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Sample records for ruminant health management

  1. Semen processing and artificial insemination in health management of small ruminants.

    PubMed

    Cseh, S; Faigl, V; Amiridis, G S

    2012-02-01

    Artificial insemination has changed the small ruminant industry and has allowed increased genetic improvement, better control of reproduction and sexually transmitted diseases, dissemination of valuable genetics and preservation of the genetics of endangered breeds. Recent developments in this technology have focused on preserving the vitality/fertilizing capability of fresh and frozen spermatozoa by improving the composition of extenders, and by changing cooling/freezing protocols. The other main issue is the development of minimal invasive techniques for proper deposition of fresh or frozen semen. The paper discusses state of the art in methodology and technology currently used in small ruminant artificial insemination, as well as future perspectives after their wide application in these animal species. PMID:22333390

  2. [The effects of self-anger on rumination and on mental health].

    PubMed

    Katsumata, Yuina

    2015-10-01

    This study investigated the effects of self-anger on rumination and mental health (depression and anxiety). In study 1, a scale to measure self-anger was developed by the review of previous studies and survey interviews. Exploratory factor analysis identified one factor of self-anger. The reliability and validity of the scale were confirmed by internal consistency measures and correlations with other anger-related scales. In study 2, which used the self-anger scale developed in study 1, undergraduate and graduate students completed a set of scales to measure self-anger, rumination, depression, anxiety, and five-factor personality traits. The results of mediation analysis indicated that self-anger effects depression and anxiety directly or through mediating rumination excluding the effect of sex and neuroticism. Finally, the possibility that self-anger management leads to the reduction of rumination and improvement of mental health was discussed. PMID:26562940

  3. Welfare issues in the reproductive management of small ruminants.

    PubMed

    Roger, P A

    2012-02-01

    Often, the welfare of sheep and goats is focussed on flock/herd management and the major issues surrounding parturition and early development of lambs/kids. There is an increased interest in the way we manage domestic species and small ruminants are perceived as having a green and welfare friendly image. The management of reproduction in these species has the potential to affect this perception and the limiting factors for these procedures are discussed. Discussion of genetic modification and manipulation has become a focal point in the critical appraisal of the management of farmed livestock and the importance of the consideration of the mental health and well being of the animal is considered as an important part of this analysis. The diversity of options that are available for this analysis and the application of these options is discussed. PMID:22326609

  4. Approaches to management and care of the neonatal nondomestic ruminant.

    PubMed

    Wolfe, Barbara A; Lamberski, Nadine

    2012-05-01

    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

  5. 9 CFR 93.405 - Health certificate for ruminants.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ...) Editorial Note: For Federal Register citations affecting § 93.405, see the List of CFR Sections Affected... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Health certificate for ruminants. 93.405 Section 93.405 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE,...

  6. 9 CFR 93.405 - Health certificate for ruminants.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ...) Editorial Note: For Federal Register citations affecting § 93.405, see the List of CFR Sections Affected... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false Health certificate for ruminants. 93.405 Section 93.405 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE,...

  7. 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...

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

    PubMed

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

    2015-02-01

    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

  9. AUTOCLAVED RUMINAL FLUID IMMEDIATELY AFTER BIRTH IMPROVES THE GROWTH AND HEALTH OF NEONATE DAIRY CALVES

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Recent work (Muscato, T.V., L.O. Tedeschi, and Russell, J.B. 2002. The effect of ruminal fluid preparations on the growth and health of new-born dairy calves. Journal Dairy Science. In press.) showed that ruminal fluid (RF) supplements (8 ml per d) decreased (P <0.05) the incidence of scours in dair...

  10. Ruminant and industrially produced trans fatty acids: health aspects.

    PubMed

    Stender, Steen; Astrup, Arne; Dyerberg, Jørn

    2008-01-01

    Fatty acids of trans configuration in our food come from two different sources - industrially produced partially hydrogenated fat (IP-TFA) used in frying oils, margarines, spreads, and in bakery products, and ruminant fat in dairy and meat products (RP-TFA). The first source may contain up to 60% of the fatty acids in trans form compared to the content in ruminant fat which generally does not exceed 6%. In Western Europe, including Scandinavia, the average daily intake of IP-TFA has decreased during the recent decade due to societal pressure and a legislative ban, whereas the intake of RP-TFA has remained stable.In spite of this decrease we have found that in many countries consumption >20 g of IP-TFA in a one-meal menu consisting of some popular foods is possible, even though the average intake of IP-TFA in these countries is low. Subgroups of the populations may therefore, on average, consume >5 g IP-TFA per day. This level of consumption is generally not possible for RP-TFA. A daily intake of 5 g TFA (primarily IP-TFA) is associated with a 29% increased risk of coronary heart disease. Such an association is not found for RP-TFA up to a daily intake of 4 g.The high amount of IP-TFA in popular foods, the evidence of a more harmful effect on health by IP-TFA than by RP-TFA, and the feasibility of eliminating IP-TFA from foods without side effects for the population, suggest that a selective elimination of IP-TFA from our food is a 'low hanging fruit' in the quest for a more healthy diet for subgroups of the population. PMID:19109659

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

    PubMed

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

    2011-04-01

    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

  12. Cadmium exposure and consequence for the health and productivity of farmed ruminants.

    PubMed

    Lane, E A; Canty, M J; More, S J

    2015-08-01

    This paper reviews Cd exposure and consequences for the health and productivity of farmed ruminants. In farmed ruminants, Cd exposure may be associated with a number of different activities, including industrial processing, mining, and agricultural practices, and is also higher in soils in some geographic regions. Cd kidney concentrations increase with age and Cd exposure. Although Cd toxicity in farmed ruminants has been demonstrated experimentally, there are no published reports of naturally occurring Cd toxicity in farmed ruminants. Clinical signs of Cd intoxication are unlikely with a daily dietary Cd intake of less than 5 mg/kg feed, which is 5-10 times higher than the maximum permitted Cd concentration in ruminant feed in the European Union. In farmed ruminants, Cd levels in tissue are largely dependent on the Cd content of diet. However, many factors affect Cd availability, relating to soils, plants and the presence of other trace elements including Ca, Cu, Fe, Mn, Mo, Se and Zn. Experimental studies have highlighted the ability of Cd to alter trace element status, and the protective effect of good mineral status, however, there remain gaps in knowledge of the impact of these interactions on the health and productivity of farmed animals. PMID:26267103

  13. Productivity, digestion, and health responses to hindgut acidosis in ruminants

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The role of large intestinal or hindgut fermentation in ruminant nutrition has received little research attention in recent decades. Though the contribution of the hindgut to total tract nutrient digestion is substantially less than the contribution from the rumen, hindgut fermentation impacts anima...

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

    PubMed Central

    Nikkhah, Akbar

    2012-01-01

    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

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

    PubMed Central

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

    2009-01-01

    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

  16. Ionophore resistance of ruminal bacteria and its potential impact on human health.

    PubMed

    Russell, James B; Houlihan, Adam J

    2003-04-01

    In recent years, there has been a debate concerning the causes of antibiotic resistance and the steps that should be taken. Beef cattle in feedlots are routinely fed a class of antibiotics known as ionophores, and these compounds increase feed efficiency by as much as 10%. Some groups have argued that ionophore resistance poses the same public health threat as conventional antibiotics, but humans are not given ionophores to combat bacterial infection. Many ruminal bacteria are ionophore-resistant, but until recently the mechanism of this resistance was not well defined. Ionophores are highly lipophilic polyethers that accumulate in cell membranes and catalyze rapid ion movement. When sensitive bacteria counteract futile ion flux with membrane ATPases and transporters, they are eventually de-energized. Aerobic bacteria and mammalian enzymes can degrade ionophores, but these pathways are oxygen-dependent and not functional in anaerobic environments like the rumen or lower GI tract. Gram-positive ruminal bacteria are in many cases more sensitive to ionophores than Gram-negative species, but this model of resistance is not always clear-cut. Some Gram-negative ruminal bacteria are initially ionophore-sensitive, and even Gram-positive bacteria can adapt. Ionophore resistance appears to be mediated by extracellular polysaccharides (glycocalyx) that exclude ionophores from the cell membrane. Because cattle not receiving ionophores have large populations of resistant bacteria, it appears that this trait is due to a physiological selection rather than a mutation per se. Genes responsible for ionophore resistance in ruminal bacteria have not been identified, but there is little evidence that ionophore resistance can be spread from one bacterium to another. Given these observations, use of ionophores in animal feed is not likely to have a significant impact on the transfer of antibiotic resistance from animals to man. PMID:12697342

  17. Silvopasture: Small ruminants for establishment, management and usage

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Small farm pastures, hayfields, and woodlots are very productive in terms of forage, animal and wood products. Inherent livestock production capability can be improved through better herbage and animal management. Woodlot management can increase economic return, species diversity, and farm aesthetic...

  18. 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)...

  19. 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...

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

    PubMed

    Gsprdy, Andrs; Efrat, Gingis; Bajcsy, Arpd Csaba; Fekete, Sndor Gyrgy

    2014-12-01

    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

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

    NASA Astrophysics Data System (ADS)

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

    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.

  2. Fish Health Management

    Technology Transfer Automated Retrieval System (TEKTRAN)

    For commercial success, a recirculating aquaculture operation must maintain fish at densities far greater than normally found in nature. At the same time, the producer must maintain an environment that supports good fish health. This chapter discusses various aspects of fish health management, inclu...

  3. Health supply chain management.

    PubMed

    Zimmerman, Rolf; Gallagher, Pat

    2010-01-01

    This chapter gives an educational overview of: * The actual application of supply chain practice and disciplines required for service delivery improvement within the current health environment. * A rationale for the application of Supply Chain Management (SCM) approaches to the Health sector. * The tools and methods available for supply chain analysis and benchmarking. * Key supply chain success factors. PMID:20407173

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

    PubMed Central

    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

    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

  5. Ruminal Prevotella spp. may play an important role in the conversion of plant lignans into human health beneficial antioxidants.

    PubMed

    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

    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

  6. Ruminant self-medication against gastrointestinal nematodes: evidence, mechanism, and origins☆

    PubMed Central

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

    2014-01-01

    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

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

    PubMed

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

    2014-01-01

    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

  8. 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...

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

    NASA Astrophysics Data System (ADS)

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

    2001-05-01

    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.

  10. Imagining the future in health anxiety: the impact of rumination on the specificity of illness-related memory and future thinking.

    PubMed

    Sansom-Daly, Ursula M; Bryant, Richard A; Cohn, Richard J; Wakefield, Claire E

    2014-01-01

    Individuals with health anxiety experience catastrophic fears relating to future illness. However, little research has explored cognitive processes involved in how health anxious individuals picture the future. Ruminative thinking has been shown to impede the ability to recall specific autobiographical memories, which in turn is related to maladaptive, categoric future thinking processes. This study examined the impact of rumination on memory and future thinking among 60 undergraduate participants with varying health anxiety (35% clinical-level health anxiety). Participants were randomized to experiential/ruminative self-focus conditions, then completed an Autobiographical Memory Test and Future Imaginings Task. Responses were coded for specificity and the presence of illness concerns. Rumination led to more specific illness-concerned memories overall, yet at the same time led to more categoric illness-related future imaginings. Rumination and health anxiety together best predicted overgeneral illness-related future imaginings. Highly specific illness-related memories may be maintained due to their personal salience. However, more overgeneral illness-related future imaginings may reflect cognitive avoidance in response to the threat of future illness. This divergent pattern of results between memory and future imaginings may exacerbate health anxiety, and may also serve to maintain maladaptive responses among individuals with realistic medical concerns, such as individuals living with chronic illness. PMID:24392700

  11. Rethinking Rumination.

    PubMed

    Nolen-Hoeksema, Susan; Wisco, Blair E; Lyubomirsky, Sonja

    2008-09-01

    The response styles theory (Nolen-Hoeksema, 1991) was proposed to explain the insidious relationship between rumination and depression. We review the aspects of the response styles theory that have been well-supported, including evidence that rumination exacerbates depression, enhances negative thinking, impairs problem solving, interferes with instrumental behavior, and erodes social support. Next, we address contradictory and new findings. Specifically, rumination appears to more consistently predict the onset of depression rather than the duration, but rumination interacts with negative cognitive styles to predict the duration of depressive symptoms. Contrary to original predictions, the use of positive distractions has not consistently been correlated with lower levels of depressive symptoms in correlational studies, although dozens of experimental studies show positive distractions relieve depressed mood. Further, evidence now suggests that rumination is associated with psychopathologies in addition to depression, including anxiety, binge eating, binge drinking, and self-harm. We discuss the relationships between rumination and worry and between rumination and other coping or emotion-regulation strategies. Finally, we highlight recent research on the distinction between rumination and more adaptive forms of self-reflection, on basic cognitive deficits or biases in rumination, on its neural and genetic correlates, and on possible interventions to combat rumination. PMID:26158958

  12. Intelligent Vehicle Health Management

    NASA Technical Reports Server (NTRS)

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

    2005-01-01

    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.

  13. EFFECT OF DIFFERENT ECOSYSTEMS AND MANAGEMENT PRACTICES ON TOXOPLASMA GONDII AND NEOSPORA CANINUM INFECTIONS IN WILD RUMINANTS IN SPAIN.

    PubMed

    San Miguel, José M; Gutiérrez-Expósito, Daniel; Aguado-Martínez, Adriana; González-Zotes, Elena; Pereira-Bueno, Juana; Gómez-Bautista, Mercedes; Rubio, Pedro; Ortega-Mora, Luis M; Collantes-Fernández, Esther; Álvarez-García, Gema

    2016-04-28

    Toxoplasma gondii and Neospora caninum are two major abortifacient protozoans in domestic small ruminants and cattle, respectively, and they also parasitize a wide range of wildlife. Numerous serosurveys have been conducted in wild ruminants worldwide. However, the potential effect of different ecosystems and management practices on these infections has not been investigated. We studied the prevalence of antibodies to T. gondii and N. caninum in wild ruminants between 2007 and 2012 from four national wildlife reserves: three open space reserves in northwest Spain (Ancares, Mampodre, and Riaño) and a fenced reserve in central Spain (Quintos de Mora). Sera from roe deer ( Capreolus capreolus ) and chamois ( Rupicapra rupicapra ) were collected in Ancares (roe deer), Mampodre (both species), and Riaño (both species), whereas red deer ( Cervus elaphus ) sera were collected only in Quintos de Mora. The results of immunofluorescence antibody tests showed a T. gondii antibody prevalence significantly higher in red deer (13%; 17/131) than in roe deer (2%; 5/228) and chamois (4%; 6/149) (P<0.05, Fisher's exact test). Moreover, N. caninum -specific antibodies were only detected in 1% of animals (2/131 red deer, 2/228 roe deer, and 2/149 chamois). Management measures were implemented in the Quintos de Mora reserve and T. gondii antibody prevalence in red deer decreased from 13% to 2% after 5 yr. In contrast, N. caninum antibody prevalences were very low (<2%) over the years. The results suggest a low frequency of sylvatic life cycles in the hunting reservations studied, so interconnection between sylvatic and domestic life cycles is unlikely. Regardless, a sustainable exploitation of natural resources in wildlife reserves may help to reduce the prevalence of T. gondii infection. PMID:26967135

  14. Vehicle health management

    NASA Astrophysics Data System (ADS)

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

    1994-06-01

    Vehicle health management (VHM) for space system avionics can ensure system readiness for launch vehicles and space-based dormant vehicles. In a research to evaluate space system avionics VHM for its guidance, navigation, and control systems (GN&C), researchers examined fault tolerance, redundancy, and levels of built-in test coverage needed to meet system performance requirements. They also analyzed ground and on-orbit test and check-out frequency to determine the tests necessary to meet availability requirements through maintained confidence in GN&C reliability. In addition, they defined the interface between current and advanced diagnostic techniques. Finally, they came up with concepts for commonality between VHM elements and ground-based testing equipment, and avionics laboratory requirements for conducting VHM research and development.

  15. [Health management in private health insurance].

    PubMed

    Ziegenhagen, D J; Schilling, M K

    2000-09-01

    German private health insurance faces new challenges. The classical tools of cost containment are no longer sufficient to keep up with ever increasing expenses for health care, and international competitors with managed care experience from their home markets are on the point of entering business in Germany. Although the American example of managed care is not fully compatible with customer demands and state regulations, some elements of this approach will gradually be introduced. First agreements were signed with networks or individual preferred providers in outpatient care and rehabilitation medicine. Insurance companies become more and more interested in supporting evidence based guidelines and programmes for disease and case management. The pros and cons of various other health management tools are discussed against the specific background of the quite unique German health care system. PMID:10992797

  16. Public health financial management competencies.

    PubMed

    Honoré, Peggy A; Costich, Julia F

    2009-01-01

    The absence of appropriate financial management competencies has impeded progress in advancing the field of public health finance. It also inhibits the ability to professionalize this sector of the workforce. Financial managers should play a critical role by providing information relevant to decision making. The lack of fundamental financial management knowledge and skills is a barrier to fulfilling this role. A national expert committee was convened to examine this issue. The committee reviewed standards related to financial and business management practices within public health and closely related areas. Alignments were made with national standards such as those established for government chief financial officers. On the basis of this analysis, a comprehensive set of public health financial management competencies was identified and examined further by a review panel. At a minimum, the competencies can be used to define job descriptions, assess job performance, identify critical gaps in financial analysis, create career paths, and design educational programs. PMID:19395980

  17. Disaster Management: Mental Health Perspective.

    PubMed

    Math, Suresh Bada; Nirmala, Maria Christine; Moirangthem, Sydney; Kumar, Naveen C

    2015-01-01

    Disaster mental health is based on the principles of 'preventive medicine' This principle has necessitated a paradigm shift from relief centered post-disaster management to a holistic, multi-dimensional integrated community approach of health promotion, disaster prevention, preparedness and mitigation. This has ignited the paradigm shift from curative to preventive aspects of disaster management. This can be understood on the basis of six 'R's such as Readiness (Preparedness), Response (Immediate action), Relief (Sustained rescue work), Rehabilitation (Long term remedial measures using community resources), Recovery (Returning to normalcy) and Resilience (Fostering). Prevalence of mental health problems in disaster affected population is found to be higher by two to three times than that of the general population. Along with the diagnosable mental disorders, affected community also harbours large number of sub-syndromal symptoms. Majority of the acute phase reactions and disorders are self-limiting, whereas long-term phase disorders require assistance from mental health professionals. Role of psychotropic medication is very limited in preventing mental health morbidity. The role of cognitive behaviour therapy (CBT) in mitigating the mental health morbidity appears to be promising. Role of Psychological First Aid (PFA) and debriefing is not well-established. Disaster management is a continuous and integrated cyclical process of planning, organising, coordinating and implementing measures to prevent and to manage disaster effectively. Thus, now it is time to integrate public health principles into disaster mental health. PMID:26664073

  18. Disaster Management: Mental Health Perspective

    PubMed Central

    Math, Suresh Bada; Nirmala, Maria Christine; Moirangthem, Sydney; Kumar, Naveen C.

    2015-01-01

    Disaster mental health is based on the principles of ‘preventive medicine’ This principle has necessitated a paradigm shift from relief centered post-disaster management to a holistic, multi-dimensional integrated community approach of health promotion, disaster prevention, preparedness and mitigation. This has ignited the paradigm shift from curative to preventive aspects of disaster management. This can be understood on the basis of six ‘R’s such as Readiness (Preparedness), Response (Immediate action), Relief (Sustained rescue work), Rehabilitation (Long term remedial measures using community resources), Recovery (Returning to normalcy) and Resilience (Fostering). Prevalence of mental health problems in disaster affected population is found to be higher by two to three times than that of the general population. Along with the diagnosable mental disorders, affected community also harbours large number of sub-syndromal symptoms. Majority of the acute phase reactions and disorders are self-limiting, whereas long-term phase disorders require assistance from mental health professionals. Role of psychotropic medication is very limited in preventing mental health morbidity. The role of cognitive behaviour therapy (CBT) in mitigating the mental health morbidity appears to be promising. Role of Psychological First Aid (PFA) and debriefing is not well-established. Disaster management is a continuous and integrated cyclical process of planning, organising, coordinating and implementing measures to prevent and to manage disaster effectively. Thus, now it is time to integrate public health principles into disaster mental health. PMID:26664073

  19. Intelligent Integrated System Health Management

    NASA Technical Reports Server (NTRS)

    Figueroa, Fernando

    2012-01-01

    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

  20. The effect of ruminal fluid preparations on the growth and health of newborn, milk-fed dairy calves.

    PubMed

    Muscato, T V; Tedeschi, L O; Russell, J B

    2002-03-01

    The objective of this study was to determine the effect of oral doses of ruminal fluid (RF) on the growth and health of newborn, milk-fed heifer dairy calves (0 to 6 wk of age). Calves given 8 ml of RF each day until weaning gained more weight and had fewer scours than controls that did not receive RF. Because RF that was exposed to oxygen or was autoclaved also gave a response, it is unlikely that the preparations were acting as a probiotic. When the RF was centrifuged to separate the cells (RFC) from the fluid (RFS), both fractions had similar activity, and this result indicated that the response was not nutritional; that is, 1) RFC supplied a small amount of protein (approximately 8 mg/d), but RFS had much less protein, and 2) RFS had volatile fatty acid, but RFC had little if any volatile fatty acid. However, both RFS and RFC had bacterial polysaccharide, and bacterial polysaccharide has strong antigenic properties. In the first three studies, treated calves were given RF preparations each day until weaning (6 wk), but a subsequent experiment indicated that calves given autoclaved RF for only 5 d (d 1 to 5) also had greater body weight gains during the first 2 wk of life and fewer scours than untreated controls. Given that the dosage of RF was small and the material could be autoclaved to prevent disease transmission, RF supplementation could be a practical tool for improving calf health. PMID:11949870

  1. Managed care and reproductive health.

    PubMed

    Cohen, S S; Williams, D R

    1998-01-01

    Managed care poses special challenges to midwives providing reproductive health care. This is owing to the sensitive nature of issues surrounding reproductive health and aspects of managed care that may impede a woman's ability to obtain continuous, confidential, and comprehensive care from the provider of her choice. Variations across payers (ie, Medicare, Medicaid, and commercial insurers) regarding covered benefits and reimbursement of midwifery services also may create obstacles. Furthermore, some physicians and managed care organizations are embracing policies that threaten the ability of midwives to function as primary health care providers for women. Despite these hurdles, midwives have the potential to remain competitive in the new marketplace. This article underscores the importance of being knowledgeable about legislation and policy issues surrounding the financing of midwifery services, quality performance measurement for HMOs as they pertain to reproductive health, and discussions regarding which clinicians should be defined as primary care providers. PMID:9674347

  2. Gamification and geospatial health management

    NASA Astrophysics Data System (ADS)

    Wortley, David

    2014-06-01

    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.

  3. Outcomes management in women's health.

    PubMed

    Houston, S; Fleschler, R

    1997-01-01

    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

  4. Paratuberculosis on small ruminant dairy farms in Ontario, Canada: A survey of management practices.

    PubMed

    Bauman, Cathy A; Jones-Bitton, Andria; Menzies, Paula; Jansen, Jocelyn; Kelton, David

    2016-05-01

    A cross-sectional study was undertaken (October 2010 to August 2011) to determine the risk factors for dairy goat herds and dairy sheep flocks testing positive for paratuberculosis (PTB) in Ontario, Canada. A questionnaire was administered to 50 producers during a farm visit in which concurrently, 20 randomly selected, lactating animals over the age of 2 years underwent sampling for paratuberculosis testing. Only 1 of 50 farms (2.0%) was closed to animal movement, whereas 96.6% of dairy goat farms and 94.1% of sheep farms purchased livestock from other producers. Only 10.3% of dairy goat, and no dairy sheep farms used artificial insemination. Manure was spread on grazing pastures by 65.5% and 70.6% of dairy goat and dairy sheep farms, respectively. Because of the high true-prevalence of paratuberculosis infection detected, no risk factor analysis could be performed. This study demonstrates that biosecurity practices conducive to transmission of PTB are highly prevalent in Ontario small ruminant dairy farms. PMID:27152042

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

    ERIC Educational Resources Information Center

    Gravina, Nicole E.; Siers, Brian P.

    2011-01-01

    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…

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

    ERIC Educational Resources Information Center

    Gravina, Nicole E.; Siers, Brian P.

    2011-01-01

    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

  7. Change management in health care.

    PubMed

    Campbell, Robert James

    2008-01-01

    This article introduces health care managers to the theories and philosophies of John Kotter and William Bridges, 2 leaders in the evolving field of change management. For Kotter, change has both an emotional and situational component, and methods for managing each are expressed in his 8-step model (developing urgency, building a guiding team, creating a vision, communicating for buy-in, enabling action, creating short-term wins, don't let up, and making it stick). Bridges deals with change at a more granular, individual level, suggesting that change within a health care organization means that individuals must transition from one identity to a new identity when they are involved in a process of change. According to Bridges, transitions occur in 3 steps: endings, the neutral zone, and beginnings. The major steps and important concepts within the models of each are addressed, and examples are provided to demonstrate how health care managers can actualize the models within their health care organizations. PMID:18510142

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

    NASA Technical Reports Server (NTRS)

    Garbos, Raymond J.; Mouyos, William

    1998-01-01

    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.

  9. Families, Managed Care, & Children's Mental Health.

    ERIC Educational Resources Information Center

    McManus, Marilyn C., Ed.

    1996-01-01

    This theme issue of a bulletin on family support and children's mental health focuses on managed care and the impact on children who are in need of mental health services. Articles include: "Private Sector Managed Care and Children's Mental Health" (Ira S. Lourie and others); "Just What Is Managed Care?" (Chris Koyanagi); "Managed Behavioral…

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

    NASA Technical Reports Server (NTRS)

    Mouyos, William; Wangu, Srimal

    1998-01-01

    To reduce operations costs, Reusable Launch Vehicles (RLVS) must include highly reliable robust subsystems which are designed for simple repair access with a simplified servicing infrastructure, and which incorporate 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 incorporates Vehicle Health Management (VHM), ground processing associated with the vehicle fleet (GVHM), and Ground Infrastructure Health Management (GIHM). The primary objective of SHM is to provide an automated and paperless health decision, maintenance, and logistics system. Sanders, a Lockheed Martin Company, is leading the design, development, and integration of the SHM system for RLV and for X-33 (a sub-scale, sub-orbit Advanced Technology Demonstrator). Many critical technologies are necessary to make SHM (and more specifically VHM) practical, reliable, and cost effective. This paper will present the X-33 SHM design which forms the baseline for the RLV SHM, and it will discuss applications of advanced technologies to future RLVs. In addition, this paper will describe a Virtual Design Environment (VDE) which is being developed for RLV. This VDE will allow for system design engineering, as well as program management teams, to accurately and efficiently evaluate system designs, analyze the behavior of current systems, and predict the feasibility of making smooth and cost-efficient transitions from older technologies to newer ones. The RLV SHM design methodology will reduce program costs, decrease total program life-cycle time, and ultimately increase mission success.

  11. Understanding managed behavioral health care.

    PubMed

    Hoge, M A; Thakur, N M; Jacobs, S

    2000-06-01

    Managed care can be understood from an historical perspective as a reaction to perceived abuses by providers or an extension of earlier efforts to manage care in the public sector. It can be viewed as a young and emerging force--a fourth party to the health care transaction--that is rapidly progressing through a series of generations that redefine the approach to organizing and delivering services. And finally, because managed care emerges with so many faces, consumers and providers can perhaps best understand its implementation in a specific state or community by examining the multiple dimensions, such as those outlined herein, on which these initiatives vary. Until the forms and functions are more uniform, no simple definition of managed care will exist. PMID:10909105

  12. The physiology of stress and effects on immune health in ruminants

    Technology Transfer Automated Retrieval System (TEKTRAN)

    As researchers have continued to explore the complex interactions among stress and production parameters such as growth, feed efficiency, and health, multidisciplinary efforts have emerged leading to a greater understanding of homeostatic regulation. The immune system can be regulated by several dif...

  13. 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...

  14. Invited review: effect, persistence, and virulence of coagulase-negative Staphylococcus species associated with ruminant udder health.

    PubMed

    Vanderhaeghen, W; Piepers, S; Leroy, F; Van Coillie, E; Haesebrouck, F; De Vliegher, S

    2014-09-01

    The aim of this review is to assess the effect of coagulase-negative staphylococci (CNS) species on udder health and milk yield in ruminants, and to evaluate the capacity of CNS to cause persistent intramammary infections (IMI). Furthermore, the literature on factors suspected of playing a role in the pathogenicity of IMI-associated CNS, such as biofilm formation and the presence of various putative virulence genes, is discussed. The focus is on the 5 CNS species that have been most frequently identified as causing bovine IMI using reliable molecular identification methods (Staphylococcus chromogenes, Staphylococcus simulans, Staphylococcus haemolyticus, Staphylococcus xylosus, and Staphylococcus epidermidis). Although the effect on somatic cell count and milk production is accepted to be generally limited or nonexistent for CNS as a group, indications are that the typical effects differ between CNS species and perhaps even strains. It has also become clear that many CNS species can cause persistent IMI, contrary to what has long been believed. However, this trait appears to be quite complicated, being partly strain dependent and partly dependent on the host's immunity. Consistent definitions of persistence and more uniform methods for testing this phenomenon will benefit future research. The factors explaining the anticipated differences in pathogenic behavior appear to be more difficult to evaluate. Biofilm formation and the presence of various staphylococcal virulence factors do not seem to (directly) influence the effect of CNS on IMI but the available information is indirect or insufficient to draw consistent conclusions. Future studies on the effect, persistence, and virulence of the different CNS species associated with IMI would benefit from using larger and perhaps even shared strain collections and from adjusting study designs to a common framework, as the large variation currently existing therein is a major problem. Also within-species variation should be investigated. PMID:24952781

  15. Vehicle health management technology needs

    NASA Technical Reports Server (NTRS)

    Hammond, Walter E.; Jones, W. G.

    1992-01-01

    Background material on vehicle health management (VHM) and health monitoring/control is presented. VHM benefits are described and a list of VHM technology needs that should be pursued is presented. The NASA funding process as it impacts VHM technology funding is touched upon, and the VHM architecture guidelines for generic launch vehicles are described. An example of a good VHM architecture, design, and operational philosophy as it was conceptualized for the National Launch System program is presented. Consideration is given to the Strategic Avionics Technology Working Group's role in VHM, earth-to-orbit, and space vehicle avionics technology development considerations, and some actual examples of VHM benefits for checkout are given.

  16. Vaccination schedules in small ruminant farms.

    PubMed

    Lacasta, D; Ferrer, L M; Ramos, J J; González, J M; Ortín, A; Fthenakis, G C

    2015-12-14

    Development and implementation of health management plans is the cornerstone of profitable farms; prevention of microbial diseases by means of vaccination is an integral part of such a plan. In every production type and management system in small ruminants, microbial diseases have a major significance, hence their proper control must be based in good health management practices, including use of effective and safe vaccines. Development of various types of vaccines is evolving very quickly in recent years and the improvement of new type of vaccines offers prospects. The article reviews and discusses vaccination programs and latest advances in development of vaccines against diseases that cause major economic losses in small ruminants. Specifically, vaccination schedules for the following diseases are reviewed: bacterial abortion (abortion associated with Brucella melitensis, Campylobacter spp., Chlamydophila abortus, Coxiella burnetii, Salmonella abortus ovis or Salmonella brandenburg), caseous lymphadenitis, clostridial diseases, colibacillosis, contagious echtyma, epididymitis caused by Brucella ovis, footrot, mammary diseases (contagious agalactia, mastitis), paratuberculosis and respiratory diseases (respiratory disease caused by Mannheimia haemolytica or other Pasteurellaceae). PMID:26220514

  17. SSME Advanced Health Management: Project Overview

    NASA Technical Reports Server (NTRS)

    Plowden, John

    2000-01-01

    This document is the viewgraphs from a presentation concerning the development of the Health Management system for the Space Shuttle Main Engine (SSME). It reviews the historical background of the SSME Advanced Health Management effort through the present final Health management configuration. The document includes reviews of three subsystems to the Advanced Health Management System: (1) the Real-Time Vibration Monitor System, (2) the Linear Engine Model, and (3) the Optical Plume Anomaly Detection system.

  18. Peste des petits ruminants

    PubMed Central

    Parida, S.; Muniraju, M.; Mahapatra, M.; Muthuchelvan, D.; Buczkowski, H.; Banyard, A.C.

    2015-01-01

    Peste des petits ruminants virus causes a highly infectious disease of small ruminants that is endemic across Africa, the Middle East and large regions of Asia. The virus is considered to be a major obstacle to the development of sustainable agriculture across the developing world and has recently been targeted by the World Organisation for Animal Health (OIE) and the Food and Agriculture Organisation (FAO) for eradication with the aim of global elimination of the disease by 2030. Fundamentally, the vaccines required to successfully achieve this goal are currently available, but the availability of novel vaccine preparations to also fulfill the requisite for differentiation between infected and vaccinated animals (DIVA) may reduce the time taken and the financial costs of serological surveillance in the later stages of any eradication campaign. Here, we overview what is currently known about the virus, with reference to its origin, updated global circulation, molecular evolution, diagnostic tools and vaccines currently available to combat the disease. Further, we comment on recent developments in our knowledge of various recombinant vaccines and on the potential for the development of novel multivalent vaccines for small ruminants. PMID:26443889

  19. Peste des petits ruminants.

    PubMed

    Parida, S; Muniraju, M; Mahapatra, M; Muthuchelvan, D; Buczkowski, H; Banyard, A C

    2015-12-14

    Peste des petits ruminants virus causes a highly infectious disease of small ruminants that is endemic across Africa, the Middle East and large regions of Asia. The virus is considered to be a major obstacle to the development of sustainable agriculture across the developing world and has recently been targeted by the World Organisation for Animal Health (OIE) and the Food and Agriculture Organisation (FAO) for eradication with the aim of global elimination of the disease by 2030. Fundamentally, the vaccines required to successfully achieve this goal are currently available, but the availability of novel vaccine preparations to also fulfill the requisite for differentiation between infected and vaccinated animals (DIVA) may reduce the time taken and the financial costs of serological surveillance in the later stages of any eradication campaign. Here, we overview what is currently known about the virus, with reference to its origin, updated global circulation, molecular evolution, diagnostic tools and vaccines currently available to combat the disease. Further, we comment on recent developments in our knowledge of various recombinant vaccines and on the potential for the development of novel multivalent vaccines for small ruminants. PMID:26443889

  20. 9 CFR 93.417 - Import permit and declaration for ruminants.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... ruminants. 93.417 Section 93.417 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants Canada 8 § 93.417 Import permit and declaration for ruminants. (a) For ruminants intended for importation from Canada, the importer shall...

  1. 9 CFR 93.422 - Import permit and declaration for ruminants.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... ruminants. 93.422 Section 93.422 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants Central America and West Indies 9 § 93.422 Import permit and declaration for ruminants. (a) For ruminants intended for importation...

  2. 9 CFR 93.417 - Import permit and declaration for ruminants.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... ruminants. 93.417 Section 93.417 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants Canada 8 § 93.417 Import permit and declaration for ruminants. (a) For ruminants intended for importation from Canada, the importer shall...

  3. 9 CFR 93.422 - Import permit and declaration for ruminants.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... ruminants. 93.422 Section 93.422 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants Central America and West Indies 9 § 93.422 Import permit and declaration for ruminants. (a) For ruminants intended for importation...

  4. 9 CFR 93.424 - Import permits and applications for inspection of ruminants.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... inspection of ruminants. 93.424 Section 93.424 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION... PRODUCTS; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants Mexico 10 § 93.424 Import permits and applications for inspection of ruminants. (a) For ruminants intended for importation...

  5. 9 CFR 93.422 - Import permit and declaration for ruminants.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... ruminants. 93.422 Section 93.422 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants Central America and West Indies 9 § 93.422 Import permit and declaration for ruminants. (a) For ruminants intended for importation...

  6. 9 CFR 93.417 - Import permit and declaration for ruminants.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... ruminants. 93.417 Section 93.417 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants Canada 8 § 93.417 Import permit and declaration for ruminants. (a) For ruminants intended for importation from Canada, the importer shall...

  7. 9 CFR 93.417 - Import permit and declaration for ruminants.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... ruminants. 93.417 Section 93.417 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants Canada 8 § 93.417 Import permit and declaration for ruminants. (a) For ruminants intended for importation from Canada, the importer shall...

  8. 9 CFR 93.422 - Import permit and declaration for ruminants.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... ruminants. 93.422 Section 93.422 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants Central America and West Indies 9 § 93.422 Import permit and declaration for ruminants. (a) For ruminants intended for importation...

  9. 9 CFR 93.417 - Import permit and declaration for ruminants.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... ruminants. 93.417 Section 93.417 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants Canada 8 § 93.417 Import permit and declaration for ruminants. (a) For ruminants intended for importation from Canada, the importer shall...

  10. 9 CFR 93.424 - Import permits and applications for inspection of ruminants.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... inspection of ruminants. 93.424 Section 93.424 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION... PRODUCTS; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants Mexico 10 § 93.424 Import permits and applications for inspection of ruminants. (a) For ruminants intended for importation...

  11. 9 CFR 93.422 - Import permit and declaration for ruminants.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... ruminants. 93.422 Section 93.422 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants Central America and West Indies 9 § 93.422 Import permit and declaration for ruminants. (a) For ruminants intended for importation...

  12. 9 CFR 93.424 - Import permits and applications for inspection of ruminants.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... inspection of ruminants. 93.424 Section 93.424 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION... PRODUCTS; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants Mexico 10 § 93.424 Import permits and applications for inspection of ruminants. (a) For ruminants intended for importation...

  13. The role of epidemiological knowledge and grazing management for helminth control in small ruminants.

    PubMed

    Barger, I A

    1999-01-01

    There is no single requirement more crucial to the rational and sustainable control of helminth parasites in grazing animals than a comprehensive knowledge of the epidemiology of the parasite as it interacts with the host in a specific climatic, management and production environment. In its absence, anthelmintic treatment is either given suppressively, which provokes resistance, or therapeutically, which risks clinical disease and production losses. Sustainable parasite-control programmes require knowledge of seasonal larval availability, origin of larvae contributing to any peaks and climatic requirements for worm egg hatching, larval development and survival. Control measures based on this knowledge include strategic anthelmintic treatments and various forms of grazing management. While these measures can reduce the frequency of anthelmintic treatment required, their effect on selection for drench resistance is more problematical, unless they can be combined with other forms of control to reduce our current dependence on anthelmintics. PMID:10048818

  14. Prevention through health risk management.

    PubMed

    Friedman, G M

    1992-08-01

    Risk can lead to catastrophe. Risk-management systems are highly effective in preventing the catastrophes of fire, earthquakes, and work-site injuries. No such effective systems are present to prevent health and social problems. A practical, cost-effective system to manage risk in children is being developed by the nonprofit Arizona Health Evaluation and Longevity Planning (HELP) Foundation. Information regarding such risk is collected in the school setting. This voluntary information comes from the administration, the school nurse, physical fitness testing, blood testing by the local hospital, self-esteem instruments, and parent, teacher, and child questionnaires. The HELP Foundation then develops an individual child and class risk profile that is presented to the teacher, school nurse, principal, and parent. Those involved with each child then prioritize, plan, and implement programs and activities to manage the identified risk(s). Risks is tracked throughout the child's school career by periodic reassessment. Evaluation of change in problem outcome will be a natural extension of the process. PMID:1643740

  15. [Considerations about health risk management].

    PubMed

    Bossi, A; Abetti, P; De Luca, S; Masullo, M

    2003-01-01

    From the birth of doctrines of Risk Management to today a lot of time is passed. From the initial application in the field of the insurances and the management of the enterprises, theories inspired to the identification, evaluation and correction of connected risks to the activity and the industrial trial has been figurative to the health, field in which the application of these principles results to be how much never profit and productive of benefits above all for the patients that suffer consequences of errors but also for the physicians and the personnel that, perfectly inserted in an organization aware of the trials to put into effect, can bring their contribution to underline the weak points of the relief trial. The economic cost and consequences of errors can decrease if a new culture is established inspired to the learning and the communication of the adverse events, to minimize the possibility that they again occurs. PMID:14969298

  16. Management Education in Public Health: Further Considerations

    PubMed Central

    Darr, Kurt J.

    2015-01-01

    Knowing and applying the basic management functions of planning, organizing, staffing, directing, and controlling, as well as their permutations and combinations, are vital to effective delivery of public health services. Presently, graduate programs that prepare public health professionals neither emphasize teaching management theory, nor its application. This deficit puts those who become managers in public health and those they serve at a distinct disadvantage. This deficit can be remedied by enhanced teaching of management subjects PMID:26673475

  17. Managing anthelmintic resistance in small ruminant livestock of resource-poor farmers in South Africa.

    PubMed

    Vattaa, A F; Lindberg, A L E

    2006-03-01

    Gastrointestinal parasitism is one of the most important disease complexes of sheep and goats impacting on the resource-poor livestock farmer. Of the responsible nematodes, Haemonchus contortus, a blood-sucking worm of the abomasum, poses possibly the greatest threat. Over the past several decades, the worm has been controlled through the use of anthelmintics, but the emergence of anthelmintic resistance has threatened this chemotherapeutic approach. In Africa, the overall prevalence of anthelmintic resistance has not been extensively investigated, particularly within the resource-poor farming sector, but resistance has been reported from at least 14 countries with most of the reports emanating from Kenya and South Africa and the majority concerning H. contortus. While levels of resistance under commercial sheep farming systems in South Africa is considered to be amongst the worst in the world, resistance has also been reported from the resource-poor farming sector. Increases in productivity and reproduction of livestock and the development of markets for sale of animals are seen by international funding bodies as a way out of poverty for communities that keep livestock. This must lead to the greater need for parasite control. At such times, the risk of levels of anthelmintic resistance escalating is much greater and there is therefore a need to look at alternatives to their use. Proposed strategies include the appropriate, but judicious use of anthelmintics by application of the FAMACHA system and the use of alternatives to anthelmintics such as strategic nutrient supplementation. It is also very clear that there is a strong demand for knowledge about animal diseases, including helminthosis, and their effective management in the resource-poor livestock farming communities. This is an important challenge to meet. PMID:16700468

  18. Interactions between nutrition and reproduction in the management of the mature male ruminant.

    PubMed

    Martin, G B; Blache, D; Miller, D W; Vercoe, P E

    2010-07-01

    In mature male sheep and goats, changes in feed intake seem to have little effect on gonadal endocrine function but induce profound changes on sperm production. These outcomes are due to changes in size of the seminiferous tubules and in spermatogenic efficiency. Except with severe underfeeding, there are only minor changes in the endocrine function of the testis (testosterone production) unless season-long treatments are imposed. For cattle, nutrition clearly affects testicular development and the production of spermatozoa in young bulls, as it does in other species but, after the period of rapid growth has ended, there appears to be little or no response to nutrition. We are developing a clear picture of the metabolic signals, neuroendocrine processes and hormonal control systems that are involved, particularly for the mature male sheep. The energetic components of the diet, rather than protein, seem to be responsible, so we have envisaged a model of the relationship between energy balance and reproduction that has 4 'dimensions': genotype, structure (organs), communication (chemical and neural signals, nutrient sensing) and time (dynamics, metabolic memory, programming). We have linked these perspectives to 'resource allocation theory' and incorporated them into strategies for 'clean, green and ethical animal production'. In contrast to the clear outcomes with respect to spermatogenesis, the effects of nutrition on sexual behaviour are more difficult to define, perhaps because the behaviour is affected by a complex mix of physiological factors and because of flawed methods for quantifying male behaviour. For example, sexual behaviour is compromised by severe feed restriction, but male sexual behaviour requires intensive motor activity so a decline in libido could be caused by general weakness rather than specific nutritional limitations. The interaction between sexual activity and feeding behaviour also complicates the issue under field conditions. At the other end of the scale, overweight males can show reduced sexual success because they have difficulty courting and mounting. For this reason, exercise can enhance the fertilising capacity of rams. This will be important in extensive mating systems where males need to assemble and guard a harem and then mate many times for several weeks. For artificial insemination centres, there seems to be very few data on the nutritional management of males, but problems with overfed animals appear to be a risk. Future research should concentrate on the intra-testicular systems mediating the effects of nutrition on the production of spermatozoa. PMID:22444618

  19. Spirulina in health care management.

    PubMed

    Kulshreshtha, Archana; Zacharia, Anish J; Jarouliya, Urmila; Bhadauriya, Pratiksha; Prasad, G B K S; Bisen, P S

    2008-10-01

    Spirulina is a photosynthetic, filamentous, spiral-shaped and multicellular edible microbe. It is the nature's richest and most complete source of nutrition. Spirulina has a unique blend of nutrients that no single source can offer. The alga contains a wide spectrum of prophylactic and therapeutic nutrients that include B-complex vitamins, minerals, proteins, gamma-linolenic acid and the super anti-oxidants such as beta-carotene, vitamin E, trace elements and a number of unexplored bioactive compounds. Because of its apparent ability to stimulate whole human physiology, Spirulina exhibits therapeutic functions such as antioxidant, anti-bacterial, antiviral, anticancer, anti-inflammatory, anti-allergic and anti-diabetic and plethora of beneficial functions. Spirulina consumption appears to promote the growth of intestinal micro flora as well. The review discusses the potential of Spirulina in health care management. PMID:18855693

  20. Future preparation of occupational health nurse managers.

    PubMed

    Scalzi, C C; Wilson, D L; Ebert, R

    1991-03-01

    This article presents the results of a national survey of job activities of corporate level occupational health nurse managers. The survey was designed to identify the relative amount of time spent and importance attributed to specific areas of their current job. In general this sample tended to have more management experience and educational preparation than previously cited studies: over 50% had completed a graduate degree. The scores for importance and time spent were highly correlated. That is, occupational health corporate nurse managers seemed to allocate their time to job responsibilities they considered most important. Management activities related to policy, practice standards, quality assurance, staff development, and systems for client care delivery appear to represent the core responsibilities of occupational health nursing management. Curriculum recommendations for management positions in occupational health include: health policy, program planning, and evaluation; business strategy; applications of management information systems; quality assurance; and marketing. PMID:2001272

  1. Environmental scanning and the health care manager.

    PubMed

    Layman, Elizabeth J; Bamberg, Richard

    2005-01-01

    Health care managers and supervisors work in an environment of major changes and ongoing turbulence. Basic terms and strategic approaches are described to enable managers and supervisors to better understand the process of environmental scanning in the turbulent health care environment. Drawing from multiple disciplines, the information allows health care managers and supervisors to improve their skills as environmental scanners as they develop and implement strategic plans in this environment. PMID:16131929

  2. Software for Intelligent System Health Management

    NASA Technical Reports Server (NTRS)

    Trevino, Luis C.

    2004-01-01

    This viewgraph presentation describes the characteristics and advantages of autonomy and artificial intelligence in systems health monitoring. The presentation lists technologies relevant to Intelligent System Health Management (ISHM), and some potential applications.

  3. Computer Applications in Mental Health Management

    PubMed Central

    Hedlund, James L.; Wurster, Cecil R.

    1982-01-01

    This paper presents an overview of computer applications in mental health management. It makes a distinction between general (omnibus) mental health information systems and management information systems, between administrative and clinical computer applications, and summarizes the trend toward efficient, well-defined minimal-data-base management systems, with smaller, less expensive hardware. It also comments briefly on other current trends, including the move from central batch processing on mainframe computers to interactive, distributed processing using minicomputers at regional centers, greatly improved, more flexible data base management systems, and a new NIMH prototype management information system for community mental health centers.

  4. Loop-mediated isothermal amplification for diagnosis of 18 World Organization for Animal Health (OIE) notifiable viral diseases of ruminants, swine and poultry.

    PubMed

    Mansour, Shimaa M G; Ali, Haytham; Chase, Christopher C L; Cepica, Arnost

    2015-12-01

    Loop-mediated isothermal amplification (LAMP) is a simple, powerful state-of-the-art gene amplification technique used for the rapid diagnosis and early detection of microbial diseases. Many LAMP assays have been developed and validated for important epizootic diseases of livestock. We review the LAMP assays that have been developed for the detection of 18 viruses deemed notifiable of ruminants, swine and poultry by the World Organization for Animal Health (OIE). LAMP provides a fast (the assay often takes less than an hour), low cost, highly sensitive, highly specific and less laborious alternative to detect infectious disease agents. The LAMP procedure can be completed under isothermal conditions so thermocyclers are not needed. The ease of use of the LAMP assay allows adaptability to field conditions and works well in developing countries with resource-limited laboratories. However, this technology is still underutilized in the field of veterinary diagnostics despite its huge capabilities. PMID:25900363

  5. The inverse of managed health.

    PubMed

    Borremans, V

    1978-01-01

    In providing a non-professional view on health, on health in a desirable modern world, the modern form of "medicalized health" is contrasted with the conception of health among the Aztecs before the arrival of the Spaniards. Health was "medicalized" in the 1960s; the medical model of health care was determined mostly by what physicians do. Since that time, 4 distinct professional approaches each have challenged the monopoly of doctors over the definition of health. 1 of the key mistakes of modern civilization is to assume that there is only 1 health - a universal health, which is given in the form of health services and imposed on the people. In actuality, there are many different kinds of health - as many as there are cultures. In modern society health will be high when 2 conditions are met: 1) when society distributes equitably what it produces; and 2) when society produces just barely as many goods and services as are needed to equip people equitably with the tools they need for the most effective level of autonomous action. The answer is not simply to redistribute health. People need to be involved in determining their own health needs. A lesson can be learned from what the Spaniards did to the Aztecs in Mexico. In 1519 there was a population of 25 million in Mexico, but by 1608 there were just 1 million after the Spaniards had begun their campaign to bring health to the Aztecs. PMID:12260676

  6. The role of health information managers in hospital financial management.

    PubMed

    Margrif, F D

    1991-11-01

    One area of internal analysis that has attracted increasing attention from healthcare managers is product line management. The coded data produced by the health information management professional is integrated with financial data to provide decision makers with valuable information about service quality and profitability. PMID:10117696

  7. New developments concerning health care financial management.

    PubMed

    Drati, Nathan; Kleiner, Brian

    2005-01-01

    Managed care has become one of the leading developments in health care financial management, but ignorance and confusion surround its meaning and origins. Managed care seeks to reduced costs and increase profits while maintaining quality, yet the evidence that it is able to achieve these aims is mixed. The following analysis is a review of the events leading to the establishment of managed care and what it has become. Various terms and health care organizations involved in managed care are identified, with emphasis placed on the strengths and weaknesses of managed care programs. This analysis is performed to gain insight and better understanding of the direction health care financial management is headed in the 21st century. PMID:18972972

  8. [The characteristics of public health resources management].

    PubMed

    2011-01-01

    The article analyses the position of human health in the system of social economic relationships. The notion of material and technical resources in health institutions is defined. It is demonstrated that they are characterized by number of health institutions, their structure according levels and stages of medical care provision, costs of fixed assets, their structure and wear. The conceptual characteristics of actual management of public health resources are analyzed. PMID:22279808

  9. Understanding and managing organizational change: implications for public health management.

    PubMed

    Thompson, Jon M

    2010-01-01

    Managing organizational change has become a significant responsibility of managers. Managing the change process within public health organizations is important because appropriately and systematically managing change is linked to improved organizational performance. However, change is difficult and the change process poses formidable challenges for managers. Managers themselves face increased pressure to respond to environmental influences and provide the necessary leadership to their organizations in the change process. In fact, managing organizational change has become a key competency for healthcare managers. This article addresses the important topic of organizational change in public health organizations. It provides a conceptual foundation for understanding organizational change and its relationship to healthcare organizational performance, and then discusses the types and nature of change, using some examples and evidence from those organizations that have successfully managed change. A framework for guiding public health managers in the change management process is provided. The article concludes with suggested management competencies to establish a change-oriented organization with the culture and capacity for change. PMID:20150801

  10. Concept Development for Software Health Management

    NASA Technical Reports Server (NTRS)

    Riecks, Jung; Storm, Walter; Hollingsworth, Mark

    2011-01-01

    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.

  11. Future developments in health care performance management.

    PubMed

    Crema, Maria; Verbano, Chiara

    2013-01-01

    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

  12. Future developments in health care performance management

    PubMed Central

    Crema, Maria; Verbano, Chiara

    2013-01-01

    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

  13. A Population Health Management Approach to Oral Health.

    PubMed

    Hummel, Jeff; Phillips, Kathryn E

    2016-03-01

    Clinical outcomes have been shown to be better, and total costs lower, when patients with chronic illness such as diabetes are managed using a population health strategy in a primary care setting that includes structured coordination of care with specialty services. This "population health management approach" offers a promising new vision for addressing oral disease as a chronic illness through a collaborative partnership between primary care teams and dental professionals. PMID:27044237

  14. A guide to performance management for the Health Information Manager.

    PubMed

    Leggat, Sandra G

    2009-01-01

    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

  15. Rotorcraft Health Management Issues and Challenges

    NASA Technical Reports Server (NTRS)

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

    2006-01-01

    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.

  16. Development and Testing of Propulsion Health Management

    NASA Technical Reports Server (NTRS)

    Hunter, Gary W.; Lekki, John D.; Simon, Donald L.

    2012-01-01

    An Integrated Vehicle Health Management system aims to maintain vehicle health through detection, diagnostics, state awareness, prognostics, and lastly, mitigation of detrimental situations for each of the vehicle subsystems and throughout the vehicle as a whole. This paper discusses efforts to advance Propulsion Health Management technology for in-flight applications to provide improved propulsion sensors measuring a range of parameters, improve ease of propulsion sensor implementation, and to assess and manage the health of gas turbine engine flow-path components. This combined work is intended to enable real-time propulsion state assessments to accurately determine the vehicle health, reduce loss of control, and to improve operator situational awareness. A unique aspect of this work is demonstration of these maturing technologies on an operational engine.

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

    PubMed

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

    2015-02-01

    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

  18. Managed care in four managed competition OECD health systems.

    PubMed

    Shmueli, Amir; Stam, Piet; Wasem, Jürgen; Trottmann, Maria

    2015-07-01

    Managed care emerged in the American health system in the 1980s as a way to manage suppliers' induced demand and to contain insurers' costs. While in Israel the health insurers have always been managed care organizations, owning health care facilities, employing medical personnel or contracting selectively with independent providers, European insurers have been much more passive, submitting themselves to collective agreements between insurers' and providers' associations, accompanied by extensive government regulation of prices, quantities, and budgets. With the 1990s reforms, and the introduction of risk-adjusted "managed competition", a growing pressure to allow the European insurers to manage their own care - including selective contracting with providers - has emerged, with varying speed of the introduction of policy changes across the individual countries. This paper compares experiences with managed care in Israel, The Netherlands, Germany and Switzerland since the 1990s. After a brief description of the health insurance markets in the four countries, we focus comparatively on the emergence of managed care in the markets for ambulatory care and inpatient market care. We conclude with an evaluation of the current situation and a discussion of selected health policy issues. PMID:25776034

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

    NASA Astrophysics Data System (ADS)

    Zervas, G.; Tsiplakou, E.

    2012-03-01

    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.

  20. Financial management in leading health care systems.

    PubMed

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

    2000-01-01

    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

  1. Integrated System Health Management Development Toolkit

    NASA Technical Reports Server (NTRS)

    Figueroa, Jorge; Smith, Harvey; Morris, Jon

    2009-01-01

    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.

  2. How Four Health Plans Manage Biotech Drugs

    PubMed Central

    CARLSON, BOB

    2004-01-01

    With the number of market-approved biotech drugs approved by the U.S. Food and Drug Administration expected to jump soon, health plans are scrambling to redesign benefit structures, manage utilization, and get a handle on the costs of these new therapies. Here’s how four health plans are addressing these issues. PMID:23372496

  3. Managing terminology assets in Electronic Health Records.

    PubMed

    Abrams, Kelly; Schneider, Sue; Scichilone, Rita

    2009-01-01

    Electronic Health Record (EHR)systems rely on standard terminologies and classification systems that require both Information Technology (IT) and Information Management (IM) skills. Convergence of perspectives is necessary for effective terminology asset management including evaluation for use, maintenance and intersection with software applications. Multiple terminologies are necessary for patient care communication and data capture within EHRs and other information management tasks. Terminology asset management encompasses workflow and operational context as well as IT specifications and software application run time requirements. This paper identifies the tasks, skills and collaboration of IM and IT approaches for terminology asset management. PMID:19380984

  4. Management noninformation systems in health care organizations.

    PubMed

    Herzlinger, R

    1976-01-01

    The health care manager is often an unwitting accomplice in the creation of noninformation systems because he fails to assume leadership in designing, installing and operating the system. There's also strong evidence that many managers could use a good course in basic accounting. PMID:10241307

  5. Home Health Management Aide. Final Report.

    ERIC Educational Resources Information Center

    Mincemoyer, Betty Jane

    The report describes a demonstration project to provide a course of study at the senior high level in home health management for the academically handicapped. The course consisted of practice in nursing skills, home management and laboratory work in food preparation techniques, the family, and child care. Activities included field trips,…

  6. Financial management of health system pharmacy practice.

    PubMed

    Abramowitz, P W

    1997-01-01

    The financial management of pharmacies and health systems is a combination of the traditional management of personnel and drug and supply costs with the management of the total costs of care. It includes determining the consequences of less than optimal drug therapy, improving drug therapy, and reengineering pharmacy departments and services across all patient care settings to deliver optimal pharmacotherapy. Prevention and reduction of adverse drug events, disease state management, and other methods to improve quality of care are of major importance. Future articles in this series on the financial management of pharmacy practice in health care systems will provide examples of applications of financial management in acute care, ambulatory care, long term care, and across sites of care. They also will include the justification of the development of new types of patient care services. PMID:10164163

  7. Research collaboration in health management research communities

    PubMed Central

    2013-01-01

    Background This study uses scientometrics methodology to reveal the status quo and emerging issues of collaboration in health management. Methods We searched all the articles with the keyword “health management” in the period 1999–2011 in Web of Knowledge, then 3067 articles were found. Methods such as Social network analysis (SNA), co-authorship, co-word analysis were used in this study. Results Analysis of the past 13 years of research in the field of health management indicates that, whether the production of scientific research, or authors, institutions and scientific research collaboration at the national level, collaboration behavior has been growing steadily across all collaboration types. However, the international scientific research cooperation about health management study between countries needs to be further encouraged. 17 researchers can be seen as the academic leaders in this field. 37 research institutions play a vital role in the information dissemination and resources control in health management. The component analysis found that 22 research groups can be regarded as the backbone in this field. The 8 institution groups consisting of 33 institutions form the core of this field. USA, UK and Australia lie in the center by cohesive subgroup analysis; Based on keywords analysis, 44 keywords with high frequency such as care, disease, system and model were involved in the health management field. Conclusions This study demonstrates that although it is growing steadily, collaboration behavior about health management study needs to be enhanced, especially between different institutions or countries/regions, which would promote the progress and internationalization of health management. Besides, researchers should pay attention to the cooperation of representative scholars and institutions, as well as the hot areas of research, because their experience would help us promote the research development of our nation. PMID:23617236

  8. [Demographic changes and health management].

    PubMed

    Calero, Juan del Rey

    2006-01-01

    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

  9. Simulation modeling for the health care manager.

    PubMed

    Kennedy, Michael H

    2009-01-01

    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

  10. Job redesign and the health care manager.

    PubMed

    Layman, Elizabeth J

    2007-01-01

    Health care supervisors and managers are often asked to redesign jobs in their departments. Frequently, little information accompanies the directive. This article lists sources of change in work and defines key terms. Also reviewed are factors that supervisors and managers can weigh in their redesigns. The article suggests actions aligned to common problems in the work environment. Finally, guidelines for a practical, step-by-step approach are provided. For health care supervisors and managers, the key to a successful job redesign is to achieve the unique balance of factors that matches the situation. PMID:17464222

  11. 9 steps to effective population health management.

    PubMed

    Handmaker, Karen; Hart, Juliana

    2015-04-01

    A focus on population health management is a necessary ingredient for success under value-based payment models. As part of that effort, nine ways to embrace technology can help healthcare organizations improve population health, enhance the patient experience, and reduce costs: Use predictive analytics for risk stratification. Combine predictive modeling with algorithms for financial risk management. Use population registries to identify care gaps. Use automated messaging for patient outreach. Engage patients with automated alerts and educational campaigns. Automate care management tasks. Build programs and organize clinicians into care teams. Apply new technologies effectively. Use analytics to measure performance of organizations and providers. PMID:26665527

  12. 9 CFR 93.403 - Ports designated for the importation of ruminants.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... of ruminants. 93.403 Section 93.403 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION... PRODUCTS; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants § 93.403 Ports designated for the importation of ruminants. (a) Air and ocean ports. The following ports have APHIS...

  13. 9 CFR 93.407 - Declaration and other documents for ruminants.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... ruminants. 93.407 Section 93.407 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants § 93.407 Declaration and other documents for ruminants. (a) The certificates, declarations, and affidavits required by the regulations in...

  14. 9 CFR 93.403 - Ports designated for the importation of ruminants.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... of ruminants. 93.403 Section 93.403 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION... PRODUCTS; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants § 93.403 Ports designated for the importation of ruminants. (a) Air and ocean ports. The following ports have APHIS...

  15. 9 CFR 93.403 - Ports designated for the importation of ruminants.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... of ruminants. 93.403 Section 93.403 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION... PRODUCTS; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants § 93.403 Ports designated for the importation of ruminants. (a) Air and ocean ports. The following ports have APHIS...

  16. 9 CFR 93.407 - Declaration and other documents for ruminants.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... ruminants. 93.407 Section 93.407 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants § 93.407 Declaration and other documents for ruminants. (a) The certificates, declarations, and affidavits required by the regulations in...

  17. 9 CFR 93.407 - Declaration and other documents for ruminants.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... ruminants. 93.407 Section 93.407 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants § 93.407 Declaration and other documents for ruminants. (a) The certificates, declarations, and affidavits required by the regulations in...

  18. 9 CFR 93.403 - Ports designated for the importation of ruminants.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... of ruminants. 93.403 Section 93.403 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION... PRODUCTS; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants § 93.403 Ports designated for the importation of ruminants. (a) Air and ocean ports. The following ports have APHIS...

  19. 9 CFR 93.407 - Declaration and other documents for ruminants.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... ruminants. 93.407 Section 93.407 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants § 93.407 Declaration and other documents for ruminants. (a) The certificates, declarations, and affidavits required by the regulations in...

  20. 9 CFR 93.407 - Declaration and other documents for ruminants.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... ruminants. 93.407 Section 93.407 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants § 93.407 Declaration and other documents for ruminants. (a) The certificates, declarations, and affidavits required by the regulations in...

  1. 9 CFR 93.403 - Ports designated for the importation of ruminants.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... of ruminants. 93.403 Section 93.403 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION... PRODUCTS; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants § 93.403 Ports designated for the importation of ruminants. (a) Air and ocean ports. The following ports have APHIS...

  2. 9 CFR 94.3 - Organs, glands, extracts, or secretions of ruminants or swine.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... secretions of ruminants or swine. 94.3 Section 94.3 Animals and Animal Products ANIMAL AND PLANT HEALTH... RESTRICTED IMPORTATIONS § 94.3 Organs, glands, extracts, or secretions of ruminants or swine. The importation of fresh (chilled or frozen) organs, glands, extracts, or secretions derived from ruminants or...

  3. 9 CFR 94.3 - Organs, glands, extracts, or secretions of ruminants or swine.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... secretions of ruminants or swine. 94.3 Section 94.3 Animals and Animal Products ANIMAL AND PLANT HEALTH... RESTRICTED IMPORTATIONS § 94.3 Organs, glands, extracts, or secretions of ruminants or swine. The importation of fresh (chilled or frozen) organs, glands, extracts, or secretions derived from ruminants or...

  4. 9 CFR 94.3 - Organs, glands, extracts, or secretions of ruminants or swine.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... secretions of ruminants or swine. 94.3 Section 94.3 Animals and Animal Products ANIMAL AND PLANT HEALTH... RESTRICTED IMPORTATIONS § 94.3 Organs, glands, extracts, or secretions of ruminants or swine. The importation of fresh (chilled or frozen) organs, glands, extracts, or secretions derived from ruminants or...

  5. 9 CFR 93.409 - Articles accompanying ruminants.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Articles accompanying ruminants. 93.409 Section 93.409 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants § 93.409 Articles accompanying...

  6. Management academy for public health: creating entrepreneurial managers.

    PubMed

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

    2007-04-01

    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

  7. Quality management in Irish health care.

    PubMed

    Ennis, K; Harrington, D

    1999-01-01

    This paper reports on the findings from a quantitative research study of quality management in the Irish health-care sector. The study findings suggest that quality management is what hospitals require to become more cost-effective and efficient. The research also shows that the culture of health-care institutions must change to one where employees experience pride in their work and where all are involved and committed to continuous quality improvement. It is recommended that a shift is required from the traditional management structures to a more participative approach. Furthermore, all managers whether from a clinical or an administration background must understand one another's role in the organisation. Finally, for quality to succeed in the health-care sector, strong committed leadership is required to overcome tensions in quality implementation. PMID:10724566

  8. Ruminant nitrogen usage

    SciTech Connect

    Not Available

    1985-01-01

    This book brings together the latest research on protein absorption by ruminants and takes a look at the calculation of optimum nutrient requirements, including bacterial digestion, in the calculations. It also describes the parameters of nitrogen conversion in the ruminant and examines the different kinds of protein found in animal feedstuffs.

  9. Grazing management and ecosystem health

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Herbivore activity interacts with weather and vegetation to markedly affect soil condition, biotic activity, and nutrient cycling in pasture and range. In turn, soil condition regulates the impact of environment on nutrient cycling, vegetation, herd or flock management, and animal productivity. Ther...

  10. Graduate capabilities for health service managers: reconfiguring health management education @UNSW.

    PubMed

    Meyer, Lois D; Hodgkinson, Alan R; Knight, Rosemary; Ho, Maria Theresa; di Corpo, Sophie K; Bhalla, Sonal

    2007-08-01

    The Master of Health Administration program at UNSW was extensively revised in 2006 to ensure that it effectively meets the challenging and dynamic environment of health service managers in local and global health contexts. This paper describes the innovative approach to the redesign of the health management program within the Faculty of Medicine. It outlines the method and considerations undertaken, particularly in identifying and embedding new graduate capabilities within the program. The paper concludes that using an outcomes-based approach and engaging with key stakeholders provides opportunity to identify and promote critical capabilities needed by managers to support the challenges confronting health services, including workforce flexibility. Further research is required on how such curriculum initiatives might impact on the performance of health service managers, but initial indications are that the health industry recognises the need and value of this approach. PMID:17669060

  11. Reviving managed care with health savings accounts.

    PubMed

    Hall, Mark A; Havighurst, Clark C

    2005-01-01

    Although health savings accounts (HSAs) and managed care are often seen as antithetical, they can be integrated in fruitful ways. Moreover, combining these approaches would serve policy objectives by clarifying the payment responsibilities of patients, health plans, and premium payers, thus altering important perceptions about health care decision making. The availability in HSAs of funds that patients can use to pay for services not covered under insurance contracts should help to relegitimize the predetermination of benefits and enable the public and the legal system to take a more benign view of corporate health plans as agents of their subscribers. PMID:16284021

  12. Management Academy for Public Health: Creating Entrepreneurial Managers

    PubMed Central

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

    2007-01-01

    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

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

    PubMed

    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

    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

  14. Physicians in health care management: 10. Managing conflict through negotiation.

    PubMed Central

    Lemieux-Charles, L

    1994-01-01

    The recent focus on collaborative relationships in health care means that people and groups must cooperate to accomplish clinical and management tasks. This increasing interdependence may also cause increased organizational conflict. The management of conflicts is critical to the effectiveness of an organization. Negotiating strategies, based on Fisher and Ury's method of "principled negotiation," include establishing superordinate goals, separating the people from the problem, focussing on interests, inventing options, using objective criteria and defining success in terms of gains. PMID:7922944

  15. Health care management in workers' compensation.

    PubMed

    Nikolaj, S; Boon, B

    1998-01-01

    A high-performing, effective health care delivery system is critical to the recovery of injured workers within a workers' compensation insurance system. Timely and effective health care has the potential to minimize indemnity costs and therefore contribute to the insurer's financial state. While costs remain a concern to insurers, cost-containment initiatives within the health care arena have evolved from a strict "deep discount" approach to more sophisticated health care strategies that follow managed care-style models. In the future, health care strategies are likely to become more integrated within the business operations of workers' compensation insurance systems. The next evolution of health care strategy within workers' compensation will likely include consensus-based contracts with providers that stipulate the role and function of each party while reinforcing a continuous improvement mindset. It is probable that a component of this evolving system will include shared risk and reimbursement that is based on performance. Insurers who begin to evaluate the true impact of a comprehensive health care strategy will find it necessary and advantageous to modify their business relationship with health care providers. Those who are able to articulate a business strategy that capitalizes on the skills of the health care community are likely to gain a competitive advantage. Most importantly, this bridging of intellectual capacity across the insurance and health care domains will result in a delivery system that is valued by, and contributes to, its key participants--the employers and the injured workers. PMID:9589449

  16. Strategic service quality management for health care.

    PubMed

    Anderson, E A; Zwelling, L A

    1996-01-01

    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

  17. Towards Open Information Management in Health Care

    PubMed Central

    Yli-Hietanen, J; Niiranen, S

    2008-01-01

    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 automate certain information management tasks. The current technological approach for this automation relies on structured, formally coded representation of information. We discuss the limitations of the current technological approach and present a viewpoint, grounded on previous research and the authors’ own experiences, on how to progress. We present that a bottleneck in the automation of the management of constantly evolving clinical information is caused by the fact that the current technological approach requires the formal coding of information to be static in nature. This inherently hinders the expandability of the information case space to be managed. We present a new paradigm entitled open information management targeting unlimited case spaces. We also present a conceptual example from clinical medicine demonstrating open information management principles and mechanisms. PMID:19415134

  18. Learning, changing and managing in mental health.

    PubMed

    Henderson, J

    2001-11-01

    This paper draws on research which considers the implications for practitioners and managers of implementing new ideas for practice gained from learning and education in mental health in the UK. Using a questionnaire survey followed by eight semi-structured interviews, the research set out to identify the issues facing workers trying to implement change in the workplace as a result of new learning gained from study of an Open University mental health course. The paper argues that much management literature on change within organisations is problematic in this specific context. This is largely because it takes insufficient account of the complexities surrounding work within social care (particularly mental health). Findings show that workers who have undertaken learning in mental health often feel disempowered and isolated when attempting to introduce new ideas for practice into the workplace. The first line manager operates at the intersection of practice and learning and has a key role in enabling and supporting staff through practice as well as service change and professional development. This paper locates the distance learning experience within a wider framework of student/practitioner support, and explores the role of the first line manager in supporting and enabling staff. PMID:11725583

  19. Relationship between Managers' Performance and Organizational Health

    ERIC Educational Resources Information Center

    Mohammadisadr, Mohammad; Siadat, Seyyedali; Arbabisarjou, Azizollah

    2012-01-01

    The main purpose of this paper is to study the relationship between managers' performance in the field of interpersonal, informational and decision-making tasks with organizational health. To measure the indicators of the model, a questionnaire was prepared and distributed among 113 company of Tehran stock Exchange Market. According to the…

  20. Software Health Management with Bayesian Networks

    NASA Technical Reports Server (NTRS)

    Mengshoel, Ole; Schumann, JOhann

    2011-01-01

    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.

  1. Integrated Systems Health Management for Intelligent Systems

    NASA Technical Reports Server (NTRS)

    Figueroa, Fernando; Melcher, Kevin

    2011-01-01

    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.

  2. 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...

  3. Convergent Evolution of Health Information Management and Health Informatics

    PubMed Central

    Gibson, C. J.; Abrams, K.

    2015-01-01

    Summary Clearly defined boundaries are disappearing among the activities, sources, and uses of health care data and information managed by health information management (HIM) and health informatics (HI) professionals. Definitions of the professional domains and scopes of practice for HIM and HI are converging with the proliferation of information and communication technologies in health care settings. Convergence is changing both the roles that HIM and HI professionals serve in their organizations as well as the competencies necessary for training future professionals. Many of these changes suggest a blurring of roles and responsibilities with increasingly overlapping curricula, job descriptions, and research agendas. Blurred lines in a highly competitive market create confusion for students and employers. In this essay, we provide some perspective on the changing landscape and suggest a course for the future. First we review the evolving definitions of HIM and HI. We next compare the current domains and competencies, review the characteristics as well as the education and credentialing of both disciplines, and examine areas of convergence. Given the current state, we suggest a path forward to strengthen the contributions HIM and HI professionals and educators make to the evolving health care environment. PMID:25848421

  4. Viral diseases of the ruminant nervous system.

    PubMed

    Callan, Robert J; Van Metre, David C

    2004-07-01

    This article presents the etiology, epidemiology, clinical features,and diagnosis of the primary viral neurologic diseases observed in ruminants. In general, these viral neurologic diseases are uncommon but often fatal. Rabies virus is perhaps the most important cause of encephalitis in cattle because of the public health implications. Other viral encephalitis diseases in ruminants include bovine herpesvirus encephalomyelitis, pseudorabies, malignant catarrhal fever, ovine and caprine lentiviral encephalitis, West Nile virus encephalitis, Borna disease, paramyxoviral sporadic bovine encephalomyelitis,and ovine encephalomyelitis (louping-ill). PMID:15203229

  5. Rumination Syndrome in Ethiopia: A Case Study

    PubMed Central

    2014-01-01

    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

  6. Creating and managing a paperless health information management department.

    PubMed

    Greene, Zelda B

    2002-08-01

    Over the last 10 to 15 years, the health care industry has experienced dramatic changes in health care delivery, consumer needs, and demands. The medical record, a recapitulation of the care patients receive, continues to be one of the most vital components of the health care delivery system. It serves as a crucial administrative, clinical, financial, and research tool. Health information managers, striving to meet ever-changing requirements, have turned to electronic record processing to meet these changes. The following article describes one hospital's journey from a cumbersome paper environment to an electronic environment that not only resulted in improved customer service but also provided employees with renewed job satisfaction and increased skill levels. PMID:12402633

  7. Best practices for health technology management.

    PubMed

    2006-12-01

    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

  8. Managing the health of the employee.

    PubMed

    Collings, G H

    1982-01-01

    In summary, we now visualize the ideal preventive-health program as one which identifies target subpopulations with precision; intervenes in those populations with selectivity based on anticipated yield; modifies and tailors each intervention to maximize its individual effectiveness; and delivers the whole program through health-care delivery machinery that can itself be managed for maximum efficiency. This cannot be done without sophisticated information processing capability which permits the individualization of intervention. Consequently, most prevention and health maintenance efforts in the work setting are, for a time at least, going to have to be satisfied with less than ideal characteristics and less than optimum cost-effective ratios. That does not mean that there is nothing that can be done, or that all current programs are obsolete, or that no results can be achieved. It does mean that professionals and managers who are planning and directing such programs will increase their success to the extent that their programs can be made consistent with the principles involved, to the extent that all programs can be tailored to fit individual employee circumstances, and to the extent that the whole health-care management effort can be integrated into one smoothly functioning, efficient system. PMID:7054475

  9. Value-managed mental health benefits.

    PubMed

    Burton, W N; Conti, D J

    1991-03-01

    The First National Bank of Chicago's comprehensive program for mental health services has been shown to be an effective response to the rising demand and cost of mental health care. By assertively managing a benefit plan rather than capriciously cutting it, employees are afforded quality care while the corporation is able to handle the costs of a worthwhile benefit. The plan represented a collaboration of the Benefits and Medical Units, which brought together philosophies of benefit plan management and research regarding primary prevention and early intervention. Employees are afforded education and early intervention while at the work site and appropriate referrals to cost-efficient providers outside the bank. Should they need time away from the work site for treatment, this along with their reentry is also managed to increase the probability of successful recovery. In this way continuity of care is assured so that recurrent disability (eg, rehospitalization, further STD) may be reduced. The 4-year follow-up investigation of the program reveals management of overall mental health care costs, reduction in inpatient psychiatric hospitalization costs, and reduction in the average length of psychiatric short-term disability episodes for employees. PMID:1903154

  10. On Management Matters: Why We Must Improve Public Health Management Through Action: Comment on "Management Matters: A Leverage Point for Health Systems Strengthening in Global Health".

    PubMed

    Willacy, Erika; Bratton, Shelly

    2016-01-01

    Public health management is a pillar of public health practice. Only through effective management can research, theory, and scientific innovation be translated into successful public health action. With this in mind, the U.S. Centers for Disease Control and Prevention (CDC) has developed an innovative program called Improving Public Health Management for Action (IMPACT) which aims to address this critical need by building an effective cadre of public health managers to work alongside scientists to prepare for and respond to disease threats and to effectively implement public health programs. IMPACT is a 2-year, experiential learning program that provides fellows with the management tools and opportunities to apply their new knowledge in the field, all while continuing to serve the Ministry of Health (MoH). IMPACT will launch in 2016 in 2 countries with the intent of expanding to additional countries in future years resulting in a well-trained cadre of public health managers around the world. PMID:26673653

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

    ERIC Educational Resources Information Center

    Goldenberg, Jamie L.; Arndt, Jamie

    2008-01-01

    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.…

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

    ERIC Educational Resources Information Center

    Goldenberg, Jamie L.; Arndt, Jamie

    2008-01-01

    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.

  13. Comparison of rumination activity measured using rumination collars against direct visual observations and analysis of video recordings of dairy cows in commercial farm environments.

    PubMed

    Ambriz-Vilchis, V; Jessop, N S; Fawcett, R H; Shaw, D J; Macrae, A I

    2015-03-01

    Automated systems for monitoring the behavior of cows have become increasingly important for management routines and for monitoring health and welfare. In the past few decades, various devices that record rumination have been developed. The aim of the present study was to compare rumination activity measured with a commercially available rumination collar (RC) against that obtained by direct visual observations and analysis of video recordings in commercial dairy cows. Rumination time from video recordings was recorded by a trained observer. To assess observer reliability, data were recorded twice, and the duration of recorded behaviors was very similar and highly correlated between these 2 measurements (mean=39±4 and 38±4 min/2 h). Measurements of rumination time obtained with RC when compared with analysis of video recordings and direct observations were variable: RC output was significantly positively related to observed rumination activity when dealing with animals housed indoors (trial 1 video recordings: slope=1.02, 95% CI=0.92-1.12), and the limits of agreement method (LoA) showed differences (in min per 2-h block) to be within -26.92 lower and 24.27 upper limits. Trial 1 direct observations: slope=1.08, 95% CI=0.62-1.55, and the LoA showed differences to be within -28.54 lower and 21.98 upper limits. Trial 2: slope=0.93, 95% CI=0.64-1.23, and the LoA showed differences to be within -32.56 lower and 19.84 upper limits. However, the results were poor when cows were outside grazing grass (trial 3: slope=0.57, 95% CI=0.13-1.02, and the LoA showed differences to be within wider limits -51.16 lower and 53.02 upper). Our results suggest that RC can determine rumination activity and are an alternative to visual observations when animals are housed indoors. However, they are not an alternative to direct observations with grazing animals on pasture and its use is not advisable until further research and validation are carried out. PMID:25622871

  14. FAILSAFE Health Management for Embedded Systems

    NASA Technical Reports Server (NTRS)

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

    2010-01-01

    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.

  15. Making Technology Ready: Integrated Systems Health Management

    NASA Technical Reports Server (NTRS)

    Malin, Jane T.; Oliver, Patrick J.

    2007-01-01

    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.

  16. Health record completion guidelines. American Health Information Management Association.

    PubMed

    DeVitt, M P; Haenke, B M; Picukaric, J M; Kerwin, J M; Hettel, S; Cameron, M; Testa, F A; Fainter, J; Feste, L

    1991-11-01

    It is a pleasure to introduce this important project report to the American Health Information Management Association (AHIMA) membership. Analyzing records for omissions, notifying physicians of needed information, counting delinquent records, and pursuing late documentation are some of the biggest chores in today's health information management departments. And they are chores that take time away from other priorities--managing, analyzing, and presenting health data, planning and implementing computerization, assessing and meeting customer needs. The heart of this statement is simple: it points out that there are other options to the traditional, detailed, record-by-record analysis. And those options may give us the results we need--timely and complete health records--while freeing up valuable staff time for other priorities. Take a serious look at the statement. If you are eager to make a change in your department's practices in records analysis and completion, it will back you up. If you are comparing the value of your department's records completion work to its benefit, this statement will give you ideas for change. And if you don't think you'd ever challenge tradition, this statement will give you food for thought. An added value to this statement is the fact that the ideas in it, and the very statement itself, are the product of our own profession. We are fortunate that leading-edge practitioners gave their expertise to the entire profession. The members of the strategy group for this project are listed above, we thank them for their wisdom. PMID:10117694

  17. Structural health management for aging aircraft

    NASA Astrophysics Data System (ADS)

    Ikegami, Roy; Haugse, Eric D.

    2001-06-01

    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.

  18. Integrated Systems Health Management for Intelligent Systems

    NASA Technical Reports Server (NTRS)

    Figueroa, Fernando; Melcher, Kevin

    2011-01-01

    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.

  19. 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 ...

  20. Forest health, collective behaviors, and management.

    PubMed

    Kijtewachakul, Nitaya; Shivakoti, Ganesh P; Webb, Edward L

    2004-05-01

    This study compares community-based managed forests under different purposes of management, namely, state-driven "conservation" or community-designed utilization in two villages located in the Sopsai watershed, Nan Province, northern Thailand. The forest health under different intensity of uses is assessed in association with the collective behaviors and long-term purposes embedded in village social-cultural context. The study found no significant differences in forest succession and proportion in diameter at 1.3 m (dbh) class and height-class distribution of the forest under different use intensity. The forest for utilization also showed higher density and basal area of the local preferred species than the "conservation" forest. In the utilization forest, we also found a higher number of multipurpose and preferred species than in the "conservation" forest, which actually responded to the needs of the community in the long term to have more wood products (both firewood and timbers). The community-based forest management (CBFM) for utilization can also lead to natural regeneration and biodiversity similar to "conservation" forests. Through CBFM, forest resources can be managed to maintain the healthy condition under different intensities and respond to both community needs and external expectation. The findings also emphasize the importance of recognizing community needs and management objectives in watershed restoration and improving the productivity of forests under collective management. PMID:15503384

  1. 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...

  2. Management continuity in local health networks

    PubMed Central

    Breton, Mylaine; Haggerty, Jeannie; Roberge, Danile; Freeman, George K

    2012-01-01

    Introduction Patients increasingly receive care from multiple providers in a variety of settings. They expect management continuity that crosses boundaries and bridges gaps in the healthcare system. To our knowledge, little research has been done to assess coordination across organizational and professional boundaries from the patients perspective. Our objective was to assess whether greater local health network integration is associated with management continuity as perceived by patients. Method We used the data from a research project on the development and validation of a generic and comprehensive continuity measurement instrument that can be applied to a variety of patient conditions and settings. We used the results of a cross-sectional survey conducted in 2009 with 256 patients in two local health networks in Quebec, Canada. We compared four aspects of management continuity between two contrasting network types (highly integrated vs. poorly integrated). Results The scores obtained in the highly integrated network are better than those of the poorly integrated network on all dimensions of management continuity (coordinator role, role clarity and coordination between clinics, and information gaps between providers) except for experience of care plan. Conclusion Some aspects of care coordination among professionals and organizations are noticed by patients and may be valid indicators to assess care coordination. PMID:22977427

  3. Should health care managers adopt Theory Z?

    PubMed

    Safranski, S R; Kwon, I W; Walker, W R; Unger, M

    1986-04-01

    Health care administrators should carefully consider the situations in which they apply management methods used in industry, since such methods may not be effective in motivating certain groups of hospital employees. Physicians, for example, may display little loyalty to the health care organization, even though as a group they exert significant influence on policies, standards, and administration. As a result, management styles such as Theory Z that focus on holistic concern, individual decision-making responsibility, and long-term employment guarantees may fail to interest them. Nurses also may be reluctant to commit themselves to an organization because of the high rate of turnover in their profession in recent years. Support staff, however, probably would be receptive to management techniques that offer security through long-term employment guarantees. Other factors necessary for the effective use of Theory Z industrial management techniques are a clear hierarchy with well-defined reporting relationships, moderately specialized career paths, and trust among employees that the organization's concern for their welfare is genuine. The key consideration, however, in applying any theory is that only those aspects which best serve the organization's needs should be adopted. PMID:10275907

  4. Quality in occupational health care: management's view.

    PubMed

    Callahan, E W

    1994-04-01

    Total Quality Management (TQM) is a continual improvement process that requires common sense, education and training, and the ability to communicate and work as part of a team. TQM can improve all aspects of a business, including health, safety, and environmental functions. Physicians and nonphysician managers can use TQM to identify and respond to customer needs and improve the efficiency and effectiveness of programs. Examples of TQM to improve medical programs have included (1) an Audit Program that assesses medical programs and provides specific measurements ("metrics") of medical programs, and (2) a team that developed an Alternative Return-to-Work Program, which now assists in early rehabilitation of injured employees. In addition to expecting its physicians to be knowledgeable, fair, and objective, management expects them to use and understand TQM principles. PMID:8014711

  5. Review on Mycotoxin Issues in Ruminants: Occurrence in Forages, Effects of Mycotoxin Ingestion on Health Status and Animal Performance and Practical Strategies to Counteract Their Negative Effects

    PubMed Central

    Gallo, Antonio; Giuberti, Gianluca; Frisvad, Jens C.; Bertuzzi, Terenzio; Nielsen, Kristian F.

    2015-01-01

    Ruminant diets include cereals, protein feeds, their by-products as well as hay and grass, grass/legume, whole-crop maize, small grain or sorghum silages. Furthermore, ruminants are annually or seasonally fed with grazed forage in many parts of the World. All these forages could be contaminated by several exometabolites of mycotoxigenic fungi that increase and diversify the risk of mycotoxin exposure in ruminants compared to swine and poultry that have less varied diets. Evidence suggests the greatest exposure for ruminants to some regulated mycotoxins (aflatoxins, trichothecenes, ochratoxin A, fumonisins and zearalenone) and to many other secondary metabolites produced by different species of Alternaria spp. (e.g., AAL toxins, alternariols, tenuazonic acid or 4Z-infectopyrone), Aspergillus flavus (e.g., kojic acid, cyclopiazonic acid or β-nitropropionic acid), Aspergillus fuminatus (e.g., gliotoxin, agroclavine, festuclavines or fumagillin), Penicillium roqueforti and P. paneum (e.g., mycophenolic acid, roquefortines, PR toxin or marcfortines) or Monascus ruber (citrinin and monacolins) could be mainly related to forage contamination. This review includes the knowledge of mycotoxin occurrence reported in the last 15 years, with special emphasis on mycotoxins detected in forages, and animal toxicological issues due to their ingestion. Strategies for preventing the problem of mycotoxin feed contamination under farm conditions are discussed. PMID:26274974

  6. Review on Mycotoxin Issues in Ruminants: Occurrence in Forages, Effects of Mycotoxin Ingestion on Health Status and Animal Performance and Practical Strategies to Counteract Their Negative Effects.

    PubMed

    Gallo, Antonio; Giuberti, Gianluca; Frisvad, Jens C; Bertuzzi, Terenzio; Nielsen, Kristian F

    2015-08-01

    Ruminant diets include cereals, protein feeds, their by-products as well as hay and grass, grass/legume, whole-crop maize, small grain or sorghum silages. Furthermore, ruminants are annually or seasonally fed with grazed forage in many parts of the World. All these forages could be contaminated by several exometabolites of mycotoxigenic fungi that increase and diversify the risk of mycotoxin exposure in ruminants compared to swine and poultry that have less varied diets. Evidence suggests the greatest exposure for ruminants to some regulated mycotoxins (aflatoxins, trichothecenes, ochratoxin A, fumonisins and zearalenone) and to many other secondary metabolites produced by different species of Alternaria spp. (e.g., AAL toxins, alternariols, tenuazonic acid or 4Z-infectopyrone), Aspergillus flavus (e.g., kojic acid, cyclopiazonic acid or β-nitropropionic acid), Aspergillus fuminatus (e.g., gliotoxin, agroclavine, festuclavines or fumagillin), Penicillium roqueforti and P. paneum (e.g., mycophenolic acid, roquefortines, PR toxin or marcfortines) or Monascus ruber (citrinin and monacolins) could be mainly related to forage contamination. This review includes the knowledge of mycotoxin occurrence reported in the last 15 years, with special emphasis on mycotoxins detected in forages, and animal toxicological issues due to their ingestion. Strategies for preventing the problem of mycotoxin feed contamination under farm conditions are discussed. PMID:26274974

  7. ISWHM: Tools and Techniques for Software and System Health Management

    NASA Technical Reports Server (NTRS)

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

    2010-01-01

    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.

  8. An Assessment of Integrated Health Management Frameworks

    SciTech Connect

    Lybeck, Nancy; Coble, Jamie B.; Tawfik, Magdy; Bond, Leonard J.

    2012-05-18

    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 NPPs presents many challenges. The 2009 Light Water Reactor Sustainability Workshop identified online monitoring of active and structural components as essential to better understanding and management of the challenges posed by aging NPPs. 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 an 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 an 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.

  9. Structural Health Management for Future Aerospace Vehicles

    NASA Technical Reports Server (NTRS)

    Prosser, W. H.; Allison, S. G.; Woodard, S. E.; Wincheski, R. A.; Cooper, E. G.; Price, D. C.; Hedley, M.; Prokopenko, M.; Scott, D. A.; Tessler, A.

    2004-01-01

    Structural Health Management (SHM) will be of critical importance to provide the safety, reliability and affordability necessary for the future long duration space missions described in America's Vision for Space Exploration. Long duration missions to the Moon, Mars and beyond cannot be accomplished with the current paradigm of periodic, ground based structural integrity inspections. As evidenced by the Columbia tragedy, this approach is also inadequate for the current Shuttle fleet, thus leading to its initial implementation of on-board SHM sensing for impact detection as part of the return to flight effort. However, future space systems, to include both vehicles as well as structures such as habitation modules, will require an integrated array of onboard in-situ sensing systems. In addition, advanced data systems architectures will be necessary to communicate, store and process massive amounts of SHM data from large numbers of diverse sensors. Further, improved structural analysis and design algorithms will be necessary to incorporate SHM sensing into the design and construction of aerospace structures, as well as to fully utilize these sensing systems to provide both diagnosis and prognosis of structural integrity. Ultimately, structural integrity information will feed into an Integrated Vehicle Health Management (IVHM) system that will provide real-time knowledge of structural, propulsion, thermal protection and other critical systems for optimal vehicle management and mission control. This paper will provide an overview of NASA research and development in the area of SHM as well as to highlight areas of technology improvement necessary to meet these future mission requirements.

  10. A Distributed Prognostic Health Management Architecture

    NASA Technical Reports Server (NTRS)

    Bhaskar, Saha; Saha, Sankalita; Goebel, Kai

    2009-01-01

    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.

  11. COMPARATIVE GUT PHYSIOLOGY SYMPOSIUM: Comparative physiology of glucagon-like peptide-2: Implications and applications for production and health of ruminants.

    PubMed

    Connor, E E; Evock-Clover, C M; Walker, M P; Elsasser, T H; Kahl, S

    2015-02-01

    Glucagon-like peptide-2 (GLP-2) is a 33-amino acid peptide derived from proteolytic cleavage of proglucagon by prohormone convertase 1/3 in enteroendocrine L cells. Studies conducted in humans, in rodent models, and in vitro indicate that GLP-2 is secreted in response to the presence of molecules in the intestinal lumen, including fatty acids, carbohydrates, amino acids, and bile acids, which are detected by luminal chemosensors. The physiological actions of GLP-2 are mediated by its G protein-coupled receptor expressed primarily in the intestinal tract on enteric neurons, enteroendocrine cells, and myofibroblasts. The biological activity of GLP-2 is further regulated by dipeptidyl peptidase IV, which rapidly cleaves the N-terminus of GLP-2 that is responsible for GLP-2 receptor activation. Within the gut, GLP-2 increases nutrient absorption, crypt cell proliferation, and mesenteric blood flow and decreases gut permeability and motility, epithelial cell apoptosis, and inflammation. Outside the gut, GLP-2 reduces bone resorption, can suppress appetite, and is cytoprotective in the lung. Thus, GLP-2 has been studied intensively as a therapeutic to improve intestinal function of humans during parenteral nutrition and following small bowel resection and, more recently, as a treatment for osteoporosis and obesity-related disorders and to reduce cellular damage associated with inflammation of the gut and lungs. Recent studies demonstrate that many biological actions and properties of GLP-2 in ruminants are similar to those in nonruminants, including the potential to reduce intestinal nitro-oxidative stress in calves caused by parasitic diseases such as coccidiosis. Because of its beneficial impacts on nutrient absorption, gut healing, and normal gut development, GLP-2 therapy offers significant opportunities to improve calf health and production efficiency. However, GLP-2 therapies require an extended time course to achieve desired physiological responses, as well as daily administration because of the hormone's short half-life. Thus, practical means of administration and alternative strategies to enhance basal GLP-2 secretion (e.g., through specific feed additives), which are more likely to achieve consumer acceptance, are needed. Opportunities to address these challenges are discussed. PMID:26020740

  12. [Justification to health managers: cost-benefit of osteoporosis management].

    PubMed

    Hernández-García, César

    2011-09-01

    Medicines are strictly regulated and controlled until they reach the patients. Once in the market, the mechanisms governing their use are very complex due to the large number of actors playing different roles. It is necessary to extend an evaluation culture among all involved and to make economic analysis a structured part of decisions made by physicians and health managers. Since physicians occupy a central place in this market of medicines, it is necessary that they assume their responsibility by actively participating in this evaluation. PMID:21924214

  13. Sensor Systems for Prognostics and Health Management

    PubMed Central

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

    2010-01-01

    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

  14. Investigation of Integrated Vehicle Health Management Approaches

    NASA Technical Reports Server (NTRS)

    Paris, Deidre

    2005-01-01

    This report is to present the work that was performed during the summer in the Advance Computing Application office. The NFFP (NASA Faculty Fellow Program) had ten summer faculty members working on IVHM (Integrated Vehicle Health Management) technologies. The objective of this project was two-fold: 1) to become familiar with IVHM concepts and key demonstrated IVHM technologies; and 2) to integrate the research that has been performed by IVHM faculty members into the MASTLAB (Marshall Avionic Software Test Lab). IVHM is a NASA-wide effort to coordinate, integrate and apply advanced software, sensors and design technologies to increase the level of intelligence, autonomy, and health state of future vehicles. IVHM is an important concept because it is consistent with the current plan for NASA to go to the moon, mars, and beyond. In order for NASA to become more involved in deep exploration, avionic systems will need to be highly adaptable and autonomous.

  15. Enabling medication management through health information technology (Health IT).

    PubMed Central

    McKibbon, K Ann; Lokker, Cynthia; Handler, Steve M; Dolovich, Lisa R; Holbrook, Anne M; O'Reilly, Daria; Tamblyn, Robyn; J Hemens, Brian; Basu, Runki; Troyan, Sue; Roshanov, Pavel S; Archer, Norman P; Raina, Parminder

    2011-01-01

    OBJECTIVES The objective of the report was to review the evidence on the impact of health information technology (IT) on all phases of the medication management process (prescribing and ordering, order communication, dispensing, administration and monitoring as well as education and reconciliation), to identify the gaps in the literature and to make recommendations for future research. DATA SOURCES We searched peer-reviewed electronic databases, grey literature, and performed hand searches. Databases searched included MEDLINE®, Embase, CINAHL (Cumulated Index to Nursing and Allied Health Literature), Cochrane Database of Systematic Reviews, International Pharmaceutical Abstracts, Compendex, Inspec (which includes IEEE Xplore), Library and Information Science Abstracts, E-Prints in Library and Information Science, PsycINFO, Sociological Abstracts, and Business Source Complete. Grey literature searching involved Internet searching, reviewing relevant Web sites, and searching electronic databases of grey literatures. AHRQ also provided all references in their e-Prescribing, bar coding, and CPOE knowledge libraries. METHODS Paired reviewers looked at citations to identify studies on a range of health IT used to assist in the medication management process (MMIT) during multiple levels of screening (titles and abstracts, full text and final review for assignment of questions and data abstrction). Randomized controlled trials and cohort, case-control, and case series studies were independently assessed for quality. All data were abstracted by one reviewer and examined by one of two different reviewers with content and methods expertise. RESULTS 40,582 articles were retrieved. After duplicates were removed, 32,785 articles were screened at the title and abstract phase. 4,578 full text articles were assessed and 789 articles were included in the final report. Of these, 361 met only content criteria and were listed without further abstraction. The final report included data from 428 articles across the seven key questions. Study quality varied according to phase of medication management. Substantially more studies, and studies with stronger comparative methods, evaluated prescribing and monitoring. Clinical decision support systems (CDSS) and computerized provider order entry (CPOE) systems were studied more than any other application of MMIT. Physicians were more often the subject of evaluation than other participants. Other health care professionals, patients, and families are important but not studied as thoroughly as physicians. These nonphysicians groups often value different aspects of MMIT, have diverse needs, and use systems differently. Hospitals and ambulatory clinics were well-represented in the literature with less emphasis placed on long-term care facilities, communities, homes, and nonhospital pharmacies. Most studies evaluated changes in process and outcomes of use, usability, and knowledge, skills, and attitudes. Most showed moderate to substantial improvement with implementation of MMIT. Economics studies and those with clinical outcomes were less frequently studied. Those articles that did address economics and clinical outcomes often showed equivocal findings on the effectiveness and cost-effectiveness of MMIT systems. Qualitative studies provided evidence of strong perceptions, both positive and negative, of the effects of MMIT and unintended consequences. We found little data on the effects of forms of medications, conformity, standards, and open source status. Much descriptive literature discusses implementation issues but little strong evidence exists. Interest is strong in MMIT and more groups and institutions will implement systems in the next decades, especially with the Federal Government's push toward more health IT to support better and more cost-effective health care. CONCLUSIONS MMIT is well-studied, although on closer examination of the literature the evidence is not uniform across phases of medication management, groups of people involved, or types of MMIT. MMIT holds the promise of improved processes; clinical and economics studies and the understanding of sustainability issues are lacking. PMID:23126642

  16. Change management with the electronic health record.

    PubMed

    Schmucker, DeeAnn

    2009-01-01

    Many medical organizations have already changed to, are implementing, or are contemplating implementing an electronic health record (EHR) system. As in all change, some people accept the switch from paper to EHRs much easier and with more enthuiasm than others. It is common for organizations to overlook the importance of including change management properties as they create the overall plan for the change from paper to paperless. Often the result of this is anger, frustration, and lack of cooperation or even sabotage from physicians and office staff who are the recipients of the training on the EHR system. This article examines the steps for, opportunities for, and positive results from incorporating change management principles from the very beginning, and the benefits accrued by understanding and utilizing the concepts of good choices, relationships, planning, and feedback. PMID:19911542

  17. Outage management and health physics issue, 2006

    SciTech Connect

    Agnihotri, Newal

    2006-05-15

    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.

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

    PubMed

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

    2014-04-01

    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

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

    PubMed Central

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

    2014-01-01

    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

  20. Requirements Flowdown for Prognostics and Health Management

    NASA Technical Reports Server (NTRS)

    Goebel, Kai; Saxena, Abhinav; Roychoudhury, Indranil; Celaya, Jose R.; Saha, Bhaskar; Saha, Sankalita

    2012-01-01

    Prognostics and Health Management (PHM) principles have considerable promise to change the game of lifecycle cost of engineering systems at high safety levels by providing a reliable estimate of future system states. This estimate is a key for planning and decision making in an operational setting. While technology solutions have made considerable advances, the tie-in into the systems engineering process is lagging behind, which delays fielding of PHM-enabled systems. The derivation of specifications from high level requirements for algorithm performance to ensure quality predictions is not well developed. From an engineering perspective some key parameters driving the requirements for prognostics performance include: (1) maximum allowable Probability of Failure (PoF) of the prognostic system to bound the risk of losing an asset, (2) tolerable limits on proactive maintenance to minimize missed opportunity of asset usage, (3) lead time to specify the amount of advanced warning needed for actionable decisions, and (4) required confidence to specify when prognosis is sufficiently good to be used. This paper takes a systems engineering view towards the requirements specification process and presents a method for the flowdown process. A case study based on an electric Unmanned Aerial Vehicle (e-UAV) scenario demonstrates how top level requirements for performance, cost, and safety flow down to the health management level and specify quantitative requirements for prognostic algorithm performance.

  1. Sustainability and the health care manager: Part II.

    PubMed

    Ramirez, Bernardo; Oetjen, Reid M; Malvey, Donna

    2011-01-01

    Are there additional costs associated with achieving goals of sustainable health care? Will going green enhance or impede financial performance? These are questions that all health care managers should confront, yet there is little evidence to show that health care sustainability is affordable or profitable. This article considers what is presently known and suggests that health care managers use an assessment framework to determine whether they are ready to achieve health care sustainability. PMID:21808179

  2. Managing conscientious objection in health care institutions.

    PubMed

    Wicclair, Mark R

    2014-09-01

    It is argued that the primary aim of institutional management is to protect the moral integrity of health professionals without significantly compromising other important values and interests. Institutional policies are recommended as a means to promote fair, consistent, and transparent management of conscience-based refusals. It is further recommended that those policies include the following four requirements: (1) Conscience-based refusals will be accommodated only if a requested accommodation will not impede a patient's/surrogate's timely access to information, counseling, and referral. (2) Conscience-based refusals will be accommodated only if a requested accommodation will not impede a patient's timely access to health care services offered within the institution. (3) Conscience-based refusals will be accommodated only if the accommodation will not impose excessive burdens on colleagues, supervisors, department heads, other administrators, or the institution. (4) Whenever feasible, health professionals should provide advance notification to department heads or supervisors. Formal review may not be required in all cases, but when it is appropriate, several recommendations are offered about standards and the review process. A key recommendation is that when reviewing an objector's reasons, contrary to what some have proposed, it is not appropriate to adopt an adversarial approach modelled on military review boards' assessments of requests for conscientious objector status. According to the approach recommended, the primary function of reviews of objectors' reasons is to engage them in a process of reflecting on the nature and depth of their objections, with the objective of facilitating moral clarity on the part of objectors rather than enabling department heads, supervisors, or ethics committees to determine whether conscientious objections are sufficiently genuine. PMID:24975827

  3. Cyanobacterial toxins: risk management for health protection

    SciTech Connect

    Codd, Geoffrey A.; Morrison, Louise F.; Metcalf, James S

    2005-03-15

    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 45 countries, and in numerous brackish, coastal, and marine environments. The principal toxigenic genera are listed. Known sources of the families of cyanobacterial toxins (hepato-, neuro-, and cytotoxins, irritants, and gastrointestinal toxins) are briefly discussed. Key procedures in the risk management of cyanobacterial toxins and cells are reviewed, including derivations (where sufficient data are available) of tolerable daily intakes (TDIs) and guideline values (GVs) with reference to the toxins in drinking water, and guideline levels for toxigenic cyanobacteria in bathing waters. Uncertainties and some gaps in knowledge are also discussed, including the importance of exposure media (animal and plant foods), in addition to potable and recreational waters. Finally, we present an outline of steps to develop and implement risk management strategies for cyanobacterial cells and toxins in waterbodies, with recent applications and the integration of Hazard Assessment Critical Control Point (HACCP) principles.

  4. Impact of health management, health treatments, and zilpaterol hydrochloride supplementation on carcass quality, color, and palatability traits in heifers.

    PubMed

    Bloomberg, B D; Mafi, G G; Pye, B J; Wahrmund, J L; Richards, C J; Morgan, J B; Vanoverbeke, D L

    2013-07-01

    Two hundred sixty-eight strip loins were collected from heifers fed at Oklahoma State University in Stillwater, OK. In Exp. 1, heifers (n = 127) were assigned to 1 of 3 health management treatment groups: antimicrobial administrations were given based on standard feedlot protocol (SFP) or ruminal temperature (RT) or given a metaphylactic treatment of tulathromycin (MT) followed by visual assessment (VA). In Exp. 2, heifers (n = 155) were assigned to the same treatment groups as above and were supplemented zilpaterol hydrochloride (ZH) or control (CON). Three steaks were collected from each strip loin, 1 each for retail display, sensory evaluation, and Warner-Bratzler shear force (WBSF). Color was evaluated from the retail display steak using a trained color panel and objectively using a HunterLab Miniscan XE. An Instron Universal Testing Machine with a Warner-Bratzler head was used for evaluation of instrumental tenderness, and a trained sensory panel was used to assess palatability traits. Heifers treated by VA had the least number of antimicrobial administrations and lowest yield grade and also had the lightest HCW (P < 0.05) compared with the heifers treated by the other health management protocols. There were no subjective color attribute differences or sensory panel differences (P > 0.05) across all health management systems or antimicrobial administrations. There were no differences in carcass and performance traits for any antimicrobial administrations treatment groups (P > 0.05). Heifers who had 0 or 1 antimicrobial administrations had lower (P < 0.05) a* (redness/greenness: positive values = red and negative values = green), and b* (yellowness/blueness: positive values = yellow and negative values = blue) values compared with those who had 2 antimicrobial administrations. In Exp. 2, heifers treated by VA had the least number (P < 0.05) of antimicrobial administrations when compared with MT and RT. Health management group did not have any other effects on carcass, sensory, or color attributes. Zilpaterol hydrochloride supplementation caused a decrease (P < 0.05) in internal fat and yield grade, but no interactions were observed between the number of antimicrobial administrations and ZH supplementation. With the supplementation of ZH, WBSF significantly increased (P < 0.05). At the end of retail display, the control group had a greater (P < 0.05) surface discoloration when compared with the ZH group. Treatment and detection of bovine respiratory diseases (BRD) is critical to the industry economically and results from this study show that different methods can be used to detect BRD without dramatically impacting carcass, sensory, and retail case life characteristics. PMID:23658348

  5. Strategies for effective management participation in community health partnerships.

    PubMed

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

    2000-01-01

    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

  6. 76 FR 64110 - Safety and Health Management Programs for Mines

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-17

    ... miners. B. OSHA's Injury and Illness Prevention Programs The Occupational Safety and Health... hazards and prevent injuries and illnesses at mines. Safety and health management programs are an... interested in safety and health management programs that have shown results in: Reduced injury and......

  7. Health Care Financial Management: Curriculum Objectives and Bibliography.

    ERIC Educational Resources Information Center

    Zelman, William N., Ed.; And Others

    Curriculum objectives for health care financial management, a bibliography and examples of financial management curricula are presented. The outline of curriculum objectives identifies a core of knowledge and skills in financial management that health administration students might obtain in their academic training. The outline's content is divided…

  8. Immunization against Small Ruminant Lentiviruses

    PubMed Central

    Reina, Ramsés; de Andrés, Damián; Amorena, Beatriz

    2013-01-01

    Multisystemic disease caused by Small Ruminant Lentiviruses (SRLV) in sheep and goats leads to production losses, to the detriment of animal health and welfare. This, together with the lack of treatments, has triggered interest in exploring different strategies of immunization to control the widely spread SRLV infection and, also, to provide a useful model for HIV vaccines. These strategies involve inactivated whole virus, subunit vaccines, DNA encoding viral proteins in the presence or absence of plasmids encoding immunological adjuvants and naturally or artificially attenuated viruses. In this review, we revisit, comprehensively, the immunization strategies against SRLV and analyze this double edged tool individually, as it may contribute to either controlling or enhancing virus replication and/or disease. PMID:23917352

  9. Immunization against small ruminant lentiviruses.

    PubMed

    Reina, Ramsés; de Andrés, Damián; Amorena, Beatriz

    2013-08-01

    Multisystemic disease caused by Small Ruminant Lentiviruses (SRLV) in sheep and goats leads to production losses, to the detriment of animal health and welfare. This, together with the lack of treatments, has triggered interest in exploring different strategies of immunization to control the widely spread SRLV infection and, also, to provide a useful model for HIV vaccines. These strategies involve inactivated whole virus, subunit vaccines, DNA encoding viral proteins in the presence or absence of plasmids encoding immunological adjuvants and naturally or artificially attenuated viruses. In this review, we revisit, comprehensively, the immunization strategies against SRLV and analyze this double edged tool individually, as it may contribute to either controlling or enhancing virus replication and/or disease. PMID:23917352

  10. The limitations and promise of health education in managed care.

    PubMed

    Golaszewski, T

    2000-08-01

    Managed care has become the predominant form of health insurance in the United States. With its features of capitation, provider monetary risk, and population perspective, managed care represents a huge growth opportunity for advocates of disease prevention and health promotion, including those in the field of health education. In reality, however, health education's role has fallen far short of expectations. This article is presented to initiate a dialogue on the role of health education and its subset, worksite health promotion, within managed care. The worksite is emphasized because of its attractiveness as a site in delivering population-based medicine. Furthermore, employers exercise considerable influence in shaping the health care marketplace. A list of recommendations is presented, offering suggestions on what health education needs to do to increase its impact in the managed care movement. These arguments are posed to better position this profession in a changing health care environment. PMID:10929748

  11. Dissemination of parasites by animal movements in small ruminant farms.

    PubMed

    Vasileiou, N G C; Fthenakis, G C; Papadopoulos, E

    2015-09-30

    The present paper discusses the spread of parasites by animal movements in small ruminant farms; it focuses in dissemination of parasitic forms that would lead to subsequent infection of sheep or goats. Systems of small ruminant production involve a component of animal movement (e.g., grazing) as part of routine husbandry, which favors spread of parasitic forms; that refers mainly to parasites of the digestive system (nematodes, trematodes, cestodes, protozoa), as well as helminthes of the respiratory system, although dissemination of the various parasitic forms in the environment would not always result to subsequent infection; external parasites may also be disseminated during movements, e.g., to inhabit wooden poles used in fencing. New livestock into a farm constitutes a biosecurity hazard and the most common means to introducing new parasitic pathogens into a farm; in contemporary small ruminant health management, this contributes in dissemination of anthelmintic resistant parasitic strains; other parasitic disease agents (e.g., mange mites, ticks) may also be spread into a farm that way. Often, especially in small scale farming, visits of rams or bucks take place from one farm to another during the mating season; in such cases, ectoparasites (e.g., mange mites) can be disseminated through direct contact of animals, as well other pathogens (e.g., Toxoplasma gondii, Neospora caninum) via the semen. During transportation of sheep/goats, parasitic forms can also spread, as well as during movement of sheep or goats to slaughterhouses, in which case dogs present in these places would contribute to their dissemination. Spread of life forms of various parasites can also occur from animal species present in the environment of sheep or goats; these include animals present within a farm, stray dogs roaming around a farm (e.g., for spread of Multiceps multiceps, Echinococcus granulosus, Taenia hydatigena, N. caninum), cats commanding the environment of a farm (e.g., for spread of T. gondii), cats or rats responsible for dissemination of fleas, which may also be spread by humans as well, and, finally, wildlife animals. Finally, life forms of parasites of small ruminants may be also spread indirectly, by material associated with sheep or goats (e.g., materials of humans visiting farms, animal feeds) that had been contaminated by faecal material of animals. PMID:26012856

  12. Ruminant Nutrition Symposium: Role of fermentation acid absorption in the regulation of ruminal pH.

    PubMed

    Aschenbach, J R; Penner, G B; Stumpff, F; Gäbel, G

    2011-04-01

    Highly fermentable diets are rapidly converted to organic acids [i.e., short-chain fatty acids (SCFA) and lactic acid] within the rumen. The resulting release of protons can constitute a challenge to the ruminal ecosystem and animal health. Health disturbances, resulting from acidogenic diets, are classified as subacute and acute acidosis based on the degree of ruminal pH depression. Although increased acid production is a nutritionally desired effect of increased concentrate feeding, the accumulation of protons in the rumen is not. Consequently, mechanisms of proton removal and their quantitative importance are of major interest. Saliva buffers (i.e., bicarbonate, phosphate) have long been identified as important mechanisms for ruminal proton removal. An even larger proportion of protons appears to be removed from the rumen by SCFA absorption across the ruminal epithelium, making efficiency of SCFA absorption a key determinant for the individual susceptibility to subacute ruminal acidosis. Proceeding initially from a model of exclusively diffusional absorption of fermentation acids, several protein-dependent mechanisms have been discovered over the last 2 decades. Although the molecular identity of these proteins is mostly uncertain, apical acetate absorption is mediated, to a major degree, via acetate-bicarbonate exchange in addition to another nitrate-sensitive, bicarbonate-independent transport mechanism and lipophilic diffusion. Propionate and butyrate also show partially bicarbonate-dependent transport modes. Basolateral efflux of SCFA and their metabolites has to be mediated primarily by proteins and probably involves the monocarboxylate transporter (MCT1) and anion channels. Although the ruminal epithelium removes a large fraction of protons from the rumen, it also recycles protons to the rumen via apical sodium-proton exchanger, NHE. The latter is stimulated by ruminal SCFA absorption and salivary Na(+) secretion and protects epithelial integrity. Finally, SCFA absorption also accelerates urea transport into the rumen, which via ammonium recycling, may remove protons from rumen to the blood. Ammonium absorption into the blood is also stimulated by luminal SCFA. It is suggested that the interacting transport processes for SCFA, urea, and ammonia represent evolutionary adaptations of ruminants to actively coordinate energy fermentation, protein assimilation, and pH regulation in the rumen. PMID:20952531

  13. Health Plans Respond to Parity: Managing Behavioral Health Care in the Federal Employees Health Benefits Program

    PubMed Central

    Ridgely, M Susan; Burnam, M Audrey; Barry, Colleen L; Goldman, Howard H; Hennessy, Kevin D

    2006-01-01

    The government often uses the Federal Employees Health Benefits (FEHB) Program as a model for both public and private health policy choices. In 2001, the U.S. Office of Personnel Management (OPM) implemented full parity, requiring that FEHB carriers offer mental health and substance abuse benefits equal to general medical benefits. OPM instructed carriers to alter their benefit design but permitted them to determine whether they would manage care and what structures or processes they would use. This article reports on the experience of 156 carriers and the government-wide BlueCross and BlueShield Service Benefit Plan. Carriers dropped cost-restraining benefit limits. A smaller percentage also changed the management of the benefit, but these changes affected the care of many enrollees, making the overall parity effect noteworthy. PMID:16529573

  14. Outage management and health physics issue, 2007

    SciTech Connect

    Agnihotri, Newal

    2007-05-15

    The focus of the May-June issue is on outage management and health physics. Major articles/reports in this issue include: India: a potential commercial opportunity, a U.S. Department of Commerce Report, by Joe Neuhoff and Justin Rathke; The changing climate for nuclear energy, by Skip Bowman, Nuclear Energy Insitute; Selecting protective clothing, by J. Mark Price, Southern California Edison; and Succssful refurbishment outage, by Sudesh K. Gambhir, Omaha Public Power District. Industry innovation articles in this issue are: Containment radiation monitoring spiking, by Michael W. Lantz and Robert Routolo, Arizona Public Service Company; Improved outage performance, by Michael Powell and Troy Wilfong, Arizona Public Service Company, Palo Verde Nuclear Generating Station; Stop repacking valves and achieve leak-free performance, by Kenneth Hart, PPL Susquehanna LLC; and Head assembly upgrade package, by Timothy Petit, Dominion Nuclear.

  15. Outage management and health physics issue, 2009

    SciTech Connect

    Agnihotri, Newal

    2009-05-15

    The focus of the May-June issue is on outage management and health physics. Major articles include the following: Planning and scheduling to minimize refueling outage, by Pat McKenna, AmerenUE; Prioritizing safety, quality and schedule, by Tom Sharkey, Dominion; Benchmarking to high standards, by Margie Jepson, Energy Nuclear; Benchmarking against U.S. standards, by Magnox North, United Kingdom; Enabling suppliers for new build activity, by Marcus Harrington, GE Hitachi Nuclear Energy; Identifying, cultivating and qualifying suppliers, by Thomas E. Silva, AREVA NP; Creating new U.S. jobs, by Francois Martineau, Areva NP. Industry innovation articles include: MSL Acoustic source load reduction, by Amir Shahkarami, Exelon Nuclear; Dual Methodology NDE of CRDM nozzles, by Michael Stark, Dominion Nuclear; and Electronic circuit board testing, by James Amundsen, FirstEnergy Nuclear Operating Company. The plant profile article is titled The future is now, by Julia Milstead, Progress Energy Service Company, LLC.

  16. Rocket Testing and Integrated System Health Management

    NASA Technical Reports Server (NTRS)

    Figueroa, Fernando; Schmalzel, John

    2005-01-01

    Integrated System Health Management (ISHM) describes a set of system capabilities that in aggregate perform: determination of condition for each system element, detection of anomalies, diagnosis of causes for anomalies, and prognostics for future anomalies and system behavior. The ISHM should also provide operators with situational awareness of the system by integrating contextual and timely data, information, and knowledge (DIaK) as needed. ISHM capabilities can be implemented using a variety of technologies and tools. This chapter provides an overview of ISHM contributing technologies and describes in further detail a novel implementation architecture along with associated taxonomy, ontology, and standards. The operational ISHM testbed is based on a subsystem of a rocket engine test stand. Such test stands contain many elements that are common to manufacturing systems, and thereby serve to illustrate the potential benefits and methodologies of the ISHM approach for intelligent manufacturing.

  17. Soil health paradigms and implications for disease management.

    PubMed

    Larkin, Robert P

    2015-01-01

    Soil health has been defined as the capacity of soil to function as a vital living system to sustain biological productivity, maintain environmental quality, and promote plant, animal, and human health. Building and maintaining soil health are essential to agricultural sustainability and ecosystem function. Management practices that promote soil health, including the use of crop rotations, cover crops and green manures, organic amendments, and conservation tillage, also have generally positive effects on the management of soilborne diseases through a number of potential mechanisms, including increasing soil microbial biomass, activity, and diversity, resulting in greater biological suppression of pathogens and diseases. However, there also may be particular disease issues associated with some soil health management practices. In this review, research and progress made over the past twenty years regarding soil health, sustainability, and soil health management practices, with an emphasis on their implications for and effects on plant disease and disease management strategies, are summarized. PMID:26002292

  18. Integrated Systems Health Management for Space Exploration

    NASA Technical Reports Server (NTRS)

    Uckun, Serdar

    2005-01-01

    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.

  19. Ruminant abortion diagnostics.

    PubMed

    Holler, Larry D

    2012-11-01

    Successful abortion diagnosis in ruminants involves input from the producer, practitioner, and diagnostician. Unfortunately, despite best efforts, many investigations still result in a diagnosis of idiopathic abortion. If this diagnosis is made after a complete and systematic investigation of appropriate and reasonably preserved samples, some comfort can be taken that practitioners and diagnosticians did their best for the benefit of the producer. As new diagnostic technology is developed for abortion diseases, hopefully this best will only get better. PMID:23101668

  20. The Overview of the Health Monitoring Management System

    NASA Astrophysics Data System (ADS)

    Zhong-Ji, Tan; Zhiqiang, Zhang; Yan-Bin, Shi

    The health monitoring management system has prominent function to improve the security and dependability of the aircraft, can also shortens the maintain cycle by a large margin, improves the sortie rate at the same time. This paper has explained the concept, the development in domestic and international and the key technology of the health monitoring management system of aircraft; Construct the structure of the aircraft health monitoring management system, and has carried on analysis and research to its implementation method.

  1. Integrated Vehicle Health Management (IVHM) Activities at Kennedy Space Center

    NASA Technical Reports Server (NTRS)

    Fox, Jack

    2000-01-01

    Integrated Vehicle Health Management (IVHM) goals are to develop and integrate the technologies which can provide a continuous, intelligent, and adaptive health state of a vehicle and use this information to improve safety and reduce the costs of operations.

  2. Herd health and management of dairy cow

    NASA Astrophysics Data System (ADS)

    Ćaǧlayan, Alper; Yüca, Songül

    2016-04-01

    Herd management requires multidisciplinary practices including animal feeding, gynecology, artificial insemination, immunology, and similar topics. Animal feeding is the most delicate subject as the fodder expense is 70% of the farm cost and as nearly all of the metabolic diseases arising out as health problem are because of misfeeding. However, a business organization's being able to maintain making profit will be possible by taking a healthy calf from breeding herd every year. For this reason, precision registrations of birth and artificial insemination, following-up pregnant state of animals, and making the other animals pregnant as soon as possible should be primary aim. It should not be forgotten that diarrhea and pneumonia in calves are among the most frequently witnessed infection related health problems. Mastitis, metritis and foot diseases take an important place in mature cows. These diseases can be minimized by vaccinations that are done properly and in suitable time, in-service training of staffs, making shelters suitable for animals welfare, and improving the hygienic conditions.

  3. Health Management Applications for International Space Station

    NASA Technical Reports Server (NTRS)

    Alena, Richard; Duncavage, Dan

    2005-01-01

    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.

  4. Behavioral Health Emergencies Managed by School Nurses Working with Adolescents

    ERIC Educational Resources Information Center

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

    2013-01-01

    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

  5. Managed care in mental health: the ethical issues.

    PubMed

    Boyle, P J; Callahan, D

    1995-01-01

    Praise and blame of managed mental health care are on the rise on many fronts, including allegations that it could adversely affect quality of care, access to care, the physician/patient relationship, and informed patient choice. Given the heterogeneity among managed mental health care organizations--each with differing practices--it is difficult to sift the ethically defensible concerns from the indefensible ones. In this paper we identify and examine the different moral concerns about managed mental health care and mark which problems have been addressed or are in need of resolution. We also identify which problems are unique to managed mental health care. PMID:7498905

  6. Meeting global health challenges through operational research and management science

    PubMed Central

    2011-01-01

    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

  7. The adoption of mobile health management services: an empirical study.

    PubMed

    Hung, Ming-Chien; Jen, Wen-Yuan

    2012-06-01

    As their populations age, many countries are facing the increasing economic pressure of providing healthcare to their people. In Taiwan, this problem is exacerbated by an increasing rate of obesity and obesity-related conditions. Encouraging the adoption of personal health management services is one way to maintain current levels of personal health and to efficiently manage the distribution of healthcare resources. This study introduces Mobile Health Management Services (MHMS) and employs the Technology Acceptance Model (TAM) to explore the intention of students in Executive Master of Business Management programs to adopt mobile health management technology. Partial least squares (PLS) was used to analyze the collected data, and the results revealed that "perceived usefulness" and "attitude" significantly affected the behavioral intention of adopting MHMS. Both "perceived ease of use" and "perceived usefulness," significantly affected "attitude," and "perceived ease of use" significantly affected "perceived usefulness" as well. The results also show that the determinants of intention toward MHMS differed with age; young adults had higher intention to adopt MHMS to manage their personal health. Therefore, relevant governmental agencies may profitably promote the management of personal health among this population. Successful promotion of personal health management will contribute to increases in both the level of general health and the efficient management of healthcare resources. PMID:20878452

  8. Physiological Roles of Adipokines, Hepatokines, and Myokines in Ruminants

    PubMed Central

    Roh, Sang-Gun; Suzuki, Yutaka; Gotoh, Takafumi; Tatsumi, Ryuichi; Katoh, Kazuo

    2016-01-01

    Since the discovery of leptin secreted from adipocytes, specialized tissues and cells have been found that secrete the several peptides (or cytokines) that are characterized to negatively and positively regulate the metabolic process. Different types of adipokines, hepatokines, and myokines, which act as cytokines, are secreted from adipose, liver, and muscle tissue, respectively, and have been identified and examined for their physiological roles in humans and disease in animal models. Recently, various studies of these cytokines have been conducted in ruminants, including dairy cattle, beef cattle, sheep, and goat. Interestingly, a few cytokines from these tissues in ruminants play an important role in the post-parturition, lactation, and fattening (marbling) periods. Thus, understanding these hormones is important for improving nutritional management in dairy cows and beef cattle. However, to our knowledge, there have been no reviews of the characteristics of these cytokines in beef and dairy products in ruminants. In particular, lipid and glucose metabolism in adipose tissue, liver tissue, and muscle tissue are very important for energy storage, production, and synthesis, which are regulated by these cytokines in ruminant production. In this review, we summarize the physiological roles of adipokines, hepatokines, and myokines in ruminants. This discussion provides a foundation for understanding the role of cytokines in animal production of ruminants. PMID:26732322

  9. Physiological Roles of Adipokines, Hepatokines, and Myokines in Ruminants.

    PubMed

    Roh, Sang-Gun; Suzuki, Yutaka; Gotoh, Takafumi; Tatsumi, Ryuichi; Katoh, Kazuo

    2016-01-01

    Since the discovery of leptin secreted from adipocytes, specialized tissues and cells have been found that secrete the several peptides (or cytokines) that are characterized to negatively and positively regulate the metabolic process. Different types of adipokines, hepatokines, and myokines, which act as cytokines, are secreted from adipose, liver, and muscle tissue, respectively, and have been identified and examined for their physiological roles in humans and disease in animal models. Recently, various studies of these cytokines have been conducted in ruminants, including dairy cattle, beef cattle, sheep, and goat. Interestingly, a few cytokines from these tissues in ruminants play an important role in the post-parturition, lactation, and fattening (marbling) periods. Thus, understanding these hormones is important for improving nutritional management in dairy cows and beef cattle. However, to our knowledge, there have been no reviews of the characteristics of these cytokines in beef and dairy products in ruminants. In particular, lipid and glucose metabolism in adipose tissue, liver tissue, and muscle tissue are very important for energy storage, production, and synthesis, which are regulated by these cytokines in ruminant production. In this review, we summarize the physiological roles of adipokines, hepatokines, and myokines in ruminants. This discussion provides a foundation for understanding the role of cytokines in animal production of ruminants. PMID:26732322

  10. 9 CFR 93.428 - Sheep and goats and wild ruminants from Mexico.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... from Mexico. 93.428 Section 93.428 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION... PRODUCTS; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants Mexico 10 § 93.428 Sheep and goats and wild ruminants from Mexico. (a) Sheep and goats intended for importation from...

  11. 9 CFR 93.428 - Sheep and goats and wild ruminants from Mexico.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... from Mexico. 93.428 Section 93.428 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION... PRODUCTS; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants Mexico 10 § 93.428 Sheep and goats and wild ruminants from Mexico. (a) Sheep and goats intended for importation from...

  12. Needs Assessment for Health Care Management Education in Russia

    ERIC Educational Resources Information Center

    Rekhter, Natalia; Togunov, Igor A.

    2006-01-01

    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…

  13. Needs Assessment for Health Care Management Education in Russia

    ERIC Educational Resources Information Center

    Rekhter, Natalia; Togunov, Igor A.

    2006-01-01

    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

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

    ERIC Educational Resources Information Center

    Jancey, Jonine; Meuleners, Lynn; Phillips, Maureen

    2011-01-01

    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

  15. Managing Evaluation in a Federal Public Health Setting

    ERIC Educational Resources Information Center

    Schooley, Michael W.

    2009-01-01

    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…

  16. Managing Evaluation in a Federal Public Health Setting

    ERIC Educational Resources Information Center

    Schooley, Michael W.

    2009-01-01

    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

  17. Technology Maturation of Integrated System Health Management

    NASA Astrophysics Data System (ADS)

    Feather, Martin S.; Uckun, Serdar; Hicks, Kenneth A.

    2008-01-01

    Despite two decades of significant investments in R&D of Integrated System Health Management (ISHM), mission-critical applications of it in aerospace are few and far between. ISHM is subject to the general difficulty of transitioning technologies out of R&D labs and into practical applications. New and unproven methods such as ISHM introduce multiple mission risks (technology, schedule, cost), and may require a transition to unconventional and as-yet-unproven operations concepts in order to be effective. Laboratory and flight demonstrations are necessary but insufficient to adequately reduce those risks. What is needed is a solid business case before a new technology can be considered for fleetwide deployment. To address these problems, we recently applied a technology maturation assessment process developed at NASA's Jet Propulsion Laboratory to study the challenges of ISHM technology maturation. This application resulted in identification of the technologies (and technology maturation activities) that would result in the greatest risk reduction per investment dollar. Our approach and its results are described herein.

  18. Managed care in the public mental health system.

    PubMed

    Cuffel, B J; Snowden, L; Masland, M; Piccagli, G

    1996-04-01

    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 an overview of managed care definitions, organizational arrangements, administrative techniques, and roles and responsibilities using a theoretical framework adopted from economics referred to as principal-agent theory. Consistent with this theory, we assert that the primary function of the managed care organization is to act as agent for the payor and to manage the relationships between payors, providers, and consumers. From this perspective, managed care organizations in the public mental health system will be forced to manage an extremely complex set of relationships between multiple government payors, communities, mental health providers, and consumers. In each relationship, we have identified many challenges for managed care including the complexity of public financing, the vulnerable nature of the population served, and the importance of synchronization between managed care performance and community expectations for the public mental health system. In our view, policy regarding the role of managed care in the public mental health system must evolve from an understanding of the dynamics of government-community-provider-consumer "agency relationships". PMID:8777868

  19. Cassia fistula Linn: Potential candidate in the health management

    PubMed Central

    Rahmani, Arshad H.

    2015-01-01

    Cassia fistula Linn is known as Golden shower has therapeutics importance in health care since ancient times. Research findings over the last two decade have confirmed the therapeutics consequence of C. fistula in the health management via modulation of biological activities due to the rich source of antioxidant. Several findings based on the animal model have confirmed the pharmacologically safety and efficacy and have opened a new window for human health management. This review reveals additional information about C. fistula in the health management via in vivo and in vitro study which will be beneficial toward diseases control. PMID:26130932

  20. Simulation: A Complementary Method for Teaching Health Services Strategic Management

    PubMed Central

    Reddick, W. T.

    1990-01-01

    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.

  1. Managed care and the public health challenge of TB.

    PubMed Central

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

    1997-01-01

    Managed care is fast becoming the dominant form of medical care delivery and financing in the United States, yet its effects on public health practice remain largely unknown. Tuberculosis (TB) is a classic example of a disease with both public health and medical care implications, and as such it provides an opportunity for examining the impact on public health of the shift towards managed care in the medical marketplace. The authors approach the role of managed care in TB control by first considering the need for interorganizational coordination at the community level. The authors identify four basic models of how managed care organizations may fit into TB control efforts in local communities, using observations from 12 local public health jurisdictions to illustrate these models. These TB control models provide insight into the general mechanisms through which managed care organizations may affect other areas of public health practice. Images p22-a p23-a p25-a p28-a PMID:9018283

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

    ERIC Educational Resources Information Center

    Waller, Erika M.; Rose, Amanda J.

    2013-01-01

    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…

  3. Measuring State-Specific Rumination: Development of the Rumination about an Interpersonal Offense Scale

    ERIC Educational Resources Information Center

    Wade, Nathaniel G.; Vogel, David L.; Liao, Kelly Yu-Hsin; Goldman, Daniel B.

    2008-01-01

    The tendency to ruminate has been consistently linked to psychological disturbances, such as increased stress, anger, and fear in response to provocations. However, existing measures of rumination focus on the disposition to ruminate rather than on rumination about a specific situation. This limits the ability to explore rumination about a…

  4. Management Education in Public Health: Further Considerations Comment on "Management Matters: A Leverage Point for Health Systems Strengthening in Global Health".

    PubMed

    Darr, Kurt J

    2015-01-01

    Knowing and applying the basic management functions of planning, organizing, staffing, directing, and controlling, as well as their permutations and combinations, are vital to effective delivery of public health services. Presently, graduate programs that prepare public health professionals neither emphasize teaching management theory, nor its application. This deficit puts those who become managers in public health and those they serve at a distinct disadvantage. This deficit can be remedied by enhanced teaching of management subjects. PMID:26673475

  5. Decentralisation of general management within the New Zealand health system.

    PubMed

    Malcolm, L; Alp, B; Bryson, J

    1994-11-01

    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

  6. Management Matters: A Leverage Point for Health Systems Strengthening in Global Health

    PubMed Central

    Bradley, Elizabeth H.; Taylor, Lauren A.; Cuellar, Carlos J.

    2015-01-01

    Despite a renewed focus in the field of global health on strengthening health systems, inadequate attention has been directed to a key ingredient of high-performing health systems: management. We aimed to develop the argument that management – defined here as the process of achieving predetermined objectives through human, financial, and technical resources – is a cross-cutting function necessary for success in all World Health Organization (WHO) building blocks of health systems strengthening. Management within health systems is particularly critical in low-income settings where the efficient use of scarce resources is paramount to attaining health goals. More generally, investments in management capacity may be viewed as a key leverage point in grand strategy, as strong management enables the achievement of large ends with limited means. We also sought to delineate a set of core competencies and identify key roles to be targeted for management capacity building efforts. Several effective examples of management interventions have been described in the research literature. Together, the existing evidence underscores the importance of country ownership of management capacity building efforts, which often challenge the status quo and thus need country leadership to sustain despite inevitable friction. The literature also recognizes that management capacity efforts, as a key ingredient of effective systems change, take time to embed, as new protocols and ways of working become habitual and integrated as standard operating procedures. Despite these challenges, the field of health management as part of global health system strengthening efforts holds promise as a fundamental leverage point for achieving health system performance goals with existing human, technical, and financial resources. The evidence base consistently supports the role of management in performance improvement but would benefit from additional research with improved methodological rigor and longer-time horizon investigations. Meanwhile, greater emphasis on management as a critical element of global health efforts may open new and sustainable avenues for advancing health systems performance. PMID:26188805

  7. Management Matters: A Leverage Point for Health Systems Strengthening in Global Health.

    PubMed

    Bradley, Elizabeth H; Taylor, Lauren A; Cuellar, Carlos J

    2015-07-01

    Despite a renewed focus in the field of global health on strengthening health systems, inadequate attention has been directed to a key ingredient of high-performing health systems: management. We aimed to develop the argument that management - defined here as the process of achieving predetermined objectives through human, financial, and technical resources - is a cross-cutting function necessary for success in all World Health Organization (WHO) building blocks of health systems strengthening. Management within health systems is particularly critical in low-income settings where the efficient use of scarce resources is paramount to attaining health goals. More generally, investments in management capacity may be viewed as a key leverage point in grand strategy, as strong management enables the achievement of large ends with limited means. We also sought to delineate a set of core competencies and identify key roles to be targeted for management capacity building efforts. Several effective examples of management interventions have been described in the research literature. Together, the existing evidence underscores the importance of country ownership of management capacity building efforts, which often challenge the status quo and thus need country leadership to sustain despite inevitable friction. The literature also recognizes that management capacity efforts, as a key ingredient of effective systems change, take time to embed, as new protocols and ways of working become habitual and integrated as standard operating procedures. Despite these challenges, the field of health management as part of global health system strengthening efforts holds promise as a fundamental leverage point for achieving health system performance goals with existing human, technical, and financial resources. The evidence base consistently supports the role of management in performance improvement but would benefit from additional research with improved methodological rigor and longer-time horizon investigations. Meanwhile, greater emphasis on management as a critical element of global health efforts may open new and sustainable avenues for advancing health systems performance. PMID:26188805

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

    ERIC Educational Resources Information Center

    Bainbridge, J.; Sapirie, S.

    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

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

    ERIC Educational Resources Information Center

    Bainbridge, J.; Sapirie, S.

    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…

  10. Environmental Management of Pediatric Asthma: Guidelines for Health Care Providers

    ERIC Educational Resources Information Center

    Roberts, James R.; McCurdy, Leyla Erk

    2005-01-01

    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…

  11. Children and Managed Health Care. Analysis and Recommendations.

    ERIC Educational Resources Information Center

    Deal, Lisa W.; Shiono, Patricia H.; Behrman, Richard E.

    1998-01-01

    Reviews the changes managed health care has brought to the delivery and use of medical services and recommends specific steps that will make the existing system more responsive to the needs of children. Systemwide health care reforms must give children stable medical care that emphasizes preventive health and developmental services. (SLD)

  12. Behavioral Health Emergencies Managed by School Nurses Working with Adolescents

    ERIC Educational Resources Information Center

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

    2013-01-01

    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…

  13. [Managing health risks of workers in business trip].

    PubMed

    Gevorkian, E V

    2014-01-01

    The article presents data of prospective observation over the risk management system concerning health of international oil and gas company workers in business trips. The management system included training and screening of workers under risk, specific prophylaxis and other measures. The authors described problems of the risk management system implementation, suggested recommendations to control risks connected with business trips. PMID:25881395

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

    NASA Astrophysics Data System (ADS)

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

    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.

  15. Systematic Motorcycle Management and Health Care Delivery: A Field Trial

    PubMed Central

    Rerolle, Francois; Rammohan, Sonali V.; Albohm, Davis C.; Muwowo, George; Moseson, Heidi; Sept, Lesley; Lee, Hau L.; Bendavid, Eran

    2016-01-01

    Objectives. We investigated whether managed transportation improves outreach-based health service delivery to rural village populations. Methods. We examined systematic transportation management in a small-cluster interrupted time series field trial. In 8 districts in Southern Zambia, we followed health workers at 116 health facilities from September 2011 to March 2014. The primary outcome was the average number of outreach trips per health worker per week. Secondary outcomes were health worker productivity, motorcycle performance, and geographical coverage. Results. Systematic fleet management resulted in an increase of 0.9 (SD = 1.0) trips to rural villages per health worker per week (P < .001), village-level health worker productivity by 20.5 (SD = 5.9) patient visits, 10.2 (SD = 1.5) measles immunizations, and 5.2 (SD = 5.4) child growth assessments per health worker per week. Motorcycle uptime increased by 3.5 days per week (P < .001), use by 1.5 days per week (P < .001), and mean distance by 9.3 kilometers per trip (P < .001). Geographical coverage of health outreach increased in experimental (P < .001) but not control districts. Conclusions. Systematic motorcycle management improves basic health care delivery to rural villages in resource-poor environments through increased health worker productivity and greater geographical coverage. PMID:26562131

  16. Pesticides and public health: integrated methods of mosquito management.

    PubMed Central

    Rose, R. I.

    2001-01-01

    Pesticides have a role in public health as part of sustainable integrated mosquito management. Other components of such management include surveillance, source reduction or prevention, biological control, repellents, traps, and pesticide-resistance management. We assess the future use of mosquito control pesticides in view of niche markets, incentives for new product development, Environmental Protection Agency registration, the Food Quality Protection Act, and improved pest management strategies for mosquito control. PMID:11266290

  17. European organic dairy farmers' preference for animal health management within the farm management system.

    PubMed

    van Soest, F J S; Mourits, M C M; Hogeveen, H

    2015-11-01

    The expertise and knowledge of veterinary advisors on improving animal health management is key towards a better herd health status. However, veterinary advisors are not always aware of the goals and priorities of dairy farmers. To dairy farmers animal health is only one aspect of farm management and resources may be allocated to other more preferred areas. Veterinary advisors may experience this as non-compliant with their advice. To explore the preferences of European Union (EU) organic dairy farmers for improved animal health management relative to other farm management areas an adaptive conjoint analysis (ACA) was performed. A total of 215 farmers participated originating from organic dairy farms in France (n = 70), Germany (n = 60), Spain (n = 28) and Sweden (n = 57). The management areas udder health and claw health represented animal health management whereas barn, calf and pasture management represented potential conflicting management areas. Results indicate that EU organic dairy farmers differ in their preferences for improved animal health management within the farming system. In general, improved calf management was the most preferred area and improved claw health management was found to be least preferred, the remaining areas were of intermediate interest. Cluster analyses on claw health measures and udder health measures resulted in respectively seven and nine distinct preference profiles. The results indicate a high degree of variation in farmers' preference, which cannot be explained by the typical herd characteristics. With the individual preferences revealed by ACA, a veterinary advisor can now find out whether his intended advice is directed at a favourable or unfavourable management area of the farmer. If the latter is the case the veterinarian should first create awareness of the problem to the farmer. Insights in individual farmers preferences will allow veterinary advisors to better understand why farmers were incompliant with their advice and improve their advice by showing, for example, the potential benefits of their advice. PMID:26179079

  18. Women's health services: restructuring for Medicaid managed care.

    PubMed

    Loughlin, J; Bronner, E F; Mascari, J S

    1997-04-01

    New Jersey health care providers face the need to change dramatically the way health care is delivered as it enters a new era of managed care. This year, more than 24% of New Jersey's total population is enrolled in commercial managed care plans (New Jersey Department of Insurance, 1996). In addition, the state's Medicaid agency took steps to improve the delivery of health services to recipients by initiating implementation activities to transition from the traditional Medicaid program to a managed care model. Eighty-two percent of New Jersey's Aid to Families with Dependent Children (AFDC) and related populations have already been enrolled in managed care. The state plans to expand enrollment in managed care to the remaining 400,000 Medicaid beneficiaries. Communities with high Medicaid populations are challenged with the need to move through the managed care evolution at an accelerated rate. PMID:10181608

  19. Sensor Technology for Integrated Vehicle Health Management of Aerospace Vehicles

    NASA Technical Reports Server (NTRS)

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

    2002-01-01

    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.

  20. Health Technologies for the Improvement of Chronic Disease Management

    PubMed Central

    Nikitovic, M; Brener, S

    2013-01-01

    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

  1. Ruminal microbiology, biotechnology, and ruminant nutrition: progress and problems.

    PubMed

    Wallace, R J

    1994-11-01

    Present methods for manipulating ruminal fermentation that involve microbial biotechnology include dietary ionophores, antibiotics, and microbial feed additives. Developments in recombinant DNA technology mean that future methods will have a much wider scope. It has been suggested that genetically engineered ruminal microorganisms will be used in future to improve ruminal fermentation. Several technical objectives must be achieved before that will be possible. First, methods for inserting foreign or modified genes into ruminal microorganisms and ensuring their efficient expression must be developed. Broad host range plasmids and transposons have been used successfully to introduce new DNA into ruminal bacteria, as have shuttle vectors constructed as chimeras of plasmids from ruminal species and Escherichia coli. Although so far only antibiotic resistance markers have been transferred, the prospects for introducing other genes into selected ruminal bacteria are excellent. Second, the expression of the gene product(s) should be known to be nutritionally useful in vivo. A few examples of this type of benefit have been demonstrated, and many more proposed, including polysaccharidases for improving fiber digestion, methods for improving the amino acid composition of ruminal bacteria, and breakdown of plant toxins. Third, the difficulty that has been examined least, yet may prove most difficult to overcome, is that mechanisms have to be found for introducing and maintaining the new strain in the mixed ruminal population. Factors governing the survival of new strains in vivo are ill-understood, and attempts to select in favor of added new organisms have so far been unsuccessful. Because of the last obstacle, it may be advantageous, at least in the short term, to use nonruminal organisms, such as Saccharomyces cerevisiae, rather than indigenous ruminal species as a vehicle for implementing the benefits of recombinant DNA technology to ruminal fermentation. Yeast is already in widespread use as a feed additive, so no enrichment is necessary; and its genetics are already well known. Alternatively, adding particular enzymes to the diet may achieve some of the objectives described above, with the advantage that the manipulation could be achieved without the release of a recombinant microorganism. PMID:7730195

  2. Health care emergency management: establishing the science of managing mass casualty and mass effect incidents.

    PubMed

    Macintyre, Anthony G; Barbera, Joseph A; Brewster, Peter

    2009-06-01

    Particularly since 2001, the health care industry has witnessed many independent and often competing efforts to address mitigation and preparedness for emergencies. Clinicians, health care administrators, engineers, safety and security personnel, and others have each developed relatively independent efforts to improve emergency response. A broader conceptual approach through the development of a health care emergency management profession should be considered to integrate these various critical initiatives. When based on long-standing emergency management principles and practices, health care emergency management provides standardized, widely accepted management principles, application concepts, and terminology. This approach could also promote health care integration into the larger community emergency response system. The case for a formally defined health care emergency management profession is presented with discussion points outlining the advantages of this approach. PMID:19491589

  3. Financial coping strategies of mental health consumers: managing social benefits.

    PubMed

    Caplan, Mary Ager

    2014-05-01

    Mental health consumers depend on social benefits in the forms of supplemental security income and social security disability insurance for their livelihood. Although these programs pay meager benefits, little research has been undertaken into how this population makes ends meet. Using a qualitative approach, this study asks what are the financial coping strategies of mental health consumers? Seven approaches were identified: subsidies, cost-effective shopping, budgeting, prioritizing, technology, debt management, and saving money. Results illustrate the resourcefulness of mental health consumers in managing meager social benefits and highlight the need to strengthen community mental health efforts with financial capabilities education. PMID:24346222

  4. Case management in the social health maintenance organization demonstrations

    PubMed Central

    Yordi, Cathleen L.

    1988-01-01

    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

  5. "Burnout": definitions and health care management.

    PubMed

    Beemsterboer, J; Baum, B H

    1984-01-01

    This paper examines the existing definitions and perceptions of the concept of "burnout" in the health professions. The authors suggest that the understanding of "burnout" is hindered by the lack of a single operational definition and a clear set of criteria. An example of social workers in a community mental health setting serves as an illustration. PMID:6515524

  6. Clinical and Management Requirements for Computerized Mental Health Information Systems

    PubMed Central

    Levinton, Paula H.; Dunning, Tessa F.E.

    1980-01-01

    Information requirements of mental health providers are sufficiently different from those of other health care managers to warrant a different approach to the development of management information systems (MIS). Advances in computer technology and increased demands for fiscal accountability have led to developing integrated mental health information systems (MHIS) that support clinical and management requirements. In a study made to define a set of generic information requirements of mental health providers that can be supported by an MHIS, it was found that basic data needs can be defined and classified in functional terms: clinical, management, and consultation/education requirements. A basic set of data to support these needs was defined: demographic, financial, clinical, programmatic, and service delivery data.

  7. Sensors and Rotordynamics Health Management Research for Aircraft Turbine Engines

    NASA Technical Reports Server (NTRS)

    Lekki, J.; Abdul-Aziz, A.; Adamovsky, G.; Berger, D.; Fralick, G.; Gyekenyesi, A.; Hunter, G.; Tokars, R.; Venti, M.; Woike, M.; Wrbanek, J.; Wrbanek, S.

    2011-01-01

    Develop Advanced Sensor Technology and rotordynamic structural diagnostics to address existing Aviation Safety Propulsion Health Management needs as well as proactively begin to address anticipated safety issues for new technologies.

  8. Secure e-Health: managing risks to patient health data.

    PubMed

    Kluge, Eike-Henner W

    2007-01-01

    e-Health, as an inter-jurisdictional enterprise, presents risks to patient health data that involve not only technology and professional protocols but also laws, regulations and professional security cultures. The USA Patriot Act is one example of how national laws can shape these concerns. Secure e-Health therefore requires not only national standardization of professional education and protocols but also global interoperability of regulations and laws. Some progress in this regard has been made in the European context; however, even here developments are incomplete, and nothing similar has been accomplished on a global scale. Professional health information organizations must take the lead in developing appropriate high-level principles for professional certification and security protocols and in harmonizing these on a global basis, so that they can provide a firm and consistent foundation for international treaties. Such developments should occur in concert with other health professions, so that coordinated requirements are integrated into revisions of the relevant codes of ethics. This presentation identifies and addresses some of the ethical and legal issues and proposes a series of recommendations. PMID:17084665

  9. Context-aware workflow management of mobile health applications.

    PubMed

    Salden, Alfons; Poortinga, Remco

    2006-01-01

    We propose a medical application management architecture that allows medical (IT) experts readily designing, developing and deploying context-aware mobile health (m-health) applications or services. In particular, we elaborate on how our application workflow management architecture enables chaining, coordinating, composing, and adapting context-sensitive medical application components such that critical Quality of Service (QoS) and Quality of Context (QoC) requirements typical for m-health applications or services can be met. This functional architectural support requires learning modules for distilling application-critical selection of attention and anticipation models. These models will help medical experts constructing and adjusting on-the-fly m-health application workflows and workflow strategies. We illustrate our context-aware workflow management paradigm for a m-health data delivery problem, in which optimal communication network configurations have to be determined. PMID:17095803

  10. Management Development in Health Care: Exploring the Experiences of Clinical Nurse Managers

    ERIC Educational Resources Information Center

    Purcell, Laura; Milner, Brigid

    2005-01-01

    Purpose--The purpose of this paper is to investigate the dramatic reforms in the health service in recent years. Design/methodology/approach--Examines management development in health care, and explores the experiences of clinical nurse managers. Findings--Duplication of agencies and multiplication of roles have led to tensions in terms of both…

  11. Management Development in Health Care: Exploring the Experiences of Clinical Nurse Managers

    ERIC Educational Resources Information Center

    Purcell, Laura; Milner, Brigid

    2005-01-01

    Purpose--The purpose of this paper is to investigate the dramatic reforms in the health service in recent years. Design/methodology/approach--Examines management development in health care, and explores the experiences of clinical nurse managers. Findings--Duplication of agencies and multiplication of roles have led to tensions in terms of both

  12. Toward a Conceptual Knowledge Management Framework in Health

    PubMed Central

    Lau, Francis

    2004-01-01

    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

  13. Corporate social responsibility and the future health care manager.

    PubMed

    Collins, Sandra K

    2010-01-01

    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

  14. Dual-Use Aspects of System Health Management

    NASA Technical Reports Server (NTRS)

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

    1994-01-01

    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.

  15. Knowledge Representation and Care Planning for Population Health Management.

    PubMed

    Merahn, Steven

    2015-01-01

    The traditional organizing principles of medical knowledge may be insufficient to allow for problem representations that are relevant to solution development in emerging models of care such as population health management. Operational classification and central management of clinical and quality objectives and associated strategies will allow for productive innovation in care design and better support goal-directed collaboration among patients and their health resource communities. PMID:26665485

  16. Managing risk in a changing health care system.

    PubMed

    Paterson, M A; Wendel, J

    1996-01-01

    This article examines the information requirements and other strategies needed to manage business and financial risk in health care organizations. The business and financial risk of providers in the changing health care market is defined. The major factors that are increasing risk are outlined, and strategies for measuring and managing risk are discussed. The interaction of business and financial risk is described, and strategic goals that will minimize the effect of this interaction are presented. PMID:8777704

  17. Control of paratuberculosis in small ruminants.

    PubMed

    Robbe-Austerman, Suelee

    2011-11-01

    The clinical presentation of paratuberculosis in small ruminants is unthriftiness (poor body condition); severe diarrhea is not a common clinical sign. In the USA, goats are primarily infected with bovine strains of paratuberculosis and sheep are primarily infected with ovine strains. Because ovine strains cannot be easily cultured, confirmation of a diagnosis is best done by polymerase chain reaction on tissue or fecal samples. Control programs must be tailored to the business objectives of the herd/flock owner and primarily involved changes in herd management, with diagnostic testing used strategically. PMID:22023839

  18. Prevalence of Rift Valley Fever among ruminants, Mayotte.

    PubMed

    Cêtre-Sossah, Catherine; Pédarrieu, Aurélie; Guis, Hélène; Defernez, Cédric; Bouloy, Michèle; Favre, Jacques; Girard, Sébastien; Cardinale, Eric; Albina, Emmanuel

    2012-06-01

    Rift Valley fever threatens human and animal health. After a human case was confirmed in Comoros in 2007, 4 serosurveys among ruminants in Mayotte suggested that Rift Valley fever virus had been circulating at low levels since 2004, although no clinical cases occurred in animals. Entomologic and ecologic studies will help determine outbreak potential. PMID:22607651

  19. Measuring adverse selection in managed health care.

    PubMed

    Frank, R G; Glazer, J; McGuire, T G

    2000-11-01

    Health plans paid by capitation have an incentive to distort the quality of services they offer to attract profitable and to deter unprofitable enrollees. We characterize plans' rationing as a "shadow price" on access to various areas of care and show how the profit maximizing shadow price depends on the dispersion in health costs, individuals' forecasts of their health costs, the correlation between use in different illness categories, and the risk adjustment system used for payment. These factors are combined in an empirically implementable index that can be used to identify the services that will be most distorted by selection incentives. PMID:11186848

  20. [Health alert management and emerging risk].

    PubMed

    Pillonel, J

    2010-12-01

    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

  1. Health management system with smart TV using zero-configuration.

    PubMed

    Bae, Sungchul; Kim, Il Kon; Yi, Byoung-kee; Lee, Do-Youn

    2013-01-01

    The health services using mobile devices are available in the world. But mobile services with mobile devices still have Zero configuration problem. If the problem is solved, various services are available. Smart TV has input problem. The service using Smart TV is not yet activated. So In this Study, we propose new health management service using Smart TV using Zero-configuration. PMID:23920944

  2. Managed Mental Health Care: Intentional Misdiagnosis of Mental Disorders

    ERIC Educational Resources Information Center

    Braun, Sharon A.; Cox, Jane A.

    2005-01-01

    In this article, the authors provide an overview of the effectiveness of managed health care systems and their impact on mental health counselors. They review ethical and legal dilemmas involving informed consent, confidentiality, client autonomy, competence, treatment plans, and termination that had not existed prior to the introduction of…

  3. An Examination of Health Information Management by the Deaf

    ERIC Educational Resources Information Center

    Karras, Elizabeth

    2010-01-01

    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…

  4. An Examination of Health Information Management by the Deaf

    ERIC Educational Resources Information Center

    Karras, Elizabeth

    2010-01-01

    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

  5. Software for the occupational health and safety integrated management system

    SciTech Connect

    Vătăsescu, Mihaela

    2015-03-10

    This paper intends to present the design and the production of a software for the Occupational Health and Safety Integrated Management System with the view to a rapid drawing up of the system documents in the field of occupational health and safety.

  6. Protozoal causes of reproductive failure in domestic ruminants.

    PubMed

    Anderson, M L; Barr, B C; Conrad, P A

    1994-11-01

    Protozoan parasites are a significant cause of abortion and infertility in domestic ruminants. Toxoplasma gondii, a widespread cause of abortion in sheep and goats, and Sarcocystis spp., which cause a common, frequently asymptomatic infection of domestic ruminants, both have a two-host life cycle. Carnivorous definitive hosts spread the infection through their feces and domestic ruminants are intermediate hosts. A similar, recently recognized protozoa, Neospora sp., has emerged as an important cause of reproductive disease, especially as an abortifacient in dairy cattle. Neospora is presumed to also have a two-host life cycle, although the definitive host(s) has not been identified. The venereally transmitted Tritrichomonas foetus is an important cause of pregnancy loss in naturally bred cattle throughout the world. In the absence of effective methods for vaccination or treatment, control of these parasites is based on management procedures to reduce infection and transmission. PMID:7728629

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

    PubMed

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

    2004-11-01

    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

  8. Examining the Efficacy of Management for Pennsylvania School Health Programs

    ERIC Educational Resources Information Center

    Jacobi, Wendy J.

    2010-01-01

    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

  9. Integrated healthcare delivery systems: an overview for health information managers.

    PubMed

    Jones-Burns, M

    1997-10-01

    As integrated healthcare delivery systems stake their claims for the future, it is rapidly becoming the health information manager's duty to integrate and manage healthcare data. Read on for a general outlook on the changes surrounding integration activities, from new trends to integration's impact on the profession. PMID:10173202

  10. School Nurse Case Management: Achieving Health and Educational Outcomes

    ERIC Educational Resources Information Center

    Bonaiuto, Maria M.

    2007-01-01

    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

  11. Examining the Efficacy of Management for Pennsylvania School Health Programs

    ERIC Educational Resources Information Center

    Jacobi, Wendy J.

    2010-01-01

    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…

  12. Audit Trail Management System in Community Health Care Information Network.

    PubMed

    Nakamura, Naoki; Nakayama, Masaharu; Nakaya, Jun; Tominaga, Teiji; Suganuma, Takuo; Shiratori, Norio

    2015-01-01

    After the Great East Japan Earthquake we constructed a community health care information network system. Focusing on the authentication server and portal server capable of SAML&ID-WSF, we proposed an audit trail management system to look over audit events in a comprehensive manner. Through implementation and experimentation, we verified the effectiveness of our proposed audit trail management system. PMID:26262379

  13. Decision support systems for health care marketing managers.

    PubMed

    Malhotra, N K

    1989-06-01

    Health care organizations are encouraged to implement decision support systems geared to meeting the challenges of tomorrow. The author outlines a decision support system (DSS) and illustrates its usefulness for health care marketing managers. A schematic representation of a DSS is described. Applications of DSS in strategic marketing and planning, product, promotion, pricing, and distribution decisions are discussed. Potential problems of integrating DSS into the health care organization are identified and some useful guidelines for implementation are offered. PMID:10293671

  14. Health Information Systems Implementation: Review of change management issues

    NASA Astrophysics Data System (ADS)

    Teixeira, Paulo

    It is common for information system projects' implementation to fail. One of the most mentioned reasons is implementation management, particularly the change management during the implementation cycle. This study provides a literature review that aims at supporting this assertion, and identifies some of the most evident issues on the subject. The study highlights the need for new approaches on the Change Management process in the implementation of health information systems.

  15. Health services management manpower and educational needs with American health reform.

    PubMed

    Weil, T P

    1996-05-01

    This paper argues that our previous health services management (HSM) manpower projections may be overly optimistic as the health networks, managed care, capitated payment, and eventually global budgetary targets become the dominant themes to implement cost restraints, universal access, and social equity. HSM programs should, therefore, focus more on their educational pursuits to produce leaders for clinical management teams, who are able to allocate scarce clinical resources. A sensible strategy for HSM programs is to develop closer ties with the schools of medicine, public health, nursing, or allied health. These cooperative efforts would be particularly beneficial in teaching 'clinical-fiscal performance methodologies' to familiarize students with such concepts as clinical benchmarking, managing quality, resource management, and continuous quality improvement (CQI). PMID:10156915

  16. What passes and fails as health policy and management.

    PubMed

    Chinitz, David; Rodwin, Victor G

    2014-10-01

    The field of health policy and management (HPAM) faces a gap between theory, policy, and practice. Despite decades of efforts at reforming health policy and health care systems, prominent analysts state that the health system is "stuck" and that models for change remain "aspirational." We discuss four reasons for the failure of current ideas and models for redesigning health care: (1) the dominance of microeconomic thinking; (2) the lack of comparative studies of health care organizations and the limits of health management theory in recognizing the importance of local contexts; (3) the separation of HPAM from the rank and file of health care, particularly physicians; and (4) the failure to expose medical students to issues of HPAM. We conclude with suggestions for rethinking how the field of HPAM might generate more-promising policies for health care providers and managers by abandoning the illusion of context-free theories and, instead, seeking to facilitate the processes by which organizations can learn to improve their own performance. PMID:25037829

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

    PubMed

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

    2009-09-01

    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

  18. Reusable Rocket Engine Turbopump Health Management System

    NASA Technical Reports Server (NTRS)

    Surko, Pamela

    1994-01-01

    A health monitoring expert system software architecture has been developed to support condition-based health monitoring of rocket engines. Its first application is in the diagnosis decisions relating to the health of the high pressure oxidizer turbopump (HPOTP) of Space Shuttle Main Engine (SSME). The post test diagnostic system runs off-line, using as input the data recorded from hundreds of sensors, each running typically at rates of 25, 50, or .1 Hz. The system is invoked after a test has been completed, and produces an analysis and an organized graphical presentation of the data with important effects highlighted. The overall expert system architecture has been developed and documented so that expert modules analyzing other line replaceable units may easily be added. The architecture emphasizes modularity, reusability, and open system interfaces so that it may be used to analyze other engines as well.

  19. Management of patients with mental health needs.

    PubMed

    Goode, Debbie; Melby, Vidar; Ryan, Assumpta

    2014-09-01

    This article presents findings from the first phase of a two-part study that examined the knowledge and experience of emergency department (ED) staff who work with people with mental health needs. In the first part of the study, 19 semi-structured interviews were conducted with multidisciplinary team (MDT) members and the results were analysed. The interviews covered the ED environment, participants' attitudes towards, ability to communicate with, and knowledge and experience of patients with mental health needs. One of the study's main findings was that MDT members require more appropriate training to raise their awareness of issues related to mental health. The findings informed the development of a questionnaire, which was distributed to a large cohort of ED staff and social workers. PMID:25185925

  20. Reusable rocket engine turbopump health management system

    NASA Astrophysics Data System (ADS)

    Surko, Pamela

    1994-10-01

    A health monitoring expert system software architecture has been developed to support condition-based health monitoring of rocket engines. Its first application is in the diagnosis decisions relating to the health of the high pressure oxidizer turbopump (HPOTP) of Space Shuttle Main Engine (SSME). The post test diagnostic system runs off-line, using as input the data recorded from hundreds of sensors, each running typically at rates of 25, 50, or .1 Hz. The system is invoked after a test has been completed, and produces an analysis and an organized graphical presentation of the data with important effects highlighted. The overall expert system architecture has been developed and documented so that expert modules analyzing other line replaceable units may easily be added. The architecture emphasizes modularity, reusability, and open system interfaces so that it may be used to analyze other engines as well.

  1. Total quality management as a health care corporate strategy.

    PubMed

    Johnson, J A; Omachonu, V K

    1995-01-01

    Total quality management (TQM) must become a part of corporate strategy if it is to become a way of life in health care. TQM should be understood in the context of a cultural transformation. The greatest challenge for top management is to create an organization in which every employee, department and function is linked inextricably to the organization's mission and vision. One of the key benefits of TQM is the use of teams to work on and achieve organizational objectives. Health care managers must understand motivation in order to carry the workforce with them to attain those objectives. PMID:10165402

  2. Health Information Management System for Elderly Health Sector: A Qualitative Study in Iran

    PubMed Central

    Sadoughi, Farahnaz; Shahi, Mehraban; Ahmadi, Maryam; Davaridolatabadi, Nasrin

    2016-01-01

    Background: There are increasing change and development of information in healthcare systems. Given the increase in aging population, managers are in need of true and timely information when making decision. Objectives: The aim of this study was to investigate the current status of the health information management system for the elderly health sector in Iran. Materials and Methods: This qualitative study was conducted in two steps. In the first step, required documents for administrative managers were collected using the data gathering form and observed and reviewed by the researcher. In the second step, using an interview guide, the required information was gathered through interviewing experts and faculty members. The convenience, purposeful and snowball sampling methods were applied to select interviewees and the sampling continued until reaching the data saturation point. Finally, notes and interviews were transcribed and content analysis was used to analyze them. Results: The results of the study showed that there was a health information management system for the elderly health sector in Iran. However, in all primary health care centers the documentation of data was done manually; the data flow was not automated; and the analysis and reporting of data are also manually. Eventually, decision makers are provided with delayed information. Conclusions: It is suggested that the steward of health in Iran, the ministry of health, develops an appropriate infrastructure and finally puts a high priority on the implementation of the health information management system for elderly health sector in Iran. PMID:27186383

  3. The School Health Innovative Programs: integrating school health and managed care in San Diego.

    PubMed

    Taras, H; Nader, P; Swiger, H; Fontanesi, J

    1998-01-01

    Managed care organizations (MCOs) are being recruited to support school health services delivered in school clinics. Schools without clinics already provide numerous health services and could provide more if they had support from managed care organizations. This article describes the first two years of a San Diego-based collaborative consisting of MCOs, school districts, and other health care agencies. By establishing trust, developing overriding principles, and creating an interagency communication infrastructure, this collaborative has encouraged shared management of many student health issues. Because the agreements apply to all schools, programs can reduce high rates of absenteeism district-wide and avoid unnecessary doctor appointments for common health problems. These collaborative agreements are designed to be financially self-sustaining. However, data collection, the logistics of obtaining parental consent, and getting health professionals to communicate with each other in new ways remain to be significant challenges. PMID:9553903

  4. Guidelines for Management Information Systems in Canadian Health Care Facilities

    PubMed Central

    Thompson, Larry E.

    1987-01-01

    The MIS Guidelines are a comprehensive set of standards for health care facilities for the recording of staffing, financial, workload, patient care and other management information. The Guidelines enable health care facilities to develop management information systems which identify resources, costs and products to more effectively forecast and control costs and utilize resources to their maximum potential as well as provide improved comparability of operations. The MIS Guidelines were produced by the Management Information Systems (MIS) Project, a cooperative effort of the federal and provincial governments, provincial hospital/health associations, under the authority of the Canadian Federal/Provincial Advisory Committee on Institutional and Medical Services. The Guidelines are currently being implemented on a “test” basis in ten health care facilities across Canada and portions integrated in government reporting as finalized.

  5. Medicaid enrollment choice into managed care health plans.

    PubMed

    Morton, L W

    1998-06-01

    Rural Aid to Families with Dependent Children (AFDC) Medicaid recipients were surveyed to identify factors that influenced their enrollment choice between two managed care health plans and the traditional Medicaid free-for-service plan. Bivariate and logistic regression analyses provided evidence that the Medicaid institutional information structure directly influenced recipient decision to enroll in managed care plans. Current smokers were more likely to choose a managed care plan in this sample. There was no evidence that health status, health service use patterns, marital status, or ethnicity was related to the enrollment decision. Of those who chose the traditional Medicaid fee-for-service plan, 41 percent reported that they did not understand what managed care was. PMID:9615563

  6. The integration of quality management into chronic disease health services.

    PubMed

    Shayesteh, Sheila Golnaz; Kliewer, Gordon; Morrin, Louise

    2010-01-01

    Quality management strategies can be integrated into health services and processes to evaluate, measure, and improve the health services delivered to patients. Over a 6-month period, Living Well with a Chronic Condition program, a chronic disease management health service, had its support services evaluated and significantly improved, reducing the delays that participants experienced trying to access education and exercise classes. Through the use of quality management tools, including process mapping, performance data collection and evaluation, and participant feedback, the program intake process was improved significantly. Wait times of up to 90 days, with an average of 45 days, were reduced to less than 1 week. Postimprovement measures continued to demonstrate improved service, indicating that involving the staff and participants in quality management strategies can lead to significant optimization of services to participants. PMID:20351542

  7. Investigation of health care waste management in Binzhou District, China

    SciTech Connect

    Ruoyan, Gai; Xu Lingzhong; Li Huijuan; Zhou Chengchao; He Jiangjiang; Yoshihisa, Shirayama; Tang Wei; Chushi, Kuroiwa

    2010-02-15

    In China, national regulations and standards for health care waste management were implemented in 2003. To investigate the current status of health care waste management at different levels of health care facilities (HCF) after the implementation of these regulations, one tertiary hospital, one secondary hospital, and four primary health care centers from Binzhou District were visited and 145 medical staff members and 24 cleaning personnel were interviewed. Generated medical waste totaled 1.22, 0.77, and 1.17 kg/bed/day in tertiary, secondary, and primary HCF, respectively. The amount of medical waste generated in primary health care centers was much higher than that in secondary hospitals, which may be attributed to general waste being mixed with medical waste. This study found that the level of the HCF, responsibility for medical waste management in departments and wards, educational background and training experience can be factors that determine medical staff members' knowledge of health care waste management policy. Regular training programs and sufficient provision of protective measures are urgently needed to improve occupational safety for cleaning personnel. Financing and administrative monitoring by local authorities is needed to improve handling practices and the implementation of off-site centralized disposal in primary health care centers.

  8. Economics, management, and public health nutrition.

    PubMed

    Dahl, T

    1977-02-01

    Research has shown that including a nutritional functional area in comprehensive health care delivery can reduce the total cost per registrant. The savings occur when nutritionists substitute for more costly medical personnel in a team-care setting. Further research has demonstrated that the cost of nutritional care is related to the performance of nutritional staff, i.e., productivity, which may be improved as much as 25 to 70% through simple managerial techniques. The implications for nutritional planning and operations are discussed. Nevertheless, the greatest potential for improving nutritional health rests with the patient himself. Thus, the future orientation in public health nutrition must be directed toward the problems of shifting the major part of the responsibility from the provider to the patient, with accompanying competence in self-care and health maintenance. A promising approach to the idea of greater patient responsibility and autonomy is the so-called Vinland Center concept. Originally developed in Norway, a center incorporating the principles is now being planned in Minnesota and is expected to begin operation in 1979. Funds for the planning effort were given to the U.S. as a Bicentennial gift from Norway. The concept is explained. PMID:402409

  9. Managing Health and Safety in Primary Science

    ERIC Educational Resources Information Center

    Borrows, Peter

    2003-01-01

    Since science in primary schools is very safe, the coordinator's role in respect of health and safety can be a relatively modest one and integrated with other parts of the job. In this article, the author outlines the role of the science coordinator and sources of advice.

  10. The Internet in managed health care.

    PubMed

    Kennedy, C

    1998-01-01

    Blue Shield of California recognized it could realize business gains by implementing solutions that would streamline health care administration. It began looking for opportunities to apply the Internet to the core business and defining which of those services would benefit quickly from implementation. It selected Internet technology from Healtheon Corp., a Silicon Valley startup in Palo Alto, California. PMID:10177285

  11. Governance in managing public health resources in Brazilian municipalities.

    PubMed

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

    2014-09-01

    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

  12. Retention of health workers in Malawi: perspectives of health workers and district management

    PubMed Central

    Manafa, Ogenna; McAuliffe, Eilish; Maseko, Fresier; Bowie, Cameron; MacLachlan, Malcolm; Normand, Charles

    2009-01-01

    Background Shortage of human resources is a major problem facing Malawi, where more than 50% of the population lives in rural areas. Most of the district health services are provided by clinical health officers specially trained to provide services that would normally be provided by fully qualified doctors or specialists. As this cadre and the cadre of enrolled nurses are the mainstay of the Malawian health service at the district level, it is important that they are supported and motivated to deliver a good standard of service to the population. This study explores how these cadres are managed and motivated and the impact this has on their performance. Methods A quantitative survey measured health workers' job satisfaction, perceptions of the work environment and sense of justice in the workplace, and was reported elsewhere. It emerged that health workers were particularly dissatisfied with what they perceived as unfair access to continuous education and career advancement opportunities, as well as inadequate supervision. These issues and their contribution to demotivation, from the perspective of both management and health workers, were further explored by means of qualitative techniques. Focus group discussions were held with health workers, and key-informant interviews were conducted with members of district health management teams and human resource officers in the Ministry of Health. The focus groups used convenience sampling that included all the different cadres of health workers available and willing to participate on the day the research team visited the health facility. The interviews targeted district health management teams in three districts and the human resources personnel in the Ministry of Health, also sampling those who were available and agreed to participate. Results The results showed that health workers consider continuous education and career progression strategies to be inadequate. Standard human resource management practices such as performance appraisal and the provision of job descriptions were not present in many cases. Health workers felt that they were inadequately supervised, with no feedback on performance. In contrast to health workers, managers did not perceive these human resources management deficiencies in the system as having an impact on motivation. Conclusion A strong human resource management function operating at the district level is likely to improve worker motivation and performance. PMID:19638222

  13. ADVANCES IN PLANT HEALTH MANAGEMENT IN THE TWENTIETH CENTURY.

    PubMed

    Cook, R. James

    2000-01-01

    Plant health management is the science and practice of understanding and overcoming the succession of biotic and abiotic factors that limit plants from achieving their full genetic potential as crops, ornamentals, timber trees, or other uses. Although practiced as long as agriculture itself, as a science-based concept, plant heath management is even younger than integrated pest management (IPM), and includes and builds upon but is not a replacement for IPM. Probably the greatest collection of success stories for plant health management is the number of diseases managed by cleaning up the planting material. The record for root health management is more mixed, with the loss or phase-out of soil fumigants, and practices such as crop rotation and clean tillage being replaced with more intensive cropping and less or no tillage. Perhaps the greatest scientific and technical advances for plant health management have come from the work aimed at management of the pathogens, pests, and other hazards that arrive by air. Flor's work on flax rust, which produced the gene-for-gene model, is possibly the most significant contribution of plant pathology to the life sciences in the twentieth century. Research aimed at the management of foliar pathogens is also the basis for modern theory on epidemiology, population biology, aerobiology, and disease prediction and decision-support systems. Even IPM arose mainly in response to the need to protect crops from pests that arrive by air. If the definition of biological control includes the plant induced or genetically modified to defend itself, as it should, then biological control has been the most significant approach to plant health management during the twentieth century and promises through modern biotechnology to be even more significant in the twenty-first century. Rather than "reducing losses," the advances are discussed here within the simple framework of achieving the attainable yield by increasing the actual and/or affordable and hence the average yield. Each of these four benchmark yields, as well as the absolute yield for crops, and their significance to the goals and achievements of plant health management are defined. Plant health management is a moving target, which I discuss metaphorically like an American football game, where one team is science and technology and the other is nature, where the S & T team is only beginning to know nature's rules while playing itself with the three sets of rules written to, respectively, satisfy the laws of economics, protect the environment, and gain social acceptance. PMID:11701838

  14. Health care management. A tool for the future.

    PubMed

    Dees, J P; Taylor, J R

    1990-02-01

    As a result of increasing health care costs in the U.S., the skilled, knowledgeable occupational health nurse can implement a plan to reduce these costs with benefits personnel. Using accepted business principles such as the Deming/Shewart cycle, health data can be obtained from the provider, trends can be analyzed, and strategies can be planned for the population. Health and subsequent costs can be managed through the use of the natural history of disease, the three levels of prevention, occupational health nurses' relationships with people, and their access to confidential data. Short-term strategies should include catastrophic and intermediate case management. These systems ensure results in terms of quality and cost. PMID:2306309

  15. [Population surveys as management tools and health care models].

    PubMed

    Andrade, Flávia Reis de; Narvai, Paulo Capel

    2013-12-01

    The article briefly systematizes health care models, emphasizes the role of population surveys as a management tool and analyzes the specific case of the Brazilian Oral Health Survey (SBBrasil 2010) and its contribution to the consolidation process of health care models consistent with the principles of the Sistema Único de Saúde (SUS, Public Health Care System). While in legal terms SUS corresponds to a health care model, in actual practice the public policy planning and health action, the system gives rise to a care model which is not the result of legal texts or theoretical formulations, but rather the praxis of the personnel involved. Bearing in mind that the management of day-to-day health affairs is a privileged space for the production and consolidation of health care models, it is necessary to stimulate and support the development of technical and operational skills which are different from those required for the management of care related to individual demands. PMID:24626592

  16. Implementing performance management in the Irish Health Sector.

    PubMed

    Byrne, Michael

    2006-01-01

    To realize the goals of successive health strategies, managers in the Irish Health Sector will have to proactively facilitate optimal employee performance in line with policy objectives. Along with developing employee and teams' capabilities, these managers have begun to implement performance management to achieve the latter. However, there typically are a variety of foundational organizational characteristics required for the successful implementation of performance management. These include providing top-down support for line management buy-in, providing ongoing managerial and performance management training so that trusting relationships and a culture of consensus and cooperation are developed, and appropriately managing expectations. Agreement on employee role definitions and provision of team-based conflict resolution training is also needed to facilitate performance management. There is a need for negotiated performance indicators that are of various types, specific, measurable, and aligned with strategy objectives. Associated reward systems need to be holistic and imaginative, and personal development plans need to have a broader focus than merely improving current job skills and performance. Performance review needs to be ongoing, conducted in a transparent manner, and allocated sufficient discussion time. Managers also need to be mindful of managing overperformance. PMID:16699325

  17. Ruminants, climate change and climate policy

    NASA Astrophysics Data System (ADS)

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

    2014-01-01

    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.

  18. Rumination and multi-modal emotional reactivity.

    PubMed

    Hilt, Lori M; Aldao, Amelia; Fischer, Kelsey

    2015-01-01

    Rumination, a cognitive process that involves passively and repetitively focusing on negative feelings and their consequences, has been linked to negative emotional outcomes. Previous research suggests that rumination may lead to deleterious outcomes through prolonging emotional reactivity; however, evidence supporting the link between rumination and reactivity has been mixed. In the present study, we examined the relationship between state and trait rumination and multi-modal emotional reactivity (i.e., hypothalamic-pituitary-adrenal axis, autonomic nervous system, subjective experience). Fifty undergraduates participated in a social evaluative laboratory stressor. They also reported on their general tendency to ruminate and their use of rumination in response to this particular laboratory stressor. State, but not trait, rumination was associated with increases in cortisol and negative affect. Findings underscore the importance of multi-modal assessment of emotional reactivity and suggest important implications for rumination following a stressor. PMID:25506808

  19. The emerging need for transformational leadership in health information management.

    PubMed

    Balloun, J L; Stebbins, L H; Von Bergen, C W

    1995-02-01

    The prospect of national healthcare reform, new clinical and information technologies, and the need to cut the cost of health care delivery are contributing factors in the restructuring of the health care system. In light of these rapid changes and great uncertainties, health information management (HIM) leadership must radically change its style. The appropriate new styles will move the HIM practitioner from the specialized medical records department to a larger, more professional role. The successful transformational leader will help HIM emerge as a central function in the new health care industries. PMID:10140303

  20. Health service integration: a case study in change management.

    PubMed

    Allen, Connie; Stevens, Stella

    2007-05-01

    Health service integration seems a logical and desirable strategy to improve both the efficiency and quality of service delivery. Failure of implementation is common but may not be inevitable. This paper reports on a case study involving structured interviews and focus groups within one health service which has attempted to integrate one area of its acute and community health services. Health service integration was regarded very positively by clinicians and administrators in this case study but the change management process utilised in its implementation was not, suggesting a need for greater planning and transparency. PMID:17470048

  1. Integrated Systems Health Management (ISHM) Toolkit

    NASA Technical Reports Server (NTRS)

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

    2013-01-01

    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.

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

    PubMed

    Antoun, Joseph; Phillips, Frank; Johnson, Tricia

    2011-01-01

    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

  3. Veterinary dairy herd health management in Europe: constraints and perspectives.

    PubMed

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

    2006-03-01

    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 laborious regulations, while still commercially competing with farmers outside the EU and not subject to the same rules. Veterinarians should adapt their knowledge and skills to the new challenges and developments of the dairy sector. Dairy farmers nowadays ask for support in areas that go beyond clinical activities: environmental protection, welfare, nutrition, grassland management, economics and business management. Bovine practitioners should be able to advise in many different areas and subjects--that is the challenge to our profession. Veterinary education with regards to cattle health management should start with individual animal clinical work, which constitutes the basis of herd health advisory programmes. The bovine practitioner should then look beyond that and regard the herd as the unit. Each diseased cow or group of cows should be detected early enough to avoid financial losses or such losses should be prevented altogether by detecting and managing risk factors contributing to disease occurrence. Herd health and production management programmes represent the first level to optimise dairy farm performance. Expansions to that should further be considered, comprising both animal health and welfare issues, as well as food safety and public health issues. The latter could be addressed by quality risk management programmes following the HACCP-principles. Cattle veterinarians should follow recent developments and invest in new skills and knowledge in order to maintain their usefulness to the modern dairy farmer. Finally we are convinced that the cattle practitioner should evolve into this direction, otherwise the veterinarian as we know him will miss the train in the next years. PMID:16605158

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

    PubMed Central

    Weimer, Paul J.

    2015-01-01

    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. PMID:25914693

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

    PubMed

    Weimer, Paul J

    2015-01-01

    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. PMID:25914693

  6. [Nursing and planning in health: management report as an instrument of health planning].

    PubMed

    Farias, Sharon Martins; Beck, Carmem Lúcia Colomé; Colomé, Clara Marques

    2004-01-01

    The involvement of the future nurse in the construction of the Management Report of the Actions of Health of a city in the interior of Rio Grande do Sul was the main objective of this study. The methodological strategy consisted of meetings with coordinators and technicians responsible for the sanitary units, the General Director Group and planning team of the health of the city, participation in the collection of data and elaboration of the related report. The literature revision contemplated: politics of health, a management report as an instrument of health planning, continued education and the role of the nurse on SUS improvement. This work contributed to the improvement of the report of health management, with sights to the planning and implementation of resolute and effective actions. PMID:15603497

  7. Risk management frameworks for human health and environmental risks.

    PubMed

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

    2003-01-01

    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 to change the decision if new information becomes available. Comprehensive and sound principles are critical to providing structure and integrity to risk management frameworks. Guiding principles are intended to provide an ethical grounding for considering the many factors involved in risk management decision making. Ten principles are proposed to guide risk management decision making. The first four principles were adapted and modified from Hattis (1996) along with the addition of two more principles by Hrudey (2000). These have been supplemented by another four principles to make the 10 presented. The principles are based in fundamental ethical principles and values. These principles are intended to be aspirational rather than prescriptive--their application requires flexibility and practical judgement. Risk management is inherently a process in search of balance among competing interests and concerns. Each risk management decision will be "balancing act" of competing priorities, and trade-offs may sometimes have to be made between seemingly conflicting principles. The 10 decision-making principles, with the corresponding ethical principle in italics are: 1. Do more good than harm (beneficence, nonmalificence).- The ultimate goal of good risk management is to prevent or minimize risk, or to "do good" as much as possible. 2. Fair process of decision making (fairness, natural justice). - Risk management must be just, equitable, impartial, unbiased, dispassionate, and objective as far as possible given the circumstances of each situation. 3. Ensure an equitable distribution of risk (equity). - An equitable process of risk management would ensure fair outcomes and equal treatment of all concerned through an equal distribution of benefits and burdens (includes the concept of distributive justice, i.e., equal opportunities for all individuals). 4. Seek optimal use of limited risk management resources (utility). - Optimal risk management demands using limited resources where they will achieve the most risk reduction of overall benefit. 5. Promise no more risk management that can be delivered (honesty).- Unrealistic expectations of risk management can be avoided with honest and candid public accounting of what we know and don't know, and what we can and can't do using risk assessment and risk management. 6. Impose no more risk that you would tolerate yourself (the Golden Rule). - The Golden Rule is important in risk management because it forces decision makers to abandon complete detachment from their decisions so they may understand the perspectives of those affected. 7. Be cautious in the face of uncertainty ("better safe than sorry"). - Risk management must adopt a cautious approach when faced with a potentially serous risk, even if the evidence is uncertain. 8. Foster informed risk decision making for all stakeholders (autonomy). - Fostering autonomous decision making involves both providing people with the opportunity to participate, and full and honest disclosure of all the information required for informed decisions. 9. Risk management processes must be flexible and evolutionary to be open to new knowledge and understanding (evolution, evaluation, iterative process). - The incorporation of new evidence requires that risk management be a flexible, evolutionary, and iterative process, and that evaluation is employed at the beginning and througthout the process. 10. the complete elimination fo risk is not possible (life is not risk free).- Risk is pervasive in our society, and cannot be totally eliminated despite an oft-expressed public desire for "zero risk". However, the level of risk that may ve tolerable by any individual is dependent on values of beliefs, as well as scientific information. Each agency must continue to employ a process that meets the needs of their specific application of risk management. A single approach cannot satisfy the diverse areas to which risk decisions are being applied. However, with increasing experience in the application of the approaches, we are evolving to a common understanding of the essential elements and principles required for successful risk assessment, risk management, and risk communication. Risk management will continue to be a balancing act of competing priorities and needs. Flexibility and good judgement are ultimately the key to successfully making appropriate risk decisions. PMID:14698953

  8. Health@Home: The Work of Health Information Management in the Household (HIMH): Implications for Consumer Health Informatics (CHI) Innovations

    PubMed Central

    Moen, Anne; Brennan, Patricia Flatley

    2005-01-01

    Objective: Contemporary health care places enormous health information management demands on laypeople. Insights into their skills and habits complements current developments in consumer health innovations, including personal health records. Using a five-element human factors model of work, health information management in the household (HIMH) is characterized by the tasks completed by individuals within household organizations, using certain tools and technologies in a given physical environment. Design: We conducted a descriptive-exploratory study of the work of HIMH, involving 49 community-dwelling volunteers from a rural Midwestern community. Measurements: During in-person interviews, we collected data using semistructured questionnaires and photographs of artifacts used for HIMH. Results: The work of HIMH is largely the responsibility of a single individual, primarily engaged in the tasks of acquiring, managing, and organizing a diverse set of health information. Paper-based tools are most common, and residents develop strategies for storing information in the household environment aligned with anticipated use. Affiliative relationships, e.g., parent-child or spousal, within the household serve as the organization that gives rise to health information management practices. Synthesis of these findings led to identification of several storage strategies employed in HIMH. These strategies are labeled “just-in-time,” “just-because,” “just-in-case,” and “just-at-hand,” reflecting location of the artifacts of health information and anticipated urgency in the need to retrieve it. Conclusion: Laypeople develop and employ robust, complex strategies for managing health information in the home. Capitalizing on these strategies will complement and extend current consumer health innovations to provide functional support to people who face increasing demands to manage personal health information. PMID:16049230

  9. Regional governance: strategies and disputes in health region management

    PubMed Central

    dos Santos, Adriano Maia; Giovanella, Ligia

    2014-01-01

    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

  10. Prevalence and consequences of subacute ruminal acidosis in German dairy herds

    PubMed Central

    2013-01-01

    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 < 0,05). Conclusions The study shows 11 out of 26 of herds likely experiencing SARA. Bigger herds tend to be at a higher risk for SARA, while individuals with low ruminal pH tend to be lower in body condition. The study points to the importance of management in preventing SARA. PMID:23805878

  11. An Intelligent Content Discovery Technique for Health Portal Content Management

    PubMed Central

    2014-01-01

    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

  12. Business integration of safety, health and environmental management

    SciTech Connect

    Clement, D.L.; Soemarman, M.

    1996-11-01

    Over the past decade, safety, health and environmental management has become an important part of the strategic focus and direction of most international oil companies. International standards such as SO 9000, the total quality management standards and the soon to be adopted SO 14000 standards concerning environmental management and auditing are increasingly becoming a requirement to being successful in the global market place. This paper examines the processes that CALTEX PACIFIC INDONESIA (CPI) in cooperation with PERTAMINA is using to systematically integrate safety, health and the environment into its business activities as it structures itself to meet the competitive challenges of today and tomorrow. With the recent emergence of safety, health and environmental (SH&E) management systems and the evolution of our total quality management approach to all of our business activities, we embarked on a long range plan to implement state-of-the-art SH&E management systems into all phases of our business. This paper describes the development of a unified SH&E Policy, integration into the business strategic plan, conducting a baseline environmental management systems audit and the ongoing implementation into the processes at the operating level. This paper outlines our organizational structure improvements as the company reorganized itself from a functionally-based organization to a team-based organization Structured around asset value optimization that instills ownership at the field level. The paper explores the alignment of CPI`s management systems to the requirements and intent of several industry approaches as well as SO 14000. The paper concludes that only through a structured SH&E management system approach, in cooperation with all the stakeholders, the shareholders, government and the public, can exemplary safety, health and environmental performance be achieved.

  13. Fundamental Technology Development for Gas-Turbine Engine Health Management

    NASA Technical Reports Server (NTRS)

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

    2007-01-01

    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.

  14. Supporting cancer patients’ unanchored health information management with mobile technology

    PubMed Central

    Klasnja, Predrag; Hartzler, Andrea; Powell, Christopher; Pratt, Wanda

    2011-01-01

    Cancer patients often need to manage care-related information when they are away from home, when they are experiencing pain or treatment side effects, or when their abilities to deal with information effectively are otherwise impaired. In this paper, we describe the results from a four-week evaluation of HealthWeaver Mobile, a mobile phone application that we developed to support such “unanchored” patient information activities. Based on experiences from nine cancer patients, our results indicate that HealthWeaver Mobile can help patients to access care-related information from anywhere, to capture information whenever a need arises, and to share information with clinicians during clinic visits. The enhanced ability to manage information, in turn, helps patients to manage their care and to feel more confident in their ability to stay in control of their information and their health. PMID:22195130

  15. Preserving workers' compensation benefits in a managed health care environment.

    PubMed

    Dembe, A E

    1998-01-01

    Managed care techniques are increasingly being applied in the workers' compensation setting. Many workers, labor representatives and public health advocates fear that the introduction of managed care into workers' compensation may reflect a broader employer-driven campaign to erode benefits, tighten eligibility criteria, and weaken employees' control over health care and compensation issues. The potential threats to workers can be mitigated by involving them in the design of the workers' compensation health plan and selection of provider organization, assuring access to appropriate specialists and diagnostic testing, minimizing delays, increasing accountability through contract provisions and government oversight, and enhancing communications through the use of ombudsmen and alternative dispute resolution approaches. Additional outcomes studies assessing the long-term impact of managed care in workers' compensation are needed. PMID:9670702

  16. Chemical-management policy: prioritizing children's health.

    PubMed

    2011-05-01

    The American Academy of Pediatrics recommends that chemical-management policy in the United States be revised to protect children and pregnant women and to better protect other populations. The Toxic Substance Control Act (TSCA) was passed in 1976. It is widely recognized to have been ineffective in protecting children, pregnant women, and the general population from hazardous chemicals in the marketplace. It does not take into account the special vulnerabilities of children in attempting to protect the population from chemical hazards. Its processes are so cumbersome that in its more than 30 years of existence, the TSCA has been used to regulate only 5 chemicals or chemical classes of the tens of thousands of chemicals that are in commerce. Under the TSCA, chemical companies have no responsibility to perform premarket testing or postmarket follow-up of the products that they produce; in fact, the TSCA contains disincentives for the companies to produce such data. Voluntary programs have been inadequate in resolving problems. Therefore, chemical-management policy needs to be rewritten in the United States. Manufacturers must be responsible for developing information about chemicals before marketing. The US Environmental Protection Agency must have the authority to demand additional safety data about a chemical and to limit or stop the marketing of a chemical when there is a high degree of suspicion that the chemical might be harmful to children, pregnant women, or other populations. PMID:21518722

  17. The Design of Health Care Management Program for Chinese Health Care Professionals

    ERIC Educational Resources Information Center

    Qiu, Xiao Ling

    2008-01-01

    Business education has been booming in China due to the increasing demand of business graduates since China's economic reform. Chinese health care professionals are eager for business education to improve their competencies. The purpose of the study was to investigate the determinants of a successful health care management program for Chinese…

  18. The School Health Innovative Programs: Integrating School Health and Managed Care in San Diego.

    ERIC Educational Resources Information Center

    Taras, Howard; Nader, Philip; Swiger, Holly; Fontanesi, John

    1998-01-01

    Describes the first two years of a San Diego-based collaborative involving managed care organizations (MCO's), school districts, and other health care agencies. By establishing trust, developing overriding principles, and creating an interagency communication infrastructure, this collaborative has encouraged shared management of many student…

  19. Managing Academic Health Centers: Meeting the Challenges of the New Health Care World.

    ERIC Educational Resources Information Center

    Commonwealth Fund, New York, NY.

    This report focuses on strategies documented by the Commonwealth Fund Task Force on Academic Health Centers (AHCs) concerning AHCs' management of patient care and research missions. Whatever challenges AHCs face in the future, their ability to respond effectively will be determined by the quality of their governance and management. To improve…

  20. Behavioral health and managed care contracting under SCHIP.

    PubMed

    Rosenbaum, Sara; Sonosky, Colleen; Shaw, Karen; Mauery, D Richard

    2002-09-01

    This Policy Brief examines behavioral health managed care contracting under separately administered State Children's Health Insurance Programs (SCHIP), i.e., programs that operate under the direct authority of Title XXI of the Social Security Act rather than as expansions of Medicaid. Most separate SCHIP programs buy managed care style health insurance for some or most of their enrolled children. Because Title XXI provides states with far greater administrative flexibility than Medicaid with respect to coverage and benefit design, provision of services, and administration of managed care arrangements,studying separate SCHIP managed care products sheds important light on how states might approach insurance and managed care design generally in the area of behavioral health were Medicaid modified through section 1115 demonstration or federal statutory authority to permit greater latitude. To conduct this analysis, two nationwide databases maintained by the George Washington University Center for Health Services Research and Policy (CHSRP) were used: a database consisting of all Medicaid MCO-style managed care contracts in use in Calendar Year 2000; and a nationwide database consisting of contracts used by separate SCHIP programs for the same calendar year. As of the point of collection in 2000 there were 33 such separate programs; according to CMS' latest website information, that total has now reached 35. Both sets of contracts were analyzed and separated into their components by lawyers experienced in managed care contract analysis and interpretation. The data were entered into working tables that organize the contents of the contracts into a series of searchable domains. PMID:12542079

  1. Alternative futures for health economics: implications for nursing management.

    PubMed

    Mannion, Russell; Small, Neil; Thompson, Carl

    2005-09-01

    As nursing has been subject to successive waves of 'managerialism' there has been a drive on the part of government and elements within the profession to enhance the science base and promote cost-effective health care interventions. This has generated new interest in the 'economics of nursing' as efficiency and 'value for money' are viewed as necessary precondition for the provision of a high quality nursing service. As an academic subject health economics has brought an elegant set of theories to bear on the topic of health and health care. However, mainstream health economics is premised on a series of simplifying assumptions that, if applied uncritically, can induce a range of unintended and adverse consequences. This paper asks how ideas developed in one sphere (health economics) can be become influential in another (nursing management and practice) and it seeks explanations in the theories of Michel Foucault, specifically in his exploration of the reciprocal relationship between power and knowledge. How are our assumptions about what is possible and desirable shaped, how far do mechanisms of surveillance and self-subjugation extend? A range of alternative economic approaches have been developed which challenge many mainstream health economics assumptions. Some of these are better suited to the complex social environment present within health care. Nurses, nurse managers and researchers should question the assumptions of dominant economic models and explore a range of economic frameworks when planning services and evaluating their practice. PMID:16108775

  2. Balancing Management and Leadership in Complex Health Systems

    PubMed Central

    Kwamie, Aku

    2015-01-01

    Health systems, particularly those in low- and middle-income countries (LMICs), need stronger management and leadership capacities. Management and leadership are not synonymous, yet should be considered together as there can be too much of one and not enough of the other. In complex adaptive health systems, the multiple interactions and relationships between people and elements of the system mean that management and leadership, so often treated as domains of the individual, are additionally systemic phenomena, emerging from these relational interactions. This brief commentary notes some significant implications for how we can support capacity strengthening interventions for complex management and leadership. These would necessarily move away from competency-based models focused on training for individuals, and would rather encompass longer-term initiatives explicitly focused on systemic goals of accountability, innovation, and learning. PMID:26673472

  3. 75 FR 54627 - Best Management Practices for Unused Pharmaceuticals at Health Care Facilities

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-08

    ... AGENCY Best Management Practices for Unused Pharmaceuticals at Health Care Facilities AGENCY... guidance document entitled, Best Management Practices for Unused Pharmaceuticals at Health Care Facilities... been studying unused pharmaceutical disposal practices at health care facilities, prompted by...

  4. Ruminant thiamine requirement in perspective.

    PubMed

    Edwin, E E; Jackman, R

    1982-05-01

    Thiaminases play an important role in the aetiology of CCN being responsible for the state of thiamine-deficiency which is an essential feature of the disease, evidence for which is presented here. These studies have led to a greater appreciation of the role of thiamine and thiaminases in ruminant nutrition especially as ruminal thiaminase activity is not confined to clinically affected animals but is of wider distribution. The importance of thiaminases in intensive beef production and the possibility of the need for thiamine supplementation in the form of a thiaminase resistant derivative is discussed. PMID:7051526

  5. The health-care manager's guide to managing change in challenging times.

    PubMed

    Lombardi, D N

    1996-01-01

    Fifteen years ago, Bill Gates was a college dropout working for a four-member, fledgling company in New Mexico. Today, he is the richest man in America and the head of perhaps the most powerful company in recent corporate history. Ten years ago, managed health care was merely a concept discussed in academic and industry observer circles. Now it is a norm in almost every health-care organization nationally. Five years ago, health-care professionals in every discipline believed the maxim that, ¿as long as people get sick, health-care professionals will have jobs.¿ In 1995, health-care executives have alternately referred to the widescale process of laying off employees as reengineering, rightsizing, downsizing, or RIF (reduction in force). With this massive amount of change, both societally and professionally, health-care managers have been contending with the change management process. Although a breadth of concepts borrowed from other industries and a plethora of conceptual practicums have entered the health-care educational realm, a straightforward, immediately useful approach to managing change is probably more beneficial, as the need to manage change quickly and effectively becomes the paramount criterion for health-care management success in the second half of this decade of change. In this article we will explore the four areas where mistakes are made most frequently by leaders in the change process, and we will provide specific strategies to not only avoid these mistakes but moreover reduce resistance to change, activate positive action, and ultimately improve performance through optimum staff contribution. The four critical areas we will explore are the reasons for resistance to change, the management of the proactive phase of change, creating staff interdependence, and key leadership roles for change management. PMID:10154378

  6. SSFF Health Management Analysis Report. Part 2: Proof of Concept

    NASA Technical Reports Server (NTRS)

    Wilson, L.; Spruill, J.; Hong, Y.

    1995-01-01

    In this Proof of Concept analysis on SSFF Health Management the following area was described: the Gas Distribution Subsystem (GDS) was studied and evaluated utilizing the PDR Configuration and with respect to the design features encompassing Health Management (HM) aspects outlined in the Generic Handbook. From the results of this study, it was found that there is a definite need for coordinating measurements within and between the subsystems that will ensure that Functional Failures are properly revealed and substantiated as valid by other measurements, even those from other interfacing subsystems.

  7. Health management and controls for earth to orbit propulsion systems

    NASA Technical Reports Server (NTRS)

    Bickford, R. L.

    1992-01-01

    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.

  8. Competencies for health management practice: a practitioner's perspective.

    PubMed

    Wenzel, F J; Grady, R; Freedman, T J

    1995-01-01

    The current health care environment will require executive leadership with a new set of management competencies to effectively lead and manage the various components of a restructured health care delivery system. The traditional management skills of planning, organizing, directing, controlling, and staffing resources will remain relevant, but the true measure of professional success will be the development of conceptual skills. This means the ability to look at the health care enterprise as a whole, and recognize how changes in the environment shape your strategic mission, goals, and objectives. The successful health care leader will have a demonstrated ability to apply these conceptual skills to the development of information systems and integrated networks that position their organization to accept capitated risks. This paper examines the United States and Canadian health care systems from the perspective of both the more traditional hospital and the emerging medical care organizations. New importance of the team approach to leadership and management and all that entails is stressed. PMID:10156840

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

    PubMed Central

    Alberti, Philip

    2014-01-01

    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. PMID:25848631

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

    PubMed Central

    2010-01-01

    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

  11. Human resource management in the health care industry.

    PubMed

    Siddiqui, J; Kleiner, B H

    1998-01-01

    Human resource management practices with special reference to the latest developments of the 1990s such as environmental effects and managing diversity, were investigated. The purpose of the study was to unveil how the health care industry can benefit from these new concepts, as well as to describe how the traditional health care facilities can adapt these new ideas. Specific examples were provided to illustrate this point. In compilation of this report, both primary and secondary research was used. As primary research, many reputable individuals in the health care industry were consulted, and asked to comment on the rough draft of this report. Secondary sources included many journal articles, original researches and books that were written on this technical subject. It can be concluded from this research, that the health care industry should adapt the latest methods to compete and survive, such as use more marketing tools to attract human resource management personnel from other industries, promote diversity at the work place, promote from within the company, and cross-train personnel whenever possible. Health care industry has generally lagged behind other industries in securing high-performance individuals and marketing personnel; however, with the development of health maintenance organizations, this trend is changing. PMID:10346316

  12. The transfer of a health insurance/managed care business.

    PubMed

    Gavin, John N; Goodman, George; Goroff, David B

    2007-01-01

    The owners of a health insurance/managed care business may want to sell that business for a variety of reasons. Health care provider systems may want to exit that business due to operating losses, difficulty in complying with regulations, the inherent conflict in operating that business as part of a provider system, or the desire to focus on being a health care provider. Health insurers/HMOs may want to sell all or a portion of their business due to operating losses, difficulty in servicing a particular market, or a desire to focus on other markets. No matter what reason prompts a seller to undertake a sale, a sale of health insurance/managed care business can be a complicated transaction involving a multitude of issues. This article will focus first on the ways in which such a sale may be structured. The article will then discuss some transactional issues that may arise in the negotiations for the sale of a health insurance/managed care business. The article will then focus on some particular legal issues that arise in each sale-e.g., antitrust, HIPAA, regulatory approvals, and charitable issues. Finally, this article will provide an overview of tax structuring considerations. PMID:18972991

  13. Rumination and Performance in Dynamic, Team Sport

    PubMed Central

    Roy, Michael M.; Memmert, Daniel; Frees, Anastasia; Radzevick, Joseph; Pretz, Jean; Noël, Benjamin

    2016-01-01

    People high in rumination are good at tasks that require persistence whereas people low in rumination is good at tasks that require flexibility. Here we examine real world implications of these differences in dynamic, team sport. In two studies, we found that professional male football (soccer) players from Germany and female field hockey players on the US national team were lower in rumination than were non-athletes. Further, low levels of rumination were associated with a longer career at a higher level in football players. Results indicate that athletes in dynamic, team sport might benefit from the flexibility associated with being low in rumination. PMID:26779110

  14. Rumination and Performance in Dynamic, Team Sport.

    PubMed

    Roy, Michael M; Memmert, Daniel; Frees, Anastasia; Radzevick, Joseph; Pretz, Jean; Noël, Benjamin

    2015-01-01

    People high in rumination are good at tasks that require persistence whereas people low in rumination is good at tasks that require flexibility. Here we examine real world implications of these differences in dynamic, team sport. In two studies, we found that professional male football (soccer) players from Germany and female field hockey players on the US national team were lower in rumination than were non-athletes. Further, low levels of rumination were associated with a longer career at a higher level in football players. Results indicate that athletes in dynamic, team sport might benefit from the flexibility associated with being low in rumination. PMID:26779110

  15. Evaluating the impact of the Management Academy for Public Health: developing entrepreneurial managers and organizations.

    PubMed

    Umble, Karl E; Orton, Stephen; Rosen, Benson; Ottoson, Judith

    2006-01-01

    The Management Academy for Public Health is a management development program with the goals of helping public health managers learn to manage people, data, and finance, to think and plan like entrepreneurs, and to strengthen public health organizations. Managers enroll as teams and develop business plans in the Academy's extensive project-based learning component. Extensive internal and external evaluation shows that the program improves managers' knowledge, skills, and confidence in key curriculum areas; that participants apply many of the skills in their jobs; that many of the business plans receive funding, resulting in new public health programs; that the training experience helped agencies respond and plan after September 11, 2001; and that many participants report beginning to think more like entrepreneurs through activities like teaming, partnering, innovating, negotiating, finding funds, and generating revenue. The program demonstrates that robust training including extensive work-based project work with coaching can help public health managers gain many skills needed for the drive to "reinvent" government. PMID:16912605

  16. Commercial Aircraft Integrated Vehicle Health Management Study

    NASA Technical Reports Server (NTRS)

    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

    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.

  17. Continuity in health care: lessons from supply chain management.

    PubMed

    Meijboom, Bert R; Bakx, Saskia J W G C; Westert, Gert P

    2010-01-01

    In health care, multidisciplinary collaboration is both indispensable and complicated. We discuss organizational problems that occur in situations where multiple health care providers are required to cooperate for patients with complex needs. Four problem categories, labelled as communication, patient safety, waiting times and integration are distinguished. Then we develop a supply chain perspective on these problems in the sense of discussing remedies according to supply chain management (SCM) literature. This perspective implies a business focus on inter-organizational conditions and requirements necessary for delivering health care and cure across organizational borders. We conclude by presenting some strategic and policy recommendations. PMID:21069770

  18. Pathophysiological evaluation of subacute ruminal acidosis (SARA) by continuous ruminal pH monitoring.

    PubMed

    Sato, Shigeru

    2016-02-01

    Evaluation of the radio-transmission pH-measurement system for monitoring the ruminal pH and subacute ruminal acidosis (SARA) in cattle is described. This is done in order to reveal the possible application of this system for detection and pathophysiological research of SARA by continuous ruminal pH measurement. The possibility of using this system for assessment of the ruminal pH in SARA cattle, and the presence of negative correlation between the ruminal pH and ruminal temperature in heathy and SARA cattle were determined. In addition, the 16S rRNA gene pyrosequencing analysis showed that the ruminal microbial community was simpler in SARA cattle, and the bacterial numbers in SARA cattle were lower than those in healthy hay-fed cattle. Concentrate feeding might have reduced the diversity of the ruminal microbial community. Changes in the ruminal microbial community of SARA cattle might be related to the changes in ruminal pH followed by the decrease in the number of some bacteria. Continuous monitoring of the ruminal pH using the radio-transmission pH-measurement system would be applied for detection and prevention of SARA in the field and pathophysiological research of SARA, including ruminal zymology and bacteriology, which have been determined previously by sampling of the ruminal fluid and measuring of ruminal pH. PMID:26279060

  19. Understanding and managing the health needs of veterans.

    PubMed

    Fullwood, Danielle

    2015-11-01

    Military service has many possible consequences for an individual's health. However, the health needs of veterans are not well understood by healthcare professionals. A veteran may present with overlapping symptoms of mental and physical ill health. Problems such as hazardous levels of alcohol consumption and aggressive behaviour may be evident alongside anxiety, depression, post-traumatic stress disorder, chronic pain and disfigurement. Female veterans may present with other complex health issues, such as military sexual trauma. The author suggests that pre-registration curricula for all healthcare professionals should include learning on veterans as a vulnerable patient group. Primary care settings often have first contact with veterans and their families, and every new patient should be asked about their employment history. Collaboration between healthcare professions is vital in assessing and managing the health needs of veterans. PMID:26530591

  20. Management of mental health problems by general practitioners in Quebec

    PubMed Central

    Fleury, Marie-Josée; Farand, Lambert; Aubé, Denise; Imboua, Armelle

    2012-01-01

    Abstract Objective To document the management of mental health problems (MHPs) by general practitioners. Design A mixed-method study consisting of a self-administered questionnaire and qualitative interviews. An analysis was also performed of Régie de l’assurance maladie du Québec administrative data on medical procedures. Setting Quebec. Participants Overall, 1415 general practitioners from different practice settings were invited to complete a questionnaire; 970 general practitioners were contacted. A subgroup of 60 general practitioners were contacted to participate in interviews. Main outcome measures The annual frequency of consultations over MHPs, either common (CMHPs) or serious (SMHPs), clinical practices, collaborative practices, factors that either support or interfere with the management of MHPs, and recommendations for improving the health care system. Results The response rate was 41% (n = 398 general practitioners) for the survey and 63% (n = 60) for the interviews. Approximately 25% of visits to general practitioners are related to MHPs. Nearly all general practitioners manage CMHPs and believed themselves competent to do so; however, the reverse is true for the management of SMHPs. Nearly 20% of patients with CMHPs are referred (mainly to psychosocial professionals), whereas nearly 75% of patients with SMHPs are referred (mostly to psychiatrists and emergency departments). More than 50% of general practitioners say that they do not have any contact with resources in the mental health field. Numerous factors influence the management of MHPs: patients’ profiles (the complexity of the MHP, concomitant disorders); individual characteristics of the general practitioner (informal network, training); the professional culture (working in isolation, formal clinical mechanisms); the institutional setting (multidisciplinarity, staff or consultant); organization of services (resources, formal coordination); and environment (policies). Conclusion The key role played by general practitioners and their support of the management of MHPs were evident, especially for CMHPs. For more optimal management of primary mental health care, multicomponent strategies, such as shared care, should be used more often. PMID:23242904

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

    PubMed Central

    Bednarz, Daniel; Bae, Jaeyong; Pierce, Jessica

    2011-01-01

    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

  2. Training evaluation: a case study of training Iranian health managers

    PubMed Central

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

    2009-01-01

    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

  3. Adapting and using quality management methods to improve health promotion.

    PubMed

    Becker, Craig M; Glascoff, Mary A; Felts, William Michael; Kent, Christopher

    2015-01-01

    Although the western world is the most technologically advanced civilization to date, it is also the most addicted, obese, medicated, and in-debt adult population in history. Experts had predicted that the 21st century would be a time of better health and prosperity. Although wealth has increased, our quest to quell health problems using a pathogenic approach without understanding the interconnectedness of everyone and everything has damaged personal and planetary health. While current efforts help identify and eliminate causes of problems, they do not facilitate the creation of health and well-being as would be done with a salutogenic approach. Sociologist Aaron Antonovsky coined the term salutogenesis in 1979. It is derived from salus, which is Latin for health, and genesis, meaning to give birth. Salutogenesis, the study of the origins and creation of health, provides a method to identify an interconnected way to enhance well-being. Salutogenesis provides a framework for a method of practice to improve health promotion efforts. This article illustrates how quality management methods can be used to guide health promotion efforts focused on improving health beyond the absence of disease. PMID:25777291

  4. PHYLOGENETIC ANALYSIS OF RUMINANT RHADINOVIRUSES

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Seven new rhadinoviruses were identified in a variety of ruminants, namely domestic sheep, goats, bighorn sheep, bison, oryx, black-tailed deer and elk, which represent a second distinct subgroup. No association with disease has yet been found for this subgroup. The genetic relationships of these ...

  5. Acute phase proteins in ruminants.

    PubMed

    Ceciliani, F; Ceron, J J; Eckersall, P D; Sauerwein, H

    2012-07-19

    The physiological response to infections and injuries involves local inflammation and the initiation of events leading to a systemic response, also called acute phase reaction (APR). This multiplicity of changes is distant from the site of injury, and includes fever, leukocytosis and quantitative and qualitative modification of a group of non-structurally related proteins present in blood and other biological fluids, collectively named Acute Phase Proteins (APP). Proteomic investigations of serum or plasma following natural or experimental infection frequently reveal substantial alterations in the APP, several of which are high abundance proteins in these fluids. The present review will focus on the results of recent research on ruminant APP. Highlight points will include: - The structure and the functions of the main APPs in ruminants, as well as the regulatory mechanisms that trigger their systemic and local expression in both physiological and pathological conditions.- The clinical aspects of APPs in ruminants, including the current and future application to veterinary diagnosis and animal production.- The APP in small and wildlife ruminants.- Alteration in APP detected by proteomic investigations. PMID:22521269

  6. 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...

  7. Emergency mental health management in bioterrorism events.

    PubMed

    Benedek, David M; Holloway, Harry C; Becker, Steven M

    2002-05-01

    The United States has not suffered significant psychosocial or medical consequences from the use of biological weapons within its territories. This has contributed to a "natural" state of denial at the community level. This denial could amplify the sense of crisis, anxiety, fear, chaos, and disorder that would accompany such a bioterrorist event. A key part of primary prevention involves counteracting this possibility before an incident occurs. Doing so will require realistic information regarding the bioterrorism threat followed by the development of a planned response and regular practice of that response. Unlike in natural disasters or other situations resulting in mass casualties, emergency department physicians or nurses and primary care physicians (working in concert with epidemiologic agencies), rather than police, firemen, or ambulance personnel, will be most likely to first identify the unfolding disaster associated with a biological attack. Like community leaders, this group of medical responders must be aware of its own susceptibility to mental health sequelae and performance decrement as the increasing demands of disaster response outpace the availability of necessary resources. A bioterrorist attack will necessitate treatment of casualties who experience neuropsychiatric symptoms and syndromes. Although symptoms may result from exposure to infection with specific biological agents, similar symptoms may result from the mere perception of exposure or arousal precipitated by fear of infection, disease, suffering, and death. Conservative use of psychotropic medications may reduce symptoms in exposed and uninfected individuals, as may cognitive-behavioral interventions. Clear, consistent, accessible, reliable, and redundant information (received from trusted sources) will diminish public uncertainty about the cause of symptoms that might otherwise prompt persons to seek unnecessary treatment. Training and preparation for contingencies experienced in an attack have the potential to enhance delivery of care. Initiating supportive social, psychotherapeutic, and psychopharmacologic treatments judiciously for symptoms and syndromes known to accompany the traumatic stress response can aid the efficient treatment of some patients and reduce long-term morbidity in affected individuals. Preventive strategies and planning must take into account the idea that specific groups within the population are at higher risk for psychiatric morbidity. First responders comprise one group at psychologic risk in this situation, and healthcare providers comprise another. These and other high-risk groups will benefit from the same supportive interventions developed for the community as a whole. PMID:12120485

  8. Health Promotion, Disability Management, and Rehabilitation in the Workplace.

    ERIC Educational Resources Information Center

    Galvin, Donald E.

    1986-01-01

    This article discusses industry-based efforts to improve the quality of work life through various methods including health promotion programs; early intervention and disability management; and rehabilitation of industrially injured workers. Program models in each of these areas are described. (CB)

  9. School Nurse Case Management: Achieving Health and Educational Outcomes

    ERIC Educational Resources Information Center

    Bonaiuto, Maria M.

    2007-01-01

    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…

  10. Outcomes Assessment in Accredited Health Information Management Programs

    ERIC Educational Resources Information Center

    Bennett, Dorine

    2010-01-01

    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,

  11. Institutional Values of Managed Mental Health Care: Efficiency or Oppression?

    ERIC Educational Resources Information Center

    Wilcoxon, S. Allen; Magnuson, Sandy; Norem, Ken

    2008-01-01

    The authors suggest that many managed mental health care (MMHC) practices have oppressive effects on members of cultural and ethnic minority groups. They examine the dissonance between institutional practices and cultural traditions that reflect insensitivity and forced conformity, particularly regarding time, pace, and intervention uniformity as…

  12. Outcomes Assessment in Accredited Health Information Management Programs

    ERIC Educational Resources Information Center

    Bennett, Dorine

    2010-01-01

    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,…

  13. Teaching Classroom Management-- A Potential Public Health Intervention?

    ERIC Educational Resources Information Center

    Marlow, Ruth; Hansford, Lorraine; Edwards, Vanessa; Ukoumunne, Obioha C; Norman, Shelley; Ingarfield, Sara; Sharkey, Siobhan; Logan, Stuart; Ford, Tamsin

    2015-01-01

    Purpose: The purpose of this paper is to explore the feasibility of a classroom management course as a public health intervention. Improved socio-emotional skills may boost children's developmental and academic trajectory, while the costs of behaviour problems are enormous for schools with considerable impact on others' well-being.…

  14. 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...

  15. [Health agencies and the every day management of bioethics].

    PubMed

    Byk, Christian

    2014-06-01

    Taking into account their acquired experience, would not health agencies become the place where biomedical practices will be managed on an every day basis? Would in a near future these agencies have the role to interprete the principles of the bioethics law to adapt them to concrete issues? PMID:25272796

  16. A 2015 Medical Informatics Perspective on Health and Clinical Management: Will Cloud and Prioritization Solutions Be the Future of Health Data Management?

    PubMed Central

    Conchon, E.

    2015-01-01

    Summary Objectives Summarize current excellent research and trends in the field of Health and Clinical management. Methods Synopsis of the articles selected for the IMIA Yearbook 2015 Results Three papers from international peer-reviewed journals have been selected for the Health and Clinical Management section. Conclusion Telemedicine is still very active in Health and clinical management, but the new tendencies on which we focus this year were firstly the introduction of cloud for health data management, with some specific security problems, and secondly an emerging expectation of prioritization tools in health care Management. PMID:26293850

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

    PubMed Central

    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

    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

  18. [Ongoing Health Education in Brazil:education or ongoing management?].

    PubMed

    Lemos, Cristiane Lopes Simão

    2016-03-01

    The scope of this study was to analyze the concept and principles of Ongoing Health Education (OHE) - the Brazilian acronym is PNEPS. The methodology was based on the analysis of documents from the Ministry of Health and related scientific articles. It was revealed that the concept of OHE transcends its pedagogical significance and is undergoing a service restructuring process in the face of the new demands of the model. Precisely at the time in which jobs are increasingly unstable and precarious, the Ministry of Health engages in discourse regarding innovative management, focusing on the issue of OHE. The idea is not one of ongoing education, but of ongoing management. Rather than being an instrument for radical transformation, OHE becomes an attractive ideology due to its appearance as a pedagogical novelty. PMID:26960103

  19. Critical systems for public health management of floods, North Dakota.

    PubMed

    Wiedrich, Tim W; Sickler, Juli L; Vossler, Brenda L; Pickard, Stephen P

    2013-01-01

    Availability of emergency preparedness funding between 2002 and 2009 allowed the North Dakota Department of Health to build public health response capabilities. Five of the 15 public health preparedness capability areas identified by the Centers for Disease Control and Prevention in 2011 have been thoroughly tested by responses to flooding in North Dakota in 2009, 2010, and 2011; those capability areas are information sharing, emergency operations coordination, medical surge, material management and distribution, and volunteer management. Increasing response effectiveness has depended on planning, implementation of new information technology, changes to command and control procedures, containerized response materials, and rapid contract procedures. Continued improvement in response and maintenance of response capabilities is dependent on ongoing funding. PMID:23348522

  20. Nature experience reduces rumination and subgenual prefrontal cortex activation.

    PubMed

    Bratman, Gregory N; Hamilton, J Paul; Hahn, Kevin S; Daily, Gretchen C; Gross, James J

    2015-07-14

    Urbanization has many benefits, but it also is associated with increased levels of mental illness, including depression. It has been suggested that decreased nature experience may help to explain the link between urbanization and mental illness. This suggestion is supported by a growing body of correlational and experimental evidence, which raises a further question: what mechanism(s) link decreased nature experience to the development of mental illness? One such mechanism might be the impact of nature exposure on rumination, a maladaptive pattern of self-referential thought that is associated with heightened risk for depression and other mental illnesses. We show in healthy participants that a brief nature experience, a 90-min walk in a natural setting, decreases both self-reported rumination and neural activity in the subgenual prefrontal cortex (sgPFC), whereas a 90-min walk in an urban setting has no such effects on self-reported rumination or neural activity. In other studies, the sgPFC has been associated with a self-focused behavioral withdrawal linked to rumination in both depressed and healthy individuals. This study reveals a pathway by which nature experience may improve mental well-being and suggests that accessible natural areas within urban contexts may be a critical resource for mental health in our rapidly urbanizing world. PMID:26124129

  1. Nature experience reduces rumination and subgenual prefrontal cortex activation

    PubMed Central

    Bratman, Gregory N.; Hamilton, J. Paul; Hahn, Kevin S.; Daily, Gretchen C.; Gross, James J.

    2015-01-01

    Urbanization has many benefits, but it also is associated with increased levels of mental illness, including depression. It has been suggested that decreased nature experience may help to explain the link between urbanization and mental illness. This suggestion is supported by a growing body of correlational and experimental evidence, which raises a further question: what mechanism(s) link decreased nature experience to the development of mental illness? One such mechanism might be the impact of nature exposure on rumination, a maladaptive pattern of self-referential thought that is associated with heightened risk for depression and other mental illnesses. We show in healthy participants that a brief nature experience, a 90-min walk in a natural setting, decreases both self-reported rumination and neural activity in the subgenual prefrontal cortex (sgPFC), whereas a 90-min walk in an urban setting has no such effects on self-reported rumination or neural activity. In other studies, the sgPFC has been associated with a self-focused behavioral withdrawal linked to rumination in both depressed and healthy individuals. This study reveals a pathway by which nature experience may improve mental well-being and suggests that accessible natural areas within urban contexts may be a critical resource for mental health in our rapidly urbanizing world. PMID:26124129

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

    PubMed

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

    2014-09-01

    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

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

    NASA Astrophysics Data System (ADS)

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

    2012-12-01

    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.

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

    PubMed

    Grossmeier, Jessica; Terry, Paul E; Anderson, David R; Wright, Steven

    2012-06-01

    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

  5. Integrated approach for managing health risks at work--the role of occupational health nurses.

    PubMed

    Marinescu, Luiza G

    2007-02-01

    Currently, many organizations are using a department-centered approach to manage health risks at work. In such a model, segregated departments are providing employee benefits such as health insurance, workers' compensation, and short- and long-term disability or benefits addressing work-life issues. In recent years, a new model has emerged: health and productivity management (HPM). This is an employee-centered, integrated approach, designed to increase efficiency, reduce competition for scarce resources, and increase employee participation in prevention activities. Evidence suggests that corporations using integrated HPM programs achieve better health outcomes for their employees, with consequent increased productivity and decreased absenteeism. Occupational health nurses are well positioned to assume leadership roles in their organizations by coordinating efforts and programs across departments that offer health, wellness, and safety benefits. To assume their role as change agents to improve employees' health, nurses should start using the language of business more often by improving their communication skills, computer skills, and ability to quantify and articulate results of programs and services to senior management. PMID:17323873

  6. Organizing and managing care in a changing health system.

    PubMed Central

    Kohn, L T

    2000-01-01

    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

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

    PubMed Central

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

    2014-01-01

    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 minute before, and 1, 10, 20, 60, and 120 minutes 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=.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

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

    PubMed

    Lynch, Tim; Cox, Paul

    2006-01-01

    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

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

    SciTech Connect

    Al-Khatib, Issam A. Sato, Chikashi

    2009-08-15

    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.

  10. Characterizing the Ruminative Process in Young Adolescents

    PubMed Central

    Hilt, Lori M.; Pollak, Seth D.

    2014-01-01

    Objective Rumination involves repeatedly and passively dwelling on negative feelings and brooding about their causes and consequences. Prior work has found that rumination predicts many forms of psychopathology including anxiety, binge eating, binge drinking, self-injury, and especially depression (Nolen-Hoeksema, Wisco, & Lyubomirsky, 2008). In the present study, we attempt to characterize the ruminative process in real time in young adolescents, specifically by examining factors that predict rumination following an interpersonal stressor. Method A community sample of 105 youth ages 9-14 (70% girls; 66% Caucasian) completed questionnaires regarding depressive symptoms and trait rumination along with an assessment of selective attention using an emotional faces dot-probe task. Participants then underwent an interpersonal stressor and audio rumination induction in the laboratory during which time thoughts were sampled regularly and coded. Results Results indicate that negative self-referential thought is a common response to the stressor and is predicted by trait rumination scores. While most participants were able to disengage from this type of thinking, 10.5% persisted through (i.e., ruminated) until the end of the study. These individuals were characterized by higher depressive symptoms and an attentional bias away from happy (relative to neutral) faces. Conclusions Differences in attentional processes may characterize rumination in youth. Implications for the measurement of rumination as well as treatment are discussed. PMID:23477416

  11. Characterizing the ruminative process in young adolescents.

    PubMed

    Hilt, Lori M; Pollak, Seth D

    2013-01-01

    Rumination involves repeatedly and passively dwelling on negative feelings and brooding about their causes and consequences. Prior work has found that rumination predicts many forms of psychopathology including anxiety, binge eating, binge drinking, self-injury, and especially depression (Nolen-Hoeksema, Wisco, & Lyubomirsky, 2008 ). In the present study, we attempt to characterize the ruminative process in real time in young adolescents, specifically by examining factors that predict rumination following an interpersonal stressor. A community sample of 105 youth ages 9 to 14 (70% girls; 66% Caucasian) completed questionnaires regarding depressive symptoms and trait rumination along with an assessment of selective attention using an emotional faces dot-probe task. Participants then underwent an interpersonal stressor and audio rumination induction in the laboratory during which time thoughts were sampled regularly and coded. Results indicate that negative self-referential thought is a common response to the stressor and is predicted by trait rumination scores. Although most participants were able to disengage from this type of thinking, 10.5% persisted through (i.e., ruminated) until the end of the study. These individuals were characterized by higher depressive symptoms and an attentional bias away from happy (relative to neutral) faces. Differences in attentional processes may characterize rumination in youth. Implications for the measurement of rumination as well as treatment are discussed. PMID:23477416

  12. Quality and cost-effective management of mental health care.

    PubMed

    Burton, W N; Hoy, D A; Bonin, R L; Gladstone, L

    1989-04-01

    Corporations have reduced their mental health care benefits by limits on coverage for such services. We report on a comprehensive mental health care program, including prevention and early intervention, hospital utilization review, and consulting psychiatrist, which has improved the quality and has significantly reduced inpatient insurance psychiatric hospitalization costs. Mental health service coverage was actually enhanced. Inpatient psychiatric hospitalization costs 12 months before and after the implementation of a concurrent psychiatric hospital utilization review program were reviewed for a major corporation. Total hospital days and average length of stay decreased by 43% whereas total inpatient psychiatric hospital charges decreased by $309,518. Total inpatient days decreased by 1045. Quality and cost-effective comprehensive psychiatric health care services can be offered by major corporations providing that such benefits are carefully designed and managed. PMID:2715844

  13. Good practice in health, environment and safety management in enterprise.

    PubMed

    Michalak, J

    2001-01-01

    Good practice in health, environment and safety management in enterprise (GP HESME) is a process that aims at continuous improvement in health, environment and safety performance, involving all stakeholders within and outside the enterprise. This WHO program is supported by other international organizations, and the declaration of Ministers of Health and Ministers of Environment adopted in 1999. The basic issues of the GP HESME concept are presented as well as its prerequisites, benefits and participants. The key partners in GP HESME are employers and their organizations, representatives of employees, governmental agencies, local authorities, financial and insurance institutions, occupational health services, environmental and social services, associations of professionals, research and training institutions. The HESME system is intended to function at different levels: international, national, local community, and enterprise settings. The lists of expected benefits for each group of stakeholders are discussed. Evaluation of GP HESME is based on the criteria and indicators, the most important of them are briefly presented. PMID:11428254

  14. Social work management in emerging health care systems.

    PubMed

    Kenney, J J

    1990-02-01

    An overview of the health care industry's trend toward multihealth systems is presented and specific adaptive strategies for social work managers in health care are suggested. The challenges to social work leaders during this transition from largely free-standing, privately owned health care institutions to corporately owned, horizontally and vertically integrated delivery systems are discussed in terms of identity, style, and substance. Directors of social work departments in multihealth corporations will need to resolve issues of institutional versus corporate identity as well as those of corporate versus professional identity. A multioptional management style that incorporates networking and political expertise should be cultivated. Substantive demands in the areas of management information systems, productivity, quality assurance, and budgeting also must be addressed. The emergence of multihealth systems poses major challenges and unique opportunities to the social work profession. Awareness of managerial strategies and critical content areas can help social work leaders enhance the role and contribution of social work in these exciting and complex health care delivery systems. PMID:2318461

  15. [Mastitis management in Swiss dairy farms with udder health problems].

    PubMed

    Kretzschmar, L; van den Borne, B H P; Kaufmann, T; Reist, M; Strabel, D; Harisberger, M; Steiner, A; Bodmer, M

    2013-08-01

    The objective of this study was to describe the udder health management in Swiss dairy herds with udder health problems. One hundred dairy herds with a yield-corrected somatic cell count of 200'000 to 300'000 cells/ml during 2010 were selected. Data concerning farm structure, housing system, milking technique, milking procedures, dry-cow and mastitis management were collected during farm visits between September and December 2011. In addition, quarter milk samples were collected for bacteriological culturing from cows with a composite somatic cell count ≥ 150'000 cells/ml. The highest quarter level prevalence was 12.3 % for C. bovis. Eighty-two percent of the pipeline milking machines in tie-stalls and 88 % of the milking parlours fulfilled the criteria for the vacuum drop, and only 74 % of the pipeline milking machines met the criteria of the 10-l-water test. Eighty-five percent of the farms changed their milk liners too late. The correct order of teat preparation before cluster attachment was carried out by 37 % of the farmers only. With these results, Swiss dairy farmers and herd health veterinarians can be directed to common mistakes in mastitis management. The data will be used for future information campaigns to improve udder health in Swiss dairy farms. PMID:23919972

  16. Open source electronic health records and chronic disease management

    PubMed Central

    Goldwater, Jason C; Kwon, Nancy J; Nathanson, Ashley; Muckle, Alison E; Brown, Alexa; Cornejo, Kerri

    2014-01-01

    Objective To study and report on the use of open source electronic health records (EHR) to assist with chronic care management within safety net medical settings, such as community health centers (CHC). Methods and Materials The study was conducted by NORC at the University of Chicago from April to September 2010. The NORC team undertook a comprehensive environmental scan, including a literature review, a dozen key informant interviews using a semistructured protocol, and a series of site visits to CHC that currently use an open source EHR. Results Two of the sites chosen by NORC were actively using an open source EHR to assist in the redesign of their care delivery system to support more effective chronic disease management. This included incorporating the chronic care model into an CHC and using the EHR to help facilitate its elements, such as care teams for patients, in addition to maintaining health records on indigent populations, such as tuberculosis status on homeless patients. Discussion The ability to modify the open-source EHR to adapt to the CHC environment and leverage the ecosystem of providers and users to assist in this process provided significant advantages in chronic care management. Improvements in diabetes management, controlled hypertension and increases in tuberculosis vaccinations were assisted through the use of these open source systems. Conclusions The flexibility and adaptability of open source EHR demonstrated its utility and viability in the provision of necessary and needed chronic disease care among populations served by CHC. PMID:23813566

  17. [Health locus of control of patients in disease management programmes].

    PubMed

    Schnee, M; Grikscheit, F

    2013-06-01

    Health locus of control beliefs plays a major role in improving self-management skills of the chronically ill - a main goal in disease management programmes (DMP). This study aims at characterising participants in disease management regarding their health locus of control. Data are based on 4 cross-sectional postal surveys between spring and autumn of 2006 and 2007 within the Health Care Monitor of the Bertelsmann Foundation. Among the 6 285 respondents, 1 266 are chronically ill and not enrolled in a DMP and 327 are participating in a DMP. A high internal locus of control (HLC) occurs significantly less often in DMP patients than in normal chronically ill patients (and healthy people) controlling for age, gender and social class. With increasing age, a high internal locus of control is also significantly less likely. When comparing healthy people, the chronically ill and the DMP participants a social gradient of a high internal locus of control belief can be observed. The weaker internal and higher doctor-related external locus of control of DMP participants should be carefully observed by the physician when trying to strengthen the patients' self-management skills. Evaluators of DMP should take into account the different baselines of DMP patients and relevant control groups and incorporate these differences into the evaluation. PMID:22864845

  18. A knowledge management tool for public health: health-evidence.ca

    PubMed Central

    2010-01-01

    Background The ultimate goal of knowledge translation and exchange (KTE) activities is to facilitate incorporation of research knowledge into program and policy development decision making. Evidence-informed decision making involves translation of the best available evidence from a systematically collected, appraised, and analyzed body of knowledge. Knowledge management (KM) is emerging as a key factor contributing to the realization of evidence-informed public health decision making. The goal of health-evidence.ca is to promote evidence-informed public health decision making through facilitation of decision maker access to, retrieval, and use of the best available synthesized research evidence evaluating the effectiveness of public health interventions. Methods The systematic reviews that populate health evidence.ca are identified through an extensive search (1985-present) of 7 electronic databases: MEDLINE, EMBASE, CINAHL, PsycINFO, Sociological Abstracts, BIOSIS, and SportDiscus; handsearching of over 20 journals; and reference list searches of all relevant reviews. Reviews are assessed for relevance and quality by two independent reviewers. Commonly-used public health terms are used to assign key words to each review, and project staff members compose short summaries highlighting results and implications for policy and practice. Results As of June 2010, there are 1913 reviews in the health-evidence.ca registry in 21 public health and health promotion topic areas. Of these, 78% have been assessed as being of strong or moderate methodological quality. Health-evidence.ca receives approximately 35,000 visits per year, 20,596 of which are unique visitors, representing approximately 100 visits per day. Just under half of all visitors return to the site, with the average user spending six minutes and visiting seven pages per visit. Public health nurses, program managers, health promotion workers, researchers, and program coordinators are among the largest groups of registered users, followed by librarians, dieticians, medical officers of health, and nutritionists. The majority of users (67%) access the website from direct traffic (e.g., have the health-evidence.ca webpage bookmarked, or type it directly into their browser). Conclusions Consistent use of health-evidence.ca and particularly the searching for reviews that correspond with current public health priorities illustrates that health-evidence.ca may be playing an important role in achieving evidence-informed public health decision making. PMID:20718970

  19. Zoonotic risks from small ruminants.

    PubMed

    Ganter, M

    2015-12-14

    Zoonoses are infections that spread naturally between species (sometimes by a vector) from animals to other animal species or to humans or from humans to animals. Most of the zoonoses diagnosed in sheep and goats are transmitted by close contact of man with these animals and are, more often, occupational diseases that principally affect breeders, veterinarians and/or slaughterhouse workers. Some other diseases have an airborne transmission and affect the population in the vicinity of sheep/goat farms. Due to the fact that small ruminants are almost the only remaining animals which are migrating in industrialised countries, there is a severe risk for transmitting the diseases. Some other zoonotic diseases are foodborne diseases, which are mainly transmitted from animals to humans and to other animal species by contaminated food and water. Within the last decade central Europe was threatened by some new infections, e.g., bluetongue disease and schmallenberg disease, which although not of zoonotic interest, are caused by pathogens transmitted by vectors. Causal agents of both diseases have found highly effective indigenous vectors. In the future, climate change may possibly modify conditions for the vectors and influence their distribution and competence. By this, other vector-borne zoonotic infections may propagate into former disease free countries. Changes in human behaviour in consummation and processing of food, in animal housing and management may also influence future risks for zoonosis. Monitoring, prevention and control measures are proposed to limit further epidemics and to enable the containment of outbreaks. Measures depend mainly on the damage evoked or anticipated by the disease, the local situation, and the epidemiology of the zoonoses, the presence of the infective agent in wild and other animals, as well as the resistance of the causal microorganisms in the environment and the possibility to breed sheep and goats which are resistant to specific infections. In this review, the clinical signs in animals and humans of the main sheep and goat zoonoses, as well as the transmission route and the control measures are reported. Brucellosis, chlamydophilosis, Q fever, Orf, Rift valley fever and Bovine Spongiform Encephalopathy are described in greater detail, in order to determine factors that contribute to the choice of the control strategies. PMID:26275853

  20. Managing patients with high-deductible health plans and health savings accounts.

    PubMed

    Weaver, Catherine M

    2009-01-01

    High-deductible health plans and health savings accounts have many patients and providers mutually mystified. It is very important for providers and their staff to understand and manage these emerging products. If the current growth rate of enrollment in these plans continues, 25% of your patients will be presenting with this coverage in fewer than six years. Mishandling these products can cause unnecessary cash flow issues, but a little proactivity, education, and training now, will go a long way. PMID:19743709

  1. Managing workplace depression: an untapped opportunity for occupational health professionals.

    PubMed

    Putnam, Kelly; McKibbin, Laura

    2004-03-01

    Depression is one of the most prevalent and costly health issues affecting the American work force. Despite well established research demonstrating the association between employee depression and reduced on-the-job productivity, increased absenteeism, and higher health care use, most employers remain largely unresponsive to the need for company based depression initiatives. Organizational and individual barriers can prevent companies from effectively managing employee depression. Organizational barriers include information gaps, lack of data to justify increased investment in employee mental health programs, and employers' ambiguous roles in addressing depression. Individual barriers such as an inability to recognize signs and symptoms; stigma; confidentiality and privacy concerns; and unavailability of easily accessible, quality resources can keep employees who are depressed from seeking treatment. Many occupational health professionals may feel ill prepared or uncomfortable taking the lead in creating more aggressive worksite responses to depression, but they are, perhaps, in the best of all possible positions within an organization to succeed. Occupational health professionals have the credentials, credibility, training, and experience necessary to build a strong case for business leaders for why investing in workplace depression programs is so important. Occupational health professionals are the most qualified to design and deliver destigmatized, customer friendly programs and services for employees to access for help with depression, and to integrate their services with other departments such as benefits, health promotion, EAP, and human resources, to create an effective, organization-wide depression initiative. PMID:15068103

  2. Does social anxiety predict rumination and co-rumination among adolescents?

    PubMed

    Jose, Paul E; Wilkins, Holly; Spendelow, Jason S

    2012-01-01

    Social anxiety in adolescence is manifested by anxiety about and avoidance of social interactions. The present study examined whether social anxiety predicts higher levels of both rumination and co-rumination over time. Rumination and co-rumination were studied as possible outcomes because the cognitive content of these processes often involves interpersonal concerns. A three-wave longitudinal study of 575 adolescents (aged 13-16 years old) was conducted over 6 months. Adolescent girls reported higher levels of social anxiety, rumination, and co-rumination than boys. Structural equation modelling analysis showed that social anxiety directly predicted higher levels of rumination and indirectly predicted higher levels of co-rumination over time. A gender difference was noted in that these relationships were more robust for girls than for boys. PMID:22233248

  3. How AIDS funding strengthens health systems: progress in pharmaceutical management.

    PubMed

    Embrey, Martha; Hoos, David; Quick, Jonathan

    2009-11-01

    In recent years, new global initiatives responding to the AIDS crisis have dramatically affected-and often significantly improved-how developing countries procure, distribute, and manage pharmaceuticals. A number of developments related to treatment scale-up, initially focused on AIDS-related products, have created frameworks for widening access to medicines for other diseases that disproportionally impact countries with limited resources and for strengthening health systems overall. Examples of such systems strengthening have come in the areas of drug development and pricing; policy and regulation; pharmaceutical procurement, distribution, and use; and management systems, such as for health information and human resources. For example, a hospital in South Africa developed new tools to decentralize provision of antiretroviral therapy to local clinics-bringing treatment closer to patients and shifting responsibility from scarce pharmacists to lower level pharmacy staff. Successful, the system was expanded to patients with other chronic conditions, such as mental illness. Progress toward universal access to HIV prevention, treatment, care, and support will continue the push to strengthen pharmaceutical sectors that serve not only HIV-related needs but all health needs; health experts can likely take these achievements further to maximize their expansion into the wider health system. PMID:19858936

  4. The health plan choices of retirees under managed competition.

    PubMed Central

    Buchmueller, T C

    2000-01-01

    OBJECTIVE: To investigate the effect of price on the health insurance decisions of Medicare-eligible retirees in a managed competition setting. DATA SOURCE: The study is based on four years of administrative data from the University of California (UC) Retiree Health Benefits Program, which closely resembles the managed competition model upon which several leading Medicare reform proposals are based. STUDY DESIGN: A change in UC's premium contribution policy between 1993 and 1994 created a unique natural experiment for investigating the effect of price on retirees' health insurance decisions. This study consists of two related analyses. First, I estimate the effect of changes in out-of-pocket premiums between 1993 and 1994 on the decision to switch plans during open enrollment. Second, using data from 1993 to 1996, I examine the extent to which rising premiums for fee-for-service Medigap coverage increased HMO enrollment among Medicare-eligible UC retirees. PRINCIPLE FINDINGS: Price is a significant factor affecting the health plan decisions of Medicare-eligible UC retirees. However, these retirees are substantially less price sensitive than active UC employees and the non-elderly in other similar programs. This result is likely attributable to higher nonpecuniary switching costs facing older individuals. CONCLUSIONS: Although it is not clear exactly how price sensitive enrollees must be in order to generate price competition among health plans, the behavioral differences between retirees and active employees suggest that caution should be taken in extrapolating from research on the non-elderly to the Medicare program. PMID:11130806

  5. Applying total quality management concepts to public health organizations.

    PubMed Central

    Kaluzny, A D; McLaughlin, C P; Simpson, K

    1992-01-01

    Total quality management (TQM) is a participative, systematic approach to planning and implementing a continuous organizational improvement process. Its approach is focused on satisfying customers' expectations, identifying problems, building commitment, and promoting open decision-making among workers. TQM applies analytical tools, such as flow and statistical charts and check sheets, to gather data about activities within an organization. TQM uses process techniques, such as nominal groups, brainstorming, and consensus forming to facilitate communication and decision making. TQM applications in the public sector and particularly in public health agencies have been limited. The process of integrating TQM into public health agencies complements and enhances the Model Standards Program and assessment methodologies, such as the Assessment Protocol for Excellence in Public Health (APEX-PH), which are mechanisms for establishing strategic directions for public health. The authors examine the potential for using TQM as a method to achieve and exceed standards quickly and efficiently. They discuss the relationship of performance standards and assessment methodologies with TQM and provide guidelines for achieving the full potential of TQM in public health organizations. The guidelines include redefining the role of management, defining a common corporate culture, refining the role of citizen oversight functions, and setting realistic estimates of the time needed to complete a task or project. PMID:1594734

  6. Managed competition in health care and the unfinished agenda

    PubMed Central

    Enthoven, Alain C.

    1986-01-01

    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

  7. Health crises and media relations: relationship management-by-fire.

    PubMed

    Springston, Jeffrey K; Weaver-Lariscy, Ruthann

    2007-01-01

    Media relations is an important function in the operation of any health organization, yet it is often relegated as a simple task function. Such an orientation can be problematic, particularly in times of crisis. This article provides an overview of some of the inherent internal conflicts within health organizations that may mitigate against the best media relations practices in times of crises. The article surveys some of the predominant theoretical models used for crisis management, and suggests directions for the further development of media relations and crisis communication theory and practice. PMID:19042529

  8. Health Policy and Management: in praise of political science

    PubMed Central

    Hunter, David J

    2015-01-01

    Health systems have entered a third era embracing whole systems thinking and posing complex policy and management challenges. Understanding how such systems work and agreeing what needs to be put in place to enable them to undergo effective and sustainable change are more pressing issues than ever for policy-makers. The theory-policy-practice-gap and its four dimensions, as articulated by Chinitz and Rodwin, is acknowledged. It is suggested that insights derived from political science can both enrich our understanding of the gap and suggest what changes are needed to tackle the complex challenges facing health systems. PMID:26029899

  9. Stress and microbial endocrinology: prospects for ruminant nutrition.

    PubMed

    Freestone, P; Lyte, M

    2010-07-01

    The feed efficiency of ruminant meat and dairy livestock can be significantly influenced by factors within their living environments. In particular, events perceived by the animals as stressful (such as parturition, transport or handling) have been found to affect susceptibility to infection. It has been well documented that even minor stress such as weighing can result in an increase in colonisation and faecal shedding of enteric pathogens such as Salmonella enterica and Escherichia coli O157:H7. Such infections affect both ruminant overall health and therefore performance, and are a particular problem for the meat production industries. Prior explanations for stress enhancing the likelihood of infection is that activation of the sympathetic nervous system under stress leads to the release of neuroendocrine mediators such as the catecholamine stress hormones noradrenaline and adrenaline, which may impair innate and adaptive immunity. More recently, however, another equally compelling explanation, viewed through the lens of the newly recognised microbiological discipline of microbial endocrinology is that the myriad of bacteria within the ruminant digestive tract are as responsive to the hormonal output of stress as the cells of their host. Work from our laboratories has shown that enteric pathogens have evolved systems for directly sensing stress hormones. We have demonstrated that even brief exposure of enteric pathogens to physiological concentrations of stress hormones can result in massive increases in growth and marked changes in expression of virulence factors such as adhesins and toxins. Happy, less stressed ruminants may therefore be better-nourished animals and safer sources of meat. This article reviews evidence that stress, as well as affecting nutrition, in ruminants is correlated with increased risk of enteric bacterial infections, and examines the molecular mechanisms that may be at work in both processes. PMID:22444620

  10. An Agile Enterprise Regulation Architecture for Health Information Security Management

    PubMed Central

    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

    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

  11. An agile enterprise regulation architecture for health information security management.

    PubMed

    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

    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

  12. Managed competition and consumer price sensitivity in social health insurance.

    PubMed

    Schut, Frederik T; Hassink, Wolter H J

    2002-11-01

    This paper examines whether the introduction of managed competition in Dutch social health insurance has resulted in effective price competition among insurance funds. We find evidence of limited price competition, which may be caused by low consumer price sensitivity. Using aggregate panel data from all insurance funds over the period 1996-1998, estimated premium elasticities of market share are -0.3 for compulsory coverage and -0.8 for supplementary coverage. These elasticities are much smaller than in managed competition settings in US group insurance. This may be explained by differences in switching experience and higher search costs associated with individual insurance. PMID:12475123

  13. Managing patients with high-deductible health plans and health savings accounts: part 2.

    PubMed

    Weaver, Catherine M

    2009-01-01

    High-deductible health plans and health savings accounts have many patients and providers mutually mystified. It is very important for providers and their staff to understand and manage these emerging products that are becoming more common. This article examines a case study of a family of four with these products. The case study shows the reader the number of moving parts as well as how quickly the patient liability can increase faster than the funds in the health savings account. Mishandling these products can cause unnecessary cash flow issues, but a little pro-activity, education, and training now will go a long way. PMID:19911550

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

    PubMed Central

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

    2014-01-01

    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

  15. Opportunities for Launch Site Integrated System Health Engineering and Management

    NASA Technical Reports Server (NTRS)

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

    2005-01-01

    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.

  16. A method for optimizing integrated system health management

    NASA Astrophysics Data System (ADS)

    Jambor, Bruno; Rouch, Robin L.; Eger, George W.; Black, Stephen T.

    1996-03-01

    The cost of operating the existing fleet of launch vehicles, both expendable and reusable, is too high. The high cost is attributable to two primary sources: people-intensive checkout procedures and delayed launches. This latter has cost impacts on both launch procedures and other launch operations through ripple-down effects. Without significant changes in how the launch vehicle community does business, the next generation of vehicles shall be burdened by the same high costs. By integrating system health management into the next generation, Reusable Launch Vehicle (RLV) operations costs can be reduced. A method for optimizing Integrated System Health Management (ISHM) is being developed under a cooperative agreement between NASA and Lockheed Martin Corporation (LMC). This paper describes the work currently underway at LMC. ISHM shall be implemented on the prototype vehicle X-33 in order to demonstrate its usefulness for RLV.

  17. Analytical concepts for health management systems of liquid rocket engines

    NASA Technical Reports Server (NTRS)

    Williams, Richard; Tulpule, Sharayu; Hawman, Michael

    1990-01-01

    Substantial improvement in health management systems performance can be realized by implementing advanced analytical methods of processing existing liquid rocket engine sensor data. In this paper, such techniques ranging from time series analysis to multisensor pattern recognition to expert systems to fault isolation models are examined and contrasted. The performance of several of these methods is evaluated using data from test firings of the Space Shuttle main engines.

  18. Candidate technologies for the Integrated Health Management Program

    NASA Technical Reports Server (NTRS)

    Johnson, Neal F.; Martin, Fred H.

    1993-01-01

    The purpose of this report is to assess Vehicle Health Management (VHM) technologies for implementation as a demonstration. Extensive studies have been performed to determine technologies which could be implemented on the Atlas and Centaur vehicles as part of a bridging program. This paper discusses areas today where VHM can be implemented for benefits in reliability, performance, and cost reduction. VHM Options are identified and one demonstration is recommended for execution.

  19. Complexity of ruminant masticatory evolution.

    PubMed

    Fraser, Danielle; Rybczynski, Natalia

    2014-10-01

    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

  20. Snout Shape in Extant Ruminants

    PubMed Central

    Tennant, Jonathan P.; MacLeod, Norman

    2014-01-01

    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

  1. Transmissible spongiform encephalopathies in ruminants.

    PubMed

    Tyler, Jeff W; Middleton, John R

    2004-07-01

    Transmissible spongiform encephalopathies (TSEs) have been observed in North American sheep, cervidae, and cattle. The causative agent of TSEs seems to be proteins that induce a conformational change in normal host proteins. Common clinical signs ofTSEs include chronic weight loss and deteriorating neurologic function. Mechanisms of TSE transmission vary among host species. The diagnostic approach for TSEs of ruminants is presented,and the history and justification of regulatory programs to control and eradicate TSEs are outlined. PMID:15203228

  2. IVHM Framework for Intelligent Integration for Vehicle Health Management

    NASA Technical Reports Server (NTRS)

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

    2005-01-01

    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.

  3. [Development of a Crisis Management Manual for Occupational Health Experts].

    PubMed

    Matsuoka, Juri; Tateishi, Seiichiro; Igarashi, Yu; Ide, Hiroshi; Miyamoto, Toshiaki; Hara, Tatsuhiko; Kobashi, Masaki; Inoue, Megumi; Kawashima, Megumi; Okada, Takeo; Mori, Koji

    2015-12-01

    When crises such as natural disasters or industrial accidents occur in workplaces, not only the workers who are injured, but also those who engage in emergency or recovery work may be exposed to various health hazards. We developed a manual to enable occupational health (OH) experts to prevent health hazards. The manual includes detailed explanations of the characteristics and necessary actions for each need in the list of "OH Needs During Crisis Management" developed after an analysis of eight cases in our previous research. We changed the endings of explanatory sentences so that users could learn how often each need occurred in these eight cases. We evaluated the validity of the manual using two processes: 1) Providing the manual to OH physicians during an industrial accident; 2) Asking crisis management experts to review the manual. We made improvements based on their feedback and completed the manual. The manual includes explanations about 99 OH needs, and users can learn how and what to do for each need during various crisis cases. Because additional OH needs may occur in other crises, it is necessary to collect information about new cases and to improve the comprehensiveness of the manual continuously. It is critical that this crisis management manual be available when a crisis occurs. We need to inform potential users of the manual through various media, as well as by posting it on our website. PMID:26667194

  4. Toxicology of sulfur in ruminants: review

    SciTech Connect

    Kandylis, K.

    1984-10-01

    This review deals with the toxicology of sulfur in ruminants including toxicity, neurotoxic effects, and mechanism of toxic action of hydrogen sulfide, clinical signs, and treatment. It will report effects of excessive intake of sulfur by ruminants on feed intake, animal performance, ruminal digestion and motility, rumination, and other physiological functions. Poisoning of animals with sulfur from industrial emissions (sulfur dioxide) also is discussed. Excessive quantities of dietary sulfur (above .3 to .4%) as sulfate or elemental sulfur may cause toxic effects and in extreme cases can be fatal. The means is discussed whereby consumption of excessive amounts of sulfur leads to toxic effects. 53 references, 1 table.

  5. Role of Ayurveda in management of oral health.

    PubMed

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

    2014-01-01

    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

  6. [Methodological approaches to developing programs on children's health management].

    PubMed

    Nasybullina, G M; Makarov, E N; Polzik, E V; Kazanatsev, V S; Borisova, M N; Balakova, N V

    2002-01-01

    The development of specific plants of action to manage the health of different population groups should be based on the results of pilot studies whose purpose is to obtain information that is useful and understandable for decision makers. To improve the health of children living in the town of Gai, Orenburg Region, which is one of the most pressing problems for the town, 100 potential risk factors of frequent diseases among preschool children were analyzed. It has been shown that the frequent occurrence of diseases may be due to the influence of a complex of biomedical and sociohygienic factors. The use of multifactorial analysis permits one not only to assess a role of each factor, but to predict the effectiveness of different preventive measures. The findings yielded a scientifically grounded interdepartmental program for children's health improvement. PMID:12494573

  7. Role of Ayurveda in management of oral health

    PubMed Central

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

    2014-01-01

    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

  8. Emergency planning and management in health care: priority research topics

    PubMed Central

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

    2014-01-01

    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

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

    PubMed

    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

    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

  10. An innovative national health care waste management system in Kyrgyzstan.

    PubMed

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

    2015-02-01

    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

  11. Family management of a chronic health condition: perspectives of adolescents.

    PubMed

    Wollenhaupt, Josanne; Rodgers, Beth; Sawin, Kathleen J

    2012-02-01

    A growing number of adolescents and their families are dealing with a chronic health condition that impacts their daily life. Research using the Family Management Style Framework (FMSF) has added much to our understanding of how the family integrates chronic condition management into family life. Less clear, however, is the adolescent perspective of the FMSF components. The purpose of this secondary qualitative analysis was to explore 25 interviews of adolescents with spina bifida to uncover the adolescent's perspective of the three major FMSF components: Definition of the Situation, Management Behaviors, and Perceived Consequences. Adolescents were able to articulate their perspectives and their observations of their parents' behaviors that related to the three components and related dimensions of the framework. Data from this analysis led to proposed expansion of the FMSF definitions from an adolescent perspective. Implications for integrating the adolescent perspective into future research and clinical practice are discussed. PMID:22184753

  12. Managing corporate governance risks in a nonprofit health care organization.

    PubMed

    Troyer, Glenn T; Brashear, Andrea D; Green, Kelly J

    2005-01-01

    Triggered by corporate scandals, there is increased oversight by governmental bodies and in part by the Sarbanes-Oxley Act of 2002. Corporations are developing corporate governance compliance initiatives to respond to the scrutiny of regulators, legislators, the general public and constituency groups such as investors. Due to state attorney general initiatives, new legislation and heightened oversight from the Internal Revenue Service, nonprofit entities are starting to share the media spotlight with their for-profit counterparts. These developments are changing nonprofit health care organizations as well as the traditional role of the risk manager. No longer is the risk manager focused solely on patients' welfare and safe passage through a complex delivery system. The risk manager must be aware of corporate practices within the organization that could allow the personal objectives of a few individuals to override the greater good of the community in which the nonprofit organization serves. PMID:20200865

  13. Management of Frontotemporal Dementia in Mental Health and Multidisciplinary Settings

    PubMed Central

    Wylie, Mary Anne; Shnall, Adriana; Onyike, Chiadi U.; Huey, Edward D.

    2014-01-01

    Diagnosis of frontotemporal dementia (FTD) in the mental health setting and issues pertaining to longitudinal care of this population in a specialty clinic are reviewed. FTD is often misdiagnosed as a psychiatric disorder, most commonly as a mood disorder. FTD has features that overlap with those of major depression, mania, obsessive-compulsive disorder and schizophrenia. We describe these features and how to differentiate FTD from these psychiatric disorders. This paper also describes practical issues in the management of FTD, specifically the issues that clinicians, patients and their families face in managing this disease. Areas of clinical care along the continuum are explored; FTD care involves collaborative management of symptoms and disability, and assisting patients and families in adapting to the disease. PMID:23611352

  14. An integrated approach to worker self-management and health outcomes: chronic conditions, evidence-based practice, and health coaching.

    PubMed

    Miller, Colleen

    2011-11-01

    Employee health, prevention, and maintenance programs are growing exponentially each year as costs continue to rise across the health care continuum. Employers and payers alike continue to be challenged by chronic health risks, effective prevention strategies, optimal health and wellness strategies, and programs that are effective for America's work force. In light of these challenges, new and exciting health management approaches are evolving. Changes in occupational health nursing practice can ultimately affect the way occupational health nurses plan, structure, and conduct education sessions. New trends, such as health coaching, embrace the incorporation of health research through evidence-based practice and standards of care to provide the science clinicians need to support interventions. Through knowledge of chronic conditions, evidence-based practice, and health coaching, occupational health nurses possess the skills and strategies that form the foundation necessary to affect and safely guide employee self-discovery and self-management and produce optimal health outcomes. PMID:22045011

  15. Laboratory medicine and mobile health technologies at crossroads: Perspectives for the management of chronic diseases.

    PubMed

    Gruson, Damien; Ko, Gabriel

    2016-10-01

    Management of chronic diseases represents a leading health and economic issue worldwide. Biomarkers are critical for the diagnosis and management of both communicable and non-communicable chronic diseases, and mobile health (mHealth) technologies are about to change the "game" with regard to the management of patients with such chronic diseases. The development of efficient, accurate and interactive solutions that integrate biomarkers and mHealth opens new perspectives for caregivers for the management of chronic illness. PMID:26983900

  16. 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

    Rastorfer, Darl

    2011-01-01

    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…

  17. Balancing Management and Leadership in Complex Health Systems Comment on "Management Matters: A Leverage Point for Health Systems Strengthening in Global Health".

    PubMed

    Kwamie, Aku

    2015-01-01

    Health systems, particularly those in low- and middle-income countries (LMICs), need stronger management and leadership capacities. Management and leadership are not synonymous, yet should be considered together as there can be too much of one and not enough of the other. In complex adaptive health systems, the multiple interactions and relationships between people and elements of the system mean that management and leadership, so often treated as domains of the individual, are additionally systemic phenomena, emerging from these relational interactions. This brief commentary notes some significant implications for how we can support capacity strengthening interventions for complex management and leadership. These would necessarily move away from competency-based models focused on training for individuals, and would rather encompass longer-term initiatives explicitly focused on systemic goals of accountability, innovation, and learning. PMID:26673472

  18. Health promotion and partnerships: collaboration of a community health management center, county health bureau, and university nursing program.

    PubMed

    Huang, Chih-Ling

    2002-06-01

    Effective partnerships were established between a community health management center, a county health bureau and a university nursing program. A health fair was undertaken to heighten public health awareness through the collaboration of these various agencies. In this research, formative, process, and summative evaluations were conducted to determine the benefits of partnerships. Elements evaluated included the planning process, health fair relevancy, integration of community resources, participants satisfaction and knowledge acquisition, and partnership satisfaction. The samples of this study included (1) 529 adult participants who completed the on-site evaluation questionnaires; (2) 1,090 child participants who returned gift-reward cards; (3) 114 partners who gave written feedback on their satisfaction; and (4) 57 third-year and 16 fourth-year undergraduate nursing student participants. Data was collected from the evidence report of the Department of Health, the project proposal, activity protocols, meeting records, the project final report, students term papers, and questionnaires. The chief administrator of the County Health Bureau was very impressed with the creative exhibits in the fair and, therefore, invited a coalition to continue further workshops. Seventeen educational exhibits, two dance programs and two drama programs related to health issues were demonstrated in the fair. Resources from community organizations were successfully integrated and allocated. Community participants expressed satisfaction with the fair and anticipated similar activities in the future. Participants revealed more than 80% accuracy in health knowledge quizzes. The senior nursing students highlighted their interaction with the community, community health nurses, and health volunteers. Community-based health promotion and nursing education can be successfully connected when various disciplines and sectors form effective partnerships. PMID:12119594

  19. An Assessment of Integrated Health Management (IHM) Frameworks

    SciTech Connect

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

    2012-05-01

    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.

  20. Effect of concentrate feeder design on performance, eating and animal behavior, welfare, ruminal health, and carcass quality in Holstein bulls fed high-concentrate diets.

    PubMed

    Verdú, M; Bach, A; Devant, M

    2015-06-01

    A total of 240 Holstein bulls (121 ± 2.0 kg initial BW; 99 ± 1.0 d of age), from 2 consecutive fattening cycles, were randomly allocated in 1 of 6 pens and assigned to 1 of the 3 treatments consisting of different concentrate feeder designs: a control feeder with 4 feeding spaces (CF), a feeder with less concentrate capacity (CFL), and a single-space feeder with lateral protections (SF). Each pen had a straw feeder and a drinker. All animals were fed a high-concentrate diet for ad libitum intake. Concentrate consumption was recorded daily using a computerized feeder, straw consumption was recorded weekly, and BW was recorded every 14 d. Animal behavior was registered on d 1, 3, 5, 8, and 14 and every 28 d by scan sampling. Eating behavior at concentrate feeders was filmed on d 12, 125, and 206. On d 7, 120, and 204, samples of rumen contents were collected for measurement of pH and VFA and blood samples were obtained to analyze NEFA, haptoglobin, glucose, and insulin. Animals were slaughtered after 223 d, and HCW and lesions of the rumen wall and liver were recorded. The accumulative concentrate consumption per animal tended (P = 0.09) to be greater with CF than with CFL and SF. Also, CV of concentrate consumption was greater (P < 0.01) for SF than for CF or CFL. However, feeder design did not influence the other performance and carcass data. Also, no differences among treatments in rumen wall evaluation and liver abscesses were observed. At 7 and 204 d of study, SF bulls had greater (P < 0.05) rumen pH compared with CF and CFL bulls. On d 7, the acetate to propionate ratio from SF was greater (P < 0.05) than for CFL or CF. At d 7, NEFA of SF were greater (P < 0.05) compared with CF and CFL. Bulls fed with CF have the greatest (P < 0.01) concentrate disappearance velocity followed by bulls fed with CFL and finally by bulls fed with SF, and this was associated with different feeding behaviors. Bulls on SF spent more time (P < 0.05) eating straw and exhibited fewer (P < 0.05) displacements at concentrate feeder than CF and CFL bulls. The CFL bulls exhibited (P < 0.01) more attempted mounts and tended (P = 0.10) to exhibit more completed mounts than CF bulls. In conclusion, both alternative feeder designs (CFL and SF) are good strategies to reduce total concentrate consumption without impairing performance, rumen health, or animal welfare in Holstein bulls fed high-concentrate diets. However, at the beginning, there was evidence that animals fed using SF had problems with adaptation. PMID:26115288

  1. Health economics of weight management: evidence and cost.

    PubMed

    Kouris-Blazos, Antigone; Wahlqvist, Mark L

    2007-01-01

    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

  2. Health services management and research at Nordic School of Public Health.

    PubMed

    Karlberg, Ingvar

    2015-08-01

    In Anglo-Saxon countries the subject of health services research has long been an important academic theme. In the Nordic countries, however, this research and training area has been limited and partly hidden by integration into various other sections at universities and colleges. In this respect the Nordic School of Public Health was an exception, as the provision of managerial skills to healthcare professionals and persons working with public health was the backbone of the school during all 60 years. A variety of research in health services management, as well as publications of text books, accompanied the presented courses. Several of the scholars have earned important positions in international networks and editorial boards, as well as in boards for assessments of research grants. In the near future, this academic field will require alternative support. PMID:26311796

  3. Agricultural Pesticide Management in Thailand: Situation and Population Health Risk

    PubMed Central

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

    2012-01-01

    As an agricultural country and one of the worlds 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

  4. Assessing treatments used to reduce rumination and/or worry: a systematic review.

    PubMed

    Querstret, Dawn; Cropley, Mark

    2013-12-01

    Perseverative cognitions such as rumination and worry are key components of mental illnesses such as depression and anxiety. Given the frequent comorbidity of conditions in which rumination and worry are present, it is possible that they are underpinned by the same cognitive process. Furthermore, rumination and worry appear to be part of a causal chain that can lead to long-term health consequences, including cardiovascular disease and other chronic conditions. It is important therefore to understand what interventions may be useful in reducing their incidence. This systematic review aimed to assess treatments used to reduce worry and/or rumination. As we were interested in understanding the current treatment landscape, we limited our search from 2002 to 2012. Nineteen studies were included in the review and were assessed for methodological quality and treatment integrity. Results suggested that mindfulness-based and cognitive behavioural interventions may be effective in the reduction of both rumination and worry; with both Internet-delivered and face-to-face delivered formats useful. More broadly, it appears that treatments in which participants are encouraged to change their thinking style, or to disengage from emotional response to rumination and/or worry (e.g., through mindful techniques), could be helpful. Implications for treatment and avenues for future research are discussed. PMID:24036088

  5. Integrated medication management in mHealth applications.

    PubMed

    Ebner, Hubert; Modre-Osprian, Robert; Kastner, Peter; Schreier, Günter

    2014-01-01

    Continuous medication monitoring is essential for successful management of heart failure patients. Experiences with the recently established heart failure network HerzMobil Tirol show that medication monitoring limited to heart failure specific drugs could be insufficient, in particular for general practitioners. Additionally, some patients are confused about monitoring only part of their prescribed drugs. Sometimes medication will be changed without informing the responsible physician. As part of the upcoming Austrian electronic health record system ELGA, the eMedication system will collect prescription and dispensing data of drugs and these data will be accessible to authorized healthcare professionals on an inter-institutional level. Therefore, we propose two concepts on integrated medication management in mHealth applications that integrate ELGA eMedication and closed-loop mHealth-based telemonitoring. As a next step, we will implement these concepts and analyze--in a feasibility study--usability and practicability as well as legal aspects with respect to automatic data transfer from the ELGA eMedication service. PMID:24825709

  6. Improving hypertension self-management with community health coaches.

    PubMed

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

    2015-03-01

    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

  7. Caries management pathways preserve dental tissues and promote oral health.

    PubMed

    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

    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

  8. Examining the Role of Anxiety and Apathy in Health Consumers' Intentions to Use Patient Health Portals for Personal Health Information Management

    ERIC Educational Resources Information Center

    Torres, Carlos A.

    2011-01-01

    This study investigated college students' attitudes toward and intentions to use personal health portals (PHPs) for managing their personal health information using a survey method. The study also aimed to examine the roles electronic Personal Health Information Management (PHIM) anxiety and apathy play in influencing students' attitudes toward

  9. Examining the Role of Anxiety and Apathy in Health Consumers' Intentions to Use Patient Health Portals for Personal Health Information Management

    ERIC Educational Resources Information Center

    Torres, Carlos A.

    2011-01-01

    This study investigated college students' attitudes toward and intentions to use personal health portals (PHPs) for managing their personal health information using a survey method. The study also aimed to examine the roles electronic Personal Health Information Management (PHIM) anxiety and apathy play in influencing students' attitudes toward…

  10. Exploring the Model Design Space for Battery Health Management

    NASA Technical Reports Server (NTRS)

    Saha, Bhaskar; Quach, Cuong Chi; Goebel, Kai Frank

    2011-01-01

    Battery Health Management (BHM) is a core enabling technology for the success and widespread adoption of the emerging electric vehicles of today. Although battery chemistries have been studied in detail in literature, an accurate run-time battery life prediction algorithm has eluded us. Current reliability-based techniques are insufficient to manage the use of such batteries when they are an active power source with frequently varying loads in uncertain environments. The amount of usable charge of a battery for a given discharge profile is not only dependent on the starting state-of-charge (SOC), but also other factors like battery health and the discharge or load profile imposed. This paper presents a Particle Filter (PF) based BHM framework with plug-and-play modules for battery models and uncertainty management. The batteries are modeled at three different levels of granularity with associated uncertainty distributions, encoding the basic electrochemical processes of a Lithium-polymer battery. The effects of different choices in the model design space are explored in the context of prediction performance in an electric unmanned aerial vehicle (UAV) application with emulated flight profiles.

  11. Management initiatives in a community-based health insurance scheme.

    PubMed

    Sinha, Tara; Ranson, M Kent; Chatterjee, Mirai; Mills, Anne

    2007-01-01

    Community-based health insurance (CBHI) schemes have developed in response to inadequacies of alternate systems for protecting the poor against health care expenditures. Some of these schemes have arisen within community-based organizations (CBOs), which have strong links with poor communities, and are therefore well situated to offer CBHI. However, the managerial capacities of many such CBOs are limited. This paper describes management initiatives undertaken in a CBHI scheme in India, in the course of an action-research project. The existing structures and systems at the CBHI had several strengths, but fell short on some counts, which became apparent in the course of planning for two interventions under the research project. Management initiatives were introduced that addressed four features of the CBHI, viz. human resources, organizational structure, implementation systems, and data management. Trained personnel were hired and given clear roles and responsibilities. Lines of reporting and accountability were spelt out, and supportive supervision was provided to team members. The data resources of the organization were strengthened for greater utilization of this information. While the changes that were introduced took some time to be accepted by team members, the commitment of the CBHI's leadership to these initiatives was critical to their success. PMID:17708589

  12. Innovative requirements and technologies for future RLVs health management system

    NASA Astrophysics Data System (ADS)

    Maltecca, L.; Miccichè, L.; Russo, G.; Sellitto, M.

    2002-07-01

    The Italian aerospace research program PRORA (PROgramma nazionale di Ricerche Aerospaziali), which has been conceived and managed by CIRA (Italian Aerospace Research Center), is focused on the development of innovative technologies, also based on experience from flying test beds. One family of these test beds, designated USV (Unmanned Space Vehicle) will be dedicated to acquire the knowledge about future RLV (Reusable Launch Vehicle) technologies. Major strategic technologies identified are reusability, hypersonic flight and atmospheric re-entry. The Phase-A study has been concluded and recently approved. Laben (a Finmeccanica Company) has contributed to identify requirements for the next generations of on board Vehicle Health Management System (VHMS) and to investigate possible innovative architectures. This new generation VHMS will be able to manage in a real-time mode the health of the vehicle (structure, propulsion, avionics, etc.). The proposed approach is based on a set of decentralised computers linked via an advanced high-speed interconnect system. This paper will describe preliminary requirements analysis and trade-off's mainly in terms of HW (e.g. use of general purpose CPUs versus DSPs, interconnects and topologies).

  13. Managing the physics of the economics of integrated health care.

    PubMed

    Zismer, Daniel K; Werner, Mark J

    2012-01-01

    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

  14. Technology management: case study of an integrated health system.

    PubMed

    Dahl, D H; McFarlan, T K

    1994-12-01

    Technology management has assumed a role of vital importance in today's health care environment. Capital reserves and operating income have been stretched by pervasive and expensive technologies, while overall reimbursement has been reduced. It is imperative for hospitals to develop and consistently use technology management processes that begin prior to a technology's introduction in the hospital and continue throughout its life cycle. At Samaritan Health System (SHS), an integrated health care delivery system based in Phoenix, technology management provides tools to improve decision making and assist in the system's integration strategy as well as control expenses. SHS uses a systemwide technology-specific plan to guide acquisition and/or funding decisions. This plan describes how particular technologies can help achieve SHS' organizational goals such as promoting system integration and/or improving patient outcomes while providing good economic value. After technologies are targeted in this systemwide plan they are prioritized using a two-stage capital prioritization process. The first stage of the capital prioritization process considers the quantitative and qualitative factors critical for equitable capital distribution across the system. The second stage develops a sense of ownership among the parties that affect and are affected by the allocation at a facility level. This process promotes an efficient, effective, equitable, and defensible approach to resource allocation and technology decision making. Minimizing equipment maintenance expenditures is also an integral part of technology management at SHS. The keys to reducing maintenance expenditures are having a process in place that supports a routine fiscal evaluation of maintenance coverage options and ensuring that manufacturers are obligated to provide critical maintenance resources at the time of equipment purchase. Maintenance service options under consideration in this report include full-service contracts with the manufacturer, insurance coverage, time and materials, and independent service vendors/in-house support. Careful consideration of all the ramifications of each option is warranted because there are substantial cost differences among these methods. At SHS, technology management efforts resulted in equipment purchases and maintenance negotiations representing savings of more than $1.5 million in a single year. SHS undertakes an intensive review of purchases and maintenance expenditures, using the techniques described in this report, with the objective of reducing expenses by 10% per year. This report describes the technology management methods that SHS uses to achieve these results. PMID:10139509

  15. Effects of Peanut Butter on Ruminating.

    ERIC Educational Resources Information Center

    Greene, Katherine S.; And Others

    1991-01-01

    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…

  16. Co-rumination via cellphone moderates the association of perceived interpersonal stress and psychosocial well-being in emerging adults.

    PubMed

    Murdock, Karla Klein; Gorman, Sarah; Robbins, Maia

    2015-01-01

    Adolescents' and emerging adults' social interactions increasingly revolve around cellphone use, but little research has investigated the psychological properties of cellphone interactions. The current study explored co-rumination via cellphone; that is, the use of cellphone functions to excessively communicate about problems or negative feelings. Face-to-face co-rumination and co-rumination via cellphone were examined as potential moderators of the association between perceived interpersonal stress and psychosocial well-being (i.e., positive mental health and social burnout) in a sample of 142 college students. Face-to-face co-rumination was not a moderator. However, co-rumination via cellphone was a significant moderator such that higher levels of perceived interpersonal stress were associated with lower levels of well-being only among college students who reported higher levels of co-rumination via cellphone. Co-rumination via cellphone should be further investigated to elucidate its developmental trajectory and mental health correlates. PMID:25460677

  17. Health Weaver Mobile: Designing a Mobile Tool for Managing Personal Health Information during Cancer Care

    PubMed Central

    Klasnja, Predrag; Hartzler, Andrea; Powell, Christopher; Phan, Giovandy; Pratt, Wanda

    2010-01-01

    Cancer patients manage a great deal of information to coordinate their care. Critical aspects of this work take place while patients are away from home or have diminished attention due to symptoms or side effects. We describe the design of HealthWeaver Mobile, a mobile phone application we developed to help patients manage care-related information in such situations. We discuss findings from two participatory design groups with breast cancer patients and the design decisions made to implement functional requirements uncovered in those groups. PMID:21347007

  18. Differential rumination, intake, and enteric methane production of dairy cows in a pasture-based automatic milking system.

    PubMed

    Watt, L J; Clark, C E F; Krebs, G L; Petzel, C E; Nielsen, S; Utsumi, S A

    2015-10-01

    Proper performance monitoring of cows on pasture-based diets is crucial to inform nutritional recommendations that minimize undesirable effects of high ruminant CH4 emissions into the environment. The prediction of linkages between rumination patterns, methane emissions, and correlated production traits of cows in a pasture-based automatic milking system was tested. A previous 10-d baseline measurement of rumination activity by acoustic methodology of 156 Holstein-Friesian cows was used for frequency analysis of rumination time and identification of 2 treatment groups (n = 37 cows/group) represented by cows with consistently high (HR; 75th rumination percentile = 617.55 ± 81.37 min/d) or low (LR; 25th rumination percentile = 356.65 ± 72.67 min/d) rumination. The HR and LR cows were paired by nearest parity, days in milk, body weight (BW), and previous 10-d milk production, and within pairs randomly assigned to 1 of 2 experimental groups managed on a voluntary milking system with diets consisting of at least 75% pasture, plus concentrates. Animal traits, including rumination time, mass flux of CH4 (QCH4) and carbon dioxide (QCO2), milk production, and estimated dry matter intake according to individual QCO2 fluxes over a 22-d period were analyzed with repeated measure mixed models for a completely randomized design, structural equation modeling, and nonlinear regression. High rumination and methane was seen in older and heavier cows that had greater estimated dry matter intake and milk production. A consistent difference in rumination time and QCH4 across days was detected between HR and LR, even after adjustment for metabolic BW. Estimated dry matter intake had direct positive effects on rumination and QCH4, but no independent direct effect of rumination on QCH4 was detected. The LR cows produced more QCH4/milk, associated with lower milk, BW, concentrate intake, and greater activity at pasture. A typical dilution of maintenance effect on QCH4/milk was detected as a consequence of increasing milk yield and similar significant reduction of QCO2/milk. The results raise challenging questions regarding the rumination patterning of grazing dairy cows and alternatives to reduce ruminant methane emissions in grazing dairy cows. PMID:26254528

  19. The making of expert patients: the role of online health communities in arthritis self-management.

    PubMed

    Willis, Erin

    2014-12-01

    Chronic disease is an epidemic, one that requires patients to play an active role in managing symptoms and disease affect. This study used ethnomethodology (N = 8231) to understand how patients with arthritis use online health communities to exchange disease-related information to better manage their chronic disease. The findings show that online health communities facilitate self-management behaviors through the exchange of health information and disease experience. These online health communities act as self-management programs led by peers with the same chronic disease through the exchange of health information based on experience, working to improve members' health literacy related to arthritis. PMID:23988679

  20. Extending the recovery window: Effects of trait rumination on subsequent evening cortisol following a laboratory performance stressor.

    PubMed

    Zoccola, Peggy M; Dickerson, Sally S

    2015-08-01

    Mental rehearsal of past stressors through rumination may extend the physiological stress response and exposure to stress-related physiological mediators, such as cortisol. If repeated over time, this prolonged activation may contribute to a number of chronic health conditions. Findings from the emerging literature on the tendency to ruminate and its association with cortisol have been somewhat mixed. In the present study, we tested whether trait rumination predicted elevated cortisol concentrations in response to a performance stressor, and whether this association varied by the social-evaluative context of the stressor and gender. We also examined whether associations persisted into the evening of the stressor. Participants (50% female; mean age=19.83, SD=1.62) were randomly assigned to complete a laboratory speech stressor either in a social-evaluative (SET; n=86) or non-evaluative context (non-SET; n=58). Salivary cortisol concentrations were measured throughout the laboratory visit and later that evening. There was a main effect of trait rumination on greater total cortisol exposure into the evening of the stressor. In addition, trait rumination interacted with stressor context to predict cortisol declines: on the night of the SET stressor, high trait ruminators did not exhibit typical declines in cortisol. Different cortisol patterns emerged for men and women with tendencies to ruminate: women with higher rumination scores had flatter cortisol slopes with greater evening cortisol, whereas men with higher trait rumination scores had greater initial cortisol reactivity to the stressor. Together, these findings suggest that the relationship between the tendency to ruminate and cortisol concentrations is qualified by individual differences (gender) and stressor characteristics (social-evaluative threat). PMID:25965871

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

    PubMed

    Sobczak, Alicja; Rydlewska-Liszkowska, Izabela

    2012-01-01

    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

  2. Ground Operations Autonomous Control and Integrated Health Management

    NASA Technical Reports Server (NTRS)

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

    2014-01-01

    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.

  3. Health Vlogs as Social Support for Chronic Illness Management

    PubMed Central

    HUH, JINA; LIU, LESLIE S.; NEOGI, TINA; INKPEN, KORI; PRATT, WANDA

    2015-01-01

    Studies have shown positive impact of video blogs (vlogs) on patient education. However, we know little on how patient-initiated vlogs shape the relationships among vloggers and viewers. We qualitatively analyzed 72 vlogs on YouTube by users diagnosed with HIV, diabetes, or cancer and 1,274 comments posted to the vlogs to understand viewers’ perspectives on the vlogs. We found that the unique video medium allowed intense and enriched personal and contextual disclosure to the viewers, leading to strong community-building activities and social support among vloggers and commenters, both informationally and emotionally. Furthermore, the unique communication structure of the vlogs allowed ad hoc small groups to form, which showed different group behavior than typical text-based social media, such as online communities. We provide implications to the Health Care Industry (HCI) community on how future technologies for health vlogs could be designed to further support chronic illness management. PMID:26146474

  4. Small grant management in health and behavioral sciences: Lessons learned.

    PubMed

    Sakraida, Teresa J; D'Amico, Jessica; Thibault, Erica

    2010-08-01

    This article describes considerations in health and behavioral sciences small grant management and describes lessons learned during post-award implementation. Using the components by W. Sahlman [Sahlman, W. (1997). How to write a great business plan. Harvard Business Review, 75(4), 98-108] as a business framework, a plan was developed that included (a) building relationships with people in the research program and with external parties providing key resources, (b) establishing a perspective of opportunity for research advancement, (c) identifying the larger context of scientific culture and regulatory environment, and (d) anticipating problems with a flexible response and rewarding teamwork. Small grant management included developing a day-to-day system, building a grant/study program development plan, and initiating a marketing plan. PMID:20643328

  5. Statistical tools for prognostics and health management of complex systems

    SciTech Connect

    Collins, David H; Huzurbazar, Aparna V; Anderson - Cook, Christine M

    2010-01-01

    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.

  6. Use of information systems as management tools in health care

    NASA Astrophysics Data System (ADS)

    Davila, Fidel

    1995-10-01

    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.

  7. Managing the transition to integrated health care organizations.

    PubMed

    Griffith, J R

    1996-01-01

    Today's successful community hospitals should and will evolve into integrated health care organizations (IHCOs) that will share several common characteristics. IHCOs will have a community--not a membership--orientation, and this will be a distinguishing characteristic and a source of market appeal. The transition to IHCO will be a slow one, and to prosper, the IHCO will have to accommodate both price-oriented markets and traditional ones. Successful IHCOs will expand technical skills and capabilities to control costs and quality. New strategic competencies will have to be developed, and to do this, emerging IHCOs will improve the ability of managers to support decisions and sell them both to the buyers and the public at large. Excellent patient care will rest upon better trained, advised, and informed management teams. Making the change to an IHCO will take time and money, but organizations that make steady progress are likely to succeed. PMID:10156172

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

    NASA Technical Reports Server (NTRS)

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

    2009-01-01

    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.

  9. Natural remedies recommended for the management of oral health.

    PubMed

    Ocasio, N A; Solomowitz, B H; Sher, M R

    1999-01-01

    This paper discusses various practices recommended by homeopaths, herbalists, spiritual and natural healers for the management and maintenance of oral health. It is intended as a partial guide to educate the dental professional on self-administered, over-the-counter remedies that are easily available to the general population. Since few if any clinical studies exist assessing the efficacy or side effects of these ingested products, little is known about the beneficial or potentially harmful course these remedies may take on the human body. PMID:10474992

  10. Leader-Member Exchange Relationships in Health Information Management

    PubMed Central

    Hunt, T.J.

    2014-01-01

    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

  11. Vehicle health management for guidance, navigation and control systems

    NASA Technical Reports Server (NTRS)

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

    1993-01-01

    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.

  12. Managing health care variability to achieve quality care.

    PubMed

    Simmons, J C

    2001-05-01

    While much has been written about variation and health care, one area that has received little attention is variation within hospitals related to the operations management--which can lead to wasted money and human resources. Two Boston researchers who have been studying this area say that addressing these variations--and using techniques found in other major industries across the country--could give hospitals a new tool in addressing patient safety issues, nursing shortages, cost containment, and overall better quality of care. PMID:11400326

  13. Animal health surveillance applications: The interaction of science and management.

    PubMed

    Willeberg, Preben

    2012-08-01

    Animal health surveillance is an ever-evolving activity, since health- and risk-related policy and management decisions need to be backed by the best available scientific evidence and methodology. International organizations, trade partners, politicians, media and the public expect fast, understandable, up-to-date presentation and valid interpretation of animal disease data to support and document proper animal health management - in crises as well as in routine control applications. The delivery and application of surveillance information need to be further developed and optimized, and epidemiologists, risk managers, administrators and policy makers need to work together in order to secure progress. Promising new developments in areas such as risk-based surveillance, spatial presentation and analysis, and genomic epidemiology will be mentioned. Limitations and areas in need of further progress will be underlined, such as the general lack of a wide and open exchange of international animal disease surveillance data. During my more than 30 year career as a professor of Veterinary Epidemiology I had the good fortune of working in challenging environments with different eminent colleagues in different countries on a variety of animal health surveillance issues. My career change from professor to Chief Veterinary Officer (CVO) - "from science to application" - was caused by my desire to see for myself if and how well epidemiology would actually work to solve real-life problems as I had been telling my students for years that it would. Fortunately it worked for me! The job of a CVO is not that different from that of a professor of Veterinary Epidemiology; the underlying professional principles are the same. Every day I had to work from science, and base decisions and discussions on documented evidence - although sometimes the evidence was incomplete or data were simply lacking. A basic understanding of surveillance methodology is very useful for a CVO, since it provides a sound working platform not only for dealing with immediate questions when new or emerging disease situations arise, but also for more long-term activities, such as policy development, contingency planning and trade negotiations. Animal health issues, which emerged during my eight years as a CVO in Denmark from 1999 to 2007, will be used as examples, including BSE, FMD, HPAI and Trichinella testing. Emphasis will be placed on how science-based surveillance methodology and tools were developed, applied and documented. PMID:22305878

  14. Key issues relating to decentralization at the provincial level of health management in Cambodia.

    PubMed

    Men, Bunnan; Grundy, John; Cane, Jeff; Rasmey, Lon Chan; An, Nguon Sim; Soeung, Sann Chan; Jenkinson, Karl; Boreland, Marian; Maynard, Jim; Biggs, Beverley-Ann

    2005-01-01

    The following study was conducted as part of a review of management systems at a Provincial Health Department (Kampong Cham Province) and a National Health Programme (National Immunization Program) in 2002-2003 in Cambodia. The aim of this paper is to identify, analyse and recommend those management system factors that are critical to the success of health management performance, with a particular focus on provincial management. The review has identified critical success factors associated with health management performance at the sub-national level that include a stronger role for effective human resource management in health sector reform, elevation of the status of planning in senior level management, and the development of a more comprehensive and transparent finance system. These success factors will position the provincial level of health management to respond more effectively to the reform challenges of administrative de-concentration and political decentralization that are currently underway across a range of government sectors in Cambodia. PMID:15799454

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

    SciTech Connect

    Flynn, N.C. Bechtel Jacobs

    2008-04-21

    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.

  16. Adaptation of intensive mental health intensive case management to rural communities in the Veterans Health Administration.

    PubMed

    Mohamed, Somaia

    2013-03-01

    There has been increasing concern in recent years about the availability of mental health services for people with serious mental illness in rural areas. To meet these needs the Department of Veterans Affairs (VA) implemented the Rural Access Networks for Growth Enhancement (RANGE) program, in 2007, modeled on the Assertive Community Treatment (ACT) model. This study uses VA administrative data from the RANGE program (N = 343) to compare client characteristics at program entry, patterns of service delivery, and outcomes with those of Veterans who received services from the general VA ACT-like program (Mental Health Intensive Case Management (MHICM) (N = 3,077). Veterans in the rural program entered treatment with similar symptom severity, less likelihood of being diagnosed with schizophrenia and having had long-term hospitalization, but significantly higher suicidality index scores and greater likelihood of being dually diagnosed compared with those in the general program. RANGE Veterans live further away from their treatment teams but did not differ significantly in measures of face-to-face treatment intensity. Similar proportions of RANGE and MHICM Veterans were reported to have received rehabilitation services, crisis intervention and substance abuse treatment. The rural programs had higher scores on overall satisfaction with VA mental health care than general programs, slightly poorer outcomes on quality of life and on the suicidality index but no significant difference on other outcomes. These data demonstrate the clinical need, practical feasibility and potential effectiveness of providing intensive case management through small specialized case management teams in rural areas. PMID:22729625

  17. 9 CFR 93.414 - Milk from quarantined ruminants.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Milk from quarantined ruminants. 93...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants § 93.414 Milk from quarantined ruminants. Milk or cream from ruminants quarantined under the provisions of this part shall not be used by...

  18. 9 CFR 93.414 - Milk from quarantined ruminants.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false Milk from quarantined ruminants. 93...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants § 93.414 Milk from quarantined ruminants. Milk or cream from ruminants quarantined under the provisions of this part shall not be used by...

  19. 9 CFR 93.414 - Milk from quarantined ruminants.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false Milk from quarantined ruminants. 93...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants § 93.414 Milk from quarantined ruminants. Milk or cream from ruminants quarantined under the provisions of this part shall not be used by...

  20. 9 CFR 93.429 - Ruminants for immediate slaughter.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Ruminants for immediate slaughter. 93...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants Mexico 10 § 93.429 Ruminants for immediate slaughter. Ruminants, other than sheep and goats, may be imported from Mexico, subject to...

  1. 9 CFR 93.425 - Declaration for ruminants.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Declaration for ruminants. 93.425... FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants Mexico 10 § 93.425 Declaration for ruminants. For all ruminants offered for importation from Mexico, the importer or his or her agent shall...

  2. 9 CFR 93.425 - Declaration for ruminants.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Declaration for ruminants. 93.425... FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants Mexico 10 § 93.425 Declaration for ruminants. For all ruminants offered for importation from Mexico, the importer or his or her agent shall...

  3. 9 CFR 93.429 - Ruminants for immediate slaughter.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false Ruminants for immediate slaughter. 93...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants Mexico 10 § 93.429 Ruminants for immediate slaughter. Ruminants, other than sheep and goats, may be imported from Mexico, subject to...

  4. 9 CFR 93.425 - Declaration for ruminants.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false Declaration for ruminants. 93.425... FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants Mexico 10 § 93.425 Declaration for ruminants. For all ruminants offered for importation from Mexico, the importer or his or her agent shall...

  5. 9 CFR 93.425 - Declaration for ruminants.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false Declaration for ruminants. 93.425... FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants Mexico 10 § 93.425 Declaration for ruminants. For all ruminants offered for importation from Mexico, the importer or his or her agent shall...

  6. 9 CFR 93.409 - Articles accompanying ruminants.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Articles accompanying ruminants. 93...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants § 93.409 Articles accompanying ruminants..., blankets, or other things used for or about ruminants governed by the regulations in this part, shall...

  7. 9 CFR 93.409 - Articles accompanying ruminants.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false Articles accompanying ruminants. 93...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants § 93.409 Articles accompanying ruminants..., blankets, or other things used for or about ruminants governed by the regulations in this part, shall...

  8. 9 CFR 93.425 - Declaration for ruminants.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false Declaration for ruminants. 93.425... FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants Mexico 10 § 93.425 Declaration for ruminants. For all ruminants offered for importation from Mexico, the importer or his or her agent shall...

  9. 9 CFR 93.409 - Articles accompanying ruminants.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false Articles accompanying ruminants. 93...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants § 93.409 Articles accompanying ruminants..., blankets, or other things used for or about ruminants governed by the regulations in this part, shall...

  10. 9 CFR 93.429 - Ruminants for immediate slaughter.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false Ruminants for immediate slaughter. 93...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants Mexico 10 § 93.429 Ruminants for immediate slaughter. Ruminants, other than sheep and goats, may be imported from Mexico, subject to...

  11. 9 CFR 93.409 - Articles accompanying ruminants.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false Articles accompanying ruminants. 93...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants § 93.409 Articles accompanying ruminants..., blankets, or other things used for or about ruminants governed by the regulations in this part, shall...

  12. 9 CFR 93.429 - Ruminants for immediate slaughter.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Ruminants for immediate slaughter. 93...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants Mexico 10 § 93.429 Ruminants for immediate slaughter. Ruminants, other than sheep and goats, may be imported from Mexico, subject to...

  13. 9 CFR 93.429 - Ruminants for immediate slaughter.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false Ruminants for immediate slaughter. 93...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants Mexico 10 § 93.429 Ruminants for immediate slaughter. Ruminants, other than sheep and goats, may be imported from Mexico, subject to...

  14. 9 CFR 93.414 - Milk from quarantined ruminants.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false Milk from quarantined ruminants. 93...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants § 93.414 Milk from quarantined ruminants. Milk or cream from ruminants quarantined under the provisions of this part shall not be used by...

  15. 9 CFR 93.414 - Milk from quarantined ruminants.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Milk from quarantined ruminants. 93...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants § 93.414 Milk from quarantined ruminants. Milk or cream from ruminants quarantined under the provisions of this part shall not be used by...

  16. Environmental health risk assessment and management for global climate change

    NASA Astrophysics Data System (ADS)

    Carter, P.

    2014-12-01

    This environmental health risk assessment and management approach for atmospheric greenhouse gas (GHG) pollution is based almost entirely on IPCC AR5 (2014) content, but the IPCC does not make recommendations. Large climate model uncertainties may be large environmental health risks. In accordance with environmental health risk management, we use the standard (IPCC-endorsed) formula of risk as the product of magnitude times probability, with an extremely high standard of precaution. Atmospheric GHG pollution, causing global warming, climate change and ocean acidification, is increasing as fast as ever. Time is of the essence to inform and make recommendations to governments and the public. While the 2ºC target is the only formally agreed-upon policy limit, for the most vulnerable nations, a 1.5ºC limit is being considered by the UNFCCC Secretariat. The Climate Action Network International (2014), representing civil society, recommends that the 1.5ºC limit be kept open and that emissions decline from 2015. James Hansen et al (2013) have argued that 1ºC is the danger limit. Taking into account committed global warming, its millennial duration, multiple large sources of amplifying climate feedbacks and multiple adverse impacts of global warming and climate change on crops, and population health impacts, all the IPCC AR5 scenarios carry extreme environmental health risks to large human populations and to the future of humanity as a whole. Our risk consideration finds that 2ºC carries high risks of many catastrophic impacts, that 1.5ºC carries high risks of many disastrous impacts, and that 1ºC is the danger limit. IPCC AR4 (2007) showed that emissions must be reversed by 2015 for a 2ºC warming limit. For the IPCC AR5 only the best-case scenario RCP2.6, is projected to stay under 2ºC by 2100 but the upper range is just above 2ºC. It calls for emissions to decline by 2020. We recommend that for catastrophic environmental health risk aversion, emissions decline from 2015 (CAN International 2014), and if policy makers are limited to the IPCC AR5 we recommend RCP2.6, with emissions declining by 2020.

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

    PubMed Central

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

    1997-01-01

    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

  18. Ruminal temperature may aid in the detection of subacute ruminal acidosis.

    PubMed

    AlZahal, O; Kebreab, E; France, J; Froetschel, M; McBride, B W

    2008-01-01

    The objective of this study was to investigate the relationship between ruminal pH and ruminal temperature and to develop a predictive equation that can aid in the diagnosis of subacute ruminal acidosis (SARA). Six rumen-fistulated lactating Holstein dairy cows (639 +/- 51 kg body weight) were used in the study. Cows were randomly allocated to 1 of 2 dietary treatments: control (% of dry matter, 40% corn silage, 27% mixed haylage, 7% alfalfa hay, 18% protein supplement, 4% ground corn, and 4% wheat bran) or SARA total mixed ration (% of dry matter, 31% corn silage, 20% mixed haylage, 5% alfalfa hay, 15% protein supplement, 19% ground wheat, and 10% ground barley) and were fed daily at 0700 and 1300 h. The experiment consisted of 1 wk of adaptation followed by 1 wk of treatment. Ruminal pH and ruminal temperature were simultaneously and continuously recorded every minute for 4 d per week using the same indwelling electrode. Subacute-acidotic cows spent more time (min/d) below ruminal pH 5.6 and a greater time above 39.2 degrees C than control cows. Ruminal pH nadir had a negative relationship with its corresponding ruminal temperature (R2 = 0.77). Therefore, ruminal temperature may have potential to predict ruminal pH and thus aid in the diagnosis of SARA. PMID:18096941

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

    PubMed

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

    1997-12-01

    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

  20. Smartloss: A Personalized Mobile Health Intervention for Weight Management and Health Promotion

    PubMed Central

    Gilmore, L. Anne; Apolzan, John W; Myers, Candice A; Thomas, Diana M

    2016-01-01

    Background Synonymous with increased use of mobile phones has been the development of mobile health (mHealth) technology for improving health, including weight management. Behavior change theory (eg, the theory of planned behavior) can be effectively encapsulated into mobile phone-based health improvement programs, which is fostered by the ability of mobile phones and related devices to collect and transmit objective data in near real time and for health care or research professionals and clients to communicate easily. Objective To describe SmartLoss, a semiautomated mHealth platform for weight loss. Methods We developed and validated a dynamic energy balance model that determines the amount of weight an individual will lose over time if they are adherent to an energy intake prescription. This model was incorporated into computer code that enables adherence to a prescribed caloric prescription determined from the change in body weight of the individual. Data from the individual are then used to guide personalized recommendations regarding weight loss and behavior change via a semiautomated mHealth platform called SmartLoss, which consists of 2 elements: (1) a clinician dashboard and (2) a mobile phone app. SmartLoss includes and interfaces with a network-connected bathroom scale and a Bluetooth-connected accelerometer, which enables automated collection of client information (eg, body weight change and physical activity patterns), as well as the systematic delivery of preplanned health materials and automated feedback that is based on client data and is designed to foster prolonged adherence with body weight, diet, and exercise goals. The clinician dashboard allows for efficient remote monitoring of all clients simultaneously, which may further increase adherence, personalization of treatment, treatment fidelity, and efficacy. Results Evidence of the efficacy of the SmartLoss approach has been reported previously. The present report provides a thorough description of the SmartLoss Virtual Weight Management Suite, a professionally programmed platform that facilitates treatment fidelity and the ability to customize interventions and disseminate them widely. Conclusions SmartLoss functions as a virtual weight management clinic that relies upon empirical weight loss research and behavioral theory to promote behavior change and weight loss. PMID:26983937

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

    PubMed

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

    2015-04-01

    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

  2. Health Numeracy: Perspectives About Using Numbers in Health Management from African American Patients Receiving Dialysis

    PubMed Central

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

    2015-01-01

    Background 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 is available eliciting stakeholder perspectives from patients receiving dialysis about the construct of health numeracy. Methods Using focus groups we asked patients receiving hemodialysis open-ended questions to identify facilitators and barriers to their understanding, interpreting, and applying numeric information in kidney care. Transcripts were analyzed using content analysis. Results Twelve patients participated with a mean (SD) age of 56 (12) years. All were African American, 50% were female and 83% with 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. Conclusions 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

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

    PubMed

    Johnson, James H; Sabol, Barbara J; Baker, Edward L

    2006-01-01

    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

  4. Use of Health Information and Communication Technologies to Promote Health and Manage Behavioral Risk Factors Associated with Chronic Disease: Applications in the Field of Health Education

    ERIC Educational Resources Information Center

    Stellefson, Michael; Alber, Julia M.; Wang, Min Qi; Eddy, James M.; Chaney, Beth H.; Chaney, J. Don

    2015-01-01

    This special issue provides real-world examples of the diverse methods health education researchers are using to expand existing applications of information and communication technologies (ICTs) for health promotion and chronic disease management. The original and review articles presented in this special issue investigate eHealth, mHealth, and…

  5. Use of Health Information and Communication Technologies to Promote Health and Manage Behavioral Risk Factors Associated with Chronic Disease: Applications in the Field of Health Education

    ERIC Educational Resources Information Center

    Stellefson, Michael; Alber, Julia M.; Wang, Min Qi; Eddy, James M.; Chaney, Beth H.; Chaney, J. Don

    2015-01-01

    This special issue provides real-world examples of the diverse methods health education researchers are using to expand existing applications of information and communication technologies (ICTs) for health promotion and chronic disease management. The original and review articles presented in this special issue investigate eHealth, mHealth, and

  6. Occupational Health Management in the Lead Industry: The Korean Experience

    PubMed Central

    2011-01-01

    In 1967, the problem of occupational lead exposure came to public attention in Korea. Since then, regular progress has been made in lowering workplace lead exposures, instituting new workplace controls, and implementing health examinations of exposed workers. Past serious lead poisoning episodes made it possible to introduce biological monitoring programs on a voluntary basis in high-lead-exposure facilities in Korea. Industry-specific occupational health services for lead workers in Korea during the last 22 years can be categorized into three phases. During the first phase (1988-1993), efforts were directed at increasing awareness among workers about the hazards of lead exposure, biological monitoring of blood zinc protoporphyrin began, and a respiratory protection program was introduced. During the second phase (1994-1997), a computerized health management system for lead workers was developed, blood-lead measurement was added to biologic monitoring, and engineering controls were introduced in the workplace to lower air-lead levels to comply with air-lead regulations. Finally, during the third phase (1998-present), a new biomarker, bone-lead measurement by X-ray fluorescence, was introduced. Bone-lead measurement proved to be useful for assessing body burden and to demonstrate past lead exposure in retired workers. Occupational health service practice for lead workers, including the industry-specific group occupational health system, has brought considerable success in the prevention of lead poisoning and in reducing the lead burden in Korean lead workers during the last several decades. The successful achievement of prevention of lead poisoning in Korea was a result of the combined efforts of lead workers, employers, relevant government agencies, and academic institutes. PMID:22953192

  7. Fluid balance in ruminants: adaptation to external and internal challenges.

    PubMed

    Olsson, Kerstin

    2005-04-01

    Ruminants are widespread in hot, arid regions. This demands adaptation to large circadian temperature fluctuations and recurrent periods of food and water shortage. Pregnancy and lactation add to the demands on the adaptive mechanisms due to the greater need for food, water, and electrolytes. The blood volume increases to meet the requirements of the fetoplacental unit and the mammary glands. Unlike urine, the milk cannot be concentrated by antidiuretic hormone (vasopressin). During water deprivation, lactating animals therefore become dehydrated more rapidly than nonlactating animals. Nevertheless, desert-adapted lactating ruminants endure frequent periods of water deprivation without incurring bad health. For the offspring living in hot and dry conditions, it is an advantage that the milk is not concentrated, even if the mother has a high antidiuretic hormone concentration to enable her to concentrate the urine. Since ruminants are prey, they need to drink rapidly when they get access to water. The forestomach allows the animals to store water in the reticulorumen. There is no danger of water intoxication even if they drink to satisfaction in a couple of minutes after having lost as much as 30% of their body weight. PMID:15891020

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

    PubMed Central

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

    2001-01-01

    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

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

    PubMed

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

    2006-01-01

    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

  10. Application of statistical inference techniques in health information management.

    PubMed

    Berthelsen, C L; Nick, T G

    1995-10-01

    We have demonstrated that objective comparisons can be made using accepted statistical techniques. We have also shown that you can apply tests which don't meet the basic assumptions and still obtain valid results, in most cases. This robustness of statistics tests is particularly helpful with the type of data and analysis that health information management professionals typically deal with, where exactness of the results is not crucial. You can perform a quick analysis using simple statistical tools and obtain a P value that is fairly close to what it would be if you selected the tests more stringently. The examples of inferential statistics in this article demonstrate how to select tests based on characteristics of the data and how to interpret the results. The kinds of statistical analysis that can be performed in health information management are numerous. Below are some other ideas on how to use inferential statistics in HIM practice. 1. Set up an ordinal scale to evaluate coding accuracy to evaluate coders: Score 1 means the correct code was assigned for the principal diagnosis and only minor errors in coding among secondary diagnoses. Score 2 means the correct code was assigned for the principal diagnosis, but there are omissions or major errors among secondary diagnoses. Score 3 means a minor error in coding the principal diagnosis and only minor errors in secondary diagnoses. Score 4 means a minor error in coding the principal diagnosis and major errors or omissions in secondary diagnoses.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:10172422

  11. Health concerns and management of select veterinary drug residues.

    PubMed

    Baynes, Ronald E; Dedonder, Keith; Kissell, Lindsey; Mzyk, Danielle; Marmulak, Tara; Smith, Geof; Tell, Lisa; Gehring, Ronette; Davis, Jennifer; Riviere, Jim E

    2016-02-01

    The aim of this manuscript is to review the potential adverse health effects in humans if exposed to residues of selected veterinary drugs used in food-producing animals. Our other objectives are to briefly inform the reader of why many of these drugs are or were approved for use in livestock production and how drug residues can be mitigated for these drugs. The selected drugs include several antimicrobials, beta agonists, and phenylbutazone. The antimicrobials continue to be of regulatory concern not only because of their acute adverse effects but also because their use as growth promoters have been linked to antimicrobial resistance. Furthermore, nitroimidazoles and arsenicals are no longer approved for use in food animals in most jurisdictions. In recent years, the risk assessment and risk management of beta agonists, have been the focus of national and international agencies and this manuscript attempts to review the pharmacology of these drugs and regulatory challenges. Several of the drugs selected for this review can cause noncancer effects (e.g., penicillins) and others are potential carcinogens (e.g., nitroimidazoles). This review also focuses on how regulatory and independent organizations manage the risk of these veterinary drugs based on data from human health risk assessments. PMID:26751035

  12. Development of Structural Health Management Technology for Aerospace Vehicles

    NASA Technical Reports Server (NTRS)

    Prosser, W. H.

    2003-01-01

    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.

  13. Automation of a Comprehensive County Health Unit Management System

    PubMed Central

    Bigler, W. J.; Mittan, J. B.; Wisthuff, R. R.

    1981-01-01

    This paper describes the conceptualization, development, and implementation of a statewide management system for local health services operations in Florida. It discusses the rationale for a uniform statewide program; the structural organization of programs and services; information linkages between services, clients, providers and service facilities; information flow patterns from the source through automated data processes to production of output reports and analyses; and policies and procedures required to develop and implement the system. Benefits of the system include: 1) a mechanism for service delivery units to monitor and evaluate program effectiveness via measurement of process and outcome objectives, 2) production of accurate and reliable information required for tracking state and federal categorical programs, 3) development of personnel time and service profiles, and 4) initiation of billing and reimbursement processes for specific federal programs. Future plans and expectations include utilization of the system's data base to develop workload and staffing standards and measures, evaluate program impact on the health status of individual clients, develop program expenditure profiles, and develop related management and analytical applications.

  14. Managing waterway health in the Goulburn Broken Catchment, Victoria, Australia.

    PubMed

    Tennant, W; Sheed, J

    2001-01-01

    Historically within most catchments, resource management programs have been planned and implemented in isolation of one another. This was once the case in the Goulburn Broken Catchment, a major catchment of the Murray Darling Basin, Australia. Although only 2% of the Murray Darling Basin's land area, the catchment generates 11% of the basin's water resources. Learning from the past, a cooperative and collaborative approach to natural resource programs has developed. This approach is the envy of many other catchment communities and agencies. Through a combination of "Partnership Programs", "Operational Initiatives" and community involvement, significant programs have been implemented within the catchment, which will benefit not only the local community but communities further afield. The outcomes of the waterway health program highlight the benefits provided through the establishment of cooperative and partnership resource improvement programs. These programs were founded on the ability of the community to recognise the need for integration, base management decisions on best available science and an ability to work together. Their effective delivery has been provided through the resources provided, to the local community, by the Natural Heritage Trust with matching and State and local allocations. While programs have shown success, challenges still face the community. These challenges include verification and implementation of environmental flows, storage of the catchment's vital water resources, and maintaining community involvement and participation in on-going works programs. The Goulburn Broken Catchment community, with the support of Federal, State and Local Governments, is looking at opportunities for continued improvements in waterway health. PMID:11419136

  15. Rocket Engine Health Management: Early Definition of Critical Flight Measurements

    NASA Technical Reports Server (NTRS)

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

    2003-01-01

    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.

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

    NASA Technical Reports Server (NTRS)

    Figueroa, Fernando

    2009-01-01

    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.

  17. Rumination and behavioural factors in Parkinson's disease depression

    PubMed Central

    Julien, Camille L.; Rimes, Katharine A.; Brown, Richard G.

    2016-01-01

    Objective Parkinson's disease is associated with high rates of depression. There is growing interest in non-pharmacological management including psychological approaches such as Cognitive Behaviour Therapy. To date, little research has investigated whether processes that underpin cognitive models of depression, on which such treatment is based, apply in patients with Parkinson's disease. The study aimed to investigate the contribution of core psychological factors to the presence and degree of depressive symptoms. Methods 104 participants completed questionnaires measuring mood, motor disability and core psychological variables, including maladaptive assumptions, rumination, cognitive-behavioural avoidance, illness representations and cognitive-behavioural responses to symptoms. Results Regression analyses revealed that a small number of psychological factors accounted for the majority of depression variance, over and above that explained by overall disability. Participants reporting high levels of rumination, avoidance and symptom focusing experienced more severe depressive symptoms. In contrast, pervasive negative dysfunctional beliefs did not independently contribute to depression variance. Conclusion Specific cognitive (rumination and symptom focusing) and behavioural (avoidance) processes may be key psychological markers of depression in Parkinson's disease and therefore offer important targets for tailored psychological interventions. PMID:26944399

  18. Health management education in Europe and in the United States: a comparative review and analysis.

    PubMed

    Weil, Thomas P

    2013-08-01

    In Europe and in the United States, health management education and the role of health managers are patterned and consistent with how the country's healthcare system is organized, managed, and financed. In the United States, the fee-for-service, entrepreneurial dominated approach, resulting in health being one of the few remaining growth industries, has created a huge demand for additional health management education programs and managers. Therefore, universities finding themselves in an economic slump are attracted to establish health services administration programs (a North American term) since they require limited capital, continue to attract enrollment, and contribute to the "social good." In contrast, the European countries' healthcare systems provide universal access to care and strict, governmental fiscal control on healthcare expenditures. As a result, the American masters-level health manager model has not thrived there--although not willingly conceded is the fact that in Europe physicians continue to dominate the management ranks. After outlining a number of the current problems facing US health management education, this article focuses on: (1) a projected shuttering of the weaker American health management programs and the market for health managers being overly saturated (such as for lawyers now), because the US gross domestic product expenditures for health will decrease over the next two decades from the current level of 17.6% to be somewhat comparable to the 11.5% in Canada, France, and Germany; and (2) a projected increase in the enrollment among European health management programs for several reasons: (a) a huge spike in the demand for additional clinically oriented, health managers who can trade off concerns of cost versus quality; and (b) the constraints of most countries' statutory health insurance plans will become increasingly more evident so that privatization of healthcare services will become an option for those with above average incomes and, thereby, generate a demand for newly minted health managers similar to the US masters-level graduate. PMID:25595004

  19. 9 CFR 92.6 - Determination of the date of effective enforcement of a ruminant-to-ruminant feed ban.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... enforcement of a ruminant-to-ruminant feed ban. 92.6 Section 92.6 Animals and Animal Products ANIMAL AND PLANT... Determination of the date of effective enforcement of a ruminant-to-ruminant feed ban. (a) In order for APHIS to... BSE controlled risk, APHIS must determine the date from which a ban on the feeding of...

  20. Health sector development: from aid coordination to resource management.

    PubMed

    Walt, G; Pavignani, E; Gilson, L; Buse, K

    1999-09-01

    Aid coordination has assumed a prominent place on health policy agendas. This paper synthesizes the findings of research undertaken to explore the changing practices of aid coordination across a number of countries. It begins by reviewing the key issues giving rise to increased attention to aid coordination in the health sector. The second section describes, assesses and compares the strengths and weaknesses of the dominant mechanisms or instruments which were found to be employed to coordinate health sector aid in the case studies. From this analysis, four factors become clear. First, in many countries, coordination mechanisms have been introduced as a part of an incremental process of trying out different approaches--there is no one model that stands out at any one time. Secondly, some instruments function largely for consultation, predominantly coordinating inputs, while others are more directive and operational, and are used to manage inputs, processes and outputs. Third, many of the mechanisms have not excelled, although, fourth, it is difficult to judge the effectiveness or impact of aid coordination. It is therefore argued that concern with the effectiveness of aid coordination arrangements must give way to a broader analysis of the processes, outputs and outcomes governing the use of both external and domestic resources, focusing on institutional characteristics, the distribution and nature of influence among the actors, and the interests which they pursue through the aid regime. These factors varied considerably across the countries indicating that aid management is context dependent and subject to continuing changes. Finally, the paper looks at the findings in the light of the introduction of sector-wide approaches. PMID:10621238