Science.gov

Sample records for ruminant health management

  1. Objective structured clinical examinations (OSCEs) as a summative evaluation tool in a ruminant health management rotation for final-year DVM students.

    PubMed

    Bateman, Ken; Menzies, Paula; Sandals, David; Duffield, Todd; LeBlanc, Stephen; Leslie, Ken; Lissemore, Kerry; Swackhammer, Rob

    2008-01-01

    The objective structured clinical examination (OSCE) has been used for 10 years at the Ontario Veterinary College, University of Guelph, to evaluate the clinical competencies in ruminant health management of final-year DVM students. The performance of these students in the summative assessment, which includes the use of OSCEs, was compared to their formative assessment, given at the end of the rotation. Specifically, classification of students' performance as poor (bottom 10% of the grade range versus "serious deficits") or superior ("A grade" versus "exceeds expectations") was compared. Agreement between the two types of assessment is slight, regardless of whether assessing diagnostic process skills or technical skills--and regardless of whether all students were assessed or only those enrolled in food-animal or mixed streams in their final year--which suggests that the two assess different types of skills. OSCEs are a useful and viable tool for objectively assessing clinical skills in ruminant health management.

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

    PubMed

    Wolfe, Barbara A; Lamberski, Nadine

    2012-05-01

    Management and care of the nondomestic ruminant neonate are similar in principle to domestic animal practice. Housing of the dam, conditions for birth, preparation for intervention, and plans for treatment and hand-rearing of sick neonates must all be considered carefully before undertaking nondomestic ruminant breeding. Unfortunately, neonatal losses tend to be much higher in nondomestic calves before weaning than in domestic cattle, sheep, and goat herds.1 With continued habitat and population declines in wild species, successful captive breeding of nondomestic herds becomes more important to species sustainability and potential reintroduction programs. The primary challenges contributing to neonatal losses in nondomestic ruminants are often animal temperament and adaptation to captivity. Only through experience can some of these challenges be overcome. However, by understanding some species-specific behavioral tendencies and the fractious nature of nondomestic ruminants in general, we can improve our success in managing and maintaining healthy populations of nondomestic ruminants in captivity. PMID:22640541

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

    PubMed

    Katsumata, Yuina

    2015-10-01

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

  4. 9 CFR 93.405 - Health certificate for ruminants.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

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

  5. 9 CFR 93.405 - Health certificate for ruminants.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

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

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

    PubMed

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

    2015-02-01

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

  7. Rumination and self-defining memories in the context of health concerns.

    PubMed

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

    2016-08-01

    Individuals with health anxiety report experiencing a strong sense of vulnerability to illness. Such beliefs may be driven by the biased recollection of past illness-related events. However, little research has explored the role of memory in health anxiety. In other disorders, rumination has also been identified as a process that leads individuals to recall memories dominated by the content of their concerns. This study examined the proposition that rumination might impact the content of "self-defining" autobiographical memories among 60 college students with varying health anxiety (35% with clinical-level health anxiety). Participants were randomised to experiential/ruminative self-focus conditions, and then they completed the Self-Defining Memory Task. Responses were coded for valence and illness-relatedness. Results indicated that rumination led participants to retrieve more illness-related self-defining memories, while higher health anxiety scores were associated with more negative, but not more illness-focused memories. Ruminative thinking appears to activate health concerns, and may play a role in maintaining ongoing health anxiety.

  8. Diagnosis, Treatment and Management of Haemonchus contortus in Small Ruminants.

    PubMed

    Besier, R B; Kahn, L P; Sargison, N D; Van Wyk, J A

    2016-01-01

    Haemonchus contortus is a highly pathogenic, blood-feeding nematode of small ruminants, and a significant cause of mortalities worldwide. Haemonchosis is a particularly significant threat in tropical, subtropical and warm temperate regions, where warm and moist conditions favour the free-living stages, but periodic outbreaks occur more widely during periods of transient environmental favourability. The clinical diagnosis of haemonchosis is based mostly on the detection of anaemia in association with a characteristic epidemiological picture, and confirmed at postmortem by the finding of large numbers of H. contortus in the abomasum. The detection of impending haemonchosis relies chiefly on periodic monitoring for anaemia, including through the 'FAMACHA' conjunctival-colour index, or through faecal worm egg counts and other laboratory procedures. A range of anthelmintics for use against H. contortus is available, but in most endemic situations anthelmintic resistance significantly limits the available treatment options. Effective preventative programmes vary depending on environments and enterprise types, and according to the scale of the haemonchosis risk and the local epidemiology of infections, but should aim to prevent disease outbreaks while maintaining anthelmintic efficacy. Appropriate strategies include animal management programmes to avoid excessive H. contortus challenge, genetic and nutritional approaches to enhance resistance and resilience to infection, and the monitoring of H. contortus infection on an individual animal or flock basis. Specific strategies to manage anthelmintic resistance centre on the appropriate use of effective anthelmintics, and refugia-based treatment schedules. Alternative approaches, such as biological control, may also prove useful, and vaccination against H. contortus appears to have significant potential in control programmes.

  9. Diagnosis, Treatment and Management of Haemonchus contortus in Small Ruminants.

    PubMed

    Besier, R B; Kahn, L P; Sargison, N D; Van Wyk, J A

    2016-01-01

    Haemonchus contortus is a highly pathogenic, blood-feeding nematode of small ruminants, and a significant cause of mortalities worldwide. Haemonchosis is a particularly significant threat in tropical, subtropical and warm temperate regions, where warm and moist conditions favour the free-living stages, but periodic outbreaks occur more widely during periods of transient environmental favourability. The clinical diagnosis of haemonchosis is based mostly on the detection of anaemia in association with a characteristic epidemiological picture, and confirmed at postmortem by the finding of large numbers of H. contortus in the abomasum. The detection of impending haemonchosis relies chiefly on periodic monitoring for anaemia, including through the 'FAMACHA' conjunctival-colour index, or through faecal worm egg counts and other laboratory procedures. A range of anthelmintics for use against H. contortus is available, but in most endemic situations anthelmintic resistance significantly limits the available treatment options. Effective preventative programmes vary depending on environments and enterprise types, and according to the scale of the haemonchosis risk and the local epidemiology of infections, but should aim to prevent disease outbreaks while maintaining anthelmintic efficacy. Appropriate strategies include animal management programmes to avoid excessive H. contortus challenge, genetic and nutritional approaches to enhance resistance and resilience to infection, and the monitoring of H. contortus infection on an individual animal or flock basis. Specific strategies to manage anthelmintic resistance centre on the appropriate use of effective anthelmintics, and refugia-based treatment schedules. Alternative approaches, such as biological control, may also prove useful, and vaccination against H. contortus appears to have significant potential in control programmes. PMID:27238006

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

    PubMed

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

    2015-08-01

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

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

    PubMed

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

    2015-08-01

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

  12. Assisted reproductive technologies in the reproductive management of small ruminants.

    PubMed

    Amiridis, G S; Cseh, S

    2012-02-01

    In modern agriculture, assisted reproductive technologies are being used for out of season oestrus induction, enhancement of reproductive performance and genetic improvement. In addition, they can have substantial contribution in preservation of endangered species or breeds, as well as in eradication programs of various diseases. While their applications are widespread in cattle, in small ruminants it is almost restricted to artificial insemination. The main limitations of a wider application in small ruminants are the naturally occurring anoestrus period, the variability of response to superovulatory treatments, the fertilisation failure and the need of surgery for collection and transfer of gametes and embryos. Nonetheless, during the last 30 years, considerable progress has been made in sheep and goat embryo technologies, especially in the fields of oestrus synchronisation, superovulation and in vitro embryo production. This paper reviews the status of assisted reproductive technologies in sheep, analysing the prospects offered by recent advances in in vivo and in vitro embryo production from mature and juvenile lambs. PMID:22381207

  13. Environmental stress and the physiology, performance and health of ruminants.

    PubMed

    Webster, A J

    1983-12-01

    A satisfactory environment is one that satisfies the following four criteria: thermal comfort, physical comfort, disease control and behavioral satisfaction. Environmental stress, which may be direct or indirect, is anything that departs from these criteria. Analysis of environmental stress is best achieved by the statistical approach, obtaining correlations from large numbers of animals in natural environments with the experimental approach, and a proper analysis of these correlations into probable causative effects. The amount of scientific attention devoted to thermal stress in ruminants has been very large, yet its practical importance compared, e.g., with environmental stress and disease is relatively small. The most important environmental stresses today are those that have resulted from housing and other attempts to ameliorate the thermal environment. These include air pollution, physical injuries from building surfaces and the extremes of confinement. The contribution of environmental stresses to injury and to diseases such as mastitis and calf pneumonia are discussed and schemes are proposed for future experiments designed to analyze interactions between environment and disease. Examples are also given of approaches to the analysis of the stress of behavioral deprivation.

  14. Eating time modulations of physiology and health: life lessons from human and ruminant models.

    PubMed

    Nikkhah, Akbar

    2012-07-01

    Tissue nutrient supply may be synchronized with endogenous physiological rhythms to optimize animal and human health. Glucose tolerance and insulin sensitivity have endogenous rhythms that are not essentially dependent on food type and eating. Human glucose tolerance declines as day comes into night. Based on such evolutionary findings, large evening meals must be avoided to reduce risks of visceral adiposity, diabetes, hypertension and related cardiovascular complexities. Ruminants as extremely important food-producing livestock have evolved to ruminate mostly overnight when little grazing occurs, and when rumen reaches a larger volume and fermentation capacity. As such, eating time (e.g., evening vs. morning) will alter postprandial and diurnal patterns of food intake, rumen and peripheral metabolites production and supply, and milk and meat production efficiency. Most recent discoveries suggest that eating time modulates postprandial intake and metabolism patterns in non-grazing lactating cows. Eating rate and absolute intake can increase by evening vs. morning feeding in dairy cows. Evening feeding increased postprandial rumen volatile fatty acids (VFA) peak, and surges of blood insulin, lactate and beta-hydroxybutyrate, and induced a peripartal decline in blood glucose. As a result, milk fat and energy production were increased. While being unfavorable to human health, evening and night feeding have proved beneficial to ruminants. These findings establish a differential chronological basis for food intake and nutrient metabolism in man and food-producing animals. Eating time is a major external cue and a feasible life strategy that affects production and health physiology.

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

    PubMed

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

    2014-12-01

    The present study aimed to determine whether the improvement in postpartum energy balance frequently reported in cows under short dry period management could be due to an improvement in ruminal function related to the reduction in the number of diet changes before calving. Six multiparous and 6 primiparous Holstein cows equipped with ruminal cannula were assigned to 6 blocks of 2 cows each according to parity, projected milk production at 305 d, and expected calving date. Within each block, cows were randomly assigned to either a conventional (CDP; 63.2 ± 2.0 d) or a short dry period (SDP; 35.2 ± 2.0 d) management in a randomized complete block design. The CDP cows were fed a far-off diet until 28 d before calving, followed by a prepartum diet, whereas SDP cows received only the prepartum diet. After calving, both groups were fed the same lactation diet. Milk yield and dry matter intake (DMI) were recorded daily and milk composition, weekly. Blood samples were taken twice a week during the first 4 wk postcalving and weekly otherwise. Omasal and ruminal samples were collected approximately 3 wk prior and 3 wk after calving. From 28 d before calving until calving, when the 2 groups of cows were fed the same prepartum diet, there was no effect of the dry period length management on DMI, plasma concentrations of β-hydroxybutyrate, nonesterified fatty acids, and glucose and nutrient digestibility in the rumen. However, CDP cows tended to have lower ruminal pH and higher ruminal concentrations of total volatile fatty acids than SDP cows. From calving to 60 d in milk, daily DMI was higher for SDP than for CDP cows (22.3 ± 0.44 vs. 20.7 ± 0.30 kg), but milk production and milk concentrations and yields of fat, protein, and total solids were not affected by the dry period length management. After calving, body weight loss was reduced and body condition score tended to increase more rapidly for SDP than for CDP cows. Nutrient digestibility in the rumen, expressed in

  16. Microbial fuel cells and microbial ecology: applications in ruminant health and production research.

    PubMed

    Bretschger, Orianna; Osterstock, Jason B; Pinchak, William E; Ishii, Shun'ichi; Nelson, Karen E

    2010-04-01

    Microbial fuel cell (MFC) systems employ the catalytic activity of microbes to produce electricity from the oxidation of organic, and in some cases inorganic, substrates. MFC systems have been primarily explored for their use in bioremediation and bioenergy applications; however, these systems also offer a unique strategy for the cultivation of synergistic microbial communities. It has been hypothesized that the mechanism(s) of microbial electron transfer that enable electricity production in MFCs may be a cooperative strategy within mixed microbial consortia that is associated with, or is an alternative to, interspecies hydrogen (H(2)) transfer. Microbial fermentation processes and methanogenesis in ruminant animals are highly dependent on the consumption and production of H(2)in the rumen. Given the crucial role that H(2) plays in ruminant digestion, it is desirable to understand the microbial relationships that control H(2) partial pressures within the rumen; MFCs may serve as unique tools for studying this complex ecological system. Further, MFC systems offer a novel approach to studying biofilms that form under different redox conditions and may be applied to achieve a greater understanding of how microbial biofilms impact animal health. Here, we present a brief summary of the efforts made towards understanding rumen microbial ecology, microbial biofilms related to animal health, and how MFCs may be further applied in ruminant research.

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

    PubMed Central

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

    2009-01-01

    Microbial fuel cell (MFC) systems employ the catalytic activity of microbes to produce electricity from the oxidation of organic, and in some cases inorganic, substrates. MFC systems have been primarily explored for their use in bioremediation and bioenergy applications; however, these systems also offer a unique strategy for the cultivation of synergistic microbial communities. It has been hypothesized that the mechanism(s) of microbial electron transfer that enable electricity production in MFCs may be a cooperative strategy within mixed microbial consortia that is associated with, or is an alternative to, interspecies hydrogen (H2) transfer. Microbial fermentation processes and methanogenesis in ruminant animals are highly dependent on the consumption and production of H2in the rumen. Given the crucial role that H2 plays in ruminant digestion, it is desirable to understand the microbial relationships that control H2 partial pressures within the rumen; MFCs may serve as unique tools for studying this complex ecological system. Further, MFC systems offer a novel approach to studying biofilms that form under different redox conditions and may be applied to achieve a greater understanding of how microbial biofilms impact animal health. Here, we present a brief summary of the efforts made towards understanding rumen microbial ecology, microbial biofilms related to animal health, and how MFCs may be further applied in ruminant research. PMID:20024685

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

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

    PubMed

    Leathwick, D M; Besier, R B

    2014-07-30

    In many countries the presence of anthelmintic resistance in nematodes of small ruminants, and in some cases also in those infecting cattle and horses, has become the status quo rather than the exception. It is clear that consideration of anthelmintic resistance, and its management, should be an integral component of anthelmintic use regardless of country or host species. Many years of research into understanding the development and management of anthelmintic resistance in nematodes of small ruminants has resulted in an array of strategies for minimising selection for resistance and for dealing with it once it has developed. Importantly, many of these strategies are now supported by empirical science and some have been assessed and evaluated on commercial farms. In sheep the cost of resistance has been measured at about 10% of the value of the lamb at sale which means that losses due to undetected resistance far outweigh the cost of testing anthelmintic efficacy. Despite this many farmers still do not test for anthelmintic resistance on their farm. Many resistance management strategies have been developed and some of these have been tailored for specific environments and/or nematode species. However, in general, most strategies can be categorised as either; identify and mitigate high risk management practices, maintain an anthelmintic-susceptible population in refugia, choose the optimal anthelmintic (combinations and formulations), or prevent the introduction of resistant nematodes. Experiences with sheep farmers in both New Zealand and Australia indicate that acceptance and implementation of resistance management practices is relatively easy as long as the need to do so is clear and the recommended practices meet the farmer's criteria for practicality. A major difference between Australasia and many other countries is the availability and widespread acceptance of combination anthelmintics as a resistance management tool. The current situation in cattle and horses

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

    NASA Astrophysics Data System (ADS)

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

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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  3. Use of rumination and activity monitoring for the identification of dairy cows with health disorders: Part II. Mastitis.

    PubMed

    Stangaferro, M L; Wijma, R; Caixeta, L S; Al-Abri, M A; Giordano, J O

    2016-09-01

    The objectives of this study were to evaluate (1) the performance of an automated health-monitoring system (AHMS) to identify cows with mastitis based on an alert system (health index score, HIS) that combines rumination time and physical activity; (2) the number of days between the first HIS alert and clinical diagnosis (CD) of mastitis by farm personnel; and (3) the daily rumination time, physical activity, and HIS patterns around CD. Holstein cows (n=1,121; 451 nulliparous and 670 multiparous) were fitted with a neck-mounted electronic rumination and activity monitoring tag (HR Tags, SCR Dairy, Netanya, Israel.) from at least -21 to 80 d in milk (DIM). Raw data collected in 2-h periods were summarized per 24 h as daily rumination and activity. An HIS (0 to 100 arbitrary units) was calculated daily for individual cows with an algorithm that used rumination and activity. A positive HIS outcome was defined as an HIS of <86 units during at least 1 d from -5 to 2 d after CD. Blood concentrations of nonesterified fatty acids, β-hydroxybutyrate, total calcium, and haptoglobin were also determined in a subgroup of cows (n=459) at -11±3, -4±3, 0, 3±1, 7±1, 14±1, and 28±1 DIM. The sensitivity of the HIS was 58% [95% confidence interval (CI): 49, 67] for all cases of clinical mastitis (n=123), and 55% (95% CI: 46, 64; n=114) and 89% (95% CI: 68, 100; n=9) for cases of mastitis alone or concurrent with other health disorders, respectively. Among clinical cases, sensitivity was 80.7% (95% CI: 67, 97) for cases caused by Escherichia coli (n=31) and ranged from 45 to 48% for cases caused by gram-positive bacteria (n=39; Streptococcus agalactiae, Streptococcus dysgalactiae, Streptococcus uberis, Streptococcus spp., Staphylococcus spp., and Trueperella pyogenes), Staphylococcus aureus (n=11), or cases with no bacterial growth (n=25). Days between the first HIS <86 and CD were -0.6 (95% CI: -1.1, -0.2) for all cases of mastitis. Cows diagnosed with mastitis had alterations

  4. Health care marketing management.

    PubMed

    Cooper, P D

    1979-01-01

    Health Care Marketing Management is the process of understanding the needs and the wats of a target market. Its purpose is to provide a viewpoint from which to integrate the analysis, planning, implementation (or organization) and control of the health care delivery system.

  5. Ruminal Fermentation

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Ruminal fermentation is an exergonic process that converts feedstuffs into short chain volatile fatty acids (VFA), CO2, CH4, NH3, and heat. Some of the free energy is trapped as ATP and this energy is used to drive the growth of anaerobic ruminal microorganisms. The ruminant animals absorb VFA and...

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

    NASA Astrophysics Data System (ADS)

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

    2001-05-01

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

  7. Use of rumination and activity monitoring for the identification of dairy cows with health disorders: Part III. Metritis.

    PubMed

    Stangaferro, M L; Wijma, R; Caixeta, L S; Al-Abri, M A; Giordano, J O

    2016-09-01

    The objectives of this study were to evaluate (1) the performance of an automated health-monitoring system (AHMS) to identify cows with metritis based on an alert system (health index score, HIS) that combines rumination time and physical activity; (2) the number of days between the first HIS alert and clinical diagnosis (CD) of metritis by farm personnel; and (3) the daily rumination time, physical activity, and HIS patterns around CD. In this manuscript, the overall performance of HIS to detect cows with all disorders of interest in this study [ketosis, displaced abomasum, indigestion (companion paper, part I), mastitis (companion paper, part II), and metritis] is also reported. Holstein cattle (n=1,121; 451 nulliparous and 670 multiparous) were fitted with a neck-mounted electronic rumination and activity monitoring tag (HR Tags, SCR Dairy, Netanya, Israel) from at least -21 to 80 d in milk (DIM). Raw data collected in 2-h periods were summarized per 24 h as daily rumination and activity. An HIS (0 to 100 arbitrary units) was calculated daily for individual cows with an algorithm that used rumination and activity. A positive HIS outcome was defined as an HIS of <86 units during at least 1 d from -5 to 2 d after CD. Blood concentrations of nonesterified fatty acids, β-hydroxybutyrate, total calcium, and haptoglobin were determined in a subgroup of cows (n=459) at -11±3, -4±3, 0, 3±1, 7±1, 14±1, and 28±1 DIM. The overall sensitivity of HIS was 55% for all cases of metritis (n=349), but it was greater for cows with metritis and another disorder (78%) than for cows with metritis only (53%). Cows diagnosed with metritis and flagged based on HIS had substantial alterations in their rumination, activity, and HIS patterns around CD, alterations of blood markers of metabolic and health status around calving, reduced milk production, and were more likely to exit the herd than cows not flagged based on the HIS and cows without disease, suggesting that cows flagged

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

    PubMed

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

    2016-04-28

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

  9. Growth, ruminal measurements, and health characteristics of Holstein bull calves fed an Aspergillus oryzae fermentation extract.

    PubMed

    Yohe, T T; O'Diam, K M; Daniels, K M

    2015-09-01

    calves were treated for respiratory ailments and respiratory treatment cost was lower for AMF compared with control. Several factors may have contributed to an overall lack of observed treatment effect in this study, including include the use of a low-forage (compared with concentrate) diet, immunocompetent calves, and the selected product dose and routes of delivery. Dietary inclusion (2 g/d) of an extract of A. oryzae did not affect calf growth, intake, and ruminal or health measurements. PMID:26142841

  10. Intelligent Vehicle Health Management

    NASA Technical Reports Server (NTRS)

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

    2005-01-01

    As a part of the overall goal of developing Integrated Vehicle Health Management systems for aerospace vehicles, the NASA Faculty Fellowship Program (NFFP) at Marshall Space Flight Center has performed a pilot study on IVHM principals which integrates researched IVHM technologies in support of Integrated Intelligent Vehicle Management (IIVM). IVHM is the process of assessing, preserving, and restoring system functionality across flight and ground systems (NASA NGLT 2004). The framework presented in this paper integrates advanced computational techniques with sensor and communication technologies for spacecraft that can generate responses through detection, diagnosis, reasoning, and adapt to system faults in support of INM. These real-time responses allow the IIVM to modify the affected vehicle subsystem(s) prior to a catastrophic event. Furthermore, the objective of this pilot program is to develop and integrate technologies which can provide a continuous, intelligent, and adaptive health state of a vehicle and use this information to improve safety and reduce costs of operations. Recent investments in avionics, health management, and controls have been directed towards IIVM. As this concept has matured, it has become clear the INM requires the same sensors and processing capabilities as the real-time avionics functions to support diagnosis of subsystem problems. New sensors have been proposed, in addition, to augment the avionics sensors to support better system monitoring and diagnostics. As the designs have been considered, a synergy has been realized where the real-time avionics can utilize sensors proposed for diagnostics and prognostics to make better real-time decisions in response to detected failures. IIVM provides for a single system allowing modularity of functions and hardware across the vehicle. The framework that supports IIVM consists of 11 major on-board functions necessary to fully manage a space vehicle maintaining crew safety and mission

  11. Use of rumination and activity monitoring for the identification of dairy cows with health disorders: Part I. Metabolic and digestive disorders.

    PubMed

    Stangaferro, M L; Wijma, R; Caixeta, L S; Al-Abri, M A; Giordano, J O

    2016-09-01

    The objectives of this study were to evaluate (1) the performance of an automated health-monitoring system (AHMS) to identify cows with metabolic and digestive disorders-including displaced abomasum, ketosis, and indigestion-based on an alert system (health index score, HIS) that combines rumination time and physical activity; (2) the number of days between the first HIS alert and clinical diagnosis (CD) of the disorders by farm personnel; and (3) the daily rumination time, physical activity, and HIS patterns around CD. Holstein cattle (n=1,121; 451 nulliparous and 670 multiparous) were fitted with a neck-mounted electronic rumination and activity monitoring tag (HR Tags, SCR Dairy, Netanya, Israel) from at least -21 to 80 d in milk (DIM). Raw data collected in 2-h periods were summarized per 24 h as daily rumination and activity. A HIS (0 to 100 arbitrary units) was calculated daily for individual cows with an algorithm that used rumination and activity. A positive HIS outcome was defined as a HIS of <86 during at least 1 d from -5 to 2 d after CD. Blood concentrations of nonesterified fatty acids, β-hydroxybutyrate, total calcium, and haptoglobin were determined in a subgroup of cows (n=459) at -11±3, -4±3, 0, 3±1, 7±1, 14±1, and 28±1 DIM. The sensitivity of the HIS was 98% [95% confidence interval (CI): 93, 100] for displaced abomasum (n=41); 91% (95% CI: 83, 99) for ketosis (n=54); 89% (95% CI: 68, 100) for indigestion (n=9); and 93% (95% CI: 89, 98) for all metabolic and digestive disorders combined (n=104). Days (mean and 95% CI) from the first positive HIS <86 and CD were -3 (-3.7, -2.3), -1.6 (-2.3, -1.0), -0.5 (-1.5, 0.5), and -2.1 (-2.5, -1.6) for displaced abomasum, ketosis, indigestion, and all metabolic and digestive disorders, respectively. The patterns of rumination, activity, and HIS for cows flagged by the AHMS were characterized by lower levels than for cows without a health disorder and cows not flagged by the AHMS from -5 to 5 d after CD

  12. Subtotal Gastrectomy as “Last Resort” Consideration in the Management of Refractory Rumination Syndrome

    PubMed Central

    Cooper, Chad J.; Otoukesh, Salman; Mojtahedzadeh, Mona; Galvis, Juan M.; McCallum, Richard W.

    2014-01-01

    Rumination syndrome is a behavioral disorder resulting in effortless regurgitation of undigested food within minutes of meal intake that is subsequently either re-swallowed or ejected. It is commonly misdiagnosed, patients often undergo extensive testing and multiple therapies, many of which are directed at suspected gastroparesis. A 25-year-old Caucasian female initially presented to our care 1 year ago with a 4-year history of nausea and vomiting occurring in the immediate postprandial period, specifically within 15 minutes from oral intake. She had an extensive history of multiple diagnostic, therapeutic and surgical procedures over the previous 4 years which included cholecystectomy, botulin toxin injection into the pyloric sphincter, pyloroplasty, placement of a gastric stimulator and jejunal feeding tube with no sustained results. On a previous admission we determined the functional status of the stomach by obtaining full thickness gastric biopsies during a diagnostic laparoscopy. This revealed an adequate population number of cells of Cajal and myenteric neurons as well as normal stomach muscle. After 1 year of attempting “breathing relaxation techniques”, while being nutritionally maintained by nocturnal jejunostomy feedings, the patient presented again to our care with refractory nausea and vomiting and unable to work or function. Her weight was 90 lbs. She underwent a subtotal gastrectomy (80%) with Roux-en-Y reconstruction and continuation of jejunostomy feeding. The refractory nausea and vomiting significantly improved over the 4 weeks after discharge and breathing exercises were continued. On subsequent follow-up visits over a 6-month course, the refractory nausea and vomiting had resolved by more than 85% with and improvement in her BMI and quality of life.The recommended treatment of rumination syndrome is focused on breathing exercises and relaxation techniques to “distract” while eating. We believe our case is the first reported where a

  13. The autonomic phenotype of rumination.

    PubMed

    Ottaviani, Cristina; Shapiro, David; Davydov, Dmitry M; Goldstein, Iris B; Mills, Paul J

    2009-06-01

    Recent studies suggest that ruminative thoughts may be mediators of the prolonged physiological effects of stress. We hypothesized that autonomic dysregulation plays a role in the relation between rumination and health. Rumination was induced by an anger-recall task in 45 healthy subjects. Heart rate variability (HRV), baroreflex sensitivity (BRS), and baroreflex effectiveness index (BEI) change scores were evaluated to obtain the autonomic phenotype of rumination. Personality traits and endothelial activation were examined for their relation to autonomic responses during rumination. Degree of endothelial activation was assessed by circulating soluble intercellular adhesion molecule-1 (sICAM-1). Vagal withdrawal during rumination was greater for women than men. Larger decreases in the high frequency component of HRV were associated with higher levels of anger-in, depression, and sICAM-1 levels. BRS reactivity was negatively related to trait anxiety. BEI reactivity was positively related to anger-in, hostility, anxiety, and depression. Lower BEI and BRS recovery were associated with lower social desirability and higher anger-out, anxiety, and depression. Findings suggest that the autonomic dysregulation that characterizes rumination plays a role in the relationships between personality and cardiovascular health. PMID:19272312

  14. Listeria monocytogenes infection in ruminants: Is there a link to the environment, food and human health? A review.

    PubMed

    Walland, J; Lauper, J; Frey, J; Imhof, R; Stephan, R; Seuberlich, T; Oevermann, A

    2015-06-01

    Listeria (L.) monocytogenes is widely distributed in the environment, but also has the ability to cause serious invasive disease in ruminants and humans. This review provides an overview of listeriosis in ruminants and discusses our insufficient understanding of reservoirs and possible cycling ofL. monocytogenes between animal and human hosts, food and the environment. It indicates gaps in our knowledge of the role of genetic subtypes in L. monocytogenes ecology and virulence as well as risk factors, in vivo diagnostics and pathogenesis of listeriosis in ruminants. Filling these gaps will contribute to improving the control of L. monocytogenes and enhancing disease prevention. As the prevalence of listeriosis in ruminants in Switzerland is likely to be underestimated, propositions concerning improvement options for surveillance of listeriosis in ruminants are provided.

  15. Health policy and case management.

    PubMed

    Mark, D D

    2000-01-01

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

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

    PubMed

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

    2016-05-01

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

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

    PubMed

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

    2016-05-01

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

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

    PubMed Central

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

    2016-01-01

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

  19. Disaster Management: Mental Health Perspective

    PubMed Central

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

    2015-01-01

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

  20. Effect of soil type and fertilization level on mineral concentration of pasture: potential relationships to ruminant performance and health.

    PubMed

    Soder, K J; Stout, W L

    2003-06-01

    A three-year study was conducted to measure the effects of varying levels of dairy slurry application on mineral concentration of forages from three soils types. Slurry was applied to orchardgrass (Dactylis glomerata [L.] cv. Pennlate) growing in 60-cm diameter drainage lysimeters to measure the effect of four levels of slurry (urine and feces) N application (0, 168, 336, and 672 kg of N.ha-1.yr-1) on mineral (P, K, Ca, Mg) concentration of the forage on three soil types (Hagerstown, Hartleton, and Rayne). The results were then related to potential effects on performance and health of grazing ruminants. Forage P was not affected by slurry application (mean = 0.46% of DM). Forage grown on the Hartleton soil had the highest (P < 0.05) P concentration (0.6% of DM). Forage K increased (P < 0.05) with increased slurry (2.50, 2.85, 3.22, and 3.45% of DM, respectively), and was lowest (P < 0.05) for forage grown on the Rayne soil (2.69% of DM). Forage Ca decreased (P < 0.05) with increased slurry (0.59, 0.56, 0.50, and 0.49% of DM, respectively) and was not affected by soil type. Forage Mg also decreased (P < 0.05) with increased slurry (0.25, 0.24, 0.24, and 0.23% of DM, respectively), and was highest (P < 0.05) for the Hartleton soil (0.27% of DM). The variable results in mineral concentration associated with soil type may have, in part, been due to prior soil fertility. The P and Mg concentrations in all treatments were generally adequate for grazing ruminants. The K concentrations were high in relation to NRC recommendations for prepartum dairy cows, which might predispose them to milk fever. The Ca concentrations were inadequate for lactating dairy cows. Comprehensive forage testing and diet formulation based on individual farm situations is the best strategy to ensure proper mineral nutrition of grazing animals.

  1. Intelligent Integrated System Health Management

    NASA Technical Reports Server (NTRS)

    Figueroa, Fernando

    2012-01-01

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

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

    ERIC Educational Resources Information Center

    Gravina, Nicole E.; Siers, Brian P.

    2011-01-01

    Models of comprehensive Performance Management systems include both employee development and evaluative components. The Organizational Behavior Management discipline focuses almost exclusively on the developmental component, while the Industrial and Organizational Psychology discipline is focused on use of performance appraisals. Performance…

  3. Gamification and geospatial health management

    NASA Astrophysics Data System (ADS)

    Wortley, David

    2014-06-01

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

  4. Reengineering health care materials management.

    PubMed

    Connor, L R

    1998-01-01

    Health care executives across the country, faced with intense competition, are being forced to consider drastic cost cutting measures as a matter of survival. The entire health care industry is under siege from boards of directors, management and others who encourage health care systems to take actions ranging from strategic acquisitions and mergers to simple "downsizing" or "rightsizing," to improve their perceived competitive positions in terms of costs, revenues and market share. In some cases, management is poorly prepared to work within this new competitive paradigm and turns to consultants who promise that following their methodologies can result in competitive advantage. One favored methodology is reengineering. Frequently, cost cutting attention is focused on the materials management budget because it is relatively large and is viewed as being comprised mostly of controllable expenses. Also, materials management is seldom considered a core competency for the health care system and the organization performing these activities does not occupy a strongly defensible position. This paper focuses on the application of a reengineering methodology to healthcare materials management. PMID:9785300

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

    PubMed

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

    2014-09-01

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

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

    PubMed

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

    2014-09-01

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

  7. Managing to enhance soil health

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Healthy soils are critical for meeting current and future societal demands. Management strategies that protect the soil against erosion, build soil organic matter and promote nutrient cycling are ways to enhance soil health. Keeping soils covered and judicious use of agrochemicals are akin to us “hu...

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

    NASA Technical Reports Server (NTRS)

    Garbos, Raymond J.; Mouyos, William

    1998-01-01

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

  9. Peste des petits ruminants.

    PubMed

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

    2015-12-14

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

  10. Peste des petits ruminants.

    PubMed

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

    2015-12-14

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

  11. Peste des petits ruminants

    PubMed Central

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

    2015-01-01

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

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

    ERIC Educational Resources Information Center

    McManus, Marilyn C., Ed.

    1996-01-01

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

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

    NASA Technical Reports Server (NTRS)

    Mouyos, William; Wangu, Srimal

    1998-01-01

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

  14. 9 CFR 93.422 - Import permit and declaration for ruminants.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

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

  15. 9 CFR 93.422 - Import permit and declaration for ruminants.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  16. 9 CFR 93.424 - Import permits and applications for inspection of ruminants.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  17. 9 CFR 93.417 - Import permit and declaration for ruminants.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

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

  18. 9 CFR 93.417 - Import permit and declaration for ruminants.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

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

  19. 9 CFR 93.417 - Import permit and declaration for ruminants.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

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

  20. 9 CFR 93.424 - Import permits and applications for inspection of ruminants.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

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

  1. 9 CFR 93.417 - Import permit and declaration for ruminants.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

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

  2. 9 CFR 93.424 - Import permits and applications for inspection of ruminants.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

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

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

    Code of Federal Regulations, 2011 CFR

    2011-01-01

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

  4. 9 CFR 93.422 - Import permit and declaration for ruminants.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

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

  5. 9 CFR 93.424 - Import permits and applications for inspection of ruminants.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

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

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

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  7. 9 CFR 93.424 - Import permits and applications for inspection of ruminants.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

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

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

    Code of Federal Regulations, 2012 CFR

    2012-01-01

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

  9. Recent developments in the management of anthelmintic resistance in small ruminants - an Australasian perspective.

    PubMed

    Sutherland, I A

    2015-07-01

    There have been a number of significant advances in recent years to the theory and practice of managing anthelmintic resistance in sheep in Australasia. The general principles of resistance management are, firstly identification and mitigation of high-risk practices, secondly using effective anthelmintics, and thirdly maintaining a refuge of unselected parasites. The first of these principles has been updated recently with the findings from a series of farm-based trials in New Zealand, in which the economic benefits of both short- and long-acting anthelmintic treatments in ewes pre-lambing were found to be inconsistent and not always positive. There have also been significant changes to the second principle, particularly given the introduction of new active families onto the market. Evidence continues to favour the use of combination products to maximise efficacy and delay the onset of treatment-failure. Many farmers have readily accepted the effectiveness of maintaining a refuge of unselected parasites; the challenge for researchers and advisers is now to improve adoption of properly designed and implemented resistance management programmes. A recently completed education programme in New Zealand has demonstrated that when this is achieved, then anthelmintic resistance can be controlled, and in many cases reduced in severity.

  10. Vehicle health management technology needs

    NASA Technical Reports Server (NTRS)

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

    1992-01-01

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

  11. SSME Advanced Health Management: Project Overview

    NASA Technical Reports Server (NTRS)

    Plowden, John

    2000-01-01

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

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

    PubMed

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

    2010-07-01

    end of the scale, overweight males can show reduced sexual success because they have difficulty courting and mounting. For this reason, exercise can enhance the fertilising capacity of rams. This will be important in extensive mating systems where males need to assemble and guard a harem and then mate many times for several weeks. For artificial insemination centres, there seems to be very few data on the nutritional management of males, but problems with overfed animals appear to be a risk. Future research should concentrate on the intra-testicular systems mediating the effects of nutrition on the production of spermatozoa.

  13. Beware the Managed Health-Care Companies.

    ERIC Educational Resources Information Center

    Ashbaugh, John; Smith, Gary

    1996-01-01

    This article discusses implications of the movement toward managed health care models for long-term health care services for people with disabilities, especially people with developmental disabilities. It notes possible advantages of managed care but raises issues concerning consumer choice, management and financial capacity of managed care…

  14. 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

  15. Strategic management of health care information systems: nurse managers' perceptions.

    PubMed

    Lammintakanen, Johanna; Kivinen, Tuula; Saranto, Kaija; Kinnunen, Juha

    2009-01-01

    The aim of this study is to describe nurse managers' perceptions of the strategic management of information systems in health care. Lack of strategic thinking is a typical feature in health care and this may also concern information systems. The data for this study was collected by eight focus group interviews including altogether 48 nurse managers from primary and specialised health care. Five main categories described the strategic management of information systems in health care; IT as an emphasis of strategy; lack of strategic management of information systems; the importance of management; problems in privacy protection; and costs of IT. Although IT was emphasised in the strategies of many health care organisations, a typical feature was a lack of strategic management of information systems. This was seen both as an underutilisation of IT opportunities in health care organisations and as increased workload from nurse managers' perspective. Furthermore, the nurse managers reported that implementation of IT strengthened their managerial roles but also required stronger management. In conclusion, strategic management of information systems needs to be strengthened in health care and nurse managers should be more involved in this process.

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

    PubMed

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

    2015-12-01

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

  17. Future preparation of occupational health nurse managers.

    PubMed

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

    1991-03-01

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

  18. Blogging and the health care manager.

    PubMed

    Malvey, Donna; Alderman, Barbara; Todd, Andrew D

    2009-01-01

    The use of blogs in the workplace has emerged as a communication tool that can rapidly and simultaneously connect managers with their employees, customers, their peers, and other key stakeholders. Nowhere is this connection more critical than in health care, especially because of the uncertainty surrounding health care reform and the need for managers to have access to timely and authentic information. However, most health care managers have been slow to join the blogging bandwagon. This article examines the phenomenon of blogging and offers a list of blogs that every health care manager should read and why. This article also presents a simplified step-by-step process to set up a blog.

  19. Rumination disorder

    MedlinePlus

    ... Katzman DK, Kearney SA, Becker AE. Feeding and eating disorders. In: Feldman M, Friedman LS, Brandt LJ, eds. ... A.M. Editorial team. Related MedlinePlus Health Topics Eating Disorders Browse the Encyclopedia A.D.A.M., Inc. ...

  20. Team management in community mental health.

    PubMed

    McGuinness, M

    2000-02-01

    The community mental health team is now the established model for mental health service delivery in the community. Managing CMHTs requires a diverse range of managerial skills, role clarity and authority. More research needs to be undertaken on the role and effectiveness of the CMHT manager.

  1. From industrial safety to corporate health management.

    PubMed

    Zink, K J

    2005-04-15

    Occupational health and safety is one of the most important topics of ergonomics. In many countries the practical issues are addressed in worker protection laws or rules and most companies have some sort of occupational health and safety system. As with many other ergonomics approaches, such activities are often necessary because of legal requirements. Such efforts are often viewed by management as primarily cost intensive. To change this image, it would be helpful to have a more positive, management-oriented approach. Corporate health management as a module of an integrated management system can fulfil this goal.

  2. The inverse of managed health.

    PubMed

    Borremans, V

    1978-01-01

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

  3. [Health care reform and management models].

    PubMed

    González García, G

    2001-06-01

    This article tries to indicate the direction of progress in management being taken in health sector reforms in Latin America. The piece first discusses the tension between local forces and international neoliberal trends being manifested in the reform in various countries. The article next looks at the distinction between the tools and the management models that are being applied, presenting a taxonomy of three management levels: macromanagement (national health systems), midlevel management (hospitals, insurers, and other such institutions) and micromanagement (clinics). The piece concludes by reflecting on the future of management in the health sector in Latin America, where health systems are overadministered and undermanaged. Their future depends on multiple factors, most of which are outside the health care field itself. Better management of policies, institutions, and patients would be a tremendous tool in directing the future. Management is here to stay, with greater emphasis on either supply--hospitals and physicians--or demand--citizens or clients. For both the public and private sectors, health management is central to health sector reforms in Latin America.

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

    PubMed

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

    2015-02-01

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

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

    PubMed

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

    2015-02-01

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

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

    NASA Astrophysics Data System (ADS)

    Zervas, G.; Tsiplakou, E.

    2012-03-01

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

  7. Ruminant nitrogen usage

    SciTech Connect

    Not Available

    1985-01-01

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

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

    PubMed

    2011-01-01

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

  9. [Evaluation model for municipal health planning management].

    PubMed

    Berretta, Isabel Quint; Lacerda, Josimari Telino de; Calvo, Maria Cristina Marino

    2011-11-01

    This article presents an evaluation model for municipal health planning management. The basis was a methodological study using the health planning theoretical framework to construct the evaluation matrix, in addition to an understanding of the organization and functioning designed by the Planning System of the Unified National Health System (PlanejaSUS) and definition of responsibilities for the municipal level under the Health Management Pact. The indicators and measures were validated using the consensus technique with specialists in planning and evaluation. The applicability was tested in 271 municipalities (counties) in the State of Santa Catarina, Brazil, based on population size. The proposed model features two evaluative dimensions which reflect the municipal health administrator's commitment to planning: the guarantee of resources and the internal and external relations needed for developing the activities. The data were analyzed using indicators, sub-dimensions, and dimensions. The study concludes that the model is feasible and appropriate for evaluating municipal performance in health planning management.

  10. 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.

  11. eHealth Terminology Management in Austria.

    PubMed

    Seerainer, Carina; Sabutsch, Stefan W

    2016-01-01

    When it comes to establishing and operating a nationwide personal health record (PHR), effective and efficient terminology management including the development, administration, maintenance and publishing of terminologies is a precondition for semantic interoperability. In the Austrian national patient health record "ELGA" all relevant terminologies are provided and distributed by means of a CTS2-conformant terminology server. In the following article, issues and lessons learned from terminology management in a large-scale eHealth project are presented. Experience has proved the necessity of a national authority for medical terminology management in Austria. PMID:27577418

  12. Concept Development for Software Health Management

    NASA Technical Reports Server (NTRS)

    Riecks, Jung; Storm, Walter; Hollingsworth, Mark

    2011-01-01

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

  13. Future developments in health care performance management

    PubMed Central

    Crema, Maria; Verbano, Chiara

    2013-01-01

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

  14. 9 CFR 93.407 - Declaration and other documents for ruminants.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

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

  15. 9 CFR 93.407 - Declaration and other documents for ruminants.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  16. 9 CFR 93.403 - Ports designated for the importation of ruminants.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

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

  17. 9 CFR 94.3 - Organs, glands, extracts, or secretions of ruminants or swine.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  18. 9 CFR 94.3 - Organs, glands, extracts, or secretions of ruminants or swine.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

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

  19. 9 CFR 94.3 - Organs, glands, extracts, or secretions of ruminants or swine.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

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

  20. 9 CFR 93.403 - Ports designated for the importation of ruminants.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  1. 9 CFR 94.3 - Organs, glands, extracts, or secretions of ruminants or swine.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

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

  2. 9 CFR 93.407 - Declaration and other documents for ruminants.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

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

  3. 9 CFR 93.403 - Ports designated for the importation of ruminants.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

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

  4. 9 CFR 93.403 - Ports designated for the importation of ruminants.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

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

  5. 9 CFR 93.407 - Declaration and other documents for ruminants.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

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

  6. 9 CFR 93.407 - Declaration and other documents for ruminants.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

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

  7. 9 CFR 93.403 - Ports designated for the importation of ruminants.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

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

  8. 9 CFR 94.3 - Organs, glands, extracts, or secretions of ruminants or swine.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... secretions of ruminants or swine. 94.3 Section 94.3 Animals and Animal Products ANIMAL AND PLANT HEALTH...: PROHIBITED AND RESTRICTED IMPORTATIONS § 94.3 Organs, glands, extracts, or secretions of ruminants or swine... ruminants or swine, originating in any region where rinderpest or foot-and-mouth disease exists,...

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

    PubMed

    Leggat, Sandra G

    2009-01-01

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

  10. Fundamental mechanisms of managed behavioral health care.

    PubMed

    Mihalik, G; Scherer, M

    1998-01-01

    Making sense of managed behavioral health care organizations (MBHOs) is difficult as they rapidly evolve in response to payer, member, legislative, and market demands. This article describes the basic mechanisms involved in managed behavioral health care's evolution, including the nature of carve-out organizations, carved-in services, the array of payment mechanisms between payer and MBHO, and between MBHO and mental health care providers. Additionally, types of delivery systems and mechanisms used to control utilization are outlined in the context of continuing health care change.

  11. Is Work-Related Rumination Associated with Deficits in Executive Functioning?

    PubMed Central

    Cropley, Mark; Zijlstra, Fred R. H.; Querstret, Dawn; Beck, Sarah

    2016-01-01

    Work-related rumination, that is, perseverative thinking about work during leisure time, has been associated with a range of negative health and wellbeing issues. The present paper examined the association between work-related rumination and cognitive processes centerd around the theoretical construct of executive functioning. Executive functioning is an umbrella term for high level cognitive processes such as planning, working memory, inhibition, mental flexibility; and it underlies how people manage and regulate their goal directed behavior. Three studies are reported. Study I, reports the results of a cross-sectional study of 240 employees, and demonstrates significant correlations between work-related rumination and three proxy measures of executive functioning: cognitive failures (0.33), cognitive flexibility (-0.24), and situational awareness at work (-0.28). Study II (n = 939), expands on the findings from study 1 and demonstrates that workers reporting medium and high work-related rumination were 2.8 and 5 times, respectively, more likely to report cognitive failures relative to low ruminators. High ruminators also demonstrated greater difficulties with ‘lapses of attention’ (OR = 4.8), ‘lack of focus of attention’ (OR = 3.4), and ‘absent mindedness’ (OR = 4.3). The final study, examined the association between work-related rumination and executive functioning using interview data from 2460 full time workers. Workers were divided into tertiles low, medium, and high. The findings showed that high work-related rumination was associated with deficits in starting (OR = 2.3) and finishing projects (OR = 2.4), fidgeting (OR = 1.9), memory (OR = 2.2), pursuing tasks in order (OR = 1.8), and feeling compelled to do things (OR = 2.0). It was argued that work-related rumination may not be related to work demands per se, but appears to be an executive functioning/control issue. Such findings are important for the design and delivery of intervention

  12. Rotorcraft Health Management Issues and Challenges

    NASA Technical Reports Server (NTRS)

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

    2006-01-01

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

  13. Do employee health management programs work?

    PubMed

    Serxner, Seth; Gold, Daniel; Meraz, Angela; Gray, Ann

    2009-01-01

    Current peer review literature clearly documents the economic return and Return-on-Investment (ROI) for employee health management (EHM) programs. These EHM programs are defined as: health promotion, self-care, disease management, and case management programs. The evaluation literature for the sub-set of health promotion and disease management programs is examined in this article for specific evidence of the level of economic return in medical benefit cost reduction or avoidance. The article identifies the methodological challenges associated with determination of economic return for EHM programs and summarizes the findings from 23 articles that included 120 peer review study results. The article identifies the average ROI and percent health plan cost impact to be expected for both types of EHM programs, the expected time period for its occurrence, and caveats related to its measurement.

  14. Development and Testing of Propulsion Health Management

    NASA Technical Reports Server (NTRS)

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

    2012-01-01

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

  15. Applying business management models in health care.

    PubMed

    Trisolini, Michael G

    2002-01-01

    Most health care management training programmes and textbooks focus on only one or two models or conceptual frameworks, but the increasing complexity of health care organizations and their environments worldwide means that a broader perspective is needed. This paper reviews five management models developed for business organizations and analyses issues related to their application in health care. Three older, more 'traditional' models are first presented. These include the functional areas model, the tasks model and the roles model. Each is shown to provide a valuable perspective, but to have limitations if used in isolation. Two newer, more 'innovative' models are next discussed. These include total quality management (TQM) and reengineering. They have shown potential for enabling dramatic improvements in quality and cost, but have also been found to be more difficult to implement. A series of 'lessons learned' are presented to illustrate key success factors for applying them in health care organizations. In sum, each of the five models is shown to provide a useful perspective for health care management. Health care managers should gain experience and training with a broader set of business management models. PMID:12476639

  16. Integrated System Health Management Development Toolkit

    NASA Technical Reports Server (NTRS)

    Figueroa, Jorge; Smith, Harvey; Morris, Jon

    2009-01-01

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

  17. Financial management in leading health care systems.

    PubMed

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

    2000-01-01

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

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

    PubMed

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

    2003-11-01

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

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

    PubMed

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

    2003-11-01

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

  20. Research collaboration in health management research communities

    PubMed Central

    2013-01-01

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

  1. [Demographic changes and health management].

    PubMed

    Calero, Juan del Rey

    2006-01-01

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

  2. Job redesign and the health care manager.

    PubMed

    Layman, Elizabeth J

    2007-01-01

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

  3. Improving diabetes management with mobile health technology.

    PubMed

    Sieverdes, John C; Treiber, Frank; Jenkins, Carolyn

    2013-04-01

    Diabetes affects 25.8 million persons in the United States, and these persons make more than 35 million ambulatory care visits annually. Yet, less than half of persons with diabetes meet the recommended levels of A1C, blood pressure and lipid control. One innovative approach is to use mobile health technologies to help patients better manage their diabetes and related conditions, and 85% to 90% of patients have access to mobile health technology. A brief review of the guidelines for diabetes care and mobile health technology that can support the guidelines are reported related to (1) glycemic control and self-monitoring of blood glucose, (2) pharmacological approaches and medication management, (3) medical nutrition therapy, (4) physical activity and resistance training, (5) weight loss, (6) diabetes self-management education and (7) blood pressure control and hypertension. The patient and provider are encouraged to explore possibilities for mobile health technologies that can support behavior change.

  4. Quality management in Irish health care.

    PubMed

    Ennis, K; Harrington, D

    1999-01-01

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

  5. Grazing management and ecosystem health

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  6. [Sexual health management in oncology].

    PubMed

    Habold, Daniel; Bondil, Pierre

    2014-10-01

    The cancer and its treatments have consequences on the intimacy and the sexuality of the patients and their partners. Supporting them with valid information, by spotting risk factors, warning complications, and by bringing answers to the often commonplace concerns of the patients, is an ethical duty. This intervention concerning the sexual health is collectively realized by all the healthcare professionals, in an organization of gradual answer, and benefits ideally from the clinical and educational expertise of sex therapists associated to the supporting care offer.

  7. Applying e-health to case management.

    PubMed

    Adams, J M

    2000-01-01

    The healthcare industry is only beginning to understand e-health. E-health can be defined as the use of technology to directly improve healthcare delivery-affording patients the opportunity to participate in their own healthcare management, provider, and institution. The market is changing rapidly, and innovations, partnerships, and mergers are taking place daily. For healthcare institutions, setting a long-term, yet adaptable e-health strategy is of vital importance for the continued success of the organization. For clinicians, an understanding of and familiarity with technologies can significantly improve workflow, organization, and patient interaction. For the patient, technology can be leveraged as a means to take initiative and responsibility for his/her own health. This article defines e-health and explains the implications and benefits of e-health to nurses and their patients. The article also identifies unique opportunities e-health/e-commerce can provide case managers in promoting patient connectivity, care management, and economy in cost of care. PMID:16397993

  8. [Health services waste management: a biosafety issue].

    PubMed

    Garcia, Leila Posenato; Zanetti-Ramos, Betina Giehl

    2004-01-01

    The subject of "health services waste" is controversial and widely discussed. Biosafety, the principles of which include safeguarding occupational health, community health, and environmental safety, is directly involved in the issue of medical waste management. There are controversies as to the risks posed by medical waste, as evidenced by diverging opinions among authors: some advocate severe approaches on the basis that medical waste is hazardous, while others contend that the potential for infection from medical waste is nonexistent. The Brazilian National Health Surveillance Agency (ANVISA) has published resolution RDC 33/2003 to standardize medical waste management nationwide. There is an evident need to implement biosafety procedures in this area, including heath care workers' training and provision of information to the general population.

  9. Management of behavioral health provider networks in private health plans.

    PubMed

    Garnick, Deborah W; Horgan, Constance M; Reif, Sharon; Merrick, Elizabeth L; Hodgkin, Dominic

    2008-01-01

    We explored the techniques used by private health plans or by their contracted managed behavioral healthcare organizations (MBHOs) to maintain networks of behavioral health providers. In particular, we focused on differences by health plans' product types (health maintenance organization, point-of-service plan, or preferred provider organization) and contracting arrangements (MBHO contracts, comprehensive contracts, or no contracts). More than 94% of products selected providers using credentialing standards, particular specialists, or geographic coverage. To retain providers viewed as high quality, 54% offer reduced administrative burden and 44% higher fees. Only 16% reported steerage to a core group of highest-quality providers and few reported an annual bonus or guaranteed volume of referrals. Some standard activities are common, but some health plans are adopting other approaches to retain higher-quality providers.

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

    PubMed Central

    Lemieux-Charles, L

    1994-01-01

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

  11. Managing diversity in the health care workplace.

    PubMed

    Davidhizar, R; Dowd, S; Newman Giger, J

    1999-03-01

    Cultural diversity is increasing in the United States as increasing numbers of minorities enter the United States from abroad, and cultural diversity is especially prevalent in the health care workplace. In fact, the health care professions are particularly interested in the presence of minorities among caregivers because this often enhances the cultural competence of care delivery. Nevertheless, subtle discrimination can still be found, and managers must be alert that such behavior is not tolerated. Use of the Giger-Davidhizar Cultural Assessment Model can provide managers with information needed to respond to diversity among staff appropriately.

  12. Strategic service quality management for health care.

    PubMed

    Anderson, E A; Zwelling, L A

    1996-01-01

    Quality management has become one of the most important and most debated topics within the service sector. This is especially true for health care, as the controversy rages on how the existing American system should be restructured. Health care reform aimed at reducing costs and ensuring access to all Americans cannot be allowed to jeopardize the quality of care. As such, total quality management (TQM) has become a vital ingredient to strategic planning within the health care domain. At the heart of any such quality improvement effort is the issue of measurement. TQM cannot be effectively utilized as a competitive weapon unless quality can be accurately defined, measured, evaluated, and monitored over time. Through such analysis a hospital can elect how to expend its limited resources toward those quality improvement projects which will impact customer perceptions of service quality the most. Thus, the purpose of this report is to establish a framework by which to approach the issue of quality measurement, delineate the various components of quality that exist in health care, and explore how these elements affect one another. We propose that the issue of quality measurement in health care be approached as an integration of service quality attributes common to other service organizations and technical quality attributes unique to health care. We hope that this research will serve as a first step toward the synthesis of the various quality attributes inherent in the health care domain and encourage other researchers to address the interactions of the various quality attributes. PMID:8763215

  13. Relationship between Managers' Performance and Organizational Health

    ERIC Educational Resources Information Center

    Mohammadisadr, Mohammad; Siadat, Seyyedali; Arbabisarjou, Azizollah

    2012-01-01

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

  14. Health Occupations Education Program Management Guide.

    ERIC Educational Resources Information Center

    Iowa Univ., Iowa City. Coll. of Education.

    This final report describes a project to develop a secondary education program management guide for health occupations education in Iowa. Introductory material includes the following: a summary sheet on project objectives, a description of how the objectives were met, the audience served, an educational equity statement, a statement that the…

  15. Smart health management technology and its applications

    NASA Astrophysics Data System (ADS)

    Nakajima, Hiroshi

    2011-06-01

    As a simple observation of the world, it is composed of human beings, artifacts, and natural environment. As all of their healths are issues like expansion of healthy aging, low maintenance cost, and low energy consumption the notion of health management can be extended to be applicable to all the entities. In this article, health management technology is proposed as a general solution framework. Its important aspect is cyclic evolution based on causality which illustrates conditions of target systems. The causality can be used as problem-solving knowledge, which is composed of feature attributes extracted from sensory data and intermediate characteristics. The causality should evolve to be updated according to sophistication of sensing and control mechanisms. It also provides the important nature of transparency to humans and machines bidirectionally, which enhances human-machine collaboration. Besides the idea of health management technology, the applications of human health, manufacturing, and energy consumption are also introduced and discussed. All applications were realized by multiple sensory networking to require multivariate time series analysis. Some experiments were conducted to investigate the performance of the proposed method.

  16. Software Health Management with Bayesian Networks

    NASA Technical Reports Server (NTRS)

    Mengshoel, Ole; Schumann, JOhann

    2011-01-01

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

  17. Managing interoperability and complexity in health systems.

    PubMed

    Bouamrane, M-M; Tao, C; Sarkar, I N

    2015-01-01

    In recent years, we have witnessed substantial progress in the use of clinical informatics systems to support clinicians during episodes of care, manage specialised domain knowledge, perform complex clinical data analysis and improve the management of health organisations' resources. However, the vision of fully integrated health information eco-systems, which provide relevant information and useful knowledge at the point-of-care, remains elusive. This journal Focus Theme reviews some of the enduring challenges of interoperability and complexity in clinical informatics systems. Furthermore, a range of approaches are proposed in order to address, harness and resolve some of the many remaining issues towards a greater integration of health information systems and extraction of useful or new knowledge from heterogeneous electronic data repositories.

  18. Integrated Systems Health Management for Intelligent Systems

    NASA Technical Reports Server (NTRS)

    Figueroa, Fernando; Melcher, Kevin

    2011-01-01

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

  19. Towards a Personal Health Management Assistant.

    PubMed

    Ferguson, G; Quinn, J; Horwitz, C; Swift, M; Allen, J; Galescu, L

    2010-10-01

    We describe design and prototyping efforts for a Personal Health Management Assistant for heart failure patients as part of Project HealthDesign. An assistant is more than simply an application. An assistant understands what its users need to do, interacts naturally with them, reacts to what they say and do, and is proactive in helping them manage their health. In this project, we focused on heart failure, which is not only a prevalent and economically significant disease, but also one that is very amenable to self-care. Working with patients, and building on our prior experience with conversational assistants, we designed and developed a prototype system that helps heart failure patients record objective and subjective observations using spoken natural language conversation. Our experience suggests that it is feasible to build such systems and that patients would use them. The system is designed to support rapid application to other self-care settings. PMID:20937478

  20. Transforming health information management through technology.

    PubMed

    Mahoney, Mary Ellen

    2002-08-01

    No one would deny the need to transform health care. Information technology is capable of transforming health care organizations and delivering measurable value. However, these organizations will have to deploy effective, proactive strategies for managing information and adapting to the opportunities the technology offers. If, for example, an organization wants to become paperless, its information strategy must include appropriate tools to store and access unstructured data components of the medical record as well as structured data. An Electronic Document Management System (EDMS) is a critical element of this strategy. Also, a plan for managing change must be developed to mitigate technology risks. This can be realized through the development of a clear vision of the future and strong leadership, among other key items. PMID:12402636

  1. [PESTIVIRUSES IN RUMINANTS].

    PubMed

    Glotov, A G; Glotova, T I; Shulyak, A F

    2016-01-01

    The genus Pestivirus includes four species: bovine viral diarrhea virus 1, bovine viral diarrhea virus 2, classical swine fever disease virus, and ovine border disease virus. Pestiviruses infect many species of domestic and wild animals. Bovine viral diarrhea virus is a prototypical representative of the pestiviruses of ruminant animals. Recently, new candidates appeared for including in this genus: two viruses of the wild ruminant animals that have not been officially classified and one HoBi-like virus discovered for the first time in the bovine fetal serum. The circulation of the ruminant animal pestiviruses within population of domestic and wild animals, the presence of these viruses in bioproducts stimulates studies of the infection reservoirs and their influence on the effect of the bovine viral diarrhea control programs. PMID:27451496

  2. [PESTIVIRUSES IN RUMINANTS].

    PubMed

    Glotov, A G; Glotova, T I; Shulyak, A F

    2016-01-01

    The genus Pestivirus includes four species: bovine viral diarrhea virus 1, bovine viral diarrhea virus 2, classical swine fever disease virus, and ovine border disease virus. Pestiviruses infect many species of domestic and wild animals. Bovine viral diarrhea virus is a prototypical representative of the pestiviruses of ruminant animals. Recently, new candidates appeared for including in this genus: two viruses of the wild ruminant animals that have not been officially classified and one HoBi-like virus discovered for the first time in the bovine fetal serum. The circulation of the ruminant animal pestiviruses within population of domestic and wild animals, the presence of these viruses in bioproducts stimulates studies of the infection reservoirs and their influence on the effect of the bovine viral diarrhea control programs.

  3. Effect of concentrate level and feeding management on chewing activities, saliva production, and ruminal pH of lactating dairy cows.

    PubMed

    Maekawa, M; Beauchemin, K A; Christensen, D A

    2002-05-01

    Eight ruminally cannulated lactating Holstein cows were used in a double 4 x 4 Latin square to determine the effects of 1) proportion of barley silage [40, 50, and 60% of dry matter (DM)] in the diet, and 2) feeding a total mixed ration (TMR) compared with separate ingredients (SI) on chewing activities, saliva production, and ruminal pH. Although cows fed SI were offered a diet containing 50% silage, they actually consumed a diet containing 43% silage (DM basis). Dry matter intake and milk yield were similar for all diets (18.2 kg of DM/d and 27.2 kg/d, respectively). Cows fed the 40% silage TMR spent more time eating than cows fed SI (243 vs. 198 min/d), but rumination time was similar (546 min/d). Eating time was similar among the TMR diets, but rumination time increased from 498 to 516 and 584 min/d as silage in the TMR increased from 40 to 50, and then to 60%, respectively. The secretion of saliva per gram of feed was 4.43, 3.18, and 1.19 ml/g of DM with consumption of silage, TMR, and concentrate, respectively. Resting salivation rate was similar for all diets (101 ml/min). Regardless of the diet, cows secreted 239 +/- 17 L/d of saliva, and ruminal pH was below 5.8 for 10 h/d. Results indicated increased chewing time did not increase total daily saliva secretion because increased eating and ruminating saliva was associated with decreased resting saliva. Feeding SI increased the risk of acidosis, because cows ate a higher proportion of concentrate than intended.

  4. Convergent Evolution of Health Information Management and Health Informatics

    PubMed Central

    Gibson, C. J.; Abrams, K.

    2015-01-01

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

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

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

    PubMed

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

    2015-08-12

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

    Greene, Zelda B

    2002-08-01

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

  9. Best practices for health technology management.

    PubMed

    2006-12-01

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

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

    PubMed

    Willacy, Erika; Bratton, Shelly

    2016-01-01

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

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

    PubMed

    Willacy, Erika; Bratton, Shelly

    2015-09-30

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

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

    ERIC Educational Resources Information Center

    Goldenberg, Jamie L.; Arndt, Jamie

    2008-01-01

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

  13. TOTAL QUALITY MANAGEMENT - THE NEW PARADIGM IN HEALTH CARE MANAGEMENT.

    PubMed

    Chakravarty, A; Parmar, N K; Ranyal, R K

    2001-07-01

    Hospitals are by nature complex organisations and the complexity is compounded in service hospitals with perceived notion of service deficiencies. Quality has emerged as a major issue in health care sector and TQM has been accepted as a major long-term strategic initiative towards continuously improving quality of health care. Key concepts of TQM start with top management leadership with emphasis on process and customer focus. Implementation of TQM in service hospitals will require Quality Management awareness, training and framework development as well as development of customer awareness. TQM has been widely applied in clinical field with successful outcome. TQM is not a short-term solution, it has to be understood and practised as a long-term strategic commitment.

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

    PubMed

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

    2015-02-01

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

  15. FAILSAFE Health Management for Embedded Systems

    NASA Technical Reports Server (NTRS)

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

    2010-01-01

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

  16. Making Technology Ready: Integrated Systems Health Management

    NASA Technical Reports Server (NTRS)

    Malin, Jane T.; Oliver, Patrick J.

    2007-01-01

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

  17. Distributing shared savings for population health management.

    PubMed

    Averill, Richard F; Goldfield, Norbert; Hughes, John S

    2014-04-01

    Lessons from outcomes-based fee-for-service payment models that can be applied to population health management models include the following: Focus on outcomes, not processes. Limit the number of outcomes measures used. Ensure that the amount distributed is substantial enough to motivate behavior change. Communicate results clearly and transparently. Ensure that the financial consequence of poor performance is proportional to the cost increase it generates. Focus on reducing the rate of excess preventable outcomes.

  18. Structural health management for aging aircraft

    NASA Astrophysics Data System (ADS)

    Ikegami, Roy; Haugse, Eric D.

    2001-06-01

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

  19. Integrated Systems Health Management for Intelligent Systems

    NASA Technical Reports Server (NTRS)

    Figueroa, Fernando; Melcher, Kevin

    2011-01-01

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

  20. Health information management in the computer era.

    PubMed

    Brunner, B K

    1992-11-01

    Medical record professionals are confronted with change at practically every front. Technologic advancements are changing the technical aspects of our job responsibilities. These advancements also have implications for the interpersonal aspects of our jobs. The effect of new technology on working relationships is exacerbated by the introduction of TQM, which also encourages a change in organizational relationships through a move away from traditional heirarchical management by fostering teamwork and staff empowerment. The changes that are transforming health care organizations can be viewed in two lights: (1) as unwanted hindrances to accomplishment or (2) as opportunities to enhance accomplishment. Medical record professionals are presented with unprecedented opportunities to enhance our accomplishments and maximize our position in health care facilities. We cannot long for the way things were or be satisfied with the status quo. Such action (or lack thereof) will only ensure that our role on the health care team will be taken over by someone else. To capitalize on the opportunities presented, medical record professionals must hone the knowledge and skills we already possess, gain other knowledge and skills necessary to function in the computerized environment, and, most of all, be proactive rather than reactive. Such action will ensure that we truly become health information managers.

  1. Should health care managers adopt Theory Z?

    PubMed

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

    1986-04-01

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

  2. Conception and development of a bibliographic database of blood nutrient fluxes across organs and tissues in ruminants: data gathering and management prior to meta-analysis.

    PubMed

    Vernet, Jean; Ortigues-Marty, Isabelle

    2006-01-01

    In the organism, nutrient exchanges among tissues and organs are subject to numerous sources of physiological or nutritional variation, and the contribution of individual factors needs to be quantified before establishing general response laws. To achieve this, meta-analysis of data from publications is a useful tool. The objective of this work was to develop a bibliographic database of nutrient fluxes across organs and tissues of ruminant animals (Flora) under Access using the Merise method. The most important criteria for Flora were the ease to relate the various information, the exhaustivity and the accuracy of the data input, a complete description of the diets, taking into account the methods of the methodological procedures of measurement and analysis of blood nutrients and the traceability of the information. The conceptual data model was built in 6 parts. The first part describes the authors and source of publication, and the person in charge of data input. It clearly separates and identifies the experiments, the groups of animals and the treatments within a publication. The second part is concerned with feeds, diets and their chemical composition and nutritional value. The third and fourth parts describe the infusion of any substrates and the methods employed, respectively. The fifth part is devoted to the results of blood flows and nutrient fluxes. The sixth part gathers miscellaneous experimental information. All these parts are inter-connected. To model this database, the Merise method was utilised and 26 entities and 32 relationships were created. At the physical level, 93 tables were created, corresponding, for the majority, to entities and relationships of the data model. They were divided into reference tables (n = 65) and data tables (n = 28). Data processing was developed in Flora and included the control of the data, generic calculations of unknown data from given data, the automation of the estimation of the missing data or the chemical

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

    NASA Technical Reports Server (NTRS)

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

    2010-01-01

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

  4. An Assessment of Integrated Health Management Frameworks

    SciTech Connect

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

    2012-05-18

    In order to meet the ever increasing demand for energy, the United States nuclear industry is turning to life extension of existing nuclear power plants (NPPs). Economically ensuring the safe, secure, and reliable operation of aging NPPs presents many challenges. The 2009 Light Water Reactor Sustainability Workshop identified online monitoring of active and structural components as essential to better understanding and management of the challenges posed by aging NPPs. Additionally, there is increasing adoption of condition-based maintenance (CBM) for active components in NPPs. These techniques provide a foundation upon which a variety of advanced online surveillance, diagnostic, and prognostic techniques can be deployed to continuously monitor and assess the health of NPP systems and components. The next step in the development of advanced online monitoring is to move beyond CBM to estimating the remaining useful life of active components using prognostic tools. Deployment of prognostic health management (PHM) on the scale of an NPP requires the use of an integrated health management (IHM) framework - a software product (or suite of products) used to manage the necessary elements needed for a complete implementation of online monitoring and prognostics. This paper provides a thoughtful look at the desirable functions and features of IHM architectures. A full PHM system involves several modules, including data acquisition, system modeling, fault detection, fault diagnostics, system prognostics, and advisory generation (operations and maintenance planning). The standards applicable to PHM applications are indentified and summarized. A list of evaluation criteria for PHM software products, developed to ensure scalability of the toolset to an environment with the complexity of an NPP, is presented. Fourteen commercially available PHM software products are identified and classified into four groups: research tools, PHM system development tools, deployable architectures

  5. Management for School Environmental Health in Japan.

    PubMed

    Kitagaki, Kunihiko

    2016-01-01

    Some acts such as the Basic Environment Act are aimed at managing environmental health for a productive living environment in Japan. School is not only a place where lessons for a better future are taught but also an environment in which children spend many hours of their day. Therefore, activities involving regular checks are important to maintain and improve the school environment. Article 5 of the School Health and Safety Act states that schools must make plans and carry out regular checks on school environmental health. Article 6 prescribes that the Minister of Education, Culture, Sports, Science and Technology establish a "school environmental health standard". This standard involves metrics on the classroom environment (quality of air, illumination, and noise levels), quality of drinking/pool water and so on, and their standard values and evaluation methods. Article 23 prescribes that each school except colleges/universities have a school pharmacist. The school pharmacist plays an important role in maintaining and improving the school's environmental health. However, the current actions taken are not adequate. Therefore, prospects for future activities will be discussed based on the current situations and problems. PMID:27252052

  6. Sharing Earth Observation Data When Health Management

    NASA Astrophysics Data System (ADS)

    Cox, E. L., Jr.

    2015-12-01

    While the global community is struck by pandemics and epidemics from time to time the ability to fully utilize earth observations and integrate environmental information has been limited - until recently. Mature science understanding is allowing new levels of situational awareness be possible when and if the relevant data is available and shared in a timely and useable manner. Satellite and other remote sensing tools have been used to observe, monitor, assess and predict weather and water impacts for decades. In the last few years much of this has included a focus on the ability to monitor changes on climate scales that suggest changes in quantity and quality of ecosystem resources or the "one-health" approach where trans-disciplinary links between environment, animal and vegetative health may provide indications of best ways to manage susceptibility to infectious disease or outbreaks. But the scale of impacts and availability of information from earth observing satellites, airborne platforms, health tracking systems and surveillance networks offer new integrated tools. This presentation will describe several recent events, such as Superstorm Sandy in the United States and the Ebola outbreak in Africa, where public health and health infrastructure have been exposed to environmental hazards and lessons learned from disaster response in the ability to share data have been effective in risk reduction.

  7. Functions and Positions of Corporate Occupational Health Managers in Company-Wide Occupational Health Management.

    PubMed

    Mori, Koji; Nagata, Tomohisa; Kajiki, Shigeyuki; Hino, Yoshiyuki; Nagata, Masako

    2013-08-21

    Objectives: It has become necessary for Japanese corporations to manage occupational health (OH) programs consistently throughout their organizations. Corporations need to clarify their health policies, develop standardized programs, assign OH staff, and ensure that they communicate with each other. To realize such conditions, many occupational physicians (OPs), who have the skills to lead corporation-wide OH activities, are now being assigned to head offices of corporations and referred to as corporate OH managers. However, there has been no research to date in Japan on their actual situation and function. We conducted an interview study of corporate OH managers to clarify their functions and positions in corporations. Subjects and Methods: We conducted semi-structural interviews with 14 corporate OH managers in large corporations employing more than 5,000 workers and multiple OPs. Interview scripts were coded to identify their functions as corporate OH managers and the context of their positions within corporate-wide OH management systems. Results: Five contexts were suggested. 1) Corporate OH managers played central roles in developing corporate health policies, standards and plans. 2) Head office department managers who supervised the sites distributed the policies and standards, and corporate OH managers instructed site OPs and OH staff. 3) In some corporations, corporate OH managers participated in the evaluation process of OH programs as part of occupational safety and health management systems or business audits. 4) Corporate OH managers led communications among OPs and OH staff by facilitating corporate OH meetings, and provided technical training. 5) Corporate OH managers in positions that enabled them to report directly or indirectly to decision makers (i.e., directors in charge) on human resource issues. Discussion: The results of this study suggest that companies that promote consistent company-wide OH programs also utilized the professional knowledge

  8. A Distributed Prognostic Health Management Architecture

    NASA Technical Reports Server (NTRS)

    Bhaskar, Saha; Saha, Sankalita; Goebel, Kai

    2009-01-01

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

  9. Structural Health Management for Future Aerospace Vehicles

    NASA Technical Reports Server (NTRS)

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

    2004-01-01

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

  10. Health plans' disease management programs: extending across the medical and behavioral health spectrum?

    PubMed

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

    2008-01-01

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

  11. Nuclear transfer in ruminants.

    PubMed

    Lee, Joon-Hee; Maalouf, Walid E

    2015-01-01

    Ruminants were the first mammalian species to be cloned successfully by nuclear transplantation. Those experiments were designed to multiply high merit animals (Willadsen, Nature 320(6057):63-65, 1986; Prather et al., Biol Reprod 37(4):859-866, 1987; Wilmut et al., Nature 385(6619):810-813, 1997). Since then, cloning has provided us with a vast amount of knowledge and information on the reprogramming ability of somatic cells to different cell types which became an important basis for stem cell research and human medicine. Nowadays, the goals of most nuclear transfer work vary widely but in most cases the micromanipulation procedures remain the same. However, differences between species require different technical considerations. In this chapter, we describe in detail somatic cell nuclear transfer which is the foremost method for cloning ruminants with specific reference to sheep and cattle.

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

    PubMed

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

    2011-04-01

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

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

    PubMed

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

    2015-09-30

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

  14. Sensor Systems for Prognostics and Health Management

    PubMed Central

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

    2010-01-01

    Prognostics and health management (PHM) is an enabling discipline consisting of technologies and methods to assess the reliability of a product in its actual life cycle conditions to determine the advent of failure and mitigate system risk. Sensor systems are needed for PHM to monitor environmental, operational, and performance-related characteristics. The gathered data can be analyzed to assess product health and predict remaining life. In this paper, the considerations for sensor system selection for PHM applications, including the parameters to be measured, the performance needs, the electrical and physical attributes, reliability, and cost of the sensor system, are discussed. The state-of-the-art sensor systems for PHM and the emerging trends in technologies of sensor systems for PHM are presented. PMID:22219686

  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. PMID:22425456

  16. Outage management and health physics issue, 2006

    SciTech Connect

    Agnihotri, Newal

    2006-05-15

    The focus of the May-June issue is on outage management and health physics. Major articles/reports in this issue include: A design with experience for the U.S., by Michael J. Wallace, Constellation Generation Group; Hope to be among the first, by Randy Hutchinson, Entergy Nuclear; Plans to file COLs in 2008, by Garry Miller, Progress Energy; Evolution of ICRP's recommendations, by Lars-Erik Holm, ICRP; European network on education and training in radiological protection, by Michele Coeck, SCK-CEN, Belgium; Outage managment: an important tool for improving nuclear power plant performance, by Thomas Mazour and Jiri Mandula, IAEA, Austria; and Plant profile: Exploring new paths to excellence, by Anne Thomas, Exelon Nuclear.

  17. Change management with the electronic health record.

    PubMed

    Schmucker, DeeAnn

    2009-01-01

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

  18. Prospective Health: Duke's Approach to Improving Employee Health and Managing Health Care Costs

    ERIC Educational Resources Information Center

    Davidson, H. Clint, Jr.

    2004-01-01

    If developing a healthy workforce is critical to reining in the skyrocketing cost of health care, then why have so many attempts at preventive health or disease management fallen short? How can employers connect with employees to engage them in changing unhealthy habits or lifestyles? Duke University has launched an innovative new approach called…

  19. Outage managment and health physics issue, 2008

    SciTech Connect

    Agnihotri, Newal

    2008-05-15

    The focus of the May-June issue is on outage management and health physics. Major articles include: Outage optimization initiatives, by George B. Beam, AREVA NP, Inc.; New plant based on excellent track records, by Jim Scarola, Progress Energy; Meeting customer needs and providing environmental benefits, by Peter S. Hastings, Duke Energy; Plants with 3-D design, by Jack A. Bailey, Tennessee Valley Authority; and Highest quality with exceptional planning, by Jason A. Walls, Duke Energy. Industry innovation articles include: Integrated exposure reduction plan, by Ed Wolfe, Exelon; Performance-based radiation worker training, by Joe Giuffre and Timothy Vriezerma, American Electric Power.

  20. Pain management and health care policy.

    PubMed

    Naccache, Nicole; Abou Zeid, Hicham; Nasser Ayoub, Eliane; Antakly, Marie-Claire

    2008-01-01

    Opioid analgesics are essential for the management of moderate to severe pain. In spite of their documented effectiveness, opioids are often underutilized, a factor which has contributed significantly to the undertreatment of pain. Many countries have developed true national policies on cancer pain and palliative care, and in others only guidelines for care have been developed. Ideally, national policies facilitate and legislate not only a patient's right to care, but also the necessary components of education and drug availability which are so critical for the appropriate achievement of public health programs. PMID:19534079

  1. Measles: pathology, management and public health issues.

    PubMed

    Bentley, Jackie; Rouse, Jo; Pinfield, Jenny

    2014-05-27

    Measles is a highly contagious viral disease that continues to occur in epidemics in the UK despite efforts to eradicate it. In the acute stage, measles is associated with several complications including otitis media, but some of the most severe consequences of the disease occur months and even years after the initial infection. Worldwide, measles contributes significantly to deaths in childhood and places an additional burden on families already living with the consequence of poverty and conflict. This article aims to develop the reader's understanding of measles, including its pathophysiology, management and associated public health issues.

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

    PubMed Central

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

    2011-01-01

    OBJECTIVES The objective of the report was to review the evidence on the impact of health information technology (IT) on all phases of the medication management process (prescribing and ordering, order communication, dispensing, administration and monitoring as well as education and reconciliation), to identify the gaps in the literature and to make recommendations for future research. DATA SOURCES We searched peer-reviewed electronic databases, grey literature, and performed hand searches. Databases searched included MEDLINE®, Embase, CINAHL (Cumulated Index to Nursing and Allied Health Literature), Cochrane Database of Systematic Reviews, International Pharmaceutical Abstracts, Compendex, Inspec (which includes IEEE Xplore), Library and Information Science Abstracts, E-Prints in Library and Information Science, PsycINFO, Sociological Abstracts, and Business Source Complete. Grey literature searching involved Internet searching, reviewing relevant Web sites, and searching electronic databases of grey literatures. AHRQ also provided all references in their e-Prescribing, bar coding, and CPOE knowledge libraries. METHODS Paired reviewers looked at citations to identify studies on a range of health IT used to assist in the medication management process (MMIT) during multiple levels of screening (titles and abstracts, full text and final review for assignment of questions and data abstrction). Randomized controlled trials and cohort, case-control, and case series studies were independently assessed for quality. All data were abstracted by one reviewer and examined by one of two different reviewers with content and methods expertise. RESULTS 40,582 articles were retrieved. After duplicates were removed, 32,785 articles were screened at the title and abstract phase. 4,578 full text articles were assessed and 789 articles were included in the final report. Of these, 361 met only content criteria and were listed without further abstraction. The final report included data

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

    PubMed

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

    2015-01-01

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

  4. Health leadership and management competencies: a systemic approach.

    PubMed

    Holder, Reynaldo; Ramagem, Caroline

    2012-01-01

    The achievement of national and international health goals requires better-performing health systems. Strengthening leadership and management of health systems thus becomes essential for achieving greater efficiency and responsiveness, ultimately improving health outcomes. Building a global framework of core competencies for leadership and management needs to be approached with systems thinking and methodologies akin to complexity science that takes into account all components and levels of the health system and the possible interactions between them that influence outcomes. The results will have important policy implications for national health authorities seeking to strengthen management capacity and building transformational leadership in health systems.

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2014-04-01

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

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

    PubMed

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

    2014-04-01

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

  8. Requirements Flowdown for Prognostics and Health Management

    NASA Technical Reports Server (NTRS)

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

    2012-01-01

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

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

    PubMed

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

    2013-07-01

    Two hundred sixty-eight strip loins were collected from heifers fed at Oklahoma State University in Stillwater, OK. In Exp. 1, heifers (n = 127) were assigned to 1 of 3 health management treatment groups: antimicrobial administrations were given based on standard feedlot protocol (SFP) or ruminal temperature (RT) or given a metaphylactic treatment of tulathromycin (MT) followed by visual assessment (VA). In Exp. 2, heifers (n = 155) were assigned to the same treatment groups as above and were supplemented zilpaterol hydrochloride (ZH) or control (CON). Three steaks were collected from each strip loin, 1 each for retail display, sensory evaluation, and Warner-Bratzler shear force (WBSF). Color was evaluated from the retail display steak using a trained color panel and objectively using a HunterLab Miniscan XE. An Instron Universal Testing Machine with a Warner-Bratzler head was used for evaluation of instrumental tenderness, and a trained sensory panel was used to assess palatability traits. Heifers treated by VA had the least number of antimicrobial administrations and lowest yield grade and also had the lightest HCW (P < 0.05) compared with the heifers treated by the other health management protocols. There were no subjective color attribute differences or sensory panel differences (P > 0.05) across all health management systems or antimicrobial administrations. There were no differences in carcass and performance traits for any antimicrobial administrations treatment groups (P > 0.05). Heifers who had 0 or 1 antimicrobial administrations had lower (P < 0.05) a* (redness/greenness: positive values = red and negative values = green), and b* (yellowness/blueness: positive values = yellow and negative values = blue) values compared with those who had 2 antimicrobial administrations. In Exp. 2, heifers treated by VA had the least number (P < 0.05) of antimicrobial administrations when compared with MT and RT. Health management group did not have any other effects on

  10. Early family context and development of adolescent ruminative style: moderation by temperament.

    PubMed

    Hilt, Lori M; Armstrong, Jeffrey M; Essex, Marilyn J

    2012-01-01

    We know very little about the development of rumination, the tendency to passively brood about negative feelings. Because rumination is a risk factor for many forms of psychopathology, especially depression, such knowledge could prove important for preventing negative mental health outcomes in youth. This study examined developmental origins of rumination in a longitudinal sample (N=337; 51% girls) studied in preschool (ages 3½ and 4½ years) and early adolescence (ages 13 and 15 years). Results indicated that family context and child temperament, assessed during the preschool period, were risk factors for a ruminative style in adolescence. Specifically, early family contexts characterised by over-controlling parenting and a family style of negative-submissive expressivity predicted higher levels of later rumination. These associations were moderated by children's temperamental characteristics of negative affect and effortful control. Further, the interaction of these temperament factors exerted an additional influence on later rumination. Implications for prevention and intervention efforts are discussed.

  11. Cyanobacterial toxins: risk management for health protection.

    PubMed

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

    2005-03-15

    This paper reviews the occurrence and properties of cyanobacterial toxins, with reference to the recognition and management of the human health risks which they may present. Mass populations of toxin-producing cyanobacteria in natural and controlled waterbodies include blooms and scums of planktonic species, and mats and biofilms of benthic species. Toxic cyanobacterial populations have been reported in freshwaters in over 45 countries, and in numerous brackish, coastal, and marine environments. The principal toxigenic genera are listed. Known sources of the families of cyanobacterial toxins (hepato-, neuro-, and cytotoxins, irritants, and gastrointestinal toxins) are briefly discussed. Key procedures in the risk management of cyanobacterial toxins and cells are reviewed, including derivations (where sufficient data are available) of tolerable daily intakes (TDIs) and guideline values (GVs) with reference to the toxins in drinking water, and guideline levels for toxigenic cyanobacteria in bathing waters. Uncertainties and some gaps in knowledge are also discussed, including the importance of exposure media (animal and plant foods), in addition to potable and recreational waters. Finally, we present an outline of steps to develop and implement risk management strategies for cyanobacterial cells and toxins in waterbodies, with recent applications and the integration of Hazard Assessment Critical Control Point (HACCP) principles. PMID:15737680

  12. Cyanobacterial toxins: risk management for health protection

    SciTech Connect

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

    2005-03-15

    This paper reviews the occurrence and properties of cyanobacterial toxins, with reference to the recognition and management of the human health risks which they may present. Mass populations of toxin-producing cyanobacteria in natural and controlled waterbodies include blooms and scums of planktonic species, and mats and biofilms of benthic species. Toxic cyanobacterial populations have been reported in freshwaters in over 45 countries, and in numerous brackish, coastal, and marine environments. The principal toxigenic genera are listed. Known sources of the families of cyanobacterial toxins (hepato-, neuro-, and cytotoxins, irritants, and gastrointestinal toxins) are briefly discussed. Key procedures in the risk management of cyanobacterial toxins and cells are reviewed, including derivations (where sufficient data are available) of tolerable daily intakes (TDIs) and guideline values (GVs) with reference to the toxins in drinking water, and guideline levels for toxigenic cyanobacteria in bathing waters. Uncertainties and some gaps in knowledge are also discussed, including the importance of exposure media (animal and plant foods), in addition to potable and recreational waters. Finally, we present an outline of steps to develop and implement risk management strategies for cyanobacterial cells and toxins in waterbodies, with recent applications and the integration of Hazard Assessment Critical Control Point (HACCP) principles.

  13. Information support for health information management in regional Sri Lanka: health managers' perspectives.

    PubMed

    Ranasinghe, Kaduruwane Indika; Chan, Taizan; Yaralagadda, Prasad

    2012-01-01

    Good management, supported by accurate, timely and reliable health information, is vital for increasing the effectiveness of Health Information Systems (HIS). When it comes to managing the under-resourced health systems of developing countries, information-based decision making is particularly important. This paper reports findings of a self-report survey that investigated perceptions of local health managers (HMs) of their own regional HIS in Sri Lanka. Data were collected through a validated, pre-tested postal questionnaire, and distributed among a selected group of HMs to elicit their perceptions of the current HIS in relation to information generation, acquisition and use, required reforms to the information system and application of information and communication technology (ICT). Results based on descriptive statistics indicated that the regional HIS was poorly organised and in need of reform; that management support for the system was unsatisfactory in terms of relevance, accuracy, timeliness and accessibility; that political pressure and community and donor requests took precedence over vital health information when management decisions were made; and use of ICT was unsatisfactory. HIS strengths included user-friendly paper formats, a centralised planning system and an efficient disease notification system; weaknesses were lack of comprehensiveness, inaccuracy, and lack of a feedback system. Responses of participants indicated that HIS would be improved by adopting an internationally accepted framework and introducing ICT applications. Perceived barriers to such improvements were high initial cost of educating staff to improve computer literacy, introduction of ICTs, and HIS restructure. We concluded that the regional HIS of Central Province, Sri Lanka had failed to provide much-needed information support to HMs. These findings are consistent with similar research in other developing countries and reinforce the need for further research to verify causes of

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

    PubMed

    Golaszewski, T

    2000-08-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  17. Rocket Testing and Integrated System Health Management

    NASA Technical Reports Server (NTRS)

    Figueroa, Fernando; Schmalzel, John

    2005-01-01

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

  18. Outage management and health physics issue, 2007

    SciTech Connect

    Agnihotri, Newal

    2007-05-15

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

  19. Integrated Systems Health Management for Space Exploration

    NASA Technical Reports Server (NTRS)

    Uckun, Serdar

    2005-01-01

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

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

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

    ERIC Educational Resources Information Center

    Waller, Erika M.; Rose, Amanda J.

    2013-01-01

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

  2. Soil health paradigms and implications for disease management.

    PubMed

    Larkin, Robert P

    2015-01-01

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

  3. Soil health paradigms and implications for disease management.

    PubMed

    Larkin, Robert P

    2015-01-01

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

  4. 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.

  5. Health Management Applications for International Space Station

    NASA Technical Reports Server (NTRS)

    Alena, Richard; Duncavage, Dan

    2005-01-01

    Traditional mission and vehicle management involves teams of highly trained specialists monitoring vehicle status and crew activities, responding rapidly to any anomalies encountered during operations. These teams work from the Mission Control Center and have access to engineering support teams with specialized expertise in International Space Station (ISS) subsystems. Integrated System Health Management (ISHM) applications can significantly augment these capabilities by providing enhanced monitoring, prognostic and diagnostic tools for critical decision support and mission management. The Intelligent Systems Division of NASA Ames Research Center is developing many prototype applications using model-based reasoning, data mining and simulation, working with Mission Control through the ISHM Testbed and Prototypes Project. This paper will briefly describe information technology that supports current mission management practice, and will extend this to a vision for future mission control workflow incorporating new ISHM applications. It will describe ISHM applications currently under development at NASA and will define technical approaches for implementing our vision of future human exploration mission management incorporating artificial intelligence and distributed web service architectures using specific examples. Several prototypes are under development, each highlighting a different computational approach. The ISStrider application allows in-depth analysis of Caution and Warning (C&W) events by correlating real-time telemetry with the logical fault trees used to define off-nominal events. The application uses live telemetry data and the Livingstone diagnostic inference engine to display the specific parameters and fault trees that generated the C&W event, allowing a flight controller to identify the root cause of the event from thousands of possibilities by simply navigating animated fault tree models on their workstation. SimStation models the functional power flow

  6. Herd health and management of dairy cow

    NASA Astrophysics Data System (ADS)

    Ćaǧlayan, Alper; Yüca, Songül

    2016-04-01

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

  7. [Public health management in invasive meningococcal diseases].

    PubMed

    Ehrhard, I; Arndt, U

    2004-12-01

    At the 54(th) Scientific Congress of the German Professional Association of Public Health Service Physicians and Dentists in Marburg on 6th May 2004 the working group on meningococci (Arbeitsgemeinschaft Meningokokken, AGMK) organised the international workshop "Public Health Management of invasive Meningococcal Disease". In recent years significant changes in the epidemiology of meningococcal disease took place in Europe: in some countries and regions the number of disease caused by meningococci serogroup C has increased significantly. In the Netherlands this increase led to the introduction of an immunisation programme with conjugated meningococcal vaccines targeting children aged 1 up to 18 years. In Switzerland a peak in the number of reported meningococcal group C cases could be observed in some regions. Therefore, a regional vaccination programme has been introduced. Nevertheless, compared with Germany, the indications for vaccination against meningococci in Switzerland are more extensive. In the workshop, Professor Ulrich Vogel and Dr. Ingrid Ehrhard presented the epidemiological situation in Germany and the recommended prophylaxis regimen against meningococci. PMID:15609213

  8. Managing Scale and Innovation in Health IT.

    PubMed

    Enzmann, Dieter R; Pfeffer, Michael

    2016-09-01

    Given the high-intensity interaction between radiology and IT, radiology leadership should understand IT's new, somewhat conflicting, dual roles. Managing large-scale and small-scale projects concurrently has become an important challenge for leaders of health IT (HIT). Historical parallels of this challenge can be drawn from transportation and communication systems, in which a large-scale mind-set is needed to build the initial network, whereas a small-scale mind-set is more useful to develop the content that will traverse this network. Innovation and creativity is a cornerstone of content small-scale thinking, and in HIT, that is what is needed to extract the value from it. However, unlike the early historical transportation and communication examples, the time between the development of the infrastructure and the follow-on, value-rich content is shortened greatly because it has become nearly simultaneous in HIT. Weaving the ability to concomitantly manage both large- and small-scale projects into the fabric of the organizational HIT culture will be critical for its success. PMID:27039000

  9. Disease and health management in Asian aquaculture.

    PubMed

    Bondad-Reantaso, Melba G; Subasinghe, Rohana P; Arthur, J Richard; Ogawa, Kazuo; Chinabut, Supranee; Adlard, Robert; Tan, Zilong; Shariff, Mohamed

    2005-09-30

    Asia contributes more than 90% to the world's aquaculture production. Like other farming systems, aquaculture is plagued with disease problems resulting from its intensification and commercialization. This paper describes the various factors, providing specific examples, which have contributed to the current disease problems faced by what is now the fastest growing food-producing sector globally. These include increased globalization of trade and markets; the intensification of fish-farming practices through the movement of broodstock, postlarvae, fry and fingerlings; the introduction of new species for aquaculture development; the expansion of the ornamental fish trade; the enhancement of marine and coastal areas through the stocking of aquatic animals raised in hatcheries; the unanticipated interactions between cultured and wild populations of aquatic animals; poor or lack of effective biosecurity measures; slow awareness on emerging diseases; the misunderstanding and misuse of specific pathogen free (SPF) stocks; climate change; other human-mediated movements of aquaculture commodities. Data on the socio-economic impacts of aquatic animal diseases are also presented, including estimates of losses in production, direct and indirect income and employment, market access or share of investment, and consumer confidence; food availability; industry failures. Examples of costs of investment in aquatic animal health-related activities, including national strategies, research, surveillance, control and other health management programmes are also provided. Finally, the strategies currently being implemented in the Asian region to deal with transboundary diseases affecting the aquaculture sector are highlighted. These include compliance with international codes, and development and implementation of regional guidelines and national aquatic animal health strategies; new diagnostic and therapeutic techniques and new information technology; new biosecurity measures including

  10. Consumer-directed health care: implications for health care organizations and managers.

    PubMed

    Guo, Kristina L

    2010-01-01

    This article uses a pyramid model to illustrate the key components of consumer-directed health care. Consumer-directed health care is considered the essential strategy needed to lower health care costs and is valuable for making significant strides in health care reform. Consumer-directed health care presents new challenges and opportunities for all health care stakeholders and their managers. The viability of the health system depends on the success of managers to respond rapidly and with precision to changes in the system; thus, new and modified roles of managers are necessary to successfully sustain consumerism efforts to control costs while maintaining access and quality. PMID:20436329

  11. Consumer-directed health care: implications for health care organizations and managers.

    PubMed

    Guo, Kristina L

    2010-01-01

    This article uses a pyramid model to illustrate the key components of consumer-directed health care. Consumer-directed health care is considered the essential strategy needed to lower health care costs and is valuable for making significant strides in health care reform. Consumer-directed health care presents new challenges and opportunities for all health care stakeholders and their managers. The viability of the health system depends on the success of managers to respond rapidly and with precision to changes in the system; thus, new and modified roles of managers are necessary to successfully sustain consumerism efforts to control costs while maintaining access and quality.

  12. Management implications of the Health Insurance Portability and Accountability Act.

    PubMed

    Prince, L H; Carroll-Barefield, A

    2000-09-01

    Health care professionals are faced with ever-changing rules and regulations and technological advances. Add to this the 1996 Health Insurance Portability and Accountability Act (HIPAA) and the health care manager's list of challenges continues to expand. This article presents an overview of HIPAA requirements and tools for use by health care managers in ensuring their facility is in compliance with the latest rulings.

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

    PubMed Central

    2011-01-01

    Abstract This paper considers how operational research and management science can improve the design of health systems and the delivery of health care, particularly in low-resource settings. It identifies some gaps in the way operational research is typically used in global health and proposes steps to bridge them. It then outlines some analytical tools of operational research and management science and illustrates how their use can inform some typical design and delivery challenges in global health. The paper concludes by considering factors that will increase and improve the contribution of operational research and management science to global health. PMID:21897489

  14. A diet supplement for captive wild ruminants.

    PubMed

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

    1998-06-01

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

  15. Electrophysiological correlates of anxious rumination.

    PubMed

    Andersen, Søren Bo; Moore, Roger Anthony; Venables, Louise; Corr, Philip Joseph

    2009-02-01

    EEG coherence and EEG power response were recorded as 63 participants engaged in one of three experimental conditions: 'personal rumination', 'nominal rumination', and 'baseline counting'. The rumination conditions were separated by a neutral (counting) task to eliminate neural carry-over effects. For personal rumination, participants spent 2 min ruminating about something in their life about which they were in two minds (i.e., in a state of personal conflict). For nominal rumination, they were presented with a conflict scenario (concerning buying a car) and instructed to ruminate about that for 2 min. The baseline counting task simply involved counting forwards from 1 at a speed comfortable to the individual. Participants completed various questionnaires to measure mood and also traits of personality (including trait anxiety). EEG data were analysed in the following wavebands: 4-6 Hz, 6-8 Hz, 8-10 Hz, 10-12 Hz, 12-20 Hz and 20-30 Hz. Results revealed that the scalp-wide EEG theta (4-6 Hz and 6-8 Hz) coherence associated with personal rumination was significantly greater than that associated with nominal rumination and baseline counting. Similarly, the scalp-wide 6-8 Hz and parietal-occipital 4-6 Hz power associated with personal rumination were significantly greater than power associated with the nominal rumination and power for baseline counting. For alpha, the 10-12 Hz scalp-wide EEG coherence associated with personal rumination was significantly greater than that associated with baseline counting. Otherwise, the scalp-wide 10-12 Hz power related to both nominal rumination and personal rumination were significantly greater than in response to baseline counting. For 20-30 Hz scalp-wide EEG power, data in response to the nominal rumination condition were significantly increased compared to data associated with the baseline counting condition. In terms of questionnaire data, tense arousal, anger/frustration, hedonic tone and energetic arousal were all influenced by

  16. Modelling digestive constraints in non-ruminant and ruminant foregut-fermenting mammals.

    PubMed

    Munn, Adam J; Streich, W Jürgen; Hummel, Jürgen; Clauss, Marcus

    2008-09-01

    It has been suggested that large foregut-fermenting marsupial herbivores, the kangaroos and their relatives, may be less constrained by food intake limitations as compared with ruminants, due mainly to differences in their digestive morphology and management of ingesta particles through the gut. In particular, as the quality of forage declines with increasing contents of plant fibre (cellulose, hemicelluloses and lignin; measured as neutral-detergent fibre, NDF), the tubiform foregut of kangaroos may allow these animals to maintain food intakes more so than ruminants like sheep, which appear to be limited by fibrous bulk filling the foregut and truncating further ingestion. Using available data on dry matter intake (DMI, g kg(-0.75) d(-1)), ingesta mean retention time (MRT, h), and apparent digestibility, we modelled digestible dry matter intake (DDMI) and digestible energy intake (DEI) by ruminant sheep (Ovis aries) and by the largest marsupial herbivore, the red kangaroo (Macropus rufus). Sheep achieved higher MRTs on similar DMIs, and hence sheep achieved higher DDMIs for any given level of DMI as compared with kangaroos. Interestingly, MRT declined in response to increasing DMI in a similar pattern for both species, and the association between DMI and plant NDF contents did not support the hypothesis that kangaroos are less affected by increasing fibre relative to sheep. However, when DEI was modelled according to DDMIs and dietary energy contents, we show that the kangaroos could meet their daily maintenance energy requirements (MER) at lower levels of DMI and on diets with higher fibre contents compared with sheep, due largely to the kangaroos' lower absolute maintenance and basal energy metabolisms compared with eutherians. These results suggest that differences in the metabolic set-point of different species can have profound effects on their nutritional niche, even when their digestive constraints are similar, as was the case for these ruminant and non-ruminant

  17. Modelling digestive constraints in non-ruminant and ruminant foregut-fermenting mammals.

    PubMed

    Munn, Adam J; Streich, W Jürgen; Hummel, Jürgen; Clauss, Marcus

    2008-09-01

    It has been suggested that large foregut-fermenting marsupial herbivores, the kangaroos and their relatives, may be less constrained by food intake limitations as compared with ruminants, due mainly to differences in their digestive morphology and management of ingesta particles through the gut. In particular, as the quality of forage declines with increasing contents of plant fibre (cellulose, hemicelluloses and lignin; measured as neutral-detergent fibre, NDF), the tubiform foregut of kangaroos may allow these animals to maintain food intakes more so than ruminants like sheep, which appear to be limited by fibrous bulk filling the foregut and truncating further ingestion. Using available data on dry matter intake (DMI, g kg(-0.75) d(-1)), ingesta mean retention time (MRT, h), and apparent digestibility, we modelled digestible dry matter intake (DDMI) and digestible energy intake (DEI) by ruminant sheep (Ovis aries) and by the largest marsupial herbivore, the red kangaroo (Macropus rufus). Sheep achieved higher MRTs on similar DMIs, and hence sheep achieved higher DDMIs for any given level of DMI as compared with kangaroos. Interestingly, MRT declined in response to increasing DMI in a similar pattern for both species, and the association between DMI and plant NDF contents did not support the hypothesis that kangaroos are less affected by increasing fibre relative to sheep. However, when DEI was modelled according to DDMIs and dietary energy contents, we show that the kangaroos could meet their daily maintenance energy requirements (MER) at lower levels of DMI and on diets with higher fibre contents compared with sheep, due largely to the kangaroos' lower absolute maintenance and basal energy metabolisms compared with eutherians. These results suggest that differences in the metabolic set-point of different species can have profound effects on their nutritional niche, even when their digestive constraints are similar, as was the case for these ruminant and non-ruminant

  18. The role of health-risk appraisals in disease management.

    PubMed

    Hudson, Laurel R; Pope, James E

    2006-02-01

    Managed care organizations and disease management vendors often find themselves in the position of responding to employers who want to administer a health-risk appraisal (HRA) without committing to implementation of a comprehensive health promotion program. The assumption appears to be that information on health risks is sufficient to motivate employees to change their health behaviors in order to reduce estimated health risks. A review of the relevant literature does not substantiate the efficacy of a stand-alone HRA for motivating behavior change. The challenge is to engage employers in informed conversations on what works in health promotion and achieve cost-effective benefits.

  19. Ginseng for managing menopausal woman's health

    PubMed Central

    Lee, Hye Won; Choi, Jiae; Lee, YoungJoo; Kil, Ki-Jung; Lee, Myeong Soo

    2016-01-01

    Abstract Background: The aim of this systematic review was to update, complete, and critically evaluate the evidence from placebo-controlled randomized clinical trials (RCTs) of ginseng for managing menopausal women's health. Methods: We searched the literature using 13 databases (MEDLINE, AMED, EMBASE, the Cochrane Library, 6 Korean Medical, and 3 Chinese Databases) from their inception to July 2016 and included all double-blind RCTs that compared any type of ginseng with a placebo control in postmenopausal women. The methodological quality of all studies was assessed using a Cochrane risk of bias tool. Results: Ten RCTs met our inclusion criteria. Most RCTs had unclear risk of bias. One RCT did not show a significant difference in hot flash frequency between Korean red ginseng (KRG) and placebo. The second RCT reported positive effects of KRG on menopausal symptoms. The third RCT found beneficial effects of ginseng (Ginsena) on depression, well-being, and general health. Four RCTs failed to show significant differences in various hormones between KRG and placebo controls except dehydroepiandrosterone. Two other RCTs failed to show effects of KRG on endometrial thickness in menopausal women. The other RCT also failed to show the effects of American ginseng on oxidative stress markers and other antioxidant enzymes. Conclusion: Our systematic review provided positive evidence of ginseng for sexual function and KRG for sexual arousal and total hot flashes score in menopausal women. However, the results of KRG or ginseng failed to show specific effects on hot flash frequency, hormones, biomarkers, or endometrial thickness. The level of evidence for these findings was low because of unclear risk of bias. PMID:27661038

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

    PubMed

    Andrade, Flávia Reis de; Narvai, Paulo Capel

    2013-12-01

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

  1. Putting Management Capacity Building at the Forefront of Health Systems Strengthening: Comment on "Management Matters: A Leverage Point for Health Systems Strengthening in Global Health".

    PubMed

    Yeager, Valerie A; Bertrand, Jane

    2016-02-01

    The current limited focus on management in global health activities is highly problematic given the amounts of financial and human resources that are pouring into health system strengthening interventions and the complexity of clinical operations across settings. By ensuring that public health and healthcare practitioners in domestic and international settings receive management training in their educational programs and that we build management capacity among individuals already in the health workforce, we can begin to prepare for more effective health systems strengthening efforts. Rigorous evaluation of health systems strengthening and the impact of management capacity building is crucial to building evidence for the field. PMID:26927402

  2. Sustainable waste management in the UK: the public health role.

    PubMed

    Mohan, R; Spiby, J; Leonardi, G S; Robins, A; Jefferis, S

    2006-10-01

    This paper discusses waste management in the UK and its relationship with health. It aims to outline the role of health professionals in the promotion of waste management, and argues for a change in their role in waste management regulation to help make the process more sustainable. The most common definition of sustainable development is that by the Brundtland commission, i.e. "development that meets the needs of the present without compromising the ability of future generations to meet their own needs". Managing waste sites in a manner that minimises toxic impacts on the current and future generations is obviously a crucial part of this. Although the management of waste facilities is extremely complex, the Integrated Pollution Prevention and Control regime, which requires the input of public health professionals on the regulation of such sites, means that all waste management installations should now be operating in a fashion that minimises any toxicological risks to human health. However, the impacts upon climate change, resource use and health inequalities, as well as the effects of waste transportation, are currently not considered to be part of public health professionals' responsibilities when dealing with these sites. There is also no requirement for public health professionals to become involved in waste management planning issues. The fact that public health professionals are not involved in any of these issues makes it unlikely that the potential impacts upon health are being considered fully, and even more unlikely that waste management will become more sustainable. This paper aims to show that by only considering direct toxicological impacts, public health professionals are not fully addressing all the health issues and are not contributing towards sustainability. There is a need for a change in the way that health professionals deal with waste management issues.

  3. Sustainable waste management in the UK: the public health role.

    PubMed

    Mohan, R; Spiby, J; Leonardi, G S; Robins, A; Jefferis, S

    2006-10-01

    This paper discusses waste management in the UK and its relationship with health. It aims to outline the role of health professionals in the promotion of waste management, and argues for a change in their role in waste management regulation to help make the process more sustainable. The most common definition of sustainable development is that by the Brundtland commission, i.e. "development that meets the needs of the present without compromising the ability of future generations to meet their own needs". Managing waste sites in a manner that minimises toxic impacts on the current and future generations is obviously a crucial part of this. Although the management of waste facilities is extremely complex, the Integrated Pollution Prevention and Control regime, which requires the input of public health professionals on the regulation of such sites, means that all waste management installations should now be operating in a fashion that minimises any toxicological risks to human health. However, the impacts upon climate change, resource use and health inequalities, as well as the effects of waste transportation, are currently not considered to be part of public health professionals' responsibilities when dealing with these sites. There is also no requirement for public health professionals to become involved in waste management planning issues. The fact that public health professionals are not involved in any of these issues makes it unlikely that the potential impacts upon health are being considered fully, and even more unlikely that waste management will become more sustainable. This paper aims to show that by only considering direct toxicological impacts, public health professionals are not fully addressing all the health issues and are not contributing towards sustainability. There is a need for a change in the way that health professionals deal with waste management issues. PMID:16962620

  4. Needs Assessment for Health Care Management Education in Russia

    ERIC Educational Resources Information Center

    Rekhter, Natalia; Togunov, Igor A.

    2006-01-01

    Introduction: For more than 70 years, health care management in the Soviet Union reflected a centralized directive style familiar to the Soviet political system. Market-oriented reform in post-Soviet Russia is pushing practicing physicians and physician-executives to acquire new information and skills regarding health care management. To assist…

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

    ERIC Educational Resources Information Center

    Jancey, Jonine; Meuleners, Lynn; Phillips, Maureen

    2011-01-01

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

  6. 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…

  7. Technology Maturation of Integrated System Health Management

    NASA Astrophysics Data System (ADS)

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

    2008-01-01

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

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

    PubMed Central

    Rahmani, Arshad H.

    2015-01-01

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

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

    PubMed Central

    Reddick, W. T.

    1990-01-01

    Rapid change in the health care environment mandates a more comprehensive approach to the education of future health administrators. The area of consideration in this study is that of health care strategic management. A comprehensive literature review suggests microcomputer-based simulation as an appropriate vehicle for addressing the needs of both educators and students. Seven strategic management software packages are reviewed and rated with an instrument adapted from the Infoworld review format. The author concludes that a primary concern is the paucity of health care specific strategic management simulations.

  10. Health information technology: transforming chronic disease management and care transitions.

    PubMed

    Rao, Shaline; Brammer, Craig; McKethan, Aaron; Buntin, Melinda B

    2012-06-01

    Adoption of health information technology (HIT) is a key effort in improving care delivery, reducing costs of health care, and improving the quality of health care. Evidence from electronic health record (EHR) use suggests that HIT will play a significant role in transforming primary care practices and chronic disease management. This article shows that EHRs and HIT can be used effectively to manage chronic diseases, that HIT can facilitate communication and reduce efforts related to transitions in care, and that HIT can improve patient safety by increasing the information available to providers and patients, improving disease management and safety.

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

    PubMed

    Rahmani, Arshad H

    2015-01-01

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

  12. A Primer on Population Health Management and Its Perioperative Application.

    PubMed

    Boudreaux, Arthur M; Vetter, Thomas R

    2016-07-01

    The movement toward value-based payment models, driven by governmental policies, federal statutes, and market forces, is propelling the importance of effectively managing the health of populations to the forefront in the United States and other developed countries. However, for many anesthesiologists, population health management is a new or even foreign concept. A primer on population health management and its potential perioperative application is thus presented here. Although it certainly continues to evolve, population health management can be broadly defined as the specific policies, programs, and interventions directed at optimizing population health. The Population Health Alliance has created a particularly cogent conceptual framework and interconnected and very useful population health process model, which together identify the key components of population health and its management. Population health management provides a useful rationale for patients, providers, payers, and policymakers to move collectively away from the traditional system of individual, siloed providers to a more integrated, coordinated, team-based approach, thus creating a holistic view of the patient population. The goal of population health management is to keep the targeted patient population as healthy as possible, thus minimizing the need for costly interventions such as emergency department visits, acute hospitalizations, laboratory testing and imaging, and diagnostic and therapeutic procedures. Population health management strategies are increasingly more important to leaders of health care systems as the health of populations for which they care, especially in a strong cost risk-sharing environment, must be optimized. Most population health management efforts rely on a patient-centric team approach, coordination of care, effective communication, robust outcomes data analysis, and continuous quality improvement. Anesthesiologists have an opportunity to help lead these efforts in

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

    PubMed

    Darr, Kurt J

    2015-01-01

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

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

    PubMed

    Darr, Kurt J

    2015-08-25

    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.

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-07-01

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

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

    PubMed

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

    2015-05-20

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

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

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

    ERIC Educational Resources Information Center

    Roberts, James R.; McCurdy, Leyla Erk

    2005-01-01

    These guidelines are the product of a new Pediatric Asthma Initiative aimed at integrating environmental management of asthma into pediatric health care. This document outlines competencies in environmental health relevant to pediatric asthma that should be mastered by primary health care providers, and outlines the environmental interventions…

  20. Control of paratuberculosis in small ruminants.

    PubMed

    Robbe-Austerman, Suelee

    2011-11-01

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

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

    PubMed

    Gevorkian, E V

    2014-01-01

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

  2. HEALTH COMMUNICATION AND HEALTH MANAGEMENT IN TRADITIONAL MEDICINE : A CHALLENGE, A RESPONSE !

    PubMed Central

    Sundari, K.

    1986-01-01

    Health communication in health management process contributes to the overall efficiency of the health-care delivery systems. For this the individual health worker should be able to co-ordinate, integrate and adopt his functions. This is basically required which is minutely discussed in this paper by the author PMID:22557543

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

    ERIC Educational Resources Information Center

    Bainbridge, J.; Sapirie, S.

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

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

    NASA Astrophysics Data System (ADS)

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

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

  5. Association of rumination time with subclinical ketosis in transition dairy cows.

    PubMed

    Kaufman, E I; LeBlanc, S J; McBride, B W; Duffield, T F; DeVries, T J

    2016-07-01

    The objective of this study was to characterize the relationship between rumination and subclinical ketosis (SCK) in transition dairy cows. A study was conducted on 4 commercial dairy farms in eastern Ontario, Canada. A total of 339 Holstein dairy cows (107 primiparous and 232 multiparous) were monitored for rumination activity and SCK from 14 d before calving until 28 d after calving. Rumination was recorded daily using an automated monitoring system. A blood sample was taken from the coccygeal vein of each cow for measurement of β-hydroxybutyrate (BHB) once weekly throughout the 6-wk observation period. Cows with BHB ≥1.2mmol/L in any of the 4 postpartum samples were considered to have SCK. Cases of retained placenta, metritis, milk fever, or mastitis during the study period were also recorded. Cows were categorized into 1 of 4 groups: healthy cows (HLT) that had no SCK or any other recorded health problem (n=139); cows treated for at least one health issue other than SCK (HLT+; n=50); cows with SCK (hyperketonemia; HYK) with no other health problems during transition (n=97); or cows (HYK+) that had SCK and one or more other health problems (n=53). Daily rumination time was summarized by week and comparisons were made between HLT and HYK and HYK+. From 2 wk before calving (wk -2) to 4 wk after calving (wk +4), there was no difference in rumination time (409±9.8min/d) among HLT, HYK, and HYK+ cows in their first lactation. Multiparous cows in HLT spent an average of 459±11.3min/d ruminating from wk -2 to wk +4. Multiparous HYK cows ruminated 25±12.8min/d less than HLT cows, whereas HYK+ cows ruminated 44±15.6min/d less than HLT cows. The largest differences in rumination time between HLT and HYK+ cows were seen during wk -1, +1, and +2, when HYK+ cows ruminated 48±17.2, 73±16.0, and 65±19.4min/d less than HLT cows, respectively. In multiparous cows, increased odds of HYK were associated with greater milk yield in the previous lactation, greater loss of

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

    PubMed Central

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

    2016-01-01

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

  7. Health coaching in diabetes: empowering patients to self-manage.

    PubMed

    Wong-Rieger, Durhane; Rieger, Francis P

    2013-02-01

    To effectively manage diabetes mellitus, patients must adhere to treatment recommendations and healthy lifestyle behaviors, but research shows many patients do not do this. Education is effective when combined with self-management support but peer-support programs do not lead to lasting changes. Health coaching, or professional support, can be highly effective if it focuses on developing self-efficacy and skills such as goal-setting, problem-solving and managing cognitive and emotional barriers. This overview discusses the benefits of patient self-management for chronic conditions such as diabetes, core competencies for health coaching, theoretical bases and principles of health coaching interventions, delivery methods and the evidence that health coaching works for diabetes self-management.

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

    PubMed Central

    Rose, R. I.

    2001-01-01

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

  9. 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.

  10. No health for all without better trained management.

    PubMed

    White, D K

    1997-01-01

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

  11. No health for all without better trained management.

    PubMed

    White, D K

    1997-01-01

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

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

    PubMed

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

    2015-11-01

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

  13. Leadership and globalization: research in health management education.

    PubMed

    West, Daniel J; Ramirez, Bernardo; Filerman, Gary

    2012-01-01

    The impact of globalization on graduate health care management education is evident, yet challenging to quantify. The Commission on Healthcare Management Education (CAHME) recently authorized two research studies to gather specific information and answer important questions about accredited graduate programs in the USA and Canada. Two surveys provided the most comprehensive data impacting international health management education efforts by 70 programs. An inventory was made of 22 countries; information was compiled on 21 accrediting or quality improvement organizations. Observations on leadership and the demand for qualified health care professionals is discussed in terms of accreditation, certification, competency models, outcome assessment, improving quality, and the impact of globalization on higher education.

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

    NASA Technical Reports Server (NTRS)

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

    2002-01-01

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

  15. Total quality management in health: making it work.

    PubMed

    McLaughlin, C P; Kaluzny, A D

    1990-01-01

    Many health organizations are trying total quality management (TQM). This approach represents a total paradigm shift in health care management and presents a series of potential conflict areas in the way health organizations are managed. These areas include TQM's participatory approach versus professional and managerial authority, collective versus individual responsibility, quality assurance and standards versus continuous improvement, and flexible versus rigid objectives and plans. This article reviews the areas of conflict and suggests a number of action guidelines for the successful implementation of TQM.

  16. Health Technologies for the Improvement of Chronic Disease Management

    PubMed Central

    Nikitovic, M; Brener, S

    2013-01-01

    Background As part of ongoing efforts to improve the Ontario health care system, a mega-analysis examining the optimization of chronic disease management in the community was conducted by Evidence Development and Standards, Health Quality Ontario (previously known as the Medical Advisory Secretariat [MAS]). Objective The purpose of this report was to identify health technologies previously evaluated by MAS that may be leveraged in efforts to optimize chronic disease management in the community. Data Sources The Ontario Health Technology Assessment Series and field evaluations conducted by MAS and its partners between January 1, 2006, and December 31, 2011. Review Methods Technologies related to at least 1 of 7 disease areas of interest (type 2 diabetes, coronary artery disease, atrial fibrillation, chronic obstructive pulmonary disease, congestive heart failure, stroke, and chronic wounds) or that may greatly impact health services utilization were reviewed. Only technologies with a moderate to high quality of evidence and associated with a clinically or statistically significant improvement in disease management were included. Technologies related to other topics in the mega-analysis on chronic disease management were excluded. Evidence-based analyses were reviewed, and outcomes of interest were extracted. Outcomes of interest included hospital utilization, mortality, health-related quality of life, disease-specific measures, and economic analysis measures. Results Eleven analyses were included and summarized. Technologies fell into 3 categories: those with evidence for the cure of chronic disease, those with evidence for the prevention of chronic disease, and those with evidence for the management of chronic disease. Conclusions The impact on patient outcomes and hospitalization rates of new health technologies in chronic disease management is often overlooked. This analysis demonstrates that health technologies can reduce the burden of illness; improve patient

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

    PubMed

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

    2009-06-01

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

  18. Program management of telemental health care services.

    PubMed

    Darkins, A

    2001-01-01

    Telemedicine is a new adjunct to the delivery of health care services that has been applied to a range of health care specialties, including mental health. When prospective telemedicine programs are planned, telemedicine is often envisaged as simply a question of introducing new technology. The development of a robust, sustainable telemental health program involves clinical, technical, and managerial considerations. The major barriers to making this happen are usually how practitioners and patients adapt successfully to the technology and not in the physical installation of telecommunications bandwidth and the associated hardware necessary for teleconsultation. This article outlines the requirements for establishing a viable telemental health service, one that is based on clinical need, practitioner acceptance, technical reliability, and revenue generation. It concludes that the major challenge associated with the implementation of telemental health does not lie in having the idea or in taking the idea to the project stage needed for proof of concept. The major challenge to the widespread adoption of telemental health is paying sufficient attention to the myriad of details needed to integrate models of remote health care delivery into the wider health care system.

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

    PubMed

    Caplan, Mary Ager

    2014-05-01

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

  20. The implementation of self-managed teams in health care.

    PubMed

    Schrubb, D A

    1992-08-01

    Self-managed teams are one of the most effective tools now available for tapping the unrealized potential of health care organizations. Executives and managers involved with self-managed teams are speaking of new levels of productivity, new commitment among workers, and new optimism about meeting the challenges of competition. GSH's ability to create peak-performance teams will certainly give the hospital a critical competitive advantage over competing hospitals in the Dayton area. Success requires commitment and patience. Health care organizations that believe in the power of worker participation will not regret following the path to a self-managed team environment.

  1. Health professional's role in disaster planning: a strategic management approach.

    PubMed

    Meyer, M U; Graeter, C J

    1995-05-01

    1. The Strategic Management for Total Quality in Health Care model incorporates strategic management methods and total quality principles to enhance management of complex, interdisciplinary projects. 2. The purpose of disaster planning is to provide an effective and efficient plan to prevent personal injury and limit property damage and capital losses, as well as return to full production after a disaster. 3. Participation in disaster response planning provides health professionals with an opportunity to demonstrate the benefits they can provide for meeting their company's business needs. 4. Disaster planning is a complex, interdisciplinary project that requires a strategic management framework to facilitate development of high quality, cost effective programs.

  2. Ruminants, climate change and climate policy

    NASA Astrophysics Data System (ADS)

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

    2014-01-01

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

  3. Rumination and multi-modal emotional reactivity.

    PubMed

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

    2015-01-01

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

  4. Solving a Health Information Management Problem. An international success story.

    PubMed

    Hannan, Terry J

    2015-01-01

    The management of health care delivery requires the availability of effective 'information management' tools based on e-technologies [eHealth]. In developed economies many of these 'tools' are readily available whereas in Low and Middle Income Countries (LMIC) there is limited access to eHealth technologies and this has been defined as the "digital divide". This paper provides a short introduction to the fundamental understanding of what is meant by information management in health care and how it applies to all social economies. The core of the paper describes the successful implementation of appropriate information management tools in a resource poor environment to manage the HIV/AIDS epidemic and other disease states, in sub-Saharan Africa and how the system has evolved to become the largest open source eHealth project in the world and become the health information infrastructure for several national eHealth economies. The system is known as Open MRS [www.openmrs.org). The continuing successful evolution of the OpenMRS project has permitted its key implementers to define core factors that are the foundations for successful eHealth projects. PMID:26521384

  5. Solving a Health Information Management Problem. An international success story.

    PubMed

    Hannan, Terry J

    2015-01-01

    The management of health care delivery requires the availability of effective 'information management' tools based on e-technologies [eHealth]. In developed economies many of these 'tools' are readily available whereas in Low and Middle Income Countries (LMIC) there is limited access to eHealth technologies and this has been defined as the "digital divide". This paper provides a short introduction to the fundamental understanding of what is meant by information management in health care and how it applies to all social economies. The core of the paper describes the successful implementation of appropriate information management tools in a resource poor environment to manage the HIV/AIDS epidemic and other disease states, in sub-Saharan Africa and how the system has evolved to become the largest open source eHealth project in the world and become the health information infrastructure for several national eHealth economies. The system is known as Open MRS [www.openmrs.org). The continuing successful evolution of the OpenMRS project has permitted its key implementers to define core factors that are the foundations for successful eHealth projects.

  6. Peste des petits ruminants in Arabian wildlife.

    PubMed

    Kinne, J; Kreutzer, R; Kreutzer, M; Wernery, U; Wohlsein, P

    2010-08-01

    Recurrence of peste des petits ruminants (PPR) was diagnosed in the United Arabian Emirates in several wild ruminants confirmed by morphological, immunohistochemical, serological and molecular findings. Phylogenetic analysis revealed that the virus strain belongs to lineage IV, which is different to some previously isolated PPR strains from the Arabian Peninsula. This study shows that wild ruminants may play an important epidemiological role as virus source for domestic small ruminants.

  7. Winners show the way to good management in health care.

    PubMed

    Schwefel, D; Pons, M C

    1994-01-01

    To stimulate resourcefulness in the health care services of the Philippines, the German Agency for Technical Cooperation (GTZ) organized a competition to discover and publicize examples of good management. The results provide a rich fund of new ideas. PMID:7999220

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

    NASA Technical Reports Server (NTRS)

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

    2011-01-01

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

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

    PubMed Central

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

    1980-01-01

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

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

    PubMed

    Kluge, Eike-Henner W

    2007-01-01

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

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

    PubMed Central

    Weimer, Paul J.

    2015-01-01

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

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

    ERIC Educational Resources Information Center

    Purcell, Laura; Milner, Brigid

    2005-01-01

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

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

    PubMed

    Salden, Alfons; Poortinga, Remco

    2006-01-01

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

  14. Toward a Conceptual Knowledge Management Framework in Health

    PubMed Central

    Lau, Francis

    2004-01-01

    This paper describes a conceptual organizing scheme for managing knowledge within the health setting. First, a brief review of the notions of knowledge and knowledge management is provided. This is followed by a detailed depiction of our proposed knowledge management framework, which focuses on the concepts of production, use, and refinement of three specific knowledge sources-policy, evidence, and experience. These concepts are operationalized through a set of knowledge management methods and tools tailored for the health setting. We include two case studies around knowledge translation on parent-child relations and virtual networks in community health research to illustrate how this knowledge management framework can be operationalized within specific contexts and the issues involved. We conclude with the lessons learned and implications. PMID:18066388

  15. Knowledge management in health: a systematic literature review.

    PubMed

    Rocha, Elyrose Sousa Brito; Nagliate, Patricia; Furlan, Claudia Elisangela Bis; Rocha, Kerson; Trevizan, Maria Auxiliadora; Mendes, Isabel Amélia Costa

    2012-01-01

    Knowledge has been used as a resource for intelligent and effective action planning in organizations. Interest in research on knowledge management processes has intensified in different areas. A systematic literature review was accomplished, based on the question: what are the contributions of Brazilian and international journal publications on knowledge management in health? The sample totaled 32 items that complied with the inclusion criteria. The results showed that 78% of journals that published on the theme are international, 77% of researchers work in higher education and 65% have a Ph.D. The texts gave rise to five thematic categories, mainly: development of knowledge management systems in health (37.5%), discussion of knowledge management application in health (28.1%) and nurses' function in knowledge management (18.7%).

  16. Knowledge management in health: a systematic literature review.

    PubMed

    Rocha, Elyrose Sousa Brito; Nagliate, Patricia; Furlan, Claudia Elisangela Bis; Rocha, Kerson; Trevizan, Maria Auxiliadora; Mendes, Isabel Amélia Costa

    2012-01-01

    Knowledge has been used as a resource for intelligent and effective action planning in organizations. Interest in research on knowledge management processes has intensified in different areas. A systematic literature review was accomplished, based on the question: what are the contributions of Brazilian and international journal publications on knowledge management in health? The sample totaled 32 items that complied with the inclusion criteria. The results showed that 78% of journals that published on the theme are international, 77% of researchers work in higher education and 65% have a Ph.D. The texts gave rise to five thematic categories, mainly: development of knowledge management systems in health (37.5%), discussion of knowledge management application in health (28.1%) and nurses' function in knowledge management (18.7%). PMID:22699742

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

    PubMed

    Collins, Sandra K

    2010-01-01

    The decisions and actions of health care managers are oftentimes heavily scrutinized by the public. Given the current economic climate, managers may feel intense pressure to produce higher results with fewer resources. This could inadvertently test their moral fortitude and their social consciousness. A study was conducted to determine what corporate social responsibility orientation and viewpoint future health care managers may hold. The results of the study indicate that future health care managers may hold patient care in high regard as opposed to profit maximization. However, the results of the study also show that future managers within the industry may continue to need rules, laws, regulations, and legal sanctions to guide their actions and behavior.

  18. Dual-Use Aspects of System Health Management

    NASA Technical Reports Server (NTRS)

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

    1994-01-01

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

  19. The use of a circular external skeletal fixation device for the management of long bone osteotomies in large ruminants: an experimental study.

    PubMed

    Aithal, H P; Singh, G R; Hoque, M; Maiti, S K; Kinjavdekar, P; Pawde, A M; Setia, H C

    2004-08-01

    The study was undertaken to evaluate the feasibility of a simple, inexpensive model of circular external fixator (CEF) for use in large ruminants. A simple model of CEF frames consisting of four full rings (13-19 cm diameter, 4 cm wide and 4 mm thick with 18-24 holes) connected by threaded rods (8 mm diameter, 10-15 cm long) and nuts was developed using mild (low carbon) steel and were nickel-plated. In the first phase of the study, three male cow calves were utilized to study the feasibility of application of the fixators in the metatarsus, tibia and radius, in reference of adaptation and tolerance by animals. In the second phase, the fixators were tested in osteotomized bones. Six bull calves of 1.5-2 years of age weighing about 200-250 kg were utilized for this purpose. After preparing the area for aseptic surgery, under xylazine (at 0.1 mg/kg, i.m.)-ketamine (i.v. till effect) general anaesthesia, the test bone (metatarsus, radius and tibia in two animals each) was approached through the medial surface and an osteotomy was created with a saw and chisel at the mid-diaphysis. The pre-constructed 4-ring CEF was mounted on the limb around the test bone in such a way that it formed a cylinder with the axis of the limb at the centre. Each ring was then fixed to the bone with a pair of beaded wires (316 SS) of 3.5 mm diameter. During the post-operative period, the animals were observed for any change in behaviour, tolerance of the fixators, the weight bearing on the test limb, the status of the fixator, and the level of reduction of the osteotomy, alignment and healing at different intervals. The fixation of CEF was easier in the metatarsus and radius than in the tibia. The inner ring diameters found adequate for metatarsus, radius and tibia were 13-15 cm, 15-17 cm and 17-19 cm, respectively. The fixators applied to different bones were well-tolerated, and the animals could lay down, stand and walk freely with the fixator without any problems. All the animals showed

  20. Regulation of Nutritional Metabolism in Transition Dairy Cows: Energy Homeostasis and Health in Response to Post-Ruminal Choline and Methionine

    PubMed Central

    Sun, Feifei; Cao, Yangchun; Cai, Chuanjiang; Li, Shengxiang; Yu, Chao; Yao, Junhu

    2016-01-01

    This study investigated the effects of rumen-protected methionine (RPM) and rumen-protected choline (RPC) on energy balance, postpartum lactation performance, antioxidant capacity and immune response in transition dairy cows. Forty-eight multiparous transition cows were matched and divided into four groups: control, 15 g/d RPC, 15 g/d RPM or 15 g/d RPC + 15 g/d RPM. Diet samples were collected daily before feeding, and blood samples were collected weekly from the jugular vein before morning feeding from 21 days prepartum to 21 days postpartum. Postpartum dry matter intake (DMI) was increased by both additives (P < 0.05), and energy balance values in supplemented cows were improved after parturition (P < 0.05). Both RPC and RPM decreased the plasma concentrations of non-esterified fatty acids (NEFA), β-hydroxybutyric acid (BHBA), total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) (P < 0.05), but increased the plasma levels of glucose, very-low-density lipoprotein (VLDL) and apolipoprotein B100 (ApoB 100, P < 0.05). The supplements improved milk production (P < 0.05), and increased (P < 0.05) or tended to increase (0.05 < P < 0.10) the contents of milk fat and protein. The post-ruminal choline and methionine elevated the blood antioxidant status, as indicated by total antioxidant capacity (T-AOC), glutathione peroxidase (GSH-Px) activity and the vitamin E concentration (P < 0.05), and reduced the plasma malondialdehyde (MDA) level (P < 0.05). Furthermore, RPM and RPC elevated the plasma interleukin 2 (IL-2) concentration and the CD4+/CD8+ T lymphocyte ratio in peripheral blood (P < 0.05). Alternatively, the levels of tumor necrosis factor-α (TNF-α) and IL-6 were decreased by RPM and RPC (P < 0.05). Overall, the regulatory responses of RPC and RPM were highly correlated with time and were more effective in the postpartum cows. The results demonstrated that dietary supplementation with RPC and RPM promoted energy balance by increasing postpartal

  1. Regulation of Nutritional Metabolism in Transition Dairy Cows: Energy Homeostasis and Health in Response to Post-Ruminal Choline and Methionine.

    PubMed

    Sun, Feifei; Cao, Yangchun; Cai, Chuanjiang; Li, Shengxiang; Yu, Chao; Yao, Junhu

    2016-01-01

    This study investigated the effects of rumen-protected methionine (RPM) and rumen-protected choline (RPC) on energy balance, postpartum lactation performance, antioxidant capacity and immune response in transition dairy cows. Forty-eight multiparous transition cows were matched and divided into four groups: control, 15 g/d RPC, 15 g/d RPM or 15 g/d RPC + 15 g/d RPM. Diet samples were collected daily before feeding, and blood samples were collected weekly from the jugular vein before morning feeding from 21 days prepartum to 21 days postpartum. Postpartum dry matter intake (DMI) was increased by both additives (P < 0.05), and energy balance values in supplemented cows were improved after parturition (P < 0.05). Both RPC and RPM decreased the plasma concentrations of non-esterified fatty acids (NEFA), β-hydroxybutyric acid (BHBA), total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) (P < 0.05), but increased the plasma levels of glucose, very-low-density lipoprotein (VLDL) and apolipoprotein B100 (ApoB 100, P < 0.05). The supplements improved milk production (P < 0.05), and increased (P < 0.05) or tended to increase (0.05 < P < 0.10) the contents of milk fat and protein. The post-ruminal choline and methionine elevated the blood antioxidant status, as indicated by total antioxidant capacity (T-AOC), glutathione peroxidase (GSH-Px) activity and the vitamin E concentration (P < 0.05), and reduced the plasma malondialdehyde (MDA) level (P < 0.05). Furthermore, RPM and RPC elevated the plasma interleukin 2 (IL-2) concentration and the CD4+/CD8+ T lymphocyte ratio in peripheral blood (P < 0.05). Alternatively, the levels of tumor necrosis factor-α (TNF-α) and IL-6 were decreased by RPM and RPC (P < 0.05). Overall, the regulatory responses of RPC and RPM were highly correlated with time and were more effective in the postpartum cows. The results demonstrated that dietary supplementation with RPC and RPM promoted energy balance by increasing postpartal

  2. Regulation of Nutritional Metabolism in Transition Dairy Cows: Energy Homeostasis and Health in Response to Post-Ruminal Choline and Methionine.

    PubMed

    Sun, Feifei; Cao, Yangchun; Cai, Chuanjiang; Li, Shengxiang; Yu, Chao; Yao, Junhu

    2016-01-01

    This study investigated the effects of rumen-protected methionine (RPM) and rumen-protected choline (RPC) on energy balance, postpartum lactation performance, antioxidant capacity and immune response in transition dairy cows. Forty-eight multiparous transition cows were matched and divided into four groups: control, 15 g/d RPC, 15 g/d RPM or 15 g/d RPC + 15 g/d RPM. Diet samples were collected daily before feeding, and blood samples were collected weekly from the jugular vein before morning feeding from 21 days prepartum to 21 days postpartum. Postpartum dry matter intake (DMI) was increased by both additives (P < 0.05), and energy balance values in supplemented cows were improved after parturition (P < 0.05). Both RPC and RPM decreased the plasma concentrations of non-esterified fatty acids (NEFA), β-hydroxybutyric acid (BHBA), total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) (P < 0.05), but increased the plasma levels of glucose, very-low-density lipoprotein (VLDL) and apolipoprotein B100 (ApoB 100, P < 0.05). The supplements improved milk production (P < 0.05), and increased (P < 0.05) or tended to increase (0.05 < P < 0.10) the contents of milk fat and protein. The post-ruminal choline and methionine elevated the blood antioxidant status, as indicated by total antioxidant capacity (T-AOC), glutathione peroxidase (GSH-Px) activity and the vitamin E concentration (P < 0.05), and reduced the plasma malondialdehyde (MDA) level (P < 0.05). Furthermore, RPM and RPC elevated the plasma interleukin 2 (IL-2) concentration and the CD4+/CD8+ T lymphocyte ratio in peripheral blood (P < 0.05). Alternatively, the levels of tumor necrosis factor-α (TNF-α) and IL-6 were decreased by RPM and RPC (P < 0.05). Overall, the regulatory responses of RPC and RPM were highly correlated with time and were more effective in the postpartum cows. The results demonstrated that dietary supplementation with RPC and RPM promoted energy balance by increasing postpartal

  3. The Management Academy for Public Health: the South Carolina experience.

    PubMed

    Cumbey, Dorothy A; Ellison, Lu Anne

    2006-01-01

    In the late 1990s, the South Carolina Department of Health and Environmental Control (SCDHEC) was faced with the challenges of a workforce that was not prepared in public health; the impending loss of significant agency expertise, leadership, and institutional knowledge through retirement; the lack of available and accessible training; and continuing state budget cuts. Preparedness for bioterrorism and other public health emergencies was also of concern, a need made more urgent after 2001. To respond to current and emerging public health challenges, the SCDHEC had to have a workforce with the knowledge and skills necessary for the delivery of essential public health services. To address these challenges, the department partnered with the University of North Carolina in the pilot of the Management Academy for Public Health. The Management Academy is now integrated into the South Carolina workforce development strategy, and 199 staff members and 22 community partners have graduated from the program. Along with increased knowledge, skills, and abilities of individual staff and increased organizational and community capacity, a significant result of South Carolina's experience with the Management Academy for Public Health is the development of a training program for emergency preparedness modeled on the Management Academy. This highly successful program illustrates the replicability of the Management Academy model. PMID:16912610

  4. Behavioral health and managed care contracting under SCHIP.

    PubMed

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

    2002-09-01

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

  5. [Health alert management and emerging risk].

    PubMed

    Pillonel, J

    2010-12-01

    Following health crisis that have occurred in the nineties (contaminated blood, mad cow, asbestos, etc.) and more recently those generated by the heat wave in 2003 or by emerging infectious pathogens (SARS, West Nile, Chikungunya, H5N1, H1N1…), a real health vigilance system has been progressively developed in France. After a brief historical overview of the health alert system, this article will give the guiding principles of its current organization in France and will present two examples of recent health alerts (Chikungunya in the Reunion Island in 2005-2006 and hepatitis A outbreak in the Côtes-d'Armor in August 2007), that have needed the implementation of preventive measures regarding the blood donor selection. These two examples have shown that the position of the alert in the French health vigilance system needs to be very close to the event. In that case, health alert is a very useful tool for decision making especially when measures have to be taken to prevent transfusion-transmitted pathogens. PMID:21051258

  6. [Health alert management and emerging risk].

    PubMed

    Pillonel, J

    2010-12-01

    Following health crisis that have occurred in the nineties (contaminated blood, mad cow, asbestos, etc.) and more recently those generated by the heat wave in 2003 or by emerging infectious pathogens (SARS, West Nile, Chikungunya, H5N1, H1N1…), a real health vigilance system has been progressively developed in France. After a brief historical overview of the health alert system, this article will give the guiding principles of its current organization in France and will present two examples of recent health alerts (Chikungunya in the Reunion Island in 2005-2006 and hepatitis A outbreak in the Côtes-d'Armor in August 2007), that have needed the implementation of preventive measures regarding the blood donor selection. These two examples have shown that the position of the alert in the French health vigilance system needs to be very close to the event. In that case, health alert is a very useful tool for decision making especially when measures have to be taken to prevent transfusion-transmitted pathogens.

  7. An Examination of Health Information Management by the Deaf

    ERIC Educational Resources Information Center

    Karras, Elizabeth

    2010-01-01

    Little is known about how Deaf people perceive, access, and utilize interpersonal and media sources for health information. In light of the scarcity of research on health information management among this group, a two-phase study was conducted that included eight focus groups (N=39) and survey data (N=366) with Deaf participants to determine the…

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

    SciTech Connect

    Vătăsescu, Mihaela

    2015-03-10

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

  9. Effective outcomes management in occupational and environmental health.

    PubMed

    Kosinski, M

    1998-10-01

    In the final analysis, outcomes management is about changing behavior, specifically in the occupational and environmental health practitioner's communication process and practice patterns and in the workers' prevention and compliance behavior. Outcomes management is also about quantifying results, establishing occupational and environmental health performance benchmarks, developing a best practices model and asking even more questions. As health care embraces the use of outcomes in evaluating its effectiveness, similar developments can be anticipated in occupational and environmental health. While occupational and environmental health outcomes management is still in its infancy, nurses in the workplace are well positioned to "shape it" into a useful tool that meets the needs of all the various practice settings. As nurses in the workplace begin to evaluate, report, and benchmark results, measurement tools will be refined, data bases will grow and new, useful benchmarks will be established. Because occupational and environmental health programs usually operate as part of a larger business unit, nurses in the workplace are continually faced with the challenge of ensuring that corporate programs including workers' compensation, health and disability benefit programs, vaccination programs, injury prevention, and health promotion or wellness programs are delivered in an efficient and cost-effective manner and that the expected outcomes are achieved. Effective outcomes management programs are the vehicles to effective goal achievement.

  10. School-Based Health Centers and Managed Care.

    ERIC Educational Resources Information Center

    Office of Inspector General (DHHS), Washington, DC.

    This report describes school-based health centers and their degree of coordination with managed care providers. Although the investigation focuses on adolescents, many ideas discussed here are germane to elementary school-based health centers as well. Information was gathered through an extensive literature review, relevant legislation, and 88…

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

    PubMed Central

    2013-01-01

    Background The prevalence and the clinical consequences of subacute ruminal acidosis (SARA) in dairy cows are still poorly understood. In order to evaluate the prevalence of SARA, 26 German dairy farms were included in a field study. In each herd, between 11 and 14 lactating dairy cows were examined for their ruminal pH using rumenocentesis. Milk production data and farm management characteristics were recorded. Each farm was scored for lameness prevalence among lactating animals, and body condition score was recorded three times four to five weeks apart in all animals examined. Farms were grouped on basis of ruminal pH and compared for lameness, body condition, milk production parameters and style of management. Animals were grouped on basis of their measured ruminal pH and compared accordingly for milk production parameters and body condition score. Results Of 315 cows examined, 63 individuals (20%) exhibited a ruminal pH of ≤ 5.5 at time of rumenocentesis. Of 26 farms examined, eleven farms had three or more of their cows experiencing a ruminal pH of ≤ 5.5 and were classified as likely experiencing subacute ruminal acidosis. These farms tended to be bigger than the others and offered less lying space to the lactating cows. There was no clear tendency regarding lameness. Among individual cows, animals with a low ruminal pH of ≤ 5.5 were found to be in significantly poorer body condition than animals with higher pH values (p < 0,05). Conclusions The study shows 11 out of 26 of herds likely experiencing SARA. Bigger herds tend to be at a higher risk for SARA, while individuals with low ruminal pH tend to be lower in body condition. The study points to the importance of management in preventing SARA. PMID:23805878

  12. Leadership and management quality: key factors in effective health systems.

    PubMed

    Pfeffermann, Guy

    2012-01-01

    The effectiveness of health care systems in the developing world is related to the quality of their leadership and management, yet that factor has been neglected by academics and funders. Based on replicable existing models, the article proposes an approach to strengthening local management training institutions.

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

    ERIC Educational Resources Information Center

    Jacobi, Wendy J.

    2010-01-01

    In Pennsylvania, certified school nurses were governed by the same educational rules and administrative directives as teachers. School nurses were supervised and evaluated by non-nurse managers who had no knowledge of the scope of school nurse practice. A focus of the study was to examine the efficacy of management for school health programs. The…

  14. Integrating health sciences library resources into course management systems.

    PubMed

    Blevins, Amy E; Inman, Megan B

    2014-01-01

    As distance education and blended learning grows, so does the need for health sciences librarians to become involved with course management systems. This article will provide some information on how to become involved with course management systems and will also provide information on a few of the more popular systems available.

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

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2004-11-01

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

  17. [Pharmacogenetics--implications for health management and health care economics].

    PubMed

    Weihrauch, Thomas R

    2002-07-15

    Pharmacogenetics, which is principally concerned with drug efficacy and safety, will change the way future health care is practiced. The growing understanding of the genetic basis for drug response and use of this knowledge to predict the response of an individual patient offer new opportunities to meet the changing needs of health care systems and the demands placed upon them. For the individual patient, overall quality of life should be higher as physicians will be able to select the most effective and safest treatments for them. However, the cost of patient evaluation will need to be weighed against the additional therapeutic benefit and savings made by avoidance of unnecessary and inadequate drug use and adverse drug responses. Getting the right medicine at the right dose to the patient first time and avoidance of "try and see" prescribing also have the potential to reduce costs due a reduction in number of visits to the physician required to obtain satisfactory treatment. Application of pharmacogenetics to drug development has the potential to streamline the drug development process. Disease and therapy differentiation may lead to stratification of patient groups, and it is possible that the fragmented indications will not represent commercially attractive markets to the pharmaceutical industry with current marketing paradigms. However, the ability to target patients more accurately may represent considerable commercial value within a given market sector. Changes in health care policy and structure will be needed so that short-term budget constraints are not allowed to take precedence over mid- to long-term benefits. In order to realize the potential of pharmacogenetics, tailored communication/education programs for the key stakeholders--patients and patient groups, health care professionals, regulators, health care industry (biotechnology, pharmaceutical and diagnostic companies), health care payers, governments, and academia--will be necessary

  18. Management behaviour of one community health nurse supervisor.

    PubMed

    Field, P A; Larsen, J

    1989-03-01

    Mintzberg's theoretical framework of management, which examines the roles and functions of a manager in relation to effective communication, is used to analyse observational data of managerial conflict within a community health setting. In this setting the manager failed to establish sound interpersonal relations with her peers or with the clinic nurses. This led to a poor information base from which she could make decisions. The result was that the group became stressed and developed signs of disintegration.

  19. Public health informatics: a CDC course for public health program managers.

    PubMed Central

    O'Carroll, P. W.; Yasnoff, W. A.; Wilhoite, W.

    1998-01-01

    Information science and technology are critical to the modern practice of public health. Yet today's public health professionals generally have no formal training in public health informatics--the application of information science and technology to public health practice and research. Responding to this need, the U.S. Centers for Disease Control and Prevention (CDC) recently developed, tested, and delivered a new training course in public health informatics. The course was designed for experienced public health program managers and included sessions on general informatics principles and concepts; key information systems issues and information technologies; and management issues as they relate to information technology projects. This course has been enthusiastically received both at the state and federal levels. We plan to develop an abbreviated version for health officers, administrators, and other public health executives. PMID:9929264

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

    PubMed

    Chinitz, David; Rodwin, Victor G

    2014-10-01

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

  1. Reusable Rocket Engine Turbopump Health Management System

    NASA Technical Reports Server (NTRS)

    Surko, Pamela

    1994-01-01

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

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

    PubMed

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

    2009-09-01

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

  3. Toward effectiveness assessment of health management education in Canada.

    PubMed

    Caro, D H

    1994-01-01

    A growing theme in the management education literature is that of effectiveness assessment. Integrated effectiveness assessment systems represent an important challenge in health management education in Canada. This article examines the service effectiveness paradigm that evolved from comprehensive auditing developments in the public domain. It presents an integrated model of effectiveness assessment systems and the barriers that currently impede its full development and implementation in Canada. Finally, the evolving effectiveness assessment challenge--which will fundamentally change health management education in Canada--is examined.

  4. Rumination and Performance in Dynamic, Team Sport.

    PubMed

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

    2015-01-01

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

  5. Rumination and Performance in Dynamic, Team Sport

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  7. Problematizing health coaching for chronic illness self-management.

    PubMed

    Howard, Lisa M; Ceci, Christine

    2013-09-01

    To address the growing costs associated with chronic illness care, many countries, both developed and developing, identify increased patient self-management or self-care as a focus of healthcare reform. Health coaching, an implementation strategy to support the shift to self-management, encourages patients to make lifestyle changes to improve the management of chronic illness. This practice differs from traditional models of health education because of the interactional dynamics between nurse and patient, and an orientation to care that ostensibly centres and empowers patients. The theoretical underpinnings of coaching reflect these differences, however in its application, the practices arranged around health coaching for chronic illness self-management reveal the social regulation and professional management of everyday life. This becomes especially problematic in contexts defined by economic constraint and government withdrawal from activities related to the 'care' of citizens. In this paper, we trace the development of health coaching as part of nursing practice and consider the implications of this practice as an emerging element of chronic illness self-management. Our purpose is to highlight health coaching as an approach intended to support patients with chronic illness and at the same time, problematize the tensions contained in (and by) this practice.

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

    PubMed

    Montserrat, X

    2001-01-01

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

  9. Refocusing health care management: education and training for national health reform.

    PubMed

    Jolt, H; Lehrfeld, S; Ashley, A; Leibovici, M M

    1994-08-01

    Today's health care professionals must deal with problems of financial viability, competitiveness, quality control, and consumer focus. The major theme of this article is how appropriate is the education system that trains and prepares health care managers for these challenges. Because we are not in the health care business, but rather in the business of managing health care, the authors suggest that a new educational paradigm that incorporates indepth study of business disciplines be the health administration educational model for the 21st century. Whether or not the proposed model is alien to our basic traditional concepts of health care management, the viability of our institutions will be at stake if they do not implement a healthy business protocol to the services they provide. PMID:10152349

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

    PubMed

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

    1998-01-01

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

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

    PubMed Central

    Thompson, Larry E.

    1987-01-01

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

  12. Using matrix organization to manage health care delivery organizations.

    PubMed

    Allcorn, S

    1990-01-01

    Matrix organization can provide health care organization managers enhanced information processing, faster response times, and more flexibility to cope with greater organization complexity and rapidly changing operating environments. A review of the literature informed by work experience reveals that the use of matrix organization creates hard-to-manage ambiguity and balances of power in addition to providing positive benefits for health care organization managers. Solutions to matrix operating problems generally rely on the use of superior information and decision support systems and extensive staff training to develop attitudes and behavior consistent with the more collegial matrix organization culture. Further improvement in understanding the suitability of matrix organization for managing health care delivery organizations will involve appreciating the impact of partial implementation of matrix organization, temporary versus permanent uses of matrix organization, and the impact of the ambiguity created by dual lines of authority upon the exercise of power and authority.

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

    SciTech Connect

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

    2010-02-15

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

  14. Economics, management, and public health nutrition.

    PubMed

    Dahl, T

    1977-02-01

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

  15. [Organization of health services and tuberculosis care management].

    PubMed

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

    2012-07-01

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

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

    PubMed Central

    2016-01-01

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

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

    PubMed

    Sato, Shigeru

    2016-02-01

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

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

    PubMed

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

    2014-09-01

    This study contributes to the health governance discussion by presenting a new data set that allows for comparisons of the management of health resources among Brazilian municipalities. Research on Brazil is particularly important as the provision of health services was decentralized in 1988 and since then municipalities have been given greater responsibilities for the management of fiscal resources for public health service provision. Based on detailed information on corruption practices (such as over-invoicing, illegal procurement and fake receipts) from audit reports of health programmes in 980 randomly selected Brazilian municipalities, this study deepens understanding of the relationship between health governance institutions and the incidence of corruption at the local level by exploring the extent to which horizontal and vertical accountabilities contribute to reducing the propensity of municipal government officials to divert public health resources for private gain. The results of our multiple regression analysis suggest that the experience of health municipal councils is correlated with reductions in the incidence of corruption in public health programmes. This impact is significant over time, with each additional year of health council experience reducing corruption incidence levels by 2.1% from baseline values. The findings reported in this study do not rely on the subjectivity of corruption measures which usually conflate the actual incidence of corruption with its perception by informants. Based on our results, we provide recommendations that can assist policy makers to reduce corruption.

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

    PubMed

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

    2014-09-01

    This study contributes to the health governance discussion by presenting a new data set that allows for comparisons of the management of health resources among Brazilian municipalities. Research on Brazil is particularly important as the provision of health services was decentralized in 1988 and since then municipalities have been given greater responsibilities for the management of fiscal resources for public health service provision. Based on detailed information on corruption practices (such as over-invoicing, illegal procurement and fake receipts) from audit reports of health programmes in 980 randomly selected Brazilian municipalities, this study deepens understanding of the relationship between health governance institutions and the incidence of corruption at the local level by exploring the extent to which horizontal and vertical accountabilities contribute to reducing the propensity of municipal government officials to divert public health resources for private gain. The results of our multiple regression analysis suggest that the experience of health municipal councils is correlated with reductions in the incidence of corruption in public health programmes. This impact is significant over time, with each additional year of health council experience reducing corruption incidence levels by 2.1% from baseline values. The findings reported in this study do not rely on the subjectivity of corruption measures which usually conflate the actual incidence of corruption with its perception by informants. Based on our results, we provide recommendations that can assist policy makers to reduce corruption. PMID:23411119

  20. Occupational health management system: A study of expatriate construction professionals.

    PubMed

    Chan, I Y S; Leung, M Y; Liu, A M M

    2016-08-01

    Due to its direct impact on the safety and function of organizations, occupational health has been a concern of the construction industry for many years. The inherent complexity of occupational health management presents challenges that make a systems approach essential. From a systems perspective, health is conceptualized as an emergent property of a system in which processes operating at the individual and organizational level are inextricably connected. Based on the fundamental behavior-to-performance-to-outcome (B-P-O) theory of industrial/organizational psychology, this study presents the development of an I-CB-HP-O (Input-Coping Behaviors-Health Performance-Outcomes) health management systems model spanning individual and organizational boundaries. The model is based on a survey of Hong Kong expatriate construction professionals working in Mainland China. Such professionals tend to be under considerable stress due not only to an adverse work environment with dynamic tasks, but also the need to confront the cross-cultural issues arising from expatriation. A questionnaire was designed based on 6 focus groups involving 44 participants, and followed by a pilot study. Of the 500 questionnaires distributed in the main study, 137 valid returns were received, giving a response rate of 27.4%. The data were analyzed using statistical techniques such as factor analysis, reliability testing, Pearson correlation analysis, multiple regression modeling, and structural equation modeling. Theories of coping behaviors and health performance tend to focus on the isolated causal effects of single factors and/or posits the model at single, individual level; while industrial practices on health management tend to focus on organizational policy and training. By developing the I-CB-HP-O health management system, incorporating individual, interpersonal, and organizational perspectives, this study bridges the gap between theory and practice while providing empirical support for a

  1. Occupational health management system: A study of expatriate construction professionals.

    PubMed

    Chan, I Y S; Leung, M Y; Liu, A M M

    2016-08-01

    Due to its direct impact on the safety and function of organizations, occupational health has been a concern of the construction industry for many years. The inherent complexity of occupational health management presents challenges that make a systems approach essential. From a systems perspective, health is conceptualized as an emergent property of a system in which processes operating at the individual and organizational level are inextricably connected. Based on the fundamental behavior-to-performance-to-outcome (B-P-O) theory of industrial/organizational psychology, this study presents the development of an I-CB-HP-O (Input-Coping Behaviors-Health Performance-Outcomes) health management systems model spanning individual and organizational boundaries. The model is based on a survey of Hong Kong expatriate construction professionals working in Mainland China. Such professionals tend to be under considerable stress due not only to an adverse work environment with dynamic tasks, but also the need to confront the cross-cultural issues arising from expatriation. A questionnaire was designed based on 6 focus groups involving 44 participants, and followed by a pilot study. Of the 500 questionnaires distributed in the main study, 137 valid returns were received, giving a response rate of 27.4%. The data were analyzed using statistical techniques such as factor analysis, reliability testing, Pearson correlation analysis, multiple regression modeling, and structural equation modeling. Theories of coping behaviors and health performance tend to focus on the isolated causal effects of single factors and/or posits the model at single, individual level; while industrial practices on health management tend to focus on organizational policy and training. By developing the I-CB-HP-O health management system, incorporating individual, interpersonal, and organizational perspectives, this study bridges the gap between theory and practice while providing empirical support for a

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

    PubMed

    Cook, R. James

    2000-01-01

    Plant health management is the science and practice of understanding and overcoming the succession of biotic and abiotic factors that limit plants from achieving their full genetic potential as crops, ornamentals, timber trees, or other uses. Although practiced as long as agriculture itself, as a science-based concept, plant heath management is even younger than integrated pest management (IPM), and includes and builds upon but is not a replacement for IPM. Probably the greatest collection of success stories for plant health management is the number of diseases managed by cleaning up the planting material. The record for root health management is more mixed, with the loss or phase-out of soil fumigants, and practices such as crop rotation and clean tillage being replaced with more intensive cropping and less or no tillage. Perhaps the greatest scientific and technical advances for plant health management have come from the work aimed at management of the pathogens, pests, and other hazards that arrive by air. Flor's work on flax rust, which produced the gene-for-gene model, is possibly the most significant contribution of plant pathology to the life sciences in the twentieth century. Research aimed at the management of foliar pathogens is also the basis for modern theory on epidemiology, population biology, aerobiology, and disease prediction and decision-support systems. Even IPM arose mainly in response to the need to protect crops from pests that arrive by air. If the definition of biological control includes the plant induced or genetically modified to defend itself, as it should, then biological control has been the most significant approach to plant health management during the twentieth century and promises through modern biotechnology to be even more significant in the twenty-first century. Rather than "reducing losses," the advances are discussed here within the simple framework of achieving the attainable yield by increasing the actual and/or affordable

  3. Managing US-Mexico "border health": an organizational field approach.

    PubMed

    Collins-Dogrul, Julie

    2006-12-01

    During World War II Mexican and US health professionals and organizations constructed a transnational organizational field to manage the border's public health problems. Despite barriers to inter-organizational cooperation, including disparate administrative structures and North-South stratification, the field's transnational approach to health on the border has continued for 60 years. Using archival data to track changes in the number and types of organizations, this article argues that the field practitioners call "border health" reconfigured during the North American Free Trade Association (NAFTA) decade from an era of loosely organized professionals to a specialized bureaucracies era. This change brought new vitality to border health, with transnational ties increasing and diversifying, but has not weakened entrenched cross-border inequalities. The organizational history of the US-Mexico border health field demonstrates how macro-politics and inter-organizational stratification shape transnational public health problems. PMID:16987573

  4. Implementing performance management in the Irish Health Sector.

    PubMed

    Byrne, Michael

    2006-01-01

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

  5. Integrated Systems Health Management (ISHM) Toolkit

    NASA Technical Reports Server (NTRS)

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

    2013-01-01

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

  6. Assessment, authorization and access to medicaid managed mental health care.

    PubMed

    Masland, Mary C; Snowden, Lonnie R; Wallace, Neal T

    2007-11-01

    Examined were effects on access of managed care assessment and authorization processes in California's 57 county mental health plans. Primary data on managed care implementation were collected from surveys of county plan administrators; secondary data were from Medicaid claims and enrollment files. Using multivariate fixed effects regression, we found that following implementation of managed care, greater access occurred in county plans where assessments and treatment were performed by the same clinician, and where service authorizations were made more rapidly. Lower access occurred in county plans where treating clinicians authorized services themselves. Results confirm the significant effects of managed care processes on outcomes and highlight the importance of system capacity.

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

    PubMed

    Antoun, Joseph; Phillips, Frank; Johnson, Tricia

    2011-01-01

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

  8. [Time based management in health care system: the chosen aspects].

    PubMed

    Kobza, Joanna; Syrkiewicz-Świtała, Magdalena

    2014-01-01

    Time-based management (TBM) is the key element of the whole management process. For many years in health care systems of highly developed countries modern and effective methods of time-based management have been implemented in both primary health care and hospitals (emergency departments and operating rooms). Over the past two decades a systematic review of Polish literature (since 1990) and peer reviewed articles published in international journals based on PubMed/Medline (2001-2011) have been carried out. The collected results indicate that the demographic and health changes in the populations are one of the main challenges facing general practitioners in the nearest future. Time-based management needs new and effective tools and skills, i.e., identification of priorities, well designed planning, delegation of the tasks, proper coordination, and creation of primary care teams that include additional members and human resources management. Proper reimbursement of health services, development of IT in health care system, better collection, storage, processing, analysis and exchange of information and research findings will also be needed. The use of innovative technologies, like telemedicine consultations, provides the possibility of reducing waiting time for diagnosis and treatment and in some cases could be applied in terms of secondary care. To improve the efficiency of operating rooms it is necessary to introduce different solutions, such as operating room coordinator involvement, application of automation to guide decision-making or use of robotic tools to assist surgical procedures. Overcrowded emergency departments have a major detrimental effect on the quality of hospital functions, therefore, efforts should be made to reduce them. Time-based management training among physicians and health care management in Poland, as well as the implementation of practice-based solutions still applied in highly developed countries seem to be necessary.

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

    PubMed

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

    2003-01-01

    A comprehensive analytical review of the risk assessment, risk management, and risk communication approaches currently being undertaken by key national, provincial/state, territorial, and international agencies was conducted. The information acquired for review was used to identify the differences, commonalities, strengths, and weaknesses among the various approaches, and to identify elements that should be included in an effective, current, and comprehensive approach applicable to environmental, human health and occupational health risks. More than 80 agencies, organizations, and advisory councils, encompassing more than 100 risk documents, were examined during the period from February 2000 until November 2002. An overview was made of the most important general frameworks for risk assessment, risk management, and risk communication for human health and ecological risk, and for occupational health risk. In addition, frameworks for specific applications were reviewed and summarized, including those for (1)contaminated sites; (2) northern contaminants; (3) priority substances; (4) standards development; (5) food safety; (6) medical devices; (7) prescription drug use; (8) emergency response; (9) transportation; (10) risk communication. Twelve frameworks were selected for more extensive review on the basis of representation of the areas of human health, ecological, and occupational health risk; relevance to Canadian risk management needs; representation of comprehensive and well-defined approaches; generalizability with their risk areas; representation of "state of the art" in Canada, the United States, and/or internationally; and extent of usage of potential usage within Canada. These 12 frameworks were: 1. Framework for Environmental Health Risk Management (US Presidential/Congressional Commission on Risk Assessment and Risk Management, 1997). 2. Health Risk Determination: The Challenge of Health Protection (Health and Welfare Canada, 1990). 3. Health Canada Decision

  10. When rumination counts: Perceived social support and heart rate variability in daily life.

    PubMed

    Gerteis, Ann Kathrin S; Schwerdtfeger, Andreas R

    2016-07-01

    Rumination and social support could modulate cardiac activity. Although both variables are somehow interrelated, they are often studied independently, and their interplay is seldom considered. We aimed to analyze the interaction of rumination and perceived social support on vagally mediated heart rate variability (HRV) in daily life. The sample consisted of 117 healthy participants (57% female, mean age = 27.9, SD = 5.5 years). Ambulatory HRV (root mean squared successive differences), respiration, body position, and body movements were recorded continuously on three consecutive weekdays. Momentary social, situational, and cognitive-affective variables (affect, ruminative thoughts, perceived social support) were assessed using a computerized diary. There was a significant interaction between momentary rumination and perceived social support on ambulatory HRV: When participants were involved in social interactions with low social support, concurrent rumination was associated with attenuated HRV. However, when rumination was accompanied by a strong sense of support, HRV significantly increased. The quality of social interactions and rumination seem to interact in daily life to predict cardiac autonomic control. The results stress the necessity to consider the interplay of psychological and social factors in order to evaluate beneficial or adverse effects on cardiac health. PMID:27137911

  11. When rumination counts: Perceived social support and heart rate variability in daily life.

    PubMed

    Gerteis, Ann Kathrin S; Schwerdtfeger, Andreas R

    2016-07-01

    Rumination and social support could modulate cardiac activity. Although both variables are somehow interrelated, they are often studied independently, and their interplay is seldom considered. We aimed to analyze the interaction of rumination and perceived social support on vagally mediated heart rate variability (HRV) in daily life. The sample consisted of 117 healthy participants (57% female, mean age = 27.9, SD = 5.5 years). Ambulatory HRV (root mean squared successive differences), respiration, body position, and body movements were recorded continuously on three consecutive weekdays. Momentary social, situational, and cognitive-affective variables (affect, ruminative thoughts, perceived social support) were assessed using a computerized diary. There was a significant interaction between momentary rumination and perceived social support on ambulatory HRV: When participants were involved in social interactions with low social support, concurrent rumination was associated with attenuated HRV. However, when rumination was accompanied by a strong sense of support, HRV significantly increased. The quality of social interactions and rumination seem to interact in daily life to predict cardiac autonomic control. The results stress the necessity to consider the interplay of psychological and social factors in order to evaluate beneficial or adverse effects on cardiac health.

  12. Community control of health services. Dr. Martin Luther King, Jr. Health Center's community management system.

    PubMed

    Tichy, N M; Taylor, J I

    1976-01-01

    This article presents the case of Dr. Martin Luther King Jr. Health Center's unique community management system in which neighborhood workers have been developed to assume managerial responsibilities and are directing the Center. The Martin Luther King Center experience is instructive because the Center was able to achieve significant community control by focusing primarily on the internal dimension of control, namely, management, without experiencing destructive conflicts and the deterioration of health services.

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

    PubMed

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

    2015-07-14

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

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

    PubMed

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

    2015-07-14

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

  15. Nature experience reduces rumination and subgenual prefrontal cortex activation

    PubMed Central

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

    2015-01-01

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

  16. Decentralisation trends in the management of New Zealand's health services.

    PubMed

    Malcolm, L A

    1989-01-01

    New Zealand is in the process of implementing major changes in the organisation and funding of its health services. Central to these changes is a largely elected area health board responsible for the funding and coordination of all services for a defined population, both public as well as non-government. Four different models of decentralisation, deconcentration (administrative), devolution (political), corporatisation (functional) and privatisation (non-government), have been used to describe and analyse these changes. There is expected to be a major devolution of powers to area health boards from central government, reversing the centralising tendencies which have occurred over the past century. Within boards a pluralistic system of service management, incorporating the above models of decentralisation, is being implemented to replace the present system of institutional administration and to give greater decision-making responsibility to health professionals, non-government agencies and community groups. These initiatives are associated with population-based funding of hospital boards complemented by service planning guidelines. Of particular importance has been the recent government decision to place the funding and management of primary health care under area health boards. However, there are serious concerns as to whether such radical changes, which could put New Zealand ahead of the rest of the world in achieving an integrated health system, can be implemented given the management expertise needed.

  17. Integrating banana and ruminant production in the French West Indies.

    PubMed

    Archimède, Harry; Gourdine, Jean Luc; Fanchone, Audrey; Tournebize, Regis; Bassien-Capsa, Mylène; González-García, Eliel

    2012-08-01

    Using a mechanistic model, we compared five alternative farming systems with the purpose of transforming monoculture (MON) banana farms into mixed farming systems (MFS) with ruminants feeding banana by-products (leaves, pseudostems and nonmarketable fruits) and forage from the fallow land. The paper presents the main structure of the model (land surface changes, available biomass for animals, stocking rates, productive or reproductive indicators), and impact assessment (change in farm productivity) is discussed. Five MFS with typical local ruminant production systems were used to compare MON to the strategies using forage from fallow and/or integrating Creole cattle (CC), Creole goats (CG) or Martinik sheep (MS) into banana farming. One hectare MON shifted into an MFS allows a stocking rate of 1,184, 285, and 418 kg of live weight per hectare for CC, CG and MS, respectively. Banana by-products seem to be better valorized by the CC scenario. However, parameters such as length of the cycle, local prices for cattle, goat and sheep meat, work time and farmer's skills in ruminant management may have been taken into account by the farmer when choosing the ruminant species to rear.

  18. Managing organizational change: strategies for the female health care supervisor.

    PubMed

    Davies, G

    1990-07-01

    In responding to resistance to change in the current health care organization, the new female supervisor can learn to support her staff in encountering and accepting these changes. The strategies and skills discussed above are characteristic of a supervisory style that may naturally occur for women, but also can be incorporated into the leadership style of men in health care management today. Health care leaders of tomorrow must work from an androgynous framework in which the behavior patterns and responses of each gender are learned and used appropriately by both men and women. Sargent suggests that the best managers are androgynous and that this is the inevitable wave of the future. Whether man or woman, a supervisor should learn, accept, and use methods that are characteristic of both sexes to be successful in managing people. Women and men must learn from each other's strengths and share these diverse skills. Given that women now outnumber men in health care management positions and organizations are changing to a more nurturing environment, the androgynous supervisor will be the successful leader of the future. Finally, women in health care supervisory positions have the potential to bring change where it is badly needed. Women in these roles often have a system wide view of health care policy issues that recognizes less federal commitment to social programs. Many women in health care positions believe that the issues of children, women, the elderly, the poor, and the homeless need focused attention. The growing number of women in health care supervisory and leadership roles is an important factor in changing national health policy for the benefit of these groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:10105044

  19. Managing organizational change: strategies for the female health care supervisor.

    PubMed

    Davies, G

    1990-07-01

    In responding to resistance to change in the current health care organization, the new female supervisor can learn to support her staff in encountering and accepting these changes. The strategies and skills discussed above are characteristic of a supervisory style that may naturally occur for women, but also can be incorporated into the leadership style of men in health care management today. Health care leaders of tomorrow must work from an androgynous framework in which the behavior patterns and responses of each gender are learned and used appropriately by both men and women. Sargent suggests that the best managers are androgynous and that this is the inevitable wave of the future. Whether man or woman, a supervisor should learn, accept, and use methods that are characteristic of both sexes to be successful in managing people. Women and men must learn from each other's strengths and share these diverse skills. Given that women now outnumber men in health care management positions and organizations are changing to a more nurturing environment, the androgynous supervisor will be the successful leader of the future. Finally, women in health care supervisory positions have the potential to bring change where it is badly needed. Women in these roles often have a system wide view of health care policy issues that recognizes less federal commitment to social programs. Many women in health care positions believe that the issues of children, women, the elderly, the poor, and the homeless need focused attention. The growing number of women in health care supervisory and leadership roles is an important factor in changing national health policy for the benefit of these groups.(ABSTRACT TRUNCATED AT 250 WORDS)

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

    PubMed Central

    dos Santos, Adriano Maia; Giovanella, Ligia

    2014-01-01

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

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

    PubMed Central

    2014-01-01

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

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

    PubMed Central

    Moen, Anne; Brennan, Patricia Flatley

    2005-01-01

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

  3. Test result management in global health settings.

    PubMed

    Palazuelos, Daniel; Payne, Jonathan D; Dalal, Anuj K

    2012-09-01

    Across the globe, the ways in which patients' test results are managed are as varied as the many different types of healthcare systems that manage these data. The outcomes, however, are often not too dissimilar: too many clinically significant test results fall through the cracks. The consequences of not following up test results in a timely manner are serious and often devastating to patients: diagnoses are delayed, treatments are not initiated or altered in time, and diseases progress. In resource-poor settings, test results too commonly get filed away within the paper chart in ways that isolate them and prevent passage to future providers caring for a patient. To make matters worse, the onus to act upon these test results often rests on patients who need to return to the clinic within a specified timeframe in order to obtain their results but who may not have the means or are too ill to do so. Even in more developed healthcare settings that use electronic records, clinical data residing in the electronic medical record (EMR) are often stubbornly "static"-key pieces of clinical information are frequently not recognized, retrieved, or shared easily. In this way, EMRs are not unlike paper record systems, and therefore, EMRs alone will not solve this problem. To illustrate this problem, consider the case of a patient newly diagnosed with HIV in 3 different healthcare delivery settings.

  4. Test Result Management in Global Health Settings

    PubMed Central

    Palazuelos, Daniel; Payne, Jonathan D.

    2012-01-01

    OVERVIEW Across the globe, the ways in which patients' test results are managed are as varied as the many different types of healthcare systems that manage these data. The outcomes, however, are often not too dissimilar: too many clinically significant test results fall through the cracks. The consequences of not following up test results in a timely manner are serious and often devastating to patients: diagnoses are delayed, treatments are not initiated or altered in time, and diseases progress. In resource-poor settings, test results too commonly get filed away within the paper chart in ways that isolate them and prevent passage to future providers caring for a patient. To make matters worse, the onus to act upon these test results often rests on patients who need to return to the clinic within a specified timeframe in order to obtain their results but who may not have the means or are too ill to do so. Even in more developed healthcare settings that use electronic records, clinical data residing in the electronic medical record (EMR) are often stubbornly “static”—key pieces of clinical information are frequently not recognized, retrieved, or shared easily. In this way, EMRs are not unlike paper record systems, and therefore, EMRs alone will not solve this problem. To illustrate this problem, consider the case of a patient newly diagnosed with HIV in 3 different healthcare delivery settings. PMID:24278831

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

    NASA Technical Reports Server (NTRS)

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

    2007-01-01

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

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

    PubMed Central

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

    2011-01-01

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

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

    PubMed

    Dembe, A E

    1998-01-01

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

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

    PubMed

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

    2014-09-01

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

  9. An attentional scope model of rumination.

    PubMed

    Whitmer, Anson J; Gotlib, Ian H

    2013-09-01

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

  10. Characterizing the Ruminative Process in Young Adolescents

    PubMed Central

    Hilt, Lori M.; Pollak, Seth D.

    2014-01-01

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

  11. Reference frameworks for the health management of measles, breast cancer and diabetes (type II).

    PubMed

    Brand, Helmut; Schröder, Peter; Davies, John K; Escamilla, Ixhel; Hall, Caroline; Hickey, Kieran; Jelastopulu, Eleni; Mechtler, Reli; Yared, Wendy Tse; Volf, Jaroslav; Weihrauch, Birgit

    2006-03-01

    This paper presents reference frameworks which order effective and feasible policies and interventions for the health management of measles, breast cancer and diabetes (type II). These reference frameworks can be used to rapidly appraise regional health policy documents and existing health management systems. Furthermore, the reference frameworks can serve health policy makers for the planning of health management measures.

  12. Quality of management in the health care system.

    PubMed

    Borgenhammar, E

    1990-01-01

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

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

    ERIC Educational Resources Information Center

    Qiu, Xiao Ling

    2008-01-01

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

  14. Behavioral health and managed care contracting under SCHIP.

    PubMed

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

    2002-09-01

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

  15. Balancing Management and Leadership in Complex Health Systems

    PubMed Central

    Kwamie, Aku

    2015-01-01

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

  16. Zoonotic risks from small ruminants.

    PubMed

    Ganter, M

    2015-12-14

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

  17. Zoonotic risks from small ruminants.

    PubMed

    Ganter, M

    2015-12-14

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

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

    PubMed

    Mannion, Russell; Small, Neil; Thompson, Carl

    2005-09-01

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

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

    NASA Technical Reports Server (NTRS)

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

    1995-01-01

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

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

    NASA Technical Reports Server (NTRS)

    Bickford, R. L.

    1992-01-01

    Fault detection and isolation for advanced rocket engine controllers are discussed focusing on advanced sensing systems and software which significantly improve component failure detection for engine safety and health management. Aerojet's Space Transportation Main Engine controller for the National Launch System is the state of the art in fault tolerant engine avionics. Health management systems provide high levels of automated fault coverage and significantly improve vehicle delivered reliability and lower preflight operations costs. Key technologies, including the sensor data validation algorithms and flight capable spectrometers, have been demonstrated in ground applications and are found to be suitable for bridging programs into flight applications.

  1. Obesity, weight management, and health care costs: a primer.

    PubMed

    Bachman, Keith H

    2007-06-01

    Rational decision-making regarding health care spending for weight management requires an understanding of the cost of care provided to obese patients and the potential cost-effectiveness or cost savings of interventions. The purpose of this review is to assist health plans and disease management leaders in making informed decisions for weight management services. Among the review's findings, obesity and severe obesity are strongly and consistently associated with increased health care costs. The cost-effectiveness of obesity-related interventions is highly dependent on the risk status of the treated population, as well as the length, cost, and effectiveness of the intervention. Bariatric surgery offers high initial costs and uncertain long-term cost savings. From the perspective of a payor, obesity management services are as cost-effective as other commonly offered health services, though not likely to offer cost savings. Behavioral health promotion interventions in the worksite setting provide cost savings from the employer's perspective, if decreased rates of absenteeism are included in the analysis.

  2. 75 FR 54627 - Best Management Practices for Unused Pharmaceuticals at Health Care Facilities

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-08

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

  3. Managing the complexity of best practice health care.

    PubMed

    Brown, S J

    2001-01-01

    Best Practice Health Care is a designed product. Various types of evidence must be accessed, interpreted, and integrated into care design. This integration requires thoughtful organizational planning. The Best Practice Health Care Map provides a model for managing the characteristics of quality clinical care within the framework of multi-disciplinary professional practice. The model incorporates the contributions of various forms of evidence into pre-specification design and point-of-care design.

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

    PubMed

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

    2014-11-01

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

  5. Dual-eligible reform: a step toward population health management.

    PubMed

    Eggbeer, Bill; Bowers, Krista; Morris, Dudley

    2013-04-01

    Improved care coordination for dual eligibles has the potential to reduce hospitalizations and eliminate duplicative services. Finding common ground on program design for dual eligibles has proved difficult, and for some programs to date, the cost of care management has balanced out savings achieved. Partnering with an experienced Medicaid managed care plan could be the best strategy for market entry for all but the most experienced integrated delivery systems and health systems.

  6. Improved management of chronic disease using health information technology.

    PubMed

    Dixon, Brian E; Samarth, Anita; Starmer, Jack

    2007-10-11

    Technology can be used effectively to improve chronic disease management, impacting health care costs, safety, and quality. The Agency for Healthcare Research and Quality has funded several studies to examine best practices in using technology to impact chronic disease management. These projects have employed a variety of technologies to improve care delivery processes, patient education, and continuity of care. Their stories contain valuable lessons for others looking to enhance chronic disease care.

  7. Hands-on training in health district management.

    PubMed

    De Brouwere, V; Van Balen, H

    1996-01-01

    In 1985 in Zaire, a 12-week training course began in Kasongo district to prepare physicians to use sound management of primary and secondary health services, supervision of health centers, and commitment to team work to operate districts in an integrated way. Only 1 new physician trainee was accepted every 4 weeks. During the first week, trainees observed work at an outpatient clinic for 2-3 hours/day to learn about the links between the primary and secondary levels of health care. During the second week, they observed staff at an urban health center in Kasongo city so they could become familiar with strategies for diagnosis and treatment in curative consultations and with instructions for follow-up. During the third week, the trainees returned to the outpatient clinic to practice interviewing patients. During the fourth week, they observed work in a rural health center and in remote villages. During the second 4-week period, trainees worked in a hospital department of their choice to learn how to use files and to evaluate quality of care. They visited health centers 1-2 times/week to examine supervisory techniques of different resident physicians. Trainees were part of the health team during the third 4-week period. They were responsible for a hospital department and supervised health centers under a resident physician. The trainees also attended management committee meetings addressing quality of care, staff management, and feedback from health center supervisions. The cost for this health district management training was US $100/trainee. Between mid-1985 and mid-1988, 18 physicians underwent this training. 12 of these physicians are now working in health districts in Zaire. A follow-up survey in 1995 showed that most trainees were applying the requisite skills and knowledge acquired during the training. Further supervision or self-training, involving team analysis of problems and possible solutions, are needed. Factors contributing to the course's success

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

    PubMed

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

    2007-01-01

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

  9. Human resource management in the health care industry.

    PubMed

    Siddiqui, J; Kleiner, B H

    1998-01-01

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

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

    PubMed Central

    2010-01-01

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

  11. Roles of managers in academic health centers: strategies for the managed care environment.

    PubMed

    Guo, Kristina L

    2002-03-01

    This article addresses survival strategies of academic health centers (AHCs) in responding to market pressures and government reforms. Using six case studies of AHCs, the study links strategic changes in structure and management to managerial role performance. Utilizing Mintzberg's classification of work roles, the roles of liaison, monitor, entrepreneur, and resource allocator were found to be used by top-level managers as they implement strategies to enhance the viability of their AHCs. Based on these new roles, the study recommends improving management practices through education and training as well as changing organizational culture to support management decision making and foster the continued growth of managers and their AHCs.

  12. The metamorphosis of managed care: implications for health reform internationally.

    PubMed

    Rodwin, Marc A

    2010-01-01

    The conventional wisdom is that managed care's brief life is over and we are now in a post-managed care era. In fact, managed care has a long history and continues to thrive. Writers also often assume that managed care is a fixed thing. They overlook that managed care has evolved and neglect to examine the role that it plays in the health system. Furthermore, private actors and the state have used managed care tools to promote diverse goals. These include the following: increasing access to medical care; restricting physician entrepreneurialism; challenging professional control over the medical economy; curbing medical spending; managing medical practice and markets; furthering the growth of medical markets and private insurance; promoting for-profit medical facilities and insurers; earning bounties for reducing medical expenditures: and reducing governmental responsibility for, and oversight of, medical care. Struggles over these competing goals spurred the metamorphosis of managed care. This article explores how managed care transformed physicians' conflicts of interests and responses to them. It also examines how managed care altered the opportunities for patients/medical consumers to use exit and voice to spur change.

  13. Commercial Aircraft Integrated Vehicle Health Management Study

    NASA Technical Reports Server (NTRS)

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

    2010-01-01

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

  14. Specialty pharmaceuticals care management in an integrated health care delivery system with electronic health records.

    PubMed

    Monroe, C Douglas; Chin, Karen Y

    2013-05-01

    The specialty pharmaceuticals market is expanding more rapidly than the traditional pharmaceuticals market. Specialty pharmacy operations have evolved to deliver selected medications and associated clinical services. The growing role of specialty drugs requires new approaches to managing the use of these drugs. The focus, expectations, and emphasis in specialty drug management in an integrated health care delivery system such as Kaiser Permanente (KP) can vary as compared with more conventional health care systems. The KP Specialty Pharmacy (KP-SP) serves KP members across the United States. This descriptive account addresses the impetus for specialty drug management within KP, the use of tools such as an electronic health record (EHR) system and process management software, the KP-SP approach for specialty pharmacy services, and the emphasis on quality measurement of services provided. Kaiser Permanente's integrated system enables KP-SP pharmacists to coordinate the provision of specialty drugs while monitoring laboratory values, physician visits, and most other relevant elements of the patient's therapy. Process management software facilitates the counseling of patients, promotion of adherence, and interventions to resolve clinical, logistic, or pharmacy benefit issues. The integrated EHR affords KP-SP pharmacists advantages for care management that should become available to more health care systems with broadened adoption of EHRs. The KP-SP experience may help to establish models for clinical pharmacy services as health care systems and information systems become more integrated.

  15. Managed mental health care: reflections in a time of turmoil.

    PubMed

    VanLeit, B

    1996-06-01

    This article reviews the history, growth, and evolution of managed care in mental health and substance abuse treatment. Specific issues described are stigma, the important social dimensions and chronicity of some types of mental illness and chemical dependency, and reliance on the public sector for care. Opportunities and challenges for occupational therapists in the rapidly changing mental health system are discussed, including the use of interdisciplinary teams, the importance of measuring functional outcomes of interventions, the need to develop clinical guidelines, the importance of the community setting and a continuum of services, ethical dilemmas, and the importance of assertive occupational therapy advocacy and involvement in health care reform. PMID:8726977

  16. Family planning and sexual health organizations: management lessons for health system reform.

    PubMed

    Ambegaokar, Maia; Lush, Louisiana

    2004-10-01

    Advocates of health system reform are calling for, among other things, decentralized, autonomous managerial and financial control, use of contracting and incentives, and a greater reliance on market mechanisms in the delivery of health services. The family planning and sexual health (FP&SH) sector already has experience of these. In this paper, we set forth three typical means of service provision within the FP&SH sector since the mid-1900s: independent not-for-profit providers, vertical government programmes and social marketing programmes. In each case, we present the context within which the service delivery mechanism evolved, the management techniques that characterize it and the lessons learned in FP&SH that are applicable to the wider debate about improving health sector management. We conclude that the FP&SH sector can provide both positive and negative lessons in the areas of autonomous management, use of incentives to providers and acceptors, balancing of centralization against decentralization, and employing private sector marketing and distribution techniques for delivering health services. This experience has not been adequately acknowledged in the debates about how to improve the quality and quantity of health services for the poor in developing countries. Health sector reform advocates and FP&SH advocates should collaborate within countries and regions to apply these management lessons.

  17. MANAGEMENT ASSESSMENT AN INTEGRATED ENVIRONMENT SAFETY & HEALTH MANAGEMENT SYSTEM (ISMS) CORE FUNCTION FOR FEEDBACK & CONTINUOUS IMPROVEMENT

    SciTech Connect

    VON WEBER, M.

    2005-07-26

    Management assessment is required of US Department of Energy contractors by 10 CFR 830.122 and DOE Order 414.1. The management assessment process is a rigorous, preplanned, forward-looking review. It is required to be performed by owners of the processes that are being assessed. Written from the perspective of the Assessment Program Director and an Assessment Specialist, this paper describes the evolution of the process used by CH2MHILL to implement its management assessment program over the past two years including: roles, responsibilities, and details about our program improvement project designed to produce a clear picture of management processes and to identify opportunities for improvement. The management assessment program is essential to successful implementation, maintenance, and improvement of the CH2MHILL Integrated Environment, Safety, and Health Management System (ISMS). The management assessment program implements, in part, ISMS Core Function No. 5. ''Feedback and Continuous Improvement''. Organizations use the management assessment process to assess ISMS implementation and effectiveness. Management assessments evaluate the total picture of how well management processes are meeting organizational objectives and the customer's requirements and expectations. The emphasis is on management issues affecting performance, systems, and processes such as: strategic planning, qualification, training, staffing, organizational interfaces, communication, cost and schedule control and mission objectives. Management assessments should identify any weaknesses in the management aspects of performance and make process improvements. All managers from first line supervisors to the president and general manager are involved in the management assessment process. More senior managers, in conducting their assessment, will use data from lower levels of management. This approach will facilitate the objective of having managers closer to the work under review focusing on more

  18. [Decision-making process and health management councils: theoretical approaches].

    PubMed

    Wendhausen, Agueda; Cardoso, Sandra de Mello

    2007-01-01

    With the institutionalization of participation in health, through conferences and management councils at national, state, municipal and local levels, a process of democratization is initiated in the health area. However, in relation to the health councils in particular, there is still much to be done, including improving the quality of the decision-making process. This work aims to place the decision-making process in its theoretical context in terms of participatory democracy, elements which make up, factors which influence its development, and finally, to explore some possibilities of this theoretical basis to analyze the practices of the health councils in the area of health. It is hoped that it will make a theoretical contribution to the analyses carried out in this area, in order to provide a decision-making process that is more inclusive in terms of participation.

  19. Preparing health care organizations for successful case management programs.

    PubMed

    Bonvissuto, C A; Kastens, J M; Atwell, S R

    1997-01-01

    This article reports the results of a study of four hospital-based providers in varying stages of implementing case management programs. Three of the providers had most of the necessary elements in place to ensure success, such as a mix of reimbursement sources, an effective and integrated information management system, a full range of clinical services, and continuous quality improvement programs. The authors make several suggestions for key activities that must be pursued by any health care organization seeking to implement a case management program in an era of managed care, tightening reimbursement, and consumer demand for quality care. These include the need to (a) organize essential case management functions under a centralized structure; (b) set realistic, quantifiable targets, and (c) design a communications plan for the program. PMID:9335724

  20. Managing mechanistic and organic structure in health care organizations.

    PubMed

    Olden, Peter C

    2012-01-01

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

  1. Preparing health care organizations for successful case management programs.

    PubMed

    Bonvissuto, C A; Kastens, J M; Atwell, S R

    1997-01-01

    This article reports the results of a study of four hospital-based providers in varying stages of implementing case management programs. Three of the providers had most of the necessary elements in place to ensure success, such as a mix of reimbursement sources, an effective and integrated information management system, a full range of clinical services, and continuous quality improvement programs. The authors make several suggestions for key activities that must be pursued by any health care organization seeking to implement a case management program in an era of managed care, tightening reimbursement, and consumer demand for quality care. These include the need to (a) organize essential case management functions under a centralized structure; (b) set realistic, quantifiable targets, and (c) design a communications plan for the program.

  2. Snout Shape in Extant Ruminants

    PubMed Central

    Tennant, Jonathan P.; MacLeod, Norman

    2014-01-01

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

  3. Snout shape in extant ruminants.

    PubMed

    Tennant, Jonathan P; MacLeod, Norman

    2014-01-01

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

  4. Emergency mental health management in bioterrorism events.

    PubMed

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

    2002-05-01

    The United States has not suffered significant psychosocial or medical consequences from the use of biological weapons within its territories. This has contributed to a "natural" state of denial at the community level. This denial could amplify the sense of crisis, anxiety, fear, chaos, and disorder that would accompany such a bioterrorist event. A key part of primary prevention involves counteracting this possibility before an incident occurs. Doing so will require realistic information regarding the bioterrorism threat followed by the development of a planned response and regular practice of that response. Unlike in natural disasters or other situations resulting in mass casualties, emergency department physicians or nurses and primary care physicians (working in concert with epidemiologic agencies), rather than police, firemen, or ambulance personnel, will be most likely to first identify the unfolding disaster associated with a biological attack. Like community leaders, this group of medical responders must be aware of its own susceptibility to mental health sequelae and performance decrement as the increasing demands of disaster response outpace the availability of necessary resources. A bioterrorist attack will necessitate treatment of casualties who experience neuropsychiatric symptoms and syndromes. Although symptoms may result from exposure to infection with specific biological agents, similar symptoms may result from the mere perception of exposure or arousal precipitated by fear of infection, disease, suffering, and death. Conservative use of psychotropic medications may reduce symptoms in exposed and uninfected individuals, as may cognitive-behavioral interventions. Clear, consistent, accessible, reliable, and redundant information (received from trusted sources) will diminish public uncertainty about the cause of symptoms that might otherwise prompt persons to seek unnecessary treatment. Training and preparation for contingencies experienced in an

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

    PubMed Central

    Bednarz, Daniel; Bae, Jaeyong; Pierce, Jessica

    2011-01-01

    Petroleum is used widely in health care—primarily as a transport fuel and feedstock for pharmaceuticals, plastics, and medical supplies—and few substitutes for it are available. This dependence theoretically makes health care vulnerable to petroleum supply shifts, but this vulnerability has not been empirically assessed. We quantify key aspects of petroleum use in health care and explore historical associations between petroleum supply shocks and health care prices. These analyses confirm that petroleum products are intrinsic to modern health care and that petroleum supply shifts can affect health care prices. In anticipation of future supply contractions lasting longer than previous shifts and potentially disrupting health care delivery, we propose an adaptive management approach and outline its application to the example of emergency medical services. PMID:21778473

  6. Petroleum and health care: evaluating and managing health care's vulnerability to petroleum supply shifts.

    PubMed

    Hess, Jeremy; Bednarz, Daniel; Bae, Jaeyong; Pierce, Jessica

    2011-09-01

    Petroleum is used widely in health care-primarily as a transport fuel and feedstock for pharmaceuticals, plastics, and medical supplies-and few substitutes for it are available. This dependence theoretically makes health care vulnerable to petroleum supply shifts, but this vulnerability has not been empirically assessed. We quantify key aspects of petroleum use in health care and explore historical associations between petroleum supply shocks and health care prices. These analyses confirm that petroleum products are intrinsic to modern health care and that petroleum supply shifts can affect health care prices. In anticipation of future supply contractions lasting longer than previous shifts and potentially disrupting health care delivery, we propose an adaptive management approach and outline its application to the example of emergency medical services.

  7. [THE GLOBAL AND ECONOMIC CRISIS. AND HEALTH MANAGEMENT].

    PubMed

    del Rey Calero, Juan

    2014-01-01

    The Global and economic crisis and Health Management The Health care process discussed are 4 steps: assessment, planing, intervention and evaluation. The identify association between social factors linked to social vulnerability (socio economic status, unemployed, poverty) and objective health relate quality of life. The poverty rate is 24.2%, unemployed 26.26%, youth unemployed 56.13%.ratio worker/retired 2.29. Debts 100% GDP The health inequality influence on health related quality of life. The Health System efficiency index. according Bloomber rate (2,013) Spain is 5 degrees in the world, points 68.3 on 100, for the life expectancy 82.3 years, the personal cost of health care 2,271€. Health care 10% GDP (public 7%,private 3%), SS protected population 92.4%, retired person cost 9.2% GDP, p. capita GDP 23,737€. Cost of Care: Hospital/specialist 54%, P. Care 15%, Pharmaceutical 19.8%, P. Health 3.1%. PMID:27386674

  8. Outcomes Assessment in Accredited Health Information Management Programs

    ERIC Educational Resources Information Center

    Bennett, Dorine

    2010-01-01

    The purpose of this study was to determine the use and perceived usefulness of outcomes assessment methods in health information management programs. Additional characteristics of the outcomes assessment practices were recognized. The findings were evaluated for significant differences in results based on age of the program, type of institution,…

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

    ERIC Educational Resources Information Center

    Castro, Felipe G.; Jichaku, Patrick

    The Lifestyle Management Project is a health promotion project and research study conducted in the spring of 1984 at five Los Angeles junior college campuses. Its goal was to increase knowledge of cardiovascular disease (CHD) risk factors among 400 to 2000 junior college students in each campus. This was done via five risk factor activities: blood…

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  12. Toxicology of sulfur in ruminants: review

    SciTech Connect

    Kandylis, K.

    1984-10-01

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

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

    PubMed

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

    2013-01-01

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

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

    PubMed

    Lemos, Cristiane Lopes Simão

    2016-03-01

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

  15. Managing risk: a taxonomy of error in health policy.

    PubMed

    Joyce, Paul; Boaden, Ruth; Esmail, Aneez

    2005-12-01

    This paper discusses the current initiatives on error and adverse events within healthcare, with a particular focus on the NHS, within the context of health policy. One of the key features of the paper is the proposal for an emergent taxonomy of the medical error literature, developed from the ideologies and rationales that underpin their approaches. This taxonomy provides details of three categories--empiricists, organisational rationalists and reformers of professional culture--and these act as an organising framework for the exploration of the potential consequences of current policy on errors and adverse events. This discussion highlights the tension between optimising health outcomes for patients and managing the health system as effectively as possible. In particular, the inherent tension between explicit managerial formulations of risk and implicit risk management strategies associated with medical professionalism are considered. PMID:16435469

  16. Implementing total quality management (TQM) in health-care laboratories.

    PubMed

    Westgard, J O; Barry, P L; Tomar, R H

    1991-01-01

    Health-care organizations are beginning to apply the principles of total quality management (TQM). Implementing TQM in a health-care laboratory requires incorporating quality improvement (QI) and quality planning (QP) with quality laboratory practices (QLP), quality control (QC), and quality assurance (QA) to provide a complete quality management system. QI and QP can be initiated by developing a strategic plan as a pilot QI project. QI project teams are then introduced to accomplish the highest priority goals. This implementation approach improves strategic planning by using group problem-solving tools and techniques, such as process flow charts, brainstorming, nominal group, fishbone diagrams, consensus decision making, and Pareto analysis. The approach also improves the success of project teams by providing a clear management agenda and a commitment to project-by-project QI.

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

    PubMed

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

    2008-12-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2012-12-01

    Scientists and policy-makers are increasingly recognizing that sustainable coastal communities depend on healthy and resilient economies, ecosystems, and people, and that the condition or "health" of the coastal ocean and humans are intimately and inextricably connected. A wealth of ecosystem services provided by ocean and coastal environments are crucial for human survival and well being. Nonetheless, the health of coastal communities, their economies, connected ecosystems and ecosystem services, and people are under increasing threats from health risks associated with environmental degradation, climate change, and unwise land use practices, all of which contribute to growing burdens of naturally-occurring and introduced pathogens, noxious algae, and chemical contaminants. The occurrence, frequency, intensity, geographic range, and number and kinds of ocean health threats are increasing, with concomitant health and economic effects and eroding public confidence in the safety and wholesomeness of coastal environments and resources. Concerns in the research and public health communities, many summarized in the seminal 1999 NRC Report, From Monsoons to Microbes and the 2004 final report of the US Commission on Ocean Policy, resulted in establishment of a new "meta-discipline" known as Oceans and Human Health (OHH). OHH brings together practitioners in oceanography, marine biology, ecology, biomedical science, medicine, economics and other social sciences, epidemiology, environmental management, and public health to focus on water- and food-borne causes of human and animal illnesses associated with ocean and coastal systems and on health benefits of seafood and other marine products. It integrates information across multiple disciplines to increase knowledge of ocean health risks and benefits and communicate such information to enhance public safety. Recognizing the need for a comprehensive approach to ocean health threats and benefits, Congress passed the Oceans and

  19. Toward a national health risk management approach in Australia.

    PubMed

    O'Donnell, Carol

    2002-01-01

    There has been increasing international consensus about the importance of competition for achieving national growth and community well-being. The Australian government accordingly has introduced policies to promote such competition. Major legislative review and many public inquiries have assisted implementation of national competition policy and the development of national goals and standards related to international agreements to promote health and sustainable development. Since the 1980s, Australia has had legislation that requires the identification and control of health risks arising at work. The management structures necessary for coordinated delivery of national programs designed for effective identification and control of health risks arising in communities to achieve national health and development goals are still being developed, however. Major difficulties related to this development are discussed. National health development programs should be approached primarily through establishment of regional partnerships between bodies responsible for managing community health, local government, and employment placement, in consultation with other relevant organizations and the community. Related research and evaluation programs are required. PMID:11905388

  20. Public health emergencies and the public health/managed care challenge.

    PubMed

    Rosenbaum, Sara; Skivington, Skip; Praeger, Sandra

    2002-01-01

    The relationship between insurance and public health is an enduring topic in public health policy and practice. Insurers share certain attributes with public health. But public health agencies operate in relation to the entire community that they are empowered by public law to serve and without regard to the insurance status of community residents; on the other hand, insurers (whether managed care or otherwise) are risk-bearing entities whose obligations are contractually defined and limited to enrolled members and sponsors. Public insurers such as Medicare and Medicaid operate under similar constraints. The fundamental characteristics that distinguish managed care-style insurance and public health become particularly evident during periods of public health emergency, when a public health agency's basic obligations to act with speed and flexibility may come face to face with the constraints on available financing that are inherent in the structure of insurance. Because more than 70% of all personal health care in the United States is financed through insurance, public health agencies effectively depend on insurers to finance necessary care and provide essential patient-level data to the public health system. Critical issues of state and federal policy arise in the context of the public health/insurance relations during public health emergencies. These issues focus on coverage and the power to make coverage decisions, as well as the power to define service networks and classify certain data as exempt from public reporting. The extent to which a formal regulatory approach may become necessary is significantly affected by the extent to which private entities themselves respond to the problem with active efforts to redesign their services and operations to include capabilities and accountability in the realm of public health emergency response. PMID:12508505

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

    PubMed

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

    2012-06-01

    Although many employers offer some components of worksite-based population health management (PHM), most do not yet invest in comprehensive programs. This hesitation to invest in comprehensive programs may be attributed to numerous factors, such as other more pressing business priorities, reluctance to intervene in the personal health choices of employees, or insufficient funds for employee health. Many decision makers also remain skeptical about whether investment in comprehensive programs will produce a financial return on investment (ROI). Most peer-reviewed studies assessing the financial impact of PHM were published before 2000 and include a broad array of program and study designs. Many of these studies have also included indirect productivity savings in their assessment of financial outcomes. In contrast, this review includes only peer-reviewed studies of the direct health care cost impact of comprehensive PHM programs that meet rigorous methodological criteria. A systematic search of health sciences databases identified only 5 studies with program designs and study methods meeting these selection criteria published after 2007. This focused review found that comprehensive PHM programs can yield a positive ROI based on their impact on direct health care costs, but the level of ROI achieved was lower than that reported by literature reviews with less focused and restrictive qualifying criteria. To yield substantial short-term health care cost savings, the longer term financial return that can credibly be associated with a comprehensive, prevention-oriented population health program must be augmented by other financial impact strategies.

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

    PubMed

    Lynch, Tim; Cox, Paul

    2006-01-01

    The British Columbia Ministry of Health's Framework for Core Functions in Public Health was the catalyst that inspired this review of best practices in health emergency management. The fieldwork was conducted in the fall of 2005 between hurricane Katrina and the South Asia earthquake. These tragedies, shown on 24/7 television news channels, provided an eyewitness account of disaster management, or lack of it, in our global village world. It is not enough to just have best practices in place. There has to be a governance structure that can be held accountable. This review of best practices lists actions in support of an emergency preparedness culture at the management, executive, and corporate/governance levels of the organization. The methodology adopted a future quality management approach of the emergency management process to identify the corresponding performance indictors that correlated with practices or sets of practices. Identifying best practice performance indictors needed to conduct a future quality management audit is described as reverse quality management. Best practices cannot be assessed as stand-alone criteria; they are influenced by organizational culture. The defining of best practices was influenced by doubt about defining a practice it is hoped will never be performed, medical staff involvement, leadership, and an appreciation of the resources required and how they need to be managed. Best practice benchmarks are seen as being related more to "measures" of performance defined locally and agreed on by 2 or more parties rather than to achieving industrial standards. Relating practices to performance indicators and then to benchmarks resulted in the development of a Health Emergency Management Best Practices Matrix that lists specific practice in the different phases of emergency management.

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

    PubMed

    Lynch, Tim; Cox, Paul

    2006-01-01

    The British Columbia Ministry of Health's Framework for Core Functions in Public Health was the catalyst that inspired this review of best practices in health emergency management. The fieldwork was conducted in the fall of 2005 between hurricane Katrina and the South Asia earthquake. These tragedies, shown on 24/7 television news channels, provided an eyewitness account of disaster management, or lack of it, in our global village world. It is not enough to just have best practices in place. There has to be a governance structure that can be held accountable. This review of best practices lists actions in support of an emergency preparedness culture at the management, executive, and corporate/governance levels of the organization. The methodology adopted a future quality management approach of the emergency management process to identify the corresponding performance indictors that correlated with practices or sets of practices. Identifying best practice performance indictors needed to conduct a future quality management audit is described as reverse quality management. Best practices cannot be assessed as stand-alone criteria; they are influenced by organizational culture. The defining of best practices was influenced by doubt about defining a practice it is hoped will never be performed, medical staff involvement, leadership, and an appreciation of the resources required and how they need to be managed. Best practice benchmarks are seen as being related more to "measures" of performance defined locally and agreed on by 2 or more parties rather than to achieving industrial standards. Relating practices to performance indicators and then to benchmarks resulted in the development of a Health Emergency Management Best Practices Matrix that lists specific practice in the different phases of emergency management. PMID:16622359

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

    SciTech Connect

    Al-Khatib, Issam A. Sato, Chikashi

    2009-08-15

    Health care waste is considered a major public health hazard. The objective of this study was to assess health care waste management (HCWM) practices currently employed at health care centers (HCCs) in the West Bank - Palestinian Territory. Survey data on solid health care waste (SHCW) were analyzed for generated quantities, collection, separation, treatment, transportation, and final disposal. Estimated 4720.7 m{sup 3} (288.1 tons) of SHCW are generated monthly by the HCCs in the West Bank. This study concluded that: (i) current HCWM practices do not meet HCWM standards recommended by the World Health Organization (WHO) or adapted by developed countries, and (ii) immediate attention should be directed towards improvement of HCWM facilities and development of effective legislation. To improve the HCWM in the West Bank, a national policy should be implemented, comprising a comprehensive plan of action and providing environmentally sound and reliable technological measures.

  5. Salutogenesis and Ayurveda: indications for public health management.

    PubMed

    Morandi, Antonio; Tosto, Carmen; Roberti di Sarsina, Paolo; Dalla Libera, Dacia

    2011-12-01

    Ayurveda, the ancient traditional medicine of India, defines health as a state of complete physical, mental and spiritual well-being. The focus of Ayurveda is on a predictive, preventive and personalized medicine. This is obtained through a low-cost personalized counseling about lifestyle measures (diet, activities, etc.), trying to involve the patient directly in the process of healing, increasing his self-awareness and good relationships with other people and nature. The approach of Ayurveda toward positive health shares its features with that of salutogenesis as described by Antonovsky. Prevention strategies pragmatically suggested by Ayurveda - including factors such as promotion of health education, individual awareness, integration of spirituality and ethics in healthcare system- may be applied in public health management, in order to improve perceived and objective life quality, promote healthy aging, limit drugs use (avoiding expensive side-effects) and reduce chronic diseases social costs. Ayurveda has a universal-coverage, being person-centered and consequently intercultural. PMID:23194327

  6. Income statement management in a turbulent health care environment.

    PubMed

    Covaleski, M A

    2001-03-01

    This article considers the role of accounting information embedded in the income statement of health care providers in their increasingly difficult economic environment. This turbulent economic environment has resulted from the dramatic shift in power from the seller to the buyer of health care services, with a consequential shift of risks that will mandate that health care providers obtain access to better cost and utilization information. This article looks at the 2 critical components of the income statement--the revenue function and the cost structure-in terms of their importance in the management of enhanced economic performance in both the fee-for-service and the prepaid provision of health care services. PMID:11239384

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

    PubMed

    Zismer, Daniel K; Werner, Mark J

    2012-01-01

    The physics metaphor, as applied to the economics (and financial performance) of the integrated health system, seems appropriate when considered together with the nine principles of management framework provided. The nature of the integrated design enhances leaders' management potential as they consider organizational operations and strategy in the markets ahead. One question begged by this argument for the integrated design is the durability, efficiency and ultimate long-term survivability of the more "traditional" community health care delivery models, which, by design, are fragmented, internally competitive and less capital efficient. They also cannot exploit the leverage of teams, optimal access management or the pursuit of revenues made available in many forms. For those who wish to move from the traditional to the more integrated community health system designs (especially those who have not yet started the journey), the path requires: * Sufficient balance sheet capacity to fund the integration process-especially as the model requires physician practice acquisitions and electronic health record implementations * A well-prepared board13, 14 * A functional, durable and sustainable physician services enterprise design * A redesigned organizational and governance structure * Favorable internal financial incentives alignment design * Effective accountable physician leadership * Awareness that the system is not solely a funding strategy for acquired physicians, rather a fully -.. committed clinical and business model, one in which patient-centered integrated care is the core service (and not acute care hospital-based services) A willingness to create and exploit the implied and inherent potential of an integrated design and unified brand Last, it's important to remember that an integrated health system is a tool that creates a "new potential" (a physics metaphor reference, one last time). The design doesn't operate itself. Application of the management principles

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

    PubMed

    Schnee, M; Grikscheit, F

    2013-06-01

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

  9. Open source electronic health records and chronic disease management

    PubMed Central

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

    2014-01-01

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

  10. Rumination mediates the association between cyber-victimization and depressive symptoms.

    PubMed

    Feinstein, Brian A; Bhatia, Vickie; Davila, Joanne

    2014-06-01

    The current study examined the 3-week prospective associations between cyber-victimization and both depressive symptoms and rumination. In addition, a mediation model was tested, wherein rumination mediated the association between cyber-victimization and depressive symptoms. Participants (N = 565 college-age young adults) completed online surveys at two time points 3 weeks apart. Results indicated that cyber-victimization was associated with increases in both depressive symptoms and rumination over time. Furthermore, results of the path analysis indicated that cyber-victimization was associated with increases in rumination over time, which were then associated with greater depressive symptoms, providing support for the proposed mediation effect for women, but not men. Findings extend previous correlational findings by demonstrating that cyber-victimization is associated with increases in symptomatology over time. Findings also suggest that the negative consequences of cyber-victimization extend beyond mental health problems to maladaptive emotion regulation. In fact, rumination may be a mechanism through which cyber-victimization influences mental health problems, at least for women. Mental health professionals are encouraged to assess cyber-victimization as part of standard victimization assessments and to consider targeting maladaptive emotion regulation in addition to mental health problems in clients who have experienced cyber-victimization.

  11. Health, safety and environmental risk management in laboratory fields

    PubMed Central

    Yarahmadi, Rasoul; Moridi, Parvin; Roumiani, YarAllah

    2016-01-01

    Background: Research project risks are uncertain contingent events or situations that, if transpire, will have positive or negative effects on objectives of a project. The Management of Health and Safety at Work (MHSW) Regulations 1999 require all employers and the self-employed persons to assess the risks from their work on anyone who may be affected by their activities. Risk assessment is the first step in risk-management procedure, and due to its importance, it has been deemed to be a vital process while having a unique place in the researchbased management systems. Methods: In this research, a two-pronged study was carried out. Firstly, health and safety issues were studied and analyzed by means of ISO 14121. Secondly, environmental issues were examined with the aid of Failure Mode and Effect Analysis. Both processes were utilized to determine the risk level independently for each research laboratory and corrective measure priorities in each field (laboratory). Results: Data analysis showed that the total main and inherent risks in laboratory sites reduced by 38% to 86%. Upon comparing the average risk levels before and after implementing the control and protective actions utilizing risk management approaches which were separate from health, safety and environmental aspects, a highly effective significance (p<0.001) was obtained for inherent risk reduction. Analysis of health, safety and environmental control priorities with the purpose of comparing the ratio of the number of engineering measures to the amount of management ones showed a relatively significant increase. Conclusion: The large number of engineering measures was attributed to the employment of a variety of timeworn machinery (old technologies) along with using devices without basic protection components. PMID:27284544

  12. Long-term impact of role stress and cognitive rumination upon morning and evening saliva cortisol secretion.

    PubMed

    Rydstedt, Leif W; Cropley, Mark; Devereux, Jason

    2011-05-01

    The long-term impact of role stress (conflict and ambiguity), cognitive rumination and their interaction were analysed upon morning and evening saliva cortisol secretion. The sample consisted of 52 male and 24 female British white-collars who had participated in a survey study on psychosocial working conditions 3.5 years earlier. Saliva cortisol secretion was measured over seven consecutive days with two measures: in the morning on awakening and at 22.00 hours. Stepwise linear multiple regression analyses was used for the statistical analyses. Role ambiguity at baseline and the interaction between role ambiguity and trait rumination contributed to explaining elevations in morning saliva cortisol secretion 3.5 years later (R(2) = 0.045; F = 4.57; p < 0.05), while role conflict at baseline significantly predicted increases in long-term evening saliva cortisol (R(2) = 0.057; F = 8.99; p < 0.01). The findings support a long-term relationship between chronic stress exposure and saliva cortisol secretion and some support for the assumption of cognitive rumination moderating the stressor-strain relationship. STATEMENT OF RElevance: The study is of interest for ergonomics practice because it demonstrates that work role ambiguity and role conflict, typically associated with organisational downsizing and restructuring, may contribute to long-term psycho-physiological reactivity. This could expose workers to increased health risks. Therefore, stress management programmes should include the concept of role stress, especially at a time where many work organisations are undergoing significant change. Management should also be made aware of the importance of communicating clear goals, objectives and lines of authority as well as providing sufficient training for those in new job roles. PMID:21547788

  13. Long-term impact of role stress and cognitive rumination upon morning and evening saliva cortisol secretion.

    PubMed

    Rydstedt, Leif W; Cropley, Mark; Devereux, Jason

    2011-05-01

    The long-term impact of role stress (conflict and ambiguity), cognitive rumination and their interaction were analysed upon morning and evening saliva cortisol secretion. The sample consisted of 52 male and 24 female British white-collars who had participated in a survey study on psychosocial working conditions 3.5 years earlier. Saliva cortisol secretion was measured over seven consecutive days with two measures: in the morning on awakening and at 22.00 hours. Stepwise linear multiple regression analyses was used for the statistical analyses. Role ambiguity at baseline and the interaction between role ambiguity and trait rumination contributed to explaining elevations in morning saliva cortisol secretion 3.5 years later (R(2) = 0.045; F = 4.57; p < 0.05), while role conflict at baseline significantly predicted increases in long-term evening saliva cortisol (R(2) = 0.057; F = 8.99; p < 0.01). The findings support a long-term relationship between chronic stress exposure and saliva cortisol secretion and some support for the assumption of cognitive rumination moderating the stressor-strain relationship. STATEMENT OF RElevance: The study is of interest for ergonomics practice because it demonstrates that work role ambiguity and role conflict, typically associated with organisational downsizing and restructuring, may contribute to long-term psycho-physiological reactivity. This could expose workers to increased health risks. Therefore, stress management programmes should include the concept of role stress, especially at a time where many work organisations are undergoing significant change. Management should also be made aware of the importance of communicating clear goals, objectives and lines of authority as well as providing sufficient training for those in new job roles.

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

    PubMed Central

    2010-01-01

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

  15. Clicking away at co-rumination: co-rumination correlates across different modalities of communication.

    PubMed

    Keshishian, Ani C; Watkins, Melanie A; Otto, Michael W

    2016-11-01

    Co-rumination is associated with positive friendship quality (thought to buffer against anxiety and depression) but paradoxically higher levels of anxiety and depression. With the increasing use of technology for communication among adults, there is little known about co-rumination effects across different modalities of communication. In the current study, we examined co-rumination through four methods (i.e. in person, phone calls, text messaging, and social media) in two separate samples - college students and participants from the community. Classic co-rumination effects were found for in-person communications, and we found that co-rumination by telephone as well as by texting, for a college student sample only, mirrors some of these findings for in-person co-rumination. In studies of co-rumination, evaluation of multiple modes of communication is warranted.

  16. Clicking away at co-rumination: co-rumination correlates across different modalities of communication.

    PubMed

    Keshishian, Ani C; Watkins, Melanie A; Otto, Michael W

    2016-11-01

    Co-rumination is associated with positive friendship quality (thought to buffer against anxiety and depression) but paradoxically higher levels of anxiety and depression. With the increasing use of technology for communication among adults, there is little known about co-rumination effects across different modalities of communication. In the current study, we examined co-rumination through four methods (i.e. in person, phone calls, text messaging, and social media) in two separate samples - college students and participants from the community. Classic co-rumination effects were found for in-person communications, and we found that co-rumination by telephone as well as by texting, for a college student sample only, mirrors some of these findings for in-person co-rumination. In studies of co-rumination, evaluation of multiple modes of communication is warranted. PMID:27438655

  17. Partnerships in Health Systems: Social Organization as limits and possibilities in the Family Health Strategy Management.

    PubMed

    Silva, Vanessa Costa E; Barbosa, Pedro Ribeiro; Hortale, Virgínia Alonso

    2016-05-01

    This is a case study in the municipality of Rio de Janeiro about management in the Family Health Strategy based on the Social Organizations model. The aims were to characterize and analyze aspects of the governance system adopted by the Rio de Janeiro Municipal Health Department and identify limits and possibilities of this model as a management option in Brazil's Unified Health System. A qualitative study was performed based on a literature review, document analysisand interviews with key informants. This management model facilitated the expansion of access to primary healthcare through the Family Health Strategy in Rio - where the population covered increased from 7.2% of the population in 2008 to 45.5% in 2015. The results showthat some practices in the contractual logic need to be improved, including negotiation and accountability with autonomywith the service suppliers. Evaluation and control has focus on processes, not results, and there has not been an increase in transparency and social control. The system of performance incentives has been reported as inducing improvements in the work process of the health teams. It is concluded that the regulatory capacity of the municipal management would need to be improved. On the other hand, there is an important and significant process of learning in progress. PMID:27166887

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

    PubMed

    Weaver, Catherine M

    2009-01-01

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

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

    PubMed

    Embrey, Martha; Hoos, David; Quick, Jonathan

    2009-11-01

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

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

    PubMed Central

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

    1992-01-01

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

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

    PubMed Central

    Buchmueller, T C

    2000-01-01

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

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

    PubMed

    Putnam, Kelly; McKibbin, Laura

    2004-03-01

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

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

    PubMed

    Verdú, M; Bach, A; Devant, M

    2015-06-01

    (P < 0.05) displacements at concentrate feeder than CF and CFL bulls. The CFL bulls exhibited (P < 0.01) more attempted mounts and tended (P = 0.10) to exhibit more completed mounts than CF bulls. In conclusion, both alternative feeder designs (CFL and SF) are good strategies to reduce total concentrate consumption without impairing performance, rumen health, or animal welfare in Holstein bulls fed high-concentrate diets. However, at the beginning, there was evidence that animals fed using SF had problems with adaptation.

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

    PubMed Central

    Hunter, David J

    2015-01-01

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

  5. Managed competition in health care and the unfinished agenda

    PubMed Central

    Enthoven, Alain C.

    1986-01-01

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

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

    PubMed

    Springston, Jeffrey K; Weaver-Lariscy, Ruthann

    2007-01-01

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

  7. Low level communication management for e-health systems

    NASA Astrophysics Data System (ADS)

    Riva, Guillermo; Zerbini, Carlos; Voos, Javier; Centeno, Carlos; González, Eduardo

    2011-12-01

    The heterogeneity of e-health systems encourages the use of standards such as Health Level 7 (HL7v3) to ensure interoperability. Many actual implementations address this problem by unoptimized high level programming of top-range portable computing platforms. However, this approach could pose excessive demands on battery-powered mid-range terminals. In this work, we propose low-level support for portable HL7v3-compatible embedded systems in order to better exploit their limited processing and communications capabilities. In particular, we present our experience in mobile communication management through two different approaches, which proves the feasibility of this proposal.

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

    PubMed

    Springston, Jeffrey K; Weaver-Lariscy, Ruthann

    2007-01-01

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

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

    PubMed

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

    2013-06-01

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

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

    PubMed

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

    2010-09-01

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

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

    PubMed Central

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

    2010-01-01

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

  12. [Economic evaluation and rationale for human health risk management decisions].

    PubMed

    Fokin, S G; Bobkova, T E

    2011-01-01

    The priority task of human health maintenance and improvement is risk management using the new economic concepts based on the assessment of potential and real human risks from exposure to poor environmental factors and on the estimation of cost-benefit and cost-effectiveness ratios. The application of economic tools to manage a human risk makes it possible to assess various measures both as a whole and their individual priority areas, to rank different scenarios in terms of their effectiveness, to estimate costs per unit of risk reduction and benefit increase (damage decrease).

  13. Neural substrates of trait ruminations in depression.

    PubMed

    Mandell, Darcy; Siegle, Greg J; Shutt, Luann; Feldmiller, Josh; Thase, Michael E

    2014-02-01

    Rumination in depression is a risk factor for longer, more intense, and harder-to-treat depressions. But there appear to be multiple types of depressive rumination-whether they all share these vulnerability mechanisms, and thus would benefit from the same types of clinical attention is unclear. In the current study, we examined neural correlates of empirically derived dimensions of trait rumination in 35 depressed participants. These individuals and 29 never-depressed controls completed 17 self-report measures of rumination and an alternating emotion-processing/executive-control task during functional MRI (fMRI) assessment. We examined associations of regions of interest--the amygdala and other cortical regions subserving a potential role in deficient cognitive control and elaborative emotion-processing--with trait rumination. Rumination of all types was generally associated with increased sustained amygdala reactivity. When controlling for amygdala reactivity, distinct activity patterns in hippocampus were also associated with specific dimensions of rumination. We discuss the possibly utility of targeting more basic biological substrates of emotional reactivity in depressed patients who frequently ruminate. PMID:24661157

  14. Neural substrates of trait ruminations in depression

    PubMed Central

    Mandell, Darcy; Siegle, Greg; Shutt, Luann; Feldmiller, Josh; Thase, Michael E.

    2014-01-01

    Rumination in depression is a risk factor for longer, more intense, and harder-to-treat depressions. But there appear to be multiple types of depressive rumination – whether they all share these vulnerability mechanisms, and thus would benefit from the same types of clinical attention is unclear. In the current study, we examined neural correlates of empirically-derived dimensions of trait rumination in 35 depressed participants. These individuals and 29 never-depressed controls completed 17 self-report measures of rumination and an alternating emotion-processing/executive-control task during functional magnetic resonance imaging (fMRI) assessment. We examined associations of regions of interest—the amygdala and other cortical regions subserving a potential role in deficient cognitive control and elaborative emotion-processing—with trait rumination. Rumination of all types was generally associated with increased sustained amygdala reactivity. When controlling for amygdala reactivity, distinct activity patterns in hippocampus were also associated with specific dimensions of rumination. We discuss the possibly utility of targeting more basic biological substrates of emotional reactivity in depressed patients who frequently ruminate. PMID:24661157

  15. Effects of Peanut Butter on Ruminating.

    ERIC Educational Resources Information Center

    Greene, Katherine S.; And Others

    1991-01-01

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

  16. Study Protocol for the Fukushima Health Management Survey

    PubMed Central

    Yasumura, Seiji; Hosoya, Mitsuaki; Yamashita, Shunichi; Kamiya, Kenji; Abe, Masafumi; Akashi, Makoto; Kodama, Kazunori; Ozasa, Kotaro

    2012-01-01

    Background The accidents that occurred at the Fukushima Daiichi Nuclear Power Plant after the Great East Japan Earthquake on 11 March 2011 have resulted in long-term, ongoing anxiety among the residents of Fukushima, Japan. Soon after the disaster, Fukushima Prefecture launched the Fukushima Health Management Survey to investigate long-term low-dose radiation exposure caused by the accident. Fukushima Medical University took the lead in planning and implementing this survey. The primary purposes of this survey are to monitor the long-term health of residents, promote their future well-being, and confirm whether long-term low-dose radiation exposure has health effects. This report describes the rationale and implementation of the Fukushima Health Management Survey. Methods This cohort study enrolled all people living in Fukushima Prefecture after the earthquake and comprises a basic survey and 4 detailed surveys. The basic survey is to estimate levels of external radiation exposure among all 2.05 million residents. It should be noted that internal radiation levels were estimated by Fukushima Prefecture using whole-body counters. The detailed surveys comprise a thyroid ultrasound examination for all Fukushima children aged 18 years or younger, a comprehensive health check for all residents from the evacuation zones, an assessment of mental health and lifestyles of all residents from the evacuation zones, and recording of all pregnancies and births among all women in the prefecture who were pregnant on 11 March. All data have been entered into a database and will be used to support the residents and analyze the health effects of radiation. Conclusions The low response rate (<30%) to the basic survey complicates the estimation of health effects. There have been no cases of malignancy to date among 38 114 children who received thyroid ultrasound examinations. The importance of mental health care was revealed by the mental health and lifestyle survey and the pregnancy

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

    NASA Technical Reports Server (NTRS)

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

    2005-01-01

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

  18. Public Health Effects of Inadequately Managed Stormwater Runoff

    PubMed Central

    Gaffield, Stephen J.; Goo, Robert L.; Richards, Lynn A.; Jackson, Richard J.

    2003-01-01

    Objectives. This study investigated the scale of the public health risk from stormwater runoff caused by urbanization. Methods. We compiled turbidity data for municipal treated drinking water as an indication of potential risk in selected US cities and compared estimated costs of waterborne disease and preventive measures. Results. Turbidity levels in other US cities were similar to those linked to illnesses in Milwaukee, Wis, and Philadelphia, Pa. The estimated annual cost of waterborne illness is comparable to the long-term capital investment needed for improved drinking water treatment and stormwater management. Conclusions. Although additional data on cost and effectiveness are needed, stormwater management to minimize runoff and associated pollution appears to make sense for protecting public health at the least cost. PMID:12948975

  19. Corporate management of quality in employee health plans.

    PubMed

    Maxwell, James; Temin, Peter

    2003-01-01

    As large companies move their employees into managed care, they must concern themselves with the quality and price of their employees' health care. Based on a survey of Fortune 500 companies, we show that most are integrating several aspects of quality into their purchasing and contracting decisions by focusing on three dimensions--customer service, network composition, and clinical quality. Companies focus on the customer service dimension while the medical community emphasizes clinical quality. PMID:12638371

  20. Holistic self-management education and support: a proposed public health model for improving women's health in Zimbabwe.

    PubMed

    Kanchense, Jane Handina Murigwa

    2006-08-01

    The primary health care model of public health has been implemented in many countries around the globe since the Declaration of Alma Ata in 1978, without pilot testing the primary health care model. Therefore, many public health researchers have sought methods of improving primary health care by creating evidence-based models. Many of these researchers recognize the role of behavioral models in public health. These offshoots of primary health care include the ecological, care, central human capabilities, and the SPECIES models. Holistic self-management education and support is a capacity-building philosophy that ensures active involvement of consumers of health care in the planning and implementation and evaluation of health care services. It helps consumers of health care to achieve the desired improved quality of health and life in managing and sustaining their health at the grassroots level. The care model addresses disease management ideals of the in the original primary health care model. The SPECIES model addresses those aspects of the primary health care model that include the cultural and social factors, as well as individual health education and support in the original primary health care model. The ecological model offers an improvement of the socioeconomic ideal in the original primary health care model. Improving the health of individuals will prevent illness, thereby reducing health care costs and lessening the current strain on an overburdened health care system in Zimbabwe. Holistic self-management education and support links health care delivery systems with social processes. It is a best practices model that could better serve Zimbabwean girls and women by contributing positively to the national challenges in health care, thereby meeting the Zimbabwean primary health care and safe motherhood goals. It is here recommended that holistic self-management education and support must be pilot tested before being adopted as the most appropriate model for

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

    PubMed

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

    2015-10-01

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

  2. IVHM Framework for Intelligent Integration for Vehicle Health Management

    NASA Technical Reports Server (NTRS)

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

    2005-01-01

    Integrated Vehicle Health Management (IVHM) systems for aerospace vehicles, is the process of assessing, preserving, and restoring system functionality across flight and techniques with sensor and communication technologies for spacecraft that can generate responses through detection, diagnosis, reasoning, and adapt to system faults in support of Integrated Intelligent Vehicle Management (IIVM). These real-time responses allow the IIVM to modify the affected vehicle subsystem(s) prior to a catastrophic event. Furthermore, this framework integrates technologies which can provide a continuous, intelligent, and adaptive health state of a vehicle and use this information to improve safety and reduce costs of operations. Recent investments in avionics, health management, and controls have been directed towards IIVM. As this concept has matured, it has become clear that IIVM requires the same sensors and processing capabilities as the real-time avionics functions to support diagnosis of subsystem problems. New sensors have been proposed, in addition to augment the avionics sensors to support better system monitoring and diagnostics. As the designs have been considered, a synergy has been realized where the real-time avionics can utilize sensors proposed for diagnostics and prognostics to make better real-time decisions in response to detected failures. IIVM provides for a single system allowing modularity of functions and hardware across the vehicle. The framework that supports IIVM consists of 11 major on-board functions necessary to fully manage a space vehicle maintaining crew safety and mission objectives. These systems include the following: Guidance and Navigation; Communications and Tracking; Vehicle Monitoring; Information Transport and Integration; Vehicle Diagnostics; Vehicle Prognostics; Vehicle Mission Planning, Automated Repair and Replacement; Vehicle Control; Human Computer Interface; and Onboard Verification and Validation. Furthermore, the presented

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

    PubMed

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

    2015-12-01

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

  4. Ground Operations Autonomous Control and Integrated Health Management

    NASA Technical Reports Server (NTRS)

    Daniels, James

    2014-01-01

    The Ground Operations Autonomous Control and Integrated Health Management plays a key role for future ground operations at NASA. The software that is integrated into this system is called G2 2011 Gensym. The purpose of this report is to describe the Ground Operations Autonomous Control and Integrated Health Management with the use of the G2 Gensym software and the G2 NASA toolkit for Integrated System Health Management (ISHM) which is a Computer Software Configuration Item (CSCI). The decision rationale for the use of the G2 platform is to develop a modular capability for ISHM and AC. Toolkit modules include knowledge bases that are generic and can be applied in any application domain module. That way, there's a maximization of reusability, maintainability, and systematic evolution, portability, and scalability. Engine modules are generic, while application modules represent the domain model of a specific application. Furthermore, the NASA toolkit, developed since 2006 (a set of modules), makes it possible to create application domain models quickly, using pre-defined objects that include sensors and components libraries for typical fluid, electrical, and mechanical systems.

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

    PubMed

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

    2015-12-01

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

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

    PubMed

    Zoccola, Peggy M; Dickerson, Sally S

    2015-08-01

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

  7. The role of public health officers in preparedness planning and management of health crises.

    PubMed

    Strauss, R; Muchl, R; Kunze, M; Hrabcik, H

    2008-03-13

    The contribution of public health officers is of crucial importance in both the preparedness planning process and the response to health threats since the implementation of public health measures lies within the competence of the public health system. Thus, public health officers on regional and district level have to be involved in every stage of the planning process for crisis management. Federal structures of health systems as equivalent to the political structure of a country pose specific challenges for both the planning process and the response itself. The most important instrument for the evaluation of crisis plans, including the assessment of the public health officers' preparedness, is the performance of exercises. The success of a simulation exercise depends mainly on careful planning process, clear evaluation criteria and a work plan, that allows for necessary improvements of crisis plans of all involved organisations. Simulation exercises are an integrated element of preparedness activities on all administrative levels of the public health system. Depending on the nature of the exercise public health officers on regional and district level are involved as planners or as players PMID:18768125

  8. Exploring Healthcare Consumer Acceptance of Personal Health Information Management Technology through Personal Health Record Systems

    ERIC Educational Resources Information Center

    Wu, Huijuan

    2013-01-01

    Healthcare technologies are evolving from a practitioner-centric model to a patient-centric model due to the increasing need for technology that directly serves healthcare consumers, including healthy people and patients. Personal health information management (PHIM) technology is one of the technologies designed to enhance an individual's ability…

  9. Hospital outcomes management: the Care Continuum and Health Outcomes Project.

    PubMed

    Shadbolt, B; McCallum, J; Bourne, M; Singh, M

    1998-01-01

    The Care Continuum and Health Outcomes Project is part of a national initiative to build an outcomes management approach in health care. This paper examines the baseline performance of the study. In 1995-96, 7154 Australian Capital Territory hospital inpatients were selected to take part in a five-wave survey over six months. In addition to the survey, the project involved the unit record linkage of routine data collections. A total of 5668 people (79%) agreed to participate in the survey, with 85% of these people agreeing to release their Medicare data. There were significant variations in participation rates between hospitals and wards. Factors contributing to these variations included patient socioeconomic status, disease type and illness severity. In conclusion, the success in establishing the project indicates that it is possible to conduct a broad scientific study within the health system, and that there are strong implications that ongoing scientific evaluations can be embedded within routine clinical practice. PMID:10185682

  10. Role of Ayurveda in management of oral health

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  12. Corporately managed health care and the new role of physicians.

    PubMed

    Winkenwerder, W; Nash, D B

    1988-01-01

    The roles described are not all-inclusive, since a small proportion of physicians, as in times past, will continue to pursue diverse careers outside of an tangential to health care. Neither are the roles mutually exclusive, as physician-managers are also organizational employees, as independently contracting professionals may also be partly fee for service, as physician entrepreneurs may be fee for service practitioners or contracting professionals, and so forth. The point is, that as the delivery of health care becomes a more complex and formalized process, and as large organizations delivering and insuring health care become more predominant, the various roles of physicians are becoming more distinctly obvious. What are the implications of this trend toward greater internal segmentation of the medical profession? At this juncture, they are not entirely clear. It could mean that some groups of physicians will achieve higher status and more rewards than other groups, which might result in greater conflicts within the medical profession. Undoubtedly, the emergence of corporately managed health care and the development of new (and possibly divergent) roles for physicians confronts the medical profession and its members with the gnawing questions of who they really are and what do they really want to be? Ultimately, the greatest challenge may be in finding a common set of commitments and values which transcend our many different roles, and which provide physicians with a clear and continuing sense of ourselves as medical professionals. PMID:3288297

  13. Health technopole: innovation applied to clinical engineering & health technology management education.

    PubMed

    Vilcahuaman, L; Rivas, R

    2010-01-01

    In the Peruvian Health System, Clinical Engineering does not exist as a topic of intervention. 59% of biomedical equipment is officially classified as operational, however next to apply the correct classification methodology and include security issues, only 10% of the equipment are suitable for use in patients. The serious consequences for patients, is opposite to the increased public investment in the health sector. Reversing this context leads to structural changes at all levels of the organization and they will be achievable only through an appropriate educational program. A strategy focused on joint of capacities called Health Technopole has managed to implement an innovative Model of Education in Healthcare Technology Management HTM and Clinical Engineering CE aimed at solving this problem. The proposal focused on strategies to strengthen the educational goals such as creating HTM & CE Units in hospitals, the implementation of the methodology: Problem Based Learning and Project Management in HTM & CE in classroom and on line courses. The process includes an effective interaction with global organizations through teleconferences, Internships, Workshops and Seminars. A key component was the sustained multidisciplinary approach. Health Technopole CENGETS is an expert adviser for the Ministry of Health and is called for trainings, design training programs for regional governments and also supports global organizations such as PAHO / WHO and ORAS / CONHU. The proposal of innovation applied to HTM & CE Education is effective and is a benchmark for similar countries. PMID:21096296

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

    PubMed

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

    2015-02-01

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

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

    PubMed Central

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

    2014-01-01

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

  16. Policy Management Standards Enabling Trustworthy pHealth.

    PubMed

    Blobel, Bernd; Davis, Mike; Ruotsalainen, Pekka

    2014-01-01

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

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

    PubMed

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

    2005-01-01

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

  18. Policy Management Standards Enabling Trustworthy pHealth.

    PubMed

    Blobel, Bernd; Davis, Mike; Ruotsalainen, Pekka

    2014-01-01

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

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

    PubMed

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

    2005-01-01

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

  20. Draugen HSE-case - occupational health risk management

    SciTech Connect

    Glas, J.J.P.; Kjaer, E.

    1996-12-31

    The Draugen HSE-Case serves as a risk management tool. Originally, risk management included only major safety hazards to personnel, environment and assets. Work Environment risks such as ergonomics, psycho-social factors and exposure to chemicals and noise, was not given the same attention. The Draugen HSE-Case addresses this weakness and extends all work environment risks. In order to promote line responsibility and commitment, relevant personnel is involved in the Case development. {open_quotes}THESIS{degrees}, a software application, is used to systematize input and to generate reports. The Draugen HSE-case encompasses: HSE risk analyses related to specific activities; Control of risk related to work environment; Established tolerability criteria; Risk reducing measures; Emergency contingency measures; and Requirements for Competence and Follow-up. The development of Draugen HSE-Case is a continuous process. It will serve to minimize the potential of occupational illnesses, raise general awareness, and make occupational health management more cost-effective.

  1. 9 CFR 93.414 - Milk from quarantined ruminants.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

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

  2. 9 CFR 93.414 - Milk from quarantined ruminants.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

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

  3. 9 CFR 93.414 - Milk from quarantined ruminants.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

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

  4. 9 CFR 93.414 - Milk from quarantined ruminants.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

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

  5. 9 CFR 93.414 - Milk from quarantined ruminants.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  6. 9 CFR 93.425 - Declaration for ruminants.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

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

  7. 9 CFR 93.429 - Ruminants for immediate slaughter.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  8. 9 CFR 93.425 - Declaration for ruminants.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  9. 9 CFR 93.429 - Ruminants for immediate slaughter.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

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

  10. 9 CFR 93.429 - Ruminants for immediate slaughter.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

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

  11. 9 CFR 93.409 - Articles accompanying ruminants.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

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

  12. 9 CFR 93.409 - Articles accompanying ruminants.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

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

  13. 9 CFR 93.412 - Ruminant quarantine facilities.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Ruminant quarantine facilities. 93.412... FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants § 93.412 Ruminant quarantine facilities. (a... ruminants from the time of unloading at the port to the time of release from the quarantine facility....

  14. 9 CFR 93.409 - Articles accompanying ruminants.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

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

  15. 9 CFR 93.409 - Articles accompanying ruminants.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Articles accompanying ruminants. 93...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Ruminants § 93.409 Articles accompanying ruminants..., blankets, or other things used for or about ruminants governed by the regulations in this part, shall...

  16. 9 CFR 93.429 - Ruminants for immediate slaughter.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

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

  17. 9 CFR 93.425 - Declaration for ruminants.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

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

  18. 9 CFR 93.409 - Articles accompanying ruminants.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

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

  19. 9 CFR 93.425 - Declaration for ruminants.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

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

  20. 9 CFR 93.429 - Ruminants for immediate slaughter.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

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

  1. 9 CFR 93.425 - Declaration for ruminants.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

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

  2. [Application of health questionnaires for health management in small- and medium-sized enterprises].

    PubMed

    Kishida, K; Saito, M; Hasegawa, T; Aoki, S; Suzuki, S

    1986-01-01

    Two kinds of health questionnaires, the Todai Health Index (THI) and Cumulative Fatigue Index (CFI), were applied as a screening device for health management of workers belonging to small-medium sized enterprises. A total of 495 workers composed of 452 male workers of a glass-bottle manufacturing factory and 43 male workers of a soft-drink bottling factory were the subjects of the present study. It was found that the two kinds of health questionnaires were different from each other and have their own characteristics. Twelve scales of THI were grouped into two, the first consisting of ten scales (SUSY, RESP, EYSK, MOUT, DIGE, IMPU, MENT, DEPR, NERV, and LIFE) and the second consisting of two scales (AGGR and LISC). Nine categories of CFI were grouped into one by using principal factor analysis. It was confirmed that the twelve scale scores of THI obtained at small-medium sized factories differed from those scale scores of a reference group investigated at a large-sized enterprise. It is on the basis of the scales of aggressiveness and lies and also of the scale of mental unstability which characterizes workers, locality, job (clerical or field work), and size of industry (large or small sized) that the difference could be evaluated. Urban life characterized by a life style of staying up late at night and waking up late in the morning has been reflected on the scale of life irregularity. Irregularity of life induced by transformation of working schedule, such as two or three shifts of work and overtime, was also reflected on this scale. Two scales of THI test, i.e., many subjective symptoms and digestive organ complaints, seemed to be the representative scales indicating a close relation between work load and health level. The discriminant score for diagnosis of psychosomatic diseases is considered to be one of the most useful assessments of the individual's health condition. As mentioned above, THI is recommended as a convenient assessment method for health

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

    ERIC Educational Resources Information Center

    Rastorfer, Darl

    2011-01-01

    From February 2008 through April 2011, School Health Connection, a program of the Louisiana Public Health Institute, developed an electronic health information management system for newly established school-based health centers in Greater New Orleans. School Health Connection was established as part of a broader effort to restore community health…

  4. Issues in Business and Medical Education: Brief Literature Review on Strategic Management of Health Care Institutions.

    ERIC Educational Resources Information Center

    Smith, Alan D.

    The literature on the use of strategic management principles by health care organizations is reviewed. After considering basic concepts of strategic management and managerial problems in nonprofit organizations, strategic planning and management of health care organizations are covered. Attention is directed to the health care environment,…

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

    PubMed

    Kwamie, Aku

    2015-01-01

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

  6. Rumination and behavioural factors in Parkinson's disease depression

    PubMed Central

    Julien, Camille L.; Rimes, Katharine A.; Brown, Richard G.

    2016-01-01

    Objective Parkinson's disease is associated with high rates of depression. There is growing interest in non-pharmacological management including psychological approaches such as Cognitive Behaviour Therapy. To date, little research has investigated whether processes that underpin cognitive models of depression, on which such treatment is based, apply in patients with Parkinson's disease. The study aimed to investigate the contribution of core psychological factors to the presence and degree of depressive symptoms. Methods 104 participants completed questionnaires measuring mood, motor disability and core psychological variables, including maladaptive assumptions, rumination, cognitive-behavioural avoidance, illness representations and cognitive-behavioural responses to symptoms. Results Regression analyses revealed that a small number of psychological factors accounted for the majority of depression variance, over and above that explained by overall disability. Participants reporting high levels of rumination, avoidance and symptom focusing experienced more severe depressive symptoms. In contrast, pervasive negative dysfunctional beliefs did not independently contribute to depression variance. Conclusion Specific cognitive (rumination and symptom focusing) and behavioural (avoidance) processes may be key psychological markers of depression in Parkinson's disease and therefore offer important targets for tailored psychological interventions. PMID:26944399

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

    SciTech Connect

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

    2012-05-01

    In order to meet the ever increasing demand for energy, the United States nuclear industry is turning to life extension of existing nuclear power plants (NPPs). Economically ensuring the safe, secure, and reliable operation of aging nuclear power plants presents many challenges. The 2009 Light Water Reactor Sustainability Workshop identified online monitoring of active and structural components as essential to the better understanding and management of the challenges posed by aging nuclear power plants. Additionally, there is increasing adoption of condition-based maintenance (CBM) for active components in NPPs. These techniques provide a foundation upon which a variety of advanced online surveillance, diagnostic, and prognostic techniques can be deployed to continuously monitor and assess the health of NPP systems and components. The next step in the development of advanced online monitoring is to move beyond CBM to estimating the remaining useful life of active components using prognostic tools. Deployment of prognostic health management (PHM) on the scale of a NPP requires the use of an integrated health management (IHM) framework - a software product (or suite of products) used to manage the necessary elements needed for a complete implementation of online monitoring and prognostics. This paper provides a thoughtful look at the desirable functions and features of IHM architectures. A full PHM system involves several modules, including data acquisition, system modeling, fault detection, fault diagnostics, system prognostics, and advisory generation (operations and maintenance planning). The standards applicable to PHM applications are indentified and summarized. A list of evaluation criteria for PHM software products, developed to ensure scalability of the toolset to an environment with the complexity of a NPP, is presented. Fourteen commercially available PHM software products are identified and classified into four groups: research tools, PHM system

  8. Evaluation in health: participatory methodology and involvement of municipal managers

    PubMed Central

    de Almeida, Cristiane Andrea Locatelli; Tanaka, Oswaldo Yoshimi

    2016-01-01

    ABSTRACT OBJECTIVE To analyze scopes and limits of the use of participatory methodology of evaluation with municipal health managers and administrators. METHODS Qualitative research with health policymakers and managers of the Comissão Intergestores Regional (CIR – Regional Interagency Commission) of a health region of the state of Sao Paulo in Brazil. Representatives from seven member cities participated in seven workshops facilitated by the researchers, with the aim of assessing a specific problem of the care line, which would be used as a tracer of the system integrality. The analysis of the collected empirical material was based on the hermeneutic-dialectic methodology and aimed at the evaluation of the applied participatory methodology, according to its capacity of promoting a process of assessment capable to be used as a support for municipal management. RESULTS With the participatory approach of evaluation, we were able to promote in-depth discussions with the group, especially related to the construction of integral care and to the inclusion of the user’s perspective in decision-making, linked to the search for solution to concrete problems of managers. By joint exploration, the possibility of using data from electronic information systems was opened, as well as information coming directly from the users of the services, to enhance discussions and negotiations between partners. The participants were disbelievers of the replication potential of this type of evaluation without the direct monitoring of the academy, given the difficulty of organizing the process in everyday life, already taken by emergency and political issues. CONCLUSIONS Evaluations of programs and services carried out within the Regional Interagency Commission, starting from the local interest and facilitating the involvement of its members by the use of participatory methodologies, can contribute to the construction of integral care. To the extent that the act of evaluating stay

  9. 9 CFR 92.6 - Determination of the date of effective enforcement of a ruminant-to-ruminant feed ban.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... enforcement of a ruminant-to-ruminant feed ban. 92.6 Section 92.6 Animals and Animal Products ANIMAL AND PLANT... Determination of the date of effective enforcement of a ruminant-to-ruminant feed ban. (a) In order for APHIS to... BSE controlled risk, APHIS must determine the date from which a ban on the feeding of...

  10. Implications of Big Data Analytics on Population Health Management.

    PubMed

    Bradley, Paul S

    2013-09-01

    As healthcare providers transition to outcome-based reimbursements, it is imperative that they make the transition to population health management to stay viable. Providers already have big data assets in the form of electronic health records and financial billing system. Integrating these disparate sources together in patient-centered datasets provides the foundation for probabilistic modeling of their patient populations. These models are the core technology to compute and track the health and financial risk status of the patient population being served. We show how the probabilistic formulation allows for straightforward, early identification of a change in health and risk status. Knowing when a patient is likely to shift to a less healthy, higher risk category allows the provider to intervene to avert or delay the shift. These automated, proactive alerts are critical in maintaining and improving the health of a population of patients. We discuss results of leveraging these models with an urban healthcare provider to track and monitor type 2 diabetes patients. When intervention outcome data are available, data mining and predictive modeling technology are primed to recommend the best type of intervention (prescriptions, physical therapy, discharge protocols, etc.) with the best likely outcome.

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

    PubMed

    Kouris-Blazos, Antigone; Wahlqvist, Mark L

    2007-01-01

    is too much reliance on health workers to treat the problem, especially doctors, who have not been given additional resources to manage obesity outside a typical doctor's consultation. Gross has recommended that further changes should be made to Medicare, private health insurance, and workplace and tax legislation to give people financial incentives to change their behaviour because obesity should not just be treated by governments as a public health problem but also as a barrier to productivity and a drain on resources. A Special Report of the WMCACA (Weight Management Code Administration Council of Australia) (www.weightcouncil.org) on the "Health Economics of Weight Management" has been published in the Asia Pacific Journal of Clinical Nutrition in September 2006. This report explores the cost benefit analysis of weight management in greater detail. PMID:17392129

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

    PubMed Central

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

    2012-01-01

    As an agricultural country and one of the world’s major food exporters, Thailand relies heavily on the use of pesticides to protect crops and increase yields. During the past decade, the Kingdom of Thailand has experienced an approximate four-fold increase in pesticide use. This increase presents a challenge for the Royal Thai Government in effectively managing and controlling pesticide use based upon the current policies and legal infrastructure. We have reviewed several key components for managing agricultural pesticides in Thailand. One of the main obstacles to effective pesticide regulation in Thailand is the lack of a consolidated, uniform system designed specifically for pesticide management. This deficit has weakened the enforcement of existing regulations, resulting in misuse/overuse of pesticides, and consequently, increased environmental contamination and human exposure. This article provides a systematic review of how agricultural pesticides are regulated in Thailand. In addition, we provide our perspectives on the current state of pesticide management, the potential health effects of widespread, largely uncontrolled use of pesticides on the Thai people and ways to improve pesticide management in Thailand. PMID:22308095

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

    PubMed

    Honka, Anita; Kaipainen, Kirsikka; Hietala, Henri; Saranummi, Niilo

    2011-01-01

    Lifestyle is a key determinant in the prevention and management of chronic diseases. If we would exercise regularly, eat healthy, control our weight, sleep enough, manage stress, not smoke and use alcohol only moderately, 90% of type II diabetes, 80% of coronary heart disease, and 70% of stroke could be prevented. Health statistics show that lifestyle related diseases are increasing at an alarming rate. Public health promotion campaigns and healthcare together are not effective enough to stop this "tsunami". The solution that is offered is to empower people to manage their health with the assistance of ICT-enabled services. A lot of R&D and engineering effort is being invested in Personal Health Systems. Although some progress has been made, the market for such systems has not yet emerged. The aim of this critical review is to identify the barriers which are holding back the growth of the market. It looks into the theoretical foundations of behavior change support, the maturity of the technologies for behavior change support, and the business context in which behavior change support systems are used. PMID:22273795

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

    PubMed

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

    2013-02-01

    In May 2012, cariologists, dentists, representatives of dental organizations, manufacturers, and third party payers from several countries, met in Philadelphia, Pennsylvania, to define a common mission; goals and strategic approaches for caries management in the 21th century. The workshop started with an address by Mr. Stanley Bergman, CEO of Henry Schein Inc. which focused on the imperative for change in academia, clinical practice, and public health. For decades, new scientific evidence on caries and how it should be managed have been discussed among experts in the field. However, there has been some limited change, except in some Scandinavian countries, in the models of caries management and reimbursement which have been heavily skewed toward 'drilling and filling'. There is no overall agreement on a caries' case definition or on when to surgically intervene. The participants in the workshop defined a new mission for all caries management approaches, both conventional and new. The mission of each system should be to preserve the tooth structure, and restore only when necessary. This mission marks a pivotal line for judging when to surgically intervene and when to arrest or remineralize early noncavitated lesions. Even when restorative care is necessary, the removal of hard tissues should be lesion-focused and aim to preserve, as much as possible, sound tooth structure. Continuing management of the etiological factors of caries and the use of science-based preventive regimens also will be required to prevent recurrence and re-restoration. These changes have been debated for over a decade. The Caries Management Pathways includes all systems and philosophies, conventional and new, of caries management that can be used or modified to achieve the new mission. The choice of which system to use to achieve the mission of caries management is left to the users and should be based on the science supporting each approach or philosophy, experience, utility, and ease of use

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

    PubMed

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

    2015-03-01

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

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

    PubMed

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

    2015-03-01

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

  17. Exploring the Model Design Space for Battery Health Management

    NASA Technical Reports Server (NTRS)

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

    2011-01-01

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

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

    PubMed

    Zismer, Daniel K; Werner, Mark J

    2012-01-01

    The physics metaphor, as applied to the economics (and financial performance) of the integrated health system, seems appropriate when considered together with the nine principles of management framework provided. The nature of the integrated design enhances leaders' management potential as they consider organizational operations and strategy in the markets ahead. One question begged by this argument for the integrated design is the durability, efficiency and ultimate long-term survivability of the more "traditional" community health care delivery models, which, by design, are fragmented, internally competitive and less capital efficient. They also cannot exploit the leverage of teams, optimal access management or the pursuit of revenues made available in many forms. For those who wish to move from the traditional to the more integrated community health system designs (especially those who have not yet started the journey), the path requires: * Sufficient balance sheet capacity to fund the integration process-especially as the model requires physician practice acquisitions and electronic health record implementations * A well-prepared board13, 14 * A functional, durable and sustainable physician services enterprise design * A redesigned organizational and governance structure * Favorable internal financial incentives alignment design * Effective accountable physician leadership * Awareness that the system is not solely a funding strategy for acquired physicians, rather a fully -.. committed clinical and business model, one in which patient-centered integrated care is the core service (and not acute care hospital-based services) A willingness to create and exploit the implied and inherent potential of an integrated design and unified brand Last, it's important to remember that an integrated health system is a tool that creates a "new potential" (a physics metaphor reference, one last time). The design doesn't operate itself. Application of the management principles

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

    ERIC Educational Resources Information Center

    Torres, Carlos A.

    2011-01-01

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

  20. The role of rumination in illness trajectories in youth: linking trans-diagnostic processes with clinical staging models.

    PubMed

    Grierson, A B; Hickie, I B; Naismith, S L; Scott, J

    2016-09-01

    Research in developmental psychopathology and clinical staging models has increasingly sought to identify trans-diagnostic biomarkers or neurocognitive deficits that may play a role in the onset and trajectory of mental disorders and could represent modifiable treatment targets. Less attention has been directed at the potential role of cognitive-emotional regulation processes such as ruminative response style. Maladaptive rumination (toxic brooding) is a known mediator of the association between gender and internalizing disorders in adolescents and is increased in individuals with a history of early adversity. Furthermore, rumination shows moderate levels of genetic heritability and is linked to abnormalities in neural networks associated with emotional regulation and executive functioning. This review explores the potential role of rumination in exacerbating the symptoms of alcohol and substance misuse, and bipolar and psychotic disorders during the peak age range for illness onset. Evidence shows that rumination not only amplifies levels of distress and suicidal ideation, but also extends physiological responses to stress, which may partly explain the high prevalence of physical and mental co-morbidity in youth presenting to mental health services. In summary, the normative developmental trajectory of rumination and its role in the evolution of mental disorders and physical illness demonstrates that rumination presents a detectable, modifiable trans-diagnostic risk factor in youth. PMID:27352637