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1

Approaches to management and care of the neonatal nondomestic ruminant.  

PubMed

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

Wolfe, Barbara A; Lamberski, Nadine

2012-05-01

2

Ruminants  

NSDL National Science Digital Library

Why do cows chew their cud? This video segment from Secret of Life: Accidents of Creation describes the physical adaptations that have made ruminants some of the most important, and certainly the most efficient, plant eaters on earth.

2003-09-26

3

Viscera of Slaughtered Ruminants and Potential Threats to Human Health in the Czech Republic  

Microsoft Academic Search

Veãerek V., A. Kozák, M. Malena, P. Chloupek, V. Pi‰tûková: Viscera of Slaughtered Ruminants and Potential Threats to Human Health in the Czech Republic. Acta Vet. Brno 2003, 72: 631-638. In the present study, potential human health threats posed by the viscera of slaughtered ruminants were investigated. The categories of ruminants monitored included the cattle (except calves), calves, sheep and

V. VEâEREK; A. KOZÁK; M. MALENA; P. CHLOUPEK; V. PI

4

Rumination  

NSDL National Science Digital Library

In this activity (on pages 24-34), learners explore the four-part stomach of cows (and other grazing animals called ruminants), and compare it to the human one-part stomach and its digestive process. In Part One learners color, cut out, and assemble the parts of either a human or cow digestive system. In Part Two learners recreate ruminant digestion by letting wet cut grass or shredded lettuce leaves decay, and use their sense of smell to understand the process fermentation.

2014-01-28

5

Review article Managing helminths of ruminants in organic farming  

E-print Network

Review article Managing helminths of ruminants in organic farming Jacques CABARETa*, Michel 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

Boyer, Edmond

6

NEW CONCEPTS IN PASTURE MANAGEMENT FOR SMALL RUMINANTS. PART 1: THE PLANT  

Technology Transfer Automated Retrieval System (TEKTRAN)

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...

7

Is co-ruminating with friends related to health problems in victimized adolescents?  

PubMed

Co-rumination, or the tendency to revisit and endlessly discuss problems and negative events, has been linked to depression and other emotional difficulties (Rose, Carson, & Waller, 2007). The current study examined the moderating effect of co-rumination on the relationship between peer victimization and depression, anxiety, PTSD symptoms, and health problems in 108 adolescents aged 10-15 years. Adolescents and a parent completed measures of adolescents' peer victimization, co-rumination, depression, and health problems. Results indicate that adolescents who are both peer victimized and engaged in high levels of co-rumination were at highest risk for psychological problems. Co-rumination also moderated the relationship between peer victimization and physical health problems via general depressive symptoms (i.e., moderated mediation). PMID:25544426

Guarneri-White, Maria E; Jensen-Campbell, Lauri A; Knack, Jennifer M

2015-02-01

8

Health Manager.  

ERIC Educational Resources Information Center

This document contains materials for a college course in health management 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 by…

Kirkwood Community Coll., Cedar Rapids, IA.

9

Ruminant Nutrition Symposium: Productivity, digestion, and health responses to hindgut acidosis in ruminants.  

PubMed

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

Gressley, T F; Hall, M B; Armentano, L E

2011-04-01

10

Management effects on colostrogenesis in small ruminants: a review  

Microsoft Academic Search

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

2011-01-01

11

Eating Time Modulations of Physiology and Health: Life Lessons from Human and Ruminant Models  

PubMed Central

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

Nikkhah, Akbar

2012-01-01

12

Microbial Fuel Cells and Microbial Ecology: Applications in Ruminant Health and Production Research  

PubMed Central

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. PMID:20024685

Osterstock, Jason B.; Pinchak, William E.; Ishii, Shun’ichi; Nelson, Karen E.

2009-01-01

13

Short dry period management improves peripartum ruminal adaptation in dairy cows.  

PubMed

The present study aimed to determine whether the improvement in postpartum energy balance frequently reported in cows under short dry period management could be due to an improvement in ruminal function related to the reduction in the number of diet changes before calving. Six multiparous and 6 primiparous Holstein cows equipped with ruminal cannula were assigned to 6 blocks of 2 cows each according to parity, projected milk production at 305 d, and expected calving date. Within each block, cows were randomly assigned to either a conventional (CDP; 63.2 ± 2.0 d) or a short dry period (SDP; 35.2 ± 2.0 d) management in a randomized complete block design. The CDP cows were fed a far-off diet until 28 d before calving, followed by a prepartum diet, whereas SDP cows received only the prepartum diet. After calving, both groups were fed the same lactation diet. Milk yield and dry matter intake (DMI) were recorded daily and milk composition, weekly. Blood samples were taken twice a week during the first 4 wk postcalving and weekly otherwise. Omasal and ruminal samples were collected approximately 3 wk prior and 3 wk after calving. From 28 d before calving until calving, when the 2 groups of cows were fed the same prepartum diet, there was no effect of the dry period length management on DMI, plasma concentrations of ?-hydroxybutyrate, nonesterified fatty acids, and glucose and nutrient digestibility in the rumen. However, CDP cows tended to have lower ruminal pH and higher ruminal concentrations of total volatile fatty acids than SDP cows. From calving to 60 d in milk, daily DMI was higher for SDP than for CDP cows (22.3 ± 0.44 vs. 20.7 ± 0.30 kg), but milk production and milk concentrations and yields of fat, protein, and total solids were not affected by the dry period length management. After calving, body weight loss was reduced and body condition score tended to increase more rapidly for SDP than for CDP cows. Nutrient digestibility in the rumen, expressed in kilograms per day, was greater or tended to be greater for SDP cows, but differences were no longer significant when expressed per unit of nutrient ingested. The decrease in plasma nonesterified fatty acids and ?-hydroxybutyrate in SDP cows without effect on milk yield suggests an improved energy balance likely due to greater DMI. Results from the present study seem to indicate that reducing the number of diet changes before calving could facilitate ruminal adaptation to the lactation diet and improve energy balance postpartum. PMID:25306282

Jolicoeur, M S; Brito, A F; Santschi, D E; Pellerin, D; Lefebvre, D; Berthiaume, R; Girard, C L

2014-12-01

14

Multiplatform Airplane Health Management  

Microsoft Academic Search

The Integrated Airplane Health Management (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 health management 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

2007-01-01

15

The management of anthelmintic resistance in grazing ruminants in Australasia--strategies and experiences.  

PubMed

In many countries the presence of anthelmintic resistance in nematodes of small ruminants, and in some cases also in those infecting cattle and horses, has become the status quo rather than the exception. It is clear that consideration of anthelmintic resistance, and its management, should be an integral component of anthelmintic use regardless of country or host species. Many years of research into understanding the development and management of anthelmintic resistance in nematodes of small ruminants has resulted in an array of strategies for minimising selection for resistance and for dealing with it once it has developed. Importantly, many of these strategies are now supported by empirical science and some have been assessed and evaluated on commercial farms. In sheep the cost of resistance has been measured at about 10% of the value of the lamb at sale which means that losses due to undetected resistance far outweigh the cost of testing anthelmintic efficacy. Despite this many farmers still do not test for anthelmintic resistance on their farm. Many resistance management strategies have been developed and some of these have been tailored for specific environments and/or nematode species. However, in general, most strategies can be categorised as either; identify and mitigate high risk management practices, maintain an anthelmintic-susceptible population in refugia, choose the optimal anthelmintic (combinations and formulations), or prevent the introduction of resistant nematodes. Experiences with sheep farmers in both New Zealand and Australia indicate that acceptance and implementation of resistance management practices is relatively easy as long as the need to do so is clear and the recommended practices meet the farmer's criteria for practicality. A major difference between Australasia and many other countries is the availability and widespread acceptance of combination anthelmintics as a resistance management tool. The current situation in cattle and horses in many countries indicates a failure to learn the lessons from resistance development in small ruminants. The cattle and equine industries have, until quite recently, remained generally oblivious to the issue of anthelmintic resistance and the need to take pre-emptive action. In Australasia, as in other countries, a perception was held that resistance in cattle parasites would develop very slowly, if it developed at all. Such preconceptions are clearly incorrect and the challenge ahead for the cattle and equine industries will be to maximise the advantages for resistance management from the extensive body of research and experience gained in small ruminants. PMID:24439840

Leathwick, D M; Besier, R B

2014-07-30

16

Electronic monitoring of rumination activity as an indicator of health status and production traits in high-yielding dairy cows.  

PubMed

In view of the demonstrated relationship between rumination time and health status, the general welfare and metabolic condition of ruminants are often assessed by the examination of rumen function. The main goal of this study was to monitor the daily rumination activity (RA) and its connection with actual liveweight (LW), milk yield (MY) and with two diseases (subclinical hyperketonaemia - SHK, uterine disease - UD) in 96 cows on the basis of a total of 1638 observations in Israel. The studied sample gave a highly significant response, showing that the selected diseases had a diminishing impact on RA and LW and no influence on MY. It can be concluded that the change of RA as determined by electronic monitoring, complemented by the change of LW, is a useful general indicator of health status and subclinical disease before the appearance of clinical signs. PMID:25410387

Gáspárdy, András; Efrat, Gingis; Bajcsy, Arpád Csaba; Fekete, Sándor György

2014-12-01

17

Small ruminant producer gastrointestinal nematode (GIN) management survey  

Technology Transfer Automated Retrieval System (TEKTRAN)

The objective was to determine, by survey, sheep and goat producer GIN management methods. Respondents from GA (n equal to 62), FL (n equal to 30), PR (n equal to 7), LA (n equal to 14) and other southern states (n equal to 11) had a total of 4434 goats (67.4 plus or minus 3.9 percent of responders)...

18

Tools for managing internal parasites in small ruminants: Sericea Lespedeza  

Technology Transfer Automated Retrieval System (TEKTRAN)

Control of internal parasites, especially of Haemonchus contortus (barber pole worm, stomach worm), is a primary concern for the majority of sheep and goat producers. These parasites have become more difficult to manage because of increasing resistance to nearly all available dewormers. A severe inf...

19

Rumination mediates the relationships between depressed mood and both sleep quality and self-reported health in young adults.  

PubMed

The psychological mechanisms by which depressed mood can lead to impaired sleep and poorer overall health remain unclear. The goal of this study was to investigate the extent to which a tendency to ruminate accounts for the associations between depressed mood and both sleep quality and self-reported health in 165 healthy young adults. Self-reported assessments of anxiety, depressed mood, rumination, sleep quality, and general health were collected at two different time points approximately 2 months apart. Structural equation modeling revealed that rumination measured at the earlier time point mediated the relationships between depressed mood and both sleep quality and health, all measured at the later time point, in a model that was a good fit to the data overall, ?(2) (50, N = 165) = 103.08, p < 0.001; RMSEA = 0.08 (0.06-0.10), TLI = 0.91, CFI = 0.94. Results were similar whether or not anxiety was controlled. Results indicate that rumination may be a psychological mechanism by which negative mood leads to impaired sleep and poorer perceived health. PMID:25195078

Slavish, Danica C; Graham-Engeland, Jennifer E

2015-04-01

20

The effect of condensed tannins on the nutrition and health of ruminants fed fresh temperate forages: a review  

Microsoft Academic Search

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

B. R Min; T. N Barry; G. T Attwood; W. C McNabb

2003-01-01

21

[Society and health management].  

PubMed

The Health Management require acting according the social reality. The economic crisis for the unemployments and the State debts could affected to support Health System. The cost per capita: 1,800 euros. At Alma-Ata 1970 WHO improve Primary Care as open door in the Heath System. Some problems are common to all countries (frequency of diseases, demands, danger individual and community, feasibility of action, economic consequences, (PC in our country 15,7%). Should improve the Community development, and the environment. The participation of Primary Health Workers in the Management cover health care and community development and coaching, should be regularly supervised, and to avoid Risk Factor to Health. PMID:24294715

Del Rey Calero, Juan

2012-01-01

22

Applications of diagnostic ultrasonography in small ruminant reproductive management.  

PubMed

Modern portable ultrasound machines provide the veterinary clinician with an inexpensive and non-invasive method to further examine the reproductive tract of both male and female sheep on farm which should take no more than 5 min with the results available immediately. Unlike cattle, ultrasound examination of the ovaries is not undertaken because failure to cycle during the normal season is rare in sheep and there are no common ovarian conditions causing acyclicity. Accurate diagnosis of foetal number has greatly improved the nutritional management of late gestation ewes over the past 30 years. Late gestation nutritional supply in response to foetal demand greatly reduces perinatal lamb mortality by ensuring lamb birthweight and ewe colostrum accumulation. The contents of vaginal prolapse have been determined using ultrasonography which has led to an improved method for correction. A retained foetus when second stage labour is considered to have been completed, and uterine torsion, can be identified during ultrasound examination allowing timely correction. Ultrasonographic examination of palpable scrotal abnormalities can provide much useful information particularly in the diagnosis of epididymitis, orchitis and testicular atrophy. PMID:22341010

Scott, P R

2012-02-01

23

Willingness to Pay for Annual Health Care Services in Small Ruminants: The Case of South India  

NASA Astrophysics Data System (ADS)

A study was undertaken in southern peninsular State of India, the Tamil Nadu State, to assess the farmers Willingness To Pay` (WTP) for annual health care services in small ruminants. The districts of the State were categorized as Livestock Developed (LD) and Livestock Under Developed (LUD) based on initial base line developed. Contingent Valuation (CV) approach was used to study the farmers maximum WTP value for two types of health care services: (a) providing animal health care services at government veterinary centres, (b) extending animal health care services at farmers door steps. A Payment Card (PC) format was used to assess the farmers` maximum WTP for ensuring health care services to sheep and goat. The Maximum Likelihood technique was used on interval midpoints. The study revealed that the farmers were willing to pay a maximum of INR 56.34 and INR 61.61 for availing health services to their sheep and goat, respectively, by in-centre services, while they were ready to offer INR 87.49 and INR 95.27 for the animal health services delivered at doorsteps. The mean maximum WTP value was found to be more for goats than sheep, postulated both in-centre and home services. Of the factors incorporated in the in-centre service model for sheep, age of respondent, livelihood share of livestock, number of sheep and VLU owned and distance from nearest public veterinary centre were found to significantly influence the WTP values. Unlike sheep, age of respondent, VLU possession, distance of the public veterinary centre and district versatility had a significant role in determining WTP values for goats. WTP values in sheep for home service were found to be significantly predisposed by all the significant factors of in-centre services model, except number of sheep owned. Similarly, in goat, the age of respondent turned to be insignificant in home services model. The results indicated that the people were willing to pay more for getting their small ruminants adequately protected from diseases and treated at once with quality services.

Kathiravan, G.; Thirunavukkarasu, M.; Michealraj, P.

24

Management systems with extended milking intervals in ruminants: Regulation of production and quality of milk1,2  

E-print Network

Management systems with extended milking intervals in ruminants: Regulation of production and quality of milk1,2 P. G. Marnet3 and M. Komara Joint Unit l'Institut National de la Recherche Agronomique/Agrocampus Rennes "Research on milk production", 65 rue de St Brieuc, 35042 Rennes cedex, France ABSTRACT

Paris-Sud XI, Université de

25

American Health Information Management Association  

MedlinePLUS

... a healthcare organization that demonstrates outstanding health information management across its organization and community. Submit your nomination ... YouTube Copyright © 2014 by The American Health Information Management Association. All Rights Reserved.

26

Ruminal Prevotella spp. May Play an Important Role in the Conversion of Plant Lignans into Human Health Beneficial Antioxidants  

PubMed Central

Secoisolariciresinol diglucoside (SDG), the most abundant lignan in flaxseed, is metabolized by the ruminal microbiota into enterolignans, which are strong antioxidants. Enterolactone (EL), the main mammalian enterolignan produced in the rumen, is transferred into physiological fluids, with potentially human health benefits with respect to menopausal symptoms, hormone-dependent cancers, cardiovascular diseases, osteoporosis and diabetes. However, no information exists to our knowledge on bacterial taxa that play a role in converting plant lignans into EL in ruminants. In order to investigate this, eight rumen cannulated cows were used in a double 4×4 Latin square design and fed with four treatments: control with no flax meal (FM), or 5%, 10% and 15% FM (on a dry matter basis). Concentration of EL in the rumen increased linearly with increasing FM inclusion. Total rumen bacterial 16S rRNA concentration obtained using Q-PCR did not differ among treatments. PCR-T-RFLP based dendrograms revealed no global clustering based on diet indicating between animal variation. PCR-DGGE showed a clustering by diet effect within four cows that had similar basal ruminal microbiota. DNA extracted from bands present following feeding 15% FM and absent with no FM supplementation were sequenced and it showed that many genera, in particular Prevotella spp., contributed to the metabolism of lignans. A subsequent in vitro study using selected pure cultures of ruminal bacteria incubated with SDG indicated that 11 ruminal bacteria were able to convert SDG into secoisolariciresinol (SECO), with Prevotella spp. being the main converters. These data suggest that Prevotella spp. is one genus playing an important role in the conversion of plant lignans to human health beneficial antioxidants in the rumen. PMID:24709940

Schogor, Ana L. B.; Huws, Sharon A.; Santos, Geraldo T. D.; Scollan, Nigel D.; Hauck, Barbara D.; Winters, Ana L.; Kim, Eun J.; Petit, Hélène V.

2014-01-01

27

Ruminant self-medication against gastrointestinal nematodes: evidence, mechanism, and origins?  

PubMed Central

Gastrointestinal helminths challenge ruminants in ways that reduce their fitness. In turn, ruminants have evolved physiological and behavioral adaptations that counteract this challenge. Ruminants display anorexia and avoidance behaviors, which tend to reduce the incidence of parasitism. In addition, ruminants appear to learn to self-medicate against gastrointestinal parasites by increasing consumption of plant secondary compounds with antiparasitic actions. This selective feeding improves health and fitness. Here, we review the evidence for self-medication in ruminants, propose a hypothesis to explain self-medicative behaviors (based on post-ingestive consequences), and discuss mechanisms (e.g., enhanced neophilia, social transmission) that may underlie the ontogeny and spread of self-medicative behaviors in social groups. A better understanding of the mechanisms that underlie and trigger self-medication in parasitized animals will help scientists devise innovative and more sustainable management strategies for improving ruminant health and well-being. PMID:24971486

Villalba, Juan J.; Miller, James; Ungar, Eugene D.; Landau, Serge Y.; Glendinning, John

2014-01-01

28

Intelligent Vehicle Health Management  

NASA Technical Reports Server (NTRS)

As a part of the overall goal of developing Integrated Vehicle Health Management systems for aerospace vehicles, the NASA Faculty Fellowship Program (NFFP) at Marshall Space Flight Center has performed a pilot study on IVHM principals which integrates researched IVHM technologies in support of Integrated Intelligent Vehicle Management (IIVM). IVHM is the process of assessing, preserving, and restoring system functionality across flight and ground systems (NASA NGLT 2004). The framework presented in this paper integrates advanced computational techniques with sensor and communication technologies for spacecraft that can generate responses through detection, diagnosis, reasoning, and adapt to system faults in support of INM. These real-time responses allow the IIVM to modify the affected vehicle subsystem(s) prior to a catastrophic event. Furthermore, the objective of this pilot program is to develop and integrate technologies which can provide a continuous, intelligent, and adaptive health state of a vehicle and use this information to improve safety and reduce costs of operations. Recent investments in avionics, health management, and controls have been directed towards IIVM. As this concept has matured, it has become clear the INM requires the same sensors and processing capabilities as the real-time avionics functions to support diagnosis of subsystem problems. New sensors have been proposed, in addition, to augment the avionics sensors to support better system monitoring and diagnostics. As the designs have been considered, a synergy has been realized where the real-time avionics can utilize sensors proposed for diagnostics and prognostics to make better real-time decisions in response to detected failures. IIVM provides for a single system allowing modularity of functions and hardware across the vehicle. The framework that supports IIVM consists of 11 major on-board functions necessary to fully manage a space vehicle maintaining crew safety and mission objectives: Guidance and Navigation; Communications and Tracking; Vehicle Monitoring; Information Transport and Integration; Vehicle Diagnostics; Vehicle Prognostics; Vehicle mission Planning; Automated Repair and Replacement; Vehicle Control; Human Computer Interface; and Onboard Verification and Validation. Furthermore, the presented framework provides complete vehicle management which not only allows for increased crew safety and mission success through new intelligence capabilities, but also yields a mechanism for more efficient vehicle operations. The representative IVHM technologies for computer platform using heterogeneous communication, 3) coupled electromagnetic oscillators for enhanced communications, 4) Linux-based real-time systems, 5) genetic algorithms, 6) Bayesian Networks, 7) evolutionary algorithms, 8) dynamic systems control modeling, and 9) advanced sensing capabilities. This paper presents IVHM technologies developed under NASA's NFFP pilot project and the integration of these technologies forms the framework for IIVM.

Paris, Deidre E.; Trevino, Luis; Watson, Michael D.

2005-01-01

29

Medical and Health Services Managers  

MedlinePLUS

... managers often work closely with medical staff to plan, direct, and coordinate the delivery of healthcare. Quick ... managers, also called healthcare executives or healthcare administrators, plan, direct, and coordinate medical and health services. They ...

30

Holmium:YAG laser lithotripsy for the management of urolithiasis in small ruminants and pot-bellied pigs  

NASA Astrophysics Data System (ADS)

Obstructive urolithiasis is a common problem in small ruminants and pot-bellied pigs. The most common site of urinary tract obstruction in these species is the urethra. Surgical procedures developed to relieve obstructions, in our experience have been effective in approximately 75% of cases. Urethral stricture is a common complication if the mucosa of the urethra is disrupted. The objective of this project was to evaluate endoscopy guided laser lithotripsy as a therapeutic modality to relieve urethral obstructions in small ruminants and pot-bellied pigs. The study population consisted of patients presented to the Veterinary Medical Teaching Hospital at the University of California Davis with obstructive urolithiasis. Lithotripsy was performed using a Holmium:YAG laser via a 200-micron low water quartz fiber passed through a flexible mini-endoscope. Two types of urinary calculi were managed with this technique, calcium carbonate and calcium hydroxyphosphate. Laser lithotripsy was effective at relieving obstructions caused by both types of calculi when conventional methods had failed. Laser lithotripsy performed via urethral endoscopy is a safe and effective therapeutic modality for management of obstructive urolithiasis in small ruminants and pot-bellied pigs and reduces the risk of post procedural urethral stricture.

Halland, Spring K.; House, John K.; George, Lisle

2001-05-01

31

Ruminal Fermentation  

Technology Transfer Automated Retrieval System (TEKTRAN)

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...

32

Knowledge Management in Health care  

Microsoft Academic Search

While knowledge management (KM) is becoming an established discipline with many applications and techniques, its adoption in health care has been challenging. Though, the health care sector relies heavily on knowledge and evidenc e based medicine is expected to be implemented in daily health care activities; beside s, delivery of care replies on cooperation of several partners that need to

Christo El Morr; Julien Subercaze

33

Managing the Care of Health  

E-print Network

. Part II of this paper uses this line of argument to reframe four major issues in this system exist to integrate, or coordi- nate, work in organizations.1 These are illustrated in Figure 1 the work. Key words: differentiation, integration, health care management, health care organization, health

Barthelat, Francois

34

Health policy and case management.  

PubMed

The purpose of this article is to analyze the performance of and support for case management using a policy framework in order to increase case managers' awareness of policy making and facilitate successful planning for future policy initiatives. Feldstein's (1996) theory of opposing legislative outcomes indicates that legislation can be viewed on a continuum, ranging from legislation that meets the needs of the public to legislation considered to be in the self-interest of the participants and legislators. The current health care system requires that case managers working for publicly funded health care organizations balance the need for stewardship of U.S. tax dollars and the health care needs of consumers. It is apparent from the literature that case managers are successfully achieving this balance. However, certain conditions should exist that allow for case manager decision-making that promotes effective and efficient utilization of health care resources. Case managers must work within the context of the health care policy environment. Realizing that it is more likely that the conflicts between stewardship and the provision of health care services will continue, case managers' knowledge and influence regarding policy making becomes imperative in order to ensure that these conflicting goals do not become mutually exclusive. PMID:11398572

Mark, D D

2000-01-01

35

Intelligent Integrated System Health Management  

NASA Technical Reports Server (NTRS)

Intelligent Integrated System Health Management (ISHM) is the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system (Management: storage, distribution, sharing, maintenance, processing, reasoning, and presentation). Presentation discusses: (1) ISHM Capability Development. (1a) ISHM Knowledge Model. (1b) Standards for ISHM Implementation. (1c) ISHM Domain Models (ISHM-DM's). (1d) Intelligent Sensors and Components. (2) ISHM in Systems Design, Engineering, and Integration. (3) Intelligent Control for ISHM-Enabled Systems

Figueroa, Fernando

2012-01-01

36

Gamification and geospatial health management  

NASA Astrophysics Data System (ADS)

Sensor and Measurement technologies are rapidly developing for many consumer applications which have the potential to make a major impact on business and society. One of the most important areas for building a sustainable future is in health management. This opportunity arises because of the growing popularity of lifestyle monitoring devices such as the Jawbone UP bracelet, Nike Fuelband and Samsung Galaxy GEAR. These devices measure physical activity and calorie consumption and, when visualised on mobile and portable devices, enable users to take more responsibility for their personal health. This presentation looks at how the process of gamification can be applied to develop important geospatial health management applications that could not only improve the health of nations but also significantly address some of the issues in global health such as the ageing society and obesity.

Wortley, David

2014-06-01

37

Outcomes management in women's health.  

PubMed

Outcomes management uses a quality and research approach to reducing costs in health care. Populations may be targeted for high volumes or their potential for cost savings. Outcomes are identified and measured through data collection and analysis. System and care processes that drive these outcomes are analyzed. Tenets related to outcomes management include questioning practice, administrative and physician involvement; recognizing that change is necessary; accepting uncontrollable factors; and valuing the outcomes management process. Resources necessary for managing outcomes include the use of collaborative practice teams, outcomes assessment, information systems, and educational support services. The women's health population can benefit from an outcomes management effort by improving and standardizing care for mothers and infants across the continuum. There is the opportunity to affect the wellness of this population even before the pregnancy occurs. PMID:9170599

Houston, S; Fleschler, R

1997-01-01

38

Serological investigation of Peste des Petits Ruminants (PPR) in small ruminants managed under pastoral and agro-pastoral systems in Ethiopia  

Microsoft Academic Search

A cross-sectional study to investigate Peste des Petits Ruminants (PPR) seroprevalence was conducted between October 2009 and April 2010 in Gambella and Afar regions of Ethiopia. A total of 1163 serum samples were collected from 251 sheep and 912 goats. Competitive Enzyme Linked Immunosorbent Assay (c-ELISA) was used to detect the presence of antibodies in the sera of animals as

B. Megersa; D. Biffa; T. Belina; E. Debela; A. Regassa; F. Abunna; T. Rufael; S. M. Stubsjøen; E. Skjerve

2011-01-01

39

DEAF HEALTH TALKS: Stress Management  

E-print Network

#12;Stress Hormones · Cortisol ­ primary stress hormone · Increases: sugars in blood & brain's useDEAF HEALTH TALKS: Stress Management Student Development Center October 12, 2011 This presentation Research (NCDHR) · Matthew Starr and Michael McKee · Student Life Team #12;So What is Stress? · Normal

Goldman, Steven A.

40

X-33/RLV System Health Management/ Vehicle Health Management  

NASA Technical Reports Server (NTRS)

To reduce operations cost, the RLV must include the following elements: highly reliable, robust subsystems designed for simple repair access with a simplified servicing infrastructure and incorporating expedited decision making about faults and anomalies. A key component for the Single Stage to Orbit (SSTO) RLV System used to meet these objectives is System Health Management (SHM). SHM deals with the vehicle component- Vehicle Health Management (VHM), the ground processing associated with the fleet (GVHM) and the Ground Infrastructure Health Management (GIHM). The objective is to provide an automated collection and paperless health decision, maintenance and logistics system. Many critical technologies are necessary to make the SHM (and more specifically VHM) practical, reliable and cost effective. Sanders is leading the design, development and integration of the SHM system for RLV and X-33 SHM (a sub-scale, sub-orbit Advanced Technology Demonstrator). This paper will present the X-33 SHM design which forms the baseline for RLV SHM. This paper will also discuss other applications of these technologies.

Garbos, Raymond J.; Mouyos, William

1998-01-01

41

Studienordnung des Masterstudiengangs ,,Health Care Management"  

E-print Network

Studienordnung des Masterstudiengangs ,,Health Care Management" an der Ernst-Moritz-Arndt-Universität Greifswald die fol- gende Studienordnung für den Masterstudiengang ,,Health Care Manage- ment" als Satzung Masterstudiengang (M.Sc.) ,,Health Care Management" an der Ernst-Moritz- Arndt-Universität Greifswald vom 15. März

Greifswald, Ernst-Moritz-Arndt-Universität

42

Studienordnung des Masterstudiengangs ,,Health Care Management"  

E-print Network

1 Studienordnung des Masterstudiengangs ,,Health Care Management" an der Ernst-Moritz-Arndt-Universität Greifswald die folgende Studienordnung für den Masterstudiengang ,,Health Care Management" als Satzung Master- studiengang (M.Sc.) ,,Health Care Management" an der Ernst-Moritz-Arndt-Universität Greifswald

Greifswald, Ernst-Moritz-Arndt-Universität

43

Fachprfungsordnung des Masterstudiengangs Health Care Management  

E-print Network

Fachprüfungsordnung des Masterstudiengangs Health Care Management an der Ernst-Moritz-Arndt-Universität Greifs- wald die folgende Prüfungsordnung für den Masterstudiengang (M. Sc.) ,,Health Care Management Prüfungsverfahren im Studiengang ,,Health Care Management". Ergänzend gilt die Gemeinsame Prüfungsord- nung für

Greifswald, Ernst-Moritz-Arndt-Universität

44

Agent-based health care management An Agent-based Approach to Health Care Management  

E-print Network

Agent-based health care management 1 An Agent-based Approach to Health Care Management Jun Huang1, London WC2A 3PX, UK. Abbreviated title: Agent-based health care management Complete Mailing Address. London E1 4NS UK #12;Agent-based health care management 2 Abstract The provision of medical care

Mascardi, Viviana

45

Current challenges of personal health information management  

Microsoft Academic Search

Purpose – Health care has come to a turning point. Particularly due to aging societies and economic pressure placed on health care system, health is rapidly becoming one's own responsibility. This fundamental paradigm shift does not only affect the way health care services that will be provided in the near future but it also places enormous health information management demands

Janne Lahtiranta

2009-01-01

46

States' embrace of managed mental health care.  

PubMed

Historically, state mental health authorities have dominated public mental health services, operating with fixed resources and responsible for a large population. A good public mental health system has many of the attributes of a well-managed private mental health system. Unfortunately, public systems are not flexible enough to contract creatively with multiple providers; they lack many of the tools of modern managed care. As a consequence, state mental health authorities have begun to contract with private managed care firms to assist them in managing their health care reform efforts, particularly reform of Medicaid. This paper examines the forces shaping managed behavioral health care in the public sector and describes strategies for managing care, such as contracting, utilization review, and monitoring. PMID:7498902

Essock, S M; Goldman, H H

1995-01-01

47

Square Pegs and Round Holes: Ruminations on the Relationship between Performance Appraisal and Performance Management  

ERIC Educational Resources Information Center

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…

Gravina, Nicole E.; Siers, Brian P.

2011-01-01

48

Characteristics of effective health care managers.  

PubMed

This article provides an overview of traditional and contemporary management theories. Concerns, characteristics, and skills of effective managers are also presented. Further, a self-assessment (survey) of 7 highly effective health care managers in a South Georgia community was conducted to determine their ratings on 6 management indices. The assessment or Scale of Transformational Leadership uses a Likert-type scale to allow for the evaluation of managers. The scale contains 6 management elements for assessment: attention, meaning, trust, self, vision, and feeling. Individual ratings and group summary skills rating are presented. Findings revealed the order of managerial importance of the elements as follows (from highest to lowest): Management of Trust, Management of Attention, Management of Self, Management of Feeling, Management of Meaning, and Management of Risk. As a second tier, the final ratings are corroborated by health care management interns. PMID:15923923

Johnson, Sherryl W

2005-01-01

49

Square Pegs and Round Holes: Ruminations on the Relationship Between Performance Appraisal and Performance Management  

Microsoft Academic Search

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 appraisals have several well-documented shortcomings. Despite those limitations, an examination of Performance Management models suggests that they often include an

Nicole E. Gravina; Brian P. Siers

2011-01-01

50

The employer's case for health management.  

PubMed

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 health management 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

Coulter, Christopher H

2006-01-01

51

Personal Health Information Management: Consumers' Perspectives  

Microsoft Academic Search

Personal health information management (PHIM) refers to activities that support consumers' access, integration, organization, and use of their personal health information. We investigated PHIM in the health consumer population using a focus group and participatory design. In collaboration with health consumers, we identified PHIM activities and ex- plored the design of new supportive technology. Our findings describe prominent PHIM activities

Andrea Civan; Meredith M. Skeels; Anna Stolyar; Wanda Pratt

52

Emerging trends in health and productivity management.  

PubMed

Many large U.S. employers have generally embraced a Health and Productivity Management (HPM) perspective to guide their multiple employee health management efforts. In looking ahead there are a number of emerging trends that are helping to shape these efforts. As health promotion professionals assess the implications of these trends on their respective role and function within the worksite, it may provide a very useful process for refining strategies for programming and professional development. The identified trends also have a variety of implications for health promotion vendors and the growth of the health management marketplace. PMID:17894264

Goetzel, Ron Z; Ozminkowski, Ronald J; Pelletier, Kenneth R; Metz, R Douglas; Chapman, Larry S

2007-01-01

53

Leadership in Health Care Systems: Health Care Organization Management  

E-print Network

Leadership in Health Care Systems: Health Care Organization Management and Leadership Track ­ Program Evaluation in 2007: Our grads told us they needed more leadership, informatics and management, employer interviews, needs assessment The Program #12;Leadership in Heath Care Systems · Three tracks

Goldman, Steven A.

54

HEALTH SERVICES 431: HEALTH CARE ORGANIZATIONAL BEHAVIOR AND MANAGEMENT SKILLS  

Microsoft Academic Search

Organizations are held accountable to multiple stakeholders. New systems to manage the changing face of organizational processes are continually being created necessitating constant change in the way we work together in the healthcare workplace. Today's health care manager requires a clear understanding of the complexity in which health care organizations function and a commensurate stable of knowledge, skills and abilities

Diana W. Hilberman

55

Tools for managing internal parasites in small ruminants: Copper wire particles  

Technology Transfer Automated Retrieval System (TEKTRAN)

Internal parasite management, especially of Haemonchus contortus (barber pole worm, stomach worm), is a primary concern for the majority of sheep and goat producers. These parasites have become more difficult to manage because of developed resistance to nearly all available dewormers. A severe infec...

56

Bachelor of Science, Health Science Studies, Health Informatics and Information Management Emphasis, 2013-2014  

E-print Network

Bachelor of Science, Health Science Studies, Health Informatics and Information Management Emphasis 3 Health Informatics and Information Management Emphasis ACCT 205 Introduction to Financial Accounting ACCT 206 Introduction to Managerial Accounting HLTHST 330 Health Information Management I with lab

Barrash, Warren

57

Bachelor of Science, Health Science Studies, Health Informatics and Information Management Emphasis, 2014-2015  

E-print Network

Bachelor of Science, Health Science Studies, Health Informatics and Information Management Emphasis 3 Health Informatics and Information Management Emphasis ACCT 205 Introduction to Financial Accounting ACCT 206 Introduction to Managerial Accounting HLTHST 330 Health Information Management I with lab

Barrash, Warren

58

Bachelor of Science, Health Science Studies, Health Informatics and Information Management Emphasis, 2012-2013  

E-print Network

Bachelor of Science, Health Science Studies, Health Informatics and Information Management Emphasis Health Informatics and Information Management Emphasis ACCT 205 Introduction to Financial Accounting ACCT 206 Introduction to Managerial Accounting HLTHST 330 Health Information Management I with lab HLTHST

Barrash, Warren

59

Knowledge Management for the Urban Health Context  

Microsoft Academic Search

\\u000a This chapter explains why contemporary and innovative ­knowledge-based concepts can be of benefit to the urban health environment.\\u000a The notion of “knowledge gaps” is often cited as a major impediment to effective management in the urban health context (examples\\u000a of which are included throughout this book). The tools, technologies and strategies of Knowledge Management are particularly\\u000a applicable to urban health.

M. Chris Gibbons; Rajeev K. Bali; Nilmini Wickramasinghe

60

Nurse managed occupational health centers: an overview.  

PubMed

1. Nurse managed centers provide clients with direct access to professional nursing care. 2. Lillian Wald, Mary Breckenridge, and Margaret Sanger established nurse managed centers at the beginning of this century. 3. Primary, secondary, and tertiary prevention programs and services are based on the mission, outcomes, staffing, and financing of the occupational health center. 4. Essential parameters for comprehensively evaluating an occupational health nurse managed center include, client outcomes, client satisfaction, and cost-benefit. PMID:9384001

Wachs, J E

1997-10-01

61

Poetry as a health care management tool  

Microsoft Academic Search

An overlooked, or certainly infrequently seen form of management communique is the poem. Health care management provides a set of examples—demonstrating psychotherapeutic value to the variety of groups living and working in such a setting. Poetry is shown to be an artful partner not only as a therapeutic tool, but also to have purposeful value in management practice.

Ralph K. Allen

1993-01-01

62

Janet Craig Occupational Health Manager  

E-print Network

Black review of sickness absence - Working for a Healthier Tomorrow · Health, work and wellbeing of Occupational Safety and Health Emerging trends - Government strategy for Health and Work Service Dame Carol programme ­ a cross-departmental government programme to improve the health and well-being of people

Schnaufer, Achim

63

Future developments in health care performance management  

PubMed Central

This paper highlights the challenges of performance management in health care, wherein multiple different objectives have to be pursued. The literature suggests starting with quality performance, following the sand cone theory, but considering a multidimensional concept of health care quality. Moreover, new managerial approaches coming from an industrial context and adapted to health care, such as lean management and risk management, can contribute to improving quality performance. Therefore, the opportunity to analyze them arises from studying their overlaps and links in order to identify possible synergies and to investigate the opportunity to develop an integrated methodology enabling improved performance. PMID:24255600

Crema, Maria; Verbano, Chiara

2013-01-01

64

Concept Development for Software Health Management  

NASA Technical Reports Server (NTRS)

This report documents the work performed by Lockheed Martin Aeronautics (LM Aero) under NASA contract NNL06AA08B, delivery order NNL07AB06T. The Concept Development for Software Health Management (CDSHM) program was a NASA funded effort sponsored by the Integrated Vehicle Health Management Project, one of the four pillars of the NASA Aviation Safety Program. The CD-SHM program focused on defining a structured approach to software health management (SHM) through the development of a comprehensive failure taxonomy that is used to characterize the fundamental failure modes of safety-critical software.

Riecks, Jung; Storm, Walter; Hollingsworth, Mark

2011-01-01

65

Operationalizing knowledge management in health care.  

PubMed

Being able to leverage the collective clinical knowledge that a health system acquires on a daily basis and then apply that knowledge to elevate productivity and maintain clinical quality would be nirvana for health system executives. Although it is difficult to bring knowledge management to health care, it is not impossible. Architects of knowledge management solutions in health care will need to balance what an organization hopes to achieve in its market (business strategy); how they hope to achieve it (operating strategy); and where information technology is needed to enable what they hope to achieve and how they hope to achieve it (information strategy). PMID:11234728

Zazzara, P

2001-02-01

66

From Personal Health Informatics to Health Self-management  

Microsoft Academic Search

Our research team is developing Salud!, an open and free infrastructure for developing and deploying personal health informatics applications. In addition, we are investigating and designing interaction techniques that support individuals engaged in health self- management. These interaction techniques make use of personal informatics applications' potential to guide

Yevgeniy Medynskiy; Elizabeth D. Mynatt

2010-01-01

67

A guide to performance management for the Health Information Manager.  

PubMed

This paper provides a summary of human resource management practices that have been identified as being associated with better outcomes in performance management. In general, essential practices include transformational leadership and a coherent program of goal setting, performance monitoring and feedback. Some Health Information Managers may feel they require training assistance to develop the necessary skills in the establishment of meaningful work performance goals for staff and the provision of useful and timely feedback. This paper provides useful information to assist Health Information Managers enhance the performance of their staff. PMID:19875850

Leggat, Sandra G

2009-01-01

68

Rumination activity of dairy cows in the 24 hours before and after calving.  

PubMed

Monitoring rumination behavior serves multiple purposes in feeding and herd management of dairy cows. The process of calving is a major event for cows, and a detailed understanding of alterations in behavioral patterns of animals in the time around calving is important in calving detection. The objective of this study was to describe the short-term changes in rumination patterns in dairy cows immediately before and after parturition. In total, 17 cows were fitted with rumination sensors that were able to monitor rumination time, number of rumination boli, and number of rumination jaw movements. Rumination time was decreased in the last 4h antepartum and in the first 8h postpartum. Cows stopped ruminating 123 ± 58 min (mean ± standard deviation) before calving and resumed ruminating 355 ± 194 min after calving. The number of rumination jaw movements and boli per day were decreased in the 24-h period postpartum. Rumination rate, the number of rumination jaw movements per rumination minute, and the number of boli per rumination minute changed little around calving. The calving event primarily influenced the duration and frequency of various rumination characteristics but not rumination intensity. Among detected characteristics, rumination time showed the greatest potential for monitoring of calving events. PMID:25218749

Pahl, Christian; Hartung, Eberhard; Grothmann, Anne; Mahlkow-Nerge, Katrin; Haeussermann, Angelika

2014-11-01

69

Rotorcraft Health Management Issues and Challenges  

NASA Technical Reports Server (NTRS)

This paper presents an overview of health management issues and challenges that are specific to rotorcraft. Rotorcraft form a unique subset of air vehicles in that their propulsion system is used not only for propulsion, but also serves as the primary source of lift and maneuvering of the vehicle. No other air vehicle relies on the propulsion system to provide these functions through a transmission system with single critical load paths without duplication or redundancy. As such, health management of the power train is a critical and unique part of any rotorcraft health management system. This paper focuses specifically on the issues and challenges related to the dynamic mechanical components in the main power train. This includes the transmission and main rotor mechanisms. This paper will review standard practices used for rotorcraft health management, lessons learned from fielded trials, and future challenges.

Zakrajsek, James J.; Dempsey, Paula J.; Huff, Edward M.; Augustin, Michael; Safa-Bakhsh, Robab; Ephraim, Piet; Grabil, Paul; Decker, Harry J.

2006-01-01

70

Applying business management models in health care.  

PubMed

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

Trisolini, Michael G

2002-01-01

71

Quality management in Malaysian public health care  

Microsoft Academic Search

Purpose – The main aim of the study is to provide an empirical analysis of quality management practice among Malaysian Ministry of Health hospital employees, ranging from medical specialists to health attendants. Design\\/methodology\\/approach – Self-administered questionnaires collected data and cluster sampling used to select hospitals, while stratified random sampling selected employee respondents. The research was limited to peninsular Malaysian public

Noor Hazilah Abd. Manaf

2005-01-01

72

Financial management in leading health care systems.  

PubMed

To understand better the financial management practices and strategies of modern health care organizations, we conducted interviews with chief financial officers (CFOs) of several leading health care systems. In this introduction, we present an overview of the project and summary responses on corporate financial structures and strategic challenges facing CFOs. PMID:10845383

Smith, D G; Wheeler, J R; Rivenson, H L; Reiter, K L

2000-01-01

73

Integrated System Health Management Development Toolkit  

NASA Technical Reports Server (NTRS)

This software toolkit is designed to model complex systems for the implementation of embedded Integrated System Health Management (ISHM) capability, which focuses on determining the condition (health) of every element in a complex system (detect anomalies, diagnose causes, and predict future anomalies), and to provide data, information, and knowledge (DIaK) to control systems for safe and effective operation.

Figueroa, Jorge; Smith, Harvey; Morris, Jon

2009-01-01

74

Assessment of time management attitudes among health managers.  

PubMed

These days, working people are finding it difficult to manage their time, get more done at work, and find some balance in their work and personal lives. Successful time management is often suggested to be a product of organizing skills, however, what works for one person may not work for others. Context current competence assessment formats for physicians, health professionals, and managers during their training years reliably test core knowledge and basic skills. However, they may underemphasize some important domains of professional medical practice. Thus, in addition to assessments of basic skills, new formats that assess clinical reasoning, expert judgment, management of ambiguity, professionalism, time management, learning strategies, and teamwork to promise a multidimensional assessment while maintaining adequate reliability and validity in classic health education and health care institutional settings are needed to be worked on. It should be kept in mind that institutional support, reflection, and mentoring must accompany the development of assessment programs. This study was designed to describe the main factors that consume time, effective hours of work, time management opportunities, and attitudes and behaviors of health professionals and managers on time management concept through assessment by the assessment tool Time Management Inquiry Form (TMIQ-F). The study was conducted at the State Hospital, Social Security Hospital, and University Hospital at Kirikkale, Turkey between October 1999 and January 2000, including 143 subjects defined as medical managers and medical specialists. According to the results, a manager should give priority to the concept of planning, which may be counted among the efficient time management techniques, and educate him/herself on time management. PMID:16131933

Sarp, Nilgun; Yarpuzlu, Aysegul Akbay; Mostame, Fariba

2005-01-01

75

Structural health management for aging aircraft  

Microsoft Academic Search

An effective structural health management (SHM) system can be a useful tool for making aircraft fleet management decisions ranging from individual aircraft maintenance scheduling and usage restrictions to fleet rotation strategies. This paper discusses the end-user requirements for the elements and architecture of an effective SHM system for application to both military and commercial aging aircraft fleets. The elements discussed

Roy Ikegami; Eric D. Haugse

2001-01-01

76

Simulation modeling for the health care manager.  

PubMed

This article addresses the use of simulation software to solve administrative problems faced by health care managers. Spreadsheet add-ins, process simulation software, and discrete event simulation software are available at a range of costs and complexity. All use the Monte Carlo method to realistically integrate probability distributions into models of the health care environment. Problems typically addressed by health care simulation modeling are facility planning, resource allocation, staffing, patient flow and wait time, routing and transportation, supply chain management, and process improvement. PMID:19668066

Kennedy, Michael H

2009-01-01

77

Improving the management of environmental health.  

PubMed Central

Environmental health regulation has been developed on the premise that both problems and solutions are obvious, requiring only attention and commitment. The result has been impossible legislative goals and frenetic, unfocused agency efforts to deal with too many issues. Preventing all environmental health problems is impossible and not the best approach; instead, attention ought to be shifted toward reacting quickly to problems before irreversible, severe health damage has occurred. Rather than having regulatory agencies attempt to manage all problems, they should be focused on exemplifying goals and productive approaches, and on handling a few major issues. Regulatory agencies should be managing the nonregulatory institutions to ensure that they are effective in dealing with the myriad issues that the agencies will never be able to handle. The inherent limitations of federal regulatory agencies must be recognized to restructure environmental health management to be more effective in lowering risks while being efficient, administratively simple, and more equitable. PMID:4085439

Lave, L B

1985-01-01

78

Management academy for public health: creating entrepreneurial managers.  

PubMed

The Management Academy for Public Health develops public health managers' management skills. Ultimately, the program aims to develop civic entrepreneurs who can improve the efficiency and the effectiveness of their organizations. With help from a coach, teams write public health business plans to meet needs in their communities. An external evaluation found that 119 teams trained during the first 3 years of the program generated more than $6 million in enhanced revenue-including grants, contracts, and fees through their business plans--from $2 million in program funding. Approximately 38% of the teams expected to generate revenue from an academy business plan or a spin-off plan. Action-learning methods can help midcareer managers transfer their training to the workplace and build entrepreneurial skills. PMID:17329658

Orton, Stephen; Umble, Karl; Zelt, Sue; Porter, Janet; Johnson, Jim

2007-04-01

79

Managing the quality of health care.  

PubMed

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

Larson, James S; Muller, Andreas

2002-01-01

80

[Demographic changes and health management].  

PubMed

Since our Constitution declaration in 1978 and General Law for Health in 1986, to date, the Spanish society has undergorne marked social changes. Socio-economic and health indicators in Spain have also improved as to an increased life expectancy, important reduction in infant mortality, and favourable changes reported in the national Health Survey. Risk factors influence the main causes of death, thus it is said that "man does not die but it kills himself". Healthy health practices are specified, and there is empirical evidence of greater disability-adjusted life years, a better adherence to Mediterranean diet, no smoking, moderate consumption of alcohol, enough time of sleeping, weight control, avoiding obsity and overweight, and increased physical activity, all the above practices achieving a healthier life. At a global scale in the world we live, famine has no frontiers, and fighting against this plague can not await longer. Overall, health and poverty are correlated and it must be overcome for reasons of human dignity, universal rights (even in ius gentium), and ethical dimension as normative of new socio-economic structures. Present must be transformed to recover hope in ou global world, still hungry, and in need of justice, enlightenment and solidarity. PMID:17172218

Calero, Juan del Rey

2006-01-01

81

ENERGY MANAGEMENT AND GLOBAL HEALTH  

Microsoft Academic Search

Energy and energy technologies have a central role in social and economic development at all scales, from household and community to regional and national. Among its welfare effects, energy is closely linked with public health both positively and negatively, the latter through environmental pollution and degradation. We review the current research on how energy use and energy technologies influence public

Majid Ezzati; Robert Bailis; Daniel M. Kammen; Tracey Holloway; Lynn Price; Luis A. Cifuentes; Brendon Barnes; Akanksha Chaureyy; Kiran N. Dhanapala

2004-01-01

82

Medicaid managed care and public health data.  

PubMed

In summary, there are a number of ways in which state public health data can be of value in the design of Medicaid managed care plans. At the level of the purchaser, such as a state Medicaid agency, public health data can assist in decision-making around pricing policy and can be useful in prioritizing interventions for those conditions that most severely affect the covered population. Quality assurance standards such as the HEDIS clinical performance measures can be used to define a baseline of prevention-oriented services or, by adding additional customized data points, to emphasize a particular service. From the standpoint of the managed care plan, public health data can be useful in understanding the needs of a community it serves or would like to serve and in estimating the prevalence of various conditions in that community that will influence the premium it will charge. Thus, there are multiple routes through which public health goals and priorities can be incorporated into managed care and can leverage the power of managed care to improve the public's health. PMID:10476991

Rutherford, G W; Backer, H D

1999-01-01

83

Second discipline in Health Management and Policy HMP 401, US Health Care Systems  

E-print Network

Research I [Health Management track], or HMP 702, Quantitative Methods in Epidemiology [Public Health track problems using epidemiological reasoning, methods, and analyses. Lab. HMP 721 - Managing Health Care, Epidemiology and Community Medicine HMP 721, Managing Health Care Organizations Either HMP 711, Health Systems

New Hampshire, University of

84

Strategic service quality management for health care.  

PubMed

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

Anderson, E A; Zwelling, L A

1996-01-01

85

Managing County Employee Health Care Costs The Problem  

E-print Network

.pdf Health Fair Planning Guide http://fcs.tamu.edu/health/health_fair_ planning_guide/index.php HealthManaging County Employee Health Care Costs The Problem If food costs increased at same rate as health care, one dozen eggs would cost $80.20! 87.5% of health-care claims are due to employees

86

Cyanobacterial toxins: risk management for health protection  

Microsoft Academic Search

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

2005-01-01

87

Risk contracts in managed mental health care  

Microsoft Academic Search

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

1995-01-01

88

Towards Open Information Management in Health Care  

Microsoft Academic Search

The utilization of information technology as tool in health care is increasing. The main benefits stem from the fact that information in electronic form can be transferred to different locations rapidly and from the possibility to auto- mate certain information management tasks. The current technological approach for this automation relies on structured, formally coded representation of information. We discuss the

J. Yli-Hietanen; S. Niiranen

2008-01-01

89

Chasing helminths and their economic impact on farmed ruminants.  

PubMed

Global agriculture will be required to intensify production from a shrinking natural resource base. Helminth infections of ruminants are a major constraint on efficient livestock production. The current challenge is to develop diagnostic methods that detect the production impact of helminth infections on farms in order to target control measures and contribute to the global challenge of preserving food security. We review here our understanding of the effects of helminth infections and control practices on productivity and the diagnostic tools that can inform on this. By combining advances in helminth laboratory diagnostics and animal health economics, sustainable management of helminth infections can be integrated into the whole-farm economic context. PMID:24888669

Charlier, Johannes; van der Voort, Mariska; Kenyon, Fiona; Skuce, Philip; Vercruysse, Jozef

2014-07-01

90

Integrated Systems Health Management for Intelligent Systems  

NASA Technical Reports Server (NTRS)

The implementation of an integrated system health management (ISHM) capability is fundamentally linked to the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system. It is akin to having a team of experts who are all individually and collectively observing and analyzing a complex system, and communicating effectively with each other in order to arrive at an accurate and reliable assessment of its health. In this paper, concepts, procedures, and approaches are presented as a foundation for implementing an intelligent systems ]relevant ISHM capability. The capability stresses integration of DIaK from all elements of a system. Both ground-based (remote) and on-board ISHM capabilities are compared and contrasted. The information presented is the result of many years of research, development, and maturation of technologies, and of prototype implementations in operational systems.

Figueroa, Fernando; Melcher, Kevin

2011-01-01

91

Software Health Management with Bayesian Networks  

NASA Technical Reports Server (NTRS)

Most modern aircraft as well as other complex machinery is equipped with diagnostics systems for its major subsystems. During operation, sensors provide important information about the subsystem (e.g., the engine) and that information is used to detect and diagnose faults. Most of these systems focus on the monitoring of a mechanical, hydraulic, or electromechanical subsystem of the vehicle or machinery. Only recently, health management systems that monitor software have been developed. In this paper, we will discuss our approach of using Bayesian networks for Software Health Management (SWHM). We will discuss SWHM requirements, which make advanced reasoning capabilities for the detection and diagnosis important. Then we will present our approach to using Bayesian networks for the construction of health models that dynamically monitor a software system and is capable of detecting and diagnosing faults.

Mengshoel, Ole; Schumann, JOhann

2011-01-01

92

The Implications of Death for Health: A Terror Management Health Model for Behavioral Health Promotion  

ERIC Educational Resources Information Center

This article introduces a terror management health model (TMHM). The model integrates disparate health and social psychology literatures to elucidate how the conscious and nonconscious awareness of death can influence the motivational orientation that is most operative in the context of health decisions. Three formal propositions are presented.…

Goldenberg, Jamie L.; Arndt, Jamie

2008-01-01

93

An assessment of GHG emissions from small ruminants in comparison with GHG emissions from large ruminants and monogastric livestock  

NASA Astrophysics Data System (ADS)

Greenhouse gas (GHG) emissions are expected to cause global warming which results in extreme weather changes that could affect crop yields and productivity, food supplies and food prices. It is also expected that climate change will have an impact on animal metabolism and health, reproduction and productivity. On the other hand, the expected increased demand of animal origin products in the coming years will increase the reared animal numbers and consequently GHG emissions. This paper outlines the main GHGs emitted from livestock which are CO2, CH4 and N2O, coming from respiration, enteric fermentation and manure management respectively, with CH4 and N2O having the highest global warming potential. Ruminant livestock has the highest contribution to these GHG emissions with small ruminants share being 12.25% of the total GHG emissions from livestock's enteric and manure CH4, and manure N2O in CO2 equivalent, producing 9.45 kg CO2 equivalent per kg body weight with the respective values for cattle, pigs and poultry being 5.45, 3.97 and 3.25. Since the production systems significantly affect the GHG emissions, the grazing, livestock crop complex, and intensive ones account for 30.5%, 67.29% and 5.51% for total CH4 emission (from enteric fermentation and manure management) and 24.32%, 68.11% and 7.57% for N2O respectively. Taking into account the positive and negative impacts of small ruminant livestock production systems to the environmental aspects in general, it is recommended that a number of potentially effective measures should be taken and the appropriate mitigation technologies should be applied in order to reduce effectively and essentially the GHG emissions to the atmosphere, with no adverse effects on intensification and increased productivity of small ruminants production systems.

Zervas, G.; Tsiplakou, E.

2012-03-01

94

UNIVERSITY OF HOUSTON ENVIRONMENTAL HEALTH AND RISK MANAGEMENT  

E-print Network

UNIVERSITY OF HOUSTON ENVIRONMENTAL HEALTH AND RISK MANAGEMENT POLICIES AND PROCEDURES SECTION through the proper management of asbestos containing material (ACM) throughout campus buildings. II. SCOPE

Azevedo, Ricardo

95

Best practices for health technology management.  

PubMed

In 2006, ECRI's Health Devices Group instituted the Health Devices Achievement Award to honor excellence in health technology management. The application process for this award yielded descriptions of many unique and effective technology management initiatives. This Guidance Article presents some of the best practices gleaned from the top award submissions. The following topics are discussed: The role of human factors testing in the technology management process. We describe one facility's approach to solving a particularly vexing problem: slow telemetry-alarm response times. The use of performance-based service contracting to improve inspection and preventive maintenance (IPM) completion rates. The advantages associated with one health system's process for grouping ventilator-dependent patients who are being cared for outside the intensive care unit. The ability of a technology assessment committee to bring a disciplined approach to the adoption of new technologies. The importance of customer satisfaction to a clinical engineering department. We describe how meeting the caregivers' needs contributes to building a patient-safe environment. The successful implementation of a new patient care technology: local anesthetic pumps. PMID:17300103

2006-12-01

96

Conflict management styles in the health professions.  

PubMed

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

Sportsman, Susan; Hamilton, Patti

2007-01-01

97

Using rangeland health assessment to inform successional management  

Technology Transfer Automated Retrieval System (TEKTRAN)

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 ...

98

Integrated fly management in European ruminant operations from the perspective of directive 2009/128/EC on sustainable use of pesticides.  

PubMed

Integrated pest management (IPM) in agriculture animals remains undeveloped as compared to IPM in crops. With respect to the range of external nuisance arthropods that may bother farm animals, development and implementation of systematic IPM strategies are difficult to carry out. However, recurrent outbreaks of blue tongue disease in sheep and cattle, the public threats regarding the prophylactic use of veterinary insecticides and the need to preserve the efficacy of available actives have to lead the reflexion on new control strategies for arthropod pests of livestock. A recent extension of EU regulation on the use of pesticides in crops provides an opportunity to compare IPM strategies and to suggest new lines of reflection for the control of nuisance pests in ruminants under European conditions. In this paper, actions suggested by the Annex III of the Directive 2009/128/CE on Sustainable Use of Pesticides and related National Action Plans from 28 member states of the EU were reviewed from an animal production perspective by a group of veterinary entomologists. Eight lines of action have been identified and thus challenged with respect to current husbandry practices in modern European ruminant operations. Many IPM strategies for crops were identified to be unsuitable for large animals. Suggestions for implementing tools, opportunities and constraint assessment, and needs for support were also discussed. Only control of pest development sites and monitoring of harmful organisms were considered achievable in the near future; both in conjunction with the use of topical insecticides. Complementary actions such as alternatives to chemical control require further researches and industrial development. Marketing of IGR-based feed additives would be of great interest, but development of new compounds for veterinary medicines is very unlikely with respect to the European regulatory environment and associated cost of development. PMID:25547079

Durel, Luc; Estrada-Peña, Augustin; Franc, Michel; Mehlhorn, Heinz; Bouyer, Jérémy

2015-02-01

99

Entrepreneurship management in health services: an integrative model.  

PubMed

This research develops an integrated systems model of entrepreneurship management as a method for achieving health care organizational survival and growth. Specifically, it analyzes current health care environment challenges, identifies roles of managers and discusses organizational theories that are relevant to the health care environment, outlines the role of entrepreneurship in health care, and describes the entrepreneurial manager in the entrepreneurial management process to produce desirable organizational outcomes. The study concludes that as current health care environment continues to show intense competition, entrepreneurial managers are responsible for creating innovations, managing change, investing in resources, and recognizing opportunities in the environment to increase organizational viability. PMID:16583849

Guo, Kristina L

2006-01-01

100

ISWHM: Tools and Techniques for Software and System Health Management  

NASA Technical Reports Server (NTRS)

This presentation presents status and results of research on Software Health Management done within the NRA "ISWHM: Tools and Techniques for Software and System Health Management." Topics include: Ingredients of a Guidance, Navigation, and Control System (GN and C); Selected GN and C Testbed example; Health Management of major ingredients; ISWHM testbed architecture; and Conclusions and next Steps.

Schumann, Johann; Mengshoel, Ole J.; Darwiche, Adnan

2010-01-01

101

College of Health Sciences CLM Clinical Leadership and Management  

E-print Network

College of Health Sciences CLM Clinical Leadership and Management KEY: # = new course * = course of government will be examined. The power and influence that politics, money, the media, and special interest MANAGEMENT OF HEALTH CARE INSTITUTIONS. (3) A review of financial management practices in health care

MacAdam, Keith

102

Studienordnung fr den Masterstudiengang (M.Sc.) ,,Health Care Management"  

E-print Network

Studienordnung für den Masterstudiengang (M.Sc.) ,,Health Care Management" an der Ernst- Moritz den Masterstudiengang (M.Sc.) ,,Health Care Management" als Sat- zung: Inhaltsverzeichnis § 1.Sc.) ,,Health Care Management" an der Ernst-Moritz-Arndt-Universität Greifswald vom 18.07.2006 das Studium

Greifswald, Ernst-Moritz-Arndt-Universität

103

Studienordnung fr den Masterstudiengang (M.Sc.) ,,Health Care Management"  

E-print Network

Studienordnung für den Masterstudiengang (M.Sc.) ,,Health Care Management" an der Ernst- Moritz den Masterstudiengang (M.Sc.) ,,Health Care Management" als Satzung: Inhaltsverzeichnis § 1.Sc.) ,,Health Care Management" an der Ernst-Moritz- Arndt-Universität Greifswald vom 18.07.2006 das Studium

Greifswald, Ernst-Moritz-Arndt-Universität

104

Health Management and Informatics Alumni Organization An Affiliate of  

E-print Network

BYLAWS of the Health Management and Informatics Alumni Organization An Affiliate of The University The name of the organization shall be the Health Management and Informatics Organization hereinafter referred to as the Organization. ARTICLE II: PURPOSE The Health Management and Informatics Organization

Missouri-Columbia, University of

105

Health Plans' Disease Management Programs: Extending across the Medical and Behavioral Health Spectrum?  

PubMed Central

While the disease management industry has expanded rapidly, there is little nationally representative data regarding medical and behavioral health disease management programs at the health plan level. National estimates from a survey of private health plans indicate that 90% of health plan products offered disease management for general medical conditions such as diabetes, but only 37% had depression programs. The frequency of specific depression disease management activities varied widely. Program adoption was significantly related to product type and behavioral health contracting. In health plans, disease management has penetrated more slowly into behavioral health, and depression program characteristics are highly variable. PMID:18806594

Merrick, Elizabeth Levy; Horgan, Constance M.; Garnick, Deborah W.; Hodgkin, Dominic; Morley, Melissa

2015-01-01

106

FAILSAFE Health Management for Embedded Systems  

NASA Technical Reports Server (NTRS)

The FAILSAFE project is developing concepts and prototype implementations for software health management in mission- critical, real-time embedded systems. The project unites features of the industry-standard ARINC 653 Avionics Application Software Standard Interface and JPL s Mission Data System (MDS) technology (see figure). The ARINC 653 standard establishes requirements for the services provided by partitioned, real-time operating systems. The MDS technology provides a state analysis method, canonical architecture, and software framework that facilitates the design and implementation of software-intensive complex systems. The MDS technology has been used to provide the health management function for an ARINC 653 application implementation. In particular, the focus is on showing how this combination enables reasoning about, and recovering from, application software problems.

Horvath, Gregory A.; Wagner, David A.; Wen, Hui Ying; Barry, Matthew

2010-01-01

107

Data Management for Meeting Global Health Challenges Tapan S. Parikh  

E-print Network

Data Management for Meeting Global Health Challenges Tapan S. Parikh UC Berkeley School global health challenges are becoming increasingly data driven. Governments and donors are demanding activities, and responding to remote outbreaks of disease. Data challenges in global health intersect

Parikh, Tapan S.

108

Making Technology Ready: Integrated Systems Health Management  

NASA Technical Reports Server (NTRS)

This paper identifies work needed by developers to make integrated system health management (ISHM) technology ready and by programs to make mission infrastructure ready for this technology. This paper examines perceptions of ISHM technologies and experience in legacy programs. Study methods included literature review and interviews with representatives of stakeholder groups. Recommendations address 1) development of ISHM technology, 2) development of ISHM engineering processes and methods, and 3) program organization and infrastructure for ISHM technology evolution, infusion and migration.

Malin, Jane T.; Oliver, Patrick J.

2007-01-01

109

Health management of breast cancer survivors  

Microsoft Academic Search

Breast cancer is defined as a chronic disease. Increasing amounts of attention have been paid to the health management of\\u000a breast cancer survivors. An important issue is how to find the most appropriate method of follow-up in order to detect long-term\\u000a complications of treatment, local recurrence and distant metastasis and to administer appropriate treatment to the survivors\\u000a with recurrence in

Min Li; Juan Chen; Zhendong Chen

2009-01-01

110

Evidence-based health care management: what is the research evidence available for health care managers?  

PubMed

In light of increasing interest in evidence-based management, we conducted a scoping review of systematic reviews (SRs) and meta-analyses (MAs) to determine the availability and accessibility of evidence for health care managers; 14 MAs and 61 SRs met the inclusion criteria. Most reviews appeared in medical journals (53%), originated in the United States (29%) or United Kingdom (22%), were hospital-based (55%), and targeted clinical providers (55%). Topics included health services organization (34%), quality/patient safety (17%), information technology (15%), organization/workplace management (13%), and health care workforce (12%). Most reviews addressed clinical topics of relevance to managers; management-related interventions were rare. The management issues were mostly classified as operational (65%). Surprisingly, 96.5% of search results were not on target. A better classification within PubMed is needed to increase the accessibility of meaningful resources and facilitate evidence retrieval. Health care journals should take initiatives encouraging the publication of reviews in relevant management areas. PMID:24296471

Jaana, Mirou; Vartak, Smruti; Ward, Marcia M

2014-09-01

111

Structural health management for aging aircraft  

NASA Astrophysics Data System (ADS)

An effective structural health management (SHM) system can be a useful tool for making aircraft fleet management decisions ranging from individual aircraft maintenance scheduling and usage restrictions to fleet rotation strategies. This paper discusses the end-user requirements for the elements and architecture of an effective SHM system for application to both military and commercial aging aircraft fleets. The elements discussed include the sensor systems for monitoring and characterizing the health of the structure, data processing methods for interpreting sensor data and converting it into useable information, and automated methods for erroneous data detection, data archiving and information dissemination. Current and past SHM technology development/maturation efforts in these areas at the Boeing Company will be described. An evolutionary technology development strategy is developed in which the technologies needed will be matured, integrated into a vehicle health management system, and benefits established without requiring extensive changes to the end-user's existing operation and maintenance infrastructure. Issues regarding the end-user customer acceptance of SHM systems are discussed and summarized.

Ikegami, Roy; Haugse, Eric D.

2001-06-01

112

Integrated Systems Health Management for Intelligent Systems  

NASA Technical Reports Server (NTRS)

The implementation of an integrated system health management (ISHM) capability is fundamentally linked to the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system. Management implies storage, distribution, sharing, maintenance, processing, reasoning, and presentation. ISHM is akin to having a team of experts who are all individually and collectively observing and analyzing a complex system, and communicating effectively with each other in order to arrive at an accurate and reliable assessment of its health. In this chapter, concepts, procedures, and approaches are presented as a foundation for implementing an ISHM capability relevant to intelligent systems. The capability stresses integration of DIaK from all elements of a system, emphasizing an advance toward an on-board, autonomous capability. Both ground-based and on-board ISHM capabilities are addressed. The information presented is the result of many years of research, development, and maturation of technologies, and of prototype implementations in operational systems.

Figueroa, Fernando; Melcher, Kevin

2011-01-01

113

Interaction between bunk management and monensin concentration on finishing performance, feeding behavior, and ruminal metabolism during an acidosis challenge with feedlot cattle.  

PubMed

Two commercial feedlot experiments and a metabolism study were conducted to evaluate the effects of monensin concentrations and bunk management strategies on performance, feed intake, and ruminal metabolism. In the feedlot experiments, 1,793 and 1,615 steers were used in Exp. 1 and 2, respectively, in 18 pens for each experiment (six pens/treatment). Three treatments were evaluated: 1) ad libitum bunk management with 28.6 mg/kg monensin and clean bunk management strategies with either 2) 28.6 or 3) 36.3 mg/kg monensin. In both experiments, 54 to 59% of the clean bunk pens were clean at targeted clean time, or 2200, compared with 24 to 28% of the ad libitum pens. However, only 13% of the pens were clean by 2000 in Exp. 1 (summer), whereas 44% of the pens in Exp. 2 (winter) were clean by 2000. In Exp. 1, bunk management and monensin concentration did not affect carcass-adjusted performance. In Exp. 2, steers fed ad libitum had greater DMI (P < 0.01) and carcass-adjusted ADG (P < 0.01) but feed efficiency (P > 0.13) similar to that of clean bunk-fed steers. Monensin concentration had no effect on carcass-adjusted performance (P > 0.20) in either experiment. A metabolism experiment was conducted with eight fistulated steers in a replicated 4 x 4 Latin square acidosis challenge experiment. An acidosis challenge was imposed by feeding 125% of the previous day's DMI, 4 h later than normal. Treatments consisted of monensin concentrations (mg/kg) of 0, 36.7, 48.9, or 36.7 until challenged and switched to 48.9 on the challenge day and 4 d following. Each replicate of the Latin square was managed with separate bunk management strategies (clean bunk or ad libitum). Feeding any concentration of monensin increased number of meals and decreased DMI rate (%/h) (P < 0.12) for the 4 d following the acidosis challenge. Meal size, pH change, and pH variance were lower (P < 0.10) for steers fed monensin with clean bunk management. However, no monensin effect was observed for steers fed ad libitum. Bunk management strategy has the potential to decrease DMI and ADG when steers managed on a clean bunk program are restricted relative to traditional, ad libitum bunk programs. Monensin helps control intake patterns for individuals, but increasing concentration above currently approved levels in this study seemed to have little effect. PMID:14601891

Erickson, G E; Milton, C T; Fanning, K C; Cooper, R J; Swingle, R S; Parrott, J C; Vogel, G; Klopfenstein, T J

2003-11-01

114

Health leadership and management competencies: a systemic approach.  

PubMed

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

Holder, Reynaldo; Ramagem, Caroline

2012-01-01

115

Rumination syndrome: a review of current concepts and treatments.  

PubMed

Rumination is a normal and common phenomenon among ruminant animals; but in humans, it is always regarded as symptom indicative of abnormal function of the upper gastrointestinal tract, and understanding of the mechanisms explaining this event are still evolving. Learning-based theories, organic factors such as gastroesophageal reflux disease and psychological disturbances (eg, depression, anxiety) and the role of life stresses have been postulated as potential mechanisms of rumination. In this review, we take the approach that rumination syndrome is a distinct and discrete functional gastroduodenal disorder. We review current concepts of the pathophysiology of this entity and diagnostic approaches, then detail the treatment paradigms that have been pursued in rumination syndrome in adults. Patients with rumination syndrome have a very distinct set of symptoms. It was focused on the immediate postprandial period, but recently, there is an awareness of an expanding spectrum of the clinical presentation. This includes the concept of "conditioned vomiting" occurring in the setting of delayed gastric emptying (gastroparesis). Physicians' awareness of rumination syndrome is essential in the diagnosis and management of this disorder. Stress and psychological aspects in rumination syndrome are invariably in the background and have to be addressed. The crucial steps in the treatment strategy for rumination syndrome rely on reassurance, education and a physiologic explanation to the patient and family that this is not a "disease," followed by behavioral and relaxation programs and addressing stress factors. PMID:24642653

Hejazi, Reza A; McCallum, Richard W

2014-10-01

116

Total quality management strategies in mental health systems  

Microsoft Academic Search

This paper introduces the concept of total quality management (TQM) to top managers of mental health systems. While TQM is\\u000a a philosophy of management at the cutting edge of U.S. business, it has only recently entered the vocabulary of health care\\u000a managers. To our knowledge, TQM has yet to be systematically applied to the state mental health service delivery system.

William V. Rago; William H. Reid

1991-01-01

117

[Health economic evaluation of disease management programs].  

PubMed

Disease management has become an important element in the improvement of care for people with chronic illnesses and has become embedded in the discussion on health policy in recent years. The approach has been introduced very differently to the health systems worldwide. Since 1 January 2003 accredited disease management programs (DMPs) have been a part of the risk structure compensation scheme of the German statutory health insurance. This is seen as the first step to a morbidity orientation of the risk structure compensation. DMPs have to be evaluated according the German Social Law, especially whether the objectives of the programs and the criteria for inclusion of the patients have been met and the quality of care for the patients is insured. The criteria for evaluation are threefold: medical issues, economic issues and subjective quality of life of the patients. Due to the immense amounts of data which can be expected the evaluation of the German DMPs is a huge logistical challenge. Until now not very much is known about the data quality. The evaluation is focused on the perspective of the sickness funds as e.g. information about indirect cost is not collected. In the article the methods for evaluation are described and critically discussed. PMID:16320012

Greiner, W

2006-01-01

118

A Distributed Prognostic Health Management Architecture  

NASA Technical Reports Server (NTRS)

This paper introduces a generic distributed prognostic health management (PHM) architecture with specific application to the electrical power systems domain. Current state-of-the-art PHM systems are mostly centralized in nature, where all the processing is reliant on a single processor. This can lead to loss of functionality in case of a crash of the central processor or monitor. Furthermore, with increases in the volume of sensor data as well as the complexity of algorithms, traditional centralized systems become unsuitable for successful deployment, and efficient distributed architectures are required. A distributed architecture though, is not effective unless there is an algorithmic framework to take advantage of its unique abilities. The health management paradigm envisaged here incorporates a heterogeneous set of system components monitored by a varied suite of sensors and a particle filtering (PF) framework that has the power and the flexibility to adapt to the different diagnostic and prognostic needs. Both the diagnostic and prognostic tasks are formulated as a particle filtering problem in order to explicitly represent and manage uncertainties; however, typically the complexity of the prognostic routine is higher than the computational power of one computational element ( CE). Individual CEs run diagnostic routines until the system variable being monitored crosses beyond a nominal threshold, upon which it coordinates with other networked CEs to run the prognostic routine in a distributed fashion. Implementation results from a network of distributed embedded devices monitoring a prototypical aircraft electrical power system are presented, where the CEs are Sun Microsystems Small Programmable Object Technology (SPOT) devices.

Bhaskar, Saha; Saha, Sankalita; Goebel, Kai

2009-01-01

119

Integrated electronic health records management system.  

PubMed

Computer systems and communication technologies are making a strong and influential presence in the different fields of medicine. The cornerstone of a functional medical information system represents the electronic health records management system. Due to a very sensitive nature of medical information, such systems are faced with a number of stringent requirements, like security and confidentiality of patients' related data, different media type's management, diversity of medical data that need to be processed etc. At present most clinical software systems are closed with little or no operability between them, and the medical information are locked in a variety of different incompatible databases. As the result of these facts, it is very hard for the developers to provide the solution for an integrated health computing environment, which would considerably improve the quality of medical care in general. This paper presents the framework for a functional EHR management system that meets these demands, but also follows the initiative taken by the Next Generation Network (NGN) approach, which includes user mobility, service transparency and common communication platform for transferring and serving different types of information, services and media. PMID:17095822

Di Giacomo, P; Ricci, Fabrizio L; Bocchi, Leonardo

2006-01-01

120

Sensor Systems for Prognostics and Health Management  

PubMed Central

Prognostics and health management (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. PMID:22219686

Cheng, Shunfeng; Azarian, Michael H.; Pecht, Michael G.

2010-01-01

121

Outage management and health physics issue, 2006  

SciTech Connect

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.

Agnihotri, Newal (ed.)

2006-05-15

122

Health management performance : A review of measures and indicators  

Microsoft Academic Search

A bewildering variety of performance measures and indicators in health management is evident in the literature and in practice. Reviews measures useful for health management performance accountability, and expands on the traditional notion of health performance measures to incorporate nominal and ordinal measures. The research is performed in the interest of stimulating discussion in the public domain and with the

K. A. Van Peursem; M. J. Prat; S. R. Lawrence

1995-01-01

123

Strategies for effective management participation in community health partnerships.  

PubMed

This article develops guidelines for effective health services management participation in community health partnerships. Drawing on our study of Community Care Network (CCN) Demonstration, the strategic alliance literature, and other research, we describe six challenges that health services managers are likely to face as partnership participants and discuss the strategies that they might use to deal with them. PMID:10937337

Weiner, B J; Alexander, J A; Zuckerman, H S

2000-01-01

124

Prfungsordnung fr den Masterstudiengang (M.Sc.) ,,Health Care Management "  

E-print Network

Prüfungsordnung für den Masterstudiengang (M.Sc.) ,,Health Care Management " an der Ernst ,,Health Care Management" (HCM) als Satzung: Inhaltsverzeichnis § 1 Regelungsgegenstand § 2* Regelungsgegenstand (1) Diese Prüfungsordnung regelt das Prüfungsverfahren im Masterstudiengang ,,Health Care

Greifswald, Ernst-Moritz-Arndt-Universität

125

Managing the health of the elite athlete: a new integrated performance health management and coaching model  

PubMed Central

Elite athletes endeavour to train and compete even when ill or injured. Their motivation may be intrinsic or due to coach and team pressures. The sports medicine physician plays an important role to risk-manage the health of the competing athlete in partnership with the coach and other members of the support team. The sports medicine physician needs to strike the right ethical and operational balance between health management and optimising performance. It is necessary to revisit the popular delivery model of sports medicine and science services to elite athletes based on the current reductionist multispecialist system lacking in practice an integrated approach and effective communication. Athlete and coach in isolation or with a member of the multidisciplinary support team, often not qualified or experienced to do so, decide on the utilisation of services and how to apply the recommendations. We propose a new Integrated Performance Health Management and Coaching model based on the UK Athletics experience in preparation for the London Olympic and Paralympic Games. The Medical and Coaching Teams are managed by qualified and experienced individuals operating in synergy towards a common performance goal, accountable to a Performance Director and ultimately to the Board of Directors. We describe the systems, processes and implementation strategies to assist the athlete, coach and support teams to continuously monitor and manage athlete health and performance. These systems facilitate a balanced approach to training and competing decisions, especially while the athlete is ill or injured. They take into account the best medical advice and athlete preference. This Integrated Performance Health Management and Coaching model underpinned the Track and Field Gold Medal performances at the London Olympic and Paralympic Games. PMID:24620040

Dijkstra, H Paul; Pollock, N; Chakraverty, R; Alonso, J M

2014-01-01

126

Managing the health of the elite athlete: a new integrated performance health management and coaching model.  

PubMed

Elite athletes endeavour to train and compete even when ill or injured. Their motivation may be intrinsic or due to coach and team pressures. The sports medicine physician plays an important role to risk-manage the health of the competing athlete in partnership with the coach and other members of the support team. The sports medicine physician needs to strike the right ethical and operational balance between health management and optimising performance. It is necessary to revisit the popular delivery model of sports medicine and science services to elite athletes based on the current reductionist multispecialist system lacking in practice an integrated approach and effective communication. Athlete and coach in isolation or with a member of the multidisciplinary support team, often not qualified or experienced to do so, decide on the utilisation of services and how to apply the recommendations. We propose a new Integrated Performance Health Management and Coaching model based on the UK Athletics experience in preparation for the London Olympic and Paralympic Games. The Medical and Coaching Teams are managed by qualified and experienced individuals operating in synergy towards a common performance goal, accountable to a Performance Director and ultimately to the Board of Directors. We describe the systems, processes and implementation strategies to assist the athlete, coach and support teams to continuously monitor and manage athlete health and performance. These systems facilitate a balanced approach to training and competing decisions, especially while the athlete is ill or injured. They take into account the best medical advice and athlete preference. This Integrated Performance Health Management and Coaching model underpinned the Track and Field Gold Medal performances at the London Olympic and Paralympic Games. PMID:24620040

Dijkstra, H Paul; Pollock, N; Chakraverty, R; Alonso, J M

2014-04-01

127

Occupational Health & Safety: The Management Challenge of the Nineties  

Microsoft Academic Search

In this paper, the major developments related to occupational health and safety in Australia over the last 20 years are reviewed As part of this review reasons are cited why Occupational Health and Safety has not developed more rapidly as an integral part of effective managment in Australia. An approach to safety management as it relates to quality management is

Robert Hetzel

1990-01-01

128

Health Advisor An Online Game for Managing Healthcare Delivery  

E-print Network

to "serious" games. Our research paradigm is premised on the notion that a large number of people addressingHealth Advisor An Online Game for Managing Healthcare Delivery Tennenbaum Institute Georgia, an online game for managing healthcare delivery ­ Health Advisor. Each player manages a set of clients

129

Purslane: A Potential Forage for Small Ruminants  

Technology Transfer Automated Retrieval System (TEKTRAN)

Sustainable small ruminant production on small-acreage farms in Appalachia depends upon use of various plant resources to meet nutritional and health requirements of animals and provide meat products that satisfy consumer desires and expectations. While traditional forage species can supply nutrien...

130

‘My health is not a job’: a qualitative exploration of personal health management and imperatives of the ‘new public health  

PubMed Central

Background There is an increasing push in Western healthcare for people to ‘manage’ their health, a key aspect of what has been called the ‘new public health’. It has been argued that this ‘personal health management’ – informal work done to monitor, inform, or influence one’s health – may be a burden, with potential to contribute to poor health outcomes. However, there is little research actually examining perceptions of personal health management and the ‘burden’ of these activities, particularly for generally healthy individuals. Methods We conducted exploratory qualitative interviews with 30 generally healthy men and women about their perceptions and experiences of personal health management. Questions focused on health behaviours (e.g., information seeking), as well as feelings about these behaviours and perceptions of the time dedicated to health. Audio-recorded interviews were transcribed and analyzed qualitatively using NVivo 10. Where appropriate, quantitative codes were applied and descriptive statistics are reported alongside qualitative findings. Results Participants were generally satisfied with the amount of time spent on their health and few perceived personal health management as a burden. Many participants took issue with the concept of ‘work’ being associated with health and stressed the importance of taking personal responsibility for health. Conclusions Our findings suggest that generally healthy people have internalised the notion of the ‘new public health’ and accepted the imperative of personal health responsibility. On the one hand, this bodes well for healthy individuals; their positive attitude may lead to better health outcomes, and the manageable amount of time spent suggests personal health management is unlikely to cause negative health consequences associated with stress. On the other hand, our findings may indicate that other factors, such as social determinants of health, are ignored in health promotion efforts and that those who cannot manage their own health may fall further behind. Future research should continue to explore the time people spend ‘working’ for their health, and how they perceive and respond to ‘new public health’ imperatives. PMID:25030501

2014-01-01

131

Rumination Syndrome in Ethiopia: A Case Study  

PubMed Central

Eating disorders are commonly believed to be rare or nonexistent in Africa. However, due to exposure to Western culture, a rise in eating disorders among African women is reported in the literature. This case study describes a 17-year-old Ethiopian girl who meets the DSM-IV-TR and DSM-5 diagnostic criteria for bulimia nervosa and the Rome III Diagnostic Criteria for Functional Gastrointestinal Disorders criteria for rumination syndrome. The article discusses the diagnostic delays, the difficulties in terms of therapy, and the context determinants that—combined with individual psychopathological features—are thought to contribute to the disorders. Health professionals should be informed about the prevalence of eating disorders in Africa and, more specifically, of rumination syndrome in young women with normal intelligence. In light of this case study, it seems necessary to raise awareness with regard to the insufficient evidence on effective therapies for rumination syndrome in individuals without intellectual impairment. PMID:25667799

2014-01-01

132

Behavioral Health Emergencies Managed by School Nurses Working with Adolescents  

ERIC Educational Resources Information Center

Background: As members of interdisciplinary teams, school nurses provide behavioral health services. Studies indicate that school nurses may lack sufficient continuing education in adolescent behavioral health and in the management of behavioral health emergencies, specifically. We conducted this study to describe the adolescent behavioral health

Ramos, Mary M.; Greenberg, Cynthia; Sapien, Robert; Bauer-Creegan, Judith; Hine, Beverly; Geary, Cathy

2013-01-01

133

ENVIRONMENT, HEALTH & SAFETY Risk Management Services, University of Alberta  

E-print Network

ENVIRONMENT, HEALTH & SAFETY Risk Management Services, University of Alberta www, monitoring and inspection of facilities and equipment Compliance assurance Consultation in facility Provide technical expertise and service to departments in aspects of hazardous waste management, re

Machel, Hans

134

75 FR 54804 - Safety and Health Management Programs for Mines  

Federal Register 2010, 2011, 2012, 2013, 2014

... The American National Standards Institute's (ANSI's) and American Industrial Hygiene Association's (AIHA's) ANSI/AIHA's Z10- 2005, Occupational Health and Safety Management Systems; The International Standards...

2010-09-09

135

Reducing Health Cost: Health Informatics and Knowledge Management as a Business and Communication Tool  

Microsoft Academic Search

\\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

2010-01-01

136

Meeting global health challenges through operational research and management science  

PubMed Central

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. PMID:21897489

2011-01-01

137

Small Ruminant Theileriosis  

Microsoft Academic Search

\\u000a Theileria parasites, the causative agents of theileriosis, infect a vast number of wild and domestic animals and are transmitted\\u000a transstadially by various members of tick vectors of the family Ixodidae. Three Theileria species infecting small ruminants\\u000a have been shown to be responsible for losses in small ruminant production. Two of them, T. uilenbergi and T. luwenshuni have been described to

Jabbar Ahmed; Hong Yin; Mohammed Bakheit; Zhijie Liu; Heinz Mehlhorn; Ulrike Seitzer

138

Evaluation of feeding glycerol on free-fatty acid production and fermentation kinetics of mixed ruminal microbes in vitro  

Technology Transfer Automated Retrieval System (TEKTRAN)

Strategies to enrich ruminant-derived foods with unsaturated fatty acids are desired as these are considered beneficial for good human health. Ruminant-derived foods contain high proportions of saturated fats, a result of ruminal biohydrogenation, which rapidly saturates and thus limits the availab...

139

World Health Organization's Management of Substance Abuse  

NSDL National Science Digital Library

Part of the larger World Health Organization's (WHO) site this section on the management of substance abuse has a variety of useful information for students, teachers and those practicing in the field. Some of the most useful are several resources related to terminology and classifications including the WHO lexicon of alcohol and drug terms. The lexicon, developed in 1994, supplies clinicians, researchers and other users with a set of definitions of terms related to tobacco, alcohol and other drugs. Also available is a Facts and Figures section which provides users with basic information about the use and misuse of alcohol and other drugs worldwide. The Activities pages allow users to get a glimpse into the research that WHO is currently undertaking that is related to substance abuse. Sections on publications, research tools, and other links round out this very useful site.

140

Managed Care Rebound? Recent Changes in Health Plans' Cost Containment Strategies. Health Affairs Web Exclusive  

Microsoft Academic Search

Large increases in health care costs combined with an economic slowdown have created pressures for health plans and employers to reconsider cost containment strategies that were scaled back after the managed care backlash. This paper examines how plans’ approaches to cost containment and care management have evolved since 2001. Plans reintroduced and refocused some utilization management techniques during 2002 and

Glen P. Mays; Gary Claxton; Justin White

2004-01-01

141

Integrated Systems Health Management for Space Exploration  

NASA Technical Reports Server (NTRS)

Integrated Systems Health Management (ISHM) is a system engineering discipline that addresses the design, development, operation, and lifecycle management of components, subsystems, vehicles, and other operational systems with the purpose of maintaining nominal system behavior and function and assuring mission safety and effectiveness under off-nominal conditions. NASA missions are often conducted in extreme, unfamiliar environments of space, using unique experimental spacecraft. In these environments, off-nominal conditions can develop with the potential to rapidly escalate into mission- or life-threatening situations. Further, the high visibility of NASA missions means they are always characterized by extraordinary attention to safety. ISHM is a critical element of risk mitigation, mission safety, and mission assurance for exploration. ISHM enables: In-space maintenance and repair; a) Autonomous (and automated) launch abort and crew escape capability; b) Efficient testing and checkout of ground and flight systems; c) Monitoring and trending of ground and flight system operations and performance; d) Enhanced situational awareness and control for ground personnel and crew; e) Vehicle autonomy (self-sufficiency) in responding to off-nominal conditions during long-duration and distant exploration missions; f) In-space maintenance and repair; and g) Efficient ground processing of reusable systems. ISHM concepts and technologies may be applied to any complex engineered system such as transportation systems, orbital or planetary habitats, observatories, command and control systems, life support systems, safety-critical software, and even the health of flight crews. As an overarching design and operational principle implemented at the system-of-systems level, ISHM holds substantial promise in terms of affordability, safety, reliability, and effectiveness of space exploration missions.

Uckun, Serdar

2005-01-01

142

Health Management Applications for International Space Station  

NASA Technical Reports Server (NTRS)

Traditional mission and vehicle management involves teams of highly trained specialists monitoring vehicle status and crew activities, responding rapidly to any anomalies encountered during operations. These teams work from the Mission Control Center and have access to engineering support teams with specialized expertise in International Space Station (ISS) subsystems. Integrated System Health Management (ISHM) applications can significantly augment these capabilities by providing enhanced monitoring, prognostic and diagnostic tools for critical decision support and mission management. The Intelligent Systems Division of NASA Ames Research Center is developing many prototype applications using model-based reasoning, data mining and simulation, working with Mission Control through the ISHM Testbed and Prototypes Project. This paper will briefly describe information technology that supports current mission management practice, and will extend this to a vision for future mission control workflow incorporating new ISHM applications. It will describe ISHM applications currently under development at NASA and will define technical approaches for implementing our vision of future human exploration mission management incorporating artificial intelligence and distributed web service architectures using specific examples. Several prototypes are under development, each highlighting a different computational approach. The ISStrider application allows in-depth analysis of Caution and Warning (C&W) events by correlating real-time telemetry with the logical fault trees used to define off-nominal events. The application uses live telemetry data and the Livingstone diagnostic inference engine to display the specific parameters and fault trees that generated the C&W event, allowing a flight controller to identify the root cause of the event from thousands of possibilities by simply navigating animated fault tree models on their workstation. SimStation models the functional power flow for the ISS Electrical Power System and can predict power balance for nominal and off-nominal conditions. SimStation uses realtime telemetry data to keep detailed computational physics models synchronized with actual ISS power system state. In the event of failure, the application can then rapidly diagnose root cause, predict future resource levels and even correlate technical documents relevant to the specific failure. These advanced computational models will allow better insight and more precise control of ISS subsystems, increasing safety margins by speeding up anomaly resolution and reducing,engineering team effort and cost. This technology will make operating ISS more efficient and is directly applicable to next-generation exploration missions and Crew Exploration Vehicles.

Alena, Richard; Duncavage, Dan

2005-01-01

143

Workplace health promotion: the role and responsibility of health care managers.  

PubMed

The World Health Organization's (WHO) Ottawa Charter for Health Promotion in 1986 provided the catalyst from which the Health Promoting Workplace movement emerged. Here, an extensive review of the available workplace-related health literature provides the basis for critical discussion and recommendations for health care managers. The findings suggest that health care managers, who practice in all health service settings, should be aiming to initiate and promote radical health promotion reform as set out in the WHO settings-based movement. Developing and implementing sustainable health promotion-orientated and organization-wide healthy workplace policy initiatives represent the most effective way for health care managers to directly benefit from the desirable outcomes that come from creating and maintaining a healthy workforce. PMID:16359447

Whitehead, Dean

2006-01-01

144

Health care managers as a crucial component of health care workforce in Serbia.  

PubMed

The aim of the paper was to describe and analyse health services management in Serbia, commencing with present status and projecting, as accurately as possible, future changes over the next years, skills and required competencies of the health management workforce. The study was done as a part of Ministry of Health/EU funded Project "Preparation for Health Management Training Programme in Serbia" by a desk review of current and draft legislation, related projects in the health sector and relevant local and international literature; semi-structured interviews with key local and international stakeholders and a structural analysis of the health management sector. The results of the study have shown that there was a big gap in knowledge and skills regarding Health Management in Serbia and a true need for such type of education. PMID:21086769

Vasic, Milena; Markovic, Roberta; Korac, Vesna; Krstic, Maja

2010-01-01

145

Managing Evaluation in a Federal Public Health Setting  

ERIC Educational Resources Information Center

The author, a federal manager who leads development and maintenance of evaluation for specific public health programs at the Centers for Disease Control and Prevention, tells the story of developing an evaluation unit in the Office on Smoking and Health. Lessons about managing evaluation, including his practices and related principles, are…

Schooley, Michael W.

2009-01-01

146

Managed care in the public mental health system  

Microsoft Academic Search

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

1996-01-01

147

Approach for measuring health-related quality management  

Microsoft Academic Search

Purpose – The purpose of this paper is to develop an approach to measuring health-related quality management based on earlier research on the connection between quality management and employee health. Design\\/methodology\\/approach – A questionnaire was developed and a research study was carried out at a manufacturing company. The constructs were tested for internal reliability using Cronbach's alpha tests. The dimensions’

Yvonne Lagrosen; Ingela Bäckström; Håkan Wiklund

2012-01-01

148

Health management and controls for earth to orbit propulsion systems  

Microsoft Academic Search

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 health management. Aerojet's Space Transportation Main Engine controller for the National Launch System is the state of the art in fault tolerant engine avionics. Health management systems provide high levels of automated

R. L. Bickford

1992-01-01

149

Needs Assessment for Health Care Management Education in Russia  

ERIC Educational Resources Information Center

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…

Rekhter, Natalia; Togunov, Igor A.

2006-01-01

150

State substance abuse and mental health managed care evaluation program  

Microsoft Academic Search

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

Dennis McCarty; Joan Dilonardo; Milton Argeriou

2003-01-01

151

Health Professionals' Perceptions of Sexual Assault Management: A Delphi Study  

ERIC Educational Resources Information Center

Objective: To explore health professionals' perceptions of sexual assault management practices and identify issues related to these practices across Western Australia (WA). Design: A two-round electronic Delphi study was undertaken with health professionals (medical doctors, registered nurses, social workers and managers). Setting: Healthcare…

Jancey, Jonine; Meuleners, Lynn; Phillips, Maureen

2011-01-01

152

Health care managers as educational evaluators and accreditation support personnel.  

PubMed

Although health care managers and administrators are often heralded as the foundational support for multifaceted health care institutions, few have been duly credited for their role in evaluating students that they train and precept in the clinical arena. Likewise, the uses and magnitude of the evaluations are often underestimated. This article presents an overview of the traditional role of health care managers, along with their expanded role as evaluators of students in clinical settings. This article also highlights the use of the evaluations from 35 health care managers in the professional development of students and as accreditation support for a university's business college. PMID:20686398

Johnson, Sherryl W

2010-01-01

153

Simulation: A Complementary Method for Teaching Health Services Strategic Management  

PubMed Central

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.

Reddick, W. T.

1990-01-01

154

Health Project Management. A Manual of Procedures for Formulating and Implementing Health Projects.  

ERIC Educational Resources Information Center

The manual presents 16 main steps for health project management, from project formulation through termination. The manual defines a health project as a temporary intensive effort to set up and put into operation a new or revised service that will result in the reduction of specific health or health-related problems. (Typical examples include the…

Bainbridge, J.; Sapirie, S.

155

Managing Home Health Care (For Parents)  

MedlinePLUS

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 ...

156

Decentralisation of general management within the New Zealand health system.  

PubMed

The radical organisation changes implemented in the New Zealand health system in recent years are discussed and analysed in this study which is based upon a review of documents and interviews with general managers of area health boards. Service management, which involves the decentralisation of general management to programme or product groupings (medicine, child health etc) has been widely implemented in almost all boards completely replacing the traditional disciplinary hierarchies. It is also leading to a population-rather than an institutional-based system of management. General managers report positively on the achievements of service management including greater accountability and commitment of clinical staff, innovation and team building, improved performance and service quality, the integration of hospital and community-based care and a customer rather than an occupational orientation. There is an increasing trend towards the recognition of primary health care as a key service entity. PMID:10138683

Malcolm, L; Alp, B; Bryson, J

1994-11-01

157

Reducing Health Cost: Health Informatics and Knowledge Management as a Business and Communication Tool  

NASA Astrophysics Data System (ADS)

Health informatics has the potential to improve the quality and provision of care while reducing the cost of health care delivery. However, health informatics is often falsely regarded as synonymous with information management (IM). This chapter (i) provides a clear definition and characteristic benefits of health informatics and information management in the context of health care delivery, (ii) identifies and explains the difference between health informatics (HI) and managing knowledge (KM) in relation to informatics business strategy and (iii) elaborates the role of information communication technology (ICT) KM environment. This Chapter further examines how KM can be used to improve health service informatics costs, and identifies the factors that could affect its implementation and explains some of the reasons driving the development of electronic health record systems. This will assist in avoiding higher costs and errors, while promoting the continued industrialisation of KM delivery across health care communities.

Gyampoh-Vidogah, Regina; Moreton, Robert; Sallah, David

158

Environmental Management of Pediatric Asthma: Guidelines for Health Care Providers  

ERIC Educational Resources Information Center

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…

Roberts, James R.; McCurdy, Leyla Erk

2005-01-01

159

Geograpical Management of Cancer Health Disparities Program (GMaP)  

Cancer.gov

The Geographical Management of Cancer Health Disparities Program (GMaP), developed with American Recovery and Reinvestment Act (ARRA) administrative supplements, is a systematic and comprehensive approach to facilitating collaboration, cooperation, information- and resource-sharing, and capacity-building among cancer health disparities researchers, trainees, outreach workers, and organizations, with the key goal of advancing cancer health disparities (CHD) research and training.

160

Supporting cancer patients' unanchored health information management with mobile technology  

E-print Network

, Seattle, WA Abstract Cancer patients often need to manage care-related information when they are away from that HealthWeaver Mobile can help patients to access care-related information from anywhere, to capture. The enhanced ability to manage information, in turn, helps patients to manage their care and to feel more

Anderson, Richard

161

Faith and health self-management of rural older adults.  

PubMed

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

Arcury, T A; Quandt, S A; McDonald, J; Bell, R A

2000-01-01

162

[Managing diversity in Swiss Health care].  

PubMed

The development of Migrant Friendly Hospitals is an important first step towards eliminating health care disparities in Switzerland and an important reminder to health policy makers and practitioners across the health care system of their responsibility to provide non-discriminatory quality health care to all patients. PMID:25603570

Bodenmann, P; Bossart, R; Di Bernardo, N; Dominice Dao, M; Durieux, S; Faucherre, F; Hudelson, P; Keller, M; Schuster, S; Zellweger, E; Houmard, S

2014-11-19

163

Recent research in public health surveillance and health management  

Microsoft Academic Search

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,

K. L. Tsui; D. Goldsman; W. Jiang; S. Y. Wong

2010-01-01

164

UNIVERSITY OF CONNECTICUT HEALTH CENTER CORRECTIONAL MANAGED HEALTH CARE  

E-print Network

with fluid retention due to heart failure, renal failure, or hepatic failure. 4. Mechanically Soft Diet concepts related to preventive health maintenance, including health education services and training in self-care skills as a part of inmate health service. Printed education materials shall be made available to all

Oliver, Douglas L.

165

UNIVERSITY OF CONNECICUT HEALTH CENTER CORRECTIONAL MANAGED HEALTH CARE  

E-print Network

include, but is not limited to, emergency health care, sick call, access to medication, dental and mental may sign up for medical, dental, and mental health care, using one form for each request. All services MENTAL HEALTH SERVICES DENTAL SERVICES A completed inmate request form, placed in the "Medical" box

Oliver, Douglas L.

166

Health and safety management systems: liability or asset?  

PubMed

Health and safety management systems have a background in theory and in various interests among employers and workplace health and safety professionals. These have resulted in a number of national systems emanating from national standard-writing centres and from employers' organizations. In some cases these systems have been recognized as national standards. The contenders for an international standard have been the International Organization of Standardization (ISO) and the International Labour Organization (ILO). The quality and environmental management systems of ISO indicate what an ISO health and safety management standard would look like. The ILO Guidelines on Safety and Health Management Systems, by contrast, are stringent, specific and potentially effective in improving health and safety performance in the workplace. PMID:12108116

Bennett, David

2002-01-01

167

No health for all without better trained management.  

PubMed

This article notes that existing health professionals and managers constitute the first 'generation' working in a world where Health for All is a practical possibility because, if founded on community-based public and primary health care with hospitals in support and good intersectoral help, we now have the appropriate technology, access to finance and adequate numbers of health workers. What we still lack are sufficient health professionals, at all levels, with the managerial skills and experience to apply the technology, generate the funding and motivate the staff; making full use of community involvement, the co-operation of other sectors and good relationships with local and central government. Management can be learned both at the workplace and in the training room, and from the managers a few of them will emerge as leaders, with the vision to secure the willing support of others in reaching worthwhile health goals. A very useful publication is the Training Manual on Management of Human Resources for Health, WHO/EDUC/93.201 from World Health Organisation, Geneva, Switzerland. The paper closes with examples illustrating four principles for health management development: finding key points of entry; reaching large numbers; accelerating national self-sufficiency; and international. PMID:10169451

White, D K

1997-01-01

168

Evaluating Soil Health Summary: Soil health can be measured, monitored and managed to increase sustainability and  

E-print Network

to assess the effect of management or evaluate problem areas. Chemical soil characteristics, including pH, soil organic matter, nutrient levels and cation exchange capacity are often part of routine soilEvaluating Soil Health Summary: Soil health can be measured, monitored and managed to increase

Lawrence, Rick L.

169

Health Technologies for the Improvement of Chronic Disease Management  

PubMed Central

Background As part of ongoing efforts to improve the Ontario health care system, a mega-analysis examining the optimization of chronic disease management in the community was conducted by Evidence Development and Standards, Health Quality Ontario (previously known as the Medical Advisory Secretariat [MAS]). Objective The purpose of this report was to identify health technologies previously evaluated by MAS that may be leveraged in efforts to optimize chronic disease management in the community. Data Sources The Ontario Health Technology Assessment Series and field evaluations conducted by MAS and its partners between January 1, 2006, and December 31, 2011. Review Methods Technologies related to at least 1 of 7 disease areas of interest (type 2 diabetes, coronary artery disease, atrial fibrillation, chronic obstructive pulmonary disease, congestive heart failure, stroke, and chronic wounds) or that may greatly impact health services utilization were reviewed. Only technologies with a moderate to high quality of evidence and associated with a clinically or statistically significant improvement in disease management were included. Technologies related to other topics in the mega-analysis on chronic disease management were excluded. Evidence-based analyses were reviewed, and outcomes of interest were extracted. Outcomes of interest included hospital utilization, mortality, health-related quality of life, disease-specific measures, and economic analysis measures. Results Eleven analyses were included and summarized. Technologies fell into 3 categories: those with evidence for the cure of chronic disease, those with evidence for the prevention of chronic disease, and those with evidence for the management of chronic disease. Conclusions The impact on patient outcomes and hospitalization rates of new health technologies in chronic disease management is often overlooked. This analysis demonstrates that health technologies can reduce the burden of illness; improve patient outcomes; reduce resource utilization intensity; be cost-effective; and be a viable contributing factor to chronic disease management in the community. Plain Language Summary People with chronic diseases rely on the health care system to help manage their illness. Hospital use can be costly, so community-based alternatives are often preferred. Research published in the Ontario Health Technology Assessment Series between 2006 and 2011 was reviewed to identify health technologies that have been effective or cost-effective in helping to manage chronic disease in the community. All technologies identified led to better patient outcomes and less use of health services. Most were also cost-effective. Two technologies that can cure chronic disease and 1 that can prevent chronic disease were found. Eight technologies that can help manage chronic disease were also found. Health technologies should be considered an important part of chronic disease management in the community. PMID:24228075

Nikitovic, M; Brener, S

2013-01-01

170

Sensor Technology for Integrated Vehicle Health Management of Aerospace Vehicles  

NASA Technical Reports Server (NTRS)

NASA is focusing considerable efforts on technology development for Integrated Vehicle Health Management systems. The research in this area is targeted toward increasing aerospace vehicle safety and reliability, while reducing vehicle operating and maintenance costs. Onboard, real-time sensing technologies that can provide detailed information on structural integrity are central to such a health management system. This paper describes a number of sensor technologies currently under development for integrated vehicle health management. The capabilities, current limitations, and future research needs of these technologies are addressed.

Prosser, W. H.; Brown, T. L.; Woodard, S. E.; Fleming, G. A.; Cooper, E. G.

2002-01-01

171

Negotiating the new health system: purchasing publicly accountable managed care.  

PubMed

The transformation to managed care is one of the most important and complex changes ever to take place in the American health system. One key aspect of this transformation is its implications for public health policy and practice. Both public and private buyers purchase managed care; increasingly, public programs that used to act as their own insurers (i.e., Medicare, Medicaid and CHAMPUS) are purchasing large quantities of managed care insurance from private companies. The transformation to managed care is altering the manner in which public health policy makers conceive of and carry out public health activities (particularly activities that involve the provision of personal health services). The degree to which managed care changes public health and in turn is altered by public health will depend in great measure on the extent to which public and private policy makers understand the implications of their choices for various aspects of public health and take steps to address them. Because both publicly and privately managed care arrangements are relatively deregulated, much of the dialogue between public health and managed care purchasers can be expected to take place within the context of the large service agreements that are negotiated between buyers and sellers of managed care products. This is particularly true for Medicaid because of the importance of Medicaid coverage, payment and access policies to public health policy makers, and because of the public nature of the Medicaid contracting process. A nationwide study of Medicaid managed care contracts offers the first detailed analysis of the content and structure of managed care service agreements and the public health issues they raise. Four major findings emerge from a review of the contracts. First, most of the agreements fail to address key issues regarding which Medicaid-covered services and benefits are the contractor's responsibility and which remain the residual responsibility of the state agency. Second, most contracts fail to address the legal and structural issues arising from the relationship between the managed care service system and the public health system, including such key matters as access to care for communicable diseases and contractors' relationship to state public health laboratories. Third, many contracts are silent on health agencies' access to data for surveillance and community health measurement purposes. Finally, many contracts may be developed with only a limited understanding of the key public health-related issues facing the community from which the members will be drawn. The CDC and state and local public health agencies must expand their activities in the area of managed care contract specifications. For several years the CDC has been involved in an ongoing effort to develop quality of care measures to be collected from all companies through the HEDIS process. As important as this effort is, it represents only an attempt to measure what managed care does rather than an a priori effort to shape the underlying policy and organizational structure of managed care itself. Integrating managed care with public health policy will require this type of affirmative effort with both Medicaid agencies as well as other managed care purchasers. PMID:9566940

Rosenbaum, S

1998-04-01

172

UNIVERSITY OF CENTRAL FLORIDA 348 Undergraduate Catalog 2014-2015 Health Informatics and Information Management -  

E-print Network

hrs) HIM 3006 Foundations of Health Information Management (HIM) 3 hrs HIM 4508C Quality Management 3 and Information Management - Minor College of Health and Public Affairs Department of Health Management hrs HIM 4656C Health Information Management Systems 3 hrs HSC 3537 Medical Terminology 3 hrs HIM 4226C

Wu, Shin-Tson

173

[Training of the modern clinical physician and public health managers].  

PubMed

Arguments of Russian and foreign specialists that the activities of a modern physician are based on knowledge, habits and skills of a clinician and experience, habits and skills of a manager are discussed. The author proves that managing skills acquired by physician as an element in his/her professional activity through experience should be supplemented by knowledge of modern theory and practice of management. In the twenty-first century modern theory and practice of management should become a universal basis and element of professional cooperation of clinical physicians, physicians working in administration of public health organs and institutions, and public health economists. PMID:11593819

Mitronin, V K

2001-01-01

174

Case management in the social health maintenance organization demonstrations  

PubMed Central

In this article, case management departments and roles during the early years of the social health maintenance organization (S/HMO) demonstrations are compared. These organizations provide acute and chronic care services under a prepaid plan for the elderly. Eligibility criteria for case management and chronic care services at each site are compared, followed by a description of the resultant case mix of members receiving chronic care benefits. Case managers principal activities are described, and a preliminary assessment is made about the strength of the linkages that have been developed between the case management component of these plans and the larger health care system. PMID:10312977

Yordi, Cathleen L.

1988-01-01

175

Aircraft health management network: A user interface  

Microsoft Academic Search

Network management is one of the most discussed topics in the networking fraternity. The efficiency of the network management suit is measured by the number of parameters\\/components handled by the application while making decisions. In the case of Internet-enabled aircrafts, along with network security, even aircraft safety needs to be considered as a factor while designing the network management suit.

N. Thanthry; R. Pendse

2009-01-01

176

School nurse case management: achieving health and educational outcomes.  

PubMed

Educators and health care professionals alike understand that healthy students are likely to be successful learners. The goal of school nurse case management is to support students so that they are ready to learn. This article describes the outcomes of a 4-year process improvement project designed to show the impact of school nurse case management on attendance, behavior, academic performance, quality of life, and health compliance in a large southeastern urban school district. Recognizing a need for standardized practice, the School Health Leadership Team created a case management policy, procedures, forms, a data collection process, and ongoing education and mentoring. The policy enabled school nurses to select students with health and learning needs, target specific outcomes, implement interventions, and document the gains made. In the 4 years of this project, 84% of the students case managed improved in 1 or more of the 5 target areas. PMID:17676967

Bonaiuto, Maria M

2007-08-01

177

Fish Health Management Considerations in Recirculating Aquaculture Systems -Part 1  

E-print Network

Cir 120 Fish Health Management Considerations in Recirculating Aquaculture Systems - Part 1, Tropical Aquaculture Laboratory, Ruskin FL 33570, Program in Fisheries and Aquatic Sciences, School Cooperating. Nick T. Place , Dean Introduction Recirculating aquaculture systems, also known as water reuse

Watson, Craig A.

178

Active Social Media Management: The Case of Health Care  

E-print Network

Given the demand for authentic personal interactions over social media, it is unclear how much firms should actively manage their social media presence. We study this question empirically in a health care setting. We show ...

Miller, Amalia R.

179

Risk management frameworks for human health and environmental risks.  

PubMed

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 Managing Health 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

Jardine, Cindy; Hrudey, Steve; Shortreed, John; Craig, Lorraine; Krewski, Daniel; Furgal, Chris; McColl, Stephen

2003-01-01

180

Dual-Use Aspects of System Health Management  

NASA Technical Reports Server (NTRS)

System Health Management functionality is an essential part of any space launch system. Health management functionality is an integral part of mission reliability, since it is needed to verify the reliability before the mission starts. Health Management is also a key factor in life cycle cost reduction and in increasing system availability. The degree of coverage needed by the system and the degree of coverage made available at a reasonable cost are critical parameters of a successful design. These problems are not unique to the launch vehicle world. In particular, the Intelligent Vehicle Highway System, commercial aircraft systems, train systems, and many types of industrial production facilities require various degrees of system health management. In all of these applications, too, the designers must balance the benefits and costs of health management in order to optimize costs. The importance of an integrated system is emphasized. That is, we present the case for considering health management as an integral part of system design, rather than functionality to be added on at the end of the design process. The importance of maintaining the system viewpoint is discussed in making hardware and software tradeoffs and in arriving at design decisions. We describe an approach to determine the parameters to be monitored in any system health management application. This approach is based on Design of Experiments (DOE), prototyping, failure modes and effects analyses, cost modeling and discrete event simulation. The various computer-based tools that facilitate the approach are discussed. The approach described originally was used to develop a fault tolerant avionics architecture for launch vehicles that incorporated health management as an integral part of the system. Finally, we discuss generalizing the technique to apply it to other domains. Several illustrations are presented.

Owens, P. R.; Jambor, B. J.; Eger, G. W.; Clark, W. A.

1994-01-01

181

Corporate social responsibility and the future health care manager.  

PubMed

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

Collins, Sandra K

2010-01-01

182

Toward a Conceptual Knowledge Management Framework in Health  

PubMed Central

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. PMID:18066388

Lau, Francis

2004-01-01

183

College of Health Sciences HSM Health Services Management  

E-print Network

, medical/moral problems, malpractice, tax laws, contracts, labor law, regulation and institutional of instructor. HSM 354 HEALTH LAW. (3) Introduction to concepts of administrative and tort law applicable

MacAdam, Keith

184

Application of Customer Relationship Management in Health Care  

Microsoft Academic Search

Health care sectors of many nations are now opting for Customer Relationship Management (CRM) for building a bridge of trust between hospital and customer. The CRM system enables health care sectors to get essential customer information and use it as efficiently as possible. CRM orchestrates a number of methodologies in a synchronized approach to delivering healthcare. As one of the

Wan Yina

2010-01-01

185

Managed Care: What Mental Health Counselors Need To Know.  

ERIC Educational Resources Information Center

Surveys leaders from various roles in the managed-care and mental-health professions to identify current and future marketplace trends affecting the clinical practice of mental-health counseling. Identifies training and continuing education needs based upon these interviews. (Author/GCP)

Lawless, Linda L.; Ginter, Earl J.; Kelly, Kevin R.

1999-01-01

186

An Examination of Health Information Management by the Deaf  

ERIC Educational Resources Information Center

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…

Karras, Elizabeth

2010-01-01

187

Fraud in mental health practice: A risk management perspective  

Microsoft Academic Search

Mental health practitioners sometimes face the dilemma of being ethical and honest and thus not meeting client needs, or of committing fraud to meet those needs. This paper presents some precipitants for fraud in mental health. Some costs of fraud are reviewed for administration, policy, and planning, for ethical and legal issues, and in research. Risk management implications are also

William A. Maesen

1991-01-01

188

HELICOPTER HEALTH MONITORING AND FAILURE PREVENTION THROUGH VIBRATION MANAGEMENT  

E-print Network

1 HELICOPTER HEALTH MONITORING AND FAILURE PREVENTION THROUGH VIBRATION MANAGEMENT ENHANCEMENT-58D) helicopters. The instrumented aircraft are at the SCARNG-AASF at McEntire Air National Guard, and the development of long-term helicopter health monitoring and failure prevention methodology based on in

Giurgiutiu, Victor

189

Total quality management in health care: taking stock.  

PubMed

Total quality management (TQM) is gaining momentum in health care. The experiences of pioneering organizations provide insights into the hurdles that many organizations face in implementing TQM. Based on their observations of these pioneers, the authors conclude that there are six key success factors for TQM in health care. This article reviews the success factors, considers the common obstacles to achieving them, and looks at some of the future directions for TQM in health care. PMID:10131012

Melum, M M; Sinioris, M E

1993-01-01

190

Predictors of nurse managers' health in Canadian restructured healthcare settings.  

PubMed

Although nursing leadership roles have been greatly transformed as a result of dramatic changes within healthcare over the past decade, there is little research on the nature of nurse manager work life in current work environments. The purpose of this study was to test a theoretical model derived from Kanter's theory of organizational empowerment: linking nurse managers' perceptions of structural and psychological empowerment to burnout, job satisfaction and physical and mental health. A descriptive, correlational design was used in a sample of 286 first-line (n=202) and middle-level (n=84) hospital-based nurse managers obtained from a provincial registry. Ironically, managers reported high levels of burnout, but good mental and physical health. Middle managers were more empowered and satisfied with their jobs than first-line managers. In both groups, approximately 45% of the variance in job satisfaction and 18-52% of the variance in physical and mental health was explained by empowerment and burnout. Empowered work environments were associated with lower nurse manager burnout and better physical and mental health. The results suggest that creating work environments that provide access to empowerment structures may be a fruitful strategy for creating healthy work environments for nurse managers. PMID:15656251

Laschinger, Heather K Spence; Almost, Joan; Purdy, Nancy; Kim, Julia

2004-11-01

191

School Nurse Case Management: Achieving Health and Educational Outcomes  

ERIC Educational Resources Information Center

Educators and health care professionals alike understand that healthy students are likely to be successful learners. The goal of school nurse case management is to support students so that they are ready to learn. This article describes the outcomes of a 4-year process improvement project designed to show the impact of school nurse case management

Bonaiuto, Maria M.

2007-01-01

192

Job satisfaction and subjective health among sales managers  

Microsoft Academic Search

Purpose – The aim of this study is to examine gender and age correlates of job satisfaction and to test the relationship between job satisfaction and subjective mental and physical health in a sample of sales managers. Design\\/methodology\\/approach – Survey of 200 employees holding the managers' positions (105 men and 95 women) in sales' organizations across the biggest Lithuania's cities

Loreta Gustainien?; Auks? Endriulaitien?

2009-01-01

193

Modelling of risk management in health care facilities  

Microsoft Academic Search

Purpose – To evaluate the use of neural networks in healthcare facilities risk management. Design\\/methodology\\/approach – The data used to develop the input to the national health service facilities risk exposure system (NHSFRES) was solicited from 60 healthcare managers. Risk exposure system has been developed using the risk knowledge that was articulated from experienced healthcare operators through postal questionnaires and

M. I. Okoroh; B. D. Ilozor; P. P. Gombera

2006-01-01

194

Examining the Efficacy of Management for Pennsylvania School Health Programs  

ERIC Educational Resources Information Center

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…

Jacobi, Wendy J.

2010-01-01

195

Physicochemical modifications of conjugated linoleic acid for ruminal protection and oxidative stability  

Microsoft Academic Search

Conjugated linoleic acid (CLA) is a mixture of positional and geometric isomers of octadecadienoic acid [linoleic acid (LA), 18:2n-6]. Although ruminant milk and meat products represent the largest natural source of CLA and therefore, their concentration in ruminant lipids are of interest to human health, chemical or physical modifications of CLA should be needed as a means to enhance oxidative

Hyun-Seuk Moon; Hong-Gu Lee; Chung-Soo Chung; Yun-Jaie Choi; Chong-Su Cho

2008-01-01

196

Identity crisis: financial management in health.  

PubMed

Financial management is something quite different from the "bean-counting" image of the traditional "finance man". It is proactive and is closely tied to the broader range of organizational strategy and environmental constraints. What are the interrelationships that must be recognized in order to make the transition to the central role of financial decision making and management? PMID:10241316

Silvers, J B

1976-01-01

197

Occupational health nurses--the solution to absence management?  

PubMed

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

Wallace, Myra A

2009-03-01

198

What health care managers do: applying Mintzberg's structured observation method.  

PubMed

Aim The aim of the present study was to explore and describe what characterizes first- and second-line health care managers' use of time. Background Many Swedish health care managers experience difficulties managing their time. Methods Structured and unstructured observations were used. Ten first- and second-line managers in different health care settings were studied in detail from 3.5 and 4 days each. Duration and frequency of different types of work activities were analysed. Results The individual variation was considerable. The managers' days consisted to a large degree of short activities (<9 minutes). On average, nearly half of the managers' time was spent in meetings. Most of the managers' time was spent with subordinates and <1% was spent alone with their superiors. Sixteen per cent of their time was spent on administration and only a small fraction on explicit strategic work. Conclusions The individual variations in time use patterns suggest the possibility of interventions to support changes in time use patterns. Implications for nursing management A reliable description of what managers do paves the way for analyses of what they should do to be effective. PMID:19694915

Arman, Rebecka; Dellve, Lotta; Wikström, Ewa; Törnström, Linda

2009-09-01

199

Practices of excellent companies in the managed health care industry.  

PubMed

The health care profession in the USA has traditionally attracted some of the best talent the country has to offer, with medical practitioners enjoying high incomes due to employer-paid medical indemnity insurance plans. There was no oversight process or quality standards governing the health care delivery process and no motivating factors to contain costs. Prior to the introduction of the Knox-Keene Act in the 1970s requiring employers to offer managed care as an alternative indemnity coverage, the only known managed care company was the Kaiser Permanente Medical Plan. Until just over a decade ago, the concept of managed care was stereotyped as a low quality method of health care delivery. Criticisms from providers themselves suggested managed care systems meant withholding medical care for the sake of profit; "production line" medicine, and compromise in the delivery of quality health care. In order to refute that notion and grow as an industry, managed health care companies were required to take steps to prove their integrity, high quality of care, and cost-effective methods. Today the industry is fast growing, setting management practices that are becoming benchmark standards for other industries too. PMID:10177369

Wade, J; Kleiner, B H

1998-01-01

200

[CESAMES, French-speaking international scheme for health managers].  

PubMed

A "Programme de création du Cycle d'Etudes Supérieures Africain en Management des Etablissements Sanitaires" (CESAMES, Plan for African hospital management senior course) was officially launched during the VIth International Hospital Events, organised in Libreville (Gabon) from November 21-23rd 2000. In the context of health systems reforms in African countries, priority is given to adapting and upgrading the qualifications of health care managers. Creating CESAMES is a major element within a general strategy aiming at supporting health systems and present reforms. The aim is to develop, from an African teaching body, a French-speaking pool of skills in order to increase the managers' expertise and to address the problem of critical mass of professionals for training within each country. Creating an international training pool will produce a human resources development and expansion tool in the area of health institutions management. This programme should ensure the transfer of know-how and capitalization between training centres. Beyond the training system, creating CESAMES should expand the documentation resources and ensure the creation of a French-speaking professional network of health institution managers. PMID:11372252

Montserrat, X

2001-01-01

201

Data Base Management System for Tracking Occupational Health  

PubMed Central

There is growing interest in the field of occupational medicine concerning employee health. This interest has been prompted by responsible corporate management as well as to the passage of Federal Legislation. An Occupational Health Information System (OHIS) has been developed to perform data base management functions for tracking employee health. OHIS is comprised of 3 modules which contain personnel, medical, and industrial hygiene/toxicology information. Each module contains information which is integrated into one data base. A dictionary system defining all possible data elements provides powerful analysis and reporting of selected data keys. The present system not only enhances health care delivery by virtue of its reporting and data management capabilities, but provides powerful data analysis capabilities which are otherwise impossible by manual recordkeeping systems.

Soto, R. J.; Kalan, D. A.; Tordoff, R.; Falbo, L. L.; Galatowitsch, J.; Smith, L. W.

1980-01-01

202

Ruminant toxicology diagnostics.  

PubMed

The most common sources of ruminant poisoning are feed and water. Diagnoses are based on history, clinical signs, lesions, laboratory examinations, and analytical chemistry. A complete history is necessary for developing the scheme of laboratory investigation and may be valuable in case of litigation. This article outlines the toxicology involved, as well as the procedures and analytic capability of the tests used for differential diagnosis in these cases. PMID:23101675

Ensley, Steve; Rumbeiha, Wilson

2012-11-01

203

[Organization of health services and tuberculosis care management].  

PubMed

The scope of this study was to analyze the discourse of managers regarding the relationship between the organization of the health services and tuberculosis care management in a city in the metropolitan region of João Pessoa, State of Pernambuco. Using qualitative research in the analytical field of the French line of Discourse Analysis, 16 health workers who worked as members of the management teams took part in the study. The transcribed testimonials were organized using Atlas.ti version 6.0 software. After detailed reading of the empirical material, an attempt was made to identify the paraphrasic, polyssemic and metaphoric processes in the discourses, which enabled identification of the following discourse formation: Organization of the health services and the relation with TB care management: theory and practice. In the discourse of the managers the fragmentation of the actions of control of tuberculosis, the lack of articulation between the services and sectors, the compliance of the specific activities for TB, as well as the lack of strategic planning for management of care of the disease are clearly revealed. In this respect, for the organization of the health services to be effective, it is necessary that tuberculosis be considered a priority and acknowledged as a social problem in the management agenda. PMID:22872350

Barrêto, Anne Jaquelyne Roque; de Sá, Lenilde Duarte; Nogueira, Jordana de Almeida; Palha, Pedro Fredemir; Pinheiro, Patrícia Geórgia de Oliveira Diniz; de Farias, Nilma Maria Porto; Rodrigues, Débora Cezar de Souza; Villa, Tereza Cristina Scatena

2012-07-01

204

Governance in managing public health resources in Brazilian municipalities.  

PubMed

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

Avelino, George; Barberia, Lorena G; Biderman, Ciro

2014-09-01

205

[Health alert management and emerging risk].  

PubMed

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

Pillonel, J

2010-12-01

206

Model Formulation: Health@HomeThe Work of Health Information Management in the Household (HIMH): Implications for Consumer Health Informatics (CHI) Innovations  

Microsoft Academic Search

ObjectiveContemporary 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

Anne Moen; Patricia Flatley Brennan

2005-01-01

207

Post-Soviet transition: improving health services delivery and management.  

PubMed

During the post-Soviet transition of the last 2 decades, ex-Communist countries of the Eastern Bloc, including eastern and central Europe, the Soviet Union, and its satellite and aligned states, have undergone major health system reforms. Many health systems of those countries--previously adopting a Soviet-type Semashko model--are currently called "in transition," as reform agendas, such as shifting to a Bismarck, Beveridge, or mixed financing scheme or adopting new health delivery management policies, are still in development. In this article, we first review common characteristics of Semashko health systems (the predominant health system of Communist countries during the Soviet era) and then discuss the "new public management" principles that ex-Communist countries have recently started to adopt with various degrees of success. We then illustrate experiences with these principles using 2 case studies, from Russia and Albania, and propose health policy options for both cases. Based on a review of the literature and on the our work experience in Russia and Albania, we found that the 2 ex-Semashko systems have not fully capitalized on expected positive outcomes of new public management principles due to low local healthcare financing levels, depreciated healthcare infrastructure and operational capacities, overlapping and contradicting ideology and policies of the former and newer health systems, and finally, lack of leadership that has successful experience with these principles. In the case of pharmaceutical pricing, reimbursement, and access in Russia, we show how a well-intentioned but suboptimally designed and managed pharmaceutical coverage scheme has suffered moral hazard and adverse selection and has adversely impacted the new public management promise of efficient medicine coverage. In the case of Albania, the delayed investment in human resource reform within a depreciated and underfinanced delivery system has adversely affected the implementation of new public management principles. PMID:21598269

Antoun, Joseph; Phillips, Frank; Johnson, Tricia

2011-01-01

208

Regional governance: strategies and disputes in health region management  

PubMed Central

OBJECTIVE To analyze the regional governance of the health systemin relation to management strategies and disputes. METHODOLOGICAL PROCEDURES A qualitative study with health managers from 19 municipalities in the health region of Bahia, Northeastern Brazil. Data were drawn from 17 semi-structured interviews of state, regional, and municipal health policymakers and managers; a focus group; observations of the regional interagency committee; and documents in 2012. The political-institutional and the organizational components were analyzed in the light of dialectical hermeneutics. RESULTS The regional interagency committee is the chief regional governance strategy/component and functions as a strategic tool for strengthening governance. It brings together a diversity of members responsible for decision making in the healthcare territories, who need to negotiate the allocation of funding and the distribution of facilities for common use in the region. The high turnover of health secretaries, their lack of autonomy from the local executive decisions, inadequate technical training to exercise their function, and the influence of party politics on decision making stand as obstacles to the regional interagency committee’s permeability to social demands. Funding is insufficient to enable the fulfillment of the officially integrated agreed-upon program or to boost public supply by the system, requiring that public managers procure services from the private market at values higher than the national health service price schedule (Brazilian Unified Health System Table). The study determined that “facilitators” under contract to health departments accelerated access to specialized (diagnostic, therapeutic and/or surgical) services in other municipalities by direct payment to physicians for procedure costs already covered by the Brazilian Unified Health System. CONCLUSIONS The characteristics identified a regionalized system with a conflictive pattern of governance and intermediate institutionalism. The regional interagency committee’s managerial routine needs to incorporate more democratic devices for connecting with educational institutions, devices that are more permeable to social demands relating to regional policy making. PMID:25210821

dos Santos, Adriano Maia; Giovanella, Ligia

2014-01-01

209

Diabetes in pregnancy: health risks and management  

Microsoft Academic Search

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

Sarah Ali; Anne Dornhorst

2011-01-01

210

Web Application for Managing Electronic Health Records  

Cancer.gov

Technology to empower clinical staff in requesting and designing order sets can be transformative for hospitals and other health care organizations. This software is proving itself vital in building greater order set development efficiencies and in communication among key stakeholders responsible for certain aspects of an order set within an organization.

211

The leadership role of health services managers  

Microsoft Academic Search

This is an overview of the home care sector’s evolution in Canada, including current models and delivery structures, funding, eligibility criteria, and services provided. Cost escalations of the traditional healthcare system and a reduction in federal funding has driven health reform in Canada. This has been accompanied by a major but sporadic expansion of the home care sector across the

Sister Elizabeth Davis

1997-01-01

212

An Intelligent Content Discovery Technique for Health Portal Content Management  

PubMed Central

Background Continuous content management of health information portals is a feature vital for its sustainability and widespread acceptance. Knowledge and experience of a domain expert is essential for content management in the health domain. The rate of generation of online health resources is exponential and thereby manual examination for relevance to a specific topic and audience is a formidable challenge for domain experts. Intelligent content discovery for effective content management is a less researched topic. An existing expert-endorsed content repository can provide the necessary leverage to automatically identify relevant resources and evaluate qualitative metrics. Objective This paper reports on the design research towards an intelligent technique for automated content discovery and ranking for health information portals. The proposed technique aims to improve efficiency of the current mostly manual process of portal content management by utilising an existing expert-endorsed content repository as a supporting base and a benchmark to evaluate the suitability of new content Methods A model for content management was established based on a field study of potential users. The proposed technique is integral to this content management model and executes in several phases (ie, query construction, content search, text analytics and fuzzy multi-criteria ranking). The construction of multi-dimensional search queries with input from Wordnet, the use of multi-word and single-word terms as representative semantics for text analytics and the use of fuzzy multi-criteria ranking for subjective evaluation of quality metrics are original contributions reported in this paper. Results The feasibility of the proposed technique was examined with experiments conducted on an actual health information portal, the BCKOnline portal. Both intermediary and final results generated by the technique are presented in the paper and these help to establish benefits of the technique and its contribution towards effective content management. Conclusions The prevalence of large numbers of online health resources is a key obstacle for domain experts involved in content management of health information portals and websites. The proposed technique has proven successful at search and identification of resources and the measurement of their relevance. It can be used to support the domain expert in content management and thereby ensure the health portal is up-to-date and current. PMID:25654440

2014-01-01

213

Community Health Needs Assessments: Filling Data Gaps for Population Health Research and Management  

PubMed Central

Introduction: Community health needs assessments (CHNA) are completed to meet varied regulatory and statutory requirements for local public health departments, tax-exempt 501(c)(3) hospitals, and Federally Qualified Health Centers. Although compliance is a motivating factor, these entities are committed to understanding the communities they serve and to developing strategies to address health needs and inequities in health and health care. Filling Data Gaps: CHNAs have the potential to improve the health of communities and populations by giving crucial qualitative and quantitative context to hospital and patient data, thereby enhancing opportunities for health services and clinical outcomes researchers. Filling in these data gaps can help to improve population health by highlighting community-and social determinant-related dynamics relevant to the improved health of the community. CHNAs and EHRs for Population Health: Successful models exist that that have used CHNAs and the resulting data to improve population health management and reduce inequities, as do health systems that have used the EHR and community-based performance measurement data to achieve population health goals.

Alberti, Philip

2014-01-01

214

Original article Ruminal fermentative parameters  

E-print Network

of acute lactic acidosis. acidosis / rumen fermentation / protozoa / blood / acid-base status 513 Anim. ResOriginal article Ruminal fermentative parameters and blood acido-basic balance changes during used to study the long-term effects of an acidotic diet on ruminal parameters and blood acid

Paris-Sud XI, Université de

215

Fundamental Technology Development for Gas-Turbine Engine Health Management  

NASA Technical Reports Server (NTRS)

Integrated vehicle health management technologies promise to dramatically improve the safety of commercial aircraft by reducing system and component failures as causal and contributing factors in aircraft accidents. To realize this promise, fundamental technology development is needed to produce reliable health management components. These components include diagnostic and prognostic algorithms, physics-based and data-driven lifing and failure models, sensors, and a sensor infrastructure including wireless communications, power scavenging, and electronics. In addition, system assessment methods are needed to effectively prioritize development efforts. Development work is needed throughout the vehicle, but particular challenges are presented by the hot, rotating environment of the propulsion system. This presentation describes current work in the field of health management technologies for propulsion systems for commercial aviation.

Mercer, Carolyn R.; Simon, Donald L.; Hunter, Gary W.; Arnold, Steven M.; Reveley, Mary S.; Anderson, Lynn M.

2007-01-01

216

The ethical imperative in health services governance and management.  

PubMed

Increasingly, administrative and biomedical ethical issues affect decision making in health services organizations. Although the ethics of biomedical decision making affect governance and management, this article is limited to administrative ethics: fiduciary duty, conflicts of interest, confidential information, resource allocation, and consent. Those who govern and manage health services organizations face an ethical imperative: They are moral agents with an independent duty to protect patients and further their interests. This duty is separate from any existing between care givers--such as physicians--and patients. It may complement other relationships, but it is always present. This imperative will become more difficult to attain. The potential conflict between economic and patient interests lies close to the surface in the patient care relationship, and maintaining it undoubtedly will be exacerbated by competitive pressures. The ethical implications of this conflict for those who govern and manage health services organizations are enormous. PMID:10275565

Darr, K; Longest, B B; Rakich, J S

1986-01-01

217

Factors affecting usage of a personal health record (PHR) to manage health.  

PubMed

As the health care industry shifts into the digital age, patients are increasingly being provided with access to electronic personal health records (PHRs) that are tethered to their provider-maintained electronic health records. This unprecedented access to personal health information can enable patients to more effectively manage their health, but little is actually known about patients' ability to successfully use a PHR to perform health management tasks or the individual factors that influence task performance. This study evaluated the ability of 56 middle-aged adults (40-59 years) and 51 older adults (60-85 years) to use a simulated PHR to perform 15 common health management tasks encompassing medication management, review/interpretation of lab/test results, and health maintenance activities. Results indicated that participants in both age groups experienced significant difficulties in using the PHR to complete routine health management tasks. Data also showed that older adults, particularly those with lower numeracy and technology experience, encountered greater problems using the system. Furthermore, data revealed that the cognitive abilities predicting one's task performance varied according to the complexity of the task. Results from this study identify important factors to consider in the design of PHRs so that they meet the needs of middle-aged and older adults. As deployment of PHRs is on the rise, knowledge of the individual factors that impact effective PHR use is critical to preventing an increase in health care disparities between those who are able to use a PHR and those who are not. PMID:24364414

Taha, Jessica; Czaja, Sara J; Sharit, Joseph; Morrow, Daniel G

2013-12-01

218

Evaluation of computerized health management information system for primary health care in rural India  

PubMed Central

Background The Comprehensive Rural Health Services Project Ballabgarh, run by All India Institute of Medical Sciences (AIIMS), New Delhi has a computerized Health Management Information System (HMIS) since 1988. The HMIS at Ballabgarh has undergone evolution and is currently in its third version which uses generic and open source software. This study was conducted to evaluate the effectiveness of a computerized Health Management Information System in rural health system in India. Methods The data for evaluation were collected by in-depth interviews of the stakeholders i.e. program managers (authors) and health workers. Health Workers from AIIMS and Non-AIIMS Primary Health Centers were interviewed to compare the manual with computerized HMIS. A cost comparison between the two methods was carried out based on market costs. The resource utilization for both manual and computerized HMIS was identified based on workers' interviews. Results There have been no major hardware problems in use of computerized HMIS. More than 95% of data was found to be accurate. Health workers acknowledge the usefulness of HMIS in service delivery, data storage, generation of workplans and reports. For program managers, it provides a better tool for monitoring and supervision and data management. The initial cost incurred in computerization of two Primary Health Centers was estimated to be Indian National Rupee (INR) 1674,217 (USD 35,622). Equivalent annual incremental cost of capital items was estimated as INR 198,017 (USD 4213). The annual savings is around INR 894,283 (USD 11,924). Conclusion The major advantage of computerization has been in saving of time of health workers in record keeping and report generation. The initial capital costs of computerization can be recovered within two years of implementation if the system is fully operational. Computerization has enabled implementation of a good system for service delivery, monitoring and supervision. PMID:21078203

2010-01-01

219

Brief Report: Adolescents' Co-Rumination with Mothers, Co-Rumination with Friends, and Internalizing Symptoms  

ERIC Educational Resources Information Center

The current research examined co-rumination (extensively discussing, rehashing, and speculating about problems) with mothers and friends. Of interest was exploring whether adolescents who co-ruminate with mothers were especially likely to co-ruminate with friends as well as the interplay among co-rumination with mothers, co-rumination with…

Waller, Erika M.; Rose, Amanda J.

2013-01-01

220

Quality of management in the health care system.  

PubMed

Quality of management is a necessary, yet not sufficient, prerequisite in quality of care. There are two main approaches to improved quality. One is the individualist approach, where the role of the manager is emphasized. The other is the contextual approach. Focus is on managerial prerequisites such as organizational structure, culture, participation in decision making, and use of management time. Individualist as well as contextualist approaches are presented. Each decade during the 20th century has had its own "pet theory" regarding what problems the manager should allocate time on. A study of 41 Nordic public health researchers illustrates that cost-benefit analysis is the best known of ten theories. Management ethics, with the manager as ideologist, is seen as particularly demanding on managerial creativity. PMID:1983249

Borgenhammar, E

1990-01-01

221

Integrated Systems Health Management (ISHM) Toolkit  

NASA Technical Reports Server (NTRS)

A framework of software components has been implemented to facilitate the development of ISHM systems according to a methodology based on Reliability Centered Maintenance (RCM). This framework is collectively referred to as the Toolkit and was developed using General Atomics' Health MAP (TM) technology. The toolkit is intended to provide assistance to software developers of mission-critical system health monitoring applications in the specification, implementation, configuration, and deployment of such applications. In addition to software tools designed to facilitate these objectives, the toolkit also provides direction to software developers in accordance with an ISHM specification and development methodology. The development tools are based on an RCM approach for the development of ISHM systems. This approach focuses on defining, detecting, and predicting the likelihood of system functional failures and their undesirable consequences.

Venkatesh, Meera; Kapadia, Ravi; Walker, Mark; Wilkins, Kim

2013-01-01

222

A diet supplement for captive wild ruminants.  

PubMed

Nutritional husbandry of captive wild ruminants often requires feeding these animals a supplemental diet to enhance their health, reproductive performance, and productivity. Although supplemental diets for wild ruminants are commercially available, few have been evaluated in controlled intake and digestion trials. Voluntary intake, digestive efficiency, nitrogen retention, and gross energy utilization of pronghorn (Antilocapra americana), mule deer (Odocoileus hemionus), mountain sheep (Ovis canadensis), mountain goats (Oreamnos americanus), and wapiti (Cervus elaphus) consuming a high-energy, high-protein pelleted supplement were compared. Voluntary intake of dry matter, energy, and nitrogen were similar (P > 0.34) between mountain goats and mountain sheep and consistently lower (P < 0.03) for these species than for pronghorn, mule deer, and wapiti. Differences in digestive efficiency among species were inversely related to dry matter intake rates. Apparent digestibility of dry matter, organic matter, and neutral-detergent fiber was 10-20% higher for mountain goats and mountain sheep than for the other species (P < 0.04). Although these findings suggest a superior digestive efficiency for mountain goats and mountain sheep, species comparisons are inconclusive because of the confounding effects of season and ambient temperature on voluntary intake and digestion. Under the conditions of this experiment, the diet tested was safe, nutritious, and highly palatable. Protein and energy concentrations appear to be sufficient to meet or exceed known nutritional requirements of captive wild ruminants. PMID:9732028

Baker, D L; Stout, G W; Miller, M W

1998-06-01

223

A Hierarchical Model-based approach to Systems Health Management  

Microsoft Academic Search

Integrated Systems Health Management (ISHM) provides the ability to maintain system health and performance over the life of a system. For safety-critical systems, ISHM must maintain safe operations while increasing availability by preserving functionality and minimizing downtime. This paper discusses a model-based approach to ISHM that combines fault detection, isolation and identification, fault-adaptive control, and prognosis into a common framework.

Gautam Biswas; Sankaran Mahadevan

2007-01-01

224

Managing stress in health social work roles today.  

PubMed

Stress on social workers in health settings is of increasing professional interest and concern. This article suggests individual and system sources of such stress and outlines pathways for nurture of the authentic and creative self in health careers. Replenishing measures include empowerment through teamwork, stress management techniques, consciousness raising to alter self defeating cognitions, and activities within and outside the setting to enrich definition and use of self. PMID:2237717

Dillon, C

1990-01-01

225

Perspectives on HealthCare Resource Management Problems  

Microsoft Academic Search

\\u000a Research devoted to health-care applications has grown increasingly within operations research over the past 30 years, with\\u000a over 200 presentations at the 2008 INFORMS conference. Resource management is of particular importance within healthcare because\\u000a of the system’s unique objectives and challenges. We provide a perspective of the current health-care literature, focusing\\u000a on recent papers in planning and scheduling and reviewing

Jonathan Turner; Sanjay Mehrotra; Mark S. Daskin

226

Health management and controls for earth to orbit propulsion systems  

NASA Astrophysics Data System (ADS)

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 health management. Aerojet's Space Transportation Main Engine controller for the National Launch System is the state of the art in fault tolerant engine avionics. Health management 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.

Bickford, R. L.

1992-08-01

227

Health Management Technology as a General Solution Framework  

NASA Astrophysics Data System (ADS)

Health maintenance and improvement of humans, artifacts, and nature are pressing requirements considering the problems human beings have faced. In this article, the health management technology is proposed by centering cause-effect structure. The important aspect of the technology is evolvement through human-machine collaboration in response to changes of target systems. One of the reasons why the cause-effect structure is centered in the technology is its feature of transparency to humans by instinct point of view. The notion has been spreaded over wide application areas such as quality control, energy management, and healthcare. Some experiments were conducted to prove effectiveness of the technology in the article.

Nakajima, Hiroshi; Hasegawa, Yoshifumi; Tasaki, Hiroshi; Iwami, Taro; Tsuchiya, Naoki

228

Your Money or Your Life: Managing Health, Managing Money  

Microsoft Academic Search

Using the Panel Study of Income Dynamics, this paper examines the relationship between non-collateralized debt (NCD) and health\\u000a behaviors. The results reveal that households whose members tend to lead less healthy lifestyles are more likely to hold NCD.\\u000a There are three possible underlying hypotheses that may explain these relationships: (a) common factors, such as preferences,\\u000a shaping both debt and poorer

Irina B. Grafova

2007-01-01

229

Faith and health self-management of rural older adults  

Microsoft Academic Search

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

2000-01-01

230

Peste des petits ruminants.  

PubMed

The peste des petits ruminants (PPR) is proving to be a disease which has an increasingly significant economic impact on a number of countries in Africa and the Middle East, and possibly also on the Indian sub-continent. The antigenic relationships which exist between the PPR and rinderpest viruses pose problems for diagnosis which complicates rinderpest control and eradication programmes. Progress has recently been made in regard to diagnosis (specific nucleic probes and monoclonal antibodies), as well as control (homologous vaccine). International legislation remains to be established and epidemiological surveys should be conducted in order to determine the exact geographical distribution of the disease. PMID:2132714

Lefèvre, P C; Diallo, A

1990-12-01

231

Petroleum and Health Care: Evaluating and Managing Health Care's Vulnerability to Petroleum Supply Shifts  

PubMed Central

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. PMID:21778473

Bednarz, Daniel; Bae, Jaeyong; Pierce, Jessica

2011-01-01

232

MSc/PgDip Global Health and Management Student Information booklet  

E-print Network

MSc/PgDip Global Health and Management Student Information booklet Work based placements Providing opportunities for MSc Global Health & Management students to engage with organisations to undertake meaningful projects www.abdn.ac.uk/msc/global-health #12;Contents About the MSc Global Health & Management Programme 3

Levi, Ran

233

Continuous Case Management of a German Statutory Health Insurance  

PubMed Central

To support insured patients, especially those with chronic illnesses or disabilities, the German statutory health insurance Techniker Krankenkasse (TK) offers continuous case management (CCM) under a rehabilitation advisory program serving more than 150,000 insurees each year. Rehabilitation advisors provide individual counseling, generally by telephone. They inform patients about treatment and rehabilitation options, about health care providers, and about other TK services. In a key feature, the model coordinates care across different health care sectors. Through the CCM approach, TK not only assures the best possible care for its insurees, but also safeguards its long-term financial sustainability PMID:17288078

Hecke, Torsten L.; Erzberger, Melanie

2005-01-01

234

School Health Connection Goes Electronic: Developing a Health Information Management System for New Orleans' School-Based Health Centers. Program Results Report  

ERIC Educational Resources Information Center

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

Rastorfer, Darl

2011-01-01

235

Towards a Framework for Requirement Change Management in HealthCare Software Applications  

E-print Network

Towards a Framework for Requirement Change Management in HealthCare Software Applications Arash Management, Design, Standardization. Keywords Software Requirement; Change management; Ontology; Agent 1. 1). This framework helps to capture, track, represent and manage the changes in a formal

Haarslev, Volker

236

Health insurance in India: need for managed care expertise.  

PubMed

Health insurers in India currently face many challenges, including poor consumer awareness, strict regulations, and inefficient business practices. They operate under a combination of stifling administrative costs and high medical expense ratios which have ensured that insurers operate under steep losses. External factors (eg, onerous regulations, lack of standards, high claims payouts) and internal factors (eg, high administrative costs, dependence on indemnity models that cover inpatient treatment costs only) have forced the health insurance industry into a regressive spiral. To overcome these challenges, health insurers need to innovate in their product offerings and tighten their existing processes and cost structures. But as a long-term strategy, it is imperative that health insurers deploy managed care concepts, which will go a long way toward addressing the systemic issues in the current operational models of health plans. PMID:21473657

Thomas, Thomas K

2011-02-01

237

The impact of an integrated population health enhancement and disease management program on employee health risk, health conditions, and productivity.  

PubMed

This study evaluated the impact of an integrated population health enhancement program on employee health risks, health conditions, and productivity. Specifically, we analyzed changes in these measures among a cohort of 543 employees who completed a health risk assessment in both 2003 and 2005. We compared these findings with 2 different sets of employees who were not offered health enhancement programming. We found that the DIRECTV cohort showed a significant reduction in health risks after exposure to the program. Relative to a matched comparison group, the proportion of low-risk employees at DIRECTV in 2005 was 8.2 percentage points higher; the proportion of medium-risk employees was 7.1 percentage points lower; and the proportion of high-risk employees was 1.1 percentage points lower (p < 0.001). The most noticeable changes in health risk were a reduction in the proportion of employees with high cholesterol; an improvement in diet; a reduction of heavy drinking; management of high blood pressure; improved stress management; increased exercise; fewer smokers; and a drop in obesity rates. We also found that a majority of employees who improved their risk levels from 2003 to 2005 maintained their gains in 2006. Employees who improved their risks levels also demonstrated relative improvement in absenteeism. Overall, this study provides additional evidence that integrated population health enhancement positively impacts employees' health risk and productivity; it also reinforces the view that "good health is good business." PMID:19108644

Loeppke, Ron; Nicholson, Sean; Taitel, Michael; Sweeney, Matthew; Haufle, Vince; Kessler, Ronald C

2008-12-01

238

Health and wellness: the shift from managing illness to promoting health.  

PubMed

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

Draper, Debra A; Tynan, Ann; Christianson, Jon B

2008-06-01

239

Can action research strengthen district health management and improve health workforce performance? A research protocol  

PubMed Central

Introduction The single biggest barrier for countries in sub-Saharan Africa (SSA) to scale up the necessary health services for addressing the three health-related Millennium Development Goals and achieving Universal Health Coverage is the lack of an adequate and well-performing health workforce. This deficit needs to be addressed both by training more new health personnel and by improving the performance of the existing and future health workforce. However, efforts have mostly been focused on training new staff and less on improving the performance of the existing health workforce. The purpose of this paper is to disseminate the protocol for the PERFORM project and reflect on the key challenges encountered during the development of this methodology and how they are being overcome. Methods The overall aim of the PERFORM project is to identify ways of strengthening district management in order to address health workforce inadequacies by improving health workforce performance in SSA. The study will take place in three districts each in Ghana, Tanzania and Uganda using an action research approach. With the support of the country research teams, the district health management teams (DHMTs) will lead on planning, implementation, observation, reflection and redefinition of the activities in the study. Taking into account the national and local human resource (HR) and health systems (HS) policies and practices already in place, ‘bundles’ of HR/HS strategies that are feasible within the context and affordable within the districts’ budget will be developed by the DHMTs to strengthen priority areas of health workforce performance. A comparative analysis of the findings from the three districts in each country will add new knowledge on the effects of these HR/HS bundles on DHMT management and workforce performance and the impact of an action research approach on improving the effectiveness of the DHMTs in implementing these interventions. Discussion Different challenges were faced during the development of the methodology. These include the changing context in the study districts, competing with other projects and duties for the time of district managers, complexity of the study design, maintaining the anonymity and confidentiality of study participants as well as how to record the processes during the study. We also discuss how these challenges are being addressed. The dissemination of this research protocol is intended to generate interest in the PERFORM project and also stimulate discussion on the use of action research in complex studies such as this on strengthening district health management to improve health workforce performance. PMID:23996825

Mshelia, C; Huss, R; Mirzoev, T; Elsey, H; Baine, S O; Aikins, M; Kamuzora, P; Bosch-Capblanch, X; Raven, J; Wyss, K; Green, A; Martineau, T

2013-01-01

240

21 CFR 589.2000 - Animal proteins prohibited in ruminant feed.  

Code of Federal Regulations, 2012 CFR

...2012-04-01 2012-04-01 false Animal proteins prohibited in ruminant feed...HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS SUBSTANCES PROHIBITED FROM USE IN ANIMAL FOOD OR FEED Listing of...

2012-04-01

241

21 CFR 589.2000 - Animal proteins prohibited in ruminant feed.  

Code of Federal Regulations, 2011 CFR

...2011-04-01 2011-04-01 false Animal proteins prohibited in ruminant feed...HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS SUBSTANCES PROHIBITED FROM USE IN ANIMAL FOOD OR FEED Listing of...

2011-04-01

242

21 CFR 589.2000 - Animal proteins prohibited in ruminant feed.  

Code of Federal Regulations, 2013 CFR

...2013-04-01 2013-04-01 false Animal proteins prohibited in ruminant feed...HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS SUBSTANCES PROHIBITED FROM USE IN ANIMAL FOOD OR FEED Listing of...

2013-04-01

243

21 CFR 589.2000 - Animal proteins prohibited in ruminant feed.  

Code of Federal Regulations, 2014 CFR

...2014-04-01 2014-04-01 false Animal proteins prohibited in ruminant feed...HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS SUBSTANCES PROHIBITED FROM USE IN ANIMAL FOOD OR FEED Listing of...

2014-04-01

244

Training evaluation: a case study of training Iranian health managers  

PubMed Central

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 health managers and trainers. This process was also intended to develop the capacity of the National Public Health Management Centre in Tabriz, Iran, to enable it to organize relevant short courses in health management on a continuing basis. A total of seven short training courses were implemented, three in the United Kingdom and four in Tabriz, with 35 participants. A detailed evaluation of the courses was undertaken to guide future development of the training programmes. Methods The Kirkpatrick framework for evaluation of training was used to measure participants' reactions, learning, application to the job, and to a lesser extent, organizational impact. Particular emphasis was put on application of learning to the participants' job. A structured questionnaire was administered to 23 participants, out of 35, between one and 13 months after they had attended the courses. Respondents, like the training course participants, were predominantly from provincial universities, with both health system and academic responsibilities. Interviews with key informants and ex-trainees provided supplemental information, especially on organizational impact. Results Participants' preferred interactive methods for learning about health planning and management. They found the course content to be relevant, but with an overemphasis on theory compared to practical, locally-specific information. In terms of application of learning to their jobs, participants found specific information and skills to be most useful, such as health systems research and group work/problem solving. The least useful areas were those that dealt with training and leadership. Participants reported little difficulty in applying learning deemed "useful", and had applied it often. In general, a learning area was used less when it was found difficult to apply, with a few exceptions, such as problem-solving. Four fifths of respondents claimed they could perform their jobs better because of new skills and more in-depth understanding of health systems, and one third had been asked to train their colleagues, indicating a potential for impact on their organization. Interviews with key informants indicated that job performance of trainees had improved. Conclusion The health management training programmes in Iran, and the external university involved in capacity building, benefited from following basic principles of good training practice, which incorporated needs assessment, selection of participants and definition of appropriate learning outcomes, course content and methods, along with focused evaluation. Contracts for external assistance should include specific mention of capacity building, and allow for the collaborative development of courses and of evaluation plans, in order to build capacity of local partners throughout the training cycle. This would also help to develop training content that uses material from local health management situations to demonstrate key theories and develop locally required skills. Training evaluations should as a minimum assess participants' reactions and learning for every course. Communication of evaluation results should be designed to ensure that data informs training activities, as well as the health and human resources managers who are investing in the development of their staff. PMID:19265528

Omar, Maye; Gerein, Nancy; Tarin, Ehsanullah; Butcher, Christopher; Pearson, Stephen; Heidari, Gholamreza

2009-01-01

245

Occupational health and safety management in polish enterprises implementing total quality management systems.  

PubMed

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

Podgórski, D

2000-01-01

246

Oceans and Human Health: Linking Ocean, Organism, and Human Health for Sustainable Management of Coastal Ecosystems  

NASA Astrophysics Data System (ADS)

Scientists and policy-makers are increasingly recognizing that sustainable coastal communities depend on healthy and resilient economies, ecosystems, and people, and that the condition or "health" of the coastal ocean and humans are intimately and inextricably connected. A wealth of ecosystem services provided by ocean and coastal environments are crucial for human survival and well being. Nonetheless, the health of coastal communities, their economies, connected ecosystems and ecosystem services, and people are under increasing threats from health risks associated with environmental degradation, climate change, and unwise land use practices, all of which contribute to growing burdens of naturally-occurring and introduced pathogens, noxious algae, and chemical contaminants. The occurrence, frequency, intensity, geographic range, and number and kinds of ocean health threats are increasing, with concomitant health and economic effects and eroding public confidence in the safety and wholesomeness of coastal environments and resources. Concerns in the research and public health communities, many summarized in the seminal 1999 NRC Report, From Monsoons to Microbes and the 2004 final report of the US Commission on Ocean Policy, resulted in establishment of a new "meta-discipline" known as Oceans and Human Health (OHH). OHH brings together practitioners in oceanography, marine biology, ecology, biomedical science, medicine, economics and other social sciences, epidemiology, environmental management, and public health to focus on water- and food-borne causes of human and animal illnesses associated with ocean and coastal systems and on health benefits of seafood and other marine products. It integrates information across multiple disciplines to increase knowledge of ocean health risks and benefits and communicate such information to enhance public safety. Recognizing the need for a comprehensive approach to ocean health threats and benefits, Congress passed the Oceans and Human Health Act of 2004. Major outcomes of the OHH Act of 2004 include: --A national focus on ocean health and its relation to human health and well-being; --Enhanced interagency coordination and cooperation in research, development, and education; --Emphasis on development of a new, interdisciplinary community of practice; --Increased understanding of linkages between marine animal health and human health and the dangers of transmission of zoonotic diseases from the marine environment; --A richer understanding of factors affecting the occurrence and impacts of ocean health threats; --An enhanced ability of the ocean science and public health communities to respond to health-related emergencies; --A strong focus on development of ecological forecasts that are providing early warning of ocean health threats and impacts, thus improving the effectiveness of protection and mitigation actions. Taken together, these outcomes contribute significantly to more sustainable management of coastal resources and communities.

Sandifer, P. A.; Trtanj, J.; Collier, T. K.

2012-12-01

247

Managing mechanistic and organic structure in health care organizations.  

PubMed

Managers at all levels in a health care organization must organize work to achieve the organization's mission and goals. This requires managers to decide the organization structure, which involves dividing the work among jobs and departments and then coordinating them all toward the common purpose. Organization structure, which is reflected in an organization chart, may range on a continuum from very mechanistic to very organic. Managers must decide how mechanistic versus how organic to make the entire organization and each of its departments. To do this, managers should carefully consider 5 factors for the organization and for each individual department: external environment, goals, work production, size, and culture. Some factors may push toward more mechanistic structure, whereas others may push in the opposite direction toward more organic structure. Practical advice can help managers at all levels design appropriate structure for their departments and organization. PMID:23111488

Olden, Peter C

2012-01-01

248

Multi Source Data Integration for Aircraft Health Management  

Microsoft Academic Search

Modern aircraft are capable of generating and collecting massive quantities of data from flight recorders, maintenance reports, logistics, and mission-readiness reporting systems. Current aircraft system health management schemes are developed based on data sources consisting of the aircraft's system operational conditions or maintenance and repair actions; however, crucial information regarding flight condition and situational parameters are often disregarded or used

Estefan M. Ortiz; G. J. Clark; A. Babbar; J. L. Vian; V. L. Syrmos; M. M. Arita

2008-01-01

249

IMPROVING METHODS FOR MANAGING HEALTH AND EXPOSURE DATA  

EPA Science Inventory

The project in Colorado is evaluating the use of GIS as a tool for studying the potential impacts of exposure to DBPs from different disinfection treatments on reproductive health in populations in Colorado. GIS is a data management and visualization tool that is assisting in stu...

250

Snapshots of health care managers: a measure of leadership.  

PubMed

Based on a global survey of leaders, this article examines the challenges facing health care managers today and uncovers best practices to develop and select leaders, especially those on the frontline. Highlights include hiring processes that identify motivated, potential leaders who have the knowledge, experience, competencies, and attributes to get the job done. PMID:17314629

Burns, Janice

2007-01-01

251

Managing Mental Health Crises of Foreign College Students.  

ERIC Educational Resources Information Center

Notes that student services professionals manage a number of mental health crises as part of their job responsibilities. Examines some issues that arise from assisting foreign college students experiencing such crises, with special focus on psychiatric committal, withdrawal from school, and return to the home country. (Author)

Oropeza, Barbara A. Clark; And Others

1991-01-01

252

Executive Education Graduate Certificate in Health Care Management  

E-print Network

identify key benefits that affect care and satisfaction issues for different patient segments. They also advantage and growth in their organizations. Strategic Marketing and Patient Management Participants critical hospital-based health care processes, while improving efficiency and maintaining patient safety

253

Dr. Martin Luther King, Jr. Health Center's Community Management System  

Microsoft Academic Search

This article presents the case of the Dr. Martin Luther King Jr. Health Center's unique community management system in which neighborhood workers have been developed to assume managerial responsibilities and are directing the Center. The Martin Luther King Center experience is instructive because the Center was able to achieve significant community control by focusing primarily on the internal dimension of

Noel M. Tichy; June Irmiger Taylor

1976-01-01

254

Lifestyle Management Program: Promoting Cardiovascular Health: in Community College Campuses.  

ERIC Educational Resources Information Center

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: blood…

Castro, Felipe G.; Jichaku, Patrick

255

Leadership Succession Management in a University Health Faculty  

ERIC Educational Resources Information Center

We report on a succession planning pilot project in an Australian university health faculty. The programme aimed to enhance organisational stability and develop leadership capacity in middle level academics. Six monthly sessions addressed university and general leadership topics, communication, decision-making, working with change, self-management

McMurray, Anne M.; Henly, Debra; Chaboyer, Wendy; Clapton, Jayne; Lizzio, Alf; Teml, Martin

2012-01-01

256

Veterinary dairy herd health management in Europe Constraints and perspectives  

Microsoft Academic Search

The nature of veterinary work in dairy health management in Europe has changed over the past years and will change even more dramatically in the near future. The consumers and the media show increasing concern about animal welfare, safety of products of animal origin and traceability of animal products. Farmers in Europe have to produce under strict, often expensive and

J. Cannas da Silva; J. P. T. M. Noordhuizen; M. Vagneur; R. Bexiga; C. C. Gelfert; W. Baumgartner

2006-01-01

257

Outcomes Assessment in Accredited Health Information Management Programs  

ERIC Educational Resources Information Center

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,…

Bennett, Dorine

2010-01-01

258

[Financial incentives in workers' health management].  

PubMed

In the countries of the European Union, several million workers meet with an accident every year. In the national economy, the costs of accidents at work and occupational diseases are born by different institutions in different proportions, and they are estimated at several percent of the gross domestic product of each of these countries. The issue concerning economic consequences of occupational diseases and accidents at work has been emphasized in the section on health and safety at work of the Community Strategy for 2007-2012. Bearing this in mind, the need have arose to strengthen the efficiency of legal instruments and economic stimuli to motivate actions aimed at improving work conditions. Economic stimuli and legal instruments complement each other in the process of motivating various institutions. The following kinds of economic stimuli have been distinguished: subsidies, grants and financial assistance of the state and stimuli incorporated into tax and insurance systems. Economic evaluation at the information, allocation and educational levels, being an economic tool, may support policymakers who can use this tool to asses economic efficiency of decisions made in the area of health and safety of workers as well as to asses economic consequences of the functioning of legal instruments. The aim of the project, implemented under the Seventh Framework Program by the Nofer Institute of Occupational Medicine, is to promote the system of economic stimuli understood as an incentive to undertake actions for the improvement of work conditions. Owing to this project the discussion forum, addressed to relevant and interested social partners, will be established, and experts in the field will assist in determining directions of further actions aimed at advancing motivation systems. PMID:19227888

Rydlewska-Liszkowska, Izabela

2008-01-01

259

9 CFR 98.14 - Health certificate.  

Code of Federal Regulations, 2010 CFR

...IMPORTATION OF CERTAIN ANIMAL EMBRYOS AND ANIMAL SEMEN Ruminant and Swine Embryos From Regions Where Rinderpest or Foot-and-Mouth Disease Exists § 98.14 Health certificate. (a) Ruminant and swine embryos shall not be...

2010-01-01

260

[Operational units for health risk management (patient safety)].  

PubMed

In 1995 INSALUD began to develop performance measures in the field of risk management, and following transfer of powers to the regions, these led to the development of operational units in individual healthcare centres. These units, which consist of a group of health professionals, including managers, aim to identify, evaluate, analyse and deal with health risks, to enhance patient safety. Their organisational structure can vary in accordance with the needs, resources and philosophy of each individual organisation. This paper presents the experience of the risk management units developed in four Spanish regions: Madrid, the Basque Country, Galicia and INGESA (Ceuta and Melilla). It also includes reflections on assessment of their impact and on their future role in improving safety in healthcare services. PMID:19572456

Pardo Hernández, A; Claveria Fontán, A; García Urbaneja, M; López Barba, J

2008-12-01

261

Solid health care waste management status at health care centers in the West Bank - Palestinian Territory  

SciTech Connect

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 4720.7 m{sup 3} (288.1 tons) of SHCW are generated monthly by the HCCs in the West Bank. This study concluded that: (i) current HCWM practices do not meet HCWM standards recommended by the World Health Organization (WHO) or adapted by developed countries, and (ii) immediate attention should be directed towards improvement of HCWM facilities and development of effective legislation. To improve the HCWM in the West Bank, a national policy should be implemented, comprising a comprehensive plan of action and providing environmentally sound and reliable technological measures.

Al-Khatib, Issam A. [Institute of Environmental and Water Studies, Birzeit University, P.O. Box 14, Birzeit, Ramallah, West Bank (Palestinian Territory, Occupied)], E-mail: ikhatib@birzeit.edu; Sato, Chikashi [Department of Civil and Environmental Engineering, Idaho State University, Pocatello, Idaho (United States)

2009-08-15

262

Financial impact of population health management programs: reevaluating the literature.  

PubMed

Although many employers offer some components of worksite-based population health management (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

2012-06-01

263

Commercial Aircraft Integrated Vehicle Health Management Study  

NASA Technical Reports Server (NTRS)

Statistical data and literature from academia, industry, and other government agencies were reviewed and analyzed to establish requirements for fixture work in detection, diagnosis, prognosis, and mitigation for IVHM related hardware and software. Around 15 to 20 percent of commercial aircraft accidents between 1988 and 2003 involved inalftfnctions or failures of some aircraft system or component. Engine and landing gear failures/malfunctions dominate both accidents and incidents. The IVI vl Project research technologies were found to map to the Joint Planning and Development Office's National Research and Development Plan (RDP) as well as the Safety Working Group's National Aviation Safety Strategic. Plan (NASSP). Future directions in Aviation Technology as related to IVHlvl were identified by reviewing papers from three conferences across a five year time span. A total of twenty-one trend groups in propulsion, aeronautics and aircraft categories were compiled. Current and ftiture directions of IVHM related technologies were gathered and classified according to eight categories: measurement and inspection, sensors, sensor management, detection, component and subsystem monitoring, diagnosis, prognosis, and mitigation.

Reveley, Mary S.; Briggs, Jeffrey L.; Evans, Joni K.; Jones, Sharon Monica; Kurtoglu, Tolga; Leone, Karen M.; Sandifer, Carl E.; Thomas, Megan A.

2010-01-01

264

Organizing and managing care in a changing health system.  

PubMed Central

OBJECTIVE: To examine ways in which the management and organization of medical care is changing in response to the shifting incentives created by managed care. DATA SOURCES: Site visits conducted in 12 randomly selected communities in 1996/ 1997. STUDY DESIGN: Approximately 35-60 interviews were conducted per site with key informants in healthcare and community organizations; about half were with providers. DATA COLLECTION: A standardized interview protocol was implemented across all sites, enabling cross-site comparisons. Multiple respondents were interviewed on each issue. PRINCIPAL FINDINGS: A great deal of experimentation and apparent duplication exist in efforts to develop programs to influence physician practice patterns. Responsibility for managing care is being contested by health plans, medical groups and hospitals, as each seeks to accrue the savings that can result from the more efficient delivery of care. To manage the financial and clinical risk, providers are aggressively consolidating and reorganizing. Most significant was the rapid formation of intermediary organizations, such as independent practice arrangements (IPAs), physician-hospital organizations (PHOs), or management services organizations (MSOs), for contracting with managed care organizations. CONCLUSIONS: Managed care appears to have only a modest effect on how healthcare organizations deliver medical care, despite the profound effect that managed care has on how providers are organized. Rather than improving the efficiency of healthcare organizations, provider efforts to build large systems and become indispensable to health plans are exacerbating problems of excess capacity. It is not clear if new organizational arrangements will help providers manage the changing incentives they face, or if their intent is to blunt the effects of the incentives by forming larger organizations to improve their bargaining power and resist change. PMID:10778823

Kohn, L T

2000-01-01

265

Graduate Research Assistant Position in Health Informatics One Graduate Research Assistant position is available at Department of Health Management and  

E-print Network

of Health Management and Informatics University of Missouri School of Medicine CE728 Clinical Support Graduate Research Assistant Position in Health Informatics One Graduate Research Assistant position is available at Department of Health Management and Informatics (HMI) for full time resident

Noble, James S.

266

Reverse quality management: developing evidence-based best practices in health emergency management.  

PubMed

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

Lynch, Tim; Cox, Paul

2006-01-01

267

9 CFR 93.425 - Declaration for ruminants.  

Code of Federal Regulations, 2010 CFR

...2010-01-01 false Declaration for ruminants. 93.425 Section 93.425 Animals...OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants Mexico 10 § 93.425 Declaration for ruminants. For all ruminants offered for...

2010-01-01

268

9 CFR 93.414 - Milk from quarantined ruminants.  

Code of Federal Regulations, 2010 CFR

...2010-01-01 false Milk from quarantined ruminants. 93.414 Section 93.414 Animals...OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants § 93.414 Milk from quarantined ruminants. Milk or cream from ruminants...

2010-01-01

269

BERNARDO RAMIREZ, M.D., M.B.A. Department of Health Management and Informatics  

E-print Network

; Managerial Epidemiology; Issues and Trends for the Health Professions; The U.S.A. Healthcare System). Courses Developed: International Healthcare Systems; Strategic Management; Health Ethics, Managed Care; Managerial Epidemiology; Interdisciplinary Study Abroad in Costa Rica; The Costa Rican Healthcare System

Wu, Shin-Tson

270

Risk management assessment of Health Maintenance Organisations participating in the National Health Insurance Scheme  

PubMed Central

Background: The National Health Insurance Scheme (NHIS), operated majorly in Nigeria by health maintenance organisations (HMOs), took off formally in June 2005. In view of the inherent risks in the operation of any social health insurance, it is necessary to efficiently manage these risks for sustainability of the scheme. Consequently the risk-management strategies deployed by HMOs need regular assessment. This study assessed the risk management in the Nigeria social health insurance scheme among HMOs. Materials and Methods: Cross-sectional survey of 33 HMOs participating in the NHIS. Results: Utilisation of standard risk-management strategies by the HMOs was 11 (52.6%). The other risk-management strategies not utilised in the NHIS 10 (47.4%) were risk equalisation and reinsurance. As high as 11 (52.4%) of participating HMOs had a weak enrollee base (less than 30,000 and poor monthly premium and these impacted negatively on the HMOs such that a large percentage 12 (54.1%) were unable to meet up with their financial obligations. Most of the HMOs 15 (71.4%) participated in the Millennium development goal (MDG) maternal and child health insurance programme. Conclusions: Weak enrollee base and poor monthly premium predisposed the HMOs to financial risk which impacted negatively on the overall performance in service delivery in the NHIS, further worsened by the non-utilisation of risk equalisation and reinsurance as risk-management strategies in the NHIS. There is need to make the scheme compulsory and introduce risk equalisation and reinsurance. PMID:25298605

Campbell, Princess Christina; Korie, Patrick Chukwuemeka; Nnaji, Feziechukwu Collins

2014-01-01

271

Managed competition in health care and the unfinished agenda  

PubMed Central

A market made up of health care financing and delivery plans and individual consumers, without a carefully drawn set of rules to mitigate market failures, and without mediation by collective action on the demand side, cannot produce efficiency and equity. The concept of competition that can achieve these goals, at least to a satisfactory approximation, is managed competition, with intelligent active agents on the demand side, called sponsors, that contract with the competing health care plans and continuously structure and adjust the market to overcome its tendencies to failure. A great deal remains to be done to achieve the goals envisioned by the “procompetition reformers.” PMID:10311922

Enthoven, Alain C.

1986-01-01

272

Errors as allies: error management training in health professions education.  

PubMed

This paper adopts methods from the organisational team training literature to outline how health professions education can improve patient safety. We argue that health educators can improve training quality by intentionally encouraging errors during simulation-based team training. Preventable medical errors are inevitable, but encouraging errors in low-risk settings like simulation can allow teams to have better emotional control and foresight to manage the situation if it occurs again with live patients. Our paper outlines an innovative approach for delivering team training. PMID:23293120

King, Aimee; Holder, Michael G; Ahmed, Rami A

2013-06-01

273

An Agile Enterprise Regulation Architecture for Health Information Security Management  

PubMed Central

Abstract Information security management for healthcare enterprises is complex as well as mission critical. Information technology requests from clinical users are of such urgency that the information office should do its best to achieve as many user requests as possible at a high service level using swift security policies. This research proposes the Agile Enterprise Regulation Architecture (AERA) of information security management for healthcare enterprises to implement as part of the electronic health record process. Survey outcomes and evidential experiences from a sample of medical center users proved that AERA encourages the information officials and enterprise administrators to overcome the challenges faced within an electronically equipped hospital. PMID:20815748

Chen, Ying-Pei; Hsieh, Sung-Huai; Chien, Tsan-Nan; Chen, Heng-Shuen; Luh, Jer-Junn; Lai, Jin-Shin; Lai, Feipei; Chen, Sao-Jie

2010-01-01

274

An agile enterprise regulation architecture for health information security management.  

PubMed

Information security management for healthcare enterprises is complex as well as mission critical. Information technology requests from clinical users are of such urgency that the information office should do its best to achieve as many user requests as possible at a high service level using swift security policies. This research proposes the Agile Enterprise Regulation Architecture (AERA) of information security management for healthcare enterprises to implement as part of the electronic health record process. Survey outcomes and evidential experiences from a sample of medical center users proved that AERA encourages the information officials and enterprise administrators to overcome the challenges faced within an electronically equipped hospital. PMID:20815748

Chen, Ying-Pei; Hsieh, Sung-Huai; Cheng, Po-Hsun; Chien, Tsan-Nan; Chen, Heng-Shuen; Luh, Jer-Junn; Lai, Jin-Shin; Lai, Feipei; Chen, Sao-Jie

2010-09-01

275

At the Crossroads: Managed Mental Health Care, the Ethics Code, and Ethnic Minorities  

Microsoft Academic Search

Mental health clinicians are facing an increasing number of ethical problems related to the delivery of managed mental health care services to ethnic minorities. The authors argue that (a) economic pressures have led to the development of the managed health care movement; (b) the combination of such economic pressures and the development of that managed care movement have influenced the

Martin J. La Roche; Castellano Turner

2002-01-01

276

Zweite Satzung zur nderung der Studienordnung des Masterstudiengangs ,,Health Care Management" an der  

E-print Network

1 Zweite Satzung zur �nderung der Studienordnung des Masterstudiengangs ,,Health Care Management die folgende �nderungssatzung der Studienordnung für den Masterstudiengang ,,Health Care Management" (HCM) als Satzung: Artikel 1 Die Studienordnung für den Masterstudiengang ,,Health Care Management" (M

Greifswald, Ernst-Moritz-Arndt-Universität

277

Dritte Satzung zur nderung der Studienordnung fr den Masterstudiengang ,,Health Care Management"  

E-print Network

Dritte Satzung zur �nderung der Studienordnung für den Masterstudiengang ,,Health Care Management-Moritz-Arndt-Universität Greifswald die folgende Satzung zur �nderung der Studienordnung für den Masterstudiengang ,,Health Care Management" (HCM): Artikel 1 Die Studienordnung für den Masterstudiengang ,,Health Care Management" (M

Greifswald, Ernst-Moritz-Arndt-Universität

278

Erste Satzung zur nderung der Studienordnung des Masterstudiengangs ,,Health Care Management" an der  

E-print Network

1 Erste Satzung zur �nderung der Studienordnung des Masterstudiengangs ,,Health Care Management �nderungssatzung der Studienordnung für den Masterstudiengang ,,Health Care Management" (HCM) als Satzung: Artikel 1 Die Studienordnung für den Masterstudiengang ,,Health Care Management" (M.Sc.) vom 18. Juli 2006

Greifswald, Ernst-Moritz-Arndt-Universität

279

Nichtamtliche Lesefassung der Fachprfungsordnung M.Sc. Health Care Management Fachprfungsordnung  

E-print Network

Nichtamtliche Lesefassung der Fachprüfungsordnung M.Sc. Health Care Management Fachprüfungsordnung des Masterstudiengangs Health Care Management an der Ernst-Moritz-Arndt-Universität Greifswald vom 15-Moritz-Arndt-Universität Greifs- wald die folgende Prüfungsordnung für den Masterstudiengang (M. Sc.) ,,Health Care Management

Greifswald, Ernst-Moritz-Arndt-Universität

280

Submitted to the International Journal of Health Planning and Management, June 2011 Mental Health in France, Policies and Actors  

E-print Network

1 Submitted to the International Journal of Health Planning and Management, June 2011 Mental Health) ; Nicolas Daumerie (CCOMS, Lille) ; Jean-Luc Roelandt (CCOMS, Lille) SUMMARY : The new mental health care the 2000s: the emphasis is shifting from psychiatry to mental health care. This shift focuses mainly

Paris-Sud XI, Université de

281

Opportunities for Launch Site Integrated System Health Engineering and Management  

NASA Technical Reports Server (NTRS)

The launch site processing flow involves operations such as functional verification, preflight servicing and launch. These operations often include hazards that must be controlled to protect human life and critical space hardware assets. Existing command and control capabilities are limited to simple limit checking durig automated monitoring. Contingency actions are highly dependent on human recognition, decision making, and execution. Many opportunities for Integrated System Health Engineering and Management (ISHEM) exist throughout the processing flow. This paper will present the current human-centered approach to health management as performed today for the shuttle and space station programs. In addition, it will address some of the more critical ISHEM needs, and provide recommendations for future implementation of ISHEM at the launch site.

Waterman, Robert D.; Langwost, Patricia E.; Waterman, Susan J.

2005-01-01

282

District health managers’ perceptions of supervision in Malawi and Tanzania  

PubMed Central

Background Mid-level cadres are being used to address human resource shortages in many African contexts, but insufficient and ineffective human resource management is compromising their performance. Supervision plays a key role in performance and motivation, but is frequently characterised by periodic inspection and control, rather than support and feedback to improve performance. This paper explores the perceptions of district health management teams in Tanzania and Malawi on their role as supervisors and on the challenges to effective supervision at the district level. Methods This qualitative study took place as part of a broader project, “Health Systems Strengthening for Equity: The Power and Potential of Mid-Level Providers”. Semi-structured interviews were conducted with 20 district health management team personnel in Malawi and 37 council health team members in Tanzania. The interviews covered a range of human resource management issues, including supervision and performance assessment, staff job descriptions and roles, motivation and working conditions. Results Participants displayed varying attitudes to the nature and purpose of the supervision process. Much of the discourse in Malawi centred on inspection and control, while interviewees in Tanzania were more likely to articulate a paradigm characterised by support and improvement. In both countries, facility level performance metrics dominated. The lack of competency-based indicators or clear standards to assess individual health worker performance were considered problematic. Shortages of staff, at both district and facility level, were described as a major impediment to carrying out regular supervisory visits. Other challenges included conflicting and multiple responsibilities of district health team staff and financial constraints. Conclusion Supervision is a central component of effective human resource management. Policy level attention is crucial to ensure a systematic, structured process that is based on common understandings of the role and purpose of supervision. This is particularly important in a context where the majority of staff are mid-level cadres for whom regulation and guidelines may not be as formalised or well-developed as for traditional cadres, such as registered nurses and medical doctors. Supervision needs to be adequately resourced and supported in order to improve performance and retention at the district level. PMID:24007354

2013-01-01

283

Computer-based cognitive and socio-emotional training in personal health information management  

Microsoft Academic Search

Personal information management (PIM) pervades every aspect of our lives, including health care. As users of the health care system, we rely on our ability to manage information to combat illness and stay healthy. When seeking help for a health-related problem or question, we navigate a complex system where health services are distributed across multiple clinicians in a variety of

Rudolf Volner; Dasa Ticha; Hedvika Palasthy

2011-01-01

284

[Management nurses's attitudes in the family health program: view of the family health group].  

PubMed

This article was a part of a research called Management Competences required from the nurse in the Family Health Program (FHP) and has as aim to identify the management attitudes required from the nurse to the manager of the nurse assistance in the Family Health Units (FHU) of a city of the "catarinense" seashore under a perception from these professionals. It was a descrptive-exploratory study based on a semi-structured questionary for data colection. The population was constituted by 72 participants that scored from 01 and 05 to each item of the questionary. The study pointed to the emphasis in the development of new competences by the nurses that lead the reach of the performances and consequently the quality of the assistance and to the community satisfaction. PMID:17684910

Benito, Gladys Amélia Vélez; Becker, Luciana Corrêa

2007-01-01

285

Factors influencing students to enroll in health information management programs.  

PubMed

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. PMID:22783152

Safian, Shelley C

2012-01-01

286

IVHM Framework for Intelligent Integration for Vehicle Health Management  

NASA Technical Reports Server (NTRS)

Integrated Vehicle Health Management (IVHM) systems for aerospace vehicles, is the process of assessing, preserving, and restoring system functionality across flight and techniques with sensor and communication technologies for spacecraft that can generate responses through detection, diagnosis, reasoning, and adapt to system faults in support of Integrated Intelligent Vehicle Management (IIVM). These real-time responses allow the IIVM to modify the affected vehicle subsystem(s) prior to a catastrophic event. Furthermore, this framework integrates technologies which can provide a continuous, intelligent, and adaptive health state of a vehicle and use this information to improve safety and reduce costs of operations. Recent investments in avionics, health management, and controls have been directed towards IIVM. As this concept has matured, it has become clear that IIVM requires the same sensors and processing capabilities as the real-time avionics functions to support diagnosis of subsystem problems. New sensors have been proposed, in addition to augment the avionics sensors to support better system monitoring and diagnostics. As the designs have been considered, a synergy has been realized where the real-time avionics can utilize sensors proposed for diagnostics and prognostics to make better real-time decisions in response to detected failures. IIVM provides for a single system allowing modularity of functions and hardware across the vehicle. The framework that supports IIVM consists of 11 major on-board functions necessary to fully manage a space vehicle maintaining crew safety and mission objectives. These systems include the following: Guidance and Navigation; Communications and Tracking; Vehicle Monitoring; Information Transport and Integration; Vehicle Diagnostics; Vehicle Prognostics; Vehicle Mission Planning, Automated Repair and Replacement; Vehicle Control; Human Computer Interface; and Onboard Verification and Validation. Furthermore, the presented framework provides complete vehicle management which not only allows for increased crew safety and mission success through new intelligence capabilities, but also yields a mechanism for more efficient vehicle operations.

Paris, Deidre; Trevino, Luis C.; Watson, Michael D.

2005-01-01

287

The skills gap in hospital management in the South African public health sector.  

PubMed

A lack of management capacity has been identified as the key stumbling block to the transformation and reconceptualization of the public sector in South Africa into a more effective, efficient, and responsive system of health delivery. As part of the overall management development process, this research aimed to identify the skills important for public sector health management and to evaluate managers' self-assessed proficiency in each of these skills. A cross-sectional survey using a self-administered questionnaire was conducted among hospital managers in the South African public health sector. Respondents were asked to rate the level of importance that each proposed competency had in their job and to indicate their proficiency in each skill. Self-assessment of levels of competency showed that managers felt most competent in strategic planning, people management, and self-management, and relatively less competent in the task-related skills and their ability to deliver healthcare. People management, self-management, and task-related skills were rated as being most important, followed by strategic management and health delivery skills, respectively. The largest differences between mean importance rating and mean skill rating were for people management skills, task-related and self-management skills. These findings reflect the reality of the local health service environment and the needs of health managers and will be useful in the conceptualization, design, and delivery of health management programs aimed at enhancing current and future management and leadership capacity in the public health sector in South Africa. PMID:18708881

Pillay, Rubin

2008-01-01

288

Role of Ayurveda in management of oral health  

PubMed Central

Oral diseases continue to be a major health problem world-wide. Oral health is integral to general well-being and relates to the quality-of-life that extends beyond the functions of the craniofacial complex. The standard Western medicine has had only limited success in the prevention of periodontal disease and in the treatment of a variety of oral diseases. Hence, the search for alternative products continues and natural phytochemicals isolated from plants used in traditional medicine are considered to be good alternatives to synthetic chemicals. The botanicals in the Ayurvedic material medica have been proven to be safe and effective, through several hundred to several thousand years of use. The exploration of botanicals used in traditional medicine may lead to the development of novel preventive or therapeutic strategies for oral health. The present scientific evidence based review is focused on the possible role of Ayurveda in the management of various orofacial disorders. PMID:24600192

Torwane, Nilesh Arjun; Hongal, Sudhir; Goel, Pankaj; Chandrashekar, B. R.

2014-01-01

289

[Managed care--a possibility for German Health Insurance?].  

PubMed

Health services systems in nearly all developed countries face similar problems. This fact raises the question whether concepts used in different countries can be changed without affecting the historically grown foundations of national health services as have been accepted by majority. A group of experts of the German Medical Services of the Statutory Health Insurance were asked to analyse whether the managed care approach could play a substantial role in reforming the German "Bismarck model", given that the advisory responsibility of the social medical service for the sick funds is respected in such a consideration and that basic essentials of the system are maintained. The group concludes, in brief, that managed care and the "German model" are contradictory in respect of preconditions, aims and assumed results. Furthermore, the experts share the view that the "German model" incorporates sufficient to cope with its problems without changing the nature of health services, based on principles of solidarity in Germany. The system needs structural reforms rather than changes in monetary mechanisms. PMID:10535216

Gaertner, T; von Mittelstaedt, G; Jelastopulu, E; Schwoerer, P; Niehoff, J U; Voltz, G; Krell, H; Finger, C; Knigge, W; Sambale, M; Strippel, H

1999-01-01

290

Emergency planning and management in health care: priority research topics  

PubMed Central

Many major incidents have significant impacts on people's health, placing additional demands on health-care organisations. The main aim of this paper is to suggest a prioritised agenda for organisational and management research on emergency planning and management relevant to U.K. health care, based on a scoping study. A secondary aim is to enhance knowledge and understanding of health-care emergency planning among the wider research community, by highlighting key issues and perspectives on the subject and presenting a conceptual model. The study findings have much in common with those of previous U.S.-focused scoping reviews, and with a recent U.K.-based review, confirming the relative paucity of U.K.-based research. No individual research topic scored highly on all of the key measures identified, with communities and organisations appearing to differ about which topics are the most important. Four broad research priorities are suggested: the affected public; inter- and intra-organisational collaboration; preparing responders and their organisations; and prioritisation and decision making. PMID:25013721

Boyd, Alan; Chambers, Naomi; French, Simon; Shaw, Duncan; King, Russell; Whitehead, Alison

2014-01-01

291

Prevalence and consequences of subacute ruminal acidosis in German dairy herds  

PubMed Central

Background The prevalence and the clinical consequences of subacute ruminal acidosis (SARA) in dairy cows are still poorly understood. In order to evaluate the prevalence of SARA, 26 German dairy farms were included in a field study. In each herd, between 11 and 14 lactating dairy cows were examined for their ruminal pH using rumenocentesis. Milk production data and farm management characteristics were recorded. Each farm was scored for lameness prevalence among lactating animals, and body condition score was recorded three times four to five weeks apart in all animals examined. Farms were grouped on basis of ruminal pH and compared for lameness, body condition, milk production parameters and style of management. Animals were grouped on basis of their measured ruminal pH and compared accordingly for milk production parameters and body condition score. Results Of 315 cows examined, 63 individuals (20%) exhibited a ruminal pH of???5.5 at time of rumenocentesis. Of 26 farms examined, eleven farms had three or more of their cows experiencing a ruminal pH of???5.5 and were classified as likely experiencing subacute ruminal acidosis. These farms tended to be bigger than the others and offered less lying space to the lactating cows. There was no clear tendency regarding lameness. Among individual cows, animals with a low ruminal pH of???5.5 were found to be in significantly poorer body condition than animals with higher pH values (p?ruminal pH tend to be lower in body condition. The study points to the importance of management in preventing SARA. PMID:23805878

2013-01-01

292

An innovative national health care waste management system in Kyrgyzstan.  

PubMed

A novel low-cost health care waste management system was implemented in all rural hospitals in Kyrgyzstan. The components of the Kyrgyz model include mechanical needle removers, segregation using autoclavable containers, safe transport and storage, autoclave treatment, documentation, recycling of sterilized plastic and metal parts, cement pits for anatomical waste, composting of garden wastes, training, equipment maintenance, and management by safety and quality committees. The gravity-displacement autoclaves were fitted with filters to remove pathogens from the air exhaust. Operating parameters for the autoclaves were determined by thermal and biological tests. A hospital survey showed an average 33% annual cost savings compared to previous costs for waste management. All general hospitals with >25 beds except in the capital Bishkek use the new system, corresponding to 67.3% of all hospital beds. The investment amounted to US$0.61 per capita covered. Acceptance of the new system by the staff, cost savings, revenues from recycled materials, documented improvements in occupational safety, capacity building, and institutionalization enhance the sustainability of the Kyrgyz health care waste management system. PMID:25649402

Toktobaev, Nurjan; Emmanuel, Jorge; Djumalieva, Gulmira; Kravtsov, Alexei; Schüth, Tobias

2015-02-01

293

Policy Management Standards Enabling Trustworthy pHealth.  

PubMed

Current paradigm changes for improving safety, quality and efficiency of care processes under massive deployment of information and communication technologies (ICT) place high requirements on privacy and security. These mainly focus on privilege management and access control harmonized in international standards and their further evolution. NIST and ISO, but especially HL7 play a prominent role in this context. Starting with classic role-based access control (RBAC) foundations to new specifications for security and privacy labeling of segmented health information, HL7 security is presented as a scalable intermediate solution on the way to comprehensive privilege management and access control by explicit, ontology-based, formal and therefore machine-processable policies. The successfully balloted HL7 labeling specification supports context-sensitive communication and cooperation between different stakeholders and processes with different purposes of use, based on meta-data of information, actors and processes involved. Basics of policy management and practical solutions are discussed. PMID:24851957

Blobel, Bernd; Davis, Mike; Ruotsalainen, Pekka

2014-01-01

294

Implications of managed care for health systems, clinicians, and patients.  

PubMed Central

The rhetoric and realities of managed care are easily confused. The rapid growth of managed care in the United States has had many implications for patients, doctors, employers, state and federal programmes, the health insurance industry, major medical institutions, medical research, and vulnerable patient populations. It has restricted patients' choice of doctors and limited access to specialists, reduced the professional autonomy and earnings of doctors, shifted power from the non-profit to the for-profit sectors and from hospitals and doctors to private corporations. It has also raised issues about the future structuring and financing of medical education and research and about practice ethics. However, managed care has also accorded greater prominence to the assessment of patient satisfaction, profiling and monitoring of doctors' work, the use of clinical guidelines and quality assurance procedures and indicated the potential to improve the integration and outcome of care. PMID:9224138

Fairfield, G.; Hunter, D. J.; Mechanic, D.; Rosleff, F.

1997-01-01

295

Redundancy, resilience, and host specificity of the ruminal microbiota: implications for engineering improved ruminal fermentations  

PubMed Central

The ruminal microbial community is remarkably diverse, containing 100s of different bacterial and archaeal species, plus many species of fungi and protozoa. Molecular studies have identified a “core microbiome” dominated by phyla Firmicutes and Bacteroidetes, but also containing many other taxa. The rumen provides an ideal laboratory for studies on microbial ecology and the demonstration of ecological principles. In particular, the microbial community demonstrates both redundancy (overlap of function among multiple species) and resilience (resistance to, and capacity to recover from, perturbation). These twin properties provide remarkable stability that maintains digestive function for the host across a range of feeding and management conditions, but they also provide a challenge to engineering the rumen for improved function (e.g., improved fiber utilization or decreased methane production). Direct ruminal dosing or feeding of probiotic strains often fails to establish the added strains, due to intensive competition and amensalism from the indigenous residents that are well-adapted to the historical conditions within each rumen. Known exceptions include introduced strains that can fill otherwise unoccupied niches, as in the case of specialist bacteria that degrade phytotoxins such as mimosine or fluoroacetate. An additional complicating factor in manipulating the ruminal fermentation is the individuality or host specificity of the microbiota, in which individual animals contain a particular community whose species composition is capable of reconstituting itself, even following a near-total exchange of ruminal contents from another herd mate maintained on the same diet. Elucidation of the interactions between the microbial community and the individual host that establish and maintain this specificity may provide insights into why individual hosts vary in production metrics (e.g., feed efficiency or milk fat synthesis), and how to improve herd performance.

Weimer, Paul J.

2015-01-01

296

Ruminants, climate change and climate policy  

NASA Astrophysics Data System (ADS)

Greenhouse gas emissions from ruminant meat production are significant. Reductions in global ruminant numbers could make a substantial contribution to climate change mitigation goals and yield important social and environmental co-benefits.

Ripple, William J.; Smith, Pete; Haberl, Helmut; Montzka, Stephen A.; McAlpine, Clive; Boucher, Douglas H.

2014-01-01

297

Ruminal acidosis challenge impact on ruminal temperature in feedlot cattle.  

PubMed

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

2012-08-01

298

Rethinking health: ICT-enabled services to empower people to manage their health.  

PubMed

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

2011-01-01

299

Ruminant cluster CD14.  

PubMed

Following the analysis of flow cytometry data on ovine and bovine cells and immunoprecipitation, immunohistochemistry and competitive binding studies, a cluster of three monoclonal antibodies (mAbs) (VPM65, VPM66 and VPM67) appeared to be specific for the ruminant CD14 (Gupta, V.K., McConnell, I., Dalziel, R.G. and Hopkins, J., 1996. Identification of the sheep homologue of the monocyte cell surface molecule-CD14. Vet. Immunol. Immunopathol. in press; Hopkins, J. and Gupta, V.K., 1996. Characterization of 3rd Worshop monoclonal antibodies specific for sheep macrophages/monocytes. Vet. Immunol. Immunopathol., 52:329-339). According to flow cytometry results from human CD14-transfected COS-7 cells and from bovine peripheral blood mononuclear cells, another mAb (CC-G33), not submitted to the Workshop, recognised a bovine CD14 epitope which is conserved in the human CD14 (Sopp, P., Kwong, L.S. and Howard, C.J., 1996. Identification of bovine CD14. Vet. Immunol. Immunopathol., 52: 323-328). PMID:8896206

Berthon, P; Hopkins, J

1996-08-01

300

Managing Costs, Managing Benefits: Employer Decisions in Local Health Care Markets  

PubMed Central

Objectives To better understand employer health benefit decision making, how employer health benefits strategies evolve over time, and the impact of employer decisions on local health care systems. Data Sources/Study Setting. Data were collected as part of the Community Tracking Study (CTS), a longitudinal analysis of health system change in 12 randomly selected communities. Study Design This is an observational study with data collection over a six-year period. Data Collection/Extraction Methods The study used semistructured interviews with local respondents, combined with monitoring of local media, to track changes in health care systems over time and their impact on community residents. Interviewing began in 1996 and was carried out at two-year intervals, with a total of approximately 2,200 interviews. The interviews provided a variety of perspectives on employer decision making concerning health benefits; these perspectives were triangulated to reach conclusions. Principal Findings The tight labor market during the study period was the dominant consideration in employer decision making regarding health benefits. Employers, in managing employee compensation, made independent decisions in pursuit of individual goals, but these decisions were shaped by similar labor market conditions. As a result, within and across our study sites, employer decisions in aggregate had an important impact on local health care systems, although employers' more highly visible public efforts to bring about health system change often met with disappointing results. Conclusions General economic conditions in the 1990s had an important impact on the configuration of local health systems through their effect on employer decision making regarding health benefits offered to employees, and the responses of health plans and providers to those decisions. PMID:12650371

Christianson, Jon B; Trude, Sally

2003-01-01

301

Inducible bacteriophages from ruminal bacteria.  

PubMed Central

The incidence of temperate bacteriophage in a wide range of ruminal bacteria was investigated by means of induction with mitomycin C. Supernatant liquid from treated cultures was examined for phagelike particles by using transmission electron microscopy. Of 38 ruminal bacteria studied, nine organisms (23.7%) representing five genera (Eubacteria, Bacteroides, Butyrivibrio, Ruminococcus, and Streptococcus) produced phagelike particles. Filamentous particles from Butyrivibrio fibrisolvens are the first of this morphological type reported from ruminal bacteria. All of the other particles obtained possessed polyhedral heads and long, noncontractile tails (group B-type phage). The limited range of morphological types produced by mitomycin C induction cannot yet account for the much wider range of types found in ruminal contents by direct examination. The presence of viral genetic material in a significant percentage of the bacteria tested, as well as in a range of different genera, indicates that viral genetic material may be a normal constituent of the genome of appreciable numbers of ruminal bacteria. Images PMID:2504111

Klieve, A V; Hudman, J F; Bauchop, T

1989-01-01

302

Inducible bacteriophages from ruminal bacteria.  

PubMed

The incidence of temperate bacteriophage in a wide range of ruminal bacteria was investigated by means of induction with mitomycin C. Supernatant liquid from treated cultures was examined for phagelike particles by using transmission electron microscopy. Of 38 ruminal bacteria studied, nine organisms (23.7%) representing five genera (Eubacteria, Bacteroides, Butyrivibrio, Ruminococcus, and Streptococcus) produced phagelike particles. Filamentous particles from Butyrivibrio fibrisolvens are the first of this morphological type reported from ruminal bacteria. All of the other particles obtained possessed polyhedral heads and long, noncontractile tails (group B-type phage). The limited range of morphological types produced by mitomycin C induction cannot yet account for the much wider range of types found in ruminal contents by direct examination. The presence of viral genetic material in a significant percentage of the bacteria tested, as well as in a range of different genera, indicates that viral genetic material may be a normal constituent of the genome of appreciable numbers of ruminal bacteria. PMID:2504111

Klieve, A V; Hudman, J F; Bauchop, T

1989-06-01

303

An Assessment of Integrated Health Management (IHM) Frameworks  

SciTech Connect

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 health management (PHM) on the scale of a NPP requires the use of an integrated health management (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.

N. Lybeck; M. Tawfik; L. Bond; J. Coble

2012-05-01

304

Health economics of weight management: evidence and cost.  

PubMed

The World Health Organization estimates that around one billion people throughout the world are overweight and that over 300 million of these are obese and if current trends continue, the number of overweight persons will increase to 1.5 billion by 2015. The number of obese adults in Australia is estimated to have risen from 2.0 million in 1992/93 to 3.1 million in 2005. The prevalence of obesity has been increasing due to a convergence of factors--the rise of TV viewing, our preference for takeaway and pre-prepared foods, the trend towards more computer-bound sedentary jobs, and fewer opportunities for sport and physical exercise. Obesity is not only linked to lack of self esteem, social and work discrimination, but also to illnesses such as the metabolic syndrome and hyperinsulinaemia (which increases the risk of developing heart disease, diabetes, hypertension, fatty liver), cancer, asthma, dementia, arthritis and kidney disease. It has been estimated that the cost of obesity in Australia in 2005 was $1,721 million. Of this amount, $1,084 million were direct health costs, and $637 million indirect health costs (due to lost work productivity, absenteeism and unemployment). The prevalence cost per year for each obese adult has been estimated at $554 and the value of an obesity cure is about $6,903 per obese person. Government efforts at reducing the burden remain inadequate and a more radical approach is needed. The Australian government, for example, has made changes to Medicare so that GPs can refer people with chronic illness due to obesity to an exercise physiologist and dietitian and receive a Medicare rebate, but so far these measures are having no perceptible effect on obesity levels. There is a growing recognition that both Public Health and Clinical approaches, and Private and Public resources, need to be brought to this growing problem. Australian health economist, Paul Gross, from the Institute of Health Economics and Technology Assessment claims there is too much reliance on health workers to treat the problem, especially doctors, who have not been given additional resources to manage obesity outside a typical doctor's consultation. Gross has recommended that further changes should be made to Medicare, private health insurance, and workplace and tax legislation to give people financial incentives to change their behaviour because obesity should not just be treated by governments as a public health problem but also as a barrier to productivity and a drain on resources. A Special Report of the WMCACA (Weight Management Code Administration Council of Australia) (www.weightcouncil.org) on the "Health Economics of Weight Management" has been published in the Asia Pacific Journal of Clinical Nutrition in September 2006. This report explores the cost benefit analysis of weight management in greater detail. PMID:17392129

Kouris-Blazos, Antigone; Wahlqvist, Mark L

2007-01-01

305

Toxicology/Cell Biology Ruminant Production  

E-print Network

Fletcher Poultry Health Management PHP Isabel Gimeno Poultry Health Management PHP James Flowers Parasitology PHP Bernie Hansen Critical Care Medicine DOCS Lizette Hardie Department Head DOCS Craig Harms Radiology MBS Jay Levine Epidemiology/Public Health PHP Michael Levy Parasitology PHP Greg Lewbart Aquatic

Langerhans, Brian

306

Agricultural Pesticide Management in Thailand: Situation and Population Health Risk  

PubMed Central

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. PMID:22308095

Panuwet, Parinya; Siriwong, Wattasit; Prapamontol, Tippawan; Ryan, P. Barry; Fiedler, Nancy; Robson, Mark G.; Barr, Dana Boyd

2012-01-01

307

News from the Health Services Administration Alumni Chapter Fall 2008 Department of Health Management and Informatics College of Health and Public Affairs  

E-print Network

Management and Informatics · College of Health and Public Affairs in the College of Health and Public Affairs for health services administration graduate students. Scholarships of development and alumni relations for the College of Health and Public Affairs, at (407) 823-1600 or kkorkosz

Wu, Shin-Tson

308

From a traditional behavioral management program to an m-health app: Lessons learned in developing m-health apps for existing health care programs  

Microsoft Academic Search

M-health applications provide a unique new way to deliver healthcare. Developing m-health applications involves new challenges different from those encountered when developing traditional healthcare programs and e-health applications. This paper describes the development of an m-health application for behavioral migraine management, and presents lessons learned during the development process from software engineers' perspective.

Qing Zhu; Chang Liu; Kenneth A. Holroyd

2012-01-01

309

Managed Mental Health Care: A History of the Federal Policy Initiative  

Microsoft Academic Search

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 managed health 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

1991-01-01

310

Thinking Fat and Feeling Blue: Eating Behaviors, Ruminative Coping, and Depressive Symptoms in College Women  

Microsoft Academic Search

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

Zaje A. T. Harrell; Benita Jackson

2008-01-01

311

Master's Degree in Agriculture Plant Health Management Option Option Title: Master of Science (MS) in Agriculture: Plant Health  

E-print Network

Master's Degree in Agriculture ­ Plant Health Management Option Option Title: Master of Science (MS) in Agriculture: Plant Health Management Department(s) or Program(s): Supported of Agricultural, Human, and Natural Resource Sciences (CAHNRS) Contact Name: Dr. Kim Kidwell, Director MS

Collins, Gary S.

312

Improving hypertension self-management with community health coaches.  

PubMed

Approximately two thirds of those older than 60 years have a hypertension diagnosis. The aim of our program, Health Coaches for Hypertension Control, is to improve hypertension self-management among rural residents older than 60 years through education and support offered by trained community volunteers called Health Coaches. Participants received baseline and follow-up health risk appraisals with blood work, educational materials, and items such as blood pressure monitors and pedometers. Data were collected at baseline, 8 weeks, and 16 weeks on 146 participants who demonstrated statistically significant increases in hypertension-related knowledge from baseline to 8 weeks that persisted at 16 weeks, as well as significant improvements in stage of readiness to change behaviors and in actual behaviors. Furthermore, clinically significant decreases in all outcome measures were observed, with statistically significant changes in systolic blood pressure (-5.781 mmHg; p = .001), weight (-2.475 lb; p < .001), and glucose (-5.096 mg/dl; p = .004) after adjusting for multiple comparisons. Although 40.4% of participants met the Healthy People 2020 definition of controlled hypertension at baseline, the proportion of participants meeting this definition at 16 weeks postintervention increased to 51.0%. This article describes a university-community-hospital system model that effectively promotes hypertension self-management in a rural Appalachian community. PMID:24837989

Dye, Cheryl J; Williams, Joel E; Evatt, Janet Hoffman

2015-03-01

313

Managing the physics of the economics of integrated health care.  

PubMed

The physics metaphor, as applied to the economics (and financial performance) of the integrated health system, seems appropriate when considered together with the nine principles of management framework provided. The nature of the integrated design enhances leaders' management potential as they consider organizational operations and strategy in the markets ahead. One question begged by this argument for the integrated design is the durability, efficiency and ultimate long-term survivability of the more "traditional" community health care delivery models, which, by design, are fragmented, internally competitive and less capital efficient. They also cannot exploit the leverage of teams, optimal access management or the pursuit of revenues made available in many forms. For those who wish to move from the traditional to the more integrated community health system designs (especially those who have not yet started the journey), the path requires: * Sufficient balance sheet capacity to fund the integration process-especially as the model requires physician practice acquisitions and electronic health record implementations * A well-prepared board13, 14 * A functional, durable and sustainable physician services enterprise design * A redesigned organizational and governance structure * Favorable internal financial incentives alignment design * Effective accountable physician leadership * Awareness that the system is not solely a funding strategy for acquired physicians, rather a fully -.. committed clinical and business model, one in which patient-centered integrated care is the core service (and not acute care hospital-based services) A willingness to create and exploit the implied and inherent potential of an integrated design and unified brand Last, it's important to remember that an integrated health system is a tool that creates a "new potential" (a physics metaphor reference, one last time). The design doesn't operate itself. Application of the management principles presented here are necessary as a complete recipe. Leaders of health systems moving toward integration are cautioned to apply the recipe in full. This article ends with two questions. First, if not an integrated model of health care, what's the alternative? Since it seems clear that many of the existing community-based models are excessively fragmented and inefficient, especially in a reforming U.S. health care marketplace, is there a new model that is superior to the integrated models and, if so, what is it and what are its functional principles? The second question: Is there more than one functional form of integration? This article argues for the most integrated form. Others would argue that clinical integration is sufficient,'s and full integration isn't required. The stability, durability and adaptability of the fully integrated models have, arguably, been tested. The lesser integrated models remain to be proven in an unstable health care marketplace seeking higher levels of economic efficiency. PMID:23888674

Zismer, Daniel K; Werner, Mark J

2012-01-01

314

Managing the health effects of the explosive remnants of war.  

PubMed

Many civilian deaths and injuries across the globe are a consequence of 'explosive remnants of war' (ERW). These ERW include mines, unexploded ordnance (UXO) and cluster bombs. The numbers of deaths, injuries and resulting disabilities from ERW are expected to increase as armed conflicts proliferate. This will have a substantial effect on all aspects of health. This article first describes the mechanisms of these ERW and the nature of the injuries they can cause. It then briefly outlines the immediate medical management such injuries require; the long-term outcomes and sequelae, and what can be done to manage them. It highlights how research and medical interventions must take into account cultural, social and economic factors in addition to utilising safe and appropriate techniques and practices. The article concludes by noting that medical personnel are well placed not only to intervene and manage the direct health effects of ERW, but also indirectly by advocating on behalf of those affected by adding their voices to campaigns against their proliferation. PMID:15602994

Kett, Maria E; Mannion, Steve J

2004-11-01

315

Caries management pathways preserve dental tissues and promote oral health.  

PubMed

In May 2012, cariologists, dentists, representatives of dental organizations, manufacturers, and third party payers from several countries, met in Philadelphia, Pennsylvania, to define a common mission; goals and strategic approaches for caries management in the 21th century. The workshop started with an address by Mr. Stanley Bergman, CEO of Henry Schein Inc. which focused on the imperative for change in academia, clinical practice, and public health. For decades, new scientific evidence on caries and how it should be managed have been discussed among experts in the field. However, there has been some limited change, except in some Scandinavian countries, in the models of caries management and reimbursement which have been heavily skewed toward 'drilling and filling'. There is no overall agreement on a caries' case definition or on when to surgically intervene. The participants in the workshop defined a new mission for all caries management approaches, both conventional and new. The mission of each system should be to preserve the tooth structure, and restore only when necessary. This mission marks a pivotal line for judging when to surgically intervene and when to arrest or remineralize early noncavitated lesions. Even when restorative care is necessary, the removal of hard tissues should be lesion-focused and aim to preserve, as much as possible, sound tooth structure. Continuing management of the etiological factors of caries and the use of science-based preventive regimens also will be required to prevent recurrence and re-restoration. These changes have been debated for over a decade. The Caries Management Pathways includes all systems and philosophies, conventional and new, of caries management that can be used or modified to achieve the new mission. The choice of which system to use to achieve the mission of caries management is left to the users and should be based on the science supporting each approach or philosophy, experience, utility, and ease of use. This document also presents a new 'Caries Management Cycle' that should be followed regardless of which approach is adopted for caries prevention, detection, diagnosis, and treatment. To aid success in the adoption of the new mission, a new reimbursement system that third party payers may utilize is proposed (for use by countries other than Scandinavian countries or other countries where such systems already exist). The new reimbursement/incentive model focuses on the mission of preservation of tooth structure and outcomes of caries management. Also described, is a research agenda to revitalize research on the most important and prevalent world-wide human disease. The alliance of major dental organizations and experts that started in Philadelphia will hopefully propel over the next months and years, a change in how caries is managed by dentists all over the world. A new mission has been defined and it is time for all oral health professionals to focus on the promotion of oral health and preservation of sound teeth rather than counting the number of surgical restorative procedures provided. PMID:24916676

Ismail, Amid I; Tellez, Marisol; Pitts, Nigel B; Ekstrand, Kim R; Ricketts, David; Longbottom, Christopher; Eggertsson, Hafsteinn; Deery, Christopher; Fisher, Julian; Young, Douglas A; Featherstone, John D B; Evans, Wendell; Zeller, Gregory G; Zero, Domenick; Martignon, Stefania; Fontana, Margherita; Zandona, Andrea

2013-02-01

316

The crucible of public health practice: major trends shaping the design of the Management Academy for Public Health.  

PubMed

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

2006-01-01

317

Proceedings of the International Conference on Prognostics and Health Management, Denver, CO, October 2008. Abstract--Prognostics and Health Management (PHM)  

E-print Network

ROI assessments described in this section contain valuable insight into the cost drivers, most costProceedings of the International Conference on Prognostics and Health Management, Denver, CO, October 2008. Abstract--Prognostics and Health Management (PHM) provides an opportunity for lowering

Sandborn, Peter

318

The contributions of managed care plans to public health practice: evidence from the nation's largest local health departments.  

PubMed Central

OBJECTIVE: The authors examine the extent and nature of managed care plans participating in local public health activities. METHODS: In 1998, the authors surveyed the directors of all US local health departments serving jurisdictions of at least 100,000 residents to collect information about public health activities performed in their jurisdictions and about organizations participating in the activities. Multivariate logistic and linear regression models were used to examine organizational and market characteristics associated with managed care plan participation in public health activities. RESULTS: Managed care plans were reported to participate in public health activities in 164 (46%) of the jurisdictions surveyed, and to contribute to 13% of the public health activities performed in the average jurisdiction. Plans appeared most likely to participate in public health activities involving the delivery or management of personal health services and the exchange of health-related information. Managed care participation was more likely to occur in jurisdictions with higher HMO penetration, fewer competing plans, and larger proportions of plans enrolling Medicaid recipients. Participation was positively associated with the overall scope and perceived effectiveness of local public health activities. CONCLUSIONS: Although plans participate in a narrow range of activities, these contributions may complement the work of public health agencies. PMID:11889275

Mays, G. P.; Halverson, P. K.; Stevens, R.

2001-01-01

319

A cow-level association of ruminal pH on body condition score, serum beta-hydroxybutyrate and postpartum disorders in Thai dairy cattle.  

PubMed

Subacute ruminal acidosis in dairy cows occurs when ruminal pH is below about 5.5. However, the exact threshold level of ruminal pH affecting cow health is still in debate. This investigation was carried out in 505 cows within 31 farms. The postpartum disorders, including dystocia, retained placenta, anestrus, cystic ovary, metritis, clinical mastitis and lameness, were analyzed. Ruminal pH, serum beta-hydroxy butyrate (SBHB), serum urea nitrogen and body condition score (BCS) were measured once during the 3 to 6 weeks postpartum, while BCS was determined once more at 1 week before calving. Ruminal pH was determined by ruminocentesis technique. The ruminal pH was evaluated to study the association with BCS, SBHB and postpartum disorders using linear regression in a generalized linear mixed model with farm as a random effect. The results show that low ruminal pH was associated with dystocia, metritis and lameness. Moreover, a low ruminal pH can be found in cows with a high loss of BCS after calving and also in cows with low SBHB postpartum. These findings confirmed the feasibility of the ruminocentesis technique and the association of low ruminal pH on various postpartum disorders at the individual cow level. However, the consequences of low ruminal pH on dairy cow health still needs more exploration for a better understanding of the physiological mechanisms. PMID:24961478

Chaidate, Inchaisri; Somchai, Chanpongsang; Jos, Noordhuizen; Henk, Hogeveen

2014-09-01

320

[Occupational health service management--the concept and application of lean management].  

PubMed

One of the most effective management systems is the so-called lean management (LM) aimed at loss minimization of institutions' activities while maximizing value and satisfaction to the clients. The system implementation comprises not only typical business areas but also health care sectors. The aim of the article is to present the concept and opportunity of improving the management of occupational health units. Due to its multi-profile nature of tasks and diverse relations with the environment occupational health could be a good institutional example of LM implementation. Operational perspective consists of five guidelines: describing values expected by final clients, setting value flow eliminating needless elements, creating the integrated, coherent and smooth sequence of valuable activities, offering the values to clients, and aiming at continuing improvement. LM could be implemented in occupational health units in the following areas: timing and tasks coordination, leaning some tasks and expanding others in order to maximize clients' value, cost rationalizing, improving the quality of services by eliminating mistakes, avoiding repetition of activities. PMID:23373329

Sobczak, Alicja; Rydlewska-Liszkowska, Izabela

2012-01-01

321

Ground Operations Autonomous Control and Integrated Health Management  

NASA Technical Reports Server (NTRS)

An intelligent autonomous control capability has been developed and is currently being validated in ground cryogenic fluid management operations. The capability embodies a physical architecture consistent with typical launch infrastructure and control systems, augmented by a higher level autonomous control (AC) system enabled to make knowledge-based decisions. The AC system is supported by an integrated system health management (ISHM) capability that detects anomalies, diagnoses causes, determines effects, and could predict future anomalies. AC is implemented using the concept of programmed sequences that could be considered to be building blocks of more generic mission plans. A sequence is a series of steps, and each executes actions once conditions for the step are met (e.g. desired temperatures or fluid state are achieved). For autonomous capability, conditions must consider also health management outcomes, as they will determine whether or not an action is executed, or how an action may be executed, or if an alternative action is executed instead. Aside from health, higher level objectives can also drive how a mission is carried out. The capability was developed using the G2 software environment (www.gensym.com) augmented by a NASA Toolkit that significantly shortens time to deployment. G2 is a commercial product to develop intelligent applications. It is fully object oriented. The core of the capability is a Domain Model of the system where all elements of the system are represented as objects (sensors, instruments, components, pipes, etc.). Reasoning and decision making can be done with all elements in the domain model. The toolkit also enables implementation of failure modes and effects analysis (FMEA), which are represented as root cause trees. FMEA's are programmed graphically, they are reusable, as they address generic FMEA referring to classes of subsystems or objects and their functional relationships. User interfaces for integrated awareness by operators have been created.

Figueroa, Fernando; Walker, Mark; Wilkins, Kim; Johnson, Robert; Sass, Jared; Youney, Justin

2014-01-01

322

Functional analysis and intervention for chronic rumination.  

PubMed

We conducted a functional analysis and treatment evaluation of chronic rumination in a 19-year-old man with intellectual disabilities. Outcomes of the functional analysis suggested that rumination was maintained by automatic reinforcement. Results of the intervention evaluation suggested that (a) noncontingent access to food after meals reduced rumination more effectively than did noncontingent access to inedible stimuli, (b) a particular type of food was associated with lower levels of rumination than other types of food, and (c) both presession and continuous access to food reduced levels of rumination more effectively than did fixed-time access to food. PMID:24114108

Woods, Kathryn E; Luiselli, James K; Tomassone, Shanon

2013-01-01

323

Use of information systems as management tools in health care  

NASA Astrophysics Data System (ADS)

Information systems that can be used as effective management tools in healthcare do not exist. This is because current information systems do not accurately reflect reality and because they do not provide information to important end-users, i.e., clinicians. To reflect reality, healthcare information systems must assess total health care costs. These not only include the direct economic costs (dollars paid) but also the indirect economic costs (dollars lost, spent, or saved) from having a person ill. These systems must also accurately assess the adjusted, qualitative costs of human life and human pain and suffering resulting from the illness and healthcare provided. Once information systems reflect reality, they can be used to manage healthcare by profiling utilization, projecting need, modeling programs, assessing quality of care and establishing guidelines.

Davila, Fidel

1995-10-01

324

Statistical tools for prognostics and health management of complex systems  

SciTech Connect

Prognostics and Health Management (PHM) is increasingly important for understanding and managing today's complex systems. These systems are typically mission- or safety-critical, expensive to replace, and operate in environments where reliability and cost-effectiveness are a priority. We present background on PHM and a suite of applicable statistical tools and methods. Our primary focus is on predicting future states of the system (e.g., the probability of being operational at a future time, or the expected remaining system life) using heterogeneous data from a variety of sources. We discuss component reliability models incorporating physical understanding, condition measurements from sensors, and environmental covariates; system reliability models that allow prediction of system failure time distributions from component failure models; and the use of Bayesian techniques to incorporate expert judgments into component and system models.

Collins, David H [Los Alamos National Laboratory; Huzurbazar, Aparna V [Los Alamos National Laboratory; Anderson - Cook, Christine M [Los Alamos National Laboratory

2010-01-01

325

Leader-Member Exchange Relationships in Health Information Management  

PubMed Central

This article seeks to raise awareness of the leader-member exchange (LMX) theory of leadership and its potential benefit to the health information management (HIM) profession. A literature review that was conducted identified a leadership challenge for HIM practitioners. The review also provides examples of leadership definitions, and potential benefits of LMX to HIM professionals in leading people and influencing leaders in their organizations. The LMX concept may be an avenue to investigate in preparing future and current HIM professionals for leadership. PMID:24808805

Hunt, T.J.

2014-01-01

326

Vehicle health management for guidance, navigation and control systems  

NASA Technical Reports Server (NTRS)

The objective of the program was to architect a vehicle health management (VHM) system for space systems avionics that assures system readiness for launch vehicles and for space-based dormant vehicles. The platforms which were studied and considered for application of VHM for guidance, navigation and control (GN&C) included the Advanced Manned Launch System (AMLS), the Horizontal Landing-20/Personnel Launch System (HL-20/PLS), the Assured Crew Return Vehicle (ACRV) and the Extended Duration Orbiter (EDO). This set was selected because dormancy and/or availability requirements are driving the designs of these future systems.

Radke, Kathleen; Frazzini, Ron; Bursch, Paul; Wald, Jerry; Brown, Don

1993-01-01

327

Integrated System Health Management: Foundational Concepts, Approach, and Implementation.  

NASA Technical Reports Server (NTRS)

Implementation of integrated system health management (ISHM) capability is fundamentally linked to the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system. It is akin to having a team of experts who are all individually and collectively observing and analyzing a complex system, and communicating effectively with each other in order to arrive to an accurate and reliable assessment of its health. We present concepts, procedures, and a specific approach as a foundation for implementing a credible ISHM capability. The capability stresses integration of DIaK from all elements of a system. The intent is also to make possible implementation of on-board ISHM capability, in contrast to a remote capability. The information presented is the result of many years of research, development, and maturation of technologies, and of prototype implementations in operational systems (rocket engine test facilities). The paper will address the following topics: 1. ISHM Model of a system 2. Detection of anomaly indicators. 3. Determination and confirmation of anomalies. 4. Diagnostic of causes and determination of effects. 5. Consistency checking cycle. 6. Management of health information 7. User Interfaces 8. Example implementation ISHM has been defined from many perspectives. We define it as a capability that might be achieved by various approaches. We describe a specific approach that has been matured throughout many years of development, and pilot implementations. ISHM is a capability that is achieved by integrating data, information, and knowledge (DIaK) that might be distributed throughout the system elements (which inherently implies capability to manage DIaK associated with distributed sub-systems). DIaK must be available to any element of a system at the right time and in accordance with a meaningful context. ISHM Functional Capability Level (FCL) is measured by how well a system performs the following functions: (1) detect anomalies, (2) diagnose causes, (3) predict future anomalies/failures, and (4) provide the user with an integrated awareness about the condition of every element in the system and guide user decisions.

Figueroa, Fernando; Schmalzel, John; Walker, Mark; Venkatesh, Meera; Kapadia, Ravi; Morris, Jon; Turowski, Mark; Smith, Harvey

2009-01-01

328

Advanced Health Management of a Brushless Direct Current Motor/Controller  

NASA Technical Reports Server (NTRS)

This effort demonstrates that health management can be taken to the component level for electromechanical systems. The same techniques can be applied to take any health management system to the component level, based on the practicality of the implementation for that particular system. This effort allows various logic schemes to be implemented for the identification and management of failures. By taking health management to the component level, integrated vehicle health management systems can be enhanced by protecting box-level avionics from being shut down in order to isolate a failed computer.

Pickett, R. D.

2003-01-01

329

Sleep problems may mediate associations between rumination and PTSD and depressive symptoms among OIF/OEF veterans.  

PubMed

Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) veterans have high rates of posttraumatic stress disorder (PTSD), depression, and sleep problems. Identifying potential contributing factors to these mental health problems is crucial for improving treatments in this population. Rumination, or repeated thoughts about negative experiences, is associated with worse PTSD, depression, and sleep problems in nonveterans. Therefore, we hypothesized that rumination would be associated with worse sleep problems, PTSD, and depressive symptoms in OIF/OEF veterans. Additionally, we proposed a novel hypothesis that sleep problems are a mechanism by which rumination contributes to depressive and PTSD symptoms. In this cross-sectional study, 89 OIF/OEF veterans completed measures of trait rumination, sleep problems, and PTSD and depressive symptoms. Analyses confirmed that greater rumination was associated with worse functioning on all mental health measures. Moreover, greater global sleep problems statistically mediated the association between higher rumination and more PTSD and depressive symptoms. Specifically, sleep disturbance and daytime somnolence but not sleep quantity emerged as significant mediators. Although it is impossible with the current nonexperimental data to test causal mediation, these results support the idea that rumination could contribute to impaired sleep, which in turn could contribute to psychological symptoms. We suggest that interventions targeting both rumination and sleep problems may be an effective way to treat OIF/OEF veterans with PTSD or depressive symptoms. (PsycINFO Database Record PMID:25793596

Borders, Ashley; Rothman, David J; McAndrew, Lisa M

2015-01-01

330

Health numeracy: Perspectives about using numbers in health management from African American patients receiving dialysis.  

PubMed

Health numeracy is linked to important clinical outcomes. Kidney disease management relies heavily on patient numeracy skills across the continuum of kidney disease care. Little data are available eliciting stakeholder perspectives from patients receiving dialysis about the construct of health numeracy. Using focus groups, we asked patients receiving hemodialysis open-ended questions to identify facilitators and barriers to their understanding, interpretation, and application of numeric information in kidney care. Transcripts were analyzed using content analysis. Twelve patients participated with a mean (standard deviation) age of 56 (12) years. All were African American, 50% were women, and 83% had an annual income <$20,000/year. Although patients felt numbers were critical to every aspect in life, they noted several barriers to understanding, interpreting and applying quantitative information specifically to manage their health. Low patient self-efficacy related to health numeracy and limited patient-provider communication about quantitatively based feedback, were emphasized as key barriers. Through focus groups of key patient stakeholders we identified important modifiable barriers to effective kidney care. Additional research is needed to develop tools that support numeracy-sensitive education and communication interventions in dialysis. PMID:25358522

Wright Nunes, Julie A; Osborn, Chandra Y; Ikizler, T Alp; Cavanaugh, Kerri L

2015-04-01

331

What would it take? Stakeholders' views and preferences for implementing a health care manager program in community mental health clinics under health care reform.  

PubMed

Health care manager interventions can improve the physical health of people with serious mental illness (SMI). In this study, we used concepts from the theory of diffusion of innovations, the consolidated framework for implementation research and a taxonomy of implementation strategies to examine stakeholders' recommendations for implementing a health care manager intervention in public mental health clinics serving Hispanics with SMI. A purposive sample of 20 stakeholders was recruited from mental health agencies, primary care clinics, and consumer advocacy organizations. We presented participants a vignette describing a health care manager intervention and used semistructured qualitative interviews to examine their views and recommendations for implementing this program. Interviews were recorded, professionally transcribed, and content analyzed. We found that a blend of implementation strategies that demonstrates local relative advantage, addresses cost concerns, and enhances compatibility to organizations and the client population is critical for moving health care manager interventions into practice. PMID:25542194

Cabassa, Leopoldo J; Gomes, Arminda P; Lewis-Fernández, Roberto

2015-02-01

332

Environmental Management Waste Management Facility (EMWMF) Site-Specific Health and Safety Plan, Oak Ridge, Tennessee  

SciTech Connect

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.

Flynn, N.C. Bechtel Jacobs

2008-04-21

333

Brief report: preliminary evidence that co-rumination fosters adolescents' depression risk by increasing rumination.  

PubMed

Mounting research shows that the tendency to co-ruminate with peers regarding ongoing problems increases adolescents' depression risk; however, the means by which this interpersonal process fosters risk has not been identified. This said, theorists have proposed that co-rumination increases depression risk, in part, by increasing one's tendency to ruminate when alone. We tested this hypothesis in a study of 201 high-school freshmen who completed two assessments, six months apart. Supporting the proposed model, co-rumination predicted prospective increases in rumination and rumination predicted increases in depressive symptoms. The direct effect of co-rumination on depressive symptom change was not significant. Results indicate that co-rumination with friends may serve to increase rumination, which in turn increases depression risk. PMID:25460674

Stone, Lindsey B; Gibb, Brandon E

2015-01-01

334

Mental health services of the future: Managed care, unmanaged care, mismanaged care  

Microsoft Academic Search

Rising costs. Treatable disorders. No treatment for many. High indirect expenses. The response to this contemporary set of circumstances has been managed mental health care. The transition from fee?for?service to managed behavioral health services has meant the industrialization of mental health care, an entirely new culture for providers, and a melding of the traditional public and private sectors. This article

Jeffrey L. Geller

1996-01-01

335

Assurance of Learning Assessment Matrix -MS Health Care Management Learning Goals Learning Objectives Assessment/Assignment  

E-print Network

Assurance of Learning Assessment Matrix - MS Health Care Management Learning Goals Learning Objectives Assessment/Assignment Understand and master core concepts and methods in the health care concepts and tools in the health care management discipline to develop integrated and innovative strategies

Niebur, Ernst

336

BioHealth--the need for security and identity management standards in eHealth.  

PubMed

The experience gained in these last years and the several lesson learned have clearly shown that eHealth is more than just a simple change from paper records to electronic records. It necessitates a change of paradigms, on the one hand and the use of new technologies and introduction of new procedures on the other. Interoperability becomes a crucial issue. Security and confidentiality are vital for the acceptance of the new approaches and for the support of eHealth. Shared care and across-border interactions require a reliable and stable normative framework based on the application of standardized solutions, which are often not yet sufficiently known, diffused and implemented. Feeling this gap, a group of international experts in the medical area proposed to the EC the BioHealth project whose main aim is to create awareness about standardization in eHealth and to facilitate its practical implementation. The project will address all the stakeholders concerning their respective domain. It will evaluate the socio-economic and cultural aspects concerning eHealth with particular reference to the growing introduction of emerging technologies such as health cards, biometrics, RFID (radio-frequency identification) and NFC (Near field communication) tags. By providing information and expert advice on standardization and best practices it will raise the acceptance on standardization. Furthermore, the project will deeply approach the ethical and accessibility issues connected to identity management in eHealth, which -together with privacy- represent probably the most significant obstacles for the wide diffusion of eHealth procedures. PMID:17095831

Hildebrand, Claudia; Pharow, Peter; Engelbrecht, Rolf; Blobel, Bernd; Savastano, Mario; Hovsto, Asbjorn

2006-01-01

337

Post-stress rumination predicts HPA axis responses to repeated acute stress.  

PubMed

Failure of the hypothalamus-pituitary-adrenal (HPA) axis to habituate to repeated stress exposure is related with adverse health outcomes, but our knowledge of predictors of non-habituation is limited. Rumination, defined as repetitive and unwanted past-centered negative thinking, is related with exaggerated HPA axis stress responses and poor health outcomes. The aim of this study was to test whether post-stress rumination was related with non-habituation of cortisol to repeated stress exposure. Twenty-seven participants (n=13 females) were exposed to the Trier Social Stress Test (TSST) twice on consecutive afternoons. Post-stress rumination was measured after the first TSST, and HPA axis responses were assessed by measuring salivary cortisol 1 min before, and 1, 10, 20, 60, and 120 min after both TSSTs. Stress exposure induced HPA axis activation on both days, and this activation showed habituation indicated by lower responses to the second TSST (F=3.7, p=0.015). Post-stress rumination after the first TSST was associated with greater cortisol reactivity after the initial stress test (r=0.45, p<0.05) and with increased cortisol responses to the second TSST (r=0.51, p<0.01), indicating non-habituation, independently of age, sex, depressive symptoms, perceived life stress, and trait rumination. In summary, results showed that rumination after stress predicted non-habituation of HPA axis responses. This finding implicates rumination as one possible mechanism mediating maladaptive stress response patterns, and it might also offer a pathway through which rumination might lead to negative health outcomes. PMID:25127082

Gianferante, Danielle; Thoma, Myriam V; Hanlin, Luke; Chen, Xuejie; Breines, Juliana G; Zoccola, Peggy M; Rohleder, Nicolas

2014-11-01

338

Assessing the implementation of performance management of health care workers in Uganda  

PubMed Central

Background The performance management concept is relatively new to the Ugandan health sector. Uganda has been implementing health sector reforms for nearly two decades. The reforms included the introduction of the results-oriented management in the public sector and the decentralisation of the management of health care workers from central to local governments. This study examined the implementation of performance management of health care workers in order to propose strategies for improvement. Methods The study was a descriptive survey carried out in the Kumi, Mbale, Sironko and Tororo districts and utilising mixed research methodology. A self-administered questionnaire was used to collect quantitative data from the health care workers. A semi-structured interview guide was used to collect qualitative data from the health service managers. The sample for the quantitative method was selected using stratified random sampling. Purposive sampling was used to select health service managers. Quantitative data were analysed using Statistical Package for Social Sciences (version 18.0). Qualitative data were categorised according to the themes and analysed manually. Results The findings show that to some extent performance management is implemented in the health sector; however, there were loopholes in its implementation. There were inadequacies in setting performance targets and performance management planning was hardly done. Although many health care workers had job descriptions, the performance indicators and standards were not clearly defined and known to all workers and managers. Additionally the schedules for performance assessments were not always adhered to. There were limited prospects for career progression, inadequate performance feedback and poor rewarding mechanisms. Conclusions Performance management of health care workers is inadequately done in the districts. Performance management is a key component of attempts to improve health sector outcomes. As a result of this study, suggestions to enhance health sector performance management in the districts have been put forward. The authors are optimistic that if these suggestions are implemented, the performance of health care workers is likely to improve. PMID:24044774

2013-01-01

339

Molecular virology of ruminant herpesviruses  

Microsoft Academic Search

Molecular virology has served to establish bovine herpesvirus 1 (BHV-1) as the prototype member of ruminant herpesviruses. Based on the genomic sequence of the virus, we aim to identify and characterize virus-specified components, to explain their concerted action, and to predict how the chain of events during the lytic and latent phases of the viral life cycle may be interrupted.

Martin Schwyzer; Mathias Ackermann

1996-01-01

340

Alternative pastures for small ruminants  

Technology Transfer Automated Retrieval System (TEKTRAN)

Small ruminant livestock have some unique considerations for grazing compared to cattle. Like cattle, sheep are natural grazers that readily eat grass, but goats are browsers that prefer to eat leaves from shrubs. Sheep and goats require greater nutritive quality in the diet than cattle, and if st...

341

Rocket Engine Health Management: Early Definition of Critical Flight Measurements  

NASA Technical Reports Server (NTRS)

The NASA led Space Launch Initiative (SLI) program has established key requirements related to safety, reliability, launch availability and operations cost to be met by the next generation of reusable launch vehicles. Key to meeting these requirements will be an integrated vehicle health management ( M) system that includes sensors, harnesses, software, memory, and processors. Such a system must be integrated across all the vehicle subsystems and meet component, subsystem, and system requirements relative to fault detection, fault isolation, and false alarm rate. The purpose of this activity is to evolve techniques for defining critical flight engine system measurements-early within the definition of an engine health management system (EHMS). Two approaches, performance-based and failure mode-based, are integrated to provide a proposed set of measurements to be collected. This integrated approach is applied to MSFC s MC-1 engine. Early identification of measurements supports early identification of candidate sensor systems whose design and impacts to the engine components must be considered in engine design.

Christenson, Rick L.; Nelson, Michael A.; Butas, John P.

2003-01-01

342

Integrated System Health Management: Foundational Concepts, Approach, and Implementation  

NASA Technical Reports Server (NTRS)

A sound basis to guide the community in the conception and implementation of ISHM (Integrated System Health Management) capability in operational systems was provided. The concept of "ISHM Model of a System" and a related architecture defined as a unique Data, Information, and Knowledge (DIaK) architecture were described. The ISHM architecture is independent of the typical system architecture, which is based on grouping physical elements that are assembled to make up a subsystem, and subsystems combine to form systems, etc. It was emphasized that ISHM capability needs to be implemented first at a low functional capability level (FCL), or limited ability to detect anomalies, diagnose, determine consequences, etc. As algorithms and tools to augment or improve the FCL are identified, they should be incorporated into the system. This means that the architecture, DIaK management, and software, must be modular and standards-based, in order to enable systematic augmentation of FCL (no ad-hoc modifications). A set of technologies (and tools) needed to implement ISHM were described. One essential tool is a software environment to create the ISHM Model. The software environment encapsulates DIaK, and an infrastructure to focus DIaK on determining health (detect anomalies, determine causes, determine effects, and provide integrated awareness of the system to the operator). The environment includes gateways to communicate in accordance to standards, specially the IEEE 1451.1 Standard for Smart Sensors and Actuators.

Figueroa, Fernando

2009-01-01

343

Development of Structural Health Management Technology for Aerospace Vehicles  

NASA Technical Reports Server (NTRS)

As part of the overall goal of developing Integrated Vehicle Health Management (IVHM) systems for aerospace vehicles, NASA has focused considerable resources on the development of technologies for Structural Health Management (SHM). The motivations for these efforts are to increase the safety and reliability of aerospace structural systems, while at the same time decreasing operating and maintenance costs. Research and development of SHM technologies has been supported under a variety of programs for both aircraft and spacecraft including the Space Launch Initiative, X-33, Next Generation Launch Technology, and Aviation Safety Program. The major focus of much of the research to date has been on the development and testing of sensor technologies. A wide range of sensor technologies are under consideration including fiber-optic sensors, active and passive acoustic sensors, electromagnetic sensors, wireless sensing systems, MEMS, and nanosensors. Because of their numerous advantages for aerospace applications, most notably being extremely light weight, fiber-optic sensors are one of the leading candidates and have received considerable attention.

Prosser, W. H.

2003-01-01

344

All Authorizations for Use and Disclosure of Personal Health Information Forms must be completed and submitted to the Health Information Management Office at  

E-print Network

and submitted to the Health Information Management Office at: University Health Services Health Information in situations of medical emergency. Please contact the Health Information Management Office at 850All Authorizations for Use and Disclosure of Personal Health Information Forms must be completed

McQuade, D. Tyler

345

A ride in the time machine: information management capabilities health departments will need.  

PubMed

We have proposed needed information management capabilities for future US health departments predicated on trends in health care reform and health information technology. Regardless of whether health departments provide direct clinical services (and many will), they will manage unprecedented quantities of sensitive information for the public health core functions of assurance and assessment, including population-level health surveillance and metrics. Absent improved capabilities, health departments risk vestigial status, with consequences for vulnerable populations. Developments in electronic health records, interoperability and information exchange, public information sharing, decision support, and cloud technologies can support information management if health departments have appropriate capabilities. The need for national engagement in and consensus on these capabilities and their importance to health department sustainability make them appropriate for consideration in the context of accreditation. PMID:25033122

Foldy, Seth; Grannis, Shaun; Ross, David; Smith, Torney

2014-09-01

346

The importance of human resources management in health care: a global context  

PubMed Central

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. This paper will reveal how human resources management is essential to any health care system and how it can improve health care models. Challenges in the health care systems in Canada, the United States of America and various developing countries are examined, with suggestions for ways to overcome these problems through the proper implementation of human resources management practices. Comparing and contrasting selected countries allowed a deeper understanding of the practical and crucial role of human resources management in health care. Conclusion Proper management of human resources is critical in providing a high quality of health care. A refocus on human resources management in health care and more research are needed to develop new policies. Effective human resources management strategies are greatly needed to achieve better outcomes from and access to health care around the world. PMID:16872531

Kabene, Stefane M; Orchard, Carole; Howard, John M; Soriano, Mark A; Leduc, Raymond

2006-01-01

347

Predicted health impacts of urban air quality management  

PubMed Central

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. PMID:14729886

Mindell, J; Joffe, M

2004-01-01

348

DEVELOPMENT OF MY HEALTH COMPANION© TO ENHANCE SELF-CARE MANAGEMENT OF CHRONIC HEALTH CONDITIONS IN RURAL DWELLERS  

PubMed Central

Appropriate self-management support is needed to help individuals and their families meet the challenges of living with chronic health conditions. Such support is characterized by productive interactions between informed, active individuals and their health care providers. The purposes of this paper are to describe the challenges to achieving self-management support and a tool, My Health Companion© (MHC), which was developed to meet that challenge. The MHC is a paper personal health record designed to help rural women with chronic health conditions to better manage and understand their health information. The selection of content for the MHC was based on the literature, input from health care experts, and chronically ill individuals, and its development incorporated principles of personal health records and clear communication. The MHC was anecdotally shown to be useful to rural women with chronic health conditions in preparing for and enhancing their visits with health care providers. As a source of information, the MHC had potential for: being beneficial to providers in recommending appropriate treatment; contributing to more informed health decision making by ill individuals; and serving as a vehicle for the establishment of more productive interactions that contributed to the achievement of true client-provider partnerships in health care. PMID:20525099

Weinert, Clarann; Cudney, Shirley; Kinion, Elizabeth

2011-01-01

349

POSITION ANNOUNCEMENT Public Service Assistant: Integrated Pest Management and Forest Health Program  

E-print Network

POSITION ANNOUNCEMENT Public Service Assistant: Integrated Pest Management and Forest Health Program Coordinator - The Center for Invasive Species and Ecosystem Health University of Georgia Position: Twelve month, non- tenure track Public Service Assistant with responsibilities in Integrated Pest

Arnold, Jonathan

350

Not-so-strange bedfellows: models of interaction between managed care plans and public health agencies.  

PubMed

Alliances between managed care plans and public health agencies are a growing phenomenon in local health care markets, with profound implications for health care quality, cost, and accessibility. A typology of interorganizational relations between managed care plans and local public health agencies is drawn from observations of over 60 public health jurisdictions. Relations are described along three dimensions corresponding to the strategic intent, functional operation, and structural design of each alliance type. The identified models of interaction reveal the motivations for forming alliances, the mechanics of their operation, and the possible outcomes. These alliances suggest that a wide range of interorganizational strategies is possible in order to pursue the shared interests of local public health agencies and managed care plans. Nonetheless, public health agencies may face challenges in forging managed care alliances that benefit community-wide populations and that are open to participation by the full spectrum of health care providers in the community. PMID:9063302

Halverson, P K; Mays, G P; Kaluzny, A D; Richards, T B

1997-01-01

351

By: Latarsha Chisholm, MSW, Ph.D. Department of Health Management & Informatics  

E-print Network

report their health as fair or poor compared to White women Black, Hispanic, and American IndianBy: Latarsha Chisholm, MSW, Ph.D. Department of Health Management & Informatics University of Central Florida #12;Health Disparities Health disparities refers to population-specific differences

Wu, Shin-Tson

352

Improving Imperfect Data from Health Management Information Systems in Africa Using Space–Time Geostatistics  

Microsoft Academic Search

Background Reliable and timely information on disease-specific treatment burdens within a health system is critical for the planning and monitoring of service provision. Health management information systems (HMIS) exist to address this need at national scales across Africa but are failing to deliver adequate data because of widespread underreporting by health facilities. Faced with this inadequacy, vital public health decisions

Peter W. Gething; Abdisalan M. Noor; Priscilla W. Gikandi; Esther A. A. Ogara; Simon I. Hay; Mark S. Nixon; Robert W. Snow; Peter M. Atkinson

2006-01-01

353

An Attentional Scope Model of Rumination  

PubMed Central

Rumination, defined as repetitive thinking about negative information, has been found to lead to serious maladaptive consequences, including longer and more severe episodes of major depression. In this review, we present and discuss research findings motivated by the formulation that individual differences in cognitive processes that control how information is processed influence the likelihood that thoughts will become repetitive and negative. A number of studies have demonstrated that a tendency to ruminate (i.e., trait rumination) is related to difficulties updating working memory (WM) and disengaging from and forgetting no-longer-relevant information. Other investigators have documented that trait rumination is also associated with an enhanced ability to ignore distracting information and to more stable maintenance of task-relevant information. In contrast to trait rumination, a state of rumination has been found to be related to widespread deficits in cognitive control. In this paper we discuss how the current accounts of control functioning cannot explain this pattern of anomalous control functioning. To explain these findings, including unexpected and contradictory results, we present an attentional scope model of rumination that posits that a constricted array of thoughts, percepts, and actions that are activated in WM or available for selection from LTM affects the control functioning of trait ruminators. This model explains, at a cognitive level, why rumination is particularly likely to arise when individuals are in a negative mood state; it also accounts for a number of findings outside of the rumination-control literature and generates several novel predictions. PMID:23244316

Whitmer, Anson J.; Gotlib, Ian H.

2013-01-01

354

Building public health goals into the purchasing process: managed care perspective.  

PubMed

Public health and managed care organizations are increasingly developing contracts for the care of Medicaid patients. Factors leading to this relationship include increasing managed care interest in returning to the concept of "health maintenance" and population medicine, and the decreasing funding available to public health. Each partner has strengths that can be utilized in such relationships. Obstacles exist in the development of this relationship, including the already considerable reporting burdens on managed care organizations and issues surrounding the contracts and delegation of services. Despite this there are many examples of public health managed care partnerships. PMID:9566942

Rosnick, M

1998-04-01

355

Vehicle Health Management Communications Requirements for AeroMACS  

NASA Technical Reports Server (NTRS)

As the development of standards for the aeronautical mobile airport communications system (AeroMACS) progresses, the process of identifying and quantifying appropriate uses for the system is progressing. In addition to defining important elements of AeroMACS standards, indentifying the systems uses impacts AeroMACS bandwidth requirements. Although an initial 59 MHz spectrum allocation for AeroMACS was established in 2007, the allocation may be inadequate; studies have indicated that 100 MHz or more of spectrum may be required to support airport surface communications. Hence additional spectrum allocations have been proposed. Vehicle health management (VHM) systems, which can produce large volumes of vehicle health data, were not considered in the original bandwidth requirements analyses, and are therefore of interest in supporting proposals for additional AeroMACS spectrum. VHM systems are an emerging development in air vehicle safety, and preliminary estimates of the amount of data that will be produced and transmitted off an aircraft, both in flight and on the ground, have been prepared based on estimates of data produced by on-board vehicle health sensors and initial concepts of data processing approaches. This allowed an initial estimate of VHM data transmission requirements for the airport surface. More recently, vehicle-level systems designed to process and analyze VHM data and draw conclusions on the current state of vehicle health have been undergoing testing and evaluation. These systems make use of vehicle system data that is mostly different from VHM data considered previously for airport surface transmission, and produce processed system outputs that will be also need to be archived, thus generating additional data load for AeroMACS. This paper provides an analysis of airport surface data transmission requirements resulting from the vehicle level reasoning systems, within the context of overall VHM data requirements.

Kerczewski, Robert J.; Clements, Donna J.; Apaza, Rafael D.

2012-01-01

356

Integrating complementary and alternative medicine into mainstream healthcare services: the perspectives of health service managers  

PubMed Central

Background Complementary and alternative medicine (CAM) is increasingly included within mainstream integrative healthcare (IHC) services. Health service managers are key stakeholders central to ensuring effective integrative health care services. Yet, little research has specifically investigated the role or perspective of health service managers with regards to integrative health care services under their management. In response, this paper reports findings from an exploratory study focusing exclusively on the perspectives of health service managers of integrative health care services in Australia regarding the role of CAM within their service and the health service managers rational for incorporating CAM into clinical care. Methods Health service managers from seven services were recruited using purposive and snowball sampling. Semi-structured interviews were conducted with the health service managers. The services addressed trauma and chronic conditions and comprised: five community-based programs including drug and alcohol rehabilitation, refugee mental health and women’s health; and two hospital-based specialist services. The CAM practices included in the services investigated included acupuncture, naturopathy, Western herbal medicine and massage. Results Findings reveal that the health service managers in this study understand CAM to enhance the holistic capacity of their service by: filling therapeutic gaps in existing healthcare practices; by treating the whole person; and by increasing healthcare choices. Health service managers also identified CAM as addressing therapeutic gaps through the provision of a mind-body approach in psychological trauma and in chronic disease management treatment. Health service managers describe the addition of CAM in their service as enabling patients who would otherwise not be able to afford CAM to gain access to these treatments thereby increasing healthcare choices. Some health service managers expressly align the notion of treating the whole person within a health promotion model and focus on the relevance of diet and lifestyle factors as central to a CAM approach. Conclusions From the perspectives of the health service managers, these findings contribute to our understanding around the rationale to include CAM within mainstream health services that deal with psychological trauma and chronic disease. The broader implications of this study can help assist in the development of health service policy on CAM integration in mainstream healthcare services. PMID:24885066

2014-01-01

357

Intelligent Integrated Health Management for a System of Systems  

NASA Technical Reports Server (NTRS)

An intelligent integrated health management system (IIHMS) incorporates major improvements over prior such systems. The particular IIHMS is implemented for any system defined as a hierarchical distributed network of intelligent elements (HDNIE), comprising primarily: (1) an architecture (Figure 1), (2) intelligent elements, (3) a conceptual framework and taxonomy (Figure 2), and (4) and ontology that defines standards and protocols. Some definitions of terms are prerequisite to a further brief description of this innovation: A system-of-systems (SoS) is an engineering system that comprises multiple subsystems (e.g., a system of multiple possibly interacting flow subsystems that include pumps, valves, tanks, ducts, sensors, and the like); 'Intelligent' is used here in the sense of artificial intelligence. An intelligent element may be physical or virtual, it is network enabled, and it is able to manage data, information, and knowledge (DIaK) focused on determining its condition in the context of the entire SoS; As used here, 'health' signifies the functionality and/or structural integrity of an engineering system, subsystem, or process (leading to determination of the health of components); 'Process' can signify either a physical process in the usual sense of the word or an element into which functionally related sensors are grouped; 'Element' can signify a component (e.g., an actuator, a valve), a process, a controller, an actuator, a subsystem, or a system; The term Integrated System Health Management (ISHM) is used to describe a capability that focuses on determining the condition (health) of every element in a complex system (detect anomalies, diagnose causes, prognosis of future anomalies), and provide data, information, and knowledge (DIaK) not just data to control systems for safe and effective operation. A major novel aspect of the present development is the concept of intelligent integration. The purpose of intelligent integration, as defined and implemented in the present IIHMS, is to enable automated analysis of physical phenomena in imitation of human reasoning, including the use of qualitative methods. Intelligent integration is said to occur in a system in which all elements are intelligent and can acquire, maintain, and share knowledge and information. In the HDNIE of the present IIHMS, an SoS is represented as being operationally organized in a hierarchical-distributed format. The elements of the SoS are considered to be intelligent in that they determine their own conditions within an integrated scheme that involves consideration of data, information, knowledge bases, and methods that reside in all elements of the system. The conceptual framework of the HDNIE and the methodologies of implementing it enable the flow of information and knowledge among the elements so as to make possible the determination of the condition of each element. The necessary information and knowledge is made available to each affected element at the desired time, satisfying a need to prevent information overload while providing context-sensitive information at the proper level of detail. Provision of high-quality data is a central goal in designing this or any IIHMS. In pursuit of this goal, functionally related sensors are logically assigned to groups denoted processes. An aggregate of processes is considered to form a system. Alternatively or in addition to what has been said thus far, the HDNIE of this IIHMS can be regarded as consisting of a framework containing object models that encapsulate all elements of the system, their individual and relational knowledge bases, generic methods and procedures based on models of the applicable physics, and communication processes (Figure 2). The framework enables implementation of a paradigm inspired by how expert operators monitor the health of systems with the help of (1) DIaK from various sources, (2) software tools that assist in rapid visualization of the condition of the system, (3) analical software tools that assist in reasoning about the condition, (4) sharing of information via

Smith, Harvey; Schmalzel, John; Figueroa, Fernando

2008-01-01

358

Distributed Prognostics and Health Management with a Wireless Network Architecture  

NASA Technical Reports Server (NTRS)

A heterogeneous set of system components monitored by a varied suite of sensors and a particle-filtering (PF) framework, with the power and the flexibility to adapt to the different diagnostic and prognostic needs, has been developed. Both the diagnostic and prognostic tasks are formulated as a particle-filtering problem in order to explicitly represent and manage uncertainties in state estimation and remaining life estimation. Current state-of-the-art prognostic health management (PHM) systems are mostly centralized in nature, where all the processing is reliant on a single processor. This can lead to a loss in functionality in case of a crash of the central processor or monitor. Furthermore, with increases in the volume of sensor data as well as the complexity of algorithms, traditional centralized systems become for a number of reasons somewhat ungainly for successful deployment, and efficient distributed architectures can be more beneficial. The distributed health management architecture is comprised of a network of smart sensor devices. These devices monitor the health of various subsystems or modules. They perform diagnostics operations and trigger prognostics operations based on user-defined thresholds and rules. The sensor devices, called computing elements (CEs), consist of a sensor, or set of sensors, and a communication device (i.e., a wireless transceiver beside an embedded processing element). The CE runs in either a diagnostic or prognostic operating mode. The diagnostic mode is the default mode where a CE monitors a given subsystem or component through a low-weight diagnostic algorithm. If a CE detects a critical condition during monitoring, it raises a flag. Depending on availability of resources, a networked local cluster of CEs is formed that then carries out prognostics and fault mitigation by efficient distribution of the tasks. It should be noted that the CEs are expected not to suspend their previous tasks in the prognostic mode. When the prognostics task is over, and after appropriate actions have been taken, all CEs return to their original default configuration. Wireless technology-based implementation would ensure more flexibility in terms of sensor placement. It would also allow more sensors to be deployed because the overhead related to weights of wired systems is not present. Distributed architectures are furthermore generally robust with regard to recovery from node failures.

Goebel, Kai; Saha, Sankalita; Sha, Bhaskar

2013-01-01

359

Empowering primary care workers to improve health services: results from Mozambique's leadership and management development program.  

PubMed

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 development program created by Management Sciences for Health (MSH). Through this program, managers from 40 countries have learned to work in teams to identify their priority challenges and act to implement effective responses. From 2003 to 2004, 11 health units in Nampula Province, participated in a leadership and management development program called the Challenges Program. This was following an assessment which found that the quality of health services was poor, and senior officials determined that the underlying cause was the lack of human resource capacity in leadership and management in a rapidly decentralizing health care system. The program was funded by the US Agency for International Development (USAID) and implemented in partnership between the Mozambican Ministry of Health (MOH) Provincial Directorate in Nampula and Management Sciences for Health (MSH). The Challenges Program used simple management and leadership tools to assist the health units and their communities to address health service challenges. An evaluation of the program in 2005 showed that 10 of 11 health centers improved health services over the year of the program. The Challenges Program used several strategies that contributed to successful outcomes. It integrated leadership strengthening into the day-to-day challenges that staff were facing in the health units. The second success factor in the Challenges Program was the creation of participatory teams. After the program, people no longer waited passively to be trained but instead proactively requested training in needed areas. MOH workers in Nampula reported that the program's approach to improving management and leadership capacity at all levels promoted the efficient use of resources and empowered staff to make a difference. PMID:18651973

Perry, Cary

2008-01-01

360

Empowering primary care workers to improve health services: results from Mozambique's leadership and management development program  

PubMed Central

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 development program created by Management Sciences for Health (MSH). Through this program, managers from 40 countries have learned to work in teams to identify their priority challenges and act to implement effective responses. From 2003 to 2004, 11 health units in Nampula Province, participated in a leadership and management development program called the Challenges Program. This was following an assessment which found that the quality of health services was poor, and senior officials determined that the underlying cause was the lack of human resource capacity in leadership and management in a rapidly decentralizing health care system. The program was funded by the US Agency for International Development (USAID) and implemented in partnership between the Mozambican Ministry of Health (MOH) Provincial Directorate in Nampula and Management Sciences for Health (MSH). The Challenges Program used simple management and leadership tools to assist the health units and their communities to address health service challenges. An evaluation of the program in 2005 showed that 10 of 11 health centers improved health services over the year of the program. The Challenges Program used several strategies that contributed to successful outcomes. It integrated leadership strengthening into the day-to-day challenges that staff were facing in the health units. The second success factor in the Challenges Program was the creation of participatory teams. After the program, people no longer waited passively to be trained but instead proactively requested training in needed areas. MOH workers in Nampula reported that the program's approach to improving management and leadership capacity at all levels promoted the efficient use of resources and empowered staff to make a difference. PMID:18651973

Perry, Cary

2008-01-01

361

Concepts of health and well-being in managers: An organizational study  

PubMed Central

Global changes and new managerial challenges require new concepts of health and well-being in organizational contexts. In the South African context, health and well-being of managers have gained relevance in organizations and in management sciences. International organizations, in particular, attempt to address the increasing demand for health care and the delivery of health services to their managers. Careful and appropriate health management requires research to evaluate context-specific health concepts and strategies. The purpose and aim of this article is to assess managerial concepts on health and well-being that could be used by the organization to contribute to managerial well-being by implementing health promotion according to managerial needs. At the same time, this article contributes to salutogenetic health research that is very rare with regard to the South African organizational management research. This study is a multi-method research study conducted in a selected international organization in South Africa. However, in this article, selected qualitative findings will only be presented. This organizational study presents selected research findings on health concepts and strategies employed by managers. Findings demonstrate that the managerial concepts of health and strategies mainly refer to not only physical but also to mental and spiritual aspects, with a priority on physical health and well-being. The findings presented are based on qualitative research methods and their research criteria. This assessment serves as a foundation for new approaches to health management within the international work context in South Africa. It also contributes to a paradigm shift from pathogenetic to salutogenetic concepts of health and well-being within the South African organizational work context. The article produces new insights into the qualitative health concepts of South African managers and expatriates and contributes to promoting salutogenesis in organization within South Africa. PMID:22028736

Boness, Christian

2011-01-01

362

9 CFR 93.415 - Manure from quarantined ruminants.  

Code of Federal Regulations, 2010 CFR

...2010-01-01 false Manure from quarantined ruminants. 93.415 Section 93.415 Animals...OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants § 93.415 Manure from quarantined ruminants. No manure shall be removed from...

2010-01-01

363

Adoption of online health management tools among healthy older adults: An exploratory study.  

PubMed

As the population ages and chronic diseases abound, overburdened healthcare systems will increasingly require individuals to manage their own health. Online health management tools, quickly increasing in popularity, have the potential to diminish or even replace in-person contact with health professionals, but overall efficacy and usage trends are unknown. The current study explored perceptions and usage patterns among users of online health management tools, and identified barriers and barrier-breakers among non-users. An online survey was completed by 169 computer users (aged 50+). Analyses revealed that a sizable minority (37%) of participants use online health management tools and most users (89%) are satisfied with these tools, but a limited range of tools are being used and usage occurs in relatively limited domains. Improved awareness and education for online health management tools could enhance people's abilities to remain at home as they age, reducing the financial burden on formal assistance programs. PMID:25149210

Zettel-Watson, Laura; Tsukerman, Dmitry

2014-08-22

364

Distributed Prognostic Health Management with Gaussian Process Regression  

NASA Technical Reports Server (NTRS)

Distributed prognostics architecture design is an enabling step for efficient implementation of health management systems. A major challenge encountered in such design is formulation of optimal distributed prognostics algorithms. In this paper. we present a distributed GPR based prognostics algorithm whose target platform is a wireless sensor network. In addition to challenges encountered in a distributed implementation, a wireless network poses constraints on communication patterns, thereby making the problem more challenging. The prognostics application that was used to demonstrate our new algorithms is battery prognostics. In order to present trade-offs within different prognostic approaches, we present comparison with the distributed implementation of a particle filter based prognostics for the same battery data.

Saha, Sankalita; Saha, Bhaskar; Saxena, Abhinav; Goebel, Kai Frank

2010-01-01

365

Cyanotoxin management and human health risk mitigation in recreational waters.  

PubMed

The occurrence and severity of harmful cyanobacterial or blue-green algal blooms (HABs) have increased in recent decades, posing a serious threat of illness to humans. In some countries, water contaminated with cyanotoxins that is used for drinking or haemodialysis has posed a particularly serious risk. However, it is now recognized that recreational exposure to natural toxins by skin contact, accidental swallowing of water or inhalation can also cause a wide range of acute or chronic illnesses. In this review, we focus on the importance of cyanotoxin management in recreational waters. The symptoms related with HAB poisonings, the recommended safety concentrations limit for cyanobacteria and cyanotoxins in such waters, as well as early health hazard indicators of their presence and their monitoring are all discussed. We also present in this review an overview of the methods developed in recent decades for eliminating cyanobacteria and the toxic compounds that they produce. PMID:24664523

Koreivien?, Judita; Anne, Olga; Kasperovi?ien?, J?rat?; Burškyt?, Vilma

2014-07-01

366

Unintended outcomes of health care delivery and the need for a national risk management approach.  

PubMed

Unlike the situation in occupational health and safety, there is no nationally coordinated approach to risk management to prevent unintended outcomes of health care provision and improve health care quality. There is a related absence of linkages between quality assurance process, other programs aimed at patient injury prevention and professional indemnity insurance systems. This article discusses the Australian health policy direction and argues for a coordinated national health risk management approach developed through contract requirements which include duty of care and information provision, nationally approved standards and codes, professional liability requirements, and supporting health education, research and information technology development. PMID:10387905

O'Donnell, C

1999-01-01

367

Perceptions of Health Information Management Educational and Practice Experiences  

PubMed Central

Introduction Undergraduate students’ progress toward achievement of learning outcomes and entry-level competencies is an essential ingredient in efforts to meet the needs of the evolving national healthcare information infrastructure. Therefore, studies to evaluate variance in outcome assessment methods and perceived adequacy of educational curricula used by health information management (HIM) programs are vital. This study examined perceptions of HIM students, faculty, and individuals employed in healthcare regarding educational experiences and career preparation. Methods A convenience sample of attendees from the American Health Information Management Association (AHIMA) national conference in Atlanta, Georgia, was obtained. A survey was developed on the basis of a review of current literature related to the assessment of HIM educational programming. The authors used a prepared script to describe the study purpose and survey when approaching potential respondents. Completion of the survey was voluntary. Results Of the 100 surveys distributed, 58 were returned. Twenty-six respondents were employed in healthcare, 25 were students, and 7 were HIM faculty members; no respondents were HIM program directors. Ninety-six percent of the student respondents indicated that the programs’ HIM curriculum prepared them for an entry-level position, while 86 percent of the faculty respondents and 70 percent of the respondents employed in healthcare agreed with this statement. More than half (56 percent) of the respondents who were employed in healthcare indicated that they needed additional training when they entered their first entry-level position. The majority of the respondents indicated that they were not matched with a mentor during their educational experience. Conclusions This research supports the complementary roles that educational coursework and practical experiences provide individuals within the HIM field. However, additional research is needed to assess the potential impact of varied practical experiences and mentoring relationships on the students’ successful transition into the workforce. PMID:25214821

Bates, Mari; Black, Clarence; Blair, Franchesica; Davis, Laquanda; Ingram, Steven; Lane, DaQuandra; McElderry, Alicia; Peagler, Bianca; Pickett, Jamie; Plettenberg, Cheryl; Hart-Hester, Susan

2014-01-01

368

Health Technologies for Monitoring and Managing Diabetes: A Systematic Review  

PubMed Central

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. PMID:20144402

Russell-Minda, Elizabeth; Jutai, Jeffrey; Speechley, Mark; Bradley, Kaitlin; Chudyk, Anna; Petrella, Robert

2009-01-01

369

Advanced Health Management System for the Space Shuttle Main Engine  

NASA Technical Reports Server (NTRS)

Boeing-Canoga Park (BCP) and NASA-Marshall Space Flight Center (NASA-MSFC) are developing an Advanced Health Management System (AHMS) for use on the Space Shuttle Main Engine (SSME) that will improve Shuttle safety by reducing the probability of catastrophic engine failures during the powered ascent phase of a Shuttle mission. This is a phased approach that consists of an upgrade to the current Space Shuttle Main Engine Controller (SSMEC) to add turbomachinery synchronous vibration protection and addition of a separate Health Management Computer (HMC) that will utilize advanced algorithms to detect and mitigate predefined engine anomalies. The purpose of the Shuttle AHMS is twofold; one is to increase the probability of successfully placing the Orbiter into the intended orbit, and the other is to increase the probability of being able to safely execute an abort of a Space Transportation System (STS) launch. Both objectives are achieved by increasing the useful work envelope of a Space Shuttle Main Engine after it has developed anomalous performance during launch and the ascent phase of the mission. This increase in work envelope will be the result of two new anomaly mitigation options, in addition to existing engine shutdown, that were previously unavailable. The added anomaly mitigation options include engine throttle-down and performance correction (adjustment of engine oxidizer to fuel ratio), as well as enhanced sensor disqualification capability. The HMC is intended to provide the computing power necessary to diagnose selected anomalous engine behaviors and for making recommendations to the engine controller for anomaly mitigation. Independent auditors have assessed the reduction in Shuttle ascent risk to be on the order of 40% with the combined system and a three times improvement in mission success.

Davidson, Matt; Stephens, John

2004-01-01

370

Brief report: adolescents' co-rumination with mothers, co-rumination with friends, and internalizing symptoms.  

PubMed

The current research examined co-rumination (extensively discussing, rehashing, and speculating about problems) with mothers and friends. Of interest was exploring whether adolescents who co-ruminate with mothers were especially likely to co-ruminate with friends as well as the interplay among co-rumination with mothers, co-rumination with friends, and anxious/depressed symptoms. Early- to mid-adolescents (N = 393) reported on co-rumination and normative self-disclosure with mothers and friends and on their internalizing symptoms in this cross-sectional study. Co-rumination with mothers (but not normative self-disclosure) was concurrently associated with adolescents' co-rumination with friends. In addition, the relation between co-rumination with mothers and adolescents' anxious/depressed symptoms reported previously (Waller & Rose, 2010) became non-significant when co-rumination with friends was statistically controlled. This suggests that the relation between friendship co-rumination and anxious/depressed symptoms may help explain the relation between mother-child co-rumination and anxious/depressed symptoms. Potential implications for promoting adolescents' well-being are discussed. PMID:23398818

Waller, Erika M; Rose, Amanda J

2013-04-01

371

9 CFR 93.404 - Import permits for ruminants and for ruminant test specimens for diagnostic purposes; and...  

Code of Federal Regulations, 2011 CFR

...be required in the form of certificates concerning specific diseases to which the ruminants are susceptible, as well as vaccinations or other precautionary treatments to which the ruminants or ruminant test specimens have been subjected. Notice of any...

2011-01-01

372

Health promotion and disease prevention: a look at demand management programs.  

PubMed

This Issue Brief describes employers' efforts to contain health expenditures through demand management programs. These programs are designed to reduce utilization by focusing on disease prevention and health promotion. Demand management includes work site health promotion, wellness programs, and access management. Work site health promotion is a comprehensive approach to improving health and includes awareness, health education, behavioral change, and organizational health initiatives. Wellness programs usually include stress management, smoking cessation, weight management, back care, health screenings, nutrition education, work place safety, prenatal and well baby care, CPR and first aid classes, and employee assistance programs (EAPs). These programs are often viewed positively by workers and can have long-term benefits for employers above and beyond health care cost containment. Demand management can benefit employers by increasing productivity, employee retention, and employee morale and by reducing turnover, absenteeism, future medical claims, and ultimately expenditures on health care. Even though a growing number of employers are offering wellness programs, only 37 percent of full-time workers employed in medium and large private establishments were eligible for wellness programs by 1993. However, a recent survey found that 88 percent of major employers have introduced some form of health promotion, disease prevention, or early intervention initiative to encourage healthy lifestyles among their salaried employees. Distinctions must be drawn between short- and long-term strategies. Demand management can be thought of as a short-term strategy when the focus of the program is on creating more appropriate and efficient health care utilization. Disease prevention is characterized by longer-term health improvement objectives. Whether the purpose is to reduce utilization in the short term or in the long term, the ultimate goal remains the same: to reduce health care expenditures while improving overall health. This goal can be achieved through the use of health risk appraisals, organizational health risk appraisals, high risk programs, awareness programs, medical call centers, return to work programs, EAPs, and smoking cessation programs. Studies of a health program's cost effectiveness must disentangle the effects of many competing factors on cost effectiveness. For example, a health risk appraisal program may identify health problems of which the patient and the health care provider were unaware, resulting in the treatment of these health problems. At the same time, the employer may have switched from a nonmanaged pharmaceutical program to a managed program with incentives for participants to utilize generic and/or mail order drugs. As a result, when evaluating a health promotion program, the long-run impact on the program's cost effectiveness is most important. PMID:10161533

Fronstin, P

1996-09-01

373

Data Fusion for Enhanced Aircraft Engine Prognostics and Health Management  

NASA Technical Reports Server (NTRS)

Aircraft gas-turbine engine data is available from a variety of sources, including on-board sensor measurements, maintenance histories, and component models. An ultimate goal of Propulsion Health Management (PHM) is to maximize the amount of meaningful information that can be extracted from disparate data sources to obtain comprehensive diagnostic and prognostic knowledge regarding the health of the engine. Data fusion is the integration of data or information from multiple sources for the achievement of improved accuracy and more specific inferences than can be obtained from the use of a single sensor alone. The basic tenet underlying the data/ information fusion concept is to leverage all available information to enhance diagnostic visibility, increase diagnostic reliability and reduce the number of diagnostic false alarms. This report describes a basic PHM data fusion architecture being developed in alignment with the NASA C-17 PHM Flight Test program. The challenge of how to maximize the meaningful information extracted from disparate data sources to obtain enhanced diagnostic and prognostic information regarding the health and condition of the engine is the primary goal of this endeavor. To address this challenge, NASA Glenn Research Center, NASA Dryden Flight Research Center, and Pratt & Whitney have formed a team with several small innovative technology companies to plan and conduct a research project in the area of data fusion, as it applies to PHM. Methodologies being developed and evaluated have been drawn from a wide range of areas including artificial intelligence, pattern recognition, statistical estimation, and fuzzy logic. This report will provide a chronology and summary of the work accomplished under this research contract.

Volponi, Al

2005-01-01

374

Prognostics Health Management for Advanced Small Modular Reactor Passive Components  

SciTech Connect

In the United States, sustainable nuclear power to promote energy security is a key national energy priority. Advanced small modular reactors (AdvSMR), which are based on modularization of advanced reactor concepts using non-light-water reactor (LWR) coolants such as liquid metal, helium, or liquid salt may provide a longer-term alternative to more conventional LWR-based concepts. The economics of AdvSMRs will be impacted by the reduced economy-of-scale savings when compared to traditional LWRs and the controllable day-to-day costs of AdvSMRs are expected to be dominated by operations and maintenance costs. Therefore, achieving the full benefits of AdvSMR deployment requires a new paradigm for plant design and management. In this context, prognostic health management of passive components in AdvSMRs can play a key role in enabling the economic deployment of AdvSMRs. In this paper, the background of AdvSMRs is discussed from which requirements for PHM systems are derived. The particle filter technique is proposed as a prognostics framework for AdvSMR passive components and the suitability of the particle filter technique is illustrated by using it to forecast thermal creep degradation using a physics-of-failure model and based on a combination of types of measurements conceived for passive AdvSMR components.

Meyer, Ryan M.; Ramuhalli, Pradeep; Coble, Jamie B.; Mitchell, Mark R.; Wootan, David W.; Hirt, Evelyn H.; Berglin, Eric J.; Bond, Leonard J.; Henager, Charles H.

2013-10-18

375

Snout Shape in Extant Ruminants  

PubMed Central

Snout shape is a prominent aspect of herbivore feeding ecology, interacting with both forage selectivity and intake rate. Previous investigations have suggested ruminant feeding styles can be discriminated via snout shape, with grazing and browsing species characterised by ‘blunt’ and ‘pointed’ snouts respectively, often with specification of an ‘intermediate’ sub-grouping to represent ambiguous feeding styles and/or morphologies. Snout shape morphology is analysed here using a geometric morphometric approach to compare the two-dimensional profiles of the premaxilla in ventral aspect for a large sample of modern ruminant species, for which feeding modes are known from secondary criteria. Results suggest that, when browsing and grazing ruminants are classified ecologically based on a range of feeding style indicators, they cannot be discriminated unambiguously on the basis of snout profile shape alone. Profile shapes in our sample form a continuum with substantial overlap between groupings and a diverse range of morphologies. Nevertheless, we obtained an 83.8 percent ratio of correct post hoc feeding style categorisations based on the proximity of projected profile shapes to group centroids in the discriminant space. Accordingly, this procedure for identifying species whose feeding strategy is ‘unknown’ can be used with a reasonable degree of confidence, especially if backed-up by additional information. Based on these results we also refine the definitions of snout shape varieties, taking advantage of the descriptive power that geometric morphometrics offers to characterize the morphological disparities observed. The shape variance exhibited by both browsing and grazing ruminants corresponds strongly to body mass, providing further evidence for an interaction between snout shape, feeding style, and body size evolution. Finally, by exploring the role of phylogenetic similarity in snout shape, we find a slight increase in successful categorisation when repeating the analysis with phylogenetic control on the geometric profiles. PMID:25372878

Tennant, Jonathan P.; MacLeod, Norman

2014-01-01

376

Snout shape in extant ruminants.  

PubMed

Snout shape is a prominent aspect of herbivore feeding ecology, interacting with both forage selectivity and intake rate. Previous investigations have suggested ruminant feeding styles can be discriminated via snout shape, with grazing and browsing species characterised by 'blunt' and 'pointed' snouts respectively, often with specification of an 'intermediate' sub-grouping to represent ambiguous feeding styles and/or morphologies. Snout shape morphology is analysed here using a geometric morphometric approach to compare the two-dimensional profiles of the premaxilla in ventral aspect for a large sample of modern ruminant species, for which feeding modes are known from secondary criteria. Results suggest that, when browsing and grazing ruminants are classified ecologically based on a range of feeding style indicators, they cannot be discriminated unambiguously on the basis of snout profile shape alone. Profile shapes in our sample form a continuum with substantial overlap between groupings and a diverse range of morphologies. Nevertheless, we obtained an 83.8 percent ratio of correct post hoc feeding style categorisations based on the proximity of projected profile shapes to group centroids in the discriminant space. Accordingly, this procedure for identifying species whose feeding strategy is 'unknown' can be used with a reasonable degree of confidence, especially if backed-up by additional information. Based on these results we also refine the definitions of snout shape varieties, taking advantage of the descriptive power that geometric morphometrics offers to characterize the morphological disparities observed. The shape variance exhibited by both browsing and grazing ruminants corresponds strongly to body mass, providing further evidence for an interaction between snout shape, feeding style, and body size evolution. Finally, by exploring the role of phylogenetic similarity in snout shape, we find a slight increase in successful categorisation when repeating the analysis with phylogenetic control on the geometric profiles. PMID:25372878

Tennant, Jonathan P; MacLeod, Norman

2014-01-01

377

Complexity of ruminant masticatory evolution.  

PubMed

The evolution of robust jaws, hypsodont teeth, and large chewing muscles among grazing ruminants is a quintessential example of putative morphological adaptation. However, the degree of correlated evolution (i.e., to what extent the grazer feeding apparatus represents an evolutionary module), especially of soft and hard tissues, remains poorly understood. Recent generation of large datasets and phylogenetic information has made testing hypotheses of correlated evolution possible. We, therefore, test for correlated evolution among various traits of the ruminant masticatory apparatus including tooth crown height, jaw robustness, chewing muscle size, and characters of the molar occlusal surfaces, using phylogenetic and nonphylogenetic comparative methods as well as phylogenetic evolutionary model selection. We find that the large masseter muscles of grazing ruminants evolved with the inclusion of grass in the diet, an increase in the proportion of occlusal enamel bands oriented parallel to the chewing stroke, and possibly hypsodonty. We suggest that the masseter evolved under two evolutionary regimes: i) selection for higher masticatory forces during chewing and ii) flattening of the tooth profile, which resulted in reduced tooth guidance and, thus, a requirement for more chewing muscle activity during each chewing stroke, in agreement with previous research. The linear jaw metrics (depth of the mandibular angle, mandibular angle width, and length of the superficial masseteric scar) all show correlated evolution with hypsodonty and the proportion of enamel bands oriented parallel to the chewing stroke. We suggest that changes in the shape of the mandible represent the combined effects of selection for a reorientation of the chewing stroke, so as to emphasize horizontal translation of the teeth, and accommodation of high-crowned teeth. Our analyses show that the ruminant feeding apparatus is an evolutionary mosaic with its various components showing both correlated and independent evolution. PMID:24753298

Fraser, Danielle; Rybczynski, Natalia

2014-10-01

378

Health Care Autonomy in Children with Chronic Conditions: Implications for Self Care and Family Management  

PubMed Central

Synopsis Health care autonomy typically occurs during late adolescence but health care providers and families often expect children with chronic health conditions to master self-care earlier. Few studies have examined the development of health care autonomy as it pertains to self-care and family management. This review will link the three concepts and discuss implications for families and health care providers. Case studies are provided as exemplars to highlight areas where intervention and research is needed. PMID:23659815

Beacham, Barbara L.; Deatrick, Janet A.

2013-01-01

379

The Impact of the Massachusetts Managed Mental Health\\/Substance Abuse Program on Outpatient Mental Health Clinics  

Microsoft Academic Search

Medicaid managed care initiatives pose special challenges to outpatient providers. During the first two full years of the Massachusetts Mental Health\\/Substance Abuse initiative, an analysis of cost and utilization data showed that outpatient mental health utilization and expenditures dropped slightly, although far less than did expenditures and utilization for inpatient facilities. In a telephone survey of a stratified random sample

Richard H. Beinecke; Sylvia B. Perlman

1997-01-01

380

Managed Mental Health Care: Implications for Social Work Practice and Social Work Education  

Microsoft Academic Search

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 managed health care plans operating regionally and nationally and demonstrates the cumbersome application process. Fee schedules for each of the plans are listed. Ethical

Howard M. Turney; Patricia G. Conway

2001-01-01

381

Public sector managed care for substance abuse treatment: Opportunities for health services research  

Microsoft Academic Search

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

2001-01-01

382

Automated information systems provide health information management support to veterans' healthcare.  

PubMed

The Veterans Health Administration has implemented a comprehsnsive DHCP which supports the VA healthcare system at both local and national levels. Numerous clinical and management modules have been developed; an overview was given of selected applications impacting health information managers. Continuing development includes an automated clinical record and expanded electronic data exchange. PMID:10119086

Lloyd, S S

1992-06-01

383

People Management Practices in the Public Health Sector: Developments from Victoria, Australia  

ERIC Educational Resources Information Center

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

2004-01-01

384

Interviewing Key Informants: Strategic Planning for a Global Public Health Management Program  

ERIC Educational Resources Information Center

The Centers for Disease Control and Prevention's Sustainable Management Development Program (SMDP) partners with low- and middle-resource countries to develop management capacity so that effective global public health programs can be implemented and better health outcomes can be achieved. The program's impact however, was variable. Hence, there…

Kun, Karen E.; Kassim, Anisa; Howze, Elizabeth; MacDonald, Goldie

2013-01-01

385

An Integrated Framework for Risk Management and Population Health  

Microsoft Academic Search

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

2007-01-01

386

Smart Sensors' Role in Integrated System Health Management  

NASA Technical Reports Server (NTRS)

During the last decade, there has been a major effort in the aerospace industry to reduce the cost per pond of payload and become competitive in the international market. Competition from Europe, Japan, and China has reduced this cost to almost a third from 1990 to 2000. This cost has leveled in recent years to an average price of around $12,000/pound of payload. One of NASA's goals is to promote the development of technologies to reduce this cost by a factor of 10 or more Exploration of space, specially manned exploration missions, involves very complex launch and flight vehicles, associated ground support systems, and extensive human support during all phases of the mission. When considering the Space Shuttle Program, we can see that vehicle and ground support systems' processing, operation, and maintenance represent a large percentage of the program cost and time. Reducing operating, processing and maintenance costs will greatly reduce the cost of Exploration programs. The Integrated System Health Management (ISHM) concept is one of the technologies that will help reduce these operating, processing and maintenance costs. ISHM is an integrated health monitoring system applicable to both flight and ground systems. It automatically and autonomously acquires information from sensors and actuators and processes that information using the ISHM-embedded knowledge. As a result, it establishes the health of the system based on the acquired information and its prior knowledge. When this concept is fully implemented, ISHM systems shall be able to perform failure prediction and remediation before actual hard failures occurs, preventing its costly consequences. Data sources, sensors, and their associated data acquisition systems, constitute the foundation of the system. A smart sensing architecture is required to support the acquisition of reliable, high quality data, required by the ISHM. A thorough definition of the smart sensor architectures, their embedded diagnostic agents, and communication protocols need to be established and standardized to allow the embedding and exchange of health information among sensors and ISHM. This workshop is aimed to foster the exchange of ideas and lessons learned between government, industry and academia to aid in the establishment of ISHM (and smart sensors) standards and guidelines as well as to identify present technology gaps that will have to be overcome to successfully achieve this goal.

Perotti, Jose M.; Mata, Carlos

2005-01-01

387

Climate change and health risks: assessing and responding to them through 'adaptive management'.  

PubMed

Climate change and associated changing weather patterns, including severe weather events, are expected to increase the prevalence of a wide range of health risks. Yet there is uncertainty about the timing, location, and severity of these changes. Adaptive management, a structured process of decision making in the face of imperfect information, is an approach that can help the public health field effectively anticipate, plan for, and respond to the health risks of climate change. In this article I describe adaptive management and how it could increase the effectiveness of local and national strategies, policies, and programs to manage climate-sensitive health outcomes. PMID:21555476

Ebi, Kristie

2011-05-01

388

Managed competition versus industrial purchasing of health care among the Fortune 500.  

PubMed

The theory of managed competition has found favor with many health policy analysts and academic economists alike. Three characteristics--consumer choice, defined contribution, and dissemination of information--signal managed competition strategy. By requiring private employers to provide their employees with a choice of health carriers, a fixed-dollar strategy (defined contribution), and quality information to make appropriate choices among carriers, managed competition offers to remedy imperfections in both the consumer and provider sides of the market for health insurance. In an extensive survey of health care purchasing practices among Fortune 500 companies we found that major companies are not using the managed competition approach to health care purchasing. Instead, most of the companies surveyed are purchasing health care in the same way as they do other inputs to production--a pattern we call industrial purchasing. PMID:11942420

Maxwell, James; Temin, Peter

2002-02-01

389

Leadership frames and perceptions of effectiveness among health information management program directors.  

PubMed

Leadership is important to health science education. For program effectiveness, directors should possess leadership skills to appropriately lead and manage their departments. Therefore, it is important to explore the leadership styles of programs' leaders as health science education is undergoing reform. Program directors of two and four-year health information management programs were surveyed to determine leadership styles. The study examined leadership styles or frames, the number of leadership frames employed by directors, and the relationship between leadership frames and their perceptions of their effectiveness as a manager and as a leader. The study shows that program directors are confident of their human resource and structural skills and less sure of the political and symbolic skills required of leaders. These skills in turn are correlated with their self-perceived effectiveness as managers and leaders. Findings from the study may assist program directors in their career development and expansion of health information management programs as a discipline within the health science field. As academic health centers receive greater pressure from the Institute of Medicine and accrediting agencies to reform health science education, the question of leadership arises. These centers have taken a leadership role in reforming health professional education by partnering with educational institutions to improve the health of communities. To achieve health education reform, health sciences educators must apply effective leadership skills.1 College and university leadership is challenged on how to best approach educational reform across health science fields. This article discusses leadership styles employed by program directors of one health science department, health information management, in directing programs for health science education reform. PMID:18066358

Sasnett, Bonita; Ross, Thomas

2007-01-01

390

A pragmatic approach to educating rural health services on quality management.  

PubMed

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

Turner, R; Hartley, R

1997-03-01

391

Fish Health and Fisheries, Implications for Stock Assessment and Management: The Mediterranean Example  

Microsoft Academic Search

Although fish health may influence key population-level processes, particularly those dealing with natural mortality, reproduction, and growth, which, in turn, affect stock productivity, little emphasis has been placed on the links between fish health and the management of marine fisheries. This article addresses this gap and illustrates how knowledge of fish health could provide insight for marine fisheries biologists, stock

J. Lloret; E. Faliex; G. E. Shulman; J.-A. Raga; P. Sasal; M. Muñoz; M. Casadevall; A. E. Ahuir-Baraja; F. E. Montero; A. Repullés-Albelda; M. Cardinale; H.-J. Rätz; S. Vila; D. Ferrer

2012-01-01

392

The Role of Labor-Management Committees in Safeguarding Worker Safety and Health.  

ERIC Educational Resources Information Center

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…

Ruttenberg, Ruth

393

Promoting Stress Management: The Role of Comprehensive School Health Programs. ERIC Digest.  

ERIC Educational Resources Information Center

This Digest examines how Comprehensive School Health Programs (CSHPs) may promote stress management in children and adolescents. CSHPs contain four key elements. The first element, community participation and focus, can be achieved through school health newsletters, health fairs, local newspaper, radio, and television promotions, and guest…

Massey, Marilyn S.

394

Organizational network analysis provides evidence-based decision support for health department managers preparing for accreditation  

E-print Network

Organizational network analysis provides evidence-based decision support for health department health practice decisions. "Show source of infor- mation concerning the evi- dence-based or promising managers preparing for accreditation Evidence demonstrates that local health departments can benefit from

Sadeh, Norman M.

395

Incorporating Personal Health Records into the Disease Management of Rural Heart Failure Patients  

ERIC Educational Resources Information Center

Personal Health Records (PHRs) allow patients to access and in some cases manage their own health records. Their potential benefits include access to health information, enhanced asynchronous communication between patients and clinicians, and convenience of online appointment scheduling and prescription refills. Potential barriers to PHR use…

Baron, Karen Parsley

2012-01-01

396

Cyber-Management of People with Chronic Disease: A Potential Solution to eHealth Challenges  

ERIC Educational Resources Information Center

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

Laakso, E-Liisa; Armstrong, Kylie; Usher, Wayne

2012-01-01

397

Herbals and Ruminant Health: A Review  

Technology Transfer Automated Retrieval System (TEKTRAN)

Traditional sheep, hair sheep and meat goat industries are growing rapidly in the Appalachian Region, particularly on small farms, to help produce meats to satisfy ethnic markets demands. Increasing demand for pasture-raised meat and dairy products for these niche markets provides production incent...

398

A review of health leadership and management capacity in the Solomon Islands.  

PubMed

ACCESS AND UTILISATION OF HEALTH CARE: The armed conflict that engulfed the Solomon Islands between 1998 and 2003 significantly disrupted the provision of health care especially in rural and remote areas. There is one doctor for 3,300 people and approximately 13 nurses and midwives for 10,000 people. Despite limitations 87% of people seek health care when sick. FINANCING THE HEALTH SYSTEM: The SIG placed a series of reservations on ministerial goods and services budgets that effectively the budget by 33%, severely impacting provincial budgets and resulting in acquired debts. Shortfalls have been addressed by allocating Health Sector Support Program funds to the provinces to allow services to continue, a strategy that will likely recur, but by which donor support replaces government provision Provincial health accountants have received training in MYOB in 2009 but acquittal systems require higher level accounting skills for reports to be submitted on time to permit the release of subsequent funding tranches. HUMAN RESOURCES FOR HEALTH: The shortage of doctors and specialists is a key challenge. As at December 2010, there were a total of 2,728 health workers in the public sector in Solomon Islands. Staff costs consume on average 55% of provincial health grants Filled Public Service Division staff establishments and budgetary reservations have reduced the ability to meet the salary and wage costs of new graduates. Solomon Islands is currently negotiating to assist Vanuatu in filling its nursing staff vacancies with its surplus The return of 75 Cuban trained medical officers from 2013 presents the management challenge of accessing budget provisions for so many new positions and in funding the infrastructure needed to house, equip and maintain them in service. HEALTH MANAGEMENT STRUCTURE: Provincial health managers are operationally responsive to local needs, managerially responsible to provincial governments, while being concerned with adherence to central MHMS policy and to Ministry of Finance and Public Service Division regulations. The delineation of central and provincial health authorities' responsibilities requires guidelines in a changing system, where both population-based and targeted vertical programs are implemented at local levels. NUMBER AND DISTRIBUTION OF MANAGERS: Nine of the 10 positions of Provincial Health Director have experienced high turnover, which reportedly occurs without adequate handover to incoming appointees, most of whom are recent clinical graduates. Health services in the Honiara urban area are provided through the Honiara City Council. Church health services are staffed by government employees. COMPETENCE OF DISTRICT HEALTH MANAGERS: Management skills are reportedly weak at the provincial level. The Regional Assistance Mission to Solomon Islands provides governance training inputs to provincial government staff. Provincial health departments have limited financial and human resource management capacity. They also have clinical backgrounds and no training in public health planning or health services management, other than that provided by donors, the Regional Assistance Mission itself and the MHMS. MANAGEMENT WORKING ENVIRONMENT: Provincial health directors have limited control over health staff. Little supportive supervision in management is provided to new provincial health directors. No performance management systems are in place to ensure that staff are properly assessed and supported to do their best Large numbers of non-government organisations working at the provincial level in youth and women's programs require coordination by Provincial health directors to avoid duplication or implementation of programs that will require ongoing funding, but this is not done. FUNCTIONING OF MANAGEMENT SUPPORT SYSTEMS: Management support systems for budgeting and finance, management information and procurement and supply do not function adequately to support provincial health directors to manage effectively. THE SOCIO-CULTURAL CONTEXT: Socio-cultural issues such as favouritism based on kinship, discrim

Asante, Augustine; Roberts, Graham; Hall, John

2012-04-01

399

[Managed health care: scope, concept and strategic management potentials from the viewpoint of the Swiss Accident Insurance Fund].  

PubMed

The following item presents briefly the cost relevant factors in health care in Switzerland. The principal key issues and reasons for managed health care programs are dealt with by recognizing the new health care law. In order to present the central strategies for improvement in managed care from an integral point of view, managed health care is being treated in the context of a widely founded conceptional framework. A very detailed and medically complete as well as performance oriented case statistic of medical treatments is a strategic success and key factor. The author represents the thesis that the given opportunities and micro-management tools could be much more widely used, that they should be extended and that, therefore, the strength of our independent and liberal health care system could be much better integrated in the context of a necessary social acceptance. This shall not only be reached by maximising the individual revenues, but by optimizing structures and increasing organizational effectiveness in medical health care. The existing readiness of the health care suppliers, especially the physicians, to take over responsibility in improving health care outcome is the core to this strategy. PMID:9312392

Bapst, L

1996-01-01

400

The new market in health care: prospects for managed care in Australia.  

PubMed

Most developed countries are experimenting or moving at full speed to implement new forms of health delivery based in part on capitation arrangements and stronger accountability of health service providers. Proposals for introduction of capitation or managed care have been advanced in Australia but have attracted strong opposition from the medical profession. This paper reviews the policy issues surrounding the introduction of managed care, including how Australia's current institutional forms may evolve into managed care provision. PMID:10159218

Duckett, S

1996-01-01

401

Gender Differences in Medication Management Capacity in HIV Infection: The Role of Health Literacy and Numeracy  

Microsoft Academic Search

Health literacy is emerging as a key element for successful medication management and empirical support for the efficacy of\\u000a numeracy in the health context is rising as well. Little is known, however, about their unique effects among women and men.\\u000a Given the importance of accurate medication management for effective treatment of HIV, the relation of these variables to\\u000a medication management

Drenna Waldrop-Valverde; Deborah L. Jones; Dushyantha Jayaweera; Peggy Gonzalez; Javier Romero; Raymond L. Ownby

2009-01-01

402

A Resource Management Tool for Public Health Continuity of Operations During Disasters  

PubMed Central

Objective We developed and validated a user-centered information system to support the local planning of public health continuity of operations for the Community Health Services Division, Public Health - Seattle & King County, Washington. Methods The Continuity of Operations Data Analysis (CODA) system was designed as a prototype developed using requirements identified through participatory design. CODA uses open-source software that links personnel contact and licensing information with needed skills and clinic locations for 821 employees at 14 public health clinics in Seattle and King County. Using a web-based interface, CODA can visualize locations of personnel in relationship to clinics to assist clinic managers in allocating public health personnel and resources under dynamic conditions. Results Based on user input, the CODA prototype was designed as a low-cost, user-friendly system to inventory and manage public health resources. In emergency conditions, the system can run on a stand-alone battery-powered laptop computer. A formative evaluation by managers of multiple public health centers confirmed the prototype design’s usefulness. Emergency management administrators also provided positive feedback about the system during a separate demonstration. Conclusions Validation of the CODA information design prototype by public health managers and emergency management administrators demonstrates the potential usefulness of building a resource management system using open-source technologies and participatory design principles. PMID:24618165

Turner, Anne M.; Reeder, Blaine; Wallace, James C.

2014-01-01

403

[Development of an instrument for the assessment of demand and monitoring of the health management in a health insurance].  

PubMed

To identify and follow up the health relevant effects of change-management-projects and to determine improvements in activities following this change a specific health-controlling instrument with benchmarking options has been developed. This instrument applies scientific quality standards and shows the organisational value in form of an index (BGM-Systemindex). It shows the correlation between the four indices management system, health-related actions, health and absence rate and allows a qualitative view of corporate health promotion on and its long term effects. The initiator for the project was an employee survey, which showed a need for action to improve job satisfaction. The survey was the reason that management initiated an integral change-management-project. The project showed many interfaces with the corporate health promotion (BGM), thus enabling consequent changes to be made and their effects to be evaluated. The aim of the project was to clearly increase employee satisfaction up to the next employee survey. Overall the project can be considered a success as the main aim of the project to increase the employees job satisfaction in the given period of time was clearly accomplished. The BGM-Systemindex also stood the test for comprehensive monitoring of the employees health. The project was able to prove that the health relevant parameters could be optimised and that the quality, acceptance and efficiency of the intervention methods had improved. It also showed a positive development of the early and long term health indicators. This is a positive contrast to available literature, which shows that an insufficient or incorrectly used change management results in a lower employee satisfaction. As a result it was decided to use the tool in future. PMID:25000628

Burnus, M; Benner, V; Becker, L; Müller, D; Stock, S

2014-06-01

404

Focusing on the software of managing health workers: what can we learn from high commitment management practices?  

PubMed

Knowledge of what constitutes best practice in human resource management (HRM) in public-oriented services is limited and the operational aspects of managing health 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

Marchal, Bruno; Kegels, Guy

2008-01-01

405

Supporting academic health centers with knowledge management: learning from the Web.  

PubMed

In a 2003 publication, the Association of Academic Health Sciences Libraries (AAHSL) made explicit the many ways in which a library might contribute to an academic health center's success through knowledge management (KM). Building on Success: Charting the Future of Knowledge Management within the Academic Health Center elucidated the ways in which a library can serve as the center of an organization's KM initiatives. The study and application of knowledge management tools is formidable; unlike information management (IM), the field of knowledge management has roots in a seemingly infinite and wide-ranging number of professional and academic disciplines. The planning of institutional KM initiatives is not commonly discussed, and history shows knowledge management projects often fail to thrive. This column introduces the topic of knowledge management and includes suggested Web-based resources for further understanding and project planning. PMID:19384717

Littleton, Dawn

2009-01-01

406

Competency requirements for middle and senior managers in community health services.  

PubMed

The Australian health system has been subjected to rapid changes in the last 20 years to meet increasingly unmet health needs. Improvement of the efficiency and comprehensiveness of community-based services is one of the solutions to reducing the increasing demand for hospital care. Competent managers are one of the key contributors to effective and efficient health service delivery. However, the understanding of what makes a competent manager, especially in the community health services (CHS), is limited. Using an exploratory and mixed-methods approach, including focus group discussions and an online survey, this study identified five key competencies required by senior and mid-level CHS managers in metropolitan, regional and rural areas of Victoria: Interpersonal, communication qualities and relationship management; Operations, administration and resource management; Knowledge of the health care environment; Leading and managing change; and Evidence-informed decision-making. This study confirms that core competencies do exist across different management levels and improves our understanding of managerial competency requirements for middle to senior CHS managers, with implications for current and future health service management workforce development. PMID:23007275

Liang, Zhanming; Howard, Peter F; Koh, Lee C; Leggat, Sandra

2013-01-01

407

Effects of Peanut Butter on Ruminating.  

ERIC Educational Resources Information Center

Effects of supplementary peanut butter on rumination behavior among five institutionalized mentally retarded adults were studied, by independently manipulating caloric density versus consistency of the peanut butter. Results showed an inverse relationship between rates of rumination and amount of peanut butter consumed, an effect primarily…

Greene, Katherine S.; And Others

1991-01-01

408

Perfectionism Cognitions, Rumination, and Psychological Distress  

Microsoft Academic Search

The current study examined the extent to which dimensions of perfectionism are associated with a ruminative response orientation and the experience of cognitive intrusions in response to stressful events. Our main goal was to test the hypothesis that individuals characterized by frequent automatic thoughts involving perfectionistic themes would also be characterized by a ruminative response orientation when distressed and they

Gordon L. Flett; Dara Madorsky; Paul L. Hewitt; Marnin J. Heisel

2002-01-01

409

Review article Ruminant milk fat plasticity  

E-print Network

Review article Ruminant milk fat plasticity: nutritional control of saturated, polyunsaturated effects of diet on ruminant milk fat composition. Special attention is given to fatty acids that could:5, C22:5 and C22:6, from the duodenum to the milk, is reviewed. The main dietary factors taken

Paris-Sud XI, Université de

410

BachelorofHealthSciences/BachelorofManagement PublicHealth/GeneralManagementor  

E-print Network

campuses serve adult learners who may be in the work force wanting to further their education - Public Health Ethics Public Health 4000 - Advanced Public Health Economics 1010 - Introduction - Medical Microbiology Health Sciences 2600/Women and Gender Studies 2100 - Women and Health Health Sciences

Seldin, Jonathan P.

411

A Support Database System for Integrated System Health Management (ISHM)  

NASA Technical Reports Server (NTRS)

The development, deployment, operation and maintenance of Integrated Systems Health Management (ISHM) applications require the storage and processing of tremendous amounts of low-level data. This data must be shared in a secure and cost-effective manner between developers, and processed within several heterogeneous architectures. Modern database technology allows this data to be organized efficiently, while ensuring the integrity and security of the data. The extensibility and interoperability of the current database technologies also allows for the creation of an associated support database system. A support database system provides additional capabilities by building applications on top of the database structure. These applications can then be used to support the various technologies in an ISHM architecture. This presentation and paper propose a detailed structure and application description for a support database system, called the Health Assessment Database System (HADS). The HADS provides a shared context for organizing and distributing data as well as a definition of the applications that provide the required data-driven support to ISHM. This approach provides another powerful tool for ISHM developers, while also enabling novel functionality. This functionality includes: automated firmware updating and deployment, algorithm development assistance and electronic datasheet generation. The architecture for the HADS has been developed as part of the ISHM toolset at Stennis Space Center for rocket engine testing. A detailed implementation has begun for the Methane Thruster Testbed Project (MTTP) in order to assist in developing health assessment and anomaly detection algorithms for ISHM. The structure of this implementation is shown in Figure 1. The database structure consists of three primary components: the system hierarchy model, the historical data archive and the firmware codebase. The system hierarchy model replicates the physical relationships between system elements to provide the logical context for the database. The historical data archive provides a common repository for sensor data that can be shared between developers and applications. The firmware codebase is used by the developer to organize the intelligent element firmware into atomic units which can be assembled into complete firmware for specific elements.

Schmalzel, John; Figueroa, Jorge F.; Turowski, Mark; Morris, John

2007-01-01

412

Controls and Health Management Technologies for Intelligent Aerospace Propulsion Systems  

NASA Technical Reports Server (NTRS)

With the increased emphasis on aircraft safety, enhanced performance and affordability, and the need to reduce the environmental impact of aircraft, there are many new challenges being faced by the designers of aircraft propulsion systems. The Controls and Dynamics Technology Branch at NASA (National Aeronautics and Space Administration) Glenn Research Center (GRC) in Cleveland, Ohio, is leading and participating in various projects in partnership with other organizations within GRC and across NASA, the U.S. aerospace industry, and academia to develop advanced controls and health management technologies that will help meet these challenges through the concept of an Intelligent Engine. The key enabling technologies for an Intelligent Engine are the increased efficiencies of components through active control, advanced diagnostics and prognostics integrated with intelligent engine control to enhance component life, and distributed control with smart sensors and actuators in an adaptive fault tolerant architecture. This paper describes the current activities of the Controls and Dynamics Technology Branch in the areas of active component control and propulsion system intelligent control, and presents some recent analytical and experimental results in these areas.

Garg, Sanjay

2004-01-01

413

Intelligent model-based diagnostics for vehicle health management  

NASA Astrophysics Data System (ADS)

The recent advances in sensor technology, remote communication and computational capabilities, and standardized hardware/software interfaces are creating a dramatic shift in the way the health of vehicles is monitored and managed. These advances facilitate remote monitoring, diagnosis and condition-based maintenance of automotive systems. With the increased sophistication of electronic control systems in vehicles, there is a concomitant increased difficulty in the identification of the malfunction phenomena. Consequently, the current rule-based diagnostic systems are difficult to develop, validate and maintain. New intelligent model-based diagnostic methodologies that exploit the advances in sensor, telecommunications, computing and software technologies are needed. In this paper, we will investigate hybrid model-based techniques that seamlessly employ quantitative (analytical) models and graph-based dependency models for intelligent diagnosis. Automotive engineers have found quantitative simulation (e.g. MATLAB/SIMULINK) to be a vital tool in the development of advanced control systems. The hybrid method exploits this capability to improve the diagnostic system's accuracy and consistency, utilizes existing validated knowledge on rule-based methods, enables remote diagnosis, and responds to the challenges of increased system complexity. The solution is generic and has the potential for application in a wide range of systems.

Luo, Jianhui; Tu, Fang; Azam, Mohammad S.; Pattipati, Krishna R.; Willett, Peter K.; Qiao, Liu; Kawamoto, Masayuki

2003-08-01

414

A structural model decomposition framework for systems health management  

NASA Astrophysics Data System (ADS)

Systems health management (SHM) is an important set of technologies aimed at increasing system safety and reliability by detecting, isolating, and identifying faults; and predicting when the system reaches end of life (EOL), so that appropriate fault mitigation and recovery actions can be taken. Model-based SHM approaches typically make use of global, monolithic system models for online analysis, which results in a loss of scalability and efficiency for large-scale systems. Improvement in scalability and efficiency can be achieved by decomposing the system model into smaller local submodels and operating on these submodels instead. In this paper, the global system model is analyzed offline and structurally decomposed into local submodels. We define a common model decomposition framework for extracting submodels from the global model. This framework is then used to develop algorithms for solving model decomposition problems for the design of three separate SHM technologies, namely, estimation (which is useful for fault detection and identification), fault isolation, and EOL prediction. We solve these model decomposition problems using a three-tank system as a case study.

Roychoudhury, I.; Daigle, M.; Bregon, A.; Pulido, B.

415

Propulsion Integrated Vehicle Health Management Technology Experiment (PITEX) Conducted  

NASA Technical Reports Server (NTRS)

The Propulsion Integrated Vehicle Health Management (IVHM) Technology Experiment (PITEX) is a continuing NASA effort being conducted cooperatively by the NASA Glenn Research Center, the NASA Ames Research Center, and the NASA Kennedy Space Center. It was a key element of a Space Launch Initiative risk-reduction task performed by the Northrop Grumman Corporation in El Segundo, California. PITEX's main objectives are the continued maturation of diagnostic technologies that are relevant to second generation reusable launch vehicle (RLV) subsystems and the assessment of the real-time performance of the PITEX diagnostic solution. The PITEX effort has considerable legacy in the NASA IVHM Technology Experiment for X-vehicles (NITEX) that was selected to fly on the X-34 subscale RLV that was being developed by Orbital Sciences Corporation. NITEX, funded through the Future-X Program Office, was to advance the technology-readiness level of selected IVHM technologies within a flight environment and to begin the transition of these technologies from experimental status into RLV baseline designs. The experiment was to perform realtime fault detection and isolation and suggest potential recovery actions for the X-34 main propulsion system (MPS) during all mission phases by using a combination of system-level analysis and detailed diagnostic algorithms.

Maul, William A.; Chicatelli, Amy K.; Fulton, Christopher E.

2004-01-01

416

Integrated System Health Management (ISHM) Technology Demonstration Project Final Report  

NASA Technical Reports Server (NTRS)

Integrated System Health Management (ISHM) is an essential capability that will be required to enable upcoming explorations mission systems such as the Crew Exploration Vehicle (CEV) and Crew Launch Vehicle (CLV), as well as NASA aeronautics missions. However, the lack of flight experience and available test platforms have held back the infusion by NASA Ames Research Center (ARC) and the Jet Propulsion Laboratory (JPL) of ISHM technologies into future space and aeronautical missions. To address this problem, a pioneer project was conceived to use a high-performance aircraft as a low-cost proxy to develop, mature, and verify the effectiveness of candidate ISHM technologies. Given the similarities between spacecraft and aircraft, an F/A-18 currently stationed at Dryden Flight Research Center (DFRC) was chosen as a suitable host platform for the test bed. This report describes how the test bed was conceived, how the technologies were integrated on to the aircraft, and how these technologies were matured during the project. It also describes the lessons learned during the project and a forward path for continued work.

Mackey, Ryan; Iverson, David; Pisanich, Greg; Toberman, Mike; Hicks, Ken

2006-01-01

417

Introduction to System Health Engineering and Management in Aerospace  

NASA Technical Reports Server (NTRS)

This paper provides a technical overview of Integrated System Health Engineering and Management (ISHEM). We define ISHEM as "the paper provides a techniques, and technologies used to design, analyze, build, verify, and operate a system to prevent faults and/or minimize their effects." This includes design and manufacturing techniques as well operational and managerial methods. ISHEM is not a "purely technical issue" as it also involves and must account for organizational, communicative, and cognitive f&ms of humans as social beings and as individuals. Thus the paper will discuss in more detail why all of these elements, h m the technical to the cognitive and social, are necessary to build dependable human-machine systems. The paper outlines a functional homework and architecture for ISHEM operations, describes the processes needed to implement ISHEM in the system life-cycle, and provides a theoretical framework to understand the relationship between the different aspects of the discipline. It then derives from these and the social and cognitive bases a set of design and operational principles for ISHEM.

Johnson, Stephen B.

2005-01-01

418

Integrated Vehicle Health Management (IVHM) for Aerospace Systems  

NASA Technical Reports Server (NTRS)

To achieve NASA's ambitious Integrated Space Transportation Program objectives, aerospace systems will implement a variety of new concept in health management. System level integration of IVHM technologies for real-time control and system maintenance will have significant impact on system safety and lifecycle costs. IVHM technologies will enhance the safety and success of complex missions despite component failures, degraded performance, operator errors, and environment uncertainty. IVHM also has the potential to reduce, or even eliminate many of the costly inspections and operations activities required by current and future aerospace systems. This presentation will describe the array of NASA programs participating in the development of IVHM technologies for NASA missions. Future vehicle systems will use models of the system, its environment, and other intelligent agents with which they may interact. IVHM will be incorporated into future mission planners, reasoning engines, and adaptive control systems that can recommend or execute commands enabling the system to respond intelligently in real time. In the past, software errors and/or faulty sensors have been identified as significant contributors to mission failures. This presentation will also address the development and utilization of highly dependable sohare and sensor technologies, which are key components to ensure the reliability of IVHM systems.

Baroth, Edmund C.; Pallix, Joan

2006-01-01

419

A Structural Model Decomposition Framework for Systems Health Management  

NASA Technical Reports Server (NTRS)

Systems health management (SHM) is an important set of technologies aimed at increasing system safety and reliability by detecting, isolating, and identifying faults; and predicting when the system reaches end of life (EOL), so that appropriate fault mitigation and recovery actions can be taken. Model-based SHM approaches typically make use of global, monolithic system models for online analysis, which results in a loss of scalability and efficiency for large-scale systems. Improvement in scalability and efficiency can be achieved by decomposing the system model into smaller local submodels and operating on these submodels instead. In this paper, the global system model is analyzed offline and structurally decomposed into local submodels. We define a common model decomposition framework for extracting submodels from the global model. This framework is then used to develop algorithms for solving model decomposition problems for the design of three separate SHM technologies, namely, estimation (which is useful for fault detection and identification), fault isolation, and EOL prediction. We solve these model decomposition problems using a three-tank system as a case study.

Roychoudhury, Indranil; Daigle, Matthew J.; Bregon, Anibal; Pulido, Belamino

2013-01-01

420

Measuring and managing progress in the establishment of basic health services: the Afghanistan health sector balanced scorecard.  

PubMed

The Ministry of Public Health (MOPH) of Afghanistan has adopted the Balanced Scorecard (BSC) as a tool to measure and manage performance in delivery of a Basic Package of Health Services. Based on results from the 2004 baseline round, the MOPH identified eight of the 29 indicators on the BSC as priority areas for improvement. Like the 2004 round, the 2005 and 2006 BSCs involved a random selection of more than 600 health facilities, 1700 health workers and 5800 patient-provider interactions. The 2005 and 2006 BSCs demonstrated substantial improvements in all eight of the priority areas compared to 2004 baseline levels, with increases in median provincial scores for presence of active village health councils, availability of essential drugs, functional laboratories, provider knowledge, health worker training, use of clinical guidelines, monitoring of tuberculosis treatment, and provision of delivery care. For three of the priority indicators-drug availability, health worker training and provider knowledge-scores remained unchanged or decreased between 2005 and 2006. This highlights the need to ensure that early gains achieved in establishment of health services in Afghanistan are maintained over time. The use of a coherent and balanced monitoring framework to identify priority areas for improvement and measure performance over time reflects an objectives-based approach to management of health services that is proving to be effective in a difficult environment. PMID:18435428

Hansen, Peter M; Peters, David H; Niayesh, Haseebullah; Singh, Lakhwinder P; Dwivedi, Vikas; Burnham, Gilbert

2008-01-01

421

Managed behavioral health care and supply-side economics. 1998 Carl Taube Lecture.  

PubMed

BACKGROUND: Within the past decade, the mental health care system in the United States has undergone a significant transformation in terms of delivery, financing and work force configuration. Contracting between managed care organizations (MCOs) and providers has become increasingly prevalent, paralleling the trend in health care in general. These managed care carve-outs in behavioral health depend on networks of providers who agree to capitated rates or discounted fees for service for those patients covered by the carve-out contracts. Moreover, the carve-outs use a broader array of mental health providers than is typically found in traditional indemnity plans, encourage time-limited versus long-term treatments and favor providers who are engaged in outpatient care. This phenomenal growth in managed behavioral health care over the past decade includes the rapid growth and quick consolidation of mental health MCOs. The period 1992-1998 shows steady and substantial annual increases in the number of enrollees in mental health MCOs, the figure more than doubling from 78.1 million people in 1992 to a projected 156.6 million in 1998, or 70% of insured lives. Moreover, these vast numbers of enrollees are becoming increasingly consolidated into a smaller number of firms. In 1997, 12 companies controlled nearly 85% of the managed behavioral health care market, with 60% of the market held by the three largest firms. STUDY AIMS: This article reviews empirical data and draws policy implications from the literature on managed behavioral health care in the United States. Starting with spending and spending trend estimates that show the average annual growth rate of mental health expenditures to be lower than that of health care expenditures in general over the past decade, the author examines utilization and price factors that may account for managed-care-induced cost reductions in behavioral health care, with special attention to hospital use patterns, fee discounting and the supply and earnings patterns of various types of mental health provider. In addition, data on staffing ratios and provider mixes of health maintenance organizations and mental health MCOs are reviewed as they reveal at least part of the dynamics of reconfiguration of the mental health work force in this era of managed care. CONCLUSIONS: As measured by changes in utilization and price, widespread application of "classic" managed care techniques such as preadmission review (gatekeeping), concurrent review, case management, standardized clinical guidelines and protocols, volume purchase of services and fee discounting appears to have led to significant cost reductions for providers of both impatient and outpatient mental health services. However, amidst a complex flux of market variables such as risk shifting, changing financial incentives and intensity of competition, not all of the reduction or slowdown in spending can be clearly and purely attributed to managed care. The data on the ongoing reconfiguration of the mental health work force are clearer in their implications: with an oversupply of all types of mental health providers, managed care has significant potential to increase the incidence of provider substitutions and spur the growth of integrated group practices. IMPLICATIONS FOR FURTHER RESEARCH: The current body of empirical and policy literature in mental health economics suggests several salient areas of follow-up. Is the proportionately greater impact of managed care on the annual growth rate of mental health care spending a temporary phenomenon or does it signal an enduring difference in the rates of increase between behavioral health care and health care in general? Beyond industry downsizing, what are the substitutions among mental health providers that are going on, and will go on, to produce cost-effective practices? What are the new financial or risk-sharing arrangements between providers and MCOs that will produce appropriate and high-quality mental health services? PMID:11967404

Scheffler, Richard M.

1999-03-01

422

Exploiting parallels between livestock and wildlife: Predicting the impact of climate change on gastrointestinal nematodes in ruminants.  

PubMed

Global change, including climate, policy, land use and other associated environmental changes, is likely to have a major impact on parasitic disease in wildlife, altering the spatio-temporal patterns of transmission, with wide-ranging implications for wildlife, domestic animals, humans and ecosystem health. Predicting the potential impact of climate change on parasites infecting wildlife will become increasingly important in the management of species of conservation concern and control of disease at the wildlife-livestock and wildlife-human interface, but is confounded by incomplete knowledge of host-parasite interactions, logistical difficulties, small sample sizes and limited opportunities to manipulate the system. By exploiting parallels between livestock and wildlife, existing theoretical frameworks and research on livestock and their gastrointestinal nematodes can be adapted to wildlife systems. Similarities in the gastrointestinal nematodes and the life-histories of wild and domestic ruminants, coupled with a detailed knowledge of the ecology and life-cycle of the parasites, render the ruminant-GIN host-parasite system particularly amenable to a cross-disciplinary approach. PMID:25197625

Rose, Hannah; Hoar, Bryanne; Kutz, Susan J; Morgan, Eric R

2014-08-01

423

Abstract--Health management systems have been gaining substantial attentions in power engineering areas in recent years  

E-print Network

and nuclear power plant showed great interest in health management systems since the failuresAbstract--Health management systems have been gaining substantial attentions in power engineering will describe a health management system developed in Advanced Diagnosis, Automation, and Control Lab at North

Chow, Mo-Yuen

424

Ribotyping to compare Fusobacterium necrophorum isolates from bovine liver abscesses, ruminal walls, and ruminal contents.  

PubMed Central

Restriction fragment length polymorphism analysis of rRNA genes was employed to genetically compare Fusobacterium necrophorum subsp. necrophorum and F. necrophorum subsp. funduliforme isolates from multiple abscesses of the same liver and isolates from liver abscesses, the ruminal wall, and ruminal contents from the same animal. Four livers with multiple abscesses and samples of ruminal contents, ruminal walls, and liver abscesses were collected from 11 cattle at slaughter. F. necrophorum was isolated from all liver abscesses, nine ruminal walls, and six ruminal content samples. Chromosomal DNA of the isolates was extracted and single or double digested with restriction endonucleases (EcoRI, EcoRV, SalI, and HaeIII); then restriction fragments were hybridized with a digoxigenin-labeled cDNA probe transcribed from a mixture of 16S and 23S rRNAs from Escherichia coli. EcoRI alone or in combination with EcoRV yielded the most discriminating ribopatterns for comparison. Within the subspecies multiple isolates from the same liver were indistinguishable based on the ribopattern obtained with EcoRI. The hybridization patterns of liver abscess isolates were concordant with those of the corresponding isolates from ruminal walls in eight of nine sets of samples. None of the six ruminal content isolates matched either the liver abscess isolates or the ruminal wall isolates. The genetic similarity between the isolates from liver abscesses and ruminal walls supports the hypothesis that F. necrophorum isolates of liver abscesses originate from the rumen. PMID:9406386

Narayanan, S; Nagaraja, T G; Okwumabua, O; Staats, J; Chengappa, M M; Oberst, R D

1997-01-01

425

Cost accounting, management control, and planning in health care.  

PubMed

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

Siegrist, R B; Blish, C S

1988-02-01

426

Effects of Diabetic Case Management on Knowledge, Self-Management Abilities, Health Behaviors, and Health Service Utilization for Diabetes in Korea  

PubMed Central

Purpose This study aimed to evaluate the effects of a case management program for diabetics, using a pre-post comparison design. Materials and Methods The study population comprised 6007 diabetics who received case management intervention in 2006 and were sampled nationwide in Korea. Before and after the intervention, the study population answered questions regarding their knowledge of diabetes, self-management ability, and health behaviors. Body mass index (BMI) was also calculated. Healthcare service utilization for diabetes was extracted from health insurance claim data from 2005 to 2007. Results The case management program significantly improved the study population's knowledge of diabetes and ability to self-manage nutrition, blood glucose monitoring, foot and oral care, and medications. This program also significantly changed the study population's health behaviors regarding smoking, alcohol drinking, and exercise, and BMI was positively affected. In the over-serviced subgroup, there was a significant decrease in the number of consultations (mean=7.0; SD=19.5) after intervention. Conversely, in the under-serviced subgroup, there was a significant increase in the number of consultations (mean=3.2; SD=7.9) and the days of prescribed medication (mean=66.4; SD=120.3) after intervention. Conclusion This study showed that the case management program led the study population to improve their knowledge, self-management ability, health behaviors, and utilization of health care. It is necessary in future studies to evaluate the appropriateness of healthcare usage and clinical outcome by using a control group to determine the direct effectiveness of this case management program. PMID:25510771

Shin, Soon Ae; Lee, Kunsei; Lin, Vivian; Liu, George; Shin, Eunyoung

2015-01-01

427

Systems Modeling to Implement Integrated System Health Management Capability  

NASA Technical Reports Server (NTRS)

ISHM capability includes: detection of anomalies, diagnosis of causes of anomalies, prediction of future anomalies, and user interfaces that enable integrated awareness (past, present, and future) by users. This is achieved by focused management of data, information and knowledge (DIaK) that will likely be distributed across networks. Management of DIaK implies storage, sharing (timely availability), maintaining, evolving, and processing. Processing of DIaK encapsulates strategies, methodologies, algorithms, etc. focused on achieving high ISHM Functional Capability Level (FCL). High FCL means a high degree of success in detecting anomalies, diagnosing causes, predicting future anomalies, and enabling health integrated awareness by the user. A model that enables ISHM capability, and hence, DIaK management, is denominated the ISHM Model of the System (IMS). We describe aspects of the IMS that focus on processing of DIaK. Strategies, methodologies, and algorithms require proper context. We describe an approach to define and use contexts, implementation in an object-oriented software environment (G2), and validation using actual test data from a methane thruster test program at NASA SSC. Context is linked to existence of relationships among elements of a system. For example, the context to use a strategy to detect leak is to identify closed subsystems (e.g. bounded by closed valves and by tanks) that include pressure sensors, and check if the pressure is changing. We call these subsystems Pressurizable Subsystems. If pressure changes are detected, then all members of the closed subsystem become suspect of leakage. In this case, the context is defined by identifying a subsystem that is suitable for applying a strategy. Contexts are defined in many ways. Often, a context is defined by relationships of function (e.g. liquid flow, maintaining pressure, etc.), form (e.g. part of the same component, connected to other components, etc.), or space (e.g. physically close, touching the same common element, etc.). The context might be defined dynamically (if conditions for the context appear and disappear dynamically) or statically. Although this approach is akin to case-based reasoning, we are implementing it using a software environment that embodies tools to define and manage relationships (of any nature) among objects in a very intuitive manner. Context for higher level inferences (that use detected anomalies or events), primarily for diagnosis and prognosis, are related to causal relationships. This is useful to develop root-cause analysis trees showing an event linked to its possible causes and effects. The innovation pertaining to RCA trees encompasses use of previously defined subsystems as well as individual elements in the tree. This approach allows more powerful implementations of RCA capability in object-oriented environments. For example, if a pressurizable subsystem is leaking, its root-cause representation within an RCA tree will show that the cause is that all elements of that subsystem are suspect of leak. Such a tree would apply to all instances of leak-events detected and all elements in all pressurizable subsystems in the system. Example subsystems in our environment to build IMS include: Pressurizable Subsystem, Fluid-Fill Subsystem, Flow-Thru-Valve Subsystem, and Fluid Supply Subsystem. The software environment for IMS is designed to potentially allow definition of any relationship suitable to create a context to achieve ISHM capability.

Figueroa, Jorge F.; Walker, Mark; Morris, Jonathan; Smith, Harvey; Schmalzel, John

2007-01-01

428

A Survey of Health Management User Objectives Related to Diagnostic and Prognostic Metrics  

NASA Technical Reports Server (NTRS)

One of the most prominent technical challenges to effective deployment of health management 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 health management systems is presented. These user objectives are then mapped to the metrics typically encountered in the development and testing of two main systems health management functions: diagnosis and prognosis. Using this mapping, the gaps between user goals and the metrics associated with diagnostics and prognostics are identified and presented with a collection of lessons learned from previous