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Sample records for public management home

  1. The political economy of a public health case management program's transition into medical homes.

    PubMed

    Wells, Rebecca; Cilenti, Dorothy; Issel, L Michele

    2015-11-01

    Throughout the United States, public health leaders are experimenting with how best to integrate services for individuals with complex needs. To that end, North Carolina implemented a policy incorporating both local public health departments and other providers into medical homes for low income pregnant women and young children at risk of developmental delays. To understand how this transition occurred within local communities, a pre-post comparative case study was conducted. A total of 42 people in four local health departments across the state were interviewed immediately before the 2011 policy change and six months later: 32 professionals (24 twice) and 10 pregnant women receiving case management at the time of the policy implementation. We used constant comparative analysis of interview and supplemental data to identify three key consequences of the policy implementation. One, having medical homes increased the centrality of other providers relative to local health departments. Two, a shift from focusing on personal relationships toward medical efficiency diverged in some respects from both case managers' and mothers' goals. Three, health department staff re-interpreted state policies to fit their public health values. Using a political economy perspective, these changes are interpreted as reflecting shifts in public health's broader ideological environment. To a large extent, the state successfully induced more connection between health department-based case managers and external providers. However, limited provider engagement may constrain the implementation of the envisioned medical homes. The increased focus on medical risk may also undermine health departments' role in supporting health over time by attenuating staff relationships with mothers. This study helps clarify how state public health policy innovations unfold at local levels, and why front line practice may in some respects diverge from policy intent. Published by Elsevier Ltd.

  2. A health information network for managing innercity tuberculosis: bridging clinical care, public health, and home care.

    PubMed

    Hripcsak, G; Knirsch, C A; Jain, N L; Stazesky, R C; Pablos-Mendez, A; Fulmer, T

    1999-02-01

    The purpose of this study was to use a health information network and innovative technology to coordinate tuberculosis care. An innercity medical center, a local health department, and a home care nurse service in northern Manhattan were used. The organizations were linked with computer networks. An automated decision support system with a natural language processor was used to detect tuberculosis cases and report them to the health department, and to select patients for respiratory isolation. Educational materials were placed on the World Wide Web and a Web-based kiosk. Home care nurses were outfitted with wireless pen-based computers, and data were relayed to the medical center. Automated tuberculosis case reporting resulted in time savings but not improved accuracy. Automated rules resulted in significant improvements in respiratory isolation. Kiosk educational materials were well-used. Wireless computing led to better access to information for both nurses and physicians, but not to reduction of workload. The key success element was recognition of critical priorities. It is concluded that innovative technology can facilitate the coordination of clinical care, public health, and home care. Copyright 1999 Academic Press.

  3. Home audit program: management manual

    SciTech Connect

    Not Available

    1980-09-01

    Many public power systems have initiated home energy audit programs in response to the requests of their consumers. The manual provides smaller public power systems with the information and specific skills needed to design and develop a program of residential energy audits. The program is based on the following precepts: locally owned public systems are the best, and in many cases the only agencies available to organize and coordinate energy conservation programs in many smaller communities; consumers' rights to energy conservation information and assistance should not hinge on the size of the utility that serves them; in the short run, public power systems of all sizes should offer residential energy conservation assistance to their consumers, because such assistance is desirable, necessary, and in the public interest; and in the long run, such programs will complement national energy goals and will produce economic benefits for both consumers and the public power system. A detailed description of home audit program planning, organization, and management are given. (MCW)

  4. Home Management and Consumer Education.

    ERIC Educational Resources Information Center

    Texas Education Agency, Austin. Dept. of Occupational Education and Technology.

    Developed by an instructional materials center, this teaching guide was prepared to present home management and consumer education in the perspective of family living. Arranged in four major sections the section on Homemaking I introduces the student to management in everyday living, while Homemaking II emphasizes the management of household…

  5. Home Management and Consumer Education.

    ERIC Educational Resources Information Center

    Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

    Designed for use in consumer and homemaking education in Texas, this curriculum guide is on the subject of home management and consumer education. An introduction to the guide, covering its use and program and curriculum planning, provides a list of suggested reading. Information on teaching handicapped and disadvantaged students follows. The…

  6. Home Management and Consumer Education.

    ERIC Educational Resources Information Center

    Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

    Designed for use in consumer and homemaking education in Texas, this curriculum guide is on the subject of home management and consumer education. An introduction to the guide, covering its use and program and curriculum planning, provides a list of suggested reading. Information on teaching handicapped and disadvantaged students follows. The…

  7. Effective Public Management

    ERIC Educational Resources Information Center

    Bower, Joseph L.

    1977-01-01

    Argues that public management differs from private management not just in degree but in quality, so that American business is an inappropriate analogy for evaluating public management. In particular, "purpose,""organization," and "people" have different meaning and significance in public agencies and private businesses. (JG)

  8. Effective Public Management

    ERIC Educational Resources Information Center

    Bower, Joseph L.

    1977-01-01

    Argues that public management differs from private management not just in degree but in quality, so that American business is an inappropriate analogy for evaluating public management. In particular, "purpose,""organization," and "people" have different meaning and significance in public agencies and private businesses. (JG)

  9. Alert management for home healthcare based on home automation analysis.

    PubMed

    Truong, T T; de Lamotte, F; Diguet, J-Ph; Said-Hocine, F

    2010-01-01

    Rising healthcare for elder and disabled people can be controlled by offering people autonomy at home by means of information technology. In this paper, we present an original and sensorless alert management solution which performs multimedia and home automation service discrimination and extracts highly regular home activities as sensors for alert management. The results of simulation data, based on real context, allow us to evaluate our approach before application to real data.

  10. Home Schooling in Alabama: Perspectives of Public School Superintendents and Home Schooling Families.

    ERIC Educational Resources Information Center

    Kozlowski, Anna T.

    This paper describes home schooling in Alabama from the perspectives of public-school superintendents and home-schooling families. It is based on a study that investigated the extent, causes, and experiences of home schooling; concerns about the practice of home schooling; and the relationship between home schoolers and public-school systems. Home…

  11. Managing Home Health Care (For Parents)

    MedlinePlus

    ... Your 1- to 2-Year-Old Managing Home Health Care KidsHealth > For Parents > Managing Home Health Care A ... español La atención médica en el hogar Intensive Health Care at Home Kids can need intensive health care ...

  12. Home Management House: Reflections of Alumnae

    ERIC Educational Resources Information Center

    Tifft, Kathleen; Fletcher, Janice; Junk, Virginia W.

    2011-01-01

    Historically, curriculum for home economics included experiences in home management residences. In this qualitative study, nine alumnae and one advisor who lived in a home management house between 1939 and 1959 were interviewed about how their experiences influenced the quality of their lives in the 40-60 subsequent years. Alumnae of the residence…

  13. Home Management House: Reflections of Alumnae

    ERIC Educational Resources Information Center

    Tifft, Kathleen; Fletcher, Janice; Junk, Virginia W.

    2011-01-01

    Historically, curriculum for home economics included experiences in home management residences. In this qualitative study, nine alumnae and one advisor who lived in a home management house between 1939 and 1959 were interviewed about how their experiences influenced the quality of their lives in the 40-60 subsequent years. Alumnae of the residence…

  14. Reliability of health information for the public on the World Wide Web: systematic survey of advice on managing fever in children at home.

    PubMed Central

    Impicciatore, P.; Pandolfini, C.; Casella, N.; Bonati, M.

    1997-01-01

    OBJECTIVE: To assess the reliability of healthcare information on the world wide web and therefore how it may help lay people cope with common health problems. METHODS: Systematic search by means of two search engines, Yahoo and Excite, of parent oriented web pages relating to home management of feverish children. Reliability of information on the web sites was checked by comparison with published guidelines. MAIN OUTCOME MEASURES: Minimum temperature of child that should be considered as fever, optimal sites for measuring temperature, pharmacological and physical treatment of fever, conditions that may warrant a doctor's visit. RESULTS: 41 web pages were retrieved and considered. 28 web pages gave a temperature above which a child is feverish; 26 pages indicated the optimal site for taking temperature, most recommending rectal measurement; 31 of the 34 pages that mentioned drug treatment recommended paracetamol as an antipyretic; 38 pages recommended non-drug measures, most commonly tepid sponging, dressing lightly, and increasing fluid intake; and 36 pages gave some indication of when a doctor should be called. Only four web pages adhered closely to the main recommendations in the guidelines. The largest deviations were in sponging procedures and how to take a child's temperature, whereas there was a general agreement in the use of paracetamol. CONCLUSIONS: Only a few web sites provided complete and accurate information for this common and widely discussed condition. This suggests an urgent need to check public oriented healthcare information on the internet for accuracy, completeness, and consistency. PMID:9224132

  15. Managing Public Library Investments.

    ERIC Educational Resources Information Center

    Sager, Don

    1985-01-01

    Reports results of public library survey conducted by a Public Library Association committee that was established to study library investment practices and assess the need for establishing an investment management service. Revenue sources, investment patterns, benefits of pooling, and a proposed management service are highlighted. Six sources are…

  16. Public Library Services for Home Schooling. ERIC Digest.

    ERIC Educational Resources Information Center

    Masters, Denise G.

    Public libraries have a responsibility toward all of their patrons, including home schoolers. "Home schooling" describes the situation where parents or guardians choose not to send their children to public or private schools, but instead educate their children themselves. Libraries are very important to home schoolers because, in most…

  17. Home Care Nursing Improves Cancer Symptom Management

    Cancer.gov

    Home care nursing (HCN) improves the management of symptoms in breast and colorectal cancer patients who take the oral chemotherapy drug capecitabine, according to a study published online November 16 in the Journal of Clinical Oncology.

  18. Energy. Nebraska Home Economics Energy Management Guide.

    ERIC Educational Resources Information Center

    Nickisch, Marge Hill

    The Nebraska Home Economics Energy Management Guide is composed of 25 individual lessons in 5 units plus a resource section. The introductory unit discusses basic principles in decision-making, the historical development of energy sources and use, and the rationale for energy management. The next four units focus on energy management in housing,…

  19. Home Telecare for Chronic Disease Management

    DTIC Science & Technology

    2007-11-02

    chronic obstructive pulmonary disease ( COPD ) is increasingly common. The US experience with effective disease management has seen significant...home admissions [2] • more effective management of asthma, depression , epilepsy and AIDS [3]. Home care and ambulatory care for patients with... COPD is now an established service in many countries of the world and is beginning to demonstrate significant improvements in health care outcomes at

  20. Home management of INR in the public health system: feasibility of self-management of oral anticoagulation and long-term performance of individual POC devices in determining INR.

    PubMed

    da Silva Saraiva, Sabrina; Orsi, Fernanda Andrade; Santos, Marcos Pereira; Machado, Tania; Montalvão, Silmara; Costa-Lima, Carolina; de Paula, Erich Vinícius; Colella, Marina Pereira; Annichino-Bizzacchi, Joyce

    2016-07-01

    The home prothrombin time/international normalized ratio (PT/INR) self-management could be convenient for patients, enhancing treatment compliance and improving the quality of the oral anticoagulation. However, patient self-management (PSM) of oral anticoagulation may not be feasible for up to half of the patients due to cognitive or educational issues. In the present study, we aimed to evaluate the feasibility of a PSM program in a public health medical center that provides care for low-income patients. We also aimed to determine the accuracy of individual point-of-care devices (CoaguChek XS(®)) during long-term of home manipulation. Patients' time-in-therapeutic range (TTR) and perception of quality of life, were evaluated at scheduled study-visits to the center. Additionally, the accuracy of individual CoaguChek XS(®) was evaluated in comparison to the standard automated coagulometer at scheduled study-visits to the center. Twenty-five patients were included in the PSM program. The median TTR of patients was 75 % before inclusion, 72 % at 3 months, 75 % at 6 months and 100 % at 12 months after the beginning of self-management (P = 0.14).The median DASS scores were 64, 63, 61.5 and 71.5 before inclusion and at 3, 6 and 12 months, respectively (P = 0.09). One hundred paired INR values were obtained. Correlation between INR values delivered by individual CoaguChek XS(®) and the automated coagulometer was 94 % and the mean result bias was 0.07 INR units. The coefficient of correlation and the mean bias between methods was stable during 24 months of follow-up. The present study suggests that PSM is feasible for patients treated in the public health system and that the results delivered by CoaguChek XS(®) have long-term reliability.

  1. Outpatient management of home oxygen for bronchiolitis.

    PubMed

    Freeman, Julia Fuzak; Weng, Hsin-Yi Cindy; Sandweiss, David

    2015-01-01

    Home O2 has been shown to reduce hospitalizations for bronchiolitis but data on outpatient management of home O2 are lacking. We aim to describe outpatient management and challenges to home O2 for bronchiolitis. We surveyed Colorado and Utah (where home O2 use is prevalent) chapter members of the American Academy of Pediatrics regarding bronchiolitis home O2 management. A total of 1030 providers were surveyed. The response rate was 21% (n = 214). Ninety percent of practicing primary care providers reported experience with home O2. Of those, 46% see patients on postdischarge day 1. Most providers see patients 1 to 3 times before stopping O2. Eighty percent continue O2 for 3 to 7 days. Weaning procedures vary and 56% practice more than 1 method. Most (41%) do not use continuous pulse oximetry. Challenges include parental noncompliance (51%) and difficulty knowing when to stop the O2 (57%). Management of home O2 in patients with bronchiolitis is a common in UT and CO. Weaning practices vary. Further research is needed. © The Author(s) 2014.

  2. Pain management in the nursing home.

    PubMed

    Dumas, Linda G; Ramadurai, Murali

    2009-06-01

    This article is about pain management and some of the best practices to address the problem of pain in nursing home patients who have a serious illness and multiple comorbid conditions. Management of the emotional distress that accompanies chronic or acute pain is of foremost concern. In this article, the topics discussed include general pain management in a nursing home for a long-term care resident who has chronic pain, the relief of symptoms and suffering in a patient who is on palliative care and hospice, and the pain management of a postoperative patient with acute pain for a short transitional period (post-acute illness or surgery).

  3. Homes and Frontiers: Literacy, Home Schooling, and Articulations of the Public and the Private

    ERIC Educational Resources Information Center

    Marzluf, Phillip P.

    2009-01-01

    This interview-based study suggests that the home schooling movement represents another literacy crisis. Home-schooled students may define their commitments to the public sphere in ways that conflict with the assumptions of community literacy and other pedagogical projects. Home schoolers may adopt the values of the "literacy frontier,"…

  4. Humanism in nursing homes: the impact of top management.

    PubMed

    Castle, Nicholas G; Ferguson, Jamie C; Hughes, Kevin

    2009-01-01

    We provide a review of ways in which top managers of nursing homes can provide or impact the humanistic component of care provided in their facilities. We describe the nursing home top management team; the role of top managers in nursing homes; the role of top managers as leaders in the nursing home; the literature examining the impact of top managers in nursing homes; and, examine developments in the nursing home industry that are influencing (or could potentially influence) the humanistic components of care. We conclude with suggestions for top managers, nursing home owners, and policy makers to create more caring humanistic environments. Suggestions include resident-directed care initiatives and culture change.

  5. Home media server content management

    NASA Astrophysics Data System (ADS)

    Tokmakoff, Andrew A.; van Vliet, Harry

    2001-07-01

    With the advent of set-top boxes, the convergence of TV (broadcasting) and PC (Internet) is set to enter the home environment. Currently, a great deal of activity is occurring in developing standards (TV-Anytime Forum) and devices (TiVo) for local storage on Home Media Servers (HMS). These devices lie at the heart of convergence of the triad: communications/networks - content/media - computing/software. Besides massive storage capacity and being a communications 'gateway', the home media server is characterised by the ability to handle metadata and software that provides an easy to use on-screen interface and intelligent search/content handling facilities. In this paper, we describe a research prototype HMS that is being developed within the GigaCE project at the Telematica Instituut . Our prototype demonstrates advanced search and retrieval (video browsing), adaptive user profiling and an innovative 3D component of the Electronic Program Guide (EPG) which represents online presence. We discuss the use of MPEG-7 for representing metadata, the use of MPEG-21 working draft standards for content identification, description and rights expression, and the use of HMS peer-to-peer content distribution approaches. Finally, we outline explorative user behaviour experiments that aim to investigate the effectiveness of the prototype HMS during development.

  6. Leadership philosophy of care home managers.

    PubMed

    Rippon, Daniel; James, Ian Andrew

    Care home managers have a significant influence on staff morale and care delivery. Training methods underpinned by transformational leadership theory (TLT) have been used successfully to develop leaders in healthcare services. The aim of this preliminary study was to establish which aspects of TLT were apparent in care home managers' philosophies of leadership. A qualitative research design was used and 25 care home managers in the north-east of England took part. Participants were asked to provide their philosophies of leadership by completing a questionnaire; a thematic analysis of the responses was then conducted. Development of philosophy, enablement and interpersonal impact emerged as key themes. The findings suggested that elements of TLT were apparent in the participants' philosophies of leadership. However, the importance of gaining the support of senior management when attempting to apply a philosophy of eadership in practice was lacking. Aspects of TLT, such as supporting frontline employees to engage in education and establishing trust, were embedded in care home managers' philosophies. To develop leadership skills, managers may benefit from training programmes that involve both structured teaching and guided learning through experience.

  7. Home School and the Public School: Rethinking the Relationship.

    ERIC Educational Resources Information Center

    Romanowski, Michael H.

    2001-01-01

    Public school educators often fail to appreciate the various reasons home schooling is an increasingly attractive option for families of nearly every class, race, religion, and political perspective. Parents preferring to home school their children generally reveal one of two motivations for their decision. 'Idealogues' aim to promote specific…

  8. Shared Calendars for Home Health Management.

    PubMed

    Eschler, Jordan; Kendall, Logan; O'Leary, Katie; Vizer, Lisa M; Lozano, Paula; McClure, Jennifer B; Pratt, Wanda; Ralston, James D

    2015-03-01

    What is the role of shared calendars for home health management? Utilizing a maximum variation sampling method, we interviewed 20 adult individuals with diabetes and 20 mothers of children with asthma to understand calendar use in the context of chronic disease home health management. In comparing the experiences of these two groups, we explore participants' use of tools for organizing tasks and appointments, their strategies for capturing health and non-health events in the family calendar system, the ecology of artifacts that intersect with their scheduling tools, and the failures they experienced while managing their calendar systems. Through this work, we offer a context-specific perspective of schedule management strategies for individuals and families who must integrate their handling of chronic illnesses with everyday living.

  9. Life Management Skills, 8230. Home Economics Education.

    ERIC Educational Resources Information Center

    Loudoun County Public Schools, Leesburg, VA.

    The middle school home economics curriculum on Life Management Skills I (eighth grade) meets the needs of the early adolescent. It is based upon three major concepts: (1) basic skills; (2) self-knowledge/understanding/decision making; and (3) independence/interdependence. Emphasis on the basic skills of reading, writing, communicating, using…

  10. Energy Management Checklist for the Home.

    ERIC Educational Resources Information Center

    Pifer, Glenda

    This booklet contains a checklist of equipment and activities for the individual's use in home energy management. The categories covered include: (1) insulation; (2) windows; (3) temperature control; (4) lighting; (5) heating water; (6) laundry; (7) cleaning and maintenance; (8) cooking; (9) refrigeration; (10) dishwashing; (11) recreation; and…

  11. Ostomy: Home Management and Other Resources

    MedlinePlus

    ... someone notices a pouch leak (for example, signal system). American College of Surgeons • Division of Education Home Management and Other Resources Your Discharge Medical Professionals’ Contact Information My surgeon’s name and number: My ostomy/WOC ...

  12. Life Management Skills, 8230. Home Economics Education.

    ERIC Educational Resources Information Center

    Loudoun County Public Schools, Leesburg, VA.

    The middle school home economics curriculum on Life Management Skills I (eighth grade) meets the needs of the early adolescent. It is based upon three major concepts: (1) basic skills; (2) self-knowledge/understanding/decision making; and (3) independence/interdependence. Emphasis on the basic skills of reading, writing, communicating, using…

  13. Managing the body work of home care.

    PubMed

    England, Kim; Dyck, Isabel

    2011-02-01

    Body work is a key element of home healthcare. Recent restructuring of health and social care services means the home is increasingly a key site of long-term care. While there is a growing literature on the social dynamics between care recipients and their family caregivers, less is known about the formal work dynamic between paid care workers and care recipients and family caregivers. Drawing on interview data from an Ontario-based study of long-term home care, we explore how body work is negotiated through the embodied practices of care in the home and through care relationships associated with home care. In particular we focus on how the practices of intimate body care (such as bathing, toileting, and catheter management) show the diverse dynamics of care work through which caregivers, care recipients and homespace are constituted. We argue that the practices of care are shaped by a complex interweaving of regulatory mechanisms associated with home care along with the physical and affective dimensions of intimate body work. In turn this suggests the need for new ways of understanding body work in contemporary landscapes of care.

  14. Home Management of Hyperkinetic Children.

    ERIC Educational Resources Information Center

    Dubey, Dennis R.; Kaufman, Kenneth F.

    1978-01-01

    Six clinical programs (N=55) and one controlled, experimental program (N=25) were carried out in which parents of hyperkinetic children (ages 3-18 years) were trained in ten-week workshops to alleviate behavior problems by means of behavior modification and child management practices. Journal availability: C.V. Mosby Company, 11830 Westline…

  15. Home Management of Hyperkinetic Children.

    ERIC Educational Resources Information Center

    Dubey, Dennis R.; Kaufman, Kenneth F.

    1978-01-01

    Six clinical programs (N=55) and one controlled, experimental program (N=25) were carried out in which parents of hyperkinetic children (ages 3-18 years) were trained in ten-week workshops to alleviate behavior problems by means of behavior modification and child management practices. Journal availability: C.V. Mosby Company, 11830 Westline…

  16. Public opinion about guns in the home

    PubMed Central

    Kellermann, A.; Fuqua-Whitley, D.; Sampson, T.; Lindenmann, W.

    2000-01-01

    Objectives—(1) Determine the frequency of gun ownership, acquisition, and transfer; (2) assess gun storage practices; and (3) compare the views of firearm owning and non-owning adults regarding the protective value of keeping a gun in the home. Setting and methods—Over three different time periods (1995, 1996, and 1999) stratified, random digit telephone surveys were conducted in a five county area of metropolitan Atlanta, Georgia. Five hundred adults (aged 21+ years) responded to each survey. Results—The proportion of Atlanta area households reporting firearm ownership was generally stable over this interval (38%, 40%, and 35% respectively). The percentage of gun owning households containing a handgun (approximately 75%) was stable as well. In 1995, more than half of gun owning households kept one or more guns unlocked; since that time, the trend has been gradually downward. In 1995, 44% of gun owning respondents kept one or more guns loaded, compared with 38% in 1996 and 40% in 1999. A majority of respondents to all three surveys (55%) agreed with the statement "A home with a gun is less secure than a home without a gun, because a gun can be involved in an accidental shooting, suicide or family homicide". Among five home security measures, respondents rated a burglar alarm most effective, and keeping a gun in the home least effective. Conclusions—In Atlanta, many households keep a firearm for protection, but they are ambivalent about the associated risks. These findings suggest that education about gun safety should include a discussion of the risks of unsafe storage, and non-lethal alternatives for home security. PMID:11003183

  17. Public Managers Should Be Proactive

    ERIC Educational Resources Information Center

    Carlson, Thomas S.

    1976-01-01

    Future public managers should be proactive by creating management processes before problems arise. Planning prevents reactive or crisis managing. Future managers should also be prepared to meet dilemmas and paradoxes such as centralization versus decentralization of decision-making and work processes, politics versus administration dichotomy, and…

  18. Management of pneumonia in the nursing home.

    PubMed

    El-Solh, Ali A; Niederman, Mike S; Drinka, Paul

    2010-12-01

    Pneumonia is a major cause of morbidity and mortality among nursing home residents. The approach to managing these patients has lacked uniformity because of the paucity of clinical trials, complexity of underlying comorbid diseases, and heterogeneity of administrative structures. The decision to hospitalize nursing home patients with pneumonia varies among institutions depending on staffing level, availability of diagnostic testing, and laboratory support. In the absence of comparative studies, choice of empirical antibiotic therapy continues to be based on expert opinion. Validated prognostic scoring models are needed for risk stratification. Pneumococcal and influenza vaccination are the primary prevention measures. As of January 2010, Medicare no longer pays for consultation codes; thus, practitioners must instead use existing evaluation and management service codes when providing these services.

  19. Managing the Public Service Institution

    ERIC Educational Resources Information Center

    Drucker, Peter F.

    1976-01-01

    Important factors in managing a public service institution include knowing the publics served, phasing out an old program when introducing a new one, defining the roles of administrators and professionals, integrating individuals and the institution, and making the public aware of the value of the service performed. (PF)

  20. Job satisfaction of rural public and home health nurses.

    PubMed

    Juhl, N; Dunkin, J W; Stratton, T; Geller, J; Ludtke, R

    1993-03-01

    Based on Vroom's expectancy theory, this study was conducted to identify differences in job satisfaction between nurses working in public health settings, and staff nurses and administrators working in both settings. Questionnaires containing an adaptation of a job satisfaction scale were mailed to all 258 registered nurses practicing in public health and home health settings (response rate 57%) in a rural midwestern state. Respondents were asked to rate their satisfaction with various dimensions of their jobs, as well as how important each aspect was to them. Although both groups of nurses reported low satisfaction with salary, public health nurses were significantly less satisfied with their salaries than were home health nurses (F = 32.96, P < or = 0.001); home health nurses, however, were significantly less satisfied with benefits/rewards (F = 11.85, P < or = 0.001), task requirements (F = 8.37, P < or = 0.05), and professional status (F = 5.30, P < or = 0.05). Although administrators did not differ significantly from staff nurses on job satisfaction, they did perceive organizational climate (F = 4.50, P < or = 0.05) to be an important feature of satisfaction. These differences may be partially explained by divergent salaries, roles, and responsibilities between public health and home health nurses.

  1. Comparing Public Quality Ratings for Accredited and Nonaccredited Nursing Homes.

    PubMed

    Williams, Scott C; Morton, David J; Braun, Barbara I; Longo, Beth Ann; Baker, David W

    2017-01-01

    Compare quality ratings of accredited and nonaccredited nursing homes using the publicly available Centers for Medicare and Medicaid Services (CMS) Nursing Home Compare data set. This cross-sectional study compared the performance of 711 Joint Commission-accredited (TJC-accredited) nursing homes (81 of which also had Post-Acute Care Certification) to 14,926 non-Joint Commission-accredited (non-TJC-accredited) facilities using the Nursing Home Compare data set (as downloaded on April 2015). Measures included the overall Five-Star Quality Rating and its 4 components (health inspection, quality measures, staffing, and RN staffing), the 18 Nursing Home Compare quality measures (5 short-stay measures, 13 long-stay measures), as well as inspection deficiencies, fines, and payment denials. t tests were used to assess differences in rates for TJC-accredited nursing homes versus non-TJC-accredited nursing homes for quality measures, ratings, and fine amounts. Analysis of variance models were used to determine differences in rates using Joint Commission accreditation status, nursing home size based on number of beds, and ownership type. An additional model with an interaction term using Joint Commission accreditation status and Joint Commission Post-Acute Care Certification status was used to determine differences in rates for Post-Acute Care Certified nursing homes. Binary variables (eg, deficiency type, fines, and payment denials) were evaluated using a logistic regression model with the same covariates. After controlling for the influences of facility size and ownership type, TJC-accredited nursing homes had significantly higher star ratings than non-TJC-accredited nursing homes on each of the star rating component subscales (P < .05) (but not on the overall star rating), and TJC-accredited nursing homes with Post-Acute Care Certification performed statistically better on the overall star rating, as well as 3 of the 4 subscales (P < .05). TJC-accredited nursing homes

  2. Small Public Library Management

    ERIC Educational Resources Information Center

    Pearlmutter, Jane; Nelson, Paul

    2012-01-01

    Anyone at the helm of a small public library knows that every little detail counts. But juggling the responsibilities that are part and parcel of the job is far from easy. Finally, here's a handbook that includes everything administrators need to keep a handle on library operations, freeing them up to streamline and improve how the organization…

  3. Small Public Library Management

    ERIC Educational Resources Information Center

    Pearlmutter, Jane; Nelson, Paul

    2012-01-01

    Anyone at the helm of a small public library knows that every little detail counts. But juggling the responsibilities that are part and parcel of the job is far from easy. Finally, here's a handbook that includes everything administrators need to keep a handle on library operations, freeing them up to streamline and improve how the organization…

  4. 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.

  5. Publications Management Program

    DTIC Science & Technology

    2002-05-06

    3.21.4.2. Individuals with disabilities may have a range of functional limitations. These include deafness and, or hard of hearing; dexterity...compliant. All graphics and, or images must be properly identified by a number and a descriptive caption . Table 3.1. Coordinating a Publication...presentations) or includes authorizing VI hardware or acquiring and using VI products (audiovisual productions; e.g., films , video tapes, video disks

  6. Managing Public School Dollars.

    ERIC Educational Resources Information Center

    American Inst. of Certified Public Accountants, New York, NY.

    Although this booklet focuses on methods of accumulating and analyzing management and the financial and statistical data helpful to members of school boards, equal emphasis is placed on meeting the needs of the pupil--making him more self confident, developing his skills, instilling knowledge, and inspiring creativity. It considers changes in the…

  7. Using TQM to improve management of home health aides.

    PubMed

    Dansky, K H; Brannon, D

    1996-12-01

    Home health aides are at the front line of the home health industry, raising quality of care issues and human resource (HR) management challenges. Total quality management (TQM) provides a framework to help meet those challenges. The authors investigated the relationship between TQM and HR effectiveness in home health agencies. Results suggest that TQM practices are related to HR effectiveness. Suggestions are offered to make human resource management consistent with a TQM culture.

  8. Experiences of caregivers and relatives in public nursing homes.

    PubMed

    Häggström, Elisabeth; Kihlgren, Annica

    2007-09-01

    The aim of the present study was, by means of discussion highlighting ethical questions and moral reasonings, to increase understanding of the situations of caregivers and relatives of older persons living in a public nursing home in Sweden. The findings show that these circumstances can be better understood by considering two different perspectives: an individual perspective, which focuses on the direct contact that occurs among older people, caregivers and relatives; and a societal perspective, which focuses on the norms, values, rules and laws that govern a society. Relatives and caregivers thought that the politicians were sending out mixed messages: they were praising caregivers and relatives for their efforts, but at the same time the public health care sector was subjected to significant cutbacks in resources. Both caregivers and relatives were dissatisfied and frustrated with the present situation regarding the care of older persons in public nursing homes.

  9. Resource file: practical publications for energy management, edition III

    SciTech Connect

    Not Available

    1980-03-01

    The Resource File is an in-depth bibliography of 166 practical and action-oriented energy conservation publications and materials. It is a reference tool, designed for Federal, state, and local energy managers or people who are asked to recommend how-to conservation guides to the public. Each listing describes a publication's intended audience and provides a summary of its contents. Included are operations and maintenance manuals, life-cycle costing handbooks, home insulation manuals, films on fuel-saving driving techniques, and courses devoted exclusively to home weatherization. 166 items.

  10. THE ROLE OF THE CONSEQUENCE MANAGEMENT HOME TEAM IN THE FUKUSHIMA DAIICHI RESPONSE

    SciTech Connect

    Pemberton, Wendy; Mena, RaJah; Beal, William

    2012-05-01

    The Consequence Management Home Team is a U.S. Department of Energy/National Nuclear Security Administration asset. It assists a variety of response organizations with modeling; radiological operations planning; field monitoring techniques; and the analysis, interpretation, and distribution of radiological data. These reach-back capabilities are activated quickly to support public safety and minimize the social and economic impact of a nuclear or radiological incident. In the Fukushima Daiichi response, the Consequence Management Home Team grew to include a more broad range of support than was historically planned. From the early days of the response to the continuing involvement in supporting late phase efforts, each stage of the Consequence Management Home Team support had distinct characteristics in terms of management of incoming data streams as well as creation of products. Regardless of stage, the Consequence Management Home Team played a critical role in the Fukushima Daiichi response effort.

  11. Personal video manager: managing and mining home video collections

    NASA Astrophysics Data System (ADS)

    Wu, Peng; Obrador, Pere

    2005-07-01

    Home video collections constitute an important source of content to be experienced within the digital entertainment context. To make such content easy to access and reuse, various video analysis technologies have been researched and developed to extract video assets for management tasks, including video shot/scene detection, keyframe extraction, and video skimming/summarization. However, one less addressed issue is to investigate how useful those assets are in helping consumers managing their video collections and the usage pattern of the assets. In this paper, we present Personal Video Manager, both as a home video management system and an explorative research platform to enable a systematic analysis and understanding of consumers" demand on video assets and video processing technologies. For understanding consumer"s interest, PVM adopts database management technologies to model and archive how consumers identify video assets and utilize them for management tasks. The PVM mining engine performs data mining on such archived data to mine useful knowledge of consumer"s preference on video assets and behavior on utilizing the assets. As revealed in the experiment, consumer's interaction embeds rich information to be leveraged in developing more effective video analysis technologies.

  12. HOME MANAGEMENT AIDES, A HOME SKILLS TEACHING SERVICE FOR LOW INCOME MOTHERS.

    ERIC Educational Resources Information Center

    MURTON, BONNIE J.; AND OTHERS

    ABOUT 25 PERCENT OF ALL AID FOR DEPENDENT CHILDREN CASES IN THE CITY OF MINNEAPOLIS WERE IN TWO YOUTH DEVELOPMENT PROJECT TARGET AREAS WHERE MOTHERS OFTEN LACKED HOME MANAGEMENT SKILLS NECESSARY TO REAR THEIR CHILDREN. AS ONE OF SEVERAL DEMONSTRATION PROGRAMS TO PREVENT AND ALLEVIATE PROBLEMS OF DELINQUENCY, IN 1964 FOUR HOME MANAGEMENT AIDES…

  13. 7 CFR Exhibit A to Subpart B of... - Memorandum of Understanding Between the Federal Emergency Management Agency and the Farmers Home...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Emergency Management Agency and the Farmers Home Administration or Its Successor Agency under Public Law 103... Emergency Management Agency and the Farmers Home Administration or Its Successor Agency under Public Law 103... any FmHA or its successor agency under Public Law 103-354 County Office....

  14. West Midlands Care Home Dental Survey 2011: part 1. Results of questionnaire to care home managers.

    PubMed

    Watson, F; Tomson, M; Morris, A J; Taylor-Weetman, K; Wilson, K I

    2015-10-09

    To provide baseline data on dental issues affecting residents from the perspective of care home managers to inform oral health local needs assessments and commissioning decisions. A pre-piloted postal questionnaire was sent to all identified managers of adult care homes (1,832) in the West Midlands between February and April 2011. Quantitative analysis was complemented by seeking the views of care home managers regarding training and experience of, and access to, dental services. The response rate to the study was 63.9% (1,170/1,832). There were 194 responding care homes who reported that residents had problems accessing dental services. Nearly double the proportion of nursing care homes and care homes with residents with elderly mental impairment (EMI) reported problems accessing dental services compared with care homes without nursing care and non-EMI care homes. Issues raised included patient safety concerns, reservations regarding expertise of dental staff, difficulties with transporting residents and waiting times for treatment. The survey provided a snapshot of dental issues as reported by care home managers, these results should help inform both the dental profession and those who commission services about issues affecting the oral health of patients living in care homes.

  15. Leaving Public Schools for Home Schooling: Implications for School Public Relations.

    ERIC Educational Resources Information Center

    McLeod, Suzanne E.; Osterman, Karen F.

    2003-01-01

    Addresses the sources of dissatisfaction from parents who had removed their children from public schools to begin home schooling. Implications for public schools' community relations and practice specifically focus on three areas of greatest concern: student grouping practices, peer relationships, and the extension of the school day via homework.…

  16. Remote home management for chronic kidney disease: A systematic review.

    PubMed

    He, Ting; Liu, Xing; Li, Ying; Wu, Qiaoyu; Liu, Meilin; Yuan, Hong

    2017-01-01

    Background Remote home management is a new healthcare model that uses information technology to enhance patients' self-management of disease in a home setting. This study is designed to identify the effects of remote home management on patients with chronic kidney disease (CKD). Methods A comprehensive search of PubMed, MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials was performed in January 2015. The reference listings of the included articles in this review were also manually examined. Randomized controlled trials (RCTs) designed to evaluate the effects of remote home management on patients with CKD were included. Results Eight trials were identified. The results of this study suggest that the quality of life (QOL) enabled by remote home management was higher than typical care in certain dimensions. However, the effects of remote home management on blood pressure (BP) remain inconclusive. The studies that assessed health service utilization demonstrated a significant decrease in hospital readmission, emergency room visits, and number of days in the hospital. Another favorable result of this study is that regardless of their gender, age or nationality, patients tend to comply with remote home management programs and the use of related technologies. Conclusions The available data indicate that remote home management may be a novel and effective disease management strategy for improving CKD patients' QOL and influencing their attitudes and behaviors. And, relatively little is known about BP and cost-effectiveness, so future research should focus on these two aspects for the entire population of patients with CKD.

  17. Is There Evidence of Cream Skimming among Nursing Homes following the Publication of the Nursing Home Compare Report Card?

    ERIC Educational Resources Information Center

    Mukamel, Dana B.; Ladd, Heather; Weimer, David L.; Spector, William D.; Zinn, Jacqueline S.

    2009-01-01

    Purpose: A national quality report card for nursing homes, Nursing Home Compare, has been published since 2002. It has been shown to have some, albeit limited, positive impact on quality of care. The objective of this study was to test empirically the hypothesis that nursing homes have responded to the publication of the report by adopting cream…

  18. Is There Evidence of Cream Skimming among Nursing Homes following the Publication of the Nursing Home Compare Report Card?

    ERIC Educational Resources Information Center

    Mukamel, Dana B.; Ladd, Heather; Weimer, David L.; Spector, William D.; Zinn, Jacqueline S.

    2009-01-01

    Purpose: A national quality report card for nursing homes, Nursing Home Compare, has been published since 2002. It has been shown to have some, albeit limited, positive impact on quality of care. The objective of this study was to test empirically the hypothesis that nursing homes have responded to the publication of the report by adopting cream…

  19. Top Management Team Characteristics and Innovation in Nursing Homes.

    ERIC Educational Resources Information Center

    Castle, Nicholas G.; Banaszak-Holl, Jane

    1997-01-01

    Examines how demographic characteristics of the top management team in 236 nursing homes can affect the adoption of innovations. Results indicate that managers of non-chain nursing homes showed a greater association between demographic factors and innovation. Job tenure, educational background, and professional involvement were important…

  20. Actualizing Concepts in Home Management: Proceedings of a National Conference.

    ERIC Educational Resources Information Center

    American Home Economics Association, Washington, DC.

    The booklet prints the following papers delivered at a national conference: Actualizing Concepts in Home Management: Decision Making, Dorothy Z. Price; Innovations in Teaching: Ergonomics, Fern E. Hunt; Relevant Concepts of Home Management: Innovations in Teaching, Kay P. Edwards; Standards in a Managerial Context, Florence S. Walker; Organizing:…

  1. Health information management in the home: a human factors assessment.

    PubMed

    Zayas-Cabán, Teresa

    2012-01-01

    Achieving optimal health outcomes requires that consumers maintain myriad health data and understand how to utilize appropriate health information management applications. This case study investigated four families' health information management tasks in their homes. Four different families participated in the study: a single parent household; two nuclear family households; and an extended family household. A work system model known as the balance model was used as a guiding framework for data collection. Data collection consisted of three stages: (1) primary health information manager interviews; (2) family interviews; and (3) task observations. Overall, families reported 69 unique health information management tasks that took place in nine different locations, using 22 different information storage artifacts. Frequently occurring tasks related to health management or health coordination were conducted in public spaces. Less frequent or more time-consuming tasks, such as researching a health concern or storing medical history, were performed in private spaces such as bedrooms or studies. Similarities across households suggest potential foundational design elements that consumer health information technology application designers need to balance with tailored interventions to successfully support variations in individuals' health information management needs.

  2. Communicating with external publics: managing public opinion and behavior.

    PubMed

    Ristino, Robert J

    2007-01-01

    In health care organizational settings public relations plays an important role in managing relationships with a variety of external publics as well as with society in general. Managing these relationships involves both reactive and proactive communication activities. Reactively, public relations responds to public issues, crises and concerns, as well as inquiries from the media and other social institutions. Proactively, public relations engages in deliberately planned campaigns and programs to inform, influence or change behaviors of targeted publics for a wide range of strategic purposes. These purposes include managing the organization's image and identity; influencing public policies; supporting health promotion and education; promoting fund raising and volunteerism; and managing organizational change and crises.

  3. Quality management in home care: models for today's practice.

    PubMed

    Verhey, M P

    1996-01-01

    In less than a decade, home care providers have been a part of two major transitions in health care delivery. First, because of the advent of managed care and a shift from inpatient to community-based services, home care service delivery systems have experienced tremendous growth. Second, the principles and practices of total quality management and continuous quality improvement have permeated the organization, administration, and practice of home health care. Based on the work of Deming, Juran, and Crosby, the basic tenets of the new quality management philosophy involve a focus on the following five key areas: (1) systems and processes rather than individual performance; (2) involvement, collaboration, and empowerment; (3) internal and external "customers"; (4) data and measurement; and (5) standards, guidelines, and outcomes of care. Home care providers are among those in the forefront who are developing and implementing programs that integrate these foci into the delivery of quality home care services. This article provides a summary of current home care programs that address these five key areas of quality management philosophy and provide models for innovative quality management practice in home care. For further information about each program, readers are referred to the original reports in the home care and quality management journal literature, as cited herein.

  4. [Infection control management and practice in home care - analysis of structure quality].

    PubMed

    Spegel, H; Höller, C; Randzio, O; Liebl, B; Herr, C

    2013-02-01

    Surveillance of infection control management and practices in home care is an important task of the public health service. While infection control aspects in residential homes for the aged and nursing are increasingly being discussed this subject has been poorly recognised in home care. The aim of this study was to identify problems in hygiene regarding the transmission of infectious diseases as well as quality assessment in home care. Based on the results of this study implications for infection control in home care facilities for public health services should be developed. Statistical analyses were performed on the primary quality assessment data of home care facilities collected by the medical service of health insurances via computer-assisted personal interviews between March 2006 and March 2009. Structure quality in 194 home care facilities was analysed as well as human resources and organisational conditions. Analyses were also done in the context of the clients' risk factor load. All analyses were performed by stratifying for the size of the home care services. To assess how the involved characteristics vary according to the size of the home care services chi-square tests and non-parametric tests were calculated. About 80% of the assessed home care services disposed of an infection control management plan. Compared to larger services smaller home care services, especially services with less than 10 clients had a poor structure in infection control management and practice. They also carried a higher load of risk factors in clients. The larger services had significantly less human resources. Surveillance of infection control management and practices by the public health services should focus on the structure of the smaller home care services. At the same time smaller home care services should be supported by offering training for the staff or counselling regarding hygiene-related aspects. Furthermore, the outcome quality of the larger home care services with

  5. Quality Assurance Strategy for Existing Homes: Final Quality Management Primer for High Performing Homes

    SciTech Connect

    Del Bianco, M.; Taggart, J.; Sikora, J.; Wood, A.

    2012-12-01

    This guide is designed to help Building America (BA) Teams understand quality management and its role in transitioning from conventional to high performance home building and remodeling. It explains what quality means, the value of quality management systems, the unique need for QMS when building high performing homes, and the first steps to a implementing a comprehensive QMS. This document provides a framework and context for BA teams when they encounter builders and remodelers.

  6. Quality Assurance Strategy for Existing Homes. Final Quality Management Primer for High Performing Homes

    SciTech Connect

    Del Bianco, M.; Taggart, J.; Sikora, J.; Wood, A.

    2012-12-01

    This guide is designed to help Building America (BA) teams understand quality management and its role in transitioning from conventional to high performance home building and remodeling. It explains what quality means, the value of quality management systems, the unique need for QMS when building high performing homes, and the first steps to a implementing a comprehensive QMS. This document provides a framework and context for BA teams when they encounter builders and remodelers.

  7. Managing congestive heart failure using home telehealth.

    PubMed

    Schneider, Nina M

    2004-10-01

    Congestive heart failure (CHF) is the leading cause of rehospitalization and loss of revenue for home care agencies and hospitals. This article outlines how an agency used telehealth to provide CHF patients quality care and improved outcomes while decreasing the number of skilled home nursing visits and reducing rehospitalization rates to 1.2%.

  8. Feasibility of home management using ACT for childhood malaria episodes in an urban setting

    PubMed Central

    Nsagha, Dickson S; Elat, Jean-Bosco N; Ndong, Proper AB; Tata, Peter N; Tayong, Maureen-Nill N; Pokem, Francois F; Wankah, Christian C

    2012-01-01

    and ACT all year round is one of the challenges of home management of malaria. Although radio and television featured among the current sources of information within the community, meetings, churches, schools, and other public gatherings were the best venues for social mobilization, while community health workers and community leaders were the best sensitization agents for positive behavior change to adhere to home management of malaria. Monetary incentives should be offered to community drug distributors. This should be deducted from the combined price of ACT and rapid diagnostic testing. Conclusion For successful implementation of home management of malaria, there should be proper education, social mobilization of the population, and continuous monitoring and evaluation of field activities to ensure adequate stocks of ACT and rapid diagnostic testing within the framework of the intervention. PMID:22328833

  9. Feasibility of home management using ACT for childhood malaria episodes in an urban setting.

    PubMed

    Nsagha, Dickson S; Elat, Jean-Bosco N; Ndong, Proper Ab; Tata, Peter N; Tayong, Maureen-Nill N; Pokem, Francois F; Wankah, Christian C

    2012-01-01

    the challenges of home management of malaria. Although radio and television featured among the current sources of information within the community, meetings, churches, schools, and other public gatherings were the best venues for social mobilization, while community health workers and community leaders were the best sensitization agents for positive behavior change to adhere to home management of malaria. Monetary incentives should be offered to community drug distributors. This should be deducted from the combined price of ACT and rapid diagnostic testing. For successful implementation of home management of malaria, there should be proper education, social mobilization of the population, and continuous monitoring and evaluation of field activities to ensure adequate stocks of ACT and rapid diagnostic testing within the framework of the intervention.

  10. What do we know about care home managers? Findings of a scoping review.

    PubMed

    Orellana, Katharine; Manthorpe, Jill; Moriarty, Jo

    2017-03-01

    This article reports selected findings from a scoping review of the literature about care home managers in England. The review was undertaken between December 2013 and April 2014, with searches conducted in December 2013, and completed in July 2014. Its aim was to identify the characteristics of care home managers, descriptions of their leadership and managerial roles, their experience, skills and support, and the managers' perceptions of their work and status and to identify knowledge gaps. The databases searched included Web of Knowledge, EBSCO, ASSIA, Embase, AgeInfo, NHS Evidence, Social Care Online and the publication platforms IngentaConnect, Wiley Online and JSTOR together with specialist sites and national information providers. Sixteen relevant studies directly about care home managers, reported in 24 articles, were identified. A further body of literature pertinent to the questions was located (n = 84), including sector reports, professional press, expert opinion, enquiries and reviews, and other material, which also informed the review. A consultation exercise with stakeholders informed the findings of the review. The review found that, despite frequent allusions to their impact on organisational culture, few studies have focused on care home managers, and, such as there are, mainly relate to managers of care homes for older people. This is despite managers' major responsibilities for the care of many frail and disabled people.

  11. Identifying Home Care Clinicians’ Information Needs for Managing Fall Risks

    PubMed Central

    Alhuwail, Dari

    2016-01-01

    Summary Objectives To help manage the risk of falls in home care, this study aimed to (i) identify home care clinicians’ information needs and how they manage missing or inaccurate data, (ii) identify problems that impact effectiveness and efficiency associated with retaining, exchanging, or processing information about fall risks in existing workflows and currently adopted health information technology (IT) solutions, and (iii) offer informatics-based recommendations to improve fall risk management interventions. Methods A case study was carried out in a single not-for-profit suburban Medicare-certified home health agency with three branches. Qualitative data were collected over a six month period through observations, semi-structured interviews, and focus groups. The Framework method was used for analysis. Maximum variation sampling was adopted to recruit a diverse sample of clinicians. Results Overall, the information needs for fall risk management were categorized into physiological, care delivery, educational, social, environmental, and administrative domains. Examples include a brief fall-related patient history, weight-bearing status, medications that affect balance, availability of caregivers at home, and the influence of patients’ cultures on fall management interventions. The unavailability and inaccuracy of critical information related to fall risks can delay necessary therapeutic services aimed at reducing patients’ risk for falling and thereby jeopardizing their safety. Currently adopted IT solutions did not adequately accommodate data related to fall risk management. Conclusion The results highlight the essential information for fall risk management in home care. Home care workflows and health IT solutions must effectively and efficiently retain, exchange, and process information necessary for fall risk management. Interoperability and integration of the various health IT solutions to make data sharing accessible to all clinicians is critical

  12. Fuzzy-Logic Subsumption Controller for Home Energy Management Systems

    SciTech Connect

    Ainsworth, Nathan; Johnson, Brian; Lundstrom, Blake

    2015-10-06

    Home Energy Management Systems (HEMS) are controllers that manage and coordinate the generation, storage, and loads in a home. These controllers are increasingly necessary to ensure that increasing penetrations of distributed energy resources are used effectively and do not disrupt the operation of the grid. In this paper, we propose a novel approach to HEMS design based on behavioral control methods, which do not require accurate models or predictions and are very responsive to changing conditions. We develop a proof-of-concept behavioral HEMS controller and show by simulation on an example home energy system that it capable of making context-dependent tradeoffs between goals under challenging conditions.

  13. Home and Online Management and Evaluation of Blood Pressure (HOME BP) digital intervention for self-management of uncontrolled, essential hypertension: a protocol for the randomised controlled HOME BP trial

    PubMed Central

    Morton, Katherine; Stuart, Beth; Raftery, James; Bradbury, Katherine; Yao, Guiqing Lily; Zhu, Shihua; Little, Paul; Yardley, Lucy

    2016-01-01

    Introduction Self-management of hypertension, including self-monitoring and antihypertensive medication titration, lowers blood pressure (BP) at 1 year compared to usual care. The aim of the current trial is to assess the effectiveness of the Home and Online Management and Evaluation of Blood Pressure (HOME BP) intervention for the self-management of hypertension in primary care. Methods and analysis The HOME BP trial will be a randomised controlled trial comparing BP self-management—consisting of the HOME BP online digital intervention with self-monitoring, lifestyle advice and antihypertensive drug titration—with usual care for people with uncontrolled essential hypertension. Eligible patients will be recruited from primary care and randomised to usual care or to self-management using HOME BP. The primary outcome will be the difference in mean systolic BP (mm Hg) at 12-month follow-up between the intervention and control groups adjusting for baseline BP and covariates. Secondary outcomes (also adjusted for baseline and covariates where appropriate) will be differences in mean BP at 6 months and diastolic BP at 12 months; patient enablement; quality of life, and economic analyses including all key resources associated with the intervention and related services, adopting a broad societal perspective to include NHS, social care and patient costs, considered within trial and modelled with a lifetime horizon. Medication beliefs, adherence and changes; self-efficacy; perceived side effects and lifestyle changes will be measured for process analyses. Qualitative analyses will explore patient and healthcare professional experiences of HOME BP to gain insights into the factors affecting acceptability, feasibility and adherence. Ethics and dissemination This study has received NHS ethical approval (REC reference 15/SC/0082). The findings from HOME BP will be disseminated widely through peer-reviewed publications, scientific conferences and workshops. If

  14. A Fuzzy-Logic Subsumption Controller for Home Energy Management Systems

    SciTech Connect

    Ainstworth, Nathan; Johnson, Brian; Lundstrom, Blake

    2015-10-05

    Presentation for NAPS 2015 associated with conference publication CP-64392. Home Energy Management Systems (HEMS) are controllers that manage and coordinate the generation, storage, and loads in a home. These controllers are increasingly necessary to ensure that increasing penetrations of distributed energy resources are used effectively and do not disrupt the operation of the grid. In this paper, we propose a novel approach to HEMS design based on behavioral control methods, which do not require accurate models or predictions and are very responsive to changing conditions.

  15. Projecting a Picture of Home Economics. Public Relations in Secondary Programs.

    ERIC Educational Resources Information Center

    Anderson, Edna Page; And Others

    This guide is intended to give concrete suggestions to home economics teachers on preparing and carrying out a public relations program. Stressing that public relations should not and cannot wait for a spectacular event to attract public attention, the booklet gives a variety of strategies to portray to different audiences what home economics…

  16. Family Caregivers Define and Manage the Nursing Home Placement Process.

    PubMed

    Koplow, Sarah M; Gallo, Agatha M; Knafl, Kathleen A; Vincent, Catherine; Paun, Olimpia; Gruss, Valerie

    2015-08-01

    The nursing home placement process is complex and difficult for family caregivers. This qualitative descriptive study examines the experiences of caregivers involved in the management of care and placement of an older family member using the Family Management Style Framework. Ten caregivers were recruited from four nursing homes in the Midwest. The caregivers were interviewed shortly after placement and again 3 months post-placement. Results provide a unique understanding of care management and the nursing home placement process from the perspective of the primary family caregiver. Overall, there were similarities across the same types of caregiving dyads, for example, spousal and adult-children caregivers. Caregivers expressed the need to maintain the identity of their older family member, a familial responsibility for caregiving, and change in their family relationship over time. Appreciating caregivers' challenges and needs gives health care professionals a better understanding for how to provide assistance for a smoother nursing home transition. © The Author(s) 2015.

  17. Depression Care for Patients at Home (Depression CAREPATH): Home Care Depression Care Management Protocol

    PubMed Central

    Bruce, Martha L.; Raue, Patrick J.; Sheeran, Thomas; Reilly, Catherine; Pomerantz, Judith C.; Meyers, Barnett S.; Weinberger, Mark I.; Zukowski, Diane

    2011-01-01

    High levels of depressive symptoms are common and contribute to poorer clinical outcomes even in geriatric patients who are already taking antidepressant medication. The Depression CARE for PATients at Home (Depression CAREPATH) intervention was designed to meet the needs of medical and surgical patients who suffer from depression. The intervention’s clinical protocols are designed to guide clinicians in managing depression as part of routine home care. PMID:21881429

  18. Life Management Skills. Vocational Home Economics Education.

    ERIC Educational Resources Information Center

    Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

    This curriculum guide is one of a number of curriculum guides developed for use in vocational home economics education in Texas. The guide is correlated closely with the essential elements prescribed by the State Board of Education. The competencies in the guide are the essential elements, and the subcompetencies are the subelements prescribed in…

  19. Home Furnishings and Equipment. Money Management.

    ERIC Educational Resources Information Center

    Baran, Nancy H., Ed.

    This booklet provides guidelines for buying major home appliances from ranges and refrigerators to washers and dryers, as well as wood and upholstered furniture, and bedding and floor coverings, with helpful charts to make selection easier. It begins with suggestions on how to furnish within one's means. Next, information on equipping the home…

  20. Putting Home Data Management into Perspective

    DTIC Science & Technology

    2009-12-01

    Perspective development team: Lujo Bauer, Hardik Doshi, Jared Goerner, Nitin Gupta, Rohit Harchandani, Christina Johns, Michelle Mazurek, Prerak Mehta...Woodruff, S. Augustin, and B. E. Foucault . Sabbath Day Home Automation: It’s Like Mixing Technology and Religion. CHI (San Jose, CA, 2007), 2007. 10

  1. 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

  2. Management of Giant Sequoia on Mountain Home Demonstration State Forest

    Treesearch

    Norman J. Benson

    1986-01-01

    Established in 1946, the Mountain Home Demonstration State Forest, Tulare County, California, is managed by the California Department of Forestry. It is a multiple-use forest with recreation as its primary focus, although timber management has always played an important role. Giant sequoia (Sequoiadendron giganteum [Lindl. ] Buchholz) occurs in...

  3. Teaching and Maintaining Behavior Management Skills in the Nursing Home.

    ERIC Educational Resources Information Center

    Burgio, Louis D.; Stevens, Alan; Burgio, Kathryn L.; Roth, David L.; Paul, Penelope; Gerstle, John

    2002-01-01

    Examines the efficacy of a comprehensive behavior management skills training program for improving certified nursing assistants' (CNAs) skill performance in the nursing home. Results reveal improvement in five out of seven communication skills. Although CNAs showed a reduction in the use of ineffective behavior management strategies, they did not…

  4. A nurse owned and managed home health agency.

    PubMed

    Mariott, J

    1996-01-01

    The downsizing epidemic that has swept across the country's acute care facilities has forced many nurses to reassess their goals and explore different career options. Home care has become an important alternative to hospital nursing for many nurses. During a management reorganization of a major medical center in Oakland, California, in early 1993, several middle managers in the nursing department were laid off. What started as informal, support group meetings to help one another face the transition and explore new career alternatives led to the formation of Professional Health Care at Home (PHCH). PHCH is a nurse owned and operated home care agency serving homebound patients in the San Francisco Bay Area. In these initial meetings, many nurses expressed an interest in home care and discovered the talent in their group that enabled them to start their own company.

  5. Home Tutorials vs. the Public Schools in Los Angeles.

    ERIC Educational Resources Information Center

    Weaver, Roy A.; And Others

    1980-01-01

    Examines the Home Tutorial Program in the San Fernando Valley of California in the areas of organization, parent attitudes, learning environment, achievement, and socialization. Compare the home program with the Los Angeles Unified School District. (IRT)

  6. A public utility model for managing public land recreation enterprises.

    Treesearch

    Tom. Quinn

    2002-01-01

    Through review of relevant economic principles and judicial precedent, a case is made that public-land recreation enterprises are analogous to traditionally recognized public utilities. Given the historical concern over the societal value of recreation and associated pricing issues, public-land management policies failing to acknowledge these utility-like...

  7. Housing Operations Management System (HOMES). Volume 1. Executive Summary

    DTIC Science & Technology

    1984-08-01

    PERFORMING ORGANIZATION NAME AND ADDRESS 10. PROGRAM ELEMENT, PROJECT, TASK U.S. ARMY AREA & WORK NIT NUMBERS CONSTRUCTION ENGINEERING RESEARCH LABORATORY...Management System (HOMES) is a comprehensive, com- puter-based housing management system designed to support installation and Major Command...Army service members, and reduce the cost of managing the housing system. This volume summarizes the work done by the U.S. Army Construction Engi

  8. Guidelines for Dietitians and Public Health Nutritionists in Home Health Services.

    ERIC Educational Resources Information Center

    Community Health Service (DHEW/PHS), Bethesda, MD.

    Prepared by the Public Health Service to clarify the role of health professionals and subprofessionals in the home care field, this guide is directed to dietitians and public health nutritionists who are involved in planning, directing, carrying out, and evaluating the nutrition aspects of medical care programs for patients at home. Program…

  9. Case management considerations of progressive dementia in a home setting.

    PubMed

    Pierce, Mary Ellen

    2010-01-01

    Nursing theory, research, and best practice guidelines contribute substantially to the field of dementia care. Interventional plans are challenged most by those dementias considered progressive and deteriorative in nature, requiring ongoing reassessment and modification of care practices as the clinical course changes. The purpose of this article is to provide guidelines for case managers in the development of effective, individualized care plans for clients with progressive dementia residing in a home setting. The application of these guidelines is illustrated through the presentation of an actual case. The practice setting is a private home in the Pacific Northwest. Geriatric case management is provided by an RN case manager. Progressive dementia presents challenges to home care. Professional case management using comprehensive, holistic assessment, collaborative approaches, and best practice fundamentals serve to create an effective, individualized plan of care. The increasing geriatric population presents great opportunities for case managers in strategic management for creating successful home care models in clients with progressive dementia. Use of nursing diagnoses, dementia research, and collaborative approaches with families and other medical providers creates a viable alternative for clients with progressive dementia.

  10. Evaluating the benefits of home-based management of atrial fibrillation: current perspectives

    PubMed Central

    Sheikh, Azfar B; Felzer, Jamie R; Munir, Abdullah Bin; Morin, Daniel P; Lavie, Carl J

    2016-01-01

    Atrial fibrillation (AF) is the most common arrhythmia worldwide, leading to an extensive public health and economic burden. The increasing incidence and prevalence of AF is due to the advancing age of the population, structural heart disease, hypertension, diabetes, and thyroid disease. The majority of costs associated with AF have been attributed to the cost of hospitalization. In order to minimize costs and decrease hospitalizations, counseling on modifiable risk factors contributing to AF has been strongly emphasized. With the release of novel oral anticoagulants bypassing the need for anticoagulant bridging or laboratory monitoring, post-discharge nurse-led home intervention, and novel methods of heart rate monitoring, home-based AF management has reached a new level of ease and sophistication. In this review, we aimed to review modifiable risk factors for AF and various methods of home-based management of AF, along with their benefits. PMID:27799843

  11. Home-Schooling: Reasons Some Parents Choose This Alternative Form of Education, and a Study of the Attitudes of Home-Schooling Parents and Public School Superintendents Toward the Benefits of Home-Schooling.

    ERIC Educational Resources Information Center

    Mahan, Bernice Marie; Ware, Brenda Joyce

    Purposes of this master's research project were to (1) determine the reasons for which parents educate their children at home, and (2) compare the attitudes of home-schooling parents and public school superintendents about the benefits of home schooling. Subjects were parents who home-schooled their children and public school superintendents in a…

  12. Enabling self-management: selecting patients for home dialysis?

    PubMed

    Hutchison, Alastair J; Courthold, Jonathan J

    2011-12-01

    Pre-emptive living donor transplantation should always be promoted as the first-line treatment for kidney failure. Where that is not possible, patients must receive timely information and advice regarding all dialysis options available, including home-based peritoneal dialysis and haemodialysis. Where a dialysis unit enables and actively encourages self-management, patients will tend to select themselves, and if well motivated may overcome significant difficulties to exceed the expectations or predictions of dialysis staff. Patients then become advocates themselves and can provide other patients with the necessary motivation to consider a home treatment, such that they approach staff, rather than vice versa. For staff to be able to talk to patients with confidence requires direct experience of home dialysis, but in units which do not have a full range of home therapies, this may initially be difficult. Visiting patients in their home environment is an essential part of training for both medical and nursing staff. Before a patient is able to begin to engage in discussion about any dialysis therapy, they must have reached a point of acceptance that dialysis is necessary. If they are not at this point, then any attempt at 'education' will be largely futile. Once a patient has arrived at the point of choosing a home therapy, the pathway to their first dialysis at home must be as smooth and problem-free as possible.

  13. 7 CFR Exhibit A to Subpart B of... - Memorandum of Understanding Between the Federal Emergency Management Agency and the Farmers Home...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 14 2011-01-01 2011-01-01 false Memorandum of Understanding Between the Federal Emergency Management Agency and the Farmers Home Administration or Its Successor Agency under Public Law 103... Understanding Between the Federal Emergency Management Agency and the Farmers Home Administration or...

  14. Home-School Relationships: A School Management Perspective

    ERIC Educational Resources Information Center

    Stringer, Patricia; Hourani, Rida Blaik

    2013-01-01

    Abu Dhabi, United Arab Emirates (UAE) is in the process of initiating major education reform designed to improve schools. Parental involvement in support of student learning ranks high on the reform agenda. This study explores managerial aspects of implementing home-school relationships in seven primary Public Private Partnership (PPP) schools in…

  15. Home-School Relationships: A School Management Perspective

    ERIC Educational Resources Information Center

    Stringer, Patricia; Hourani, Rida Blaik

    2013-01-01

    Abu Dhabi, United Arab Emirates (UAE) is in the process of initiating major education reform designed to improve schools. Parental involvement in support of student learning ranks high on the reform agenda. This study explores managerial aspects of implementing home-school relationships in seven primary Public Private Partnership (PPP) schools in…

  16. Home telehealth for chronic disease management: selected findings of a narrative synthesis.

    PubMed

    Jones, Alison; Hedges-Chou, Jessica; Bates, Joanna; Loyola, Margarita; Lear, Scott A; Jarvis-Selinger, Sandra

    2014-04-01

    Chronic disease has become an increasingly important issue for individuals and healthcare organizations across Canada. Home telehealth may have the potential to alleviate the economic and social challenges associated with rising rates of chronic disease. An aim of this review was to gather and synthesize the evidence on the effectiveness of home telehealth in chronic disease management. We searched the Medline, EMBASE, Web of Science, CINAHL, and PAIS databases for studies published in English from January 1, 2005, and December 31, 2010. Academic publications, white papers, and gray literature were all considered eligible for inclusion, provided an original research element was present. Articles were screened for relevance. One hundred one articles on quantitative or mixed-methods studies reported the effects of home telehealth on disease state, symptoms, and quality of life in chronic disease patients. Studies were consistent in finding that home telehealth was equivalent or superior to usual care. The literature strongly supports the use of home telehealth as an equally effective alternative to usual care. The circumstances under which home telehealth emerges as significantly better than usual care have not been extensively researched. Further research into factors affecting the effectiveness of home telehealth would support more widespread realization of telehealth's potential benefits.

  17. Managing Community College Public Relations: An Overview.

    ERIC Educational Resources Information Center

    Romine, Larry

    1982-01-01

    Since planning is a continual process, the college public relations manager plans for what could occur and prepares for it. The manager's responsibilities include working with the board and president, budgeting, setting objectives, innovating, representing, staffing, coordinating, and directing. (MSE)

  18. Home ranges of raccoon dogs in managed and natural areas

    PubMed Central

    Süld, Karmen; Saarma, Urmas; Valdmann, Harri

    2017-01-01

    Knowledge of space use is central to understand animals’ role in ecosystems. The raccoon dog Nyctereutes procyonoides is considered as one of the most influential alien mesopredator species in Europe, having the potential to cause loss of local biodiversity and act as a vector for zoonotic diseases. We collared 12 animals to study their home range and habitat use in two areas with different management regimes in Estonia: in a protected natural area and in an intensively managed area. From May to October raccoon dogs inhabiting the natural area had considerably smaller home ranges compared to the managed area, 193.3ha±37.3SD and 391.9ha±292.9SD, respectively. This result contradicts somewhat earlier findings in other European raccoon dog populations, where the home range sizes in natural areas in summer and autumn period have usually been larger compared to managed areas. In both study areas raccoon dogs preferred watersides, where amphibians and other semi-aquatic prey are abundant, to other habitats available in their home ranges. We also studied movements of a raccoon dog pair in the managed study area in winter period. Due to mild weather conditions during the study period, raccoon dogs changed their resting sites quite often, covering a relatively large 599 ha area from November 2012 to January 2013, indicating the absence of usual winter lethargy during the mild winters. PMID:28273085

  19. Safe medication management in specialized home healthcare - an observational study.

    PubMed

    Lindblad, Marléne; Flink, Maria; Ekstedt, Mirjam

    2017-08-24

    Medication management is a complex, error-prone process. The aim of this study was to explore what constitutes the complexity of the medication management process (MMP) in specialized home healthcare and how healthcare professionals handle this complexity. The study is theoretically based in resilience engineering. Data were collected during the MMP at three specialized home healthcare units in Sweden using two strategies: observation of workplaces and shadowing RNs in everyday work, including interviews. Transcribed material was analysed using grounded theory. The MMP in home healthcare was dynamic and complex with unclear boundaries of responsibilities, inadequate information systems and fluctuating work conditions. Healthcare professionals adapted their everyday clinical work by sharing responsibility and simultaneously being authoritative and preserving patients' active participation, autonomy and integrity. To promote a safe MMP, healthcare professionals constantly re-prioritized goals, handled gaps in communication and information transmission at a distance by creating new bridging solutions. Trade-offs and workarounds were necessary elements, but also posed a threat to patient safety, as these interim solutions were not systematically evaluated or devised learning strategies. To manage a safe medication process in home healthcare, healthcare professionals need to adapt to fluctuating conditions and create bridging strategies through multiple parallel activities distributed over time, space and actors. The healthcare professionals' strategies could be integrated in continuous learning, while preserving boundaries of safety, instead of being more or less interim solutions. Patients' and family caregivers' as active partners in the MMP may be an underestimated resource for a resilient home healthcare.

  20. Return to nursing home investment: Issues for public policy

    PubMed Central

    Baldwin, Carliss Y.; Bishop, Christine E.

    1984-01-01

    Because Government policy does much to determine the return available to nursing home investment, the profitability of the nursing home industry has been a subject of controversy since Government agencies began paying a large portion of the Nation's nursing home bill. Controversy appears at several levels. First is the rather narrow concern, often conceived in accounting terms, of the appropriate reimbursement of capital-related expense under Medicaid and Medicare. Second is the concern about how return to capital affects the flow of investment into nursing homes, leading either to inadequate access to care or to over-capacity. Third is the concern about how-sources of return to nursing home investment affect the pattern of nursing home ownership and the amount of equity held by owners since the pattern of ownership and amount of equity have been linked to quality of care. PMID:10310945

  1. DECENTRALIZED STORMWATER MANAGEMENT: RETROFITTING HOMES, RESTORING WATERSHEDS

    EPA Science Inventory

    Stormwater runoff from impervious surfaces in urban and suburban areas has led to human safety risks and widespread stream ecosystem impairment. While centralized stormwater management can minimize large fluctuations in stream flows and flooding risk to urban areas, this approac...

  2. DECENTRALIZED STORMWATER MANAGEMENT: RETROFITTING HOMES, RESTORING WATERSHEDS

    EPA Science Inventory

    Stormwater runoff from impervious surfaces in urban and suburban areas has led to human safety risks and widespread stream ecosystem impairment. While centralized stormwater management can minimize large fluctuations in stream flows and flooding risk to urban areas, this approac...

  3. The power of relationships: exploring how Public Health Nurses support mothers and families during postpartum home visits.

    PubMed

    Aston, Megan; Price, Sheri; Etowa, Josephine; Vukic, Adele; Young, Linda; Hart, Christine; MacLeod, Emily; Randel, Patricia

    2015-02-01

    Postpartum home visiting by Public Health Nurses (PHNs) has been used by many health departments across Canada as a way of supporting new mothers and their families. Although positive health outcomes are linked with support from PHNs, little is known about how this occurs during the home visit. The purpose of this research was to explore how home visiting programs for mothers and babies were organized, delivered, and experienced through the everyday practices of PHNs, mothers, and managers in Nova Scotia, Canada. Feminist poststructuralism was used to guide the research and semi-structured face-to-face interviews were conducted with 16 PHNs, 16 mothers, and 4 managers. Participants described how relationships were an essential part of supporting mothers and families. These findings also challenge dominant health discourses and stereotypes that are often associated with mothering and the practice of PHNs with families. © The Author(s) 2014.

  4. Home Visitation Assessing Progress, Managing Expectations

    ERIC Educational Resources Information Center

    Daro, Deborah

    2006-01-01

    Early intervention efforts to promote healthy child development have long been a central feature of social service and public health reforms. Today, prenatal care, well-baby visits, and assessments to detect possible developmental delays are commonplace in most communities. Recently, child abuse prevention advocates have applied a developmental…

  5. Disease management: a new and exciting opportunity in home healthcare.

    PubMed

    Huffman, Melinda H

    2005-05-01

    Disease management programs are beginning to encompass providers across the healthcare continuum, including home healthcare. The premise behind disease management is that coordinated, evidence-based interventions can be applied to the care of patients with specific high-cost, high-volume chronic conditions, resulting in improved clinical outcomes and lower overall costs. Outcomes data (actual results) are central in this approach to patient care.

  6. Motivating the Private vs. Public Sector Managers.

    ERIC Educational Resources Information Center

    Khojasteh, Mak

    1993-01-01

    A questionnaire on intrinsic/extrinsic rewards received 362 responses from 380 managers. Pay and security were greater motivators for private than for public sector managers. Recognition had higher motivating potential in the public sector. Both groups were motivated by achievement and advancement. (SK)

  7. Motivating the Private vs. Public Sector Managers.

    ERIC Educational Resources Information Center

    Khojasteh, Mak

    1993-01-01

    A questionnaire on intrinsic/extrinsic rewards received 362 responses from 380 managers. Pay and security were greater motivators for private than for public sector managers. Recognition had higher motivating potential in the public sector. Both groups were motivated by achievement and advancement. (SK)

  8. “Making Do” Decisions: How Home Healthcare Personnel Manage Their Exposure to Home Hazards

    PubMed Central

    Wills, Celia E.; Polivka, Barbara J.; Darragh, Amy; Lavender, Steven; Sommerich, Carolyn; Stredney, Donald

    2016-01-01

    This study describes the decision-making processes home healthcare personnel (HHP) use to manage their personal health and safety when managing hazards in client homes. A professionally diverse national sample of 68 HHP participated in individual semi-structured interviews and focus group discussions, and described their decision making and strategies for hazard management in their work environments. HHP described 353 hazard management dilemmas within 394 specifically identified hazards, which were clustered within three broader categories: electrical/fire, slip/trip/lift, and environmental exposures. HHP described multiple types of “making do” decisions for hazard management solutions in which perceived and actual resource limitations constrained response options. A majority of hazard management decisions in the broader hazards categories (72.5%, 68.5%, and 63.5%, respectively) were classifiable as less than optimal. These findings stress the need for more support of HHPs, including comprehensive training, to improve HHP decision making and hazard management strategies, especially in context of resource constraints. PMID:26669605

  9. Disease management: atrial fibrillation and home monitoring.

    PubMed

    Ricci, Renato Pietro

    2013-06-01

    Device-detected atrial fibrillation (AF) episodes predict poor clinical outcome regardless of symptoms. Potential benefits of remote monitoring are early arrhythmia detection and patient continuous monitoring. Several studies of device remote monitoring consistently demonstrated that AF represents the most common clinical alert and that detailed information on arrhythmia onset, duration, and burden as well as on the ventricular rate may be early available for clinical evaluation. Reaction time to AF alerts was very short in all series involving either pacemakers or defibrillators and action ability of AF alerts was very high. In the Home Guide Registry, in which 1650 patients were enrolled, AF was detected in 16.3% of patients and represented 36% of all cardiovascular events during the follow-up. Timely anticoagulation introduction in asymptomatic patients may impact on the stroke rate. According to the results of repeated Monte Carlo simulations based on a real population of 166 patients, daily monitoring may reduce the 2-year stroke risk by 9-18% with an absolute reduction of 0.2-0.6%, compared with conventional inter-visit intervals of 6-12 months. In the COMPAS trial, the incidence of hospitalizations for atrial arrhythmias and related stroke was significantly higher in the control group than in the remote monitoring group. Major questions will be addressed by the ongoing IMPACT trial in which a remote monitoring guided anticoagulation strategy based on AF detection will be compared with a physician-directed standard strategy. In patients with heart failure, AF early detection combined with other indexes may help prevent hospitalizations.

  10. Chronic disease management and the home-care alternative in Ontario, Canada.

    PubMed

    Tsasis, Peter

    2009-08-01

    The pressure on our health-care system to deliver efficient, quality and cost-effective care is increasing. The debate on its sustainability is also expanding. These challenges can be managed with revisions to our health-care policy frameworks governing how and what public health-care services are delivered. Chronic disease management and home care can together ease many of the present and future pressures facing the health-care system. However, the current level of investment and the present policy are not effectively supporting movement in this direction. Updating the Canada Health Act to reflect the realities of our health-care system, and developing policies to support the areas of interdisciplinary teamwork and system integration are needed to facilitate chronic disease management and home care in Canada. This article lays out the challenges, highlights the impending issues and suggests a framework for moving forward.

  11. Monitors Enable Medication Management in Patients' Homes

    NASA Technical Reports Server (NTRS)

    2014-01-01

    Glenn Research Center awarded SBIR funding to ZIN Technologies to develop a platform that could incorporate sensors quantifying an astronaut’s health status and then communicate with the ground. ZIN created a device, developed the system further, and then formed Cleveland-based FlexLife Health to commercialize the technology. Today it is part of an anti-coagulation management system for people with cardiovascular disease.

  12. Home and Online Management and Evaluation of Blood Pressure (HOME BP) digital intervention for self-management of uncontrolled, essential hypertension: a protocol for the randomised controlled HOME BP trial.

    PubMed

    Band, Rebecca; Morton, Katherine; Stuart, Beth; Raftery, James; Bradbury, Katherine; Yao, Guiqing Lily; Zhu, Shihua; Little, Paul; Yardley, Lucy; McManus, Richard J

    2016-11-07

    Self-management of hypertension, including self-monitoring and antihypertensive medication titration, lowers blood pressure (BP) at 1 year compared to usual care. The aim of the current trial is to assess the effectiveness of the Home and Online Management and Evaluation of Blood Pressure (HOME BP) intervention for the self-management of hypertension in primary care. The HOME BP trial will be a randomised controlled trial comparing BP self-management-consisting of the HOME BP online digital intervention with self-monitoring, lifestyle advice and antihypertensive drug titration-with usual care for people with uncontrolled essential hypertension. Eligible patients will be recruited from primary care and randomised to usual care or to self-management using HOME BP. The primary outcome will be the difference in mean systolic BP (mm Hg) at 12-month follow-up between the intervention and control groups adjusting for baseline BP and covariates. Secondary outcomes (also adjusted for baseline and covariates where appropriate) will be differences in mean BP at 6 months and diastolic BP at 12 months; patient enablement; quality of life, and economic analyses including all key resources associated with the intervention and related services, adopting a broad societal perspective to include NHS, social care and patient costs, considered within trial and modelled with a lifetime horizon. Medication beliefs, adherence and changes; self-efficacy; perceived side effects and lifestyle changes will be measured for process analyses. Qualitative analyses will explore patient and healthcare professional experiences of HOME BP to gain insights into the factors affecting acceptability, feasibility and adherence. This study has received NHS ethical approval (REC reference 15/SC/0082). The findings from HOME BP will be disseminated widely through peer-reviewed publications, scientific conferences and workshops. If successful, HOME BP will be directly applicable to UK primary care

  13. Pesticide assessment: Protecting public health on the home turf

    PubMed Central

    Sears, Meg; Walker, C Robin; van der Jagt, Richard HC; Claman, Paul

    2006-01-01

    Pesticide regulation is examined in the context of Health Canada’s Pest Management Regulatory Agency’s assessment of the chlorophenoxy herbicide 2,4-dichlorophenoxyacetic acid (2,4-D) for turf. 2,4-D is the most common herbicide used to kill weeds in grass. The medical literature does not uniformly indicate harms from herbicides. However, the balance of epidemiological research suggests that 2,4-D can be persuasively linked to cancers, neurological impairment and reproductive problems. These may arise from 2,4-D itself, from breakdown products or dioxin contamination, or from a combination of chemicals. Regulators rely largely on toxicology, but experiments may not replicate exposures from 2,4-D application to lawns because environmental breakdown products (eg, 2,4-dichlorophenol) may not accumulate and selected herbicides are possibly less contaminated. Dioxins are bioaccumulative chemicals that may cause cancer, harm neurological development, impair reproduction, disrupt the endocrine system and alter immune function. No dioxin analyses were submitted to the Pest Management Regulatory Agency, and the principal contaminants of 2,4-D are not among the 17 congeners covered in pesticide regulation. Independent assessment of all dioxins is needed, in tissues and in the environment. The 2,4-D assessment does not approach standards for ethics, rigour or transparency in medical research. Canada needs a stronger regulator for pesticides. Potentially toxic chemicals should not be registered when more benign solutions exist, risks are not clearly quantifiable or potential risks outweigh benefits. Until landscaping pesticides are curtailed nationally, local bylaws and Quebec’s Pesticide Code are prudent measures to protect public health. Physicians have a role in public education regarding pesticides. PMID:19030278

  14. New Public Management and Education

    ERIC Educational Resources Information Center

    Tolofari, Sowaribi

    2005-01-01

    Public administration has always been under constant review. Such reviews were mostly parochial, incremental, initiated or driven by low-key staff and often ended as fads. From the end of the 1970s to the 1990s, however, governments around the world were engaged in widespread and sustained reforms of their public administration. These reforms were…

  15. Benchmarking management practices in Australian public healthcare.

    PubMed

    Agarwal, Renu; Green, Roy; Agarwal, Neeru; Randhawa, Krithika

    2016-01-01

    The purpose of this paper is to investigate the quality of management practices of public hospitals in the Australian healthcare system, specifically those in the state-managed health systems of Queensland and New South Wales (NSW). Further, the authors assess the management practices of Queensland and NSW public hospitals jointly and globally benchmark against those in the health systems of seven other countries, namely, USA, UK, Sweden, France, Germany, Italy and Canada. In this study, the authors adapt the unique and globally deployed Bloom et al. (2009) survey instrument that uses a "double blind, double scored" methodology and an interview-based scoring grid to measure and internationally benchmark the management practices in Queensland and NSW public hospitals based on 21 management dimensions across four broad areas of management - operations, performance monitoring, targets and people management. The findings reveal the areas of strength and potential areas of improvement in the Queensland and NSW Health hospital management practices when compared with public hospitals in seven countries, namely, USA, UK, Sweden, France, Germany, Italy and Canada. Together, Queensland and NSW Health hospitals perform best in operations management followed by performance monitoring. While target management presents scope for improvement, people management is the sphere where these Australian hospitals lag the most. This paper is of interest to both hospital administrators and health care policy-makers aiming to lift management quality at the hospital level as well as at the institutional level, as a vehicle to consistently deliver sustainable high-quality health services. This study provides the first internationally comparable robust measure of management capability in Australian public hospitals, where hospitals are run independently by the state-run healthcare systems. Additionally, this research study contributes to the empirical evidence base on the quality of

  16. Rounding, work intensification and new public management.

    PubMed

    Willis, Eileen; Toffoli, Luisa; Henderson, Julie; Couzner, Leah; Hamilton, Patricia; Verrall, Claire; Blackman, Ian

    2016-06-01

    In this study, we argue that contemporary nursing care has been overtaken by new public management strategies aimed at curtailing budgets in the public hospital sector in Australia. Drawing on qualitative interviews with 15 nurses from one public acute hospital with supporting documentary evidence, we demonstrate what happens to nursing work when management imposes rounding as a risk reduction strategy. In the case study outlined rounding was introduced across all wards in response to missed care, which in turn arose as a result of work intensification produced by efficiency, productivity, effectiveness and accountability demands. Rounding is a commercially sponsored practice consistent with new public management. Our study illustrates the impact that new public management strategies such as rounding have on how nurses work, both in terms of work intensity and in who controls their labour. © 2015 John Wiley & Sons Ltd.

  17. Outcomes for Children with Problematic Behavior in School and at Home Served By Public Mental Health

    ERIC Educational Resources Information Center

    Hodges, K.; Xue, Y.; Wotring, J.

    2004-01-01

    The authors report outcomes for 4,777 youth served by the public mental health system in Michigan who had problems in school, at home, in interpersonal relationships, or in modulating their mood. Cluster analysis identified five subgroups: Pervasive Problems with Mood Disturbance (i.e., severe or moderate impairment in school, at home, in behavior…

  18. Can Nonprofit Management Help Answer Public Management's "Big Questions?"

    ERIC Educational Resources Information Center

    Brooks, Arthur C.

    2002-01-01

    A survey of nonprofit literature on board governance, volunteer management, and performance measurement shows that study of the nonprofit sector can help inform public management's "big questions": breaking the micromanagement cycle, motivating employees, and measuring performance. Nonprofit studies could enrich public administration curricula.…

  19. Can Nonprofit Management Help Answer Public Management's "Big Questions?"

    ERIC Educational Resources Information Center

    Brooks, Arthur C.

    2002-01-01

    A survey of nonprofit literature on board governance, volunteer management, and performance measurement shows that study of the nonprofit sector can help inform public management's "big questions": breaking the micromanagement cycle, motivating employees, and measuring performance. Nonprofit studies could enrich public administration curricula.…

  20. Seniors managing multiple medications: using mixed methods to view the home care safety lens.

    PubMed

    Lang, Ariella; Macdonald, Marilyn; Marck, Patricia; Toon, Lynn; Griffin, Melissa; Easty, Tony; Fraser, Kimberly; MacKinnon, Neil; Mitchell, Jonathan; Lang, Eddy; Goodwin, Sharon

    2015-12-12

    Patient safety is a national and international priority with medication safety earmarked as both a prevalent and high-risk area of concern. To date, medication safety research has focused overwhelmingly on institutional based care provided by paid healthcare professionals, which often has little applicability to the home care setting. This critical gap in our current understanding of medication safety in the home care sector is particularly evident with the elderly who often manage more than one chronic illness and a complex palette of medications, along with other care needs. This study addresses the medication management issues faced by seniors with chronic illnesses, their family, caregivers, and paid providers within Canadian publicly funded home care programs in Alberta (AB), Ontario (ON), Quebec (QC) and Nova Scotia (NS). Informed by a socio-ecological perspective, this study utilized Interpretive Description (ID) methodology and participatory photographic methods to capture and analyze a range of visual and textual data. Three successive phases of data collection and analysis were conducted in a concurrent, iterative fashion in eight urban and/or rural households in each province. A total of 94 participants (i.e., seniors receiving home care services, their family/caregivers, and paid providers) were interviewed individually. In addition, 69 providers took part in focus groups. Analysis was iterative and concurrent with data collection in that each interview was compared with subsequent interviews for converging as well as diverging patterns. Six patterns were identified that provide a rich portrayal of the complexity of medication management safety in home care: vulnerabilities that impact the safe management and storage of medication, sustaining adequate supports, degrees of shared accountability for care, systems of variable effectiveness, poly-literacy required to navigate the system, and systemic challenges to maintaining medication safety in the home

  1. Annual expenditures for nursing home care: private and public payer price growth, 1977 to 2004.

    PubMed

    Stewart, Kate A; Grabowski, David C; Lakdawalla, Darius N

    2009-03-01

    Long-term nursing home care is primarily funded by out-of-pocket payments and public Medicaid programs. Few studies have explored price growth in nursing home care, particularly trends in the real cost of a year spent in a nursing home. To evaluate changes in private and public prices for annual nursing home care from 1977 to 2004, and to compare nursing home price growth to overall price growth and growth in the price of medical care. We estimated annual private prices for nursing home care between 1977 and 2004 using data from the National Nursing Home Survey. We compared private nursing home price growth to public prices obtained from surveys of state Medicaid offices, and evaluated the Bureau of Labor Statistics Consumer Price Indexes to compare prices for nursing homes, medical care, and general goods and services over time. Annual private pay nursing homes prices grew by 7.5% annually from $8645 in 1977 to $60,249 in 2004. Medicaid prices grew by 6.7% annually from $9491 in 1979 to $48,056 in 2004. Annual price growth for private pay nursing home care outpaced medical care and other goods and services (7.5% vs. 6.6% and 4.4%, respectively) between 1977 and 2004. The recent rapid growth in nursing home prices is likely to persist, because of an aging population and greater disability among the near-elderly. The result will place increasing financial pressure on Medicaid programs. Better data on nursing prices are critical for policy-makers and researchers.

  2. Managing chronic illness: physician practices increased the use of care management and medical home processes.

    PubMed

    Wiley, James A; Rittenhouse, Diane R; Shortell, Stephen M; Casalino, Lawrence P; Ramsay, Patricia P; Bibi, Salma; Ryan, Andrew M; Copeland, Kennon R; Alexander, Jeffrey A

    2015-01-01

    The effective management of patients with chronic illnesses is critical to bending the curve of health care spending in the United States and is a crucial test for health care reform. In this article we used data from three national surveys of physician practices between 2006 and 2013 to determine the extent to which practices of all sizes have increased their use of evidence-based care management processes associated with patient-centered medical homes for patients with asthma, congestive heart failure, depression, and diabetes. We found relatively large increases over time in the overall use of these processes for small and medium-size practices as well as for large practices. However, the large practices used fewer than half of the recommended processes, on average. We also identified the individual processes whose use increased the most and show that greater use of care management processes is positively associated with public reporting of patient experience and clinical quality and with pay-for-performance.

  3. Compensation of home health, public health, and hospital nurses. Extrinsic and intrinsic rewards.

    PubMed

    Hughes, K K; Marcantonio, R J

    1991-11-01

    Despite the proliferation of home health agencies and increased numbers of nurses working in these settings, little is known about home health nurses or how they might differ from their public health and hospital counterparts. The authors discuss differences in monetary compensation and skill usage, as well as the relationship between compensation and retention, among hospital, home health, and public health staff nurses. The results show that these nurses receive different intrinsic and extrinsic rewards and that their reasons for remaining with their employers are similar, yet unique. Implications for nurse administrators and educators are discussed, along with recommendations for further research.

  4. Public involvement in radioactive waste management decisions

    SciTech Connect

    1994-04-01

    Current repository siting efforts focus on Yucca Mountain, Nevada, where DOE`s Office of Civilian Radioactive Waste Management (OCRWM) is conducting exploratory studies to determine if the site is suitable. The state of Nevada has resisted these efforts: it has denied permits, brought suit against DOE, and publicly denounced the federal government`s decision to study Yucca Mountain. The state`s opposition reflects public opinion in Nevada, and has considerably slowed DOE`s progress in studying the site. The Yucca Mountain controversy demonstrates the importance of understanding public attitudes and their potential influence as DOE develops a program to manage radioactive waste. The strength and nature of Nevada`s opposition -- its ability to thwart if not outright derail DOE`s activities -- indicate a need to develop alternative methods for making decisions that affect the public. This report analyzes public participation as a key component of this openness, one that provides a means of garnering acceptance of, or reducing public opposition to, DOE`s radioactive waste management activities, including facility siting and transportation. The first section, Public Perceptions: Attitudes, Trust, and Theory, reviews the risk-perception literature to identify how the public perceives the risks associated with radioactivity. DOE and the Public discusses DOE`s low level of credibility among the general public as the product, in part, of the department`s past actions. This section looks at the three components of the radioactive waste management program -- disposal, storage, and transportation -- and the different ways DOE has approached the problem of public confidence in each case. Midwestern Radioactive Waste Management Histories focuses on selected Midwestern facility-siting and transportation activities involving radioactive materials.

  5. Public Reporting of Nursing Home Quality of Care: Lessons from the United States Experience for Canadian Policy Discussion

    PubMed Central

    Hutchinson, Alison M.; Draper, Kellie; Sales, Anne E.

    2009-01-01

    While the demand for continuing care services in Canada grows, the quality of such services has come under increasing scrutiny. Consideration has been given to the use of public reporting of quality data as a mechanism to stimulate quality improvement and promote public accountability for and transparency in service quality. The recent adoption of the Resident Assessment Instrument (RAI) throughout a number of Canadian jurisdictions means that standardized quality data are available for comparisons among facilities across regions, provinces and nationally. In this paper, we explore current knowledge on public reporting in nursing homes in the United States to identify what lessons may inform policy discussion regarding potential use of public reporting in Canada. Based on these findings, we make recommendations regarding how public reporting should be progressed and managed if Canadian jurisdictions were to implement this strategy. PMID:21037828

  6. Manager Perspectives on Communication and Public ...

    EPA Pesticide Factsheets

    We argue that public engagement is crucial to achieving lasting ecological success in aquatic restoration efforts, and that the most effective public engagement mechanisms are what we term iterative mechanisms. Here we look to a particular social-ecological system – the restoration community in Rhode Island, U.S.A. and the rivers, wetlands, marshes, and estuaries, and their related species, that they work to protect – to better understand land managers’ perspectives on public engagement in restoration processes. Adopting an inductive approach to critical discourse analysis of interviews with 27 local, state, and federal restoration managers and the forms of public interaction they described, we identify three distinct models of public engagement in natural resources management employed by managers: unidirectional; bidirectional; and iterative. While unidirectional and bidirectional mechanisms can help managers achieve short-term ecological successes, we suggest that adopting an iterative approach can improve the quality of stakeholder and learning interactions and, subsequently, foster lasting ecological successes. We argue that managers can design deliberately for public engagement mechanisms that are best suited to projects in particular social-ecological systems in order to create restoration projects that achieve ecological, learning, and stakeholder successes. We attempt to synthesize the lessons learned from efforts at public engagement in restoratio

  7. Strategic Management for Public Libraries: A Handbook.

    ERIC Educational Resources Information Center

    Hayes, Robert M.; Walter, Virginia A.

    Public libraries must operate in a time of increasing change, both within the library community and throughout the larger social and economic environments in which the library must function. This book is a guide to the strategic management of change in community libraries. It addresses the unique circumstances and needs of public libraries and…

  8. Risky Business: Private Management of Public Schools.

    ERIC Educational Resources Information Center

    Richards, Craig E.; And Others

    Contracting in public education is not a new development. This book examines projects that transfer the management of entire schools or school systems to private firms. Chapter 1, by Rima Shore, is a comprehensive survey of the practice of contracting out in public education. It provides a broad historical background for the U.S. education system…

  9. The Development of Public Managers' Reflexive Capacities

    ERIC Educational Resources Information Center

    Broussine, Michael; Ahmad, Yusuf

    2013-01-01

    The aim of this article is to discuss ways in which we as educators of public managers can help our students deal effectively with the challenges thrown up by the sweeping cuts in public services arising as a consequence of the fiscal crisis brought about by the failure of the banks. While our focus is on the UK, we feel that the issues raised…

  10. Economic Evidence for US Asthma Self-Management Education and Home-Based Interventions.

    PubMed

    Hsu, Joy; Wilhelm, Natalie; Lewis, Lillianne; Herman, Elizabeth

    The health and economic burden of asthma in the United States is substantial. Asthma self-management education (AS-ME) and home-based interventions for asthma can improve asthma control and prevent asthma exacerbations, and interest in health care-public health collaboration regarding asthma is increasing. However, outpatient AS-ME and home-based asthma intervention programs are not widely available; economic sustainability is a common concern. Thus, we conducted a narrative review of existing literature regarding economic outcomes of outpatient AS-ME and home-based intervention programs for asthma in the United States. We identified 9 outpatient AS-ME programs and 17 home-based intervention programs with return on investment (ROI) data. Most programs were associated with a positive ROI; a few programs observed positive ROIs only among selected populations (eg, higher health care utilization). Interpretation of existing data is limited by heterogeneous ROI calculations. Nevertheless, the literature suggests promise for sustainable opportunities to expand access to outpatient AS-ME and home-based asthma intervention programs in the United States. More definitive knowledge about how to maximize program benefit and sustainability could be gained through more controlled studies of specific populations and increased uniformity in economic assessments. Published by Elsevier Inc.

  11. A medical home: value and implications of knowledge management.

    PubMed

    Orzano, A John; McInerney, Claire R; McDaniel, Reuben R; Meese, Abigail; Alajmi, Bibi; Mohr, Stewart M; Tallia, Alfred F

    2009-01-01

    Central to the "medical home" concept is the premise that the delivery of effective primary care requires a fundamental shift in relationships among practice members and between practice members and patients. Primary care practices can potentially increase their capacity to deliver effective care through knowledge management (KM), a process of sharing and making existing knowledge available or by developing new knowledge among practice members and patients. KM affects performance by influencing work relationships to enhance learning, decision making, and task execution. We extend our previous work to further characterize, describe, and contrast how primary care practices exhibit KM and explain why KM deserves attention in medical home redesign initiatives. Case studies were conducted, drawn from two higher and lower performing practices, which were purposely selected based on disease management, prevention, and productivity measures from an improvement trial. Observations of operations, clinical encounters, meetings, and interviews with office members and patients were transcribed and coded independently using a KM template developed from a previous secondary analysis. Face-to-face discussions resolved coding differences among research team members. Confirmation of findings was sought from practice participants. Practices manifested varying degrees of KM effectiveness through six interdependent processes and multiple overlapping tools. Social tools, such as face-to-face-communication for sharing and developing knowledge, were often more effective than were expensive technical tools such as an electronic medical record. Tool use was tailored for specific outcomes, interacted with each other, and leveraged by other organizational capacities. Practices with effective KM were more open to adopting and sustaining new ways of functioning, ways reflecting attributes of a medical home. Knowledge management differences occur within and between practices and can explain

  12. Home management of hematological patients requiring hospital admission.

    PubMed

    Isaia, Gianluca; Tibaldi, Vittoria; Astengo, Marco; Ladetto, Marco; Marinello, Renata; Bo, Mario; Michelis, Giuliana; Ruatta, Fiorella; Ricauda, Nicoletta Aimonino

    2010-01-01

    The hospital-at-home service (HHS) could be considered as an alternative to the traditional ward for elderly patients. We aimed at evaluating the home management of elderly people requiring transfusions. The ever-increasing demand on acute hospital services requires alternative methods of delivering all aspects of health care. HHS demonstrated to be as efficacious as a traditional ward for elderly and functionally compromised patients. The method was a retrospective descriptive study enrolling patients needing an hospital admission from 1st January 2007 to 31st December 2007 and reporting an hematological discharge's diagnosis as primary or secondary diagnosis. A total of 54 patients were evaluated in this study. Of them, 34 (62.9%) needed a hemocomponent transfusion for a total volume of 112 blood units and 49 platelet pools. Patients requiring at least one blood or platelet transfusion were more functionally compromised and presented a higher level of acute physiology and chronic health evaluation, compared to the non-transfused ones. The conclusion was that hematological subjects mainly the frail ones and functionally highly compromised with acute illnesses could be treated at home as an alternative of the traditional medical ward. This could be the starting point for future studies that will be able to increase the power of hospital-at-home service for this type of patients.

  13. Publications Management: A Guide to Teaching Materials.

    ERIC Educational Resources Information Center

    Eberhard, Wallace B.

    Too few journalism graduates know anything about the problems of management; yet, the higher one rises in the newsroom, the more one must develop managerial skills and talents. This resource guide to teaching materials for college courses in publication management lists books, articles, pamphlets, and audiovisual materials under the following…

  14. Reflexivity and Education for Public Managers

    ERIC Educational Resources Information Center

    Quinn, Bríd

    2013-01-01

    The changing nature of the world that public managers inhabit requires strategies for sense-making. This is frequently the reason why managers engage in mid-career education. Disciplinary elements provide knowledge and insights. However, growing significance is being placed on enabling practitioners to reflect on their own practice and…

  15. Public Speaking: Managing Challenging People and Situations.

    PubMed

    Baum, Neil; Boughton, Leonarda

    2016-01-01

    Every public speaker has encountered, or most likely will encounter, a difficult member of the audience who disrupts their presentation. This is a source of anxiety and discomfort, not only for the presenter, but for the audience as well. Learning how to manage the disruptive audience member is an art form, just like being a good public speaker. A professional speaker knows how to handle this disruption without making the audience uncomfortable and without embarrassing the disruptor. This article discusses ways to manage the disruptive audience member and will help those of you who do public speaking to tactfully and professionally disengage someone who is ruining your program.

  16. Engineering for reliability in at-home chronic disease management.

    PubMed

    Kendall, Logan; Eschler, Jordan; Lozano, Paula; McClure, Jennifer B; Vizer, Lisa M; Ralston, James D; Pratt, Wanda

    2014-01-01

    Individuals with chronic conditions face challenges with maintaining lifelong adherence to self-management activities. Although reminders can help support the cognitive demands of managing daily and future health tasks, we understand little of how they fit into people's daily lives. Utilizing a maximum variation sampling method, we interviewed and compared the experiences of 20 older adults with diabetes and 19 mothers of children with asthma to understand reminder use for at-home chronic disease management. Based on our participants' experiences, we contend that many self-management failures should be viewed as systems failures, rather than individual failures and non-compliance. Furthermore, we identify key principles from reliability engineering that both explain current behavior and suggest strategies to improve patient reminder systems.

  17. Engineering for reliability in at-home chronic disease management

    PubMed Central

    Kendall, Logan; Eschler, Jordan; Lozano, Paula; McClure, Jennifer B.; Vizer, Lisa M.; Ralston, James D.; Pratt, Wanda

    2014-01-01

    Individuals with chronic conditions face challenges with maintaining lifelong adherence to self-management activities. Although reminders can help support the cognitive demands of managing daily and future health tasks, we understand little of how they fit into people’s daily lives. Utilizing a maximum variation sampling method, we interviewed and compared the experiences of 20 older adults with diabetes and 19 mothers of children with asthma to understand reminder use for at-home chronic disease management. Based on our participants’ experiences, we contend that many self-management failures should be viewed as systems failures, rather than individual failures and non-compliance. Furthermore, we identify key principles from reliability engineering that both explain current behavior and suggest strategies to improve patient reminder systems. PMID:25954384

  18. Effects of Enactment of Legislative (Public) Smoking Bans on Voluntary Home Smoking Restrictions: A Review.

    PubMed

    Monson, Eva; Arsenault, Nicole

    2017-02-01

    The positive effects of worldwide increases in enactment of legislative bans on smoking in public areas have been well documented. Relatively little is known about the effects of such bans on voluntary home smoking behavior. Meanwhile, private spaces, such as homes, have replaced public spaces as the primary milieu of secondhand smoke exposure. A systematic search of peer-reviewed articles was conducted using multiple databases including Cochrane Library, Cinahl, Embase, Global Health, Health Star, Joanna Briggs, MEDLINE, PsycINFO, PAIS International, PubMed, and Web of Science. We examined peer-reviewed studies that considered the impact of legislation-based public smoking bans on enactment of private home smoking restrictions. Sixteen articles published between 2002 and 2014 were identified and included. Our results suggest overall positive effects post-legislative ban with the majority of studies demonstrating significant increases in home smoking restrictions. Studies focusing on smoking and nonsmoking samples as well as child populations are discussed in depth. Existing evidence indicates an overall significant positive effect post-legislative ban on voluntary home smoking restrictions. While disentangling these effects over space and time remains a challenge, scientific research has converged in dispelling any notion of significant displacement of smoking into the home. Policy makers, especially those in countries without existing public smoking legislation, can rest assured that these types of bans contribute to the minimization of tobacco-related harm. Findings converge in dispelling notions of displacement of smoking into the home as a consequence of legislative bans that prohibit smoking in public spaces. Evidence from the studies reviewed suggests that through their influence on social norms, legislative bans on smoking in public places may encourage citizens to establish voluntary home smoking restrictions, thus decreasing harm related to secondhand

  19. Public sector risk management: a specific model.

    PubMed

    Lawlor, Ted

    2002-07-01

    Risk management programs for state mental health authorities are generally limited in scope and reactive in nature. Recent changes in how mental health care is provided render it necessary to redirect the risk management focus from its present institutional basis to a statewide, network-based paradigm that is integrated across public and private inpatient and community programs alike. These changes include treating an increasing number of individuals in less-secure settings and contracting for an increasing number of public mental health services with private providers. The model proposed here is closely linked to the Quality Management Process.

  20. Designing public participation training for managers

    SciTech Connect

    Bradbury, J.A.

    1993-08-01

    This paper discusses the needs assessment interviews that were conducted prior to the design and implementation of pilot training workshops in public participation for managers in the Headquarters offices and two sites of the Department of Energy (DOE) Environmental Restoration and Waste Management program. It is the first in a two-part overview of Battelle`s experience in designing and implementing public participation training for managers. The presentation is divided into four sections in addition to this introduction. Sections 1 and 2 outline the purpose and method, respectively. The findings are summarized in Section 3. Section 4 concludes with a summary of the implications for training.

  1. Variations in levels of care between nursing home patients in a public health care system

    PubMed Central

    2014-01-01

    Background Within the setting of a public health service we analyse the distribution of resources between individuals in nursing homes funded by global budgets. Three questions are pursued. Firstly, whether there are systematic variations between nursing homes in the level of care given to patients. Secondly, whether such variations can be explained by nursing home characteristics. And thirdly, how individual need-related variables are associated with differences in the level of care given. Methods The study included 1204 residents in 35 nursing homes and extra care sheltered housing facilities. Direct time spent with patients was recorded. In average each patient received 14.8 hours direct care each week. Multilevel regression analysis is used to analyse the relationship between individual characteristics, nursing home characteristics and time spent with patients in nursing homes. The study setting is the city of Trondheim, with a population of approximately 180 000. Results There are large variations between nursing homes in the total amount of individual care given to patients. As much as 24 percent of the variation of individual care between patients could be explained by variation between nursing homes. Adjusting for structural nursing home characteristics did not substantially reduce the variation between nursing homes. As expected a negative association was found between individual care and case-mix, implying that at nursing home level a more resource demanding case-mix is compensated by lowering the average amount of care. At individual level ADL-disability is the strongest predictor for use of resources in nursing homes. For the average user one point increase in ADL-disability increases the use of resources with 27 percent. Conclusion In a financial reimbursement model for nursing homes with no adjustment for case-mix, the amount of care patients receive does not solely depend on the patients’ own needs, but also on the needs of all the other residents

  2. [Strengths and weaknesses of home management of diarrhea].

    PubMed

    Gamboa-Salcedo, Tamara; Gutiérrez-Camacho, Claudia; Mota-Hernández, Felipe

    2006-01-01

    The aim of the study was to analyze mothers home practices among children with acute diarrhea. A cross sectional study was carried out in a group of 260 mothers of children with diarrhea. Mothers were requested to answer the "verbal biopsy" questionnaire to assess their practices concerning effective diarrhea management at home according to the World Health Organization and corresponding to the Norma Oficial Mexicana recommendations. Descriptive statistics and Chi square for differences were used. Two groups of mothers' were identified: those who had consulted a physician before attending the hospital (n = 191), and those who came to the hospital as their first choice (n = 69). The first group used antibiotics, antiemetics, breast-feeding and Oral Hydration Therapy more frequently than the second group (p < 0.05). The "verbal biopsy " instrument was useful to assess home management of children with diarrhea. This questionnaire was also useful to detect medical malpractice (unjustified prescription of antibiotics and antiemetics) as well as to identify best practices (continued breast feeding and oral hydration).

  3. Nursing Home Staff Characteristics and Knowledge Gain from a Didactic Workshop on Depression and Behavior Management

    ERIC Educational Resources Information Center

    Meeks, Suzanne; Burton, Elizabeth G.

    2004-01-01

    Depression is a prevalent and serious problem among nursing home residents. Nursing home staff members are gatekeepers for mental health treatment for residents, but may know little about depression and its management. We evaluated a didactic workshop for nursing home staff on depressive symptoms and management. Results for 58 staff participants…

  4. Nursing Home Staff Characteristics and Knowledge Gain from a Didactic Workshop on Depression and Behavior Management

    ERIC Educational Resources Information Center

    Meeks, Suzanne; Burton, Elizabeth G.

    2004-01-01

    Depression is a prevalent and serious problem among nursing home residents. Nursing home staff members are gatekeepers for mental health treatment for residents, but may know little about depression and its management. We evaluated a didactic workshop for nursing home staff on depressive symptoms and management. Results for 58 staff participants…

  5. 75 FR 41994 - Federal Management Regulation; Home-to-Work Transportation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-20

    ... 3090-AJ05 Federal Management Regulation; Home-to-Work Transportation AGENCY: Office of Governmentwide... Administration is amending the Federal Management Regulation (FMR) to clarify existing Home-to-Work... Register on September 12, 2000 (65 FR 54966) to establish policy regarding home-to-work...

  6. Problematising public and private work spaces: midwives' work in hospitals and in homes.

    PubMed

    Bourgeault, Ivy Lynn; Sutherns, Rebecca; Macdonald, Margaret; Luce, Jacquelyne

    2012-10-01

    as the boundaries between public and private spaces become increasingly fluid, interest is growing in exploring how those spaces are used as work environments, how professionals both construct and convey themselves in those spaces, and how the lines dividing spaces traditionally along public and private lines are blurred. This paper draws on literature from critical geography, organisational studies, and feminist sociology to interpret the work experiences of midwives in Ontario, Canada who provide maternity care both in hospitals and in clients' homes. qualitative design involving in-depth semi-structured interviews content coded thematically. Ontario, Canada. community midwives who practice at home and in hospital. the accounts of practicing midwives illustrate the ways in which hospital and home work spaces are sites of both compromise and resistance. With the intention of making birthing women feel more `at home', midwives describe how they attempt to recreate the woman's home in the hospital. Similarly, midwives also reorient women's homes to a certain degree into a more standardised work space for home birth attendance. Many midwives also described how they like `guests' in both settings. there seems to be a conscious or unconscious convergence of midwifery work spaces to accommodate Ontario midwives' unique model of practice. we link these findings of midwives' place of work on their experiences as workers to professional work experiences in both public and private spaces and offer suggestions for further exploration of the concept of professionals as guests in their places of work. Copyright © 2012. Published by Elsevier Ltd.

  7. 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.

  8. Children Without Homes: An Examination of Public Responsibility to Children in Out-of-Home Care.

    ERIC Educational Resources Information Center

    Knitzer, Jane; And Others

    This book is the seventh Children's Defense Fund report on major problems facing American children at risk of placement or already placed out of their homes. The findings are based on a survey of child welfare and probation offices in a stratified random sample of 140 counties (27 with populations over 300,000, and 113 with populations under…

  9. Smoking restrictions in homes after implementation of a smoking ban in public places.

    PubMed

    Kairouz, Sylvia; Lasnier, Benoit; Mihaylova, Tsvetelina; Montreuil, Annie; Cohen, Joanna E

    2015-01-01

    This Canadian study examines the prevalence of smoking restrictions in homes before and after the implementation of a public smoking ban, and their relation to tobacco use and cessation among a cohort of smokers. Data were from a longitudinal cohort study of 1,058 smokers in the province of Québec, Canada. Baseline data were collected through a population-based survey conducted 1 month before the implementation of the smoking ban with a representative sample of smokers. Follow-up data were collected 18 months after the ban with a response rate of 68%. Logistic regressions, paired t tests and chi-square statistics were used to examine the factors associated with smoking restrictions in homes, cigarette consumption, and quit attempts. Many smokers imposed partial or full smoking restrictions in their homes but proportions of smoke-free homes did not change significantly between baseline and follow-up. The presence of young children and nonsmokers significantly predicted full smoking restriction in the home. Knowledge about risks associated with exposure to secondhand smoke (SHS) and skepticism about the efficacy of methods to reduce exposure in the home also predicted maintenance of voluntary smoking restrictions in homes. The uptake of smoke-free homes was not associated with the quantity of cigarettes smoked or quit attempts. No significant change in home smoking bans was found 18 months after implementation of a public smoking ban. There remains a need for efforts to better inform smokers about health risks from exposure to SHS in homes and the reality that strategies other than a total smoking ban inside the home are ineffective. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  10. Smoking Restrictions in Homes After Implementation of a Smoking Ban in Public Places

    PubMed Central

    Lasnier, Benoit; Mihaylova, Tsvetelina; Montreuil, Annie; Cohen, Joanna E.

    2015-01-01

    Introduction: This Canadian study examines the prevalence of smoking restrictions in homes before and after the implementation of a public smoking ban, and their relation to tobacco use and cessation among a cohort of smokers. Methods: Data were from a longitudinal cohort study of 1,058 smokers in the province of Québec, Canada. Baseline data were collected through a population-based survey conducted 1 month before the implementation of the smoking ban with a representative sample of smokers. Follow-up data were collected 18 months after the ban with a response rate of 68%. Logistic regressions, paired t tests and chi-square statistics were used to examine the factors associated with smoking restrictions in homes, cigarette consumption, and quit attempts. Results: Many smokers imposed partial or full smoking restrictions in their homes but proportions of smoke-free homes did not change significantly between baseline and follow-up. The presence of young children and nonsmokers significantly predicted full smoking restriction in the home. Knowledge about risks associated with exposure to secondhand smoke (SHS) and skepticism about the efficacy of methods to reduce exposure in the home also predicted maintenance of voluntary smoking restrictions in homes. The uptake of smoke-free homes was not associated with the quantity of cigarettes smoked or quit attempts. Conclusions: No significant change in home smoking bans was found 18 months after implementation of a public smoking ban. There remains a need for efforts to better inform smokers about health risks from exposure to SHS in homes and the reality that strategies other than a total smoking ban inside the home are ineffective. PMID:25140045

  11. Frequency and management of respiratory incidents in invasive home ventilation.

    PubMed

    Stieglitz, Sven; George, Sandhya; Priegnitz, Christina; Hagmeyer, Lars; Randerath, Winfried

    2013-08-01

    There has been a rise in the number of patients requiring long-term ventilation, both in the in-hospital and the out-of-hospital setting. Despite this, little is known about the subsequent clinical course of these patients following hospital discharge. The purpose of this study was to determine the frequency and management of respiratory incidents in patients with invasive out-of-hospital ventilation living in a nursing home allied to a weaning centre. We evaluated retrospectively the protocols that are used to monitor the patients over a period of 2 months. The average time from hospital discharge was 386 ± 330 days. Of the total 17 patients, 9 (53%) patients remained free from any respiratory incidents, while the remaining 8 (47%) patients were responsible for a total of 95 respiratory incidents. Patients that suffered respiratory incidents had been ventilated at home for an average of 194 days, while the others were receiving out-of-hospital ventilation for an average of 557 days. Desaturation (17), dyspnoea (17) and reduced general condition (10) were the most common respiratory incidents. Also, the use of an Ambu bag (bag valve mask; 17), request for a pneumologist review (12) and replacement of the tracheal cannula (7) were the most common interventions. Respiratory incidents are common in invasive home mechanical ventilation, and so home mechanical ventilation needed to be organized safely. Being allied to a weaning centre helps to organize invasive home mechanical ventilation in a safe manner over the long-term ventilation.

  12. Public Reporting and Demand Rationing: Evidence from the Nursing Home Industry.

    PubMed

    He, Daifeng; Konetzka, R Tamara

    2015-11-01

    This paper examines an under-explored unintended consequence of public reporting: the potential for demand rationing. Public reporting, although intended to increase consumer access to high-quality products, may have provided the perverse incentive for high-quality providers facing fixed capacity and administrative pricing to avoid less profitable types of residents. Using data from the nursing home industry before and after the implementation of the public reporting system in 2002, we find that high-quality nursing homes facing capacity constraints reduced admissions of less profitable Medicaid residents while increasing the more profitable Medicare and private-pay admissions, relative to low-quality nursing homes facing no capacity constraints. These effects, although small in magnitude, are consistent with provider rationing of demand on the basis of profitability and underscore the important role of institutional details in designing effective public reporting systems for regulated industries.

  13. Impact of human resource management practices on nursing home performance.

    PubMed

    Rondeau, K V; Wagar, T H

    2001-08-01

    Management scholars and practitioners alike have become increasingly interested in learning more about the ability of certain 'progressive' or 'high-performance' human resource management (HRM) practices to enhance organizational effectiveness. There is growing evidence to suggest that the contribution of various HRM practices to impact firm performance may be synergistic in effect yet contingent on a number of contextual factors, including workplace climate. A contingency theory perspective suggests that in order to be effective, HMR policies and practices must be consistent with other aspects of the organization, including its environment. This paper reports on empirical findings from research that examines the relationship between HRM practices, workplace climate and perceptions of organizational performance, in a large sample of Canadian nursing homes. Data from 283 nursing homes were collected by means of a mail survey that included questions on HRM practices, programmes, and policies, on human resource aspects of workplace climate, as well as a variety of indicators that include employee, customer/resident and facility measures of organizational performance. Results derived from ordered probit analysis suggest that nursing homes in our sample which had implemented more 'progressive' HRM practices and which reported a workplace climate that strongly values employee participation, empowerment and accountability tended to be perceived to generally perform better on a number of valued organizational outcomes. Nursing homes in our sample that performed best overall were found to be more likely to not only have implemented more of these HRM practices, but also to report having a workplace climate that reflects the seminal value that it places on its human resources. This finding is consistent with the conclusion that simply introducing HRM practices or programmes, in the absence of an appropriately supportive workplace climate, will be insufficient to attain

  14. Association of Public Health Initiatives With Outcomes for Out-of-Hospital Cardiac Arrest at Home and in Public Locations.

    PubMed

    Fordyce, Christopher B; Hansen, Carolina M; Kragholm, Kristian; Dupre, Matthew E; Jollis, James G; Roettig, Mayme L; Becker, Lance B; Hansen, Steen M; Hinohara, Tomoya T; Corbett, Claire C; Monk, Lisa; Nelson, R Darrell; Pearson, David A; Tyson, Clark; van Diepen, Sean; Anderson, Monique L; McNally, Bryan; Granger, Christopher B

    2017-10-04

    Little is known about the influence of comprehensive public health initiatives according to out-of-hospital cardiac arrest (OHCA) location, particularly at home, where resuscitation efforts and outcomes have historically been poor. To describe temporal trends in bystander cardiopulmonary resuscitation (CPR) and first-responder defibrillation for OHCAs stratified by home vs public location and their association with survival and neurological outcomes. This observational study reviewed 8269 patients with OHCAs (5602 [67.7%] at home and 2667 [32.3%] in public) for whom resuscitation was attempted using data from the Cardiac Arrest Registry to Enhance Survival (CARES) from January 1, 2010, through December 31, 2014. The setting was 16 counties in North Carolina. Patients were stratified by home vs public OHCA. Public health initiatives to improve bystander and first-responder interventions included training members of the general population in CPR and in the use of automated external defibrillators, teaching first responders about team-based CPR (eg, automated external defibrillator use and high-performance CPR), and instructing dispatch centers on recognition of cardiac arrest. Association of resuscitation efforts with survival and neurological outcomes from 2010 through 2014. Among home OHCA patients (n = 5602), the median age was 64 years, and 62.2% were male; among public OHCA patients (n = 2667), the median age was 68 years, and 61.5% were male. After comprehensive public health initiatives, the proportion of patients receiving bystander CPR increased at home (from 28.3% [275 of 973] to 41.3% [498 of 1206], P < .001) and in public (from 61.0% [275 of 451] to 70.5% [424 of 601], P = .01), while first-responder defibrillation increased at home (from 42.2% [132 of 313] to 50.8% [212 of 417], P = .02) but not significantly in public (from 33.1% [58 of 175] to 37.8% [93 of 246], P = .17). Survival to discharge improved for arrests at home (from

  15. Publication ethics and the ghost management of medical publication.

    PubMed

    Sismondo, Sergio; Doucet, Mathieu

    2010-07-01

    It is by now no secret that some scientific articles are ghost authored - that is, written by someone other than the person whose name appears at the top of the article. Ghost authorship, however, is only one sort of ghosting. In this article, we present evidence that pharmaceutical companies engage in the ghost management of the scientific literature, by controlling or shaping several crucial steps in the research, writing, and publication of scientific articles. Ghost management allows the pharmaceutical industry to shape the literature in ways that serve its interests. This article aims to reinforce and expand publication ethics as an important area of concern for bioethics. Since ghost-managed research is primarily undertaken in the interests of marketing, large quantities of medical research violate not just publication norms but also research ethics. Much of this research involves human subjects, and yet is performed not primarily to increase knowledge for broad human benefit, but to disseminate results in the service of profits. Those who sponsor, manage, conduct, and publish such research therefore behave unethically, since they put patients at risk without justification. This leads us to a strong conclusion: if medical journals want to ensure that the research they publish is ethically sound, they should not publish articles that are commercially sponsored.

  16. Strategy Guideline: Quality Management in Existing Homes; Cantilever Floor Example

    SciTech Connect

    Taggart, J.; Sikora, J.; Wiehagen, J.; Wood, A.

    2011-12-01

    This guideline is designed to highlight the QA process that can be applied to any residential building retrofit activity. The cantilevered floor retrofit detailed in this guideline is included only to provide an actual retrofit example to better illustrate the QA activities being presented. The goal of existing home high performing remodeling quality management systems (HPR-QMS) is to establish practices and processes that can be used throughout any remodeling project. The research presented in this document provides a comparison of a selected retrofit activity as typically done versus that same retrofit activity approached from an integrated high performance remodeling and quality management perspective. It highlights some key quality management tools and approaches that can be adopted incrementally by a high performance remodeler for this or any high performance retrofit. This example is intended as a template and establishes a methodology that can be used to develop a portfolio of high performance remodeling strategies.

  17. The Effect of Publicized Quality Information on Home Health Agency Choice.

    PubMed

    Jung, Jeah Kyoungrae; Wu, Bingxiao; Kim, Hyunjee; Polsky, Daniel

    2016-12-01

    We examine consumers' use of publicized quality information in Medicare home health care markets, where consumer cost sharing and travel costs are absent. We report two findings. First, agencies with high quality scores are more likely to be preferred by consumers after the introduction of a public reporting program than before. Second, consumers' use of publicized quality information differs by patient group. Community-based patients have slightly larger responses to public reporting than hospital-discharged patients. Patients with functional limitations at the start of their care, at least among hospital-discharged patients, have a larger response to the reported functional outcome measure than those without functional limitations. In all cases of significant marginal effects, magnitudes are small. We conclude that the current public reporting approach is unlikely to have critical impacts on home health agency choice. Identifying and releasing quality information that is meaningful to consumers may help increase consumers' use of public reports.

  18. Care home managers' views of dental services for older people living in nursing and residential homes in inner city London.

    PubMed

    Belsi, A; Gonzalez-Maffe, J; Jones, K; Wright, D; Gallagher, J E

    2013-06-01

    To investigate care home managers' views on the provision of dental care (current and future; urgent, check-up and follow-up) for their residents, barriers to care and the impact of policy changes, by type of home (nursing vs residential), with a view to informing the planning and provision of care. A cross sectional postal questionnaire survey and follow-up semi-structured interviews. Care homes in South East London. PARTCIPANTS: All care home managers in three south east London boroughs. A 72% response rate (n=152) was achieved, 140 of which were designated as nursing and/or residential homes (92%). Almost all managers reported that the care homes had arrangements in place for residents to access some elements of dental care (99%, n=148). Reported barriers to care included residents' fear of treatment (53%), patients' limited mobility (45%) and waiting times for services (42%). Limited mobility (p=0.01) and transport issues (p=0.01) were more significant barriers for nursing homes, whereas fear (p=0.02) was more significant for residential homes. Access to a range of dental services and modes of service delivery were requested for the future; most notable were the demands for domiciliary services to be available to nursing homes and for residential homes to access local general dental practitioners to meet the needs of their residents. Managers report having arrangements in place for residents to access dental services; however, there was a clear view that future arrangements should be more appropriate to the needs and vulnerabilities of their residents.

  19. Publicity campaign, wellness event raise awareness of Michigan home health company, products.

    PubMed

    2007-01-01

    HoMedics, a home healthcare and wellness company in Commerce Township, MI, had a problem. As a leading manufacturer of personal wellness and home healthcare products, its product line was constantly evolving with new and innovative technological advances. But with so many rapid changes, HoMedics had trouble educating the media about its new product lines quickly enough. The solution? A multiphase public relations campaign.

  20. Managing Opioid-Tolerant Patients in the Perioperative Surgical Home.

    PubMed

    Wenzel, John T; Schwenk, Eric S; Baratta, Jaime L; Viscusi, Eugene R

    2016-06-01

    Management of acute postoperative pain is important to decrease perioperative morbidity and improve patient satisfaction. Opioids are associated with potential adverse events that may lead to significant risk. Uncontrolled pain is a risk factor in the transformation of acute pain to chronic pain. Balancing these issues can be especially challenging in opioid-tolerant patients undergoing surgery, for whom rapidly escalating opioid doses in an effort to control pain can be associated with increased complications. In the perioperative surgical home model, anesthesiologists are positioned to coordinate a comprehensive perioperative analgesic plan that begins with the preoperative assessment and continues through discharge.

  1. Management control literature and French public hospitals.

    PubMed

    Georgescu, Irène

    2013-08-01

    The introduction of activity based pricing in combination with hospitals' reorganizations has created a new financial logic in French public hospitals. The organization has an obligation to produce certain levels of activity, since hospitals' resources are directly dependent on the activity level. These changes also imply the implementation of financial results controls in these organizations. The purpose of this answer is to demonstrate how the literature on management control can help to understand what has been happening within the French public hospitals.

  2. Learning at Home: Public Library Service to Homeschoolers.

    ERIC Educational Resources Information Center

    Madden, Susan B.

    1991-01-01

    Offers definitions, statistics, and suggestions for public librarians working with homeschoolers. Library concerns are addressed, including censorship, negative staff attitudes, technology demands, and administrative limits; and ways to make homeschoolers more welcome are suggested, including compiling homeschooling resource materials, library…

  3. Embedding care management in the medical home: a case study.

    PubMed

    Daaleman, Timothy P; Hay, Sherry; Prentice, Amy; Gwynne, Mark D

    2014-04-01

    Care managers are playing increasingly significant roles in the redesign of primary care and in the evolution of patient-centered medical homes (PCMHs), yet their adoption within day-to-day practice remains uneven and approaches for implementation have been minimally reported. We introduce a strategy for incorporating care management into the operations of a PCMH and assess the preliminary effectiveness of this approach. A case study of the University of North Carolina at Chapel Hill Family Medicine Center used an organizational model of innovation implementation to guide the parameters of implementation and evaluation. Two sources were used to determine the effectiveness of the implementation strategy: data elements from the care management informatics system in the health record and electronic survey data from the Family Medicine Center providers and care staff. A majority of physicians (75%) and support staff (82%) reported interactions with the care manager, primarily via face-to-face, telephone, or electronic means, primarily for facilitating referrals for behavioral health services and assistance with financial and social and community-based resources. Trend line suggests an absolute decrease of 8 emergency department visits per month for recipients of care management services and an absolute decrease of 7.5 inpatient admissions per month during the initial 2-year implementation period. An organizational model of innovation implementation is a potentially effective approach to guide the process of incorporating care management services into the structure and workflows of PCMHs.

  4. Public/private partnerships in managed care.

    PubMed

    Bredesen, P

    1994-01-01

    Although public/private partnerships are often viewed as mechanisms for using private monies to finance public needs, partnerships among health care providers, the business and legal communities, and the public sector offer promise as a way to realign the provision of health care to special-needs communities in the present era of managed care. In Nashville, Tennessee, such a partnership promises to provide efficient, state-of-the-art medical care through a centralized city-wide clinic for HIV-positive individuals.

  5. Novel pervasive scenarios for home management: the Butlers architecture.

    PubMed

    Denti, Enrico

    2014-01-01

    Many efforts today aim to energy saving, promoting the user's awareness and virtuous behavior in a sustainability perspective. Our houses, appliances, energy meters and devices are becoming smarter and connected, domotics is increasing possibilities in house automation and control, and ambient intelligence and assisted living are bringing attention onto people's needs from different viewpoints. Our assumption is that considering these aspects together allows for novel intriguing possibilities. To this end, in this paper we combine home energy management with domotics, coordination technologies, intelligent agents, ambient intelligence, ubiquitous technologies and gamification to devise novel scenarios, where energy monitoring and management is just the basic brick of a much wider and comprehensive home management system. The aim is to control home appliances well beyond energy consumption, combining home comfort, appliance scheduling, safety constraints, etc. with dynamically-changeable users' preferences, goals and priorities. At the same time, usability and attractiveness are seen as key success factors: so, the intriguing technologies available in most houses and smart devices are exploited to make the system configuration and use simpler, entertaining and attractive for users. These aspects are also integrated with ubiquitous and pervasive technologies, geo-localization, social networks and communities to provide enhanced functionalities and support smarter application scenarios, hereby further strengthening technology acceptation and diffusion. Accordingly, we first analyse the system requirements and define a reference multi-layer architectural model - the Butlers architecture - that specifies seven layers of functionalities, correlating the requirements, the corresponding technologies and the consequent value-added for users in each layer. Then, we outline a set of notable scenarios of increasing functionalities and complexity, discuss the structure of the

  6. Services Avaliable for Nursing Care of the Sick at Home. Public Health Service Publication, No. 1265.

    ERIC Educational Resources Information Center

    1966

    The survey of agencies providing home care conducted on January 1, 1966 by the Division of Nursing showed that almost 70 percent of the population of the United States and essentially all of the population in the territories lived in areas where some type of organized home care nursing services was available. Since 1959, the number of large cities…

  7. Changes in clinical and hotel expenditures following publication of the nursing home compare report card.

    PubMed

    Mukamel, Dana B; Spector, William D; Zinn, Jacqueline; Weimer, David L; Ahn, Richard

    2010-10-01

    Nursing Home Compare first published clinical quality measures at the end of 2002. It is a quality report card that for the first time offers consumers easily accessible information about the clinical quality of nursing homes. It led to changes in consumers' demand, increasing the relative importance of clinical versus hotel aspects of quality in their search and choice of a nursing home. To examine the hypothesis that nursing homes responding to these changes in demand shifted the balance of resources from hotel to clinical activities. The study included 10,022 free-standing nursing homes nationwide during 2001 to 2006. RESEARCH DESIGN AND DATA: A retrospective multivariate statistical analysis of trends in the ratio of clinical to hotel expenditures, using Medicare cost reports, Minimum Data Set and Online Survey, Certification and Reporting data, controlling for changes in residents' acuity and facility fixed effects. Inference is based on robust standard errors. The ratio of clinical to hotel expenditures averaged 1.78. It increased significantly (P < 0.001) by 5% following the publication of the report card. The increase was larger and more significant among nursing homes with worse reported quality, lower occupancy, those located in more competitive markets, for-profit ownership and owned by a chain. The increase in the ratio of clinical to hotel expenditures following publication of the report card suggests that nursing homes responded as expected to the changes in the elasticity of demand with respect to clinical quality brought about by the public reporting of clinical quality measures. The response was stronger among nursing homes facing stronger incentives.

  8. Care home manager attitudes to balancing risk and autonomy for residents with dementia.

    PubMed

    Evans, Elizabeth A; Perkins, Elizabeth; Clarke, Pam; Haines, Alina; Baldwin, Ashley; Whittington, Richard

    2016-10-21

    To determine how care home managers negotiate the conflict between maintaining a safe environment while enabling the autonomy of residents with dementia. This is important because there is limited research with care home managers; yet, they are key agents in the implementation of national policies. Semi-structured interviews were conducted with 18 managers from care homes offering dementia care in the Northwest of England. Data were analysed using a thematic analysis approach. There were three areas in which care home staff reported balancing safety and risk against the individual needs of residents. First, the physical environment created a tension between safety and accessibility to the outside world, which meant that care homes provided highly structured or limited access to outdoor space. Second, care home managers reflected a balancing act between an individual's autonomy and the need to protect their residents' dignity. Finally, care home managers highlighted the ways in which an individual's needs were framed by the needs of other residents to the extent that on some occasions an individual's needs were subjugated to the needs of the general population of a home. There was a strong, even dominant, ethos of risk management and keeping people safe. Managing individual needs while maintaining a safe care home environment clearly is a constant dynamic interpersonal process of negotiating and balancing competing interests for care home managers.

  9. [Information use in public hospital management].

    PubMed

    Escrivão Junior, Alvaro

    2007-01-01

    This study investigates managerial perceptions of the use of information in health management and planning in 24 Public Hospitals in the São Paulo Metropolitan Region, analyzing its usefulness for the decision-making process. In addition, some characteristics of the existing information system are studied. The findings show that ample amounts of information and data are available in the hospitals covered by this study, despite some gaps, and that managers do not know about the existing data and do not use this information to guide hospital management.

  10. Home Economics. Arkansas Public School Course Content Guide.

    ERIC Educational Resources Information Center

    Arkansas State Dept. of Education, Little Rock.

    This course content guide was developed in accordance with the Standards for Accreditation of Public Schools adopted by the Arkansas State Board of Education. The guide is offered as a framework upon which a curriculum can be built. Within each subject area, the content guide identifies skills at three instructional levels: basic, developmental,…

  11. Implementing New Public Management in Educational Policy

    ERIC Educational Resources Information Center

    van der Sluis, Margriet E.; Reezigt, Gerry J.; Borghans, Lex

    2017-01-01

    This article describes how the Dutch Department of Education incorporates New Public Management (NPM) principles in educational policy, and whether conflicts of interest between the Department and schools cause deviations from NPM. We reviewed policy documents and performed secondary analyses on school data. Educational policy focuses on output…

  12. New Public Management in Lithuania's Higher Education

    ERIC Educational Resources Information Center

    Leisyte, Liudvika; Kizniene, Danguole

    2006-01-01

    The article focuses on recent shifts in modes of coordination and the emerging drive towards new public management (NPM) in higher education and examines Lithuanian higher education policy as an example. It investigates the dynamics of the shift by exploring how stakeholders define the term and how, in turn, it influences the political agenda.…

  13. New Public Management in Lithuania's Higher Education

    ERIC Educational Resources Information Center

    Leisyte, Liudvika; Kizniene, Danguole

    2006-01-01

    The article focuses on recent shifts in modes of coordination and the emerging drive towards new public management (NPM) in higher education and examines Lithuanian higher education policy as an example. It investigates the dynamics of the shift by exploring how stakeholders define the term and how, in turn, it influences the political agenda.…

  14. Dental care and treatment needs of elderly in nursing homes in Saarland: perceptions of the homes managers.

    PubMed

    Rabbo, Mohammad Abed; Mitov, Gergo; Gebhart, Florian; Pospiech, Peter

    2012-06-01

    To investigate nursing home managers' perceptions and attitudes towards oral health care and access to dental services for aged care facility residents. Questionnaires containing 28 closed-ended questions were mailed to all 114 nursing homes in Saarland, Germany. Descriptive statistics were calculated for response items. Facility response rate was 39%. None of the nursing homes in this study offered systematic dental health care. Initial dental screening was carried out only in one facility. In 81%, dental examinations only took place if required. Although stationary dental equipment was available only in one home, dental treatment was carried out in 71% of the cases by a dentist in the nursing home. Eighty-four per cent of the homes' managements rated the state of the dentition of the inhabitants as satisfying. Over half of the managers indicated satisfaction with the know-how of their nursing staff concerning oral hygiene procedures. The most significant barriers to provision of dental care in the facilities according to their managers were staff shortage, lack of interest of the inhabitants and financial concerns. The results of this study showed an urgent need for estimating a programme for systematic dental care for institutionalised elder people in the federal state of Saarland. © 2011 The Gerodontology Society and John Wiley & Sons A/S.

  15. 76 FR 71939 - Caribbean Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ... National Oceanic and Atmospheric Administration RIN 0648-XA829 Caribbean Fishery Management Council; Public... (NOAA), Commerce. ACTION: Notice of public meetings. SUMMARY: The Caribbean Fishery Management Council..., 5 Estate Bakkeroe, St. Thomas, USVI. FOR FURTHER INFORMATION CONTACT: Caribbean Fishery Management...

  16. 78 FR 26616 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-07

    ... National Oceanic and Atmospheric Administration RIN 0648-XC660 Pacific Fishery Management Council; Public... (NOAA), Commerce. ACTION: Notice of public meeting. SUMMARY: The Pacific Fishery Management Council's (Pacific Council) Groundfish Management Team (GMT) will hold a webinar to discuss the...

  17. Framing the evidence for health smart homes and home-based consumer health technologies as a public health intervention for independent aging: a systematic review.

    PubMed

    Reeder, Blaine; Meyer, Ellen; Lazar, Amanda; Chaudhuri, Shomir; Thompson, Hilaire J; Demiris, George

    2013-07-01

    There is a critical need for public health interventions to support the independence of older adults as the world's population ages. Health smart homes (HSH) and home-based consumer health (HCH) technologies may play a role in these interventions. We conducted a systematic review of HSH and HCH literature from indexed repositories for health care and technology disciplines (e.g., MEDLINE, CINAHL, and IEEE Xplore) and classified included studies according to an evidence-based public health (EBPH) typology. One thousand, six hundred and thirty-nine candidate articles were identified. Thirty-one studies from the years 1998-2011 were included. Twenty-one included studies were classified as emerging, 10 as promising and 3 as effective (first tier). The majority of included studies were published in the period beginning in the year 2005. All 3 effective (first tier) studies and 9 of 10 of promising studies were published during this period. Almost all studies included an activity sensing component and most of them used passive infrared motion sensors. The three effective (first tier) studies all used a multicomponent technology approach that included activity sensing, reminders and other technologies tailored to individual preferences. Future research should explore the use of technology for self-management of health by older adults; social support; and self-reported health measures incorporated into personal health records, electronic medical records, and community health registries. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  18. Framing the evidence for health smart homes and home-based consumer health technologies as a public health intervention for independent aging: a systematic review

    PubMed Central

    Reeder, Blaine; Meyer, Ellen; Lazar, Amanda; Chaudhuri, Shomir; Thompson, Hilaire J.; Demiris, George

    2013-01-01

    Introduction There is a critical need for public health interventions to support the independence of older adults as the world’s population ages. Health smart homes (HSH) and home-based consumer health (HCH) technologies may play a role in these interventions. Methods We conducted a systematic review of HSH and HCH literature from indexed repositories for health care and technology disciplines (e.g., MEDLINE, CINAHL, and IEEE Xplore) and classified included studies according to an evidence-based public health (EBPH) typology. Results One thousand, six hundred and thirty nine candidate articles were identified. Thirty-one studies from the years 1998–2011 were included. Twenty-one included studies were classified as emerging, 10 as promising and 3 as effective (first tier). Conclusion The majority of included studies were published in the period beginning in the year 2005. All 3 effective (first tier) studies and 9 of 10 of promising studies were published during this period. Almost all studies included an activity sensing component and most of these used passive infrared motion sensors. The three effective (first tier) studies all used a multicomponent technology approach that included activity sensing, reminders and other technologies tailored to individual preferences. Future research should explore the use of technology for self-management of health by older adults, social support and self-reported health measures incorporated into personal health records, electronic medical records, and community health registries. PMID:23639263

  19. Safety management and public spaces: restoring balance.

    PubMed

    Ball, David J; Ball-King, Laurence

    2013-05-01

    Since 2000, the reputation of health and safety in the United Kingdom has been tarnished, so much so that it has become the subject of both a media circus and a government inquiry. This not only threatens the worthy goals of health and safety, but also impacts upon the associated tool of risk assessment itself such that "risk assessment" is increasingly seen by the public at large as a term inviting ridicule, even abuse. The main thrust of the government's examination of health and safety has been its concern that safety requirements were placing a disproportionate burden on business. However, there is another source of discontent, which is public chagrin over the impact of injury control measures upon life beyond the conventional workplace, in particular upon the public spaces that people frequent in their leisure time and on the activities they engage in there. This article provides a perspective on this second dimension of the crisis in confidence. It describes how many U.K. agencies with responsibilities for a wide portfolio of public amenities ranging from the provision of play spaces for the young to the management of publicly accessible countryside, the maintenance of urban and rural trees, the stewardship of sites of cultural heritage, and the pursuit of outdoor educational activities have responded to some conflicts posed to their services by the new safety culture. It concludes with a discussion of implications for the management of public space and for risk assessment itself.

  20. Changes in the relationship between nursing home financial performance and quality of care under public reporting.

    PubMed

    Park, Jeongyoung; Werner, Rachel M

    2011-07-01

    The relationship between financial performance and quality of care in nursing homes is not well defined and prior work has been mixed. The recent focus on improving the quality of nursing homes through market-based incentives such as public reporting may have changed this relationship, as public reporting provides nursing homes with increased incentives to engage in quality-based competition. If quality improvement activities require substantial production costs, nursing home profitability may become a more important predictor of quality under public reporting. This study explores the relationship between financial performance and quality of care and test whether this relationship changes under public reporting. Using a 10-year (fiscal years 1997-2006) panel data set of 9444 skilled nursing facilities in the US, this study employs a facility fixed-effects with and without instrumental variables approach to test the effect of finances on quality improvement and correct for potential endogeneity. The results show that better financial performance, as reflected by the 1-year lagged total profit margin, is modestly associated with higher quality but only after public reporting is initiated. These findings have important policy implications as federal and state governments use market-based incentives to increase demand for high-quality care and induce providers to compete based on quality. Copyright © 2010 John Wiley & Sons, Ltd.

  1. Family caregiving at the intersection of private care by migrant home care workers and public care by nursing staff.

    PubMed

    Ayalon, Liat; Halevy-Levin, Sara; Ben-Yizhak, Zvi; Friedman, Gideon

    2013-09-01

    This study evaluated private family caregiving at the intersection of private migrant home care and public nursing care on the hospitalization of an older patient. Seventy-three individuals were interviewed, including older hospitalized patients, their family members, accompanying migrant home care workers, and nursing personnel. There was no clear consensus concerning the role of family members. Although family members emphasized care management as their main role, the other three groups emphasized that the family members' mere physical presence was their main role. All four groups identified potential barriers to family caregiving, rather than motives for family caregiving, hence pointing to a potential discrepancy between expected and performed family caregiving roles. An indication of the lack of clarity concerning family caregiving roles stems from the finding that family members were frequently viewed as unengaged and neglectful, yet at times they were criticized for being overly involved in patient care. Implications for the care of hospitalized older adults are discussed.

  2. Feasibility of using the Omaha System to represent public health nurse manager interventions.

    PubMed

    Monsen, Karen A; Newsom, Eric T

    2011-01-01

    To test the feasibility of representing public health nurse (PHN) manager interventions using a recognized standardized nursing terminology. A nurse manager in a Midwest local public health agency documented nurse manager interventions using the Omaha System for 5 months. ANALYTIC STRATEGY: The data were analyzed and the results were compared with the results from a parallel analysis of existing PHN intervention data. Interventions for 79 "clients" (projects, teams, or individuals) captured 76% of recorded work hours, and addressed 43% of Omaha System problems. Most problems were addressed at the "community" level (87.1%) versus the "individual" level (12.9%). Nursing practice differed between the 2 knowledge domains of public health family home visiting nursing and public health nursing management. Standardized nursing terminologies have the potential to represent, describe, and quantify nurse manager interventions for future evaluation and research. © 2011 Wiley Periodicals, Inc.

  3. Regulating payment for home care companionship services: legal authority and public policy.

    PubMed

    Kapp, Marshall B

    2008-01-01

    On June 11, 2007, the U.S. Supreme Court issued a ruling in the case of Long Island Care at Home Ltd. v. Coke that upheld a federal regulation exempting employees of third-party agencies who provide home-based "companionship services" to disabled persons from the protections of the minimum wage and overtime pay provisions of the Fair Labor Standards Act. This article discusses the legal issues argued in the case and the legal rationales for the court's decision. The article then identifies the important public policy questions involving the maintenance of a sufficient, competent home care workforce that were left unanswered by the legal ruling and outlines some of the pragmatic implications of potential responses to these public policy questions.

  4. Development of a brief survey to measure nursing home residents' perceptions of pain management.

    PubMed

    Teno, Joan M; Dosa, David; Rochon, Therese; Casey, Virginia; Mor, Vincent

    2008-12-01

    Persistent severe pain in nursing home residents remains an important public health problem. One major key to quality improvement efforts is the development of tools to assist in auditing and monitoring the quality of health care delivery to these patients. A qualitative synthesis of existing pain guidelines, and input from focus groups and an expert panel, were used to develop a 10-item instrument, the Resident Assessment of Pain Management (RAPM). The psychometric properties of the RAPM were examined in a sample of 107 (82% female, average age 85) cognitively intact nursing home residents living in six Rhode Island nursing homes. Reliability and internal consistency were evaluated with test-retest and Cronbach's alpha, respectively, and validity was examined against independent assessment of pain management by research nurses. After comparing the results of RAPM with the independent pain assessment and examining a frequency distribution and factor analysis, five of the 10 items were retained. Internal reliability of the final instrument was 0.55. The rate of reported concerns ranged from 8% stating that they were not receiving enough pain medication to 43% stating that pain interfered with their sleep. The median pain problem score (i.e., the count of the number of opportunities to improve) was 1, with 23% of residents reporting three or more concerns. Overall, RAPM was moderately correlated (Spearman correlation coefficient r=0.43) with an independent expert nurse assessment of the quality of pain management. Evidence of construct validity for RAPM is based on the correlation of the pain problem score with nursing home resident satisfaction with pain management (r=0.26), reported average pain intensity (r=0.41), research nurse completion of the Minimum Data Set pain items (r=0.52), and the quality of pain documentation in the medical record (r=0.28). In conclusion, RAPM is a brief survey tool easily administered to nursing home residents that identifies

  5. Family exemplars during implementation of a home pain management intervention.

    PubMed

    Wiggins, Shirley A

    2009-01-01

    Postoperative pain and symptom management at home following pediatric tonsillectomy and adenoidectomy (T & A) is challenging. There are few randomized clinical trials that have established postoperative care interventions that are specific and effective during home recovery. The purpose of this pilot feasibility study was to describe how children and their families implemented a randomly assigned alarm intervention designed to promote postoperative around-the-clock administration of analgesics. Thirteen children from 12 through 18 years of age were randomly assigned to either the around-the-clock (RTC) intervention group (n = 7) or the usual care group (UCG) of controls (n = 6). The RTC intervention group was requested to use an alarm as a reminder to awaken and administer analgesia during the nighttime hours of sleep. Children randomly assigned to the UCG of controls were given the same discharge education as the RTC intervention group that emphasized around-the-clock administration of analgesia. The UCG of controls were not requested to use the alarm intervention. Both groups documented pain intensity and other symptoms daily for 3 days in a diary. All children wore an actigraphy-score wrist monitor to assess sleep during the same 3 days. Telephone interviews were conducted with the children and mothers at 24 hours and 10 to 14 days after surgery. Nonparametric statistics were used to compare differences between the two groups. Children in the RTC intervention group administered significantly (p = .014) more analgesics by the second postoperative day than the UCG of controls. Pain intensity was moderate to severe for both groups. The mean hours of nighttime sleep for the two groups did not differ. Themes that emerged from the qualitative analysis of the interviews included painful challenges; struggling with decisions; making things work; a lengthy recovery; and family support. Results supported the need for research to establish evidenced-based home care

  6. Final Scientific/Technical Report: Context-Aware Smart Home Energy Manager (CASHEM)

    SciTech Connect

    Foslien, Wendy K.; Curtner, Keith L.

    2013-01-15

    Because of growing energy demands and shortages, residential home owners are turning to energy conservation measures and smart home energy management devices to help them reduce energy costs and live more sustainably. In this context, the Honeywell team researched, developed, and tested the Context Aware Smart Home Energy Manager (CASHEM) as a trusted advisor for home energy management. The project focused on connecting multiple devices in a home through a uniform user interface. The design of the user interface was an important feature of the project because it provided a single place for the homeowner to control all devices and was also where they received coaching. CASHEM then used data collected from homes to identify the contexts that affect operation of home appliances. CASHEM's goal was to reduce energy consumption while keeping the user's key needs satisfied. Thus, CASHEM was intended to find the opportunities to minimize energy consumption in a way that fit the user's lifestyle.

  7. Home visiting for intervention delivery to improve rural family asthma management.

    PubMed

    Horner, Sharon D

    2006-01-01

    The focus of this article is on the use of home visits in an asthma self-management intervention study with rural families who have a school-aged child with asthma. The study design involved randomization of the sample by elementary schools, then baseline (pretest) and postintervention data collection.(1) The purpose of this article is to describe challenges with, and pose solutions for, implementing home visits for asthma self-management in rural areas. Home visiting is a strategy for program delivery that takes advantage of the home context for tailoring services to address the family's individual needs. The advantages of intervening in the home include being able to (a) use actual home conditions for individualizing the asthma education to meet families' needs; (b) match home visitors with family in terms of ethnicity and language; (c) retain a high percentage of families over the year-long duration of the study; and (d) not add to family burden of managing asthma.

  8. Exposure to nontraditional pets at home and to animals in public settings: risks to children.

    PubMed

    Pickering, Larry K; Marano, Nina; Bocchini, Joseph A; Angulo, Frederick J

    2008-10-01

    Exposure to animals can provide many benefits during the growth and development of children. However, there are potential risks associated with animal exposures, including exposure to nontraditional pets in the home and animals in public settings. Educational materials, regulations, and guidelines have been developed to minimize these risks. Pediatricians, veterinarians, and other health care professionals can provide advice on selection of appropriate pets as well as prevention of disease transmission from nontraditional pets and when children contact animals in public settings.

  9. Children's Literature, the Home, and the Debate on Public versus Private Education, c.1760-1845

    ERIC Educational Resources Information Center

    Grenby, M. O.

    2015-01-01

    In Britain in the period 1760-1845 the debate on the relative merits of public (school) versus private (home) education remained unresolved and was vigorously debated in many media. It was in this same period that children's literature began to flourish: a much wider variety of books were published in much greater numbers. The new children's…

  10. Home Schools, Private Schools, Parochial Schools--What Are A Public School's Special Education Obligations?

    ERIC Educational Resources Information Center

    Opuda, Michael J.

    This paper examines issues related to the provision of special education services by public schools to students in private, parochial, or home school settings and offers guidelines for local education agencies. First, the paper reviews federal statutory and regulatory obligations, particularly those under the Individuals with Disabilities…

  11. Children's Literature, the Home, and the Debate on Public versus Private Education, c.1760-1845

    ERIC Educational Resources Information Center

    Grenby, M. O.

    2015-01-01

    In Britain in the period 1760-1845 the debate on the relative merits of public (school) versus private (home) education remained unresolved and was vigorously debated in many media. It was in this same period that children's literature began to flourish: a much wider variety of books were published in much greater numbers. The new children's…

  12. Public Involvement: The Home-School-Community Partnership. Practical Handles 3.

    ERIC Educational Resources Information Center

    Langton, Kim, Comp.

    This book contains 54 articles providing examples of how to involve the public, home, and community effectively in an educational partnership. It consists of four sections. In the first section various aspects of encouraging parent involvement are addressed, including using television to improve family relationships, bridging the gap between…

  13. Public School Center vs. Family Home Day Care: Single Parents' Reasons for Selection.

    ERIC Educational Resources Information Center

    Rothschild, Maria Stupp

    This study investigates the reasons single parents in San Diego had for choosing either a public day care center or a licensed day care home for their children. A sample of 30 single parents with children in school district administered children's centers was drawn and matched by a similarly geographically distributed sample of 23 parents with…

  14. Public, Private, and Home School Children's Views of Forgiveness and Retribution in "Cinderella."

    ERIC Educational Resources Information Center

    Knafle, June D.; Wescott, Alice Legenza

    Fifth Graders (N=626) from public, Catholic, Christian, and home schools reacted to values of forgiveness versus retribution in the two main versions of "Cinderella" by choosing which ending they preferred for themselves, for a 4-year old sister, and for a 4-year old brother. Girls preferred the forgiveness ending for themselves…

  15. Public Involvement: The Home-School-Community Partnership. Practical Handles 3.

    ERIC Educational Resources Information Center

    Langton, Kim, Comp.

    This book contains 54 articles providing examples of how to involve the public, home, and community effectively in an educational partnership. It consists of four sections. In the first section various aspects of encouraging parent involvement are addressed, including using television to improve family relationships, bridging the gap between…

  16. Managers' Compensation in a Mixed Ownership Industry: Evidence from Nursing Homes.

    PubMed

    Huang, Sean Shenghsiu; Hirth, Richard A; Smith, Dean G

    2016-01-01

    An extensive literature is devoted to differences between for-profit and non-profit health-care providers' prices, utilization, and quality. Less is known about for-profit and non-profit managers' compensation and its relationship with financial and quality performance. The aim of this study is to examine whether for-profit and non-profit nursing homes place differential weights on financial and quality performance in determining managers' compensation. Using a unique 8-year dataset on Ohio nursing homes, fixed-effect regression models of managers' compensation include financial and quality performance as well as other explanatory variables concerning firm and market characteristics and manager qualifications. Among for-profit nursing homes, compensation of owner-managers and non-owner managers are compared. Compensation of for-profit managers is significantly positively associated with profit margin and return-on-assets, while compensation of non-profit managers does not exhibit any consistent relationship with financial measures. Compensation of neither for-profit nor non-profit managers is significantly related to quality measures. Nursing home size and managers' years of experience are the only consistent determinants of compensation. Owner-managers earn significantly higher compensation than non-owner managers and their compensation is less related to nursing home performance. Finding that home size and experience are strong determinants of compensation, and the association with ownership and financial performance for for-profit nursing homes are as expected. The insignificant relationship between compensation and quality performance is potentially troublesome.

  17. Securing and Managing Nursing Home Resources: Director of Nursing Tactics.

    PubMed

    Siegel, Elena O; Young, Heather M; Zysberg, Leehu; Santillan, Vanessa

    2015-10-01

    Shrinking resources and increasing demands pose managerial challenges to nursing homes. Little is known about how directors of nursing (DON) navigate resource conditions and potential budget-related challenges. This paper describes the demands-resources tensions that DONs face on a day-to-day basis and the tactics they use to secure and manage resources for the nursing department. We conducted a secondary analysis of data from a parent study that used a qualitative approach to understand the DON position. A convenience sample of 29 current and previous DONs and administrators from more than 15 states participated in semistructured interviews for the parent study. Data analysis included open coding and thematic analysis. DONs address nursing service demands-resources tensions in various ways, including tactics to generate new sources of revenue, increase budget allocations, and enhance cost efficiencies. The findings provide a rare glimpse into the operational tensions that can arise between resource allocations and demands for nursing services and the tactics some DONs employ to address these tensions. This study highlights the DON's critical role, at the daily, tactical level of adjusting and problem-solving within existing resource conditions. How DONs develop these skills and the extent to which these skills may improve nursing home quality and value are important questions for further practice-, education-, and policy-level investigation. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  18. Asthma and food allergy management in Chicago Public Schools.

    PubMed

    Gupta, Ruchi S; Rivkina, Victoria; DeSantiago-Cardenas, Lilliana; Smith, Bridget; Harvey-Gintoft, Blair; Whyte, Stephanie A

    2014-10-01

    This study aimed to characterize asthma and food allergy reporting and management in Chicago Public Schools. Demographic and health data for students who have asthma and food allergy were extracted from the Chicago Public Schools database. Demographic and geographic variability and the existence of school health management plans were analyzed, and multiple logistic regression models were computed. Home addresses were geocoded to create maps of case counts per community area. Approximately 18,000 asthmatic and 4000 food allergic students were identified. Of asthmatic students, 9.3% had a food allergy; of food allergic students, 40.1% had asthma. Asthma odds were significantly higher among black and Hispanic students (odds ratio [OR] = 2.3 and 1.3, respectively), whereas food allergy odds were significantly higher among black students (OR = 1.1; 95% confidence interval [CI], 1.0-1.3) and significantly lower among Hispanic students (OR = 0.8; 95% CI, 0.7-0.9). Only 24.3% of students who had asthma and 50.9% of students who had food allergy had a school health management plan on file. Odds of having a school health management plan were significantly higher among students with both conditions, but the likelihood of having a plan on file was significantly lower among racial/ethnic minority and low-income students, regardless of medical condition. Only 1 in 4 students who have asthma and half of food allergic students have health management plans in schools, with lower numbers among minority and low-income students. Improving chronic disease reporting and access to school health management plans is critical. Copyright © 2014 by the American Academy of Pediatrics.

  19. Case management approaches to home support for people with dementia.

    PubMed

    Reilly, Siobhan; Miranda-Castillo, Claudia; Malouf, Reem; Hoe, Juanita; Toot, Sandeep; Challis, David; Orrell, Martin

    2015-01-05

    Over 35 million people are estimated to be living with dementia in the world and the societal costs are very high. Case management is a widely used and strongly promoted complex intervention for organising and co-ordinating care at the level of the individual, with the aim of providing long-term care for people with dementia in the community as an alternative to early admission to a care home or hospital. To evaluate the effectiveness of case management approaches to home support for people with dementia, from the perspective of the different people involved (patients, carers, and staff) compared with other forms of treatment, including 'treatment as usual', standard community treatment and other non-case management interventions. We searched the following databases up to 31 December 2013: ALOIS, the Specialised Register of the Cochrane Dementia and Cognitive Improvement Group,The Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL, LILACS, Web of Science (including Science Citation Index Expanded (SCI-EXPANDED) and Social Science Citation Index), Campbell Collaboration/SORO database and the Specialised Register of the Cochrane Effective Practice and Organisation of Care Group. We updated this search in March 2014 but results have not yet been incorporated. We include randomised controlled trials (RCTs) of case management interventions for people with dementia living in the community and their carers. We screened interventions to ensure that they focused on planning and co-ordination of care. We used standard methodological procedures as required by The Cochrane Collaboration. Two review authors independently extracted data and made 'Risk of bias' assessments using Cochrane criteria. For continuous outcomes, we used the mean difference (MD) or standardised mean difference (SMD) between groups along with its confidence interval (95% CI). We applied a fixed- or random-effects model as appropriate. For binary or dichotomous data, we generated the corresponding odds

  20. [Quality assurance and total quality management in residential home care].

    PubMed

    Nübling, R; Schrempp, C; Kress, G; Löschmann, C; Neubart, R; Kuhlmey, A

    2004-02-01

    Quality, quality assurance, and quality management have been important topics in residential care homes for several years. However, only as a result of reform processes in the German legislation (long-term care insurance, care quality assurance) is a systematic discussion taking place. Furthermore, initiatives and holistic model projects, which deal with the assessment and improvement of service quality, were developed in the field of care for the elderly. The present article gives a critical overview of essential developments. Different comprehensive approaches such as the implementation of quality management systems, nationwide expert-based initiatives, and developments towards professionalizing care are discussed. Empirically based approaches, especially those emphasizing the assessment of outcome quality, are focused on in this work. Overall, the authors conclude that in the past few years comprehensive efforts have been made to improve the quality of care. However, the current situation still requires much work to establish a nationwide launch and implementation of evidence-based quality assurance and quality management.

  1. Home management of fever in children: rational or ritual?

    PubMed

    al-Eissa, Y A; al-Zamil, F A; al-Sanie, A M; al-Salloum, A A; al-Tuwaijri, H M; al-Abdali, N M; al-Azzam, S A

    2000-04-01

    Fever is extremely common in childhood. Parents have been shown to have unrealistic fears, resulting in inappropriate management of fever in their children. This study was conducted to survey parents about their knowledge concerning home management of fever in children in their care. Parents of 560 febrile children were randomly recruited and interviewed in the waiting areas of the outpatient clinics or emergency room in four hospitals in Riyadh city using a standard questionnaire. Most of the interviewees were mothers, aged within 20-39 years. Although more than one-half of fathers and one-third of mothers in the study were well educated, most were misinformed about recognition and definition of fever. Most parents had poor knowledge regarding minimum temperatures for administering correct doses of antipyretic drugs or for sponging/bathing with water of the correct temperature. Most parents demonstrated a poor understanding of the appropriate frequency for checking the child's temperature and administering antipyretics. Only one-third of parents indicated a reasonable educational imprint by health-care providers. Considerable efforts will be required to educate parents about fever and its management.

  2. [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.

  3. Meeting people where they are: engaging public housing residents for integrated pest management.

    PubMed

    Scammell, Madeleine K; Duro, Laurie; Litonjua, Emily; Berry, Lilly; Reid, Margaret

    2011-01-01

    In a unique partnership, the Boston Public Health Commission, the Boston Housing Authority (BHA), Boston University School of Public Health, the Committee for Boston Public Housing, and the West Broadway Task Force (WBTF) led an Integrated Pest Management (IPM) intervention in Boston's public housing developments. Key to the success of the program was recruiting residents to participate. Residents who were trained as Community Health Advocates (CHAs) at the West Broadway Development in South Boston, Massachusetts, recruited over 300 homes to participate in the IPM intervention (out of 484 living units). This article describes the recruitment strategy and success from the perspective of CHAs at the West Broadway development.

  4. A disease management program for heart failure: collaboration between a home care agency and a care management organization.

    PubMed

    Gorski, Lisa A; Johnson, Kathy

    2003-01-01

    This article describes a collaborative approach to manage patients with heart failure between a home care agency and a care management agency. The resulting disease management program used a combination of home visits and phone contact. Care management plans emphasized patient education on increasing adherence to medical and diet regimens, and recognizing early symptoms of exacerbation that could lead to rehospitalization. Clinician activities and patient outcomes are described.

  5. [Quality of care and risk management in hospital at home services].

    PubMed

    Franzin-Garrec, Martine; Hoden, Romy

    2016-04-01

    Hospital at home structures are healthcare institutions in their own right, with the same obligations in terms of governance with regard to quality of care and risk management. However, hospital at home services are characterised by the remote management of the activity and the nursing staff, with specific constraints. Copyright © 2016. Published by Elsevier Masson SAS.

  6. Changes in Patient Sorting to Nursing Homes under Public Reporting: Improved Patient Matching or Provider Gaming?

    PubMed Central

    Werner, Rachel M; Konetzka, R Tamara; Stuart, Elizabeth A; Polsky, Daniel

    2011-01-01

    Objective To test whether public reporting in the setting of postacute care in nursing homes results in changes in patient sorting. Data Sources/Study Setting All postacute care admissions from 2001 to 2003 in the nursing home Minimum Data Set. Study Design We test changes in patient sorting (or the changes in the illness severity of patients going to high- versus low-scoring facilities) when public reporting was initiated in nursing homes in 2002. We test for changes in sorting with respect to pain, delirium, and walking and then examine the potential roles of cream skimming and downcoding in changes in patient sorting. We use a difference-in-differences framework, taking advantage of the variation in the launch of public reporting in pilot and nonpilot states, to control for underlying trends in patient sorting. Principal Findings There was a significant change in patient sorting with respect to pain after public reporting was initiated, with high-risk patients being more likely to go to high-scoring facilities and low-risk patients more likely to go to low-scoring facilities. There was also an overall decrease in patient risk of pain with the launch of public reporting, which may be consistent with changes in documentation of pain levels (or downcoding). There was no significant change in sorting for delirium or walking. Conclusions Public reporting of nursing home quality improves matching of high-risk patients to high-quality facilities. However, efforts should be made to reduce the incentives for downcoding by nursing facilities. PMID:21105869

  7. Elementary Rehabilitation Nursing Care; a Manual for Nurses and Ancillary Workers in Nursing Homes, Hospitals, Convalescent Facilities, and Public Health Agencies. Public Health Service Publication No. 1436.

    ERIC Educational Resources Information Center

    Colorado State Dept. of Public Health, Denver. Public Health Nursing Section.

    This guide for teacher and student use presents a comprehensive program of physical rehabilitation for aged and physically disabled patients. Developed by the Public Health Nursing Section, the manual was tested by state health department personnel and persons doing inservice teaching in their respective nursing homes. The program is designed to…

  8. Exploring the relationship between nursing home financial performance and management entrepreneurial attributes.

    PubMed

    Davis, Jullet A; Marino, Louis D; Vecchiarini, Mariangela

    2013-01-01

    degrees, nursing home administrators may view themselves as being entrepreneurial despite the intense pressures from governments, poor public perceptions, decreasing reimbursement, more impaired residents, and increasing competition from substitute providers. Further administrators may need to manage the expectations of key stakeholders when they undertake innovative programs that will support social outcomes but which may not enhance short term financial performance. This paper demonstrates the complex relationship between entrepreneurial activities and firm performance in nursing homes and has implications for the broader health care setting.

  9. Development of a managed-care team in a traditional home healthcare agency.

    PubMed

    Brown, N L; Neal, L J

    1997-10-01

    Increasing numbers of home health clients have managed-care insurance plans. Issues related to the care of these clients in the home are different from those that relate to the care of Medicare clients. The Visiting Nurse Association (VNA) of Northern Virginia developed a managed-care team whose staff is trained to work effectively and efficiently with managed-care companies while maintaining a goal of quality care. The evolution of the managed-care team concept is described and offered as a model for other traditional home health agencies. Critical success factors for implementing a dedicated managed-care team are defined. Speculation about the future of the VNA's managed-care team and the implications for nursing and home healthcare of the managed-care team concept are discussed.

  10. 77 FR 35359 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-13

    ... National Oceanic and Atmospheric Administration New England Fishery Management Council; Public Meeting...), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management Council's (Council) VMS/ Enforcement Committee and Advisory Panel will meet to consider actions affecting New England...

  11. 76 FR 31304 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-31

    ... National Oceanic and Atmospheric Administration RIN: 0648-XA462 New England Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management...

  12. 76 FR 31304 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-31

    ... National Oceanic and Atmospheric Administration RIN 0658-XA461 New England Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management...

  13. 76 FR 49452 - Caribbean Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-10

    ... National Oceanic and Atmospheric Administration RIN 0648-XA622 Caribbean Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice of public meetings. SUMMARY: The Caribbean Fishery Management Council...

  14. 77 FR 27716 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-11

    ... National Oceanic and Atmospheric Administration New England Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management Council's...

  15. 78 FR 25955 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-03

    ... National Oceanic and Atmospheric Administration RIN 0648-XC657 Pacific Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The Pacific Fishery Management...

  16. 78 FR 14078 - Caribbean Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-04

    ... National Oceanic and Atmospheric Administration RIN 0648-XC531 Caribbean Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice of public meeting. SUMMARY: The Caribbean Fishery Management...

  17. 76 FR 6402 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-04

    ... National Oceanic and Atmospheric Administration RIN 0648-XA193 Pacific Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice of public meeting. SUMMARY: The Pacific Fishery Management...

  18. 76 FR 55363 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-07

    ... National Oceanic and Atmospheric Administration RIN 0648-XA682 Pacific Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice of public meeting. SUMMARY: The Pacific Fishery Management...

  19. 78 FR 32623 - Caribbean Fishery Management Council; Public Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-31

    ... National Oceanic and Atmospheric Administration RIN 0648-XC706 Caribbean Fishery Management Council; Public Meetings AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice of public meetings. SUMMARY: The Caribbean Fishery Management...

  20. 77 FR 27717 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-11

    ... National Oceanic and Atmospheric Administration New England Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management Council's...

  1. 77 FR 31327 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-25

    ... National Oceanic and Atmospheric Administration RIN 0648-XC039 Pacific Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice of public meetings. SUMMARY: The Pacific Fishery Management...

  2. 76 FR 80890 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-27

    ... National Oceanic and Atmospheric Administration RIN 0648-XA895 Pacific Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The Pacific Fishery Management...

  3. 76 FR 26252 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-06

    ... National Oceanic and Atmospheric Administration RIN 0648-XA416 Pacific Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The Pacific Fishery Management...

  4. 77 FR 31329 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-25

    ... National Oceanic and Atmospheric Administration RIN 0648-XC046 Pacific Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The Pacific Fishery Management...

  5. 78 FR 4131 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-18

    ... National Oceanic and Atmospheric Administration RIN 0648-XC450 Pacific Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The Pacific Fishery Management...

  6. 77 FR 60380 - Caribbean Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-03

    ... National Oceanic and Atmospheric Administration RIN 0648-XC264 Caribbean Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice of public meetings. SUMMARY: The Caribbean Fishery Management...

  7. 76 FR 76387 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-07

    ... National Oceanic and Atmospheric Administration RIN 0648-XA856 Pacific Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The Pacific Fishery Management...

  8. 77 FR 47603 - Caribbean Fishery Management Council; Public Meetings; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-09

    ... National Oceanic and Atmospheric Administration RIN 0648-XC146 Caribbean Fishery Management Council; Public... Administration (NOAA), Commerce. ACTION: Notice of public meeting addendum. SUMMARY: The Caribbean Fishery... Conquistador Avenue, Fajardo, Puerto Rico. FOR FURTHER INFORMATION CONTACT: Caribbean Fishery Management...

  9. Public reporting and market area exit decisions by home health agencies.

    PubMed

    Jung, Kyoungrae; Feldman, Roger

    2012-01-01

    To examine whether home health agencies selectively discontinue services to areas with socio-economically disadvantaged people after the introduction of Home Health Compare (HHC), a public reporting program initiated by Medicare in 2003. We focused on agencies' initial responses to HHC and examined selective market-area exits by agencies between 2002 and 2004. We measured HHC effects by the percentage of quality indicators reported in public HHC data in 2003. Socio-economic status was measured by per capita income and percent college-educated at the market-area level. 2002 and 2004 Outcome and Assessment Information Set (OASIS); 2000 US Census file; 2004 Area Resource File; and 2002 Provider of Service File. WE FOUND A SMALL AND WEAK EFFECT OF PUBLIC REPORTING ON SELECTIVE EXITS: a 10-percent increase in reporting (reporting one more indicator) increased the probability of leaving an area with less-educated people by 0.3 percentage points, compared with leaving an area with high education. The small level of market-area exits under public reporting is unlikely to be practically meaningful, suggesting that HHC did not lead to a disruption in access to home health care through selective exits during the initial year of the program.

  10. Public Reporting and Market Area Exit Decisions by Home Health Agencies

    PubMed Central

    Jung, Kyoungrae; Feldman, Roger

    2012-01-01

    Objective To examine whether home health agencies selectively discontinue services to areas with socio-economically disadvantaged people after the introduction of Home Health Compare (HHC), a public reporting program initiated by Medicare in 2003. Study Design /Methods We focused on agencies' initial responses to HHC and examined selective market-area exits by agencies between 2002 and 2004. We measured HHC effects by the percentage of quality indicators reported in public HHC data in 2003. Socio-economic status was measured by per capita income and percent college-educated at the market-area level. Data Source(s) 2002 and 2004 Outcome and Assessment Information Set (OASIS); 2000 US Census file; 2004 Area Resource File; and 2002 Provider of Service File. Principal Findings We found a small and weak effect of public reporting on selective exits: a 10-percent increase in reporting (reporting one more indicator) increased the probability of leaving an area with less-educated people by 0.3 percentage points, compared with leaving an area with high education. Conclusion The small level of market-area exits under public reporting is unlikely to be practically meaningful, suggesting that HHC did not lead to a disruption in access to home health care through selective exits during the initial year of the program. PMID:24800158

  11. Challenges in making a business case for effective pain management in nursing homes.

    PubMed

    Bakerjian, Debra; Prevost, Suzanne S; Herr, Keela; Swafford, Kristen; Ersek, Mary

    2012-02-01

    The lack of a systematic and comprehensive pain management program is a common quality problem in nursing homes. The purpose of this article is to address the business case for effective pain management in this setting, including the conceptual domains and processes that should be considered in improving quality and reducing costs. Unfortunately, the literature contains very little to inform those working to implement effective and efficient pain management programs in nursing homes. This article suggests several strategies for establishing an internal business case to support the implementation of a comprehensive pain management program in a nursing home setting.

  12. Stardust@home: Enlisting Students and the Public in the Search for Interstellar Dust

    NASA Astrophysics Data System (ADS)

    Mendez, B. M.; Craig, N.; Westphal, A. J.

    2005-12-01

    In January 2006, NASA's Stardust mission returns to Earth after nearly seven years in interplanetary space. During its journey, Stardust encountered comet Wild 2, collecting dust particles from it in a special material called aerogel. At two other times in the mission, aerogel collectors were also opened to collect interstellar dust. By studying this dust, we hope to learn about the origins of the Solar System. When Stardust returns, the aerogel collectors exposed to the interstellar dust will be scanned by an automated microscope. There will be approximately 1.6 million fields of view, but perhaps only a few dozen total grains of interstellar dust in the entire collector. Finding the particles is a daunting task. We are recruiting the public in the search for these precious pieces of space dust trapped in the collectors. We call the project Stardust@home. Through Stardust@home, volunteers will search fields of view from the Stardust aerogel collector using a web-based "Virtual Microscope." Volunteers who discover interstellar dust particles will have the privilege of naming them. We are also creating a teacher's lesson guide about the origins of the Solar System that uses the Stardust@home Virtual Microscope, and are conducting training workshops for it. We are creating a section of the Stardust@home website to educate the public about the science of the project and in addition, we will provide lectures, tours, workshops, etc. about Stardust and Stardust@home for students, after school groups, and the public to widely disseminate the project.

  13. Managing a Public Library. Parts I and II.

    ERIC Educational Resources Information Center

    Aronoff, Carol; Cart, Michael

    1985-01-01

    Discusses factors that contribute to Santa Monica Public Library's excellence, including supportive city government and citizenry, city council, library board, lean top management, and the basic management team. Specific management principles and techniques, public relations, and measures of service at Beverly Hills Public Library are also…

  14. Managing a Public Library. Parts I and II.

    ERIC Educational Resources Information Center

    Aronoff, Carol; Cart, Michael

    1985-01-01

    Discusses factors that contribute to Santa Monica Public Library's excellence, including supportive city government and citizenry, city council, library board, lean top management, and the basic management team. Specific management principles and techniques, public relations, and measures of service at Beverly Hills Public Library are also…

  15. [Quality management in a public health agency].

    PubMed

    Villalbí, Joan R; Ballestín, Manuela; Casas, Conrad; Subirana, Teresa

    2012-01-01

    This article describes the introduction of quality improvement actions in a public health organization. After ISO 17025 accreditation, which was legally mandated, was granted to the official control laboratory, the management decided to expand a quality policy in 2003, through a series of actions based on process analysis and proposals for improvement, further definition of standard operating procedures, exploration of users' opinions, the creation of improvement groups, and external audits or certification. The organizational response to these initiatives was diverse. External audit or certification of services seems to be the most powerful tool for change. Costing studies showed that up to 75% of the total expenditure of the agency in 2010 was spent on public health services subject to external audit or certification.

  16. Public attitudes toward forest management: a Shawnee National Forest example

    Treesearch

    Joanne Vining

    2003-01-01

    One of the fundamental problems of modern public lands management is the accurate and representative assessment of public opinion. The purpose of this study was to examine differences in perceptions and attitudes of Shawnee National Forest management activities and plans among members of local and regional publics. A survey was administered to members of the public in...

  17. Factors of Good Collaboration in Home-Based End-of-Life Care: A Questionnaire Survey of Japanese Home Care Nurses, Home Helpers, and Care Managers.

    PubMed

    Yamamoto-Mitani, Noriko; Igarashi, Ayumi; Noguchi-Watanabe, Maiko; Takemura, Yukie; Suzuki, Miho

    2015-01-01

    Good interprofessional work (IPW) is essential to provide quality home-based end-of-life (EOL) care. The purpose of this study was to explore the factors of "good collaboration," as evaluated separately by home care nurses (HNs), home helpers (HHs), and care managers (CMs). The relationship was examined between their evaluation of good collaboration and their recent actual experience of interprofessional collaborative work for a home-based EOL case. The questionnaire was returned nationwide by 378 HNs, 305 HHs, and 476 CMs, and data were collected on 177 EOL cases from HNs, 84 cases from HHs, and 123 cases from CMs. Evaluation of good collaboration by HNs was associated with working with a CM with whom they had multiple collaborative experiences, the client being independent for their toileting until just before dying, and sharing information regarding the client's EOL decision with an HH 1 month before dying. Evaluation of good collaboration by HHs was associated with working at an agency that collaborated with fewer CM agencies and working at an agency that allowed staff to visit dying clients. Evaluation of good collaboration by CMs was associated only with the client being dependent for toileting. Our results highlighted the characteristics of how each professional seeks to collaborate depending on their preparedness, contexts, and resultant expectations toward other professionals when entering the IPW for home-based EOL care. To promote good IPW for home-based EOL care further, professionals need to understand these differences among ourselves and try to meet others' expectations.

  18. The hierarchy of work pursuits of public health managers.

    PubMed

    Braithwaite, Jeffrey; Luft, Sabine; Bender, Wolfgang; Callen, Joanne; Westbrook, Johanna I; Westbrook, Mary T; Mallock, Nadine A; Iedema, Rick; Hindle, Donald; Jochelson, Tanya

    2007-05-01

    How public health is managed in various settings is an important but under-examined issue. We examine themes in the management literature, contextualize issues facing public health managers and investigate the relative importance placed on their various work pursuits using a 14-activity management model empirically derived from studies of clinician-managers in hospitals. Ethnographic case studies of 10 managers in nine diverse public health settings were conducted. The case study accounts of managers' activities were content analysed, and substantive words encapsulating their work were categorized using the model. Managerial activities of the nine public health managers were ranked according to the number of words describing each activity. Kendall's coefficient of concordance yielded W = 0.710, P < 0.000, revealing significant similarity between the activity patterns of the public health managers. A rank order correlation between the activity patterns of the average ranks for the public health sample and for the hospital clinician-managers (n = 52) was R = 0.420, P = 0.131, indicating no significant relationship between relative activity priorities of the two groups. Public health managers put less emphasis on pursuits associated with structure, hierarchy and education, and more on external relations and decision-making. The model of hospital clinician-managers' managerial activities is applicable to public health managers while identifying differences in the way the two groups manage. The findings suggest that public health management work is more managerialist than previously thought.

  19. Outcomes of Planned Home Visits of Intern Public Health Nurses: An Example from Turkey.

    PubMed

    Ozkan, Ozlem; Ozdemir, Saadet

    This study aimed at evaluating the outcomes of planned home visits of intern public health nurses enrolled to a school of health over 8 educational years. The descriptive research consisted of 181 families (N = 745 individuals) who received primary services through the planned home visits undertaken by 431 intern public health nurses at Kocaeli province in Turkey. The data were collected from Family Nursing Process Records and Family Health Achievement Forms. Both of these data collection forms were classified according to North American Nursing Diagnosis Association (NANDA) Taxonomy II. Intern public health nurses provided primary health services to 181 families (N = 745 persons) with a total of 8771 planned home visits undertaken over 802 days and 14.874 student/practice days. A total of 1539 nursing diagnoses were identified and 1677 achievements about these diagnoses were reported. Nursing diagnosis per family and per individual turned out to be 8.50 and 2.1, respectively, and achievements were 9.3 per family and 2.3 per individual. Among the nursing diagnosis domains, health promotion (20.3%), safety/protection (16.8%), and activity/rest (16.0%) were the top 3 domains identified. The most common diagnoses turned out to be ineffective health maintenance (47.4%) in health promotion domain and risk for trauma (18.2%) in safety/protection domain. The achievements were reported most in health promotion (37.9%), activity/rest (17.6%), and safety/protection (9.6%), respectively. Planned and continuous home visits by intern public health nurses resulted in positive health achievements in families, especially for women and children. Copyright © 2016. Published by Elsevier Inc.

  20. The Home Environment and Family Asthma Management Among Ethnically Diverse Urban Youth with Asthma

    PubMed Central

    Sato, Amy F.; Kopel, Sheryl J.; McQuaid, Elizabeth L.; Seifer, Ronald; Esteban, Cynthia; Coutinho, Maria Teresa; Klein, Robert; Fritz, Gregory K.; Koinis-Mitchell, Daphne

    2013-01-01

    While the pediatric psychology literature underscores the importance of illness related aspects of the home environment for optimal family asthma management, little is known about the contribution of more global aspects of the home environment (e.g., family routines/schedule, quality of stimulation provided to child) to asthma management in ethnic minority and urban families. The goals of this study were to: 1) explore ethnic/racial group differences in global and specific dimensions of home environment quality among Latino, non-Latino white (NLW), and African American urban children with asthma; and 2) examine associations between the quality and quantity of support and stimulation within the home environment, as measured by the HOME Inventory, and family asthma management in this sample. Urban, low-income children (N=131) between the ages of 6 and 13 with asthma and a primary caregiver participated in a multi-modal assessment including an in home observation and semi structured interviews to assess aspects of home environment quality and family asthma management practices. While controlling for poverty, no ethnic group differences were found in the global home environment; however, there were significant differences in specific dimensions (e.g. Family Participation in Developmentally Stimulating Experiences, and Aspects of the Physical Environment) of home environment quality. Across the whole sample, home environment quality predicted family asthma management. When examining this association for specific ethnic groups, this finding did not hold for the Latino subsample. The results highlight the need to consider ethnic group differences in non-illness specific aspects of the home environment when addressing families’ asthma management strategies. PMID:23795627

  1. The home environment and family asthma management among ethnically diverse urban youth with asthma.

    PubMed

    Sato, Amy F; Kopel, Sheryl J; McQuaid, Elizabeth L; Seifer, Ronald; Esteban, Cynthia; Coutinho, Maria Teresa; Klein, Robert; Fritz, Gregory K; Koinis-Mitchell, Daphne

    2013-06-01

    Although the pediatric psychology literature underscores the importance of illness-related aspects of the home environment for optimal family asthma management, little is known about the contribution of more global aspects of the home environment (e.g., family routines/schedule, quality of stimulation provided to child) to asthma management in ethnic minority and urban families. The goals of this study were to (a) explore ethnic/racial group differences in global and specific dimensions of home environment quality among Latino, non-Latino White (NLW), and African American urban children with asthma; and (b) examine associations between the quality and quantity of support and stimulation within the home environment, as measured by the HOME Inventory, and family asthma management. Urban, low-income children (N = 131) between the ages of 6 and 13 with asthma and a primary caregiver participated in a multimodal assessment, including an in-home observation and semistructured interviews to assess aspects of home environment quality and family asthma management practices. While controlling for poverty, no ethnic group differences were found in the global home environment; however, there were significant differences in specific dimensions (e.g., Family Participation in Developmentally Stimulating Experiences, and Aspects of the Physical Environment) of home environment quality. Across the whole sample, home environment quality predicted family asthma management. When examining this association for specific ethnic groups, this finding did not hold for the Latino subsample. The results highlight the need to consider ethnic group differences in non-illness-specific aspects of the home environment when addressing families' asthma management strategies.

  2. Enhancing knowledge and attitudes in pain management: a pain management education program for nursing home staff.

    PubMed

    Tse, Mimi Mun Yee; Ho, Suki S K

    2014-03-01

    The aim of the study was to examine the effectiveness of a pain management program (PMP) in enhancing the knowledge and attitudes of health care workers in pain management. Many nursing home residents suffer from pain, and treatment of pain is often inadequate. Failure of health care workers to assess pain and their insufficient knowledge of pain management are barriers to adequate treatment. It was a quasiexperimental pretest and posttest study. Four nursing homes were approached, and 88 staff joined the 8-week PMP. Demographics and the knowledge and attitudes regarding pain were collected with the use of the Nurse's Knowledge and Attitudes Survey Regarding Pain-Chinese version (NKASRP-C) before and after the PMP. A deficit in knowledge and attitudes related to pain management was prominent before the PMP, and there was a significant increase in pain knowledge and attitudes from 7.9 ± SD 3.52 to 19.2 ± SD4.4 (p < .05) after the 8-week PMP. A PMP can improve the knowledge and attitudes of nursing staff and enable them to provide adequate and appropriate care to older persons in pain. PMPs for nurses and all health care professionals are important in enhancing care for older adults and to inform policy on the provision of pain management.

  3. 75 FR 2111 - New England Fishery Management Council; Public Hearings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-14

    ... National Oceanic and Atmospheric Administration RIN 0648-XT75 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Monkfish Fishery Management Plan Amendment 5; Public Hearings; Request for Comments. SUMMARY: The New England Fishery Management Council (Council) will hold six...

  4. On Information Technology Application in Public Management

    NASA Astrophysics Data System (ADS)

    Bykova, D. Yu.; Prasolov, A. V.

    2007-10-01

    Widely used mathematical models begin to penetrate in public management system. Several decades ago methods of operational calculus, decision-making under condition of uncertainty and other static theories were used. Nowadays, more and more attention is paid to dynamic systems, used as basic for various forecasting approaches. In governmental planning significant roles belong to aims and targets expressed through slogans and proclamations without numerical backing. At the same time statistical services regularly collect huge amounts of different indices. Then these indices are somehow combined into aggregates. Thus there pyramids appear consisting of aggregates, expressing public management aims and targets. However the problem of target `digitization' has more than one solution. On solving this problem some experts are involved, who are subjective, and also priorities on which aggregates are based on transform if political, economical or social situation changes. Thereby the indices pyramids are time-dependent, which makes comparison and other analysis rather complicated. Suggested in this paper method allows to choose a `natural' index instead of aggregate, but to choose with preserving the experts priorities. This method is based on defining a collation metric for time series with `natural' and aggregate indices (gained with experts' participation). A comparison of different metrics for real numerical data is made.

  5. Translation research in long-term care: improving pain management in nursing homes.

    PubMed

    Jones, Katherine R; Fink, Regina; Vojir, Carol; Pepper, Ginny; Hutt, Evelyn; Clark, Lauren; Scott, Jill; Martinez, Ruby; Vincent, Deborah; Mellis, B Karen

    2004-01-01

    Pain prevalence in nursing homes remains high, with multiple resident, staff, and physician barriers presenting serious challenges to its improvement. The study aims were to (1) develop and test a multifaceted, culturally competent intervention to improve nursing home pain practices; (2) improve staff, resident, and physician knowledge and attitudes about pain and its management; (3) improve actual pain practices in nursing homes; and (4) improve nursing home policies and procedures related to pain. A multifaceted, culturally competent intervention was developed and tested in six Colorado nursing homes, with another six nursing homes serving as control sites. Both educational and behavioral change strategies were employed. The intervention was successful in improving the percentage of residents reporting constant pain in the treatment homes. Contextual factors (implementation of Medicare's Nursing Home Compare report card) appeared to exert a positive influence on pain documentation. There was no reduction in the percentage of residents reporting pain or reporting moderate/severe pain. Multiple challenges to quality improvement exist in nursing homes. Turnover of nursing staff reduced actual exposure to the intervention, and turnover of directors of nursing influenced constancy of message and overall facility stability. Residents often failed to report their pain, and physicians were reluctant to alter their prescribing practices. Any intervention to improve pain management in nursing homes must target explicitly the residents, nursing home staff, and primary care physicians. Implementation strategies need to accommodate the high turnover rates among staff, as well as the changes among the nursing home leadership. Pain is a complex problem in the nursing home setting. Multiple factors must be considered in both the design and implementation of interventions to improve pain practices and reduce pain prevalence in nursing homes.

  6. Does the public sector outperform the nonprofit and for-profit sectors? Evidence from a national panel study on nursing home quality and access.

    PubMed

    Amirkhanyan, Anna A; Kim, Hyun Joon; Lambright, Kristina T

    2008-01-01

    Are public and private organizations fundamentally different? This question has been among the most enduring inquiries in public administration. Our study explores the impact of organizational ownership on two complementary aspects of performance: service quality and access to services for impoverished clients. Derived from public management research on performance determinants and nursing home care literature, our hypotheses stipulate that public, nonprofit, and for-profit nursing homes use different approaches to balance the strategic tradeoff between two aspects of performance. Panel data on 14,423 facilities were analyzed to compare measures of quality and access across three sectors using different estimation methods. Findings indicate that ownership status is associated with critical differences in both quality and access. Public and nonprofit organizations are similar in terms of quality, and both perform significantly better than their for-profit counterparts. When compared to nonprofit and, in some cases, for-profit facilities, public nursing homes have a significantly higher share of Medicaid recipients. The paper proposes strategies to address the identified long-term care divide.

  7. Public understanding of solar radiation management

    NASA Astrophysics Data System (ADS)

    Mercer, A. M.; Keith, D. W.; Sharp, J. D.

    2011-10-01

    We report the results of the first large-scale international survey of public perception of geoengineering and solar radiation management (SRM). Our sample of 3105 individuals in the United States, Canada and the United Kingdom was recruited by survey firms that administer internet surveys to nationally representative population samples. Measured familiarity was higher than expected, with 8% and 45% of the population correctly defining the terms geoengineering and climate engineering respectively. There was strong support for allowing the study of SRM. Support decreased and uncertainty rose as subjects were asked about their support for using SRM immediately, or to stop a climate emergency. Support for SRM is associated with optimism about scientific research, a valuing of SRM's benefits and a stronger belief that SRM is natural, while opposition is associated with an attitude that nature should not be manipulated in this way. The potential risks of SRM are important drivers of public perception with the most salient being damage to the ozone layer and unknown risks. SRM is a new technology and public opinions are just forming; thus all reported results are sensitive to changes in framing, future information on risks and benefits, and changes to context.

  8. Interdisciplinary approach to the management of medical supplies in the nursing home setting.

    PubMed

    Quintana Vargas, Isabel; Moreno Miralles, Ana; Tomás Madrid, Mónica; Monleón Ruiz, Marta; Montero Bau, Antonio; Peris Martí, Juan Francisco

    2017-07-01

    Given the impact of pressure ulcers in institutionalized elderly people, an interdisciplinary approach to the care of ulcers and the management of medical supplies is essential. The aim of this study is to describe and evaluate the management of medical supplies by an interdisciplinary team in order to promote their rational use in the nursinghome setting. An interdisciplinary team was set up, coordinated by a Pharmacy Unit including representatives of 18 elderly nursing homes (1,599 beds). Team interventions were assessed in terms of improvements in the management of wound care supplies. In addition, a retrospective descriptive study was carried out on those patients with pressure ulcers, in order to consider future interventions. The team interventions led to a selection of 15% of the 180 wound care supplies from the public tender process. The monthly savings in wound dressing material purchases was at least 17%. Furthermore, a reduction in consumption greater than 50% was found in 7 centres. The prevalence of ulcers was 5.59%. A fourth of these ulcers were originatedoutside nursing homes. The creation of an interdisciplinary team, in which the pharmacist gets closer to patient needs, and where nurses share responsibility for the selection and management of medical supplies, leads to positive results and represents an opportunity for improvement in elderly care. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  9. Technical and scale efficiency in public and private Irish nursing homes - a bootstrap DEA approach.

    PubMed

    Ni Luasa, Shiovan; Dineen, Declan; Zieba, Marta

    2016-10-27

    This article provides methodological and empirical insights into the estimation of technical efficiency in the nursing home sector. Focusing on long-stay care and using primary data, we examine technical and scale efficiency in 39 public and 73 private Irish nursing homes by applying an input-oriented data envelopment analysis (DEA). We employ robust bootstrap methods to validate our nonparametric DEA scores and to integrate the effects of potential determinants in estimating the efficiencies. Both the homogenous and two-stage double bootstrap procedures are used to obtain confidence intervals for the bias-corrected DEA scores. Importantly, the application of the double bootstrap approach affords true DEA technical efficiency scores after adjusting for the effects of ownership, size, case-mix, and other determinants such as location, and quality. Based on our DEA results for variable returns to scale technology, the average technical efficiency score is 62 %, and the mean scale efficiency is 88 %, with nearly all units operating on the increasing returns to scale part of the production frontier. Moreover, based on the double bootstrap results, Irish nursing homes are less technically efficient, and more scale efficient than the conventional DEA estimates suggest. Regarding the efficiency determinants, in terms of ownership, we find that private facilities are less efficient than the public units. Furthermore, the size of the nursing home has a positive effect, and this reinforces our finding that Irish homes produce at increasing returns to scale. Also, notably, we find that a tendency towards quality improvements can lead to poorer technical efficiency performance.

  10. Development of a Context-Aware Smart Home Energy Manager (CASHEM)

    SciTech Connect

    Srivastava, Viraj; Makhmalbaf, Atefe; Parker, Graham B.

    2013-03-01

    The research reported is part of a collaborative with Honeywell, Inc. to bring novel home energy management concepts and technologies to reduce energy consumption, reduce peak electricity demand, integrate renewable energy and storage technology, and change homeowner behavior to manage and consume less energy. The objective of the collaborative is to create a Context-Aware Smart Home Energy Manager (CASHEM) that dynamically schedules major home appliances according to conditions and homeowner convenience of service (CoS) preferences, monitors and analyzes energy consumption of appliances, recommends further energy saving actions, and engages/motivates the homeowner to adopt those recommendations.

  11. Risk management and clinical governance for complex home-based health care.

    PubMed

    Lewis, Mary; Noyes, Jane

    2007-07-01

    Healthcare professionals have an obligation to enable children with complex needs to lead 'ordinary lives' at home but the views of professionals and family members often diverge in relation to the management of risks. Nurses are increasingly taking on the clinical responsibility for children with complex needs within a multidisciplinary, multi-agency team, yet have little training or experience in adapting risk management and clinical governance frameworks to home-based settings. Risk management frameworks for home-based care for children with complex health and social care needs are introduced in this article. Best practice guidance and resources for adapting risk management frameworks are presented to meet this identified gap in knowledge and experience. Children, young people and their parents have increasing expectations relating to the type and quality of home-based support they receive. Developing and applying clinical governance and risk management frameworks are part of improving outcomes for children with complex needs and their families.

  12. Untangling home care's Gordion knot. The Home Care Information Management and Technology Forum.

    PubMed

    Wilhelm, Lawrence

    2003-03-01

    As home care and hospice technological tools have evolved over the past six years, there have been no efforts to standardize the collection, storage, and reporting of data among different systems. The rapid pace of technological change, increased use of wireless and remote technology, a greater reliance on tools for collaboration and networking, and the ever-increasing regulatory burden on home care and hospice providers have resulted in the need for polices and procedures for the standardization of data across the industry. Agency administrators, already strapped for cash and time, need to know what technology investments they need to make now in order to remain competitive in the future. The National Association for Home Care & Hospice has created a forum to address these concerns and to develop a blueprint for the future development of home care and hospice technology.

  13. The Western Apache home: landscape management and failing ecosystems

    Treesearch

    Seth Pilsk; Jeanette C. Cassa

    2005-01-01

    The traditional Western Apache home lies largely within the Madrean Archipelago. The natural resources of the region make up the basis of the Apache home and culture. Profound landscape changes in the region have occurred over the past 150 years. A survey of traditional Western Apache place names documents many of these changes. An analysis of the history and Apache...

  14. Community Service Program in Foster Home Management and Creative Arts.

    ERIC Educational Resources Information Center

    Rhode Island Univ., Kingston.

    A training program for prospective foster home operators and volunteer workers with creative arts was held in the fall of 1968 and again in the spring of 1969 under the joint sponsorship of the Program in Gerontology of the University of Rhode Island, the Cooperative Extension Service, and the Rhode Island Medical Center. The foster homes under…

  15. Assessment of radio frequency exposures in schools, homes, and public places in Belgium.

    PubMed

    Verloock, Leen; Joseph, Wout; Goeminne, Francis; Martens, Luc; Verlaek, Mart; Constandt, Kim

    2014-12-01

    Characterization of exposure from emerging radio frequency (RF) technologies in areas where children are present is important. Exposure to RF electromagnetic fields (EMF) was assessed in three "sensitive" microenvironments; namely, schools, homes, and public places located in urban environments and compared to exposure in offices. In situ assessment was conducted by performing spatial broadband and accurate narrowband measurements, providing 6-min averaged electric-field strengths. A distinction between internal (transmitters that are located indoors) and external (outdoor sources from broadcasting and telecommunication) sources was made. Ninety-four percent of the broadband measurements were below 1 V m(-1). The average and maximal total electric-field values in schools, homes, and public places were 0.2 and 3.2 V m(-1) (WiFi), 0.1 and 1.1 V m(-1) (telecommunication), and 0.6 and 2.4 V m(-1) (telecommunication), respectively, while for offices, average and maximal exposure were 0.9 and 3.3 V m(-1) (telecommunication), satisfying the ICNIRP reference levels. In the schools considered, the highest maximal and average field values were due to internal signals (WiFi). In the homes, public places, and offices considered, the highest maximal and average field values originated from telecommunication signals. Lowest exposures were obtained in homes. Internal sources contributed on average more indoors (31.2%) than outdoors (2.3%), while the average contributions of external sources (broadcast and telecommunication sources) were higher outdoors (97.7%) than at indoor positions (68.8%). FM, GSM, and UMTS dominate the total downlink exposure in the outdoor measurements. In indoor measurements, FM, GSM, and WiFi dominate the total exposure. The average contribution of the emerging technology LTE was only 0.6%.

  16. Effectiveness of Home Visits in Pregnancy as a Public Health Measure to Improve Birth Outcomes

    PubMed Central

    Ichikawa, Kayoko; Fujiwara, Takeo; Nakayama, Takeo

    2015-01-01

    Background Birth outcomes, such as preterm birth, low birth weight (LBW), and small for gestational age (SGA), are crucial indicators of child development and health. Purpose To evaluate whether home visits from public health nurses for high-risk pregnant women prevent adverse birth outcomes. Methods In this quasi-experimental cohort study in Kyoto city, Japan, high-risk pregnant women were defined as teenage girls (range 14–19 years old), women with a twin pregnancy, women who registered their pregnancy late, had a physical or mental illness, were of single marital status, non-Japanese women who were not fluent in Japanese, or elderly primiparas. We collected data from all high-risk pregnant women at pregnancy registration interviews held at a public health centers between 1 July 2011 and 30 June 2012, as well as birth outcomes when delivered from the Maternal and Child Health Handbook (N = 964), which is a record of prenatal check-ups, delivery, child development and vaccinations. Of these women, 622 women were selected based on the home-visit program propensity score-matched sample (pair of N = 311) and included in the analysis. Data were analyzed between January and June 2014. Results In the propensity score-matched sample, women who received the home-visit program had lower odds of preterm birth (odds ratio [OR], 0.62; 95% confidence interval [CI], 0.39 to 0.98) and showed a 0.55-week difference in gestational age (95% CI: 0.18 to 0.92) compared to the matched controlled sample. Although the program did not prevent LBW and SGA, children born to mothers who received the program showed an increase in birth weight by 107.8 g (95% CI: 27.0 to 188.5). Conclusion Home visits by public health nurses for high-risk pregnant women in Japan might be effective in preventing preterm birth, but not SGA. PMID:26348847

  17. Public Management Reform without Managers: The Case of German Public Schools

    ERIC Educational Resources Information Center

    Mintrop, Rick

    2015-01-01

    Purpose: The purpose of this paper is to discuss the role of principals in light of public management reforms taking place in the German educational system and in reference to the empirical patterns uncovered by the papers contained in the Special Issue. Policy makers have created new expectations and new technologies that seem to suggest to…

  18. Public Management Reform without Managers: The Case of German Public Schools

    ERIC Educational Resources Information Center

    Mintrop, Rick

    2015-01-01

    Purpose: The purpose of this paper is to discuss the role of principals in light of public management reforms taking place in the German educational system and in reference to the empirical patterns uncovered by the papers contained in the Special Issue. Policy makers have created new expectations and new technologies that seem to suggest to…

  19. Role for a Labor-Management Partnership in Nursing Home Person-Centered Care

    ERIC Educational Resources Information Center

    Leutz, Walter; Bishop, Christine E.; Dodson, Lisa

    2010-01-01

    Purpose: To investigate how a partnership between labor and management works to change the organization and focus of nursing home frontline work, supporting a transition toward person-centered care (PCC) in participating nursing homes. Design and Methods: Using a participatory research approach, we conducted case studies of 2 nursing homes…

  20. Outcomes in a Nursing Home Transition Case-Management Program Targeting New Admissions

    ERIC Educational Resources Information Center

    Newcomber, Robert; Kang, Taewoon; Graham, Carrie

    2006-01-01

    Purpose: The Providing Assistance to Caregivers in Transition (PACT) program offers nursing home discharge planning and case management for individuals in the transitional period following a return to the community. The PACT program targeted individuals newly admitted to nursing homes and worked with a family caregiver to develop and implement a…

  1. Market Research for a Proposed Natural Resources Planning and Management Program by Home Study.

    ERIC Educational Resources Information Center

    Curtis, Frederick A.; Bakshi, Trilochan S.

    1984-01-01

    Presents results of a market research survey conducted by Athabasca University to determine interest in a natural resources planning and management home study degree program. Responses related to employment prospects, usefulness for professional development, home-study options, degree offerings, proposed program design, and format of proposed…

  2. Role for a Labor-Management Partnership in Nursing Home Person-Centered Care

    ERIC Educational Resources Information Center

    Leutz, Walter; Bishop, Christine E.; Dodson, Lisa

    2010-01-01

    Purpose: To investigate how a partnership between labor and management works to change the organization and focus of nursing home frontline work, supporting a transition toward person-centered care (PCC) in participating nursing homes. Design and Methods: Using a participatory research approach, we conducted case studies of 2 nursing homes…

  3. Modeling School Choice: A Comparison of Public, Private-Independent, Private-Religious and Home-Schooled Students

    ERIC Educational Resources Information Center

    Belfield, Clive R.

    2004-01-01

    U.S. students now have four choices of schooling: public schooling, private-religious schooling, private-independent schooling, and home-schooling. Of these, home-schooling is the most novel: since legalization across the states in the last few decades, it has grown in importance and legitimacy as an alternative choice. Thus, it is now possible to…

  4. Modeling School Choice: A Comparison of Public, Private-Independent, Private-Religious, and Home-Schooled Students. Occasional Paper.

    ERIC Educational Resources Information Center

    Belfield, Clive R.

    U.S. students now have four choices of schooling: public schooling, private-religious schooling, private-independent schooling, and home-schooling. Of these options, home-schooling is the most novel. Since legalization across the states in the last few decades, it has grown in importance and legitimacy as an alternative choice. Thus, it is now…

  5. Regulating firearm advertisements that promise home protection. A public health intervention.

    PubMed

    Vernick, J S; Teret, S P; Webster, D W

    1997-05-07

    Firearms are a consumer product responsible for 38500 deaths in the United States in 1994. Like other products, firearms are advertised. In the absence of rules governing the design of firearms, regulating the way guns are advertised may be a useful public health intervention. Some gun advertisements include messages suggesting that bringing a handgun into the home is generally protective for the occupants of the home. The best available scientific information contradicts this message. Given this disjunction, regulating those advertisements may be an appropriate response. Under federal law, the Federal Trade Commission (FTC) has authority to prohibit advertisements that are "deceptive" or "unfair." Under the FTC's deception analysis, the focus is on whether consumers are misled by an advertisement. For a finding of unfairness, the FTC looks for advertisements that may cause substantial injury to consumers. Under either analysis, a strong argument can be made that firearm advertisements promising home protection are unlawful. On February 14, 1996, several organizations sent separate petitions to the FTC asking it to consider the issues raised by firearm advertisements that promise home protection. The FTC is still reviewing the information presented. There are no First Amendment or Second Amendment impediments to FTC regulation of deceptive firearm advertising under the US Constitution.

  6. Systematic review of the management of incontinence and promotion of continence in older people in care homes: descriptive studies with urinary incontinence as primary focus

    PubMed Central

    Roe, Brenda; Flanagan, Lisa; Jack, Barbara; Barrett, James; Chung, Alan; Shaw, Christine; Williams, Kate

    2011-01-01

    Aim This is a review of descriptive studies with incontinence as the primary focus in older people in care homes. Background Incontinence is prevalent among residents of care home populations. Data sources MEDLINE and CINAHL were searched from 1996 to 2007 using the highly sensitive search strings of the Cochrane Incontinence Review Group for urinary and faecal incontinence including all research designs. Search strings were modified to enhance selectiveness for care homes and older people and exclude studies involving surgical or pharmacological interventions. Searching of reference sections from identified studies was also used to supplement electronic searches. The Cochrane Library was searched for relevant systematic reviews to locate relevant studies from those included or excluded from reviews. The search was limited to English-language publications. Methods A systematic review of studies on the management of incontinence, promotion of continence or maintenance of continence in care homes was conducted in 2007–2009. This is a report of descriptive studies. Results Ten studies were identified that reported on prevalence and incidence of incontinence (urinary with or without faecal), policies, assessment, documentation, management or economic evaluation of its management. Use of incontinence pads and toileting programmes comprised the most common management approaches used. No studies were identified that attempted to maintain continence of residents in care homes. Conclusions Studies on maintaining continence and identifying components of toileting programmes that are successful in managing or preventing incontinence and promoting continence in residents of care home populations along with their economic evaluation are warranted. PMID:21105895

  7. US Department of Energy environmental management advisory board public meeting

    SciTech Connect

    Not Available

    1994-03-01

    Contents of this publication include: list of participants; March 14, 1994--opening of public meeting and subcommittee reports, and public comment session; March 15, 1994--presentation by Thomas P. Grumbly, assistant secretary for environmental management, presentations by senior environmental management officials, and committee business.

  8. Professional Certification in Public Management: A Status Report and Proposal.

    ERIC Educational Resources Information Center

    Hays, Steven W.; Duke, Bruce

    1996-01-01

    Provides a status report on the accomplishments of 16 Certified Public Manager (CPM) certification programs. Describes the growth and development of the program and argues that the interests of the public management community might be served if CPM and Master of Public Administration programs were to cooperate more aggressively. (Author/JOW)

  9. Professional Certification in Public Management: A Status Report and Proposal.

    ERIC Educational Resources Information Center

    Hays, Steven W.; Duke, Bruce

    1996-01-01

    Provides a status report on the accomplishments of 16 Certified Public Manager (CPM) certification programs. Describes the growth and development of the program and argues that the interests of the public management community might be served if CPM and Master of Public Administration programs were to cooperate more aggressively. (Author/JOW)

  10. 78 FR 40697 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-08

    ... working meeting, which is open to the public. DATES: The Policy Committee meeting will be held Tuesday... National Oceanic and Atmospheric Administration RIN 0648-XC745 Pacific Fishery Management Council; Public... (NOAA), Commerce. ACTION: Notice of public meeting. SUMMARY: The Pacific Fishery Management Council's...

  11. From Home to Public Forum: Media Events and the Public Sphere.

    ERIC Educational Resources Information Center

    Zelizer, Barbie

    1991-01-01

    Considers television viewing practices during special events. Examines how audiences organize around such programing and whether this organization changes the understanding of audience connectiveness. Considers connectiveness and privatization in conjunction with conceptions of the public sphere, reviews literature on media events, and applies…

  12. On Methodological and Technological Challenges for Proactive Health Management in Smart Homes.

    PubMed

    Wolf, Klaus-Hendrik; Dehling, Tobias; Haux, Reinhold; Sick, Bernhard; Sunyaev, Ali; Tomforde, Sven

    2017-01-01

    Health management in smart homes has advanced during the last years. With proactive health management in such environments further progress for health prevention and care is to be expected. Challenges for proactive health management in three areas are summarized and briefly discussed: pattern recognition and machine learning, information privacy and user-oriented design, and sensor-enhanced health information systems architectures.

  13. Self-Managed Work Teams in Nursing Homes: Implementing and Empowering Nurse Aide Teams

    ERIC Educational Resources Information Center

    Yeatts, Dale E.; Cready, Cynthia; Ray, Beth; DeWitt, Amy; Queen, Courtney

    2004-01-01

    Purpose: This article describes the progress of our study to examine the advantages and costs of using self-managed nurse aide teams in nursing homes, steps that are being taken to implement such teams, and management strategies being used to manage the teams. Design and Methods: A quasi-experimental design is underway where certified nurse aide…

  14. Skin tears: care and management of the older adult at home.

    PubMed

    Holmes, Regina F; Davidson, Martha W; Thompson, Bonnie J; Kelechi, Teresa J

    2013-02-01

    Skin tears experienced by older adults require special skills to promote healing. Home healthcare providers are in key positions to manage skin tears and prevent further skin trauma. Several guidelines, risk assessments, classifications, and products exist to manage high-risk patients. Frequent evaluation of the effectiveness of the treatment and prevention strategies in an overall skin care protocol for home care patients is critical to reduce skin tear incidence and promote prompt healing when skin tears are present.

  15. Home care business management software not just for scheduling.

    PubMed

    Morey, Rick

    2012-10-01

    Rule number one for running a successful, profitable home care company: It is essential to have an efficient, cost-effective administrative operation. A hard fact of the home care industry is that the location of an agency, to a large extent, dictates the billing rates as well as caregiver pay. Therefore, agency profitability is primarily dependent on how efficiently the company is run. Software, used in the right way, helps agencies become more productive andmore profitable.

  16. [Coordinating home assistance and nursing care for global patient management].

    PubMed

    Cerf, Dominique

    Enabling patients to remain in their home is only possible when the different services, both from within and outside the hospital are able to communicate and when the recommended actions are properly coordinated. Entrusting the coordination of the care to the Spasad (polyvalent service for home assistance and nursing care) enables the expectations of the patients and family carers to be analysed. This allows the team to put in place the appropriate actions both in terms of assistance and nursing care.

  17. [Coordinating home assistance and nursing care for global patient management].

    PubMed

    Cerf, Dominique

    2016-01-01

    Enabling patients to remain in their home is only possible when the different services, both from within and outside the hospital are able to communicate and when the recommended actions are properly coordinated. Entrusting the coordination of the care to the Spasad (polyvalent service for home assistance and nursing care) enables the expectations of the patients and family carers to be analysed. This allows the team to put in place the appropriate actions both in terms of assistance and nursing care.

  18. 76 FR 43987 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-22

    ... abundance-based harvest management approach for Columbia River natural tule Chinook. This meeting of the TCW... National Oceanic and Atmospheric Administration RIN 0648-XA585 Pacific Fishery Management Council; Public... (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The Pacific Fishery Management Council's...

  19. 76 FR 33705 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-09

    ... abundance-based harvest management approach for Columbia River natural tule Chinook. This meeting of the TCW... National Oceanic and Atmospheric Administration RIN 0648-XA476 Pacific Fishery Management Council; Public... (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The Pacific Fishery Management Council's...

  20. 76 FR 32143 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-03

    ... National Oceanic and Atmospheric Administration New England Fishery Management Council; Public Meeting...), Commerce. ACTION: Public meeting. SUMMARY: The New England Fishery Management Council (Council) will hold a... the New England Fishery Management Council, 50 Water Street, Mill 2, Newburyport, MA 01950; telephone...

  1. 78 FR 59657 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-27

    ... to further the Pacific Council process for considering EM. No management actions will be decided at... National Oceanic and Atmospheric Administration RIN 0648-XC890 Pacific Fishery Management Council; Public... (NOAA), Commerce. ACTION: Notice of public meeting. SUMMARY: The Pacific Fishery Management...

  2. 76 FR 39074 - Caribbean Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-05

    ... National Oceanic and Atmospheric Administration RIN 0648-XA533 Caribbean Fishery Management Council; Public... (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The Caribbean Fishery Management Council...., Isla Verde, Carolina, Puerto Rico 00979. FOR FURTHER INFORMATION CONTACT: Caribbean Fishery Management...

  3. 78 FR 34046 - Caribbean Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-06

    ... National Oceanic and Atmospheric Administration RIN 0648-XC707 Caribbean Fishery Management Council; Public... (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The Caribbean Fishery Management Council...: Caribbean Fishery Management Council, 270 Mu oz Rivera Avenue, Suite 401, San Juan, Puerto Rico 00918...

  4. 78 FR 41914 - Caribbean Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-12

    ... National Oceanic and Atmospheric Administration RIN 0648-XC754 Caribbean Fishery Management Council; Public... (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The Caribbean Fishery Management Council..., August 7, 2013, from 10 a.m. to 4:30 p.m. ADDRESSES: Caribbean Fishery Management Council Office, 270 Mu...

  5. 77 FR 26516 - Caribbean Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-04

    ... National Oceanic and Atmospheric Administration Caribbean Fishery Management Council; Public Meeting AGENCY.... ACTION: Notice of a public meeting. ] SUMMARY: The Caribbean Fishery Management Council's (Council....S.V.I. FOR FURTHER INFORMATION CONTACT: Caribbean Fishery Management Council, 268 Mu oz Rivera...

  6. 78 FR 33357 - Caribbean Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-04

    ... National Oceanic and Atmospheric Administration RIN 0648-XC713 Caribbean Fishery Management Council; Public... (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The Caribbean Fishery Management Council... Rico 00909. FOR FURTHER INFORMATION CONTACT: Caribbean Fishery Management Council, 270 Mu oz Rivera...

  7. 75 FR 48309 - Caribbean Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-10

    ... National Oceanic and Atmospheric Administration RIN 0648-XY06 Caribbean Fishery Management Council; Public... (NOAA), Commerce. ACTION: Notice of public meetings. SUMMARY: The Caribbean Fishery Management Council...: Caribbean Fishery Management Council, 268 Munoz Rivera Avenue, Suite 1108, San Juan, Puerto Rico 00918-1920...

  8. 75 FR 4348 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-27

    ... National Oceanic and Atmospheric Administration RIN 0648-XU04 Pacific Fishery Management Council; Public... (NOAA), Commerce. ACTION: Notice of public meeting. SUMMARY: The Pacific Fishery Management Council... Fishery Management Council, 7700 NE Ambassador Place, Suite 101, Portland, OR 97220-1384. FOR...

  9. 41 CFR 102-5.35 - Who is authorized home-to-work transportation?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Who is authorized home... Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION GENERAL 5-HOME-TO-WORK TRANSPORTATION Authorizing Home-to-Work Transportation § 102-5.35 Who is authorized home-to-work transportation...

  10. [Basic principles of quality management in public health service].

    PubMed

    Selbmann, H K

    1996-11-01

    Philosophy, objectives and tools of Total Quality Management are applicable in Public Health services as in every other business. However, they need special adaptation. In Public Health offices requirements of an effective Total Quality Management are the commitment of the top management, an appropriate structure of the quality management system, customer orientation and quality awareness of the personnel, quality indicators and the existence of procedures for problem recognition, good command of the tools of quality management, and the knowledge of the effectiveness of implemented traditional quality assurance measures. Certification procedures following the European Quality Award seem to be appropriate for a global evaluation of quality and quality management of a Public Health office.

  11. Managing gait disorders in older persons residing in nursing homes: a review of literature.

    PubMed

    Canavan, Paul K; Cahalin, Lawrence P; Lowe, Susan; Fitzpatrick, Diane; Harris, Meredith; Plummer-D'Amato, Prudence

    2009-05-01

    Managing gait disorders in the nursing home setting is a challenge. Nursing home residents can present with a variety of factors that may contribute to the presentation of gait abnormalities. The development of an individualized intervention program can be effective in improving a resident's ability to ambulate. This article reviews the research pertaining to the management of gait disorders including deconditioning, therapeutic exercise intervention, dementia, and cardiovascular and cardiopulmonary systems. The review provides the reader with strategies to help improve and understand gait performance in older persons residing in nursing homes.

  12. Electric Energy Management in the Smart Home: Perspectives on Enabling Technologies and Consumer Behavior

    SciTech Connect

    Zipperer, A.; Aloise-Young, P. A.; Suryanarayanan, S.; Zimmerle, D.; Roche, R.; Earle, L.; Christensen, D.; Bauleo, P.

    2013-08-01

    Smart homes hold the potential for increasing energy efficiency, decreasing costs of energy use, decreasing the carbon footprint by including renewable resources, and trans-forming the role of the occupant. At the crux of the smart home is an efficient electric energy management system that is enabled by emerging technologies in the electricity grid and consumer electronics. This article presents a discussion of the state-of-the-art in electricity management in smart homes, the various enabling technologies that will accelerate this concept, and topics around consumer behavior with respect to energy usage.

  13. Electric Energy Management in the Smart Home: Perspectives on Enabling Technologies and Consumer Behavior

    SciTech Connect

    Zipperer, Adam; Aloise-Young, Patricia A.; Suryanarayanan, Siddharth; Roche, Robin; Earle, Lieko; Christensen, Dane; Bauleo, Pablo; Zimmerle, Daniel

    2013-11-01

    Smart homes hold the potential for increasing energy efficiency, decreasing costs of energy use, decreasing the carbon footprint by including renewable resources, and transforming the role of the occupant. At the crux of the smart home is an efficient electric energy management system that is enabled by emerging technologies in the electric grid and consumer electronics. This article presents a discussion of the state-of-the-art in electricity management in smart homes, the various enabling technologies that will accelerate this concept, and topics around consumer behavior with respect to energy usage.

  14. Assessing the infection prevention components of home health emergency management plans.

    PubMed

    Rebmann, Terri; Citarella, Barbara; Subramaniam, Dipti P; Subramaniam, Divya S

    2011-12-01

    Home health emergency management plans are essential and must address infection prevention issues. Few home health planning documents exist, and many of those that have been developed do not address infection prevention issues, combine them with non-infection prevention issues, or are disease/event-specific. An all-encompassing home health infection prevention emergency management planning guide is needed. A literature review and Internet search were conducted in the summer of 2010, and data from relevant sources were extracted. A spreadsheet was created delineating home health emergency management plan components related to infection prevention. Of the sources screened, 41 were deemed relevant. Ten domains were identified: (1) having a plan; (2) assessing agency readiness; (3) having infection prevention policies and procedures; (4) having occupational health policies and procedures; (5) conducting surveillance and triage; (6) reporting incidents, having a communication plan, and managing information; (7) addressing surge capacity issues; (8) having anti-infective therapy and/or vaccines; (9) providing infection prevention education; and (10) managing water and waste management issues. Home health disaster planners or managers should use this article as an assessment tool for evaluating their agency's emergency management plan and for developing policies and procedures that will decrease the risk of infection transmission during a mass casualty event. Copyright © 2011 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  15. Public health and English local government: historical perspectives on the impact of 'returning home'.

    PubMed

    Gorsky, Martin; Lock, Karen; Hogarth, Sue

    2014-12-01

    This article uses history to stimulate reflection on the present opportunities and challenges for public health practice in English local government. Its motivation is the paradox that despite Department of Health policy-makers' allusions to 'a long and proud history' and 'returning public health home' there has been no serious discussion of that past local government experience and what we might learn from it. The article begins with a short resumé of the achievements of Victorian public health in its municipal location, and then considers the extensive responsibilities that it developed for environmental, preventive and health services by the mid-twentieth century. The main section discusses the early NHS, explaining why historians see the era as one of decline for the speciality of public health, leading to the reform of 1974, which saw the removal from local government and the abolition of the Medical Officer of Health role. Our discussion focuses on challenges faced before 1974 which raise organizational and political issues relevant to local councils today as they embed new public health teams. These include the themes of leadership, funding, integrated service delivery, communication and above all the need for a coherent vision and rationale for public health action in local authorities.

  16. 77 FR 71786 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-04

    ... National Oceanic and Atmospheric Administration RIN 0648-XC375 New England Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The New England Fishery...

  17. 77 FR 55193 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-07

    ... National Oceanic and Atmospheric Administration RIN 0648-XC182 Pacific Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: Members of the Pacific Fishery...

  18. 78 FR 4391 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-22

    ... National Oceanic and Atmospheric Administration RIN 0648-XC454 New England Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery...

  19. 77 FR 70737 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-27

    ...; ] DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration RIN 0648-XC366 New England Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England...

  20. 77 FR 65535 - North Pacific Fishery Management Council; Public Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-29

    ... National Oceanic and Atmospheric Administration RIN 0648-XC314 North Pacific Fishery Management Council; Public Meetings AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice of public meetings. SUMMARY: The North Pacific Fishery...

  1. 76 FR 13360 - North Pacific Fishery Management Council; Public Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-11

    ... National Oceanic and Atmospheric Administration RIN 0648-XA283 North Pacific Fishery Management Council; Public Meetings AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice of public meetings. SUMMARY: The North Pacific Fishery...

  2. 77 FR 67633 - North Pacific Fishery Management Council; Public Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-13

    ... National Oceanic and Atmospheric Administration RIN 0648-XC349 North Pacific Fishery Management Council; Public Meetings AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice of public meetings. SUMMARY: The North Pacific Fishery...

  3. 78 FR 54239 - North Pacific Fishery Management Council; Public Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-03

    ... National Oceanic and Atmospheric Administration RIN 0648-XC845 North Pacific Fishery Management Council; Public Meetings AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice of public meetings. SUMMARY: The North Pacific Fishery...

  4. 78 FR 44929 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-25

    ... National Oceanic and Atmospheric Administration RIN 0648-XC778 New England Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice; public meeting. ] SUMMARY: The New England Fishery...

  5. 76 FR 49453 - North Pacific Fishery Management Council; Public Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-10

    ... National Oceanic and Atmospheric Administration RIN 0648-XA624 North Pacific Fishery Management Council; Public Meetings AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice of public meetings. SUMMARY: The North Pacific Fishery...

  6. 77 FR 60381 - Caribbean Fishery Management Council (CFMC); Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-03

    ... National Oceanic and Atmospheric Administration RIN 0648-XC257 Caribbean Fishery Management Council (CFMC); Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The Caribbean Fishery...

  7. Managing the Cooperative Network: The Public Administration Model.

    ERIC Educational Resources Information Center

    Diener, Ronald E.

    1981-01-01

    Recommends that library administrators turn to public administration models in preference to business administration models for network management; this choice is predicated on the not-for-profit aspects of public service organizations. (RAA)

  8. 78 FR 65616 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-01

    ... National Oceanic and Atmospheric Administration RIN 0648-XC940 New England Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery...

  9. 78 FR 54868 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-06

    ... National Oceanic and Atmospheric Administration RIN 0648-XC854 New England Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The New England Fishery...

  10. 78 FR 65617 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-01

    ... National Oceanic and Atmospheric Administration RIN 0648-XC952 New England Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The New England Fishery...

  11. 78 FR 51712 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-21

    ... National Oceanic and Atmospheric Administration RIN 0648-XC819 New England Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery...

  12. 75 FR 62111 - Pacific Fishery Management Council; Public Hearings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-07

    ... Hearings AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice of public hearings. SUMMARY: The Pacific Fishery Management Council (Council) will hold public hearings on development of community fishing association (CFAs) provisions for...

  13. Collaboration of hospital case managers and home care liaisons when transitioning patients.

    PubMed

    Kelly, Margaret M; Penney, Erika D

    2011-01-01

    Hospital case managers frequently collaborate with home care liaisons when coordinating special discharge plans. This article focuses on the collaborative relationship between the hospital case manager and on-site liaison whose primary role centers around care coordination and patient teaching. Ineffective collaboration between hospital case managers and these clinical on-site liaisons can lead to serious lapses in care and services for patients, families, and the health care team when transitioning from hospital to home care. In a review of literature, little detail was found about the collaborative practice between hospital case managers and home care liaisons. This article discusses how collegiality, collaboration, and role clarification between hospital case managers and on-site home care liaisons can improve coordination of care and services for patients and their families in the transition from hospital to home care. Included is a set of guidelines developed by case managers at a major metropolitan acute care hospital to inform and improve their practice with home care liaisons. The authors are nursing case managers who practice in a major metropolitan teaching hospital. They met by telephone and in person with case managers from 3 metropolitan medical centers as well as on-site liaisons from 2 skilled nursing facilities and 5 home care agencies to develop practice recommendations for their department regarding work with home care liaisons. Conversations between hospital case managers and on-site home care liaisons revealed that all had experiences in which suboptimal collaboration negatively impacted home care coordination for patients and their families. Furthermore, outcomes in similar patient scenarios varied widely based on the individual practices of the case managers and liaisons involved in discharge coordination. Multiple issues were discussed, including blurred role and responsibility delineations, variations in communication styles and practices

  14. [Home parenteral nutrition (HPN): feasibility of its implementation from a public hospital].

    PubMed

    Fabeiro, M; Dalieri, M; Martínez, M; Galarraga, M; Prozzi, M; Barcellandi, P; Hernández, J; Alberti, M J; Fernández, A

    2011-01-01

    The intensive care of patients at home had probed important beneficialness for the patient and the Health System. There are very few experiences of this kind of care from the Public Hospitals. To develop a social-sanitary analysis of the feasibility of the implementation of HPN on patients with short bowel syndrome (SBS) from a Public Hospital. Patients hospitalized between 1985-2009 were included. We analyzed: age, residual intestine length (RIL), time between de indication and the beginning of HPN, HPN duration, treatment modality and clinical outcome. Social determinants: home place, habitat conditions, employment conditions, educational level, social security and Low Socioeconomic Status (LSS). The group were divided in two: 1- patients with feasibility of HPN when it was prescribed; 2- patients without feasibility of HPN. 61 patients were included, RIL x: 21.7 ± 11.6 cm. The HPN was feasible (G1) in 32 patients (52.4%) and no feasible (G2) in 29 (47.6%). The home treatment modality was in self-caring 25 (81%) and with nurses support 7 (19 %). The social determinants associated with the HPN feasibility were: more than one takecare (p 0.03), educational level (p 0.01), adequate habitat conditions (p 0.02) and Low Socioeconomis Status (LSS) (p 0.07). 17 patients reached intestinal adaptation (28%), 6 (10%) were transplanted, 19 (31%) died and 19 (31%) are actually on HPN. The HPN realized from the Public Hospital is feasible. Different social determinants were observed. The care of this group of patients must be done by an interdisciplinary group including general aspects of the child and the family.

  15. Pain management at home in children with cancer: a daily diary study.

    PubMed

    Fortier, Michelle A; Wahi, Aditi; Bruce, Colette; Maurer, Eva L; Stevenson, Robert

    2014-06-01

    With the transition of care of cancer patients from the hospital to the home setting, parents are largely responsible for children's pain management. Children's cancer pain is undermanaged, yet, there is little empirical data on the occurrence and management of cancer pain in the home setting. The purpose of the present study, therefore, was to employ a daily diary protocol to examine barriers to pain management of children's cancer pain by parents at home. Parent-child dyads were recruited from the Cancer Institute at a major children's hospital in Southern California. A total of 45 patient/parent pairs completed baseline data on demographic and personality characteristics, children's quality of life, and parental beliefs regarding analgesic use for children and then completed daily diaries of pain and analgesic administration for 14 consecutive days. Most children were reported to experience chronic pain while undergoing treatment for cancer, yet overall analgesic administration at home was low. Parents who reported misconceptions regarding analgesic use for children were less likely to administer pain medication to children. Children who were less shy, more social, or had lower quality of life were more likely to receive analgesics. A significant proportion of children receiving outpatient treatment for cancer were rated as experiencing chronic pain and pain was not optimally managed in the home setting. Further understanding and addressing barriers to children's cancer pain management in the home setting will aid in alleviating unnecessary pain in this vulnerable patient population. © 2013 Wiley Periodicals, Inc.

  16. Taking down the walls: a nurse manager's experience in acute care and home care.

    PubMed

    Gomberg, S M

    1994-12-01

    Changes in the health care system are stimulating trends in where and how nursing services are delivered. Nurse managers are responsible for the overall management of the nursing work unit and must be prepared to practice in settings other than acute care. Home care is a rapidly growing practice that emerges as patients are discharged from the hospital sooner with ongoing medical and nursing needs. The job responsibilities of a nurse manager remain similar across practice settings, including the transition from acute care to home care. A detailed checklist highlights specific similarities and differences in the nurse manager's role in acute care and home care settings. As the walls of the practice setting are taken down, nurse managers must build on current knowledge and creatively develop new skills to remain successful in ongoing job responsibilities.

  17. An exploration of nursing home managers' knowledge of and attitudes towards the management of pain in residents with dementia.

    PubMed

    Barry, Heather E; Parsons, Carole; Peter Passmore, A; Hughes, Carmel M

    2012-12-01

    The aims of this study were to explore the knowledge, attitudes and beliefs that nursing home managers hold with regard to the assessment and management of pain in residents with dementia and to determine how these may be affected by the demographic characteristics of the respondents. A questionnaire comprising six sections was mailed, on two occasions during March and April 2010, to 244 nursing home managers in Northern Ireland (representing 96% of the nursing homes in Northern Ireland). The response rate was 39%. Nearly all respondents (96%) provided care to residents with dementia, yet only 60% of managers claimed to use pain treatment guidelines within their nursing home. Respondents demonstrated good knowledge about pain in residents with dementia and acknowledged the difficulties surrounding accurate pain assessment. Nursing home managers were uncertain about how to manage pain in residents with dementia, demonstrating similar concerns about the use of opioid analgesics to those reported in previous studies about pain in older people. Managers who had received recent training (p = 0.044) were less likely to have concerns about the use of opioid analgesia than those who had not received training. Respondents' beliefs about painkillers were largely ambivalent and were influenced by the country in which they had received their nursing education. The study has revealed that accurate pain assessment, training of nursing staff and a standardised approach to pain management (the use of pain management guidelines) within nursing homes all have a significant part to play in the successful management of pain in residents with dementia. Copyright © 2012 John Wiley & Sons, Ltd.

  18. A Public Service-Dominant Logic for the Executive Education of Public Managers

    ERIC Educational Resources Information Center

    Hiedemann, Alexander M.; Nasi, Greta; Saporito, Raffaella

    2017-01-01

    Building on the concept of Public Service-Dominant Logic (PSDL), this article aims to apply the public service-dominant logic to executive education. We argue that fit-for-purpose and effective executive master programs for public managers (EMPA) need to be designed from a public service perspective. Framing executive education as a service…

  19. 77 FR 5774 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-06

    ... National Oceanic and Atmospheric Administration RIN 0648-XA980 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management..., to consider actions affecting New England fisheries in the exclusive economic zone (EEZ...

  20. 75 FR 78976 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-17

    ... National Oceanic and Atmospheric Administration RIN 0648-XA092 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management..., to consider actions affecting New England fisheries in the exclusive economic zone (EEZ...

  1. 75 FR 49466 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-13

    ... National Oceanic and Atmospheric Administration RIN 0648-XY17 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management Council's (Council) VMS/ Enforcement Committee will meet to consider actions affecting New England...

  2. 78 FR 18963 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-28

    ... National Oceanic and Atmospheric Administration RIN 0648-XC594 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management Council's (Council) Recreational Advisory Panel will meet to consider actions affecting New England...

  3. 75 FR 31425 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-03

    ... National Oceanic and Atmospheric Administration RIN 0648-XW76 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management Council's (Council) VMS/ Enforcement Committee will meet to consider actions affecting New England...

  4. 76 FR 52640 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-23

    ... National Oceanic and Atmospheric Administration RIN 0648-XA653 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management... to consider actions affecting New England fisheries in the exclusive economic zone (EEZ...

  5. 78 FR 4391 - North Pacific Fishery Management Council; Public Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-22

    ... National Oceanic and Atmospheric Administration RIN 0648-XC447 North Pacific Fishery Management Council; Public Meetings AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Meetings of the North Pacific Fishery Management Council and...

  6. 77 FR 2961 - North Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-20

    ... National Oceanic and Atmospheric Administration RIN 0648-XA945 North Pacific Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Meeting of the North Pacific Fishery Management Council Golden King...

  7. Families' perceived benefits of home visits for managing paediatric obesity outweigh the potential costs and barriers.

    PubMed

    Gehring, Nicole D; Ball, Geoff D C; Perez, Arnaldo; Holt, Nicholas L; Neuman, Daniel; Spence, Nicholas; Mercier, Laura; Jetha, Mary

    2017-09-28

    Home visits have successfully been used to deliver various health services, but what role could they play in paediatric weight management? Low treatment initiation and high attrition prompted our multidisciplinary paediatric weight management clinic to investigate how families perceived the benefits and barriers of home visits. We focused on children with obesity aged 2-17 who were enrolled in our tertiary-level clinic in Alberta, Canada. None had received a home visit. The families were interviewed face-to-face from October 2015 to October 2016 and we used a qualitative description methodological framework and manifest content analysis. The parents were the main interviewees. Of the 56 families, 89% were interested in a home visit, 82% wanted support from a dietician and 54% from an exercise specialist. The perceived benefits of home visits included comprehensive assessment (95%), convenience (86%), tailored care (29%) and family involvement (13%), while the costs and barriers included clinicians' potential judgmental attitudes (30%), loss of privacy (19%) and distractions (10%). Some thought clinicians would find home visits inconvenient (25%), with bureaucratic challenges (14%) and sustainability issues (5%). Families felt home visits were a convenient option for managing paediatric obesity and identified important benefits and barriers that could guide such interventions. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  8. A model for home care clinician and home health aide collaboration: diabetes care by nurse case managers and community health workers.

    PubMed

    Vetter, Mary Jo; Bristow, Linda; Ahrens, Joann

    2004-09-01

    Researchers at Johns Hopkins University conducted a randomized clinical trial to test the effect of nurse case management and community health worker interventions on diabetes control among inner city African Americans. The results demonstrated that the greatest improvement occurred when nurse case managers and community health workers worked together. This study has implications for how nurse/home health aide collaboration can enhance diabetes management in home care.

  9. Publicly-funded home birth in Victoria, Australia: Exploring the views and experiences of midwives and doctors.

    PubMed

    McLachlan, Helen; McKay, Heather; Powell, Rhonda; Small, Rhonda; Davey, Mary-Ann; Cullinane, Fiona; Newton, Michelle; Forster, Della

    2016-04-01

    to explore midwives' and doctors' views and experiences of publicly-funded homebirthing models. cross-sectional survey implemented two years after the introduction of publicly-funded homebirthing models. two public hospitals in Victoria, Australia. midwives and doctors (obstetric medical staff). midwives' and doctors' views regarding reasons women choose home birth; and views and experiences of a publicly-funded home birth program, including intrapartum transfers. of the 44% (74/167) of midwives who responded to the survey, the majority (86%) supported the introduction of a publicly-funded home birth model, and most considered that there was consumer demand for the model (83%). Most thought the model was safe for women (77%) and infants (78%). These views were stronger amongst midwives who had experience working in the program (compared with those who had not). Of the 25% (12/48) of doctors who responded, views were mixed; just under half-supported the introduction of a publicly-funded home birth model, and one was unsure. Doctors also had mixed views about the safety of the model. One third agreed it was safe for women, one third were neutral and one third disagreed. Half did not believe the home birth model was safe for infants. The majority of midwives (93%) and doctors (75%) believed that intrapartum transfers from home to hospital were easier when the homebirthing midwife was a member of the hospital staff (as is the case with these models). responding midwives were supportive of the introduction of publicly-funded home birth, whereas doctors had divergent views and some were concerned about safety. To ensure the success of such programs it is critical that all key stakeholders are engaged at the development and implementation stages as well as in the ongoing governance. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Independence at risk: older Californians with disabilities struggle to remain at home as public supports shrink.

    PubMed

    Kietzman, Kathryn G; Durazo, Eva M; Torres, Jacqueline M; Choi, Anne Soon; Wallace, Steven P

    2011-12-01

    This policy brief presents findings from a yearlong study that closely followed a small but typical set of older Californians with disabilities who depend on fragile arrangements of paid public programs and unpaid help to live safely and independently at home. Many of these older adults have physical and mental health needs that can rise or fall with little warning; most are struggling with increasing disability as they age. In spite of these challenges, most display resilience and fortitude, and all share a common determination to maintain their independence at almost any cost. Declines in health status and other personal circumstances among aging Californians have been exacerbated by recent reductions in public support, and will be made even worse by significant additional cuts that are pending. Policy recommendations include consolidating long-term care programs and enhancing support for caregivers.

  11. Successful Management of Public School Capital Improvement Programs.

    ERIC Educational Resources Information Center

    Filardo, Mary

    2000-01-01

    In 1999, the 21st Century School Fund interviewed seven large school districts regarding management of capital-improvement programs. Researchers found three basic models: in-house management, other-public-agency management, and private-sector management. Systematic oversight and quality-control approaches will protect school systems from…

  12. Complaints in for-profit, non-profit and public nursing homes in two Canadian provinces

    PubMed Central

    McGregor, Margaret J; Cohen, Marcy; Stocks-Rankin, Catherine-Rose; Cox, Michelle B; Salomons, Kia; McGrail, Kimberlyn M; Spencer, Charmaine; Ronald, Lisa A; Schulzer, Michael

    2011-01-01

    Background Nursing homes provide long-term housing, support and nursing care to frail elders who are no longer able to function independently. Although studies conducted in the United States have demonstrated an association between for-profit ownership and inferior quality, relatively few Canadian studies have made performance comparisons with reference to type of ownership. Complaints are one proxy measure of performance in the nursing home setting. Our study goal was to determine whether there is an association between facility ownership and the frequency of nursing home complaints. Methods We analyzed publicly available data on complaints, regulatory measures, facility ownership and size for 604 facilities in Ontario over 1 year (2007/08) and 62 facilities in British Columbia (Fraser Health region) over 4 years (2004–2008). All analyses were carried out at the facility level. Negative binomial regression analysis was used to assess the association between type of facility ownership and frequency of complaints. Results The mean (standard deviation) number of verified/substantiated complaints per 100 beds per year in Ontario and Fraser Health was 0.45 (1.10) and 0.78 (1.63) respectively. Most complaints related to resident care. Complaints were more frequent in facilities with more citations, i.e., violations of the legislation or regulations governing a home, (Ontario) and inspection violations (Fraser Health). Compared with Ontario’s for-profit chain facilities, adjusted incident rate ratios and 95% confidence intervals of verified complaints were 0.56 (0.27–1.16), 0.58 (0.34–1.00), 0.43 (0.21– 0.88), and 0.50 (0.30– 0.84) for for-profit single-site, non-profit, charitable, and public facilities respectively. In Fraser Health, the adjusted incident rate ratio of substantiated complaints in non-profit facilities compared with for-profit facilities was 0.18 (0.07–0.45). Interpretation Compared with for-profit chain facilities, non-profit, charitable

  13. Pediatric Cancer CareLink--supporting home management of childhood leukemia.

    PubMed

    Goldsmith, D M; Silverman, L B; Safran, C

    2002-01-01

    We conducted a descriptive evaluation of an Internet-based system designed to support home management of childhood leukemia (Pediatric Cancer CareLink). Twenty-five parents of children with ALL and thirty-four clinicians were interviewed to identify functional requirements and to demonstrate the system's potential to improve the experience and outcomes of children with acute lymphoblastic leukemia (ALL). Parental interviews focused on: medication and side effect management in the home; communication with the health care team; and the use of a computer for ALL home management. Results from these interviews provide strong evidence that parents of children with ALL are struggling to manage the complexity of their children's care in the home. Parents revealed an urgent need for tools that would help them to safely organize the medicines that their children receive while on ALL protocols. Forty percent of parents needed to know more about what to expect during their child's therapy and how to be prepared for it. Clinician interviews focused on the clinical impact and workflow issues associated with such a system. Decision support, prescription refill management, and educational and emotional support functions were considered key components. Clinicians were concerned that such a system would increase their already overburdened workload. Conversely, parents believed that access to such a system would eliminate unnecessary phone calls to the care team. Our findings show that parents would embrace collaborative Internet-based tools that would help with the home management of their child's leukemia.

  14. Pediatric Cancer CareLink--supporting home management of childhood leukemia.

    PubMed Central

    Goldsmith, D. M.; Silverman, L. B.; Safran, C.

    2002-01-01

    We conducted a descriptive evaluation of an Internet-based system designed to support home management of childhood leukemia (Pediatric Cancer CareLink). Twenty-five parents of children with ALL and thirty-four clinicians were interviewed to identify functional requirements and to demonstrate the system's potential to improve the experience and outcomes of children with acute lymphoblastic leukemia (ALL). Parental interviews focused on: medication and side effect management in the home; communication with the health care team; and the use of a computer for ALL home management. Results from these interviews provide strong evidence that parents of children with ALL are struggling to manage the complexity of their children's care in the home. Parents revealed an urgent need for tools that would help them to safely organize the medicines that their children receive while on ALL protocols. Forty percent of parents needed to know more about what to expect during their child's therapy and how to be prepared for it. Clinician interviews focused on the clinical impact and workflow issues associated with such a system. Decision support, prescription refill management, and educational and emotional support functions were considered key components. Clinicians were concerned that such a system would increase their already overburdened workload. Conversely, parents believed that access to such a system would eliminate unnecessary phone calls to the care team. Our findings show that parents would embrace collaborative Internet-based tools that would help with the home management of their child's leukemia. PMID:12463833

  15. [Use of physical restraints in an elderly population living in public nursing homes].

    PubMed

    Galán Cabello, Carlos María; Trinidad Trinidad, Diego; Ramos Cordero, Primitivo; Gómez Fernández, Juan Pedro; Alastruey Ruiz, Jesús Gregorio; Onrubia Pecharroman, Antonio; López Andrés, Engracia; Hernández Ovejero, Hilario

    2008-01-01

    To determine the prevalence of the use of physical restraints in public nursing homes through the Residents' Functional Classification Information System in order to assess the introduction of a protocol designed to reduce and rationalize the use of these devices. Twenty-five public nursing homes in the autonomous region of Madrid were included in this study. The following data on the use of physical restraints were analysed: frequency of use (daily or less than daily), type of device, level of functional dependence for activities of daily living, and severity of cognitive impairment. A total of 5346 residents were included. The prevalence of the use of restraints was 8.4%. When the use of bedrails was added, this percentage rose to 20.8%. Bedrails accounted for 63.4% of all restraints used, trunk restraints for 17.7%, limb restraints for 3%, and chairs preventing voluntary rising for 15.9%. A single device was used in 62.6%. Of the restraints, 71.4% were used daily and 28.6% were used temporarily. The results of this study represent an approximation to the current use of physical restraints in nursing homes. The prevalence found was similar to, or less than, that observed in previous studies. The most commonly used form of restraint was bedrails. The use of these devices is probably excessive, affecting even residents without cognitive impairment or physical dependence. To reduce the use of restraints and guarantee optimal care when their application is indicated, the Regional Social Welfare Service systematically applies a protocol for the prevention and use of physical restraints.

  16. [Consent to smoking in public places and at home the opinions of smokers and nonsmokers girls].

    PubMed

    Kowalewska, Anna

    2010-01-01

    The aim of this study was researching of dependence between current status of smoking and opinions about smoking tobacco in public places and at home of girls at the age 18. We examined 2246 girls who graduated junior high schools and were continuing their education in four types of schools: high schools, profiled high schools, technical secondary schools and vocational schools. Two-stage sampling method was used, with the team stratification by type of school. The study was conducted in November and December 2008, the auditorium method. The results show that although more than half of the girls, do not agree with smoking in various public places and by parents at home, about one quarter of them accept smoking in cafes, restaurants, pubs and bus stops, and less than 1/5 have no opinion on the subject. Applied analysis using logistic regression analysis indicate a close relationship between smoking trials undertaken by the girls examined, and their opinion about the approval for smoking by students at the school. The model attempts to smoking was a significant predictor of acceptance of smoking in cafes and pubs, and the model of the current consensus on tobacco smoking at bus stops. The presented results indicate the need for prevention activities among children and adolescents, which will contribute to the education of attitudes and skills necessary to take measures aimed at creating environments free from tobacco smoke.

  17. Managing Your Personal Finances. Home and Garden Bulletins.

    ERIC Educational Resources Information Center

    Pitts, Joyce M.

    This guide is designed to help people of all ages set up a budget and manage their money. It is organized in three sections: the Principles of Managing Your Finances, Financial Tools Used in Money Management, and Coping with Change. Section 1 consists of three chapters. The first chapter introduces the money management process, discusses goal…

  18. Postflood disaster management and the home health nurse: using theory to guide practice.

    PubMed

    Hunter Revell, Susan M; McCurry, Mary K

    2010-07-01

    Few frameworks exist to guide home health nurses during the response and recovery phases of disasters such as flooding. The Double ABCX Model of Family Adaptation is offered as an example of a guiding framework for nurses in postflood management. Phases of the model are linked to the nursing process, and management strategies are applied to individuals and families living in the community. Postcrisis decision-making is detailed through the discussion of nursing diagnoses, interventions, and evaluation. Implications highlight the value of using a theoretical framework to guide practice, develop knowledge, and clarify the home health nurse's role in postflood management.

  19. Top Management Leadership Style and Quality of Care in Nursing Homes

    ERIC Educational Resources Information Center

    Castle, Nicholas G.; Decker, Frederic H.

    2011-01-01

    Purpose: The purpose of this study was to examine the association of Nursing Home Administrator (NHA) leadership style and Director of Nursing (DON) leadership style with quality of care. Design and Methods: Leaders were categorized into 4 groups: consensus managers, consultative autocrats, shareholder managers, or autocrats. This leadership style…

  20. Top Management Leadership Style and Quality of Care in Nursing Homes

    ERIC Educational Resources Information Center

    Castle, Nicholas G.; Decker, Frederic H.

    2011-01-01

    Purpose: The purpose of this study was to examine the association of Nursing Home Administrator (NHA) leadership style and Director of Nursing (DON) leadership style with quality of care. Design and Methods: Leaders were categorized into 4 groups: consensus managers, consultative autocrats, shareholder managers, or autocrats. This leadership style…

  1. Individual Perseverance: A Theory of Home Tutors' Management of Schooling in Isolated Settings

    ERIC Educational Resources Information Center

    Tynan, Belinda; O'Neill, Marnie

    2007-01-01

    This article reports a study of parents' management of the education of primary school-aged children in their care in remote and rural locations of Western Australia. It presents a theory of the ways in which these parents, in the role of home tutors, "manage" the schooling of their children in a distance education regime in isolated…

  2. In Situ Behavior Management in Homes and Schools: Some Procedures and Problems.

    ERIC Educational Resources Information Center

    Baine, David

    The paper reviews various difficulties inherent in clinical treatment and assessment of behavior management problems. The rationale for the development of in situ management programs in homes and schools is described. Problems in non-participant observation are reviewed as a rationale for the development of automated audio-video devices. A…

  3. Individual Perseverance: A Theory of Home Tutors' Management of Schooling in Isolated Settings

    ERIC Educational Resources Information Center

    Tynan, Belinda; O'Neill, Marnie

    2007-01-01

    This article reports a study of parents' management of the education of primary school-aged children in their care in remote and rural locations of Western Australia. It presents a theory of the ways in which these parents, in the role of home tutors, "manage" the schooling of their children in a distance education regime in isolated…

  4. Responsible Management and Use of a Personal Take-Home Naloxone Supply: A Pilot Project

    ERIC Educational Resources Information Center

    McAuley, Andrew; Lindsay, George; Woods, Maureen; Louttit, Derek

    2010-01-01

    Aims: To assess if Scottish drug users, their family and friends could be trained in critical incident management and the safe and effective administration of naloxone. The project also sought to monitor whether drug users can manage their own personal take-home naloxone (THN) supply and use it appropriately in an emergency opiate overdose…

  5. A Bibliography of Materials on Behavior Management in the Home and Community.

    ERIC Educational Resources Information Center

    Kupper, Lisa, Ed.

    This brief bibliography lists 26 resource materials for managing behavior problems in the home and community. Suggested resources were published between 1985 and 1993 and cover such topics as general behavior management, self-injury, food and behavior, functional communication training, impulsivity, alternatives to punishment, anger, and…

  6. Responsible Management and Use of a Personal Take-Home Naloxone Supply: A Pilot Project

    ERIC Educational Resources Information Center

    McAuley, Andrew; Lindsay, George; Woods, Maureen; Louttit, Derek

    2010-01-01

    Aims: To assess if Scottish drug users, their family and friends could be trained in critical incident management and the safe and effective administration of naloxone. The project also sought to monitor whether drug users can manage their own personal take-home naloxone (THN) supply and use it appropriately in an emergency opiate overdose…

  7. CARELINK: partners in a caring model: a cardiac management program for home care.

    PubMed

    Shellman, Juliette; Lacey, Kimberly; Clemmens, Donna

    2008-01-01

    As a model of care, CARELINK promotes self-care and self-management of chronic illnesses for homebound older adults no longer eligible for skilled nursing services. A case-study method is used to highlight the key constructs and outcomes related to the model. The benefits of applying the CARELINK model as a cardiac management program for home care are discussed.

  8. The impact of managed competition on diversity, innovation and creativity in the delivery of home-care services.

    PubMed

    Randall, Glen E

    2008-07-01

    Reforming publicly funded healthcare systems by introducing elements of competition, often by allowing for-profit providers to compete with not-for-profit providers, is a strategy that has become commonplace in Western democracies. It is widely thought that the competitive forces of the marketplace will lead to greater efficiency, diversity and even innovation in the delivery of services. Between 1997 and 2000, a model of 'managed competition' was introduced as a major reform to the delivery of home-care services in Ontario, Canada. It was expected that by allowing greater competition within the home-care sector, this model would constrain costs and encourage provider agencies to become more innovative and creative in meeting service delivery needs. The purpose of this case study is to explore the impact of the managed competition reform on the for-profit and the not-for-profit organisations that provided rehabilitation home-care services, and, more specifically, to assess the extent to which the goal of greater diversity, innovation and creativity was achieved following implementation of the reform. A purposive sample of 49 key informants were selected for in-depth interviews, and a survey of the 36 organisations that provided rehabilitation home-care services and the 43 community care access centres that purchased services from these provider agencies was conducted. Data were collected between November 2002 and May 2003. Findings demonstrate that a combination of coercive, mimetic and normative isomorphic pressures have constrained diversity, innovation and creativity within the home-care sector. The implication is that the features that have traditionally distinguished for-profit and not-for-profit provider agencies from each other are rapidly disappearing, and a new hybrid organisational structure is evolving.

  9. Impact of telemonitoring at home on the management of elderly patients with congestive heart failure.

    PubMed

    Antonicelli, Roberto; Testarmata, Paolo; Spazzafumo, Liana; Gagliardi, Cristina; Bilo, Grzegorz; Valentini, Mariaconsuelo; Olivieri, Fabiola; Parati, Gianfranco

    2008-01-01

    We studied the effects of home telemonitoring in elderly patients with congestive heart failure (CHF) on mortality and rate of hospitalization, compliance with treatment, quality of life and costs of CHF management, by comparison with a group receiving usual care. Fifty-seven elderly CHF patients were randomized to standard care or to home telemonitoring-based care and followed for 12 months. In the subjects who were monitored, weekly reports on their clinical status were obtained and their management was modified accordingly. Home telemonitoring was associated with improvements in the composite endpoint of mortality and rate of hospitalizations (P = 0.006), a better compliance with therapy, more frequent use of beta-blockers and statins, lower total cholesterol level and a better reported health perception score. The improved results with home telemonitoring in CHF were probably due to better compliance and to closer monitoring of the patients.

  10. The Ethical Climate of Public Schooling under New Public Management.

    ERIC Educational Resources Information Center

    Dempster, Neil; Freakley, Mark; Parry, Lindsay

    2001-01-01

    Today's competitive climate is pressuring public school educators to improve schools in an environment dominated by parent and consumer choice. This article draws on two studies involving Australian principals that illustrate difficult ethical situations. Most participants found the values of marketing and economic rationalism to be inconsistent…

  11. The Ethical Climate of Public Schooling under New Public Management.

    ERIC Educational Resources Information Center

    Dempster, Neil; Freakley, Mark; Parry, Lindsay

    2001-01-01

    Today's competitive climate is pressuring public school educators to improve schools in an environment dominated by parent and consumer choice. This article draws on two studies involving Australian principals that illustrate difficult ethical situations. Most participants found the values of marketing and economic rationalism to be inconsistent…

  12. Strategic management of Public Hospitals' medical services.

    PubMed

    Hao, Aimin; Yi, Tao; Li, Xia; Wei, Lei; Huang, Pei; Xu, Xinzhou; Yi, Lihua

    2016-01-01

    Purpose: The quality of medical services provided by competing public hospitals is the primary consideration of the public in determining the selection of a specific hospital for treatment. The main objective of strategic planning is to improve the quality of public hospital medical services. This paper provides an introduction to the history, significance, principles and practices of public hospital medical service strategy, as well as advancing the opinion that public hospital service strategy must not merely aim to produce but actually result in the highest possible level of quality, convenience, efficiency and patient satisfaction.

  13. 76 FR 30306 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-25

    ... New England Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS...: The New England Fishery Management Council (Council) is scheduling a public meeting of its Scientific and Statistical Committee on June 14-15, 2011 to consider actions affecting New England fisheries in...

  14. 76 FR 17626 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-30

    ... National Oceanic and Atmospheric Administration RIN 0648-XA336 New England Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The New England Fishery Management...

  15. 76 FR 2084 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-12

    ... National Oceanic and Atmospheric Administration RIN 0648-XA136 Pacific Fishery Management Council; Public... (NOAA), Commerce. ACTION: Notice of public meeting. SUMMARY: The Pacific Fishery Management Council's (Council) Ad Hoc Groundfish Process Improvement Committee (PIC) will hold a working meeting, which is...

  16. Elements of a Knowledge Management Guide for Public Sector Organizations

    ERIC Educational Resources Information Center

    Harris, Mark Cameron

    2013-01-01

    This study explored the factors that are critical to the success of public (government) sector knowledge management initiatives and the lessons from private sector knowledge management and organizational learning that apply in the public sector. The goal was to create a concise guide, based on research-validated success factors, to aid government…

  17. Implementation of New Public Management in Norwegian Universities

    ERIC Educational Resources Information Center

    Frolich, Nicoline

    2005-01-01

    This article analyses the implementation of market-type mechanisms in the management of universities. The question of which cultural biases have been used in the implementation of New Public Management (NPM) in Norwegian universities is discussed. Cultural theory, institutional theory, and public policy studies are applied to the analysis of a…

  18. Elements of a Knowledge Management Guide for Public Sector Organizations

    ERIC Educational Resources Information Center

    Harris, Mark Cameron

    2013-01-01

    This study explored the factors that are critical to the success of public (government) sector knowledge management initiatives and the lessons from private sector knowledge management and organizational learning that apply in the public sector. The goal was to create a concise guide, based on research-validated success factors, to aid government…

  19. 75 FR 9391 - Caribbean Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-02

    ... National Oceanic and Atmospheric Administration RIN 0648-XU74 Caribbean Fishery Management Council; Public... (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The Caribbean Fishery Management Council... Shoys, Lot 7, Christiansted, n St. Croix, U.S.V.I. FOR FURTHER INFORMATION CONTACT: Caribbean Fishery...

  20. 75 FR 69054 - Caribbean Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-10

    ... National Oceanic and Atmospheric Administration RIN 0648-XA026 Caribbean Fishery Management Council; Public... (NOAA), Commerce. ACTION: Notice of public meetings. SUMMARY: The Catch Share Panel of the Caribbean...: Caribbean Fishery Management Council, 268 Mu oz Rivera Avenue, Suite 1108, San Juan, Puerto Rico 00918-2577...

  1. 75 FR 67688 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-03

    ... National Oceanic and Atmospheric Administration RIN 0648-XA014 Pacific Fishery Management Council; Public... (NOAA), Commerce. ACTION: Notice of public meetings. SUMMARY: The Pacific Fishery Management Council's...: The work session will be held at the Hyatt Place Hotel Portland Airport, 9750 NE Cascades Parkway...

  2. 77 FR 53179 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-31

    ... National Oceanic and Atmospheric Administration RIN 0648-XC203 Pacific Fishery Management Council; Public... (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The Pacific Fishery Management Council's (Pacific Council) Model Evaluation Workgroup (MEW) will hold a work session to review work products...

  3. 76 FR 36901 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-23

    ... National Oceanic and Atmospheric Administration RIN 0648-XA511 Pacific Fishery Management Council; Public... (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The Pacific Fishery Management Council's (Council's) Model Evaluation Workgroup (MEW) will hold a work session to review work products individual...

  4. 77 FR 70420 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-26

    ... National Oceanic and Atmospheric Administration RIN 0648-XC364 Pacific Fishery Management Council; Public... (NOAA), Commerce. ACTION: Notice of public meeting. SUMMARY: The Pacific Fishery Management Council's (Pacific Council) South of Humbug Policy Workgroup (Workgroup) for Pacific halibut will hold a working...

  5. 76 FR 54217 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-31

    ... National Oceanic and Atmospheric Administration RIN 0648-XA663 Pacific Fishery Management Council; Public... (NOAA), Commerce. ACTION: Notice of public meeting. SUMMARY: The Pacific Fishery Management Council (Pacific Council) will convene a meeting of the Stock Assessment Review (STAR) Panel, to consider...

  6. Translation of the Care of Persons with Dementia in their Environments (COPE) Intervention in a Publicly-Funded Home Care Context: Rationale and Research Design

    PubMed Central

    Fortinsky, Richard H.; Gitlin, Laura N.; Pizzi, Laura T.; Piersol, Catherine Verrier; Grady, James; Robison, Julie T.; Molony, Sheila

    2016-01-01

    Background Dementia is the leading cause of loss of independence in older adults worldwide. In the U.S., approximately 15 million family members provide care to relatives with dementia. This paper presents the rationale and design for a translational study in which an evidence-based, non-pharmacologic intervention for older adults with dementia and family caregivers (CGs) is incorporated into a publicly-funded home care program for older adults at risk for nursing home admission. Methods The 4-month Care of Persons with Dementia in their Environments (COPE) intervention is designed to optimize older adults’ functional independence, and to improve CG dementia management skills and health-related outcomes. COPE features 10 in-home occupational therapy visits, and 1 in-home visit and 1 telephone contact by an advanced practice nurse. COPE was deemed efficacious in a published randomized clinical trial. In the present study, older adults with dementia enrolled in the Connecticut Home Care Program for Elders (CHCPE) and their CGs are randomly assigned to receive COPE plus their ongoing CHCPE services, or to continue receiving CHCPE services only. Outcomes The primary outcome for older adults with dementia is functional independence; secondary outcomes are activity engagement, quality of life, and prevention or alleviation of neuropsychiatric symptoms. CG outcomes include perceived well-being and confidence in using activities to manage dementia symptoms. Translational outcomes include net financial benefit of COPE, and feasibility and acceptability of COPE implementation into the CHCPE. COPE has the potential to improve health-related outcomes while saving Medicaid waiver and state revenue-funded home care program costs nationwide. PMID:27394383

  7. Standardising Home Range Studies for Improved Management of the Critically Endangered Black Rhinoceros

    PubMed Central

    Plotz, Roan D.; Grecian, W. James; Kerley, Graham I.H.; Linklater, Wayne L.

    2016-01-01

    Comparisons of recent estimations of home range sizes for the critically endangered black rhinoceros in Hluhluwe-iMfolozi Park (HiP), South Africa, with historical estimates led reports of a substantial (54%) increase, attributed to over-stocking and habitat deterioration that has far-reaching implications for rhino conservation. Other reports, however, suggest the increase is more likely an artefact caused by applying various home range estimators to non-standardised datasets. We collected 1939 locations of 25 black rhino over six years (2004–2009) to estimate annual home ranges and evaluate the hypothesis that they have increased in size. A minimum of 30 and 25 locations were required for accurate 95% MCP estimation of home range of adult rhinos, during the dry and wet seasons respectively. Forty and 55 locations were required for adult female and male annual MCP home ranges, respectively, and 30 locations were necessary for estimating 90% bivariate kernel home ranges accurately. Average annual 95% bivariate kernel home ranges were 20.4 ± 1.2 km2, 53 ±1.9% larger than 95% MCP ranges (9.8 km2 ± 0.9). When home range techniques used during the late-1960s in HiP were applied to our dataset, estimates were similar, indicating that ranges have not changed substantially in 50 years. Inaccurate, non-standardised, home range estimates and their comparison have the potential to mislead black rhino population management. We recommend that more care be taken to collect adequate numbers of rhino locations within standardized time periods (i.e., season or year) and that the comparison of home ranges estimated using dissimilar procedures be avoided. Home range studies of black rhino have been data deficient and procedurally inconsistent. Standardisation of methods is required. PMID:27028728

  8. Improving heart failure in home care with chronic disease management and telemonitoring.

    PubMed

    Hall, Pamela; Morris, Mollie

    2010-01-01

    Home Health Compare rates for Emergent Care and Acute Hospitalization increased undesirably for Athens Regional Home Health. Data revealed that the increase was due to heart failure exacerbation. It was hypothesized that a chronic disease management program with telemonitoring, to include chest fluid bioimpedance, would allow for earlier intervention, thus preventing emergency department visits and acute care readmissions. This article describes the agency's performance improvement initiative that resulted in a decrease in these rates while improving patient outcomes and increasing agency referrals.

  9. Home care nurses' knowledge of evidence-based education topics for management of heart failure.

    PubMed

    Delaney, Colleen; Apostolidis, Beka; Lachapelle, Leeanne; Fortinsky, Richard

    2011-01-01

    We primarily sought to evaluate home care nurses' knowledge of evidence-based education topics in managing heart failure (HF). Moreover, we wanted to determine if differences were evident in nurses' knowledge based on education and work experience, and to identify home care nurses' specific educational needs. A cross-sectional survey design was used. Home care nurses (n = 94) were recruited from 4 home care agencies. A previously published 20-item HF knowledge questionnaire was administered to participants, and an open-ended question determined participants' need for further HF-related education. Home care nurses' scores demonstrated a 78.9% knowledge level in overall HF education principles. The mean HF knowledge score was 15.78 (SD, ±1.69) out of a possible 20 points. Nurses scored lowest on knowledge related to asymptomatic hypotension (24.5% answered correctly), daily weight monitoring (26.6% answered correctly), and transient dizziness (30.9% answered correctly). Nurses requested further information on all HF topics addressed in the survey as well as on psychosocial issues, research evidence, and more information from other healthcare providers. Our findings suggest that home care nurses may not be sufficiently knowledgeable in evidence-based education topics for managing HF. The results help confirm the need to develop educational programs for home care nurses in managing HF, which may lead to improved quality of patient education. Further research is needed to address specific deficits in the knowledge of home care nurses, and to determine if HF educational programs for nurses would enhance and sustain nurses' knowledge of HF management education. Copyright © 2011 Elsevier Inc. All rights reserved.

  10. Management challenges at the intersection of public policy environments and strategic decision making in public hospitals.

    PubMed

    Longest, Beaufort B

    2012-01-01

    Hospitals in the United States are heavily impacted by public policies that affect them. For example, Medicare and Medicaid programs account for more than half the revenue in most of the nation's almost 5,000 community hospitals, including the almost 1,100 public hospitals controlled by state and local governments (American Hospital Association, 2012). The public hospitals are especially closely aligned with and controlled by governmental entities compared with hospitals with other kinds of sponsorship. This article addresses the management challenges at the intersection of the strategic management of public hospitals and their public policy environments. Public hospitals are complicated entities designed not only to provide health services but also in many cases to play key roles in health-related research and education and to play important general economic development roles in their communities. The multi-faceted strategic decision making in these organizations is as heavily affected by their public policy environments as by their business, demographic, technological or other external environments. Effectively managing the intersection of their public policy environments and their strategic management is indeed vital for contemporary public hospitals. This article is intended to clarify certain aspects of this intersection through a description and model of the strategic activity in public hospitals and the connection between this activity and their external environments. Specific attention is focused on the concept of public policy environments and their features. Attention is also given to how managers can assess public policy environments and incorporate the results into strategic activities.

  11. 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

  12. 77 FR 8809 - New England Fishery Management Council; Public Hearings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-15

    ...; Public Hearings AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice; public hearings. SUMMARY: The New England Fishery Management Council (Council) will hold eight public hearings to solicit comment on Draft Amendment 5 to the Atlantic...

  13. 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".

  14. Electronic Publications and Collection Management -- Issues to Consider

    NASA Astrophysics Data System (ADS)

    Grothkopf, Uta

    Electronic publications affect virtually all areas of library collection management. Previously, clearly distinguished work areas could be defined, including Acquisitions, Processing, Using/Making Available, and Archiving of publications. These areas must be modified in the digital environment to remain effective. Based on the traditional model of library collection management, the article gives an overview of issues librarians should consider when dealing with electronic publications.

  15. Managing Medications During Home Hospice Cancer Care: The Needs of Family Caregivers

    PubMed Central

    Tjia, Jennifer; Ellington, Lee; Clayton, Margaret F.; Lemay, Celeste; Reblin, Maija

    2015-01-01

    Context Family caregivers (FCGs) are often at the frontline of symptom management for patients with advanced illness in home hospice. FCGs’ cognitive, social and technical skills in complex medication management have been well studied in the literature; however, few studies have tested existing frameworks in clinical cases in home hospice. Objectives This study sought to assess the applicability of Lau et al.’s caregiver medication management skills framework in the context of family caregiving in home hospice in order to further the understanding of FCGs’ essential medication management skills. Methods This was a secondary data analysis of 18 audio recorded home hospice visits transcribed verbatim; deductive content analysis of caregiver-nurse interactions was conducted. The target sample included FCGs of hospice patients who had cancer diagnoses in hospices located in the greater urban area of the Rocky Mountain West. Caregiver medication management skills were identified and categorized into the five domains of caregiver expertise. Exemplars of each domain were identified. Results An average of four medications (SD 3.5) was discussed at each home hospice visit. Medication knowledge skills were observed in the majority of home hospice visits (15 of 18). Teamwork skills were observed in 11 of 18 cases, followed by organizational and personhood skills (10 of 18). Symptom management skills occurred in 12 of 18 cases. An additional two subconstructs of the Personhood domain –1) advocacy for the caregiver and 2) skills in discontinuing medications – were proposed. Conclusion These findings support Lau et al.’s framework for caregiver medication management skills and expands upon the existing domains proposed. Future interventions to assess FCGs’ skills are recommended. PMID:26159294

  16. Managing Medications During Home Hospice Cancer Care: The Needs of Family Caregivers.

    PubMed

    Tjia, Jennifer; Ellington, Lee; Clayton, Margaret F; Lemay, Celeste; Reblin, Maija

    2015-11-01

    Family caregivers (FCGs) are often at the frontline of symptom management for patients with advanced illness in home hospice. FCGs' cognitive, social, and technical skills in complex medication management have been well studied in the literature; however, few studies have tested existing frameworks in clinical cases in home hospice. This study sought to assess the applicability of caregiver medication management skills framework by Lau et al. in the context of family caregiving in home hospice to further the understanding of FCGs' essential medication management skills. This was a secondary data analysis of 18 audio recorded home hospice visits transcribed verbatim; deductive content analysis of caregiver-nurse interactions was conducted. The target sample included FCGs of hospice patients who had cancer diagnoses in hospices located in the greater urban area of the Rocky Mountain West. Caregiver medication management skills were identified and categorized into the five domains of caregiver expertise. Exemplars of each domain were identified. An average of four medications (SD = 3.5) was discussed at each home hospice visit. Medication knowledge skills were observed in most home hospice visits (15 of 18). Teamwork skills were observed in 11 of 18 cases, followed by organizational and personhood skills (10 of 18). Symptom management skills occurred in 12 of 18 cases. An additional two subconstructs of the personhood domain-1) advocacy for the caregiver and 2) skills in discontinuing medications-were proposed. These findings support framework by Lau et al. for caregiver medication management skills and expands on the existing domains proposed. Future interventions to assess FCGs' skills are recommended. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  17. The Public and Nuclear Waste Management.

    ERIC Educational Resources Information Center

    Zinberg, Dorothy

    1979-01-01

    Discusses the public's negative attitude towards nuclear energy development. Explains the perceptions for the nuclear waste disposal problem, and the concern for the protection of the environment. (GA)

  18. The Public and Nuclear Waste Management.

    ERIC Educational Resources Information Center

    Zinberg, Dorothy

    1979-01-01

    Discusses the public's negative attitude towards nuclear energy development. Explains the perceptions for the nuclear waste disposal problem, and the concern for the protection of the environment. (GA)

  19. Total Quality Management Plan: Office of Public Affairs

    DTIC Science & Technology

    1989-07-01

    AND DATES COVERED I July 1989 4. TITLE AND SUBTITLE 5. FUNDING NUMBERS Total Quality Management Plan Office of Public Affairs 6. AUTHOR(S) 7...ANSI %to 09-10 2g6. 1O2 TOTAL QUALITY MANAGEMENT PLAN Defense Logistics Agency Office of Public Affairs Ace!;son For NT-S G":I DTTC T ,’ Ju:.. t if...12 CONCEPTS We recognize that the following concepts are vital to total quality management (TQM) as it applies specifically

  20. The impact of implementing managed competition on home care workers' turnover decisions.

    PubMed

    Denton, Margaret; Zeytinoglu, Isik Urla; Davies, Sharon; Hunter, Danielle

    2006-05-01

    This paper addresses the question: Did the implementation of managed competition in Ontario increase turnover in home care agencies? This question is addressed through a case study analysis of the impacts of tendering on the exiting home care labour force from three non-profit home care agencies during the period 1997 to 2001 in a mid-sized city in Ontario. These agencies provided 85% of the market share in 1996. Findings showed that 52% of the nurses and personal support workers (PSWs) left their agency over the five-year period. Analysis of the turnover data showed a temporal association between the implementation of managed competition and turnover. Additional support for the argument that the implementation of managed competition increased turnover is provided through analysis of a questionnaire sent to nurses and personal support workers who had left their agency during this period. Respondents indicated dissatisfaction with their pay, hours of work, benefits, heavy workload and lack of support from their supervisors/managers (all factors affected by the marketization of the home care sector) as reasons for leaving. Of those employed, only one-quarter remained in home care; most of those remaining were working in other healthcare fields such as hospitals and long-term care institutions. However, about one-third of employed PSWs were no longer working in the healthcare field.

  1. Home Health Care (HHC) Managers Perceptions About Challenges and Obstacles that Hinder HHC Services in Jordan

    PubMed Central

    Ajlouni, Musa T.; Dawani, Hania; Diab, Salah M.

    2015-01-01

    Home care aims at supporting people with various degrees of dependency to remain at home rather than use residential, long-term, or institutional-based nursing care. Demographic, epidemiological, social, and cultural trends in Jordan as in other countries are changing the traditional patterns of care with growing emphasis on home care. The purpose of this study is to highlight the most common challenges related to home health care (HHC) services in Jordan as perceived by the managers of HHC agencies. Methods: a descriptive qualitative design that depends on focus group discussions has been used to collect data from a sample of 18 managers who met the selection criteria and who are willing to participate, the study found that, the main challenges of HHC services as perceived by managers were: shortage of female staff, lack of governance and regulation, poor management, unethical practices, lack of referral systems, and low accessibility of the poor and less privileged as HHC services are not included in health insurance schemes, it concludes also that the home health care industry in Jordan is facing many challenges and problems that may have negative effects on the effectiveness, efficiency, equity and quality of services and should be addressed by health policy makers. PMID:25946949

  2. Public participation in UMTRA Project program management

    SciTech Connect

    Majors, M.J.; Ulland, L.M.

    1993-12-31

    Innovative techniques for overcoming barriers to public participation on the US Department of Energy`s Uranium Mill Tailings Remedial Action (UMTRA) Project have led to improved communications with stakeholders at project sites and improved communications within the project. On the UMTRA Project, it`s been shown that an effective public participation program is an essential element to successful project implementation.

  3. 76 FR 3878 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-21

    ... revise future work plans relative to developing an abundance-based harvest management approach for... a usable approach emerges from this process, the Council may consider a fishery management plan (FMP... National Oceanic and Atmospheric Administration RIN 0648-XA161 Pacific Fishery Management Council; Public...

  4. 78 FR 62587 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-22

    ... National Oceanic and Atmospheric Administration RIN 0648-XC923 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management...: Thomas A. Nies, Executive Director, New England Fishery Management Council; telephone: (978) 465-0492...

  5. 78 FR 48860 - New England Fishery Management Council; Public Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-12

    ... National Oceanic and Atmospheric Administration RIN 0648-XC802 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meetings. SUMMARY: The New England Fishery Management...: Thomas A. Nies, Executive Director, ] New England Fishery Management Council; telephone: (978) 465-0492...

  6. 76 FR 61345 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-04

    ... National Oceanic and Atmospheric Administration RIN 0648-XA745 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management... Management Council, 50 Water Street, Mill 2, Newburyport, MA 01950. FOR FURTHER INFORMATION CONTACT: Paul...

  7. 76 FR 7548 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-10

    ... National Oceanic and Atmospheric Administration RIN 0648-XA205 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management...) 734-9700. Council address: New England Fishery Management Council, 50 Water Street, Mill 2...

  8. 76 FR 22080 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-20

    ... access general category management program for the Northern Gulf of Maine (NGOM) area. The action may... National Oceanic and Atmospheric Administration RIN 0648-XA377 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management...

  9. 75 FR 55540 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-13

    ... adjustments to make the overall FMP more effective including adjustments to the general category management... National Oceanic and Atmospheric Administration RIN 0648-XY90 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The New England Fishery Management...

  10. 76 FR 52639 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-23

    ... state waters is accounted for in both the limited access general category management program for the... National Oceanic and Atmospheric Administration RIN 0648-XA651 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management...

  11. 76 FR 26253 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-06

    ... National Oceanic and Atmospheric Administration RIN 0648-XA417 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The New England Fishery Management...-2000; fax: (774) 634-2001. Council address: New England Fishery Management Council, 50 Water Street...

  12. Applying the ecosystem services concept to public land management

    Treesearch

    Jeffrey D. Kline; Marisa J. Mazzota; Thomas A. Spies; Mark E. Harmon

    2013-01-01

    We examine challenges and opportunities involved in applying ecosystem services to public land management with an emphasis on national forests in the United States. We review historical forest management paradigms and related economic approaches, outline a conceptual framework defining the informational needs of forest managers, and consider the feasibility of its...

  13. The Effective Public Manager. Achieving Success in Government. First Edition.

    ERIC Educational Resources Information Center

    Cohen, Steven

    The problems faced by public managers in managing an agency's internal operations and communicating with the outside world are described, and strategies for addressing these management problems are provided, as is personal advice on how to build and maintain a professional reputation and advance in the bureaucratic hierarchy. The following…

  14. 76 FR 45780 - South Atlantic Fishery Management Council; Public Hearings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-01

    ... should be sent to Bob Mahood, Executive Director, South Atlantic Fishery Management Council, 4055 Faber..., Public Information Officer, ] South Atlantic Fishery Management Council, 4055 Faber Place Drive, Suite... CONTACT: Kim Iverson, South Atlantic Fishery Management Council, 4055 Faber Place Drive, Suite 201,...

  15. The Private Management of Public Schools: The Baltimore, Maryland, Experience.

    ERIC Educational Resources Information Center

    Doughty, Sherri

    In 1992 the Baltimore City Public School District (Maryland) entered into a 5-year contract with Education Alternatives, Incorporated (EAI), to manage 9 of its schools. Baltimore's private-management model differed significantly from that of Dade County, Florida, in that EAI was given overall management responsibility. Data were gathered through a…

  16. Profiting from Public Education: Education Management Organizations and Student Achievement

    ERIC Educational Resources Information Center

    Garcia, David R.; Barber, Rebecca; Molnar, Alex

    2009-01-01

    Background/Context: Nationally, almost a quarter of charter school students attend a school managed by a for-profit education management organization (EMO). EMOs have full executive authority over the operation and management of schools, including curriculum and instruction decisions. Because charter schools are funded with public dollars, critics…

  17. Profiting from Public Education: Education Management Organizations and Student Achievement

    ERIC Educational Resources Information Center

    Garcia, David R.; Barber, Rebecca; Molnar, Alex

    2009-01-01

    Background/Context: Nationally, almost a quarter of charter school students attend a school managed by a for-profit education management organization (EMO). EMOs have full executive authority over the operation and management of schools, including curriculum and instruction decisions. Because charter schools are funded with public dollars, critics…

  18. Organizational and environmental factors associated with nursing home participation in managed care.

    PubMed Central

    Zinn, J S; Mor, V; Castle, N; Intrator, O; Brannon, D

    1999-01-01

    OBJECTIVE: To develop and test a model, based on resource dependence theory, that identifies the organizational and environmental characteristics associated with nursing home participation in managed care. DATA SOURCES AND STUDY SETTING: Data for statistical analysis derived from a survey of Directors of Nursing in a sample of nursing homes in eight states (n = 308). These data were merged with data from the On-line Survey Certification and Reporting System, the Medicare Managed Care State/County Data File, and the 1995 Area Resource File. STUDY DESIGN: Since the dependent variable is dichotomous, the logistic procedure was used to fit the regression. The analysis was weighted using SUDAAN. FINDINGS: Participation in a provider network, higher proportions of resident care covered by Medicare, providing IV therapy, greater availability of RNs and physical therapists, and Medicare HMO market penetration are associated with a greater likelihood of having a managed care contract. CONCLUSION: As more Medicare recipients enroll in HMOs, nursing home involvement in managed care is likely to increase. Interorganizational linkages enhance the likelihood of managed care participation. Nursing homes interested in managed care should consider upgrading staffing and providing at least some subacute services. PMID:10029508

  19. Childhood diabetes: parents' experience of home management and the first year following diagnosis.

    PubMed

    Lowes, L; Lyne, P; Gregory, J W

    2004-06-01

    To explore parents' experience of having a child diagnosed with Type 1 diabetes, managed at home, and their first year following diagnosis. A qualitative, longitudinal study based on 40 in-depth interviews with parents of 20 children with newly diagnosed Type 1 diabetes managed at home from diagnosis in South Wales. Many parents were alarmed by the speed of diagnosis following the gradual progress of their child's symptoms. The provision of timely, adequate information was important to all parents. Although five parents had initial concerns about going home, all parents were subsequently pleased their children had not been hospitalized. Home management enabled parents to integrate diabetes management into the family's normal lifestyle from diagnosis. Professional support, particularly accessible telephone advice, was valued by and reassured parents. Parents experienced a loss of spontaneity, a continuing fear of hypoglycaemia and did not want their child to feel different to other children. Acutely aware of the seriousness of diabetes, they did their utmost to achieve optimal glycaemic control but felt that diabetes could not 'dominate' if they were to lead a 'normal' life. The experience of parents in this study suggests that parents of children with newly diagnosed diabetes are able to cope successfully when given the opportunity to start treatment at home. Therefore, if children with diabetes are clinically well at diagnosis, this study supports home management as a system of care from the parents' point of view. These findings are relevant to clinicians, policy makers and health service managers involved in planning and providing paediatric diabetes care.

  20. Automated spoken dialogue system for hypertensive patient home management.

    PubMed

    Giorgino, Toni; Azzini, Ivano; Rognoni, Carla; Quaglini, Silvana; Stefanelli, Mario; Gretter, Roberto; Falavigna, Daniele

    2005-03-01

    Recent advances in automatic speech recognition and related technologies allow computers to carry on conversations by telephone. We developed an intelligent dialogue system that interacts with hypertensive patients to collect data about their health status. Patients thus avoid the inconvenience of traveling for frequent face to face visits to monitor the clinical variables they can easily measure at home; the physician is facilitated in acquiring patient information and cardiovascular risk, which is evaluated from the data according to noted guidelines. Controlled trials to assess the clinical efficacy are under way.

  1. Public health response to striking solid waste management.

    PubMed

    Murti, Michelle; Ayre, Reg; Shapiro, Howard; de Burger, Ron

    2011-10-01

    In 2009, the City of Toronto, Ontario, Canada, experienced a six-week labor disruption involving 24,000 city workers that included solid waste and public health employees. In an attempt to control illegal dumping and to manage garbage storage across the city during this period, 24 temporary garbage storage sites were established by the city (mostly in local parks) for residents to dispose of their household waste. No other municipality in North America has attempted to operate this many temporary sites for this long a period. Management and nonunion staff from Healthy Environments in Toronto Public Health performed daily inspections, responded to community questions, issued public health orders, and worked closely with Solid Waste Management and the Ministry of the Environment to actively manage the public health concerns associated with these sites. This intensive oversight mitigated public health risks to the community and facilitated an effective, safe solution to the temporary garbage storage problem.

  2. Public meetings on nuclear waste management: their function and organization

    SciTech Connect

    Duvernoy, E.G.; Marcus, A.A.; Overcast, T.; Schilling, A.H.

    1981-05-01

    This report focuses on public meetings as a vehicle for public participation in nuclear waste management. The nature of public meetings is reviewed and the functions served by meetings highlighted. The range of participants and their concerns are addressed, including a review of the participants from past nuclear waste management meetings. A sound understanding of the expected participants allows DOE to tailor elements of the meeting, such as notification, format, and agenda to accommodate the attendees. Finally, the report discusses the organization of public meetings on nuclear waste management in order to enhance the DOE's functions for such meetings. Possible structures are suggested for a variety of elements that are relevant prior to, during and after the public meeting. These suggestions are intended to supplement the DOE Public Participation Manual.

  3. Impact of a medication management system on nursing home admission rate in a community-dwelling nursing home-eligible Medicaid population.

    PubMed

    Schulz, Richard M; Porter, Candace; Lane, Marcia; Cornman, Carol; Branham, Len

    2011-02-01

    Community-dwelling frail elderly have an increased need for effective medication management to reside in their homes and delay or avoid admission to nursing homes. The objective of this study was to examine the impact of a medication management system on nursing home admission within the community-dwelling frail elderly. This prospective cohort study compared nursing home admission rates in intervention and control clients of a state Medicaid home and community-based waiver program. Groups were matched on age (±5 years), race, gender, and waiver program start date (±120 days). The medication management service consisted of 2 parts: 1) prescription medicines dispensed from the client's local pharmacy in a calendar card, and 2) a coordinating service by a health educator to address medication-related problems as they arose. The primary dependent variable was admission to a nursing home. A total of 273 clients agreed to participate, enrolled, and had at least 1 prescription dispensed. The matched control group was composed of 800 other clients. The client sample was 72 years of age, 73% (785/1073) non-white, 75% (804/1073) female, and enrolled in the waiver program approximately 50 months. The 2 groups were similar on all demographic variables examined. Six clients (2.2%) in the intervention group and 40 clients (5.0%) in the control group were admitted to a nursing home at least once during the study period. Logistic regression was used to test the model predicting at least 1 nursing home admission. Control group clients were 2.94 times more likely to be admitted to a nursing home than clients in the intervention group. The medication management service implemented within this study was effective in reducing nursing home admissions in a group of frail community-dwelling elderly. Copyright © 2011. Published by EM Inc USA.

  4. Clinical management of multiple sclerosis through home telehealth monitoring: results of a pilot project.

    PubMed

    Turner, Aaron P; Wallin, Mitchell T; Sloan, Alicia; Maloni, Heidi; Kane, Robert; Martz, Lore; Haselkorn, Jodie K

    2013-01-01

    This study examined the feasibility of using home telehealth monitoring to improve clinical care and promote symptom self-management among veterans with multiple sclerosis (MS). This was a longitudinal cohort study linking mailed survey data at baseline and 6-month follow-up with information from home telehealth monitors. The study was conducted in two large Department of Veterans Affairs (VA) MS clinics in Seattle, Washington, and Washington, DC, and involved 41 veterans with MS. The measures were demographic information and data from a standardized question set using a home telehealth monitor. Participants reported moderate levels of disability (median Expanded Disability Status Scale [EDSS] score, 6.5) and substantial distance from the nearest VA MS clinic (mean distance, 93.6 miles). Of the participants, 61.0% reported current use of MS disease-modifying treatments. A total of 85.4% of participants provided consistent data from home monitoring. Overall satisfaction with home telehealth monitoring was high, with 87.5% of participants rating their experience as good or better. The most frequently reported symptoms at month 1 were fatigue (95.1%), depression (78.0%), and pain (70.7%). All symptoms were reported less frequently by month 6, with the greatest reduction in depression (change of 23.2 percentage points), although these changes were not statistically significant. Home telehealth monitoring is a promising tool for the management of chronic disease, although substantial practical barriers to efficient implementation remain.

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

    PubMed

    Rosenbaum, S

    1998-04-01

    The transformation to managed care is one of the most important and complex changes ever to take place in the American health system. One key aspect of this transformation is its implications for public health policy and practice. Both public and private buyers purchase managed care; increasingly, public programs that used to act as their own insurers (i.e., Medicare, Medicaid and CHAMPUS) are purchasing large quantities of managed care insurance from private companies. The transformation to managed care is altering the manner in which public health policy makers conceive of and carry out public health activities (particularly activities that involve the provision of personal health services). The degree to which managed care changes public health and in turn is altered by public health will depend in great measure on the extent to which public and private policy makers understand the implications of their choices for various aspects of public health and take steps to address them. Because both publicly and privately managed care arrangements are relatively deregulated, much of the dialogue between public health and managed care purchasers can be expected to take place within the context of the large service agreements that are negotiated between buyers and sellers of managed care products. This is particularly true for Medicaid because of the importance of Medicaid coverage, payment and access policies to public health policy makers, and because of the public nature of the Medicaid contracting process. A nationwide study of Medicaid managed care contracts offers the first detailed analysis of the content and structure of managed care service agreements and the public health issues they raise. Four major findings emerge from a review of the contracts. First, most of the agreements fail to address key issues regarding which Medicaid-covered services and benefits are the contractor's responsibility and which remain the residual responsibility of the state agency

  6. Database Management Systems: New Homes for Migrating Bibliographic Records.

    ERIC Educational Resources Information Center

    Brooks, Terrence A.; Bierbaum, Esther G.

    1987-01-01

    Assesses bibliographic databases as part of visionary text systems such as hypertext and scholars' workstations. Downloading is discussed in terms of the capability to search records and to maintain unique bibliographic descriptions, and relational database management systems, file managers, and text databases are reviewed as possible hosts for…

  7. Database Management Systems: New Homes for Migrating Bibliographic Records.

    ERIC Educational Resources Information Center

    Brooks, Terrence A.; Bierbaum, Esther G.

    1987-01-01

    Assesses bibliographic databases as part of visionary text systems such as hypertext and scholars' workstations. Downloading is discussed in terms of the capability to search records and to maintain unique bibliographic descriptions, and relational database management systems, file managers, and text databases are reviewed as possible hosts for…

  8. Diabetes management in the nursing home: a systematic review of the literature.

    PubMed

    Garcia, Theresa J; Brown, Sharon A

    2011-01-01

    Diabetes mellitus is a disease with debilitating potential. Growing numbers of elderly individuals are being admitted to under-resourced nursing homes with this often complicated, time-intensive, and costly diagnosis. The purpose of this systematic review of the literature was to determine the trends in diabetes management in nursing homes over the last decade including the use of clinical practice guidelines and the evaluation of management outcomes. Ten medical, nursing, psychological, legal, and business databases were searched for articles written in English between 2000 and 2010 addressing diabetes management in nursing homes or long-term care settings. They were analyzed to determine diabetes management characteristics, use of clinical practice guidelines, resident outcomes associated with different regimens, and implications for improved management and outcomes. A total of 20 studies from 6 countries, primarily the United States, including both qualitative and quantitative designs and a combined sample of 779,707 residents, met the inclusion criteria. The majority of the studies described frequencies of various management practices and found rare clinical practice guideline adherence. A severe lack of research relating management practices to health and quality-of-life outcomes was evident as was a lack of the voice of the resident in determining the diabetes regimen. Clear implications were found for improvement in diabetes management education for residents, families, and all health care providers in this setting.

  9. Public Management of Science Case Studies.

    ERIC Educational Resources Information Center

    American Univ., Washington, DC. Coll. of Public Affairs.

    Presented are six papers pertaining to the management of science, research, and development by federal agencies. The papers were prepared by students in a management of science course offered at the American University, Washington, D.C. Federal agencies reviewed include: National Aeronautics and Space Administration (NASA); Department of…

  10. Visiting nurses' posthospital medication management in home health care: an ethnographic study.

    PubMed

    Kollerup, Mette Geil; Curtis, Tine; Schantz Laursen, Birgitte

    2017-08-03

    Medication management is the most challenging component of a successful transition from hospital to home, a challenge of growing complexity as the number of older persons living with chronic conditions grows, along with increasingly specialised and accelerated hospital treatment plans. Thus, many patients are discharged with complex medication regimen instructions, accentuating the risk of medication errors that may cause readmission, adverse drug events and a need for further health care. The aim of this study was to explore visiting nurses' medication management in home health care after hospital discharge and to identify key elements in patient medication for improved patient safety. Inspired by the ethnographic research cycle, participant observations and informal interviews were conducted at 12 initial visits by a nurse in a patient's home after hospital discharge. Data consisted of field notes and photographs from the patients' homes, medication lists and medical records. Field notes were analysed in four steps. The analysis showed 12 stages in medication management in which nurses strove to adjust medication management to the patients' actual health status by mediating on knowledge of the patient, information to the patient and on rules and regulations and by establishing order in medication lists and medications in the home. The nurse-patient relationship, the integration of care and the context of care challenged patient safety in visiting nurses' medication management in patients' homes after hospital discharge. The implications for practice were the following: to ensure nurses' opportunities to continuously evolve their observation skills and skills in making sound clinical judgements; to establish interprofessional working processes which support the continuous assessment of patients' needs and the adjustment of care and treatment; to clarify expectations to nurses' responsibility and patients' privacy. © 2017 Nordic College of Caring Science.

  11. Parents' experiences of managing their child's postoperative pain at home: an exploratory qualitative study.

    PubMed

    Longard, Julie; Twycross, Alison; Williams, Anna M; Hong, Paul; Chorney, Jill

    2016-09-01

    To understand parents' experiences of managing their child's postoperative pain at home. Recent changes in children's health care services often shift the responsibility of managing children's postoperative pain to parents. Although pain management is important for good postoperative outcomes, it can be a challenging task for families, and children's pain is often under-managed. This qualitative study used semi-structured interviews to explore parents' experiences of managing their child's postoperative pain at home. Participants were parents of 10 typically developing 5- and 6-year olds, who underwent (adeno)tonsillectomy, and experienced no complications leading to hospitalisation in the postoperative period. One-on-one interviews were conducted with parents within three months of their child's surgery. Interviews were transcribed verbatim and content analysis was used to identify themes in parents' experiences. All children experienced some postoperative pain. Parents' experiences of managing their child's pain were impacted by balancing the pros and cons of administering analgesic medications, managing the emotional and psychological effects of their child's pain, as well as parents' information needs. Most parents' information needs were met yet they still struggled to manage their child's pain. These findings provide insight into some of the barriers that make this process challenging for many families, and what health care centres can do to help support parents manage their child's postoperative pain at home. The results of this study may aid in the design of interventions that will support parents when managing their child's postoperative pain at home and thus improve children's experiences. © 2016 John Wiley & Sons Ltd.

  12. Older persons' experience of being assessed for and receiving public home help: do they have any influence over it?

    PubMed

    Janlöv, Ann-Christin; Hallberg, Ingalill Rahm; Petersson, Kerstin

    2006-01-01

    The aim of this qualitative study was to explore older persons' experience of participation in and influence on decisions about public home help/care when undergoing needs assessment and receiving public home help. A purposive sample of 28 home help recipients over the age of 75 were selected. Data were collected by means of in-depth interviews. A content analysis revealed one overarching category: 'Having to be satisfied, adjust, and walk a fine line when balancing between needs and available help'; and three principal categories: Balancing the comfort and guilt--receiving help from the family at the limits of their capacity; 'A necessary evil'--balancing feelings and resources against having no choice but to accept; Incorporating the home help into daily life to gain a sense of continuity. The findings indicate that older persons have difficulties coping and adapting to their new life situation and have no actual influence over the decisions about their home help. The officer told them what was available. This implies a need to pay attention to the frail persons' mental state in the needs assessment and to ensure adequate understanding of information. Further, it suggests that the needs assessment and the home help officer should to a larger extent focus on individual needs as a whole, involve and encourage the older person to strengthen his or her sense of being in control.

  13. Strategic Orientation and Nursing Home Response to Public Reporting of Quality Measures: An Application of the Miles and Snow Typology

    PubMed Central

    Zinn, Jacqueline S; Spector, William D; Weimer, David L; Mukamel, Dana B

    2008-01-01

    Objective To assess whether differences in strategic orientation of nursing homes as identified by the Miles and Snow typology are associated with differences in their response to the publication of quality measures on the Nursing Home Compare website. Data Sources Administrator survey of a national 10 percent random sample (1,502 nursing homes) of all facilities included in the first publication of the Nursing Home Compare report conducted in May–June 2004; 724 responded, yielding a response rate of 48.2 percent. Study Design The dependent variables are dichotomous, indicating whether or not action was taken and the type of action taken. Four indicator variables were created for each of the four strategic types: Defender, Analyzer, Prospector, and Reactor. Other variables were included in the seven logistic regression models to control for factors other than strategic type that could influence nursing home response to public disclosure of their quality of care. Data Collection/Extraction Methods Survey data were merged with data on quality measures and organizational characteristics from the first report (November 2002). Principal Findings About 43 percent of surveyed administrators self-typed as Defenders, followed by Analyzers (33 percent), and Prospectors (19 percent). The least self-selected strategic type was the Reactor (6.6 percent). In general, results of the regression models indicate differences in response to quality measure publication by strategic type, with Prospectors and Analyzers more likely, and Reactors less likely, to respond than Defenders. Conclusions While almost a third of administrators took no action at all, our results indicate that whether, when, and how nursing homes reacted to publication of federally reported quality measures is associated with strategic orientation. PMID:18370969

  14. First-Line Nursing Home Managers in Sweden and their Views on Leadership and Palliative Care.

    PubMed

    Håkanson, Cecilia; Cronfalk, Berit Seiger; Henriksen, Eva; Norberg, Astrid; Ternestedt, Britt-Marie; Sandberg, Jonas

    2014-01-01

    The aim of this study was to investigate first-line nursing home managers' views on their leadership and related to that, palliative care. Previous research reveals insufficient palliation, and a number of barriers towards implementation of palliative care in nursing homes. Among those barriers are issues related to leadership quality. First-line managers play a pivotal role, as they influence working conditions and quality of care. Nine first-line managers, from different nursing homes in Sweden participated in the study. Semi-structured interviews were conducted and analysed using qualitative descriptive content analysis. In the results, two categories were identified: embracing the role of leader and being a victim of circumstances, illuminating how the first-line managers handle expectations and challenges linked to the leadership role and responsibility for palliative care. The results reveal views corresponding to committed leaders, acting upon demands and expectations, but also to leaders appearing to have resigned from the leadership role, and who express powerlessness with little possibility to influence care. The first line managers reported their own limited knowledge about palliative care to limit their possibilities of taking full leadership responsibility for implementing palliative care principles in their nursing homes. The study stresses that for the provision of high quality palliative care in nursing homes, first-line managers need to be knowledgeable about palliative care, and they need supportive organizations with clear expectations and goals about palliative care. Future action and learning oriented research projects for the implementation of palliative care principles, in which first line managers actively participate, are suggested.

  15. Home-based management of fever and malaria treatment practices in Uganda.

    PubMed

    Nsungwa-Sabiiti, Jesca; Peterson, Stefan; Pariyo, George; Ogwal-Okeng, Jasper; Petzold, Max G; Tomson, Goran

    2007-12-01

    The Home-Based Management of Fever/Malaria (HBMF) strategy in rural Uganda was evaluated in a quasi-experimental study. The intervention consisted of volunteers educating mothers and providing a 3-day course of pre-packaged chloroquine plus sulfadoxine/pyrimethamine tablets (HOMAPAK), free of charge, for the treatment of under-five fevers. Using a structured questionnaire, information was obtained on care-seeking and treatment practices before (n=498) and 18 months after the introduction of HBMF (n=587). Assessment of the intervention effect indicated 13.5% improvement in the accumulated proportion of patients (1) treated, (2) treated within 24h of illness onset, (3) treated with the recommended antimalarials, (4) treated at an adequate dosage and (5) treated for the correct duration. Combining this with the antimalarial drug efficacy resulted in a 10.4% improvement in the community effectiveness of malaria treatment. HOMAPAK use was reported in 25% of 156 febrile children; 23% in the most poor compared with 50% in the least poor. Using HOMAPAK instead of other allopathic antimalarials increased the likelihood of completing all steps (odds ratio 37, 95% CI 4.8-286). Similar to other large-scale public health interventions, this study demonstrates modest practice changes at the population level. However, practices improved markedly among HOMAPAK users, suggesting that intensifying implementation efforts to increase HOMAPAK use, especially among the poorest, would be beneficial.

  16. A feasibility study of home-based contingency management with adolescent smokers of rural Appalachia.

    PubMed

    Reynolds, Brady; Harris, Millie; Slone, Stacey A; Shelton, Brent J; Dallery, Jesse; Stoops, William; Lewis, Russell

    2015-12-01

    Cigarette smoking among adolescents remains a significant public health concern. This problem is compounded in regions such as rural Appalachia where rates of smoking are consistently higher than national averages and access to treatments is limited. The current research evaluated a home-based contingency management program completed over the Internet with adolescent smokers recruited from rural Appalachia. Participants (N = 62) submitted 3 video recordings per day showing their breath carbon monoxide (CO) levels using a handheld CO monitor. Participants were assigned to either an active treatment condition (AT; n = 31) in which reductions in breath CO were reinforced or a control treatment condition (CT; n = 31) in which providing timely video recordings were reinforced with no requirement to reduce breath CO. Results revealed that participants in the AT condition reduced their breath CO levels significantly more so during treatment than participants in the CT condition. Within-group comparisons revealed that participants in both conditions significantly reduced their breath CO, self-reported smoking, and nicotine dependence ratings during treatment. However, only participants in the AT condition significantly reduced urinary cotinine levels during treatment, and only participants in this condition maintained all reductions until 6-week post treatment. Participants in the CT condition only maintained self-reported smoking reductions until posttreatment assessments. These results support the feasibility and initial efficacy of this incentive-based approach to smoking cessation with adolescent smokers living in rural locations.

  17. 41 CFR 302-10.5 - May I transport a mobile home over water?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 41 Public Contracts and Property Management 4 2013-07-01 2012-07-01 true May I transport a mobile home over water? 302-10.5 Section 302-10.5 Public Contracts and Property Management Federal Travel... transport a mobile home over water? Yes, you may transport a mobile home over water when both the points...

  18. 41 CFR 302-10.5 - May I transport a mobile home over water?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 41 Public Contracts and Property Management 4 2012-07-01 2012-07-01 false May I transport a mobile home over water? 302-10.5 Section 302-10.5 Public Contracts and Property Management Federal Travel... transport a mobile home over water? Yes, you may transport a mobile home over water when both the points...

  19. 41 CFR 302-10.5 - May I transport a mobile home over water?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false May I transport a mobile home over water? 302-10.5 Section 302-10.5 Public Contracts and Property Management Federal Travel... transport a mobile home over water? Yes, you may transport a mobile home over water when both the points...

  20. The performance measurement-management divide in public health.

    PubMed

    Schwartz, Robert; Deber, Raisa

    2016-03-01

    What happens when performance measurement and management (PMM) is applied to public health systems? This review of the experiences of high-income jurisdictions reveals considerable challenges, some familiar from the general public management literature and some more unique to public health. To aid understanding, the PMM ladder, a framework for evaluating PMM systems is developed and applied to 55 public health measurement systems from Australia, Canada, EU, New Zealand, UK and US. Results indicate that: considerable measurement is occurring for informational purposes; measurement focuses more on clinical than on population health measures; and there is relatively little use of measurement results for improving management. Results demonstrate that much public health performance measurement is restricted to population health outcomes and fails to include more proximate activity and output measures that would be more useful for managing public health organizations. There are early signs of the emergence of a new breed of public health performance measurement that attempts to do just this. The PMM ladder proved useful for assessing efforts across a range of jurisdictions. It allows policymakers and managers to easily compare their PMM efforts with others and assists researchers in assessing what happens when PMM is applied to public health. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  1. Integrating home-based medication therapy management (MTM) services in a health system.

    PubMed

    Reidt, Shannon; Holtan, Haley; Stender, Jennifer; Salvatore, Toni; Thompson, Bruce

    2016-01-01

    To describe the integration of home-based Medication Therapy Management (MTM) into the ambulatory care infrastructure of a large urban health system and to discuss the outcomes of this service. Minnesota from September 2012 to December 2013. The health system has more than 50 primary care and specialty clinics. Eighteen credentialed MTM pharmacists are located in 16 different primary care and specialty settings, with the greatest number of pharmacists providing services in the internal medicine clinic. Home-based MTM was promoted throughout the clinics within the health system. Physicians, advanced practice providers, nurses, and pharmacists could refer patients to receive MTM in their homes. A home visit had the components of a clinic-based visit and was documented in the electronic health record (EHR); however, providing the service in the home allowed for a more direct assessment of environmental factors affecting medication use. Number of home MTM referrals, reason for referral and type of referring provider, number and type of medication-related problems (MRPs). In the first 15 months, 74 home visits were provided to 53 patients. Sixty-six percent of the patients were referred from the Internal Medicine Clinic. Referrals were also received from the senior care, coordinated care, and psychiatry clinics. Approximately 50% of referrals were made by physicians. More referrals (23%) were made by pharmacists compared with advanced practice providers, who made 21% of referrals. The top 3 reasons for referral were: nonadherence, transportation barriers, and the need for medication reconciliation with a home care nurse. Patients had a median of 3 MRPs with the most common (40%) MRP related to compliance. Home-based MTM is feasibly delivered within the ambulatory care infrastructure of a health system with sufficient provider engagement as demonstrated by referrals to the service. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All

  2. Distributed personal health information management system for dermatology at the homes for senior citizens.

    PubMed

    Lavanya, J; Goh, K W; Leow, Y H; Chio, M T W; Prabaharan, K; Kim, E; Kim, Y; Soh, C B

    2006-01-01

    A distributed personal health information management system (D-PHIMS) has been tested at a nursing home for the senior citizens (NHSC) in Singapore. The personal health information management system (PHIMS) from the University of Washington was customized to Singapore's context for teledermatology. A clinical trial commenced in October 2005 is ongoing and the survey results obtained indicate that the participants are satisfied with the D-PHIMS system. The diagnosis and treatment recommendations made by the dermatologists using the D-PHIMS diagnosis module were effective in most cases based on feedback from the nursing staff at the elderly nursing home. The results suggest that a teledermatology system could become a useful tool for the nursing homes and to control increasing healthcare costs for elderly care.

  3. Land and Waste Management Research Publications

    EPA Pesticide Factsheets

    Resources from the Science Inventory database of EPA's Office of Research and Development, as well as EPA's Science Matters journal, include research on managing contaminated sites and ground water modeling and decontamination technologies.

  4. 78 FR 56659 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-13

    ... (Pacific Council) Groundfish Management Team (GMT) will hold a working meeting, which is open to the public... purpose of the GMT working meeting is to develop recommendations for 2015-16 groundfish harvest...

  5. 77 FR 57558 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-18

    ... (Pacific Council) Groundfish Management Team (GMT) will hold a working meeting, which is open to the public... working meeting is to develop recommendations on how to best integrate the use of descending devices to...

  6. 75 FR 80470 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-22

    ... (Council) Groundfish Management Team (GMT) will hold a working meeting, which is open to the public. DATES...-2280. SUPPLEMENTARY INFORMATION: The purpose of the GMT work session is to review team roles and...

  7. 78 FR 69048 - Caribbean Fishery Management Council; Public Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-18

    ... Administrative Matters --Budget Update Fiscal Year 2013/14 --Closed Session to Discuss SSC/AP/OEAP Memberships... Magnuson-Stevens Fishery Conservation and Management Act, provided that the public has been notified of the...

  8. 78 FR 47675 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-06

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF COMMERCE... (NOAA), Commerce. ACTION: Notice of public meeting. SUMMARY: The Pacific Fishery Management Council's (Pacific Council) Ad Hoc Groundfish Electronic Monitoring Committee and Ad Hoc Trawl Groundfish Electronic...

  9. 77 FR 14351 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-09

    ...; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric... will be held at the Providence Biltmore Hotel, 11 Dorrance Street, Providence, RI 02903; telephone... Director, New England Fishery Management Council; telephone: (978) 465-0492. SUPPLEMENTARY INFORMATION:...

  10. 76 FR 77214 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-12

    ...; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric... held at the Hotel Providence, 139 Mathewson Street, Providence, RI 02903; telephone: (401) 861-8000... Fishery Management Council; telephone: (978) 465-0492. SUPPLEMENTARY INFORMATION: The Scallop...

  11. 78 FR 9373 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-08

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF COMMERCE... (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The Pacific Fishery Management Council's (Council) will hold a workshop on electronic monitoring in the rationalized groundfish trawl fishery....

  12. 78 FR 49259 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-13

    ... National Oceanic and Atmospheric Administration RIN 0648-XC804 Pacific Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration.... Thompson, Acting Deputy Director, Office of Sustainable Fisheries, National Marine Fisheries...

  13. 78 FR 49259 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-13

    ... National Oceanic and Atmospheric Administration RIN 0648-XC805 Pacific Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration.... Tracey L. Thompson, Acting Deputy Director, Office of Sustainable Fisheries, National Marine...

  14. 78 FR 11820 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-20

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF COMMERCE... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management... requirements for lobster trawls, stability issues, and unintentional conflicts with mobile gear. The committee...

  15. 75 FR 43491 - Western Pacific Fishery Management Council; Public Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-26

    ... Islands. The scope meeting will, among other things, describe the existing federal management regime for... regulatory changes. DATES: Public informational scoping meetings will be held in Saipan, CNMI on August...

  16. First-Line Nursing Home Managers in Sweden and their Views on Leadership and Palliative Care

    PubMed Central

    Håkanson, Cecilia; Cronfalk, Berit Seiger; Henriksen, Eva; Norberg, Astrid; Ternestedt, Britt-Marie; Sandberg, Jonas

    2015-01-01

    The aim of this study was to investigate first-line nursing home managers’ views on their leadership and related to that, palliative care. Previous research reveals insufficient palliation, and a number of barriers towards implementation of palliative care in nursing homes. Among those barriers are issues related to leadership quality. First-line managers play a pivotal role, as they influence working conditions and quality of care. Nine first-line managers, from different nursing homes in Sweden participated in the study. Semi-structured interviews were conducted and analysed using qualitative descriptive content analysis. In the results, two categories were identified: embracing the role of leader and being a victim of circumstances, illuminating how the first-line managers handle expectations and challenges linked to the leadership role and responsibility for palliative care. The results reveal views corresponding to committed leaders, acting upon demands and expectations, but also to leaders appearing to have resigned from the leadership role, and who express powerlessness with little possibility to influence care. The first line managers reported their own limited knowledge about palliative care to limit their possibilities of taking full leadership responsibility for implementing palliative care principles in their nursing homes. The study stresses that for the provision of high quality palliative care in nursing homes, first-line managers need to be knowledgeable about palliative care, and they need supportive organizations with clear expectations and goals about palliative care. Future action and learning oriented research projects for the implementation of palliative care principles, in which first line managers actively participate, are suggested. PMID:25628769

  17. Status of Biomedical Waste Management in Nursing Homes of Delhi, India

    PubMed Central

    Kishore, Jugal; Agarwal, Ravindra; Kohli, Charu; Sharma, Pramod Kumar; Kamat, NV; Tyagi, SC

    2014-01-01

    Introduction: Improper management of biomedical waste (BMW) poses a risk for health and environment. Healthcare workers have an important responsibility to properly segregate and train the staff in its disposal. Objective: To study the awareness, attitude and practices of health care workers in biomedical waste management and to observe the appropriateness of the same in the private nursing homes in Delhi, India. Materials and Methods: A cross-sectional study was conducted among private nursing homes in Delhi. In both south and east zones, 116 nursing homes were selected by random sampling method. Data was collected using a validated questionnaire of WHO. Data was analysed using SPSS software (version 16). Chi-square or fisher tests were used and accepted statistically significant if p-value was less than 0.05. Results: 41.7% of the workers in south zone and 25% in east zone had no knowledge about BMW generation (χ2=24.26, p=0.001). 57 (95%) workers in south zone and 55 (98.2%) in east zone agreed strongly that BMW management is helpful in reducing spread diseases in the community (χ2=1.22, p=0.5). On observation, it was found that 13 (21.7%) nursing homes in south zone and 15 (26.8%) in east zone did not have black bags. Practice of biomedical waste management in nursing homes in both the zones of Delhi was poor. Conclusion: The study concluded that the awareness regarding biomedical waste management was not satisfactory among health care workers in private sector. There is a need of strict implementation of guidelines of BMW management. PMID:24783081

  18. The OCRWM Enterprise. A publication of the Office of Civilian Radioactive Waste Management

    SciTech Connect

    1998-05-01

    This serial contains the following articles related to radioactive waste management: Cross-drift excavation heralds new phase in site characterization; International conference to feature in-depth tour of Yucca Mountain; OCRWM releases revised draft RFP for waste acceptance and transportation; Busted Butte tests important to viability assessment and licensing process; Regional transportation committees meet to address national issues; OCRWM Home Page is tops and getting better; OCRWM addresses public comments in repository EIS process; Researchers turn up the heat on Yucca Mountain rock; El Nino helps scientists study water movement at Yucca Mountain; Smaller tunnel boring machine begins big excavation job at Yucca Mountain; and Transportation group works to ensure coordination.

  19. Academic Values, Institutional Management and Public Policies

    ERIC Educational Resources Information Center

    Ward, David

    2007-01-01

    The impacts of market-related policies and revenues on higher education are not uniform but globalisation has opened most institutions to new pressures. The public funding models developed 50 years ago underestimated the full cost of mass higher education as an entitlement while the sheer scale of resources needed to sustain a comprehensive…

  20. The interdisciplinary approach to the implementation of a diabetes home care disease management program.

    PubMed

    Rosa, Mary Ann; Lapides, Shawn; Hayden, Corrine; Santangelo, Roxanne

    2014-02-01

    Diabetes is a national epidemic and a leading cause of hospitalizations in the United States. Home care agencies need to be able to provide effective Diabetes Disease Management to help prevent avoidable hospitalizations and assist patients to live a good quality of life. This article describes one organization's journey toward providing patients with better diabetes care resulting in an improved quality of life.

  1. Home Management 7: Child Care Unit. Course Objectives, Content Analysis, Supporting Objectives and Content Generalizations.

    ERIC Educational Resources Information Center

    Erickson, Susan, Comp.; Martin, Joan, Ed.

    These curriculum materials represent a child care unit in a home management program which is concerned with consumer and family studies. The curriculum unit is designed to help young adolescents work successfully with small children. A career focus, that of baby sitter or child caregiver, forms the unit's conceptual framework. This publication…

  2. Model medication management process in Australian nursing homes using business process modeling.

    PubMed

    Qian, Siyu; Yu, Ping

    2013-01-01

    One of the reasons for end user avoidance or rejection to use health information systems is poor alignment of the system with healthcare workflow, likely causing by system designers' lack of thorough understanding about healthcare process. Therefore, understanding the healthcare workflow is the essential first step for the design of optimal technologies that will enable care staff to complete the intended tasks faster and better. The often use of multiple or "high risk" medicines by older people in nursing homes has the potential to increase medication error rate. To facilitate the design of information systems with most potential to improve patient safety, this study aims to understand medication management process in nursing homes using business process modeling method. The paper presents study design and preliminary findings from interviewing two registered nurses, who were team leaders in two nursing homes. Although there were subtle differences in medication management between the two homes, major medication management activities were similar. Further field observation will be conducted. Based on the data collected from observations, an as-is process model for medication management will be developed.

  3. Characteristics Associated with Home- and Community-Based Service Utilization for Medicare Managed Care Consumers

    ERIC Educational Resources Information Center

    Alkema, Gretchen E.; Reyes, Judy Y.; Wilber, Kathleen H.

    2006-01-01

    Purpose: We identified the types of home-and community-based services (HCBS) that high-risk older adults in Medicare managed care used, and we examined participant characteristics associated with service use in six areas: overall service use, four specific categories of HCBS, and referrals to insured medical services. Design and Methods: We used…

  4. Relationship between Social Class and Racial Prejudice on Home Management Skills among Black Americans.

    ERIC Educational Resources Information Center

    Wilson, Catherine Walker

    The relationship of social class and racial prejudice to the home management skills of black Americans was the focus of this study. A questionnaire (a copy of which appears in an appendix) was used to interview a sample of 100 people divided into four subgroups: low social class blacks, low social class whites, middle social class blacks, and…

  5. A Coordinated Program to Transfer Self-Management Skills from School to Home.

    ERIC Educational Resources Information Center

    Irvine, A. Blair; And Others

    1992-01-01

    This report describes a self-management skills intervention utilizing a picture schedule for four high school students with moderate to severe mental retardation. The program was initiated at school and continued at home with different tasks. Students continued to successfully use the schedules on follow up after summer vacation. (DB)

  6. Improving caregivers' home management of common childhood illnesses through community level interventions.

    PubMed

    Ebuehi, Olufunke Margaret; Adebajo, Sylvia

    2010-09-01

    The study obtained information using quantitative and qualitative techniques, on key home management practices of common childhood illnesses in Community-Integrated Management of Childhood Illnesses (C-IMCI) and non-C-IMCI implemented local government areas (LGAs) in Osun state, to determine if any differences existed between them. Data analysis was done using Epi-info version 6.0 for the quantitative survey and content analysis method for the qualitative survey. Findings revealed better key home management practices in the C-IMCI compliant LGA than in the non-CIMCI compliant LGA. The proportion of caregivers who gave appropriate home treatment for malaria during their children's illnesses differed significantly (p = 0.000) between the two LGAs. Similarly, caregivers from the compliant LGA demonstrated better treatment practices for diarrhoea and cough. Community Resource Persons (CORPs) were the major source of information on these key practices in the compliant LGA; while in the non-compliant LGA, the traditional healers, elders, and to a lesser extent, health workers gave information. Findings showed that the C-IMCI strategy improved caregivers' home management of common childhood illnesses.

  7. Improving Staff Nutritional Practices in Community-Based Group Homes: Evaluation, Training, and Management.

    ERIC Educational Resources Information Center

    Kneringer, Mary-Jean; Page, Terry J.

    1999-01-01

    This study evaluated the effectiveness of a staff training-and-management package on nutritional practices in two community-based group homes serving adults with developmental disabilities. Food storage, menu development, and meal preparation were covered. All staff behaviors increased after training and were maintained for up to one year.…

  8. Hospice Care in Nursing Homes: Does It Contribute to Higher Quality Pain Management?

    ERIC Educational Resources Information Center

    Kayser-Jones, Jeanie S.; Kris, Alison E.; Miaskowski, Christine A.; Lyons, William L.; Paul, Steven M.

    2006-01-01

    Purpose: The purpose of this study was to investigate pain management among 42 hospice and 65 non-hospice residents in two proprietary nursing homes. Design and Methods: In this prospective, anthropological, quantitative, and qualitative study, we used participant observation, event analysis, and chart review to obtain data. The Medication…

  9. How Can Home Care Patients and Their Caregivers Better Manage Fall Risks by Leveraging Information Technology?

    PubMed

    Alhuwail, Dari; Koru, Güneş; Nahm, Eun-Shim

    2016-12-01

    From the perspectives of home care patients and caregivers, this study aimed to (a) identify the challenges for better fall-risk management during home care episodes and (b) explore the opportunities for them to leverage health information technology (IT) solutions to improve fall-risk management during home care episodes. Twelve in-depth semistructured interviews with the patients and caregivers were conducted within a descriptive single case study design in 1 home health agency (HHA) in the mid-Atlantic region of the United States. Patients and caregivers faced challenges to manage fall risks such as unmanaged expectations, deteriorating cognitive abilities, and poor care coordination between the HHA and physician practices. Opportunities to leverage health IT solutions included patient portals, telehealth, and medication reminder apps on smartphones. Effectively leveraging health IT could further empower patients and caregivers to reduce fall risks by acquiring the necessary information and following clinical advice and recommendations. The HHAs could improve the quality of care by adopting IT solutions that show more promise of improving the experiences of patients and caregivers in fall-risk management.

  10. Evaluation of a Behavior Management Training Program for Nursing Home Caregivers.

    ERIC Educational Resources Information Center

    Marsiske, Michael; And Others

    This study examined the effectiveness of a new skills training program designed to increase nurse aides' knowledge of behavior management. The training program, designed as five 90-minute group learning modules, was implemented in two Western Pennsylvania nursing homes over a 5-month period. Topics covered within the training program included…

  11. Hospice Care in Nursing Homes: Does It Contribute to Higher Quality Pain Management?

    ERIC Educational Resources Information Center

    Kayser-Jones, Jeanie S.; Kris, Alison E.; Miaskowski, Christine A.; Lyons, William L.; Paul, Steven M.

    2006-01-01

    Purpose: The purpose of this study was to investigate pain management among 42 hospice and 65 non-hospice residents in two proprietary nursing homes. Design and Methods: In this prospective, anthropological, quantitative, and qualitative study, we used participant observation, event analysis, and chart review to obtain data. The Medication…

  12. Individualism and Collectivism in Business School Pedagogy: A Research Agenda for Internationalising the Home Management Student

    ERIC Educational Resources Information Center

    Waistell, Jeff

    2011-01-01

    The argument presented in this paper is that today's workplaces and universities both require and promote individual and collective responsibility for work and that students need to be adequately prepared for this. UK national culture has been characterised as highly individualist. Therefore, internationalisation of home management students in the…

  13. Values and Decision-Making. Six Historical Conference Papers in Home Management 1901-1960.

    ERIC Educational Resources Information Center

    American Home Economics Association, Washington, DC.

    This document preserves for continued study some ideas and ideals from past experience. "Revaluations," by Caroline L. Hunt in 1901, discusses the responsibility of teachers concerning value formation and realization. "The Philosophy of Home Management," by Lawrence K. Frank in 1938, focuses on recognition and effective modification of the…

  14. Individualism and Collectivism in Business School Pedagogy: A Research Agenda for Internationalising the Home Management Student

    ERIC Educational Resources Information Center

    Waistell, Jeff

    2011-01-01

    The argument presented in this paper is that today's workplaces and universities both require and promote individual and collective responsibility for work and that students need to be adequately prepared for this. UK national culture has been characterised as highly individualist. Therefore, internationalisation of home management students in the…

  15. How Can Home Care Patients and Their Caregivers Better Manage Fall Risks by Leveraging Information Technology?

    PubMed Central

    Koru, Güneş; Nahm, Eun-Shim

    2016-01-01

    Objectives: From the perspectives of home care patients and caregivers, this study aimed to (a) identify the challenges for better fall-risk management during home care episodes and (b) explore the opportunities for them to leverage health information technology (IT) solutions to improve fall-risk management during home care episodes. Methods: Twelve in-depth semistructured interviews with the patients and caregivers were conducted within a descriptive single case study design in 1 home health agency (HHA) in the mid-Atlantic region of the United States. Results: Patients and caregivers faced challenges to manage fall risks such as unmanaged expectations, deteriorating cognitive abilities, and poor care coordination between the HHA and physician practices. Opportunities to leverage health IT solutions included patient portals, telehealth, and medication reminder apps on smartphones. Conclusion: Effectively leveraging health IT could further empower patients and caregivers to reduce fall risks by acquiring the necessary information and following clinical advice and recommendations. The HHAs could improve the quality of care by adopting IT solutions that show more promise of improving the experiences of patients and caregivers in fall-risk management. PMID:28725850

  16. RiBOMS: RFID-based object management system for home environments.

    PubMed

    Iraola, Hodei; Schafer, James; Yu, Xunyi; Mullett, Gary; Ganz, Aura

    2011-01-01

    In this paper we introduce a RFID-based object management system, RiBOMS, for home environments. The system has an easy to use pictorial user interface aimed at older adults with associative memory impairments. The system technical correctness was successfully tested in a lab environment.

  17. Values and Decision-Making. Six Historical Conference Papers in Home Management 1901-1960.

    ERIC Educational Resources Information Center

    American Home Economics Association, Washington, DC.

    This document preserves for continued study some ideas and ideals from past experience. "Revaluations," by Caroline L. Hunt in 1901, discusses the responsibility of teachers concerning value formation and realization. "The Philosophy of Home Management," by Lawrence K. Frank in 1938, focuses on recognition and effective modification of the…

  18. Characteristics Associated with Home- and Community-Based Service Utilization for Medicare Managed Care Consumers

    ERIC Educational Resources Information Center

    Alkema, Gretchen E.; Reyes, Judy Y.; Wilber, Kathleen H.

    2006-01-01

    Purpose: We identified the types of home-and community-based services (HCBS) that high-risk older adults in Medicare managed care used, and we examined participant characteristics associated with service use in six areas: overall service use, four specific categories of HCBS, and referrals to insured medical services. Design and Methods: We used…

  19. Understanding Aging and Disability Perspectives on Home Care: Uncovering Facts and Values in Public-Policy Narratives and Discourse

    ERIC Educational Resources Information Center

    Clark, Phillip G.

    2007-01-01

    Every public-policy problem can be defined in terms of its empirical ("facts") and normative ("values") dimensions and the interrelationship between them. An understanding of the connection between facts and values at the foundation of the home care policy debate in the Canadian health-care system is developed through the…

  20. Home Schooling and the Request for Access to Public School Extracurricular Activities: A Legal and Policy Study of Illinois.

    ERIC Educational Resources Information Center

    Lett, David R.

    This paper reports on a study that examines legal and policy issues surrounding access to public-school extracurricular activities for home-school students. Chapter 1, "The Problem and Its Background," reviews such relevant issues as the history of choice in America and Illinois, legal foundations, regulatory disparities, research…

  1. Ten dimensions of public-sector managed care.

    PubMed

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

    1999-01-01

    Managed care in the public sector remains a poorly defined concept. It is currently understood largely through case examples, an approach of limited usefulness because each managed care initiative is shaped by local forces and is constantly changing. The authors describe ten key dimensions on which such initiatives vary and suggest that they can be used to examine essential characteristics of the initiatives and core differences between them. The dimensions are objectives, scope, organizational structures and authority, enrollment, benefit package, strategies for managing utilization, best practices, financing, quality management and outcomes measurement, and the impact of the initiative on the public mental health system. Using these dimensions to assess existing initiatives, the authors conclude that most focus on one principal dimension to the exclusion of other critical dimensions. The authors argue for a comprehensive approach to planning and implementing managed care projects that should ultimately lead to better care for public-sector populations.

  2. Remote access to medical specialists: home care interactive patient management system

    NASA Astrophysics Data System (ADS)

    Martin, Peter J.; Draghic, Nicole; Wiesmann, William P.

    1999-07-01

    Diabetes management involves constant care and rigorous compliance. Glucose control is often difficult to maintain and onset of complications further compound health care needs. Status can be further hampered by geographic isolation from immediate medical infrastructures. The Home Care Interactive Patient Management System is an experimental telemedicine program that could improve chronic illness management through Internet-based applications. The goal of the system is to provide a customized, integrated approach to diabetes management to supplement and coordinate physician protocol while supporting routine patient activity, by supplying a set of customized automated services including health data collection, transmission, analysis and decision support.

  3. In-home behavioral health case management: an integrated model for high-risk populations.

    PubMed

    Theis, Gerald A; Kozlowski, Deirdre; Behrens, Jenna

    2006-01-01

    The escalating health care costs attributed to high-risk populations have fueled a need for a proactive approach to deal with people affected by complex mental health issues that often coexist with chronic medical conditions. Through an in-home behavioral health case management (CM) program, patients with mental illnesses (some with coexisting medical conditions) receive integrated medical and mental health services through a disease-management approach that has proven effective in treating high-risk patients.

  4. Managing the Drivers of Air Flow and Water Vapor Transport in Existing Single Family Homes (Revised)

    SciTech Connect

    Cummings, J.; Withers, C.; Martin, E.; Moyer, N.

    2012-10-01

    This document focuses on managing the driving forces which move air and moisture across the building envelope. While other previously published Measure Guidelines focus on elimination of air pathways, the ultimate goal of this Measure Guideline is to manage drivers which cause air flow and water vapor transport across the building envelope (and also within the home), control air infiltration, keep relative humidity (RH) within acceptable limits, avoid combustion safety problems, improve occupant comfort, and reduce house energy use.

  5. Systematic review of the management of incontinence and promotion of continence in older people in care homes: descriptive studies with urinary incontinence as primary focus.

    PubMed

    Roe, Brenda; Flanagan, Lisa; Jack, Barbara; Barrett, James; Chung, Alan; Shaw, Christine; Williams, Kate

    2011-02-01

    This is a review of descriptive studies with incontinence as the primary focus in older people in care homes. Incontinence is prevalent among residents of care home populations. MEDLINE and CINAHL were searched from 1996 to 2007 using the highly sensitive search strings of the Cochrane Incontinence Review Group for urinary and faecal incontinence including all research designs. Search strings were modified to enhance selectiveness for care homes and older people and exclude studies involving surgical or pharmacological interventions. Searching of reference sections from identified studies was also used to supplement electronic searches. The Cochrane Library was searched for relevant systematic reviews to locate relevant studies from those included or excluded from reviews. The search was limited to English-language publications. A systematic review of studies on the management of incontinence, promotion of continence or maintenance of continence in care homes was conducted in 2007-2009. This is a report of descriptive studies. Results. Ten studies were identified that reported on prevalence and incidence of incontinence (urinary with or without faecal), policies, assessment, documentation, management or economic evaluation of its management. Use of incontinence pads and toileting programmes comprised the most common management approaches used. No studies were identified that attempted to maintain continence of residents in care homes. Studies on maintaining continence and identifying components of toileting programmes that are successful in managing or preventing incontinence and promoting continence in residents of care home populations along with their economic evaluation are warranted. © 2010 The Authors. Journal of Advanced Nursing © 2010 Blackwell Publishing Ltd.

  6. 76 FR 42684 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-19

    ...) 820-2280. SUPPLEMENTARY INFORMATION: The primary purpose of the project team working meeting is to... (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The groundfish project team responsible... Fishery Management Council (Council) will hold a working meeting, which is open to the public. DATES: The...

  7. 76 FR 17381 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-29

    ... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management Council (Council) is scheduling a public meeting of its Research Steering Committee (Committee), in April, 2011, to consider actions affecting New England fisheries in the exclusive economic zone (EEZ...

  8. 75 FR 66072 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-27

    ... Administration (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The New England Fishery Management Council (Council) is scheduling a public meeting of its Research Steering Committee (Committee), in November, 2010, to consider actions affecting New England fisheries in the exclusive economic zone (EEZ...

  9. 76 FR 7823 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-11

    ... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management Council (Council) is scheduling a public meeting of its Research Steering Committee (Committee), in February 2011, to consider actions affecting New England fisheries in the exclusive economic zone (EEZ...

  10. Intellectual Capital and New Public Management: Reintroducing Enterprise

    ERIC Educational Resources Information Center

    Mouritsen, Jan; Thorbjornsen, Stefan; Bukh, Per N.; Johansen, Mette R.

    2004-01-01

    The paper reports on public sector organisations'/institutions' work to develop knowledge management and intellectual capital statements. Building on experiences collected during 2001-2002 where 26 public sector institutions in Denmark sought to develop intellectual capital statements, this paper discusses their experiences and in particular, it…

  11. 75 FR 2488 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-15

    ... National Oceanic and Atmospheric Administration RIN 0648-XT79 Pacific Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice of public meeting. SUMMARY: The Joint Canada-U.S. Review Panel (Panel...

  12. What Kind of Reflection Do We Need in Public Management?

    ERIC Educational Resources Information Center

    Knassmüller, Monika; Meyer, Renate E.

    2013-01-01

    In a rapidly changing and increasingly complex environment, the importance of reflection for public managers has been acknowledged almost unanimously by academics as well as practitioners. In this article we highlight the necessity to look at reflection in a more nuanced way. Reflection is a broad and multifaceted concept and public sector work…

  13. Public Relations Manager Involvement in Strategic Issue Diagnosis.

    ERIC Educational Resources Information Center

    Lauzen, Martha M.

    1995-01-01

    Reports on an exploratory study that seeks to build theoretical understanding of how public relations practitioner involvement in one type of strategic organizational decision making--strategic issue diagnosis--is related to shared values with top management, diagnosis accuracy, strategy pursued, and the power of the public relations function. (TB)

  14. Rethinking Leadership Learning in Postgraduate Public Management Programmes

    ERIC Educational Resources Information Center

    Briggs, Ian; Raine, John

    2013-01-01

    Leadership forms a key component of the curriculum of most Master of Public Administration and other public management programmes, usually doing so on the basis of assumptions that leadership is (a) both a subject and a responsibility that all such students might expect to embrace in the course of their careers; and (b) in some respects at least,…

  15. 78 FR 27190 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-09

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration RIN 0648-XC662 Pacific Fishery Management Council; Public... (Pacific Council) Enforcement Consultants (EC) will hold an online webinar, which is open to the public...

  16. 78 FR 9888 - Pacific Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-12

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration RIN 0648-XC492 Pacific Fishery Management Council; Public... (Council) Ad Hoc Amendment 24 Workgroup will hold an online webinar, which is open to the public. DATES...

  17. The Steering of Higher Education Systems: A Public Management Perspective

    ERIC Educational Resources Information Center

    Ferlie, Ewan; Musselin, Christine; Andresani, Gianluca

    2008-01-01

    This article focuses on the steering of higher education systems in the light of political science and public management approaches. It first recalls that an important part of the existing literature on higher education is focused on public policies in terms of reforms and decision-making, while the other part is dedicated to discovering and…

  18. Inside Sweden's Independent Public Schools: Innovations in Management.

    ERIC Educational Resources Information Center

    Raham, Helen

    2003-01-01

    Profiles three Swedish tuition-free, independent public schools. Independent schools were formed after the Swedish government enacted school choice legislation in 1992 resulting in the replacement of private schools with a system of tuition-free, self-managed public schools. These schools (now over 800) provide parents with alternatives to…

  19. Intellectual Capital and New Public Management: Reintroducing Enterprise

    ERIC Educational Resources Information Center

    Mouritsen, Jan; Thorbjornsen, Stefan; Bukh, Per N.; Johansen, Mette R.

    2004-01-01

    The paper reports on public sector organisations'/institutions' work to develop knowledge management and intellectual capital statements. Building on experiences collected during 2001-2002 where 26 public sector institutions in Denmark sought to develop intellectual capital statements, this paper discusses their experiences and in particular, it…

  20. Public Relations Manager Involvement in Strategic Issue Diagnosis.

    ERIC Educational Resources Information Center

    Lauzen, Martha M.

    1995-01-01

    Reports on an exploratory study that seeks to build theoretical understanding of how public relations practitioner involvement in one type of strategic organizational decision making--strategic issue diagnosis--is related to shared values with top management, diagnosis accuracy, strategy pursued, and the power of the public relations function. (TB)

  1. Senator Craig's Public Lands Management Imporvement Act of 1997

    Treesearch

    Joseph E. de Steiguer

    1998-01-01

    There are currently some 50 bills before the US Congress that deal with forestry. Among the most important of these is the one introduced on October 3, 1997, by Sen. Larry Craig (R-ID). This bill, S 1253, titled the Public Lands Management Improvement Act of 1997, would have far-reaching effects on the national forests and multiple-use public lands.

  2. What Kind of Reflection Do We Need in Public Management?

    ERIC Educational Resources Information Center

    Knassmüller, Monika; Meyer, Renate E.

    2013-01-01

    In a rapidly changing and increasingly complex environment, the importance of reflection for public managers has been acknowledged almost unanimously by academics as well as practitioners. In this article we highlight the necessity to look at reflection in a more nuanced way. Reflection is a broad and multifaceted concept and public sector work…

  3. Rethinking Leadership Learning in Postgraduate Public Management Programmes

    ERIC Educational Resources Information Center

    Briggs, Ian; Raine, John

    2013-01-01

    Leadership forms a key component of the curriculum of most Master of Public Administration and other public management programmes, usually doing so on the basis of assumptions that leadership is (a) both a subject and a responsibility that all such students might expect to embrace in the course of their careers; and (b) in some respects at least,…

  4. When and Why Do University Managers Use Publication Incentive Payments?

    ERIC Educational Resources Information Center

    Opstrup, Niels

    2017-01-01

    Pay-for-performance schemes have become a widespread management strategy in the public sector. However, not much is known about the rationales that trigger the adoption of performance-related pay provisions. This article examines managerial and organisational features of university departments in Denmark that use publication incentive payments.…

  5. Effectiveness of home visits by public health nurses in maternal and child health: an empirical review.

    PubMed Central

    Combs-Orme, T; Reis, J; Ward, L D

    1985-01-01

    The effectiveness of public health nursing in promoting maternal and child health through home visits is summarized from empirical studies published between 1960 and 1984. Eight reports identified through a comprehensive reference search were first classified according to the components of nursing service studied (assessment, teaching, counseling or support, referral, and clinical services). The results of each study were then analyzed for study population characteristics, the research design and statistical methods employed, the reliability of the measures used, significant treatment effects, sample size, and statistical power. The research is evenly divided among studies employing an experimental design, a quasi-experimental design, and samples of low-income and middle-income mothers. The reliability of the measures was, with one exception, not reported. All but one study had final sample sizes for treatment and control or comparison groups of fewer than 100 subjects. Four of the studies thus had sample sizes sufficiently large to detect a medium treatment effect; power calculations showed that none could measure a small treatment impact. Within the methodological limitations of these studies, our review found that under certain circumstances public health nurses can effectively impart health knowledge to high-risk mothers and can effect positive change in maternal attitudes and parenting practices that in turn can be associated with positive changes in infant health and development. Cumulative knowledge from this body of research suggests that a priority for future evaluations of public health nursing is development of theoretical frameworks that maximize the fit between the needs of the population served and the services provided and between the outcomes measured and the nursing services being assessed. PMID:3931163

  6. Development and implementation of a postdischarge home-based medication management service.

    PubMed

    Pherson, Emily C; Shermock, Kenneth M; Efird, Leigh E; Gilmore, Vi T; Nesbit, Todd; LeBlanc, Yvonne; Brotman, Daniel J; Deutschendorf, Amy; Swarthout, Meghan Davlin

    2014-09-15

    The development and implementation of a postdischarge home-based, pharmacist-provided medication management service are described. A work group composed of pharmacy administrators, clinical specialists, physicians, and nursing leadership developed the structure and training requirements to implement the service. Eligible patients were identified during their hospital admission by acute care pharmacists and consented for study participation. Pharmacists and pharmacy residents visited the patient at home after discharge and conducted medication reconciliation, provided patient education, and completed a comprehensive medication review. Recommendations for medication optimization were communicated to the patient's primary care provider, and a reconciled medication list was faxed to the patient's community pharmacy. Demographic and medication-related data were collected to characterize patients receiving the home-based service. A total of 50 patients were seen by pharmacists in the home. Patient education provided by the home-based pharmacists included monitoring instructions, adherence reinforcement, therapeutic lifestyle changes, administration instructions, and medication disposal instructions. Pharmacists provided the following recommendations to providers to optimize medication regimens: adjust dosage, suggest laboratory tests, add medication, discontinue medication, need prescription for refills, and change product formulation. Pharmacists identified a median of two medication discrepancies per patient and made a median of two recommendations for medication optimization to patients' primary care providers. The implementation of a post-discharge, pharmacist-provided home-based medication management service enhanced the continuity of patient care during the transition from hospital to home. Pharmacists identified and resolved medication discrepancies, educated patients about their medications, and provided primary care providers and community pharmacies with a

  7. Backyard waste management - problems and benefits of individuals managing their solid waste at home

    SciTech Connect

    Whalen, M.

    1995-05-01

    The problems and benefits of individuals managing their solid wastes at home are surveyed. The survey indicates that as the population rises people tend to burn only the combustible portions of their waste. Some communities have limited ordinances that ban the burning of raw garbage, but other municipalities allow residents to burn all of their wastestream, even though some materials are not combustible and cannot be burned. Potential environmental effects involve both the ash residue and the air emissions. While selected burning can reduce some of the environmental hazards these would probably only be marginally less than the impacts of burning it all. The study clearly indicates that the environmental problems of burn barrels are not insignificant. However, the attitudes and motivations of those who burn waste will have to be addressed by the communities that attempt or should attempt to control this problem. These include: avoidance of waste collection costs; availability of trash cartage services; and habit. Habit is probably as strong a motivation as cost avoidance and ease of collection combined. Residents have often burned trash for several generations and regard the practice as a {open_quotes}god-given right.{close_quotes}

  8. The Home Independence Program with non-health professionals as care managers: an evaluation.

    PubMed

    Lewin, Gill; Concanen, Karyn; Youens, David

    2016-01-01

    The Home Independence Program (HIP), an Australian restorative home care/reablement service for older adults, has been shown to be effective in reducing functional dependency and increasing functional mobility, confidence in everyday activities, and quality of life. These gains were found to translate into a reduced need for ongoing care services and reduced health and aged care costs over time. Despite these positive outcomes, few Australian home care agencies have adopted the service model - a key reason being that few Australian providers employ health professionals, who act as care managers under the HIP service model. A call for proposals from Health Workforce Australia for projects to expand the scope of practice of health/aged care staff then provided the opportunity to develop, implement, and evaluate a service delivery model, in which nonprofessionals replaced the health professionals as Care Managers in the HIP service. Seventy older people who received the HIP Coordinator (HIPC) service participated in the outcomes evaluation. On a range of personal outcome measures, the group showed statistically significant improvement at 3 and 12 months compared to baseline. On each outcome, the improvement observed was larger than that observed in a previous trial in which the service was delivered by health professionals. However, differences in the timing of data collection between the two studies mean that a direct comparison cannot be made. Clients in both studies showed a similarly reduced need for ongoing home care services at both follow-up points. The outcomes achieved by HIPC, with non-health professionals as Care Managers, were positive and can be considered to compare favorably with the outcomes achieved in HIP when health professionals take the Care Manager role. These findings will be of interest to managers of home care services and to policy makers interested in reducing the long-term care needs of older community dwelling individuals.

  9. The Home Independence Program with non-health professionals as care managers: an evaluation

    PubMed Central

    Lewin, Gill; Concanen, Karyn; Youens, David

    2016-01-01

    The Home Independence Program (HIP), an Australian restorative home care/reablement service for older adults, has been shown to be effective in reducing functional dependency and increasing functional mobility, confidence in everyday activities, and quality of life. These gains were found to translate into a reduced need for ongoing care services and reduced health and aged care costs over time. Despite these positive outcomes, few Australian home care agencies have adopted the service model – a key reason being that few Australian providers employ health professionals, who act as care managers under the HIP service model. A call for proposals from Health Workforce Australia for projects to expand the scope of practice of health/aged care staff then provided the opportunity to develop, implement, and evaluate a service delivery model, in which nonprofessionals replaced the health professionals as Care Managers in the HIP service. Seventy older people who received the HIP Coordinator (HIPC) service participated in the outcomes evaluation. On a range of personal outcome measures, the group showed statistically significant improvement at 3 and 12 months compared to baseline. On each outcome, the improvement observed was larger than that observed in a previous trial in which the service was delivered by health professionals. However, differences in the timing of data collection between the two studies mean that a direct comparison cannot be made. Clients in both studies showed a similarly reduced need for ongoing home care services at both follow-up points. The outcomes achieved by HIPC, with non-health professionals as Care Managers, were positive and can be considered to compare favorably with the outcomes achieved in HIP when health professionals take the Care Manager role. These findings will be of interest to managers of home care services and to policy makers interested in reducing the long-term care needs of older community dwelling individuals. PMID:27382264

  10. Omnibus Public Land Management Act of 2009

    THOMAS, 111th Congress

    Sen. Bingaman, Jeff [D-NM

    2009-01-07

    03/11/2009 On motion to suspend the rules and pass the bill, as amended Failed by the Yeas and Nays: (2/3 required): 282 - 144 (Roll no. 117). (All Actions) Notes: For further action, see H.R.146, which became Public Law 111-11 on 3/30/2009. Tracker: This bill has the status Failed HouseHere are the steps for Status of Legislation:

  11. Omnibus Public Land Management Act of 2009

    THOMAS, 111th Congress

    Sen. Bingaman, Jeff [D-NM

    2009-01-07

    House - 03/11/2009 On motion to suspend the rules and pass the bill, as amended Failed by the Yeas and Nays: (2/3 required): 282 - 144 (Roll no. 117). (All Actions) Notes: For further action, see H.R.146, which became Public Law 111-11 on 3/30/2009. Tracker: This bill has the status Failed HouseHere are the steps for Status of Legislation:

  12. Omnibus Public Land Management Act of 2009

    THOMAS, 111th Congress

    Sen. Bingaman, Jeff [D-NM

    2009-01-07

    03/11/2009 On motion to suspend the rules and pass the bill, as amended Failed by the Yeas and Nays: (2/3 required): 282 - 144 (Roll no. 117). (All Actions) Notes: For further action, see H.R.146, which became Public Law 111-11 on 3/30/2009. Tracker: This bill has the status Failed HouseHere are the steps for Status of Legislation:

  13. Effective Management in Contracting Public Organizations.

    ERIC Educational Resources Information Center

    Stefonek, Tom

    The first half of this paper reviews the school enrollment trend in the state of Wisconsin and discusses the implications of school closings. It offers planning suggestions to local districts in light of statewide declining enrollments. The second half of the paper--a review of recent literature related to "cutback management"--is…

  14. Effective Management in Contracting Public Organizations.

    ERIC Educational Resources Information Center

    Stefonek, Tom

    The first half of this paper reviews the school enrollment trend in the state of Wisconsin and discusses the implications of school closings. It offers planning suggestions to local districts in light of statewide declining enrollments. The second half of the paper--a review of recent literature related to "cutback management"--is…

  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. 77 FR 20613 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-05

    ... National Oceanic and Atmospheric Administration RIN 0648-XB129 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice of cancellation of a public meeting. SUMMARY: The New England... FURTHER INFORMATION CONTACT: Paul J. Howard, Executive Director, New England Fishery Management Council...

  17. 77 FR 64490 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-22

    ... National Oceanic and Atmospheric Administration RIN 0648-XC305 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management... affecting New England fisheries in the exclusive economic zone (EEZ). Recommendations from this group will...

  18. 77 FR 16211 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-20

    ... National Oceanic and Atmospheric Administration RIN 0648-XB091 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management... affecting New England fisheries in the exclusive economic zone (EEZ). Recommendations from this group will...

  19. 77 FR 15721 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-16

    ... National Oceanic and Atmospheric Administration RIN0648-XB090 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management... affecting New England fisheries in the exclusive economic zone (EEZ). Recommendations from this group will...

  20. 76 FR 28214 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-16

    ... National Oceanic and Atmospheric Administration RIN 0648-XA437 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management... actions affecting New ] England fisheries in the exclusive economic zone (EEZ). Recommendations from this...