text:
Supplement for maintaining rumen health in ruminants
US Patent & Trademark Office Database
The present invention includes a method of maintaining rumen health in ruminants. The method includes providing to a ruminant a low-moisture block made of molasses and having a buffer. The low-moisture buffer block is specifically designed such that licking rather than chewing consumes the block. The licking action of the cows increases salivation, which acts as a natural buffer for the maintenance of the overall rumen health.
Small Ruminant Collaborative Research Support Program. Annual Report for Peru, Program Year Eight 1986-87.
National Technical Information Service (NTIS)
Contents: Evaluation and improvement of small ruminants in extensive management systems; Economic analysis of small ruminant production and marketing systems; An investigation of small ruminant health problems; Improving small ruminant nutrition, manageme...
Welfare issues in the reproductive management of small ruminants.
Often, the welfare of sheep and goats is focussed on flock/herd management and the major issues surrounding parturition and early development of lambs/kids. There is an increased interest in the way we manage domestic species and small ruminants are perceived as having a green and welfare friendly image. The management of reproduction in these species has the potential to affect this perception and the limiting factors for these procedures are discussed. Discussion of genetic modification and manipulation has become a focal point in the critical appraisal of the management of farmed livestock and the importance of the consideration of the mental health and well being of the animal is considered as an important part of this analysis. The diversity of options that are available for this analysis and the application of these options is discussed. PMID:22326609
Roger, P A
Some Ruminations about Prison Mental Health Work.
ERIC Educational Resources Information Center
Describes incidents involving mental health services in prison facilities that illustrate "Catch-22" situations, in many of which inmates perceive clinicians as people who "come to watch you drown instead of throwing you a rope." Proposes a supplementation of "administrative clinical" thinking with nonbureaucratic, collaborative efforts to assist…
Toch, Hans
Current diagnosis and management of the rumination syndrome.
The rumination syndrome is a behavioral condition characterized by postprandial regurgitation. In contrast to what many think, the disorder does not exclusively occur in mentally disabled patients or children but also in otherwise healthy adults. As symptoms of postprandial regurgitation are often mistaken for gastroesophageal reflux disease or vomiting, the rumination syndrome is an underappreciated condition. Rumination episodes are caused by an intragastric pressure increases which forces the gastric content into the esophagus and mouth and occurs during 3 distinct mechanisms: primary rumination, secondary rumination, and supragastric belch-associated rumination. Combined manometry-impedance can distinguish rumination from gastroesophageal reflux disease. Treatment of the rumination syndrome consists of a thorough explanation of the mechanisms underlying the rumination episodes and behavioral therapy. As behavioral therapy is a time-consuming and often expensive treatment, we propose that a clinical suspicion of the disorder is always confirmed by a manometry-impedance measurement. PMID:24921208
Kessing, Boudewijn F; Smout, André J P M; Bredenoord, Albert J
Ruminant and industrially produced trans fatty acids: health aspects
Fatty acids of trans configuration in our food come from two different sources – industrially produced partially hydrogenated fat (IP-TFA) used in frying oils, margarines, spreads, and in bakery products, and ruminant fat in dairy and meat products (RP-TFA). The first source may contain up to 60% of the fatty acids in trans form compared to the content in ruminant fat which generally does not exceed 6%. In Western Europe, including Scandinavia, the average daily intake of IP-TFA has decreased during the recent decade due to societal pressure and a legislative ban, whereas the intake of RP-TFA has remained stable. In spite of this decrease we have found that in many countries consumption >20 g of IP-TFA in a one-meal menu consisting of some popular foods is possible, even though the average intake of IP-TFA in these countries is low. Subgroups of the populations may therefore, on average, consume >5 g IP-TFA per day. This level of consumption is generally not possible for RP-TFA. A daily intake of 5 g TFA (primarily IP-TFA) is associated with a 29% increased risk of coronary heart disease. Such an association is not found for RP-TFA up to a daily intake of 4 g. The high amount of IP-TFA in popular foods, the evidence of a more harmful effect on health by IP-TFA than by RP-TFA, and the feasibility of eliminating IP-TFA from foods without side effects for the population, suggest that a selective elimination of IP-TFA from our food is a 'low hanging fruit' in the quest for a more healthy diet for subgroups of the population.
Stender, Steen; Astrup, Arne; Dyerberg, J?rn
Ruminant Nutrition Symposium: Productivity, digestion, and health responses to hindgut acidosis in ruminants.
Microbial fermentation of carbohydrates in the hindgut of dairy cattle is responsible for 5 to 10% of total-tract carbohydrate digestion. When dietary, animal, or environmental factors contribute to abnormal, excessive flow of fermentable carbohydrates from the small intestine, hindgut acidosis can occur. Hindgut acidosis is characterized by increased rates of production of short-chain fatty acids including lactic acid, decreased digesta pH, and damage to gut epithelium as evidenced by the appearance of mucin casts in feces. Hindgut acidosis is more likely to occur in high-producing animals fed diets with relatively greater proportions of grains and lesser proportions of forage. In these animals, ruminal acidosis and poor selective retention of fermentable carbohydrates by the rumen will increase carbohydrate flow to the hindgut. In more severe situations, hindgut acidosis is characterized by an inflammatory response; the resulting breach of the barrier between animal and digesta may contribute to laminitis and other disorders. In a research setting, effects of increased hindgut fermentation have been evaluated using pulse-dose or continuous abomasal infusions of varying amounts of fermentable carbohydrates. Continuous small-dose abomasal infusions of 1 kg/d of pectin or fructans into lactating cows resulted in decreased diet digestibility and decreased milk fat percentage without affecting fecal pH or VFA concentrations. The decreased diet digestibility likely resulted from increased bulk in the digestive tract or from increased digesta passage rate, reducing exposure of the digesta to intestinal enzymes and epithelial absorptive surfaces. The same mechanism is proposed to explain the decreased milk fat percentage because only milk concentrations of long-chain fatty acids were decreased. Pulse-dose abomasal fructan infusions (1 g/kg of BW) into steers resulted in watery feces, decreased fecal pH, and increased fecal VFA concentrations, without causing an inflammatory response. Daily 12-h abomasal infusions of a large dose of starch (~4 kg/d) have also induced hindgut acidosis as indicated by decreased fecal pH and watery feces. On the farm, watery or foamy feces or presence of mucin casts in feces may indicate hindgut acidosis. In summary, hindgut acidosis occurs because of relatively high rates of large intestinal fermentation, likely due to digestive dysfunction in other parts of the gut. A better understanding of the relationship of this disorder to other animal health disorders is needed. PMID:21415422
Gressley, T F; Hall, M B; Armentano, L E
Eating Time Modulations of Physiology and Health: Life Lessons from Human and Ruminant Models
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.
Nikkhah, Akbar
Microbial Fuel Cells and Microbial Ecology: Applications in Ruminant Health and Production Research
Microbial fuel cell (MFC) systems employ the catalytic activity of microbes to produce electricity from the oxidation of organic, and in some cases inorganic, substrates. MFC systems have been primarily explored for their use in bioremediation and bioenergy applications; however, these systems also offer a unique strategy for the cultivation of synergistic microbial communities. It has been hypothesized that the mechanism(s) of microbial electron transfer that enable electricity production in MFCs may be a cooperative strategy within mixed microbial consortia that is associated with, or is an alternative to, interspecies hydrogen (H2) transfer. Microbial fermentation processes and methanogenesis in ruminant animals are highly dependent on the consumption and production of H2in the rumen. Given the crucial role that H2 plays in ruminant digestion, it is desirable to understand the microbial relationships that control H2 partial pressures within the rumen; MFCs may serve as unique tools for studying this complex ecological system. Further, MFC systems offer a novel approach to studying biofilms that form under different redox conditions and may be applied to achieve a greater understanding of how microbial biofilms impact animal health. Here, we present a brief summary of the efforts made towards understanding rumen microbial ecology, microbial biofilms related to animal health, and how MFCs may be further applied in ruminant research.
Osterstock, Jason B.; Pinchak, William E.; Ishii, Shun'ichi; Nelson, Karen E.
Health management guide. Managing mergers.
Structural change is everywhere in the health service. Driven by political imperatives, the logic of the market and the frenetic pace of development in medical technology, the impetus on both purchasers and providers is towards merger into fewer, more influential organisations. But as health authorities combine to increase their purchasing power, moving ever closer to family health services authorities, and as trusts rethink patterns of service provision to maintain a competitive edge, are they getting it right? This Health Management Guide surveys the changing health service landscape and puts forward a practical manifesto for successful mergers. PMID:10139295
The management of anthelmintic resistance in grazing ruminants in Australasia-Strategies and experiences.
In many countries the presence of anthelmintic resistance in nematodes of small ruminants, and in some cases also in those infecting cattle and horses, has become the status quo rather than the exception. It is clear that consideration of anthelmintic resistance, and its management, should be an integral component of anthelmintic use regardless of country or host species. Many years of research into understanding the development and management of anthelmintic resistance in nematodes of small ruminants has resulted in an array of strategies for minimising selection for resistance and for dealing with it once it has developed. Importantly, many of these strategies are now supported by empirical science and some have been assessed and evaluated on commercial farms. In sheep the cost of resistance has been measured at about 10% of the value of the lamb at sale which means that losses due to undetected resistance far outweigh the cost of testing anthelmintic efficacy. Despite this many farmers still do not test for anthelmintic resistance on their farm. Many resistance management strategies have been developed and some of these have been tailored for specific environments and/or nematode species. However, in general, most strategies can be categorised as either; identify and mitigate high risk management practices, maintain an anthelmintic-susceptible population in refugia, choose the optimal anthelmintic (combinations and formulations), or prevent the introduction of resistant nematodes. Experiences with sheep farmers in both New Zealand and Australia indicate that acceptance and implementation of resistance management practices is relatively easy as long as the need to do so is clear and the recommended practices meet the farmer's criteria for practicality. A major difference between Australasia and many other countries is the availability and widespread acceptance of combination anthelmintics as a resistance management tool. The current situation in cattle and horses in many countries indicates a failure to learn the lessons from resistance development in small ruminants. The cattle and equine industries have, until quite recently, remained generally oblivious to the issue of anthelmintic resistance and the need to take pre-emptive action. In Australasia, as in other countries, a perception was held that resistance in cattle parasites would develop very slowly, if it developed at all. Such preconceptions are clearly incorrect and the challenge ahead for the cattle and equine industries will be to maximise the advantages for resistance management from the extensive body of research and experience gained in small ruminants. PMID:24439840
Leathwick, D M; Besier, R B
The effect of condensed tannins on the nutrition and health of ruminants fed fresh temperate forages: a review
The effect of condensed tannins (CT) on the nutritive value of temperate forages and on the health of grazing ruminant animals is reviewed. The CT bind with proteins and other entities mainly by hydrophobic and hydrogen bonding in a pH-reversible manner, which is influenced by the structure and molecular weights of both the CT and the proteins. These reactions can
B. R Min; T. N Barry; G. T Attwood; W. C McNabb
Applications of diagnostic ultrasonography in small ruminant reproductive management.
Modern portable ultrasound machines provide the veterinary clinician with an inexpensive and non-invasive method to further examine the reproductive tract of both male and female sheep on farm which should take no more than 5 min with the results available immediately. Unlike cattle, ultrasound examination of the ovaries is not undertaken because failure to cycle during the normal season is rare in sheep and there are no common ovarian conditions causing acyclicity. Accurate diagnosis of foetal number has greatly improved the nutritional management of late gestation ewes over the past 30 years. Late gestation nutritional supply in response to foetal demand greatly reduces perinatal lamb mortality by ensuring lamb birthweight and ewe colostrum accumulation. The contents of vaginal prolapse have been determined using ultrasonography which has led to an improved method for correction. A retained foetus when second stage labour is considered to have been completed, and uterine torsion, can be identified during ultrasound examination allowing timely correction. Ultrasonographic examination of palpable scrotal abnormalities can provide much useful information particularly in the diagnosis of epididymitis, orchitis and testicular atrophy. PMID:22341010
Scott, P R
Ruminal Prevotella spp. May Play an Important Role in the Conversion of Plant Lignans into Human Health Beneficial Antioxidants
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.
Schogor, Ana L. B.; Huws, Sharon A.; Santos, Geraldo T. D.; Scollan, Nigel D.; Hauck, Barbara D.; Winters, Ana L.; Kim, Eun J.; Petit, Helene V.
Ruminant self-medication against gastrointestinal nematodes: evidence, mechanism, and origins?
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.
Villalba, Juan J.; Miller, James; Ungar, Eugene D.; Landau, Serge Y.; Glendinning, John
Medical and Health Services Managers
... health administration often include hospital organization and management, accounting and budgeting, human resources administration, strategic planning, law and ethics, health economics, and health information systems. Some programs allow students ...
Intelligent Vehicle Health Management
NASA Technical Reports Server (NTRS)
As a part of the overall goal of developing Integrated Vehicle Health Management systems for aerospace vehicles, the NASA Faculty Fellowship Program (NFFP) at Marshall Space Flight Center has performed a pilot study on IVHM principals which integrates researched IVHM technologies in support of Integrated Intelligent Vehicle Management (IIVM). IVHM is the process of assessing, preserving, and restoring system functionality across flight and ground systems (NASA NGLT 2004). The framework presented in this paper integrates advanced computational techniques with sensor and communication technologies for spacecraft that can generate responses through detection, diagnosis, reasoning, and adapt to system faults in support of INM. These real-time responses allow the IIVM to modify the affected vehicle subsystem(s) prior to a catastrophic event. Furthermore, the objective of this pilot program is to develop and integrate technologies which can provide a continuous, intelligent, and adaptive health state of a vehicle and use this information to improve safety and reduce costs of operations. Recent investments in avionics, health management, and controls have been directed towards IIVM. As this concept has matured, it has become clear the INM requires the same sensors and processing capabilities as the real-time avionics functions to support diagnosis of subsystem problems. New sensors have been proposed, in addition, to augment the avionics sensors to support better system monitoring and diagnostics. As the designs have been considered, a synergy has been realized where the real-time avionics can utilize sensors proposed for diagnostics and prognostics to make better real-time decisions in response to detected failures. IIVM provides for a single system allowing modularity of functions and hardware across the vehicle. The framework that supports IIVM consists of 11 major on-board functions necessary to fully manage a space vehicle maintaining crew safety and mission objectives: Guidance and Navigation; Communications and Tracking; Vehicle Monitoring; Information Transport and Integration; Vehicle Diagnostics; Vehicle Prognostics; Vehicle mission Planning; Automated Repair and Replacement; Vehicle Control; Human Computer Interface; and Onboard Verification and Validation. Furthermore, the presented framework provides complete vehicle management which not only allows for increased crew safety and mission success through new intelligence capabilities, but also yields a mechanism for more efficient vehicle operations. The representative IVHM technologies for computer platform using heterogeneous communication, 3) coupled electromagnetic oscillators for enhanced communications, 4) Linux-based real-time systems, 5) genetic algorithms, 6) Bayesian Networks, 7) evolutionary algorithms, 8) dynamic systems control modeling, and 9) advanced sensing capabilities. This paper presents IVHM technologies developed under NASA's NFFP pilot project and the integration of these technologies forms the framework for IIVM.
Paris, Deidre E.; Trevino, Luis; Watson, Michael D.
Ruminants, Cattle, Sheep, and Goats: Guidelines for the Breeding, Care, and Management of Laboratory Animals.
National Technical Information Service (NTIS)
The report furnishes practical guidelines for the care and maintenance of cattle, sheep, and goats under a variety of research situations. Highlighting the increasing use of ruminants as animal models in biomedical research and comparative medicine, the r...
Experimental effects of rumination styles on salivary cortisol responses
Emerging research suggests that rumination increases risk for negative health outcomes. In the first experiment to investigate\\u000a cortisol responses during angry rumination, participants were provoked and induced to engage in self-focused rumination, provocation-focused\\u000a rumination, or distraction. Consistent with social threat theory, self-focused rumination maintained high levels of cortisol\\u000a following provocation, whereas provocation-focused rumination and distraction facilitated decreases in cortisol. However,
Thomas F. Denson; Emma C. Fabiansson; J. David Creswell; William C. Pedersen
Intelligent Integrated System Health Management
NASA Technical Reports Server (NTRS)
Intelligent Integrated System Health Management (ISHM) is the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system (Management: storage, distribution, sharing, maintenance, processing, reasoning, and presentation). Presentation discusses: (1) ISHM Capability Development. (1a) ISHM Knowledge Model. (1b) Standards for ISHM Implementation. (1c) ISHM Domain Models (ISHM-DM's). (1d) Intelligent Sensors and Components. (2) ISHM in Systems Design, Engineering, and Integration. (3) Intelligent Control for ISHM-Enabled Systems
Figueroa, Fernando
Integrated Systems Health Management for Intelligent Systems.
National Technical Information Service (NTIS)
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 sto...
F. Figueroa K. Melcher
The effect of ruminal fluid preparations on the growth and health of newborn, milk-fed dairy calves.
The objective of this study was to determine the effect of oral doses of ruminal fluid (RF) on the growth and health of newborn, milk-fed heifer dairy calves (0 to 6 wk of age). Calves given 8 ml of RF each day until weaning gained more weight and had fewer scours than controls that did not receive RF. Because RF that was exposed to oxygen or was autoclaved also gave a response, it is unlikely that the preparations were acting as a probiotic. When the RF was centrifuged to separate the cells (RFC) from the fluid (RFS), both fractions had similar activity, and this result indicated that the response was not nutritional; that is, 1) RFC supplied a small amount of protein (approximately 8 mg/d), but RFS had much less protein, and 2) RFS had volatile fatty acid, but RFC had little if any volatile fatty acid. However, both RFS and RFC had bacterial polysaccharide, and bacterial polysaccharide has strong antigenic properties. In the first three studies, treated calves were given RF preparations each day until weaning (6 wk), but a subsequent experiment indicated that calves given autoclaved RF for only 5 d (d 1 to 5) also had greater body weight gains during the first 2 wk of life and fewer scours than untreated controls. Given that the dosage of RF was small and the material could be autoclaved to prevent disease transmission, RF supplementation could be a practical tool for improving calf health. PMID:11949870
Muscato, T V; Tedeschi, L O; Russell, J B
Families, Managed Care, & Children's Mental Health.
ERIC Educational Resources Information Center
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…
McManus, Marilyn C., Ed.
X-33/RLV System Health Management/ Vehicle Health Management
NASA Technical Reports Server (NTRS)
To reduce operations cost, the RLV must include the following elements: highly reliable, robust subsystems designed for simple repair access with a simplified servicing infrastructure and incorporating expedited decision making about faults and anomalies. A key component for the Single Stage to Orbit (SSTO) RLV System used to meet these objectives is System Health Management (SHM). SHM deals with the vehicle component- Vehicle Health Management (VHM), the ground processing associated with the fleet (GVHM) and the Ground Infrastructure Health Management (GIHM). The objective is to provide an automated collection and paperless health decision, maintenance and logistics system. Many critical technologies are necessary to make the SHM (and more specifically VHM) practical, reliable and cost effective. Sanders is leading the design, development and integration of the SHM system for RLV and X-33 SHM (a sub-scale, sub-orbit Advanced Technology Demonstrator). This paper will present the X-33 SHM design which forms the baseline for RLV SHM. This paper will also discuss other applications of these technologies.
Garbos, Raymond J.; Mouyos, William
X-33/RLV System Health Management/Vehicle Health Management
NASA Technical Reports Server (NTRS)
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.
Mouyos, William; Wangu, Srimal
Research Priorities for Health Systems Management.
National Technical Information Service (NTIS)
The proceedings of a 1978 conference on research priorities for health systems management held in Washington, DC, are summarized. Participants included researchers, health care providers, and government officials. The management research needs addressed i...
S. Frawley R. C. Jones J. Corman J. Levy
IntroductionRumination syndrome is the voluntary, albeit subconscious return of gastric content to the mouth. It is socially disabling, often leads to repeated, non-diagnostic investigations and can have significant morbidity. High Resolution Manometry (HRM) with observations after drinking or a test meal is a simple, objective way of establishing the diagnosis. A variety of behaviours and manometric findings are associated with
E Tucker; J Wright; M Fox
SSME Advanced Health Management: Project Overview
NASA Technical Reports Server (NTRS)
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.
Plowden, John
Integrated Airplane Health Management System
NASA Technical Reports Server (NTRS)
The National Air Space System-Wide Simulation (NAS Sim) program advances the development and implementation of a comprehensive, integrated health management system contributing to safety and modeling of the national aviation system. This program integrates different disciplines to develop an accurate and insightful method for real-time modeling of the local integrated airplane risk exposure and monitoring of operations of the global national air space.
Bardina, Jorge; McDermott, William J.; Follen, Gregory J.; Blaser, Tammy M.; Pavlik, William R.; Zhang, Desheng; Liu, Xian-You
Square Pegs and Round Holes: Ruminations on the Relationship between Performance Appraisal and Performance Management
ERIC Educational Resources Information Center
Models of comprehensive Performance Management systems include both employee development and evaluative components. The Organizational Behavior Management discipline focuses almost exclusively on the developmental component, while the Industrial and Organizational Psychology discipline is focused on use of performance appraisals. Performance…
Gravina, Nicole E.; Siers, Brian P.
National Technical Information Service (NTIS)
Latest research on protein absorption by ruminants has been compiled into the report. Contains information on how to calculate optimal nutrient requirements for ruminants and considers bacterial digestion in the methodology. Ruminant Nitrogen Usage presen...
Adolescent rumination syndrome.
Rumination syndrome is the non-purposeful regurgitation of recently ingested food from the stomach to the mouth, where it is either expelled or reswallowed. Adolescent rumination syndrome (ARS) is a rare condition of which many physicians are unaware. Patients often are misdiagnosed or undergo costly testing, and as a result, diagnosis and treatment are often delayed. While ARS is not life-threatening, it does have medical and emotional effects on the patient and the patient's family. Diagnosis of ARS is based upon the Rome III diagnostic criteria. Antroduodenal manometry, while not required for a diagnosis, can be helpful to confirm the diagnosis. The pathogenesis of this disorder is complex and not well understood. However, because of its behavioral component, treatment of ARS requires a multidisciplinary approach that includes both medical management of symptoms and implementation of strategies that address behavioral, psychological, and general quality-of-life components of the disorder. PMID:25064317
Mousa, Hayat M; Montgomery, Mary; Alioto, Anthony
Efficiency of families managing home health care
Over the last decade, cost-containment pressures, health care reform debates, movement to case-managed health care, and reductions\\u000a in health care benefits have required most families to be responsible for selecting specific health care services that keep\\u000a costs to a minimum. As Eddy [17-20] discussed in a series of articles on making decisions in health care, the consensus among\\u000a health care
Carol E. Smith; Susan V. M. Kleinbeck; Karen Fernengel; Linda S. Mayer
Spirulina in health care management.
Spirulina is a photosynthetic, filamentous, spiral-shaped and multicellular edible microbe. It is the nature's richest and most complete source of nutrition. Spirulina has a unique blend of nutrients that no single source can offer. The alga contains a wide spectrum of prophylactic and therapeutic nutrients that include B-complex vitamins, minerals, proteins, gamma-linolenic acid and the super anti-oxidants such as beta-carotene, vitamin E, trace elements and a number of unexplored bioactive compounds. Because of its apparent ability to stimulate whole human physiology, Spirulina exhibits therapeutic functions such as antioxidant, anti-bacterial, antiviral, anticancer, anti-inflammatory, anti-allergic and anti-diabetic and plethora of beneficial functions. Spirulina consumption appears to promote the growth of intestinal micro flora as well. The review discusses the potential of Spirulina in health care management. PMID:18855693
Kulshreshtha, Archana; Zacharia, Anish J; Jarouliya, Urmila; Bhadauriya, Pratiksha; Prasad, G B K S; Bisen, P S
Management and control of nematode parasites of small ruminants in the face of total anthelmintic failure.
Total failure of modern broad spectrum anthelmintics to control nematode parasites of sheep and goats is a reality, of rapidly increasing dimension, on many farms in the tropical / subtropical regions of the world. This is primarily associated with the highly pathogenic, blood sucking parasite, Haemonchus contortus, and where it now cannot be controlled by chemotherapy, annual mortalities exceeding 20% of the flock can be expected. Thus sheep and goat enterprises become totally unsustainable, unless major changes in management are effected. These must include a change away from reliance on suppressive anthelmintic treatment and to include several non-chemotherapeutic management options. In situations where livestock numbers need to be preserved and there is no opportunity to increase the grazing area available, then zero grazing with cut-and-carry herbage from uncontaminated pasturelands is the only option. In other circumstances stocking rates need to be substantially reduced, so that short-term rotational grazing can be effectively practiced. This strategy is improved if it is combined with the biological control of the free-living stages of the parasites, using the microfungus Duddingtonia flagrans. Monitoring the parasitological status of the animals by faecal sampling sentinel sub-flocks for nematode faecal egg counts, or the use of the FAMACHA procedure, are also valuable tools. Improving overall nutrition of the flock is an important adjunct to control. As a long-term priority, attempts to change the genotype of the flocks to those breeds that have been shown to possess natural resistance to H. contortus are worthwhile. PMID:16493393
Waller, P J
Integrated Systems Health Management for Intelligent Systems.
National Technical Information Service (NTIS)
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...
F. Figueroa K. Melcher
Perfectionism, anger, and anger rumination.
Anger and anger rumination are considered to be detrimental to both physical and psychological well being. Furthermore, perfectionism, as a personality construct, seems to be related to various types of maladjustment. Whereas perfectionism has been characterized as being positive when an individual derives pleasure from striving for excellence yet recognizes and accepts individual limitations, it is deemed negative when the individual has unrealistic expectations and is never satisfied with his or her performance. The present study examined whether positive and negative perfectionism was associated with anger and anger rumination. The Farsi version of the Positive and Negative Perfectionism Scale and the Farsi version of the Anger Rumination Scale, as well as Spielberger's State-Trait Anger Scale were completed by 384 Iranian students. Results showed that anger and anger rumination were, as expected, associated negatively with positive perfectionism and associated positively with negative perfectionism. Positive perfectionism enables individuals to strive for success in a flexible manner and, thus, to experience satisfaction and pleasure rather than dissatisfaction, frustration, and anger. Conversely, negative perfectionism makes individuals vulnerable to emotional distress such as predisposition to experience anger and anger rumination through setting high standards for performance, overgeneralization of perceived failures, negative self-evaluation, self-blame, and measuring self-worth in terms of unachievable goals of accomplishment and productivity. Hence, perfectionism may be regarded as having both adaptive and maladaptive aspects with regard to health. PMID:22044082
Besharat, Mohammad Ali; Shahidi, Shahriar
Compilation and adoption of ethno-veterinary medicine, traditional and other management practices by small ruminant farmers in Edo State Nigeria.
An inventory study into the ethno-veterinary medicine and traditional management practices and the extent of their adoption in the management of small ruminants by farmers in Edo State, Nigeria was carried out. Three hundred and fifty (350) small ruminant farmers randomly chosen from the seven (7) randomly selected local government areas in the state were used for the study. Data pertaining to farmers' background information, small ruminant acquisition and rearing as well as the ethno-veterinary medicines (EVMs) adopted were collected through a scheduled interview where structured questionnaires were administered. Data collected were used in the computation of ethno-veterinary medicine use indices (EVMUIs) and were subjected to simple statistical analysis. Results showed that 60.5% of the farmers interviewed were male while 39.4% were females and 56.9% of them were above 40 years old. About 60% of the farmers had between primary and secondary education, while 33.1% have no formal education and about 86% had little or no exposure to mass media. Thirty-seven (37) different EVMs/Traditional practices were identified. Based on their EVMUIs, 11 or 29.73% were highly used, 9 or 24.32% were moderately used while 17 or 45.95% were poorly used by farmers. Materials identified were noted to be locally available and were fully discussed. It is concluded that EVMs practices are actually adapted to the culture and socio-economic realities of resource poor farmers and means of spreading the knowledge among small scale farmers should be encouraged. PMID:19412741
Bamikole, M A; Ikhatua, U J
Nurse managed occupational health centers: an overview.
1. Nurse managed centers provide clients with direct access to professional nursing care. 2. Lillian Wald, Mary Breckenridge, and Margaret Sanger established nurse managed centers at the beginning of this century. 3. Primary, secondary, and tertiary prevention programs and services are based on the mission, outcomes, staffing, and financing of the occupational health center. 4. Essential parameters for comprehensively evaluating an occupational health nurse managed center include, client outcomes, client satisfaction, and cost-benefit. PMID:9384001
Wachs, J E
[The characteristics of public health resources management].
The article analyses the position of human health in the system of social economic relationships. The notion of material and technical resources in health institutions is defined. It is demonstrated that they are characterized by number of health institutions, their structure according levels and stages of medical care provision, costs of fixed assets, their structure and wear. The conceptual characteristics of actual management of public health resources are analyzed. PMID:22279808
Future developments in health care performance management
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.
Crema, Maria; Verbano, Chiara
Future developments in health care performance management.
This paper highlights the challenges of performance management in health care, wherein multiple different objectives have to be pursued. The literature suggests starting with quality performance, following the sand cone theory, but considering a multidimensional concept of health care quality. Moreover, new managerial approaches coming from an industrial context and adapted to health care, such as lean management and risk management, can contribute to improving quality performance. Therefore, the opportunity to analyze them arises from studying their overlaps and links in order to identify possible synergies and to investigate the opportunity to develop an integrated methodology enabling improved performance. PMID:24255600
Crema, Maria; Verbano, Chiara
Rotorcraft Health Management Issues and Challenges
NASA Technical Reports Server (NTRS)
This paper presents an overview of health management issues and challenges that are specific to rotorcraft. Rotorcraft form a unique subset of air vehicles in that their propulsion system is used not only for propulsion, but also serves as the primary source of lift and maneuvering of the vehicle. No other air vehicle relies on the propulsion system to provide these functions through a transmission system with single critical load paths without duplication or redundancy. As such, health management of the power train is a critical and unique part of any rotorcraft health management system. This paper focuses specifically on the issues and challenges related to the dynamic mechanical components in the main power train. This includes the transmission and main rotor mechanisms. This paper will review standard practices used for rotorcraft health management, lessons learned from fielded trials, and future challenges.
Zakrajsek, James J.; Dempsey, Paula J.; Huff, Edward M.; Augustin, Michael; Safa-Bakhsh, Robab; Ephraim, Piet; Grabil, Paul; Decker, Harry J.
Do employee health management programs work?
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. PMID:19288852
Serxner, Seth; Gold, Daniel; Meraz, Angela; Gray, Ann
Applying State Mental Health Standards: Management Uses.
National Technical Information Service (NTIS)
Guidelines are presented to assist State mental health agencies in developing, monitoring, and using standards. The guidelines are directed to State agency directors, to members of their management teams and support systems, and to persons charged with de...
Are public health physicians fading out of management?
Background: Recent developments in health services in the local arena in Norway have challenged the theoretical and applied scientific basis for both public health medicine and management. During the 1990s although public health physicians in Norway increased in number, they worked less with public health, as well as public health management. The effects of these developments on public health management
Betty J. Pettersen; Dag Hofoss
Development and Testing of Propulsion Health Management
NASA Technical Reports Server (NTRS)
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.
Hunter, Gary W.; Lekki, John D.; Simon, Donald L.
Research collaboration in health management research communities
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.
Crisis management teams in health organisations.
Crisis management teams (CMT) are necessary to ensure adequate and appropriate crisis management planning and response to unforeseen, adverse events. This study investigated the existence of CMTs, the membership of CMTs, and the degree of training received by CMTs in Australian health and allied health organisations. This cross-sectional study draws on data provided by executive decision makers in a broad selection of health and allied health organisations. Crisis management teams were found in 44.2 per cent of the health-related organisations surveyed, which is ten per cent lower than the figure for business organisations. Membership of these CMTs was not ideal and did not conform to standard CMT membership profiles. Similarly, the extent of crisis management training in health-related organisations is 20 per cent lower than the figure for business organisations. If organisations do not become pro-active in their crisis management practices, the onus is on government to improve the situation through regulation and the provision of more physical, monetary and skill resources to ensure that the health services of Australia are sufficiently prepared to respond to adverse events. PMID:22576140
Canyon, Deon V
Cooperative Education: Training Health Managers.
ERIC Educational Resources Information Center
Health administration students attending a college or university in Los Angeles, California, participated in a study of the effect of cooperative education. Three groups of students were selected. Group 1 consisted of undergraduate minority students--five males and five females (19-28 years old) with no prior health related work experience. Groups…
Washington, William N.
Improving diabetes management with mobile health technology.
Diabetes affects 25.8 million persons in the United States, and these persons make more than 35 million ambulatory care visits annually. Yet, less than half of persons with diabetes meet the recommended levels of A1C, blood pressure and lipid control. One innovative approach is to use mobile health technologies to help patients better manage their diabetes and related conditions, and 85% to 90% of patients have access to mobile health technology. A brief review of the guidelines for diabetes care and mobile health technology that can support the guidelines are reported related to (1) glycemic control and self-monitoring of blood glucose, (2) pharmacological approaches and medication management, (3) medical nutrition therapy, (4) physical activity and resistance training, (5) weight loss, (6) diabetes self-management education and (7) blood pressure control and hypertension. The patient and provider are encouraged to explore possibilities for mobile health technologies that can support behavior change. PMID:23531961
Sieverdes, John C; Treiber, Frank; Jenkins, Carolyn
Health management of ewes during pregnancy.
The objectives of health management of ewes during pregnancy are as follows: (i) successful completion of pregnancy at term, (ii) birth of healthy and viable lambs, with optimal birth and potential weaning bodyweight, (iii) optimum milk production during the subsequent lactation and (iv) improved management in relation to drug residues in animal products. Knowledge of the physiological background of pregnancy in ewes: changes, mechanisms and interactions, during pregnancy is important for the overall health management of ewes during pregnancy. Health management of pregnant ewes includes diagnosis of pregnancy and evaluation of the number of foetuses borne, which will support strategies for subsequent management of the flock. Nutritional management of ewes depends upon the stage of lactation and specifically aims to (i) prevention of pregnancy toxaemia and other metabolic diseases during the peri-partum period, (ii) formation of colostrum in appropriate quantity and quality, (iii) production of lambs with normal future birth bodyweight and (iv) support of increased milk yield during the subsequent lactation. At the end of lactation, udder management of pregnant ewes includes its clinical examination, culling of ewes considered unsuitable for lactation and, possibly, the intramammary administration of antibiotics; objectives of that procedure are (i) to cure infections which have occurred during the previous lactation and (ii) to prevent development of new mammary infection during the dry period. Management of abortions includes the correct and timely diagnosis of the causative agent of the disorder, as well as the strategic administrations of chemotherapeutic agents, aiming to prevent abortions in flocks with confirmed infection with an abortifacient agent, especially if no appropriate vaccinations had been carried out before the mating season. During the final stage of pregnancy, health management of ewes includes administration of appropriate anthelmintic drugs, aiming to eliminate gastrointestinal helminthes (thus, increasing production output of ewes) and preventing the built-up of parasitic burdens in the environment (thus, reducing infection of lambs during their neonatal period). Vaccinations of pregnant ewes aim to protect these animals, as well as their offspring, especially against diseases which are a frequent cause of neonatal mortality (e.g., clostridial infections). Health management also aims to prevent the main metabolic disorders of pregnant ewes (i.e., pregnancy toxaemia and hypocalcaemia), as well as to monitor flocks for development of these disorders. Health management of pregnant ewes is completed with application of husbandry practices before the start of the lambing season. Finally, in some cases, health management may include induction and synchronisation of lambings, which is a management or therapeutic procedure. PMID:22356932
Fthenakis, G C; Arsenos, G; Brozos, C; Fragkou, I A; Giadinis, N D; Giannenas, I; Mavrogianni, V S; Papadopoulos, E; Valasi, I
Health maintenance and management in childhood disability.
Health and health-related needs of children with disabilities are very broad in scope, and it is impossible to adequately cover all aspects in a single article. This article has tried, however, to highlight the issues common to disability, and lay the groundwork for the development of health maintenance guidelines for this population. The prevalence of childhood disability is on the rise, yet life expectancies are improving, and it is not uncommon for children even with severe disabilities to live well into adulthood. The ICIDH2 paradigm shift to focus on health and function rather than impairment and disability fits well with the national initiative to promote health for all. There is a paucity of information on the impact of childhood interventions on health in adulthood, yet it would be prudent to surmise that early interventions will be effective. Directed attention to the basic health needs and preventive measures for the management of children with disabilities is required. This can be difficult because the management of a child with disability is dynamic and challenging, and health care providers may find their time and energies consumed with just managing the more obvious and striking disability-related problems. The widespread ramifications of disability on both the individual and society, call for teamwork between family, health care providers, and the community. Although the specific needs of such a diverse group vary widely; as a group, children with disabilities have many common needs. These include the need for basic health maintenance and health promotion measures such as nutrition, immunizations and physical fitness, as well as coordination of services, psychologic and family support, technical assistance, funding resources, communication between health and education fields, and access to a "medical home," the site for primary care of the child. As a tree is bent, so it will grow. Efforts to promote growth and maximize opportunities for development, to inculcate healthy eating habits, to encourage exercise and socialization behaviors, and to strengthen the bond between the child with disability, family, and community will help minimize disability-related problems in adulthood. As children with disabilities are drawn into the mainstream of the concept of health, we should start to see the much awaited change in societal attitudes toward disability. The conditions resulting in childhood disability are many varied. Rather than developing condition specific health guidelines, it would be more advantageous to use a general health framework of anticipatory guidance, growth, development, medical management, psychologic and vocational counseling, and resource planning. Working off this framework, health maintenance and promotion measures can then be further individualized to suit the child and family's specific needs. PMID:12465561
Ayyangar, Rita
Medicaid managed care and public health data.
In summary, there are a number of ways in which state public health data can be of value in the design of Medicaid managed care plans. At the level of the purchaser, such as a state Medicaid agency, public health data can assist in decision-making around pricing policy and can be useful in prioritizing interventions for those conditions that most severely affect the covered population. Quality assurance standards such as the HEDIS clinical performance measures can be used to define a baseline of prevention-oriented services or, by adding additional customized data points, to emphasize a particular service. From the standpoint of the managed care plan, public health data can be useful in understanding the needs of a community it serves or would like to serve and in estimating the prevalence of various conditions in that community that will influence the premium it will charge. Thus, there are multiple routes through which public health goals and priorities can be incorporated into managed care and can leverage the power of managed care to improve the public's health. Images p228-a
Rutherford, G W; Backer, H D
Managing the myths of health care.
Myths impede the effective management of health care, for example that the system is failing (indeed, that is a system), and can be fixed by detached social engineering and heroic leadership, or treating it more like a business. This field needs to reframe its management, as distributed beyond the "top"; its strategy as venturing, not planning; its organizing as collaboration beyond control, and especially itself, as a system beyond its parts. PMID:23342753
Mintzberg, Henry
Health Occupations Education Program Management Guide.
ERIC Educational Resources Information Center
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…
Iowa Univ., Iowa City. Coll. of Education.
Learning, changing and managing in mental health.
This paper draws on research which considers the implications for practitioners and managers of implementing new ideas for practice gained from learning and education in mental health in the UK. Using a questionnaire survey followed by eight semi-structured interviews, the research set out to identify the issues facing workers trying to implement change in the workplace as a result of new learning gained from study of an Open University mental health course. The paper argues that much management literature on change within organisations is problematic in this specific context. This is largely because it takes insufficient account of the complexities surrounding work within social care (particularly mental health). Findings show that workers who have undertaken learning in mental health often feel disempowered and isolated when attempting to introduce new ideas for practice into the workplace. The first line manager operates at the intersection of practice and learning and has a key role in enabling and supporting staff through practice as well as service change and professional development. This paper locates the distance learning experience within a wider framework of student/practitioner support, and explores the role of the first line manager in supporting and enabling staff. PMID:11725583
Henderson, J
Rotorcraft Health Management Issues and Challenges.
National Technical Information Service (NTIS)
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 sou...
E. M. Huff J. J. Zakrajske M. Augustin P. J. Dempsey R. Safa-Bakhsh
Integrated Systems Health Management for Intelligent Systems
NASA Technical Reports Server (NTRS)
The implementation of an integrated system health management (ISHM) capability is fundamentally linked to the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system. It is akin to having a team of experts who are all individually and collectively observing and analyzing a complex system, and communicating effectively with each other in order to arrive at an accurate and reliable assessment of its health. In this paper, concepts, procedures, and approaches are presented as a foundation for implementing an intelligent systems ]relevant ISHM capability. The capability stresses integration of DIaK from all elements of a system. Both ground-based (remote) and on-board ISHM capabilities are compared and contrasted. The information presented is the result of many years of research, development, and maturation of technologies, and of prototype implementations in operational systems.
Figueroa, Fernando; Melcher, Kevin
Relationships Between Depressive Rumination, Anger Rumination, and Borderline Personality Features
We examined relationships between depressive rumination, anger rumination, and features of borderline personality disorder in a sample of 93 students with a wide range of borderline symptoms. All completed self-report measures of borderline features; trait-level negative affect; depressive and anger rumination; and current symptoms of depression, anxiety, and stress. Depressive and anger rumination were strongly associated with borderline features after
Ruth A. Baer; Shannon E. Sauer
Protected Feeds for Ruminants.
National Technical Information Service (NTIS)
The invention relates to and has among its objects the provision of novel products for ruminant feed and methods of making them. Improved feed supplements for ruminants are prepared from protein from a leafy green source. The protein is combined with lipi...
C. K. Lyon G. O. Kohler D. A. Dinius
Creating and managing a paperless health information management department.
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
Greene, Zelda B
Mapping the literature of health care management
Objectives: The research provides an overview of the health care management literature and the indexing coverage of core journal literature. Method: Citations from five source journals for the years 2002 through 2004 were studied using the protocols of the Mapping the Literature of Allied Health Project and Mapping the Literature of Nursing Project. The productivity of cited journals was analyzed by applying Bradford's Law of Scattering. Results: Journals were the most frequently cited format, followed by books. Only 3.2% of the cited journal titles from all 5 source journals generated two-thirds of the cited titles. When only the health care management practitioner–oriented source journals were considered, two-thirds of the output of cited journal titles came from 10.8% of the titles. Science Citation Index and PubMed provided the best overall coverage of the titles cited by all 5 source journals, while the cited titles from the 2 practitioner-oriented journals were covered most completely by Social Sciences Citation Index and Business Source Complete. Conclusions: Health care management is a multidisciplinary field. Librarians must consider the needs of their users and assist them by providing the necessary materials and combination of indexes to access this field adequately.
Taylor, Mary K.; Gebremichael, Meseret D.; Wagner, Catherine E.
Promoting transboundary animal disease risk management via a multiple health and husbandry intervention strategies in upland Lao PDR.
Surveys of smallholder farmer knowledge, attitude, practice (KAP) and income were conducted in 2011 and 2012 in five northern provinces of Lao People's Democratic Republic (Lao PDR; n = 200 farmers). Participating villages were classified as either from a livelihood development project (LV; n = 80 farmers) or a livestock research project that contained both 'high-intervention' (HI; n = 60 farmers) or 'low-intervention' (LI; n = 60 farmers) villages. Farmer training plus a suite of health and productivity interventions were implemented in HI sites; only vaccination was implemented in LI sites, whilst various interventions and limited vaccination were introduced to LV sites. Farmer interviews were conducted with survey questions on socioeconomic variables and KAP of large ruminant health and disease risk management, enabling determination of quantitative and dichotomous qualitative traits and comparison of results from HI, LI and LV villages. The average farmer income from sales of large ruminants in HI was USD 621, in LI was USD 547 and in LV was USD 225 (p < 0.001). The predicted mean of total knowledge scores (/42) in the 2012 survey in HI was 28, in LI was 22 and in LV was 17 (p < 0.001). We conclude that improved KAP of large ruminant health and production can be achieved by intensive training, although with some farmers yet to apply their knowledge on husbandry and biosecurity practices, continued learning support and closed linkage of research and development projects to improve extension capacity is recommended. This multiple participatory approach promoting biosecurity in addition to vaccination may provide a more sustainable pathway for the advancement of Lao PDR on the Progressive Control Pathway for foot and mouth disease control. PMID:24310441
Nampanya, Sonevilay; Khounsy, Syseng; Rast, Luzia; Windsor, Peter A
FAILSAFE Health Management for Embedded Systems
NASA Technical Reports Server (NTRS)
The FAILSAFE project is developing concepts and prototype implementations for software health management in mission- critical, real-time embedded systems. The project unites features of the industry-standard ARINC 653 Avionics Application Software Standard Interface and JPL s Mission Data System (MDS) technology (see figure). The ARINC 653 standard establishes requirements for the services provided by partitioned, real-time operating systems. The MDS technology provides a state analysis method, canonical architecture, and software framework that facilitates the design and implementation of software-intensive complex systems. The MDS technology has been used to provide the health management function for an ARINC 653 application implementation. In particular, the focus is on showing how this combination enables reasoning about, and recovering from, application software problems.
Horvath, Gregory A.; Wagner, David A.; Wen, Hui Ying; Barry, Matthew
ISWHM: Tools and Techniques for Software and System Health Management
NASA Technical Reports Server (NTRS)
This presentation presents status and results of research on Software Health Management done within the NRA "ISWHM: Tools and Techniques for Software and System Health Management." Topics include: Ingredients of a Guidance, Navigation, and Control System (GN and C); Selected GN and C Testbed example; Health Management of major ingredients; ISWHM testbed architecture; and Conclusions and next Steps.
Schumann, Johann; Mengshoel, Ole J.; Darwiche, Adnan
Making Technology Ready: Integrated Systems Health Management
NASA Technical Reports Server (NTRS)
This paper identifies work needed by developers to make integrated system health management (ISHM) technology ready and by programs to make mission infrastructure ready for this technology. This paper examines perceptions of ISHM technologies and experience in legacy programs. Study methods included literature review and interviews with representatives of stakeholder groups. Recommendations address 1) development of ISHM technology, 2) development of ISHM engineering processes and methods, and 3) program organization and infrastructure for ISHM technology evolution, infusion and migration.
Malin, Jane T.; Oliver, Patrick J.
Distributing shared savings for population health management.
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. PMID:24757873
Averill, Richard F; Goldfield, Norbert; Hughes, John S
Management without frontiers: health system convergence leads to health care management convergence.
Health care managers and policymakers throughout the industrialized world are faced with a variety of new challenges at the same time that traditional constraints on action are becoming ever more restrictive. These pressures have stimulated a variety of health care reforms involving four different strategies for change: cost-containment efforts, quality and administrative efficiency improvements, cost-shifting efforts, and the adoption of market-related concepts from the private sector. These changes are leading to convergence among health systems, as seen by the reforms underway in the Netherlands, Germany, and the English component of the United Kingdom's National Health Service. This in turn will create convergence in the problems and issues faced by health care managers. Issues such as hospital contracting, managed mental health care, primary care gatekeeping, and four others are explored to illustrate how American managers can learn from the experiences of colleagues in other industrialized nations. A final section identifies common themes for health care executives in this period of global convergence. PMID:10136977
Kirkman-Liff, B L
Integrated Systems Health Management for Intelligent Systems
NASA Technical Reports Server (NTRS)
The implementation of an integrated system health management (ISHM) capability is fundamentally linked to the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system. Management implies storage, distribution, sharing, maintenance, processing, reasoning, and presentation. ISHM is akin to having a team of experts who are all individually and collectively observing and analyzing a complex system, and communicating effectively with each other in order to arrive at an accurate and reliable assessment of its health. In this chapter, concepts, procedures, and approaches are presented as a foundation for implementing an ISHM capability relevant to intelligent systems. The capability stresses integration of DIaK from all elements of a system, emphasizing an advance toward an on-board, autonomous capability. Both ground-based and on-board ISHM capabilities are addressed. The information presented is the result of many years of research, development, and maturation of technologies, and of prototype implementations in operational systems.
Figueroa, Fernando; Melcher, Kevin
Structural Health Management for Future Aerospace Vehicles
NASA Technical Reports Server (NTRS)
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.
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.
A Distributed Prognostic Health Management Architecture
NASA Technical Reports Server (NTRS)
This paper introduces a generic distributed prognostic health management (PHM) architecture with specific application to the electrical power systems domain. Current state-of-the-art PHM systems are mostly centralized in nature, where all the processing is reliant on a single processor. This can lead to loss of functionality in case of a crash of the central processor or monitor. Furthermore, with increases in the volume of sensor data as well as the complexity of algorithms, traditional centralized systems become unsuitable for successful deployment, and efficient distributed architectures are required. A distributed architecture though, is not effective unless there is an algorithmic framework to take advantage of its unique abilities. The health management paradigm envisaged here incorporates a heterogeneous set of system components monitored by a varied suite of sensors and a particle filtering (PF) framework that has the power and the flexibility to adapt to the different diagnostic and prognostic needs. Both the diagnostic and prognostic tasks are formulated as a particle filtering problem in order to explicitly represent and manage uncertainties; however, typically the complexity of the prognostic routine is higher than the computational power of one computational element ( CE). Individual CEs run diagnostic routines until the system variable being monitored crosses beyond a nominal threshold, upon which it coordinates with other networked CEs to run the prognostic routine in a distributed fashion. Implementation results from a network of distributed embedded devices monitoring a prototypical aircraft electrical power system are presented, where the CEs are Sun Microsystems Small Programmable Object Technology (SPOT) devices.
Bhaskar, Saha; Saha, Sankalita; Goebel, Kai
Sensor Systems for Prognostics and Health Management
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.
Cheng, Shunfeng; Azarian, Michael H.; Pecht, Michael G.
[Quality management in a public health agency].
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
Villalbí, Joan R; Ballestín, Manuela; Casas, Conrad; Subirana, Teresa
Outage managment and health physics issue, 2008
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.
Agnihotri, Newal (ed.)
Measles: pathology, management and public health issues.
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. PMID:24844521
Bentley, Jackie; Rouse, Jo; Pinfield, Jenny
Health Care Financial Management: Curriculum Objectives and Bibliography.
ERIC Educational Resources Information Center
Curriculum objectives for health care financial management, a bibliography and examples of financial management curricula are presented. The outline of curriculum objectives identifies a core of knowledge and skills in financial management that health administration students might obtain in their academic training. The outline's content is divided…
Zelman, William N., Ed.; And Others
Impact of health management, health treatments, and zilpaterol hydrochloride supplementation on carcass quality, color, and palatability traits in heifers.
Two hundred sixty-eight strip loins were collected from heifers fed at Oklahoma State University in Stillwater, OK. In Exp. 1, heifers (n = 127) were assigned to 1 of 3 health management treatment groups: antimicrobial administrations were given based on standard feedlot protocol (SFP) or ruminal temperature (RT) or given a metaphylactic treatment of tulathromycin (MT) followed by visual assessment (VA). In Exp. 2, heifers (n = 155) were assigned to the same treatment groups as above and were supplemented zilpaterol hydrochloride (ZH) or control (CON). Three steaks were collected from each strip loin, 1 each for retail display, sensory evaluation, and Warner-Bratzler shear force (WBSF). Color was evaluated from the retail display steak using a trained color panel and objectively using a HunterLab Miniscan XE. An Instron Universal Testing Machine with a Warner-Bratzler head was used for evaluation of instrumental tenderness, and a trained sensory panel was used to assess palatability traits. Heifers treated by VA had the least number of antimicrobial administrations and lowest yield grade and also had the lightest HCW (P < 0.05) compared with the heifers treated by the other health management protocols. There were no subjective color attribute differences or sensory panel differences (P > 0.05) across all health management systems or antimicrobial administrations. There were no differences in carcass and performance traits for any antimicrobial administrations treatment groups (P > 0.05). Heifers who had 0 or 1 antimicrobial administrations had lower (P < 0.05) a* (redness/greenness: positive values = red and negative values = green), and b* (yellowness/blueness: positive values = yellow and negative values = blue) values compared with those who had 2 antimicrobial administrations. In Exp. 2, heifers treated by VA had the least number (P < 0.05) of antimicrobial administrations when compared with MT and RT. Health management group did not have any other effects on carcass, sensory, or color attributes. Zilpaterol hydrochloride supplementation caused a decrease (P < 0.05) in internal fat and yield grade, but no interactions were observed between the number of antimicrobial administrations and ZH supplementation. With the supplementation of ZH, WBSF significantly increased (P < 0.05). At the end of retail display, the control group had a greater (P < 0.05) surface discoloration when compared with the ZH group. Treatment and detection of bovine respiratory diseases (BRD) is critical to the industry economically and results from this study show that different methods can be used to detect BRD without dramatically impacting carcass, sensory, and retail case life characteristics. PMID:23658348
Bloomberg, B D; Mafi, G G; Pye, B J; Wahrmund, J L; Richards, C J; Morgan, J B; Vanoverbeke, D L
Consumer-directed health care: implications for health care organizations and managers.
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
Guo, Kristina L
Rumination Reconsidered: A Psychometric Analysis
In an attempt to eliminate similar item content as an alternative explanation for the re- lation between depression and rumination, a secondary analysis was conducted using the data from S. Nolen-Hoeksema, J. Larson, and C. Grayson (1999). After construct- ing a measure of rumination unconfounded with depression content, support for a two factor model of rumination was found. These analyses
Wendy Treynor; Richard Gonzalez; Susan Nolen-Hoeksema
Implementing a Strategic Energy Management Plan for Health Care
Adopting a strategic energy management plan (SEMP) has positioned PeaceHealth to proactively manage energy use for: 1. Operational cost savings,2. Improved environmental comfort and performance,3. Effective stewardship of resources.This plan was developed collectively by PeaceHealth facilities personnel to establish a set of guiding principles for energy management system wide. The PeaceHealth network includes regional healthcare facilities in Bellingham and Longview,
Ron Tolleson; Scott Dorough; Cynthia Putnam
The Overview of the Health Monitoring Management System
NASA Astrophysics Data System (ADS)
The health monitoring management system has prominent function to improve the security and dependability of the aircraft, can also shortens the maintain cycle by a large margin, improves the sortie rate at the same time. This paper has explained the concept, the development in domestic and international and the key technology of the health monitoring management system of aircraft; Construct the structure of the aircraft health monitoring management system, and has carried on analysis and research to its implementation method.
Zhong-Ji, Tan; Zhiqiang, Zhang; Yan-Bin, Shi
Integrated Vehicle Health Management (IVHM) Activities at Kennedy Space Center
NASA Technical Reports Server (NTRS)
Integrated Vehicle Health Management (IVHM) goals are to develop and integrate the technologies which can provide a continuous, intelligent, and adaptive health state of a vehicle and use this information to improve safety and reduce the costs of operations.
Fox, Jack
Is your system ready for population health management?
Health care organizations will need to migrate to population health management sooner rather than later in response to statutory and regulatory pressures coming from the federal government. PMID:24734317
Block, Dale J
Behavioral Health Emergencies Managed by School Nurses Working with Adolescents
ERIC Educational Resources Information Center
Background: As members of interdisciplinary teams, school nurses provide behavioral health services. Studies indicate that school nurses may lack sufficient continuing education in adolescent behavioral health and in the management of behavioral health emergencies, specifically. We conducted this study to describe the adolescent behavioral health…
Ramos, Mary M.; Greenberg, Cynthia; Sapien, Robert; Bauer-Creegan, Judith; Hine, Beverly; Geary, Cathy
World Health Organization's Management of Substance Abuse
NSDL National Science Digital Library
Part of the larger World Health Organization's (WHO) site this section on the management of substance abuse has a variety of useful information for students, teachers and those practicing in the field. Some of the most useful are several resources related to terminology and classifications including the WHO lexicon of alcohol and drug terms. The lexicon, developed in 1994, supplies clinicians, researchers and other users with a set of definitions of terms related to tobacco, alcohol and other drugs. Also available is a Facts and Figures section which provides users with basic information about the use and misuse of alcohol and other drugs worldwide. The Activities pages allow users to get a glimpse into the research that WHO is currently undertaking that is related to substance abuse. Sections on publications, research tools, and other links round out this very useful site.
Rocket Testing and Integrated System Health Management
NASA Technical Reports Server (NTRS)
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.
Figueroa, Fernando; Schmalzel, John
Integrated Systems Health Management for Space Exploration
NASA Technical Reports Server (NTRS)
Integrated Systems Health Management (ISHM) is a system engineering discipline that addresses the design, development, operation, and lifecycle management of components, subsystems, vehicles, and other operational systems with the purpose of maintaining nominal system behavior and function and assuring mission safety and effectiveness under off-nominal conditions. NASA missions are often conducted in extreme, unfamiliar environments of space, using unique experimental spacecraft. In these environments, off-nominal conditions can develop with the potential to rapidly escalate into mission- or life-threatening situations. Further, the high visibility of NASA missions means they are always characterized by extraordinary attention to safety. ISHM is a critical element of risk mitigation, mission safety, and mission assurance for exploration. ISHM enables: In-space maintenance and repair; a) Autonomous (and automated) launch abort and crew escape capability; b) Efficient testing and checkout of ground and flight systems; c) Monitoring and trending of ground and flight system operations and performance; d) Enhanced situational awareness and control for ground personnel and crew; e) Vehicle autonomy (self-sufficiency) in responding to off-nominal conditions during long-duration and distant exploration missions; f) In-space maintenance and repair; and g) Efficient ground processing of reusable systems. ISHM concepts and technologies may be applied to any complex engineered system such as transportation systems, orbital or planetary habitats, observatories, command and control systems, life support systems, safety-critical software, and even the health of flight crews. As an overarching design and operational principle implemented at the system-of-systems level, ISHM holds substantial promise in terms of affordability, safety, reliability, and effectiveness of space exploration missions.
Uckun, Serdar
Hospital administrator perceptions of health information managers as future leaders in health care reform.
The article examines hospital administrators' perceptions of health information professionals moving into leadership positions within health care organizations. Data for this study were collected from a national random sample of hospital administrators (N = 62). Findings from the study suggest that, although health information managers are viewed as integral to the success of the health care organization, health information managers are perceived as lacking appropriate educational training to move into administrative or leadership positions. For the health information professional to move into a leadership position, educational training (at the master's level) must focus on quality management, statistical process control, and performance evaluation. PMID:10140307
Rudman, W J; Kearns, L
Disease and health management in Asian aquaculture.
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 risk analysis, epidemiology, surveillance, reporting and planning for emergency response to epizootics; targeted research; institutional strengthening and manpower development (education, training and extension research and diagnostic services). PMID:16099592
Bondad-Reantaso, Melba G; Subasinghe, Rohana P; Arthur, J Richard; Ogawa, Kazuo; Chinabut, Supranee; Adlard, Robert; Tan, Zilong; Shariff, Mohamed
Strengthening health management: experience of district teams in The Gambia.
The lack of basic management skills of district-level health teams is often described as a major constraint to implementation of primary health care in developing countries. To improve district-level management in The Gambia, a 'management strengthening' project was implemented in two out of the three health regions. Against a background of health sector decentralization policy the project had two main objectives: to improve health team management skills and to improve resources management under specially-trained administrators. The project used a problem-solving and participatory strategy for planning and implementing activities. The project resulted in some improvements in the management of district-level health services, particularly in the quality of team planning and coordination, and the management of the limited available resources. However, the project demonstrated that though health teams had better management skills and systems, their effectiveness was often limited by the policy and practice of the national level government and donor agencies. In particular, they were limited by the degree to which decision making was centralized on issues of staffing, budgeting, and planning, and by the extent to which national level managers have lacked skills and motivation for management change. They were also limited by the extent to which donor-supported programmes were still based on standardized models which did not allow for varying and complex environments at district level. These are common problems despite growing advocacy for more devolution of decision making to the local level. PMID:10155879
Conn, C P; Jenkins, P; Touray, S O
Several species of nematodes parasitize the respiratory tract of ruminants. Disease due to infection with these parasites occurs less frequently in North America than in other parts of the world but can be locally and regionally important. The life cycles, epidemiology, pathology, diagnosis and treatment of Dictyocaulus viviparus, Dictyocaulus filaria, and Muellerius capillaris are summarized in this article. PMID:17071354
Panuska, Carla
Developing health management for current and future inventory aircraft
Designing and implementing health management systems for current and future aircraft poses many challenges, including interfacing with legacy onboard and offboard hardware and software systems, determining and justifying new functional requirements, and validating and verifying a robust, scalable system. Lessons learned from a current research and development program as well as prior health management system development experiences are presented as
J. B. Schroede; Greg J. Clark
Managing Evaluation in a Federal Public Health Setting
ERIC Educational Resources Information Center
The author, a federal manager who leads development and maintenance of evaluation for specific public health programs at the Centers for Disease Control and Prevention, tells the story of developing an evaluation unit in the Office on Smoking and Health. Lessons about managing evaluation, including his practices and related principles, are…
Schooley, Michael W.
An Airplane Health Management approach for civil aviation
om Abstract-In order to improve the safety and economy of civil aviation, based on the Prognostics and Health Management (PHM) System, an Airplane Health Management (AHM) technology is presented in this paper. Although the PHM system contains the abilities of fault detection, fault isolation, fault prognosis and prognosis of the remaining life, extending the time of an aircraft in the
Li Shu-ming; Dan Min; Yang Lu
Review on integrated health management for aerospace plane
The references at home and abroad are summarized in this paper. This paper introduces the basic concept and the application significance of aerospace plane, the main differences between the aerospace plane and general aircraft, integrated health management system and its compositions of aerospace plane , the development status of health management for aerospace plane in domestic and foreign countries. Especially
Li Yi-bo; Liu Jin-ying
Simulation: A Complementary Method for Teaching Health Services Strategic Management
Rapid change in the health care environment mandates a more comprehensive approach to the education of future health administrators. The area of consideration in this study is that of health care strategic management. A comprehensive literature review suggests microcomputer-based simulation as an appropriate vehicle for addressing the needs of both educators and students. Seven strategic management software packages are reviewed and rated with an instrument adapted from the Infoworld review format. The author concludes that a primary concern is the paucity of health care specific strategic management simulations.
Reddick, W. T.
Managed care and the public health challenge of TB.
Managed care is fast becoming the dominant form of medical care delivery and financing in the United States, yet its effects on public health practice remain largely unknown. Tuberculosis (TB) is a classic example of a disease with both public health and medical care implications, and as such it provides an opportunity for examining the impact on public health of the shift towards managed care in the medical marketplace. The authors approach the role of managed care in TB control by first considering the need for interorganizational coordination at the community level. The authors identify four basic models of how managed care organizations may fit into TB control efforts in local communities, using observations from 12 local public health jurisdictions to illustrate these models. These TB control models provide insight into the general mechanisms through which managed care organizations may affect other areas of public health practice. Images p22-a p23-a p25-a p28-a
Halverson, P K; Mays, G P; Miller, C A; Kaluzny, A D; Richards, T B
Managing Health Care Organizations: Where Professionalism Meets Complexity Science (Articles)
This article examines the intersection of professionalism and complexity science as a source of new insights for improving the health care industry from both a clinical and business point of view. Viewing health care organizations as professional complex adaptive systems suggests eight leadership tasks for addressing the circumstances that engulf health care. Managers who adopt this view will be able
Ruth A. Anderson; Reuben R. Jr
The Poverty of Information Systems Management in Home Health Agencies
Home health agencies are increasingly being challenged to cope with economic, financial and clinical pressures. This study examines the extent to which home health agencies have cultivated their information systems as an aid for managing performance and external forces. Colorado and New Mexico home health agencies participated in the research project. The findings indicate that only modest investments have been
Howard L. Smith; Richard Discenza
Environmental Management of Pediatric Asthma: Guidelines for Health Care Providers
ERIC Educational Resources Information Center
These guidelines are the product of a new Pediatric Asthma Initiative aimed at integrating environmental management of asthma into pediatric health care. This document outlines competencies in environmental health relevant to pediatric asthma that should be mastered by primary health care providers, and outlines the environmental interventions…
Roberts, James R.; McCurdy, Leyla Erk
Children and Managed Health Care. Analysis and Recommendations.
ERIC Educational Resources Information Center
Reviews the changes managed health care has brought to the delivery and use of medical services and recommends specific steps that will make the existing system more responsive to the needs of children. Systemwide health care reforms must give children stable medical care that emphasizes preventive health and developmental services. (SLD)
Deal, Lisa W.; Shiono, Patricia H.; Behrman, Richard E.
Managed care and children with special health care needs
Providing care to children with special health care needs within a managed care environment presents special challenges for providers and parents alike. The goal of managed care is to contain costs by encouraging or requiring members to obtain services through a designated network. In managed care programs, children and families may experience limited access to specialized care and services, along
Jeanne M. Rhoades Smucker
Strengthening Care Management with Health Information Technology. A Learning Guide.
National Technical Information Service (NTIS)
By unleashing the power of health IT to support care management, Beacon Communities were able to expand, enhance and improve the quality of a range of care management services in order to improve care transitions and chronic disease management, and better...
Reframing the Pharmaceutical Manufacturer\\/ Health Plan Relationship in Managed Care
Managed care is stuck in a vendor stage of health care in- dustry evolution that is organized, primarily, to beat back costs through contracted discounts and utilization management. At the same time, the potential exists for an altogether dif- ferent managed care that is based on a more explicit mission of lowering costs through improved quality. The foundation for this
Early Family Context and Development of Adolescent Ruminative Style: Moderation by Temperament
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 3˝ and 4˝ 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 characterized 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.
Hilt, Lori M.; Armstrong, Jeffrey M.; Essex, Marilyn J.
No health for all without better trained management.
This article notes that existing health professionals and managers constitute the first 'generation' working in a world where Health for All is a practical possibility because, if founded on community-based public and primary health care with hospitals in support and good intersectoral help, we now have the appropriate technology, access to finance and adequate numbers of health workers. What we still lack are sufficient health professionals, at all levels, with the managerial skills and experience to apply the technology, generate the funding and motivate the staff; making full use of community involvement, the co-operation of other sectors and good relationships with local and central government. Management can be learned both at the workplace and in the training room, and from the managers a few of them will emerge as leaders, with the vision to secure the willing support of others in reaching worthwhile health goals. A very useful publication is the Training Manual on Management of Human Resources for Health, WHO/EDUC/93.201 from World Health Organisation, Geneva, Switzerland. The paper closes with examples illustrating four principles for health management development: finding key points of entry; reaching large numbers; accelerating national self-sufficiency; and international. PMID:10169451
White, D K
Sensor Technology for Integrated Vehicle Health Management of Aerospace Vehicles
NASA Technical Reports Server (NTRS)
NASA is focusing considerable efforts on technology development for Integrated Vehicle Health Management systems. The research in this area is targeted toward increasing aerospace vehicle safety and reliability, while reducing vehicle operating and maintenance costs. Onboard, real-time sensing technologies that can provide detailed information on structural integrity are central to such a health management system. This paper describes a number of sensor technologies currently under development for integrated vehicle health management. The capabilities, current limitations, and future research needs of these technologies are addressed.
Prosser, W. H.; Brown, T. L.; Woodard, S. E.; Fleming, G. A.; Cooper, E. G.
CORRELATION BETWEEN RUMINAL pH AND SHORT CHAIN VOLATILE FATTY ACID IN DAIRY COWS
SUMMARY Subacute rumen acidosis (SARA) represents one of the most common disorder in the intensive dairy farms that affects ruminal fermentations, animal health, productivity and farm profitability. The aim of the present study was to determine the short chain volatile fatty acids (SCVFA) and pH in ruminal fluid of lactating dairy cows. Five commercial dairy herds suspected of SARA were
9 CFR 93.436 - Ruminants from regions of minimal risk for BSE.
Physicochemical modifications of conjugated linoleic acid for ruminal protection and oxidative stability
Conjugated linoleic acid (CLA) is a mixture of positional and geometric isomers of octadecadienoic acid [linoleic acid (LA), 18:2n-6]. Although ruminant milk and meat products represent the largest natural source of CLA and therefore, their concentration in ruminant lipids are of interest to human health, chemical or physical modifications of CLA should be needed as a means to enhance oxidative
Hyun-Seuk Moon; Hong-Gu Lee; Chung-Soo Chung; Yun-Jaie Choi; Chong-Su Cho
Competencies required of health service managers in the 1990s.
A mailed survey of three hundred and twenty Australian health service managers provided a ranked list of competencies perceived as essential for effective management. A high level of concordance was evident as to the relative importance of forty-nine competencies generated in four focus groups. Of seven clusters of competencies: leadership, decision-making and public relations/communication were ranked most highly. Only eight differences between the various groups of managers reached significance and these related to level of manager, years of management experience, discipline and size and type of organisation. This study extends understanding of the 'real world' management development needs of one group of the health industry. In conclusion, it is suggested that educators and managers need to cooperate more closely to develop learning programs which facilitate the acquisition, practice and assessment of identified competencies. PMID:10121769
Harris, M G; Bleakley, M
One Health in NSW: coordination of human and animal health sector management of zoonoses of public health significance.
Zoonoses of public health significance may occur in wildlife, livestock or companion animals, and may be detected by the human or animal health sectors. Of particular public health interest are foodborne, arboviral and emerging zoonoses (known/unknown, endemic/exotic). A coordinated One Health approach to the management of zoonoses in NSW uses measures including: mutually agreed intersectoral procedures for detection and response; surveillance and notification systems for defined endemic and exotic diseases; joint meetings and exercises to ensure currency of response plans; and intersectoral communication during a response. This One Health approach is effective and ensures the interests of both the human health and animal health sectors are addressed. PMID:21781617
Adamson, Sheena; Marich, Andrew; Roth, Ian
Dual-Use Aspects of System Health Management
NASA Technical Reports Server (NTRS)
System Health Management functionality is an essential part of any space launch system. Health management functionality is an integral part of mission reliability, since it is needed to verify the reliability before the mission starts. Health Management is also a key factor in life cycle cost reduction and in increasing system availability. The degree of coverage needed by the system and the degree of coverage made available at a reasonable cost are critical parameters of a successful design. These problems are not unique to the launch vehicle world. In particular, the Intelligent Vehicle Highway System, commercial aircraft systems, train systems, and many types of industrial production facilities require various degrees of system health management. In all of these applications, too, the designers must balance the benefits and costs of health management in order to optimize costs. The importance of an integrated system is emphasized. That is, we present the case for considering health management as an integral part of system design, rather than functionality to be added on at the end of the design process. The importance of maintaining the system viewpoint is discussed in making hardware and software tradeoffs and in arriving at design decisions. We describe an approach to determine the parameters to be monitored in any system health management application. This approach is based on Design of Experiments (DOE), prototyping, failure modes and effects analyses, cost modeling and discrete event simulation. The various computer-based tools that facilitate the approach are discussed. The approach described originally was used to develop a fault tolerant avionics architecture for launch vehicles that incorporated health management as an integral part of the system. Finally, we discuss generalizing the technique to apply it to other domains. Several illustrations are presented.
Owens, P. R.; Jambor, B. J.; Eger, G. W.; Clark, W. A.
The Adoption of Mobile Health Management Services: An Empirical Study
As their populations age, many countries are facing the increasing economic pressure of providing healthcare to their people.\\u000a In Taiwan, this problem is exacerbated by an increasing rate of obesity and obesity-related conditions. Encouraging the adoption\\u000a of personal health management services is one way to maintain current levels of personal health and to efficiently manage\\u000a the distribution of healthcare resources.
Ming-Chien Hung; Wen-Yuan Jen
Knowledge management in health: a systematic literature review.
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
Rocha, Elyrose Sousa Brito; Nagliate, Patricia; Furlan, Claudia Elisangela Bis; Rocha, Kerson; Trevizan, Maria Auxiliadora; Mendes, Isabel Amélia Costa
Corporate social responsibility and the future health care manager.
The decisions and actions of health care managers are oftentimes heavily scrutinized by the public. Given the current economic climate, managers may feel intense pressure to produce higher results with fewer resources. This could inadvertently test their moral fortitude and their social consciousness. A study was conducted to determine what corporate social responsibility orientation and viewpoint future health care managers may hold. The results of the study indicate that future health care managers may hold patient care in high regard as opposed to profit maximization. However, the results of the study also show that future managers within the industry may continue to need rules, laws, regulations, and legal sanctions to guide their actions and behavior. PMID:21045586
Collins, Sandra K
Amino acid metabolism in ruminants
All animals require amino acids (AA) which are the building blocks of proteins required for optimal growth, reproduction, lactation, and maintenance. In ruminants, proteins and AA are first subject to microbial degradation in the rumen making it difficult to predict the quality and quantity of AA that are absorbed by the animal. In ruminants, absorbed AA comes from microbial protein
Limin Kung; Lyle M. Rode
Risk Management in Mental Health: Applying Lessons From Commercial Aviation
Objective: Risk management in mental health focuses on risks in patients and fails to predict rare but catastrophic events such as suicide. Commercial aviation has a similar task in preventing rare but catastrophic accidents. This article describes the systems in place in commercial aviation that allows that industry to prevent disasters and contrasts this with the situation in mental health.Conclusions:
Simon Hatcher
Application of Customer Relationship Management in Health Care
Health care sectors of many nations are now opting for Customer Relationship Management (CRM) for building a bridge of trust between hospital and customer. The CRM system enables health care sectors to get essential customer information and use it as efficiently as possible. CRM orchestrates a number of methodologies in a synchronized approach to delivering healthcare. As one of the
Wan Yina
Managed Mental Health Care: Intentional Misdiagnosis of Mental Disorders
ERIC Educational Resources Information Center
In this article, the authors provide an overview of the effectiveness of managed health care systems and their impact on mental health counselors. They review ethical and legal dilemmas involving informed consent, confidentiality, client autonomy, competence, treatment plans, and termination that had not existed prior to the introduction of…
Braun, Sharon A.; Cox, Jane A.
Managed Care: What Mental Health Counselors Need To Know.
ERIC Educational Resources Information Center
Surveys leaders from various roles in the managed-care and mental-health professions to identify current and future marketplace trends affecting the clinical practice of mental-health counseling. Identifies training and continuing education needs based upon these interviews. (Author/GCP)
Lawless, Linda L.; Ginter, Earl J.; Kelly, Kevin R.
An Examination of Health Information Management by the Deaf
ERIC Educational Resources Information Center
Little is known about how Deaf people perceive, access, and utilize interpersonal and media sources for health information. In light of the scarcity of research on health information management among this group, a two-phase study was conducted that included eight focus groups (N=39) and survey data (N=366) with Deaf participants to determine the…
Karras, Elizabeth
Overview: Adaptive Management for the Health Risks of Climate Change
\\u000a Climate change is expected to increase health risks in all countries. Although public health agencies and organizations have\\u000a impressive records of controlling the burden of climate-sensitive health outcomes, current and planned programs and activities\\u000a may need to be modified to address the additional risks of climate change. Programs and activities need to take an iterative\\u000a risk management approach if they
Kristie L. Ebi
A 3-pillar approach to integrated population health management.
Successful integrated population health management models include: A leadership team that includes financial managers, physicians, and advisers. A plan that clearly connects tactics to measurable goals. Infrastructure that includes care coordinators and robust IT to avoid duplicative care and ensure care protocols are followed. PMID:24757876
Wallace, John
[Case management: a new focus on health care].
The study is a literature review and has the goal to present a new modality of health care delivery called case management. Authors emphasize essential aspects related to this modality of care: care methodology, history, goals, practice areas. It is considered the use of case management in the Brazilian reality. PMID:12852301
Gonzales, Roxana Isabel Cardozo; Casarin, Santina Nunes Alves; Caliri, Maria Helena Larcher; Sassaki, Cinthia Midori; Monroe, Aline Aparecida; Villa, Tereza Cristina Scatena
Evaluation, Accountability and Clinical Expertise in Managed Mental Health Care
In this article, the author identifies a number of policies and practices of managed mental health care organizations that, if allowed to continue unchecked, will have deleterious effects upon the American family. Since this industry is not regulated by either state or federal statutes, managed care organizations have had free reign to disallow coverage for a variety of DSM-III-R diagnostic
Dennis A Bagarozzi
Brief Report: Adolescents' Co-Rumination with Mothers, Co-Rumination with Friends, and Internalizing Symptoms
ERIC Educational Resources Information Center
The current research examined co-rumination (extensively discussing, rehashing, and speculating about problems) with mothers and friends. Of interest was exploring whether adolescents who co-ruminate with mothers were especially likely to co-ruminate with friends as well as the interplay among co-rumination with mothers, co-rumination with…
Waller, Erika M.; Rose, Amanda J.
Self-Assessment for Managers of Health Care. How Can I Be a Better Manager? WHO Offset Publication No. 97.
ERIC Educational Resources Information Center
This booklet is intended to assist midlevel health care managers in assessing and improving their health care management skills. The first chapter uses the story of one health care manager's recognition of his own weaknesses and subsequent self-improvement to illustrate the qualities and skills that make a good manager. The second chapter, which…
Rotem, Arie; Fay, Joe
Health and productivity of traditionally managed Djallonke sheep and West African dwarf goats under high and moderate trypanosomosis risk.
Trypanosome infections, packed red cell volume levels (PCV), body weight and nematode faecal egg counts of village-based small ruminants were monitored in two areas in The Gambia with either moderate or high trypanosomosis risk for 24 and 30 months respectively. Outflows from the flock and new-born animals were recorded and data on housing and management were compiled. Reported mortality rates were higher in goats than in sheep, but for both species highest in the moderate risk area. The peak of trypanosome infections lagged the peak of tsetse densities by 1-3 months in both areas. Trypanosoma vivax was the predominant species found in the infected animals, followed by T. congolense. Trypanosome prevalence was, in general, higher in sheep than in goats but only significantly higher during Year 1 in the moderate risk area. Trypanosome infection reduced the PCV level significantly and seasonal effects indicated significantly lower PCV levels during the rains. Trypanosome infection significantly depressed weight gain in both species at periods where infection rates were highest. In both species considerably lower weight gains were observed during the rainy season. Abortion rates were higher in goats than in sheep in both study sites, and highest in the high-risk site. Trypanosome infection in ewes in the high risk area increased lamb mortality significantly but had no effect on birth weights, nor on growth rates up to 4 months. Offspring mortality up to 4 months was generally high at both sites. Trypanosome infection in the dam between 3.5 to 7 months post parturition significantly increased parturition interval in both species. Peak faecal egg output occurred at the end of the rainy season and was highest for both species in the moderate risk site. Poor grazing management was found responsible for a seasonal nutritional constraint. Based on these results, these breeds of sheep and goats can be considered as trypanotolerant since they are able to remain productive under high and moderate levels of trypanosome challenge. Nevertheless, trypanosomosis affected their health and production level as shown by reduced PCV levels, depressed weight gains, longer parturition intervals and higher lamb mortality. In addition, during the rains, helminth infections and poor management leading to nutritional constraints had also a negative impact on health and production and therefore influenced the innate resilience to trypanosomosis in those indigenous breeds. Adaptations in management may have an equal impact as certain disease control measures to improve biological and economical returns from small ruminants in tsetse infested rural areas. PMID:10321582
Osaer, S; Goossens, B; Kora, S; Gaye, M; Darboe, L
Managing interorganizational dependencies in the new health care marketplace.
To survive, let alone thrive, in an increasingly competitive and threatening environment, health care organizations must skillfully manage their dependencies. Such dependencies traditionally have been managed through marketplace exchanges (buying and selling) and ownership relationships (acquisition, merger, and business development). An alternative strategy for designing and managing interorganizational relationships, the quasi-firm, is introduced. The quasi-firm is a hybrid market/ownership arrangement that allows participating organizations to pursue strategically important purposes while simultaneously preserving a high degree of functional and legal autonomy. We suggest that this distinctive interorganizational form is particularly well suited to the features of the new health care marketplace. PMID:10302491
Pointer, D D; Begun, J W; Luke, R D
Managing the Health Needs of Vulnerable Children.
National Technical Information Service (NTIS)
This project applied qualitative methods to gain insight into the experiences of vulnerable childrens families: how they define their childrens health needs, decisions regarding where and when to seek care, and their experiences with care received.
E. J. Sobo M. Seid
[Evaluation model for human resource management in health].
This paper presents an assessment model for human resource management in health. This methodological research was structured through indicators tested in evaluative research. The Basic Operational Standard for Human Resources in the Unified National Health System (NOB/RH-SUS) was used as the baseline, and the following dimensions were analyzed: work management, workers' development, workers' health, and social control. The model was discussed and refined during a consensus workshop involving experts in human resources evaluation and management, by defining an assessment matrix with 12 indicators. The model was applied to 15 municipalities in Greater Metropolitan Florianópolis, Santa Catarina State, Brazil, and proved applicable to municipalities with different population sizes and administrative structures. Data were obtained from local information systems and official documents from the municipal health departments. The model's validity was demonstrated by the results of its application, consistent with data from the literature. PMID:20464078
Scalco, Sirlesia Vigarani; Lacerda, Josimari Telino de; Calvo, Maria Cristina Marino
Retention of health workers in Malawi: perspectives of health workers and district management
Background Shortage of human resources is a major problem facing Malawi, where more than 50% of the population lives in rural areas. Most of the district health services are provided by clinical health officers specially trained to provide services that would normally be provided by fully qualified doctors or specialists. As this cadre and the cadre of enrolled nurses are the mainstay of the Malawian health service at the district level, it is important that they are supported and motivated to deliver a good standard of service to the population. This study explores how these cadres are managed and motivated and the impact this has on their performance. Methods A quantitative survey measured health workers' job satisfaction, perceptions of the work environment and sense of justice in the workplace, and was reported elsewhere. It emerged that health workers were particularly dissatisfied with what they perceived as unfair access to continuous education and career advancement opportunities, as well as inadequate supervision. These issues and their contribution to demotivation, from the perspective of both management and health workers, were further explored by means of qualitative techniques. Focus group discussions were held with health workers, and key-informant interviews were conducted with members of district health management teams and human resource officers in the Ministry of Health. The focus groups used convenience sampling that included all the different cadres of health workers available and willing to participate on the day the research team visited the health facility. The interviews targeted district health management teams in three districts and the human resources personnel in the Ministry of Health, also sampling those who were available and agreed to participate. Results The results showed that health workers consider continuous education and career progression strategies to be inadequate. Standard human resource management practices such as performance appraisal and the provision of job descriptions were not present in many cases. Health workers felt that they were inadequately supervised, with no feedback on performance. In contrast to health workers, managers did not perceive these human resources management deficiencies in the system as having an impact on motivation. Conclusion A strong human resource management function operating at the district level is likely to improve worker motivation and performance.
Manafa, Ogenna; McAuliffe, Eilish; Maseko, Fresier; Bowie, Cameron; MacLachlan, Malcolm; Normand, Charles
Investigation of health care waste management in Binzhou District, China
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.
Ruoyan, Gai [Department of Health Policy and Planning, Graduate School of Medicine, University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 1130033 (Japan); Xu Lingzhong; Li Huijuan; Zhou Chengchao; He Jiangjiang [Institute of Social Medicine and Health Services Management, School of Public Health, Shandong University, Wen-hua-xi Road, No. 44, Jinan City, Shandong Province 250012 (China); Yoshihisa, Shirayama [Department of Health Policy and Planning, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 1130033 (Japan); Tang Wei [Institute of Social Medicine and Health Services Management, School of Public Health, Shandong University, Wen-hua-xi Road, No. 44, Jinan City, Shandong Province 250012 (China); University of Tokyo Hospital, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655 (Japan); Chushi, Kuroiwa, E-mail: firstname.lastname@example.com [Department of Health Policy and Planning, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 1130033 (Japan); Institute of Social Medicine and Health Services Management, School of Public Health, Shandong University, Wen-hua-xi Road, No. 44, Jinan City, Shandong Province 250012 (China)
Using matrix organization to manage health care delivery organizations.
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. PMID:10107388
Allcorn, S
The management of health services in Tanzania: a plea for health sector reform.
There are essentially four main approaches used in attempts to strengthen the management of health services in developing countries. These are: information system development; management training; use of planning and evaluation methodologies; and, health sector reform. As part of a collaborative research project based in Kisarawe District, Tanzania, we tested the hypothesis that a combination of the first three of these approaches would be sufficient to ensure that decisions and actions were taken to bring about major improvements in the management of health services. It was assumed that the decentralization, which took place as part of the 1982 reorganization of local government responsibilities, had provided managers with sufficient decision-making autonomy to allow them to bring about improvement in health service performance, provided that the other conditions were met. In fact, it was found that despite being presented with clear evidence of serious inefficiencies and inequities in the allocation of health resources, managers were often highly reluctant to decide upon actions which would alleviate the problems in situations where there were potential losers as well as winners, even if the benefits greatly outweighed the costs. This article argues that interventions based solely on training, information systems, or planning and evaluation protocols will make only marginal improvements to health service management, and that changes to the system as a whole are needed in order to provide managers and health professionals with incentives to rectify performance failings. Some ideas for health sector reform, to give managers power and incentives for improving efficiency and quality of care, are put forward. Since it is likely that the systemic problems of the health sector in Tanzania are shared by many other developing countries, the lessons drawn from this study probably have more general applicability. PMID:10172194
Sandiford, P; Kanga, G J; Ahmed, A M
The emerging need for transformational leadership in health information management.
The prospect of national healthcare reform, new clinical and information technologies, and the need to cut the cost of health care delivery are contributing factors in the restructuring of the health care system. In light of these rapid changes and great uncertainties, health information management (HIM) leadership must radically change its style. The appropriate new styles will move the HIM practitioner from the specialized medical records department to a larger, more professional role. The successful transformational leader will help HIM emerge as a central function in the new health care industries. PMID:10140303
Balloun, J L; Stebbins, L H; Von Bergen, C W
Total Quality Management in Health Care - A Study on TQM Implementation and its Application to the Army Health Care System.
National Technical Information Service (NTIS)
Total Quality Management (TQM) is the new management philosophy of the Army health care system. TQM consists of principles and tools which can be applied in this health care setting. TQM represents a tremendous departure from the previous traditional mana...
T. H. Auer
Reusable Rocket Engine Turbopump Health Management System
NASA Technical Reports Server (NTRS)
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.
Surko, Pamela
Transforming a health care information management system.
The article presents results from a survey of 98 top executives at Baylor Health Care System (BHCS), a large, multifunction health care organization in Dallas, Texas. The survey assessed the executives' perceptions of current BHCS quality practices using the first survey developed for the health care industry based on the Malcolm Baldrige National Quality Award (MBNQA) criteria. Findings regarding the quality of BHCS internal and external data and information include the need for a $50 million information system transformation to achieve seven critical success factors for all business units and improved internal and external data and information for the business process redesign and quality transformation. Results highlight the need for further research investigating the information and analysis MBNQA criteria. PMID:10174724
Prybutok, V R; Spink, A
Health@Home: The Work of Health Information Management in the Household (HIMH): Implications for Consumer Health Informatics (CHI) Innovations
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.
Moen, Anne; Brennan, Patricia Flatley
Managing organizational change: strategies for the female health care supervisor.
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
Davies, G
Providing and funding breast health services in urban nurse-managed health centers.
Nurse-managed health centers (NMHCs) are an innovative health care delivery model that serves as an important point of health care access for populations at risk for disparities in health outcomes. This article describes the process and outcomes of clinical breast health services in two NMHCs located in a large Midwestern city. Findings indicate that client's knowledge about breast health was increased after they received breast health services from NMHC nurses. Significant positive changes in behavior related to the early detection of breast cancer were found in the study. NMHCs, identified for expansion in the Patient Protection and Affordable Care Act, offer a unique health care services delivery model that promotes access to care and early identification of breast cancer in very low-income and uninsured women. PMID:24739700
Tsai, Pei-Yun; Peterman, Beth; Baisch, Mary Jo; Ji, Eun Sun; Zwiers, Kelly
Fundamental Technology Development for Gas-Turbine Engine Health Management
NASA Technical Reports Server (NTRS)
Integrated vehicle health management technologies promise to dramatically improve the safety of commercial aircraft by reducing system and component failures as causal and contributing factors in aircraft accidents. To realize this promise, fundamental technology development is needed to produce reliable health management components. These components include diagnostic and prognostic algorithms, physics-based and data-driven lifing and failure models, sensors, and a sensor infrastructure including wireless communications, power scavenging, and electronics. In addition, system assessment methods are needed to effectively prioritize development efforts. Development work is needed throughout the vehicle, but particular challenges are presented by the hot, rotating environment of the propulsion system. This presentation describes current work in the field of health management technologies for propulsion systems for commercial aviation.
Mercer, Carolyn R.; Simon, Donald L.; Hunter, Gary W.; Arnold, Steven M.; Reveley, Mary S.; Anderson, Lynn M.
Supporting cancer patients' unanchored health information management with mobile technology
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.
Klasnja, Predrag; Hartzler, Andrea; Powell, Christopher; Pratt, Wanda
Integrated Systems Health Management (ISHM) Toolkit
NASA Technical Reports Server (NTRS)
A framework of software components has been implemented to facilitate the development of ISHM systems according to a methodology based on Reliability Centered Maintenance (RCM). This framework is collectively referred to as the Toolkit and was developed using General Atomics' Health MAP (TM) technology. The toolkit is intended to provide assistance to software developers of mission-critical system health monitoring applications in the specification, implementation, configuration, and deployment of such applications. In addition to software tools designed to facilitate these objectives, the toolkit also provides direction to software developers in accordance with an ISHM specification and development methodology. The development tools are based on an RCM approach for the development of ISHM systems. This approach focuses on defining, detecting, and predicting the likelihood of system functional failures and their undesirable consequences.
Venkatesh, Meera; Kapadia, Ravi; Walker, Mark; Wilkins, Kim
Evaluating the management of diarrhoea in health centres in Mozambique.
An evaluation of the health centre management of paediatric cases of diarrhoea, comprising observation of the consultation, interview of the guardian immediately afterwards and home follow-up was performed in one rural and three urban areas of Mozambique. Oral Rehydration Therapy was advised for 83% of patients, of whom 71% received ORS packets. Eighty-seven per cent of mothers followed up stated that they had given ORT, but only 37% had a solution present at the time of interview. The main weakness in case management was the lack of health education, especially about the quantity of fluid to give, which was reflected in the mothers' belief that ORT is a medicine to 'stop the diarrhoea' and their consequent administration of it like a syrup, one teaspoonful three times a day. The results of the evaluation have facilitated the design of more appropriate health education and health worker training materials and methods. PMID:3379655
Cutts, F; Cliff, J; Reiss, R; Stuckey, J
Patient Health Information Management: Searching for the Right Model
Accurate and timely health information is a crucial element in the medical decision making process during a medical encounter. Inadequate or misleading patient health information can lead to medical errors, inaccurate decision making, and increased cost. Providing physicians with access to every detail of a patient's medical history is difficult. Striking the balance between adequate and effective amounts of information is difficult. The Personal Health Record and Continuity of Care Record have emerged as concepts to support that balance. This paper reviews recently published literature on (1) approaches to personal health information management, (2) distinctions between terms and definitions describing patient health information, its format, its availability, and its accessibility, (3) guidelines, studies, or standards to support the rationale of patient information data elements that should be available to the provider for any medical encounter, and (4) identification of the most important needs for patient health information that should be addressed. The purpose of the review is to clarify the benefits and detriments of the different approaches as well as to provide some recommendations for the right model of patient health information management, focusing on the idea of the appropriate health information being available when needed.
Smolij, Kamila; Dun, Kim
Evaluation of computerized health management information system for primary health care in rural India
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.
Trace Element Deficiency in Ruminants.
National Technical Information Service (NTIS)
This publication presents for the first time, an account of findings on the status and roles of the essential trace elements in ruminant livestock nutrition that is particularly relevant to the occurrence and control of trace element deficiency in Scotlan...
Behavioral health and managed care contracting under SCHIP.
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
Rosenbaum, Sara; Sonosky, Colleen; Shaw, Karen; Mauery, D Richard
Personal health information management system and its application in referral management
Abstract, We developed a web-based personal health record (PHR) that can be used by patients to collect and manage their health information (e. g., medical history, past surgeries, medi-cations, and allergies), to request self-referrals, and to store a record of their consultations. The PHR also includes a messaging system that can be structured into the workflow of referral man-agement as
Maisie Wang; Christopher Lau; Frederick A. Matsen III; Yongmin Kim
Human resource management in the health-care industry.
It has been said that managing change is a synonym for managing people through change. No other industry has experienced more change in the past ten years than the health-care industry. In order to regulate all this change, managers in health-care organizations must identify new ways to deal with the changes. The issues are as old as time: job satisfaction, cultural conflict, and compensation. This paper addresses each of these key issues with the following examples. A new nursing paradigm that was implemented at a hospital has significantly increased job satisfaction. This paper also takes a look at ways to manage cultural conflict in a diversified workforce. Finally, the results of a team approach to compensation are studied. PMID:10346306
Conant, G; Kleiner, B H
A Hierarchical Model-based approach to Systems Health Management
Integrated Systems Health Management (ISHM) provides the ability to maintain system health and performance over the life of a system. For safety-critical systems, ISHM must maintain safe operations while increasing availability by preserving functionality and minimizing downtime. This paper discusses a model-based approach to ISHM that combines fault detection, isolation and identification, fault-adaptive control, and prognosis into a common framework.
Gautam Biswas; Sankaran Mahadevan
Health Management Technology as a General Solution Framework
NASA Astrophysics Data System (ADS)
Health maintenance and improvement of humans, artifacts, and nature are pressing requirements considering the problems human beings have faced. In this article, the health management technology is proposed by centering cause-effect structure. The important aspect of the technology is evolvement through human-machine collaboration in response to changes of target systems. One of the reasons why the cause-effect structure is centered in the technology is its feature of transparency to humans by instinct point of view. The notion has been spreaded over wide application areas such as quality control, energy management, and healthcare. Some experiments were conducted to prove effectiveness of the technology in the article.
Nakajima, Hiroshi; Hasegawa, Yoshifumi; Tasaki, Hiroshi; Iwami, Taro; Tsuchiya, Naoki
SSFF Health Management Analysis Report. Part 2: Proof of Concept
NASA Technical Reports Server (NTRS)
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.
Wilson, L.; Spruill, J.; Hong, Y.
The Health Security Act's quality management and oversight requirements.
The Quality Agenda, a regular feature of THE QUALITY LETTER, offers practical models and information that leaders of healthcare organizations can adapt and use. This month, the Quality Agenda examines the quality management and oversight provisions of the Health Security Act, including a new National Quality Management Council to spearhead the development of quality measurement and improvement efforts. Readers can obtain a complete copy of the 1,343-page Health Security Act from the Government Printing Office (202/783-3238) for $45. PMID:10131338
Competencies for health management practice: a practitioner's perspective.
The current health care environment will require executive leadership with a new set of management competencies to effectively lead and manage the various components of a restructured health care delivery system. The traditional management skills of planning, organizing, directing, controlling, and staffing resources will remain relevant, but the true measure of professional success will be the development of conceptual skills. This means the ability to look at the health care enterprise as a whole, and recognize how changes in the environment shape your strategic mission, goals, and objectives. The successful health care leader will have a demonstrated ability to apply these conceptual skills to the development of information systems and integrated networks that position their organization to accept capitated risks. This paper examines the United States and Canadian health care systems from the perspective of both the more traditional hospital and the emerging medical care organizations. New importance of the team approach to leadership and management and all that entails is stressed. PMID:10156840
Wenzel, F J; Grady, R; Freedman, T J
The mental health Risk Assessment and Management Process (RAMP)
Abstract The Risk Assessment and Management ,Process (RAMP) is a whole-school process for the assessment,and management ,of student's mental ,health and ,wellbeing ,in primary ,and secondary schools. A process,evaluation revealed that RAMP was implemented,as intended across six primary and three secondary schools in Melbourne, Australia. Using the RAMP risk and protective factors monitoring form and screening processes, each school identified
Alison L. Shortt; Susan Fealy; John W. Toumbourou
Embedding Health Management into Mission Tasking for UAV Teams
Coordinated multi-vehicle autonomous systems can provide incredible functionality, but off-nominal conditions and degraded system components can render this capability ineffective. This paper presents techniques to improve mission-level functional reliability through better system self-awareness and adaptive mission planning. In particular, we extend the traditional definition of health management, which has historically referred to the process of actively monitoring and managing vehicle
Mario Valenti; Brett Bethke; Daniela Pucci de Farias; John Vian
Human resource management in the health care industry.
Human resource management practices with special reference to the latest developments of the 1990s such as environmental effects and managing diversity, were investigated. The purpose of the study was to unveil how the health care industry can benefit from these new concepts, as well as to describe how the traditional health care facilities can adapt these new ideas. Specific examples were provided to illustrate this point. In compilation of this report, both primary and secondary research was used. As primary research, many reputable individuals in the health care industry were consulted, and asked to comment on the rough draft of this report. Secondary sources included many journal articles, original researches and books that were written on this technical subject. It can be concluded from this research, that the health care industry should adapt the latest methods to compete and survive, such as use more marketing tools to attract human resource management personnel from other industries, promote diversity at the work place, promote from within the company, and cross-train personnel whenever possible. Health care industry has generally lagged behind other industries in securing high-performance individuals and marketing personnel; however, with the development of health maintenance organizations, this trend is changing. PMID:10346316
Siddiqui, J; Kleiner, B H
Petroleum and health care: evaluating and managing health care's vulnerability to petroleum supply shifts.
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
Hess, Jeremy; Bednarz, Daniel; Bae, Jaeyong; Pierce, Jessica
Petroleum and Health Care: Evaluating and Managing Health Care's Vulnerability to Petroleum Supply Shifts
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.
Bednarz, Daniel; Bae, Jaeyong; Pierce, Jessica
Health insurance in India: need for managed care expertise.
Health insurers in India currently face many challenges, including poor consumer awareness, strict regulations, and inefficient business practices. They operate under a combination of stifling administrative costs and high medical expense ratios which have ensured that insurers operate under steep losses. External factors (eg, onerous regulations, lack of standards, high claims payouts) and internal factors (eg, high administrative costs, dependence on indemnity models that cover inpatient treatment costs only) have forced the health insurance industry into a regressive spiral. To overcome these challenges, health insurers need to innovate in their product offerings and tighten their existing processes and cost structures. But as a long-term strategy, it is imperative that health insurers deploy managed care concepts, which will go a long way toward addressing the systemic issues in the current operational models of health plans. PMID:21473657
Thomas, Thomas K
Managed behavioral health care premises, accountable systems of care, and AMBHA'S perms. American Managed Behavioral Healthcare Association.
This article discusses the concepts and approaches underlying managed behavioral health care and the need to assess quality of care. The author describes the Performance Measures for Managed Behavioral Healthcare Programs (PERMS) developed by the American Managed Behavioral Healthcare Association (AMBHA), which is offered as a first step toward enhanced quality of care assessment in managed behavioral health care. PMID:10183283
Ross, E C
School Health Connection Goes Electronic: Developing a Health Information Management System for New Orleans' School-Based Health Centers. Program Results Report
ERIC Educational Resources Information Center
From February 2008 through April 2011, School Health Connection, a program of the Louisiana Public Health Institute, developed an electronic health information management system for newly established school-based health centers in Greater New Orleans. School Health Connection was established as part of a broader effort to restore community health…
Rastorfer, Darl
Management of mental health problems by general practitioners in Quebec
Abstract Objective To document the management of mental health problems (MHPs) by general practitioners. Design A mixed-method study consisting of a self-administered questionnaire and qualitative interviews. An analysis was also performed of Régie de l'assurance maladie du Québec administrative data on medical procedures. Setting Quebec. Participants Overall, 1415 general practitioners from different practice settings were invited to complete a questionnaire; 970 general practitioners were contacted. A subgroup of 60 general practitioners were contacted to participate in interviews. Main outcome measures The annual frequency of consultations over MHPs, either common (CMHPs) or serious (SMHPs), clinical practices, collaborative practices, factors that either support or interfere with the management of MHPs, and recommendations for improving the health care system. Results The response rate was 41% (n = 398 general practitioners) for the survey and 63% (n = 60) for the interviews. Approximately 25% of visits to general practitioners are related to MHPs. Nearly all general practitioners manage CMHPs and believed themselves competent to do so; however, the reverse is true for the management of SMHPs. Nearly 20% of patients with CMHPs are referred (mainly to psychosocial professionals), whereas nearly 75% of patients with SMHPs are referred (mostly to psychiatrists and emergency departments). More than 50% of general practitioners say that they do not have any contact with resources in the mental health field. Numerous factors influence the management of MHPs: patients' profiles (the complexity of the MHP, concomitant disorders); individual characteristics of the general practitioner (informal network, training); the professional culture (working in isolation, formal clinical mechanisms); the institutional setting (multidisciplinarity, staff or consultant); organization of services (resources, formal coordination); and environment (policies). Conclusion The key role played by general practitioners and their support of the management of MHPs were evident, especially for CMHPs. For more optimal management of primary mental health care, multicomponent strategies, such as shared care, should be used more often.
Fleury, Marie-Josee; Farand, Lambert; Aube, Denise; Imboua, Armelle
Oceans and Human Health: Linking Ocean, Organism, and Human Health for Sustainable Management of Coastal Ecosystems
NASA Astrophysics Data System (ADS)
Scientists and policy-makers are increasingly recognizing that sustainable coastal communities depend on healthy and resilient economies, ecosystems, and people, and that the condition or "health" of the coastal ocean and humans are intimately and inextricably connected. A wealth of ecosystem services provided by ocean and coastal environments are crucial for human survival and well being. Nonetheless, the health of coastal communities, their economies, connected ecosystems and ecosystem services, and people are under increasing threats from health risks associated with environmental degradation, climate change, and unwise land use practices, all of which contribute to growing burdens of naturally-occurring and introduced pathogens, noxious algae, and chemical contaminants. The occurrence, frequency, intensity, geographic range, and number and kinds of ocean health threats are increasing, with concomitant health and economic effects and eroding public confidence in the safety and wholesomeness of coastal environments and resources. Concerns in the research and public health communities, many summarized in the seminal 1999 NRC Report, From Monsoons to Microbes and the 2004 final report of the US Commission on Ocean Policy, resulted in establishment of a new "meta-discipline" known as Oceans and Human Health (OHH). OHH brings together practitioners in oceanography, marine biology, ecology, biomedical science, medicine, economics and other social sciences, epidemiology, environmental management, and public health to focus on water- and food-borne causes of human and animal illnesses associated with ocean and coastal systems and on health benefits of seafood and other marine products. It integrates information across multiple disciplines to increase knowledge of ocean health risks and benefits and communicate such information to enhance public safety. Recognizing the need for a comprehensive approach to ocean health threats and benefits, Congress passed the Oceans and Human Health Act of 2004. Major outcomes of the OHH Act of 2004 include: --A national focus on ocean health and its relation to human health and well-being; --Enhanced interagency coordination and cooperation in research, development, and education; --Emphasis on development of a new, interdisciplinary community of practice; --Increased understanding of linkages between marine animal health and human health and the dangers of transmission of zoonotic diseases from the marine environment; --A richer understanding of factors affecting the occurrence and impacts of ocean health threats; --An enhanced ability of the ocean science and public health communities to respond to health-related emergencies; --A strong focus on development of ecological forecasts that are providing early warning of ocean health threats and impacts, thus improving the effectiveness of protection and mitigation actions. Taken together, these outcomes contribute significantly to more sustainable management of coastal resources and communities.
Sandifer, P. A.; Trtanj, J.; Collier, T. K.
Outcomes Assessment in Accredited Health Information Management Programs
ERIC Educational Resources Information Center
The purpose of this study was to determine the use and perceived usefulness of outcomes assessment methods in health information management programs. Additional characteristics of the outcomes assessment practices were recognized. The findings were evaluated for significant differences in results based on age of the program, type of institution,…
Bennett, Dorine
Leadership Succession Management in a University Health Faculty
ERIC Educational Resources Information Center
We report on a succession planning pilot project in an Australian university health faculty. The programme aimed to enhance organisational stability and develop leadership capacity in middle level academics. Six monthly sessions addressed university and general leadership topics, communication, decision-making, working with change, self-management…
McMurray, Anne M.; Henly, Debra; Chaboyer, Wendy; Clapton, Jayne; Lizzio, Alf; Teml, Martin
The project in Colorado is evaluating the use of GIS as a tool for studying the potential impacts of exposure to DBPs from different disinfection treatments on reproductive health in populations in Colorado. GIS is a data management and visualization tool that is assisting in stu...
Management Accounting and Control in Health Care: An Economics Perspective
This chapter summarizes empirical archival accounting research in management accounting that is based on economic theory and uses health care settings. Three perspectives are investigated: (1) production cost economics, including cost structure, cost behavior, cost drivers, the design of cost allocation systems, and the appropriate level of cost aggregation; (2) agency theory, including incentives to bias information or shift costs,
Leslie Eldenburg; Ranjani Krishnan
Advanced Health Management System for the Space Shuttle Main Engine.
National Technical Information Service (NTIS)
Boeing-Canoga Park (BCP) and NASA-Marshall Space Flight Center (NASA-MSFC) are developing an Advanced Health Management System (AHMS) for use on the Space Shuttle Main Engine (SSME) that will improve Shuttle safety by reducing the probability of catastrop...
M. Davidson J. Stephens
Dr. Martin Luther King, Jr. Health Center's Community Management System
This article presents the case of the Dr. Martin Luther King Jr. Health Center's unique community management system in which neighborhood workers have been developed to assume managerial responsibilities and are directing the Center. The Martin Luther King Center experience is instructive because the Center was able to achieve significant community control by focusing primarily on the internal dimension of
Noel M. Tichy; June Irmiger Taylor
The serious problems of contaminants and environment impacts produced by human action in the subsurface (air, groundwater and rock in interaction with human activities), particularly in underground mines, require an integrated approach in terms of specific rules, laws and management systems in the domain of Occupational Safety and Health. As the ISO 14001 standard is mostly directed for the prevention
Navarro Torres; Dinis Da Gama
Propulsion safety and affordable readiness engine health management plan
A new initiative was started to address Department of Defense safety and affordable readiness for legacy turbine engines. By using the GOTChA\\/ApPRoVal methods, a baseline research plan was established that is based on prognostics and health management. This paper outlines the decision process, investment strategy, projected return on investment, validation, and transition strategies
Brian K. Beachkofski
Why competencies in graduate health management and policy education?
During the past decade there has been a growing interest in learning and competency-based systems in various areas of education, training, and professional development. As a result, a number of competency initiatives have been undertaken across the health professions, including medicine, nursing, and pharmacy. Concurrent with these activities have been the resounding calls for: 1) both curricular content and process review in health administration and related training programs, 2) rethinking and reform of current educational practices, and 3) evidence-based, outcomes-focused education in health management and policy education. In spite of governmental mandates and accrediting body specification for educational improvement, the debate about the use of competency models, competencies themselves, and competency-based education (CBE) still continues in a number of post-secondary educational settings-both within and outside of the professions. Specifically, faculties in health management and policy educational programs, including undergraduate and graduate education across the US, have questioned the need for the evolving competencies, competency models, and outcomes-based educational processes and assessment methods currently being developed and or adopted within the profession. Outlined in this paper are four of the current inflection points related to the competency/outcomes-based movement in the professions during the past decade: 1) The Changing Workforce and Workplace, 2) Reform in the Educational Continuum, 3) Evolving Accreditation Requirements, and 4) Continuous Quality Improvement (CQI) in Health Management and Policy Education. PMID:19655616
Calhoun, Judith G; Vincent, Eric T; Calhoun, Gary L; Brandsen, Laura E
Public health emergencies and the public health/managed care challenge.
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
Rosenbaum, Sara; Skivington, Skip; Praeger, Sandra
Differences in selective reticulo-ruminal particle retention as a key factor in ruminant diversification
The measurement of passage rate is important for the concept of ruminant diversification. While supporters of Hofmann's 1989 feeding type classification claim that browsing ruminants have faster passage rates than grazing ruminants, other researchers consider the passage rate to depend on body size alone. To date, no convincing comparison of ruminant passage rates has been put forward. For comparative purposes,
Marcus Clauss; Matthias Lechner-Doll
Commercial Aircraft Integrated Vehicle Health Management Study
NASA Technical Reports Server (NTRS)
Statistical data and literature from academia, industry, and other government agencies were reviewed and analyzed to establish requirements for fixture work in detection, diagnosis, prognosis, and mitigation for IVHM related hardware and software. Around 15 to 20 percent of commercial aircraft accidents between 1988 and 2003 involved inalftfnctions or failures of some aircraft system or component. Engine and landing gear failures/malfunctions dominate both accidents and incidents. The IVI vl Project research technologies were found to map to the Joint Planning and Development Office's National Research and Development Plan (RDP) as well as the Safety Working Group's National Aviation Safety Strategic. Plan (NASSP). Future directions in Aviation Technology as related to IVHlvl were identified by reviewing papers from three conferences across a five year time span. A total of twenty-one trend groups in propulsion, aeronautics and aircraft categories were compiled. Current and ftiture directions of IVHM related technologies were gathered and classified according to eight categories: measurement and inspection, sensors, sensor management, detection, component and subsystem monitoring, diagnosis, prognosis, and mitigation.
Reveley, Mary S.; Briggs, Jeffrey L.; Evans, Joni K.; Jones, Sharon Monica; Kurtoglu, Tolga; Leone, Karen M.; Sandifer, Carl E.; Thomas, Megan A.
Solid health care waste management status at health care centers in the West Bank - Palestinian Territory
Health care waste is considered a major public health hazard. The objective of this study was to assess health care waste management (HCWM) practices currently employed at health care centers (HCCs) in the West Bank - Palestinian Territory. Survey data on solid health care waste (SHCW) were analyzed for generated quantities, collection, separation, treatment, transportation, and final disposal. Estimated 4720.7 m{sup 3} (288.1 tons) of SHCW are generated monthly by the HCCs in the West Bank. This study concluded that: (i) current HCWM practices do not meet HCWM standards recommended by the World Health Organization (WHO) or adapted by developed countries, and (ii) immediate attention should be directed towards improvement of HCWM facilities and development of effective legislation. To improve the HCWM in the West Bank, a national policy should be implemented, comprising a comprehensive plan of action and providing environmentally sound and reliable technological measures.
Al-Khatib, Issam A. [Institute of Environmental and Water Studies, Birzeit University, P.O. Box 14, Birzeit, Ramallah, West Bank (Palestinian Territory, Occupied)], E-mail: firstname.lastname@example.com; Sato, Chikashi [Department of Civil and Environmental Engineering, Idaho State University, Pocatello, Idaho (United States)
Financial impact of population health management programs: reevaluating the literature.
Although many employers offer some components of worksite-based population health management (PHM), most do not yet invest in comprehensive programs. This hesitation to invest in comprehensive programs may be attributed to numerous factors, such as other more pressing business priorities, reluctance to intervene in the personal health choices of employees, or insufficient funds for employee health. Many decision makers also remain skeptical about whether investment in comprehensive programs will produce a financial return on investment (ROI). Most peer-reviewed studies assessing the financial impact of PHM were published before 2000 and include a broad array of program and study designs. Many of these studies have also included indirect productivity savings in their assessment of financial outcomes. In contrast, this review includes only peer-reviewed studies of the direct health care cost impact of comprehensive PHM programs that meet rigorous methodological criteria. A systematic search of health sciences databases identified only 5 studies with program designs and study methods meeting these selection criteria published after 2007. This focused review found that comprehensive PHM programs can yield a positive ROI based on their impact on direct health care costs, but the level of ROI achieved was lower than that reported by literature reviews with less focused and restrictive qualifying criteria. To yield substantial short-term health care cost savings, the longer term financial return that can credibly be associated with a comprehensive, prevention-oriented population health program must be augmented by other financial impact strategies. PMID:22313443
Grossmeier, Jessica; Terry, Paul E; Anderson, David R; Wright, Steven
Organizing and managing care in a changing health system.
OBJECTIVE: To examine ways in which the management and organization of medical care is changing in response to the shifting incentives created by managed care. DATA SOURCES: Site visits conducted in 12 randomly selected communities in 1996/ 1997. STUDY DESIGN: Approximately 35-60 interviews were conducted per site with key informants in healthcare and community organizations; about half were with providers. DATA COLLECTION: A standardized interview protocol was implemented across all sites, enabling cross-site comparisons. Multiple respondents were interviewed on each issue. PRINCIPAL FINDINGS: A great deal of experimentation and apparent duplication exist in efforts to develop programs to influence physician practice patterns. Responsibility for managing care is being contested by health plans, medical groups and hospitals, as each seeks to accrue the savings that can result from the more efficient delivery of care. To manage the financial and clinical risk, providers are aggressively consolidating and reorganizing. Most significant was the rapid formation of intermediary organizations, such as independent practice arrangements (IPAs), physician-hospital organizations (PHOs), or management services organizations (MSOs), for contracting with managed care organizations. CONCLUSIONS: Managed care appears to have only a modest effect on how healthcare organizations deliver medical care, despite the profound effect that managed care has on how providers are organized. Rather than improving the efficiency of healthcare organizations, provider efforts to build large systems and become indispensable to health plans are exacerbating problems of excess capacity. It is not clear if new organizational arrangements will help providers manage the changing incentives they face, or if their intent is to blunt the effects of the incentives by forming larger organizations to improve their bargaining power and resist change.
Kohn, L T
Reverse quality management: developing evidence-based best practices in health emergency management.
The British Columbia Ministry of Health's Framework for Core Functions in Public Health was the catalyst that inspired this review of best practices in health emergency management. The fieldwork was conducted in the fall of 2005 between hurricane Katrina and the South Asia earthquake. These tragedies, shown on 24/7 television news channels, provided an eyewitness account of disaster management, or lack of it, in our global village world. It is not enough to just have best practices in place. There has to be a governance structure that can be held accountable. This review of best practices lists actions in support of an emergency preparedness culture at the management, executive, and corporate/governance levels of the organization. The methodology adopted a future quality management approach of the emergency management process to identify the corresponding performance indictors that correlated with practices or sets of practices. Identifying best practice performance indictors needed to conduct a future quality management audit is described as reverse quality management. Best practices cannot be assessed as stand-alone criteria; they are influenced by organizational culture. The defining of best practices was influenced by doubt about defining a practice it is hoped will never be performed, medical staff involvement, leadership, and an appreciation of the resources required and how they need to be managed. Best practice benchmarks are seen as being related more to "measures" of performance defined locally and agreed on by 2 or more parties rather than to achieving industrial standards. Relating practices to performance indicators and then to benchmarks resulted in the development of a Health Emergency Management Best Practices Matrix that lists specific practice in the different phases of emergency management. PMID:16622359
Lynch, Tim; Cox, Paul
Emergency mental health management in bioterrorism events.
The United States has not suffered significant psychosocial or medical consequences from the use of biological weapons within its territories. This has contributed to a "natural" state of denial at the community level. This denial could amplify the sense of crisis, anxiety, fear, chaos, and disorder that would accompany such a bioterrorist event. A key part of primary prevention involves counteracting this possibility before an incident occurs. Doing so will require realistic information regarding the bioterrorism threat followed by the development of a planned response and regular practice of that response. Unlike in natural disasters or other situations resulting in mass casualties, emergency department physicians or nurses and primary care physicians (working in concert with epidemiologic agencies), rather than police, firemen, or ambulance personnel, will be most likely to first identify the unfolding disaster associated with a biological attack. Like community leaders, this group of medical responders must be aware of its own susceptibility to mental health sequelae and performance decrement as the increasing demands of disaster response outpace the availability of necessary resources. A bioterrorist attack will necessitate treatment of casualties who experience neuropsychiatric symptoms and syndromes. Although symptoms may result from exposure to infection with specific biological agents, similar symptoms may result from the mere perception of exposure or arousal precipitated by fear of infection, disease, suffering, and death. Conservative use of psychotropic medications may reduce symptoms in exposed and uninfected individuals, as may cognitive-behavioral interventions. Clear, consistent, accessible, reliable, and redundant information (received from trusted sources) will diminish public uncertainty about the cause of symptoms that might otherwise prompt persons to seek unnecessary treatment. Training and preparation for contingencies experienced in an attack have the potential to enhance delivery of care. Initiating supportive social, psychotherapeutic, and psychopharmacologic treatments judiciously for symptoms and syndromes known to accompany the traumatic stress response can aid the efficient treatment of some patients and reduce long-term morbidity in affected individuals. Preventive strategies and planning must take into account the idea that specific groups within the population are at higher risk for psychiatric morbidity. First responders comprise one group at psychologic risk in this situation, and healthcare providers comprise another. These and other high-risk groups will benefit from the same supportive interventions developed for the community as a whole. PMID:12120485
Benedek, David M; Holloway, Harry C; Becker, Steven M
Peste des petits ruminants in Arabian wildlife.
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. PMID:20067659
Kinne, J; Kreutzer, R; Kreutzer, M; Wernery, U; Wohlsein, P
Managing patients with high-deductible health plans and health savings accounts.
High-deductible health plans and health savings accounts have many patients and providers mutually mystified. It is very important for providers and their staff to understand and manage these emerging products. If the current growth rate of enrollment in these plans continues, 25% of your patients will be presenting with this coverage in fewer than six years. Mishandling these products can cause unnecessary cash flow issues, but a little proactivity, education, and training now, will go a long way. PMID:19743709
Weaver, Catherine M
Inducible bacteriophages from ruminal bacteria.
The incidence of temperate bacteriophage in a wide range of ruminal bacteria was investigated by means of induction with mitomycin C. Supernatant liquid from treated cultures was examined for phagelike particles by using transmission electron microscopy. Of 38 ruminal bacteria studied, nine organisms (23.7%) representing five genera (Eubacteria, Bacteroides, Butyrivibrio, Ruminococcus, and Streptococcus) produced phagelike particles. Filamentous particles from Butyrivibrio fibrisolvens are the first of this morphological type reported from ruminal bacteria. All of the other particles obtained possessed polyhedral heads and long, noncontractile tails (group B-type phage). The limited range of morphological types produced by mitomycin C induction cannot yet account for the much wider range of types found in ruminal contents by direct examination. The presence of viral genetic material in a significant percentage of the bacteria tested, as well as in a range of different genera, indicates that viral genetic material may be a normal constituent of the genome of appreciable numbers of ruminal bacteria. PMID:2504111
Klieve, A V; Hudman, J F; Bauchop, T
Social work management in emerging health care systems.
An overview of the health care industry's trend toward multihealth systems is presented and specific adaptive strategies for social work managers in health care are suggested. The challenges to social work leaders during this transition from largely free-standing, privately owned health care institutions to corporately owned, horizontally and vertically integrated delivery systems are discussed in terms of identity, style, and substance. Directors of social work departments in multihealth corporations will need to resolve issues of institutional versus corporate identity as well as those of corporate versus professional identity. A multioptional management style that incorporates networking and political expertise should be cultivated. Substantive demands in the areas of management information systems, productivity, quality assurance, and budgeting also must be addressed. The emergence of multihealth systems poses major challenges and unique opportunities to the social work profession. Awareness of managerial strategies and critical content areas can help social work leaders enhance the role and contribution of social work in these exciting and complex health care delivery systems. PMID:2318461
Kenney, J J
Polarity management: the key challenge for integrated health systems.
Integrated health systems are confronted with numerous dilemmas that must be managed. Many of these dilemmas are an inherent part of the system's structure, given that multiple competing hospitals, medical groups, and (sometimes) health plans are often under one organizational roof. This article presents an analysis of these dilemmas--referred to in the management literature as polarities--as they are found in six integrated health systems in Illinois. The nine polarities that must be managed include (1) hospital systems that want to be organizations of physicians; (2) system expansion by growing the physician component; (3) system centralization and physician decentralization; (4) centripetal and centrifugal forces involving physicians; (5) system objectives and physician interests; (6) system centralization and hospital decentralization; (7) primary care physicians and specialists; (8) physician autonomy via collectivization; and (9) vertical and virtual integration. The article identifies some of the solutions to the polarities that have been enacted by systems. In general, executives and physicians in integrated health systems must attend to the processes of integration as much as or more than the structures of integration. PMID:10345554
Burns, L R
Anger rumination: an antecedent of athlete aggression?
Objectives. The aim of this study was to examine the relationship between anger rumination (the propensity to think almost obsessively over past experiences that have provoked negative affect in the form of anger) and athlete aggression. It was predicted that high levels of anger rumination would be associated with an increased propensity to aggress.Method. A questionnaire comprising the Anger Rumination
J. P Maxwell
Applying total quality management concepts to public health organizations.
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.
Kaluzny, A D; McLaughlin, C P; Simpson, K
Low level communication management for e-health systems
NASA Astrophysics Data System (ADS)
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.
Riva, Guillermo; Zerbini, Carlos; Voos, Javier; Centeno, Carlos; González, Eduardo
An agile enterprise regulation architecture for health information security management.
Information security management for healthcare enterprises is complex as well as mission critical. Information technology requests from clinical users are of such urgency that the information office should do its best to achieve as many user requests as possible at a high service level using swift security policies. This research proposes the Agile Enterprise Regulation Architecture (AERA) of information security management for healthcare enterprises to implement as part of the electronic health record process. Survey outcomes and evidential experiences from a sample of medical center users proved that AERA encourages the information officials and enterprise administrators to overcome the challenges faced within an electronically equipped hospital. PMID:20815748
Chen, Ying-Pei; Hsieh, Sung-Huai; Cheng, Po-Hsun; Chien, Tsan-Nan; Chen, Heng-Shuen; Luh, Jer-Junn; Lai, Jin-Shin; Lai, Feipei; Chen, Sao-Jie
An Agile Enterprise Regulation Architecture for Health Information Security Management
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.
Chen, Ying-Pei; Hsieh, Sung-Huai; Chien, Tsan-Nan; Chen, Heng-Shuen; Luh, Jer-Junn; Lai, Jin-Shin; Lai, Feipei; Chen, Sao-Jie
Medication management and practices in prison for people with mental health problems: a qualitative study
BACKGROUND: Common mental health problems are prevalent in prison and the quality of prison health care provision for prisoners with mental health problems has been a focus of critical scrutiny. Currently, health policy aims to align and integrate prison health services and practices with those of the National Health Service (NHS). Medication management is a key aspect of treatment for
Robert A Bowen; Anne Rogers; Jennifer Shaw
Opportunities for Launch Site Integrated System Health Engineering and Management
NASA Technical Reports Server (NTRS)
The launch site processing flow involves operations such as functional verification, preflight servicing and launch. These operations often include hazards that must be controlled to protect human life and critical space hardware assets. Existing command and control capabilities are limited to simple limit checking durig automated monitoring. Contingency actions are highly dependent on human recognition, decision making, and execution. Many opportunities for Integrated System Health Engineering and Management (ISHEM) exist throughout the processing flow. This paper will present the current human-centered approach to health management as performed today for the shuttle and space station programs. In addition, it will address some of the more critical ISHEM needs, and provide recommendations for future implementation of ISHEM at the launch site.
Waterman, Robert D.; Langwost, Patricia E.; Waterman, Susan J.
Managing depression in home health care: a randomized clinical trial.
A prospective randomized trial was conducted to examine the effectiveness, feasibility, and degree of implementation of home health care quality improvement interventions when implemented under usual conditions by usual care providers. A total of 311 older adults were randomized to enhanced usual care (EUC) that included routine depression screening and staff training in depression care management for older adults or to the intervention group (INT) that included antidepressants and/or psychotherapy treatment plus EUC. Implementing a routine screening protocol using the PHQ-9 and depression care management quality improvements is feasible in diverse home health care organizations and results in consistently better (but not statistically significant) depression outcomes in the INT group. PMID:17804354
Ell, Kathleen; Unützer, Jürgen; Aranda, Maria; Gibbs, Nancy E; Lee, Pey-Jiuan; Xie, Bin
A review of interactions between dietary fibre and the intestinal mucosa, and their consequences on digestive health in young non-ruminant animals
The maintenance of gut health is complex and relies on a delicate balance between the diet, the commensal microflora and the mucosa, including the digestive epithelium and the overlying mucus layer. Superimposed on this balance is the frequent presence of enteric bacteria with pathogenic potential, the proliferation and metabolic activity of which may perturb digestive function, and lead to diarrhoea,
L Montagne; J. R Pluske; D. J Hampson
District health managers' perceptions of supervision in Malawi and Tanzania
Background Mid-level cadres are being used to address human resource shortages in many African contexts, but insufficient and ineffective human resource management is compromising their performance. Supervision plays a key role in performance and motivation, but is frequently characterised by periodic inspection and control, rather than support and feedback to improve performance. This paper explores the perceptions of district health management teams in Tanzania and Malawi on their role as supervisors and on the challenges to effective supervision at the district level. Methods This qualitative study took place as part of a broader project, "Health Systems Strengthening for Equity: The Power and Potential of Mid-Level Providers". Semi-structured interviews were conducted with 20 district health management team personnel in Malawi and 37 council health team members in Tanzania. The interviews covered a range of human resource management issues, including supervision and performance assessment, staff job descriptions and roles, motivation and working conditions. Results Participants displayed varying attitudes to the nature and purpose of the supervision process. Much of the discourse in Malawi centred on inspection and control, while interviewees in Tanzania were more likely to articulate a paradigm characterised by support and improvement. In both countries, facility level performance metrics dominated. The lack of competency-based indicators or clear standards to assess individual health worker performance were considered problematic. Shortages of staff, at both district and facility level, were described as a major impediment to carrying out regular supervisory visits. Other challenges included conflicting and multiple responsibilities of district health team staff and financial constraints. Conclusion Supervision is a central component of effective human resource management. Policy level attention is crucial to ensure a systematic, structured process that is based on common understandings of the role and purpose of supervision. This is particularly important in a context where the majority of staff are mid-level cadres for whom regulation and guidelines may not be as formalised or well-developed as for traditional cadres, such as registered nurses and medical doctors. Supervision needs to be adequately resourced and supported in order to improve performance and retention at the district level.
Corporate management of quality in employee health plans.
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
Maxwell, James; Temin, Peter
Candidate technologies for the Integrated Health Management Program
NASA Technical Reports Server (NTRS)
The purpose of this report is to assess Vehicle Health Management (VHM) technologies for implementation as a demonstration. Extensive studies have been performed to determine technologies which could be implemented on the Atlas and Centaur vehicles as part of a bridging program. This paper discusses areas today where VHM can be implemented for benefits in reliability, performance, and cost reduction. VHM Options are identified and one demonstration is recommended for execution.
Johnson, Neal F.; Martin, Fred H.
Leader-Member Exchange Relationships in Health Information Management
This article seeks to raise awareness of the leader-member exchange (LMX) theory of leadership and its potential benefit to the health information management (HIM) profession. A literature review that was conducted identified a leadership challenge for HIM practitioners. The review also provides examples of leadership definitions, and potential benefits of LMX to HIM professionals in leading people and influencing leaders in their organizations. The LMX concept may be an avenue to investigate in preparing future and current HIM professionals for leadership.
Hunt, T.J.
Moral distress among health system managers: exploratory research in two British Columbia health authorities.
Moral distress is a concept used to date in clinical literature to describe the experience of staff in circumstances in which they are prevented from delivering the kind of bedside care they believe is expected of them, professionally and ethically. Our research objective was to determine if this concept has relevance in terms of key health care managerial functions, such as priority setting and resource allocation. We conducted interviews and focus groups with mid- and senior-level managers in two British Columbia (Canada) health authorities. Transcripts were analyzed qualitatively using constant comparison to identify key themes related to moral distress. Both mid- and senior-level managers appear to experience moral distress, with both similarities and differences in how their experiences manifest. Several examples of this concept were identified including the obligation to communicate or 'sell' organizational decisions or policies with which a manager personally may disagree and situations where scarce resources compel managers to place staff in situations where they meet with predictable and potentially avoidable risks. Given that moral distress appears to be a relevant issue for at least some health care managers, further research is warranted into its exact nature, prevalence, and possible organizational and personal responses. PMID:20217482
Mitton, Craig; Peacock, Stuart; Storch, Jan; Smith, Neale; Cornelissen, Evelyn
Factors Influencing Students to Enroll in Health Information Management Programs
This nonexperimental quantitative descriptive-correlative research study was performed to describe the sources with the greatest influence on the participants' decision to enroll in a postsecondary educational program with the intent of working toward a career in health information management. Participants were asked, "Which sources have the greatest influence on an individual's decision to enroll in a postsecondary educational program with the intent of working toward a career in health information management (HIM)?" The study population was composed of matriculated students enrolled in accredited postsecondary schools offering an undergraduate medical billing and coding program at a brick-and-mortar campus in a two-county area of a South Atlantic state. The study found that an environmental source, specifically career job opportunities, was statistically significant as the greatest source of influence for these participants. This research aims to support efforts to provide the health information management subsector of the healthcare industry with a sufficient number of trained professionals to fill the identified need for trained HIM professionals, particularly medical coding specialists.
Safian, Shelley C.
IVHM Framework for Intelligent Integration for Vehicle Health Management
NASA Technical Reports Server (NTRS)
Integrated Vehicle Health Management (IVHM) systems for aerospace vehicles, is the process of assessing, preserving, and restoring system functionality across flight and techniques with sensor and communication technologies for spacecraft that can generate responses through detection, diagnosis, reasoning, and adapt to system faults in support of Integrated Intelligent Vehicle Management (IIVM). These real-time responses allow the IIVM to modify the affected vehicle subsystem(s) prior to a catastrophic event. Furthermore, this framework integrates technologies which can provide a continuous, intelligent, and adaptive health state of a vehicle and use this information to improve safety and reduce costs of operations. Recent investments in avionics, health management, and controls have been directed towards IIVM. As this concept has matured, it has become clear that IIVM requires the same sensors and processing capabilities as the real-time avionics functions to support diagnosis of subsystem problems. New sensors have been proposed, in addition to augment the avionics sensors to support better system monitoring and diagnostics. As the designs have been considered, a synergy has been realized where the real-time avionics can utilize sensors proposed for diagnostics and prognostics to make better real-time decisions in response to detected failures. IIVM provides for a single system allowing modularity of functions and hardware across the vehicle. The framework that supports IIVM consists of 11 major on-board functions necessary to fully manage a space vehicle maintaining crew safety and mission objectives. These systems include the following: Guidance and Navigation; Communications and Tracking; Vehicle Monitoring; Information Transport and Integration; Vehicle Diagnostics; Vehicle Prognostics; Vehicle Mission Planning, Automated Repair and Replacement; Vehicle Control; Human Computer Interface; and Onboard Verification and Validation. Furthermore, the presented framework provides complete vehicle management which not only allows for increased crew safety and mission success through new intelligence capabilities, but also yields a mechanism for more efficient vehicle operations.
Paris, Deidre; Trevino, Luis C.; Watson, Michael D.
Ectoparasites of small ruminants in three selected agro-ecological sites of Tigray Region, Ethiopia.
A study on ectoparasites of small ruminants in three selected agro-ecological sites of Tigray Region, Ethiopia disclosed an overall prevalence of 55.5% and 58% in each examined 750 sheep and goats, respectively. In the sheep population, Melophagus ovinus (19.1%), tick infestations (16%), Damalinia ovis (15.3%), Linognathus africanus (11.5%), and Ctenocephalides felis (9%) were the major ectoparasites. The major ectoparasites identified in goats were tick infestations (29.7%), L. africanus (27.9%), Sarcoptes scabiei var. caprae (12.5%), C. felis (11.1%), and Demodex caprae (6.8%). In sheep, there was a statistically significant difference (P < 0.001) in the prevalence of Damalinia ovis, M. ovinus, L. africanus, and ticks between midland and highland. In goats, the risk of Sarcoptes scabiei var. caprae infestation in midland (odds ratio (OR) = 17.2, P < 0.001) and lowland (OR = 5.2, P < 0.001) was 17.2 times and 5.2 times, respectively, higher than the highland. Favorable climatic conditions, backward level of management, poor level of consciousness and awareness of farmers, and weak animal health extension services are believed to have contributed for widespread distribution and occurrences of ectoparasites. The growing threat of ectoparasites to small ruminant production and the tanning industry needs well-coordinated and urgent control intervention. PMID:20369295
Mulugeta, Y; Yacob, Hailu T; Ashenafi, Hagos
Role of Ayurveda in management of oral health
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.
Torwane, Nilesh Arjun; Hongal, Sudhir; Goel, Pankaj; Chandrashekar, B. R.
Emergency planning and management in health care: priority research topics
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.
Boyd, Alan; Chambers, Naomi; French, Simon; Shaw, Duncan; King, Russell; Whitehead, Alison
Use of physician assistants in a managed health care system.
Kaiser Permanente Northwest Region is a prepaid group practice health maintenance organization. Among the employed are 65 physician assistants (PAs) who work in primary care and in certain subspecialties. Kaiser Permanente was one of the first managed health care systems to use PAs and has contributed to the historical documentation of their effectiveness. An interest in experimenting with new forms of health care delivery as well as enabling State legislation has contributed to an expanded role for nonphysician providers. Together with nurse practitioners, PAs comprise 20 percent of the primary care staff and write 25 percent of the prescriptions for the membership. The use of PAs in managed health care settings will likely increase to meet growing primary care demands. Analysts have found the cost of a PA ranges from 25 percent to 53 percent of the cost of a physician. PAs are capable of providing care for 86 percent of the diagnoses seen in outpatient primary care setting, and patient acceptance is high.
Hooker, R S; Freeborn, D K
Managed Behavioral Health Care Premises, Accountable Systems of Care, and Ambha's Perms
This article discusses the concepts and approaches underlying managed behavioral health care and the need to assess quality of care. The author describes the Performance Measures for Managed Behavioral Healthcare Programs (PERMS) developed by the American Managed Behavioral Healthcare Association (AMBHA), which is offered as a first step toward enhanced quality of care assessment in managed behavioral health care.
E. Clarke Ross
Management of Frontotemporal Dementia in Mental Health and Multidisciplinary Settings
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.
Wylie, Mary Anne; Shnall, Adriana; Onyike, Chiadi U.; Huey, Edward D.
Implications of managed care for health systems, clinicians, and patients.
The rhetoric and realities of managed care are easily confused. The rapid growth of managed care in the United States has had many implications for patients, doctors, employers, state and federal programmes, the health insurance industry, major medical institutions, medical research, and vulnerable patient populations. It has restricted patients' choice of doctors and limited access to specialists, reduced the professional autonomy and earnings of doctors, shifted power from the non-profit to the for-profit sectors and from hospitals and doctors to private corporations. It has also raised issues about the future structuring and financing of medical education and research and about practice ethics. However, managed care has also accorded greater prominence to the assessment of patient satisfaction, profiling and monitoring of doctors' work, the use of clinical guidelines and quality assurance procedures and indicated the potential to improve the integration and outcome of care.
Fairfield, G.; Hunter, D. J.; Mechanic, D.; Rosleff, F.
Managing corporate governance risks in a nonprofit health care organization.
Triggered by corporate scandals, there is increased oversight by governmental bodies and in part by the Sarbanes-Oxley Act of 2002. Corporations are developing corporate governance compliance initiatives to respond to the scrutiny of regulators, legislators, the general public and constituency groups such as investors. Due to state attorney general initiatives, new legislation and heightened oversight from the Internal Revenue Service, nonprofit entities are starting to share the media spotlight with their for-profit counterparts. These developments are changing nonprofit health care organizations as well as the traditional role of the risk manager. No longer is the risk manager focused solely on patients' welfare and safe passage through a complex delivery system. The risk manager must be aware of corporate practices within the organization that could allow the personal objectives of a few individuals to override the greater good of the community in which the nonprofit organization serves. PMID:20200865
Troyer, Glenn T; Brashear, Andrea D; Green, Kelly J
Data mining of aviation data for advancing health management
NASA Astrophysics Data System (ADS)
The operations of aircraft fleets typically result in large volumes of data collected during the execution of various operational and support processes. This paper reports on an Army-sponsored study conducted to research the applicability of data mining for processing such data. The study focused on three aspects: (1) understanding the aviation operations, maintenance environment, and data collection system; (2) investigating data analysis approaches with the purpose of identifying promising methods pertinent to aircraft health management; and (3) defining requirements for a tool to support the aviation maintenance planners and fleet managers. Results of preliminary analyses of two maintenance data and flight data sets are presented. An architecture for managing and mining aviation maintenance data and using results to update models used by diagnostic modules for fault isolation during maintenance activity is also presented.
Mathur, Amit
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
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…
Torres, Carlos A.
Molecular virology of ruminant herpesviruses
Molecular virology has served to establish bovine herpesvirus 1 (BHV-1) as the prototype member of ruminant herpesviruses. Based on the genomic sequence of the virus, we aim to identify and characterize virus-specified components, to explain their concerted action, and to predict how the chain of events during the lytic and latent phases of the viral life cycle may be interrupted.
Martin Schwyzer; Mathias Ackermann
Personal health information management system and its application in referral management.
We developed a web-based personal health record (PHR) that can be used by patients to collect and manage their health information (e.g., medical history, past surgeries, medications, and allergies), to request self-referrals, and to store a record of their consultations. The PHR also includes a messaging system that can be structured into the workflow of referral management as well as allowing more general communications. A preliminary study was conducted with 61 patients. Thirty-two patients completed a survey in which 85% of respondents were satisfied with the usability and 94% were satisfied with the overall online referral process. The consulting physicians were satisfied with the content of subjects' personal health information and referral problem descriptions and found the information detailed enough to triage all requested referrals. Patients, physicians, and patient care coordinators reported that their communications were enhanced by the system and found the messaging component convenient to use. PMID:15484434
Wang, Maisie; Lau, Christopher; Matsen, Frederick A; Kim, Yongmin
Exploratory Study of Radiology Coding in Health Information Management Practice
An exploratory study was undertaken to determine the role and practice issues of radiology coding in health information management (HIM) practice. The study sought to identify the challenges of radiology coding and the solutions implemented to address these challenges. A self-report survey was sent to 828 American Health Information Management Association (AHIMA) members identified as directors, managers, or supervisors of HIM departments and/or coding. Two hundred seventy-eight surveys were used for data analysis purposes. Sites reported that on average they have 3.4 coders devoted to radiology coding who code an average of 4,245 reports per month. Productivity standards varied by exam type ranging from 7 (interventional radiology) to 31 (diagnostic) exams coded per hour. Diagnosis codes were assigned most frequently for diagnostic, ultrasound/nuclear, MRI/CT, and mammography exams, while diagnosis and procedural codes were assigned more frequently for interventional radiology exams. The need for education specifically focused on interventional radiology coding was identified along with other issues affecting the quality of radiology coding. Suggested solutions to challenges of radiology coding such as establishing a good working relationship with physicians, radiology, and charge description master (CDM) departments were suggested.
Brodnik, Melanie
Exploring the Model Design Space for Battery Health Management
NASA Technical Reports Server (NTRS)
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.
Saha, Bhaskar; Quach, Cuong Chi; Goebel, Kai Frank
Managing the health effects of the explosive remnants of war.
Many civilian deaths and injuries across the globe are a consequence of 'explosive remnants of war' (ERW). These ERW include mines, unexploded ordnance (UXO) and cluster bombs. The numbers of deaths, injuries and resulting disabilities from ERW are expected to increase as armed conflicts proliferate. This will have a substantial effect on all aspects of health. This article first describes the mechanisms of these ERW and the nature of the injuries they can cause. It then briefly outlines the immediate medical management such injuries require; the long-term outcomes and sequelae, and what can be done to manage them. It highlights how research and medical interventions must take into account cultural, social and economic factors in addition to utilising safe and appropriate techniques and practices. The article concludes by noting that medical personnel are well placed not only to intervene and manage the direct health effects of ERW, but also indirectly by advocating on behalf of those affected by adding their voices to campaigns against their proliferation. PMID:15602994
Kett, Maria E; Mannion, Steve J
Health Weaver Mobile: Designing a Mobile Tool for Managing Personal Health Information during Cancer Care.
Cancer patients manage a great deal of information to coordinate their care. Critical aspects of this work take place while patients are away from home or have diminished attention due to symptoms or side effects. We describe the design of HealthWeaver Mobile, a mobile phone application we developed to help patients manage care-related information in such situations. We discuss findings from two participatory design groups with breast cancer patients and the design decisions made to implement functional requirements uncovered in those groups. PMID:21347007
Klasnja, Predrag; Hartzler, Andrea; Powell, Christopher; Phan, Giovandy; Pratt, Wanda
The relation of post-work ruminative thinking with eating behaviour.
Inability to unwind about work during leisure time has been associated with a number of negative health outcomes. This study was concerned with a possible behavioural pathway between unwinding and disease and examined the relationship between work-related rumination and food choice. Work-related rumination is arguably a core to understanding the 'unwinding process', and food choice is a well-established indicator of nutritional health. Two hundred and sixty-eight full-time workers from a range of white-collar occupations completed a self-report measure of ruminative thinking about work and an eating behaviour questionnaire. Three types of ruminative thinking were identified by factor analysis and labelled affective rumination, problem-solving pondering and detachment. In terms of food choice, high-relative to low-affective ruminators reported eating more unhealthy foods, and low detachers reported eating less cooked meals and more processed foods compared to high detachers. Problem-solving pondering was not associated with food choice, and none of the factors were associated with healthy food choice. It was concluded that failure to unwind from work is not necessarily related to unhealthy food choices. What appears to be the crucial factor is the type of perseverative thinking that people engage in post-work. Limitations and future directions are discussed. PMID:22259155
Cropley, Mark; Michalianou, Georgia; Pravettoni, Gabriella; Millward, Lynne J
[Occupational health service management--the concept and application of lean management].
One of the most effective management systems is the so-called lean management (LM) aimed at loss minimization of institutions' activities while maximizing value and satisfaction to the clients. The system implementation comprises not only typical business areas but also health care sectors. The aim of the article is to present the concept and opportunity of improving the management of occupational health units. Due to its multi-profile nature of tasks and diverse relations with the environment occupational health could be a good institutional example of LM implementation. Operational perspective consists of five guidelines: describing values expected by final clients, setting value flow eliminating needless elements, creating the integrated, coherent and smooth sequence of valuable activities, offering the values to clients, and aiming at continuing improvement. LM could be implemented in occupational health units in the following areas: timing and tasks coordination, leaning some tasks and expanding others in order to maximize clients' value, cost rationalizing, improving the quality of services by eliminating mistakes, avoiding repetition of activities. PMID:23373329
Sobczak, Alicja; Rydlewska-Liszkowska, Izabela
Ground Operations Autonomous Control and Integrated Health Management
NASA Technical Reports Server (NTRS)
An intelligent autonomous control capability has been developed and is currently being validated in ground cryogenic fluid management operations. The capability embodies a physical architecture consistent with typical launch infrastructure and control systems, augmented by a higher level autonomous control (AC) system enabled to make knowledge-based decisions. The AC system is supported by an integrated system health management (ISHM) capability that detects anomalies, diagnoses causes, determines effects, and could predict future anomalies. AC is implemented using the concept of programmed sequences that could be considered to be building blocks of more generic mission plans. A sequence is a series of steps, and each executes actions once conditions for the step are met (e.g. desired temperatures or fluid state are achieved). For autonomous capability, conditions must consider also health management outcomes, as they will determine whether or not an action is executed, or how an action may be executed, or if an alternative action is executed instead. Aside from health, higher level objectives can also drive how a mission is carried out. The capability was developed using the G2 software environment (www.gensym.com) augmented by a NASA Toolkit that significantly shortens time to deployment. G2 is a commercial product to develop intelligent applications. It is fully object oriented. The core of the capability is a Domain Model of the system where all elements of the system are represented as objects (sensors, instruments, components, pipes, etc.). Reasoning and decision making can be done with all elements in the domain model. The toolkit also enables implementation of failure modes and effects analysis (FMEA), which are represented as root cause trees. FMEA's are programmed graphically, they are reusable, as they address generic FMEA referring to classes of subsystems or objects and their functional relationships. User interfaces for integrated awareness by operators have been created.
Figueroa, Fernando; Walker, Mark; Wilkins, Kim; Johnson, Robert; Sass, Jared; Youney, Justin
Management and programmatic constraints on community mental health services.
While the special needs of the mentally ill are discussed in detail by society in general and by federal and state governments in particular, it is the local mental health services that must develop, integrate, and manage resources from federal and state levels and must deal with the constraints and strings attached to those resources. The author divides the constraints into several categories--clinical, administrative, fiscal, and legal--and offers suggestions for dealing with them, drawing in several cases on examples from the state of California. He feels that the control of mental health services must be kept in the hands of those who are knowledgeable about and have an investment in the delivery of those services. PMID:649067
Elpers, J R
[History of health management for radiation accident and disaster].
According to the chronological evidences of radiation accident and disaster in the world, we can easily learn the valuable lessons on radiation health effects and also a necessity of well preparatory and organized system and network of emergency radiation medicine. Especially countermeasures on emergency radiation medicine have been categorized simply into two groups: acute and chronic effects, and high-dose and low-dose consequences. Based on the identification of potential impacts on radiation health and environmental effects, referring the past accidents and disasters, comprehensive risk analysis including risk estimation, risk management and risk communication is really required for maintaining healthy lives and safeguards in the unavoidable nuclear age of the 21st century. PMID:22514911
Miyazaki, Makoto; Yamashita, Shunichi
Statistical tools for prognostics and health management of complex systems
Prognostics and Health Management (PHM) is increasingly important for understanding and managing today's complex systems. These systems are typically mission- or safety-critical, expensive to replace, and operate in environments where reliability and cost-effectiveness are a priority. We present background on PHM and a suite of applicable statistical tools and methods. Our primary focus is on predicting future states of the system (e.g., the probability of being operational at a future time, or the expected remaining system life) using heterogeneous data from a variety of sources. We discuss component reliability models incorporating physical understanding, condition measurements from sensors, and environmental covariates; system reliability models that allow prediction of system failure time distributions from component failure models; and the use of Bayesian techniques to incorporate expert judgments into component and system models.
Collins, David H [Los Alamos National Laboratory; Huzurbazar, Aparna V [Los Alamos National Laboratory; Anderson - Cook, Christine M [Los Alamos National Laboratory
Use of information systems as management tools in health care
NASA Astrophysics Data System (ADS)
Information systems that can be used as effective management tools in healthcare do not exist. This is because current information systems do not accurately reflect reality and because they do not provide information to important end-users, i.e., clinicians. To reflect reality, healthcare information systems must assess total health care costs. These not only include the direct economic costs (dollars paid) but also the indirect economic costs (dollars lost, spent, or saved) from having a person ill. These systems must also accurately assess the adjusted, qualitative costs of human life and human pain and suffering resulting from the illness and healthcare provided. Once information systems reflect reality, they can be used to manage healthcare by profiling utilization, projecting need, modeling programs, assessing quality of care and establishing guidelines.
Davila, Fidel
Dental health and management for children with congenital heart disease.
Congenital heart disease (CHD) is one of the most common developmental anomalies. Children with CHD are at increased risk of developing oral disease, and are at increased risk from the systemic effects of oral disease. Recent changes in guidelines related to prophylaxis against infective endocarditis have highlighted the importance of establishing and maintaining oral health for this group of patients. The management of children with CHD can be complex and, unfortunately, many of these children do not receive the care they require. The challenges that these children pose are discussed, and suggestions are made for the appropriate management of these patients and the key role that all those working in primary dental care have to play. PMID:20067687
FitzGerald, Kirsten; Fleming, Pádraig; Franklin, Orla
Future prospects of health management systems using cellular phones.
Abstract Background: Cellular phones enable communication between healthcare providers and patients for prevention, diagnosis, and treatment of diseases. However, few studies have examined the user-friendliness or effectiveness of cellular phone-based medical informatics (CPBMI) for healthcare. Materials and Methods: This study investigated the use of CPBMI to identify its current status within the medical field, advantages and disadvantages, practicability, clinical effectiveness, costs, and cost-saving potential. Results: CPBMI was validated in terms of practicality and provision of medical benefits. It is critical to use CPBMI in accordance with the different features of each disease and condition. Use of CPBMI is expected to be especially useful for patients with chronic disease. Conclusions: We discussed the current status of the clinical use, benefits, and risks of CPBMI. CPBMI and information technology-based health management tools are anticipated to become useful and effective components of healthcare management in the future. PMID:24693986
Kim, Hun-Sung; Hwang, Yunji; Lee, Jae-Ho; Oh, Hye Young; Kim, Yi-Jun; Kwon, Hyeon Yoon; Kang, Hyoseung; Kim, Hyunah; Park, Rae Woong; Kim, Ju Han
National ignition facility environment, safety, and health management plan
The ES&H Management Plan describes all of the environmental, safety, and health evaluations and reviews that must be carried out in support of the implementation of the National Ignition Facility (NIF) Project. It describes the policy, organizational responsibilities and interfaces, activities, and ES&H documents that will be prepared by the Laboratory Project Office for the DOE. The only activity not described is the preparation of the NIF Project Specific Assessment (PSA), which is to be incorporated into the Programmatic Environmental Impact Statement for Stockpile Stewardship and Management (PEIS). This PSA is being prepared by Argonne National Laboratory (ANL) with input from the Laboratory participants. As the independent NEPA document preparers ANL is directly contracted by the DOE, and its deliverables and schedule are agreed to separately with DOE/OAK.
Integrated System Health Management: Foundational Concepts, Approach, and Implementation.
NASA Technical Reports Server (NTRS)
Implementation of integrated system health management (ISHM) capability is fundamentally linked to the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system. It is akin to having a team of experts who are all individually and collectively observing and analyzing a complex system, and communicating effectively with each other in order to arrive to an accurate and reliable assessment of its health. We present concepts, procedures, and a specific approach as a foundation for implementing a credible ISHM capability. The capability stresses integration of DIaK from all elements of a system. The intent is also to make possible implementation of on-board ISHM capability, in contrast to a remote capability. The information presented is the result of many years of research, development, and maturation of technologies, and of prototype implementations in operational systems (rocket engine test facilities). The paper will address the following topics: 1. ISHM Model of a system 2. Detection of anomaly indicators. 3. Determination and confirmation of anomalies. 4. Diagnostic of causes and determination of effects. 5. Consistency checking cycle. 6. Management of health information 7. User Interfaces 8. Example implementation ISHM has been defined from many perspectives. We define it as a capability that might be achieved by various approaches. We describe a specific approach that has been matured throughout many years of development, and pilot implementations. ISHM is a capability that is achieved by integrating data, information, and knowledge (DIaK) that might be distributed throughout the system elements (which inherently implies capability to manage DIaK associated with distributed sub-systems). DIaK must be available to any element of a system at the right time and in accordance with a meaningful context. ISHM Functional Capability Level (FCL) is measured by how well a system performs the following functions: (1) detect anomalies, (2) diagnose causes, (3) predict future anomalies/failures, and (4) provide the user with an integrated awareness about the condition of every element in the system and guide user decisions.
Figueroa, Fernando; Schmalzel, John; Walker, Mark; Venkatesh, Meera; Kapadia, Ravi; Morris, Jon; Turowski, Mark; Smith, Harvey
Botulism--Diagnosis, Management and Public Health Considerations
Botulism is an uncommon but often fatal disease associated with ingestion of a potent neurotoxin present in improperly preserved foods. Exposures to commercially preserved foods with an odd or peculiar taste almost never represent exposure to botulism toxin. Improperly prepared home-canned products which are tasted or consumed without heating are more likely to be associated with botulism. The management of suspect and confirmed cases of botulism is presented by medical epidemiologists in the State Department of Public Health, Bureau of Communicable Disease Control, to provide physicians in California with a practical approach to this problem.
Werner, S. Benson; Chin, James
Total quality management and the Army health care system.
Total quality management (TQM) is the newest in a long line of magic formulas which have been touted as saviors for American industry and medicine. The author discusses the basic concepts of TQM and notes that much of it resembles philosophical beliefs long held by the medical community. TQM does offer many opportunities to refine old concepts and further those goals of quality care to which health care providers have always aspired. If, however, it becomes simply another codified bureaucracy, then a great deal of time and money will be invested for very little gain. PMID:1749501
Jeffer, E K
Vehicle health management for guidance, navigation and control systems
NASA Technical Reports Server (NTRS)
The objective of the program was to architect a vehicle health management (VHM) system for space systems avionics that assures system readiness for launch vehicles and for space-based dormant vehicles. The platforms which were studied and considered for application of VHM for guidance, navigation and control (GN&C) included the Advanced Manned Launch System (AMLS), the Horizontal Landing-20/Personnel Launch System (HL-20/PLS), the Assured Crew Return Vehicle (ACRV) and the Extended Duration Orbiter (EDO). This set was selected because dormancy and/or availability requirements are driving the designs of these future systems.
Radke, Kathleen; Frazzini, Ron; Bursch, Paul; Wald, Jerry; Brown, Don
Leader-member exchange relationships in health information management.
This article seeks to raise awareness of the leader-member exchange (LMX) theory of leadership and its potential benefit to the health information management (HIM) profession. A literature review that was conducted identified a leadership challenge for HIM practitioners. The review also provides examples of leadership definitions, and potential benefits of LMX to HIM professionals in leading people and influencing leaders in their organizations. The LMX concept may be an avenue to investigate in preparing future and current HIM professionals for leadership. PMID:24808805
Hunt, T J
Adaptation of intensive mental health intensive case management to rural communities in the Veterans Health Administration.
There has been increasing concern in recent years about the availability of mental health services for people with serious mental illness in rural areas. To meet these needs the Department of Veterans Affairs (VA) implemented the Rural Access Networks for Growth Enhancement (RANGE) program, in 2007, modeled on the Assertive Community Treatment (ACT) model. This study uses VA administrative data from the RANGE program (N = 343) to compare client characteristics at program entry, patterns of service delivery, and outcomes with those of Veterans who received services from the general VA ACT-like program (Mental Health Intensive Case Management (MHICM) (N = 3,077). Veterans in the rural program entered treatment with similar symptom severity, less likelihood of being diagnosed with schizophrenia and having had long-term hospitalization, but significantly higher suicidality index scores and greater likelihood of being dually diagnosed compared with those in the general program. RANGE Veterans live further away from their treatment teams but did not differ significantly in measures of face-to-face treatment intensity. Similar proportions of RANGE and MHICM Veterans were reported to have received rehabilitation services, crisis intervention and substance abuse treatment. The rural programs had higher scores on overall satisfaction with VA mental health care than general programs, slightly poorer outcomes on quality of life and on the suicidality index but no significant difference on other outcomes. These data demonstrate the clinical need, practical feasibility and potential effectiveness of providing intensive case management through small specialized case management teams in rural areas. PMID:22729625
Mohamed, Somaia
Environmental Management Waste Management Facility (EMWMF) Site-Specific Health and Safety Plan, Oak Ridge, Tennessee
The Bechtel Jacobs Company LLC (BJC) policy is to provide a safe and healthy workplace for all employees and subcontractors. The implementation of this policy requires that operations of the Environmental Management Waste Management Facility (EMWMF), located one-half mile west of the U.S. Department of Energy (DOE) Y-12 National Security Complex, be guided by an overall plan and consistent proactive approach to environment, safety and health (ES&H) issues. The BJC governing document for worker safety and health, BJC/OR-1745, 'Worker Safety and Health Program', describes the key elements of the BJC Safety and Industrial Hygiene (IH) programs, which includes the requirement for development and implementation of a site-specific Health and Safety Plan (HASP) where required by regulation (refer also to BJC-EH-1012, 'Development and Approval of Safety and Health Plans'). BJC/OR-1745, 'Worker Safety and Health Program', implements the requirements for worker protection contained in Title 10 Code of Federal Regulations (CFR) Part 851. The EMWMF site-specific HASP requirements identifies safe operating procedures, work controls, personal protective equipment, roles and responsibilities, potential site hazards and control measures, site access requirements, frequency and types of monitoring, site work areas, decontamination procedures, and outlines emergency response actions. This HASP will be available on site for use by all workers, management and supervisors, oversight personnel and visitors. All EMWMF assigned personnel will be briefed on the contents of this HASP and will be required to follow the procedures and protocols as specified. The policies and procedures referenced in this HASP apply to all EMWMF operations activities. In addition the HASP establishes ES&H criteria for the day-to-day activities to prevent or minimize any adverse effect on the environment and personnel safety and health and to meet standards that define acceptable waste management practices. The HASP is written to make use of past experience and best management practices to eliminate or minimize hazards to workers or the environment from events such as fires, falls, mechanical hazards, or any unplanned release to the environment.
Flynn, N.C. Bechtel Jacobs
Does Social Anxiety Predict Rumination and Co-Rumination Among Adolescents?
Social anxiety in adolescence is manifested by anxiety about and avoidance of social interactions. The present study examined whether social anxiety predicts higher levels of both rumination and co-rumination over time. Rumination and co-rumination were studied as possible outcomes because the cognitive content of these processes often involves interpersonal concerns. A three-wave longitudinal study of 575 adolescents (aged 13–16 years
Paul E. Jose; Holly Wilkins; Jason S. Spendelow
Improving the Effectiveness of Health Care Innovation Implementation: Middle Managers as Change Agents
The rate of successful health care innovation implementation is dismal. Middle managers have a potentially important yet poorly understood role in health care innovation implementation. This study used self-administered surveys and interviews of middle managers in health centers that implemented an innovation to reduce health disparities to address the questions: Does middle managers' commitment to health care innovation implementation influence implementation effectiveness? If so, in what ways does their commitment influence implementation effectiveness? Although quantitative survey data analysis results suggest a weak relationship, qualitative interview data analysis results indicate that middle managers' commitment influences implementation effectiveness when middle managers are proactive. Scholars should account for middle managers' influence in implementation research, and health care executives may promote implementation effectiveness by hiring proactive middle managers and creating climates in which proactivity is rewarded, supported, and expected.
Birken, Sarah A.; Lee, Shoou-Yih Daniel; Weiner, Bryan J.; Chin, Marshall H.; Schaefer, Cynthia T.
Improving the effectiveness of health care innovation implementation: middle managers as change agents.
The rate of successful health care innovation implementation is dismal. Middle managers have a potentially important yet poorly understood role in health care innovation implementation. This study used self-administered surveys and interviews of middle managers in health centers that implemented an innovation to reduce health disparities to address the questions: Does middle managers' commitment to health care innovation implementation influence implementation effectiveness? If so, in what ways does their commitment influence implementation effectiveness? Although quantitative survey data analysis results suggest a weak relationship, qualitative interview data analysis results indicate that middle managers' commitment influences implementation effectiveness when middle managers are proactive. Scholars should account for middle managers' influence in implementation research, and health care executives may promote implementation effectiveness by hiring proactive middle managers and creating climates in which proactivity is rewarded, supported, and expected. PMID:22930312
Birken, Sarah A; Lee, Shoou-Yih Daniel; Weiner, Bryan J; Chin, Marshall H; Schaefer, Cynthia T
A study for safety and health management problem of semiconductor industry in Taiwan.
The main purpose of this study is to discuss and explore the safety and health management in semiconductor industry. The researcher practically investigates and interviews the input, process and output of the safety and health management of semiconductor industry by using the questionnaires and the interview method which is developed according to the framework of the OHSAS 18001. The result shows that there are six important factors for the safety and health management in Taiwan semiconductor industry. 1. The company should make employee clearly understand the safety and health laws and standards. 2. The company should make the safety and health management policy known to the public. 3. The company should put emphasis on the pursuance of the safety and health management laws. 4. The company should prevent the accidents. 5. The safety and health message should be communicated sufficiently. 6. The company should consider safety and health norm completely. PMID:19088409
Chao, Chin-Jung; Wang, Hui-Ming; Feng, Wen-Yang; Tseng, Feng-Yi
Advanced Health Management of a Brushless Direct Current Motor/Controller
NASA Technical Reports Server (NTRS)
This effort demonstrates that health management can be taken to the component level for electromechanical systems. The same techniques can be applied to take any health management system to the component level, based on the practicality of the implementation for that particular system. This effort allows various logic schemes to be implemented for the identification and management of failures. By taking health management to the component level, integrated vehicle health management systems can be enhanced by protecting box-level avionics from being shut down in order to isolate a failed computer.
Pickett, R. D.
Rumination mediates the association between cyber-victimization and depressive symptoms.
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. PMID:24346650
Feinstein, Brian A; Bhatia, Vickie; Davila, Joanne
Brief Report: Adolescents' Co-Rumination with Mothers, Co-Rumination with Friends, and Internalizing Symptoms
The current research examined co-rumination (extensively discussing, rehashing, and speculating about problems) with mothers and friends. Of interest was exploring whether adolescents who co-ruminate with mothers were especially likely to co-ruminate with friends as well as the interplay among co-rumination with mothers, co-rumination with friends, and anxious/depressed symptoms. Early- to mid-adolescents (N = 393) reported on co-rumination and normative self-disclosure with mothers and friends and on their internalizing symptoms in this cross-sectional study. Co-rumination with mothers (but not normative self-disclosure) was concurrently associated with adolescents' co-rumination with friends. In addition, the relation between co-rumination with mothers and adolescents' anxious/depressed symptoms reported previously (Waller & Rose, 2010) became non-significant when co-rumination with friends was statistically controlled. This suggests that the relation between friendship co-rumination and anxious/depressed symptoms may help explain the relation between mother-child co-rumination and anxious/depressed symptoms. Potential implications for promoting adolescents' well-being are discussed.
Rose, Amanda J.
The value of the facilities management function in the UK NHS community health-care sector
This paper stresses the importance of the strategic integration of the organisational facilities management function as being an essential prerequisite towards facilities and organisational effectiveness. The impact of both the strategic and operational facilities management function on community health-care facility users is also documented. The value of the facilities management function in terms of other health-care related organisational core deliverables
Paul Featherstone; David Baldry
Distinguishing Rumination from Worry in Clinical Insomnia
Research has found that repetitive thought processes, such as worry and rumination, play an important role in several disorders; however, these cognitive processes have not yet been examined in insomnia. This study explores rumination and worry in insomnia by examining: 1) whether those high and low on rumination and worry differ on subjective sleep measures, and 2) whether rumination and worry are distinct processes in insomnia. Participants (N = 242) were diagnosed with an insomnia disorder by sleep experts. Participants completed measures of worry and rumination and maintained a 2-week daily sleep log. Results of a multivariate analysis of variance found no main effect of worry; although high and low ruminators differed on several sleep log indices, including sleep efficiency, wakefulness after sleep onset and sleep quality. Factor analysis supported the idea that rumination and worry are separate constructs. Whereas previous research has focused on worry in insomnia, these findings suggest that rumination is important for understanding sleep disturbance. Further, although rumination and worry are both repetitive thought processes, these results indicate that they are distinct processes within insomnia and should be treated as such. The results are discussed with respect to treatment implications for Cognitive Behavioural Therapy for Insomnia.
Carney, Colleen E.; Harris, Andrea L.; Moss, Taryn G.; Edinger, Jack D.
Integrated System Health Management: Foundational Concepts, Approach, and Implementation
NASA Technical Reports Server (NTRS)
A sound basis to guide the community in the conception and implementation of ISHM (Integrated System Health Management) capability in operational systems was provided. The concept of "ISHM Model of a System" and a related architecture defined as a unique Data, Information, and Knowledge (DIaK) architecture were described. The ISHM architecture is independent of the typical system architecture, which is based on grouping physical elements that are assembled to make up a subsystem, and subsystems combine to form systems, etc. It was emphasized that ISHM capability needs to be implemented first at a low functional capability level (FCL), or limited ability to detect anomalies, diagnose, determine consequences, etc. As algorithms and tools to augment or improve the FCL are identified, they should be incorporated into the system. This means that the architecture, DIaK management, and software, must be modular and standards-based, in order to enable systematic augmentation of FCL (no ad-hoc modifications). A set of technologies (and tools) needed to implement ISHM were described. One essential tool is a software environment to create the ISHM Model. The software environment encapsulates DIaK, and an infrastructure to focus DIaK on determining health (detect anomalies, determine causes, determine effects, and provide integrated awareness of the system to the operator). The environment includes gateways to communicate in accordance to standards, specially the IEEE 1451.1 Standard for Smart Sensors and Actuators.
Figueroa, Fernando
Rocket Engine Health Management: Early Definition of Critical Flight Measurements
NASA Technical Reports Server (NTRS)
The NASA led Space Launch Initiative (SLI) program has established key requirements related to safety, reliability, launch availability and operations cost to be met by the next generation of reusable launch vehicles. Key to meeting these requirements will be an integrated vehicle health management ( M) system that includes sensors, harnesses, software, memory, and processors. Such a system must be integrated across all the vehicle subsystems and meet component, subsystem, and system requirements relative to fault detection, fault isolation, and false alarm rate. The purpose of this activity is to evolve techniques for defining critical flight engine system measurements-early within the definition of an engine health management system (EHMS). Two approaches, performance-based and failure mode-based, are integrated to provide a proposed set of measurements to be collected. This integrated approach is applied to MSFC s MC-1 engine. Early identification of measurements supports early identification of candidate sensor systems whose design and impacts to the engine components must be considered in engine design.
Christenson, Rick L.; Nelson, Michael A.; Butas, John P.
Development of Structural Health Management Technology for Aerospace Vehicles
NASA Technical Reports Server (NTRS)
As part of the overall goal of developing Integrated Vehicle Health Management (IVHM) systems for aerospace vehicles, NASA has focused considerable resources on the development of technologies for Structural Health Management (SHM). The motivations for these efforts are to increase the safety and reliability of aerospace structural systems, while at the same time decreasing operating and maintenance costs. Research and development of SHM technologies has been supported under a variety of programs for both aircraft and spacecraft including the Space Launch Initiative, X-33, Next Generation Launch Technology, and Aviation Safety Program. The major focus of much of the research to date has been on the development and testing of sensor technologies. A wide range of sensor technologies are under consideration including fiber-optic sensors, active and passive acoustic sensors, electromagnetic sensors, wireless sensing systems, MEMS, and nanosensors. Because of their numerous advantages for aerospace applications, most notably being extremely light weight, fiber-optic sensors are one of the leading candidates and have received considerable attention.
Prosser, W. H.
Health sector development: from aid coordination to resource management.
Aid coordination has assumed a prominent place on health policy agendas. This paper synthesizes the findings of research undertaken to explore the changing practices of aid coordination across a number of countries. It begins by reviewing the key issues giving rise to increased attention to aid coordination in the health sector. The second section describes, assesses and compares the strengths and weaknesses of the dominant mechanisms or instruments which were found to be employed to coordinate health sector aid in the case studies. From this analysis, four factors become clear. First, in many countries, coordination mechanisms have been introduced as a part of an incremental process of trying out different approaches--there is no one model that stands out at any one time. Secondly, some instruments function largely for consultation, predominantly coordinating inputs, while others are more directive and operational, and are used to manage inputs, processes and outputs. Third, many of the mechanisms have not excelled, although, fourth, it is difficult to judge the effectiveness or impact of aid coordination. It is therefore argued that concern with the effectiveness of aid coordination arrangements must give way to a broader analysis of the processes, outputs and outcomes governing the use of both external and domestic resources, focusing on institutional characteristics, the distribution and nature of influence among the actors, and the interests which they pursue through the aid regime. These factors varied considerably across the countries indicating that aid management is context dependent and subject to continuing changes. Finally, the paper looks at the findings in the light of the introduction of sector-wide approaches. PMID:10621238
Walt, G; Pavignani, E; Gilson, L; Buse, K
The importance of human resources management in health care: a global context
Background This paper addresses the health care system from a global perspective and the importance of human resources management (HRM) in improving overall patient health outcomes and delivery of health care services. Methods We explored the published literature and collected data through secondary sources. Results Various key success factors emerge that clearly affect health care practices and human resources management. This paper will reveal how human resources management is essential to any health care system and how it can improve health care models. Challenges in the health care systems in Canada, the United States of America and various developing countries are examined, with suggestions for ways to overcome these problems through the proper implementation of human resources management practices. Comparing and contrasting selected countries allowed a deeper understanding of the practical and crucial role of human resources management in health care. Conclusion Proper management of human resources is critical in providing a high quality of health care. A refocus on human resources management in health care and more research are needed to develop new policies. Effective human resources management strategies are greatly needed to achieve better outcomes from and access to health care around the world.
Kabene, Stefane M; Orchard, Carole; Howard, John M; Soriano, Mark A; Leduc, Raymond
Financial Performance of Health Plans in Medicaid Managed Care
Objective This study assesses the financial performance of health plans that enroll Medicaid members across the key plan traits, specifically Medicaid dominant, publicly traded, and provider-sponsored. Data and Methods National Association of Insurance Commissioners (NAIC) financial data, coupled with selected state financial data, were analyzed for 170 Medicaid health plans for 2009. A mean test compared the mean values for medical loss, administrative cost, and operating margin ratios across these plan traits. Medicaid dominant plans are plans with 75 percent of their total enrollment in the Medicaid line of business. Findings Plans that are Medicaid dominant and publicly traded incurred a lower medical loss ratio and higher administrative cost ratio than multi-product and non-publicly traded plans. Medicaid dominant plans also earned a higher operating profit margin. Plans offering commercial and Medicare products are operating at a loss for their Medicaid line of business. Policy Implications Health plans that do not specialize in Medicaid are losing money. Higher medical cost rather than administrative cost is the underlying reason for this financial loss. Since Medicaid enrollees do not account for their primary book of business, these plans may not have invested in the medical management programs to reduce inappropriate emergency room use and avoid costly hospitalization.
McCue, Mike
Management Knowledge and Skills Required in the Health Care System of the Federation Bosnia and Herzegovina
Extremely complex health care organizations, by their structure and organization, operate in a constantly changing business environment, and such situation implies and requires complex and demanding health management. Therefore, in order to manage health organizations in a competent manner, health managers must possess various managerial skills and be familiar with problems in health care. Research, identification, analysis, and assessment of health management education and training needs are basic preconditions for the development and implementation of adequate programs to meet those needs. Along with other specific activities, this research helped to determine the nature, profile, and level of top-priority needs for education. The need for knowledge of certain areas in health management, as well as the need for mastering concrete managerial competencies has been recognized as top-priorities requiring additional improvement and upgrading.
Slipicevic, Osman; Masic, Izet
Analysing changes in the nature of health service management in England.
Health service management maintains a balance between collective values concerned with service provision and individual values concerned with health practice. It is also balanced between the application of co-ordinative and directive approaches to management. Over the last quarter century economic and ideological factors have caused health service management to experience more directive. Today, the role of health service management becoming more directive. Today, the role of health service management appears further threatened by staffing cuts and changes in traditional patterns of organising work. This, while it may lead to bifurcation between specialist and general management roles, is unlikely to restore the dominance of practitioner values or notably soften the form of management. PMID:10167070
Packwood, T
Project Minerva: Management Education for Safety and Health - Selected Case Studies.
National Technical Information Service (NTIS)
Case studies were presented to illustrate the effect of safety and health on the success of business management. The studies were intended to be used to help business administration students understand the importance of safety and health in business. The ...
Market-focused management: a model for US academic health centers
This paper describes managed care, competition and high health care costs and reductions in funding as the major market forces that affect US academic health centers. As academic health centers continue to preserve their missions of providing patient care, educating and training health professionals and conducting research, they are negatively impacted by these market changes, thus, resulting in increased expenses
Kristina L. Guo
Vehicle Health Management Communications Requirements for AeroMACS
NASA Technical Reports Server (NTRS)
As the development of standards for the aeronautical mobile airport communications system (AeroMACS) progresses, the process of identifying and quantifying appropriate uses for the system is progressing. In addition to defining important elements of AeroMACS standards, indentifying the systems uses impacts AeroMACS bandwidth requirements. Although an initial 59 MHz spectrum allocation for AeroMACS was established in 2007, the allocation may be inadequate; studies have indicated that 100 MHz or more of spectrum may be required to support airport surface communications. Hence additional spectrum allocations have been proposed. Vehicle health management (VHM) systems, which can produce large volumes of vehicle health data, were not considered in the original bandwidth requirements analyses, and are therefore of interest in supporting proposals for additional AeroMACS spectrum. VHM systems are an emerging development in air vehicle safety, and preliminary estimates of the amount of data that will be produced and transmitted off an aircraft, both in flight and on the ground, have been prepared based on estimates of data produced by on-board vehicle health sensors and initial concepts of data processing approaches. This allowed an initial estimate of VHM data transmission requirements for the airport surface. More recently, vehicle-level systems designed to process and analyze VHM data and draw conclusions on the current state of vehicle health have been undergoing testing and evaluation. These systems make use of vehicle system data that is mostly different from VHM data considered previously for airport surface transmission, and produce processed system outputs that will be also need to be archived, thus generating additional data load for AeroMACS. This paper provides an analysis of airport surface data transmission requirements resulting from the vehicle level reasoning systems, within the context of overall VHM data requirements.
Kerczewski, Robert J.; Clements, Donna J.; Apaza, Rafael D.
Intelligent Integrated Health Management for a System of Systems
NASA Technical Reports Server (NTRS)
An intelligent integrated health management system (IIHMS) incorporates major improvements over prior such systems. The particular IIHMS is implemented for any system defined as a hierarchical distributed network of intelligent elements (HDNIE), comprising primarily: (1) an architecture (Figure 1), (2) intelligent elements, (3) a conceptual framework and taxonomy (Figure 2), and (4) and ontology that defines standards and protocols. Some definitions of terms are prerequisite to a further brief description of this innovation: A system-of-systems (SoS) is an engineering system that comprises multiple subsystems (e.g., a system of multiple possibly interacting flow subsystems that include pumps, valves, tanks, ducts, sensors, and the like); 'Intelligent' is used here in the sense of artificial intelligence. An intelligent element may be physical or virtual, it is network enabled, and it is able to manage data, information, and knowledge (DIaK) focused on determining its condition in the context of the entire SoS; As used here, 'health' signifies the functionality and/or structural integrity of an engineering system, subsystem, or process (leading to determination of the health of components); 'Process' can signify either a physical process in the usual sense of the word or an element into which functionally related sensors are grouped; 'Element' can signify a component (e.g., an actuator, a valve), a process, a controller, an actuator, a subsystem, or a system; The term Integrated System Health Management (ISHM) is used to describe a capability that focuses on determining the condition (health) of every element in a complex system (detect anomalies, diagnose causes, prognosis of future anomalies), and provide data, information, and knowledge (DIaK) not just data to control systems for safe and effective operation. A major novel aspect of the present development is the concept of intelligent integration. The purpose of intelligent integration, as defined and implemented in the present IIHMS, is to enable automated analysis of physical phenomena in imitation of human reasoning, including the use of qualitative methods. Intelligent integration is said to occur in a system in which all elements are intelligent and can acquire, maintain, and share knowledge and information. In the HDNIE of the present IIHMS, an SoS is represented as being operationally organized in a hierarchical-distributed format. The elements of the SoS are considered to be intelligent in that they determine their own conditions within an integrated scheme that involves consideration of data, information, knowledge bases, and methods that reside in all elements of the system. The conceptual framework of the HDNIE and the methodologies of implementing it enable the flow of information and knowledge among the elements so as to make possible the determination of the condition of each element. The necessary information and knowledge is made available to each affected element at the desired time, satisfying a need to prevent information overload while providing context-sensitive information at the proper level of detail. Provision of high-quality data is a central goal in designing this or any IIHMS. In pursuit of this goal, functionally related sensors are logically assigned to groups denoted processes. An aggregate of processes is considered to form a system. Alternatively or in addition to what has been said thus far, the HDNIE of this IIHMS can be regarded as consisting of a framework containing object models that encapsulate all elements of the system, their individual and relational knowledge bases, generic methods and procedures based on models of the applicable physics, and communication processes (Figure 2). The framework enables implementation of a paradigm inspired by how expert operators monitor the health of systems with the help of (1) DIaK from various sources, (2) software tools that assist in rapid visualization of the condition of the system, (3) analical software tools that assist in reasoning about the condition, (4) sharing of information via
Smith, Harvey; Schmalzel, John; Figueroa, Fernando
Strategies for managing health problems among homeless women: three case studies.
The purpose of this article is to illustrate through case examples how homeless women experience coexisting health problems, and how they may conceal these stigmatizing health problems from others, including health professionals and shelter staff. The article will also address how nurse case managers can interact with these women so that together they can develop strategies about how to manage these complex health problems. PMID:10232218
Hatton, D C; Fisher, A
Distributed Prognostics and Health Management with a Wireless Network Architecture
NASA Technical Reports Server (NTRS)
A heterogeneous set of system components monitored by a varied suite of sensors and a particle-filtering (PF) framework, with the power and the flexibility to adapt to the different diagnostic and prognostic needs, has been developed. Both the diagnostic and prognostic tasks are formulated as a particle-filtering problem in order to explicitly represent and manage uncertainties in state estimation and remaining life estimation. Current state-of-the-art prognostic health management (PHM) systems are mostly centralized in nature, where all the processing is reliant on a single processor. This can lead to a loss in functionality in case of a crash of the central processor or monitor. Furthermore, with increases in the volume of sensor data as well as the complexity of algorithms, traditional centralized systems become for a number of reasons somewhat ungainly for successful deployment, and efficient distributed architectures can be more beneficial. The distributed health management architecture is comprised of a network of smart sensor devices. These devices monitor the health of various subsystems or modules. They perform diagnostics operations and trigger prognostics operations based on user-defined thresholds and rules. The sensor devices, called computing elements (CEs), consist of a sensor, or set of sensors, and a communication device (i.e., a wireless transceiver beside an embedded processing element). The CE runs in either a diagnostic or prognostic operating mode. The diagnostic mode is the default mode where a CE monitors a given subsystem or component through a low-weight diagnostic algorithm. If a CE detects a critical condition during monitoring, it raises a flag. Depending on availability of resources, a networked local cluster of CEs is formed that then carries out prognostics and fault mitigation by efficient distribution of the tasks. It should be noted that the CEs are expected not to suspend their previous tasks in the prognostic mode. When the prognostics task is over, and after appropriate actions have been taken, all CEs return to their original default configuration. Wireless technology-based implementation would ensure more flexibility in terms of sensor placement. It would also allow more sensors to be deployed because the overhead related to weights of wired systems is not present. Distributed architectures are furthermore generally robust with regard to recovery from node failures.
Goebel, Kai; Saha, Sankalita; Sha, Bhaskar
Integrating complementary and alternative medicine into mainstream healthcare services: the perspectives of health service managers
Background Complementary and alternative medicine (CAM) is increasingly included within mainstream integrative healthcare (IHC) services. Health service managers are key stakeholders central to ensuring effective integrative health care services. Yet, little research has specifically investigated the role or perspective of health service managers with regards to integrative health care services under their management. In response, this paper reports findings from an exploratory study focusing exclusively on the perspectives of health service managers of integrative health care services in Australia regarding the role of CAM within their service and the health service managers rational for incorporating CAM into clinical care. Methods Health service managers from seven services were recruited using purposive and snowball sampling. Semi-structured interviews were conducted with the health service managers. The services addressed trauma and chronic conditions and comprised: five community-based programs including drug and alcohol rehabilitation, refugee mental health and women's health; and two hospital-based specialist services. The CAM practices included in the services investigated included acupuncture, naturopathy, Western herbal medicine and massage. Results Findings reveal that the health service managers in this study understand CAM to enhance the holistic capacity of their service by: filling therapeutic gaps in existing healthcare practices; by treating the whole person; and by increasing healthcare choices. Health service managers also identified CAM as addressing therapeutic gaps through the provision of a mind-body approach in psychological trauma and in chronic disease management treatment. Health service managers describe the addition of CAM in their service as enabling patients who would otherwise not be able to afford CAM to gain access to these treatments thereby increasing healthcare choices. Some health service managers expressly align the notion of treating the whole person within a health promotion model and focus on the relevance of diet and lifestyle factors as central to a CAM approach. Conclusions From the perspectives of the health service managers, these findings contribute to our understanding around the rationale to include CAM within mainstream health services that deal with psychological trauma and chronic disease. The broader implications of this study can help assist in the development of health service policy on CAM integration in mainstream healthcare services.
Dynamics of health behavior regarding hospital waste management in Dhaka, Bangladesh: a dysfunctional health belief model.
This article examined the usefulness of the Health Belief Model (HBM) and other confounding factors in determining health behavior of individuals involved in hospital waste management and tested four components of HBM in relation to demographic variables, knowledge, and occupational practices of the respondents. The study revealed that the waste pickers had a lower level of knowledge, attitude, and safe practices than nurses and sweepers. Perceived Susceptibility and Perceived Severity were moderately associated with safe occupational practices among the respondents (p < 0.05). In addition, respondents with higher levels of education and income were more likely to have higher levels of Perceived Susceptibility, Severity, and Benefits. The study findings indicate that individuals with greater economic vulnerability might be at greater risk for not using proper protective measures in handling or picking hospital wastes in Bangladesh. PMID:19959428
Amanullah, A S M; Uddin, Jalal
Improving Pain Management in Community Health Care Settings: The Role of the Advanced Practice Nurse
Advanced practice nurses can play a key role in reducing or removing barriers to effective pain management in a variety of ways: as clinicians role modeling best practice pain management, as educators providing continuing education in pain management, as researchers incorporating evaluation research methods into pain management improvement projects, and as consultants to leaders of health care organizations and communities
Linda Torma
Self-Perpetuating Properties of Dysphoric Rumination
Hypotheses about the self-perpetuating properties of ruminative responses to depressed mood were tested in 2 laboratory studies and 2 questionnaire studies with dysphoric and nondysphoric Ss. Studies 1 and 2 supported the hypothesis that dysphorics induced to engage in self-focused rumination would report reduced willingness to engage in pleasant, distracting activities that could lift their moods, even if they believed
Sonja Lyubomirsky; Susan Nolen-Hoeksema
Neural substrates of trait ruminations in depression.
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
Mandell, Darcy; Siegle, Greg J; Shutt, Luann; Feldmiller, Josh; Thase, Michael E
The experiment was carried out at the Forage Research Unit in the Federal University of Ceará, with the objective of evaluating the ruminal Dry Matter disappeareance (RDMD) of agroindustria l by -products (AB). Three male sheep, with permanent ruminal cannulas, were used in a randomized block design. The potencial (PD) and efetive degradabilities (ED) of by-products of cashew (BC), graviola
Cyanotoxin management and human health risk mitigation in recreational waters.
The occurrence and severity of harmful cyanobacterial or blue-green algal blooms (HABs) have increased in recent decades, posing a serious threat of illness to humans. In some countries, water contaminated with cyanotoxins that is used for drinking or haemodialysis has posed a particularly serious risk. However, it is now recognized that recreational exposure to natural toxins by skin contact, accidental swallowing of water or inhalation can also cause a wide range of acute or chronic illnesses. In this review, we focus on the importance of cyanotoxin management in recreational waters. The symptoms related with HAB poisonings, the recommended safety concentrations limit for cyanobacteria and cyanotoxins in such waters, as well as early health hazard indicators of their presence and their monitoring are all discussed. We also present in this review an overview of the methods developed in recent decades for eliminating cyanobacteria and the toxic compounds that they produce. PMID:24664523
Koreivien?, Judita; Anne, Olga; Kasperovi?ien?, J?rat?; Burškyt?, Vilma
Distributed Prognostic Health Management with Gaussian Process Regression
NASA Technical Reports Server (NTRS)
Distributed prognostics architecture design is an enabling step for efficient implementation of health management systems. A major challenge encountered in such design is formulation of optimal distributed prognostics algorithms. In this paper. we present a distributed GPR based prognostics algorithm whose target platform is a wireless sensor network. In addition to challenges encountered in a distributed implementation, a wireless network poses constraints on communication patterns, thereby making the problem more challenging. The prognostics application that was used to demonstrate our new algorithms is battery prognostics. In order to present trade-offs within different prognostic approaches, we present comparison with the distributed implementation of a particle filter based prognostics for the same battery data.
Saha, Sankalita; Saha, Bhaskar; Saxena, Abhinav; Goebel, Kai Frank
Concepts of health and well-being in managers: An organizational study
Global changes and new managerial challenges require new concepts of health and well-being in organizational contexts. In the South African context, health and well-being of managers have gained relevance in organizations and in management sciences. International organizations, in particular, attempt to address the increasing demand for health care and the delivery of health services to their managers. Careful and appropriate health management requires research to evaluate context-specific health concepts and strategies. The purpose and aim of this article is to assess managerial concepts on health and well-being that could be used by the organization to contribute to managerial well-being by implementing health promotion according to managerial needs. At the same time, this article contributes to salutogenetic health research that is very rare with regard to the South African organizational management research. This study is a multi-method research study conducted in a selected international organization in South Africa. However, in this article, selected qualitative findings will only be presented. This organizational study presents selected research findings on health concepts and strategies employed by managers. Findings demonstrate that the managerial concepts of health and strategies mainly refer to not only physical but also to mental and spiritual aspects, with a priority on physical health and well-being. The findings presented are based on qualitative research methods and their research criteria. This assessment serves as a foundation for new approaches to health management within the international work context in South Africa. It also contributes to a paradigm shift from pathogenetic to salutogenetic concepts of health and well-being within the South African organizational work context. The article produces new insights into the qualitative health concepts of South African managers and expatriates and contributes to promoting salutogenesis in organization within South Africa.
Boness, Christian
Advanced Health Management System for the Space Shuttle Main Engine
NASA Technical Reports Server (NTRS)
Boeing-Canoga Park (BCP) and NASA-Marshall Space Flight Center (NASA-MSFC) are developing an Advanced Health Management System (AHMS) for use on the Space Shuttle Main Engine (SSME) that will improve Shuttle safety by reducing the probability of catastrophic engine failures during the powered ascent phase of a Shuttle mission. This is a phased approach that consists of an upgrade to the current Space Shuttle Main Engine Controller (SSMEC) to add turbomachinery synchronous vibration protection and addition of a separate Health Management Computer (HMC) that will utilize advanced algorithms to detect and mitigate predefined engine anomalies. The purpose of the Shuttle AHMS is twofold; one is to increase the probability of successfully placing the Orbiter into the intended orbit, and the other is to increase the probability of being able to safely execute an abort of a Space Transportation System (STS) launch. Both objectives are achieved by increasing the useful work envelope of a Space Shuttle Main Engine after it has developed anomalous performance during launch and the ascent phase of the mission. This increase in work envelope will be the result of two new anomaly mitigation options, in addition to existing engine shutdown, that were previously unavailable. The added anomaly mitigation options include engine throttle-down and performance correction (adjustment of engine oxidizer to fuel ratio), as well as enhanced sensor disqualification capability. The HMC is intended to provide the computing power necessary to diagnose selected anomalous engine behaviors and for making recommendations to the engine controller for anomaly mitigation. Independent auditors have assessed the reduction in Shuttle ascent risk to be on the order of 40% with the combined system and a three times improvement in mission success.
Davidson, Matt; Stephens, John
Rumination and Age: Some Things Get Better
Rumination has been defined as a mode of responding to distress that involves passively focusing one's attention on symptoms of distress without taking action. This dysfunctional response style intensifies depressed mood, impairs interpersonal problem solving, and leads to more pessimistic future perspectives and less social support. As most of these results were obtained from younger people, it remains unclear how age affects ruminative thinking. Three hundred members of the general public ranging in age from 15 to 87 years were asked about their ruminative styles using the Response Styles Questionnaire (RSQ), depression and satisfaction with life. A Mokken Scale analysis confirmed the two-factor structure of the RSQ with brooding and reflective pondering as subcomponents of rumination. Older participants (63 years and older) reported less ruminative thinking than other age groups. Life satisfaction was associated with brooding and highest for the earlier and latest life stages investigated in this study.
Sutterlin, Stefan; Paap, Muirne C. S.; Babic, Stana; Kubler, Andrea; Vogele, Claus
On robust methodologies for managing public health care systems.
Authors focus on ontology-based multidimensional data warehousing and mining methodologies, addressing various issues on organizing, reporting and documenting diabetic cases and their associated ailments, including causalities. Map and other diagnostic data views, depicting similarity and comparison of attributes, extracted from warehouses, are used for understanding the ailments, based on gender, age, geography, food-habits and other hereditary event attributes. In addition to rigor on data mining and visualization, an added focus is on values of interpretation of data views, from processed full-bodied diagnosis, subsequent prescription and appropriate medications. The proposed methodology, is a robust back-end application, for web-based patient-doctor consultations and e-Health care management systems through which, billions of dollars spent on medical services, can be saved, in addition to improving quality of life and average life span of a person. Government health departments and agencies, private and government medical practitioners including social welfare organizations are typical users of these systems. PMID:24445953
Nimmagadda, Shastri L; Dreher, Heinz V
Rumination on Anger and Sadness in Adolescence: Fueling of Fury and Deepening of Despair
We examined anger rumination and sadness rumination in clinic-referred ado- lescents (N = 121). Factor analysis indicated that items from analogous anger and sadness rumination measures loaded onto 2 factors tapping anger rumination and sadness rumination, respectively. Structural equation modeling confirmed unique re- lations between each form of rumination and specific emotional or behavioral prob- lems. Anger and anger rumination
Maya Peled; Marlene M. Moretti
Rumination on Anger and Sadness in Adolescence: Fueling of Fury and Deepening of Despair
We examined anger rumination and sadness rumination in clinic-referred adolescents (N = 121). Factor analysis indicated that items from analogous anger and sadness rumination measures loaded onto 2 factors tapping anger rumination and sadness rumination, respectively. Structural equation modeling confirmed unique relations between each form of rumination and specific emotional or behavioral problems. Anger and anger rumination were independent predictors
Maya Peled; Marlene M. Moretti
[Prevalence of tobacco smoking among health-care managers].
A whole variety of new organisational solutions are being introduced nowadays, at an increasing pace, in health-care institutions, not always preceded by appropriate information related to the upcoming changes. The situation may be conducive to the feeling of discomfort and doubt among managerial staff, as to the ultimate result of imminent innovations. A necessity to relieve the perceived tension will then arise, for example, by way of smoking. The principal objective of the present study was to examine the occurrence of tobacco-smoking among the nursing executive personnel. Two groups of employees holding high-ranking positions in the nursing subsystem were included in the study. The initial part of the project was performed throughout the first quarter of 2010, and comprised 102 departmental female nurses. The concluding part is planned for October - November, 2010, and will address the second and third-level managers. A questionnaire-based, diagnostic survey was the employed research method. The questionnaires' return rate was 85%. The Fisher-Freeman-Halton test was applied in statistical calculations (for expected values < 5). The study revealed, so far, that the performance of managerial functions induced undesirable behavioural patterns, i.e., tobacco smoking. It also affected low self-assessment of their bio-psycho-social wellness. The majority of the respondents took part in various forms of in-service, refresher training which also included information concerning behavioural patterns detrimental to health. The latter influenced the participating nurses' self-assessment of the extent of their knowledge related to tobacco smoking and its harmful effect on their health. PMID:21360945
Zysnarska, Monika; Adamek, Renata; Gromadecka-Sutkiewicz, Ma?gorzata; Bernad, Dorota; Maksymiuk, Tomasz
Data Fusion for Enhanced Aircraft Engine Prognostics and Health Management
NASA Technical Reports Server (NTRS)
Aircraft gas-turbine engine data is available from a variety of sources, including on-board sensor measurements, maintenance histories, and component models. An ultimate goal of Propulsion Health Management (PHM) is to maximize the amount of meaningful information that can be extracted from disparate data sources to obtain comprehensive diagnostic and prognostic knowledge regarding the health of the engine. Data fusion is the integration of data or information from multiple sources for the achievement of improved accuracy and more specific inferences than can be obtained from the use of a single sensor alone. The basic tenet underlying the data/ information fusion concept is to leverage all available information to enhance diagnostic visibility, increase diagnostic reliability and reduce the number of diagnostic false alarms. This report describes a basic PHM data fusion architecture being developed in alignment with the NASA C-17 PHM Flight Test program. The challenge of how to maximize the meaningful information extracted from disparate data sources to obtain enhanced diagnostic and prognostic information regarding the health and condition of the engine is the primary goal of this endeavor. To address this challenge, NASA Glenn Research Center, NASA Dryden Flight Research Center, and Pratt & Whitney have formed a team with several small innovative technology companies to plan and conduct a research project in the area of data fusion, as it applies to PHM. Methodologies being developed and evaluated have been drawn from a wide range of areas including artificial intelligence, pattern recognition, statistical estimation, and fuzzy logic. This report will provide a chronology and summary of the work accomplished under this research contract.
Volponi, Al
A New Approach to Managing Health in Swine Operations
It is proposed that just as the stethoscope and thermometer are fundamental tools for individual medicine, production and health recording systems are fundamental tools for effective population medicine. Treatment and control of clinical diseases as the primary objective is no longer considered appropriate for livestock population. Disease in populations now describes a deviation between what is happening and what is expected to happen. This redefinition of disease implies that it is of multifactorial origin and thus a different problem solving approach must be implemented. Therefore, a swine enterprise must be considered as a system, a set of interdependent components continuously interacting to produce pork. As a system, it is characterized by certain properties: change, environment, counterintuitive behavior, drift to low performance, interdependency, and organization. A redefinition of diseases implies also that they are not only "treated" but managed. Management consists of planning, monitoring, evaluation, and analysis. For this process to be implemented successfully, a goal-directed recording system providing a farm-based infrastructure for problem solving is essential. Clinical problem solving (diagnosis) is thus based on epidemiological and demographic methods.
Stein, Thomas; Martineau, Guy-Pierre; Morris, Roger; Charette, Robert
The importance of values in shaping how health systems governance and management can support universal health coverage.
In this article, we use cultural theory to investigate the nature of health systems governance and management, showing that it may be helpful in identifying key aspects of the debate about how to promote universal health coverage. Cultural theory argues that "how" we govern and manage health services depends on what we think about the nature of government organizations and the legitimacy of their scope of action. The values that are implied by universal health coverage underlie choices about "how" health systems are governed and their organizations are managed. We draw two main conclusions. First, the translation of principles and goals into practice requires exceptional efforts to design adequate decision-making arrangements (the essence of governance) and management practices. Management and governance, or "how" policies are decided and conducted, are not secondary to the selection of the best policy solutions (the "what"). Second, governance and management solutions are not independent of the values that they are expected to serve. Instead, they should be designed to be consonant with these values. Cultural theory suggests-and experience supports-the idea that "group identity" is favorable for shaping different forms of social life and public administrations. This approach should thus be a starting point for those who strive to obtain universal health coverage. PMID:23317640
Fattore, Giovanni; Tediosi, Fabrizio
Ribotyping to compare Fusobacterium necrophorum isolates from bovine liver abscesses, ruminal walls, and ruminal contents.
Restriction fragment length polymorphism analysis of rRNA genes was employed to genetically compare Fusobacterium necrophorum subsp. necrophorum and F. necrophorum subsp. funduliforme isolates from multiple abscesses of the same liver and isolates from liver abscesses, the ruminal wall, and ruminal contents from the same animal. Four livers with multiple abscesses and samples of ruminal contents, ruminal walls, and liver abscesses were collected from 11 cattle at slaughter. F. necrophorum was isolated from all liver abscesses, nine ruminal walls, and six ruminal content samples. Chromosomal DNA of the isolates was extracted and single or double digested with restriction endonucleases (EcoRI, EcoRV, SalI, and HaeIII); then restriction fragments were hybridized with a digoxigenin-labeled cDNA probe transcribed from a mixture of 16S and 23S rRNAs from Escherichia coli. EcoRI alone or in combination with EcoRV yielded the most discriminating ribopatterns for comparison. Within the subspecies multiple isolates from the same liver were indistinguishable based on the ribopattern obtained with EcoRI. The hybridization patterns of liver abscess isolates were concordant with those of the corresponding isolates from ruminal walls in eight of nine sets of samples. None of the six ruminal content isolates matched either the liver abscess isolates or the ruminal wall isolates. The genetic similarity between the isolates from liver abscesses and ruminal walls supports the hypothesis that F. necrophorum isolates of liver abscesses originate from the rumen. PMID:9406386
Narayanan, S; Nagaraja, T G; Okwumabua, O; Staats, J; Chengappa, M M; Oberst, R D
Ribotyping to compare Fusobacterium necrophorum isolates from bovine liver abscesses, ruminal walls, and ruminal contents.
Restriction fragment length polymorphism analysis of rRNA genes was employed to genetically compare Fusobacterium necrophorum subsp. necrophorum and F. necrophorum subsp. funduliforme isolates from multiple abscesses of the same liver and isolates from liver abscesses, the ruminal wall, and ruminal contents from the same animal. Four livers with multiple abscesses and samples of ruminal contents, ruminal walls, and liver abscesses were collected from 11 cattle at slaughter. F. necrophorum was isolated from all liver abscesses, nine ruminal walls, and six ruminal content samples. Chromosomal DNA of the isolates was extracted and single or double digested with restriction endonucleases (EcoRI, EcoRV, SalI, and HaeIII); then restriction fragments were hybridized with a digoxigenin-labeled cDNA probe transcribed from a mixture of 16S and 23S rRNAs from Escherichia coli. EcoRI alone or in combination with EcoRV yielded the most discriminating ribopatterns for comparison. Within the subspecies multiple isolates from the same liver were indistinguishable based on the ribopattern obtained with EcoRI. The hybridization patterns of liver abscess isolates were concordant with those of the corresponding isolates from ruminal walls in eight of nine sets of samples. None of the six ruminal content isolates matched either the liver abscess isolates or the ruminal wall isolates. The genetic similarity between the isolates from liver abscesses and ruminal walls supports the hypothesis that F. necrophorum isolates of liver abscesses originate from the rumen.
Narayanan, S; Nagaraja, T G; Okwumabua, O; Staats, J; Chengappa, M M; Oberst, R D
Concepts for image management and communication system for space vehicle health management
NASA Astrophysics Data System (ADS)
On a space vehicle, the Crew Health Care System will handle minor accidents or illnesses immediately, thereby eliminating the necessity of early mission termination or emergency rescue. For practical reasons, only trained personnel with limited medical experience can be available on space vehicles to render preliminary health care. There is the need to communicate with medical experts at different locations on earth. Interplanetary Image Management and Communication System (IIMACS) will be a bridge between worlds and deliver medical images acquired in space to physicians at different medical centers on earth. This paper discusses the implementation of IIMACS by extending the Global Picture Archiving and Communication System (GPACS) being developed to interconnect medical centers on earth. Furthermore, this paper explores system requirements of IIMACS and different user scenarios. Our conclusion is that IIMACS is feasible using the maturing technology base of GPACS.
Alsafadi, Yasser; Martinez, Ralph
Ruminant organotypic brain-slice cultures as a model for the investigation of CNS listeriosis
Central nervous system (CNS) infections in ruminant livestock, such as listeriosis, are of major concern for veterinary and public health. To date, no host-specific in vitro models for ruminant CNS infections are available. Here, we established and evaluated the suitability of organotypic brain-slices of ruminant origin as in vitro model to study mechanisms of Listeria monocytogenes CNS infection. Ruminants are frequently affected by fatal listeric rhombencephalitis that closely resembles the same condition occurring in humans. Better insight into host–pathogen interactions in ruminants is therefore of interest, not only from a veterinary but also from a public health perspective. Brains were obtained at the slaughterhouse, and hippocampal and cerebellar brain-slices were cultured up to 49 days. Viability as well as the composition of cell populations was assessed weekly. Viable neurons, astrocytes, microglia and oligodendrocytes were observed up to 49 days in vitro. Slice cultures were infected with L. monocytogenes, and infection kinetics were monitored. Infected brain cells were identified by double immunofluorescence, and results were compared to natural cases of listeric rhombencephalitis. Similar to the natural infection, infected brain-slices showed focal replication of L. monocytogenes and bacteria were predominantly observed in microglia, but also in astrocytes, and associated with axons. These results demonstrate that organotypic brain-slice cultures of bovine origin survive for extended periods and can be infected easily with L. monocytogenes. Therefore, they are a suitable model to study aspects of host–pathogen interaction in listeric encephalitis and potentially in other neuroinfectious diseases.
Guldimann, Claudia; Lejeune, Beatrice; Hofer, Sandra; Leib, Stephen L; Frey, Joachim; Zurbriggen, Andreas; Seuberlich, Torsten; Oevermann, Anna
What happens when capitated behavioral health comes to town? The transition from the fort bragg demonstration to a capitated managed behavioral health contract
Capitated managed care contracts for behavioral health services are becoming more prevalent across the country in both public and private sectors. This study followed the transition from a demonstration project for child mental health services to a capitated managed behavioral health care contract with a for-profit managed care company. The focus of the study was on the impact—at both the
Craig Anne Heflinger; Denine A. Northrup
Health Care Autonomy in Children with Chronic Conditions: Implications for Self Care and Family Management
Synopsis Health care autonomy typically occurs during late adolescence but health care providers and families often expect children with chronic health conditions to master self-care earlier. Few studies have examined the development of health care autonomy as it pertains to self-care and family management. This review will link the three concepts and discuss implications for families and health care providers. Case studies are provided as exemplars to highlight areas where intervention and research is needed.
Beacham, Barbara L.; Deatrick, Janet A.
This paper presents the results of a workshop held in August 2002 in support of an action-oriented program of research that adopts an ecosystem approach to human health in Chennai, India. The workshop brought together stakeholders and potential participants in the research program in a collaborative environment to explore environment and health relationships, identify key actors and stakeholders in managing
Martin J. Bunch; V. Madha; Dana Wilson; Beth Finnis; T. Vasantha Kumaran; Michael J. Jerrett
Health services management in primary schools (Elazig city sample)
Primary school children have low resistance to diseases. In order to live a healthy life, they should be equipped with health literacy skills. Effective primary school health services can only be achieved with the collaboration of related parties. Turkish schools generally do not employ permanent health personnel, and school health services are generally taken to be synonymous with health screening.
I. Bak?r Arabaci
Community health insurance amidst abolition of user fees in Uganda: the view from policy makers and health service managers
BACKGROUND: This paper investigates knowledge of Community Health Insurance (CHI) and the perception of its relevance by key policy makers and health service managers in Uganda. Community Health Insurance schemes currently operate in the private-not-for-profit sector, in settings where church-based facilities function. They operate in a wider policy environment where user fees in the public sector have been abolished. METHODS:
Robert K Basaza; Bart Criel; Patrick Van der Stuyft
Smart Sensors' Role in Integrated System Health Management
NASA Technical Reports Server (NTRS)
During the last decade, there has been a major effort in the aerospace industry to reduce the cost per pond of payload and become competitive in the international market. Competition from Europe, Japan, and China has reduced this cost to almost a third from 1990 to 2000. This cost has leveled in recent years to an average price of around $12,000/pound of payload. One of NASA's goals is to promote the development of technologies to reduce this cost by a factor of 10 or more Exploration of space, specially manned exploration missions, involves very complex launch and flight vehicles, associated ground support systems, and extensive human support during all phases of the mission. When considering the Space Shuttle Program, we can see that vehicle and ground support systems' processing, operation, and maintenance represent a large percentage of the program cost and time. Reducing operating, processing and maintenance costs will greatly reduce the cost of Exploration programs. The Integrated System Health Management (ISHM) concept is one of the technologies that will help reduce these operating, processing and maintenance costs. ISHM is an integrated health monitoring system applicable to both flight and ground systems. It automatically and autonomously acquires information from sensors and actuators and processes that information using the ISHM-embedded knowledge. As a result, it establishes the health of the system based on the acquired information and its prior knowledge. When this concept is fully implemented, ISHM systems shall be able to perform failure prediction and remediation before actual hard failures occurs, preventing its costly consequences. Data sources, sensors, and their associated data acquisition systems, constitute the foundation of the system. A smart sensing architecture is required to support the acquisition of reliable, high quality data, required by the ISHM. A thorough definition of the smart sensor architectures, their embedded diagnostic agents, and communication protocols need to be established and standardized to allow the embedding and exchange of health information among sensors and ISHM. This workshop is aimed to foster the exchange of ideas and lessons learned between government, industry and academia to aid in the establishment of ISHM (and smart sensors) standards and guidelines as well as to identify present technology gaps that will have to be overcome to successfully achieve this goal.
Perotti, Jose M.; Mata, Carlos
Ruminal microbe of biohydrogenation of trans-vaccenic acid to stearic acid in vitro
Background Optimization of the unsaturated fatty acid composition of ruminant milk and meat is desirable. Alteration of the milk and fatty acid profile was previously attempted by the management of ruminal microbial biohydrogenation. The aim of this study was to identify the group of ruminal trans-vaccenic acid (trans-11 C18:1, t-VA) hydrogenating bacteria by combining enrichment studies in vitro. Methods The enrichment culture growing on t-VA was obtained by successive transfers in medium containing t-VA. Fatty acids were detected by gas chromatograph and changes in the microbial composition during enrichment were analyzed by denaturing gradient gel electrophoresis (DGGE). Prominent DGGE bands of the enrichment cultures were identified by 16S rRNA gene sequencing. Results The growth of ruminal t-VA hydrogenating bacteria was monitored through the process of culture transfer according to the accumulation of stearic acid (C18:0, SA) and ratio of the substrate (t-VA) transformed to the product (SA). A significant part of the retrieved 16S rRNA gene sequences was most similar to those of uncultured bacteria. Bacteria corresponding to predominant DGGE bands in t-VA enrichment cultures clustered with t-VA biohydrogenated bacteria within Group B. Conclusions This study provides more insight into the pathway of biohydrogenation. It also may be important to control the production of t-VA, which has metabolic and physiological benefits, through management of ruminal biohydrogenation bacterium.
Interviewing Key Informants: Strategic Planning for a Global Public Health Management Program
ERIC Educational Resources Information Center
The Centers for Disease Control and Prevention's Sustainable Management Development Program (SMDP) partners with low- and middle-resource countries to develop management capacity so that effective global public health programs can be implemented and better health outcomes can be achieved. The program's impact however, was variable. Hence, there…
Kun, Karen E.; Kassim, Anisa; Howze, Elizabeth; MacDonald, Goldie
Training Health Care Professionals to Manage Overweight Adolescents: Experience in Rural Georgia Communities
ERIC Educational Resources Information Center
Context: The obesity epidemic threatens the present and future health of adolescents in the United States. Yet, health care providers lack specific training for pediatric obesity assessment and management. Purpose: This study examined the adherence of rural Georgia primary care practitioners to an overweight adolescent management protocol. The…
Dennison, David A.; Yin, Zenong; Kibbe, Debra; Burns, Susan; Trowbridge, Frederick
The Impact of Managed Behavioral Health Care on Rehabilitation Services to Persons with Serious Mental Illness.
ERIC Educational Resources Information Center
This monograph examines issues in the field of psychosocial/psychiatric rehabilitation (PSR) services for people with serious mental illness, placed in the context of a debate within the field about trends toward managed behavioral health care companies. Four main issues are addressed: (1) the degree to which managed behavioral health care…
Rutman, Irvin D.; Baron, Richard C.; Hadley, Trevor R.
IT Enactment of new Public Management: the Case Study of Health Information Systems in Kenya
In the last twenty years most African Governments have embarked on health sector reforms sponsored by international partners. Conceived under New Public Management, the majority of these reforms leverage information technology to decentralise hierarchical structures into more information efficient organizations. The paper illustrates the case study of health management information systems in Kenya in order to better understand how the
Roberta Bernardi
Update of the health care management needs of infants with sickle cell disease.
This article describes the characteristics, clinical manifestations, and health care management of infants with sickle cell disease. Also discussed are parent education issues and stressors related to coping with the health care management needs of infants with sickle cell disease. Special emphasis is given to literature focused on the concept of anticipatory grief often experienced by parents of chronically ill children. PMID:10776196
Hendricks-Ferguson, V L; Nelson, M
The detection and management of mental health disorders in pediatric primary care
We reviewed the literature on the detection and management of mental health disorders within the context of pediatric primary care. Pediatricians have displayed a low sensitivity and high specificity in research investigating the detection of mental health impairment in children. Active management efforts characterize approaches to identified cases with more recently trained primary care pediatricians displaying a wider range of
E. Wayne Holden; Wendy B. Schuman
Managed Mental Health Care: Implications for Social Work Practice and Social Work Education
Managed care has rapidly developed as the most common model of delivery of health care in this country. This article examines the implications of new demands brought to bear on social workers. This research compares six managed health care plans operating regionally and nationally and demonstrates the cumbersome application process. Fee schedules for each of the plans are listed. Ethical
Howard M. Turney; Patricia G. Conway
NASA aviation safety program: Aircraft Engine Health Management Data Mining Tools roadmap
Aircraft Engine Health Management Data Mining Tools is a project led by NASA Glenn Research Center in support of the NASA Aviation Safety Program's Aviation System Monitoring and Modeling Thrust. The objective of the Glenn-led effort is to develop enhanced aircraft engine health management prognostic and diagnostic methods through the application of data mining technologies to operational data and maintenance
Jonathan Litt; Donald L. Simon; Claudia Meyer; Hans DePold; J. R. Curtiss; Howard Winston; Yao Wang; Irv Statler; Yuri Gawdiak
Best Practices in Nurse-Managed Health Centers Conference.
National Technical Information Service (NTIS)
The National Nursing Centers Consortium's 2004 Annual Conference aimed to bring together health care professionals from across the country for three days to consider the best approaches to eliminating health disparities and producing strong health outcome...
B. Pilon L. Line T. H. Turton
Climate change and health risks: assessing and responding to them through 'adaptive management'.
Climate change and associated changing weather patterns, including severe weather events, are expected to increase the prevalence of a wide range of health risks. Yet there is uncertainty about the timing, location, and severity of these changes. Adaptive management, a structured process of decision making in the face of imperfect information, is an approach that can help the public health field effectively anticipate, plan for, and respond to the health risks of climate change. In this article I describe adaptive management and how it could increase the effectiveness of local and national strategies, policies, and programs to manage climate-sensitive health outcomes. PMID:21555476
Ebi, Kristie
Managed competition versus industrial purchasing of health care among the Fortune 500.
The theory of managed competition has found favor with many health policy analysts and academic economists alike. Three characteristics--consumer choice, defined contribution, and dissemination of information--signal managed competition strategy. By requiring private employers to provide their employees with a choice of health carriers, a fixed-dollar strategy (defined contribution), and quality information to make appropriate choices among carriers, managed competition offers to remedy imperfections in both the consumer and provider sides of the market for health insurance. In an extensive survey of health care purchasing practices among Fortune 500 companies we found that major companies are not using the managed competition approach to health care purchasing. Instead, most of the companies surveyed are purchasing health care in the same way as they do other inputs to production--a pattern we call industrial purchasing. PMID:11942420
Maxwell, James; Temin, Peter
Leadership frames and perceptions of effectiveness among health information management program directors.
Leadership is important to health science education. For program effectiveness, directors should possess leadership skills to appropriately lead and manage their departments. Therefore, it is important to explore the leadership styles of programs' leaders as health science education is undergoing reform. Program directors of two and four-year health information management programs were surveyed to determine leadership styles. The study examined leadership styles or frames, the number of leadership frames employed by directors, and the relationship between leadership frames and their perceptions of their effectiveness as a manager and as a leader. The study shows that program directors are confident of their human resource and structural skills and less sure of the political and symbolic skills required of leaders. These skills in turn are correlated with their self-perceived effectiveness as managers and leaders. Findings from the study may assist program directors in their career development and expansion of health information management programs as a discipline within the health science field. As academic health centers receive greater pressure from the Institute of Medicine and accrediting agencies to reform health science education, the question of leadership arises. These centers have taken a leadership role in reforming health professional education by partnering with educational institutions to improve the health of communities. To achieve health education reform, health sciences educators must apply effective leadership skills.1 College and university leadership is challenged on how to best approach educational reform across health science fields. This article discusses leadership styles employed by program directors of one health science department, health information management, in directing programs for health science education reform. PMID:18066358
Sasnett, Bonita; Ross, Thomas
Leadership Frames and Perceptions of Effectiveness among Health Information Management Program Directors
Leadership is important to health science education. For program effectiveness, directors should possess leadership skills to appropriately lead and manage their departments. Therefore, it is important to explore the leadership styles of programs' leaders as health science education is undergoing reform. Program directors of two and four-year health information management programs were surveyed to determine leadership styles. The study examined leadership styles or frames, the number of leadership frames employed by directors, and the relationship between leadership frames and their perceptions of their effectiveness as a manager and as a leader. The study shows that program directors are confident of their human resource and structural skills and less sure of the political and symbolic skills required of leaders. These skills in turn are correlated with their self-perceived effectiveness as managers and leaders. Findings from the study may assist program directors in their career development and expansion of health information management programs as a discipline within the health science field. As academic health centers receive greater pressure from the Institute of Medicine and accrediting agencies to reform health science education, the question of leadership arises. These centers have taken a leadership role in reforming health professional education by partnering with educational institutions to improve the health of communities. To achieve health education reform, health sciences educators must apply effective leadership skills.1 College and university leadership is challenged on how to best approach educational reform across health science fields. This article discusses leadership styles employed by program directors of one health science department, health information management, in directing programs for health science education reform.
Sasnett, Bonita; Ross, Thomas
The Poverty of Information Systems Management in Home Health Agencies: Implications for Survivability
Home health agencies are increasingly being challenged to cope with economic, financial and clinical pressures. This study examines the extent to which home health agencies have cultivated their information systems as an aid for managing performance and external forces. Colorado and New Mexico home health agencies participated in the research project. The findings indicate that only modest investments have been
Howard L. Smith; Richard Discenza
Implementing managed care in a state mental health authority: Implications for organizational change
Organizational change is a significant challenge facing providers of health services in a rapidly shifting managed care environment. Market forces have driven a massive restructuring of the health care system despite the recent failure of federal reforms. In a highly competitive environment, health care organizations have been forced to develop new techniques and technologies in order to survive. In particular,
Eileen Elias; Marc Navon
Cyber-Management of People with Chronic Disease: A Potential Solution to eHealth Challenges
ERIC Educational Resources Information Center
The evolving eHealth agenda presents a range of potential opportunities for the management and prevention of chronic disease. This paper identifies issues and barriers to the uptake of eHealth and describes a strategy ("Healthy Outcomes for Australians"[C]-HOFA) for creating a central knowledge filter and cyber space method for tracking health…
Laakso, E-Liisa; Armstrong, Kylie; Usher, Wayne
Promoting Stress Management: The Role of Comprehensive School Health Programs. ERIC Digest.
ERIC Educational Resources Information Center
This Digest examines how Comprehensive School Health Programs (CSHPs) may promote stress management in children and adolescents. CSHPs contain four key elements. The first element, community participation and focus, can be achieved through school health newsletters, health fairs, local newspaper, radio, and television promotions, and guest…
Massey, Marilyn S.
A review of health leadership and management capacity in the Solomon Islands.
ACCESS AND UTILISATION OF HEALTH CARE: The armed conflict that engulfed the Solomon Islands between 1998 and 2003 significantly disrupted the provision of health care especially in rural and remote areas. There is one doctor for 3,300 people and approximately 13 nurses and midwives for 10,000 people. Despite limitations 87% of people seek health care when sick. FINANCING THE HEALTH SYSTEM: The SIG placed a series of reservations on ministerial goods and services budgets that effectively the budget by 33%, severely impacting provincial budgets and resulting in acquired debts. Shortfalls have been addressed by allocating Health Sector Support Program funds to the provinces to allow services to continue, a strategy that will likely recur, but by which donor support replaces government provision Provincial health accountants have received training in MYOB in 2009 but acquittal systems require higher level accounting skills for reports to be submitted on time to permit the release of subsequent funding tranches. HUMAN RESOURCES FOR HEALTH: The shortage of doctors and specialists is a key challenge. As at December 2010, there were a total of 2,728 health workers in the public sector in Solomon Islands. Staff costs consume on average 55% of provincial health grants Filled Public Service Division staff establishments and budgetary reservations have reduced the ability to meet the salary and wage costs of new graduates. Solomon Islands is currently negotiating to assist Vanuatu in filling its nursing staff vacancies with its surplus The return of 75 Cuban trained medical officers from 2013 presents the management challenge of accessing budget provisions for so many new positions and in funding the infrastructure needed to house, equip and maintain them in service. HEALTH MANAGEMENT STRUCTURE: Provincial health managers are operationally responsive to local needs, managerially responsible to provincial governments, while being concerned with adherence to central MHMS policy and to Ministry of Finance and Public Service Division regulations. The delineation of central and provincial health authorities' responsibilities requires guidelines in a changing system, where both population-based and targeted vertical programs are implemented at local levels. NUMBER AND DISTRIBUTION OF MANAGERS: Nine of the 10 positions of Provincial Health Director have experienced high turnover, which reportedly occurs without adequate handover to incoming appointees, most of whom are recent clinical graduates. Health services in the Honiara urban area are provided through the Honiara City Council. Church health services are staffed by government employees. COMPETENCE OF DISTRICT HEALTH MANAGERS: Management skills are reportedly weak at the provincial level. The Regional Assistance Mission to Solomon Islands provides governance training inputs to provincial government staff. Provincial health departments have limited financial and human resource management capacity. They also have clinical backgrounds and no training in public health planning or health services management, other than that provided by donors, the Regional Assistance Mission itself and the MHMS. MANAGEMENT WORKING ENVIRONMENT: Provincial health directors have limited control over health staff. Little supportive supervision in management is provided to new provincial health directors. No performance management systems are in place to ensure that staff are properly assessed and supported to do their best Large numbers of non-government organisations working at the provincial level in youth and women's programs require coordination by Provincial health directors to avoid duplication or implementation of programs that will require ongoing funding, but this is not done. FUNCTIONING OF MANAGEMENT SUPPORT SYSTEMS: Management support systems for budgeting and finance, management information and procurement and supply do not function adequately to support provincial health directors to manage effectively. THE SOCIO-CULTURAL CONTEXT: Socio-cultural issues such as favouritism based on kinship, discrim
Asante, Augustine; Roberts, Graham; Hall, John
The development of a mental health service patient information management system
In this paper we describe the development of the Mental Health-Patient Information Management System (MH-PIMS), which is an information management system designed for use in a modern, primarily community-based, mental health service. MH-PIMS is a computerised database which was designed by clinicians and is supported by a case management system and complementary patient record set - together called the Assessment
Tom Callaly; Peter Faulkner; Graeme Hollis
Gender Differences in Medication Management Capacity in HIV Infection: The Role of Health Literacy and Numeracy
Health literacy is emerging as a key element for successful medication management and empirical support for the efficacy of\\u000a numeracy in the health context is rising as well. Little is known, however, about their unique effects among women and men.\\u000a Given the importance of accurate medication management for effective treatment of HIV, the relation of these variables to\\u000a medication management
Drenna Waldrop-Valverde; Deborah L. Jones; Dushyantha Jayaweera; Peggy Gonzalez; Javier Romero; Raymond L. Ownby
Changing office practice and health care systems to facilitate diabetes self-management
Diabetes is a self-managed disease for which patients provide 99% of their own care. For patients to succeed as diabetes self-managers,\\u000a they need office practices and health care systems that can prepare and support them in their diabetes self-management efforts\\u000a over the long term. In order to provide effective diabetes education and ongoing support, office practices and health care\\u000a systems
Martha M. Funnell; Robert M. Anderson
A Resource Management Tool for Public Health Continuity of Operations During Disasters
Objective We developed and validated a user-centered information system to support the local planning of public health continuity of operations for the Community Health Services Division, Public Health - Seattle & King County, Washington. Methods The Continuity of Operations Data Analysis (CODA) system was designed as a prototype developed using requirements identified through participatory design. CODA uses open-source software that links personnel contact and licensing information with needed skills and clinic locations for 821 employees at 14 public health clinics in Seattle and King County. Using a web-based interface, CODA can visualize locations of personnel in relationship to clinics to assist clinic managers in allocating public health personnel and resources under dynamic conditions. Results Based on user input, the CODA prototype was designed as a low-cost, user-friendly system to inventory and manage public health resources. In emergency conditions, the system can run on a stand-alone battery-powered laptop computer. A formative evaluation by managers of multiple public health centers confirmed the prototype design's usefulness. Emergency management administrators also provided positive feedback about the system during a separate demonstration. Conclusions Validation of the CODA information design prototype by public health managers and emergency management administrators demonstrates the potential usefulness of building a resource management system using open-source technologies and participatory design principles.
Turner, Anne M.; Reeder, Blaine; Wallace, James C.
Focusing on the software of managing health workers: what can we learn from high commitment management practices?
Knowledge of what constitutes best practice in human resource management (HRM) in public-oriented services is limited and the operational aspects of managing health workers at provision level have been poorly studied. The magnet hospital concept offers some insights in HRM practices that are leading to high commitment. These have been shown to lead to superior performance of industrial business firms,
Bruno Marchal; Guy Kegels
A Support Database System for Integrated System Health Management (ISHM)
NASA Technical Reports Server (NTRS)
The development, deployment, operation and maintenance of Integrated Systems Health Management (ISHM) applications require the storage and processing of tremendous amounts of low-level data. This data must be shared in a secure and cost-effective manner between developers, and processed within several heterogeneous architectures. Modern database technology allows this data to be organized efficiently, while ensuring the integrity and security of the data. The extensibility and interoperability of the current database technologies also allows for the creation of an associated support database system. A support database system provides additional capabilities by building applications on top of the database structure. These applications can then be used to support the various technologies in an ISHM architecture. This presentation and paper propose a detailed structure and application description for a support database system, called the Health Assessment Database System (HADS). The HADS provides a shared context for organizing and distributing data as well as a definition of the applications that provide the required data-driven support to ISHM. This approach provides another powerful tool for ISHM developers, while also enabling novel functionality. This functionality includes: automated firmware updating and deployment, algorithm development assistance and electronic datasheet generation. The architecture for the HADS has been developed as part of the ISHM toolset at Stennis Space Center for rocket engine testing. A detailed implementation has begun for the Methane Thruster Testbed Project (MTTP) in order to assist in developing health assessment and anomaly detection algorithms for ISHM. The structure of this implementation is shown in Figure 1. The database structure consists of three primary components: the system hierarchy model, the historical data archive and the firmware codebase. The system hierarchy model replicates the physical relationships between system elements to provide the logical context for the database. The historical data archive provides a common repository for sensor data that can be shared between developers and applications. The firmware codebase is used by the developer to organize the intelligent element firmware into atomic units which can be assembled into complete firmware for specific elements.
Schmalzel, John; Figueroa, Jorge F.; Turowski, Mark; Morris, John
[Development of an instrument for the assessment of demand and monitoring of the health management in a health insurance].
To identify and follow up the health relevant effects of change-management-projects and to determine improvements in activities following this change a specific health-controlling instrument with benchmarking options has been developed. This instrument applies scientific quality standards and shows the organisational value in form of an index (BGM-Systemindex). It shows the correlation between the four indices management system, health-related actions, health and absence rate and allows a qualitative view of corporate health promotion on and its long term effects. The initiator for the project was an employee survey, which showed a need for action to improve job satisfaction. The survey was the reason that management initiated an integral change-management-project. The project showed many interfaces with the corporate health promotion (BGM), thus enabling consequent changes to be made and their effects to be evaluated. The aim of the project was to clearly increase employee satisfaction up to the next employee survey. Overall the project can be considered a success as the main aim of the project to increase the employees job satisfaction in the given period of time was clearly accomplished. The BGM-Systemindex also stood the test for comprehensive monitoring of the employees health. The project was able to prove that the health relevant parameters could be optimised and that the quality, acceptance and efficiency of the intervention methods had improved. It also showed a positive development of the early and long term health indicators. This is a positive contrast to available literature, which shows that an insufficient or incorrectly used change management results in a lower employee satisfaction. As a result it was decided to use the tool in future. PMID:25000628
Burnus, M; Benner, V; Becker, L; Müller, D; Stock, S
Mental Health Treatment in a State Prison: Managing Challenges
Mental health services exist in prisons. Participants often abuse psychoactive substances. Substance abuse treatment programs in prison manifest a custodial culture of safety and control. Substance abuse among inmate participants in mental health programming must be dealt with in the context of mental health treatment. Mental health treatment, which is less coercive than substance abuse programming in prisons, shows a
Eric Oxelson
Adding a Genomic Healthcare Component to a Health Information Management Curriculum
The inclusion of genomic information will become routine in electronic health records (EHRs). Educating health information management (HIM) students about how to best manage, protect, properly release, and use this information for patient care is of utmost importance. This study examined the usefulness of incorporating genomic modules into an existing course in quality management. Pretest and posttest results showed that students improved in all areas related to genomics in healthcare. Also, students enjoyed the class scenarios and discussion on the ethical use of genomic information. Interspersing genomic information management throughout an existing quality management class is an effective way to add this information to an existing HIM curriculum.
Ludwig, Bailee; Zhou, Leming; Watzlaf, Valerie; Abdelhak, Mervat
Adding a genomic healthcare component to a health information management curriculum.
The inclusion of genomic information will become routine in electronic health records (EHRs). Educating health information management (HIM) students about how to best manage, protect, properly release, and use this information for patient care is of utmost importance. This study examined the usefulness of incorporating genomic modules into an existing course in quality management. Pretest and posttest results showed that students improved in all areas related to genomics in healthcare. Also, students enjoyed the class scenarios and discussion on the ethical use of genomic information. Interspersing genomic information management throughout an existing quality management class is an effective way to add this information to an existing HIM curriculum. PMID:21063543
Ludwig, Bailee; Zhou, Leming; Watzlaf, Valerie; Abdelhak, Mervat
Supporting academic health centers with knowledge management: learning from the Web.
In a 2003 publication, the Association of Academic Health Sciences Libraries (AAHSL) made explicit the many ways in which a library might contribute to an academic health center's success through knowledge management (KM). Building on Success: Charting the Future of Knowledge Management within the Academic Health Center elucidated the ways in which a library can serve as the center of an organization's KM initiatives. The study and application of knowledge management tools is formidable; unlike information management (IM), the field of knowledge management has roots in a seemingly infinite and wide-ranging number of professional and academic disciplines. The planning of institutional KM initiatives is not commonly discussed, and history shows knowledge management projects often fail to thrive. This column introduces the topic of knowledge management and includes suggested Web-based resources for further understanding and project planning. PMID:19384717
Littleton, Dawn
Helminthic control on grazing ruminants and environmental risks in South America
The control of ruminant gastrointestinal nematodes and ectoparasites, one of the major production health problems, are heavily reliant on the systematic and sometimes abusive use of anthelmintic drugs. Endectocides are the most frequently used drugs, having high potency against ar- thropods and nematodes. Their dung pat residues enhance the risk of adverse effects on non-target in- vertebrates and on the
Victor Humberto Suarez
Toxicity of unsaturated fatty acids to the biohydrogenating ruminal bacterium, Butyrivibrio fibrisolvens
: BACKGROUND: Health-promoting polyunsaturated fatty acids (PUFA) are abundant in forages grazed by ruminants and in vegetable and fish oils used as dietary supplements, but only a small proportion of PUFA finds its way into meat and milk, because of biohydrogenation in the rumen. Butyrivibrio fibrisolvens plays a major role in this activity. The aim of this study was to
Margarida RG Maia; Lal C Chaudhary; Charles S Bestwick; Anthony J Richardson; Nest McKain; Tony R Larson; Ian A Graham; Robert J Wallace
Strengthening Care Management with Health Information Technology. Learning Guide Executive Summary.
National Technical Information Service (NTIS)
By unleashing the power of health IT to support care management, Beacon Communities were able to expand, enhance and improve the quality of a range of care management services in order to improve care transitions and chronic disease management, and better...
Monitoring Health Care for Children with Chronic Conditions in a Managed Care Environment
Objective: Children with chronic health conditions face special issues in their interactions with managed care. These children often require additional and more varied services than do other children. Managed care plans increasingly include these children, especially with the growth of Medicaid managed care. This article examines the special issues facing children with chronic conditions and develops strategies for monitoring their
James M. Perrin; Karen Kuhlthau; Deborah Klein Walker; Ruth E. K. Stein; Paul W. Newacheck; Steven L. Gortmaker
A Meta-Analysis of Health Status, Health Behaviors, and Health Care Utilization Outcomes of the Chronic Disease Self-Management Program
Introduction The Chronic Disease Self-Management Program (CDSMP) is a community-based self-management education program designed to help participants gain confidence (self-efficacy) and skills to better manage their chronic conditions; it has been implemented worldwide. The objective of this meta-analysis was to quantitatively synthesize the results of CDSMP studies conducted in English-speaking countries to determine the program's effects on health behaviors, physical and psychological health status, and health care utilization at 4 to 6 months and 9 to 12 months after baseline. Methods We searched 8 electronic databases to identify CDSMP-relevant literature published from January 1, 1999, through September 30, 2009; experts identified additional unpublished studies. We combined the results of all eligible studies to calculate pooled effect sizes. We included 23 studies. Eighteen studies presented data on small English-speaking groups; we conducted 1 meta-analysis on these studies and a separate analysis on results by other delivery modes. Results Among health behaviors for small English-speaking groups, aerobic exercise, cognitive symptom management, and communication with physician improved significantly at 4- to 6-month follow-up; aerobic exercise and cognitive symptom management remained significantly improved at 9 to 12 months. Stretching/strengthening exercise improved significantly at 9 to 12 months. All measures of psychological health improved significantly at 4 to 6 months and 9 to 12 months. Energy, fatigue, and self-rated health showed small but significant improvements at 4 to 6 months but not at 9 to 12 months. The only significant change in health care utilization was a small improvement in the number of hospitalization days or nights at 4 to 6 months Conclusion Small to moderate improvements in psychological health and selected health behaviors that remain after 12 months suggest that CDSMP delivered in small English-speaking groups produces health benefits for participants and would be a valuable part of comprehensive chronic disease management strategy.
Murphy, Louise; O'Colmain, Benita J.; Beauchesne, Danielle; Daniels, Brandy; Greenberg, Michael; House, Marnie; Chervin, Doryn
Expansion of ruminant-specific microRNAs shapes target gene expression divergence between ruminant and non-ruminant species
Background Understanding how species-specific microRNAs (miRNAs) contribute to species-specific phenotypes is a central topic in biology. This study aimed to elucidate the role of ruminant-specific miRNAs in shaping mRNA expression divergence between ruminant and non-ruminant species. Results We analyzed miRNA and mRNA transcriptomes generated by Illumina sequencing from whole blood samples of cattle and a closely related non-ruminant species, pig. We found evidence of expansion of cattle-specific miRNAs by analyzing miRNA conservation among 57 vertebrate species. The emergence of cattle-specific miRNAs was accompanied by accelerated sequence evolution at their target sites. Further, the target genes of cattle-specific miRNAs show markedly reduced expression compared to their pig and human orthologues. We found that target genes with conserved or non-conserved target sites of cattle-specific miRNAs exhibit reduced expression. One of the significantly enriched KEGG pathway terms for the target genes of the cattle-specific miRNAs is the insulin signalling pathway, raising the possibility that some of these miRNAs may modulate insulin resistance in ruminants. Conclusions We provide evidence of rapid miRNA-mediated regulatory evolution in the ruminant lineage. Cattle-specific miRNAs play an important role in shaping gene expression divergence between ruminant and non-ruminant species, by influencing the expression of targets genes through both conserved and cattle-specific target sites.
Oak Ridge National Laboratory Environmenal, Safety, and Health Management Plan
The 1990 Tiger Team Appraisal of Oak Ridge National Laboratory (ORNL) revealed that neither Martin Marietta Energy Systems, Inc. (Energy Systems) nor ORNL had a strategic plan for Environmental, Safety, and Health (ES H) activities. There were no detailed plans describing ORNL's mission, objectives, and strategies for ES H activities. A number of plans do exist that cover various aspects of ES H. Their scope ranges from multiyear program plans to annual audit schedules to compliance plans to action plans from specific audits. However, there is not a single document that identifies the plans and the objectives they are to address. This document describes the strategic plan for ORNL and provides the linkage among existing plans. It gives a brief description of the organization and management of ES H activities at ORNL. The plan identifies the general strategies to be taken by ORNL, using the overall guidance from Energy Systems in its corporate ES H Strategic Plan. It also identifies more detailed plans for implementation of these strategies, where appropriate.
Not Available
Oak Ridge National Laboratory Environmenal, Safety, and Health Management Plan
The 1990 Tiger Team Appraisal of Oak Ridge National Laboratory (ORNL) revealed that neither Martin Marietta Energy Systems, Inc. (Energy Systems) nor ORNL had a strategic plan for Environmental, Safety, and Health (ES&H) activities. There were no detailed plans describing ORNL`s mission, objectives, and strategies for ES&H activities. A number of plans do exist that cover various aspects of ES&H. Their scope ranges from multiyear program plans to annual audit schedules to compliance plans to action plans from specific audits. However, there is not a single document that identifies the plans and the objectives they are to address. This document describes the strategic plan for ORNL and provides the linkage among existing plans. It gives a brief description of the organization and management of ES&H activities at ORNL. The plan identifies the general strategies to be taken by ORNL, using the overall guidance from Energy Systems in its corporate ES&H Strategic Plan. It also identifies more detailed plans for implementation of these strategies, where appropriate.
Not Available
Integrated System Health Management (ISHM) Technology Demonstration Project Final Report
NASA Technical Reports Server (NTRS)
Integrated System Health Management (ISHM) is an essential capability that will be required to enable upcoming explorations mission systems such as the Crew Exploration Vehicle (CEV) and Crew Launch Vehicle (CLV), as well as NASA aeronautics missions. However, the lack of flight experience and available test platforms have held back the infusion by NASA Ames Research Center (ARC) and the Jet Propulsion Laboratory (JPL) of ISHM technologies into future space and aeronautical missions. To address this problem, a pioneer project was conceived to use a high-performance aircraft as a low-cost proxy to develop, mature, and verify the effectiveness of candidate ISHM technologies. Given the similarities between spacecraft and aircraft, an F/A-18 currently stationed at Dryden Flight Research Center (DFRC) was chosen as a suitable host platform for the test bed. This report describes how the test bed was conceived, how the technologies were integrated on to the aircraft, and how these technologies were matured during the project. It also describes the lessons learned during the project and a forward path for continued work.
Mackey, Ryan; Iverson, David; Pisanich, Greg; Toberman, Mike; Hicks, Ken
A Structural Model Decomposition Framework for Systems Health Management
NASA Technical Reports Server (NTRS)
Systems health management (SHM) is an important set of technologies aimed at increasing system safety and reliability by detecting, isolating, and identifying faults; and predicting when the system reaches end of life (EOL), so that appropriate fault mitigation and recovery actions can be taken. Model-based SHM approaches typically make use of global, monolithic system models for online analysis, which results in a loss of scalability and efficiency for large-scale systems. Improvement in scalability and efficiency can be achieved by decomposing the system model into smaller local submodels and operating on these submodels instead. In this paper, the global system model is analyzed offline and structurally decomposed into local submodels. We define a common model decomposition framework for extracting submodels from the global model. This framework is then used to develop algorithms for solving model decomposition problems for the design of three separate SHM technologies, namely, estimation (which is useful for fault detection and identification), fault isolation, and EOL prediction. We solve these model decomposition problems using a three-tank system as a case study.
Roychoudhury, Indranil; Daigle, Matthew J.; Bregon, Anibal; Pulido, Belamino
Controls and Health Management Technologies for Intelligent Aerospace Propulsion Systems
NASA Technical Reports Server (NTRS)
With the increased emphasis on aircraft safety, enhanced performance and affordability, and the need to reduce the environmental impact of aircraft, there are many new challenges being faced by the designers of aircraft propulsion systems. The Controls and Dynamics Technology Branch at NASA (National Aeronautics and Space Administration) Glenn Research Center (GRC) in Cleveland, Ohio, is leading and participating in various projects in partnership with other organizations within GRC and across NASA, the U.S. aerospace industry, and academia to develop advanced controls and health management technologies that will help meet these challenges through the concept of an Intelligent Engine. The key enabling technologies for an Intelligent Engine are the increased efficiencies of components through active control, advanced diagnostics and prognostics integrated with intelligent engine control to enhance component life, and distributed control with smart sensors and actuators in an adaptive fault tolerant architecture. This paper describes the current activities of the Controls and Dynamics Technology Branch in the areas of active component control and propulsion system intelligent control, and presents some recent analytical and experimental results in these areas.
Garg, Sanjay
Introduction to System Health Engineering and Management in Aerospace
NASA Technical Reports Server (NTRS)
This paper provides a technical overview of Integrated System Health Engineering and Management (ISHEM). We define ISHEM as "the paper provides a techniques, and technologies used to design, analyze, build, verify, and operate a system to prevent faults and/or minimize their effects." This includes design and manufacturing techniques as well operational and managerial methods. ISHEM is not a "purely technical issue" as it also involves and must account for organizational, communicative, and cognitive f&ms of humans as social beings and as individuals. Thus the paper will discuss in more detail why all of these elements, h m the technical to the cognitive and social, are necessary to build dependable human-machine systems. The paper outlines a functional homework and architecture for ISHEM operations, describes the processes needed to implement ISHEM in the system life-cycle, and provides a theoretical framework to understand the relationship between the different aspects of the discipline. It then derives from these and the social and cognitive bases a set of design and operational principles for ISHEM.
Johnson, Stephen B.
Integrated Vehicle Health Management (IVHM) for Aerospace Systems
NASA Technical Reports Server (NTRS)
To achieve NASA's ambitious Integrated Space Transportation Program objectives, aerospace systems will implement a variety of new concept in health management. System level integration of IVHM technologies for real-time control and system maintenance will have significant impact on system safety and lifecycle costs. IVHM technologies will enhance the safety and success of complex missions despite component failures, degraded performance, operator errors, and environment uncertainty. IVHM also has the potential to reduce, or even eliminate many of the costly inspections and operations activities required by current and future aerospace systems. This presentation will describe the array of NASA programs participating in the development of IVHM technologies for NASA missions. Future vehicle systems will use models of the system, its environment, and other intelligent agents with which they may interact. IVHM will be incorporated into future mission planners, reasoning engines, and adaptive control systems that can recommend or execute commands enabling the system to respond intelligently in real time. In the past, software errors and/or faulty sensors have been identified as significant contributors to mission failures. This presentation will also address the development and utilization of highly dependable sohare and sensor technologies, which are key components to ensure the reliability of IVHM systems.
Baroth, Edmund C.; Pallix, Joan
Advanced Health Management System for the Space Shuttle Main Engine
NASA Technical Reports Server (NTRS)
Pratt & Whitney Rocketdyne, Inc., in cooperation with NASA-Marshall Space Flight Center (MSFC), has developed a new Advanced Health Management System (AHMS) controller for the Space Shuttle Main Engine (SSME) that will increase the probability of successfully placing the shuttle into the intended orbit and increase the safety of the Space Transportation System (STS) launches. The AHMS is an upgrade o the current Block II engine controller whose primary component is an improved vibration monitoring system called the Real-Time Vibration Monitoring System (RTVMS) that can effectively and reliably monitor the state of the high pressure turbomachinery and provide engine protection through a new synchronous vibration redline which enables engine shutdown if the vibration exceeds predetermined thresholds. The introduction of this system required improvements and modification to the Block II controller such as redesigning the Digital Computer Unit (DCU) memory and the Flight Accelerometer Safety Cut-Off System (FASCOS) circuitry, eliminating the existing memory retention batteries, installation of the Digital Signal Processor (DSP) technology, and installation of a High Speed Serial Interface (HSSI) with accompanying outside world connectors. Test stand hot-fire testing along with lab testing have verified successful implementation and is expected to reduce the probability of catastrophic engine failures during the shuttle ascent phase and improve safely by about 23% according to the Quantitative Risk Assessment System (QRAS), leading to a safer and more reliable SSME.
Davidson, Matt; Stephens, John; Rodela, Chris
Intelligent model-based diagnostics for vehicle health management
NASA Astrophysics Data System (ADS)
The recent advances in sensor technology, remote communication and computational capabilities, and standardized hardware/software interfaces are creating a dramatic shift in the way the health of vehicles is monitored and managed. These advances facilitate remote monitoring, diagnosis and condition-based maintenance of automotive systems. With the increased sophistication of electronic control systems in vehicles, there is a concomitant increased difficulty in the identification of the malfunction phenomena. Consequently, the current rule-based diagnostic systems are difficult to develop, validate and maintain. New intelligent model-based diagnostic methodologies that exploit the advances in sensor, telecommunications, computing and software technologies are needed. In this paper, we will investigate hybrid model-based techniques that seamlessly employ quantitative (analytical) models and graph-based dependency models for intelligent diagnosis. Automotive engineers have found quantitative simulation (e.g. MATLAB/SIMULINK) to be a vital tool in the development of advanced control systems. The hybrid method exploits this capability to improve the diagnostic system"s accuracy and consistency, utilizes existing validated knowledge on rule-based methods, enables remote diagnosis, and responds to the challenges of increased system complexity. The solution is generic and has the potential for application in a wide range of systems.
Luo, Jianhui; Tu, Fang; Azam, Mohammad S.; Pattipati, Krishna R.; Willett, Peter K.; Qiao, Liu; Kawamoto, Masayuki
Propulsion Integrated Vehicle Health Management Technology Experiment (PITEX) Conducted
NASA Technical Reports Server (NTRS)
The Propulsion Integrated Vehicle Health Management (IVHM) Technology Experiment (PITEX) is a continuing NASA effort being conducted cooperatively by the NASA Glenn Research Center, the NASA Ames Research Center, and the NASA Kennedy Space Center. It was a key element of a Space Launch Initiative risk-reduction task performed by the Northrop Grumman Corporation in El Segundo, California. PITEX's main objectives are the continued maturation of diagnostic technologies that are relevant to second generation reusable launch vehicle (RLV) subsystems and the assessment of the real-time performance of the PITEX diagnostic solution. The PITEX effort has considerable legacy in the NASA IVHM Technology Experiment for X-vehicles (NITEX) that was selected to fly on the X-34 subscale RLV that was being developed by Orbital Sciences Corporation. NITEX, funded through the Future-X Program Office, was to advance the technology-readiness level of selected IVHM technologies within a flight environment and to begin the transition of these technologies from experimental status into RLV baseline designs. The experiment was to perform realtime fault detection and isolation and suggest potential recovery actions for the X-34 main propulsion system (MPS) during all mission phases by using a combination of system-level analysis and detailed diagnostic algorithms.
Maul, William A.; Chicatelli, Amy K.; Fulton, Christopher E.
Summary A dynamic model of fiber disappearance from the digestive tract of ruminants was developed based upon acceptable and defensi- ble concepts of fiber digestion and passage kinetics, and coefficients obtained from avail- able literature. The model has applicability, manageability and comparability to experi- mental observations. Although the model can stimulate the effects of some forage and animal characteristics upon
D. R. Mertens; L. O. Ely
[Model for evaluating plans for health service waste management (MPHSW) for use by local health and environmental protection authorities].
The inadequate management of the waste the health services are producing day by day and the considerable increase in quantity of this waste are increasingly posing hazards to the health of the population. Thus, the managers in charge of establishments that originate this waste should adopt a Management Plan for Health Service Waste - MPHSW. The main responsibility of guiding and monitoring the construction and implementation of the waste management plan falls on the local health and environmental protection authorities. This paper presents a model for a questionnaire to be used by the local authorities for analyzing the MPHSW of the health services in their respective jurisdictions. The result of this analysis (including graphs and tables with the percentages of questions fitting into each criterion set in advance) will be returned to the health institution with precise instructions for improving the quality of the plan. The necessary software is easily available and allows adapting the questionnaire to the conditions and needs of each municipality. The model provides parameters enabling the involved authorities to direct their capacity-building actions, allows quick evaluation of the MPHSWs and is easily updated. PMID:18833372
Zamoner, Maristela
Physico-chemical modifications of conjugated linoleic acid for ruminal protection and oxidative stability
Conjugated linoleic acid (CLA) is a mixture of positional and geometric isomers of octadecadienoic acid [linoleic acid (LA), 18:2n-6]. Although ruminant milk and meat products represent the largest natural source of CLA and therefore, their concentration in ruminant lipids are of interest to human health, chemical or physical modifications of CLA should be needed as a means to enhance oxidative stability, to improve post-ruminal bioavailability, and to increase the clinical application. In fact, CLA are rapidly decomposed to form furan fatty acids when its are oxidized in air, and the effectiveness of dietary supplements of CLA may be related to the extent that their metabolisms by rumen bacteria are avoided. For these reasons, many scientists have examined the effect of manufacturing and protection on the stability of CLA in ruminants and food products. In this review, physico-chemical modifications of CLA for ruminal protection such as calcium salt (Ca), formaldehyde protection (FP), lipid encapsulation (LE), and amide linkage (AL), and for oxidative stability such as green tea catechin (GTC), cyclodextrin (CD), arginine (Arg), amylase, and PEGylation are proposed.
Moon, Hyun-Seuk; Lee, Hong-Gu; Chung, Chung-Soo; Choi, Yun-Jaie; Cho, Chong-Su
Cost accounting, management control, and planning in health care.
Advantages and pharmacy applications of computerized hospital management-control and planning systems are described. Hospitals must define their product lines; patient cases, not tests or procedures, are the end product. Management involves operational control, management control, and strategic planning. Operational control deals with day-to-day management on the task level. Management control involves ensuring that managers use resources effectively and efficiently to accomplish the organization's objectives. Management control includes both control of unit costs of intermediate products, which are procedures and services used to treat patients and are managed by hospital department heads, and control of intermediate product use per case (managed by the clinician). Information from the operation and management levels feeds into the strategic plan; conversely, the management level controls the plan and the operational level carries it out. In the system developed at New England Medical Center, Boston, Massachusetts, the intermediate product-management system enables managers to identify intermediate products, develop standard costs, simulate changes in departmental costs, and perform variance analysis. The end-product management system creates a patient-level data-base, identifies end products (patient-care groupings), develops standard resource protocols, models alternative assumptions, performs variance analysis, and provides concurrent reporting. Examples are given of pharmacy managers' use of such systems to answer questions in the areas of product costing, product pricing, variance analysis, productivity monitoring, flexible budgeting, modeling and planning, and comparative analysis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3284338
Siegrist, R B; Blish, C S
9 CFR 93.422 - Import permit and declaration for ruminants.
Code of Federal Regulations, 2010 CFR
...false Import permit and declaration for ruminants. 93.422 Section 93.422 Animals...CONVEYANCE AND SHIPPING CONTAINERS Ruminants Central America and West Indies 9...422 Import permit and declaration for ruminants. (a) For ruminants intended...
9 CFR 93.423 - Ruminants from Central America and the West Indies.
Code of Federal Regulations, 2010 CFR
... Ruminants from Central America and the West Indies. 93.423 Section 93.423...CONTAINERS Ruminants Central America and West Indies 9 § 93.423 Ruminants from Central America and the West Indies. (a) Ruminants...
Effects of Thymol on Ruminal Microorganisms
Thymol (5-methyl-2-isopropylphenol) is a phenolic compound that is used to inhibit oral bacteria. Because little is known\\u000a regarding the effects of this compound on ruminal microorganisms, the objective of this study was to determine the effects\\u000a of thymol on growth and lactate production by the ruminal bacteria Streptococcus bovis JB1 and Selenomonas ruminantium HD4. In addition, the effect of thymol
Jeff D. Evans; Scott A. Martin
Forgivingness, Vengeful Rumination, and Affective Traits
ABSTRACT Trait forgivingness is the disposition to forgive interper- sonal transgressions over time and across situations. We define forgive- ness as the replacement of negative unforgiving emotions with positive, other-oriented emotions. Rumination,has been suggested as a mediator between forgivingness and emotional outcomes; however, we suggest that different content of rumination,leads to different outcomes,after trans- gressions. In four studies of 179,
Jack W. Berry; Everett L. Worthington; Lynn E. O'Connor; Les Parrott III; Nathaniel G. Wade
Toward an understanding of competency identification and assessment in health care management.
Given the revolutionary changes occurring in the health care industry, there is increasing agreement that academicians and practitioners must collaborate to identify and prioritize major educational outcomes for health care management. Several competency initiatives have been undertaken or completed in health care and health care management in the last 5 to 7 years. Health care leaders who have undertaken such endeavors reveal that the task is most formidable. This article provides: (1) a summary of progress in competency identification for health management, (2) an historical overview on competency-based education and assessment, (3) a glossary of terms used in discussions on competency-based education and training, and (4) an outline of the challenges and benefits associated with competency modeling. PMID:12455340
Calhoun, Judith G; Davidson, Pamela L; Sinioris, Marie E; Vincent, Eric T; Griffith, John R
A Survey of Health Management User Objectives Related to Diagnostic and Prognostic Metrics
NASA Technical Reports Server (NTRS)
One of the most prominent technical challenges to effective deployment of health management systems is the vast difference in user objectives with respect to engineering development. In this paper, a detailed survey on the objectives of different users of health management systems is presented. These user objectives are then mapped to the metrics typically encountered in the development and testing of two main systems health management functions: diagnosis and prognosis. Using this mapping, the gaps between user goals and the metrics associated with diagnostics and prognostics are identified and presented with a collection of lessons learned from previous studies that include both industrial and military aerospace applications.
Wheeler, Kevin R.; Kurtoglu, Tolga; Poll, Scott D.
Environmental drift in health center dental practice management.
Federally qualified health centers, FQHCs, face a number of challenges providing low-cost health services and meeting their primary mission of being available to all users regardless of their ability to pay. In effect, health centers must provide services that border on free to minimal revenue-generating potential. This is especially challenging for health centers providing dental services that are often more costly on a case-by-case visit encounter than primary care services.. PMID:19831007
Russell, Bob
How do health service managers respond to qualitative research?
During 1992 a qualitative evaluation of a government health service-run community health worker (CHW) project in South Africa found that project workers were doing good work despite serious structural shortcomings related to lack of community participation and inadequate integration of the project in the health district system. Recommendations were made to develop the project in order to enhance community involvement,
Hester Van der Walt; Catherine Mathews
Mobile Mining and Information Management in HealthNet Scenarios
Health and mobility of elderly people is gaining im- portance in aging societies. New communication-based methods to provide health services with personal health care devices are considered promising elements of first-class medical care services for everybody. To achieve this vision, several technological issues have to be solved: (i) body sensors to monitor vital functions have to be developed; (ii) these
Philipp Kranen; David Kensche; Saim Kim; Nadine Zimmermann; Emmanuel Müller; Christoph Quix; Xiang Li; Thomas Gries; Thomas Seidl; Matthias Jarke; Steffen Leonhardt
Teaching Conflict Management Skills to the Health Care Professionals.
ERIC Educational Resources Information Center
The health care organization, as a specialized organizational setting, has some characteristics that make it of special concern to the conflict theorist. In a health care setting, conflict may arise as a result of (1) the complexity of medicine and the bureaucracy of health care delivery, (2) the problems of acquiring relevant information from…
Wilcox, James R.; And Others
77 FR 41986 - Division of Nursing, Public Health Nursing Community Based Model of PHN Case Management Services
Federal Register 2010, 2011, 2012, 2013
...Service Division of Nursing, Public Health Nursing Community Based Model...OCPS), Community Based Model of Public Health Nursing Case Management Services...Act, 42 U.S.C. 2011; the Public Health Service Act, as amended,...
29 CFR 1420.1 - Functions of the Service in health care industry bargaining under the Labor-Management Relations...
Code of Federal Regulations, 2013 CFR
...false Functions of the Service in health care industry bargaining under the Labor-Management...CONCILIATION SERVICE-ASSISTANCE IN THE HEALTH CARE INDUSTRY § 1420.1 Functions of the Service in health care industry bargaining under the...
Clinical risk management in mental health: a qualitative study of main risks and related organizational management practices
Background A scientific understanding of clinical risk management (CRM) in mental health care is essential for building safer health systems and for improving patient safety. While evidence on patient safety and CRM in physical health care has increased, there is limited research on these issues in mental health care. This qualitative study provides an overview of the most important clinical risks in mental health and related organizational management practices. Methods We conducted in-depth expert interviews with professionals responsible for CRM in psychiatric hospitals. Interviews were transcribed and analyzed applying qualitative content analysis to thematically sort the identified risks. Results The main concerns for CRM in mental health are a) violence and self-destructive behavior (i.e. protecting patients and staff from other patients, and patients from themselves), b) treatment errors, especially in the process of therapy, and c) risks associated with mental illnesses (e.g. psychosis or depression). This study identified critical differences to CRM in hospitals for physical disorder and challenges specific to CRM in mental health. Firstly, many psychiatric patients do not believe that they are ill and are therefore in hospital against their will. Secondly, staff safety is a much more prominent theme for CRM in mental health care as it is directly related to the specifics of mental illnesses. Conclusions The current study contributes to the understanding of patient safety and raises awareness for CRM in mental health. The mental health specific overview of central risks and related organizational management practices offers a valuable basis for CRM development in mental health and an addition to CRM in general.
Turning point revisited: launching the next generation of performance management in public health.
A decade ago, the Turning Point Performance Management Excellence Collaborative (Turning Point) developed the first public health-specific performance management (PM) system, with accompanying resource materials, assisted by the Public Health Foundation. Since then, dramatic advancements in PM and quality improvement activities have occurred in public health. Public Health Foundation gathered data that revealed Turning Point was still relevant but difficult to implement within public health. To reflect recent advances and current challenges, Public Health Foundation refreshed the Turning Point model and related guidance tools and developed new resources to facilitate PM implementation. In addition, a new fifth component, "Visible Leadership," was added to the 4-quadrant model and the Self-Assessment Tool. In the future, public health organizations should take an active leadership role in innovating and sustaining PM systems, ensuring they become accountable for producing outcomes, leveraging technology advances, and incorporating best practices from all stakeholders. PMID:25068709
DeAngelo, Julia W; Beitsch, Leslie M; Beaudry, Margaret L; Corso, Liza C; Estes, Larissa J; Bialek, Ron G
Recent developments in altering the fatty acid composition of ruminant-derived foods.
There is increasing evidence to indicate that nutrition is an important factor involved in the onset and development of several chronic human diseases including cancer, cardiovascular disease (CVD), type II diabetes and obesity. Clinical studies implicate excessive consumption of medium-chain saturated fatty acids (SFA) and trans-fatty acids (TFA) as risk factors for CVD, and in the aetiology of other chronic conditions. Ruminant-derived foods are significant sources of medium-chain SFA and TFA in the human diet, but also provide high-quality protein, essential micronutrients and several bioactive lipids. Altering the fatty acid composition of ruminant-derived foods offers the opportunity to align the consumption of fatty acids in human populations with public health policies without the need for substantial changes in eating habits. Replacing conserved forages with fresh grass or dietary plant oil and oilseed supplements can be used to lower medium-chain and total SFA content and increase cis-9 18:1, total conjugated linoleic acid (CLA), n-3 and n-6 polyunsaturated fatty acids (PUFA) to a variable extent in ruminant milk. However, inclusion of fish oil or marine algae in the ruminant diet results in marginal enrichment of 20- or 22-carbon PUFA in milk. Studies in growing ruminants have confirmed that the same nutritional strategies improve the balance of n-6/n-3 PUFA, and increase CLA and long-chain n-3 PUFA in ruminant meat, but the potential to lower medium-chain and total SFA is limited. Attempts to alter meat and milk fatty acid composition through changes in the diet fed to ruminants are often accompanied by several-fold increases in TFA concentrations. In extreme cases, the distribution of trans 18:1 and 18:2 isomers in ruminant foods may resemble that of partially hydrogenated plant oils. Changes in milk fat or muscle lipid composition in response to diet are now known to be accompanied by tissue-specific alterations in the expression of one or more lipogenic genes. Breed influences both milk and muscle fat content, although recent studies have confirmed the occurrence of genetic variability in transcript abundance and activity of enzymes involved in lipid synthesis and identified polymorphisms for several key lipogenic genes in lactating and growing cattle. Although nutrition is the major factor influencing the fatty acid composition of ruminant-derived foods, further progress can be expected through the use of genomic or marker-assisted selection to increase the frequency of favourable genotypes and the formulation of diets to exploit this genetic potential. PMID:23031638
Shingfield, K J; Bonnet, M; Scollan, N D
The impact of managed care on community mental health outpatient services in New York State.
This article explores the impact of managed care on community mental health outpatient services in New York State. A survey was sent to directors of all the licensed mental health organizations to obtain information about staff composition, services provided, training, funding, managed care affiliations, and advertising. The survey focus was on changes that had taken place in the past 4 years and those anticipated in the future due to managed care. Results indicate that managed care has led to changes in the aforementioned areas and that these changes varied by agency size, region, and type. PMID:9385715
Cypres, A; Landsberg, G; Spellmann, M
Advances in pasture management for animal productivity and health
A wide range of management techniques is available to enhance quantity and quality of forage supply to grazing animals throughout the annual production cycle. Within broad limits, dry matter (DM) production is relatively insensitive to management of defoliation frequency, severity and duration. However defoliation management has effects on feed quality which can be enhanced, in particular, by control of pasture
MG Lambert; DA Clark; AJ Litherland
Health resources management and physician control in a San Francisco, California, hospital.
The continued escalation in health care spending has caused money to become an increasingly limited resource, which may eventually affect the ability of health professionals to provide complete health care services. Health care payers have stressed efficiency and the appropriateness of health care measures and are putting greater financial pressures on health professionals by making them more accountable for services provided. Hospitals and physicians must take a more active role in monitoring health care delivery and work together to improve performance efficiency. Efficiency can be gained through a comprehensive program that emphasizes high-quality care and the effective use of health care resources. The Health Resource Management Program is a model for carrying out this function that integrates data analysis and physician input and education. Images
Rosenstein, A. H.; Stier, M. M.
Identifying management competencies for health care executives: review of a series of Delphi studies.
This analysis reviews a selected body of research that identifies the essential areas of management expertise required of future health care executives. To ensure consistency, six studies are analyzed, utilizing the Delphi technique, to query a broad spectrum of experts in different fields and sites of health care management. The analysis identifies a number of management competencies, i.e., managerial capabilities, which current and aspiring health care executives, in various settings and with differing educational backgrounds, should possess to enhance the probability of their success in current and future positions of responsibility. In addition, this review identifies the skills (technical expertise), knowledge (facts and principles) and abilities (physical, mental or legal power) required to support achievement of these competencies. Leadership and resource management, including cost and finance dimensions, are the highest-rated requisite management competencies. The dominant skills, knowledge and abilities (SKAs) are related to interpersonal skills. The lowest-rated SKAs are related to job-specific, technical skills. Recommendations include the review of this research by formal and continuing education programs to determine the content of their courses and areas for future research. Similarly, current health care executives should assess this research to assist in identifying competency gaps. Lastly, this analysis recommends that the Delphi technique, as a valid and replicable methodology, be applied toward the study of non-executive health care managers, e.g., students, clinicians, mid-level managers and integrated systems administrators, to determine their requisite management competencies and SKAs. PMID:11183260
Hudak, R P; Brooke, P P; Finstuen, K
Making It Local: Beacon Communities Use Health Information Technology to Optimize Care Management
Abstract Care management aims to provide cost-effective, coordinated, non-duplicative care to improve care quality, population health, and reduce costs. The 17 communities receiving funding from the Office of the National Coordinator for Health Information Technology through the Beacon Community Cooperative Agreement Program are leaders in building and strengthening their health information technology (health IT) infrastructure to provide more effective and efficient care management. This article profiles 6 Beacon Communities' health IT-enabled care management programs, highlighting the influence of local context on program strategy and design, and describing challenges, lessons learned, and policy implications for care delivery and payment reform. The unique needs (eg, disease burden, demographics), community partnerships, and existing resources and infrastructure all exerted significant influence on the overall priorities and design of each community's care management program. Though each Beacon Community needed to engage in a similar set of care management tasks—including patient identification, stratification, and prioritization; intervention; patient engagement; and evaluation—the contextual factors helped shape the specific strategies and tools used to carry out these tasks and achieve their objectives. Although providers across the country are striving to deliver standardized, high-quality care, the diverse contexts in which this care is delivered significantly influence the priorities, strategies, and design of community-based care management interventions. Gaps and challenges in implementing effective community-based care management programs include: optimizing allocation of care management services; lack of available technology tailored to care management needs; lack of standards and interoperability; integrating care management into care settings; evaluating impact; and funding and sustainability. (Population Health Management 2014;17:149–158)
Allen, Amy; Des Jardins, Terrisca R.; Heider, Arvela; Kanger, Chatrian R.; Lobach, David F.; McWilliams, Lee; Polello, Jennifer M.; Schachter, Abigail A.; Singh, Ranjit; Sorondo, Barbara; Tulikangas, Megan C.; Turske, Scott A.
Making it local: beacon communities use health information technology to optimize care management.
Abstract Care management aims to provide cost-effective, coordinated, non-duplicative care to improve care quality, population health, and reduce costs. The 17 communities receiving funding from the Office of the National Coordinator for Health Information Technology through the Beacon Community Cooperative Agreement Program are leaders in building and strengthening their health information technology (health IT) infrastructure to provide more effective and efficient care management. This article profiles 6 Beacon Communities' health IT-enabled care management programs, highlighting the influence of local context on program strategy and design, and describing challenges, lessons learned, and policy implications for care delivery and payment reform. The unique needs (eg, disease burden, demographics), community partnerships, and existing resources and infrastructure all exerted significant influence on the overall priorities and design of each community's care management program. Though each Beacon Community needed to engage in a similar set of care management tasks-including patient identification, stratification, and prioritization; intervention; patient engagement; and evaluation-the contextual factors helped shape the specific strategies and tools used to carry out these tasks and achieve their objectives. Although providers across the country are striving to deliver standardized, high-quality care, the diverse contexts in which this care is delivered significantly influence the priorities, strategies, and design of community-based care management interventions. Gaps and challenges in implementing effective community-based care management programs include: optimizing allocation of care management services; lack of available technology tailored to care management needs; lack of standards and interoperability; integrating care management into care settings; evaluating impact; and funding and sustainability. (Population Health Management 2014;17:149-158). PMID:24476558
Allen, Amy; Des Jardins, Terrisca R; Heider, Arvela; Kanger, Chatrian R; Lobach, David F; McWilliams, Lee; Polello, Jennifer M; Rein, Alison L; Schachter, Abigail A; Singh, Ranjit; Sorondo, Barbara; Tulikangas, Megan C; Turske, Scott A
Health services use and prescription access among uninsured patients managing chronic diseases.
Effective chronic condition management is dependent upon prescription medication access and compliance. Impacted access results in increased pain, worsening of the condition and association of additional health-related problems. Prescription medication costs constitute a significant burden for patients who are uninsured and managing chronic conditions. This burden links to the likelihood of medication non-compliance. The purpose of this research was to test the ability of the Andersen Behavioral Model of Health Services Use to examine health behaviors among adult uninsured patients managing physician-diagnosed chronic conditions. To enhance its chronic disease management model for uninsured patients diagnosed with chronic conditions requiring prescription regimens, a local community health center added a pharmaceutical access component to its health care delivery model. The Andersen Behavioral Model of Health Services Use was employed to gain insight on how the predictors of predisposing, enabling and need factors impact the change in clinical outcomes and the number of non-urgent triage telephone encounters, physician visits, and emergency department visits of each uninsured patient diagnosed with a chronic condition requiring prescription medication treatment and receiving care at this facility. Individual health behavior patterns are based on predisposition to care, factors that impede or enable the use of care and overall need for care. In this study, there was a statistically significant relationship between population characteristics and health behavior; between health behavior and outcomes; and between population characteristics and outcomes. PMID:24338075
Shepherd, Jewel Goodman; Locke, Elizabeth; Zhang, Qi; Maihafer, George
Alzheimer's Disease: Managing the Later Stages in the Health Care Setting.
National Technical Information Service (NTIS)
The videotape provides professional caregivers with information to help them effectively manage problems associated with the later stages of Alzheimer's disease in the health care setting. It focuses on 4 key areas of patient care: how to establish a safe...
Review of ?Managing Arsenic in the Environment: From Soil to Hman Health?
This is a book review of "Managing Arsenic in the Environment: From Soil to Human Health," R. Naidu, E. Smith, G. Owens, P. Bhattacharya, and P. Nadebaum eds., CSIRO Publishing, Melbourne, Australia, 656 pp.,...
Systems Engineering Processes for the Acquisition of Prognostic and Health Management Systems.
National Technical Information Service (NTIS)
Prognostic and Health Management (PHM) systems often experience delayed fielding and lengthened maturation cycles due to their relative immaturity and their status as non-flight critical systems. The national fiscal crisis and rising debt of the United St...
M. P. Begin
Vehicle Integrated Propulsion Research for the Study of Health Management Capabilities
NASA Technical Reports Server (NTRS)
Presentation on vehicle integrated propulsion research results and planning. This research emphasizes the testing of advanced health management sensors and diagnostics in an aircraft engine that is operated through multiple baseline and fault conditions.
Lekki, John D.; Simon, Donald L.; Hunter, Gary W.; Woike, Mary; Tokars, Roger P.
Management Information System for Community Mental Health Centers. Volume I: Requirements Statement.
National Technical Information Service (NTIS)
The purpose of this report is to state the information requirements of Community Mental Health Centers (CMHCs) and to identify those which can be supported by an automated Management Information System (MIS). This requirements analysis contains a descript...
Promoting Geriatric Self-Care: Enhancing the Management of Chronic Health Problems.
National Technical Information Service (NTIS)
The Univ. of Rhode Island developed the project to refine a model educational program to encourage older persons to assume more responsibility for managing their health-related behavior with regard to arthritis, diabetes, and heart disease. Products devel...
R. J. Marshall P. G. Clark
CRCHD Geographical Management of Cancer Health Disparities Program (GMaP)
GEOGRAPHICAL MANAGEMENT OF CANCER HEALTH DISPARITIES PROGRAM (GMaP) Overview Developed with American Recovery and Reinvestment Act administrative supplements, GMaP is a national program that links CRCHD's flagship programs (the Comprehensive Partnership
Constructing an Efficient Self-Tuning Aircraft Engine Model for Control and Health Management Applications.
National Technical Information Service (NTIS)
Self-tuning aircraft engine models can be applied for control and health management applications. The self-tuning feature of these models minimizes the mismatch between any given engine and the underlying engineering model describing an engine family. Thi...
D. L. Simon J. B. Armstrong
Study of Public Sector Comprehensive Health Planning as a Management Function.
National Technical Information Service (NTIS)
A study was conducted at the University of Texas to: (1) examine the management effectiveness of public sector comprehensive health planning; and (2) test the hypothesis that the underlying principles of business planning models can be applied to public s...
H. Nesenholtz
How Grantees Manage of Interest in Research Funded by the National Institutes of Health.
National Technical Information Service (NTIS)
To determine the nature of financial conflicts of interest reported by grantee institutions to the National Institutes of Health (NIH) in fiscal year (FY) 2006. To determine how grantee institutions managed, reduced, or eliminated these financial conflict...
Fiscal Issues for the District of Columbia Behavioral Health Managed Care Initiative Demonstration Development. Volume 1.
National Technical Information Service (NTIS)
This is the report of a project to assist the District of Columbia in developing the budget model for the Distrct's initiatives in managed behavioral health care. The District needed better information on proposed rates for acute care services, particular...
Financial Management Information System for Health Maintenance Organizations. Volume III: Accounting Principles, Standards, and Controls.
National Technical Information Service (NTIS)
Accounting principles associated with a financial management information system (FMIS) for health maintenance organizations (HMO's) are detailed. The accounting structure for the FMIS uses the double entry system. It is designed to disclose the full range...
A Cryogenic Fluid System Simulation in Support of Integrated Systems Health Management
NASA Technical Reports Server (NTRS)
Simulations serve as important tools throughout the design and operation of engineering systems. In the context of sys-tems health management, simulations serve many uses. For one, the underlying physical models can be used by model-based health management tools to develop diagnostic and prognostic models. These simulations should incorporate both nominal and faulty behavior with the ability to inject various faults into the system. Such simulations can there-fore be used for operator training, for both nominal and faulty situations, as well as for developing and prototyping health management algorithms. In this paper, we describe a methodology for building such simulations. We discuss the design decisions and tools used to build a simulation of a cryogenic fluid test bed, and how it serves as a core technology for systems health management development and maturation.
Barber, John P.; Johnston, Kyle B.; Daigle, Matthew
Managed Care, Access to Mental Health Specialists, and Outcomes Among Primary Care Patients with Depressive Symptoms
OBJECTIVE To determine whether managed care is associated with reduced access to mental health specialists and worse outcomes among primary care patients with depressive symptoms. DESIGN Prospective cohort study. SETTING Offices of 261 primary physicians in private practice in Seattle. PATIENTS Patients (N = 17,187) were screened in waiting rooms, enrolling 1,336 adults with depressive symptoms. Patients (n = 942) completed follow-up surveys at 1, 3, and 6 months. MEASUREMENTS AND RESULTS For each patient, the intensity of managed care was measured by the managedness of the patient's health plan, plan benefit indexes, presence or absence of a mental health carve-out, intensity of managed care in the patient's primary care office, physician financial incentives, and whether the physician read or used depression guidelines. Access measures were referral and actually seeing a mental health specialist. Outcomes were the Symptom Checklist for Depression, restricted activity days, and patient rating of care from primary physician. Approximately 23% of patients were referred to mental health specialists, and 38% saw a mental health specialist with or without referral. Managed care generally was not associated with a reduced likelihood of referral or seeing a mental health specialist. Patients in more-managed plans were less likely to be referred to a psychiatrist. Among low-income patients, a physician financial withhold for referral was associated with fewer mental health referrals. A physician productivity bonus was associated with greater access to mental health specialists. Depressive symptom and restricted activity day outcomes in more-managed health plans and offices were similar to or better than less-managed settings. Patients in more-managed offices had lower ratings of care from their primary physicians. CONCLUSIONS The intensity of managed care was generally not associated with access to mental health specialists. The small number of managed care strategies associated with reduced access were offset by other strategies associated with increased access. Consequently, no adverse health outcomes were detected, but lower patient ratings of care provided by their primary physicians were found.
Grembowski, David E; Martin, Diane; Patrick, Donald L; Diehr, Paula; Katon, Wayne; Williams, Barbara; Engelberg, Ruth; Novak, Louise; Dickstein, Deborah; Deyo, Richard; Goldberg, Harold I
How many ruminal bacteria are there?
With the development of strictly anaerobic techniques and habitat-simulating media, a variety of bacteria were isolated from the rumen in the 1940s and 1950s. Based on standard morphological and physiological characteristics, the microbial ecosystem of the rumen contains a very complex population of bacteria. In recent years, ruminal bacteria have been re-evaluated with newer, more objective, and genetically valid methods of classification. Ribosomes are complicated structures, and their DNA-encoding sequences are relatively free from selective pressure. Because ribosomes have evolved slowly, they provide a long-term natural history of evolution. The invariable and hypervariable regions of rRNA genes can be used to group bacteria into kingdoms, genera, and species. The 16S rRNA sequences have provided a basis for renaming some ruminal species (Bacteroides amylophilus is now Ruminobacter amylophilus and Bacteroides succinogenes is now Fibrobacter succinogenes) and for classifying at least one recently isolated ruminal bacterium (e.g., Clostridium aminophilum). The DNA:DNA hybridization is a more sensitive method of assessing bacterial relatedness than is 16S rRNA. Bacterial strains within a species should have a high degree of DNA:DNA homology, but some species of ruminal bacteria (e.g., Prevotella ruminicola and Butyrivibrio fibrisolvens) had highly unrelated strains. Studies of 16S rRNA and DNA:DNA hybridization indicate that the diversity of ruminal bacteria has been greatly underestimated. Traditional studies of phylogeny of ruminal bacteria were stymied by the fastidious growth requirements of many ruminal bacteria, and enumeration was tedious and inaccurate. Modern methods of bacterial classification do not require in vitro culture and have the potential of detecting even a single cell. PMID:8880472
Krause, D O; Russell, J B
Utilizing a nurse practitioner to enhance diabetes management programs in home health.
There are challenges in caring for patients with diabetes. Home health should utilize nurse practitioners who have specialty diabetes programs for homebound individuals within their practice. Agencies benefit from designing specific disease management program models that provide standardized delivery of care with defined outcomes that can be evaluated for program effectiveness. Collaboration between programs like DOS and chronic disease management programs within home health agencies can achieve optimal patient outcomes and potential cost savings. PMID:19266749
Litchman, Michelle; Hartman, Amy; Reed, Pat
Improving health research governance and management in the Western Pacific: a WHO expert consultation.
Repeated calls have been made in recent decades to increase investments in health research, especially in low- and middle-income countries (LMIC). However, the perceived low relevance and quality of health research, poor visibility of outputs, and difficulties in tracking current levels of and returns on investments have undermined efforts to advocate for additional investments in these countries. Some of these issues emanate from inadequate governance and management systems for health research at the national level, which are ineffective in tracking and steering the research portfolio and investments, ensuring quality, and facilitating access to research outputs. In spite of this, the value, necessity, and cost of performing health research management and governance functions are not well appreciated, especially in LMIC. To address this, the World Health Organization (WHO) Regional Office for the Western Pacific organized an expert consultation in August 2011, involving experts from 14 of its developed and developing member states and from leading research organizations such as the Wellcome Trust. The consultation identified essential health research governance and management functions that must be performed by appropriate organizational entities to maximize returns on health research investments. In addition, three specific areas for intervention were considered: (1) prospective research registration in publicly accessible national health research registries; (2) systematic health research data archiving and wider access; and (3) national research ethics systems. A consensus was reached on the need to invest more in essential health research and management functions, including establishing publicly accessible web-based national health research registries for prospective registration of health research, setting up systems to archive and share health research data, and improving the governance of research ethics committees. The consultation also concluded that the costs of performing these functions are legitimate and necessary research costs that must be shouldered by research funding organizations. PMID:23672750
Rani, Manju; Bekedam, Hendrik; Buckley, Brian S
The effect of health promotion on diagnosis and management of diabetes
Background Undiagnosed disease is one of the critical public health problems in the world. In 2002 South Korean introduced the nation's first comprehensive public health promotion policy, Health Plan 2010. The first phase of Health Plan 2010 started in 2002, promoting early detection of diseases and preventative care and continued until 2005. Methods Using the 2001 and 2005 Korean National Health and Nutrition Examination Surveys that were fielded before and after the health promotion program, we investigate changes in health care utilization and its impacts on the prevalence of diagnosed and undiagnosed diabetes as well as the good management of the disease. Results A significant rise in diabetes diagnoses has occurred during this time period, especially for those with low education and older age. We find that, during this time period, the prevalence of undiagnosed diabetes was significantly reduced especially among older and less educated Koreans, the principal targets of the program. We also find that this health promotion had significant positive effects on good management of diabetes. Conclusions The increase of preventative health care through medical check-up among less-educated, older people suggests that the implementation of free medical check-ups for age 40 and older may have a positive impact on those who had not previously used preventative care. The positive experience in South Korea indicates that similarly designed public health campaigns in other countries have enormous potential in improving the detection and management of chronic disease.
Lee, Jinkook; Smith, James P.
Nutrition Training Improves Health Workers' Nutrition Knowledge and Competence to Manage Child Undernutrition: A Systematic Review
Background: Medical and nursing education lack adequate practical nutrition training to fit the clinical reality that health workers face in their practices. Such a deficit creates health workers with poor nutrition knowledge and child undernutrition management practices. In-service nutrition training can help to fill this gap. However, no systematic review has examined its collective effectiveness. We thus conducted this study to examine the effectiveness of in-service nutrition training on health workers' nutrition knowledge, counseling skills, and child undernutrition management practices. Methods: We conducted a literature search on nutrition interventions from PubMed/MEDLINE, CINAHL, EMBASE, ISI Web of Knowledge, and World Health Organization regional databases. The outcome variables were nutrition knowledge, nutrition-counseling skills, and undernutrition management practices of health workers. Due to heterogeneity, we conducted only descriptive analyses. Results: Out of 3910 retrieved articles, 25 were selected as eligible for the final analysis. A total of 18 studies evaluated health workers' nutrition knowledge and showed improvement after training. A total of 12 studies with nutrition counseling as the outcome variable also showed improvement among the trained health workers. Sixteen studies evaluated health workers' child undernutrition management practices. In all such studies, child undernutrition management practices and competence of health workers improved after the nutrition training intervention. Conclusion: In-service nutrition training improves quality of health workers by rendering them more knowledge and competence to manage nutrition-related conditions, especially child undernutrition. In-service nutrition training interventions can help to fill the gap created by the lack of adequate nutrition training in the existing medical and nursing education system. In this way, steps can be taken toward improving the overall nutritional status of the child population.
Sunguya, Bruno F.; Poudel, Krishna C.; Mlunde, Linda B.; Urassa, David P.; Yasuoka, Junko; Jimba, Masamine
Sensing and Knowledge Mining for Structural Health Management
NASA Astrophysics Data System (ADS)
Current economic conditions necessitate the extension of service lives for a variety of aerospace systems. As a result, there is an increased need for structural health management (SHM) systems to increase safety, extend life, reduce maintenance costs, and minimize downtime, lowering life cycle costs for these aging systems. The implementation of such a system requires a collaborative research effort in a variety of areas such as novel sensing techniques, robust algorithms for damage interrogation, high fidelity probabilistic progressive damage models, and hybrid residual life estimation models. This dissertation focuses on the sensing and damage estimation aspects of this multidisciplinary topic for application in metallic and composite material systems. The primary means of interrogating a structure in this work is through the use of Lamb wave propagation which works well for the thin structures used in aerospace applications. Piezoelectric transducers (PZTs) were selected for this application since they can be used as both sensors and actuators of guided waves. Placement of these transducers is an important issue in wave based approaches as Lamb waves are sensitive to changes in material properties, geometry, and boundary conditions which may obscure the presence of damage if they are not taken into account during sensor placement. The placement scheme proposed in this dissertation arranges piezoelectric transducers in a pitch-catch mode so the entire structure can be covered using a minimum number of sensors. The stress distribution of the structure is also considered so PZTs are placed in regions where they do not fail before the host structure. In order to process the data from these transducers, advanced signal processing techniques are employed to detect the presence of damage in complex structures. To provide a better estimate of the damage for accurate life estimation, machine learning techniques are used to classify the type of damage in the structure. A data structure analysis approach is used to reduce the amount of data collected and increase computational efficiency. In the case of low velocity impact damage, fiber Bragg grating (FBG) sensors were used with a nonlinear regression tool to reconstruct the loading at the impact site.
Coelho, Clyde
Sensor Needs for Control and Health Management of Intelligent Aircraft Engines
NASA Technical Reports Server (NTRS)
NASA and the U.S. Department of Defense are conducting programs which support the future vision of "intelligent" aircraft engines for enhancing the affordability, performance, operability, safety, and reliability of aircraft propulsion systems. Intelligent engines will have advanced control and health management capabilities enabling these engines to be self-diagnostic, self-prognostic, and adaptive to optimize performance based upon the current condition of the engine or the current mission of the vehicle. Sensors are a critical technology necessary to enable the intelligent engine vision as they are relied upon to accurately collect the data required for engine control and health management. This paper reviews the anticipated sensor requirements to support the future vision of intelligent engines from a control and health management perspective. Propulsion control and health management technologies are discussed in the broad areas of active component controls, propulsion health management and distributed controls. In each of these three areas individual technologies will be described, input parameters necessary for control feedback or health management will be discussed, and sensor performance specifications for measuring these parameters will be summarized.
Simon, Donald L.; Gang, Sanjay; Hunter, Gary W.; Guo, Ten-Huei; Semega, Kenneth J.
Smartphone interventions for long-term health management of chronic diseases: an integrative review.
Abstract Introduction: Long-term health management is challenging for the rapidly growing number of patients with chronic diseases. Smartphone interventions offer promising solutions. This article presents features of smartphone interventions for long-term chronic condition management, illustrating how these applications benefit patients with chronic diseases. Materials and Methods: Systematic searches for smartphone health interventions were conducted in five publication databases. Articles were included only if (1) the smartphone application (app) was exclusively developed for patients with chronic diseases and (2) the article incorporated a defined outcome measurement to evaluate the effects of the implemented intervention. Sixteen articles were included in the final review, including studies in diabetes, mental health problems, overweight, cancer, and chronic obstructive pulmonary disease. Results: These studies found that the smartphone intervention was a completely or at least partially effective tool to assist in managing some chronic diseases. With the help of health-related smartphone apps, patients with chronic conditions (1) felt secure in the knowledge that their illnesses were closely monitored, (2) participated in their own health management more effectively, and (3) felt that they had not been forgotten by their doctors and were taken good care of even outside the hospital/clinic. Conclusions: However, there are limited smartphone apps for the long-term health management of chronic diseases. More smartphone apps need to be developed to help people manage chronic diseases. PMID:24787747
Wang, Jingting; Wang, Yuanyuan; Wei, Chunlan; Yao, Nengliang Aaron; Yuan, Avery; Shan, Yuying; Yuan, Changrong
Management of health system reform: a view of changes within New Zealand.
This paper reports on the context and process of health system reform in New Zealand. The study is based on interviews conducted with 31 managers from three Crown Health Enterprises (publicly funded hospital-based health care organizations). A number of countries with publicly funded health services (e.g., UK, Australia and New Zealand) have sought to shift from the traditional 'passive' health management style (using transactional management skills to balance historically-based expenditure budgets) to 'active' transformational leadership styles that reflect a stronger 'private sector' orientation (requiring active management of resources--including a return on 'capital' investment, identification of costs and returns on 'product lines', 'marketing' a 'product mix', reducing non-core activities and overhead costs, and a closer relationship with 'shareholders', suppliers and customers/clients). Evidence of activities and processes associated with transformational leadership are identified. Success of the New Zealand health reforms will be determined by the approach the new managers adopt to improve their organization's performance. Transformational leadership has been frequently linked to the successful implementation of significant organizational change in other settings (Kurz et al., 1988; Dunphy and Stace, 1990) but it is too early to assess whether this is applicable in a health care context. PMID:10181886
Ritchie, D
Health services management development: what formal knowledge should support the skills and experience required?
This study reports on an analysis of 17 postgraduate programs in health services management. Public information was collected from websites in February 2010. Data analysed included core subject abstracts, admission requirements and length and aims of each course. Findings indicate that only three out of 16 subjects identified as core are common to more than 50% of the programs, with the eight most common individual subjects appearing in only a third of programs. This suggests diversity in what is deemed core foundational knowledge in managing health services and the approach taken to management development. We believe there should be greater consensus on core subjects in a specialist health services management qualification. WHAT IS KNOWN ABOUT THE TOPIC? With changes in the organisational structure of health organisations in Australia over the past two decades, managerial positions and roles have also changed. The educational preparation for those managerial roles would also be expected to have changed but core foundational knowledge should remain similar between the various academic institutions.WHAT DOES THIS PAPER ADD? This paper indicates greater diversity in core knowledge areas in health services management education than expected despite a similar target audience.WHAT ARE THE IMPLICATIONS FOR PRACTITIONERS? There are differences in what are deemed to be core foundational areas of knowledge required in specialist management development between academic programs. Management development requires a balance between knowledge, skills and experience and intending st PMID:23498856
Ritchie, David J; Yen, Margaret L
A structured management approach to implementation of health promotion interventions in Head Start.
Improving the health and health literacy of low-income families is a national public health priority in the United States. The federal Head Start program provides a national infrastructure for implementation of health promotion interventions for young children and their families. The Health Care Institute (HCI) at the Anderson School of Management at the University of California, Los Angeles, developed a structured approach to health promotion training for Head Start grantees using business management principles. This article describes the HCI approach and provides examples of implemented programs and selected outcomes, including knowledge and behavior changes among Head Start staff and families. This prevention-focused training platform has reached 60,000 Head Start families in the United States since its inception in 2001. HCI has demonstrated consistent outcomes in diverse settings and cultures, suggesting both scalability and sustainability. PMID:24028835
Herman, Ariella; Nelson, Bergen B; Teutsch, Carol; Chung, Paul J
Community Health Centers: Challenges in Transitioning to Prepaid Managed Care.
National Technical Information Service (NTIS)
In 1989, the Congress mandated that state Medicaid programs reimbuse health centers for the cost of services that the centers provide to their beneficiaries. The more recent change from cost-based reimbursement to a monthly per capita amount for health ce...
The role of insurance in health care management in India
Purpose – Health insurance in India has shown little development. It has not been able to evoke enthusiasm among Indian insurers. Consequently, several reports on Indian health care insurance have been produced. The purpose of this paper is to offer a review of this matter. Design\\/methodology\\/approach – Critical review of related published and grey literature. Findings – Almost 79 per
Hima Gupta
Management of Teenage Pregnancies in Three Different Health Care Settings.
ERIC Educational Resources Information Center
This paper reports a retrospective study undertaken to determine if differences existed in obstetric outcome, contraceptive usage, and repeat pregnancy rates of teenage patients cared for in three different health care settings: the Rochester Adolescent Maternity Project (RAMP), a traditional obstetric clinic, and a neighborhood health center.…
Tatelbaum, Robert
Deutero-learning: implications for managing public health change
Purpose – The purpose of this paper is to apply an allied health subculture model to clarify key contextual factors that can emerge in the evolution of an allied health subculture as a consequence of deutero-learning. Design\\/methodology\\/approach – Two case studies are compared to illustrate these two extreme variations in deutero-learning. Findings – The first case – characterised by pathological
Patricia A. Rowe; Rosalie A. Boyce
Managing uncertainty in conversations about treatment preferences: A study of home health care nurses
Inappropriate efforts to manage uncertainty may account for difficulties associated with communication about serious illness. This study tested a series of predictions concerning the relationship between the amount of uncertainty associated with a communicative task and health care providers' comfort levels when engaging in that task. A mailed survey of 540 home health care nurses confirmed expectations that discussions of
Stephen C. Hines; Nan Leslie; Laurie Badzek; Jackie Glover
Preventive Interventions under Managed Care: Mental Health and Substance Abuse Services. Special Report.
ERIC Educational Resources Information Center
Programs and services that prevent substance abuse and mental health disorders have the potential to lessen an enormous burden of suffering and to reduce both the cost of future treatment and lost productivity at work and home. The availability and accessibility of these interventions to Americans whose health care is provided by managed care…
Dorfman, Sharon L.
Providing Health Care and Education To Migrant Farmworkers in Nurse-Managed Centers.
ERIC Educational Resources Information Center
Migrant Health Service, Inc., was established to address the health needs of migrant farmworkers and their families. Ten satellite nurse-managed centers and two mobile units use a voucher system to provide financial support for clients. The centers also provide clinical experiences for nursing students. (Contains 22 references.) (JOW)
Guasasco, Charlene; Heuer, Loretta Jean; Lausch, Cheryl
The purpose of this research and development project was to develop a method, a design, and a prototype for gathering, managing, and presenting data about occupational injuries.^ State-of-the-art systems analysis and design methodologies were applied to the long standing problem in the field of occupational safety and health of processing workplace injuries data into information for safety and health program
Managing the violent patient: A guide for psychologists and other mental health professionals
Being threatened, harassed, attacked, or confronted by a patient with a weapon is becoming more common and is likely to occur at some point in a mental health professional's career. Effective violence management programs can reduce the incidence of violence. Yet, few resources have been provided to assist psychologists and other mental health professionals to deal with aggressive patients. The
Carl L. Tishler; Lisa B. Gordon; Laura Landry-Meyer
School Nurse Case Management for Children with Chronic Illness: Health, Academic, and Quality of Life Outcomes
ERIC Educational Resources Information Center
More children with chronic illnesses are attending school, and some of them struggle academically because of issues related to their health. School-based case management has been suggested as one strategy to improve the academic success of these children. This study tracked the academic, health, and quality of life outcomes for 114 children with…
Engelke, Martha Keehner; Guttu, Martha; Warren, Michelle B.; Swanson, Melvin
Mass casualty chemical incidents—towards guidance for public health management
The aim of this paper is two-fold. A review of mass casualty chemical incidents occurring naturally or as a result of industrial activities or deliberate release provided an opportunity to consider the problems experienced in medical and public health response. In addition, a literature review of procedures to assist in the management of chemical incidents by medical and public health
V Murray; F Goodfellow
An Exploration of the Working Alliance in Mental Health Case Management
ERIC Educational Resources Information Center
The working alliance between clients and helpers has been identified as a common factor of treatment effectiveness, yet very little research has explored variables associated with working alliance between mental health case managers and their consumers. This study explored the potential covariates of working alliance within community mental health…
Kondrat, David C.; Early, Theresa J.
Domestic violence management in Malaysia: A survey on the primary health care providers
AIM: To assess the knowledge, attitudes and practices of primary health care providers regarding the identification and management of domestic violence in a hospital based primary health care setting. METHOD: A survey of all clinicians and nursing staff of the outpatient, casualty and antenatal clinics in University Malaya Medical Centre using a self-administered questionnaire. RESULTS: Hundred and eight out of
Sajaratulnisah Othman; Noor Azmi Mat Adenan
Supplier Relationship Management: A Case Study in the Context of Health Care
Supplier Relationship Management (SRM) plays an important role in the reduction of costs and the optimization of performance in industrial enterprises. Despite enormous investments in innovation, the health care sector has not experienced fundamental change yet. However, increased market dynamics and the implementation of economic principles will force health service providers to optimize cost structures as well as effectiveness and
Tobias Mettler; Peter Rohner
A method for assessing health and safety management systems from the resilience engineering perspective
This article introduces a method for assessing health and safety management systems (MAHS) that has two innovative characteristics: (a) it brings together the three main auditing approaches to health and safety (HS) – the structural approach (which assesses the system prescribed), the operational approach (which assesses what is really happening on the shop-floor) and the performance approach (which assesses the
Marcelo Fabiano Costella; Tarcisio Abreu Saurin; Lia Buarque de Macedo Guimarăes
The Impact of Managed Care on Mental Health Services for Children and Their Families.
ERIC Educational Resources Information Center
Preliminary results from the Health Care Reform Tracking Project's baseline survey and site visits to 10 states show that managed care has generally improved access to health care for children, but it has made it more difficult for youths with serious emotional disorders, and uninsured children, to obtain care. (SLD)
Stroul, Beth A.; Pires, Sheila A.; Armstrong, Mary I.; Meyers, Judith C.
Youth Psychotherapy Change Trajectories and Outcomes in Usual Care: Community Mental Health versus Managed Care Settings
ERIC Educational Resources Information Center
Objective: The authors compared symptom change trajectories and treatment outcome categories in children and adolescents receiving routine outpatient mental health services in a public community mental health system and a private managed care organization. Method: Archival longitudinal outcome data from parents completing the Youth Outcome…
Warren, Jared S.; Nelson, Philip L.; Mondragon, Sasha A.; Baldwin, Scott A.; Burlingame, Gary M.
Managers' Understanding of Workplace Health Promotion within Small and Medium-Sized Enterprises: A Phenomenological Study
ERIC Educational Resources Information Center
Objective: This study aimed at exploring managers' understanding of workplace health promotion and experiences of workplace health promotion activity within small and medium-sized enterprises. Design: A Heideggerian interpretive phenomenological methodology was adopted. Setting: This study was undertaken with small and medium-sized enterprise…
Moore, Ann; Parahoo, Kader; Fleming, Paul
Differences in Osteoarthritis Self-Management Support Intervention Outcomes According to Race and Health Literacy
ERIC Educational Resources Information Center
We explored whether the effects of a telephone-based osteoarthritis (OA) self-management support intervention differed by race and health literacy. Participants included 515 veterans with hip and/or knee OA. Linear mixed models assessed differential effects of the intervention compared with health education (HE) and usual care (UC) on pain…
Sperber, Nina R.; Bosworth, Hayden B.; Coffman, Cynthia J.; Lindquist, Jennifer H.; Oddone, Eugene Z.; Weinberger, Morris; Allen, Kelli D.
Mycotoxicoses of ruminants and horses.
In the current study, mycotoxicoses of ruminants and horses are reviewed, with an emphasis on the occurrence of these diseases in South America. The main mycotoxicoses observed in grazing cattle include intoxications by indole-diterpenoid mycotoxins (Paspalum spp. contaminated by Claviceps paspali, Lolium perenne infected by Neotyphodium lolii, Cynodon dactylon infected by Claviceps cynodontis, and Poa huecu), gangrenous ergotism and dysthermic syndrome (hyperthermia) caused by Festuca arundinacea (syn. Festuca elatior) infected by Neotyphodium coenophialum (syn. Acremonium coenophialum), and photosensitization in pastures contaminated by toxigenic Pithomyces chartarum. Other mycotoxicoses in grazing cattle include slaframine toxicity in clover pastures infected by Rhizoctonia leguminicola and diplodiosis in cattle grazing in corn stubbles. The mycotoxicoses caused by contaminated concentrated food or byproducts in cattle include poisoning by toxins of Aspergillus clavatus, which contaminate barley or sugar beetroot by-products, gangrenous ergotism or dysthermic syndrome caused by wheat bran or wheat screenings contaminated with Claviceps purpurea, and acute respiratory distress caused by damaged sweet potatoes (Ipomoea batatas). The main mycotoxicosis of horses is leukoencephalomalacia caused by the fumonisins B1 and B2 produced by Fusarium spp. Poisoning by C. purpurea and F. elatior infected by N. coenophialum has also been reported as a cause of agalactia and neonatal mortality in mares. Slaframine toxicosis caused by the ingestion of alfalfa hay contaminated by R. leguminicola has also been reported in horses. PMID:24091682
Riet-Correa, Franklin; Rivero, Rodolfo; Odriozola, Ernesto; Adrien, Maria de Lourdes; Medeiros, Rosane M T; Schild, Ana Lucia
Implementing health information exchange for public health reporting: a comparison of decision and risk management of three regional health information organizations in New York state.
Health information exchange (HIE) is a significant component of healthcare transformation strategies at both the state and national levels. HIE is expected to improve care coordination, and advance public health, but implementation is massively complex and involves significant risk. In New York, three regional health information organizations (RHIOs) implemented an HIE use case for public health reporting by demonstrating capability to deliver accurate responses to electronic queries via a set of services called the Universal Public Health Node. We investigated process and outcomes of the implementation with a comparative case study. Qualitative analysis was structured around a decision and risk matrix. Although each RHIO had a unique operational model, two common factors influenced risk management and implementation success: leadership capable of agile decision-making and commitment to a strong organizational vision. While all three RHIOs achieved certification for the public health reporting, only one has elected to deploy a production version. PMID:23975626
Phillips, Andrew B; Wilson, Rosalind V; Kaushal, Rainu; Merrill, Jacqueline A
Managing the pursuit of health and wealth: the key challenges.
This article forms part of a six-part Series on trade and health, and sets the stage for this Series by analysing key aspects of the relationship between trade and health. The Series takes stock of this relation and provides timely analysis of the key challenges facing efforts to achieve an appropriate balance between trade and health across a diverse range of issues. This introductory article reviews how trade and health have risen and expanded on global policy agendas in the past decade in unprecedented ways, describes how trade and health issues are respectively governed in international relations, examines the ongoing search for policy coherence between the two policy spheres, and highlights the topics of the remaining articles in the Series. PMID:19167061
Fidler, David P; Drager, Nick; Lee, Kelley
Managing the pursuit of health and wealth: the key challenges
This article forms part of a six-part Series on trade and health, and sets the stage for this Series by analysing key aspects of the relationship between trade and health. The Series takes stock of this relation and provides timely analysis of the key challenges facing efforts to achieve an appropriate balance between trade and health across a diverse range of issues. This introductory article reviews how trade and health have risen and expanded on global policy agendas in the past decade in unprecedented ways, describes how trade and health issues are respectively governed in international relations, examines the ongoing search for policy coherence between the two policy spheres, and highlights the topics of the remaining articles in the Series.
Fidler, David P; Drager, Nick; Lee, Kelley
Designing Health Care Risk Management On-Line: Meeting Regulators' Concerns for Fixed-Hour Curriculum
ERIC Educational Resources Information Center
This paper describes the experience of creating a continuing professional education on-line risk management program that is designed to meet Florida's educational requirements for licensure as a risk manager in health-care settings and details the challenges faced when the in-class didactic program of 15 eight-hour sessions is reformatted as an…
Hyer, Kathryn; Taylor, Heidi H.; Nanni, Kenneth
Beyond Resistance: Exploring Health Managers' Propensity for Participatory Evaluation in a Developing Country
ERIC Educational Resources Information Center
The evaluation of interventions is becoming increasing common and now often seeks to involve managers in the process. Such practical participatory evaluation (PPE) aims to increase the use of evaluation results through the participation of stakeholders. This study focuses on the propensity of health managers for PPE, as measured through the…
Smits, Pernelle A.; Champagne, Francois; Farand, Lambert
Occupational health guidelines for the management of low back pain: an international comparison
Background: The enormous socioeconomic burden of low back pain emphasises the need for effective management of this problem, especially in an occupational context. To address this, occupational guidelines have been issued in various countries.Aims: To compare available international guidelines dealing with the management of low back pain in an occupational health care setting.Methods: The guidelines were compared regarding generally accepted
J B Staal; H Hlobil; M W van Tulder; G Waddell; A K Burton; B W Koes; W van Mechelen
Financial Management for the Office of the Civilian Health and Medical Program of the Uniformed Services.
National Technical Information Service (NTIS)
Introduction. The Federal Financial Management Act of 1994, Public Law 103-356, requires DoD to provide the Office of Management and Budget with consolidated financial statements for FY 1996. The Office of Civilian Health and Medical Program of the Unifor...
Application of occupational health and safety management system at sewage treatment plants
Sewage treatment plant (STP) operators are exposed to variety of hazard during wastewater processing. The aim of this study is to identify and manage these hazards, particularly in a local STP in Malaysia, through Occupational Health and Safety Management System (OSHMS). Initially, reported hazards data were collected via review of literatures, questionnaire distribution and interview with experts. Then, the most
Amirhossein Malakahmad; Alan Giffin Downe; Siti Dhamina Muhamad Fadzil
Mobile phone health apps for diabetes management: current evidence and future developments.
Can an app help manage diabetes? We discuss how the advent of mobile health apps in connecting patients to providers is creating new opportunities for the management of diabetes. Although there are promising outcomes, there is still much to be learned about how such technology could be fully exploited. PMID:24106313
Goyal, S; Cafazzo, J A
A demonstration of a helicopter health management information portal for U.S. Army aviation
The US Army relies heavily on their helicopter fleet to provide close air support, troop transport, reconnaissance and logistics support capabilities for a variety of mission profiles. High operational readiness and availability of the helicopter fleet is critical to achieving their mission objectives. The Army has developed and implemented helicopter health management technology known as the Vibration Management Enhancement Program
J. Banks; T. Bair; K. Reichard; D. Blackstock; D. McCall; J. Berry
Virtual Reality Environments for Integrated Systems Health Management of Rocket Engine Tests
Integrated Systems Health Management (ISHM) consists of processes managing erroneous conditions that systems may encounter during their operational life by either designing out failures early on or defending and mitigating any possible failures. A successful implementation of ISHM consists of the following four components: data sensors, computations, data sinks, and visualization modules. In this paper, we explore the use of
Jonathan A. Morris; John L. Schmalzel; Shreekanth Mandayam
Factors affecting lysine degradation by ruminal fusobacteria.
Fusobacterium necrophorum can readily be enriched from the rumen with lysine, and its deamination rate is very rapid. The addition of F. necrophorum JB2 to mixed ruminal bacteria significantly increased lysine degradation, but only if the ratio of ruminal fluid to basal medium was less than 25%. If more ruminal fluid (pH 6.1) was added, ammonia production decreased by as much as 80%. Clarified, autoclaved ruminal fluid was also inhibitory. When F. necrophorum JB2 was grown in a lysine-limited continuous culture (0.1 h(-1) dilution rate) and pH was decreased using HCl, optical density decreased linearly, and the culture washed out at pH 5.6. Batch cultures of F. necrophorum JB2 deaminated as much lysine at pH 6.1 as at pH 6.6, but only if fermentation acids were not present. Sodium acetate (100 mM) had little effect at pH 6.6, but the same concentration inhibited ammonia production by 80% at pH 6.1. The idea that fermentation acids could prevent the enrichment of fusobacteria in vivo was supported by the observation that dietary lysine supplementation did not enhance the lysine deamination rate of the mixed ruminal bacteria. PMID:16542401
Russell, James B
Ruminant Nutrition Symposium: Improving cell wall digestion and animal performance with fibrolytic enzymes.
This paper aimed to summarize published responses to treatment of cattle diets with exogenous fibrolytic enzymes (EFE), to discuss reasons for variable EFE efficacy in animal trials, to recommend strategies for improving enzyme testing and EFE efficacy in ruminant diets, and to identify proteomic differences between effective and ineffective EFE. A meta-analysis of 20 dairy cow studies with 30 experiments revealed that only a few increased lactational performance and the response was inconsistent. This variability is attributable to several enzyme, feed, animal, and management factors that were discussed in this paper. The variability reflects our limited understanding of the synergistic and sequential interactions between exogenous glycosyl hydrolases, autochthonous ruminal microbes, and endogenous fibrolytic enzymes that are necessary to optimize ruminal fiber digestion. An added complication is that many of the standard methods of assaying EFE activities may over- or underestimate their potential effects because they are based on pure substrate saccharification and do not simulate ruminal conditions. Our recent evaluation of 18 commercial EFE showed that 78 and 83% of them exhibite