections, responded to community questions, issued public health orders, and worked closely with Solid Waste Management and the Ministry of the Environment to actively manage the public health concerns associated with these sites. This intensive oversight mitigated public health risks to the community and facilitated an effective, safe solution to the temporary garbage storage problem. PMID:22010330
Murti, Michelle; Ayre, Reg; Shapiro, Howard; de Burger, Ron
Pesticides have a role in public health as part of sustainable integrated mosquito management. Other components of such management include surveillance, source reduction or prevention, biological control, repellents, traps, and pesticide-resistance management. We assess the future use of mosquito control pesticides in view of niche markets, incentives for new product development, Environmental Protection Agency registration, the Food Quality Protection Act, and improved pest management strategies for mosquito control.
The Business Coalition on Health is concerned about the future of Connecticut's health care system and its ability to provide high quality care that is accessible to state residents. The development of medical technologies and interventions to improve the...
The management capabilities and performance of primary health care (PHC) can be improved by strengthening the information system. This study focuses on the Palestinian HealthManagement Information System (HMIS), used in PHC and reports on the achievements and shortcomings. A retrospective review and content analysis of the HMIS documentation was carried out and a Strengths, Weaknesses, Opportunities, and Threats (SWOT)
Tayser Abu Mourad; Mohammed A. Afifi; Suzanne Shashaa; Dimitris Kounalakis; Christos Lionis; Anastas Philalithis
The annual health devices achievement award competition provides a valuable opportunity for us to learn about--and share--some of the outstanding technology management initiatives implemented by our members. This year's top submissions describe best practices and effective techniques that other healthcare facilities can emulate to improve patient safety, reduce costs, and facilitate better strategic management of health technology. PMID:21309305
|Purpose--The purpose of this paper is to investigate the dramatic reforms in the health service in recent years. Design/methodology/approach--Examines management development in health care, and explores the experiences of clinical nurse managers. Findings--Duplication of agencies and multiplication of roles have led to tensions in terms of both…
A sound basis to guide the community in the conception and implementation of ISHM (Integrated System HealthManagement) capability in operational systems was provided. The concept of 'ISHM Model of a System' and a related architecture defined as a unique ...
Information requirements of mental health providers are sufficiently different from those of other health care managers to warrant a different approach to the development of management information systems (MIS). Advances in computer technology and increased demands for fiscal accountability have led to developing integrated mental health information systems (MHIS) that support clinical and management requirements. In a study made to define a set of generic information requirements of mental health providers that can be supported by an MHIS, it was found that basic data needs can be defined and classified in functional terms: clinical, management, and consultation/education requirements. A basic set of data to support these needs was defined: demographic, financial, clinical, programmatic, and service delivery data.
A comprehensive analytical review of the risk assessment, risk management, and risk communication approaches currently being undertaken by key national, provincial/state, territorial, and international agencies was conducted. The information acquired for review was used to identify the differences, commonalities, strengths, and weaknesses among the various approaches, and to identify elements that should be included in an effective, current, and comprehensive approach applicable to environmental, human health and occupational health risks. More than 80 agencies, organizations, and advisory councils, encompassing more than 100 risk documents, were examined during the period from February 2000 until November 2002. An overview was made of the most important general frameworks for risk assessment, risk management, and risk communication for human health and ecological risk, and for occupational health risk. In addition, frameworks for specific applications were reviewed and summarized, including those for (1)contaminated sites; (2) northern contaminants; (3) priority substances; (4) standards development; (5) food safety; (6) medical devices; (7) prescription drug use; (8) emergency response; (9) transportation; (10) risk communication. Twelve frameworks were selected for more extensive review on the basis of representation of the areas of human health, ecological, and occupational health risk; relevance to Canadian risk management needs; representation of comprehensive and well-defined approaches; generalizability with their risk areas; representation of "state of the art" in Canada, the United States, and/or internationally; and extent of usage of potential usage within Canada. These 12 frameworks were: 1. Framework for Environmental Health Risk Management (US Presidential/Congressional Commission on Risk Assessment and Risk Management, 1997). 2. Health Risk Determination: The Challenge of Health Protection (Health and Welfare Canada, 1990). 3. Health Canada Decision-Making Framework for Identifying, Assessing and ManagingHealth Risks (Health Canada, 2000). 4. Canadian Environmental Protection Act: Human Health Risk Assessment of Priority Substances(Health Canada, 1994). 5. CSA-Q8550 Risk Management: Guidelines for Decision-Makers (Canada Standards Association, 1997). 6. Risk Assessment in the Federal Government: Managing the Process (US National Research Council, 1983). 7. Understanding Risk: Informing Decisions in a Democratic Society (US National Research Council, 1996). 8. Environmental Health Risk Assessment (enHealth Council of Australia, 2002). 9. A Framework for Ecological Risk Assessment (CCME, 1996). 10. Ecological Risk Assessments of Priority Substances Under the Canadian Environmental Protection Act (Environment Canada, 1996).11. Guidelines for Ecological Risk Assessment (US EPA, 1998b). 12. Proposed Model for Occupational Health Risk Assessment and Management (Rampal & Sadhra, 1999). Based on the extensive review of these frameworks, seven key elements that should be included in a comprehensive framework for human health, ecological, and occupational risk assessment and management were identified: 1. Problem formulation stage. 2. Stakeholder involvement. 3. Communication. 4. Quantitative risk assessment components. 5. Iteration and evaluation. 6. Informed decision making. 7. Flexibility. On the basis of this overarching approach to risk management, the following "checklist" to ensure a good risk management decision is proposed: - Make sure you're solving the right problem. - Consider the problem and the risk within the full context of the situation, using a broad perspective. - Acknowledge, incorporate, and balance the multiple dimensions of risk. - Ensure the highest degree of reliability for all components of the risk management process. - Involve interested and effected parties from the outset of the process. - Commit to honest and open communication between all parties. - Employ continuous evaluation throughout the process (formative, process, and outcome evaluation), and be prepared t
The decisions and actions of health care managers are oftentimes heavily scrutinized by the public. Given the current economic climate, managers may feel intense pressure to produce higher results with fewer resources. This could inadvertently test their moral fortitude and their social consciousness. A study was conducted to determine what corporate social responsibility orientation and viewpoint future health care managers may hold. The results of the study indicate that future health care managers may hold patient care in high regard as opposed to profit maximization. However, the results of the study also show that future managers within the industry may continue to need rules, laws, regulations, and legal sanctions to guide their actions and behavior. PMID:21045586
This paper describes a conceptual organizing scheme for managing knowledge within the health setting. First, a brief review of the notions of knowledge and knowledge management is provided. This is followed by a detailed depiction of our proposed knowledge management framework, which focuses on the concepts of production, use, and refinement of three specific knowledge sources-policy, evidence, and experience. These concepts are operationalized through a set of knowledge management methods and tools tailored for the health setting. We include two case studies around knowledge translation on parent-child relations and virtual networks in community health research to illustrate how this knowledge management framework can be operationalized within specific contexts and the issues involved. We conclude with the lessons learned and implications.
Accountability of air quality management is often measured by tracking ambient pollution concentrations over time. These changes\\u000a in ambient air quality are rarely linked to changes in public health, a major driver for such programs. We propose a method\\u000a to assess the accountability of air quality management programs with respect to improvements in public health by estimating\\u000a national temporal trends
Hwashin Hyun Shin; Richard T. Burnett; David M. Stieb; Barry Jessiman
Rift Valley fever threatens human and animal health. After a human case was confirmed in Comoros in 2007, 4 serosurveys among ruminants in Mayotte suggested that Rift Valley fever virus had been circulating at low levels since 2004, although no clinical cases occurred in animals. Entomologic and ecologic studies will help determine outbreak potential.
Rift Valley fever threatens human and animal health. After a human case was confirmed in Comoros in 2007, 4 serosurveys among ruminants in Mayotte suggested that Rift Valley fever virus had been circulating at low levels since 2004, although no clinical cases occurred in animals. Entomologic and ecologic studies will help determine outbreak potential. PMID:22607651
In this article, the authors provide an overview of the effectiveness of managedhealth care systems and their impact on mental health counselors. They review ethical and legal dilemmas involving informed consent, confidentiality, client autonomy, competence, treatment plans, and termination that had not existed prior to the introduction of…
Little is known about how Deaf people perceive, access, and utilize interpersonal and media sources for health information. In light of the scarcity of research on health information management among this group, a two-phase study was conducted that included eight focus groups (N=39) and survey data (N=366) with Deaf participants to determine the…
|Little is known about how Deaf people perceive, access, and utilize interpersonal and media sources for health information. In light of the scarcity of research on health information management among this group, a two-phase study was conducted that included eight focus groups (N=39) and survey data (N=366) with Deaf participants to determine the…
In this paper, we propose a new architecture for managing data in a Ubiquitous Health Monitoring System (UHMS). The purpose of this architecture is to enhance the privacy of patients and furthermore to decongest the Health Monitoring Center (HMC) from the enormous amount of biomedical data generated by the users' wearable sensors. This is achieved by using personal agents that
state with both correct function and satisfactory performance at the same time. To realize healthmanagement of ATE, the self-test and calibration method is introduced. High light is focused on ATE calibration interval prediction. To predict calibration intervals, a health state modeling and prognostic method was proposed based on Weibull distribution, which can provide an accurate prediction even with small
Parents always desire to take good care of their children and manage their numerous responsibilities. One of parents' main responsibilities is to manage their children's health. Through their actions of caring for their children, parents want to know they're doing the best job to ensure their children's well being. Unfortunately, much of the time this responsibility is a challenge-particularly for
In Pennsylvania, certified school nurses were governed by the same educational rules and administrative directives as teachers. School nurses were supervised and evaluated by non-nurse managers who had no knowledge of the scope of school nurse practice. A focus of the study was to examine the efficacy of management for school health programs. The…
|In Pennsylvania, certified school nurses were governed by the same educational rules and administrative directives as teachers. School nurses were supervised and evaluated by non-nurse managers who had no knowledge of the scope of school nurse practice. A focus of the study was to examine the efficacy of management for school health programs. The…
Purpose – The purpose of this paper is to study the managing of emergencies pertinent to public health which is critical to the well-being of a society; as such, the management mechanisms employed should be of great interest and significance for research. Design\\/methodology\\/approach – This paper first relies on extensive literature to describe the mechanism used in the USA from
This paper builds effective wireless patient management system (WPMS) using open software that can be accessed via a personal digital assistance (PDA) or a cell phone. This allows health care professionals to gain access to patient information from anywhere at anytime. In this project, the wireless patient management system was built using Java technology. The client side was implemented using
Stress management training interventions have become one of the most popular treatment programs in health psychology practice. Although numerous clinical approaches are available, limited attention is given to the matching of intervention with the clinical needs of individuals. As a result, stress management programs are more frequently marketed in clinical and community settings as palliative techniques without sufficient exploration of
GPs did not recognise much of the mental health issues that presented in their practices. However the re- sults of the MaGPIe study strongly discounts this view. This study showed that GPs recognise the pres- ence of significant mental health con- cerns in over 50% of consultations.2 My view is that the GP needs to have a low threshold when
|This booklet is intended to assist midlevel health care managers in assessing and improving their health care management skills. The first chapter uses the story of one health care manager's recognition of his own weaknesses and subsequent self-improvement to illustrate the qualities and skills that make a good manager. The second chapter, which…
This article examines the intersection of professionalism and complexity science as a source of new insights for improving the health care industry from both a clinical and business point of view. Viewing health care organizations as professional complex adaptive systems suggests eight leadership tasks for addressing the circumstances that engulf health care. Managers who adopt this view will be able to create new levers for positive movement in their organizations. PMID:10710732
By 1995, 108 million Americans were enrolled in managed care mental health programs. Managed care is likely to have a differential impact on women, as indicated by epidemiologic patterns, psychodynamic theory, and data from outcome and cost studies. The challenge of providing compassionate, confidential, and effective care within a budget can be solved by a combination of new treatment methods, better focused managed care interventions, and legislation. PMID:9127996
Business and industry are currently focused on increasing employee productivity, reducing employee injuries and lost work time, and minimizing costs. Absence from work due to either injury or health-related leave negatively affects both direct and indirect costs. Absenteeism, regardless of reason, negatively impacts company profit. To decrease the multiple costs of unplanned absences, the occupational health nurse can collaborate with Human Resources professionals and management to create cost-saving short- and long-term disability programs, manage Family and Medical Leave Act programs, and case manage the care of all employees with workers' compensation claims. PMID:19338262
At the onset of health system decentralization as a primary health care strategy, which constituted a key feature of health sector reforms across the developing world, efficient and effective healthmanagement information systems (HMIS) were widely acknowledged and adopted as a critical element of district healthmanagement strengthening programmes. The focal concern was about the performance and long-term sustainability of
The aim of the article, based on field data collected from a continuing education program for primary health clinic administrators, was to analyze the functioning of a health service management strategy called "management committees". Different meanings and operational modalities emerged in the committees. Various antimonies appeared in the way the committees operate (autonomy versus heteronomy, reproduction of "instituted" versus "instituting" processes, and communicative versus instrumental reasoning), thus reflecting the level of complexity in this management mechanism. Healthcare provision per se by the clinics only appeared occasionally on the committees' agenda, which mainly focused on administrative issues. The article suggests that further research is needed on the coordinator's involvement in the field of forces constituting the management committee, besides developing pedagogical strategies to support the clinic coordinators and health teams in building the committees. The primary data were submitted to an epistemological discussion anchored in the idea of double hermeneutics, multiple validation of research results, and the relationship between theory and practice. PMID:20464074
This handbook, prepared for the National Health Service Corps outlines the set of written administrative policies and procedures necessary for each medical facility receiving a National Service Corps assignee. In addition, these policies and procedures pe...
This project applied qualitative methods to gain insight into the experiences of vulnerable childrens families: how they define their childrens health needs, decisions regarding where and when to seek care, and their experiences with care received.
Following health crisis that have occurred in the nineties (contaminated blood, mad cow, asbestos, etc.) and more recently those generated by the heat wave in 2003 or by emerging infectious pathogens (SARS, West Nile, Chikungunya, H5N1, H1N1…), a real health vigilance system has been progressively developed in France. After a brief historical overview of the health alert system, this article will give the guiding principles of its current organization in France and will present two examples of recent health alerts (Chikungunya in the Reunion Island in 2005-2006 and hepatitis A outbreak in the Côtes-d'Armor in August 2007), that have needed the implementation of preventive measures regarding the blood donor selection. These two examples have shown that the position of the alert in the French health vigilance system needs to be very close to the event. In that case, health alert is a very useful tool for decision making especially when measures have to be taken to prevent transfusion-transmitted pathogens. PMID:21051258
Background Shortage of human resources is a major problem facing Malawi, where more than 50% of the population lives in rural areas. Most of the district health services are provided by clinical health officers specially trained to provide services that would normally be provided by fully qualified doctors or specialists. As this cadre and the cadre of enrolled nurses are the mainstay of the Malawian health service at the district level, it is important that they are supported and motivated to deliver a good standard of service to the population. This study explores how these cadres are managed and motivated and the impact this has on their performance. Methods A quantitative survey measured health workers' job satisfaction, perceptions of the work environment and sense of justice in the workplace, and was reported elsewhere. It emerged that health workers were particularly dissatisfied with what they perceived as unfair access to continuous education and career advancement opportunities, as well as inadequate supervision. These issues and their contribution to demotivation, from the perspective of both management and health workers, were further explored by means of qualitative techniques. Focus group discussions were held with health workers, and key-informant interviews were conducted with members of district healthmanagement teams and human resource officers in the Ministry of Health. The focus groups used convenience sampling that included all the different cadres of health workers available and willing to participate on the day the research team visited the health facility. The interviews targeted district healthmanagement teams in three districts and the human resources personnel in the Ministry of Health, also sampling those who were available and agreed to participate. Results The results showed that health workers consider continuous education and career progression strategies to be inadequate. Standard human resource management practices such as performance appraisal and the provision of job descriptions were not present in many cases. Health workers felt that they were inadequately supervised, with no feedback on performance. In contrast to health workers, managers did not perceive these human resources management deficiencies in the system as having an impact on motivation. Conclusion A strong human resource management function operating at the district level is likely to improve worker motivation and performance.
This study contributes to the health governance discussion by presenting a new data set that allows for comparisons of the management of health resources among Brazilian municipalities. Research on Brazil is particularly important as the provision of health services was decentralized in 1988 and since then municipalities have been given greater responsibilities for the management of fiscal resources for public health service provision. Based on detailed information on corruption practices (such as over-invoicing, illegal procurement and fake receipts) from audit reports of health programmes in 980 randomly selected Brazilian municipalities, this study deepens understanding of the relationship between health governance institutions and the incidence of corruption at the local level by exploring the extent to which horizontal and vertical accountabilities contribute to reducing the propensity of municipal government officials to divert public health resources for private gain. The results of our multiple regression analysis suggest that the experience of health municipal councils is correlated with reductions in the incidence of corruption in public health programmes. This impact is significant over time, with each additional year of health council experience reducing corruption incidence levels by 2.1% from baseline values. The findings reported in this study do not rely on the subjectivity of corruption measures which usually conflate the actual incidence of corruption with its perception by informants. Based on our results, we provide recommendations that can assist policy makers to reduce corruption. PMID:23411119
The article presents results from a survey of 98 top executives at Baylor Health Care System (BHCS), a large, multifunction health care organization in Dallas, Texas. The survey assessed the executives' perceptions of current BHCS quality practices using the first survey developed for the health care industry based on the Malcolm Baldrige National Quality Award (MBNQA) criteria. Findings regarding the quality of BHCS internal and external data and information include the need for a $50 million information system transformation to achieve seven critical success factors for all business units and improved internal and external data and information for the business process redesign and quality transformation. Results highlight the need for further research investigating the information and analysis MBNQA criteria. PMID:10174724
The measurement of passage rate is important for the concept of ruminant diversification. While supporters of Hofmann's 1989 feeding type classification claim that browsing ruminants have faster passage rates than grazing ruminants, other researchers consider the passage rate to depend on body size alone. To date, no convincing comparison of ruminant passage rates has been put forward. For comparative purposes,
This study aims to compare and contrast how specific information health technologies (IHTs) have been debated, how they have\\u000a proliferated, and what they have enabled in Germany’s and England’s healthcare systems. For this a discourse analysis was\\u000a undertaken that specifically focussed on future-scenarios articulated in policy documents and strategy papers released by\\u000a relevant actors from both healthcare systems. The study
Diabetes in pregnancy is increasing and therefore it is important to raise awareness of the associated health risks to the mother, the growing fetus, and the future child. Perinatal mortality and morbidity is increased in diabetic pregnancies through increased stillbirths and congenital malformation rates. These are mainly the result of early fetal exposure to maternal hyperglycaemia. In the mother, pregnancy
Objective: Contemporary health care places enormous health information management demands on laypeople. Insights into their skills and habits complements current developments in consumer health innovations, including personal health records. Using a five-element human factors model of work, health information management in the household (HIMH) is characterized by the tasks completed by individuals within household organizations, using certain tools and technologies in a given physical environment. Design: We conducted a descriptive-exploratory study of the work of HIMH, involving 49 community-dwelling volunteers from a rural Midwestern community. Measurements: During in-person interviews, we collected data using semistructured questionnaires and photographs of artifacts used for HIMH. Results: The work of HIMH is largely the responsibility of a single individual, primarily engaged in the tasks of acquiring, managing, and organizing a diverse set of health information. Paper-based tools are most common, and residents develop strategies for storing information in the household environment aligned with anticipated use. Affiliative relationships, e.g., parent-child or spousal, within the household serve as the organization that gives rise to health information management practices. Synthesis of these findings led to identification of several storage strategies employed in HIMH. These strategies are labeled “just-in-time,” “just-because,” “just-in-case,” and “just-at-hand,” reflecting location of the artifacts of health information and anticipated urgency in the need to retrieve it. Conclusion: Laypeople develop and employ robust, complex strategies for managinghealth information in the home. Capitalizing on these strategies will complement and extend current consumer health innovations to provide functional support to people who face increasing demands to manage personal health information.
The objective of this experiment was to determine if ruminal temperature rise coincides with pH reduction using an acidosis challenge model. Twelve ruminally cannulated steers (518 ± 28 kg BW) were administered ruminal temperature-monitoring devices that recorded temperature every 2 min. Steers were fed a 63% concentrate diet at 1.6% BW for 20 d before being randomly assigned to 1 of 3 acidosis challenge treatments: no dietary change (CON), one-half of daily DMI replaced with cracked corn (HALF), or all of daily DMI replaced with cracked corn (CORN). The challenge was initiated by ruminally dosing steers with their treatment diets. Ruminal pH and rectal temperatures (T(rec)) were recorded every 3 h for 72 h. All steers were offered CON diets at 24 and 48 h after challenge. Ruminal pH showed a treatment × day effect (P = 0.01). Ruminal pH of CORN steers was lower (P = 0.03) than that of HALF steers on d 1, was lower (P ? 0.004) than that of HALF and CON steers on d 2, and tended to be lower (P ? 0.10) than that of HALF and CON steers on d 3. Treatment did not affect (P ? 0.42) RecT. Ruminal temperature (T(rum)) showed a treatment · d(-1) · h(-1) after feeding interaction (P < 0.01). At 3 h after challenge, T(rum) of CORN and HALF steers was higher (P ? 0.01) than that of CON steers. On d 2, T(rum) of CORN steers was higher (P ? 0.03) than that of CON between 6 and 12 h after feeding. From 15 to 21 h after feeding on d 2, T(rum) of HALF steers was higher (P < 0.01) than that of CORN and CON steers. On d 3, at the time of feeding until 3 h later, T(rum) of CORN steers was lower (P ? 0.04) than that of all other steers. Rectal temperature was correlated (P ? 0.01) with T(rum) on all days for CON and CORN steers. Ruminal pH was negatively correlated (P ? 0.04) with T(rec) on d 2 and T(rum) on d 1 in CORN steers, and T(rum) was negatively correlated (P ? 0.02) with ruminal pH in HALF and CON steers on d 1 and 3, respectively. The amount of time above T(rum) of 39.0°C or 39.45°C was correlated (P ? 0.05) with the time spent below a ruminal pH of 5.5 in CORN steers; however, time above T(rum) of 39.0°C did not differ (P = 0.87) among treatments. Results indicate that there is a negative relationship between T(rum) and ruminal pH during an acidotic episode; therefore, T(rum) monitoring can detect a potential acidotic episode. PMID:22408086
Wahrmund, J L; Ronchesel, J R; Krehbiel, C R; Goad, C L; Trost, S M; Richards, C J
OBJECTIVE: To study the ways in which allocating the risk for behavioral health care expenses between employers and a managed behavioral health organization affects costs and the use of services. DATA SOURCES: Claims from 87 plans that cover mental health and substance abuse services covering over one million member years in 1996/1997. STUDY DESIGN: Multi-part regression models for health care cost are used. Dependent variables are health care costs decomposed into access to any care, costs per user, any inpatient use, costs per outpatient user, and costs per inpatient user. The study compares full-risk plans, in which the managed care organization provides managed care services and acts as the insurer by assuming the risk for claims costs, with contracts in which the managed care organization only manages care (for a fixed administrative fee) and the employer retains the risk for claims. PRINCIPAL FINDINGS: Full-risk plans are not statistically significantly different from non-risk plans in terms of any mental health specialty use or hospitalization rates, but costs per user are significantly lower, in particular for inpatients. CONCLUSIONS: Risk contracts do not affect initial access to mental health specialty care or hospitalization rates, but patients in risk contracts have lower costs, either because of lower intensity of care or because they are treated by less expensive providers.
Absorption of selenium and copper is much lower in ruminants than in nonruminants. The low absorption of these minerals in ruminants is due to modifications that occur in the rumen environment. Selenium bioavailability is reduced by high dietary sulfur and the presence of cyanogenetic glycosides in certain legumes. Feeding organic selenium from selenomethionine or selenized yeast results in much higher tissue and milk selenium concentrations than are obtained with selenite. High dietary molybdenum in combination with moderate to high dietary sulfur results in formation of thiomolybdates in the rumen. Thiomolybdates greatly reduce copper absorption, and certain thiomolybdate species can be absorbed and interfere systemically with copper metabolism. Independent of molybdenum, high dietary sulfur reduces copper absorption perhaps via formation of copper sulfide. High dietary iron also reduces copper bioavailability. Dietary factors that affect bioavailability of zinc in ruminants are not well defined. Phytate does not affect zinc absorption in ruminants because microbial phytase in the rumen degrades phytate. Manganese is very poorly absorbed in ruminants, and limited research suggests that high dietary calcium and phosphorus may reduce manganese absorption. PMID:12730454
Developing strategies to address the health needs of the National Health Services (NHS) workforce are of concern to many health care managers. Focal to the development of such strategies are of being in receipt of baseline information about employees expressed health needs and concerns. This article addresses obtaining such baseline information and presents the findings of a health needs survey of acute hospital staff in a trust in North Wales. The total population of trust employees were surveyed (n = 2300) and a 44% (n = 1021) response rate was achieved. A number of positive findings are given. Included are that the majority of those surveyed stated that their current health status is good, are motivated to improve their health further, do not smoke and their alcohol consumption is within recommended levels. There appears, however, to be a number of areas where trust managers can help its staff improve their health. Included are trust initiatives that focus on weight control and taking more exercise. In addition, there appears to be a reported lack of knowledge and positive health behaviour amongst the male respondents surveyed that would imply the trust needs to be more effective in promoting well man type issues. Finally there appears to be a general lack of pride in working for the trust and a pervasive feeling that the trust does not care about its employees that needs to be addressed. It is concluded that the findings of this survey have implications for management practices in the trust where the survey was conducted and also wider applicability to the management of health care professionals. For example, addressing work-related psychological and physical problems of employees are of importance to all health care managers. This is especially so when considering recruitment and retention issues. PMID:12930541
|Critical decisions that need to be made by faculties of health administration education programs when developing and assessing the health services management portion of the curriculum are identified. Decisions should draw from the information available concerning professional target roles of graduates, graduate behavior expected, resources for…
Association of Univ. Programs in Health Administration, Washington, DC.
Lifestyle is a key determinant in the prevention and management of chronic diseases. If we would exercise regularly, eat healthy, control our weight, sleep enough, manage stress, not smoke and use alcohol only moderately, 90% of type II diabetes, 80% of coronary heart disease, and 70% of stroke could be prevented. Health statistics show that lifestyle related diseases are increasing
Anita Honka; Kirsikka Kaipainen; Henri Hietala; Niilo Saranummi
Ruminal acidosis in pre-ruminant calves is caused primarily by the inefficient function of the esophageal groove, producing an abnormal accumulation of fermentable liquid in the rumen. This issue of Large Animal Veterinary Rounds describes the most important factors that induce esophageal groove dysfunction and the etiological, pathogenic, and clinical aspects of ruminal acidosis in milk-fed calves. This issue will also
Arcangelo Gentile; Jonathan M. Naylor; Charles S. Rhodes; David G. Wilson; Ken Armstrong; Emeritus Sue Ashburner; Jeremy Bailey
Objectives. The aim of this study was to examine the relationship between anger rumination (the propensity to think almost obsessively over past experiences that have provoked negative affect in the form of anger) and athlete aggression. It was predicted that high levels of anger rumination would be associated with an increased propensity to aggress.Method. A questionnaire comprising the Anger Rumination
Worry and rumination both refer to unproductive, repetitive thought processes. Few studies have addressed the relationship between these two constructs, with most researchers exclusively relating rumination to depression and worry to anxiety. The present study examined relationships between self-reported rumination as assessed by the Children's Response Style Scale (CRSS), worry as measured by the Penn State Worry Questionnaire for Children
Peter Muris; Jeffrey Roelofs; Cor Meesters; Petra Boomsma
The Management Academy for Public Health is a management development program with the goals of helping public healthmanagers learn to manage people, data, and finance, to think and plan like entrepreneurs, and to strengthen public health organizations. Managers enroll as teams and develop business plans in the Academy's extensive project-based learning component. Extensive internal and external evaluation shows that the program improves managers' knowledge, skills, and confidence in key curriculum areas; that participants apply many of the skills in their jobs; that many of the business plans receive funding, resulting in new public health programs; that the training experience helped agencies respond and plan after September 11, 2001; and that many participants report beginning to think more like entrepreneurs through activities like teaming, partnering, innovating, negotiating, finding funds, and generating revenue. The program demonstrates that robust training including extensive work-based project work with coaching can help public healthmanagers gain many skills needed for the drive to "reinvent" government. PMID:16912605
Umble, Karl E; Orton, Stephen; Rosen, Benson; Ottoson, Judith
As nursing has been subject to successive waves of 'managerialism' there has been a drive on the part of government and elements within the profession to enhance the science base and promote cost-effective health care interventions. This has generated new interest in the 'economics of nursing' as efficiency and 'value for money' are viewed as necessary precondition for the provision of a high quality nursing service. As an academic subject health economics has brought an elegant set of theories to bear on the topic of health and health care. However, mainstream health economics is premised on a series of simplifying assumptions that, if applied uncritically, can induce a range of unintended and adverse consequences. This paper asks how ideas developed in one sphere (health economics) can be become influential in another (nursing management and practice) and it seeks explanations in the theories of Michel Foucault, specifically in his exploration of the reciprocal relationship between power and knowledge. How are our assumptions about what is possible and desirable shaped, how far do mechanisms of surveillance and self-subjugation extend? A range of alternative economic approaches have been developed which challenge many mainstream health economics assumptions. Some of these are better suited to the complex social environment present within health care. Nurses, nurse managers and researchers should question the assumptions of dominant economic models and explore a range of economic frameworks when planning services and evaluating their practice. PMID:16108775
Fault detection and isolation for advanced rocket engine controllers are discussed focusing on advanced sensing systems and software which significantly improve component failure detection for engine safety and healthmanagement. Aerojet's Space Transportation Main Engine controller for the National Launch System is the state of the art in fault tolerant engine avionics. Healthmanagement systems provide high levels of automated fault coverage and significantly improve vehicle delivered reliability and lower preflight operations costs. Key technologies, including the sensor data validation algorithms and flight capable spectrometers, have been demonstrated in ground applications and are found to be suitable for bridging programs into flight applications.
Health services management, which is described as the process of mobilizing and deploying resources for the efficient provision of effective health services, has taken the center stage in business discussions across the globe. Poor management is unanimously blamed for the diminishing fortunes of most health industries. The present study was designed to review the managerial skills of health administrators and
Coordinated multi-vehicle autonomous systems can provide incredible functionality, but off-nominal conditions and degraded system components can render this capability ineffective. This paper presents techniques to improve mission-level functional reliability through better system self-awareness and adaptive mission planning. In particular, we extend the traditional definition of healthmanagement, which has historically referred to the process of actively monitoring and managing vehicle
Mario Valenti; Brett Bethke; Daniela Pucci de Farias; John Vian
This analysis uses in-depth interview data collected from 145 AfricanAmerican, European American and Native American men and women aged 70and older who reside in two rural North Carolina counties to understand therole of religious faith and prayer in the health self-management of theseolder adults. The analysis addresses three specific questions: how do theseolder adults use religion to help them manage
Thomas A. Arcury; Sara A. Quandt; Juliana McDonald; Ronny A. Bell
This work presents an automated contingency management (ACM) software simulation test bed developed in Simulink that can be applied to various unmanned platforms for developing; testing and verifying automated fault accommodation strategies. Specifically, this paper introduces the required software components and integrated healthmanagement and control architecture for performing these tasks and applies it to the unmanned combat armed rotorcraft
Jianhua Ge; Michael I. Roemer; George Vachtsevanos
We discuss the effects of managed care on the structure of the health care delivery system, focusing on managed-care-induced consolidation among health care providers. We empirically investigate the relationship between HMO market share and mammography providers. We find evidence of consolidation: increases in HMO activity are associated with reductions in the number of mammography providers and with increases in the number of services produced by remaining providers. We also find that increases in HMO market share are associated with reductions in costs for mammography and with increases in waiting times for appointments, but not with worse health outcomes. PMID:10558503
Total Quality Management (TQM) is defined as the management approach of the organization aimed at long-term success through client satisfaction, and which benefits all members of the organization and society (ISO 8402; International Organization for Standardization, 1994a). The objective of the study was to evaluate management methods applied to improve working conditions in Polish enterprises implementing TQM. The investigation was conducted in the form of interviews, which covered relevant connections between the TQM concept and occupational health and safety (OHS) systematic management rules. The results revealed that the criteria adopted in investigated enterprises for OHS management systems, as well as the implemented management methods and tools, can be evaluated positively. However, many require significant improvement in order to ensure better compliance with the existing law provisions. Elements of OHS management systems also require better integration with the overall management system of the enterprise. PMID:10828155
This paper, and the former report on the experience of adolescent care in an ambulatory and multidisciplinary center based on a bifocal medical and psychological strategy. This process integrates the health care providers in the center as well as family and school people interacting with the adolescent who is looked at as the central issue. In this paper, the initial elucidation of the adolescent complaint and its content are detailed and illustrated. The follow-up modalities are also discussed, particularly the variable temporal sequence in medical and psychological intervention. PMID:9713213
Worldwide, programs to improve udder health are implemented using communication tools and methods that inform and persuade dairy farmers. This study evaluated 2 communication strategies used in a mastitis control program in the Netherlands. To improve farmers' udder healthmanagement, tools such as instruction cards, treatment plans, checklists and software were developed following an argument-based comprehensive "central route." These tools were used during on-farm study group meetings for farmers organized by veterinarians and also during individual veterinarian-farmer interactions. The second strategy aimed at adopting a single management practice to increase the use of milking gloves during milking. This approach followed a straightforward "peripheral" route that used implicit persuasion techniques. Results of an online survey of 374 Dutch dairy farmers showed that most farmers were able and willing to use the educational management tools to increase udder health on their farms. They evaluated the tools positively regardless of the mastitis problems on their farms. This seems to indicate that the central route of communication is most effective when farmers are motivated to work on udder health in general. Results of repeated random telephone surveys before, during, and after the campaign on the use of milking gloves showed that the use of gloves increased from 20.9 to 42.0% of the respondents. Respondents' opinions about milking gloves also changed favorably, indicating that a relatively short peripheral campaign on a single action can have a sustained effect on farmers' behavior. Both communication strategies seem to be potentially successful in disseminating knowledge to a specific target group of farmers and in changing that group's behavior. However, to reach as many farmers as possible, the strategies should be combined. When optimizing these strategies, both the farmers' motivation to work on udder health and the aim of the campaign should be considered. When aiming to improve general udder healthmanagement, the central route seems to be effective if farmers are already motivated to optimize their udder healthmanagement. For farmers who are less motivated to work on udder health, the peripheral route seems to be most effective when aiming to change a single management practice. The evaluated communication strategies are examples of how management practices to control mastitis can be effectively communicated to farmers. As such, this study contributes to optimizing future programs to control and prevent diseases. PMID:20105532
In health care, multidisciplinary collaboration is both indispensable and complicated. We discuss organizational problems that occur in situations where multiple health care providers are required to cooperate for patients with complex needs. Four problem categories, labelled as communication, patient safety, waiting times and integration are distinguished. Then we develop a supply chain perspective on these problems in the sense of discussing remedies according to supply chain management (SCM) literature. This perspective implies a business focus on inter-organizational conditions and requirements necessary for delivering health care and cure across organizational borders. We conclude by presenting some strategic and policy recommendations. PMID:21069770
Meijboom, Bert R; Bakx, Saskia J W G C; Westert, Gert P
With the institutionalization of participation in health, through conferences and management councils at national, state, municipal and local levels, a process of democratization is initiated in the health area. However, in relation to the health councils in particular, there is still much to be done, including improving the quality of the decision-making process. This work aims to place the decision-making process in its theoretical context in terms of participatory democracy, elements which make up, factors which influence its development, and finally, to explore some possibilities of this theoretical basis to analyze the practices of the health councils in the area of health. It is hoped that it will make a theoretical contribution to the analyses carried out in this area, in order to provide a decision-making process that is more inclusive in terms of participation. PMID:18041561
Restrained and binge eating are related to depressive symptomatology in women; we examined the role of ruminative coping in\\u000a this association. Sample participants (N?=?329) were female college students in the Midwestern U.S. who completed a health behaviors survey. Multiple regression models\\u000a examining the pathway between eating (restrained and bingeing, respectively) and depressive symptoms were tested; ruminative\\u000a coping was examined as
Wireless sensing is part of our lives; major technological breakthroughs in the areas of sensors, integrated circuits, and also on wireless communications, led to the creation of wireless sensor networks (WSNs). Such networks have multiple uses, from monitoring and tracking of people and goods, to the coordination and processing of activities in different contexts; they are used in industry, defence and healthcare applications. As part of this use in healthcare applications KeepCare, a solution based on monitoring, tracking and processing of healthcare related information, is presented in this paper. This solution uses a WSN based application to monitor peoples' health and quality of life through vital signs and activity information received via wireless sensors. This solution monitors users such as elderly, people suffering from chronic conditions in their home environment, but can as well be used in athletes or other professionals (e.g. first responders) that need to be monitored under hazardous conditions. PMID:22942032
Petroleum is used widely in health care—primarily as a transport fuel and feedstock for pharmaceuticals, plastics, and medical supplies—and few substitutes for it are available. This dependence theoretically makes health care vulnerable to petroleum supply shifts, but this vulnerability has not been empirically assessed. We quantify key aspects of petroleum use in health care and explore historical associations between petroleum supply shocks and health care prices. These analyses confirm that petroleum products are intrinsic to modern health care and that petroleum supply shifts can affect health care prices. In anticipation of future supply contractions lasting longer than previous shifts and potentially disrupting health care delivery, we propose an adaptive management approach and outline its application to the example of emergency medical services.
|The authors suggest that many managed mental health care (MMHC) practices have oppressive effects on members of cultural and ethnic minority groups. They examine the dissonance between institutional practices and cultural traditions that reflect insensitivity and forced conformity, particularly regarding time, pace, and intervention uniformity as…
This article presents the reflections of three faculty members from New York University based on more than two years of experience in a healthmanagement education (HME) partnership with institutions in the Republic of Albania. The most significant point to be shared with colleagues considering similar initiatives in other countries is that aiding other professionals in developing healthmanagement education programs involves much more than the transfer of technical information among professionals. Based on experience in Albania, we argue that the development of viable management and policy analysis programs will require assistance to counterparts in Central and Eastern Europe in: (1) building constituencies for these activities among influential leaders and sustaining this support through changes in government; (2) providing models of and motivations for using styles of pedagogy that vary significantly from those now common in this part of the world; and (3) reconciling conflicts between pressures for investments in the largely hospital-based activity of healthmanagement and the largely public-health-based needs of relatively poor countries. PMID:10387233
|This article discusses industry-based efforts to improve the quality of work life through various methods including health promotion programs; early intervention and disability management; and rehabilitation of industrially injured workers. Program models in each of these areas are described. (CB)|
Majority of the health risks and diseases in the modern world are related to lifestyles, e.g., overweight, unhealthy diet, physical inactivity, sleep deprivation, and stress. Behavioral change towards healthy lifestyles is the key to the prevention and management of these risks, but early and efficient interventions are scarcely available. We present the Nuadu Concept, an ICT (Information and Communication Technologies)
E. Mattila; I. Korhonen; R. Lappalainen; A. Ahtinen; L. Hopsu; T. Leino
According to the electrical power supply system analysis, a system of prognostic and healthmanagement (PHM) for the electrical power supply system is presented. The PHM system can accomplish the condition assessment of the key characteristics and device in the electrical power supply system without additional test equipment. The condition of rotating rectifier, contact resistance and so on can be
|The purpose of this study was to determine the use and perceived usefulness of outcomes assessment methods in health information management programs. Additional characteristics of the outcomes assessment practices were recognized. The findings were evaluated for significant differences in results based on age of the program, type of institution,…
The purpose of this study was to determine the use and perceived usefulness of outcomes assessment methods in health information management programs. Additional characteristics of the outcomes assessment practices were recognized. The findings were evaluated for significant differences in results based on age of the program, type of institution,…
The purpose of this paper is to informally lay out for health planning agencies the basic principles of personal time management. It does not address the general problem of budgeting overall staff time through the use of agency work programs. Rather, it f...
The serious problems of contaminants and environment impacts produced by human action in the subsurface (air, groundwater and rock in interaction with human activities), particularly in underground mines, require an integrated approach in terms of specific rules, laws and management systems in the domain of Occupational Safety and Health. As the ISO 14001 standard is mostly directed for the prevention
Nurses working within managed care systems often face moral conflicts. Ethical nursing practice seems to require justice with integrity, that is, treating persons in like circumstances similarly (formal justice); helping to shape public policy regarding the provision of health care benefits and burdens (distributive justice): discussing with patients the benefits that are and are not provided by particular insurance policies
The paper presents a model of systematic occupational health and safety management of a company with focus on three feedback loops where exposed hazards and risk are channelled through a regulatory regime, market stakeholders and the industrial system. The purpose of this paper is to improve the understanding of how an enterprise, as part of an industrial context, develops barriers
|The Lifestyle Management Project is a health promotion project and research study conducted in the spring of 1984 at five Los Angeles junior college campuses. Its goal was to increase knowledge of cardiovascular disease (CHD) risk factors among 400 to 2000 junior college students in each campus. This was done via five risk factor activities:…
Purpose – This paper seeks to concentrate on the question whether any parallels can be found between the industrial sector and health care services with respect to the developments that have taken place in the area of Supply Chain Management. Starting from an analysis of existing literature, it is intended that different modes of Supply Chain integration will be discussed.
This paper presents an integrated approach to switching mode power supply healthmanagement that implements techniques from engineering disciplines including statistical reliability modeling, damage accumulation models, physics of failure modeling, and sensor-based condition monitoring using automated reasoning algorithms. Novel features extracted from sensed parameters such as temperature, power quality, and efficiency were analyzed using advanced fault detection and damage accumulation
Rolf Orsagh; Douglas Brown; Michael Roemer; T. Dabnev; Andrew Hess
The focus of this paper is to present the advances, benefits and challenges in measuring, monitoring and managing the health of aircraft avionics systems as well as the support equipment used to test these systems. Most people are skeptical when avionics and prognostics are used in the same sentence. For the purpose of this discussion, we will grant that most
Larry V. Kirkland; T. Pombo; K. Nelson; F. Berghout
This paper presents a comparison of different pattern recognition algorithms to identify slow time scale anomalies for healthmanagement of aircraft gas turbine engines. A new tool of anomaly detection, based on symbolic dynamics and information theory, is compared with traditional pattern recognition tools of principal component analysis (PCA) and artificial neural network (ANN). Time series data of the observed
This article considers the critical roles of risk and risk assessment in the management of health emergencies and disasters. The Task Force on Quality Control of Disaster Management (TFQCDM) has defined risk as the "objective (mathematical) or subjective (inductive) probability that something negative will occur (happen)". Risks with the greatest relevance to health emergency management include: (1) the probability that a health hazard exists or will occur; (2) the probability that the hazard will become an event; (3) the probability that the event will lead to health damage; and (4) the probability that the health damage will lead to a health disaster. The overall risk of a health disaster is the product of these four probabilities. Risk assessments are the tools that help systems at risk-healthcare organizations, communities, regions, states, and countries-transform their visceral reactions to threats into rational strategies for risk reduction. Type I errors in risk assessment occur when situations are predicted that do not occur (risk is overestimated). Type II errors in risk assessment occur when situations are not predicted that do occur (risk is underestimated). Both types of error may have serious, even lethal, consequences. Errors in risk assessment may be reduced through strategies that optimize risk assessment, including the: (1) adoption of the TFQCDM definition of risk and other terms; (2) specification of the system at risk and situations of interest (hazard, event, damage, and health disaster); (3) adoption of a best practice approach to risk assessment methodology; (4) assembly of the requisite range of expert participants and information; (5) adoption of an evidence-based approach to using information; (6) exclusion of biased, irrelevant, and obsolete information; and (7) complete characterizations of any underlying fault and event trees. PMID:16018501
Availability of emergency preparedness funding between 2002 and 2009 allowed the North Dakota Department of Health to build public health response capabilities. Five of the 15 public health preparedness capability areas identified by the Centers for Disease Control and Prevention in 2011 have been thoroughly tested by responses to flooding in North Dakota in 2009, 2010, and 2011; those capability areas are information sharing, emergency operations coordination, medical surge, material management and distribution, and volunteer management. Increasing response effectiveness has depended on planning, implementation of new information technology, changes to command and control procedures, containerized response materials, and rapid contract procedures. Continued improvement in response and maintenance of response capabilities is dependent on ongoing funding. PMID:23348522
Wiedrich, Tim W; Sickler, Juli L; Vossler, Brenda L; Pickard, Stephen P
Health-care organizations are beginning to apply the principles of total quality management (TQM). Implementing TQM in a health-care laboratory requires incorporating quality improvement (QI) and quality planning (QP) with quality laboratory practices (QLP), quality control (QC), and quality assurance (QA) to provide a complete quality management system. QI and QP can be initiated by developing a strategic plan as a pilot QI project. QI project teams are then introduced to accomplish the highest priority goals. This implementation approach improves strategic planning by using group problem-solving tools and techniques, such as process flow charts, brainstorming, nominal group, fishbone diagrams, consensus decision making, and Pareto analysis. The approach also improves the success of project teams by providing a clear management agenda and a commitment to project-by-project QI. PMID:10113715
Despite an acknowledged lack of evidence of investment payoff, health plan initiatives to promote health and wellness are now commonplace, according to findings from the Center for Studying Health System Change's (HSC) 2007 site visits to 12 nationally representative metropolitan communities. Much of the impetus has come from employers--primarily large employers--that are incorporating health and wellness activities into benefit designs that place more responsibility on employees for health care decisions and costs. Health plans now offer a range of health and wellness activities, including traditional worksite health fairs, screenings and educational seminars; access to behavior modification programs, such as weight management and smoking cessation; and online tools, including health risk assessments. Engaging enrollees in these activities, however, is challenging because participation typically is voluntary. Another barrier is employee privacy concerns. More health plans and employers are turning to financial incentives to secure greater participation. Ultimately, however, the credibility of health and wellness activities as mechanisms to improve health and contain costs is dependent on evidence demonstrating their clinical and financial effectiveness, as well as consumers' acceptance and validation of their legitimacy. PMID:18536150
From February 2008 through April 2011, School Health Connection, a program of the Louisiana Public Health Institute, developed an electronic health information management system for newly established school-based health centers in Greater New Orleans. School Health Connection was established as part of a broader effort to restore community health…
The British Columbia Ministry of Health's Framework for Core Functions in Public Health was the catalyst that inspired this review of best practices in health emergency management. The fieldwork was conducted in the fall of 2005 between hurricane Katrina and the South Asia earthquake. These tragedies, shown on 24/7 television news channels, provided an eyewitness account of disaster management, or lack of it, in our global village world. It is not enough to just have best practices in place. There has to be a governance structure that can be held accountable. This review of best practices lists actions in support of an emergency preparedness culture at the management, executive, and corporate/governance levels of the organization. The methodology adopted a future quality management approach of the emergency management process to identify the corresponding performance indictors that correlated with practices or sets of practices. Identifying best practice performance indictors needed to conduct a future quality management audit is described as reverse quality management. Best practices cannot be assessed as stand-alone criteria; they are influenced by organizational culture. The defining of best practices was influenced by doubt about defining a practice it is hoped will never be performed, medical staff involvement, leadership, and an appreciation of the resources required and how they need to be managed. Best practice benchmarks are seen as being related more to "measures" of performance defined locally and agreed on by 2 or more parties rather than to achieving industrial standards. Relating practices to performance indicators and then to benchmarks resulted in the development of a Health Emergency Management Best Practices Matrix that lists specific practice in the different phases of emergency management. PMID:16622359
Using a mechanistic model, we compared five alternative farming systems with the purpose of transforming monoculture (MON) banana farms into mixed farming systems (MFS) with ruminants feeding banana by-products (leaves, pseudostems and nonmarketable fruits) and forage from the fallow land. The paper presents the main structure of the model (land surface changes, available biomass for animals, stocking rates, productive or reproductive indicators), and impact assessment (change in farm productivity) is discussed. Five MFS with typical local ruminant production systems were used to compare MON to the strategies using forage from fallow and/or integrating Creole cattle (CC), Creole goats (CG) or Martinik sheep (MS) into banana farming. One hectare MON shifted into an MFS allows a stocking rate of 1,184, 285, and 418 kg of live weight per hectare for CC, CG and MS, respectively. Banana by-products seem to be better valorized by the CC scenario. However, parameters such as length of the cycle, local prices for cattle, goat and sheep meat, work time and farmer's skills in ruminantmanagement may have been taken into account by the farmer when choosing the ruminant species to rear. PMID:22258310
Summary The recycling of rendered animal products back into the feed of ruminant livestock species has had a positive impact both on the efficiency of livestock production and the availability of meat and milk for consumers at an affordable price. Rendered animal products are distinguished by a high protein content containing amino acids that resist microbial degradation in the rumen,
Presented is the report by the Working Group on the education of managers in health services in the World Health Organization, European Region. The report is organized into the following sections: health care management and managers; key issues in health service management (public policy-making and health care management, the managerial role of…
World Health Organization, Copenhagen (Denmark). Regional Office for Europe.
|Presented is the report by the Working Group on the education of managers in health services in the World Health Organization, European Region. The report is organized into the following sections: health care management and managers; key issues in health service management (public policy-making and health care management, the managerial role of…
World Health Organization, Copenhagen (Denmark). Regional Office for Europe.
Currently, many organizations are using a department-centered approach to managehealth risks at work. In such a model, segregated departments are providing employee benefits such as health insurance, workers' compensation, and short- and long-term disability or benefits addressing work-life issues. In recent years, a new model has emerged: health and productivity management (HPM). This is an employee-centered, integrated approach, designed to increase efficiency, reduce competition for scarce resources, and increase employee participation in prevention activities. Evidence suggests that corporations using integrated HPM programs achieve better health outcomes for their employees, with consequent increased productivity and decreased absenteeism. Occupational health nurses are well positioned to assume leadership roles in their organizations by coordinating efforts and programs across departments that offer health, wellness, and safety benefits. To assume their role as change agents to improve employees' health, nurses should start using the language of business more often by improving their communication skills, computer skills, and ability to quantify and articulate results of programs and services to senior management. PMID:17323873
Although many employers offer some components of worksite-based population healthmanagement (PHM), most do not yet invest in comprehensive programs. This hesitation to invest in comprehensive programs may be attributed to numerous factors, such as other more pressing business priorities, reluctance to intervene in the personal health choices of employees, or insufficient funds for employee health. Many decision makers also remain skeptical about whether investment in comprehensive programs will produce a financial return on investment (ROI). Most peer-reviewed studies assessing the financial impact of PHM were published before 2000 and include a broad array of program and study designs. Many of these studies have also included indirect productivity savings in their assessment of financial outcomes. In contrast, this review includes only peer-reviewed studies of the direct health care cost impact of comprehensive PHM programs that meet rigorous methodological criteria. A systematic search of health sciences databases identified only 5 studies with program designs and study methods meeting these selection criteria published after 2007. This focused review found that comprehensive PHM programs can yield a positive ROI based on their impact on direct health care costs, but the level of ROI achieved was lower than that reported by literature reviews with less focused and restrictive qualifying criteria. To yield substantial short-term health care cost savings, the longer term financial return that can credibly be associated with a comprehensive, prevention-oriented population health program must be augmented by other financial impact strategies. PMID:22313443
Grossmeier, Jessica; Terry, Paul E; Anderson, David R; Wright, Steven
Ruminative coping has been shown to heighten the risk and severity of depression. The authors hypothesized that ruminators who smoke would experience greater depressive symptoms than ruminators who do not. The rationale is that, by heightening attentional focus, nicotine may increase ruminators' ability to focus on negative thoughts, augmenting depressed mood. Participants (N = 145) self-reported smoking status, rumination, and
Malia Richmond; Bonnie Spring; Beth Kaplan Sommerfeld; Dennis McChargue
Background: Managers’ lives have become a never-ending race against time, technology, and targets. This race creates tension, which leads to dissatisfaction and frustration and eventually manifests itself as psychological and physiological stress with mental and emotional drain. This modern lifestyle intensifies the stress leading to “Excessive Tension” and consequent deterioration in “Executive Efficiency.” Objective: To assess mental health in managers undergoing yoga-based Self-Management of Excessive Tension (SMET) program. Materials and Methods: 72 managers with 48.75±3.86 years of mean age were participated in this study of single group pre–post design. The General Health Questionnaire data were taken on the first and sixth day of 5 days SMET program. Results: The data analysis showed 68.25% decrease (P<0.001) in somatic symptoms, 66.29% decrease (P<0.001) in anxiety and insomnia, 65.00% decrease (P<0.001) in social dysfunction, 87.08% decrease (P<0.001) in severe depression, and 71.47% decrease (P<0.001) in all medical complaints. Conclusion: These results suggest that participation in a SMET program was associated with improvement in mental health and may have implications for “Executive Efficiency.”
Health crisis management is a crisis management of life, body, and mind. This is the most important role for today's public health center. However, few of the personnel realize health crisis as an urgent problem. Through the establishment of a coordinated system in the region and the implementation of cooperative practice, we are keenly aware of the importance of agreeing
...FRL-9197-7] Best Management Practices for Unused Pharmaceuticals at Health Care Facilities AGENCY: Environmental...document entitled, Best Management Practices for Unused Pharmaceuticals at Health Care Facilities. The...
The primary health care model of public health has been implemented in many countries around the globe since the Declaration of Alma Ata in 1978, without pilot testing the primary health care model. Therefore, many public health researchers have sought methods of improving primary health care by creating evidence-based models. Many of these researchers recognize the role of behavioral models in public health. These offshoots of primary health care include the ecological, care, central human capabilities, and the SPECIES models. Holistic self-management education and support is a capacity-building philosophy that ensures active involvement of consumers of health care in the planning and implementation and evaluation of health care services. It helps consumers of health care to achieve the desired improved quality of health and life in managing and sustaining their health at the grassroots level. The care model addresses disease management ideals of the in the original primary health care model. The SPECIES model addresses those aspects of the primary health care model that include the cultural and social factors, as well as individual health education and support in the original primary health care model. The ecological model offers an improvement of the socioeconomic ideal in the original primary health care model. Improving the health of individuals will prevent illness, thereby reducing health care costs and lessening the current strain on an overburdened health care system in Zimbabwe. Holistic self-management education and support links health care delivery systems with social processes. It is a best practices model that could better serve Zimbabwean girls and women by contributing positively to the national challenges in health care, thereby meeting the Zimbabwean primary health care and safe motherhood goals. It is here recommended that holistic self-management education and support must be pilot tested before being adopted as the most appropriate model for ensuring population health. PMID:16844675
We describe the impact of community health workers (CHWs) providing community-based support services to enrollees who are high consumers of health resources in a Medicaid managed care system. We conducted a retrospective study on a sample of 448 enrollees who were assigned to field-based CHWs in 11 of New Mexico's 33 counties. The CHWs provided patients education, advocacy and social support for a period up to 6 months. Data was collected on services provided, and community resources accessed. Utilization and payments in the emergency department, inpatient service, non-narcotic and narcotic prescriptions as well as outpatient primary care and specialty care were collected on each patient for a 6 month period before, for 6 months during and for 6 months after the intervention. For comparison, data was collected on another group of 448 enrollees who were also high consumers of health resources but who did not receive CHW intervention. For all measures, there was a significant reduction in both numbers of claims and payments after the community health worker intervention. Costs also declined in the non-CHW group on all measures, but to a more modest degree, with a greater reduction than in the CHW group in use of ambulatory services. The incorporation of field-based, community health workers as part of Medicaid managed care to provide supportive services to high resource-consuming enrollees can improve access to preventive and social services and may reduce resource utilization and cost. PMID:21953498
Total quality management (TQM) is a participative, systematic approach to planning and implementing a continuous organizational improvement process. Its approach is focused on satisfying customers' expectations, identifying problems, building commitment, and promoting open decision-making among workers. TQM applies analytical tools, such as flow and statistical charts and check sheets, to gather data about activities within an organization. TQM uses process techniques, such as nominal groups, brainstorming, and consensus forming to facilitate communication and decision making. TQM applications in the public sector and particularly in public health agencies have been limited. The process of integrating TQM into public health agencies complements and enhances the Model Standards Program and assessment methodologies, such as the Assessment Protocol for Excellence in Public Health (APEX-PH), which are mechanisms for establishing strategic directions for public health. The authors examine the potential for using TQM as a method to achieve and exceed standards quickly and efficiently. They discuss the relationship of performance standards and assessment methodologies with TQM and provide guidelines for achieving the full potential of TQM in public health organizations. The guidelines include redefining the role of management, defining a common corporate culture, refining the role of citizen oversight functions, and setting realistic estimates of the time needed to complete a task or project.
We assess the satisfaction of mental health providers using four dimensions from the medical practice literature--degree of autonomy, relationship with patients, compensation, and administrative burden--and extend current work on professional satisfaction to include frontline service providers rather than only psychiatrists or other physicians. In contrast to results reported for primary care settings, we find that the impact of managed care on satisfaction is minimal for the mental health providers in our study of a Medicaid capitation demonstration in the southeastern US. Instead, variables relevant to everyday working conditions have an important effect on job satisfaction. PMID:19002581
Isett, Kimberley R; Ellis, Alan R; Topping, Sharon; Morrissey, Joseph P
Media relations is an important function in the operation of any health organization, yet it is often relegated as a simple task function. Such an orientation can be problematic, particularly in times of crisis. This article provides an overview of some of the inherent internal conflicts within health organizations that may mitigate against the best media relations practices in times of crises. The article surveys some of the predominant theoretical models used for crisis management, and suggests directions for the further development of media relations and crisis communication theory and practice. PMID:19042529
The heterogeneity of e-health systems encourages the use of standards such as Health Level 7 (HL7v3) to ensure interoperability. Many actual implementations address this problem by unoptimized high level programming of top-range portable computing platforms. However, this approach could pose excessive demands on battery-powered mid-range terminals. In this work, we propose low-level support for portable HL7v3-compatible embedded systems in order to better exploit their limited processing and communications capabilities. In particular, we present our experience in mobile communication management through two different approaches, which proves the feasibility of this proposal.
Oral health information was included in 89.5% of diabetes education programs in states with high diabetes prevalence compared to 85.9% in low prevalence states (P = 0.22). Comparing the high to low diabetes prevalence states, there were significant differences in odds for responding "yes" to the topics "show patients proper tooth brushing (and flossing) techniques" and "managing dry mouth" (Ps = 0.02). However, management of dry mouth, demonstrations and return demonstrations of oral hygiene techniques were covered by 27.0%, 10.1% and < 1% programs, respectively. PMID:21030100
Yuen, Hon K; Marlow, Nicole M; Mahoney, Samantha; Slate, Elizabeth; Jenkins, Carolyn; London, Steven
...outcomes. Case management involves the...members of the health care team. Quality...the cost of health care, case management has proven its...determine the health care priorities...the PHN case management program...
Healthcare waste streams are persistent waste streams and which are consistently increasing in volume and complexity in developed and developing countries. When poorly managed, through inappropriate health care waste management systems, they can cause adverse effects to human health and the environment.This paper presents an evaluation of health care waste management systems in Cameroon, based on a survey of five
Veronica E. Manga; Osric Tening Forton; Linus A. Mofor; Ryan Woodard
BACKGROUND: Common mental health problems are prevalent in prison and the quality of prison health care provision for prisoners with mental health problems has been a focus of critical scrutiny. Currently, health policy aims to align and integrate prison health services and practices with those of the National Health Service (NHS). Medication management is a key aspect of treatment for
This paper presents applications of A.I. in turbine engines fault diagnosis and healthmanagement. Self-organizing map and back-propagation neural networks supported with fuzzy-logic decision-making tool were developed and integrated together as diagnostics software for turbine engines. Two different neural network architectures were trained and used. An unsupervised network (SOM) was used to cluster sensors data to distinct locations on a
Richard Hans Mgaya; Charles D. McCurry; Saleh Zein-Sabatto
This article describes considerations in health and behavioral sciences small grant management and describes lessons learned during post-award implementation. Using the components by W. Sahlman [Sahlman, W. (1997). How to write a great business plan. Harvard Business Review, 75(4), 98–108] as a business framework, a plan was developed that included (a) building relationships with people in the research program and
Teresa J. Sakraida; Jessica D'Amico; Erica Thibault
Angry rumination is perseverative thinking about a personally meaningful anger-inducing event and is a risk factor for aggression. This article presents a new model for understanding angry rumination across five levels of analysis: cognitive, neurobiological, affective, executive control, and behavioral. The type of rumination that occurs at the cognitive level moderates affective responding and neurobiological activation, which influences executive control and aggression. Angry rumination recruits brain regions implicated in cognitive control, emotion regulation, negative affect, physiological arousal, social cognition, and self-reflection on emotional states. Moreover, angry rumination temporarily reduces self-control, which can increase aggression. The article suggests a functional account of angry rumination, identifies gaps in our knowledge, and proposes future research directions based on hypotheses derived from the model. PMID:23175519
The contribution of public health officers is of crucial importance in both the preparedness planning process and the response to health threats since the implementation of public health measures lies within the competence of the public health system. Thus, public health officers on regional and district level have to be involved in every stage of the planning process for crisis management. Federal structures of health systems as equivalent to the political structure of a country pose specific challenges for both the planning process and the response itself. The most important instrument for the evaluation of crisis plans, including the assessment of the public health officers' preparedness, is the performance of exercises. The success of a simulation exercise depends mainly on careful planning process, clear evaluation criteria and a work plan, that allows for necessary improvements of crisis plans of all involved organisations. Simulation exercises are an integrated element of preparedness activities on all administrative levels of the public health system. Depending on the nature of the exercise public health officers on regional and district level are involved as planners or as players PMID:18768125
This nonexperimental quantitative descriptive-correlative research study was performed to describe the sources with the greatest influence on the participants’ decision to enroll in a postsecondary educational program with the intent of working toward a career in health information management. Participants were asked, “Which sources have the greatest influence on an individual's decision to enroll in a postsecondary educational program with the intent of working toward a career in health information management (HIM)?” The study population was composed of matriculated students enrolled in accredited postsecondary schools offering an undergraduate medical billing and coding program at a brick-and-mortar campus in a two-county area of a South Atlantic state. The study found that an environmental source, specifically career job opportunities, was statistically significant as the greatest source of influence for these participants. This research aims to support efforts to provide the health information management subsector of the healthcare industry with a sufficient number of trained professionals to fill the identified need for trained HIM professionals, particularly medical coding specialists.
The long-term impact of role stress (conflict and ambiguity), cognitive rumination and their interaction were analysed upon morning and evening saliva cortisol secretion. The sample consisted of 52 male and 24 female British white-collars who had participated in a survey study on psychosocial working conditions 3.5 years earlier. Saliva cortisol secretion was measured over seven consecutive days with two measures: in the morning on awakening and at 22.00 hours. Stepwise linear multiple regression analyses was used for the statistical analyses. Role ambiguity at baseline and the interaction between role ambiguity and trait rumination contributed to explaining elevations in morning saliva cortisol secretion 3.5 years later (R(2) = 0.045; F = 4.57; p < 0.05), while role conflict at baseline significantly predicted increases in long-term evening saliva cortisol (R(2) = 0.057; F = 8.99; p < 0.01). The findings support a long-term relationship between chronic stress exposure and saliva cortisol secretion and some support for the assumption of cognitive rumination moderating the stressor-strain relationship. STATEMENT OF RElevance: The study is of interest for ergonomics practice because it demonstrates that work role ambiguity and role conflict, typically associated with organisational downsizing and restructuring, may contribute to long-term psycho-physiological reactivity. This could expose workers to increased health risks. Therefore, stress management programmes should include the concept of role stress, especially at a time where many work organisations are undergoing significant change. Management should also be made aware of the importance of communicating clear goals, objectives and lines of authority as well as providing sufficient training for those in new job roles. PMID:21547788
A series of recent studies has shown that a number of dietary variables affect ruminative behavior in institutionalized retarded persons. This experiment extends an earlier study that examined the influence of the caloric level of the diet on the frequency of ruminating. Subjects consumed regular portions of food that varied between phases from normal to high caloric levels. The data show a clear but modest inverse relation between the caloric value of the diet and the rates of postmeal ruminating.
Johnston, J M; Greene, K S; Rawal, A; Vazin, T; Winston, M
Rumination is a relatively rare, potentially fatal syndrome in infants. This article reviews the historical and current treatment\\u000a of rumination. Two cases are presented: a six-month-old who narrowly escaped surgery when the disorder was not recognized,\\u000a and a complicated case from the neonatology intensive care unit. Environmental changes and enhanced mothering are described\\u000a as being critical to correction of rumination
BACKGROUND: This paper addresses the health care system from a global perspective and the importance of human resources management (HRM) in improving overall patient health outcomes and delivery of health care services. METHODS: We explored the published literature and collected data through secondary sources. RESULTS: Various key success factors emerge that clearly affect health care practices and human resources management.
Stefane M. Kabene; Carole Orchard; John M. Howard; Mark A. Soriano; Raymond Leduc
Moral distress is a concept used to date in clinical literature to describe the experience of staff in circumstances in which they are prevented from delivering the kind of bedside care they believe is expected of them, professionally and ethically. Our research objective was to determine if this concept has relevance in terms of key health care managerial functions, such as priority setting and resource allocation. We conducted interviews and focus groups with mid- and senior-level managers in two British Columbia (Canada) health authorities. Transcripts were analyzed qualitatively using constant comparison to identify key themes related to moral distress. Both mid- and senior-level managers appear to experience moral distress, with both similarities and differences in how their experiences manifest. Several examples of this concept were identified including the obligation to communicate or 'sell' organizational decisions or policies with which a manager personally may disagree and situations where scarce resources compel managers to place staff in situations where they meet with predictable and potentially avoidable risks. Given that moral distress appears to be a relevant issue for at least some health care managers, further research is warranted into its exact nature, prevalence, and possible organizational and personal responses. PMID:20217482
The volcano on Montserrat, after being dormant for over 400 years, has been active for the past two years, last erupting on 27 June, 1997. With the capital, Plymouth, in the unsafe zone, major dislocation of people, facilities and services has occurred. The Health Department is splintered over five sites across an eight mile span and the temporary 30 bed hospital, sited at a primary school, is separated from its Casualty and Out-patient Department and Operating Theatre by 0.25 mile. In order to maintain continuity of care for communities, efforts have been made to keep evacuated clients and their community health workers as close together as possible. The mass emigration has depleted the health services, creating severe stress for those remaining. Elderly relatives have frequently been left behind, necessitating the establishment of special geriatric care facilities to cater to their needs. Increased and continuous health surveillance and mass media education have been integral to the prevention of major disease outbreak--particularly with added challenges to food safety, and management of liquid and solid waste disposal. Cooperation from neighbouring states, particularly Antigua, Barbados and Guadeloupe, as well as from the United Kingdom, has been critical in the management of the continuing crisis. PMID:10368618
Triggered by corporate scandals, there is increased oversight by governmental bodies and in part by the Sarbanes-Oxley Act of 2002. Corporations are developing corporate governance compliance initiatives to respond to the scrutiny of regulators, legislators, the general public and constituency groups such as investors. Due to state attorney general initiatives, new legislation and heightened oversight from the Internal Revenue Service, nonprofit entities are starting to share the media spotlight with their for-profit counterparts. These developments are changing nonprofit health care organizations as well as the traditional role of the risk manager. No longer is the risk manager focused solely on patients' welfare and safe passage through a complex delivery system. The risk manager must be aware of corporate practices within the organization that could allow the personal objectives of a few individuals to override the greater good of the community in which the nonprofit organization serves. PMID:20200865
Troyer, Glenn T; Brashear, Andrea D; Green, Kelly J
This study investigated college students' attitudes toward and intentions to use personal health portals (PHPs) for managing their personal health information using a survey method. The study also aimed to examine the roles electronic Personal Health Information Management (PHIM) anxiety and apathy play in influencing students' attitudes toward…
In order to meet the ever increasing demand for energy, the United States nuclear industry is turning to life extension of existing nuclear power plants (NPPs). Economically ensuring the safe, secure, and reliable operation of aging nuclear power plants presents many challenges. The 2009 Light Water Reactor Sustainability Workshop identified online monitoring of active and structural components as essential to the better understanding and management of the challenges posed by aging nuclear power plants. Additionally, there is increasing adoption of condition-based maintenance (CBM) for active components in NPPs. These techniques provide a foundation upon which a variety of advanced online surveillance, diagnostic, and prognostic techniques can be deployed to continuously monitor and assess the health of NPP systems and components. The next step in the development of advanced online monitoring is to move beyond CBM to estimating the remaining useful life of active components using prognostic tools. Deployment of prognostic healthmanagement (PHM) on the scale of a NPP requires the use of an integrated healthmanagement (IHM) framework - a software product (or suite of products) used to manage the necessary elements needed for a complete implementation of online monitoring and prognostics. This paper provides a thoughtful look at the desirable functions and features of IHM architectures. A full PHM system involves several modules, including data acquisition, system modeling, fault detection, fault diagnostics, system prognostics, and advisory generation (operations and maintenance planning). The standards applicable to PHM applications are indentified and summarized. A list of evaluation criteria for PHM software products, developed to ensure scalability of the toolset to an environment with the complexity of a NPP, is presented. Fourteen commercially available PHM software products are identified and classified into four groups: research tools, PHM system development tools, deployable architectures, and peripheral tools.
As an agricultural country and one of the world’s major food exporters, Thailand relies heavily on the use of pesticides to protect crops and increase yields. During the past decade, the Kingdom of Thailand has experienced an approximate four-fold increase in pesticide use. This increase presents a challenge for the Royal Thai Government in effectively managing and controlling pesticide use based upon the current policies and legal infrastructure. We have reviewed several key components for managing agricultural pesticides in Thailand. One of the main obstacles to effective pesticide regulation in Thailand is the lack of a consolidated, uniform system designed specifically for pesticide management. This deficit has weakened the enforcement of existing regulations, resulting in misuse/overuse of pesticides, and consequently, increased environmental contamination and human exposure. This article provides a systematic review of how agricultural pesticides are regulated in Thailand. In addition, we provide our perspectives on the current state of pesticide management, the potential health effects of widespread, largely uncontrolled use of pesticides on the Thai people and ways to improve pesticide management in Thailand.
Panuwet, Parinya; Siriwong, Wattasit; Prapamontol, Tippawan; Ryan, P. Barry; Fiedler, Nancy; Robson, Mark G.; Barr, Dana Boyd
Lifestyle is a key determinant in the prevention and management of chronic diseases. If we would exercise regularly, eat healthy, control our weight, sleep enough, manage stress, not smoke and use alcohol only moderately, 90% of type II diabetes, 80% of coronary heart disease, and 70% of stroke could be prevented. Health statistics show that lifestyle related diseases are increasing at an alarming rate. Public health promotion campaigns and healthcare together are not effective enough to stop this "tsunami". The solution that is offered is to empower people to manage their health with the assistance of ICT-enabled services. A lot of R&D and engineering effort is being invested in Personal Health Systems. Although some progress has been made, the market for such systems has not yet emerged. The aim of this critical review is to identify the barriers which are holding back the growth of the market. It looks into the theoretical foundations of behavior change support, the maturity of the technologies for behavior change support, and the business context in which behavior change support systems are used. PMID:22273795
Honka, Anita; Kaipainen, Kirsikka; Hietala, Henri; Saranummi, Niilo
Health and human service organizations are becoming increasingly liable for violations of patient privacy as a result of recent federal mandates at both state and federal levels of government. Under such conditions it would seem likely that managers would act to quickly implement such guidelines and mandates, especially in sensitive specialty areas such as mental health. This study sought to examine the degree and type of patient information confidentiality measures adopted in mental health delivery settings, through a national survey of accredited US health information managers. Results suggest that significant nonadoption of basic confidentiality measures continues to exist, despite federal mandates to the contrary. Further examined was the degree to which confidentiality management varies across adoption levels of computerized patient records. Significant variation was found in adoption of patient confidentiality measures between highly computerized and paper-based medical record functions. Similar levels of variation in adoption across practice settings was also discovered. Ramifications for national policy and patient information protection are discussed. PMID:15255227
The Italian aerospace research program PRORA (PROgramma nazionale di Ricerche Aerospaziali), which has been conceived and managed by CIRA (Italian Aerospace Research Center), is focused on the development of innovative technologies, also based on experience from flying test beds. One family of these test beds, designated USV (Unmanned Space Vehicle) will be dedicated to acquire the knowledge about future RLV (Reusable Launch Vehicle) technologies. Major strategic technologies identified are reusability, hypersonic flight and atmospheric re-entry. The Phase-A study has been concluded and recently approved. Laben (a Finmeccanica Company) has contributed to identify requirements for the next generations of on board Vehicle HealthManagement System (VHMS) and to investigate possible innovative architectures. This new generation VHMS will be able to manage in a real-time mode the health of the vehicle (structure, propulsion, avionics, etc.). The proposed approach is based on a set of decentralised computers linked via an advanced high-speed interconnect system. This paper will describe preliminary requirements analysis and trade-off's mainly in terms of HW (e.g. use of general purpose CPUs versus DSPs, interconnects and topologies).
Maltecca, L.; Miccichè, L.; Russo, G.; Sellitto, M.
The objective of this Short Communication is to promulgate an inventory of 87 papers pertaining to health care waste management practices and challenges in 40 low and middle income countries worldwide amassed through a multi-language systematic review. Herein, we discuss the major gaps, failures, and frequently reported themes by geographic region. Following this we outline a proposed research agenda moving forward, and conclude that greater research and attention towards these unintended consequences of technologic progress in medical care delivery is needed to address and understand this growing public health threat around the world. PMID:19735368
Harhay, Michael O; Halpern, Scott D; Harhay, Jason S; Olliaro, Piero L
The Health Maintenance Organization (HMO) Act of 1973, which sought to balance quality health care against cost-containment efforts, gave rise to the rapid growth of managedhealth care systems, especially HMOs. This article traces the legislative history of HMOs, the inclusion of mental health care benefits, the recognition of psychologists under Medicare law as autonomous health care providers, and other
Patrick H. DeLeon; Gary R. VandenBos; Elizabeth Q. Bulatao
Summary Importance of peripubertal mammary development as a foundation for subsequent mammary growth and milk production was discussed. Morphological differences in peripubertal mammary growth in rodents and ruminants were described. The relevance of tissue interactions and association with hormones and growth factors in mammary development were delineated. Data from specific studies with ruminant mammary parenchyma were outlined for comparison with
Rumination, or recursive self-focused thinking, has important implications for understanding the development and maintenance of depressive episodes. Rumination is associated with the worsening of negative mood states, greater affective responding to negative material, and increased access to negative memories. The present study was designed to use fMRI to examine neural aspects of rumination in depressed and healthy control individuals. We used a rumination induction task to assess differences in patterns of neural activation during ruminative self-focus as compared with a concrete distraction condition and with a novel abstract distraction condition in 14 participants who were diagnosed with major depressive disorder and 14 healthy control participants. Depressed participants exhibited increased activation in the orbitofrontal cortex, subgenual anterior cingulate, and dorsolateral prefrontal cortex as compared with healthy controls during rumination versus concrete distraction. Neural activity during rumination versus abstract distraction was greater for depressed than for control participants in the amygdala, rostral anterior cingulate/medial prefrontal cortex, dorsolateral prefrontal cortex, posterior cingulate, and parahippocampus. These findings indicate that ruminative self-focus is associated with enhanced recruitment of limbic and medial and dorsolateral prefrontal regions in depression. Supplemental materials for this article may be downloaded from http://cabn.psychonomic-journals.org/content/supplemental. PMID:21098808
Cooney, Rebecca E; Joormann, Jutta; Eugène, Fanny; Dennis, Emily L; Gotlib, Ian H
The Bechtel Jacobs Company LLC (BJC) policy is to provide a safe and healthy workplace for all employees and subcontractors. The implementation of this policy requires that operations of the Environmental Management Waste Management Facility (EMWMF), located one-half mile west of the U.S. Department of Energy (DOE) Y-12 National Security Complex, be guided by an overall plan and consistent proactive approach to environment, safety and health (ES&H) issues. The BJC governing document for worker safety and health, BJC/OR-1745, 'Worker Safety and Health Program', describes the key elements of the BJC Safety and Industrial Hygiene (IH) programs, which includes the requirement for development and implementation of a site-specific Health and Safety Plan (HASP) where required by regulation (refer also to BJC-EH-1012, 'Development and Approval of Safety and Health Plans'). BJC/OR-1745, 'Worker Safety and Health Program', implements the requirements for worker protection contained in Title 10 Code of Federal Regulations (CFR) Part 851. The EMWMF site-specific HASP requirements identifies safe operating procedures, work controls, personal protective equipment, roles and responsibilities, potential site hazards and control measures, site access requirements, frequency and types of monitoring, site work areas, decontamination procedures, and outlines emergency response actions. This HASP will be available on site for use by all workers, management and supervisors, oversight personnel and visitors. All EMWMF assigned personnel will be briefed on the contents of this HASP and will be required to follow the procedures and protocols as specified. The policies and procedures referenced in this HASP apply to all EMWMF operations activities. In addition the HASP establishes ES&H criteria for the day-to-day activities to prevent or minimize any adverse effect on the environment and personnel safety and health and to meet standards that define acceptable waste management practices. The HASP is written to make use of past experience and best management practices to eliminate or minimize hazards to workers or the environment from events such as fires, falls, mechanical hazards, or any unplanned release to the environment.
In 2002, 2 million American women of reproductive age were infertile. Infertility is also common among men. The Centers for Disease Control and Prevention (CDC) conducts surveillance and research on the causes of infertility, monitors the safety and efficacy of infertility treatment, and sponsors national prevention programs. A CDC-wide working group found that, despite this effort, considerable gaps and opportunities exist in surveillance, research, communication, and program and policy development. We intend to consult with other federal agencies, professional and consumer organizations, the scientific community, the health care community, industry, and other stakeholders, and participate in the development of a national public health plan for the prevention, detection, and management of infertility. PMID:18992879
Macaluso, Maurizio; Wright-Schnapp, Tracie J; Chandra, Anjani; Johnson, Robert; Satterwhite, Catherine L; Pulver, Amy; Berman, Stuart M; Wang, Richard Y; Farr, Sherry L; Pollack, Lori A
The purpose of this study was to examine pediatricians' familiarity with expert committee recommendations on the management of childhood obesity and their use of health information technology for obesity-related care. The authors interviewed 35 pediatricians from 17 primary care practices using an electronic health record; immersion crystallization facilitated analysis of the qualitative data. Nearly all pediatricians were unfamiliar with expert recommendations; however, all participants reported using growth charts and providing nutrition and physical activity counseling. Most participants wanted easy access to educational materials they could print for patients. The majority of participants were in favor of an electronic alert to identify obese patients, remind clinicians of current guidelines, and facilitate ordering, believing it would help standardize care. Concerns included "alert fatigue," distraction, and disruption of workflow. Suggestions for future electronic functions included tailored educational materials and physical activity resources customized by patient address. PMID:21565885
McDonald, Julia; Goldman, Roberta E; O'Brien, Ashley; Ayash, Christine; Mitchell, Kathy; Marshall, Richard; Simon, Steven R; Taveras, Elsie M
Propionic acidemia is a relatively rare inborn error of metabolism. Individuals with propionic acidemia often have life-threatening episodes of hyperammonemia and metabolic acidosis, as well as intellectual disability. There are many reports of additional problems, including poor growth, stroke-like episodes of the basal ganglia, seizures, cardiomyopathy, long QTc syndrome, immune defects, pancreatitis and optic neuropathy; however, there is little information about the incidence of these problems in this rare disease. Additionally, there are no clear guidelines for medical or surgical management of individuals with propionic acidemia. Through a comprehensive and systematic review of the current medical literature and survey of expert opinion, we have developed practice guidelines for the chronic management of individuals with propionic acidemia, including dietary therapy, use of medications, laboratory monitoring, chronic health supervision, use of gastrostomy tubes and liver transplantation. PMID:21963082
The ES&H Management Plan describes all of the environmental, safety, and health evaluations and reviews that must be carried out in support of the implementation of the National Ignition Facility (NIF) Project. It describes the policy, organizational responsibilities and interfaces, activities, and ES&H documents that will be prepared by the Laboratory Project Office for the DOE. The only activity not described is the preparation of the NIF Project Specific Assessment (PSA), which is to be incorporated into the Programmatic Environmental Impact Statement for Stockpile Stewardship and Management (PEIS). This PSA is being prepared by Argonne National Laboratory (ANL) with input from the Laboratory participants. As the independent NEPA document preparers ANL is directly contracted by the DOE, and its deliverables and schedule are agreed to separately with DOE/OAK.
Public health leaders and managers need new leadership and management skills as well as greater entrepreneurial acumen to respond effectively to broad demographic, socioeconomic, and political trends reshaping public health. This article asserts that the need for such training and skills was the impetus for the conceptualization, design, and launch of the Management Academy for Public Health--an innovative executive education program jointly offered by the schools of business and public health at the University of North Carolina at Chapel Hill. PMID:16912602
Johnson, James H; Sabol, Barbara J; Baker, Edward L
Many of today's methods of inspecting structures are very time consuming, labor intensive and in many cases (due to limited access), impractical. In addition, long shutdown times are required to perform the inspections, thus creating tremendous expenses associated with manpower, materials and lost production. With continuing advances in signal processing and communications a significant interest has been shown in developing new diagnostic technologies for monitoring the integrity of structures with known defects, or for detecting new defects, in real time with minimum human involvement. The continued use of aging structures, especially in regard to the airworthiness of aging aircraft, is a major area of concern. Recent developments in both active and passive Acoustic Emission monitoring as an advanced tool for 'Structural HealthManagement Systems (SHMS),' are illustrated by using two recently developed acoustic emission systems; the Acoustic Emission-Health and Usage Monitoring System (AE-HUMS) helicopter drivetrain health monitoring system, and the Acoustic Emission Flight Instrument System (AEFIS) composite health monitoring system. The data collected with these types of systems is processed with advanced data screening and classification techniques, which are employed to take full advantage of parametric and waveform-based acoustic emission.
Finlayson, Richard D.; Friesel, Mark A.; Carlos, Mark F.; Miller, Ronnie; Godinez, Valery
Botulism is an uncommon but often fatal disease associated with ingestion of a potent neurotoxin present in improperly preserved foods. Exposures to commercially preserved foods with an odd or peculiar taste almost never represent exposure to botulism toxin. Improperly prepared home-canned products which are tasted or consumed without heating are more likely to be associated with botulism. The management of suspect and confirmed cases of botulism is presented by medical epidemiologists in the State Department of Public Health, Bureau of Communicable Disease Control, to provide physicians in California with a practical approach to this problem.
This article delineates concordance and adherence; two fundamental positions pertaining to the role of the nurse in medicine management. Taking the form of a debate, it uses mental health nursing to describe the role and function of concordance and adherence in practice. Each author presents their case and responds briefly to the other in order to show why they see the adoption of one term or another as central to medicines interventions with the patient. The purpose of the paper is to encourage readers to consider their own position in relation to this important debate. PMID:23132002
Total quality management (TQM) is the newest in a long line of magic formulas which have been touted as saviors for American industry and medicine. The author discusses the basic concepts of TQM and notes that much of it resembles philosophical beliefs long held by the medical community. TQM does offer many opportunities to refine old concepts and further those goals of quality care to which health care providers have always aspired. If, however, it becomes simply another codified bureaucracy, then a great deal of time and money will be invested for very little gain. PMID:1749501
Animal health surveillance is an ever-evolving activity, since health- and risk-related policy and management decisions need to be backed by the best available scientific evidence and methodology. International organizations, trade partners, politicians, media and the public expect fast, understandable, up-to-date presentation and valid interpretation of animal disease data to support and document proper animal healthmanagement - in crises as well as in routine control applications. The delivery and application of surveillance information need to be further developed and optimized, and epidemiologists, risk managers, administrators and policy makers need to work together in order to secure progress. Promising new developments in areas such as risk-based surveillance, spatial presentation and analysis, and genomic epidemiology will be mentioned. Limitations and areas in need of further progress will be underlined, such as the general lack of a wide and open exchange of international animal disease surveillance data. During my more than 30 year career as a professor of Veterinary Epidemiology I had the good fortune of working in challenging environments with different eminent colleagues in different countries on a variety of animal health surveillance issues. My career change from professor to Chief Veterinary Officer (CVO) - "from science to application" - was caused by my desire to see for myself if and how well epidemiology would actually work to solve real-life problems as I had been telling my students for years that it would. Fortunately it worked for me! The job of a CVO is not that different from that of a professor of Veterinary Epidemiology; the underlying professional principles are the same. Every day I had to work from science, and base decisions and discussions on documented evidence - although sometimes the evidence was incomplete or data were simply lacking. A basic understanding of surveillance methodology is very useful for a CVO, since it provides a sound working platform not only for dealing with immediate questions when new or emerging disease situations arise, but also for more long-term activities, such as policy development, contingency planning and trade negotiations. Animal health issues, which emerged during my eight years as a CVO in Denmark from 1999 to 2007, will be used as examples, including BSE, FMD, HPAI and Trichinella testing. Emphasis will be placed on how science-based surveillance methodology and tools were developed, applied and documented. PMID:22305878
The rate of successful health care innovation implementation is dismal. Middle managers have a potentially important yet poorly understood role in health care innovation implementation. This study used self-administered surveys and interviews of middle managers in health centers that implemented an innovation to reduce health disparities to address the questions: Does middle managers’ commitment to health care innovation implementation influence implementation effectiveness? If so, in what ways does their commitment influence implementation effectiveness? Although quantitative survey data analysis results suggest a weak relationship, qualitative interview data analysis results indicate that middle managers’ commitment influences implementation effectiveness when middle managers are proactive. Scholars should account for middle managers’ influence in implementation research, and health care executives may promote implementation effectiveness by hiring proactive middle managers and creating climates in which proactivity is rewarded, supported, and expected.
Birken, Sarah A.; Lee, Shoou-Yih Daniel; Weiner, Bryan J.; Chin, Marshall H.; Schaefer, Cynthia T.
This article is the third article in the Human Resources for Health journal's feature on the theme of leadership and management in public health. The series of six articles has been contributed by Management Sciences for Health (MSH) and will be published article-by-article over the next few weeks. The third article presents a successful application in Mozambique of a leadership
Objective. To examine how health plans have changed their approaches for managing costs and utilization in the wake of the recent backlash against managed care. Data Sources\\/Study Setting. Semistructured interviews with health plan executives, employers, providers, and other health care decision makers in 12 metropolitan areas that were randomly selected to be nationally representative of communities with more than 200,000
Purpose – The purpose of this paper is to extend awareness that workplace bullying impacts on the health of individuals both within and outside the workplace and that there are implications for workplace healthmanagement. Design\\/methodology\\/approach – The paper contextualises the problem of workplace bullying and workplace healthmanagement and introduces the five articles in the special issue. Findings –
The relationship between the perceived importance of managerial skills and self-assessed proficiency in each skill among health-system pharmacy managers in Canada was examined, and the demo- graphic characteristics associated with pharmacy managers who lack these skills were analyzed. Surveys were mailed to 514 health- system pharmacy managers in Canada in July 2000. The survey listed 61 specific managerial skills, under
The development of managed care plans is the most dramatic change in the USA’s health care system in recent decades. Despite the widespread growth, society is increasingly concerned with the quality of managed care programs. This article addresses the regulatory pressures that are being placed on managed care organisations, and examines what health care practitioners can do to minimize the
In 1967, the problem of occupational lead exposure came to public attention in Korea. Since then, regular progress has been made in lowering workplace lead exposures, instituting new workplace controls, and implementing health examinations of exposed workers. Past serious lead poisoning episodes made it possible to introduce biological monitoring programs on a voluntary basis in high-lead-exposure facilities in Korea. Industry-specific occupational health services for lead workers in Korea during the last 22 years can be categorized into three phases. During the first phase (1988-1993), efforts were directed at increasing awareness among workers about the hazards of lead exposure, biological monitoring of blood zinc protoporphyrin began, and a respiratory protection program was introduced. During the second phase (1994-1997), a computerized healthmanagement system for lead workers was developed, blood-lead measurement was added to biologic monitoring, and engineering controls were introduced in the workplace to lower air-lead levels to comply with air-lead regulations. Finally, during the third phase (1998-present), a new biomarker, bone-lead measurement by X-ray fluorescence, was introduced. Bone-lead measurement proved to be useful for assessing body burden and to demonstrate past lead exposure in retired workers. Occupational health service practice for lead workers, including the industry-specific group occupational health system, has brought considerable success in the prevention of lead poisoning and in reducing the lead burden in Korean lead workers during the last several decades. The successful achievement of prevention of lead poisoning in Korea was a result of the combined efforts of lead workers, employers, relevant government agencies, and academic institutes.
Historically within most catchments, resource management programs have been planned and implemented in isolation of one another. This was once the case in the Goulburn Broken Catchment, a major catchment of the Murray Darling Basin, Australia. Although only 2% of the Murray Darling Basin's land area, the catchment generates 11% of the basin's water resources. Learning from the past, a cooperative and collaborative approach to natural resource programs has developed. This approach is the envy of many other catchment communities and agencies. Through a combination of "Partnership Programs", "Operational Initiatives" and community involvement, significant programs have been implemented within the catchment, which will benefit not only the local community but communities further afield. The outcomes of the waterway health program highlight the benefits provided through the establishment of cooperative and partnership resource improvement programs. These programs were founded on the ability of the community to recognise the need for integration, base management decisions on best available science and an ability to work together. Their effective delivery has been provided through the resources provided, to the local community, by the Natural Heritage Trust with matching and State and local allocations. While programs have shown success, challenges still face the community. These challenges include verification and implementation of environmental flows, storage of the catchment's vital water resources, and maintaining community involvement and participation in on-going works programs. The Goulburn Broken Catchment community, with the support of Federal, State and Local Governments, is looking at opportunities for continued improvements in waterway health. PMID:11419136
The amount of waste produced is connected with the degree of a country's economic development; more developed countries produce more waste. This paper reviews the quantities, manipulation and treatment methods of medical waste in Croatia, as well as hazardous potentials of medical waste for human health. Medical waste must be collected and sorted in containers suitable for its characteristics, amount, means of transportation and treatment method in order to prevent contact with environment and to protect people who are working with waste. Hazardous medical waste in Croatia is largely produced by hospitals. Even though only one hospital has a licence to incinerate infectious medical waste, many other hospitals incinerate their hazardous waste in inappropriate facilities. Healthcare institutions also store great amounts of old medical waste, mostly pharmaceutical, anti-infectious, and cytostatic drugs and chemical waste. Data on waste treatment effects on human health are scarce, while environmental problems are covered better. Croatian medical waste legislation is not being implemented. It is very important to establish a medical waste management system that would implement the existing legislation in all waste management cycles from waste production to treatment and final disposal. PMID:15969205
Multiple environmental, ecological, and socio-political forces are converging to increase the occurrence of both natural and technological disasters. Ten forces are of most concern in this regard. These are: 1) global warming, with its consequent weather extremes and climate changes; 2) continued rapid human population growth and concomitant increased urbanization; 3) decreased bio-diversity and consequent ecological fragility; 4) deforestation and loss of natural habitat for animal species, with resultant greater overlap of human and animal habitats, human exposure to animal pathogens, and other ecological perturbations; 5) increased technological development throughout the world (especially in developing countries with their typically immature safety programs); 6) globalization and increased population mobility; 7) sub-national religious and ethnic conflicts, and their potential for conflict escalation and large scale displacement of populations; 8) the collapse of several major countries and consequent unraveling of national identity and social order; 9) the rise of terrorism; and 10) dramatic advances in the science and technology of computing, communications, biotechnology, and genomics. This paper describes 10 lessons learned relative to the public health aspects of emergency management, especially as they pertain to disasters. 1) Planning pays; 2) A bad situation can be made worse by inappropriate responses; 3) Most life saving interventions will occur before the disaster happens and immediately afterwards by local action; 4) Public health emergency management is not a democratic process; 5) Psychological impacts are usually greater than anticipated; 6) Communications and information management are vital, but often are the weak link in the response chain; 7) Collaboration and partnerships are essential; 8) Unsolicited volunteers and aid are inevitable and must be planned for and managed; 9) Never assume anything, and always expect the unexpected; and 10) Post-event evaluation is important, and must be coordinated. The paramount lesson learned from past emergencies is that the untoward impact of these events can be anticipated and significantly ameliorated by appropriate planning and preparation. On the other hand, preparation for emergency events has deteriorated because of health-care financial constraints, and resources to support planning and needed infrastructure have diminished. Given these realities, the major unresolved challenge is how to ensure that planning for the common good is supported and, in fact, gets done. PMID:11227611
Background An aging population poses significant challenges to health care in China. Healthmanagement has been implemented to reduce the costs of care, raise health service utilization, increase health knowledge and improve quality of life. Several studies have tried to verify the effectiveness of healthmanagement in achieving these goals worldwide. However, there have been insufficient randomized control trials (RCTs) to draw reliable conclusions. The few small-scale studies conducted in China include mostly the general population rather than the elderly. Our study is designed to evaluate the impact of community-based healthmanagement on the health of the elderly through an RCT in Nanjing, China. Methods Two thousand four hundred participants, aged 60 or older and who gave informed consent, were randomly allocated 1:1 into management and control groups, the randomization schedule was concealed from community health service center staff until allocation. Community-based healthmanagement was applied in the former while the latter was only given usual care. After 18 months, three categories of variables (subjective grading health indices, objective health indices and health service utilization) were measured based on a questionnaire, clinical monitoring and diagnostic measurements. Differences between the two groups were assessed before and after the intervention and analyzed with t-test, ?2-test, and multiple regression analysis. Results Compared with the control group, the management group demonstrated improvement on the following variables (P<0.01): health knowledge score, self-evaluated psychological conditions, overall self-evaluated health conditions, diet score, physical activity duration per week, regular blood pressure monitoring, waist-to-hip ratio, systolic blood pressure and fasting blood sugar. The number of outpatient clinic visits did not differ significantly (P=0.60) between the two groups before intervention, while after intervention it was smaller in the management group than in the control group (P<0.01). However, the number of hospital admissions in the preceding 6 months was not different between the two groups even after intervention (P=0.36). Multiple regression analysis showed that gender, age, education level, chronic disease status and self-evaluated psychological conditions were important factors affecting health knowledge score, BMI, and waist-to-hip ratio. Conclusion Community-based healthmanagement improved both subjective grading health indices, objective health indices and decreased the number of outpatient clinic visits, demonstrating effectiveness in improving elderly health. Trial registration ChiCTR-OCH-11001716
Central nervous system (CNS) infections in ruminant livestock, such as listeriosis, are of major concern for veterinary and public health. To date, no host-specific in vitro models for ruminant CNS infections are available. Here, we established and evaluated the suitability of organotypic brain-slices of ruminant origin as in vitro model to study mechanisms of Listeria monocytogenes CNS infection. Ruminants are frequently affected by fatal listeric rhombencephalitis that closely resembles the same condition occurring in humans. Better insight into host–pathogen interactions in ruminants is therefore of interest, not only from a veterinary but also from a public health perspective. Brains were obtained at the slaughterhouse, and hippocampal and cerebellar brain-slices were cultured up to 49 days. Viability as well as the composition of cell populations was assessed weekly. Viable neurons, astrocytes, microglia and oligodendrocytes were observed up to 49 days in vitro. Slice cultures were infected with L. monocytogenes, and infection kinetics were monitored. Infected brain cells were identified by double immunofluorescence, and results were compared to natural cases of listeric rhombencephalitis. Similar to the natural infection, infected brain-slices showed focal replication of L. monocytogenes and bacteria were predominantly observed in microglia, but also in astrocytes, and associated with axons. These results demonstrate that organotypic brain-slice cultures of bovine origin survive for extended periods and can be infected easily with L. monocytogenes. Therefore, they are a suitable model to study aspects of host–pathogen interaction in listeric encephalitis and potentially in other neuroinfectious diseases.
Guldimann, Claudia; Lejeune, Beatrice; Hofer, Sandra; Leib, Stephen L; Frey, Joachim; Zurbriggen, Andreas; Seuberlich, Torsten; Oevermann, Anna
Background Optimization of the unsaturated fatty acid composition of ruminant milk and meat is desirable. Alteration of the milk and fatty acid profile was previously attempted by the management of ruminal microbial biohydrogenation. The aim of this study was to identify the group of ruminal trans-vaccenic acid (trans-11 C18:1, t-VA) hydrogenating bacteria by combining enrichment studies in vitro. Methods The enrichment culture growing on t-VA was obtained by successive transfers in medium containing t-VA. Fatty acids were detected by gas chromatograph and changes in the microbial composition during enrichment were analyzed by denaturing gradient gel electrophoresis (DGGE). Prominent DGGE bands of the enrichment cultures were identified by 16S rRNA gene sequencing. Results The growth of ruminal t-VA hydrogenating bacteria was monitored through the process of culture transfer according to the accumulation of stearic acid (C18:0, SA) and ratio of the substrate (t-VA) transformed to the product (SA). A significant part of the retrieved 16S rRNA gene sequences was most similar to those of uncultured bacteria. Bacteria corresponding to predominant DGGE bands in t-VA enrichment cultures clustered with t-VA biohydrogenated bacteria within Group B. Conclusions This study provides more insight into the pathway of biohydrogenation. It also may be important to control the production of t-VA, which has metabolic and physiological benefits, through management of ruminal biohydrogenation bacterium.
Study objective: The 1995 UK Environment Act required local authorities to review air quality and, where UK National Air Quality Strategy objectives (except ozone) are likely to be exceeded in 2005, to declare local air quality management areas and prepare action plans. This study modelled the impacts on health of reductions from current levels of PM10 to these objectives. Design: The framework for conducting quantified health impact assessment assessed causality, then, if appropriate, examined the shape and magnitude of the exposure-response relations. The study modelled declines in pollution to achieve the objectives, then modelled the numbers of deaths and admissions affected if air pollution declined from existing levels to meet the objectives, using routine data. Setting: Westminster, central London. Main results: Attaining the 2004 PM10 24 hour objective in Westminster results in 1–21 lives no longer shortened in one year (annual deaths 1363). Reducing exceedences from 35 to seven almost doubles the estimates. The 2009 objective for the annual mean requires a substantial reduction in PM10, which would delay 8–20 deaths. About 20 respiratory and 14–20 circulatory admissions would be affected and around 5% of emergency hospital attendances for asthma by attaining the lower annual mean target. The effects of long term exposure to particulates may be an order of magnitude higher: models predict about 24 deaths are delayed by reaching the 2004 annual target (40 µg/m3[gravimetric]) and a hundred deaths by reducing annual mean PM10 to 20 µg/m3[gravimetric]. Conclusions: Modelling can be used to estimate the potential health impacts of air quality management programmes.
Ruminant repellent compositions consisting essentially of active ingredients derived from, or equivalent to, chemicals found in plants in the Amaryllidaceae family. Particularly, ruminant repellent compositions consisting essentially of at least one of: Methods are also provided for protecting foliage from grazing by ruminants comprising applying a ruminant repellent composition of the present invention to the foliage, thereby imparting the taste and/or smell of certain plants in the Amaryllidaceae family to the vegetation, which is thus made unpalatable to browsing ruminants.
Extremely complex health care organizations, by their structure and organization, operate in a constantly changing business environment, and such situation implies and requires complex and demanding healthmanagement. Therefore, in order to managehealth organizations in a competent manner, healthmanagers must possess various managerial skills and be familiar with problems in health care. Research, identification, analysis, and assessment of healthmanagement education and training needs are basic preconditions for the development and implementation of adequate programs to meet those needs. Along with other specific activities, this research helped to determine the nature, profile, and level of top-priority needs for education. The need for knowledge of certain areas in healthmanagement, as well as the need for mastering concrete managerial competencies has been recognized as top-priorities requiring additional improvement and upgrading.
Implementing improved management control systems has become a high priority within publicly planned health care systems in recent years. This article explores present management control practices and dilemmas within the Finnish health care system. Based upon an intensive case study of one central hospital district, the article analyzes current intra-institutional and cross-institutional management efforts. Subsequently it evaluates implications from the study's findings for both the Finnish and other publicly planned health care systems. PMID:10285388
The National Animal Health Monitoring Systems (NAHMS) Dairy 96 study was designed to provide both participants and the industry with information on the nations milk cows for education and research. This report is the third in a series of releases document...
This manual was designed for use by qualified substance abuse and mental health clinicians who work with substance abuse and mental health clients with concurrent anger problems. The manual describes a 12-week cognitive behavioral anger management group t...
Background Little is known about the practitioners in managed behavioral healthcare organization (MBHO) networks who are treating mental and substance use disorders among privately insured patients in the United States. It is likely that the role of the private sector in treating behavioral health will increase due to the recent implementation of federal parity legislation and the inclusion of behavioral health as a required service in the insurance exchange plans created under healthcare reform. Further, the healthcare reform legislation has highlighted the need to ensure a qualified workforce in order to improve access to quality healthcare, and provides an additional focus on the behavioral health workforce. To expand understanding of treatment of mental and substance use disorders among privately insured patients, this study examines practitioner types, experience, specialized expertise, and demographics of in-network practitioners providing outpatient care in one large national MBHO. Methods Descriptive analyses used 2004 practitioner credentialing and other administrative data for one MBHO. The sample included 28,897 practitioners who submitted at least one outpatient claim in 2004. Chi-square and t-tests were used to compare findings across types of practitioners. Results About half of practitioners were female, 12% were bilingual, and mean age was 53, with significant variation by practitioner type. On average, practitioners report 15.3?years of experience (SD?=?9.4), also with significant variation by practitioner type. Many practitioners reported specialized expertise, with about 40% reporting expertise for treating children and about 60% for treating adolescents. Conclusions Overall, these results based on self-report indicate that the practitioner network in this large MBHO is experienced and has specialized training, but echo concerns about the aging of this workforce. These data should provide us with a baseline of practitioner characteristics as we enter an era that anticipates great change in the behavioral health workforce.
This pilot study assessed occupational health and safety (OHS) management system audit finding reliability using a modified test-retest method. Two industrial hygienists with similar training and education conducted four, 1-day management system audits in four dissimilar organizational environments. The researchers examined four auditable sections (employee participation, training, controls, and communications) contained in a publicly available OHS management system assessment instrument. At each site, 102 auditable clauses were evaluated using a progressive 6-point scale. The team examined both the consistency of and agreement between the scores of the two auditors. Consistency was evaluated by calculating the Pearson r correlations for the two auditors' scores at each site and for each section within each site. Pearson correlations comparing overall scores for each site were all very low, ranging from 0.206 to 0.543. Training and communication system assessments correlated the highest, whereas employee participation and control system scores correlated the least. To measure agreement, t-tests were first calculated to determine whether the differences were statistically significant. Aggregate mean scores for two of the four sites were significantly different. Of the 16 total sections evaluated (i.e., 4 sections per site), seven scores were significantly different. Finally, the agreement of the scores between the two auditors for the four sites was evaluated by calculating two types of intraclass correlation coefficients, all of which failed to meet the minimum requirement for agreement. These findings suggest that opportunities for improving the reliability of the instrument and the audit process exist. Future research should include governmental and commercial OHS program assessments and related environmental management systems and their attendant audit protocols. PMID:14674807
This case report describes an 83 year-old immobilised patient with multiple diseases and on polypharmacy. Nursing care is developed at home. The patient is included in patient care programs for the anticoagulated and polymedicated patient. Nursing assessments were made using the Marjory Gordon functional health patterns, by which we identified, among others, problems related to non-compliance with the pharmacological treatment. The Nurse's Diagnosis was: Ineffective Management of own health. With the support of NANDA, NOC and NIC taxonomy we determined the nursing objectives and interventions. The expected results of the Care Plan were achieved. Polypharmacy in the elderly can lead to treatment problems, increasing hospital admissions, morbidity and mortality and health expenditure Nursing care at home is a continuous development process and is increasing due to aging of the population, the prevalence of chronic diseases, as well as the increased life expectancy. It is estimated that in 2030, 24% of the Spanish population will be over 64 years. The physical, sensory, cognitive and chronic disabilities of aging make this type of care necessary. It is a major element in the comprehensive care of these patients, by checking the correct use of medication, symptom control, helping them to be autonomous in managing their disease and establishing a fluid relationship between the patients and their family. PMID:22284363
OBJECTIVES--To find out the sources of advice that were helpful to managers of family health services authorities in drawing up the criteria for admission of general practitioners to the child health surveillance lists; to determine the criteria used for admission of general practitioners to the family health services authorities' child health surveillance lists; to find out the changes general practitioners
The use of anthelmintics is strongly limited in organic farming. This may induce a change in the intensity (no of worms) and diversity (proportions of species) of helminth infection. Helminths remain a major preoccupation in organic sheep farming: high levels of infection have been recorded on several farms and helminth diversity is always higher. The helminth infection in milk cattle
Accountability, cost effectiveness, and continuous quality improvement are essential features of all managedhealth care systems.\\u000a However, application of these principles to mental health treatments has lagged behind other health care services. In this\\u000a article, administrative, practice, and technical issues are addressed through a joint effort between academically based researchers\\u000a and administrators from two large managedhealth care organizations. Principles
Gary M. Burlingame; Michael J. Lambert; Curtis W. Reisinger; Wayne M. Neff; Julie Mosier
The purpose of this study was to investigate the impact of mindfulness-based stress reduction (MBSR; Kabat-Zinn, 1982, 1990) training on a self-selected adult community sample in the areas of mindfulness, rumination, depressive symptomatology and overall well-being. Targeting rumination was considered particularly important because a tendency toward rumination in nondepressed populations has been found to be predictive of subsequent onset of depression. As hypothesized, completers of the MBSR class showed increases in mindfulness and overall wellbeing, and decreases in rumination and symptoms of depression. Limitations of the study are discussed, as are the implications of these findings. PMID:19733812
Despite a rapid and continuous expansion in aquaculture industries, Australia has not experienced significant disease emergencies in farmed aquatic animal populations. However, recent events in relation to wild, farmed, native and introduced aquatic animals have provided warning signals. The development of a national response mechanism for fisheries and aquaculture emergencies became a high priority following the pilchard mortality outbreak in 1995. In terms of more general policy, a special Task Force has provided a framework for managing exotic pests, weeds and diseases and identifying key principles and issues. This Task Force also recommended closer consultation between relevant industry organisations and government agencies. The authors describe the framework of the comprehensive five-year national strategic plan for aquatic animal health ('AQUAPLAN') developed by Australia, and the aquatic animal disease veterinary emergency plan developed within this framework ('AQUAVETPLAN'). PMID:10190217
Chronic kidney disease (CKD) is becoming a worldwide major public health problem that is rapidly approaching epidemic proportions due to its high prevalence, as well as the associated increase of cardiovascular morbidity and mortality in these patients. Early detection and prevention may have an impact on both slowing the progression of CKD and reducing cardiovascular morbidity and mortality. CKD prevention programmes can be more cost-efficient over time without negative impacts on quality of care. Until now, reimbursement in CKD has been segmented and usually focused on the end of the process (dialysis) when cost is higher, whereas new models focused on provider integration, while balancing quality and costs, are needed to respond to today’s challenges. Traditionally, “pay for services” has been used in state-assisted dialysis centres, but this model has the risk of inducing an increase in demand. Integrated management would respond to this challenge with comprehensive solutions that manage kidney disease at all levels of health care risk. It is based on a comprehensive model that typically includes several products and services, often including pharmacological treatments. The rate of reimbursement directly depends on the achievement of previously defined quality control parameters. The third model is based on a “capitation” model that consists of the provider receiving a set amount of resources per population for a particular time regardless of the volume of services provided. The complexity and the progressive nature of CKD along with the associated morbidity rates in these patients force us to consider a global approach rather than a sum of different services. In our opinion, the first method of reimbursement in CKD that should be considered is a bundle rate, and when this model has been consolidated, tending toward a global capitation model. PMID:23712220
Background The primary objective of this review was to determine the strength of evidence for the effectiveness of self-monitoring devices and technologies for individuals with type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM) based on specific health-related outcome measures. Self-monitoring devices included those that assist patients with managing diabetes and preventing cardiovascular complications (CVCs). A secondary objective was to explore issues of feasibility, usability, and compliance among patients and providers. Methods Study criteria included individuals ?14 years and youth (7–14 years) with T1DM or T2DM, intervention with a self-monitoring device, assessment of clinical outcomes with the device, literature in English, and ?10 participants. Relevant published literature was searched from 1985 to 2008. Randomized controlled trials and observational studies were included. Data were extracted for clinical outcomes, feasibility and compliance methods, and results. Selected studies were independently evaluated with a validated instrument for assessing methodological quality. Results Eighteen trials were selected. Predominant types of device interventions included self-monitoring of blood glucose, pedometers, and cell phone or wireless technologies. Feasibility and compliance were measured in the majority of studies. Conclusions Self-monitoring of blood glucose continues to be an effective tool for the management of diabetes. Wireless technologies can improve diabetes self-care, and pedometers are effective lifestyle modification tools. The results of this review indicate a need for additional controlled trial research on existing and novel technologies for diabetes self-monitoring, on health outcomes associated with diabetes and CVCs, and device feasibility and compliance.
Over the past 30 years, mental health practitioners, encouraged by rigorous empirical studies and literature and meta-analytic reviews, have increasingly appreciated the ability of hypnosis to modulate attention, imagination, and motivation in the service of therapeutic goals. This article describes how hypnosis can be used as an adjunctive procedure in the treatment of depression and rumination symptoms, in particular. The
Steven Jay Lynn; Sean Barnes; Amanda Deming; Michelle Accardi
Infections with gastrointestinal nematodes (GIN) remain a major threat for ruminant production, health and welfare associated with outdoor breeding. The control of these helminth parasites has relied on the strategic or tactical use of chemical anthelmintic (AH) drugs. However, the expanding development and diffusion of anthelmintic resistance in nematode populations imposes the need to explore and validate novel solutions (or
Summary A dynamic model of fiber disappearance from the digestive tract of ruminants was developed based upon acceptable and defensi- ble concepts of fiber digestion and passage kinetics, and coefficients obtained from avail- able literature. The model has applicability, manageability and comparability to experi- mental observations. Although the model can stimulate the effects of some forage and animal characteristics upon
This report summarizes the results of a three-year LDRD project on prognostics and healthmanagement. System failure over some future time interval (an alternative definition is the capability to predict the remaining useful life of a system). Prognostics are integrated with health monitoring (through inspections, sensors, etc.) to provide an overall PHM capability that optimizes maintenance actions and results in higher availability at a lower cost. Our goal in this research was to develop PHM tools that could be applied to a wide variety of equipment (repairable, non-repairable, manufacturing, weapons, battlefield equipment, etc.) and require minimal customization to move from one system to the next. Thus, our approach was to develop a toolkit of reusable software objects/components and architecture for their use. We have developed two software tools: an Evidence Engine and a Consequence Engine. The Evidence Engine integrates information from a variety of sources in order to take into account all the evidence that impacts a prognosis for system health. The Evidence Engine has the capability for feature extraction, trend detection, information fusion through Bayesian Belief Networks (BBN), and estimation of remaining useful life. The Consequence Engine involves algorithms to analyze the consequences of various maintenance actions. The Consequence Engine takes as input a maintenance and use schedule, spares information, and time-to-failure data on components, then generates maintenance and failure events, and evaluates performance measures such as equipment availability, mission capable rate, time to failure, and cost. This report summarizes the capabilities we have developed, describes the approach and architecture of the two engines, and provides examples of their use. 'Prognostics' refers to the capability to predict the probability of
Swiler, Laura Painton; Campbell, James E.; Doser, Adele Beatrice; Lowder, Kelly S.
On a space vehicle, the Crew Health Care System will handle minor accidents or illnesses immediately, thereby eliminating the necessity of early mission termination or emergency rescue. For practical reasons, only trained personnel with limited medical experience can be available on space vehicles to render preliminary health care. There is the need to communicate with medical experts at different locations on earth. Interplanetary Image Management and Communication System (IIMACS) will be a bridge between worlds and deliver medical images acquired in space to physicians at different medical centers on earth. This paper discusses the implementation of IIMACS by extending the Global Picture Archiving and Communication System (GPACS) being developed to interconnect medical centers on earth. Furthermore, this paper explores system requirements of IIMACS and different user scenarios. Our conclusion is that IIMACS is feasible using the maturing technology base of GPACS.
Thymol (5-methyl-2-isopropylphenol) is a phenolic compound that is used to inhibit oral bacteria. Because little is known\\u000a regarding the effects of this compound on ruminal microorganisms, the objective of this study was to determine the effects\\u000a of thymol on growth and lactate production by the ruminal bacteria Streptococcus bovis JB1 and Selenomonas ruminantium HD4. In addition, the effect of thymol
Occupational health and safety, environmental, and quality (SEQ) issues are commonly managed by three separate departments within organizations. Because of a number of commonalities in the three management systems, there could be a degree of overlap that might lead to inefficiencies. By integrating these three management systems into one SEQ system, the duplication of effort could be minimized and the health and safety, environmental, and quality issues could be managed by one common proactive approach. The draft Australian standard for an occupational health and safety (OHS) management system and the internationally accepted standards for environmental (ISO 14001) and quality (ISO 9001) management systems were analyzed to identify all requirements of the three management systems and integrate this into one SEQ management system standard. PMID:9436237
In 2005, St. Luke's Hospital in Chesterfield, Mo., launched the "Passport to Wellness" program to help employers reduce preventable illnesses by providing access to screenings, health education, health coaching, disease management, and healthy lifestyle programs. The program was designed to influence consumer choice of hospitals and physicians and influence health insurance purchasing decisions. St. Luke's program also met goals created by local businesses, including identifying health risks of each employer's workforce and reducing health-related costs. PMID:22734331
The Military Health System (MHS) and the Veterans Health Administration (VHA) have been among the nation s leaders in health information technology (IT), including the development of health IT systems and electronic health records (EHRs) that summarize pa...
This study provides a look into a small rural municipality in Mexico and analyzes the association between public health and water management. While first touching on the public health aspects of drinking water distribution, the study introduces the specific case of water management in Latin America and specifically Mexico, focusing on the difficulties of distributing clean, potable water. The case
Increased costs of managing otitis media and its complications may result from delays in diagnosis and treatment. The Agency for Health Care Policy and Research developed guidelines to assist in the management of chronic otitis media with effusion. We examined the medical care adherence to Agency for Health Care Policy and Research guidelines in 59 consecutive patients referred because of
GRIFFITH S. HSU; SAMUEL C. LEVINE; G. SCOTT GIEBINK
We reviewed the literature on the detection and management of mental health disorders within the context of pediatric primary care. Pediatricians have displayed a low sensitivity and high specificity in research investigating the detection of mental health impairment in children. Active management efforts characterize approaches to identified cases with more recently trained primary care pediatricians displaying a wider range of
Managed care has rapidly developed as the most common model of delivery of health care in this country. This article examines the implications of new demands brought to bear on social workers. This research compares six managedhealth care plans operating regionally and nationally and demonstrates the cumbersome application process. Fee schedules for each of the plans are listed. Ethical
Drugs are a major technology in preventing and combating disease both at the individual and community levels. Managing this valuable resource for optimum public health benefit is paramount. Pharmacists have been recognized by the World Health Organisation and others as having a key role to play in promoting rational drug use and strengthening effective drug management. However, the profession needs
There is a growing trend in re-orientating occupational health research towards risk management. Such a trend is accelerated by the increasing attention to occupational safety and healthmanagement systems. The trend, also seen in many Asian countries, is offering new opportunities for strengthening primary prevention. Useful examples are provided from recent work improvement projects dealing with technology transfer, small workplaces
Objective: To examine child and pediatric psychologists' ethical beliefs and attitudes toward managed mental health care. Methods: In a survey mailed in spring 1997, 252 child and pediatric psychologists responded to three vignettes depicting ethical dilemmas related to working with managed mental health care (confidentiality, re- striction of services, misdiagnosis). Data were collected about psychologists' ethical choices and reasons given
|Context: The obesity epidemic threatens the present and future health of adolescents in the United States. Yet, health care providers lack specific training for pediatric obesity assessment and management. Purpose: This study examined the adherence of rural Georgia primary care practitioners to an overweight adolescent management protocol. The…
Dennison, David A.; Yin, Zenong; Kibbe, Debra; Burns, Susan; Trowbridge, Frederick
|This monograph examines issues in the field of psychosocial/psychiatric rehabilitation (PSR) services for people with serious mental illness, placed in the context of a debate within the field about trends toward managed behavioral health care companies. Four main issues are addressed: (1) the degree to which managed behavioral health care…
Rutman, Irvin D.; Baron, Richard C.; Hadley, Trevor R.
|This study investigates the impact on human resource management (HRM) practices in the public health sector in Victoria, Australia of two different government policy environments. First, it explores the Liberal Coalition Government's decentralisation of public health sector management, from 1992-1999 and second, the Labor Government's…
Stanton, Pauline; Bartram, Timothy; Harbridge, Raymond
Observations of reduced utilization of alcohol and drug abuse treatment following the introduction of managed behavioral health care suggest that substance abuse services may be especially responsive to managed care restrictions and limits. In publicly funded treatment systems, patient attributes, system and provider characteristics, and financing mechanisms may heighten susceptibility to unintended effects. The State Substance Abuse and Mental Health
Dennis McCarty; Milton Argeriou; Gabrielle Denmead; Joan Dilonardo
Provides tips for children's advocates to assure that managed mental health care is implemented in a manner which best meets the needs of children, families, and care providers. Explains managed care through specialized mental health and substance abuse services. Discusses elements necessary for early intervention and the need to address risk…
In their much-cited paper, "Can patient self-management help explain the SES health gradient?"Goldman and Smith (2002) use samples of diabetic and HIV+ patients in the United States to conclude that disease self-management is an important explanation for the much-documented positive gradient in education and health outcomes. In this paper, I revisit their analysis and point to some fundamental difficulties in interpreting their results as conclusive evidence in favor of self-management. I also argue that for individuals for whom self-management might be expected to matter -i.e. populations of patients managing complex conditions - economic factors such as resource availability and insurance access might be a more important mechanism behind the gradient than medical compliance. The impact of self-management, though it might matter, is likely to be small. PMID:20117869
The traditional medical model of health and health policy development has focused on individuals and the role of medical care in preventing and treating disease and injury. Recent attention to health inequities and social determinants of health has raised the profile of population heath and evidence-based strategies for improving the health of whole populations. At the same time, risk science
Daniel Krewski; Victoria Hogan; Michelle C. Turner; Patricia L. Zeman; Ian McDowell; Nancy Edwards; Joseph Losos
The purpose of the present study was to examine the content emphasis of courses of public health administration and management (A & M) among member institutions of the Asia-Pacific Academic Consortium for Public Health (APACPH), to determine comparability of curricula across campuses.A survey of course syllabi from, APACPH schools was conducted by three separate reviewers to identify topical subject matter
There is increasing evidence to indicate that nutrition is an important factor involved in the onset and development of several chronic human diseases including cancer, cardiovascular disease (CVD), type II diabetes and obesity. Clinical studies implicate excessive consumption of medium-chain saturated fatty acids (SFA) and trans-fatty acids (TFA) as risk factors for CVD, and in the aetiology of other chronic conditions. Ruminant-derived foods are significant sources of medium-chain SFA and TFA in the human diet, but also provide high-quality protein, essential micronutrients and several bioactive lipids. Altering the fatty acid composition of ruminant-derived foods offers the opportunity to align the consumption of fatty acids in human populations with public health policies without the need for substantial changes in eating habits. Replacing conserved forages with fresh grass or dietary plant oil and oilseed supplements can be used to lower medium-chain and total SFA content and increase cis-9 18:1, total conjugated linoleic acid (CLA), n-3 and n-6 polyunsaturated fatty acids (PUFA) to a variable extent in ruminant milk. However, inclusion of fish oil or marine algae in the ruminant diet results in marginal enrichment of 20- or 22-carbon PUFA in milk. Studies in growing ruminants have confirmed that the same nutritional strategies improve the balance of n-6/n-3 PUFA, and increase CLA and long-chain n-3 PUFA in ruminant meat, but the potential to lower medium-chain and total SFA is limited. Attempts to alter meat and milk fatty acid composition through changes in the diet fed to ruminants are often accompanied by several-fold increases in TFA concentrations. In extreme cases, the distribution of trans 18:1 and 18:2 isomers in ruminant foods may resemble that of partially hydrogenated plant oils. Changes in milk fat or muscle lipid composition in response to diet are now known to be accompanied by tissue-specific alterations in the expression of one or more lipogenic genes. Breed influences both milk and muscle fat content, although recent studies have confirmed the occurrence of genetic variability in transcript abundance and activity of enzymes involved in lipid synthesis and identified polymorphisms for several key lipogenic genes in lactating and growing cattle. Although nutrition is the major factor influencing the fatty acid composition of ruminant-derived foods, further progress can be expected through the use of genomic or marker-assisted selection to increase the frequency of favourable genotypes and the formulation of diets to exploit this genetic potential. PMID:23031638
The State of Kansas community mental health system uses an automated information management system for state and federal accountability and for local quality improvement. Researchers interviewed 25 of the state's 28 directors of children's community-based mental health services to learn about the automated system's local applications. Two-thirds of the directors used the automated system for either programmatic decision making or
Knowledge of what constitutes best practice in human resource management (HRM) in public-oriented services is limited and the operational aspects of managinghealth workers at provision level have been poorly studied. The magnet hospital concept offers some insights into HRM practices that are leading to high commitment. These have been shown to lead to superior performance in not only industrial business firms, but also service industries and the public service. The mechanisms that drive these practices include positive psychological links between managers and staff, organizational commitment and trust. Conditions for successful high commitment management (HiCoM) include health service managers with a strong vision and able to transmit this vision to their staff, appropriate decision spaces for healthcare managers and a pool of reasonable well-trained health workers. For this, adequate remuneration is the first condition. Equally important are the issues of cultural fit and of 'commitment'. What would staff expect from management in return for their commitment to the organization? Salary buys indeed time of employees, but other practices ensure their commitment. Only if these drivers are understood will managers be able to make their HRM practices more responsive to the needs and expectations of the health workers. PMID:17624868
Effective aerospace healthmanagement integrates component, subsystem and system level health monitoring strategies, consisting of anomaly\\/diagnostic\\/prognostic technologies, with an integrated modeling architecture that addresses failure mode mitigation and life cycle costs. Included within such healthmanagement systems will be various failure mode diagnostic and prognostic (D\\/P) approaches ranging from generic signal processing and experience-based algorithms to the more complex knowledge
GoalsUndertreatment of cancer pain remains a major health-care problem. We utilized focus groups of hospice and home-health nurses and patients to elucidate factors contributing to inadequate pain management and to generate solutions for closing the gap between the current reality and optimal pain management.Patients and methodsFocus groups were conducted among hospice and home-health-care nurses (two groups; n=22) and patients (six
Elizabeth Randall-David; Judy Wright; Deborah S. Porterfield; Glenn Lesser
AIM This review aims to develop disaster management practice using a health system strengthening approach through two objectives. Firstly, to review the disaster management literature to test the hypothesis that a holistic health system approach has not been established in practice or evaluated in the core literature. Secondly, to collate the worldwide experience of disaster management found in the core literature according to the components of a health system. METHOD A systematic review was conducted of the core literature published between January 2000 and November 2011 on the MEDLINE and Embase databases. Search terms combined the WHO's descriptors for a health system with disaster terms. Non-restrictive inclusion criteria were applied. Papers were assessed using a quality appraisal tool. Content analysis identified the disaster management components discussed within the context of the health system. RESULTS The search yielded 143 relevant disaster management documents for collation. The review found that none of these publications described a holistic health system approach to disaster management, and none evaluated such an approach. CONCLUSION The findings of this review demonstrate that a holistic health system approach to disaster management has not been established in practice or evaluated in the core literature. Important lessons identified through the collation and analyses of isolated disaster-related experience require further research to incorporate them within a holistic health system approach. This approach, supported by the resolution passed at the World Health Assembly in 2011, aims to build health system resilience to protect immediate and long-term population health in the face of all-hazards disasters. Citation: Bayntun C. A health system approach to all-hazards disaster management: A systematic review. PLOS Currents Disasters. 2012 Aug 22. doi: 10.1371/50081cad5861d. PMID:23066519
AIM This review aims to develop disaster management practice using a health system strengthening approach through two objectives. Firstly, to review the disaster management literature to test the hypothesis that a holistic health system approach has not been established in practice or evaluated in the core literature. Secondly, to collate the worldwide experience of disaster management found in the core literature according to the components of a health system. METHOD A systematic review was conducted of the core literature published between January 2000 and November 2011 on the MEDLINE and Embase databases. Search terms combined the WHO’s descriptors for a health system with disaster terms. Non-restrictive inclusion criteria were applied. Papers were assessed using a quality appraisal tool. Content analysis identified the disaster management components discussed within the context of the health system. RESULTS The search yielded 143 relevant disaster management documents for collation. The review found that none of these publications described a holistic health system approach to disaster management, and none evaluated such an approach. CONCLUSION The findings of this review demonstrate that a holistic health system approach to disaster management has not been established in practice or evaluated in the core literature. Important lessons identified through the collation and analyses of isolated disaster-related experience require further research to incorporate them within a holistic health system approach. This approach, supported by the resolution passed at the World Health Assembly in 2011, aims to build health system resilience to protect immediate and long-term population health in the face of all-hazards disasters. Citation: Bayntun C. A health system approach to all-hazards disaster management: A systematic review. PLOS Currents Disasters. 2012 Aug 22. doi: 10.1371/50081cad5861d.
Diabetes is a self-managed disease for which patients provide 99% of their own care. For patients to succeed as diabetes self-managers,\\u000a they need office practices and health care systems that can prepare and support them in their diabetes self-management efforts\\u000a over the long term. In order to provide effective diabetes education and ongoing support, office practices and health care\\u000a systems
Despite the popularity of Total Quality Management (TQM) with its use of multidisciplinary process improvement teams, little appears to have been achieved in rural health services using this approach. Reviewing the literature suggests few publications. Even traditional Quality Assurance (QA) activities in many of the smaller rural health services are reasonably undeveloped. Against this backdrop, the Rural Health Education and Research Centre successfully marketed and ran several experiential TQM workshops for rural health workers across NSW, resulting in 60 TQM projects being successfully completed. The purpose of this paper is to present the model we use to enable more rural health workers to participate in and benefit from quality management. PMID:9107600
To many, the U.S. health care system has become an unintelligible alphabet soup of three-letter health plans. There is little agreement about which characteristics distinguish one type of plan from another. In this article we chip away at what has become a Tower of Babel of managed care and health insurance terminology. We review past and current trends in the market for nontraditional health benefit plans and propose a taxonomy, or system of classification, that will aid in understanding how managed care plans differ from conventional health insurance and from one another. Also included is a comprehensive glossary of terms. PMID:8320444
The inclusion of genomic information will become routine in electronic health records (EHRs). Educating health information management (HIM) students about how to best manage, protect, properly release, and use this information for patient care is of utmost importance. This study examined the usefulness of incorporating genomic modules into an existing course in quality management. Pretest and posttest results showed that students improved in all areas related to genomics in healthcare. Also, students enjoyed the class scenarios and discussion on the ethical use of genomic information. Interspersing genomic information management throughout an existing quality management class is an effective way to add this information to an existing HIM curriculum.
Health literacy is emerging as a key element for successful medication management and empirical support for the efficacy of numeracy in the health context is rising as well. Little is known, however, about their unique effects among women and men. Given the importance of accurate medication management for effective treatment of HIV, the relation of these variables to medication management needs to be assessed. We therefore tested the relation of health literacy (reading comprehension) and numeracy to one's ability to manage a “mock” HIV regimen and whether men and women differed in these abilities. Results showed that women were less able than men to follow medication instructions and answer questions about the mock regimen. Numeracy mediated the relationship between gender and medication management. These findings highlight skills used in managing medication regimens and suggest avenues to target for identification and intervention in medication management among women and men with HIV.
Waldrop-Valverde, Drenna; Jones, Deborah L.; Jayaweera, Dushyantha; Gonzalez, Peggy; Romero, Javier; Ownby, Raymond L.
Urban Native Americans represent a small, diverse minority with unique health needs. The purposes of this descriptive retrospective study were to describe (a) the characteristics and primary health problems of urban Native Americans who receive primary health care at an urban nurse managed center (NMC) and (b) the nursing interventions provided at an urban NMC to urban Native Americans. A
Donna Felber Neff; Elizabeth S. Kinion; Christen Cardina
The U.S. Public Health Service has released new recommendations for the management of health care personnel who experience occupational exposures to blood or other body fluids that might contain human immunodeficiency virus. [Workplace Health Saf 2013;61(11):504.]. PMID:24169957
Nowadays, the need for effective integrated health information management is very high, with which each individual can monitor his\\/her health status and the ever increasing healthcare cost can be significantly reduced therefore. Moreover, advancements in information, communication and sensor technology have made readily available many types of highly accurate yet affordable PHDs (Personal Health Devices) including glucose meter and blood
Sung-Hyun Leel; Joon Hyun Song; Jung-Hoon Ye; Hyo Jeong Lee; Byoung-Kee Yi; Il Kon Kim
The Ministry of Health and Family Welfare, Government of India administers a large number of national health programs such as Malaria control program, Blindness control program, National AIDS control program, Reproductive and Child Health (RCH) Program and so on. However, effective management of these programs has always come under scrutiny, as these programs consume a large amount of resources. As
The introduction of the National Rural Health Mission has increased the demand for micro-level data on population and health for use in monitoring, planning and programme implementation. This calls for the introduction of a HealthManagement Information System (HMIS). The launching of a national portal-based HMIS by Government of India in 2008 was a bold and innovative step. However, there
There are thousands of labor-management committees for occupational safety and health in the United States. Most were established or activated after passage of the Occupational Safety and Health Act of 1970. Such committees can be an important tool when used as part of a comprehensive effort to achieve safety and health in the workplace. In the…
|The evolving eHealth agenda presents a range of potential opportunities for the management and prevention of chronic disease. This paper identifies issues and barriers to the uptake of eHealth and describes a strategy ("Healthy Outcomes for Australians"[C]-HOFA) for creating a central knowledge filter and cyber space method for tracking health…
Retention in treatment is one of the strongest predictors of positive mental health outcomes. Adolescents, however, are particularly challenging to retain in mental health treatment. Concurrent case management services may offer one strategy for retaining youth in mental health treatment as it aims to reduce barriers to services, coordinate multiple services, and establish a consistent relationship between each client and
Simulation of patient flow is a remarkably useful management tool. With today's software for personal computers, simulation is no longer just for academics and consultants. Senior and mid-level managers should actively seek out simulation as a problem-solving technique. This article provides health-care managers with the fundamental knowledge needed to individually initiate simulation studies of their departments. PMID:1391745
The purpose of this research was to examine a case study by evaluating performance outcomes of a technology change management initiative in a health care organization. This study was developed with an array of issues surrounding change management programs with technology platforms, the management of complex change and the amount of criticism that became the impetus behind the implementation of
The purpose of this research was to examine a case study by evaluating performance outcomes of a technology change management initiative in a health care organization. This study was developed with an array of issues surrounding change management programs with technology platforms, the management of complex change and the amount of criticism that became the impetus behind the implementation of
The national Health project has set the healthcare system the task of intensifying disease prevention, reducing morbidity, and increasing the lifespan and active longevity of the national population. Population health is the aggregate of the health of individuals. Modern biomedical science considers the quantification of human health to be an extremely complicated and yet unsolved problem. Some researchers [2?4] believe
The use of a coordinated team of allied health professionals (AHPs) to treat patients with rheumatoid arthritis assigned to experimental groups (EG) and comparison groups (CG) was assessed. The EG patients were evaluated regularly by each AHP team member, whereas CG patients were seen by AHPs only upon referral. Of the 10 EG and 13 CG patients who remained in the study for 2 years, the EG patients initially exhibited somewhat greater disease activity than CG (as reflected by erythrocyte sedimentation rate and duration of morning stiffness). After 2 years, EG patients demonstrated less disease activity than at the outset, whereas CG patients either showed little change in these parameters or deteriorated during the study. Grip strength, which was initially similar in the two groups, improved in EG patients but decreased in CG patients, so that after 2 years a significant difference was noted between the two groups (p less than .05). Tendency to lose hand range of motion was also greater in CG than in EG patients. Some EG patients showed improvement in finger flexion deformities during the study. Furthermore, EG patients showed a greater tendency to acquire positive attitudes regarding themselves and family relationships. These results suggest that ongoing "team care" may be more efficacious than episodic use of AHPs in management of patients with mild rheumatoid arthritis. PMID:6486240
AUPHA faculty members have had the opportunity to provide health care executive training and to work in partnership with academic institutions in Central and Eastern Europe and in the New Independent States of the former Soviet Union. This article presents some observations on healthmanagement education that demonstrate the similarity in issues faced by programs in the U.S. and in CEE. The healthmanagement educational partnership program was designed to provide technical assistance to emerging healthmanagement programs in the CEE. The partnership program has been mutually beneficial for several reasons. The role of physicians in leadership and the management educational needs that result provide one example of an issue that healthmanagement educational programs must address. The emergence of the roles of other health professions and growing contribution that they will make has its parallel in the American ascendance of the role of interdisciplinary team in clinical decision making. The partnership and executive training experiences have caused U.S. partners to focus consciously on pedagogical methods. The nature of the issues faced by emerging CEE healthmanagement programs suggests that mutual support among programs in the region after the partnership program is necessary in order to provide a forum for debate. The focus of the debate should continue to be on the role of management in health reform, content of curriculum, research focus and pedagogical methods appropriate for health care management undergraduate and graduate programs. The result will be a strengthening of the healthmanagement academic discipline in the region. The future of the AUPHA should predicated on the same principles, the roots from which it has grown. PMID:10387229
...ruminants into the medium or minimum security facility, a new compliance agreement...Administrator, before a new lot of ruminants...facility. (F) For medium security facilities...and other design features of a privately owned medium security...
A consortium of health care consumers and providers, consisting of 11 institutions and agencies in Alabama and Tennessee, which represents an alliance of health and education interests to produce adequate health manpower and improve health care delivery i...
Advantages and pharmacy applications of computerized hospital management-control and planning systems are described. Hospitals must define their product lines; patient cases, not tests or procedures, are the end product. Management involves operational control, management control, and strategic planning. Operational control deals with day-to-day management on the task level. Management control involves ensuring that managers use resources effectively and efficiently to accomplish the organization's objectives. Management control includes both control of unit costs of intermediate products, which are procedures and services used to treat patients and are managed by hospital department heads, and control of intermediate product use per case (managed by the clinician). Information from the operation and management levels feeds into the strategic plan; conversely, the management level controls the plan and the operational level carries it out. In the system developed at New England Medical Center, Boston, Massachusetts, the intermediate product-management system enables managers to identify intermediate products, develop standard costs, simulate changes in departmental costs, and perform variance analysis. The end-product management system creates a patient-level data-base, identifies end products (patient-care groupings), develops standard resource protocols, models alternative assumptions, performs variance analysis, and provides concurrent reporting. Examples are given of pharmacy managers' use of such systems to answer questions in the areas of product costing, product pricing, variance analysis, productivity monitoring, flexible budgeting, modeling and planning, and comparative analysis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3284338
Introduction The Chronic Disease Self-Management Program (CDSMP) is a community-based self-management education program designed to help participants gain confidence (self-efficacy) and skills to better manage their chronic conditions; it has been implemented worldwide. The objective of this meta-analysis was to quantitatively synthesize the results of CDSMP studies conducted in English-speaking countries to determine the program’s effects on health behaviors, physical and psychological health status, and health care utilization at 4 to 6 months and 9 to 12 months after baseline. Methods We searched 8 electronic databases to identify CDSMP-relevant literature published from January 1, 1999, through September 30, 2009; experts identified additional unpublished studies. We combined the results of all eligible studies to calculate pooled effect sizes. We included 23 studies. Eighteen studies presented data on small English-speaking groups; we conducted 1 meta-analysis on these studies and a separate analysis on results by other delivery modes. Results Among health behaviors for small English-speaking groups, aerobic exercise, cognitive symptom management, and communication with physician improved significantly at 4- to 6-month follow-up; aerobic exercise and cognitive symptom management remained significantly improved at 9 to 12 months. Stretching/strengthening exercise improved significantly at 9 to 12 months. All measures of psychological health improved significantly at 4 to 6 months and 9 to 12 months. Energy, fatigue, and self-rated health showed small but significant improvements at 4 to 6 months but not at 9 to 12 months. The only significant change in health care utilization was a small improvement in the number of hospitalization days or nights at 4 to 6 months Conclusion Small to moderate improvements in psychological health and selected health behaviors that remain after 12 months suggest that CDSMP delivered in small English-speaking groups produces health benefits for participants and would be a valuable part of comprehensive chronic disease management strategy.
The role of cost-sharing in health care is a crucial, yet contentious issue. In conflict situations, cost-sharing becomes even more controversial as health and other institutions are failing. In such situations, NGOs managehealth programmes which aim to aid populations in crisis and improve or at least sustain a deteriorating health system. This study looks at the issue of cost-sharing
Background: Major depression is associated with cognitive deficits, particularly those requiring central executive functioning. Depressed patients also tend to focus on and think about their symptoms and problems (“ruminate”) more than non-depressed controls. Although an association has been found between rumination and impaired performance on a central executive processing task, the causal relation between impaired executive functioning and rumination has
Most viral infections that affect the central nervous system of ruminants are exotic to Australia. As such, this review focuses on viruses of importance in Australian ruminants, including Akabane virus and the ruminant pestiviruses, bovine viral diarrhoea virus and border disease virus, as well as bluetongue virus. Each virus is discussed in terms of pathogenesis, clinical signs and diagnosis. PMID:21864304
This article analyzes the management system in a health district in the State of Rio Grande do Sul, Brazil, through qualitative analysis, using a case study as the methodology and macro-organization theory as the analytical framework. For the current management system in the 6th Health Region, a clear mission statement and wide acceptance by health workers are facilitating factors for the current organizational practices within the health system. Nevertheless, the way health coordinators are currently prioritizing their time has diverted necessary resources from critical problems towards more remedial issues. The 6th Health Region has encouraged social control (or public oversight) in order to improve accountability. However, there is room for improvement in quality assurance management, since there were no well-defined goals, objectives, or accountability. Decentralized consultancy provided to the municipalities and the funding model itself have both promoted decentralization and autonomy, although the strategy requires better regional integration and greater commitment in managerial practices. PMID:16951890
Lima, Juliano de Carvalho; Rivera, Francisco Javier Uribe
This guidance document is a reference for air quality policymakers and managers providing state-of-the-art, evidence-based information on key determinants of air quality management decisions. The document reflects the findings of five annual meetings of the NERAM (Network for Environmental Risk Assessment and Management) International Colloquium Series on Air Quality Management (2001-2006), as well as the results of supporting international research. The topics covered in the guidance document reflect critical science and policy aspects of air quality risk management including i) health effects, ii) air quality emissions, measurement and modeling, iii) air quality management interventions, and iv) clean air policy challenges and opportunities. PMID:18569631
Craig, Lorraine; Brook, Jeffrey R; Chiotti, Quentin; Croes, Bart; Gower, Stephanie; Hedley, Anthony; Krewski, Daniel; Krupnick, Alan; Krzyzanowski, Michal; Moran, Michael D; Pennell, William; Samet, Jonathan M; Schneider, Jurgen; Shortreed, John; Williams, Martin
Methods were developed for the determination of oligoalanine and other short-chain peptides and peptide analogs in ruminal fluid by using reverse-phase high-pressure liquid chromatography. Chromatographic analysis of the breakdown of (Ala)3 and (Ala)4 in ruminal fluid in vitro revealed that the predominant mechanism of hydrolysis was a dipeptidyl peptidase-like activity. Hydrolysis proceeded from the N terminal of the peptide chain; N-acetyl-(Ala)3 was broken down at 11% of the rate of breakdown of (Ala)3 or (Ala)3-p-nitroanilide. (Ala)2-p-nitroanilide was hydrolyzed most rapidly of the arylamide substrates tested, but fluorogenic 4-methoxy-2-naphthylamide (MNA) compounds were more convenient and potentially more versatile substrates than p-nitroanilides. Gly-Arg-MNA was the most rapidly hydrolyzed dipeptidyl peptidase substrate, suggesting that ruminal peptidase activity was predominantly of a type I specificity.
In the course of investigating the malignant catarrhal fever (MCF) subgroup of rhadinoviruses, seven novel rhadinoviruses were identified in a variety of ruminants, including domestic sheep, bighorn sheep, bison, black-tailed deer, mule deer, fallow deer, elk and addax. Based on the DNA polymerase gene sequences, these newly recognized viruses clustered into a second distinct subgroup in ruminants with three members identified previously in cattle, goats and oryx. Phylogenetic analysis revealed that the currently known ruminant rhadinoviruses appear to comprise three distinct genetic lineages: (i) the MCF subgroup, defined by sequence identity and the presence of the 15A antigenic epitope; (ii) a second distinct subgroup, devoid of the 15A epitope, which contains the previously reported bovine lymphotropic herpesvirus and related viruses; and (iii) a third distinct subgroup represented by Bovine herpesvirus 4. Comparison of phylogenetic trees between the rhadinoviruses and their corresponding hosts further supports the gammaherpesvirus and host co-evolution theory. PMID:16227223
Li, Hong; Gailbreath, Katherine; Flach, Edmund J; Taus, Naomi S; Cooley, Jim; Keller, Janice; Russell, George C; Knowles, Donald P; Haig, David M; Oaks, J Lindsay; Traul, Donald L; Crawford, Timothy B
Peste des petits ruminants (PPR) is an endemic disease of small ruminants, and vaccination has been the method of control but outbreaks are continuously occurring in Pakistan. The following study presents a detailed investigation of an outbreak, suspected to be PPR, probably introduced by PPRV-infected sheep and goats from Sindh Province (north-west) to Punjab Province (central) of Pakistan during the flood relief campaign in 2011. A total of 70 serum samples from 28 different flocks were tested with competitive ELISA (H antibodies), which detected 24 (34.2%) samples positive for PPRV antibodies. Nasal swabs and faeces were tested with immunocapture ELISA (N antigen), which detected 18 (25.7%) samples positive for PPRV antigen. The RNA detected positive (n = 28, 40%) using real-time PCR was subjected to conventional PCR for the amplification of the fusion and nucleoprotein genes. Sequencing of both genes and subsequent phylogenetic analysis indicated the grouping of all the sequences to be in lineage IV along with other Asian isolates of PPRV. However, sequences of both genes were divided into two groups within lineage IV. One group of viruses clustered with previously characterized Pakistani isolates, whereas the other group was distinctly clustered with isolates from the Middle East or India. The sequence identity indicated the introduction of at least one population of PPRV from a different source and circulation in the local flocks of small ruminants, which emphasized the need to obtain health clearance certificate before movement of animals. The results of this study provide baseline data for the genetic characterization of different PPRV populations in Pakistan. PMID:23590481
Munir, M; Saeed, A; Abubakar, M; Kanwal, S; Berg, M
... false Functions of the Service in health care industry bargaining under the Labor-Management...CONCILIATION SERVICE-ASSISTANCE IN THE HEALTH CARE INDUSTRY Â§ 1420.1 Functions of the Service in health care industry bargaining under the...
|The health care organization, as a specialized organizational setting, has some characteristics that make it of special concern to the conflict theorist. In a health care setting, conflict may arise as a result of (1) the complexity of medicine and the bureaucracy of health care delivery, (2) the problems of acquiring relevant information from…
Earlier studies from Norway indicate that organic dairy farms enjoy better animal health than conventional dairy farms. However, these studies use veterinary treatment records and may not reflect the true health status since animal health may be handled differently, i.e. there might be different treatment schemes on organic versus in conventional farms.A study of animal health and health handling on
P. S. Valle; G. Lien; O. Flaten; M. Koesling; M. Ebbesvik
According to their feeding habits, ruminants can be classified as grazers, concentrate selectors and those of intermediate type. The different feeding types are reflected in distinct anatomical properties of the forestomachs. The present study was designed to investigate whether the intrinsic innervation patterns of the rumen (the main part of the forestomach) differ between intermediate types and grazers. Myenteric plexus preparations from the rumen of goats (intermediate type), fallow deer (intermediate type), cattle (grazer) and sheep (grazer) were analysed by immunohistochemical detection of the following antigens: Hu-protein (HuC/D), choline acetyltransferase (ChAT), nitric oxide synthase (NOS), vasoactive intestinal peptide (VIP), neuropeptide Y (NPY), substance P (SP), calbindin (CALB) and somatostatin (SOM). Myenteric ganglia of cattle contained 73 +/- 6 neurons per ganglion, whereas the ganglia of sheep were significantly smaller (45 +/- 18 neurons per ganglion). The ganglion density of the myenteric plexus was highest in fallow deer (15 +/- 3 ganglia per cm(2)) and lowest in cattle (6 +/- 1 ganglia per cm(2)). All myenteric neurons were either ChAT or NOS positive. The proportion of NOS-positive neurons was significantly lower in sheep (29.5 +/- 8.2% of all neurons) than in goats (44.2 +/- 9.8%). In all species, additional analysis of the different neuropeptides revealed the following subpopulations in descending order of percentile appearance: ChAT/SP > NOS/VIP/NPY > ChAT/- > NOS/NPY. Expression of CALB was detected in a minority of the ChAT-positive neurons in all species. Somatostatin immunoreactive somata were found only in preparations obtained from fallow deer and sheep. These data suggest that the rumen of grazers is under stronger cholinergic control than the rumen of species belonging to the intermediate type, although most subpopulations of neurons are present in all species. However, whether the strong mixing patterns of low quality roughage during digestion are enabled by the prominent excitatory input of the rumen of grazers requires elucidation in further studies. PMID:18657258
According to their feeding habits, ruminants can be classified as grazers, concentrate selectors and those of intermediate type. The different feeding types are reflected in distinct anatomical properties of the forestomachs. The present study was designed to investigate whether the intrinsic innervation patterns of the rumen (the main part of the forestomach) differ between intermediate types and grazers. Myenteric plexus preparations from the rumen of goats (intermediate type), fallow deer (intermediate type), cattle (grazer) and sheep (grazer) were analysed by immunohistochemical detection of the following antigens: Hu-protein (HuC/D), choline acetyltransferase (ChAT), nitric oxide synthase (NOS), vasoactive intestinal peptide (VIP), neuropeptide Y (NPY), substance P (SP), calbindin (CALB) and somatostatin (SOM). Myenteric ganglia of cattle contained 73 ± 6 neurons per ganglion, whereas the ganglia of sheep were significantly smaller (45 ± 18 neurons per ganglion). The ganglion density of the myenteric plexus was highest in fallow deer (15 ± 3 ganglia per cm2) and lowest in cattle (6 ± 1 ganglia per cm2). All myenteric neurons were either ChAT or NOS positive. The proportion of NOS-positive neurons was significantly lower in sheep (29.5 ± 8.2% of all neurons) than in goats (44.2 ± 9.8%). In all species, additional analysis of the different neuropeptides revealed the following subpopulations in descending order of percentile appearance: ChAT/SP > NOS/VIP/NPY > ChAT/– > NOS/NPY. Expression of CALB was detected in a minority of the ChAT-positive neurons in all species. Somatostatin immunoreactive somata were found only in preparations obtained from fallow deer and sheep. These data suggest that the rumen of grazers is under stronger cholinergic control than the rumen of species belonging to the intermediate type, although most subpopulations of neurons are present in all species. However, whether the strong mixing patterns of low quality roughage during digestion are enabled by the prominent excitatory input of the rumen of grazers requires elucidation in further studies.
Background Before a new test is introduced in clinical practice, evidence is needed to demonstrate that its use will lead to improvements in patient health outcomes. Studies reporting test accuracy may not be sufficient, and clinical trials of tests that measure patient health outcomes are rarely feasible. Therefore, the consequences of testing on patient management are often investigated as an intermediate step in the pathway. There is a lack of guidance on the interpretation of this evidence, and patient management studies often neglect a discussion of the limitations of measuring patient management as a surrogate for health outcomes. Methods We discuss the rationale for measuring patient management, describe the common study designs and provide guidance about how this evidence should be reported. Results Interpretation of patient management studies relies on the condition that patient management is a valid surrogate for downstream patient benefits. This condition presupposes two critical assumptions: the test improves diagnostic accuracy; and the measured changes in patient management improve patient health outcomes. The validity of this evidence depends on the certainty around these critical assumptions and the ability of the study design to minimise bias. Three common designs are test RCTs that measure patient management as a primary endpoint, diagnostic before-after studies that compare planned patient management before and after testing, and accuracy studies that are extended to report on the actual treatment or further tests received following a positive and negative test result. Conclusions Patient management can be measured as a surrogate outcome for test evaluation if its limitations are recognised. The potential consequences of a positive and negative test result on patient management should be pre-specified and the potential patient benefits of these management changes clearly stated. Randomised comparisons will provide higher quality evidence about differences in patient management using the new test than observational studies. Regardless of the study design used, the critical assumption that patient management is a valid surrogate for downstream patient benefits or harms must be discussed in these studies.
This review is based largely, but not entirely, on the assumption that gamete quality is directly linked to sperm output and thus testicular mass, an approach made necessary by the absence of a large body of data on factors that affect gamete quality in ruminants. On the other hand, there is a change in the efficiency of sperm production per gram of testicular tissue when the testis is growing or shrinking, a clear indicator of changes in the rates of cell loss during the process of spermatogenesis, probably through apoptosis. We therefore postulate that the spermatozoa that do survive when the testis is shrinking are of a lower quality than those that are produced when the testis is growing and the rate of sperm survival is increasing. In adult small ruminants in particular, testicular mass and sperm production are highly labile and can be manipulated by management of photoperiod (melatonin), nutrition, genetics and behaviour ('mating pressure'). Importantly, these factors do not act independently of each other - rather, the outcomes in terms of sperm production are dictated by interactions. It therefore seems likely that spermatozoa quality will be affected by these same factors, but definitive answers await detailed studies. PMID:22394713
Martin, G B; de St Jorre, T Jorre; Al Mohsen, F A; Malecki, I A
The VA Office of Inspector General (OIG), Office of Healthcare Inspections completed an evaluation of Veterans Health Administration (VHA) medical facilities quality management (QM) programs. The purposes of the evaluation were to determine whether VHA fa...
Qualitative Rangeland Health Assessments are extremely useful because they provide a relative indication of resource problems on rangelands. Additionally, theSuccessional Management framework identifies three primary causes of plantcommunity change, ecological processes, and factors that modify thes...
The VA Office of Inspector General Office of Healthcare Inspections completed an evaluation of the management of multidrug-resistant organisms (MDRO) in Veterans Health Administration facilities. The purposes of the evaluation were to determine whether fa...
Accounting principles associated with a financial management information system (FMIS) for health maintenance organizations (HMO's) are detailed. The accounting structure for the FMIS uses the double entry system. It is designed to disclose the full range...
The VA Office of Inspector General Office of Healthcare Inspections completed an evaluation of the management of workplace violence (WPV) in Veterans Health Administration (VHA) facilities. The purpose of the evaluation was to determine the extent to whic...
At the request of the Chairman of the House Committee on Veterans Affairs, we evaluated the management and acquisition practices the Veterans Health Administration (VHA) used to procure prosthetic limbs. We examined the suitability of procurement practice...
Defense personnel who are responsible for managing funds provided to reduce the Military Retirement Health Benefits (MRHB) liability should read this report. The report discusses how the Defense Finance and Accounting Service invests funds from the Medica...
Collaborative strategic management of public health emergency and homeland security issues can address gaps in roles and responsibilities and foster better coordinated planning at the federal level. Recent changes in the alignment of the national planning...
One of the most prominent technical challenges to effective deployment of healthmanagement systems is the vast difference in user objectives with respect to engineering development. In this paper, a detailed survey on the objectives of different users of...
Prognostic and HealthManagement (PHM) systems often experience delayed fielding and lengthened maturation cycles due to their relative immaturity and their status as non-flight critical systems. The national fiscal crisis and rising debt of the United St...
The Health Care Guide to Pollution Prevention Implementation through Environmental Management Systems provides example EMS procedures and forms used in four ISO 14001 EMS certified hospitals. The latest revisions include more EMS hospital case studies, more compliance resources, ...
OBJECTIVE To determine whether managed care is associated with reduced access to mental health specialists and worse outcomes among primary care patients with depressive symptoms. DESIGN Prospective cohort study. SETTING Offices of 261 primary physicians in private practice in Seattle. PATIENTS Patients (N = 17,187) were screened in waiting rooms, enrolling 1,336 adults with depressive symptoms. Patients (n = 942) completed follow-up surveys at 1, 3, and 6 months. MEASUREMENTS AND RESULTS For each patient, the intensity of managed care was measured by the managedness of the patient's health plan, plan benefit indexes, presence or absence of a mental health carve-out, intensity of managed care in the patient's primary care office, physician financial incentives, and whether the physician read or used depression guidelines. Access measures were referral and actually seeing a mental health specialist. Outcomes were the Symptom Checklist for Depression, restricted activity days, and patient rating of care from primary physician. Approximately 23% of patients were referred to mental health specialists, and 38% saw a mental health specialist with or without referral. Managed care generally was not associated with a reduced likelihood of referral or seeing a mental health specialist. Patients in more-managed plans were less likely to be referred to a psychiatrist. Among low-income patients, a physician financial withhold for referral was associated with fewer mental health referrals. A physician productivity bonus was associated with greater access to mental health specialists. Depressive symptom and restricted activity day outcomes in more-managedhealth plans and offices were similar to or better than less-managed settings. Patients in more-managed offices had lower ratings of care from their primary physicians. CONCLUSIONS The intensity of managed care was generally not associated with access to mental health specialists. The small number of managed care strategies associated with reduced access were offset by other strategies associated with increased access. Consequently, no adverse health outcomes were detected, but lower patient ratings of care provided by their primary physicians were found.
Grembowski, David E; Martin, Diane; Patrick, Donald L; Diehr, Paula; Katon, Wayne; Williams, Barbara; Engelberg, Ruth; Novak, Louise; Dickstein, Deborah; Deyo, Richard; Goldberg, Harold I
We assessed the feasibility of using organizational network analysis in a local public health organization. The research setting was an urban/suburban county health department with 156 employees. The goal of the research was to study communication and information flow in the department and to assess the technique for public healthmanagement. Network data were derived from survey questionnaires. Computational analysis was performed with the Organizational Risk Analyzer. Analysis revealed centralized communication, limited interdependencies, potential knowledge loss through retirement, and possible informational silos. The findings suggested opportunities for more cross program coordination but also suggested the presences of potentially efficient communication paths and potentially beneficial social connectedness. Managers found the findings useful to support decision making. Public health organizations must be effective in an increasingly complex environment. Network analysis can help build public health capacity for complex system management.
In this case study we describe a method that has potential to provide systematic support for public health information management. Public health agencies depend on specialized information that travels throughout an organization via communication networks among employees. Interactions that occur within these networks are poorly understood and are generally unmanaged. We applied organizational network analysis, a method for studying communication networks, to assess the method’s utility to support decision making for public healthmanagers, and to determine what links existed between information use and agency processes. Data on communication links among a health department’s staff was obtained via survey with a 93% response rate, and analyzed using Organizational Risk Analyzer (ORA) software. The findings described the structure of information flow in the department’s communication networks. The analysis succeeded in providing insights into organizational processes which informed public healthmanagers’ strategies to address problems and to take advantage of network strengths.
Ethnic minority women are well represented in the work force and in the health care system in general, but do not have a similar level of representation in the management sector. This paper explores three strategies for schools of health administration to consider to lessen the effect of a "glass ceiling" that may be encountered by ethnic minority women aspiring to positions of leadership in health services agencies. These strategies are advancing affirmative action, valuing ethnic women in health administration education, and investigating diversity management. Inherent in each of the three strategies is the need for acknowledgment and more open discussion of the "glass ceiling." Problem-solving in relation to the potential for systemic discrimination adversely affecting ethnic minority women in senior health care management positions, and greater study of the three strategies using both qualitative and quantitative methodologies is also needed. PMID:10539612
Clinical and health-care knowledge management (KM) as a discipline has attracted increasing worldwide attention in recent years. The approach encompasses a plethora of interrelated themes including aspects of clinical informatics, clinical governance, artificial intelligence, privacy and security, data mining, genomic mining, information management, and organizational behavior. This paper introduces key manuscripts which detail health-care and clinical KM cases and applications. PMID:16138531
Bali, Rajeev K; Feng, David Dagan; Burstein, Frada; Dwivedi, Ashish N
Medicaid, Americaâ€™s largest government-funded health insurance program, plays a pivotal role in providing health services to eight million adults with disabilities. Since the mid-1990s, many Medicaid programs have aggressively introduced managed care, which reconfigures service delivery using business principles. Most states have insufficient experience in developing managed care plans for Medicaid beneficiaries with disabilities. Middle-aged adults with physical disabilities present
The aims and goals in setting up an Information Management and Technology Laboratory in the Lyman Maynard Stowe Library at the University of Connecticut Health Center are outlined. Health professionals have a chance in the Laboratory to try software and machines and acquaint themselves with some of the new technology. The Laboratory can save individual departments time, the necessity for extensive research and money and will be used to give students and staff experience in information management techniques.
IN 1954 we put forward a hypothesis1 that the trans-acids content of the depot fats of ruminants may be explained by the hydrogenation of the dietary fatty acids from pasture effected by the rumen bacteria. No trans-acids were detected in pasture-fed non-ruminants and the small amounts of these acids found in the pig were attributed to the skim-milk diet. This
Central nervous system (CNS) infections in ruminant livestock, such as listeriosis, are of major concern for veterinary and public health. To date, no host-specific in vitro models for ruminant CNS infections are available. Here, we established and evaluated the suitability of organotypic brain-slices of ruminant origin as in vitro model to study mechanisms of Listeria monocytogenes CNS infection. Ruminants are frequently affected by fatal listeric rhombencephalitis that closely resembles the same condition occurring in humans. Better insight into host-pathogen interactions in ruminants is therefore of interest, not only from a veterinary but also from a public health perspective. Brains were obtained at the slaughterhouse, and hippocampal and cerebellar brain-slices were cultured up to 49 days. Viability as well as the composition of cell populations was assessed weekly. Viable neurons, astrocytes, microglia and oligodendrocytes were observed up to 49 days in vitro. Slice cultures were infected with L. monocytogenes, and infection kinetics were monitored. Infected brain cells were identified by double immunofluorescence, and results were compared to natural cases of listeric rhombencephalitis. Similar to the natural infection, infected brain-slices showed focal replication of L. monocytogenes and bacteria were predominantly observed in microglia, but also in astrocytes, and associated with axons. These results demonstrate that organotypic brain-slice cultures of bovine origin survive for extended periods and can be infected easily with L. monocytogenes. Therefore, they are a suitable model to study aspects of host-pathogen interaction in listeric encephalitis and potentially in other neuroinfectious diseases. PMID:22804762
Guldimann, Claudia; Lejeune, Beatrice; Hofer, Sandra; Leib, Stephen L; Frey, Joachim; Zurbriggen, Andreas; Seuberlich, Torsten; Oevermann, Anna
Objective To determine why hospitals enter into “capitated” contracts, which often generate accounting losses. The authors’ hypothesis is that hospitals coordinate contracts to keep beds full and that in principal, capitated contracts reflect sound capacity management. Summary Background Data In high-overhead industries, different consumers pay different prices for similar services (e.g., full-fare vs. advanced-purchase plane tickets, full tuition vs. financial aid). Some consumers gain access by paying less than total cost. Hospitals, like other high-overhead business enterprises, must optimize the use of their capacity, amortizing overhead over as many patients as possible. This necessity for enhanced throughput forces hospitals and health systems to discount empty beds, sometimes to the point where they incur accounting losses serving some payors. Methods The authors analyzed the cost accounting system at their university teaching hospital to compare hospital and intensive care unit (ICU) lengths of stay (LOS), variable direct costs (VDC), overhead of capitated patients, and reimbursement versus other payors for all hospital discharges (n = 29,036) in fiscal year 1998. The data were analyzed by diagnosis-related groups (DRGs), length of stay (LOS), insurance carrier, proximity to hospital, and discharge disposition. Patients were then distinguished across payor categories based on their resource utilization, proximity to the hospital, DRG, LOS, and discharge status. Results The mean cost for capitated patients was $4,887, less than half of the mean cost of $10,394 for the entire hospitalized population. The mean capitated reimbursement was $928/day, exceeding the mean daily VDC of $616 but not the total cost of $1,445/day. Moreover, the mean total cost per patient day of treating a capitated patient was $400 less than the mean total cost per day for noncapitated patients. The hospital’s capitated health maintenance organization (HMO) patients made up 16.0% of the total admissions but only 9.4% of the total patient days. Both the mean LOS of 3.4 days and the mean ICU LOS of 0.3 days were significantly different from the overall values of 5.8 days and 1 day, respectively, for the noncapitated population. For patients classified with a DRG with complication who traveled from more than 60 miles away, the mean LOS was 10.7 days and the mean total cost was $21,658. This is in contrast to all patients who traveled greater than 60 miles, who had an LOS of 7.2 days and a mean total cost of $12,569. Conclusion The capitated payor directed the bulk of its subscribers to one hospital (other payors transferred their sicker patients). This was reflected in the capitated group’s lower costs and LOS. This stable stream of relatively low-acuity patients enhanced capacity utilization. For capitated patients, the hospital still benefits by recovering the incremental cost (VDC) of treating these patients, and only a portion of the assigned overhead. Thus, in the short run, capitated patients provide a positive economic benefit. Other payors’ higher-acuity patients arrive more randomly, place greater strains on capacity, and generate higher overhead costs. This results in differential reimbursement to cover this incremental overhead. Having a portfolio of contracts allows the hospital to optimize capacity both in terms of patient flows and acuity. One risk of operating near capacity is that capitated patients could displace other higher-paying patients.
Taheri, Paul A.; Butz, David A.; Greenfield, Lazar J.
Objective To investigate socioeconomic disparities in access to home health visits and durable medical equipment by persons enrolled in two Medicare managed care health plans. Data Sources A telephone survey of 4,613 Medicare managed care enrollees conducted between April and October of 2000 and linked to administrative claims for a subsequent 12-month period. Study Design We estimated a series of logistic regression models to determine which socioeconomic factors were related to home health visits and the use of durable medical equipment (DME) among Medicare managed care enrollees. Principal Findings Controlling for health and demographic differences, Medicare managed care enrollees in the lowest tertile for nonhousing assets had 50 percent greater odds than those in the highest tertile of having one or more home health visits. All else equal, enrollees with less than a high school education had 30 percent lower odds than those who had graduated from high school of using durable medical equipment. Conclusions Medicare managed care enrollees of low socioeconomic status do not appear to have reduced access to home health visits; however, use of durable medical equipment is considerably lower for enrollees with less than a high school education. Physicians and therapists working with Medicare managed care enrollees may want to actively target DME prescriptions to those with educational disadvantages.
Freedman, Vicki A; Rogowski, Jeannette; Wickstrom, Steven L; Adams, John; Marainen, Jonas; Escarce, Jose J
Disasters are fortunately rare occurrences. However, accurate and timely information and communication are vital to adequately prepare individual health organizations for such events. The current article investigates the health related communication and information systems for emergency management in Iran. A mixed qualitative and quantitative methodology was used in this study. A sample of 230 health service managers was surveyed using a questionnaire and 65 semi-structured interviews were also conducted with public health and therapeutic affairs managers who were responsible for emergency management. A range of problems were identified including fragmentation of information, lack of local databases, lack of clear information strategy and lack of a formal system for logging disaster related information at regional or local level. Recommendations were made for improving the national emergency management information and communication system. The findings have implications for health organizations in developing and developed countries especially in the Middle East. Creating disaster related information databases, creating protocols and standards, setting an information strategy, training staff and hosting a center for information system in the Ministry of Health to centrally manage and share the data could improve the current information system. PMID:20703530
Current economic conditions necessitate the extension of service lives for a variety of aerospace systems. As a result, there is an increased need for structural healthmanagement (SHM) systems to increase safety, extend life, reduce maintenance costs, and minimize downtime, lowering life cycle costs for these aging systems. The implementation of such a system requires a collaborative research effort in a variety of areas such as novel sensing techniques, robust algorithms for damage interrogation, high fidelity probabilistic progressive damage models, and hybrid residual life estimation models. This dissertation focuses on the sensing and damage estimation aspects of this multidisciplinary topic for application in metallic and composite material systems. The primary means of interrogating a structure in this work is through the use of Lamb wave propagation which works well for the thin structures used in aerospace applications. Piezoelectric transducers (PZTs) were selected for this application since they can be used as both sensors and actuators of guided waves. Placement of these transducers is an important issue in wave based approaches as Lamb waves are sensitive to changes in material properties, geometry, and boundary conditions which may obscure the presence of damage if they are not taken into account during sensor placement. The placement scheme proposed in this dissertation arranges piezoelectric transducers in a pitch-catch mode so the entire structure can be covered using a minimum number of sensors. The stress distribution of the structure is also considered so PZTs are placed in regions where they do not fail before the host structure. In order to process the data from these transducers, advanced signal processing techniques are employed to detect the presence of damage in complex structures. To provide a better estimate of the damage for accurate life estimation, machine learning techniques are used to classify the type of damage in the structure. A data structure analysis approach is used to reduce the amount of data collected and increase computational efficiency. In the case of low velocity impact damage, fiber Bragg grating (FBG) sensors were used with a nonlinear regression tool to reconstruct the loading at the impact site.
Objectives This study describes complementary and alternative medicine (CAM) use among rural older adults with diabetes, delineates the relationship of health self-management predictors to CAM therapy use, and furthers conceptual development of CAM use within a health self-management framework. Methods Survey interview data were collected from a random sample of 701 community dwelling African American, Native American, and White elders residing in two rural North Carolina counties. We summarize CAM use for general use and for diabetes care and use multiple logistic modeling to estimate the effects of health self-management predictors on use of CAM therapies. Results The majority of respondents used some form of CAM for general purpose, whereas far fewer used CAM for diabetes care. The most widely used CAM categories were food home remedies, other home remedies, and vitamins. The following health self-management predictors were related to the use of different categories of CAM therapies: personal characteristics (ethnicity), health status (number of health conditions), personal resources (education), and financial resources (economic status). Discussion CAM is a widely used component of health self-management among rural among older adults with diabetes. Research on CAM use will benefit from theory that considers the specific behavior and cognitive characteristics of CAM therapies.
Arcury, Thomas A.; Bell, Ronny A.; Snively, Beverly M.; Smith, Shannon L.; Skelly, Anne H.; Wetmore, Lindsay K.; Quandt, Sara A.
In China, there is a conflict between fast economic growth and slow growth of national public health, and even the health care has become a rich and difficult problem. This paper choose infant death ratio of the total death and some other variables to deputy economic growth, health care system and national public health. The outcome shows that there is
The current study investigated the short-term effects of mindful and ruminative forms of self-focused attention on a behavioral measure of distress tolerance in individuals with borderline personality disorder (BPD) who had completed an angry mood induction. Participants included 40 individuals who met criteria for BPD and were currently involved in mental health treatment. Each completed an individual 1-hr session. Following an angry mood induction, each participant was randomly assigned to engage in ruminative or mindful self-focus for several minutes. All participants then completed the computerized Paced Auditory Serial Addition Test (PASAT-C), a behavioral measure of willingness to tolerate distress in the service of goal-directed behavior. The mindfulness group persisted significantly longer than the rumination group on the distress tolerance task and reported significantly lower levels of anger following the self-focus period. Results are consistent with previous studies in suggesting that distinct forms of self-focused attention have distinct outcomes and that, for people with BPD, mindful self-observation is an adaptive alternative to rumination when feeling angry. PMID:22452758
Alfalfa (Medicago sativa) has one of the highest crude protein contents among forage crops, but the crude protein is rapidly and extensively degraded by microorganisms in the rumen. Our objectives were to i) identify the major specific proteins in alfalfa, and ii) quantify the rate of ruminal degra...
Rangelands throughout the world contain varying but often substantial proportions of shrubs. Shrubs are generally heavily chemically defended, and herbivores must either contend with their plant secondary metabolites (PSM) or avoid a significant component of the available forage. Browsing ruminants are exposed to thousands of chemicals in infinite combinations and concentrations that are constantly changing both temporally and spatially. The
A disease causing anorexia and ruminal indigestion in cattle and goats, and also edema of the lips, tongue and face in goats, was associated with the ingestion of Centratherum brachylepis in pastures containing large amounts of the plant. On 3 farms with a total of 217 cattle and 140 goats, 57 (26%) cattle and 56 (40%) goats were affected, and
Rosane M. T. Medeiros; Juliana K. M. Yassaki; José A. S. de Araujo; Antônio F. M. Dantas; Franklin Riet-Correa
Perennial ryegrass is the primary forage component of ruminant diets in New Zealand. It is persistent and palatable, and immature ryegrass has a high nutritive value (NV). However, seed-head development substantially lowers its feeding value (FV) as fibre concentration increases, the rate and extent of digestibility decreases, and voluntary intake declines. Ryegrass pastures are susceptible to accumulation of endophytic and
The rapid growth of the biofuels industry in the Midwest in the past 10 years has created an increased supply of corn coproduct feed for animals. This article discusses the tolerance and toxicology of biofuels coproducts in ruminants, including polioencephalomalacia, sulfur toxicosis, sulfur metabolism, mycotoxins, antibiotic residue, and biodiesel by-product toxicosis. PMID:21575771
This fact sheet summarizes the results of two continuous culture fermentor studies that evaluated the effects of molasses supplementation on ruminal fermentation of a pasture diet. The first study compared molasses with corn supplementation. Diets consisted of pasture only, molasses plus pasture, co...
Improving the health and health literacy of low-income families is a national public health priority in the United States. The federal Head Start program provides a national infrastructure for implementation of health promotion interventions for young children and their families. The Health Care Institute (HCI) at the Anderson School of Management at the University of California, Los Angeles, developed a structured approach to health promotion training for Head Start grantees using business management principles. This article describes the HCI approach and provides examples of implemented programs and selected outcomes, including knowledge and behavior changes among Head Start staff and families. This prevention-focused training platform has reached 60,000 Head Start families in the United States since its inception in 2001. HCI has demonstrated consistent outcomes in diverse settings and cultures, suggesting both scalability and sustainability.
In recent years, there has been significant interest in the application of continuous quality improvement (CQI) and total quality management (TQM), and patient-focused care (PFC) in health care organisations around the globe. The hospital industry has substantially embraced the concepts of CQI and TQM with the belief that these concepts and programmes will lead to an improvement in both the quality and efficiency with which health services are delivered. The objective of this article is to achieve better outcomes in health care services with fewer resources by studying the implementation of patient-focused care in the health care provision context and particularly in the area of pharmaceutical care management as an integrated process in the delivery of health care in a hospital setting. The changes in health care provision have in many instances meant that the provision of pharmaceutical services needed re-assessing. PMID:10346328
Improving the health and health literacy of low-income families is a national public health priority in the United States. The federal Head Start program provides a national infrastructure for implementation of health promotion interventions for young children and their families. The Health Care Institute (HCI) at the Anderson School of Management at the University of California, Los Angeles, developed a structured approach to health promotion training for Head Start grantees using business management principles. This article describes the HCI approach and provides examples of implemented programs and selected outcomes, including knowledge and behavior changes among Head Start staff and families. This prevention-focused training platform has reached 60,000 Head Start families in the United States since its inception in 2001. HCI has demonstrated consistent outcomes in diverse settings and cultures, suggesting both scalability and sustainability. PMID:24028835
Herman, Ariella; Nelson, Bergen B; Teutsch, Carol; Chung, Paul J
... were written or produced by Forest Service personnel and are in the public domain. ... Contributing to the decline of forest health are such factors as the extensive ... forest health decline in the Western United States A management strategy to ... Government employees on official time, and is therefore in the public domain.
|Objective: This study aimed at exploring managers' understanding of workplace health promotion and experiences of workplace health promotion activity within small and medium-sized enterprises. Design: A Heideggerian interpretive phenomenological methodology was adopted. Setting: This study was undertaken with small and medium-sized enterprise…
|Preliminary results from the Health Care Reform Tracking Project's baseline survey and site visits to 10 states show that managed care has generally improved access to health care for children, but it has made it more difficult for youths with serious emotional disorders, and uninsured children, to obtain care. (SLD)|
Stroul, Beth A.; Pires, Sheila A.; Armstrong, Mary I.; Meyers, Judith C.
|We explored whether the effects of a telephone-based osteoarthritis (OA) self-management support intervention differed by race and health literacy. Participants included 515 veterans with hip and/or knee OA. Linear mixed models assessed differential effects of the intervention compared with health education (HE) and usual care (UC) on pain…
Sperber, Nina R.; Bosworth, Hayden B.; Coffman, Cynthia J.; Lindquist, Jennifer H.; Oddone, Eugene Z.; Weinberger, Morris; Allen, Kelli D.
A risk management program is presented which is effective in handling occupational health risks in a diversified multinational corporation. The three-step program of plant reviews involves initial assessment visits designed to determine the compliance status and degree of sophistication of the occupational health program. These assessments are followed by more formal assurance reviews which include consultation, training, and program support.
The working alliance between clients and helpers has been identified as a common factor of treatment effectiveness, yet very little research has explored variables associated with working alliance between mental health case managers and their consumers. This study explored the potential covariates of working alliance within community mental health…
Objective: The authors compared symptom change trajectories and treatment outcome categories in children and adolescents receiving routine outpatient mental health services in a public community mental health system and a private managed care organization. Method: Archival longitudinal outcome data from parents completing the Youth Outcome…
Warren, Jared S.; Nelson, Philip L.; Mondragon, Sasha A.; Baldwin, Scott A.; Burlingame, Gary M.
The study objective was to determine the feasibility of implementation of personal health records (PHRs) by case managers (CMs) in a Veterans Affairs Medical Center (VAMC) Continuity of Care (COC) Clinic, to ascertain the impact of PHRs on patient access to vital health information, and to assess the effect on provider–patient communication. One hundred and fifty patients and 8 nurse
Joanne K Tobacman; Pamella Kissinger; Marilyn Wells; Joan Prokuski; Mary Hoyer; Patricia McPherson; Julie Wheeler; Joyce Kron-Chalupa; Carol Parsons; Patricia Weller; Bridget Zimmerman
AIM: To assess the knowledge, attitudes and practices of primary health care providers regarding the identification and management of domestic violence in a hospital based primary health care setting. METHOD: A survey of all clinicians and nursing staff of the outpatient, casualty and antenatal clinics in University Malaya Medical Centre using a self-administered questionnaire. RESULTS: Hundred and eight out of
Psychologists bring great value to health care systems, but our ethnocentrism regarding the medical community often limits our effectiveness as agents of change. Based on experience in developing pain management services within the Department of Veterans Affairs health care system, we discuss cultural issues as central to effective systems change and provide specific recommendations for psychologists aspiring to change organized
In this paper, an approach for integrating the information obtained from structural health monitoring in a life-cycle bridge management framework is proposed. The framework is developed on the basis of life-cycle system performance concepts that are also presented in this paper. The performance of the bridge is quantified by incorporating prior knowledge and information obtained from structural health monitoring using
Health and disease management, a clinical improvement process that integrates best practice principles in a comprehensive manner throughout the entire continuum of care, is likely to be the dominant style of health care delivery in the future. The goal of these programs is to eliminate or reduce unacceptable variations in cost and quality between various providers by developing guidelines that
David B. Bernard; Raymond R. Townsend; Mario F. Sylvestri
|More children with chronic illnesses are attending school, and some of them struggle academically because of issues related to their health. School-based case management has been suggested as one strategy to improve the academic success of these children. This study tracked the academic, health, and quality of life outcomes for 114 children with…
|Older adults represent an increasing percentage of both the whole U.S. population and persons living with one or more chronic health conditions. However, extant research has largely overlooked older adults when examining current Internet users and the potential for the Internet as a healthmanagement resource. In this study, the researchers…
Older adults represent an increasing percentage of both the whole U.S. population and persons living with one or more chronic health conditions. However, extant research has largely overlooked older adults when examining current Internet users and the potential for the Internet as a healthmanagement resource. In this study, the researchers conducted focus groups with urban elders in Detroit to
This study used a content analysis of Apple's lawsuit concerning hearing loss, exploring how for-profit organizations managehealth-related crises when products are suspected of having a potentially devastating impact on consumers’ health. By integrating two major approaches in a crisis communication, this study found that severity of damage, locus of control, business size, and the external public's claim were major
This article introduces a method for assessing health and safety management systems (MAHS) that has two innovative characteristics: (a) it brings together the three main auditing approaches to health and safety (HS) – the structural approach (which assesses the system prescribed), the operational approach (which assesses what is really happening on the shop-floor) and the performance approach (which assesses the
Marcelo Fabiano Costella; Tarcisio Abreu Saurin; Lia Buarque de Macedo Guimarães
Objective To assess the role of management practices for acute respiratory infections (ARIs) in improving the competency of community health volunteers in diagnosing and treating acute respiratory infections among children. Methods Data were collected by a group of research physicians who observed the performance of a sample of 120 health volunteers in 10 sub-districts in Bangladesh in which Bangladesh Rural
Preliminary results from the Health Care Reform Tracking Project's baseline survey and site visits to 10 states show that managed care has generally improved access to health care for children, but it has made it more difficult for youths with serious emotional disorders, and uninsured children, to obtain care. (SLD)
Stroul, Beth A.; Pires, Sheila A.; Armstrong, Mary I.; Meyers, Judith C.
Objectives: Policymakers and researchers in all countries like to know whether the implementation of Quality Management (QM) in health care is proceeding satisfactorily. Longitudinal surveys can reveal whether sufficient progress is being made. The main objective of the study was to investigate the progress in QM in Dutch health care organizations during the period 1995-2000. A second objective was to
More children with chronic illnesses are attending school, and some of them struggle academically because of issues related to their health. School-based case management has been suggested as one strategy to improve the academic success of these children. This study tracked the academic, health, and quality of life outcomes for 114 children with…
The study of the health workforce has gained in prominence in recent years, as the dynamic interconnections between human resource issues and health system effectiveness have come into sharper focus. This paper reviews lessons relating to strategic management challenges emerging from the growing literature in this area. Workforce issues are strategic: they affect overall system performance as well as the
The purpose of this inquiry was to explore, analyze, and synthesize the current research findings regarding the role of low health literacy in asthma self-management. The authors obtained relevant articles by conducting a search in the following databases: Cumulative Index of Nursing and Allied Health (CINAHL), MEDLINE (Ovid), PubMed Plus, and Google Scholar. Search terms included combinations of asthma, peak
Public participation in health-service management is an increasingly prominent policy internationally. Frequently, though, academic studies have found it marginalized by health professionals who, keen to retain control over decision-making, undermine the legitimacy of involved members of the public, in particular by questioning their representativeness. This paper examines this negotiation of representative legitimacy between staff and involved users by drawing on
With this paper it was tried to give a broad perspective about the responsiveness level of Turkish health care system, and how Turkish health care system meets the expectations of its citizens. For achieving the main purpose of this study a sample of hospital managers (n = 172) was selected, and the responsiveness questionnaire developed by WHO was administered. If
Through a cooperative agreement with the Centers for Disease Control and Prevention (CDC), the Clinical and Laboratory Standards Institute and CDC Laboratory Strengthening Department implemented quality management systems (QMS) into the two national public health laboratories in Tbilisi, Georgia. The QMS was based on CLSI's document Quality Management System: A Model for Laboratory Services; Approved Guideline and ISO 15189, Medical
Background: Little detail is known about the types of activities intensive care unit (ICU) nurses perform to support medication management in ICUs in order to contribute to patient safety and quality of care.Objective: To understand nurses’ perceptions of the frequency and importance of medication management activities, including those related to using health information technologies (IT).Method: A survey was developed, validated,
A. Joy Rivera-Rodriguez; Hélène Faye; Ben-Tzion Karsh; Pascale Carayon; Christine Baker; Matthew C. Scanlon
Purpose – This paper aims to focus on the management capacity assessment of the Reproductive and Child Health (RCH) program at the state level. Design\\/methodology\\/approach – Based on an extensive literature survey, and discussions with senior officers in charge of RCH program at the central and state level, the authors have developed a conceptual framework for management capacity assessment. Central
An instrument was designed to determine relationships between constructs of the Expanded Health Belief Model and to identify characteristics of college students who successfully manage their diabetes. The Diabetes College Scale was developed to measure attitudes and behaviors pertinent to diabetes management and college life. It was tested for content validity, test–retest reliability, and internal consistency. Data were collected from
Melissa J. Wdowik; Patricia A. Kendall; Mary A. Harris; Garry Auld
A nationwide survey of clinical dietitians and clinical nutrition managers was conducted to assess the prevalence of outsourcing in health care dietetics services and to evaluate perceived performance of dietetics services. A questionnaire was developed, validated by an expert panel, and pilot tested prior to data collection. Members of the Clinical Nutrition Management Dietetic Practice Group (N=1,668) were selected as
|Results are reported of an intensive evaluation of a statewide continuing education program in health care management based on interviews with program participants, their supervisors, and the administrators of their institutions. Focus is not how much knowledge was conveyed, but on how widely learning was reflected in improved management…
|This paper describes the experience of creating a continuing professional education on-line risk management program that is designed to meet Florida's educational requirements for licensure as a risk manager in health-care settings and details the challenges faced when the in-class didactic program of 15 eight-hour sessions is reformatted as an…
Background: The enormous socioeconomic burden of low back pain emphasises the need for effective management of this problem, especially in an occupational context. To address this, occupational guidelines have been issued in various countries.Aims: To compare available international guidelines dealing with the management of low back pain in an occupational health care setting.Methods: The guidelines were compared regarding generally accepted
J B Staal; H Hlobil; M W van Tulder; G Waddell; A K Burton; B W Koes; W van Mechelen
In this paper, the American management mechanism for public health emergency is studied in order to provide references for the establishment and improvement of such a mechanism in China. The mechanism used in the US is summarized from three aspects - organizational structure, management system, and logistics network. To be comparable, the Chinese version of the mechanism is also introduced
Farmers who practice alternative crop management strategies lack a framework for understanding and managing practical relationships between rotations, organic manure, young soil organic matter, N-flows, root health, and potential crop yields. Therefore we are developing a monitoring and budgeting sy...
The rational or 'expert' approach to risk sees it as a technical matter to be tackled with more science and better risk communication. Risk is understood as an objective concept, relating to the management of future uncertainties, through rational action based on calculations of probability. Within this paradigm professional strategies for preventing and managing disease involve health professionals acting as
A baseline survey was conducted in 1995 on management perspectives of occupational health and safety (OHS) structures and practices in Kenya. This was achieved by interviewing management and supervisory staff attending 1 week multi-disciplinary courses that were organized by the Federation of Kenya Employers (FKE) and the International Labour Office (ILO) at hotel venues in Kenya. The purpose of the
C. F. L. Mbakaya; H. A. Onyoyo; S. A. Lwaki; O. J. Omondi
It has been suggested that precautionary approaches to managing the possible health risks of mobile telecommunications (MT) technology may cause or exacerbate public concerns. In contrast, precautionary approaches to managing such risks in the UK have been framed as a way of reducing public concerns. This article presents evidence from a series of focus groups about the understanding of the
The US Army relies heavily on their helicopter fleet to provide close air support, troop transport, reconnaissance and logistics support capabilities for a variety of mission profiles. High operational readiness and availability of the helicopter fleet is critical to achieving their mission objectives. The Army has developed and implemented helicopter healthmanagement technology known as the Vibration Management Enhancement Program
J. Banks; T. Bair; K. Reichard; D. Blackstock; D. McCall; J. Berry
|The result of a project to develop short courses to help health care administrators and supervisors in developing practical, up-to-date management skills, this instructional workbook provides information and exercises applicable to on-the-job situations. Unit I covers the following leadership considerations: self-awareness, time management,…
Data from child and adolescent emergency mental health screening episodes prior and subsequent to privatized Medicaid managed care in Massachusetts are used to investigate the relationship between payer source and disposition and to compare the match between clinical need and disposition level of care. Having Medicaid as the payer in the post-Medicaid managed care period decreased the odds of hospitalization
Joanne Nicholson; Stephen Dine Young; Lorna J. Simon; William H. Fisher; Anne Bateman
This paper identifies the principal components of a prospective strategy for management of public mental health systems: single stream funding and prepayment, prevention and promotion programs for the at-risk population, decision support systems to identify at risk populations and interventions such as managed care of high-risk clients and the most severe and persistently mentally ill. Pertinent literature and major studies
Suggests a framework for conceptualizing consultation and education (C and E) activity within the context of sound management principles. Emphasizes the relationship of the C and E function and the community mental health center as a whole. Reviews basic management functions and how they apply to C and E programming. (Author/BH)
Background Management training is fundamental to developing human resources for health. Particularly as Liberia revives its health delivery system, facility and county health team managers are central to progress. Nevertheless, such management skills are rarely prioritized in health training, and sustained capacity building in this area is limited. We describe a healthmanagement delivery program in which a north and south institution collaborated to integrate classroom and field-based training in healthmanagement and to transfer the capacity for sustained management development in Liberia. Methods We developed and implemented a 6-month training program in healthmanagement skills (i.e. strategic problem solving, financial management, human resource management and leadership) delivered by Yale University and Mother Patern College from Liberia, with support from the Clinton HIV/AIDS Initiative. Over three 6-month cycles, responsibility for course instruction was transferred from the north institution to the south institution. A self-administered survey was conducted of all participants completing the course to measure changes in self-rated management skills, the degree to which the course was helpful and met its stated objectives, and faculty members' responsiveness to participant needs as the transfer process occurred. Results Respondents (n = 93, response rate 95.9%) reported substantial improvement in self-reported management skills, and rated the helpfulness of the course and the degree to which the course met its objectives highly. Levels of improvement and course ratings were similar over the three cohorts as the course was transferred to the south institution. We suggest a framework of five elements for implementing successful management training programs that can be transferred and sustained in resource-limited settings, including: 1) use a short-course format focusing on four key skill areas with practical tools; 2) include didactic training, on-site projects, and on-site mentoring; 3) collaborate with an in-country academic institution, willing and able to scale-up and maintain the training; 4) provide training for the in-country academic faculty; and 5) secure Ministry-level support to ensure participation. Conclusion Our findings demonstrate key elements for scaling up and replicating educational initiatives that address management skills essential for long-term health systems strengthening in resource-poor settings.
|This curriculum guide is designed to assist students in developing the ability to understand the many aspects of personal/social/mental health. It emphasizes student performance objectives in physical well-being, disease, reproduction, heredity, mental health and aging. It is also designed to assist the local teacher with organization and…
This paper reports a retrospective study undertaken to determine if differences existed in obstetric outcome, contraceptive usage, and repeat pregnancy rates of teenage patients cared for in three different health care settings: the Rochester Adolescent Maternity Project (RAMP), a traditional obstetric clinic, and a neighborhood health center.…
Health and safety risk features of the Heber Binary Project (HBP) are identified. Applicable health and safety requirements and standards to ensure their incorporation in the plant design, construction, and operation and maintenance are presented. Monitoring and training programs, special safety plans, and operating and maintenance programs, special safety plans, and operating and maintenance procedures are identified for inclusion in the HBP. (MHR)
With the advancement of communication technology, it is possible to integrate heterogeneous data repositories form the diverse data source. At present most of current public health information systems are lacking the support of on spot dynamic data uploading, visualization, analyzing and decision making. It is essential to integrate public health information system with the geospatial data repositories for on time
We study the specication of access control policy in large-scale distributed systems. We present Cassandra, a language and system for expressing policy, and the results of a substantial case study, a security policy for a national Electronic Health Record system, based on the requirements for the ongoing UK National Health Service procurement exercise. Cassandra policies are expressed in a language
Employees in household hazardous waste management facilities encounter a variety of potentially hazardous exposures. The purpose of this study was to evaluate both chemical and physical hazards at a representative group of household hazardous waste management facilities in Minnesota. Sampling results suggest that chemical exposures are generally not a problem when chemical bulking is performed outside the facility. For facilities
The aim of this paper is to review the resources and steps required for development and evaluation of training in public health and management of public health as experienced in Kaunas University of Medicine, Lithuania. The transition from Departments of Social Medicine and Hygiene to a Faculty of Public Health of international standards requires a process of adaptation and development of human resources more than physical facilities. After restoration of independence in 1990, rapid development of training in public health was started in Lithuania. Great support was provided by the international projects Baltic Rim Partnership for Public Health (BRIMHEALTH) and European Union Trans-European Mobility Scheme for University Students (TEMPUS). Undergraduate and postgraduate training programs were successfully implemented in the Faculty of Public Health, Kaunas University of Medicine. Lithuanian experience could serve as an example of success and pitfalls in training a critical mass of professionals who should act as powerful advocates for health, promoting analysis, continuity and success of public health interventions, and health care reforms in countries in transition. PMID:12613703
This article forms part of a six-part Series on trade and health, and sets the stage for this Series by analysing key aspects of the relationship between trade and health. The Series takes stock of this relation and provides timely analysis of the key challenges facing efforts to achieve an appropriate balance between trade and health across a diverse range of issues. This introductory article reviews how trade and health have risen and expanded on global policy agendas in the past decade in unprecedented ways, describes how trade and health issues are respectively governed in international relations, examines the ongoing search for policy coherence between the two policy spheres, and highlights the topics of the remaining articles in the Series.
Community case management (CCM) is a promising task-shifting strategy for expanding treatment of childhood illness that is increasingly adopted by low-income countries. Its success depends in part on how the strategy is perceived by those responsible for its implementation. This study uses qualitative methods to explore health workers' and managers' perceptions about CCM provided by health surveillance assistants (HSAs) during the program's first year in Malawi. Managers and HSAs agreed that CCM contributed beneficially by expanding access to the underserved and reducing caseloads at health facilities. Managers differed among themselves in their endorsements of CCM, most offered constrained endorsement, and a few had stronger justifications for CCM. In addition, HSAs uniformly wanted continued expansion of their clinical role, while managers preferred to view CCM as a limited mandate. The HSAs also reported motivating factors and frustrations related to system constraints and community pressures related to CCM. The impact of CCM on motivation and workload of HSAs is noted and deserves further attention.