WorldWideScience

Sample records for care manpower planning

  1. Aggregation in manpower planning

    OpenAIRE

    Wijngaard, J

    1983-01-01

    In manpower planning, as in all other kinds of planning, an important choice is the level of aggregation. The proper level of aggregation depends on the flexibility (mobility) of the personnel. This dependency is investigated in this paper. The manpower system considered is characterized by two dimensions, level and function group. Conditions are derived for aggregate long-term planning (aggregation over function group) combined with one-period disaggregation being optimal.

  2. AB Manpower Plan 2007

    CERN Document Server

    Myers, Stephen

    2007-01-01

    The present exercise is not as such a "manpower plan" but a purely budgetary comparison of known plus requested resources with the known commitments over the period 2007-2012. From a purely budgetary point of view, AB will have the capacity to maintain all those recently hired staff who fulfill the criteria for long term employment at CERN. Following this budgetary exercise, AB proposes to perform a CERN-wide staff work plan so as to compare the manpower available to the quantity of work to be done in the totality of the work-packages. If there is a significant mismatch between these two quantities then we propose the following measures which would create personnel economies and allow us to redress the mismatch by increased recruitment: a new job severance scheme; CERN restructuring; use of the new CERN-ITER agreement; more flexibility in transfers from Materials to Personnel budgets. Failing this a re-examination of possible closure of lower priority facilities may be needed.

  3. Manpower development - planning and implementation

    International Nuclear Information System (INIS)

    The demands of a nuclear technology programme on the manpower resources of a developing country are very onerous. Unlike other industries, as well as the planning and operating staff, nuclear technology requires an additional administrative infrastructure to regulate the various activities. To minimize the effect of manpower shortage, the planning and development of manpower resources need to be carried out on a national scale. To introduce a nuclear programme, a special preparatory phase is required. During this phase the special conditions appertaining to the country are first considered, as are the evaluation and then the promotional aspects of the programme. In a second phase, all the partners involved in the implementation are considered, with reference to their roles and interrelationships. Their various tasks and obligations are fully assessed. This is a wide-ranging study covering, in addition to the construction of a nuclear power plant, the industrial collaboration and licensing agreements, and the utility operational training schemes. Finally, the third phase considers the different and necessary educational requirements, and the existent and developed level of the manpower, with respect to the scope and content of the know-how transfer. When all the relevant aspects have been considered, the expansion of the universities and educational establishments must be carried out. This whole phase needs to be started as early as possible because it involves a period of some years. (author)

  4. Agri-Manpower Forecasting and Educational Planning

    Science.gov (United States)

    Ramarao, D.; Agrawal, Rashmi; Rao, B. V. L. N.; Nanda, S. K.; Joshi, Girish P.

    2014-01-01

    Purpose: Developing countries need to plan growth or expansion of education so as to provide required trained manpower for different occupational sectors. The paper assesses supply and demand of professional manpower in Indian agriculture and the demands are translated in to educational requirements. Methodology: The supply is assessed from the…

  5. Manpower Planning Criteria Manual, Construction Grants Section.

    Science.gov (United States)

    Texas State Dept. of Water Resources, Austin.

    This document presents the material developed in conjunction with a project directed to test a methodology that a state water pollution control agency can use in determining its manpower and training needs. Included is a compilation of the manpower planning criteria used to relate numbers and types of personnel with deferred workloads. It also…

  6. Manpower Planning: The Need for a Diagnostic Approach.

    Science.gov (United States)

    Fyfe, John

    1980-01-01

    Makes observations about progress in the field of manpower planning in highly industrialized and developed countries. Discusses the internal and external labor market, the state of the art of manpower planning at the micro level, and an economic framework. (CT)

  7. Manpower Planning for Wastewater Treatment Plants.

    Science.gov (United States)

    Davies, J. Kenneth; And Others

    This document discusses the components necessary in the development of a forecasting process by which manpower needs can be determined and the development of action programs by which the projected needs may be satisfied. The primary focus of this manual is directed at that person in a state agency who has the responsibility for planning the…

  8. Health Manpower Planning: A Comparative Study in Four Countries. Volume 1. Health Manpower References.

    Science.gov (United States)

    Whiteside, Daniel F.; And Others

    The health manpower planning experiences of four countries reported here were presented in a traveling seminar held for member countries of the Pan American Health Organization. Focus was on what should be carried out in any country to coordinate the training of health workers with the operation of health services. Following the introduction, the…

  9. Plan for developing a comprehensive energy manpower information system

    Energy Technology Data Exchange (ETDEWEB)

    Stewart, Lawrence G.

    1979-09-01

    The report is designed to make a beginning in broadening the scope of the comprehensive manpower information system for energy research, development, and demonstration, so that it could cover all manpower related to energy. It develops a plan for this extension, including determining which taxonomies require change, specifying the subsequent stages involved in expanding CEMIS to all energy manpower, and providing the basis for cost estimates for this work. The report is organized as follows: The analytical rationale is described in Chapter II. Chapter III reviews the status of manpower data in a number of energy sectors, notes limitations and gaps in the data, and discusses improvements and additions that should be made. The scope and structure of CEMIS are laid out in Chapter IV, with particular reference to the development of analytical processes, and of analytical linking functions between bodies of data, and a description of their application in anticipating the employment impact of energy changes. The appropriate steps recommended for the further development of CEMIS are described in Chapter V.

  10. NATO Conference on Manpower Planning and Organization Design

    CERN Document Server

    Niehaus, Richard

    1978-01-01

    This volume is the proceedings of the conference entitled "Manpower Planning and Organization Design" which was held in Stresa, Italy, 20-24 June 1977. The Conference was sponsored by the NATO Scientific Affairs Division and organized jointly through the Special Programs Panels on Human Factors and on Systems Science. Two Conference Directors were appointed with overall responsibilities for the programme and for policy, and they were assisted in their tasks by a small advisory panel consisting of Professor A. Charnes (University of Texas), Professor W.W. Cooper (Carnegie Mellon University, now at Harvard University) and Dr. F.A. Heller (TavistQck Institute of Human Relations). Professor R. Florio of Bergamo kindly agreed to become Administrative Director and, as such, was responsible for all the local arrangements. The Conference Directors were further assisted by "national points of contact" appointed from each of the member countries of NATO. These national representatives played a substantial part in the s...

  11. System dynamics of manpower planning strategies under various demand scenarios

    Directory of Open Access Journals (Sweden)

    Michael Mutingi

    2012-09-01

    Full Text Available The development of human resources recruitment and training strategies in a dynamic environment poses a challenge to many policy makers in various organisations. The goal of every human resource manager is to recruit, train and deploy the right personnel at the right place and at the right time in order to meet organizational requirements. We develop a system dynamics simulation model that captures the dynamic behaviour of a typical corporate manpower system. Three major strategies are indentified and simulated under different manpower demand scenarios. Based on a set of performance indices, the impact of the strategies is simulated under assumed demand scenarios including steady increasing, fluctuating, and s-shaped demand. Useful managerial insights are derived from the study. The model is a decision support tool for developing reliable dynamic manpower policies in terms of recruitment, training capacity, available skills, and attrition. This approach can assist organizations to design effective manpower strategies.

  12. OPTIMAL MANPOWER PLANNING DECISION WITH SINGLE EMPLOYEE TYPE CONSIDERING MINIMAL EMPLOYMENT PERIOD CONSTRAINT

    OpenAIRE

    YONGJIAN LI; JIAN CHEN; XIAOQIANG CAI; BENGSHENG TU

    2010-01-01

    In this paper, we investigate a manpower planning problem with single employee type over a long planning horizon. The dynamic demand for manpower must be fulfilled by allocating enough number of employees and each employee has a minimal employment period. A cost objective is concerned where the costs for every employee include salary, recruitment and dismissal costs, in particular, setup cost when recruitment activity occurs in one period. In this paper we first formulate the problem as a dyn...

  13. Health Manpower: Profile, Stock and Requirements

    OpenAIRE

    Development Academy of the Philippines

    1995-01-01

    This study provides basic information on the status of Philippine health professionals that will serve as input for health manpower planning and for the preparation of health care financing scheme. An inventory of the existing manpower personnel is provided. In addition, factors affecting manpower supply and demand in the health sector is analyzed. This is in the hope of helping policy makers in providing market incentives for an efficient health care financing system in the future.

  14. Rostering and Task Scheduling:Applications in Manpower Planning

    OpenAIRE

    Dohn, Anders Høeg; Larsen, Jesper; Clausen, Jens

    2010-01-01

    In a modern society, manpower can be both a scarce and an expensive resource. Skilled personnel is usually in high demand and accounts for a significant part of total expenses in many companies. When the work is divided in shifts, a roster is compiled to allocate these to the employees. The rostering process is non-trivial and especially when service is required around the clock, rostering may involve considerable effort from a designated planner. Therefore, in order to minimize costs and ove...

  15. Market-Based Manpower Planning with Labour Market Signals.

    Science.gov (United States)

    Van Adams, Arvil; And Others

    1992-01-01

    Labor market planning techniques must take into account the dynamic nature of economies. A better approach than labor needs forecasting is use of labor market signals developed by monitoring wage and employment changes and evaluating training programs. (SK)

  16. Developments in the analysis and planning of labour and manpower.

    OpenAIRE

    Cohen, S I

    1986-01-01

    ILO pub-WEP pub. Working paper on the use of econometric models in human resources planning - discusses short term economic analysis of labour markets, medium term simulation of labour supply, and evaluation of training and educational expenditure; considers sample survey data collecting for national accounting. Graphs, references, statistical tables.

  17. Manpower development for nuclear power

    International Nuclear Information System (INIS)

    This Guidebook provides policy-makers and managers of nuclear power programmes with information and guidance on the role, requirements, planning and implementation of manpower development programmes. It presents and discusses the manpower requirements associated with the activities of a nuclear power programme, the technical qualifications of this manpower and the manpower development corresponding to these requirements and qualifications. The Guidebook also discusses the purpose and conditions of national participation in the activities of a nuclear power programme

  18. Advance Care Planning

    Science.gov (United States)

    ... put on a breathing machine. Organ and tissue donation allows organs or body parts from a generally healthy person ... to your driver’s license. Some people also include organ donation in their advance care planning documents. At the ...

  19. Manpower Planning for the Wastewater Treatment Workforce of Texas: An Emerging Function. Presented at the Annual Meeting of the Texas Water Utilities Association (58th, College Station, Texas, March, 1976).

    Science.gov (United States)

    Jackson, Tom

    This paper, presented at the 58th annual meeting of the Texas Water Utilities Association, attempts to point out the need for manpower planning for the wastewater treatment workforce of Texas. As reasons for manpower planning, this document discloses estimates of 1400-1500 new jobs, 1300 of which will be in wastewater treatment facilities of 1 MGD…

  20. Collaborative Health Care Plan Support

    OpenAIRE

    Amir, Ofra; Grosz, Barbara J.; Law, Edith Lok Man; Stern, Roni

    2013-01-01

    This paper envisions a multi-agent system that assists patients and their health care providers. This system would support a diverse, evolving team in formulating, monitoring and revising a shared "care plan" that operates on multiple time scales in uncertain environments. It would also enhance communication of health information within this planning framework. The coordination of care for children with complex conditions (CCC), which is a compelling societal need, is presented as a model env...

  1. The Brazilian nuclear power manpower development programme

    International Nuclear Information System (INIS)

    Since the early stages of decision making, manpower availability has been recognized to be a key factor for the implementation of Brazil's nuclear power programme. Though care has been given to securing an industrial base and financial resources, the consequences of a lack of sufficient qualified manpower could be critical for the success of the whole programme. The broad scope of the Brazilian nuclear power programme which, as a main concept, aimed at establishing in the country a complete fuel cycle industry together with the construction of nuclear power plants, added another burden to the already complex task of providing appropriate human resources when advanced technologies are introduced in a developing country. Thus, not only the work-force required for nuclear power plant operation but also that needed for plant design, component manufacture, fuel cycle plant design and operation, had to be made available in number and qualification in accordance with the standards of the nuclear industry. The feasibility of the Brazilian programme depended on a complete transfer of technology, essentially achieved through personnel training. Again, the process of manpower preparation for an efficient know-how transfer required careful planning, and the great difficulty in its implementation was the lack of reliable experience at the time. (author)

  2. Human resource development: the Asian experience in employment and manpower planning - an overview

    OpenAIRE

    Amjad, Rashid

    1987-01-01

    The overview based on country studies included in this volume investigates the extent to which it has been possible to integrate human resource development and give priority to this important goal within the overall planning process. While it is clear that the development of human resources has to compete with other pressing demands for limited resources available for development, the key question still remains whether overall socioeconomic development undertaken has incorporated the preferre...

  3. Advance Care Planning i sykehjem

    OpenAIRE

    Hydal, Anne-Marthe Bering

    2015-01-01

    Bakgrunn: Advance care planning (ACP) er en kommunikativ prosess, som utforsker pasienters preferanser for fremtidig medisinsk behandling og pleie ved livets slutt. Flere land har tatt i bruk ACP, men i Norge finnes få føringer for nedtegnelse av pasientpreferanser. Hensikt: Undersøke hvilke ACP programmer som er implementert i sykehjem utenfor Norge, og hva de ulike programmene inneholder. Videre å undersøke hvilke implementeringsstrategier som er tatt i bruk, og hvilke erfaringer som beskri...

  4. Meeting nuclear utilities manpower needs

    International Nuclear Information System (INIS)

    The nuclear-power industry must attract and train 57,000 employees during the next decade, according to a survey which found a high rate of personnel turnover, 8790 unfilled positions, and 75 new plants scheduled to come on line. The Institute of Nuclear Power Operators (INPO) and the industry need to address personnel planning to find out how to meet these needs. Studies indicate a history of on-site staffing and training deficiencies. Regulatory requirements also contribute to manpower shortages. This article examines manpower problems and suggests initiatives the industry can take to support educational programs, expand training, provide employee incentives, and pool technical resources. 7 tables

  5. How to plan research in palliative care

    Directory of Open Access Journals (Sweden)

    Santosh K Chaturvedi

    2011-01-01

    Full Text Available Research in palliative care has its challenges. However, research in different aspects of palliative care is important. This paper gives simple methods of planning and conducting a research in the area of palliative care in India.

  6. Nuclear manpower development

    International Nuclear Information System (INIS)

    The nuclear manpower development project has concentrated on the systemisation and specialization of education and training programs and has actively carried out diverse activities to create new nuclear courses based on the experience of the Nuclear Training and Education Center (NTC) accumulated over the past years. As the demand of education program for training nuclear manpower is increasing due to the remarkable growth of nuclear industry, NTC developed customized education programs making the most use of nuclear experiment equipment and providing practical exercise with research reactor. For improving organizational performance and the development of skilled manpower, KAERI-ACE 2.0 system offered diverse programs addressing the type of occupation and position based on individual competency. Also education on IT was carried out to improve public relations on nuclear and field trips were arranged to encourage local residents' better understanding of the nuclear industry. As a continuous effort, In 2011, NTC specially conducted a survey of employees who are attached to small and medium sized business, and analyzed the present business situations and education requirements for the development of a Pre/under job education program. Prior to this, a briefing session took place for mutual exchange of opinions of industry and academia, based on which a test operation on 'Basic Radiation Education' was carried out. This program has a significance that it was first step toward connection between the nuclear industry and academia as well as an opportunity to educate the employee involved in nuclear engineering field. In 2012, this program is planned to be expanded. With reference to the in-house training, NTC established an 'e-HRD system' providing available resources concerned with education program for cultivating talented personnel. All the education programs are based on individual competency. The e-HRD system will be test operated in 2012 and applied to the

  7. Interdisciplinary Care Planning and the Written Care Plan in Nursing Homes: A Critical Review

    Science.gov (United States)

    Dellefield, Mary Ellen

    2006-01-01

    Purpose: This article is a critical review of the history, research evidence, and state-of-the-art technology in interdisciplinary care planning and the written plan of care in American nursing homes. Design and Methods: We reviewed educational and empirical literature. Results: Interdisciplinary care planning and the written care plan are…

  8. A personalized care plan in chronic care: implementation and evaluation

    OpenAIRE

    Jeanny Engels; Marjolein Rebel; Doortje Boshuizen

    2012-01-01

    Purpose Implementation and evaluation of a personalized care plan for approximately 350 people with (an increased risk of) cardiovascular disease in ten general practices in the Netherlands. Context The ‘Healthy Vessels’ (‘Vitale Vaten’) care standard of 2009 describes the optimum care for people with (an increased risk of) cardiovascular disease and is based on the Chronic Care Model. New: working with a personalized care plan, with detailed attention for the promotion of self-management and...

  9. Managed Care Plans: Getting Good Care for Your Child

    Science.gov (United States)

    ... a Pediatrician Family Life Medical Home Health Insurance Pediatric Specialists Family Dynamics Media Work & Play Getting Involved in Your Community Healthy Children > Family Life > Medical Home > Health Insurance > Managed Care Plans: Getting Good Care for Your Child Family ...

  10. Medicare Managed Care plan Performance, A Comparison...

    Data.gov (United States)

    U.S. Department of Health & Human Services — The study evaluates the performance of Medicare managed care, Medicare Advantage, Plans in comparison to Medicare fee-for-service Plans in three states with...

  11. The History of Manpower Forecasting in Modelling Labour Market

    OpenAIRE

    Stefano Spalletti

    2008-01-01

    The manpower forecasting approach (MFA) was one of the first attempts in educational planning purposes. Manpower planners attempted: 1) to calculate the demand for manpower classified by occupation; 2) to convert this classification of demand by occupation into demand by educational attainment; 3) to devise plans and policies aimed at equating projected demands and probable supplies. The paper recalls the basic principles of the MFA from the perspective of the history of the economic thought ...

  12. VA Health Care and Health Manpower Training Legislation. Hearing before the Subcommittee on Health and Hospitals of the Committee on Veterans' Affairs; United States Senate, Ninety-second Congress. First Session on S.2219, S.2354, S.2355, S.1924, S.2304, S.1635, S.2340, H. J. Res. 748, H. R. 481, and Related Bills.

    Science.gov (United States)

    Congress of the U.S., Washington, DC. Senate Committee on Veteran's Affairs.

    Ten legislative bills related to VA health manpower training and education and to veterans' health care were considered at this hearing. The bills concerned the following: (1) establishment of new public nonprofit medical, health profession, and allied health schools and the expansion and improvement of health manpower training programs in VA…

  13. Care plans and care planning in long term conditions: a conceptual model

    OpenAIRE

    Burt, J.; J. Rick; Blakeman, T; Protheroe, J; Roland, M; Bower, P.

    2013-01-01

    The prevalence and impact of long term conditions continues to rise. Care planning for people with long term conditions has been a policy priority for chronic disease management in a number of health care systems. However, patients and providers appear unclear about the formulation and implementation of care planning. Further work in this area is therefore required to inform the development, implementation and evaluation of future care planning initiatives. We distinguish between ‘care planni...

  14. Manpower Implications of Mechanization.

    Science.gov (United States)

    Cargill, B. F.

    The fruit and vegetable industry is on the road to total mechanization. The scientific and social communities need to collaborate as technological innovations influence manpower development and utilization. An awareness of the implications of technological advancement and manpower problems is required so that the U. S. fruit and vegetable grower…

  15. [Health manpower in Mexico].

    Science.gov (United States)

    Martuscelli, J

    1986-01-01

    Population increase, rural-to-urban migration, excessive population concentration side by side with scattered rural populations, and the economic crisis provide the primary framework for this analysis of health manpower in Mexico. The secondary frame of reference is the primary causes of mortality (in 1981): the leading cause, accidents and violence; the second, heart disease; the third, influenza and pneumonia; and the fourth, enteric diseases and diarrheas. Data are supplied on the number of new physicians graduating (this number rose from 2,493 in 1976 to 14,099 in 1983), and on the number of nurses (about 98,000, of which 40% are professionals). The growth pattern of the contingent of dentists is the same as that of physicians, namely, disproportionate and inefficient. The Federal Government is now trying to set up a National Health System that will fulfill the constitutional right of all Mexican citizens to health protection. On the basis of the disequilibrium apparent in every part of the health sector, the author recommends that educational and health institutions plan and coordinate the training of physicians so that the number of graduates may meet the country's needs, and the quality of their education may be improved. PMID:3780502

  16. Computerized Nursing Care Planning Utilizing Nursing Diagnosis

    OpenAIRE

    Crosley, Joan M.

    1984-01-01

    This paper presents a brief description of the beginning phase of a long term project introducing computerized nursing care planning utilizing nursing diagnoses within one nursing department. Areas for future study are proposed.

  17. Standardized care plan of postpartum mastitis

    Directory of Open Access Journals (Sweden)

    Maria Ángeles Carrasco García

    2012-07-01

    Full Text Available Introduction: Puerperal mastitis or mastitis Breastfeeding is a postpartum condition that represents one of the main reasons for abandoning breastfeeding. Mainly usually occurs between weeks 2 and 3 ª postpartum. The scientific evidence confirms that the stop breastfeeding before an attack of mastitis is not conducive to recovery and that of exclusive breastfeeding and no restrictions are effective measures to prevent milk stasis and the spread of infection.Objective: The main objective is to unify criteria for the care and integrated health care levels of care through continuity of care to promote breast-specific care to prevent the emergence of this disease.Methodology: Development of a standardized care plan to enable effective communication between professionals and implementation of quality care.Conclusions: The midwife and the nurse plays an important role in identifying those women with early-onset symptoms of postpartum mastitis in the middle, both in the maternity ward and in the primary care clinic.

  18. Manpower management information system /MIS/

    Science.gov (United States)

    Gravette, M. C.; King, W. L.

    1971-01-01

    System of programs capable of building and maintaining data bank provides all levels of management with regular manpower evaluation reports and data source for special management exercises on manpower.

  19. Highlights of the Manpower Report

    Science.gov (United States)

    Manpower, 1975

    1975-01-01

    The article summarizes the 1975 Manpower Report chapters on: the employment and unemployment record; achievements and open issues of public service employment; changing role of women; CETA Progress report; Program responses to manpower needs; manpower impact of government policy and procedure; and Report of the Secretary of Health, Education, and…

  20. Family Planning Services: An Essential Component of Preconception Care

    OpenAIRE

    Klerman, Lorraine V.

    2006-01-01

    Family planning services are necessary for the widespread adoption of preconception care for two reasons. First, preconception care is more likely if pregnancies are planned, and family planning services encourage pregnancy planning. Second, family planning services usually include counseling, and counseling provides an opportunity to discuss the advantages of preconception care. However, the potential of family planning services to promote preconception care is limited by underutilization of...

  1. Social marketing: planning before conceiving preconception care.

    Science.gov (United States)

    Prue, Christine E; Daniel, Katherine Lyon

    2006-09-01

    Social marketing approaches can help to shape the formation of and to create demand for preconception care services. This article describes four components of social marketing, often referred to as the 4 P's, that should be carefully researched and set in place before a national effort to launch and sustain preconception care services is pursued. First, the product or package of services must be defined and adapted using the latest in scientific and health care standards and must be based on consumer needs and desires. Second, the pricing of the services in financial or opportunity costs must be acceptable to the consumer, insurers, and health care service providers. Third, the promotion of benefits must be carefully crafted to reach and appeal to both consumers and providers. Fourth, the placement and availability of services in the marketplace must be researched and planned. With the application of market research practices that incorporate health behavior theories in their exploration of each component, consumer demand for preconception care can be generated, and providers can take preconception care to the market with confidence. PMID:16755400

  2. Implicações de custo financeiro e recursos humanos em assistência odontológica no Brasil segundo o modelo escandinavo Implications in terms of costs and manpower of using the Scandinavian dental care model in Brazil

    Directory of Open Access Journals (Sweden)

    Jefferson L. Traebert

    1996-12-01

    Full Text Available Objetivou-se detectar e analisar as implicações em custos e recursos humanos em odontologia de uma hipotética aplicação dos conceitos escandinavos de atenção odontológica no Brasil. Duas sociedades foram escolhidas para serem estudadas: Suécia, país da Escandinávia, e Santa Catarina, Estado da região Sul do Brasil. A análise teórica dessas implicações foi realizada a partir da determinação das necessidades de recursos humanos em odontologia, considerando-se os altos índices de doenças bucais no Estado brasileiro. Utilizou-se o programa de software "Health Through Oral Health" da Organização Mundial da Saúde-Federação Dentária Internacional (1989. Os resultados mostraram alto custo financeiro e a necessidade de se aumentar em até 85% o recurso humano disponível para atuar em saúde bucal no Estado de Santa Catarina. Concluiu-se que os princípios de alta provisão de recursos humanos e financeiros, característicos do modelo escandinavo, não serviriam para serem adotados por Santa Catarina e, extensivamente, pelo Brasil.The implications in terms of dental manpower and costs of applying the Scandinavian system of dental care in Brazil are specified and analysed. Two societies were chosen for study: those of Sweden, in Scandinavia and Santa Catarina, State in southern Brazil. The theoretical analysis of the implications was undertaken on the basis of an estimate of dental and auxiliary manpower required to deal with the high levels of oral disease and needs (caries, teeth needing extraction, periodontal diseases and the need for full dentures in Santa Catarina. This estimate was undertaken by means of the World Health Organization-Fédération Dentaire Internationale (WHO-FDI Model "Health Through Oral Health" (1989. The implications in costs, taking the total Swedish expenditure per dentist as a basis, were calculated and applied to the manpower calles for by the WHO-FDI model. The high costs resulting showed that the

  3. 42 CFR 441.103 - Alternate plans of care.

    Science.gov (United States)

    2010-10-01

    ... Medicaid for Individuals Age 65 or Over in Institutions for Mental Diseases § 441.103 Alternate plans of... otherwise need care in an institution for mental diseases. (b) These alternate plans of care must— (1)...

  4. 42 CFR 456.180 - Individual written plan of care.

    Science.gov (United States)

    2010-10-01

    ... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Plan of Care § 456.180 Individual written plan of care. (a) Before admission to a mental hospital...

  5. Usage Analysis of a Shared Care Planning System

    OpenAIRE

    Warren, Jim; Gu, Yulong; Humphrey, Gayl

    2012-01-01

    We examined the content of electronically mediated communications in a trial of shared care planning (SCP) for long-term condition management. Software supports SCP by sharing patient records and care plans among members of the multidisciplinary care team (with patient access). Our analysis focuses on a three-month period with 73 enrolled patients, 149 provider-assigned tasks, 64 clinical notes and 48 care plans with 162 plan elements. Results show that content of notes entries is often relat...

  6. A framework for health care planning and control

    OpenAIRE

    Hans, Erwin W.; Houdenhoven, van, M.; Hulshof, Peter J.H.

    2011-01-01

    Rising expenditures spur health care organizations to organize their processes more efficiently and effectively. Unfortunately, health care planning and control lags far behind manufacturing planning and control. Successful manufacturing planning and control concepts can not be directly copied, because of the unique nature of health care delivery. We analyze existing planning and control concepts or frameworks for health care operations management, and find that they do not properly address v...

  7. How to Create an Anti-Aging Skin Care Plan

    Science.gov (United States)

    ... library Find a dermatologist How to create an anti-aging skin care plan Skin care in your 40s ... Years of research supports each of these recommendations. Anti-aging skin care tips Protect your skin from the ...

  8. A Critical Review of Forecasting Models to Predict Manpower Demand

    Directory of Open Access Journals (Sweden)

    James Wong

    2012-11-01

    Full Text Available Forecasting manpower requirements has been useful for economic planners, policy makers and training providers in order to avoid the imbalance of skills in the labour market. Although reviews of the manpower planning models have been conducted previously, with the accumulated experience and the booming of advanced statistical techniques and computer programs, the study of forecasting practices has undrgone considerable changes and achieved maturity during the past decade. This paper assesses the latest employment and manpower dmand estimating methods by examining their rationale, strength and constraints. It aims to identify enhancements for further development of manpower forecasting model for the construction industry and compare the reliability and capacity of different forecasting metodologies. It is cocluded that the top-down forecasting approach is the dominant methodology to forecast occupational manpower demand. It precedes other methodologies by its dynamic nature and sensitivity to aa variety of factors affecting the level and structure of employment. Given the improvement of the data available, advanced modelling techniques and computer programs, manpower planning is likely to be more accessible with improved accuracy at every level of the society.  

  9. Nuclear Manpower Development

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, I. A.; Lee, T. J.; Lee, K. B.; and others

    2012-12-15

    The nuclear manpower development project has concentrated on the systemization and specialization of education and training programs and has actively carried out diverse activities to create new nuclear courses based on the experience of the Nuclear Training and Education Center (NTC) accumulated over the past years. NTC has developed customized education programs on 'Nuclear Introduction' to educate new employees of the Korea Electric Power Corporation (KEPCO) and on 'Technical education for criticality and shielding analysis of the spent fuel' for employees of the Doosan Heavy Industries and Construction. NTC has also developed specialized education programs for the students of nuclear engineering departments and sciences and engineering departments in universities making the most use of experimental equipment at KAERI and providing practical exercise with the research reactor, HANARO. For improving organizational performance and the development of skilled manpower, KAERI-ACE system has offered diverse programs addressing individual competency of industry personnel in terms of type of occupation and position. Also education on IT has been carried out to improve public relations on nuclear and field trips have been arranged to encourage local residents' better understanding of the nuclear industry. As the final outcome, NTC has developed 6 new education programs for employees in industry and students in academia, and offered 64 courses to 9,630 persons (273 domestic nuclear personnel, 509 university students, 8,075 KAERI staff, 773 local resident). Especially, in 2012, NTC is honored to won 'Presidential Awards of National Quality Management Awards'. This present that KAERI-ACE system has performed well through a improvement in recent years.

  10. Medical Planning and Care in Radiation Accidents

    International Nuclear Information System (INIS)

    As part of a broad effort intended to mitigate the consequences of radiation accidents, the United States Atomic Energy Commission has developed a program to train physicians and to orient hospital staffs in the treatment of accident victims. Seminars have been conducted to date for approximately 120 physicians on medical planning and care in radiation accidents. This paper presents the scope and specific topics covered in the seminars, together with an analysis of. experience gained during development and presentation of the seminars. More recently the program has been expanded to encompass orientation of hospital administrators and other para-medical personnel on the handling and admittance of victims of radiation accidents. The latter problem is the subject of a new color film premiered at the Symposium. (author)

  11. Models for Designing Long-Term Care Service Plans and Care Programs for Older People

    OpenAIRE

    Shogo Kato; Satoko Tsuru; Yoshinori Iizuka

    2013-01-01

    The establishment of a system for providing appropriate long-term care services for older people is a national issue in Japan, and it will likely become a worldwide issue in the years to come. Under Japanese Long-term Care Insurance System, long-term care is provided based on long-term care programs, which were designed by care providers on the basis of long-term care service plans, which were designed by care managers. However, defined methodology for designing long-term care service plans a...

  12. Multidisciplinary care planning in the primary care management of completed stroke: a systematic review

    Directory of Open Access Journals (Sweden)

    Erikssen Lars

    2008-08-01

    Full Text Available Abstract Background Chronic disease management requires input from multiple health professionals, both specialist and primary care providers. This study sought to assess the impact of co-ordinated multidisciplinary care in primary care, represented by the delivery of formal care planning by primary care teams or shared across primary-secondary teams, on outcomes in stroke, relative to usual care. Methods A Systematic review of Medline, EMBASE, CINAHL (all 1990–2006, Cochrane Library (Issue 1 2006, and grey literature from web based searching of web sites listed in the CCOHA Health Technology Assessment List Analysis used narrative analysis of findings of randomised and non-randomised trials, and observational and qualitative studies of patients with completed stroke in the primary care setting where care planning was undertaken by 1 a multi-disciplinary primary care team or 2 through shared care by primary and secondary providers. Results One thousand and forty-five citations were retrieved. Eighteen papers were included for analysis. Most care planning took part in the context of multidisciplinary team care based in hospitals with outreach to community patients. Mortality rates are not impacted by multidisciplinary care planning. Functional outcomes of the studies were inconsistent. It is uncertain whether the active engagement of GPs and other primary care professionals in the multidisciplinary care planning contributed to the outcomes in the studies showing a positive effect. There may be process benefits from multidisciplinary care planning that includes primary care professionals and GPs. Few studies actually described the tasks and roles GPs fulfilled and whether this matched what was presumed to be provided. Conclusion While multidisciplinary care planning may not unequivocally improve the care of patients with completed stroke, there may be process benefits such as improved task allocation between providers. Further study on the impact

  13. Nuclear Manpower Development

    International Nuclear Information System (INIS)

    Nuclear Training Center (NTC) has concentrated its efforts on the systemization and specialization of education and training programs and has actively carried out diverse activities to create new nuclear courses based on its experience accumulated over the past years. The systematic and comprehensive education systems have been set up by streamlining the education systems for internal employees conducted sporadically over the past years. For the development of efficient education courses, expansion and diversification of education and training programs have been carried out based on the study of the Systematic Approach to Training (SAT) methodology and a survey of manpower development in on-site industry. Furthermore, despite the decrease in the number of potential trainees due to various government-enforced regulations and the increase in the number of other nuclear education institutions, the consistent efforts to develop new courses and to improve previous programs based on evaluations from the trainees have led to an upgrade in the level of education and the efficiency of the operation compared to previous years. In terms of development, 7 education programs were improved accordingly and 10 new courses were created. The year 2008 was especially considered a landmark, as NTC was authenticated as one of the best Human Resource Development (HRD) institutions for providing various kinds of education in the field of nuclear energy. Today, it is recognized as the leading HRD center in Korea

  14. Nuclear Manpower Training

    International Nuclear Information System (INIS)

    Nuclear Training Center (NTC) has concentrated its efforts on the systemisation and specialization of education and training and has actively carried out diverse activities to create new education courses based on the experience accumulated so far. The systematic and comprehensive education system(KAERI-ACE) has been set up by streamlining the education systems for internal employees conducted sporadically over the past year and expansion and diversification of education and training has been built through a study on Systematic Approach Training (SAT) methodology for the development of efficient education courses and a survey of manpower development in on-site industry. The 6 education programs have been developed and 18 courses were newly developed and improved. Especially to be noted in relation to education program development is that NTC has compiled and published a book titled 'Practical Research Ethics'. NTC has played a leading role in providing a research ethics education, in helping to promote the importance of research ethics by publishing a research ethics book and distributing them to government, research institutes, universities, etc. The total number of people who receive education for the year of 2007 was 2,998 and a total of 65 training courses were established and 106 times operated. The number of industry courses was 31, 56 times operated, and 1,309 persons participated and that nuclear R and D personnel education areas (internal employees' education) was 34 courses, 50 times operated, 2,689 persons participated

  15. Nuclear Manpower Training

    International Nuclear Information System (INIS)

    Nuclear Training Center (NTC) has concentrated its efforts on the systemisation and specialization of education and training and has actively carried out diverse activities to create new education courses based on the experience accumulated so far. The systematic and comprehensive education systems have been set up by streamlining the education systems for internal employees conducted sporadically over the past years and expansion and diversification of education and training has been built through a study on Systematic Approach to Training (SAT) methodology for the development of efficient education courses and a survey of manpower development in on-site industry. The 6 education programs have been developed and 15 courses were newly developed and improved. Especially to be noted in relation to education program development is that NTC has compiled and published a book titled 'current status of research ethics of science and technology and cases' and has also conducted a survey targeted at the 30 electric power/electricity industries related to nuclear power. The total number of people who receive education for the year of 2006 was 4,186 and a total of 130 training courses were established and 125 times operated. Among them, the number of collective education was 64 courses, 104 times operated and 3,190 persons participated while as for cyber education(on-line language education), 39 courses in 3 foreign language areas established, 21 times operated and 996 persons participated

  16. Abbreviated Pandemic Influenza Planning Template for Primary Care Offices

    Energy Technology Data Exchange (ETDEWEB)

    HCTT CHE

    2010-01-01

    The Abbreviated Pandemic Influenza Plan Template for Primary Care Provider Offices is intended to assist primary care providers and office managers with preparing their offices for quickly putting a plan in place to handle an increase in patient calls and visits, whether during the 2009-2010 influenza season or future influenza seasons.

  17. My Cancer Care Plan as a Web-Solution.

    Science.gov (United States)

    Westman, Bodil; Cornelius, Birgitta

    2016-01-01

    The Swedish National Cancerplan states that patients should be offered an Individual Care Plan (ICP) for the treatment and survivorship care and rehabilitation planning. As there is no web-solution for ICP available, the project aim is to develop a non-commercial web-solution based on communication between the contact nurse and the patient. PMID:27332410

  18. Advance care planning in South Korea: Social work perspective.

    Science.gov (United States)

    Kwon, Sung Ae; Kolomer, Stacey

    2016-08-01

    As ethical issues arise concerning the continuation of futile medical treatment for dying patients in Korean society, advance directive planning initiatives have been put into place to guide practice. This article describes the awareness and attitudes of social workers in Korea regarding advance care planning and related factors. A total of 246 gerontological/geriatric social workers completed a mailed or in-person survey regarding awareness and attitudes toward advance care planning. Seventy-three percent (n = 180) of the participants reported no knowledge of advance directives. Social workers who emphasized self-determination as a professional value, professed a preference for hospice care, and who were comfortable discussing death were more likely to have a positive attitudes toward advance care planning. This study reinforces the need for the infusion of advance care planning and end-of-life training in social work education in Korea. PMID:27428654

  19. Social Marketing: Planning Before Conceiving Preconception Care

    OpenAIRE

    E. Prue, Christine; Daniel, Katherine Lyon

    2006-01-01

    Social marketing approaches can help to shape the formation of and to create demand for preconception care services. This article describes four components of social marketing, often referred to as the 4 P’s, that should be carefully researched and set in place before a national effort to launch and sustain preconception care services is pursued. First, the product or package of services must be defined and adapted using the latest in scientific and health care standards and must be based on ...

  20. Development and evaluation of an aged care specific Advance Care Plan

    OpenAIRE

    Silvester, William; Parslow, Ruth A; Lewis, Virginia J; Fullam, Rachael S; Sjanta, Rebekah; Jackson, Lynne; White, Vanessa; Hudson, Rosalie

    2013-01-01

    Objectives To report on the quality of advance care planning (ACP) documents in use in residential aged care facilities (RACF) in areas of Victoria Australia prior to a systematic intervention; to report on the development and performance of an aged care specific Advance Care Plan template used during the intervention. Design An audit of the quality of pre-existing documentation used to record resident treatment preferences and end-of-life wishes at participating RACFs; development and pilot ...

  1. OPTIMAL TRAINING POLICY FOR PROMOTION - STOCHASTIC MODELS OF MANPOWER SYSTEMS

    Directory of Open Access Journals (Sweden)

    V.S.S. Yadavalli

    2012-01-01

    Full Text Available In this paper, the optimal planning of manpower training programmes in a manpower system with two grades is discussed. The planning of manpower training within a given organization involves a trade-off between training costs and expected return. These planning problems are examined through models that reflect the random nature of manpower movement in two grades. To be specific, the system consists of two grades, grade 1 and grade 2. Any number of persons in grade 2 can be sent for training and after the completion of training, they will stay in grade 2 and will be given promotion as and when vacancies arise in grade 1. Vacancies arise in grade 1 only by wastage. A person in grade 1 can leave the system with probability p. Vacancies are filled with persons in grade 2 who have completed the training. It is assumed that there is a perfect passing rate and that the sizes of both grades are fixed. Assuming that the planning horizon is finite and is T, the underlying stochastic process is identified as a finite state Markov chain and using dynamic programming, a policy is evolved to determine how many persons should be sent for training at any time k so as to minimize the total expected cost for the entire planning period T.

  2. Requirements for and development of trained manpower resources

    International Nuclear Information System (INIS)

    The Brazilian nuclear programme will require, by 1990, the installation of at least 10 000 MWe of nuclear power capacity, the implementation of the entire fuel cycle complex, and the creation of a reactor heavy components manufacturing industry and of a nuclear power plant engineering capability. It has been estimated that such a programme will have to employ until 1985, some 7000 to 8000 people at the engineering and technician levels. As a consequence, planning the manpower preparation and qualification, involving such large numbers, required not only thorough analyses of sectoral requirements but also careful consideration of depletion rates and losses during the training process. Taking this into account, the Universities and Technical Schools will need to graduate, in average, 450 - 550 additional engineers and technicians respectively per year during the next 10 years. For this purpose, the maximum possible use of the existing educational system in the country will refrain from excessive reliance upon external sources and strengthen the local infrastructure. Crash specialization courses have been developed, in conjunction with the Universities, to specifically comply with the requirements of the nuclear programme. Only in the case where no industrial experience can be provided in the country, on-the-job training in foreign firms is being considered. Training of nuclear power plant operators is also to be a local activity. An Operators Training Center, by using a plant simulator, is under implementation with a scheduled operational date in the early eighties. For the implementation of the nuclear manpower programme, Comissao Nacional de Energia Nuclear (CNEN) has been given the task of promoting and coordinating the nuclear academic education, whereas Empresas Nucleares Brasileiras S.A. (NUCLEBRAS) has the responsibility for the specialization and training of personnel in the nuclear technological fields

  3. Trained manpower resources in Brazil. Estimates and preparations

    International Nuclear Information System (INIS)

    The Brazilian nuclear programme will require by 1990 the installation of at least 10000MW(e) of nuclear power capacity, the implementation of the entire fuel cycle complex, and the creation of a reactor heavy-components manufacturing industry and of a nuclear power plant engineering capability. It has been estimated that such a programme will have to employ, up to 1985, some 7000-8000 people at the engineering and technician levels. The paper summarizes the consequent planning for preparation and qualification of manpower, which, as it involved such large numbers, required not only thorough analyses of sectoral requirements but also careful consideration of depletion rates and losses during the training process. Taking this into account, the Universities and Technical Schools will need to graduate, on average, 450 additional engineers and 550 additional technicians per year during the next ten years. For this purpose, the maximum use of the existing educational system in Brazil will avoid excessive reliance on external sources and will strengthen the local infrastructure. Crash specialization courses have been developed, in conjunction with the Universities, to comply specifically with the requirements of the nuclear programme. Only when no industrial experience can be provided in the country is on-the-job training in foreign firms considered. Training of nuclear power plant operators is also to be a local activity. An Operators Training Centre, by using a plant simulator, is being implemented with a scheduled operational date in the early 1980s. To implement the nuclear manpower programme, the Comissao Nacional de Energia Nuclear has been given the task of promoting and co-ordinating the nuclear academic education, while Empresas Nucleares Brasileiras SA is responsible for specialization and training of personnel in nuclear technology. (author)

  4. Advance Care Planning: Medical Issues to Consider

    Science.gov (United States)

    ... cancer or end stage chronic illness accompanied by anorexia (lack of appetite) and cachexia (muscles wasting away ... care and administrative program support. Share this: Twitter Facebook Google Search for: Choosing a Hospice: 16 Questions ...

  5. Manpower Division Looks at CETA

    Science.gov (United States)

    American Vocational Journal, 1977

    1977-01-01

    The Manpower Division at the American Vocational Association (AVA) convention in Houston was concerned about youth unemployment and about the Comprehensive Employment and Training Act (CETA)--its problems and possibilities. The panel discussion reported here reveals some differing perspectives and a general consensus--that to improve their role in…

  6. Health Care Procedure Considerations and Individualized Health Care Plans

    Science.gov (United States)

    Heller, Kathryn Wolff; Avant, Mary Jane Thompson

    2011-01-01

    Teachers need to maintain a safe, healthy environment for all their students in order to promote learning. However, there are additional considerations when students require health care procedures, such as tube feeding or clean intermittent catheterization. Teachers must effectively monitor their students and understand their roles and…

  7. Managing Health Care After Cancer Treatment: A Wellness Plan

    OpenAIRE

    Moye, Jennifer; Langdon, Maura; Jones, Janice M.; Haggstrom, David; Naik, Aanand D.

    2014-01-01

    Many patients and health care providers lack awareness of both the existence of, and treatments for, lingering distress and disability after treatment. A cancer survivorship wellness plan can help ensure that any referral needs for psychosocial and other restorative care after cancer treatment are identified.

  8. [Individualised care plan during extracorporeal membrane oxygenation. A clinical case].

    Science.gov (United States)

    Call Mañosa, S; Pujol Garcia, A; Chacón Jordan, E; Martí Hereu, L; Pérez Tejero, G; Gómez Simón, V; Estruga Asbert, A; Gallardo Herrera, L; Vaquer Araujo, S; de Haro López, C

    2016-01-01

    An individualised care plan is described for a woman diagnosed with pneumonia, intubated, and on invasive mechanical ventilation, who was admitted to the Intensive Care Unit for extracorporeal membrane oxygenation (ECMO). A nursing care plan was designed based on Marjory Gordon functional patterns. The most important nursing diagnoses were prioritised, using a model of clinical reasoning model (Analysis of the current status) and NANDA taxonomy. A description is presented on, death anxiety, impaired gas exchange, decreased cardiac output, dysfunctional gastrointestinal motility, risk for disuse syndrome, infection risk, and bleeding risk. The principal objectives were: to reduce the fear of the family, achieve optimal respiratory and cardiovascular status, to maintain gastrointestinal function, to avoid immobility complications, and to reduce the risk of infection and bleeding. As regards activities performed: we gave family support; correct management of the mechanical ventilation airway, cardio-respiratory monitoring, skin and nutritional status; control of possible infections and bleeding (management of therapies, care of catheters…). A Likert's scale was used to evaluate the results, accomplishing all key performance indicators which were propose at the beginning. Individualised care plans with NNN taxonomy using the veno-venous ECMO have not been described. Other ECMO care plans have not used the same analysis model. This case can help nurses to take care of patients subjected to veno-venous ECMO treatment, although more cases are needed to standardise nursing care using NANDA taxonomy. PMID:27137415

  9. Quality of Care in Family Planning Program in China

    Institute of Scientific and Technical Information of China (English)

    Zhen-ming XIE; Hong-yan LIU

    2006-01-01

    Objective To sum up the theory of quality care according to the experience of F.P. program in China.Methods The author summarized the QOC theory and draw on its experiences and strength in family planning program in China.Results The theory facilitated the earnest program of the population and family planning program during the tenth five-year plan period, benefited the realization of the innovation of system and mechanism in population and family planning work, and the creation of a nice population environment for the healthy social and economic development in China.Conclusion The development of QOC has displayed a conspicuous theory in China's family planning program.

  10. Action Planning for Daily Mouth Care in Long-Term Care: The Brushing Up on Mouth Care Project

    Directory of Open Access Journals (Sweden)

    Mary E. McNally

    2012-01-01

    Full Text Available Research focusing on the introduction of daily mouth care programs for dependent older adults in long-term care has met with limited success. There is a need for greater awareness about the importance of oral health, more education for those providing oral care, and organizational structures that provide policy and administrative support for daily mouth care. The purpose of this paper is to describe the establishment of an oral care action plan for long-term care using an interdisciplinary collaborative approach. Methods. Elements of a program planning cycle that includes assessment, planning, implementation, and evaluation guided this work and are described in this paper. Findings associated with assessment and planning are detailed. Assessment involved exploration of internal and external factors influencing oral care in long-term care and included document review, focus groups and one-on-one interviews with end-users. The planning phase brought care providers, stakeholders, and researchers together to design a set of actions to integrate oral care into the organizational policy and practice of the research settings. Findings. The establishment of a meaningful and productive collaboration was beneficial for developing realistic goals, understanding context and institutional culture, creating actions suitable and applicable for end-users, and laying a foundation for broader networking with relevant stakeholders and health policy makers.

  11. Impact of advance care planning on the care of patients with heart failure: study protocol for a randomized controlled trial

    OpenAIRE

    Malhotra, Chetna; Sim, David Kheng Leng; Jaufeerally, Fazlur; Vikas, Nivedita Nadkarni; Sim, Genevieve Wong Cheng; Tan, Boon Cheng; Ng, Clarice Shu Hwa; Tho, Pei Leng; Lim, Jingfen; Chuang, Claire Ya-Ting; Fong, Florence Hui Mei; Liu, Joy; Finkelstein, Eric A.

    2016-01-01

    Background Despite the promise and popularity of advance care planning, there is insufficient evidence that advance care planning helps patients to meet their end-of-life care preferences, especially in Asian settings. Thus, the proposed study aims to assess whether patients with advanced heart failure who are receiving advance care planning have a greater likelihood of receiving end-of-life care consistent with their preferences compared to patients receiving usual care. Secondary objectives...

  12. Planning of Nursing Home Care Services in Jordan: Its Reality and Challenges

    Directory of Open Access Journals (Sweden)

    Hasan Salih Suliman Al-Qudah

    2011-09-01

    Full Text Available United Nations Principles for Older Persons acknowledge five rights to elderly or older persons, these rights are the right of "independence, care, self, fulfillment, dignity, participation.The demographic Indication witnessed increasing trends in population pyramid at developed countries on aging rates world wide, especially in most of developing countries. So in order to address this growing dilemma at our civilized world its proved at statistics surveys, on current research work as it will try to expose to efforts the plans made by many Jordanian Civil &Governmental initiatives for facing this category for the purpose of providing high standards services at both health and social care services for elderly people and to help them reaching a self-realization, and to encourage them in developing their potential through resources available in different aspects of the community educationally, culturally, spiritually and even through recreational activities.The present study aims to identify current capabilities that available in serving elderly people at two main Nursing Home Centers in Jordan located in Amman. Its limitation to only two most serving accommodated numbers of elder's Nursing Home centers the first is: White Beds Society and the second is: Centre for Princess Muna older women Nursing homes / Orthodox Charity as both are largest and oldest of Nursing homes centers serving elderly.The research concluded many numerous results most important are: There shall specialized cooperation bodies in charge of deals with other institutions working in the field of aging society, as of governmental organizations, hospitals, accredited qualified manpower to deal with this deer category of our society.secondly. Assist homes for elderly in budgetary provisions of adequate budget to them.

  13. Health Care Consumerism: Lessons My 401(k) Plan Taught Me.

    Science.gov (United States)

    Steinberg, Allen T

    2015-01-01

    Changes to the U.S. health care system are here. As we think about how individuals will pay for health care--while actively employed and while retired--our experiences with 401(k) plans provide some valuable lessons. In order to support employees in this new health care world--a challenge arguably more daunting than the 401(k) challenge we faced 20 years ago--some very different types of support are needed. Employers should consider providing their employees with the resources to manage health care changes. PMID:26666089

  14. Palliative Care, Hospice, and Advance Care Planning: Views of People Living with HIV and Other Chronic Conditions.

    Science.gov (United States)

    Slomka, Jacquelyn; Prince-Paul, Maryjo; Webel, Allison; Daly, Barbara J

    2016-01-01

    People living with HIV (PLWH) who survive to older adulthood risk developing multiple chronic medical conditions. Health policymakers recognize the role of early palliative care and advance care planning in improving health quality for at-risk populations, but misperceptions about palliative care, hospice, and advance care planning are common. Before testing a program of early palliative care for PLWH and other chronic conditions, we conducted focus groups to elicit perceptions of palliative care, hospice, and advance care planning in our target population. Overall, participants were unfamiliar with the term palliative care, confused concepts of palliative care and hospice, and/or associated hospice care with dying. Participants misunderstood advance care planning, but valued communication about health care preferences. Accepting palliative care was contingent on distinguishing it from hospice and historical memories of HIV and dying. Provision of high-quality, comprehensive care will require changing public perceptions and individuals' views in this high-risk population. PMID:27053406

  15. Strategic Facilities Planning: A Focus On Health Care

    Directory of Open Access Journals (Sweden)

    Ellen D. Hoadley

    2011-01-01

    Full Text Available Turbulent market conditions have forced the health care sector to re-examine its business and operational practices.  Health care has become increasingly complex as decisions and planning are reframed in light of the current lagging economy, an increased demand for services, new global competition, and impending legislation reform.  The stress is felt most keenly within the nation’s hospitals and consortia of health care facilities.  Facility planning decisions are no exception.  Hospital administrators are abandoning the once commonplace rules governing aging infrastructure renovations.  Instead, administrators are basing decisions within their respective strategic context and are attempting to align buildings, services, personnel, and technology to an overall plan that looks at markets, operations, and finances as resources for competitive advantage.  This paper reviews the strategic facilities planning literature and applies those best practices which support this organizational alignment for health care.  An application in the mid-Atlantic demonstrates that hospital facilities, by design, need to support the current and future needs of health care delivery systems, while dated structures impede industry advances.  Health care infrastructure improvements must proactively address technological, regulatory, and financial changes facing the sector.

  16. Homecare Nurses' Decision-Making During Admission Care Planning.

    Science.gov (United States)

    Sockolow, Paulina; Bass, Ellen J; Eberle, Carl L; Bowles, Kathryn H

    2016-01-01

    The re-hospitalization rate of homecare patients within 60 days of hospital discharge is 30%. Enhanced care planning based on better information may reduce this rate. However, very little is known about the homecare admission and care planning processes. The research team collected data during observations of three nursing visits to admit homecare patients in Camden NJ, and conducted thematic content analysis on these data. Human factors methods helped to identify nurse decision-making related to selection of the plan of care problems, non-nursing resources, and the nursing visit pattern. They identified how the electronic health record (EHR) assisted the nurse in visit pattern frequency decisions. Major themes that emerged included reduced efficiency due to use of redundant intra-team communication methods to augment EHR documentation, redundant documentation, and workarounds and reorganization of clinical workflow. PMID:27332156

  17. Solving the Puzzle of Child Care: Report of the Cuyahoga County Child Day Care Planning Project.

    Science.gov (United States)

    Child Day Care Planning Project, Cleveland, OH.

    This report describes the Child Day Care Planning Project, which was developed by private and public representatives to meet the needs for child care in Cuyahoga County, Ohio. The project consisted of five major components. The first component, the Data Project, documented the needs and resources of the community. The second component, the Quality…

  18. Survivorship care plans: Prevalence and barriers to use

    OpenAIRE

    Birken, Sarah A.; Mayer, Deborah K.; Weiner, Bryan J.

    2013-01-01

    Survivorship care plans (SCPs) are intended to educate survivors and providers about survivors’ transition from cancer treatment to follow-up care. Using a survey of 23 cancer programs in the South Atlantic United States, we (1) describe the prevalence and barriers to SCP use and (2) assess relationships between SCP use and (a) barriers and (b) cancer program characteristics. Most cancer programs (86%) reported some SCP use; however, less than a quarter of cancer programs’ providers had ever ...

  19. Changing workforce demographics necessitates succession planning in health care.

    Science.gov (United States)

    Collins, Sandra K; Collins, Kevin S

    2007-01-01

    Health care organizations continue to be plagued by labor shortage issues. Further complicating the already existing workforce challenges is an aging population poised to retire en masse within the next few years. With fewer cohorts in the age group of 25 to 44 years (Vital Speeches Day. 2004:71:23-27), a more mobile workforce (Grow Your Own Leaders: How to Identify, Develop, and Retain Leadership Talent, 2002), and an overall reduction in the number of individuals seeking employment in the health care field (J Healthc Manag. 2003:48:6-11), the industry could be faced with an unmanageable number of vacant positions throughout the organization. Bracing for the potential impact of these issues is crucial to the ongoing business continuity of health care organization. Many health care organizations have embraced succession planning to combat the potential labor famine. However, the health care industry as a whole seems to lag behind other industries in terms of succession planning efforts (Healthc Financ Manage. 2005;59:64-67). This article seeks to provide health care managers with a framework for improving the systematic preparation of the next generation of managers by analyzing the succession planning process. The proposition of these models is to initiate and simplify the gap reduction between theoretical concepts and future organizational application. PMID:17992105

  20. Exploring the usefulness of comprehensive care plans for children with medical complexity (CMC: a qualitative study

    Directory of Open Access Journals (Sweden)

    Adams Sherri

    2013-01-01

    Full Text Available Abstract Background The Medical Home model recommends that Children with Special Health Care Needs (CSHCN receive a medical care plan, outlining the child’s major medical issues and care needs to assist with care coordination. While care plans are a primary component of effective care coordination, the creation and maintenance of care plans is time, labor, and cost intensive, and the desired content of the care plan has not been studied. The purpose of this qualitative study was to understand the usefulness and desired content of comprehensive care plans by exploring the perceptions of parents and health care providers (HCPs of children with medical complexity (CMC. Methods This qualitative study utilized in-depth semi-structured interviews and focus groups. HCPs (n = 15 and parents (n = 15 of CMC who had all used a comprehensive care plan were recruited from a tertiary pediatric academic health sciences center. Themes were identified through grounded theory analysis of interview and focus group data. Results A multi-dimensional model of perceived care plan usefulness emerged. The model highlights three integral aspects of the care plan: care plan characteristics, activating factors and perceived outcomes of using a care plan. Care plans were perceived as a useful tool that centralized and focused the care of the child. Care plans were reported to flatten the hierarchical relationship between HCPs and parents, resulting in enhanced reciprocal information exchange and strengthened relationships. Participants expressed that a standardized template that is family-centered and includes content relevant to both the medical and social needs of the child is beneficial when integrated into overall care planning and delivery for CMC. Conclusions Care plans are perceived to be a useful tool to both health care providers and parents of CMC. These findings inform the utility and development of a comprehensive care plan template as well as a model of how

  1. Reliability of an Interactive Computer Program for Advance Care Planning

    OpenAIRE

    Schubart, Jane R.; Levi, Benjamin H.; Camacho, Fabian; Whitehead, Megan; Farace, Elana; Green, Michael J.

    2012-01-01

    Despite widespread efforts to promote advance directives (ADs), completion rates remain low. Making Your Wishes Known: Planning Your Medical Future (MYWK) is an interactive computer program that guides individuals through the process of advance care planning, explaining health conditions and interventions that commonly involve life or death decisions, helps them articulate their values/goals, and translates users' preferences into a detailed AD document. The purpose of this study was to demon...

  2. Fisheries manpower development in the eighties

    OpenAIRE

    Olaniawa, A.A.

    1986-01-01

    An examination is made of training programmes in the Federal Fisheries School, Lagos, detailing training objectives, manpower requirement and training strategies, indicating also areas for improvement and development

  3. Discharge Planning in Acute Care Hospitals in Israel: Services Planned and Levels of Implementation and Adequacy

    Science.gov (United States)

    Auslander, Gail K.; Soskolne, Varda; Stanger, Varda; Ben-Shahar, Ilana; Kaplan, Giora

    2008-01-01

    This study aimed to examine the implementation, adequacy, and outcomes of discharge planning. The authors carried out a prospective study of 1,426 adult patients discharged from 11 acute care hospitals in Israel. Social workers provided detailed discharge plans on each patient. Telephone interviews were conducted two weeks post-discharge. Findings…

  4. IAEA activities in manpower development for nuclear power - moving to meet challenges

    International Nuclear Information System (INIS)

    Need for excellence in human performance in all activities involved in nuclear power - The challenge of providing qualified manpower when required - Planning and preparing nuclear power programmes and projects - Design, construction and commissioning of nuclear power plants - Operation and maintenance, plant performance - Safe, reliable and economic operation - the national manpower development effort - Role of foreign assistance and of the IAEA - The Agency's comprehensive programme, objectives, means - Experience - Training courses, guidebooks, standards - Current trends - Examples. (orig.)

  5. 42 CFR 409.43 - Plan of care requirements.

    Science.gov (United States)

    2010-10-01

    ... skilled nursing, physical therapy, speech-language pathology services, or occupational therapy visit in a... 42 Public Health 2 2010-10-01 2010-10-01 false Plan of care requirements. 409.43 Section 409.43 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES...

  6. Evidence Based Order Sets as a Nursing Care Planning System

    OpenAIRE

    LaCrosse, Lisa M.; Heermann, Judith; Azevedo, Karen; Sorrentino, Catherine; Straub, Dawn; O'Dowd, Gloria

    2002-01-01

    The process for developing the nursing care planning (NCP) function for integration into a clinical information system (CIS) will be described. This NCP system uses evidence based order sets or interventions that are specific to a problem with associated patient focused goals or outcomes. The problem, order set, goal framework will eventually be used by all disciplines in the patient focused record.

  7. Understanding the Context for Long-Term Care Planning.

    Science.gov (United States)

    Broyles, Ila H; Sperber, Nina R; Voils, Corrine I; Konetzka, R Tamara; Coe, Norma B; Van Houtven, Courtney Harold

    2016-06-01

    Evolving family structure and economic conditions may affect individuals' ability and willingness to plan for future long-term care (LTC) needs. We applied life course constructs to analyze focus group data from a study of family decision making about LTC insurance. Participants described how past exposure to caregiving motivated them to engage in LTC planning; in contrast, child rearing discouraged LTC planning. Perceived institutional and economic instability drove individuals to regard financial LTC planning as either a wise precaution or another risk. Perceived economic instability also shaped opinions that adult children are ill-equipped to support parents' LTC. Despite concerns about viability of social insurance programs, some participants described strategies to maximize gains from them. Changing norms around aging and family roles also affected expectations of an active older age, innovative LTC options, and limitations to adult children's involvement. Understanding life course context can inform policy efforts to encourage LTC planning. PMID:26553887

  8. Planning parenthood: Health care providers' perspectives on pregnancy intention, readiness, and family planning.

    Science.gov (United States)

    Stevens, Lindsay M

    2015-08-01

    A major health care goal in the United States is increasing the proportion of pregnancies that are planned. While many studies examine family planning from the perspective of individual women or couples, few investigate the perceptions and practices of health care providers, who are gatekeepers to medicalized fertility control. In this paper, I draw on 24 in-depth interviews with providers to investigate how they interpret and enact the objective to "plan parenthood" and analyze their perspectives in the context of broader discourses about reproduction, family planning, and motherhood. Interviews reveal two central discourses: one defines pregnancy planning as an individual choice, that is as patients setting their own pregnancy intentions; the second incorporates normative expectations about what it means to be ready to have a baby that exclude poor, single, and young women. In the latter discourse, planning is a broader process of achieving middle-class life markers like a long-term relationship, a good job, and financial stability, before having children. Especially illuminating are cases where a patient's pregnancy intention and the normative expectations of "readiness" do not align. With these, I demonstrate that providers may prioritize normative notions of readiness over a patient's own intentions. I argue that these negotiations of intention and readiness reflect broader tensions in family planning and demonstrate that at times the seemingly neutral notion of "planned parenthood" can mask a source of stratification in reproductive health care. PMID:26151389

  9. Manpower Projections to 1980. Econometric Study.

    Science.gov (United States)

    Kubota, Gordon H.; Tsukahara, Theodore, Jr.

    The objective of this study was to develop an economic approach to the forecasting of allied health manpower in markets in the State of California. The health manpower categories considered included: (1) Medical technology, (2) occupational therapy, (3) dietetic and nutritional services, (4) physical therapy, (5) health administration, (6)…

  10. Mass mobilisation for a realistic manpower plan

    CERN Document Server

    Association du personnel

    2007-01-01

    The CERN staff turned out in force on Thursday to sign the Staff Association petition. The staff showed in a responsible manner its desire to keep staff numbers at a vital level to guarantee the future of the Organization.

  11. Continuity of Care: Sharing the Medication Treatment Plan.

    Science.gov (United States)

    Spahni, Stéphane

    2016-01-01

    The shared medication treatment plan is a key element for supporting the continuity of care. Indeed a substantial amount of emergency hospitalization is linked to medication - 5% to 10% according to some studies. Methods and tools helping all healthcare providers to have a better knowledge of the complete medication plan are therefore required in order to limit side effects linked to an insufficient knowledge of what the patient is taking. The workshop intends to present various initiatives and open the discussion about the limits, pros and cons of various initiatives. PMID:27332315

  12. Optimal Manpower Recruitment and Dismissal Decision for Single-type Job

    Institute of Scientific and Technical Information of China (English)

    XudongLi; FengshengTu; YongjianLi; XiaoqiangCai

    2004-01-01

    We consider a manpower planning problem with single employee type over a long planning horizon and analyze the optimal recruitment and dismissal polices. Dynamic demands for manpower must be fulfilled by allocating enough number of employees. Costs for every employee include salary, recruitment and dismissal costs, in particular, setup costs when recruitment/dismissal activities occur. We formulate the problem as a multi-period decision model. Then we analyze properties of the problem and give an improved dynamic programming algorithm to minimize the total cost over the entire planning horizon. We report computational results to illustrate the effectiveness of the approach.

  13. China's Experience of Quality Care in Family Planning

    Institute of Scientific and Technical Information of China (English)

    Er-sheng GAO; Wei YUAN; Ning LIU

    2006-01-01

    Objective To evaluate and overview the experience of quality care of family planning of China.Methods The framework of quality care of China was summarized and analyzed, that was clients, technology and management triangle program system.Results The 8 fundamental elements of quality care in China were presented:1) policy environment of QoC, 2) comprehensive services, 3) choice of method, 4) IEC to policy-makers and providers, 5) technical competence, 6) interpersonal communications, 7) institutional guideline and regulation, 8) appropriate constellation of service.Conclusion FP sectors should prepare different constellations of service to meet their individual reproductive health need for different clients and develop institutional guideline and regulation for FP service to follow up in practice. QoC should be a kind of standardized service process.

  14. SOCIAL RESEARCH AND HEALTH CARE PLANNING IN SOUTH ASIA - PART 1

    OpenAIRE

    Leslie, Charles

    1988-01-01

    This paper discuses the social research and health care planning systems of South Asia. Also, the Author attempts to indicate the scope and nature of this work done in this territory to identity elements relevant to health care planning.

  15. Developing Strategies to Improve Advance Care Planning in Long Term Care Homes: Giving Voice to Residents and Their Family Members

    OpenAIRE

    Kimberly Ramsbottom; Mary Lou Kelley

    2014-01-01

    Long term care (LTC) homes, also known as residential care homes, commonly care for residents until death, making palliative care and advance care planning (ACP) important elements of care. However, limited research exists on ACP in LTC. In particular, research giving voice to family members and substitute decision makers is lacking. The objective of this research was to understand experiences, perspectives, and preferences to guide quality improvement of ACP in LTC. This qualitative descript...

  16. Care planning and decision-making in teams in Swedish elderly care: a study of interprofessional collaboration and professional boundaries.

    Science.gov (United States)

    Duner, Anna

    2013-05-01

    In front-line practice, joint working between different professionals in health/social care and rehabilitation is regarded as a means to reach a comprehensive assessment of the needs of the older care recipients, leading to decisions on appropriate care and services. The aim of this study was to examine professional collaboration and professional boundaries in interprofessional care planning teams. Two different care planning teams were studied, one performing care planning in the homes of older individuals and the other performing care planning for older people in hospital wards. The empirical data consisted of audio-recorded care planning meetings and interviews with the professionals in the teams. The integration between the professionals involved was most noticeable in the investigation and assessment phase, while it was lower in the planning phase and almost non-existent in decision-making. The home care planning team tended to work in a more integrated manner than the discharge planning team. The importance of clarifying the roles of all professions concerned with needs assessment and care planning for older people became evident in this study. PMID:23343434

  17. Development and Validation of a Questionnaire to Detect Behavior Change in Multiple Advance Care Planning Behaviors

    OpenAIRE

    Sudore, Rebecca L.; Stewart, Anita L.; Knight, Sara J.; McMahan, Ryan D.; Feuz, Mariko; Miao, Yinghui; Barnes, Deborah E.

    2013-01-01

    Introduction Advance directives have traditionally been considered the gold standard for advance care planning. However, recent evidence suggests that advance care planning involves a series of multiple discrete behaviors for which people are in varying stages of behavior change. The goal of our study was to develop and validate a survey to measure the full advance care planning process. Methods The Advance Care Planning Engagement Survey assesses “Process Measures” of factors known from Beha...

  18. Manpower training and development for nuclear power

    International Nuclear Information System (INIS)

    Determination of the manpower required for implementation of a nuclear programme is a very important factor from the national viewpoint, as it is drawn from many sectors of industry. The author provides a case-study of manpower requirements in France. He is in favour of the establishment of a manpower programme within the educational system, involving schools and universities since technicians and engineers have an important role to play throughout the different stages of a nuclear programme. In this context, he describes the IAEA contribution to acquisition of know-how by means of training courses for developing countries. (NEA)

  19. Current status of SMPRs and manpower development for nuclear power

    International Nuclear Information System (INIS)

    The development of SMPRs could make it possible for countries with small electrical grids to use nuclear power. SMPRs are still in the developing stages and none of them have the capability of good plant performance. Most of the SMPRs are in the 300 MWe range and a grid capacity of at least 2000 MWe would be required before such a power plant can be connected to the grid. There is a possibility that SMPRs could generate electricity cheaper coal plants requiring desulphurization. An unexpected increase in coal price and adverse environmental effects could make it necessary to use nuclear power in the future. Qualified manpower is required to plan, build and properly operate a nuclear power plant; and the availability of qualified manpower is a pre-condition for deciding to use nuclear power. There is a possibility that Sri Lanka would be able to use nuclear power in the next 15-20 years and a total dependence upon foreign expertise is neither possible nor desirable. Therefore pre-project activities should be considering such things as teaching nuclear science and engineering in the universities and retraining existing professionals, say from the coal power industry. Adequate emphasis must be given to manpower development and to the need to scheduling this development

  20. Cohort effects on the need for health care and implications for health care planning in Canada.

    Science.gov (United States)

    Whittaker, William; Birch, Stephen; MacKenzie, Adrian; Murphy, Gail Tomblin

    2016-01-01

    The sustainability of publicly funded health care systems is an issue for governments around the world. The economic climate limits governments' fiscal capacity to continue to devote an increasing share of public funds to health care. Meanwhile the demands for health care within populations continue to increase. Planning the future requirements for health care is typically based on applying current levels of health service use by age to demographic projections of the population. But changes in age-specific levels of health over time would undermine this 'constant use by age' assumption. We use representative Canadian survey data (Canadian Community Health Survey) covering the period 2001-2012, to identify the separate trends in demography (population ageing) and epidemiology (population health) on self-reported health. We propose an approach to estimating future health care requirements that incorporates cohort trends in health. Overall health care requirements for the population increase as the size and mean age of the population increase, but these effects are mitigated by cohort trends in health-we find the estimated need for health care is lower when models account for cohort effects in addition to age effects. PMID:26586614

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

    Science.gov (United States)

    Siegrist, R B; Blish, C S

    1988-02-01

    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

  2. Developing a promotion plan for health care marketing.

    Science.gov (United States)

    Hallums, A

    1994-07-01

    Promotion of a health care provider's services is essential for communication with its customers and consumers. It is relevant to an organization's marketing strategy and is an element of what is described as the marketing mix. This paper considers the relationship of promotion to the marketing of services and proposes a plan for the promotion of the organization as a whole which can also be applied to an individual service or specialty. Whilst specific reference is made to an National Health Service (NHS) Trust it is also relevant to a Directly Managed Unit. PMID:7952707

  3. Manpower development in Africa and the regional manpower development project RAF/0/003. Special evaluation

    International Nuclear Information System (INIS)

    At the start of the Agency's technical co-operation activities in 1958, many of its developing Member States were just embarking on nuclear activities. To make basic nuclear training available for these countries became the first concern of the Agency and initially fellowships constituted more than 80% of the assistance provided. During the 1960s, while the programmes' expert and equipment components grew steadily, fellowships still represented more than 50% of the assistance provided to individual Member States. As counterpart institutions slowly build up small cadres of qualified staff, the share of training in the Agency's programme of technical co-operation became less dominant and, by 1986, only 22% of the funds spent on country programmes were devoted to fellowships. In the Africa region, where the share of fellowship training provided to individual Member States had dropped even below the 20% mark, and where the participation in group training events was the lowest of any region, this was having serious consequences on manpower development, as was pointed out in two separate evaluations. At least some opportunities exist in about 60% of the countries in the region for training in selected areas of nuclear science and technology, but only 20% of the countries provide training up to the MSc/PhD level. The number of trainees in nuclear science and technology graduating each year from national institutions is very small and cannot be considered adequate to satisfy existing manpower needs of the country concerned and of the region as a whole. Very few - if any - opportunities for nuclear training abroad are available for candidates from the region other than those funded by the Agency. There is very little awareness at the national level as to the actual training needs in the nuclear field in most countries of the region, underlining the importance of the role of the Agency, not only as a provider of training, but also as an adviser on assessing training needs at

  4. Care of Patients at the End of Life: Advance Care Planning.

    Science.gov (United States)

    Ackermann, Richard J

    2016-08-01

    Advance directives are legal documents that give instructions about how to provide care when patients develop life-threatening illnesses and can no longer communicate their wishes. Two types of documents are widely used-a living will and a durable power of attorney for health care. Most states also authorize physician orders for life-sustaining treatment. Physicians should encourage patients, particularly those with severe chronic or terminal conditions, to prepare advance directives. Medicare now reimburses billing codes for advance care consultations. Directions regarding cardiopulmonary resuscitation and artificial ventilation often are included in advance care plans, and use of artificial nutrition and hydration (ANH) also should be addressed, particularly for patients with advanced dementia. Evidence shows that in such patients, ANH does not prolong survival, increase comfort, or improve quality of life. Given the lack of benefit, physicians should recommend against use of ANH for patients with dementia. Finally, physicians should encourage use of hospice services by patients whose life expectancy is 6 months or less. Although Medicare and most other health care insurers cover hospice care, and despite evidence that patient and family satisfaction increase when hospice services are used, many patients do not use these services. PMID:27490070

  5. Theory of Planned Behavior, Self-Care Motivation, and Blood Pressure Self-Care

    OpenAIRE

    Peters, Rosalind M.; Templin, Thomas N

    2010-01-01

    The theory of planned behavior (TPB) was integrated within the theory of self-care (SCT) to explore the predictive value of extending TPB to measure attitudes and beliefs regarding a behavioral goal, and determine the ability of goal beliefs to predict engagement in the combined, multiple behaviors necessary to control BP. The hypothesized model was evaluated in a sample of 306 community-dwelling African Americans between 21 and 65 years of age. Scales developed for the study achieved accepta...

  6. Training capability required during plant operation to meet manpower needs

    International Nuclear Information System (INIS)

    A methodology is described for planning the training capability required during nuclear power plant operation to meet future manpower needs. The methodology involves the identification of the appropriate initial training programs and requalification training programs for each job position, and the computation of student throughput rates for each program. Application of the methodology to a subset of all job positions in a typical utility organization shows that minimum training costs may be achieved when the utility's training investment is minimized by using outside assistance from qualified training sources for certain training functions

  7. Advance Care Planning in Nursing Homes: Correlates of Capacity and Possession of Advance Directives

    Science.gov (United States)

    Allen, Rebecca S.; DeLaine, Shermetra R.; Chaplin, William F.; Marson, Daniel C.; Bourgeois, Michelle S.; Dijkstra, Katinka; Burgio, Louis D.

    2003-01-01

    Purpose: The identification of nursing home residents who can continue to participate in advance care planning about end-of-life care is a critical clinical and bioethical issue. This study uses high quality observational research to identify correlates of advance care planning in nursing homes, including objective measurement of capacity. Design…

  8. An overview of the need of manpower supply for a nuclear programme

    International Nuclear Information System (INIS)

    The present paper deals with the need for trained manpower and special features of nuclear power affecting manpower requirements and gives a manpower loading schedule for the different nuclear power activities and programmes for manpower development. (orig./RW)

  9. States, Congress confront abortion services under Medicaid, health care plan.

    Science.gov (United States)

    1994-01-13

    Abortion coverage under various health care reform proposals has dominated the political reproductive rights debate, while poor women's access to abortion under Medicaid presents a current practical concern. Under the Clinton administration's proposed Health Security Act, abortion would be covered under "services for pregnant women," and Medicaid would eventually be incorporated into the national health plan. A final version is a long way off. For now, the Hyde amendment, limiting Medicaid coverage of abortion, controls the issue. Congress has made only negligible progress in freeing federal funds for Medicaid abortions: only in situations of life endangerment, rape, or incest. States are required to cover abortions that are medically necessary under the new guidelines, which now include pregnancy arising from rape and incest. The federal policy defers to state law on the definition of rape and incest, allowing for reasonable reporting or documentation requirements, while disallowing unduly burdensome regulations by allowing the treating physician reimbursement when the physician certifies that the patient was unable for physical or psychological reasons to comply with the requirement. States disagreeing with the new abortion policy immediately registered their opposition. Utah's health department, which has a "life only" law, has pledged not to implement the new federal policy until there is further clarification. The Health Care Financing Administrator responded by writing that "the decision to implement this policy nationwide was not discretionary." Congress chose not to add statutory language deferring to the states, and under U.S. Constitutional law, where state law or policy conflicts with federal law, federal law takes precedence. The next battle will certainly center on attempts to amend the Hyde amendment itself as well as health care legislation along the "states' option" lines. PMID:12345518

  10. The economic evidence for advance care planning: systematic review of evidence

    OpenAIRE

    Dixon, Josie; Matosevic, Tihana; Knapp, Martin

    2015-01-01

    Background: Advance care planning (ACP), a process of discussion and review concerning future care in the event of losing capacity. Aimed at improving the appropriateness and quality of care, it is also often considered a means of controlling health spending at the end of life. Aim: To review and summarise economic evidence on advance care planning. Design: A systematic review of academic literature. Data sources: We searched for English language peer-reviewed journal articles, 1990 to 201...

  11. Reliability of an interactive computer program for advance care planning.

    Science.gov (United States)

    Schubart, Jane R; Levi, Benjamin H; Camacho, Fabian; Whitehead, Megan; Farace, Elana; Green, Michael J

    2012-06-01

    Despite widespread efforts to promote advance directives (ADs), completion rates remain low. Making Your Wishes Known: Planning Your Medical Future (MYWK) is an interactive computer program that guides individuals through the process of advance care planning, explaining health conditions and interventions that commonly involve life or death decisions, helps them articulate their values/goals, and translates users' preferences into a detailed AD document. The purpose of this study was to demonstrate that (in the absence of major life changes) the AD generated by MYWK reliably reflects an individual's values/preferences. English speakers ≥30 years old completed MYWK twice, 4 to 6 weeks apart. Reliability indices were assessed for three AD components: General Wishes; Specific Wishes for treatment; and Quality-of-Life values (QoL). Twenty-four participants completed the study. Both the Specific Wishes and QoL scales had high internal consistency in both time periods (Knuder Richardson formula 20 [KR-20]=0.83-0.95, and 0.86-0.89). Test-retest reliability was perfect for General Wishes (κ=1), high for QoL (Pearson's correlation coefficient=0.83), but lower for Specific Wishes (Pearson's correlation coefficient=0.57). MYWK generates an AD where General Wishes and QoL (but not Specific Wishes) statements remain consistent over time. PMID:22512830

  12. Reliability of an Interactive Computer Program for Advance Care Planning

    Science.gov (United States)

    Levi, Benjamin H.; Camacho, Fabian; Whitehead, Megan; Farace, Elana; Green, Michael J

    2012-01-01

    Abstract Despite widespread efforts to promote advance directives (ADs), completion rates remain low. Making Your Wishes Known: Planning Your Medical Future (MYWK) is an interactive computer program that guides individuals through the process of advance care planning, explaining health conditions and interventions that commonly involve life or death decisions, helps them articulate their values/goals, and translates users' preferences into a detailed AD document. The purpose of this study was to demonstrate that (in the absence of major life changes) the AD generated by MYWK reliably reflects an individual's values/preferences. English speakers ≥30 years old completed MYWK twice, 4 to 6 weeks apart. Reliability indices were assessed for three AD components: General Wishes; Specific Wishes for treatment; and Quality-of-Life values (QoL). Twenty-four participants completed the study. Both the Specific Wishes and QoL scales had high internal consistency in both time periods (Knuder Richardson formula 20 [KR-20]=0.83–0.95, and 0.86–0.89). Test-retest reliability was perfect for General Wishes (κ=1), high for QoL (Pearson's correlation coefficient=0.83), but lower for Specific Wishes (Pearson's correlation coefficient=0.57). MYWK generates an AD where General Wishes and QoL (but not Specific Wishes) statements remain consistent over time. PMID:22512830

  13. The manpower training and development programs of NUCLEBRAS for the Brazilian nuclear program

    International Nuclear Information System (INIS)

    As technology transfer is one of the main objectives of the Brazilian Nuclear Program, the principal aim of manpower training has been to provide the conditions for absorbing this technology. The strategy used for such a program required a quantitative and qualitative planning of manpower needs, through medium-range and long-term forecasts, with the condition of maximum utilization of the existing educational infra-structure. On-the-job training which is considered one of the most important means for technology transfer, was given highest priority. Also, management development was considered very important for the implementation of the Nuclear Program. This paper shows the results achieved from 1973 up to now by the manpower training and development programs. (Author)

  14. A new horizon for planning services and health care infrastructure for the elderly

    OpenAIRE

    Nauta, N.J.; Perenboom, R.J.M.; Galindo Garre, F.

    2009-01-01

    Since the devolution of capacity planning for care for the elderly in the Netherlands in 1998, no innovations on assessing health needs and on forecasting were made for planning health care services for the elderly. The introduction of Horizon in 2006, which uses needs and deficiencies instead of linear demographic planning has been warmly welcomed. The innovation is to step away from planning on the basis of policies and to forecast demands of services on the basis of actual deficiencies and...

  15. Advance Care Planning and Goals of Care Communication in Older Adults with Cardiovascular Disease and Multi-Morbidity.

    Science.gov (United States)

    Lum, Hillary D; Sudore, Rebecca L

    2016-05-01

    This article provides an approach to advance care planning (ACP) and goals of care communication in older adults with cardiovascular disease and multi-morbidity. The goal of ACP is to ensure that the medical care patients receive is aligned with their values and preferences. In this article, the authors outline common benefits and challenges to ACP for older adults with cardiovascular disease and multimorbidity. Recognizing that these patients experience diverse disease trajectories and receive care in multiple health care settings, the authors provide practical steps for multidisciplinary teams to integrate ACP into brief clinic encounters. PMID:27113144

  16. Evaluation of Cardiology Training and Manpower Requirements.

    Science.gov (United States)

    Adams, Forrest H., Ed.; Mendenhall, Robert C., Ed.

    Begun in June, 1971 and completed in October 1973, the study had the following specific goals: to define the cardiologist's role; to determine cardiology training program objectives; to determine manpower needs for cardiologists; and to determine the educational needs of cardiologists. The major information was sought from all active cardiologists…

  17. Agri-Business Manpower Project Manual.

    Science.gov (United States)

    Amberson, Max L.; And Others

    A final segment of the Montana research effort on agri-business manpower, this report summarizes the methods involved in and the conclusions and recommendations resulting from a study to develop an economical, efficient, and effective method of assessing current and anticipated agri-business employment opportunities and educational needs in…

  18. Yellowstone County Health Manpower and Education Profile.

    Science.gov (United States)

    Callen, John; And Others

    The profile is a concise description of the demographic and economic characteristics, existing health manpower employed, and health education programs for the Yellowstone County area of Montana, one of seven surveyed in the Mountain States region (Idaho, Montana, Wyoming, and Nevada). The first section of the profile provides general population…

  19. Indian manpower for mega nuclear project

    CERN Multimedia

    2003-01-01

    "India is supplying critical scientific manpower and high-tech components needed for building a Large Hadron Collider (LHC) - an accelerator used in particle physics research - a mega scientific project of the European Organisation for Nuclear Research (CERN) worth billions of dollars" (1/2 page).

  20. Dental underemployment: a study of uncontrolled dental manpower immigration.

    Science.gov (United States)

    Mann, J; Gat, E; Lubliner, D; Malowanczyk, C; Shwatz, C; Zusman, S; Ela, K

    1993-08-01

    In the 1980s three studies were conducted in Israel utilising different methods of dental manpower evaluations. All identified a large future surplus of dentists. The current study re-evaluates the manpower supply and discusses possible solutions. A random sample of 800 dentists was approached by three mailings and a telephone call follow-up with a response of 49.7 per cent. Almost 90 per cent of dentists reported an undersupply of patients, with a mean working load of 26.3 hours/week, but being willing to add up to 3.4 working hours/week. The oversupply of dentists has been dramatically affected by the addition of almost 1000 dentists who emigrated to Israel in 1991-92. To prevent a significant unemployment rate among dentists and an uncontrolled free market, it is urgently suggested for the benefit of both provider and consumer that; the demand for services be increased and additional financing of dental care be made available, that the total number of dentists be decreased by various measures and that their geographical distribution be improved. If necessary limits should be placed on the number of practices or the number of patients permitted per practice. PMID:8276515

  1. 42 CFR 485.711 - Condition of participation: Plan of care and physician involvement.

    Science.gov (United States)

    2010-10-01

    ... reviewed by a physician, or by a physical therapist or speech pathologist respectively. (a) Standard.... (1) For each patient there is a written plan of care established by the physician or by the physical therapist or speech-language pathologist who furnishes the services. (2) The plan of care for...

  2. Family planning and maternal health care in Egypt.

    Science.gov (United States)

    El-mouelhy, M T

    1990-01-01

    The Government of Egypt is introducing policies to reduce the mortality of women of reproductive age. However, family planning and maternal-child health care programs are unlikely to have the desired impact without corresponding improvements in the status of Egyptian women. Women's status in the areas of education, health, poverty, employment, the family, government, and the community is a crucial determinant of their willingness and ability to accept a smaller family size ideal and become contraceptive users. At present, only 6% of Egyptian women are a part of the work force and 60% are illiterate. In a society in which women are valued on the basis of the number of children they produce for their husbands, those practice birth control risk abandonment and isolation. The powerlessness and insecurity that lead Egyptian women to have an average of at least 5 children impeded national development and thus delay creation of the socioeconomic conditions that could liberate women from their domestic role. Equal opportunities in education and employment would represent a first step toward improving women's status by giving them a source of income and increased independence. Also needed are modifications in archaic marriage, divorce, and custody laws. PMID:12317075

  3. LOCATION AND PLANNING OF HEALTH CARE DELIVERY SYSTEM AT THE DISTICT LEVEL

    OpenAIRE

    Rajguru. S. A

    2015-01-01

    There is a wide variety of health systems around the world, with as many histories and organizational structures as there are nations. In some countries, health system planning is distributed among market participants. In others, there is a concerted effort among governments, trade unions, charities, religious, or other coordinate bodies to deliver planned health care services targeted to the populations they serve. However, health care planning has been described as often e...

  4. Care plan for the patient with a dependent personality disorder

    Directory of Open Access Journals (Sweden)

    Ana María Ruiz Galán

    2010-11-01

    Full Text Available Personality is unique for each individual and can be defined as the dynamic collection of characteristics relative to emotions, thought and behaviour.Personality trout’s only mean a Personality Disorder (PD when they are inflexible and maladjusted and cause notable functional deterioration or uneasiness.According to Bermudez personality is “the enduring organization of structural and functional features, innate and acquired under the special conditions of each one’s development that shape the particular and specific collection of behaviour to face different situations”.According to the Diagnostic a Statistical Manual of Mental Disorders (DSM-IV, a Personality Disorder is “an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the person’s culture is pervasive and an inflexible, is stable over time and leads to distress or impairment. The onset of these patterns of behaviour is the beginning of the adulthood and, in rare instances, early adolescence”.There are several types of Personality Disorders (paranoid, schizoid, borderline, antisocial, dependent…. Dependent Personality Disorder is one of the most frequent in the Mental Health Services.People who suffer from this disorder are unable to take a decision by themselves because they don’t have confidence in themselves. They need a lot of social support and affection until the point of deny their individuality by subordinating their desires to other person’s desires and permitting these persons to manage their lives. Maybe they feel desolated by separation and loss and can support any situation, even maltreatment to keep a relationship.As we a deduce this diagnosis is sensible to cultural influences. This work aims to elaborate an standarized plan of cares for the patient with Dependent Personality Disorder by using nursing Diagnosis of NANDA II, Outcomes Criteria (NOC and Interventions Criteria (NIC.

  5. Attitudes on end-of-life care and advance care planning in the lesbian and gay community.

    Science.gov (United States)

    Stein, G L; Bonuck, K A

    2001-01-01

    Gay men and lesbians have special interests in documenting their preferences regarding advance care planning and end-of-life care. A 64-item survey instrument was developed to ascertain the preferences of this community regarding approaches to end-of-life care, viewpoints on physician-assisted suicide (PAS) and euthanasia, and practices regarding advance care planning. The survey was completed by 575 participants recruited through community-based health care and social service organizations serving the lesbian and gay community, primarily in the New York metropolitan area. Respondents represent a diverse group of women (36%) and men (63%) from various age, racial/ethnic, and religious/spiritual backgrounds; 10% were human immunodeficiency virus (HIV)-positive. Respondents' perspectives on end-of-life care are generally consistent with findings from other attitudinal studies of U.S. adults: a majority supported legalization of PAS and preferred a palliative approach to end-of-life care. However, the gay community sample revealed even stronger support for assisted suicide and palliative care. Although respondents completed advance directives at a higher rate than adults generally, the legal importance for gay men and lesbians to execute directives should encourage health care providers and community organizations to assume a larger educational role on advance care planning. Results confirm other reports on the need to address provider communication skills. It is speculated that the HIV epidemic was a major influence behind these results because of the overwhelming personal impact of the epidemic on most gay men and lesbians during the past two decades. PMID:11441626

  6. Developing Strategies to Improve Advance Care Planning in Long Term Care Homes: Giving Voice to Residents and Their Family Members

    Directory of Open Access Journals (Sweden)

    Kimberly Ramsbottom

    2014-01-01

    Full Text Available Long term care (LTC homes, also known as residential care homes, commonly care for residents until death, making palliative care and advance care planning (ACP important elements of care. However, limited research exists on ACP in LTC. In particular, research giving voice to family members and substitute decision makers is lacking. The objective of this research was to understand experiences, perspectives, and preferences to guide quality improvement of ACP in LTC. This qualitative descriptive study conducted 34 individual semistructured interviews in two LTC homes, located in Canada. The participants were 31 family members and three staff, consisting of a front line care worker, a registered nurse, and a nurse practitioner. All participants perceived ACP conversations as valuable to provide “resident-centred care”; however, none of the participants had a good understanding of ACP, limiting its effectiveness. Strategies generated through the research to improve ACP were as follows: educating families and staff on ACP and end-of-life care options; better preparing staff for ACP conversations; providing staff skills training and guidelines; and LTC staff initiating systematic, proactive conversations using careful timing. These strategies can guide quality improvement of palliative care and development of ACP tools and resources specific to the LTC home sector.

  7. [Nine Equivalents of Nursing Manpower Use Score (NEMS): a study of its historical process].

    Science.gov (United States)

    Canabarro, Simone Travi; Velozo, Kelly Dayane Stochero; Eidt, Olga Rosária; Piva, Jefferson Pedro; Garcia, Pedro Celiny Ramos

    2010-09-01

    This study aims to describe, through an integrative review of literature, the historical trajectory of therapeutic intervention scores with emphasis on Nine Equivalents of Nursing Manpower Use Score in Intensive Care Units. The descriptors "Intensive care units" and "scales" were looked up in publications issued between 2000 and 2009. The terms selected were: "Nine Equivalents of Nursing Manpower Use Score" or "NEMS", "Unidade de Terapia Intensiva", "Therapeutic Intervention Scoring System-76", "Therapeutic Intervention Scoring System-28 or "TISS-28". As to the publications, "Medical Literature Analysis and Retrieval System Online" (MEDLINE) and "Literatura Latino-Americana e do Caribe em Ciências da Saúde" (LILACS) were selected Among the 295 papers reviewed, 18 were chosen, of which 55,5% were in English. The studies deal with NEMS (33,3%), Therapeutic Intervention Scoring System-76 (11,1%), TISS-28 (33,3%), among others. Research emphasized that NEMS has been a useful, operational and succinct tool. PMID:21574347

  8. Recovery-focused care planning and coordination in England and Wales: a cross-national mixed methods comparative case study

    OpenAIRE

    Simpson, A; Bannigan, B.; Coffey, M.; Barlow, S.; Cohen, R.; Jones, A.; Všetečková,, J.; Faulkner, A.; Thornton, A; Cartwright, M

    2016-01-01

    Background: In the UK, concerns about safety and fragmented community mental health care led to the development of the care programme approach in England and care and treatment planning in Wales. These systems require service users to have a care coordinator, written care plan and regular reviews of their care. Processes are required to be collaborative, recovery-focused and personalised but have rarely been researched. We aimed to obtain the views and experiences of stakeholders involved in ...

  9. Recovery-focused care planning and coordination in England and Wales: a cross-national mixed methods comparative case study

    OpenAIRE

    Simpson, Alan; Hannigan, Ben; Coffey, Michael; Barlow, Sally; Cohen, Rachel; Jones, Aled; Všetečková, Jitka; Faulkner, Alison; Thornton, Alexandra; Cartwright, Martin

    2016-01-01

    Background In the UK, concerns about safety and fragmented community mental health care led to the development of the care programme approach in England and care and treatment planning in Wales. These systems require service users to have a care coordinator, written care plan and regular reviews of their care. Processes are required to be collaborative, recovery-focused and personalised but have rarely been researched. We aimed to obtain the views and experiences of stakeholders involved in c...

  10. Type of Plan and Provider Network (Affordable Care Act)

    Science.gov (United States)

    Skip navigation Individuals & Families Small Businesses Search Get Coverage Change or Update Your Plan Get Answers For Employers For Employees Get Answers Menu Log in Español Individuals & Families Small Businesses Log in Español Get Coverage Change or Update Your Plan Get Answers ...

  11. Manpower development strategy for the operation of the proposed nuclear power programme (NPP) in Nigeria

    International Nuclear Information System (INIS)

    The availability of adequately qualified manpower is the major challenge of the nation's power programme. Without qualified manpower, no nuclear power plant can be planned, built or operated properly. It is estimated that about 800 - 1000 personnel would be needed for the successful operation of the planned 1000MW nuclear power plant in Nigeria. Presently, the country has only a handful of nuclear professionals, and thus the need for an increase in human capital development efforts cannot be overemphasized. This paper examined the existing organisational, educational and industrial structure in terms of capacity building and access to and transfer of nuclear knowledge. It recommended strategies based on lessons learnt and good practices elsewhere that will catalyze the development of knowledge and human resources needed for the nuclear power programme.

  12. A “best practices” strategy to improve quality in Medicaid managed care plans

    OpenAIRE

    Brodsky, Karen L.; Baron, Richard J.

    2000-01-01

    Medicaid managed care is delivered through organizations operating in very heterogeneous environments that confront similar barriers to success. Because Medicaid managed care is implemented differently in each state, health plans have been isolated from each other and have not had an opportunity to learn how others may have surmounted commonly encountered barriers. After interviewing Medicaid health plan medical directors, we developed a learning collaborative model based on shared categories...

  13. Talking about sensitive topics during the advance care planning discussion: A peek into the black box

    DEFF Research Database (Denmark)

    Andreassen, Pernille; Neergaard, Mette Asbjørn; Brogaard, Trine; Skorstengaard, Marianne Hjorth; Jensen, Anders Bonde

    2015-01-01

    OBJECTIVE: Advance care planning (ACP) discussions are emphasized as a valuable way of improving communication about end-of-life care. Yet we have very little knowledge of what goes on during actual ACP discussions. The aim of our study was to explore how the sensitive topics of end-of-life decis...

  14. Planning for a radiological emergency in health care institutions

    International Nuclear Information System (INIS)

    The possible occurrence of accidents involving sources of ionizing radiation calls for response plans to mitigate the consequences of radiological accidents. An emergency planning framework is suggested for institutions which use medical applications of ionizing radiation. Bearing in mind that the prevention of accidents is of prime importance in dealing with radioactive materials and other sources of ionizing radiation, it is recommended that emergency instructions and procedures address certain aspects of the causes of these radiological events. Issues such as identification of radiological events in medical practices and their consequences, protective measures, planning for an emergency response and maintenance of emergency capacity are considered. (author)

  15. Developing a mental health care plan in a low resource setting: the theory of change approach.

    OpenAIRE

    Hailemariam, M; Fekadu, A.; Selamu, M; Alem, A.; Medhin, G; Giorgis, TW; DeSilva, M.; Breuer, E

    2015-01-01

    Background Scaling up mental healthcare through integration into primary care remains the main strategy to address the extensive unmet mental health need in low-income countries. For integrated care to achieve its goal, a clear understanding of the organisational processes that can promote and hinder the integration and delivery of mental health care is essential. Theory of Change (ToC), a method employed in the planning, implementation and evaluation of complex community initiatives, is an i...

  16. How Do General Practitioners Conceptualise Advance Care Planning in Their Practice? A Qualitative Study

    OpenAIRE

    De Vleminck, Aline; Pardon, Koen; Beernaert, Kim; Houttekier, Dirk; Vander Stichele, Robert; Deliens, Luc

    2016-01-01

    Objectives To explore how GPs conceptualise advance care planning (ACP), based on their experiences with ACP in their practice. Methods Five focus groups were held with 36 GPs. Discussions were analysed using a constant comparative method. Results Four overarching themes in the conceptualisations of ACP were discerned: (1) the organisation of professional care required to meet patients’ needs, (2) the process of preparing for death and discussing palliative care options, (3) the discussion of...

  17. The value of Medicare managed care plans and their prescription drug benefits

    OpenAIRE

    Anne E. Hall

    2007-01-01

    I estimate the welfare, both gross and net, provided by the Medicare managed care program in 1999 through 2002. First, I estimate a model of demand for the benefits offered by managed care plans to Medicare beneficiaries. I then use the demand estimates to form estimates of welfare provided by the program. Medicare beneficiaries derived $14.9 billion of gross welfare per year from the Medicare HMO program. Depending on the amount of selection in the program, the Medicare managed care program ...

  18. [Part I. End-stage chronic organ failures: a position paper on shared care planning. The Integrated Care Pathway].

    Science.gov (United States)

    Gristina, Giuseppe R; Orsi, Luciano; Carlucci, Annalisa; Causarano, Ignazio R; Formica, Marco; Romanò, Massimo

    2014-01-01

    In Italy the birth rate decrease together with the continuous improvement of living conditions on one hand, and the health care progress on the other hand, led in recent years to an increasing number of patients with chronic mono- or multi-organ failures and in an extension of their life expectancy. However, the natural history of chronic failures has not changed and the inescapable disease's worsening at the end makes more rare remissions, increasing hospital admissions rate and length of stay. Thus, when the "end-stage" get close clinicians have to engage the patient and his relatives in an advance care planning aimed to share a decision making process regarding all future treatments and related ethical choices such as patient's best interests, rights, values, and priorities. A right approach to the chronic organ failures end-stage patients consists therefore of a careful balance between the new powers of intervention provided by the biotechnology and pharmacology (intensive care), both with the quality of remaining life supplied by physicians to these patients (proportionality and beneficence) and the effective resources rationing and allocation (distributive justice). However, uncertainty still marks the criteria used by doctors to assess prognosis of these patients in order to make decisions concerning intensive or palliative care. The integrated care pathway suggested in this position paper shared by nine Italian medical societies, has to be intended as a guide focused to identify end-stage patients and choosing for them the best care option between intensive treatments and palliative care. PMID:24553592

  19. Grandmother and household viability in Botswana: family planning, child care and survival in changing tswana society.

    OpenAIRE

    Ingstad B

    1989-01-01

    Examines the roles and influence of grandmothers with respect to nutrition, breastfeeding, quality of child care and family planning usage; the maternal grandmother is much more involved with grandchildren than the paternal grandmother. Accordingly this category may be a target for programmes and activities to promote child welfare and family planning.

  20. Concurrent Planning and beyond: Family-Centered Services for Children in Foster Care

    Science.gov (United States)

    Hudson, Lucy; Almeida, Connie; Bentley, Dawn; Brown, Josie; Harlin, Daria; Norris, Judy

    2008-01-01

    Family reunification is not always possible for children who have been removed from the care of their biological parents because of abuse or neglect. Concurrent planning puts into place a secondary plan for a permanent home should family reunification prove to be impossible. Working in four diverse communities around the country in an innovative…

  1. THE FEASIBILITY OF A SYSTEMATIC STUDY OF MANPOWER REQUIREMENTS AND EDUCATION AND TRAINING PROGRAMS OF SELECTED HEALTH OCCUPATIONS.

    Science.gov (United States)

    POLLIARD, FORBES W.

    TO DETERMINE THE FEASIBILITY OF A STUDY, MEETINGS WERE HELD WITH GROUPS INCLUDING PATHOLOGISTS, RADIOLOGISTS, AND COMMUNITY HEALTH AND EDUCATIONAL LEADERS, 30 ADDITIONAL PERSONS CONCERNED WITH HEALTH SERVICES AND EDUCATION WERE INTERVIEWED, DISCUSSIONS WERE HELD WITH OTHER GROUPS AND INDIVIDUALS INTERESTED IN HEALTH MANPOWER RESEARCH AND PLANNING,…

  2. Effects of Constraints and Consequences on Plan Complexity in Conversations About End-of-Life Care.

    Science.gov (United States)

    Russell, Jessica

    2015-01-01

    The current study assessed the role of health care provider constraints and perceived consequences on plan complexity for conversations with patients about end-of-life care. Meta-goal constraints, perceived consequences associated with conversational engagement and planning theory provides the basis for research questions and hypotheses posed. Findings suggested that while the meta-goals of efficiency and politeness were each recognized as important, providers indicated greater concern for politeness during patient interactions concerning treatment options. Reported constraints had no impact on plan complexity. Perceived consequences of conversational engagement were predominantly positive and concerned the patient. Findings may enhance the understanding of social workers in their educational role regarding the potential training needs of health care team members in palliative care contexts. PMID:26654064

  3. Evaluating the systematic implementation of the 'Let Me Decide' advance care planning programme in long term care through focus groups: staff perspectives.

    LENUS (Irish Health Repository)

    Cornally, Nicola

    2015-11-01

    The \\'Let Me Decide\\' Advance Care Planning (LMD-ACP) programme offers a structured approach to End-of-Life (EoL) care planning in long-term care for residents with and without capacity to complete an advance care directive\\/plan. The programme was implemented in three homes in the South of Ireland, with a view to improving quality of care at end of life. This paper will present an evaluation of the systematic implementation of the LMD-ACP programme in the homes.

  4. Brazil: Angra 2 NPP. Manpower and documentation. Annex 2B

    International Nuclear Information System (INIS)

    This annex deals with manpower and documentation. Several initiatives were implemented during the suspension period to preserve manpower and documentation at Angra 2 NPP. They have paid off and construction of the NPP was resumed with relatively little unexpected difficulties. This annex outlines the essentials of these initiatives. (author)

  5. Development of the Manpower Demand Forecast Model of Nuclear Industry Using the System Dynamics Method - Operation Sector

    International Nuclear Information System (INIS)

    Recently, the resource management of nuclear engineering manpower has become an important issue in Korean nuclear industry. The government's plan for increasing the number of domestic nuclear power plants and the recent success of nuclear power plant export to UAE (United Arab Emirates) will increase demand for nuclear engineers in Korea. Accordingly, the Korean government decided to supplement 2,246 engineers in the public sector of nuclear industry in the year 2010 to resolve the manpower shortage problem in the short term. However, the experienced engineers which are essentially important in the nuclear industry cannot be supplied in the short term. Therefore, development of the long term manpower demand forecast model of nuclear industry is needed. The system dynamics (SD) is useful method for forecasting nuclear manpower demand. It is because the time-delays which is important in constructing plants and in recruiting and training of engineers, and the feedback effect including the qualitative factor can be effectively considered in the SD method. Especially, the qualitative factor like 'Productivity' is very important concept in Human Resource Management (HRM) but it cannot be easily considered in the other methods. In this paper, the concepts of the nuclear manpower demand forecast model using the SD method are presented and the some simulation results are being discussed especially for the 'Operation Sector'

  6. They know! - do they? A qualitative study of residents and relatives views on advance care planning, end-of-life care, and decision-making in nursing homes.

    OpenAIRE

    Bollig, Georg; Gjengedal, Eva; Rosland, Jan Henrik

    2015-01-01

    Background: Residents living in long-term care facilities are a vulnerable population. For many residents, a nursing home is their place of death. Palliative care and end-of-life decisions are important components of their care provision. Aim: To study the views of cognitively able residents and relatives on advance care planning, end-of-life care, and decision-making in nursing homes. Design: A qualitative study with in-depth interviews with nursing home residents and focus group inter...

  7. Bridging knowledge to develop an action plan for integrated care for chronic diseases in Greece.

    Science.gov (United States)

    Tsiachristas, Apostolos; Lionis, Christos; Yfantopoulos, John

    2015-01-01

    The health, social and economic impact of chronic diseases is well documented in Europe. However, chronic diseases threaten relatively more the 'memorandum and peripheral' Eurozone countries (i.e., Greece, Spain, Portugal and Ireland), which were under heavy recession after the economic crisis in 2009. Especially in Greece, where the crisis was the most severe across Europe, the austerity measures affected mainly people with chronic diseases. As a result, the urgency to tackle the threat of chronic diseases in Greece by promoting public health and providing effective chronic care while flattening the rising health care expenditure is eminent. In many European countries, integrated care is seen as a means to achieve this. The aim of this paper was to support Greek health policy makers to develop an action plan from 2015 onwards, to integrate care by bridging local policy context and needs with knowledge and experience from other European countries. To achieve this aim, we adopted a conceptual framework developed by the World Health Organization on one hand to analyse the status of integrated care in Greece, and on the other to develop an action plan for reform. The action plan was based on an analysis of the Greek health care system regarding prerequisite conditions to integrate care, a clear understanding of its context and successful examples of integrated care from other European countries. This study showed that chronic diseases are poorly addressed in Greece and integrated care is in embryonic stage. Greek policy makers have to realise that this is the opportunity to make substantial reforms in chronic care. Failing to reform towards integrated care would lead to the significant risk of collapse of the Greek health care system with all associated negative consequences. The action plan provided in this paper could support policy makers to make the first serious step to face this challenge. The details and specifications of the action plan can only be decided by

  8. Bridging knowledge to develop an action plan for integrated care for chronic diseases in Greece

    Directory of Open Access Journals (Sweden)

    Apostolos Tsiachristas

    2015-10-01

    Full Text Available The health, social and economic impact of chronic diseases is well documented in Europe. However, chronic diseases threaten relatively more the ‘memorandum and peripheral’ Eurozone countries (i.e., Greece, Spain, Portugal and Ireland, which were under heavy recession after the economic crisis in 2009. Especially in Greece, where the crisis was the most severe across Europe, the austerity measures affected mainly people with chronic diseases. As a result, the urgency to tackle the threat of chronic diseases in Greece by promoting public health and providing effective chronic care while flattening the rising health care expenditure is eminent. In many European countries, integrated care is seen as a means to achieve this.The aim of this paper was to support Greek health policy makers to develop an action plan from 2015 onwards, to integrate care by bridging local policy context and needs with knowledge and experience from other European countries. To achieve this aim, we adopted a conceptual framework developed by the World Health Organization on one hand to analyse the status of integrated care in Greece, and on the other to develop an action plan for reform. The action plan was based on an analysis of the Greek health care system regarding prerequisite conditions to integrate care, a clear understanding of its context and successful examples of integrated care from other European countries. This study showed that chronic diseases are poorly addressed in Greece and integrated care is in embryonic stage.Greek policy makers have to realise that this is the opportunity to make substantial reforms in chronic care. Failing to reform towards integrated care would lead to the significant risk of collapse of the Greek health care system with all associated negative consequences. The action plan provided in this paper could support policy makers to make the first serious step to face this challenge. The details and specifications of the action plan

  9. Planning the Marketing Activity in the Health Care Services

    OpenAIRE

    Violeta Radulescu; Iuliana Cetina; Gheorghe Orzan

    2008-01-01

    The integration of marketing in the field of health care, starting with the 50’s, was accompanied by a series of controversies generated by the ethical and moral aspects that this type of services imply, as well as by the difficulty in determining exactly the demand, the unequal access to information of participants, the regulated mechanism for the establishment of prices and of rates and the intervention of the third party payer, the significant role of the state in ensuring the fair access ...

  10. Structure and Function: Planning a New Intensive Care Unit to Optimize Patient Care

    Directory of Open Access Journals (Sweden)

    Jozef Kesecioğlu

    2014-08-01

    Full Text Available To survey the recent medical literature reporting effects of intensive care unit (ICU design on patients’ and family members’ well-being, safety and functionality. Features of ICU design linked to the needs of patients and their family are single-rooms, privacy, quiet surrounding, exposure to daylight, views of nature, prevention of infection, a family area and open visiting hours. Other features such as safety, working procedures, ergonomics and logistics have a direct impact on the patient care and the nursing and medical personnel. An organization structured on the needs of the patient and their family is mandatory in designing a new intensive care. The main aims in the design of a new department should be patient centered care, safety, functionality, innovation and a future-proof concept.

  11. Manpower development for the biomedical industry space.

    Science.gov (United States)

    Goh, James C H

    2013-01-01

    The Biomedical Sciences (BMS) Cluster is one of four key pillars of the Singapore economy. The Singapore Government has injected research funding for basic and translational research to attract companies to carry out their commercial R&D activities. To further intensify the R&D efforts, the National Research Foundation (NRF) was set up to coordinate the research activities of different agencies within the larger national framework and to fund strategic R&D initiatives. In recent years, funding agencies began to focus on support of translational and clinical research, particularly those with potential for commercialization. Translational research is beginning to have traction, in particular research funding for the development of innovation medical devices. Therefore, the Biomedical Sciences sector is projected to grow which means that there is a need to invest in human capital development to achieve sustainable growth. In support of this, education and training programs to strengthen the manpower capabilities for the Biomedical Sciences industry have been developed. In recent years, undergraduate and graduate degree courses in biomedical engineering/bioengineering have been developing at a rapid rate. The goal is to train students with skills to understand complex issues of biomedicine and to develop and implement of advanced technological applications to these problems. There are a variety of career opportunities open to graduates in biomedical engineering, however regardless of the type of career choices, students must not only focus on achieving good grades. They have to develop their marketability to employers through internships, overseas exchange programs, and involvement in leadership-type activities. Furthermore, curriculum has to be developed with biomedical innovation in mind and ensure relevance to the industry. The objective of this paper is to present the NUS Bioengineering undergraduate program in relation to manpower development for the biomedical

  12. Web-based collaboration in individual care planning challenges the user and the provider roles – toward a power transition in caring relationships

    Directory of Open Access Journals (Sweden)

    Bjerkan J

    2014-12-01

    Full Text Available Jorunn Bjerkan,1,2 Solfrid Vatne,3 Anne Hollingen4 1Norwegian Research Centre for Electronic Health Records (EHR, Medical Faculty, Norwegian University of Science and Technology, Trondheim, 2Faculty of Health Science, Nord-Trøndelag University College, Levanger, 3Faculty of Health Science, Molde University College, 4Møre og Romsdal Hospital Trust, Molde, Norway Background and objective: The Individual Care Plan (ICP was introduced in Norway to meet new statutory requirements for user participation in health care planning, incorporating multidisciplinary and cross-sector collaboration. A web-based solution (electronic ICP [e-ICP] was used to support the planning and documentation. The aim of this study was to investigate how web-based collaboration challenged user and professional roles. Methods: Data were obtained from 15 semistructured interviews with users and eight with care professionals, and from two focus-group interviews with eight care professionals in total. The data were analyzed using systematic text condensation in a stepwise analysis model. Results: Users and care professionals took either a proactive or a reluctant role in e-ICP collaboration. Where both user and care professionals were proactive, the pairing helped to ensure that the planning worked well; so did pairings of proactive care professionals and reluctant users. Proactive users paired with reluctant care professionals also made care planning work, thanks to the availability of information and the users' own capacity or willingness to conduct the planning. Where both parties were reluctant, no planning activities occurred. Conclusion: Use of the e-ICP challenged the user–professional relationship. In some cases, a power transition took place in the care process, which led to patient empowerment. This knowledge might be used to develop a new understanding of how role function can be challenged when users and care professionals have equal access to health care

  13. PLAN FOR PRIMARY HEALTH CARE IN MINAS GERAIS AND SCIENTIFIC PRODUCTION

    Directory of Open Access Journals (Sweden)

    Tatiana Oliveira Silva Bittencourt

    2014-05-01

    Full Text Available This study aimed to identify studies on the Master Plan for Primary Health Care from the year 2003. We conducted a bibliographic study on MEDLINE, LILACS, SCIELO , BDENF and Google Scholar . The results are detailed in tables and discussed from four themes. The Master Plan for Primary Health Care is an innovative and daring in the reorganization of primary care in the municipalities miners. Gave the participants an important opportunity for professional qualification. Difficulties in its implementation outperformed the potential and were present in most of the municipalities surveyed. Among the main challenges for its implementation highlights the lack of professional motivation and credibility by some involved in this process. The literature made little progress on this issue , and we hope that further research be undertaken in order to contribute to studies of evaluation of public policies and in particular the extension and consolidation of this plan.

  14. Delphi study into planning for care of children in major incidents

    OpenAIRE

    Carley, S; Mackway-Jones, K; Donnan, S

    1999-01-01

    This paper describes a Delphi study used to identify and improve areas of concern in the planning of care for children in major incidents. The Delphi was conducted over three rounds and used a multidisciplinary panel of 22 experts. Experts were selected to include major incident, immediate care, emergency medicine, and paediatric specialists. This paper presents a series of consensus statements that represent the Delphi group's opinion on the management of children in maj...

  15. Improving Olympic health services: what are the common health care planning issues?

    OpenAIRE

    Kononovas, K.; Black, G.; Taylor, J; Raine, R

    2014-01-01

    INTRODUCTION: Due to their scale, the Olympic and Paralympic Games have the potential to place significant strain on local health services. The Sydney 2000, Athens 2004, Beijing 2008, Vancouver 2010, and London 2012 Olympic host cities shared their experiences by publishing reports describing health care arrangements. HYPOTHESIS: Olympic planning reports were compared to highlight best practices, to understand whether and which lessons are transferable, and to identify recurring health care p...

  16. Using machine learning algorithms to guide rehabilitation planning for home care clients

    OpenAIRE

    Hirdes John P; Zhang Zhanyang; Zhu Mu; Stolee Paul

    2007-01-01

    Abstract Background Targeting older clients for rehabilitation is a clinical challenge and a research priority. We investigate the potential of machine learning algorithms – Support Vector Machine (SVM) and K-Nearest Neighbors (KNN) – to guide rehabilitation planning for home care clients. Methods This study is a secondary analysis of data on 24,724 longer-term clients from eight home care programs in Ontario. Data were collected with the RAI-HC assessment system, in which the Activities of D...

  17. Treatment planning for Hodgkin's Disease: a patterns of care study

    International Nuclear Information System (INIS)

    Purpose: To conduct a survey of the process of treatment planning for the radiation treatment of Hodgkin's Disease in the United States, and to compare survey results with consensus guidelines as determined by recognized experts. Methods and Materials: A consensus committee developed guidelines for the radiotherapeutic management of Hodgkin's Disease. A series of survey forms were designed to evaluate the standards of practice and compare these with the consensus guidelines. A total of 61 facilities divided evenly into the strata of academic, hospital based, and free standing had eligible Hodgkin's Disease cases. There were 275 eligible cases of Hodgkin's Disease evaluated. Data collected from the radiation oncology records included treatment-specific parameters such as energy, dose, blocking, and calculations, as well as treatment planning practices. Statistical analysis was performed on each data element and for all institution strata. Results: For a number of treatment parameters, there were some discrepancies noted between the current United States practice and the consensus guidelines. Some significant differences were found in practice between the stratified institution types. A representative sample of results are: the majority of Hodgkin's Disease patients are treated with x-ray energies in the recommended range, between 4 and 10 MV. Standard mantle (for upper extended field treatment) and modified spade (for lower extended field treatments) are the fields of choice for all types of facilities. The consensus guidelines recommended that dose calculations at multiple points be obtained; however, 15% of patients in the survey received only a single point calculation. Current irregular field dosimetry calculation software does not take account of inhomogeneities. Thirty percent of Hodgkin's Disease patients do not receive a gap calculation for the abutment of upper and lower extended fields. In 70% of treatment fields, no compensation is used. Very few patients

  18. Quality of Dying in Nursing Home Residents Dying with Dementia: Does Advanced Care Planning Matter? A Nationwide Postmortem Study

    OpenAIRE

    Vandervoort, An; Houttekier, Dirk; Vander Stichele, Robert; van der Steen, Jenny T; Van den Block, Lieve

    2014-01-01

    Background Advance care planning is considered a central component of good quality palliative care and especially relevant for people who lose the capacity to make decisions at the end of life, which is the case for many nursing home residents with dementia. We set out to investigate to what extent (1) advance care planning in the form of written advance patient directives and verbal communication with patient and/or relatives about future care and (2) the existence of written advance general...

  19. Reforming primary care in England--again. Plans for improving the quality of care.

    Science.gov (United States)

    Baker, R

    2000-06-01

    An extensive programme of health service reform has begun in England. Improvement in the quality of care is a key objective of the reforms, and several initiatives are being introduced in response. These include systems to provide national guidance about appropriate treatment and services, a local system to support quality improvement and arrangements to monitor performance, including a new performance framework, an inspection agency and an annual survey of patients. The local quality improvement system has features of particular interest. These include arrangements for setting objectives for quality improvement, the use of various quality improvement methods tailored to local needs and a new system to provide accountability to both the health service and the public. The introduction of clinical governance and all the other reforms presents primary care practitioners with a major challenge. However, if sufficient time is allowed and adequate resources are made available, the reforms do have the potential to improve health care in England. PMID:10944059

  20. After you: conversations between patients and healthcare professionals in planning for end of life care

    Directory of Open Access Journals (Sweden)

    Almack Kathryn

    2012-09-01

    Full Text Available Abstract Background This study explores with patients, carers and health care professionals if, when and how Advance Care Planning conversations about patients’ preferences for place of care (and death were facilitated and documented. Methods The study adopted an exploratory case study design using qualitative interviews, across five services delivering palliative care to cancer and non-cancer patients within an urban and rural English region. The study recruited 18 cases made up of patients (N = 18; 10 men; 8 women; median age 75; nominated relatives (N = 11; 7 women; 4 men; median age 65 and healthcare professionals (N = 15 caring for the patient. Data collection included: 18 initial interviews (nine separate interviews with patients and 9 joint interviews with patients and relatives and follow up interviews in 6 cases (involving a total of 5 patients and 5 relatives within one year of the first interview. Five group interviews were conducted with 15 healthcare professionals; 8 of whom also participated in follow up interviews to review their involvement with patients in our study. Results Patients demonstrated varying degrees of reticence, evasion or reluctance to initiate any conversations about end of life care preferences. Most assumed that staff would initiate such conversations, while staff were often hesitant to do so. Staff-identified barriers included the perceived risks of taking away hope and issues of timing. Staff were often guided by cues from the patient or by intuition about when to initiate these discussions. Conclusions This study provides insights into the complexities surrounding the initiation of Advance Care Planning involving conversations about end of life care preferences with patients who are identified as having palliative care needs, in particular in relation to the risks inherent in the process of having conversations where mortality must be acknowledged. Future research is needed to examine how to

  1. Exploring the district nurse role in facilitating individualised advance care planning.

    Science.gov (United States)

    Boot, Michelle

    2016-03-01

    Health-care policy recognises the importance of engaging people in making decisions related to the management of their health. Advance care planning (ACP) offers a framework for decision making on end-of-life care. There are positive indicators that ACP enables health professionals to meet people's preferences. However, there are reports of insensitive attempts to engage people in end-of-life care decision making. District nurses are in the ideal position to facilitate ACP, as they have the opportunity to build relationships with the people they are caring for--an antecedent to sensitive ACP--and in recognising and fulfilling this role, they could ameliorate the risk of insensitive ACP. Distric nurse leaders also have a role to play in ensuring that organisational and environmental factors support appropriate ACP facilitation including: training, fostering a team culture that empowers district nurses to recognise and meet their ACP role, and advocating for appropriate ACP evaluation outcome measures. PMID:26940617

  2. Commentary: Personalized health planning and the Patient Protection and Affordable Care Act: an opportunity for academic medicine to lead health care reform.

    Science.gov (United States)

    Dinan, Michaela A; Simmons, Leigh Ann; Snyderman, Ralph

    2010-11-01

    The Patient Protection and Affordable Care Act of 2010 (PPACA) mandates the exploration of new approaches to coordinated health care delivery--such as patient-centered medical homes, accountable care organizations, and disease management programs--in which reimbursement is aligned with desired outcomes. PPACA does not, however, delineate a standardized approach to improve the delivery process or a specific means to quantify performance for value-based reimbursement; these details are left to administrative agencies to develop and implement. The authors propose that coordinated care can be implemented more effectively and performance quantified more accurately by using personalized health planning, which employs individualized strategic health planning and care relevant to the patient's specific needs. Personalized health plans, developed by providers in collaboration with their patients, quantify patients' health and health risks over time, identify strategies to mitigate risks and/or treat disease, deliver personalized care, engage patients in their care, and measure outcomes. Personalized health planning is a core clinical process that can standardize coordinated care approaches while providing the data needed for performance-based reimbursement. The authors argue that academic health centers have a significant opportunity to lead true health care reform by adopting personalized health planning to coordinate care delivery while conducting the research and education necessary to enable its broad clinical application. PMID:20844424

  3. Development and validation of a questionnaire to detect behavior change in multiple advance care planning behaviors.

    Directory of Open Access Journals (Sweden)

    Rebecca L Sudore

    Full Text Available INTRODUCTION: Advance directives have traditionally been considered the gold standard for advance care planning. However, recent evidence suggests that advance care planning involves a series of multiple discrete behaviors for which people are in varying stages of behavior change. The goal of our study was to develop and validate a survey to measure the full advance care planning process. METHODS: The Advance Care Planning Engagement Survey assesses "Process Measures" of factors known from Behavior Change Theory to affect behavior (knowledge, contemplation, self-efficacy, and readiness, using 5-point Likert scales and "Action Measures" (yes/no of multiple behaviors related to surrogate decision makers, values and quality of life, flexibility for surrogate decision making, and informed decision making. We administered surveys at baseline and 1 week later to 50 diverse, older adults from San Francisco hospitals. Internal consistency reliability of Process Measures was assessed using Cronbach's alpha (only continuous variables and test-retest reliability of Process and Action Measures was examined using intraclass correlations. For discriminant validity, we compared Process and Action Measure scores between this cohort and 20 healthy college students (mean age 23.2 years, SD 2.7. RESULTS: Mean age was 69.3 (SD 10.5 and 42% were non-White. The survey took a mean of 21.4 minutes (±6.2 to administer. The survey had good internal consistency (Process Measures Cronbach's alpha, 0.94 and test-retest reliability (Process Measures intraclass correlation, 0.70; Action Measures, 0.87. Both Process and Action Measure scores were higher in the older than younger group, p<.001. CONCLUSION: A new Advance Care Planning Engagement Survey that measures behavior change (knowledge, contemplation, self-efficacy, and readiness and multiple advance care planning actions demonstrates good reliability and validity. Further research is needed to assess whether survey

  4. Designing an Operational Planning Model for Level-one Iranian Primary Health Care Systems

    Directory of Open Access Journals (Sweden)

    Amir-Ashkan Nasiripour

    2008-01-01

    Full Text Available Introduction: This research was performed in 2008 in order to design an operational planning model for Iranian primary health care systems at level one. Methods: In this applied study, which was done in a descriptive and cross-sectional manner, some countries and international organizations which had comprehensive planning systems and some local organizations were studied. The required data from the selected countries were collected through data collection forms, and for local organizations, the data were collected through interview, and the initial model was presented accordingly. The model was tested via Delphi technique and taking the authorities’ views into account, the required changes were made and the ultimate model was prepared. Results: All the studied overseas and indigenous organizations had programming systems. However, none of the level-one Iranian primary health care units had a coherent planning system, and they did not follow any specific models. Since 2008, the model of operational planning has also been utilized by Iranian Ministry of Health, Care and Medical Education at headquarters levels; however, there was no model at lower levels especially in rural and urban health care centers. In all selected countries, the model of programs included title, objectives or expected results, schedule, activities, budget system and evaluation and monitoring indexes. Though these parts existed in the common models in Iran, no scientific basis could be observed in compiling the operational programs. The mechanism of designing the initial suggested operational planning had eight stages, but after three stages of reviewing by authorities, seven stages were ratified. Conclusion: Utilizing the suggested operational planning model can enhance the level-one performance indicators of health care networks in Iran

  5. Manpower requirements for nuclear power programmes in nations of intermediate capacity

    International Nuclear Information System (INIS)

    A study is made of the manpower required for initiating and carrying out a nuclear power programme in countries which have not developed their own nuclear technology but where the technical and economic level is such to permit a substantial input from local industry. The discussion is based on Spanish experience. The three basic elements in a nuclear programme are taken to be the operating company, the regulating authority and the engineering firm involved. The role of each of these is briefly considered and the manpower requirements during the design, construction and operational phases of a power station are evaluated. A short account is also given of the manpower requirements of other enterprises such as those involved in the civil engineering, the assembly and construction control. The variations in the labour force are described with the aim of deriving estimates of the number of people involved in the development of a nuclear power programme as a function of time: actual numbers are given for the case of the Spanish national energy plan. A brief description is given of the various courses on nuclear science and engineering provided in Spain and the requirements laid down by the regulations. A short account is given of Spanish nuclear development, with emphasis on the work carried out by the Nuclear Energy Board, not only as a research organization but also in its promotional and training capacities and as a source of personnel for industry. Finally, some comments are made on the possibilities opened up by international co-operation. (author)

  6. Timely identification of palliative patients and anticipatory care planning by GPs: practical application of tools and a training programme

    OpenAIRE

    Thoonsen, Bregje; Groot, Marieke; Verhagen, Stans; van Weel, Chris; Vissers, Kris; Engels, Yvonne

    2016-01-01

    Background Palliative care is mainly restricted to terminal care. General practitioners (GPs) are not trained to early identify palliative patients with cancer, COPD or heart failure. With the help of the RADboud indicators for PAlliative Care needs (RADPAC), we trained GPs to identify patients’ needs and to make a proactive care plan. They were also able to join two role-plays where they discussed the patient’s future, and consulted a palliative care consultant to fine-tune the care plan. We...

  7. On nuclear manpower development in Vietnam

    International Nuclear Information System (INIS)

    Vietnam began to be interested in education and training on nuclear sciences and related subjects since the early 1960's. A department of Nuclear Physics and Engineering was established in 1970 at the Hanoi University of Technology (HUT), which is the biggest interdisciplinary technological education centre of the country. In Vietnam there are several institutions where exist programmes of education on nuclear sciences and nuclear engineering. But HUT has been being since 1970 the only institution that has underway programme of education on nuclear engineer degree. Although the Department was renamed and its education programme was adjusted, but the objectives of its education programme have been being followed without changes. These objectives are as follows: 1) To develop peaceful applications of atomic energy in Vietnam; 2) To train up engineers on nuclear instrumentation for supporting the first objective; and 3) To prepare initial manpower for introduction of Nuclear Power in Vietnam. Nuclear community of Vietnam is still not so large. Total number of its members increased until 1986, and then decreases up to now. Present average age of members of the community is of 45. In 15 coming years at least 500-700 young people must be educated on programmes on nuclear engineer degree and on nuclear bachelor degree. This is a very difficult task for a developing country such as Vietnam. From a point of view of development, the above-mentioned number is too small, and it must be much more. This makes the task much more difficult. In addition, education on nuclear engineering in the country at present is in a hard situation because of lacking in experienced people, as well as in teaching material and equipment, and, because of weakness of the education programme. So, it may be impossible to achieve success in realization of the task without a large and effective international cooperation in education on nuclear science and engineering. That is why the Asian Network for

  8. Family participation in care plan meetings : Promoting a collaborative organizational culture in nursing homes

    NARCIS (Netherlands)

    Dijkstra, Ate

    2007-01-01

    In this study, the author evaluated a project in The Netherlands that aimed to promote family members' participation in care plan meetings at a psychogeriatric nursing home. The small-scale pilot project, which was conducted in four wards of the nursing home, was designed to involve families in heal

  9. 42 CFR 414.39 - Special rules for payment of care plan oversight.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Special rules for payment of care plan oversight. 414.39 Section 414.39 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH...

  10. CMS proposes prioritizing patient preferences, linking patients to follow-up care in discharge planning process.

    Science.gov (United States)

    2016-03-01

    Hospital providers voice concerns about a proposed rule by the Centers for Medicare and Medicaid Services (CMS) that would require providers to devote more resources to discharge planning. The rule would apply to inpatients as well as emergency patients requiring comprehensive discharge plans as opposed to discharge instructions. CMS states that the rule would ensure the prioritization of patient preferences and goals in the discharge planning process, and also would prevent avoidable complications and readmissions. However, hospital and emergency medicine leaders worry that community resources are not yet in place to facilitate the links and follow-up required in the proposed rule, and that the costs associated with implementation would be prohibitive. The proposed rule would apply to acute care hospitals, EDs, long-term care facilities, inpatient rehabilitation centers, and home health agencies. Regardless of the setting, though, CMS is driving home the message that patient preferences should be given more weight during the discharge planning process. Under the rule, hospitals or EDs would need to develop a patient-centered discharge plan within 24 hours of admission or registration, and complete the plan prior to discharge or transfer to another facility. Under the rule, emergency physicians would determine which patients require a comprehensive discharge plan. Both the American Hospital Association and the American College of Emergency Physicians worry that hospitals will have to take on more staff, invest in training, and make changes to their electronic medical record systems to implement the provisions in the proposed rule. PMID:26979045

  11. LGBT people's knowledge of and preparedness to discuss end-of-life care planning options.

    Science.gov (United States)

    Hughes, Mark; Cartwright, Colleen

    2014-09-01

    Despite the devastating impact of HIV/AIDS, end-of-life care planning among lesbian, gay, bisexual and transgender (LGBT) communities is relatively under-researched, especially in Australia. This paper reports findings of a survey of 305 LGBT people living in New South Wales, which examined their knowledge of and attitudes towards end-of-life care. The focus of this paper is their preparedness to discuss with healthcare providers any end-of-life care plans. The results highlight that while the majority of respondents were aware of three of the four key end-of-life care planning options available in New South Wales--enduring powers of attorney, enduring guardians and person responsible (only a minority had heard of advance healthcare directives)--a much smaller number of people had actually taken up these options. Only a minority of respondents were able to identify correctly who had the legal right to make treatment decisions for a person who is unconscious following a car accident. A small proportion of people had discussed end-of-life care options with general practitioners or another main healthcare provider, and only in very few cases were these issues raised by the practitioners themselves. Those most likely to not feel comfortable discussing these issues with practitioners included younger people, those not fully open about their sexuality to family members, and transgender people and others who do not define their gender as male or female. The paper highlights the importance of education strategies to raise awareness of the end-of-life care planning options among LGBT people, as well as strategies for increasing health providers' preparedness to discuss these issues with LGBT patients. PMID:24935483

  12. How Peru introduced a plan for comprehensive HIV prevention and care for transwomen

    Science.gov (United States)

    Salazar, Ximena; Núnez-Curto, Arón; Villayzán, Jana; Castillo, Regina; Benites, Carlos; Caballero, Patricia; Cáceres, Carlos F

    2016-01-01

    Introduction As a group, transwomen in Peru have the highest prevalence of HIV (>20%) in the country, but they have little access to HIV prevention, testing and care services. Until recently, Peru's national HIV programme did not recognize transwomen and had remained essentially static for decades. This changed in December 2014, when the Ministry of Health expressed its commitment to improve programming for transwomen and to involve transwomen organizations by prioritizing the development of a “Targeted Strategy Plan of STIs/HIV/AIDS Prevention and Comprehensive Care for Transwomen.” Discussion A policy dialogue between key stakeholders – Peru's Ministry of Health, academic scientists, civil society, transgender leaders and international agencies – created the conditions for a change in Peru's national HIV policy for transwomen. Supported by the effective engagement of all sectors, the Ministry of Health launched a plan to provide comprehensive HIV prevention and care for transwomen. The five-year plan includes new national guidelines for HIV prevention, care and support, and country-level investments in infrastructure and equipment. In addition to new biomedical strategies, the plan also incorporates several strategies to address structural factors that contribute to the vulnerability of transwomen. We identified three key factors that created the right conditions for this change in Peru's HIV policy. These factors include (1) the availability of solid evidence, based on scientific research; (2) ongoing efforts within the transwomen community to become better advocates of their own rights; and (3) a dialogue involving honest discussions between stakeholders about possibilities of changing the nation's HIV policy. Conclusions The creation of Peru's national plan for HIV prevention and care for transwomen shows that long-term processes, focused on human rights for transwomen in Peru, can lead to organizational and public-policy change. PMID:27431469

  13. Implementing advance care planning: a qualitative study of community nurses' views and experiences

    Directory of Open Access Journals (Sweden)

    Kennedy Sheila

    2010-04-01

    Full Text Available Abstract Background Advance care planning (ACP is a process of discussion about goals of care and a means of setting on record preferences for care of patients who may lose capacity or communication ability in the future. Implementation of ACP is widely promoted by policy makers. This study examined how community palliative care nurses in England understand ACP and their roles within ACP. It sought to identify factors surrounding community nurses' implementation of ACP and nurses' educational needs. Methods An action research strategy was employed. 23 community nurses from two cancer networks in England were recruited to 6 focus group discussions and three follow up workshops. Data were analysed using a constant comparison approach. Findings Nurses understood ACP to be an important part of practice and to have the potential to be a celebration of good nursing care. Nurses saw their roles in ACP as engaging with patients to elicit care preferences, facilitate family communication and enable a shift of care focus towards palliative care. They perceived challenges to ACP including: timing, how to effect team working in ACP, the policy focus on instructional directives which related poorly to patients' concerns; managing differences in patients' and families' views. Perceived barriers included: lack of resources; lack of public awareness about ACP; difficulties in talking about death. Nurses recommended the following to be included in education programmes: design of realistic scenarios; design of a flow chart; practical advice about communication and documentation; insights into the need for clinical supervision for ACP practice. Conclusions Nurses working in the community are centrally involved with patients with palliative care needs who may wish to set on record their views about future care and treatment. This study reveals some important areas for practice and educational development to enhance nurses' use and understanding of ACP.

  14. Economic (gross cost) analysis of systematically implementing a programme of advance care planning in three Irish nursing homes

    OpenAIRE

    O’Sullivan, Ronan; Murphy, Aileen; O’Caoimh, Rónán; Cornally, Nicola; Svendrovski, Anton; Daly, Brian; Fizgerald, Carol; Twomey, Cillian; McGlade, Ciara; Molloy, D. William

    2016-01-01

    Background Although advance care planning (ACP) and the use of advanced care directives (ACD) and end-of-life care plans are associated with a reduction in inappropriate hospitalisation, there is little evidence supporting the economic benefits of such programmes. We assessed the economic impact (gross savings) of the Let Me Decide (LMD) ACP programme in Ireland, specifically the impact on hospitalisations, bed days and location of resident deaths, before and after systematic implementation o...

  15. Menu planning in long-term care: toward resident-centred menus.

    Science.gov (United States)

    Ducak, Kate; Keller, Heather H

    2011-01-01

    Factors that influence the menu planning process in Ontario long-term care (LTC) homes were studied, as were key informants' perspectives on how this process could be improved to promote resident-centred menus. Key informants were interviewed by telephone to obtain qualitative data through standardized open-ended questions. The key informants (n=35) were randomly selected nutrition managers of Ontario LTC homes. Selected registered dietitians from the Ontario Long-Term Care Action Group also participated (n=5). Descriptive thematic analysis was completed on data provided. Three over arching themes emerged from the data as drivers in the menu planning process: resource limitations, Ontario Ministry of Health and Long-Term Care standards, and the accommodation of diverse and evolving preferences. Challenges involving resources include insufficient food labour and raw food funding, the workload involved with altering menus, and providing food items for special diets or preferences. In terms of ministry standards, participants reported barriers to complying with rotation and portion standards. Other common obstacles within LTC homes include accommodating personal preferences, cultural preferences, and therapeutic diets. Ontario LTC homes face numerous challenges in the planning of menus for residents, regardless of a home's size, location, or profit status. Suggestions are aimed at improving the menu planning process and providing high-quality, palatable, and culturally appropriate food in these homes so that menus are resident-centred. PMID:21645428

  16. Implementing the Affordable Care Act: choosing an essential health benefits benchmark plan.

    Science.gov (United States)

    Corlette, Sabrina; Lucia, Kevin W; Levin, Max

    2013-03-01

    To improve the adequacy of private health insurance, the Affordable Care Act requires insurers to cover a minimum set of medical benefits, known as "essential health benefits." In implementing this requirement, states were asked to select a "benchmark plan" to serve as a reference point. This issue brief examines state action to select an essential health benefits benchmark plan and finds that 24 states and the District of Columbia selected a plan. All but five states will have a small-group plan as their benchmark. Each state, whether or not it made a benchmark selection, will have a set of essential health benefits that reflects local, employer-based health insurance coverage currently sold in the state. States adopted a variety of approaches to selecting a benchmark, including intergov­ernmental collaboration, stakeholder engagement, and research on benchmark options. PMID:23547335

  17. The Role of the Medical School in Manpower Planning.

    Science.gov (United States)

    Johnson, Iris Crenshaw; Robertson, Ramon V.

    1982-01-01

    The Physician Information System, a computerized monitoring system developed by the Southern Illinois University of Medicine, is described. It obtains information about the distribution and practice characteristics of area physicians. (MLW)

  18. Planning for the integration of the digital library, clinical decision support, and evidence at the point of care.

    Science.gov (United States)

    Schwartz, Linda Matula; Iobst, Barbara

    2008-01-01

    Integrating knowledge-based resources at the point of care is an important opportunity for hospital library involvement. In the progression of an IAIMS planning grant, the digital library is recognized as pivotal to the success of information domain integration throughout the institution. The planning process, data collection, and evolution of the planning project are discussed. PMID:18844088

  19. Advance care planning – a multi-centre cluster randomised clinical trial: the research protocol of the ACTION study

    OpenAIRE

    Rietjens, Judith; Dunleavy, Lesley Jane; Preston, Nancy Jean; Payne, Sheila Alison

    2016-01-01

    Background Awareness of preferences regarding medical care should be a central component of the care of patients with advanced cancer. Open communication can facilitate this but can occur in an ad hoc or variable manner. Advance care planning (ACP) is a formalized process of communication between patients, relatives and professional caregivers about patients’ values and care preferences. It raises awareness of the need to anticipate possible future deterioration of health. ACP has the potenti...

  20. Advance care planning - a multi-centre cluster randomised clinical trial: the research protocol of the ACTION study

    OpenAIRE

    Rietjens, Judith AC; Korfage, Ida J.; Dunleavy, Lesley; Preston, Nancy J.; Jabbarian, Lea J.; Christensen, Caroline Arnfeldt; de Brito, Maja; Bulli, Francesco; Caswell, Glenys; Červ, Branka; Delden, Johannes; Deliens, Luc; Gorini, Giuseppe; Groenvold, Mogens; Houttekier, Dirk

    2016-01-01

    Background: Awareness of preferences regarding medical care should be a central component of the care of patients with advanced cancer. Open communication can facilitate this but can occur in an ad hoc or variable manner. Advance care planning (ACP) is a formalized process of communication between patients, relatives and professional caregivers about patients' values and care preferences. It raises awareness of the need to anticipate possible future deterioration of health. ACP has the potent...

  1. Use of a hand-held computer observational tool to improve communication for care planning and psychosocial well-being

    OpenAIRE

    Corazzini, Kirsten; Rapp, Carla Gene; McConnell, Eleanor S.; Anderson, Ruth A.

    2009-01-01

    Staff development nurses in long-term care are challenged to implement training programs that foster quality unlicensed assistive personnel (UAP) care and improve the transfer of their observations to licensed nursing staff for care planning. This study describes the outcomes of a program where UAP recorded behavioral problems of residents to inform care. Findings suggest staff development nurses who aim to improve UAP reporting without simultaneously targeting licensed nursing staff behavior...

  2. Advance care planning: A systematic review of randomised controlled trials conducted with older adults.

    Science.gov (United States)

    Weathers, Elizabeth; O'Caoimh, Rónán; Cornally, Nicola; Fitzgerald, Carol; Kearns, Tara; Coffey, Alice; Daly, Edel; O'Sullivan, Ronan; McGlade, Ciara; Molloy, D William

    2016-09-01

    Advance care planning (ACP), involving discussions between patients, families and healthcare professionals on future healthcare decisions, in advance of anticipated impairment in decision-making capacity, improves satisfaction and end-of-life care while respecting patient autonomy. It usually results in the creation of a written advanced care directive (ACD). This systematic review examines the impact of ACP on several outcomes (including symptom management, quality of care and healthcare utilisation) in older adults (>65years) across all healthcare settings. Nine randomised controlled trials (RCTs) were identified by searches of the CINAHL, PubMed and Cochrane databases. A total of 3646 older adults were included (range 72-88 years). Seven studies were conducted with community dwellers and the other two RCTs were conducted in nursing homes. Most studies did not implement a standardised ACD, or measure the impact on quality of end-of-life care or on the death and dying experience. All studies had some risk of bias, with most scoring poorly on the Oxford Quality Scale. While ACP interventions are well received by older adults and generally have positive effects on outcomes, this review highlights the need for well-designed RCTs that examine the economic impact of ACP and its effect on quality of care in nursing homes and other sectors. PMID:27451328

  3. Measuring and monitoring quality of care in family planning: are we ignoring negative experiences?

    OpenAIRE

    Reichenbach, Laura

    2016-01-01

    Shannon Harris,1 Laura Reichenbach,2 Karen Hardee2 1Public Health Consultant, Seattle, WA, USA; 2The Evidence Project, Population Council, Washington, DC, USA Abstract: Despite decades of emphasis on quality of care, qualitative research continues to describe incidents of poor quality client–provider interactions in family planning provision. Using an emerging framework on disrespect and abuse (D and A) in maternal health services, we reviewed the global published literature for qu...

  4. Measuring and monitoring quality of care in family planning: are we ignoring negative experiences?

    OpenAIRE

    Harris S; Reichenbach L; Hardee K

    2016-01-01

    Shannon Harris,1 Laura Reichenbach,2 Karen Hardee2 1Public Health Consultant, Seattle, WA, USA; 2The Evidence Project, Population Council, Washington, DC, USA Abstract: Despite decades of emphasis on quality of care, qualitative research continues to describe incidents of poor quality client–provider interactions in family planning provision. Using an emerging framework on disrespect and abuse (D and A) in maternal health services, we reviewed the global published literature for quanti...

  5. Connection, Regulation, and Care Plan Innovation: A Case Study of Four Nursing Homes

    OpenAIRE

    Colón-Emeric, Cathleen S.; Lekan-Rutledge, Deborah; Utley-Smith, Queen; Ammarell, Natalie; Bailey, Donald; Piven, Mary L.; Corazzini, Kirsten; Anderson, Ruth A.

    2006-01-01

    We describe how connections among nursing home staff impact the care planning process using a complexity science framework. We completed six-month case studies of four nursing homes. Field observations (n = 274), shadowing encounters (n = 69), and in-depth interviews (n = 122) of 390 staff at all levels were conducted. Qualitative analysis produced a conceptual/thematic description and complexity science concepts were used to produce conceptual insights. We observed that greater levels of sta...

  6. In consumer-directed health plans, a majority of patients were unaware of free or low-cost preventive care.

    Science.gov (United States)

    Reed, Mary E; Graetz, Ilana; Fung, Vicki; Newhouse, Joseph P; Hsu, John

    2012-12-01

    Consumer-directed health plans are plans with high deductibles that typically require patients to bear no out-of-pocket costs for preventive care, such as annual physicals or screening tests, in order to ease financial barriers and encourage patients to seek such care. We surveyed people in California who had a consumer-directed health plan and found that fewer than one in five understood that their plan exempted preventive office visits, medical tests, and screenings from their deductible, meaning that this care was free or had a modest copayment. Roughly one in five said that they had delayed or avoided a preventive office visit, test, or screening because of cost. Those who were confused about the exemption were significantly more likely to report avoiding preventive visits because of cost concerns. Special efforts to educate consumers about preventive care cost-sharing exemptions may be necessary as more health plans, including Medicare, adopt this model. PMID:23213148

  7. The Role of Health Care Provider Goals, Plans, and Physician Orders for Life-Sustaining Treatment (POLST) in Preparing for Conversations About End-of-Life Care.

    Science.gov (United States)

    Russell, Jessica

    2016-09-01

    The Physician Orders for Life-Sustaining Treatment (POLST) is a planning tool representative of an emerging paradigm aimed at facilitating elicitation of patient end-of-life care preferences. This study assessed the impact of the POLST document on provider goals and plans for conversations about end-of-life care treatment options. A 2 (POLST: experimental, control) × 3 (topic of possible patient misunderstanding: cardiopulmonary resuscitation, medical intervention, artificially administered nutrition) experimental design was used to assess goals, plan complexity, and strategies for plan alterations by medical professionals. Findings suggested that the POLST had little impact on plan complexity or reaction time with initial plans. However, preliminary evidence suggested that the utility of the POLST surfaced with provider responses to patient misunderstanding, in which differences in conditions were identified. Significant differences in goals reported as most important in driving conversational engagement emerged. Implications for findings are discussed. PMID:27442346

  8. Improved operations through manpower management in the oil sector

    International Nuclear Information System (INIS)

    The need for improved operations was never higher than today in the oil industry. The world's demand for energy, especially for oil and natural gas, is rising rapidly and for many years to come. In order to meet this rising demand and to keep price volatility to a minimum; oil companies worldwide are looking for ways to improve operations in order to achieve increased production with decreased costs. This paper describes data from Southern Area Oil Operations (SAOO); an organization within the Saudi Arabian Oil Company (ARAMCO), to show how manpower management can be used to achieve improved operations. For the years 1983 to 2004, manpower management in SAOO focused on addressing both the quantity and quality dimensions of manpower. First, the level of manpower gradually declined by 35% for both the Saudi Arab and Expatriate categories for the entire period. Expatriate labor is defined as labor in three main categories: US/Canadian, UK, and Asians and Other Arabs. Second, the level of training slowly increased to align manpower to better fit organizational functions and work responsibilities. Not only a number of new training and development programs were initiated but also the percentage of employees involved in such programs doubled from 4.5% in 1990 to 8.9% in 2004. Third, technology based initiatives such as the use of computers, Internet, and intranet were heavily introduced to employees in the last 10 yrs. Due to these three changes reduced costs and increased manpower efficiency were achieved. In the period 1983 to 2004 the total labor bill declined by 35% and Net Direct Expenditures NDE by 24% after adjusting for inflation and using 2004 dollars. Net Direct Expenditure NDE is defined by SAOO to be the summation of labor cost, material cost, invoices cost, and net service income. In addition two signs of improved efficiency of manpower were apparent in the same period. First, SAOO manpower, despite its smaller size, could actually sustain an increased

  9. Advance Care Planning in Norwegian nursing homes-Who is it for?

    Science.gov (United States)

    Thoresen, Lisbeth; Ahlzén, Rolf; Solbrække, Kari Nyheim

    2016-08-01

    Advance care planning (ACP) is an international concept for improving patient autonomy and communication in the context of anticipated deterioration and end-of-life care. In a preparatory conversation, health care professionals facilitate one or more conversations where nursing home residents are invited to reflect on, and articulate wishes and preferences concerning future medical treatment and end-of-life care. Our aim with this study was to increase knowledge of existing ACP practices in Norwegian nursing homes. We wanted to know how nursing home residents, relatives and nursing home staff take part in the conversations, and to what extent these conversations can be regarded as promoting autonomy, legal rights and individual needs for the residents. We conducted participant observation of seven preparatory conversations, followed by interviews with health care staff (together) and resident and relative (together). In the result section, we present an informative case example of an ACP conversation where common and important characteristics running through our data are present. These are further elaborated under the following headings: Life critical questions, Residents' quiet participation in the conversations, the Dying phase - a clinical issue, Nurses and physicians; different domains and Timing. We find that nursing home staff in our study wants to contribute to open awareness, autonomy and a good death, but there are little reflections about the purpose and content of the conversations, how they should be carried out and when, and what frail nursing home residents are able to understand and express in ACP conversations. PMID:27531449

  10. Developing a national dissemination plan for collaborative care for depression: QUERI Series

    Directory of Open Access Journals (Sweden)

    Rubenstein Lisa V

    2008-12-01

    Full Text Available Abstract Background Little is known about effective strategies for disseminating and implementing complex clinical innovations across large healthcare systems. This paper describes processes undertaken and tools developed by the U.S. Department of Veterans Affairs (VA Mental Health Quality Enhancement Research Initiative (MH-QUERI to guide its efforts to partner with clinical leaders to prepare for national dissemination and implementation of collaborative care for depression. Methods An evidence-based quality improvement (EBQI process was used to develop an initial set of goals to prepare the VA for national dissemination and implementation of collaborative care. The resulting product of the EBQI process is referred to herein as a "National Dissemination Plan" (NDP. EBQI participants included: a researchers with expertise on the collaborative care model for depression, clinical quality improvement, and implementation science, and b VA clinical and administrative leaders with experience and expertise on how to adapt research evidence to organizational needs, resources and capacity. Based on EBQI participant feedback, drafts of the NDP were revised and refined over multiple iterations before a final version was approved by MH-QUERI leadership. 'Action Teams' were created to address each goal. A formative evaluation framework and related tools were developed to document processes, monitor progress, and identify and act upon barriers and facilitators in addressing NDP goals. Results The National Dissemination Plan suggests that effectively disseminating collaborative care for depression in the VA will likely require attention to: Guidelines and Quality Indicators (4 goals, Training in Clinical Processes and Evidence-based Quality Improvement (6 goals, Marketing (7 goals, and Informatics Support (1 goal. Action Teams are using the NDP as a blueprint for developing infrastructure to support system-wide adoption and sustained implementation of

  11. Advance care planning in stroke: influence of time on engagement in the process

    Directory of Open Access Journals (Sweden)

    Green T

    2014-01-01

    Full Text Available Theresa Green1, Shreyas Gandhi2, Tessa Kleissen1, Jessica Simon1,3, Shelley Raffin-Bouchal1, Karla Ryckborst41Faculty of Nursing, University of Calgary, Calgary, AB, Canada; 2Health Sciences, McMaster University, Hamilton, ON, Canada; 3Department of Medicine, University of Calgary, Calgary, AB, Canada; 4Calgary Stroke Program, Alberta Health Services, Calgary, AB, CanadaPurpose: Individuals who experience stroke have a higher likelihood of subsequent stroke events, making it imperative to plan for future medical care. In the event of a further serious health event, engaging in the process of advanced care planning (ACP can help family members and health care professionals (HCPs make medical decisions for individuals who have lost the capacity to do so. Few studies have explored the views and experiences of patients with stroke about discussing their wishes and preferences for future medical events, and the extent to which stroke HCPs engage in conversations around planning for such events. In this study, we sought to understand how the process of ACP unfolded between HCPs and patients post-stroke.Patients and methods: Using grounded theory (GT methodology, we engaged in direct observation of HCP and patient interactions on an acute stroke unit and two stroke rehabilitation units. Using semi-structured interviews, 14 patients and four HCPs were interviewed directly about the ACP process.Results: We found that open and continual ACP conversations were not taking place, patients experienced an apparent lack of urgency to engage in ACP, and HCPs were uncomfortable initiating ACP conversations due to the sensitive nature of the topic.Conclusion: In this study, we identified lack of engagement in ACP post-stroke, attributable to patient and HCP factors. This encourages us to look further into the process of ACP in order to develop open communication between the patient with stroke, their families, and stroke HCPs.Keywords: qualitative, engagement

  12. The views of older Malaysians on advanced directive and advanced care planning: a qualitative study.

    Science.gov (United States)

    Htut, Y; Shahrul, K; Poi, P J H

    2007-01-01

    The provision of optimum care for the ageing population is dependent on the understanding of their views and values on end of life issues. A qualitative descriptive study was conducted to describe views of elderly Malaysians on Advanced Care Planning (henceforth ACP) and Advanced Directives (henceforth AD), and explore factors influencing these views. Fifteen elderly subjects with ages ranging from 65 to 83 years, representing different ethnic and religious groups in Malaysia were selected for in-depth interviews guided by a questionnaire. Five core themes were extracted from the interviews: 1) Considering the future 2) Contingency plans for future illnesses 3) Attitudes towards life prolonging treatment procedures 4) Doctor-patient relationships and 5) Influence of religion on decisions related to future illness. Despite the lack of knowledge on ACP and AD, older respondents were very receptive to their concept. Although the majority agreed on the importance of planning for future medical management and having open discussion on end of life issues with their doctor, they felt it unnecessary to make a formal written AD. Most felt that the future was best left to fate or God, and none had made any contingency plan for severe future illnesses citing religion as reason for this view. Cardiopulmonary resuscitation, mechanical ventilation and dialysis were considered by most to be invasive life prolonging treatments. We suggest that doctors initiate discussions on end of life care with every older patient and their family so as to promote awareness and introduce the concept of ACP/AD to a Malaysian setting. PMID:18330404

  13. Health care professionals' perspectives of advance care planning for people with dementia living in long-term care settings: a narrative review of the literature.

    Science.gov (United States)

    2016-05-27

    This comprehensive synthesis of published literature from a team in Northern Ireland focused on the perspectives of healthcare professionals in relation to ACP for people with dementia living in long-term care settings. From the 14 papers discussed, the authors identified that people with dementia are often not recognised as having a terminal illness. Four key themes were identified: ■ Early integration and planning for palliative care in dementia is important. ■ Healthcare professionals' perspectives on ACP are influenced by ethical and moral concerns including presumptions regarding capacity of the person with dementia towards ACP and the impact of the increased role of the family in the decision-making processes. ■ Challenges in communicating with people who have dementia and their families. ■ A need for improvement in healthcare professionals' knowledge of the disease trajectory of dementia with emphasis on end of life care, and a greater understanding of the process of ACP itself. This would assist them in engaging in ACP discussions. PMID:27231081

  14. Learning to plan? A critical fiction about the facilitation of professional and practice development plans in primary care.

    Science.gov (United States)

    Elwyn, Glyn; Hocking, Paul; Burtonwood, Ann; Harry, Karan; Turner, Arthur

    2002-11-01

    A shift from continuing medical education towards professional and organisational development policies, coupled with the introduction of accountability frameworks (clinical governance), has generated interest in professional and practice development plans (PPDPs) in general practice. The problems of implementing this change in an independent contractor-based service remain unexplored and the aims of this study were to focus on the facilitator's experience of the issues that hampered or fostered development in general practice. Facilitators of PPDPs were asked to document their experience of supporting 12 practices in an all Wales feasibility study. In order to maintain organisational anonymity while reporting accurate accounts of the obstacles encountered, a method known as critical fiction was employed. This method allowed the authors to write detailed reflective accounts that were then fictionalised. The culture of general practice reflects the development of an independent contractor service that has developed into partnerships that employ some professionals (practice nurses, managers and administrative staff) and collaborate with others in variable arrangements (community nurses, health visitors, midwives and others). Developing organisation-wide systems in so-called 'primary health care teams' is a difficult exercise, given the ethos of autonomous decision-making processes and the lack of experience of 'whole systems' approaches in primary care. The potential for multiprofessional synergy and the evidence that systematic changes lead to sustained health care improvements are well established. But the implementation issues of these concepts have not been addressed. Existing educational policies are based in uniprofessional paradigms and the protected time requirements and funding streams required for PPDPs have not been clarified. PMID:12487843

  15. Are Marketplace Plans Affordable? Consumer Perspectives from the Commonwealth Fund Affordable Care Act Tracking Survey, March-May 2015.

    Science.gov (United States)

    Collins, Sara R; Gunja, Munira; Rasmussen, Petra W; Doty, Michelle M; Beutel, Sophie

    2015-09-01

    Most employers who provide health insurance to employees subsidize their premiums and provide a comprehensive benefit package. Before the Affordable Care Act, people who lacked health insurance through a job and purchased it on their own paid the full cost of their plans, which often came with skimpy benefit packages and high deductibles. Findings from the Commonwealth Fund Affordable Care Act Tracking Survey, March--May 2015, indicate that the law's tax credits have made premium costs in health plans sold through the marketplaces roughly comparable to employer plans, at least for people with low and moderate incomes. At higher incomes, the phase-out of the subsidies means that adults in marketplace plans have higher premium costs than those in employer plans. Overall, larger shares of adults in marketplace plans reported deductibles of $1,000 or more, compared with those in employer plans, though these differences were narrower among low-and moderate-income adults. PMID:26445739

  16. Comprehensive Care Plan Development Using Resident Assessment Instrument Framework: Past, Present, and Future Practices

    Directory of Open Access Journals (Sweden)

    Mary Ellen Dellefield

    2015-10-01

    Full Text Available Development of the comprehensive care plan (CCP is a requirement for nursing homes participating in the federal Medicare and Medicaid programs, referred to as skilled nursing facilities. The plan must be developed within the context of the comprehensive interdisciplinary assessment framework—the Resident Assessment Instrument (RAI. Consistent compliance with this requirement has been difficult to achieve. To improve the quality of CCP development within this framework, an increased understanding of complex factors contributing to inconsistent compliance is required. In this commentary, we examine the history of the comprehensive care plan; its development within the RAI framework; linkages between the RAI and registered nurse staffing; empirical evidence of the CCP’s efficacy; and the limitations of extant standards of practices in CCP development. Because of the registered nurse’s educational preparation, professional practice standards, and licensure obligations, the essential contributions of professional nurses in CCP development are emphasized. Recommendations for evidence-based micro and macro level practice changes with the potential to improve the quality of CCP development and regulatory compliance are presented. Suggestions for future research are given.

  17. Treatment planning structure and process in the United States: a 'patterns of care' study

    International Nuclear Information System (INIS)

    Purpose: To conduct a study of the structure and process of treatment planning in the United States. Methods and Materials: A Patterns of Care treatment planning consensus committee developed a survey form that was used to gather data for 106 items relating to the structure and process of treatment planning. These questions were general in nature and not specific to any particular disease site. Seventy-three facilities were randomly selected for site visits from the 1321 radiation therapy facilities in the United States: 21 academic, 26 hospital, and 26 free-standing. During the site visit the facility physicist, assisted by the site-visit physicist, completed the form. Results: Twenty-nine percent of facilities have cobalt-60 machines; 25% have 4 MV linacs; 75% have photon energies in the range of 5-8 MV; and less than 10% have energies greater than 20 MV. Academic facilities led hospital and free-standing facilities by about 30 percentage points in the availability of all electron energies (88 vs. 58%, approximately, in the range 4-13 MeV and scaling downward to about 60 vs. 30% at the highest energies). The national averages for the availability of Cs-137, Ir-192, and I-125 were 87, 73, and 44%, respectively. Computerized tomography (CT) scanning is not available or not used in 15% of hospital and free-standing facilities. Ninety-six percent of facilities have treatment planning computers; at 10% of facilities physicians do not participate in treatment planning. The estimated national averages of facilities having formal quality assurance (QA) programs for treatment planning systems, simulators, film processors, and blocking systems are 44, 79, 62, and 55%, respectively. Sixty-three percent of facilities obtain independent machine calibrations. Conclusion: This is the first patterns of treatment planning study carried out in the United States and the results reported here will establish a baseline for future studies. The present study has identified some

  18. Planning for interprofessional change in primary health care: exploring the use of the Interprofessional Resource Centre

    Directory of Open Access Journals (Sweden)

    Patterson C

    2013-05-01

    Full Text Available Christine Patterson,1 Heather Arthur,1,2 Gladys Peachey,1 Julie Vohra,1 David Price,3 Dave Pearson,4 Rob Mariani51School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada; 2Heart and Stroke Foundation of Ontario/Michael G DeGroote Endowed Chair in Cardiovascular Nursing Research, McMaster University, Hamilton, ON, Canada; 3Department of Family Medicine, McMaster University, Hamilton, ON, Canada; 4Central West Local Health Integration Network, Brampton, ON, Canada; 5Ascentum Consulting, Ottawa, ON, CanadaImportance: Resources to support change are needed for solo practitioners who are transitioning to family health teams (FHTs which involve multiple health disciplines working together to provide team-based care.Objective: The purpose of this project was: (1 to explore the use of an online resource, the Interprofessional Resource Centre (IRC, when planning for interprofessional change and; (2 to explore the experience of planning interprofessional change.Design and setting: Six FHTs organized under the structure of one Local Health Integrated Network (LHIN in Ontario, Canada.Intervention: Participants in six FHTs were directed to the IRC to support planning interprofessional change. In addition, two of the six FHTs participated in pilot site meetings with investigators where they received in-person support to apply the information from the IRC to an interprofessional activity.Results: Pilot site participants reported the IRC was useful for planning, but they cited lack of time to use it as a key barrier. When planning for interprofessional change, providers experienced challenges with physician buy-in and team dynamics. As a strategy for change, providers would like to learn from other FHTs who have experienced success with interprofessional change; at the LHIN level, they saw a need for more educational opportunities. Participation was found to be low among those only receiving online support.Conclusion and

  19. A review of manpower training for Nigeria's fishing industry

    OpenAIRE

    Olaniawo, A.A.

    1983-01-01

    An examination is made of the organization and administration of fisheries training institutes in Nigeria, highlighting their inadequacies in achieving required goals. A systems approach to fisheries manpower training is described which is based on 4 principles: 1) wholeness; 2) systematization; 3) compatibility; and 4) optimization

  20. The Political Economy of Military Manpower Procurement in Peacetime.

    Science.gov (United States)

    Withers, Glenn Alexander

    The study examines military manpower procurement for peacetime. It considers the broad alternative systems of conscription and voluntarism and develops models of demand and supply for military labor to show how these are affected by the choice of procurement system. Empirical applications are made using evidence from Australia, Canada, Great…

  1. Employee Performance and State Mental Health Manpower Development.

    Science.gov (United States)

    McCullough, Paul M.

    A project explored the manpower issue termed "burnout" and the impact of this phenomenon on mental health service programs. (In the framework of this study burnout is defined as that state of non-productivity, non-motivation, and indifference which interferes with a worker's delivering services effectively.) Existing literature does not clearly…

  2. Wound healing and nutrition: going beyond dressings with a balanced care plan.

    Science.gov (United States)

    Gruen, Douglas

    2010-09-01

    As the largest organ of the body, the human skin protects all subcutaneous tissues. Despite its many attributes, the skin is vulnerable to pressure ulcers. The number of pressure ulcers and venous leg ulcers is on the rise, but healing rates have not improved over the past decade. The reason may be a tendency to focus on one or two fundamentals of wound healing, but not on all 3 fundamentals equally. The 3 fundamentals of wound healing are (1) pressure relief and nursing care, (2) dressings, and (3) nutrition. Nutrition is the area that is most often overlooked, which commonly causes the care plan to be out of balance. In the United States, few clinicians would consider malnutrition to be an issue in the homecare and long-term care setting, yet nutritional status and risk for pressure ulcer formation are well documented and strongly correlated. Our aging population will continue to survive previously catastrophic events, only to present with pressure ulcers or the potential for developing pressure ulcers. Clinicians caring for residents with pressure ulcers must strike a balance between pressure relief, dressings, and nutrition. Functional gastrointestinal-tract impairments must be diagnosed and addressed. Wounds must be treated aggressively with high-protein calorically-balanced diets because wounds heal from the inside out. PMID:24527147

  3. Early experience with digital advance care planning and directives, a novel consumer-driven program

    OpenAIRE

    Fine, Robert L.; Yang, Zhiyong; Spivey, Christy; Boardman, Bonnie; Courtney, Maureen

    2016-01-01

    Barriers to traditional advance care planning (ACP) and advance directive (AD) creation have limited the promise of ACP/AD for individuals and families, the healthcare team, and society. Our objectives were to determine the results of a digital ACP/AD through which consumers create, store, locate, and retrieve their ACP/AD at no charge and with minimal physician involvement, and the ACP/AD can be integrated into the electronic health record. The authors chose 900 users of MyDirectives, a digi...

  4. Corporate compliance plans in health care organizations: a top-down perspective.

    Science.gov (United States)

    Forgione, D A

    1998-01-01

    Recently, at an all-day professional meeting that was targeted at about 100 junior-level health care financial professionals, we covered a whole spectrum of subjects. We covered topics ranging from the Hill-Burton Act to Medicare managed care organizations (MCOs) and capitation; the Stark rules on physician self-referral; the financial incentives within various payment systems for physicians, hospitals, and other providers; Medicare fraud and abuse rules; and the need for well-designed corporate compliance plans. After responding to a number of the participants' questions, I could not help but be reminded of the students every semester who ask me, "Will this be on the test?" In other words, if there are no real teeth in the subject, then they have too many other urgent priorities demanding their attention to give the issue serious consideration. Perhaps this highlights the need for taking corporate compliance planning seriously--starting at the top levels of the organization. It is well documented that leadership attitudes filter downward in any organization. If change for the better is going to take place in the area of corporate compliance, it needs to begin with each of us as individuals, from the top down. PMID:9612741

  5. Stillwater Wildlife Management Area Wildlife Inventory Plan

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The Wildlife Inventory Plan discusses the following protocols; wildlife inventory procedures, physical facility needs, manpower days, and special considerations.

  6. Family planning: formal health care providers’ challenges in the district of Antananarivo Avaradrano

    Directory of Open Access Journals (Sweden)

    Barbara Elyan Edwige Vololonarivelo

    2013-06-01

    Full Text Available Background: Recorded contraceptive prevalence may not represent all the women using contraceptives. Nevertheless, it serves as a fundamental tool in decision-making at Ministry and international level. This study aims to determine the actual contraceptive prevalence and identify factors determining users’ positions about modern contraception and local services deliveries in the district of Antananarivo Avaradrano. Methods: A cross-sectional survey was conducted, where an interviewer-administered questionnaire has been used to collect data. Targeted female respondents aged 18-39 were asked about their contraceptive use, knowledge and information sources on family planning, perception of social support and perception on the local health care providers. Results: Contraceptive prevalence is underestimated. Moreover, it is higher among women aged 35 to 39 and those having two children or more, but lower among those who have reached university level of education. Women who are able to tell two benefits of family planning, informed by the community health agents (CHA, and deciding with their partners on contraception use are more likely to use contraceptives on a regular basis. Women complain on their poor relationship with health care providers and doubt about their real competence. Conclusions: This study demonstrates the evidence of an underestimation of contraceptive prevalence. The challenge is how to collect reliable data, thus recording systems have to be improved. Besides, government efforts in increasing contraceptive use ought to be targeted on adolescents and young people aged 20-25, the couple itself, health-care provider – woman relationship, and on the CHA’s activities. [Int J Res Med Sci 2013; 1(3.000: 204-211

  7. The AB Staff Plan

    CERN Document Server

    Boillot, J; Delahaye, J P; Myers, S; CERN. Geneva. AB Department

    2003-01-01

    The present report summarises the staff plan of the newly created Accelerators and Beams (AB) Division following the restructuring of the Accelerator Sector and covering the period 2003 to 2010. It underlines the refocusing of the staff on priority work, especially the LHC Project and is coherent with the recently adopted CERN Long Term Plan (LTP). It compares the requested and available manpower (both staff and industrial support) for each Project, Programme and Activity (PPA) split in work packages and highlights the missing manpower for each category of personnel.

  8. Effectiveness of improvement plans in primary care practice accreditation: a clustered randomized trial.

    Directory of Open Access Journals (Sweden)

    Elvira Nouwens

    Full Text Available BACKGROUND: Accreditation of healthcare organizations is a widely used method to assess and improve quality of healthcare. Our aim was to determine the effectiveness of improvement plans in practice accreditation of primary care practices, focusing on cardiovascular risk management (CVRM. METHOD: A two-arm cluster randomized controlled trial with a block design was conducted with measurements at baseline and follow-up. Primary care practices allocated to the intervention group (n = 22 were instructed to focus improvement plans during the intervention period on CVRM, while practices in the control group (n = 23 could focus on any domain except on CVRM and diabetes mellitus. Primary outcomes were systolic blood pressure <140 mmHg, LDL cholesterol <2.5 mmol/l and prescription of antiplatelet drugs. Secondary outcomes were 17 indicators of CVRM and physician's perceived goal attainment for the chosen improvement project. RESULTS: No effect was found on the primary outcomes. Blood pressure targets were reached in 39.8% of patients in the intervention and 38.7% of patients in the control group; cholesterol target levels were reached in 44.5% and 49.0% respectively; antiplatelet drugs were prescribed in 82.7% in both groups. Six secondary outcomes improved: smoking status, exercise control, diet control, registration of alcohol intake, measurement of waist circumference, and fasting glucose. Participants' perceived goal attainment was high in both arms: mean scores of 7.9 and 8.2 on the 10-point scale. CONCLUSIONS: The focus of improvement plans on CVRM in the practice accreditation program led to some improvements of CVRM, but not on the primary outcomes. ClinicalTrials.gov NCT00791362.

  9. Quality control in health care: an experiment in radiotherapy planning for breast cancer patients after mastectomy

    International Nuclear Information System (INIS)

    Purpose: The importance of evaluating and improving quality in clinical practice is now generally acknowledged. In this study we estimated different sources of variation in radiotherapy planning for breast cancer patients after mastectomy and sought to test the applicability of a reproducibility and repeatability (R and R) study in a clinical context. Methods: Eleven radiation oncologists planned radiotherapy three times for three different kinds of breast cancer patients without knowing they were handling the same patient three times. Variation was divided into different components: physicians as operators, patients as parts, and repeated measurements as trials. Variation due to difference across trials (repeatability), that across the physicians (reproducibility), and that across the patients (variability) were estimated, as well as interactions between physicians and patients. Calculation was based on the sum of squares, and analysis was supported by various graphical presentations such as range charts and box plots. Results: Some parts of the planning process were characterized by higher and different kinds of variation than the others. Interphysician variation (i.e., reproducibility) was not high but there were some clearly outlying physicians. The highest variation was in repeatability (intraphysician variation). The major part of the variation was, however, that from patient to patient: 33% of the total in Parameter 1 and 85% of the total in Parameter 2. Conclusions: R and R studies are applicable and are needed to evaluate and improve quality in clinical practice. This kind of analysis provides opportunities to establish which kinds of patients require particularly careful attention, which points in the process are most critical for variation, which are the most difficult aspects for each physician and call for more careful description in documents, and which physicians need further training

  10. Where We Are Headed--and Why? A Step-by-Step Guide to Strategic Planning in Center-Based Child Care.

    Science.gov (United States)

    Ratekin, Cindy; Bess, Gary

    1995-01-01

    Argues that strategic planning by all involved in a child care center facilitates planning for the future. This planning includes representation of all parties concerned; attendance at planning events; equal participation; analysis of center's current status; planning sessions in places encouraging creativity; and a skilled, impartial facilitator.…

  11. Development of an interactive model for planning the care workforce for Alberta: case study

    Directory of Open Access Journals (Sweden)

    Bloom Judy

    2012-08-01

    Full Text Available Abstract Introduction In common with other jurisdictions, Alberta faces challenges in ensuring a balance in health worker supply and demand. As the provider organization with province-wide responsibility, Alberta Health Services needed to develop a forecasting tool to inform its position on key workforce parameters, in the first instance focused on modeling the situation for Registered Nurses, Licensed Practical Nurses and health care aides. This case study describes the development of the model, highlighting the choices involved in model development. Case description A workforce planning model was developed to test the effect of different assumptions (for instance about vacancy rates or retirement and different policy choices (for example about the size of intakes into universities and colleges, different composition of the workforce. This case study describes the choices involved in designing the model. The workforce planning model was used as part of a consultation process and to develop six scenarios (based on different policy choices. Discussion and evaluation The model outputs highlighted the problems with continuation of current workforce strategies and the impact of key policy choices on workforce parameters. Conclusions Models which allow for transparency of the underlying assumptions, and the ability to assess the sensitivity of assumptions and the impact of policy choices are required for effective workforce planning.

  12. An Assessment to Inform Pediatric Cancer Provider Development and Delivery of Survivor Care Plans.

    Science.gov (United States)

    Warner, Echo L; Wu, Yelena P; Hacking, Claire C; Wright, Jennifer; Spraker-Perlman, Holly L; Gardner, Emmie; Kirchhoff, Anne C

    2015-12-01

    Current guidelines recommend all pediatric cancer survivors receive a survivor care plan (SCP) for optimal health management, yet clinical delivery of SCPs varies. We evaluated oncology providers' familiarity with and preferences for delivering SCPs to inform the implementation of a future SCP program at our institution. From November 2013 to April 2014, oncology providers from the Primary Children's Hospital in Salt Lake City, UT, completed a survey (n=41) and a 45-min focus group (n=18). Participants reported their familiarity with and training in SCP guidelines, opinions on SCPs, and barriers to delivering SCPs. As a secondary analysis, we examined differences in survey responses between physicians and nurses with Fisher's exact tests. Focus group transcripts and open-ended survey responses were content analyzed. Participants reported high familiarity with late effects of cancer treatment (87.8%) and follow-up care that cancer survivors should receive (82.5%). Few providers had delivered an SCP (oncologists 35.3% and nurses 5.0%; p=0.03). Barriers to providing SCPs included lack of knowledge (66.7%), SCP delivery is not expected in their clinic (53.9%), and no champion (48.7%). In qualitative comments, providers expressed that patient age variation complicated SCP delivery. Participants supported testing an SCP intervention program (95.1%) and felt this should be a team-based approach. Strategies for optimal delivery of SCPs are needed. Participants supported testing an SCP program to improve the quality of patient care. Team-based approaches, including nurses and physicians, that incorporate provider training on and support for SCP delivery are needed to improve pediatric cancer care. PMID:25893925

  13. The Role of Social Workers in Spiritual Care to Facilitate Coping With Chronic Illness and Self-Determination in Advance Care Planning.

    Science.gov (United States)

    Francoeur, Richard B; Burke, Nancy; Wilson, Alicia M

    2016-01-01

    Spiritual values and beliefs of patients and families influence resilience during chronic illness and shape patient choices during advance care planning. The spiritual needs of Baby Boomers will be more diverse than previous generations, in connection with the questioning, experimental mind-set of this group and the fact that it includes a higher proportion of immigrant populations outside the Judeo-Christian tradition. Social workers are trained explicitly to intervene with diverse populations and are well positioned to offer spiritual support in ways that do not necessarily conform to traditional religions. To the extent of their individual expertise and competence, social workers should assess and provide spiritual care to clients, including those who either are underserved or prefer not to seek assistance from clergy or chaplains because they feel alienated from religious institutions and representatives. They should also be aware of ethical dilemmas in consulting with spiritual care professionals in developing spiritual interventions. Social work education should address clients' humanistic and existential concerns, beliefs and behaviors of the major religions, and forms of nontraditional religious and spiritual experiences; it should also provide experiential opportunities for engaging with grief and earlier advance care planning. There should be attention to different theodical perspectives of the major religions regarding the problem of good and evil, which may preoccupy even clients who no longer participate in organized religion, because these unresolved existential issues may weaken client coping with chronic conditions and may diminish clarity and self-awareness for engaging authentically and effectively in advance care planning. PMID:27187806

  14. Fuzzy system dynamics and optimization with application to manpower systems

    Directory of Open Access Journals (Sweden)

    C. Mbohwa

    2012-10-01

    Full Text Available The dynamics of human resource recruitment and training in an uncertain environment creates a challenge for many policy makers in various organisations. In the presence of fuzzy manpower demand and training capacity, many companies fear losing critical human resources when their employees leave. As such, the development of effective dynamic policies for recruitment and training in a fuzzy dynamic environment is imperative. In this frame of mind, a fuzzy systems dynamics modelling approach is proposed to enable the policy maker to develop reliable dynamic policies relating recruitment, training, and available skills, from a systems perspective. It is anticipated in this study that fuzzy system dynamics and optimization approach would help organizations to design effective manpower policies and strategies.

  15. Training of manpower resources at the National Atomic Energy Commission of Argentina

    International Nuclear Information System (INIS)

    The main factors that influenced the development of the manpower resources required by CNEA over its thirty years of life are discussed: a careful specialized training; basic and applied research groups as a basic support for the other activities; teams responsible for the applications and for the concrete realizations of increasing complexity carried out by CNEA, culminating with the nuclear power plants; CNEA's relations with the national educational system regarding nuclear specialization; CNEA's international interaction, either by the participation of foreigners in its internal courses, by the commissioning of Argentinians abroad, and by the cooperation with international agencies in organizing courses, seminars and conferences; the influence of the radiological protection and nuclear safety requirements on the training programs, on nuclear industry, and on the users of radioisotopes and radiations; the importance of feeding the results of each activity back into the system so as to obtain a dynamic programming adapted to the requirements at all times. (M.E.L.)

  16. Training of manpower resources at the National Atomic Energy Commission of Argentina

    Energy Technology Data Exchange (ETDEWEB)

    Ambrosis de Libanati, N. (Comision Nacional de Energia Atomica, Buenos Aires (Argentina). Dept. de Capacitacion y Evaluacion de Personal)

    The main factors that influenced the development of the manpower resources required by CNEA over its thirty years of life are discussed: a careful specialized training; basic and applied research groups as a basic support for the other activities; teams responsible for the applications and for the concrete realizations of increasing complexity carried out by CNEA, culminating with the nuclear power plants; CNEA's relations with the national educational system regarding nuclear specialization; CNEA's international interaction, either by the participation of foreigners in its internal courses, by the commissioning of Argentinians abroad, and by the cooperation with international agencies in organizing courses, seminars and conferences; the influence of the radiological protection and nuclear safety requirements on the training programs, on nuclear industry, and on the users of radioisotopes and radiations; the importance of feeding the results of each activity back into the system so as to obtain a dynamic programming adapted to the requirements at all times.

  17. Solving a manpower scheduling problem for airline catering using metaheuristics

    DEFF Research Database (Denmark)

    Ho, Sin C.; Leung, Janny M. Y.

    2010-01-01

    We study a manpower scheduling problem with job time-windows and job-skills compatibility constraints. This problem is motivated by airline catering operations, whereby airline meals and other supplies are delivered to aircrafts on the tarmac just before the flights take-off.  Jobs (flights) must...... simulated annealing heuristic approach to solve the problem. Computational experiments show that the tabu search approach outperforms the simulated annealing approach, and is capable of finding good solutions....

  18. CLINICAL PSYCHOLOGY – ACTUAL DIRECTION IN GROUNDING OF HEALTH MANPOWER

    OpenAIRE

    M.G. Kucherov; E.S. Olenсo; A.I. Kodochigova; V.F. Kirichuk; A. A. Svistunov; P.V. Glybochko; E.A. Krovaykova

    2007-01-01

    In 90-ies years of last century in our country happened the crash of the system of values with transition to the standards of capitalistic society, and it lead to the formation of chronicle psychosocial stress of high and medium levels. Medics of all directions started to face functional psychosomatic diseases. Raised the necessity in grounding of health manpower in discipline of clinical psychology, with the learning of psychophisiological bases of diseases and possibilities if their correct...

  19. Fuzzy system dynamics and optimization with application to manpower systems

    OpenAIRE

    Mbohwa, C; M. Mutingi

    2012-01-01

    The dynamics of human resource recruitment and training in an uncertain environment creates a challenge for many policy makers in various organisations. In the presence of fuzzy manpower demand and training capacity, many companies fear losing critical human resources when their employees leave. As such, the development of effective dynamic policies for recruitment and training in a fuzzy dynamic environment is imperative. In this frame of mind, a fuzzy systems dynamics modelling approach is ...

  20. Selection an Appropriate Leadership Style to Direct Hospital Manpower

    OpenAIRE

    Arab, M.; Tajvar, M; F Akbari

    2006-01-01

    This research has tried to find most proper leadership styles based on a approved model to direct hospital manpower appropriately. The main objective of this research was the comparison between manager’s existing leadership styles and suggested styles to them in order to direct existing styles toward suggested ones. In this cross- sectional study all Qom province hospital managers participated. From the hospital the staff, 385 persons were selected by randomized stratifying sampling. Data wer...

  1. Forecasting the manpower demand for quantity surveyors in Hong Kong

    Directory of Open Access Journals (Sweden)

    Paul H K Ho

    2013-09-01

    Full Text Available Recently, there has been a massive infrastructure development and an increasing demand for public and private housing, resulting in a shortage of qualified quantity surveyors. This study aims to forecast the demand for qualified quantity surveyors in Hong Kong from 2013 to 2015. Literature review indicates that the demand for quantity surveyors is a function of the gross values of building, civil engineering and maintenance works. The proposed forecasting method consists of two steps. The first step is to estimate the gross values of building, civil engineering and maintenance works by time series methods and the second step is to forecast the manpower demand for quantity surveyors by causal methods. The data for quantity surveyors and construction outputs are based on the ‘manpower survey reports of the building and civil engineering industry’ and the ‘gross value of construction works performed by main contractors’ respectively. The forecasted manpower demand for quantity surveyors in 2013, 2014 and 2015 are 2,480, 2,632 and 2,804 respectively. Due to the low passing rate of the assessment of professional competence (APC and the increasing number of retired qualified members, there will be a serious shortage of qualified quantity surveyors in the coming three years.

  2. Third corporate plan September 1991

    International Nuclear Information System (INIS)

    The Science and Engineering Research Council (SERC) published its first Corporate Plan in 1985 and its second in 1989. This third plan comes at a time of considerable change for the Council. Funding is tightly constrained, with the costs of research rising. Changes in funding patterns have made the pursuit of research in the higher-education sector - where the SERC deploys much of its resource -much harder, yet major new challenges and opportunities are opening up. The refocusing of a large organisation like the SERC is not accomplished overnight and needs careful preparation. This plan is therefore an interim document describing some important decisions recently taken and the reviews now being carried out to set future priorities. A fourth plan, to be published early in 1993, will describe the outcome of this reappraisal and set a definitive path towards the end of the century. The aims for the following programmes are stated and the funding objectives stated: the science board materials commission, engineering board, astronomy and planetary science board, nuclear physics board, fellowships, central computing, repayment work administration. Corporate plan actions for the neutron facilities, nuclear structure research, particle physics, information technology, engineering and international cooperation are presented. The impact of the reused plan on the manpower requirements is discussed. (author)

  3. Exploring motivations to seek and undergo prosthodontic care: an empirical approach using the Theory of Planned Behavior construct

    OpenAIRE

    Vieira AH; Leles CR

    2014-01-01

    Antonio Hélio Vieira, Cláudio Rodrigues Leles Department of Prevention and Oral Rehabilitation, School of Dentistry, Federal University of Goias, Goiania, Goias, Brazil Abstract: Motivations for seeking and undergoing prosthodontic care are poorly understood and are not often explored for clinical purposes when determining treatment need and understanding the factors related to the demand for health care and effective use. This article uses the Theory of Planned Behavi...

  4. Efficacy of an Intervention Based on the Theory of Planned Behavior on Foot Care Performance in Type II Diabetic Patients

    OpenAIRE

    Beiranvand; Asadizaker; Fayazi; Yaralizadeh

    2015-01-01

    Background It is known that health education on foot care is a common strategy for preventing diabetic foot and reducing the rate of lower limb amputation. Objectives To evaluate the efficacy of an intervention based on the theory of planned behavior for improving foot care in patients with type II diabetes in 2013 in Ahvaz, Iran. Patients and Methods In this clinical trial, 69 pat...

  5. Using machine learning algorithms to guide rehabilitation planning for home care clients

    Directory of Open Access Journals (Sweden)

    Hirdes John P

    2007-12-01

    Full Text Available Abstract Background Targeting older clients for rehabilitation is a clinical challenge and a research priority. We investigate the potential of machine learning algorithms – Support Vector Machine (SVM and K-Nearest Neighbors (KNN – to guide rehabilitation planning for home care clients. Methods This study is a secondary analysis of data on 24,724 longer-term clients from eight home care programs in Ontario. Data were collected with the RAI-HC assessment system, in which the Activities of Daily Living Clinical Assessment Protocol (ADLCAP is used to identify clients with rehabilitation potential. For study purposes, a client is defined as having rehabilitation potential if there was: i improvement in ADL functioning, or ii discharge home. SVM and KNN results are compared with those obtained using the ADLCAP. For comparison, the machine learning algorithms use the same functional and health status indicators as the ADLCAP. Results The KNN and SVM algorithms achieved similar substantially improved performance over the ADLCAP, although false positive and false negative rates were still fairly high (FP > .18, FN > .34 versus FP > .29, FN. > .58 for ADLCAP. Results are used to suggest potential revisions to the ADLCAP. Conclusion Machine learning algorithms achieved superior predictions than the current protocol. Machine learning results are less readily interpretable, but can also be used to guide development of improved clinical protocols.

  6. Brazilian public policies for reproductive health: family planning, abortion and prenatal care.

    Science.gov (United States)

    Guilhem, Dirce; Azevedo, Anamaria Ferreira

    2007-08-01

    This study is an ethical reflection on the formulation and application of public policies regarding reproductive health in Brazil. The Integral Assistance Program for Women's Health (PAISM) can be considered advanced for a country in development. Universal access for family planning is foreseen in the Brazilian legislation, but the services do not offer contraceptive methods for the population in a regular and consistent manner. Abortion is restricted by law to two cases: risk to the woman's life and rape. This reality favors the practice of unsafe abortion, which is the third largest cause of maternal death in Brazil. Legal abortion is regulated by the State and the procedure is performed in public health centers. However, there is resistance on the part of professionals to attend these women. Prenatal care is a priority strategy for promoting the quality of life of these women and of future generations. Nonetheless, it is still difficult for these women to access the prenatal care services and to have the required number of consultations. Moreover, managers and health professionals need to be made aware of the importance of implementing the actions indicated by the public policies in the area of sexual and reproductive health, favoring respect for autonomy in a context of personal freedom. PMID:17614992

  7. Survivorship care planning in a comprehensive cancer center using an implementation framework.

    Science.gov (United States)

    Garcia, Sofia F; Kircher, Sheetal M; Oden, Megan; Veneruso, Aubri; McKoy, June M; Pearman, Timothy; Penedo, Frank J

    2016-05-01

    Cancer survivorship care plans (SCPs) have been recommended to improve clinical care and patient outcomes. Research is needed to establish their efficacy and identify best practices. Starting in 2015, centers accredited by the American College of Surgeons Commission on Cancer must deliver SCPs to patients completing primary cancer treatment with curative intent. We describe how we established routine SCP delivery at the Robert H Lurie Comprehensive Cancer Center in Chicago, Illinois, using the Quality Implementation Framework. We evaluated local practices, gathered clinician and patient stakeholder input, developed customized SCP templates within the electronic health record (EHR), and implemented 2 complementary delivery models. Clinician interviews (n = 41) and survey responses (n = 12), along with input from patients (n = 68) and a patient advisory board (n = 15), indicated support for SCPs and survivorship services. To promote feasible implementation and leverage existing workflows, we harmonized 2 SCP delivery models: integrated care within clinics where patients received treatment, and referral to a centralized survivorship clinic. We are implementing SCP delivery with prominent disease sites and will extend services to survivors of other cancers in the future. We developed four electronic disease-specific SCP templates for breast, colorectal, lung, and prostate cancers and a fifth, generic template that can be used for other malignancies. The templates reduced free-text clinician entry by auto-populating 20% of the fields from existing EHR data, and using drop-down menus for another 65%. Mean SCP completion time is 12 minutes (range, 10-15; n = 64). We designed our framework to facilitate ongoing evaluation of implementation and quality improvement. Funding/sponsorship Robert H Lurie Comprehensive Cancer Center, the Coleman Foundation, and the Lynn Sage Cancer Research Foundation. PMID:27258051

  8. Consumer-directed health plans: are medical and health savings accounts viable options for financing American health care?

    Science.gov (United States)

    Masri, Maysoun Demachkie; Oetjen, Reid M; Campbell, Claudia

    2010-01-01

    When Americans voted in November 2008, many had the presidential candidates' positions on health care reform in mind. Health savings accounts, which are high deductible health plans coupled with a tax-protected savings account, are 1 type of consumer-directed health plan (CDHP) that gained strong support from the Bush administration. Despite evidence of the effectiveness of CDHPs in constraining costs in other countries, the Obama health plan contains no mention of their role in future US health reform. This article seeks to provide the reader with a better understanding of how CDHPs can help to improve the use of health resources and reduce national health care expenditures by exploring the history and previous research on several types of consumer-directed plans and by providing a comparative analysis of the use of CDHPs in other countries. PMID:20686396

  9. Planning for long-term care : filial behavior and relationship quality of adult children with independent parents

    OpenAIRE

    Bromley, Mark Calvin

    1990-01-01

    This study is an investigation of the long-term care planning entered into by 170 adult children who had independent parents. A decision-making process with four stages was hypothesized. Sons and daughters entered into planning activities primarily at the "consideration" and "discussion" stages. This involvement proceeds along a sequence of stages with lower stage activities being completed before entering into more advanced stages. Minimal involvement from adult children in "preliminary p...

  10. Financial Planning for Military Child Care Centers: A Guidebook Based on the Experiences of the Fort Lewis Child Care Center.

    Science.gov (United States)

    Office of the Assistant Secretary of Defense for Manpower and Reserve Affairs (DOD), Washington, DC.

    Good record keeping--along with a constant and detailed knowledge of expenses, income, profit, and loss--is the first step toward profitable management of a child care center. Good record keeping is especially important in a center that provides "drop-in" or occasional care because income may fluctuate greatly as a result of the variable number of…

  11. Improving Demand-oriented Quality Care in Family Planning--A Review of Practice and Experience in Family Planning Programme of Qianjiang, Hubei

    Institute of Scientific and Technical Information of China (English)

    Jia-yuan LIAO; Meng-ye PENG; Er-sheng GAO

    2003-01-01

    @@ With the mainstreaming being the demand from the people at reproductive age, we systematically analyzed the ideas and ways to implement quality care (QC) in family planning (FP) in Qianjiang, including advocating the conception of quality care, carrying out health education and counseling, strengthening capacity building of service system and reforming measurement of the evaluation and other aspects. The demand-oriented QC in FP has met personalized and verified demands from people of reproductive age satisfactorily, and kept the fertility rate at a lower level while uplifting satisfaction of the public. The demand-oriented QC in FP in Qianjiang county proved to be a successful and great worth practice.

  12. Reliability of a patient survey assessing cost-related changes in health care use among high deductible health plan enrollees

    Directory of Open Access Journals (Sweden)

    Galbraith Alison A

    2011-05-01

    Full Text Available Abstract Background Recent increases in patient cost-sharing for health care have lent increasing importance to monitoring cost-related changes in health care use. Despite the widespread use of survey questions to measure changes in health care use and related behaviors, scant data exists on the reliability of such questions. Methods We administered a cross-sectional survey to a stratified random sample of families in a New England health plan's high deductible health plan (HDHP with ≥ $500 in annualized out-of-pocket expenditures. Enrollees were asked about their knowledge of their plan, information seeking, behavior change associated with having a deductible, experience of delay in care due in part to cost, and hypothetical delay in care due in part to cost. Initial respondents were mailed a follow-up survey within two weeks of each family returning the original survey. We computed several agreement statistics to measure the test-retest reliability for select questions. We also conducted continuity adjusted chi-square, and McNemar tests in both the original and follow-up samples to measure the degree to which our results could be reproduced. Analyses were stratified by self-reported income. Results The test-retest reliability was moderate for the majority of questions (0.41 - 0.60 and the level of test-retest reliability did not differ substantially across each of the broader domains of questions. The observed proportions of respondents with delayed or foregone pediatric, adult, or any family care were similar when comparing the original and follow-up surveys. In the original survey, respondents in the lower-income group were more likely to delay or forego pediatric care, adult care, or any family care. All of the tests comparing income groups in the follow-up survey produced the same result as in the original survey. Conclusions In this population of HDHP beneficiaries, we found that survey questions concerning plan knowledge, information

  13. Patient-centered cancer treatment planning: improving the quality of oncology care. Summary of an Institute of Medicine workshop.

    Science.gov (United States)

    Balogh, Erin P; Ganz, Patricia A; Murphy, Sharon B; Nass, Sharyl J; Ferrell, Betty R; Stovall, Ellen

    2011-01-01

    The Institute of Medicine's National Cancer Policy Forum recently convened a workshop on patient-centered cancer treatment planning, with the aim of raising awareness about this important but often overlooked aspect of cancer treatment. A primary goal of patient-centered treatment planning is to engage patients and their families in meaningful, thorough interactions with their health care providers to develop an accurate, well-conceived treatment plan, using all available medical information appropriately while also considering the medical, social, and cultural needs and desires of the patient and family. A cancer treatment plan can be shared among the patient, family, and care team in order to facilitate care coordination and provide a roadmap to help patients navigate the path of cancer treatment. There are numerous obstacles to achieving patient-centered cancer treatment planning in practice. Some of these challenges stem from the patient and include patients' lack of assertiveness, health literacy, and numeracy, and their emotional state and concurrent illnesses. Others are a result of physician limitations, such as a lack of time to explain complex information and a lack of tools to facilitate treatment planning, as well as insensitivity to patients' informational, cultural, and emotional needs. Potential solutions to address these obstacles include better training of health care providers and patients in optimal communication and shared decision making, and greater use of support services and tools such as patient navigation and electronic health records. Other options include greater use of quality metrics and reimbursement for the time it takes to develop, discuss, and document a treatment plan. PMID:22128118

  14. Development of a web-based pharmaceutical care plan to facilitate collaboration between healthcare providers and patients

    NARCIS (Netherlands)

    Geurts, Marlies M E; Ivens, Martijn; van Gelder, Egbert; de Gier, Johan J

    2013-01-01

    BACKGROUND: In medication therapy management there is a need for a tool to document medication reviews and pharmaceutical care plans (PCPs) as well as facilitate collaboration and sharing of patient data between different healthcare providers. Currently, pharmacists and general practitioners (GPs) h

  15. Old-age Care Modes and Facility Planning Based on the Concept of “Continuum of Care”

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    Through the comparative analysis on the theories and practical experience of the development of old-age care (OAC) in both China and other countries,and based on the interview and questionnaire survey in Zhejiang Province and Hangzhou City,this paper proposes the research and analysis framework for the old-age service system,i.e.,"OAC mode-OAC service system-OAC facility system." The paper argues that,oriented by OAC mode of "taking community-and home-based care as the main body and institution-based care as supplement," China should build an OAC facility system and planning thoughts that take "continuum of care" as concept and long-term care system as core.Taking Zhejiang Province and Hangzhou City as examples,the paper conducts the optimization research on current OAC facilities planning in terms of hierarchical system,scale,and differentiation,so as to formulate more systematic and operable planning standards for OAC facilities.

  16. A vision of long-term care. To care for tomorrow's elderly, hospitals must plan now, not react later.

    Science.gov (United States)

    Kodner, D L

    1989-12-01

    In the next two decades, rapid, fundamental changes will take place in the way we finance, organize, and provide long-term care services. Because the elderly make up such a large portion of the patient population, America's hospitals should be concerned--and involved. There are six keys to the future of long-term care: a sharp increase in elderly population, a new generation of elderly, restrained government role, intergenerational strains, growing corporate concern, and the rise of "gerotechnology." These trends and countertrends will result in a new look in the long-term care landscape. By the year 2010, changes will include a true public-private financing system, provider reimbursement on the basis of capitation and prospective payment, coordinated access to services, dominant alternative delivery systems, a different breed of nursing homes, fewer staffing problems, patient-centered care, a new importance in housing, and an emphasis on prevention. For hospitals, this future vision of long-term care means that significant opportunities will open up to meet the needs of the elderly-at-risk and to achieve a competitive position in the burgeoning elderly care industry. PMID:10313396

  17. Role of Advance Care Planning in Proxy Decision Making Among Individuals With Dementia and Their Family Caregivers.

    Science.gov (United States)

    Kwak, Jung; De Larwelle, Jessica A; Valuch, Katharine O'Connell; Kesler, Toni

    2016-03-01

    Health care proxies make important end-of-life decisions for individuals with dementia. A cross-sectional survey was conducted to examine the role of advance care planning in proxy decision making for 141 individuals with cognitive impairment, Alzheimer's disease, or other types of dementia. Proxies who did not know the preferences of individuals with dementia for life support treatments reported greater understanding of their values. Proxies of individuals with dementia who did not want life support treatments anticipated receiving less support and were more uncertain in decision making. The greater knowledge proxies had about dementia trajectory, family support, and trust of physicians, the more informed, clearer, and less uncertain they were in decision making. In addition to advance care planning, multiple factors influence proxy decision making, which should be considered in developing interventions and future research to support informed decision making for individuals with dementia and their families. [Res Gerontol Nurs. 2016; 9(2):72-80.]. PMID:26020579

  18. Advance care planning in patients with brain tumours: A prospective cohort study

    Directory of Open Access Journals (Sweden)

    Krystal Song

    2015-08-01

    Full Text Available Objectives: To assess and understand the awareness and experience of brain tumour (BT patients in discussing Advance Care Planning (ACP, to identify main symptoms experienced, physical and functional status perceived quality of life, and level of coping. Methods: A prospective cohort study with an initial open-ended questionnaire followed by semi-structured interview questions regarding ACP with 18 patients diagnosed with BT (WHO Grade I-IV, metastatic BT in hospital and community. Standardized assessments measured coping strategies, and quality of life (QoL. Interview transcripts regarding ACP discussions were analyzed, coded and interpreted using qualitative analytic techniques for thematic analyses. Results: Participants' mean age was 51 years (range 22-65 years, female (61%; median time since BT diagnosis was 1.5 years and just over half (56% had glioblastoma multiforme (GBM. Fatigue was the most common symptom reported by 83% of participants. Overall, participants indicated good QoL and used more problem-focused coping strategies including ‘acceptance’ and ‘positive reframing’. Thematic analyses indicated that participants had limited awareness and understanding of ACP, variable views on appropriate timing of ACP discussions and change of decisions over illness trajectory. Most felt able to discuss ACP and preferred dedicated sessions by a trained health professional. Conclusion: This study highlights the importance of providing timely information regarding ACP to BT patients during the course of their disease. Established ACP discussions have an important role in enhancing patient autonomy and to guide delivery of end-of-life care. The demonstrated low uptake of ACP in this pilot study shows need for improved awareness in clinical practice for timely ACP discussions and multifaceted interventions system-wide in implementing ACP

  19. Structured nursing communication on interdisciplinary acute care teams improves perceptions of safety, efficiency, understanding of care plan and teamwork as well as job satisfaction

    Directory of Open Access Journals (Sweden)

    Gausvik C

    2015-01-01

    Full Text Available Christian Gausvik,1 Ashley Lautar,2 Lisa Miller,2 Harini Pallerla,3 Jeffrey Schlaudecker4,5 1University of Cincinnati College of Medicine, 2The Christ Hospital, Cincinnati, OH, USA; 3Department of Family and Community Medicine, 4Division of Geriatric Medicine, University of Cincinnati, Cincinnati, OH, USA; 5Geriatric Medicine Fellowship Program, University of Cincinnati/The Christ Hospital, Cincinnati, OH, USA Abstract: Efficient, accurate, and timely communication is required for quality health care and is strongly linked to health care staff job satisfaction. Developing ways to improve communication is key to increasing quality of care, and interdisciplinary care teams allow for improved communication among health care professionals. This study examines the patient- and family-centered use of structured interdisciplinary bedside rounds (SIBR on an acute care for the elderly (ACE unit in a 555-bed metropolitan community hospital. This mixed methods study surveyed 24 nurses, therapists, patient care assistants, and social workers to measure perceptions of teamwork, communication, understanding of the plan for the day, safety, efficiency, and job satisfaction. A similar survey was administered to a control group of 38 of the same staff categories on different units in the same hospital. The control group units utilized traditional physician-centric rounding. Significant differences were found in each category between the SIBR staff on the ACE unit and the control staff. Nurse job satisfaction is an important marker of retention and recruitment, and improved communication may be an important aspect of increasing this satisfaction. Furthermore, improved communication is key to maintaining a safe hospital environment with quality patient care. Interdisciplinary team rounds that take place at the bedside improve both nursing satisfaction and related communication markers of quality and safety, and may help to achieve higher nurse retention and safer

  20. Airline Maintenance Manpower Optimization from the De Novo Perspective

    Science.gov (United States)

    Liou, James J. H.; Tzeng, Gwo-Hshiung

    Human resource management (HRM) is an important issue for today’s competitive airline marketing. In this paper, we discuss a multi-objective model designed from the De Novo perspective to help airlines optimize their maintenance manpower portfolio. The effectiveness of the model and solution algorithm is demonstrated in an empirical study of the optimization of the human resources needed for airline line maintenance. Both De Novo and traditional multiple objective programming (MOP) methods are analyzed. A comparison of the results with those of traditional MOP indicates that the proposed model and solution algorithm does provide better performance and an improved human resource portfolio.

  1. CLINICAL PSYCHOLOGY – ACTUAL DIRECTION IN GROUNDING OF HEALTH MANPOWER

    Directory of Open Access Journals (Sweden)

    M.G. Kucherov

    2007-09-01

    Full Text Available In 90-ies years of last century in our country happened the crash of the system of values with transition to the standards of capitalistic society, and it lead to the formation of chronicle psychosocial stress of high and medium levels. Medics of all directions started to face functional psychosomatic diseases. Raised the necessity in grounding of health manpower in discipline of clinical psychology, with the learning of psychophisiological bases of diseases and possibilities if their correction. This direction of development of soviet medical education and health service in general seems progressive and prospective.

  2. Expected Time To Recruitment In A Two Grade Manpower System

    Directory of Open Access Journals (Sweden)

    J.SRIDHARAN,

    2014-02-01

    Full Text Available In this paper a two graded organization is considered in which depletion of manpower occurs due to its policy decisions. Three mathematical models are constructed by assuming the loss of man-hours and the inter-decision times form an order statistics. Mean and variance of time to recruitment are obtained using an univariate recruitment policy based on shock model approach and the analytical results are numerically illustrated by assuming different distributions for the thresholds. The influence of the nodal parameters on the system characteristics is studied and relevant conclusions are presented.

  3. Current status of neonatal intensive care in India.

    Science.gov (United States)

    Karthik Nagesh, N; Razak, Abdul

    2016-05-01

    Globally, newborn health is now considered as high-level national priority. The current neonatal and infant mortality rate in India is 29 per 1000 live births and 42 per 1000 live births, respectively. The last decade has seen a tremendous growth of neonatal intensive care in India. The proliferation of neonatal intensive care units, as also the infusion of newer technologies with availability of well-trained medical and nursing manpower, has led to good survival and intact outcomes. There is good care available for neonates whose parents can afford the high-end healthcare, but unfortunately, there is a deep divide and the poor rural population is still underserved with lack of even basic newborn care in few areas! There is increasing disparity where the 'well to do' and the 'increasingly affordable middle class' is able to get the most advanced care for their sick neonates. The underserved urban poor and those in rural areas still contribute to the overall high neonatal morbidity and mortality in India. The recent government initiative, the India Newborn Action Plan, is the step in the right direction to bridge this gap. A strong public-private partnership and prioritisation is needed to achieve this goal. This review highlights the current situation of neonatal intensive care in India with a suggested plan for the way forward to achieve better neonatal care. PMID:26944066

  4. Early Years of Neutron Scattering and Its Manpower Development in Indonesia

    International Nuclear Information System (INIS)

    In this paper I shall give a short history of the development of neutron scattering at the Research Centre for Nuclear Techniques (PPTN), in Bandung, and the early development of a more advanced facilities at the Neutron Scattering Laboratory (NSL BATAN), Centre of Technology for Nuclear Industrial Materials, in Serpong. The first research reactor in Indonesia was the TRIGA MARK II in Bandung, which became operational in 1965, with a power of 250 KW, upgraded to 1 MW in 1971, and to 2 MW in 2000. The neutron scattering activities was started in 1967, with the design and construction of the first powder diffractometer, and put in operation in 1970. It was followed by the second instrument, the filter detector spectrometer built in 1975 in collaboration with the Bhabha Atomic Research Centre (BARC), India. A powder diffractometer for magnetic studies was built in 1980, and finally, a modification of the filter detector spectrometer to measure textures was made in 1986. A brief description of the design and construction of the instruments, and a highlight of some research topics will be presented. Early developments of neutron scattering activities at the 30 MW, RSG-GAS reactor in Serpong in choosing suitable research program, which will be mainly centred around materials testing/characterization, and materials/condensed matter researches has been agreed. Instrument planning and layout which were appropriate to carry out the program had been decided. Manpower development for the neutron scattering laboratory is a severe problem. The efforts to overcome this problem has been solved. International Cooperation through workshops and on the job trainings also support the supply of qualified manpower

  5. Early Years of Neutron Scattering and Its Manpower Development in Indonesia

    Science.gov (United States)

    Marsongkohadi

    2008-03-01

    In this paper I shall give a short history of the development of neutron scattering at the Research Centre for Nuclear Techniques (PPTN), in Bandung, and the early development of a more advanced facilities at the Neutron Scattering Laboratory (NSL BATAN), Centre of Technology for Nuclear Industrial Materials, in Serpong. The first research reactor in Indonesia was the TRIGA MARK II in Bandung, which became operational in 1965, with a power of 250 KW, upgraded to 1 MW in 1971, and to 2 MW in 2000. The neutron scattering activities was started in 1967, with the design and construction of the first powder diffractometer, and put in operation in 1970. It was followed by the second instrument, the filter detector spectrometer built in 1975 in collaboration with the Bhabha Atomic Research Centre (BARC), India. A powder diffractometer for magnetic studies was built in 1980, and finally, a modification of the filter detector spectrometer to measure textures was made in 1986. A brief description of the design and construction of the instruments, and a highlight of some research topics will be presented. Early developments of neutron scattering activities at the 30 MW, RSG-GAS reactor in Serpong in choosing suitable research program, which will be mainly centred around materials testing/characterization, and materials/condensed matter researches has been agreed. Instrument planning and layout which were appropriate to carry out the program had been decided. Manpower development for the neutron scattering laboratory is a severe problem. The efforts to overcome this problem has been solved. International Cooperation through workshops and on the job trainings also support the supply of qualified manpower.

  6. The Effects of Guided Careful Online Planning on Complexity, Accuracy and Fluency in Intermediate EFL Learners' Oral Production: The Case of English Articles

    Science.gov (United States)

    Ahmadian, Mohammad Javad

    2012-01-01

    The purpose of the study reported in this article was twofold: First, to see whether guided careful online planning assists intermediate learners of English as a foreign language (EFL) in accurate oral production of English articles ("an/a" and "the"); and, second, to see whether guided careful online planning has any effects on global complexity…

  7. Consensus views on advance care planning for dementia: a Delphi study.

    Science.gov (United States)

    Sinclair, James B; Oyebode, Jan R; Owens, R Glynn

    2016-03-01

    The uptake of advance care planning (ACP) is particularly low among people with dementia. This may reflect barriers to communication between professionals, patients and families in the face of lack of consensus about the process. This study aimed to methodically investigate consensus views of how ACP should be explained and carried out with people with dementia. A three-round Delphi study explored views of how and when ACP should be addressed, what should be covered, who should be involved and why rates of ACP are low. Seventeen participants took part comprising family members, old age psychiatrists and policy makers. Thirty-two items reached consensus. The panel agreed on 11 different areas for discussion. They concurred that ACP was best addressed after the person has come to terms with the diagnosis when the individual feels ready to do so. There was a consensus view that the process should be couched in terms of 'certain possibilities'. Consensus items emphasised personal choice and autonomy, while also prioritising the need to discuss financial aspects and to include spouses. There was no consensus that professionals should be involved, although the panel viewed them as carrying some responsibility for low uptake. It is suggested that ACP should include general discussion of values as well as coverage of specific points. Professionals need to offer discussion and information on ACP, but also make clear that the patient has the right to choose whether to pursue ACP or not. PMID:25684278

  8. The Manpower Aspect in the Field of Sport

    Directory of Open Access Journals (Sweden)

    Melania Kiswandari

    2012-09-01

    Full Text Available As a result of enhanced professionalism and commercialization in the field of sports, it has become an industry of its own. Professionalism and industrialization are correlated; therefore sports actors’ performance achieved as a result of their professionalism lead to the commercialization, and even to the industrialization of certain (branches of sports. On the other hand, it is considered that industrialization which involves the commercial aspect is able to maintain, and even enhance sports actors’ professionalism/performance. In practice, such correlation is not always directly proportional, but inversely proportional. There have been cases of issues related to sports actors’ welfare not being properly fulfilled, in fact, being far below the general manpower standards applicable to people doing work (workers/laborers. In general such cases include late or non-payment of wages, reducing bonuses, implementation of contract not accordance with the initial agreement, unilateral termination of contract without compensation for damages and others. The frequently arising question is whether sports actors, particularly athletes, have the status of ‘nonemployee’ professionals, or the status of ‘employees’. The various existing opinions related to such issue of status raise certain legal implications, particularly from the manpower aspect which emphasizes the welfare and legal protection of ‘workers’, which are also often experienced by athletes. It is expected that this article will be able to provide to the readers a broader view regarding the status of athletes’ ‘manpower’ status.

  9. Training and manpower development for nuclear energy programme

    International Nuclear Information System (INIS)

    The purpose is to train and develop the adequately qualified manpower in the areas of nuclear science and technology. Various options were introduced by the science departments, based on the existing facilities within the university. Twenty final year students were selected annually to attend a summer school in reactor physics and technology at the Karlsruhe Institute for Nuclear Research in West Germany. Also, there was approval for an annual recruitment quota of twelve graduate assistants for the nuclear project. Fifty qualified students were trained for various courses in nuclear science and technology both in the country and abroad. There had been graduates in nuclear science and technology courses up to the doctorate degree level. Part of efforts in the manpower has been directed towards the acquisition of adequate equipment for the teaching laboratories. The establishment of a training center in nuclear technology at Ahmadu Bello University and at University of Ife can only be considered as the zero phase in the nuclear programme of Nigeria. Funding of the nuclear programme must be guaranteed. It is also suggested that the nuclear project be allocated sufficient foreign exchange to meet all its commitments. (A.S.)

  10. Learning to plan? A critical fiction about the facilitation of professional and practice development plans in primary care.

    NARCIS (Netherlands)

    Elwyn, G.; Hocking, P.; Burtonwood, A.; Harry, K.; Turner, A.

    2002-01-01

    A shift from continuing medical education towards professional and organisational development policies, coupled with the introduction of accountability frameworks (clinical governance), has generated interest in professional and practice development plans (PPDPs) in general practice. The problems of

  11. Report of New Manpower Researchers Conference. September 22-23, 1971.

    Science.gov (United States)

    Taggart, Robert

    This report contains abstracts and discussions of papers and speeches delivered at the 1971 New Manpower Researchers Conference. These include speeches by Charles Schultze on incentives in the public sector, one by Congressman William Steiger on manpower reform, and one by Maurice Mann on government economic controls. The abstracted topics include…

  12. 75 FR 28295 - Cummins Filtration, Including On-Site Leased Workers From Manpower and Spherion Staffing...

    Science.gov (United States)

    2010-05-20

    ... workers of Cummins Filtration, including on-site leased workers from Manpower, Lake Mills, Iowa. The notice was published in the Federal Register on December 11, 2009 (74 FR 65798). At the request of the... Employment and Training Administration Cummins Filtration, Including On-Site Leased Workers From Manpower...

  13. A model plan for the uninsured: delivering quality and affordability in a limited benefit managed care safety net program in Flint, Michigan.

    Science.gov (United States)

    Creech, Constance J; Kornblau, Barbara; Strugar-Fritsch, Donna

    2012-02-01

    This paper presents the background and multiyear outcome data for a limited benefit safety-net care program in Michigan. It is a possible solution for policymakers and hospital/clinic administrators to consider when evaluating plans to provide primary care for the 30 million uninsured Americans who will be affected by the Affordable Care Act. PMID:22643481

  14. End-of-life communication in Korean older adults: With focus on advance care planning and advance directives.

    Science.gov (United States)

    Shin, Dong Wook; Lee, Ji Eun; Cho, BeLong; Yoo, Sang Ho; Kim, SangYun; Yoo, Jun-Hyun

    2016-04-01

    The present article aimed to provide a comprehensive review of current status of end-of-life (EOL) care and sociocultural considerations in Korea, with focus on the EOL communication and use of advance directives (AD) in elderly Koreans. Through literature review, we discuss the current status of EOL care and sociocultural considerations in Korea, and provide a look-ahead. In Korea, patients often receive life-sustaining treatment until the very end of life. Advance care planning is rare, and most do-not-resuscitate decisions are made between the family and physician at the very end of patient's life. Koreans, influenced mainly by Confucian tradition, prefer a natural death and discontinuation of life-sustaining treatment. Although Koreans generally believe that death is natural and unavoidable, they tend not to think about or discuss death, and regard preparation for death as unnecessary. As a result, AD are completed by just 4.7% of the general adult population. This situation can be explained by several sociocultural characteristics including opting for natural death, wish not to burden others, preference for family involvement and trust in doctor, avoidance of talking about death, and filial piety. Patients often receive life-sustaining treatment until the very EOL, advance care planning and the use of AD is not common in Korea. This was related to unique sociocultural characteristics of Korea. A more active role of physicians, development of a more deliberate EOL discussion process, development of culturally appropriate AD and promotion of advance care planning might be required to provide good EOL care in Korea. Geriatr Gerontol Int 2016; 16: 407-415. PMID:26459613

  15. Daily Care

    Science.gov (United States)

    ... to Know Online Tools Enhancing Daily Life Daily Plan Activities Communication Food & Eating Music & Art Personal Care Incontinence Bathing ... Tweet Email | Print Create a Daily Routine Daily Plan Activities Communication Food/Eating Get Tips on Personal Care Bathing ...

  16. One day at a time: living with frailty: implications for the practice of advance care planning: a multiple case study

    OpenAIRE

    Bramley, Louise

    2016-01-01

    Background: Advance care planning (ACP) was originally designed to promote autonomy and is commonly conceptualised as informing treatment and decisions in the event of a person’s loss of capacity. In the UK, healthcare policy has emphasised the potential for ACP to significantly contribute to improvements in experiences of death and dying for patients and their significant others. Older people with progressive frailty are at high risk of mortality, loss of capacity and increasing dependency o...

  17. Exploring motivations to seek and undergo prosthodontic care: an empirical approach using the Theory of Planned Behavior construct.

    Science.gov (United States)

    Vieira, Antonio Hélio; Leles, Cláudio Rodrigues

    2014-01-01

    Motivations for seeking and undergoing prosthodontic care are poorly understood and are not often explored for clinical purposes when determining treatment need and understanding the factors related to the demand for health care and effective use. This article uses the Theory of Planned Behavior construct to identify factors related to the motivations of edentulous subjects to seek and undergo prosthodontic treatment. The conceptual framework of the Theory of Planned Behavior includes attitude toward behavior, an individual's positive or negative evaluation of self-performance of the particular behavior; the subjective norm, an individual's perception of social normative pressures or relevant others' beliefs that he or she should or should not perform such behavior; and perceived behavioral control, or an individual's perceived ease or difficulty in performing the particular behavior, determined by the total set of accessible control beliefs. These components mediate a subject's intention and behavior toward an object and may also explain health-related behaviors, providing strong predictions across a range of health behaviors. This study suggests categories for each component of the Theory of Planned Behavior, based on clinical evidence and practical reasoning. Attitudes toward behavior include perceived consequences of no treatment, perceived potential benefits and risks of treatment, dental anxiety, previous experiences, and interpersonal abilities of the health care providers. The subjective norm includes the opinions of relevant others, advertisement, professionally defined normative need, perceived professional skills, and technical quality of care. Perceived behavioral control includes subject's time, availability and opportunity, treatment costs, subject's perceived need, and accessibility to dental care. This conceptual model represents a theoretical multidimensional model that may help clinicians better understand the patient's treatment behaviors and

  18. Providers’ Perspectives on Provision of Family Planning to HIV-Positive Individuals in HIV Care in Nyanza Province, Kenya

    Directory of Open Access Journals (Sweden)

    Sara J. Newmann

    2013-01-01

    Full Text Available Objective. To inform an intervention integrating family planning into HIV care, family planning (FP knowledge, attitudes and practices, and perspectives on integrating FP into HIV care were assessed among healthcare providers in Nyanza Province, Kenya. Methods. Thirty-one mixed-method, structured interviews were conducted among a purposive sample of healthcare workers (HCWs from 13 government HIV care facilities in Nyanza Province. Structured questions and case scenarios assessed contraceptive knowledge, training, and FP provision experience. Open-ended questions explored perspectives on integration. Data were analyzed descriptively and qualitatively. Results. Of the 31 HCWs interviewed, 45% reported previous FP training. Few providers thought long-acting methods were safe for HIV-positive women (19% viewed depot medroxyprogesterone acetate as safe and 36% viewed implants and intrauterine contraceptives as safe; fewer felt comfortable recommending them to HIV-positive women. Overall, providers supported HIV and family planning integration, yet several potential barriers were identified including misunderstandings about contraceptive safety, gendered power differentials relating to fertility decisions, staff shortages, lack of FP training, and contraceptive shortages. Conclusions. These findings suggest the importance of considering issues such as patient flow, provider burden, commodity supply, gender and cultural issues affecting FP use, and provider training in FP/HIV when designing integrated FP/HIV services in high HIV prevalence areas.

  19. Awareness and pattern of utilizing family planning services among women attending urban health care center Azizabad Sukkur

    International Nuclear Information System (INIS)

    To assess level of awareness and pattern of utilizing family planning services among women (15-49 years) of reproductive age at Urban Health Center, Azizabad Sukkur, Sindh. A cross-sectional study was conducted from April to June 2005 at Urban Health Care Center Azizabad Sukkur. Two hundred women of reproductive age group were interviewed by using a pre tested semi structured questionnaire visiting the health care center during the study period. Information was obtained after taking informed consent regarding socio demographic characteristics, knowledge, attitude and pattern of utilizing family planning services. The data was entered and analyzed by using statistical package SPSS version 13. About 75% of women and 42.5% husbands were found illiterate, 85% women were housewives, 69.5% were married before 18 years of age and 54% had nuclear family. Regarding desired number of children women responded one child (3%), 2-3 children (11%), 4-5 (37.5%), more than five children (36%), 5.5% said that children are God gifted and 7% did not answer. About 60% of women reported use of at least one contraceptive method and 40% had never used any contraceptive method. The women who received counseling from the health care provider were 48.5% and only 6% received information through media. Religious prohibition, shortage of female staff and cost of family planning contraceptive methods were the main reasons identified for not utilizing contraceptive methods. The unsatisfactory variables were long waiting hours at the center, non-availability of contraceptive, shortage of the female staff and cost. Limited number of women was aware and practice contraception in the area and utilization of family planning services were low. The efforts should be made for providing information to couple and improving quality of family planning services in the area. (author)

  20. A practical guide to applying lean tools and management principles to health care improvement projects.

    Science.gov (United States)

    Simon, Ross W; Canacari, Elena G

    2012-01-01

    Manufacturing organizations have used Lean management principles for years to help eliminate waste, streamline processes, and cut costs. This pragmatic approach to structured problem solving can be applied to health care process improvement projects. Health care leaders can use a step-by-step approach to document processes and then identify problems and opportunities for improvement using a value stream process map. Leaders can help a team identify problems and root causes and consider additional problems associated with methods, materials, manpower, machinery, and the environment by using a cause-and-effect diagram. The team then can organize the problems identified into logical groups and prioritize the groups by impact and difficulty. Leaders must manage action items carefully to instill a sense of accountability in those tasked to complete the work. Finally, the team leaders must ensure that a plan is in place to hold the gains. PMID:22201573

  1. Tactics research of enterprise's manpower capital investment%论企业人力资本投资策略

    Institute of Scientific and Technical Information of China (English)

    栗会敏; 周霞

    2004-01-01

    In the era of knowledge- driven economy, the manpower capital is the most active factor of production and core of social economic development. This text proceeds with the concept of capital manpower, and probes into the importance of manpower capital investment to the survival and development of enterprises. In order to maximize the income of manpower capital investment, enterprises need to set up corresponding incentive mechanism to inspire the enthusiasm of manpower capital, and it is also the key factors that promoting the development modern economic and the enterprises' success.

  2. 38 CFR 17.32 - Informed consent and advance care planning.

    Science.gov (United States)

    2010-07-01

    .... Decision-making capacity. The ability to understand and appreciate the nature and consequences of health... communicate decisions concerning health care. If the patient lacks decision-making capacity or has been... lack decision-making capacity in the following order of priority: (1) Health care agent; (2)...

  3. The development of KAERI management information system -First year: The development of manpower information management system-

    International Nuclear Information System (INIS)

    The purpose of this report is to describe the implementation of the management information system for manpower. This job is the first year's for development KAERI management information system. It is important to properly manage a manpower to cope with the external circumstances promptly and to maximize the productivity of the organization. This report aims at basic management of manpower and uses multimedia to keep abreast with the times and introduces the concept of GUI (Graphic User Interface) to user for ease access. (Author)

  4. Challenges in physician supply planning: the case of Belgium

    Directory of Open Access Journals (Sweden)

    Léonard Christian

    2010-12-01

    Full Text Available Abstract Introduction Planning human resources for health (HRH is a complex process for policy-makers and, as a result, many countries worldwide swing from surplus to shortage. In-depth case studies can help appraising the challenges encountered and the solutions implemented. This paper has two objectives: to identify the key challenges in HRH planning in Belgium and to formulate recommendations for an effective HRH planning, on the basis of the Belgian case study and lessons drawn from an international benchmarking. Case description In Belgium, a numerus clausus set up in 1997 and effective in 2004, aims to limit the total number of physicians working in the curative sector. The assumption of a positive relationship between physician densities and health care utilization was a major argument in favor of medical supply restrictions. This new regulation did not improve recurrent challenges such as specialty imbalances, with uncovered needs particularly among general practitioners, and geographical maldistribution. New difficulties also emerged. In particular, limiting national training of HRH turned out to be ineffective within the open European workforce market. The lack of integration of policies affecting HRH was noteworthy. We described in the paper what strategies were developed to address those challenges in Belgium and in neighboring countries. Discussion and evaluation Planning the medical workforce involves determining the numbers, mix, and distribution of health providers that will be required at some identified future point in time. To succeed in their task, health policy planners have to take a broader perspective on the healthcare system. Focusing on numbers is too restrictive and adopting innovative policies learned from benchmarking without integration and coordination is unfruitful. Evolving towards a strategic planning is essential to control the effects of the complex factors impacting on human resources. This evolution requires

  5. Focus on care policy for children and adolescents: federal public budget and analysis of multiannual plans

    Directory of Open Access Journals (Sweden)

    Ana Carolina Vidigal

    2013-12-01

    Full Text Available This article discuss the government planning, expressed in the multiannual plans, and to know what is being planned for the Treatment Politic for Children and Adolescents, assuming the priority contained in the Statute of Children and Adolescents, enabling control of what is being planned and the demand for its implementation. Therefore, the objective of analyzing the Multiannual Plan for the years 2004 to 2007 and from 2008 to 2011 the Federal Government, with the scope to identify how the attendance policy to children and adolescents are being treated in government planning. For the research we opted for an approach that allows joint basic research quantitative and qualitative perspective of data integration. We performed a literature search on the public budget, then it was also used to document research, public documents related to the federal budget. The results presented in this article was that Pluriannual Plans from 2004 to 2007 and from 2008 to 2011 found themselves the focus on children and adolescents, primarily in the Social Assistance and Education Policy, whereas in the area of education the focus is on the two largest plans, thereby presenting government's intentions regarding this segment and how they will be met. There are no plans in both a call and differential priority to children and adolescents, but these appear included through programs targeted to Basic Education and Income Transfer Programs linked to Social Assistance.

  6. Quality of dying in nursing home residents dying with dementia: does advanced care planning matter? A nationwide postmortem study.

    Directory of Open Access Journals (Sweden)

    An Vandervoort

    Full Text Available Advance care planning is considered a central component of good quality palliative care and especially relevant for people who lose the capacity to make decisions at the end of life, which is the case for many nursing home residents with dementia. We set out to investigate to what extent (1 advance care planning in the form of written advance patient directives and verbal communication with patient and/or relatives about future care and (2 the existence of written advance general practitioner orders are related to the quality of dying of nursing home residents with dementia.Cross-sectional study of deaths (2010 using random cluster-sampling. Representative sample of nursing homes in Flanders, Belgium. Deaths of residents with dementia in a three-month period were reported; for each the nurse most involved in care, GP and closest relative completed structured questionnaires.We identified 101 deaths of residents with dementia in 69 nursing homes (58% response rate. A written advance patient directive was present for 17.5%, GP-orders for 56.7%. Controlling for socio-demographic/clinical characteristics in multivariate regression analyses, chances of having a higher mean rating of emotional well-being (less fear and anxiety on the Comfort Assessment in Dying with Dementia scale were three times higher with a written advance patient directive and more specifically when having a do-not-resuscitate order (AOR 3.45; CI,1.1-11 than for those without either (AOR 2.99; CI,1.1-8.3. We found no association between verbal communication or having a GP order and quality of dying.For nursing home residents with dementia there is a strong association between having a written advance directive and quality of dying. Where wishes are written, relatives report lower levels of emotional distress at the end of life. These results underpin the importance of advance care planning for people with dementia and beginning this process as early as possible.

  7. Can Individualized Health Care Plans Help Increase Continence in Children with Dysfunctional Elimination Syndrome?

    Science.gov (United States)

    Boisclair-Fahey, Anne

    2009-01-01

    School-age children with dysfunctional elimination syndrome (DES) do not always have school support for their treatment plans, including an every 2-hr voiding schedule. The objective of this study was to increase school support of treatment plans by allowing access to bathrooms, thereby improving continence. An eight-question survey about bathroom…

  8. Investigating robot navigation in health care with the Giraff telepresence robot

    OpenAIRE

    Kåven, Ove Henrik

    2013-01-01

    The Norwegian public healthcare system will not have the manpower to care for the elderly at the same level as now, unless technological solutions are found to make the most of the available manpower. This thesis investigates potential technologies for allowing the Giraff, a telepresence robot, to navigate and patrol an eldercare center autonomously, thus letting caregivers save time when checking on the care recipients. It describes the design and implementation of a platform to interface wi...

  9. The Moses Mabhida Medical Plan: medical care planning and execution at a FIFA2010 stadium; the Durban experience

    Directory of Open Access Journals (Sweden)

    Timothy C Hardcastle

    2010-12-01

    Full Text Available Timothy C Hardcastle1,2, Mergan Naidoo3,4, Sanjay Samlal5,6, Morgambery Naidoo5,6, Timothy Larsen5,6, Muzi Mabasu5,6,7, Sibongiseni Ngema6,81Inkosi Albert Luthuli Hospital, Mayville, South Africa; 2Department of Surgery, University of KwaZulu-Natal, Durban, South Africa; 3Wentworth Hospital, Durban, South Africa; 4Department of Family Medicine, University of KwaZulu-Natal, Durban, South Africa; 5Emergency Medical Rescue Service, KwaZulu-Natal, South Africa; 6Department of Health, KwaZulu-Natal, South Africa; 7EMRS 2010 Planning Committee, KwaZulu-Natal, South Africa; 8School of Public Administration and Development Management, University of KwaZulu-Natal, Durban, South AfricaAim: This paper aims to outline the medical services provided at the Moses Mabhida Stadium, Durban, South Africa for the Fédération Internationale de Football Association (FIFA 2010 Soccer World Cup and audit the clinical services delivered to persons seeking medical assistance.Methods: Descriptive report of the medical facilities at the Moses Mabhida Stadium including the staff deployment. Retrospective data review of medical incident reports from the Stadium Medical Team.Results: Medical staffing exceeded the local norms and was satisfactory to provide rapid intervention for all incoming patients. Senior medical presence decreased the transport to hospital rate (TTHR. A total of 316 spectators or support staff were treated during the seven matches played at the stadium. The majority of patients were male (60%, mostly of local origin, with mostly minor complaints that were treated and discharged (88.2% Green codes. The most common complaints were headache, abdominal disorders, and soft-tissue injuries. One fatality was recorded. The patient presentation rate (PPR was 0.66/10,000 and the TTHR was overall 4.1% of all treated patients (0.027/10,000 spectators.Conclusion: There was little evidence to guide medical planning for staffing from the FIFA governing body. Most

  10. Directors' duty of care to monitor information systems in HMOs: some lessons from the Oxford Health Plan.

    Science.gov (United States)

    O'Byrne, M E

    This paper examines the legal and strategic issues raised by the use of information systems in health maintenance organizations (HMOs) and other managed care organizations. Given the critical nature of information systems to an HMO's business success and regulatory compliance, the large financial investment HMOs make in their systems, and the widely publicized concerns over the year 2000 "millennium bug" problem, information systems are appropriately a matter of concern to an HMO's board of directors. The recent experience of Oxford Health Plans, Inc. offers a case study in the apparent failure of the directors to monitor adequately the in-house development of an information system. The systems disaster which this corporation suffered in 1997 led to a dramatic drop in stock price, from which the company has yet to recover, as well as intense scrutiny by state and federal regulators and countless shareholder derivative actions against the directors. Corporate directors are subject to the fiduciary duty of care. Despite statutes in some states requiring directors to act prudently, state courts almost always apply the standard of gross negligence. As a result, even when directors act without due deliberation in their decision, it is rare that a court will find them to have failed in their duty of care. The business and regulatory community may find otherwise, however, when directors fail to evaluate information systems options carefully and the business suffers as a result. PMID:11187367

  11. Financial requirements and manpower needs of nuclear energetics for the next fifty years

    International Nuclear Information System (INIS)

    Forecasts on financial and manpower requirements of rich and poor countries for NPPs construction by 2050 showed that the NPPs capacities will increase from 320 up to 2500 GW, whereby the ratio between the rich and poor countries will constitute approximately 2:1. Investments in NPPs construction will equal from 1600 up to 2700 billions dollars. Global need in manpower for NPPs will constitute by 2050 240000 man/year

  12. A Markov decision process approach to optimal control of a multi-level hierarchical manpower system

    OpenAIRE

    Udom, Akaninyene U.

    2013-01-01

    A recurrent problem in manpower control is how to attain the desired structural configuration in an optimal way, since it is possible to reach a desired structural configuration using different control inputs. The major aim of this paper is to develop a Markov Decision Process for optimal control of a Multi-level Hierarchical Manpower System (MHMS) by promotion and interdepartmental transfers. This is examined under control by intervention and contraction cost Markov Decision Process.

  13. Manpower Consideration to Reduce Development Time for New Model in Automotive Industry

    Directory of Open Access Journals (Sweden)

    N. M.Z.N. Mohamed

    2005-01-01

    Full Text Available A study of manpower consideration to reduce development time for new model in automotive industry is presented in this study. The approach taken are by studying the existing practice in car development and suggesting various ways for manpower improvement such as through early involvement and input from manufacturing personnel, the proper job scope structure, proper training to the new staffs to accomplish an important task at the specific timing and clear definition of criteria for a Project Manager's appointment.

  14. Exploring motivations to seek and undergo prosthodontic care: an empirical approach using the Theory of Planned Behavior construct

    Directory of Open Access Journals (Sweden)

    Vieira AH

    2014-09-01

    Full Text Available Antonio Hélio Vieira, Cláudio Rodrigues Leles Department of Prevention and Oral Rehabilitation, School of Dentistry, Federal University of Goias, Goiania, Goias, Brazil Abstract: Motivations for seeking and undergoing prosthodontic care are poorly understood and are not often explored for clinical purposes when determining treatment need and understanding the factors related to the demand for health care and effective use. This article uses the Theory of Planned Behavior construct to identify factors related to the motivations of edentulous subjects to seek and undergo prosthodontic treatment. The conceptual framework of the Theory of Planned Behavior includes attitude toward behavior, an individual’s positive or negative evaluation of self-performance of the particular behavior; the subjective norm, an individual’s perception of social normative pressures or relevant others’ beliefs that he or she should or should not perform such behavior; and perceived behavioral control, or an individual’s perceived ease or difficulty in performing the particular behavior, determined by the total set of accessible control beliefs. These components mediate a subject’s intention and behavior toward an object and may also explain health-related behaviors, providing strong predictions across a range of health behaviors. This study suggests categories for each component of the Theory of Planned Behavior, based on clinical evidence and practical reasoning. Attitudes toward behavior include perceived consequences of no treatment, perceived potential benefits and risks of treatment, dental anxiety, previous experiences, and interpersonal abilities of the health care providers. The subjective norm includes the opinions of relevant others, advertisement, professionally defined normative need, perceived professional skills, and technical quality of care. Perceived behavioral control includes subject’s time, availability and opportunity, treatment costs

  15. 42 CFR 441.102 - Plan of care for institutionalized recipients.

    Science.gov (United States)

    2010-10-01

    ... days after approval of the State plan provision for services in institutions for mental disease; and... SPECIFIC SERVICES Medicaid for Individuals Age 65 or Over in Institutions for Mental Diseases §...

  16. Manpower development in the US nuclear power industry

    International Nuclear Information System (INIS)

    This paper reviews the history and current status of the university nuclear education sector and the utility training sector of the United States (US) nuclear power industry. Recently, the number of programs in the university nuclear education sector has declined, and the remaining programs are in need of both strong governmental and industrial assistance if they are to remain a stable source for educating nuclear engineers and health physicists to staff the resurgence of the nuclear power industry. The utility training sector has undergone remarkable development since the TMI-2 accident. Programs to recruit, train, and qualify the variety of personnel needed, as well as the steps to accredit these programs, are being developed on a systematic, industry-wide basis. A number of new technologies for educating and training personnel are emerging which may be used to create or improve learning environments. Manpower development for the US nuclear power industry is a shared responsibility among the universities, the nuclear utilities, and the nuclear suppliers. This shared responsibility can continue to be best discharged by enhancement of the interaction among all parties with respect to evaluating the proper level of cognitive development within the utility training program

  17. Selection an Appropriate Leadership Style to Direct Hospital Manpower

    Directory of Open Access Journals (Sweden)

    M Arab

    2006-07-01

    Full Text Available This research has tried to find most proper leadership styles based on a approved model to direct hospital manpower appropriately. The main objective of this research was the comparison between manager’s existing leadership styles and suggested styles to them in order to direct existing styles toward suggested ones. In this cross- sectional study all Qom province hospital managers participated. From the hospital the staff, 385 persons were selected by randomized stratifying sampling. Data were collected by two types of validated questionnaires, one for the staff and another for managers, and analyzed by SPSS software. The finding showed that among four types of leadership styles, 75% of manager’s leadership style was “consultative” and rest were “exploitative- authoritative” or “benevolent- authoritative”, but in the view of about 78% of the staff, manager’s leadership style was “benevolent- authoritative” and only 0.8% of them believed that manager’s style was participative .In general, based on the staff point of view, managers behaved less participative. On the other hand, Tannenbaum and Schmidt leadership style continuum model proved that the best leadership style for all the hospital managers was the “consultative” one. It can be concluded that there was 25% gap between existing leadership styles and suggested ones and it should be tried to close this gap as far as posible.

  18. Effect of mechanization level on manpower needs in forestry

    Directory of Open Access Journals (Sweden)

    Błuszkowska Urszula

    2014-12-01

    Full Text Available High work consumption in forest operations is above all the result of the character and task realization mode in works undertaken in forestry. Development of mechanization in forest management activities allows to considerably decrease manpower needs. In the present study, there were analyzed the possibilities of reduction of work consumption by improving the mechanization level of forest works. The method was developed to consider the following assessments: 1 variant W1 - basic option comprising factual work consumption values in works carried out on the area administered by the Regional Directorate of State Forests (RDLP; 2 W2 - showing the effect of 25% upgrade of works to a higher level of mechanization; 3 W3 - showing the effect of 50% upgrade of works to a higher level of mechanization; 4 W4 - comprising analogous calculations to those in variant W1 , but work consumption upgrading was 75%. Simulation calculations revealed considerable differences in needs for labor of different categories of forest workers. On the other hand, with increasing mechanization level, there increase the demands concerning worker qualifications, e.g. a harvester operator must be trained for about 2 years, and the training has to include both simulator exercises (first using software and next - harvester simulator and field work under supervision to gain sufficient experience. The introduction of higher levels of mechanization into forest operations, and hence considerable reduction of jobs for unqualified workers who are replaced by qualified employees, can help decreasing work consumption in forest operations.

  19. [Oncologic after-care--a patient-oriented concept. Basic diagnostic plan for pediatric oncology patients].

    Science.gov (United States)

    Duffner, U; Sauter, S; Bergsträsser, E; Brandis, M; Niemeyer, C

    1995-01-01

    With intensive treatment many children and young adults with cancer can be cured of their disease. Therefore, the recognition of late effects of therapy will become increasingly important. Future concepts of follow-up care in pediatric oncology will have to serve two purposes: First, to determine the status of the malignant disease with early diagnosis of relapse and second, to recognize relevant side effects of treatment. We present a comprehensive approach of follow-up care which is primarily based on the definition of risk criteria for the development of relevant organ toxicity after different treatment modalities. For each patient a standardized summary of therapy delivered is documented. According to the definition of the risk criteria an individualized schedule for follow-up is decided upon. We hope that this structured concept will result in appropriate patient care while keeping the diagnostic efforts and costs limited. PMID:7564151

  20. Advocacy for eye care

    Directory of Open Access Journals (Sweden)

    Thulasiraj D Ravilla

    2012-01-01

    Full Text Available The effectiveness of eye care service delivery is often dependant on how the different stakeholders are aligned. These stakeholders range from the ministries of health who have the capacity to grant government subsidies for eye care, down to the primary healthcare workers who can be enrolled to screen for basic eye diseases. Advocacy is a tool that can help service providers draw the attention of key stakeholders to a particular area of concern. By enlisting the support, endorsement and participation of a wider circle of players, advocacy can help to improve the penetration and effectiveness of the services provided. There are several factors in the external environmental that influence the eye care services - such as the availability of trained manpower, supply of eye care consumables, government rules and regulations. There are several instances where successful advocacy has helped to create an enabling environment for eye care service delivery. Providing eye care services in developing countries requires the support - either for direct patient care or for support services such as producing trained manpower or for research and dissemination. Such support, in the form of financial or other resources, can be garnered through advocacy.

  1. Expected Time to Recruitment in A Two - Grade Manpower System Using Order Statistics for Inter-Decision Times and Attrition

    Directory of Open Access Journals (Sweden)

    J. Sridharan

    2014-02-01

    Full Text Available In this paper, a two-grade organization subjected to random exit of personal due to policy decisions taken by the organization is considered. There is an associated loss of manpower if a person quits. As the exit of personnel is unpredictable, a new recruitment policy involving two thresholds for each grade-one is optional and the other mandatory is suggested to enable the organization to plan its decision on recruitment. Based on shock model approach three mathematical models are constructed using an appropriate univariate policy of recruitment. Performance measures namely mean and variance of the time to recruitment are obtained for all the models when (i the loss of man-hours and the inter decision time forms an order statistics (ii the optional and mandatory thresholds follow different distributions. The analytical results are substantiated by numerical illustrations and the influence of nodal parameters on the performance measures is also analyzed.

  2. Human Papillomavirus Vaccination Coverage Among Female Adolescents in Managed Care Plans - United States, 2013.

    Science.gov (United States)

    Ng, Judy; Ye, Faye; Roth, Lindsey; Sobel, Katherine; Byron, Sepheen; Barton, Mary; Lindley, Megan; Stokley, Shannon

    2015-10-30

    Human papillomavirus (HPV) is the most common sexually transmitted infection, with a reported 79 million persons aged 15–59 years in the United States currently infected with HPV, and approximately 14 million new cases diagnosed each year. Although most HPV infections are asymptomatic, transient, and do not cause disease, persistent HPV infection can lead to cervical, vulvar, vaginal, anal, penile, and oropharyngeal cancer. In the United States, approximately 27,000 HPV-attributable cancers occur each year. HPV vaccination is an effective primary prevention strategy that can reduce many of the HPV infections that lead to cancer, and is routinely recommended for adolescents aged 11–12 years. To determine whether the recommended HPV vaccination series is currently being administered to adolescents with health insurance, CDC and the National Committee for Quality Assurance (NCQA) assessed 2013 data from the Healthcare Effectiveness Data and Information Set (HEDIS). The HEDIS HPV Vaccine for Female Adolescents performance measure evaluates the proportion of female adolescent members in commercial and Medicaid health plans who receive the recommended 3-dose HPV vaccination series by age 13 years. In 2013, in the United States, the median HPV vaccination coverage levels for female adolescents among commercial and Medicaid plans were 12% and 19%, respectively (ranges = 0%–34% for commercial plans; 5%–52% for Medicaid plans). Improving HPV vaccination coverage and understanding of what health plans might do to support HPV vaccination are needed, including understanding the barriers to, and facilitators for, vaccination coverage. PMID:26513219

  3. Planning for End-of-Life Care: Findings from the Canadian Study of Health and Aging

    Science.gov (United States)

    Garrett, Douglas D.; Tuokko, Holly; Stajduhar, Kelli I.; Lindsay, Joan; Buehler, Sharon

    2008-01-01

    Steps involved in formalizing end-of-life care preferences and factors related to these steps are unclear in the literature. Using data from the third wave of the Canadian Study of Health and Aging (CSHA-3), we examined the relations between demographic and health predictors, on the one hand, and three outcomes, on the other (whether participants…

  4. Menu Planning, Food Consumption, and Sanitation Practices in Day Care Facilities.

    Science.gov (United States)

    Kuratko, Connye N.; Martin, Ruth E.; Lan, William Y.; Chappell, James A.; Ahmad, Mahassen

    2000-01-01

    In 102 day care centers, data were collected on nutritional content of menus, compliance with guidelines, children's food consumption, and safety/sanitation. Although menus exceeded recommended daily allowances, quantities of food were below recommendations. No menu components were consumed by more than 65% of children. Sanitation problems were…

  5. 42 CFR 418.56 - Condition of participation: Interdisciplinary group, care planning, and coordination of services.

    Science.gov (United States)

    2010-10-01

    ... professional roles: (i) A doctor of medicine or osteopathy (who is an employee or under contract with the hospice). (ii) A registered nurse. (iii) A social worker. (iv) A pastoral or other counselor. (2) If the... supervise the care and services. The hospice must designate a registered nurse that is a member of...

  6. Hazards of Immobility: Bedsores. Adult Residential Care Home, Lesson Plan No. 5.

    Science.gov (United States)

    Lin, Kathleen

    Developed as part of a 104-hour course on adult residential care homes (ARCHs), this 50-minute lesson is designed to enable a student to: (1) define a bedsore; (2) list and describe three major causes of bedsores; (3) identify potential bedsore sites in the back-lying, side-lying, and sitting positions; and (4) calculate the risk for developing…

  7. 78 FR 69418 - Patient Protection and Affordable Care Act; Exchanges and Qualified Health Plans, Quality Rating...

    Science.gov (United States)

    2013-11-19

    ... safety, prevention, population health, patient engagement, patient experience, and efficient resource use... Department of Health and Human Services (the Secretary) holds primary responsibility for establishing the... performance data for the QRS in general topics, such as clinical effectiveness of care, patient safety,...

  8. Health Manpower Source Book. Manpower Supply and Educational Statistics for Selected Health Occupations: 1968. Public Health Service Publication Number 263, Section 20.

    Science.gov (United States)

    National Institutes of Health (DHEW), Bethesda, MD. Bureau of Health Professions Education and Manpower Training.

    This publication is a compilation of statistics on supply and education of health manpower in medicine and osteopathy, dentistry, optometry, pharmacy, podiatry, veterinary medicine, nursing, public health, and eight selected allied health occupations. The material is organized by occupations and the following information is presented for each…

  9. 76 FR 77392 - Patient Protection and Affordable Care Act; Establishment of Consumer Operated and Oriented Plan...

    Science.gov (United States)

    2011-12-13

    ... bring meaningful resolution to the lack of consumer choice in the health insurance market. The commenter... program (CO-OP) to foster the creation of new consumer-governed, private, nonprofit health insurance issuers. In addition to improving consumer choice and plan accountability, the CO- OP program also...

  10. Developing a national dissemination plan for collaborative care for depression: QUERI Series

    OpenAIRE

    Rubenstein Lisa V; Owen Richard R; Williams John W; Smith Jeffrey L; Chaney Edmund

    2008-01-01

    Abstract Background Little is known about effective strategies for disseminating and implementing complex clinical innovations across large healthcare systems. This paper describes processes undertaken and tools developed by the U.S. Department of Veterans Affairs (VA) Mental Health Quality Enhancement Research Initiative (MH-QUERI) to guide its efforts to partner with clinical leaders to prepare for national dissemination and implementation of collaborative care for depression. Methods An ev...

  11. Two Case Studies Using Mock-Ups for Planning Adult and Neonatal Intensive Care Facilities

    Directory of Open Access Journals (Sweden)

    Sue Hignett

    2010-01-01

    Full Text Available This paper describes two case studies using a 5-step protocol to determine functional space requirements for cardiac and neonatal intensive care clinical activities. Functional space experiments were conducted to determine the spatial requirements (defined as the minimumsized rectangle to encompass the Link Analysis. The data were collected with multi-directional filming and analysed frame-by-frame to plot the movements between the nurses and other components in the space. The average clinical functional space for the adult critical care unit was 22.83m2 (excluding family and hygiene space and in-room storage. The average functional clinical space for neonatal intensive care unit was 13.5m2 (excluding circulation and storage. The use of the 5-step protocol is reviewed, with limitations in case study 1 addressed in case study 2. The findings from both case studies have been incorporated into government guidance and achieved knowledge transfer by being implemented in building design.

  12. Physical and Visual Accessibilities in Intensive Care Units: A Comparative Study of Open-Plan and Racetrack Units.

    Science.gov (United States)

    Rashid, Mahbub; Khan, Nayma; Jones, Belinda

    2016-01-01

    This study compared physical and visual accessibilities and their associations with staff perception and interaction behaviors in 2 intensive care units (ICUs) with open-plan and racetrack layouts. For the study, physical and visual accessibilities were measured using the spatial analysis techniques of Space Syntax. Data on staff perception were collected from 81 clinicians using a questionnaire survey. The locations of 2233 interactions, and the location and length of another 339 interactions in these units were collected using systematic field observation techniques. According to the study, physical and visual accessibilities were different in the 2 ICUs, and clinicians' primary workspaces were physically and visually more accessible in the open-plan ICU. Physical and visual accessibilities affected how well clinicians' knew their peers and where their peers were located in these units. Physical and visual accessibilities also affected clinicians' perception of interaction and communication and of teamwork and collaboration in these units. Additionally, physical and visual accessibilities showed significant positive associations with interaction behaviors in these units, with the open-plan ICU showing stronger associations. However, physical accessibilities were less important than visual accessibilities in relation to interaction behaviors in these ICUs. The implications of these findings for ICU design are discussed. PMID:27575795

  13. Continuing Care

    Science.gov (United States)

    ... Care Obesity at Midlife May Speed Alzheimer’s Onset Hello from my mom Easing the Behavior Problems of ... Managers Continuing Care FOR MORE ARTICLES CLICK HERE Hello from my mom Common Estate Planning Errors Alzheimer’s ...

  14. Detailed statistical analysis plan for the Danish Palliative Care Trial (DanPaCT)

    DEFF Research Database (Denmark)

    Johnsen, Anna Thit; Petersen, Morten Aagaard; Gluud, Christian;

    2014-01-01

    from being referred to 'early SPC'. DanPaCT is a multicenter, parallel-group, superiority clinical trial with 1:1 randomization. The planned sample size was 300 patients. The primary data collection for DanPaCT is finished. To prevent outcome reporting bias, selective reporting, and data-driven results......, we present a detailed statistical analysis plan (SAP) for DanPaCT here. RESULTS: This SAP provides detailed descriptions of the statistical analyses of the primary and secondary outcomes in DanPaCT. The primary outcome is the change in the patient's 'primary need'. The 'primary need' is a patient...... primary outcome, but each scale evaluated individually for all patients, and survival. The detailed description includes chosen significance levels, models for multiple imputations, sensitivity analyses and blinding. In addition, we discuss the patient-individualized primary outcome, blinding, missing...

  15. MOD* Lite: An Incremental Path Planning Algorithm Taking Care of Multiple Objectives.

    Science.gov (United States)

    Oral, Tugcem; Polat, Faruk

    2016-01-01

    The need for determining a path from an initial location to a target one is a crucial task in many applications, such as virtual simulations, robotics, and computer games. Almost all of the existing algorithms are designed to find optimal or suboptimal solutions considering only a single objective, namely path length. However, in many real life application path length is not the sole criteria for optimization, there are more than one criteria to be optimized that cannot be transformed to each other. In this paper, we introduce a novel multiobjective incremental algorithm, multiobjective D* lite (MOD* lite) built upon a well-known path planning algorithm, D* lite. A number of experiments are designed to compare the solution quality and execution time requirements of MOD* lite with the multiobjective A* algorithm, an alternative genetic algorithm we developed multiobjective genetic path planning and the strength Pareto evolutionary algorithm. PMID:25730837

  16. Poor planning, communication lead to missteps in care of Ebola patient.

    Science.gov (United States)

    2015-11-01

    A panel of experts examining the diagnosis and care of Thomas Eric Duncan, a patient diagnosed with Ebola Virus Disease (EVD) in the United States in 2014, and the cases of two nurses who contracted EVD while caring for Duncan, has unveiled its findings along with recommendations to prevent many of the missteps that occurred during the crisis. While the independent panel was convened at the direction of Texas Health Resources, the parent company of Texas Health Presbyterian Hospital in Dallas, observers and the panel itself note that the findings should help hospitals, EDs, and communities across the country prepare for the next infectious disease event. The expert panel noted that ED personnel relied too heavily on the electronic medical record (EMR) to communicate with other members of the care team, and that important information, such as the patient's travel history, was not prioritized or highlighted in the EMR. Patient satisfaction and other operational objectives took precedence over patient safety during Duncan's ED visit, according to the expert panel's findings. The clinical team failed to pick up on changes in the patient's clinical status, missing an opportunity to re-evaluate Duncan and properly diagnosis him with EVD during his first visit to the ED. Confusion over the roles and responsibilities of local and federal health authorities, and inadequate preparation for an infectious disease event led to missteps. The expert panel suggests conducting practice drills that include all participating organizations, and hospital leaders should consider infectious disease threats as well as other types of disasters. PMID:26550674

  17. Wound Healing and Nutrition: Going Beyond Dressings With a Balanced Care Plan

    OpenAIRE

    Gruen, Douglas

    2010-01-01

    As the largest organ of the body, the human skin protects all subcutaneous tissues. Despite its many attributes, the skin is vulnerable to pressure ulcers. The number of pressure ulcers and venous leg ulcers is on the rise, but healing rates have not improved over the past decade. The reason may be a tendency to focus on one or two fundamentals of wound healing, but not on all 3 fundamentals equally. The 3 fundamentals of wound healing are (1) pressure relief and nursing care, (2) dressings, ...

  18. Role of health sector contingency plan in emergency preparedness and response: Orissa experiences.

    Science.gov (United States)

    Biswas, R; Dasgupta, A

    2009-01-01

    A study was organized to orient the district level health sector disaster managers to review, revise and update the health sector contingency plan (HSCP) against common natural calamities, followed by its execution and evaluation. An inter-state 3 days workshop was organized at Kolkata during the month of October 2004 to review the district level HSCP and its execution in 5 (five) worst affected districts. The District Health Officers, in consultation with the investigators, revised and updated the HSCP. Thereafter, status survey was conducted to examine the implementation of the contingency plan. During flood, the HSCP was found to be followed in the districts. Control room, construction/identification of flood shelter, sanitation and other preventive measures were taken care of, with an exception of Kendra Para, where lack of man power was noted. Technical support, trained manpower, relief materials, ambulance, Communication and information system were present in all the 5 (five) districts. PMID:20108889

  19. The search for the Holy Grail: combining decentralised planning and contracting mechanisms in the French health care system.

    Science.gov (United States)

    Bellanger, Martine M; Mossé, Philippe R

    2005-09-01

    France has recently adopted one of the least market-oriented models for reforming its health care system, where competition does not feature at all prominently in the overall policy design. This country has a strong tradition of top-down public administration, and health professionals, trade unions and the general public are all uneasy about the idea of introducing market forces and privatising public health provision. The main reforms discussed in this article were based on planning, rationalisation, cost-containment, efficiency and equity. However, some embryonic changes and emerging practices can be detected which might seem to relate to the 'new public management' approach, and which could also serve as a basis for future market initiatives. PMID:16161194

  20. Efficacy of misoprostol for the treatment of postpartum hemorrhage: current knowledge and implications for health care planning

    Directory of Open Access Journals (Sweden)

    Prata N

    2016-07-01

    Full Text Available Ndola Prata, Karen Weidert Bixby Center for Population, Health and Sustainability, School of Public Health, University of California at Berkeley, Berkeley, CA, USA Background: A myriad of interventions exist to treat postpartum hemorrhage (PPH, ranging from uterotonics and hemostatics to surgical and aortic compression devices. Nonetheless, PPH remains the leading cause of maternal mortality worldwide. The purpose of this article is to review the available evidence on the efficacy of misoprostol for the treatment of primary PPH and discuss implications for health care planning. Data and methods: Using PubMed, Web of Science, and GoogleScholar, we reviewed the literature on randomized controlled trials of interventions to treat PPH with misoprostol and non-randomized field trials with controls. We discuss the current knowledge and implications for health care planning, especially in resource-poor settings. Results: The treatment of PPH with 800 µg of misoprostol is equivalent to 40 IU of intravenous oxytocin in women who have received oxytocin for the prevention of PPH. The same dose might be an option for the treatment of PPH in women who did not receive oxytocin for the prevention of PPH and do not have access to oxytocin for treatment. Adding misoprostol to standard uterotonics has no additional benefits to women being treated for PPH, but the beneficial adjunctive role of misoprostol to conventional uterotonics is important in reducing intra- and postoperative hemorrhage during cesarean section. Conclusion: Misoprostol is an effective uterotonic agent in the treatment of PPH. Clinical guidelines and treatment protocols should be updated to reflect the current knowledge on the efficacy of misoprostol for the treatment of PPH with 800 µg sublingually. Keywords: PPH treatment, uterotonics, low-resource settings, cesarean section, retained placenta

  1. Optimization of Patrol Manpower Allocation Using Goal Programming Approach -A Case Study

    Directory of Open Access Journals (Sweden)

    K. Venkata Subbaiah

    2015-10-01

    Full Text Available One of the most difficult tasks of the patrol administrators is allocation of manpower; i.e. determining the. most effective level of operational manpower for patrol tasks. Typically, administrators resolve the allocation problem by relying on prior statistical data and by employing subjective analysis. In general, only limited systematic analyses have been applied to the problem. This thesis presents a non linear goal programming model for allocating patrolmen to road segments within a patrol region. The model is demonstrated via a case example of the East section of Visakhapatnam. The results of the model are valuable to the patrol administrator for considering departmental goals and priority structure, in addition to available historical data, in the assignment of patrol manpower for a given urban area.

  2. Care staff intentions to support adults with an intellectual disability to engage in physical activity: An application of the Theory of Planned Behaviour

    OpenAIRE

    Martin, Emma; McKenzie, Karen; Newman, Emily; Bowden, Keith; Morris, Paul Graham

    2011-01-01

    Researchers suggest that people with an intellectual disability (ID) undertake less physical activity than the general population and many rely, to some extent, on others to help them to access activities. The Theory of Planned Behaviour (TPB) model was previously found to significantly predict the intention of care staff to facilitate a healthy diet in those they supported. The present study examined whether the TPB was useful in predicting the intentions of 78 Scottish care staff to support...

  3. [Advance Care Planning and Decisions to limit treatment at the end of life - the view from medical ethics and psychooncology].

    Science.gov (United States)

    Winkler, Eva C; Heußner, Pia

    2016-03-01

    Decisions to limit treatment are important in order to avoid overtreatment at the end of life. They proceed more than half of expected deaths in Europe and the US, but are not always communicated with the patient in advance. One reason for non-involvement is that conversations that prepare patients for end-of-life decisions and work out their preferences do not take place on a regular basis. At the same time there is growing evidence that such communication improves patients' quality of life, reduces anxiety and depression and allows patients to develop a realistic understanding of their situation - which in turn is a prerequisite for shared decision making about limiting treatment.In this paper we define "treatment limitation" and explain the medical ethics perspective. The main focus, however, is on the causes that hinder advanced care planning and conversations about limiting treatment in the care of patients with advanced disease. Finally the evidence for approaches to improve the situation is presented with concrete suggestions for solutions. PMID:26983109

  4. Role of the community matron in advance care planning and 'do not attempt CPR' decision-making: a qualitative study.

    Science.gov (United States)

    Kazmierski, Mandy; King, Nigel

    2015-01-01

    The community matron (CM) is often the key worker caring for patients with chronic, life-limiting, long-term conditions, but these patients are not always recognised as palliative cases. This study explored the experiences of CMs with regard to advance care planning (ACP) and 'do not attempt cardiopulmonary resuscitation' (DNACPR) decision-making to understand whether or not they felt adequately prepared for this aspect of their role, and why. Qualitative data were generated from six CMs using a broad interpretive phenomenological approach. Face-to-face recorded interviews were analysed using template analysis. The study found that although participants faced complex ethical situations around ACP and DNACPR almost on a daily basis, none had received any formal training despite the emphasis on training in national and local guidelines. Participants often struggled to get their patients accepted on to the Gold Standards Framework. The research found variability and complexity of cases to be the main barriers to clear identification of the palliative phase. PMID:25559025

  5. Automated Telephone Self-Management Support for Diabetes in a Low-Income Health Plan: A Health Care Utilization and Cost Analysis.

    Science.gov (United States)

    Quan, Judy; Lee, Alexandra K; Handley, Margaret A; Ratanawongsa, Neda; Sarkar, Urmimala; Tseng, Samuel; Schillinger, Dean

    2015-12-01

    The objective was to determine whether automated telephone self-management support (ATSM) for low-income, linguistically diverse health plan members with diabetes affects health care utilization or cost. A government-sponsored managed care plan for low-income patients implemented a demonstration project between 2009 and 2011 that involved a 6-month ATSM intervention for 362 English-, Spanish-, or Cantonese-speaking members with diabetes from 4 publicly funded clinics. Participants were randomized to immediate intervention or a wait-list. Medical and pharmacy claims used in this analysis were obtained from the managed care plan. Medical claims included hospitalizations, ambulance use, emergency department visits, and outpatient visits. In the 6-month period following enrollment, intervention participants generated half as many emergency department visits and hospitalizations (rate ratio 0.52, 95% CI 0.26, 1.04) compared to wait-listed participants, but these differences did not reach statistical significance (P=0.06). With adjustment for prior year cost, intervention participants also had a nonsignificant reduction of $26.78 in total health care costs compared to wait-listed individuals (P=0.93). The observed trends suggest that ATSM could yield potential health service benefits for health plans that provide coverage for chronic disease patients in safety net settings. ATSM should be further scaled up to determine whether it is associated with a greater reduction in health care utilization and costs. PMID:26102298

  6. Health insurance coverage and use of family planning services among current and former foster youth: implications of the health care reform law.

    Science.gov (United States)

    Dworsky, Amy; Ahrens, Kym; Courtney, Mark

    2013-04-01

    This research uses data from a longitudinal study to examine how two provisions in the Patient Protection and Affordable Care Act could affect health insurance coverage among young women who have aged out of foster care. It also explores how allowing young people to remain in foster care until age twenty-one affects their health insurance coverage, use of family planning services, and information about birth control. We find that young women are more likely to have health insurance if they remain in foster care until their twenty-first birthday and that having health insurance is associated with an increase in the likelihood of receiving family planning services. Our results also suggest that many young women who would otherwise lack health insurance after aging out of foster care will be eligible for Medicaid under the health care reform law. Because having health insurance is associated with use of family planning services, this increase in Medicaid eligibility may result in fewer unintended pregnancies among this high-risk population. PMID:23262773

  7. Standards and general criteria for the planning and certification of need of megavoltage radiation oncology units in health care facilities

    International Nuclear Information System (INIS)

    Minimum standards and guidelines to be applied by State agencies and New Jersey health systems agencies in the examination of certificate-of-need applications and in the development of planning activities for radiation oncology units in health care facilities are presented. Radiation oncology is a medical discipline devoted to education and research in the use of ionizing radiation for the treatment of neoplastic disease. The proper application of radiation can be directed at either curative or palliative intent. It is an important and effective technique for the management of cancer. Radiotherapy equipment in clinical use is divided into four main categories: superficial, orthovoltage, megavoltage, and treatment planning facilities. Particular attention is given to megavoltage equipment which emits or generates rays over 1,000 kilovolts. These high energy rays effect better penetration of human tissue and are skin-sparing in nature, thus allowing for better tumor-to- skin dose ratios. The regionalization of megavoltage therapy services is discussed. Data on hospital megavoltage facilities in New Jersey for 1974, 1975, and 1976 are provided. The standards and guidelines pertain to utilization, personnel, and general criteria. A form for use by megavoltage radiation therapy units is appended

  8. 75 FR 45158 - Holcim (US) Inc. Corporate Division Including On-Site Leased Workers From Manpower, Office Team...

    Science.gov (United States)

    2010-08-02

    ...., Corporate Division, including on-site leased workers from Manpower and Office Team, Dundee, Michigan. The notice was published in the Federal Register on June 7, 2010 (75 FR 32223). At the request of the State... From Manpower, Office Team and Advance Temporary Services; Dundee, MI; Amended Certification...

  9. Vocational Guidance in Manpower Development: Papers Presented at the Asian Regional Conference-Workshop (Manila, Philippines, 1977).

    Science.gov (United States)

    ERIC Clearinghouse on Counseling and Personnel Services, Ann Arbor, MI.

    The unemployment of youth and adults has surfaced as a problem and a challenge to Asian Third World governments. Industry and business continue to experience a shortage of skilled and technical manpower. A manpower development conference was held in the Philippines on topics which included: (1) the role of private educational institutions in…

  10. Chronic Kidney Disease – Where Next? Predicting Outcomes and Planning Care Pathways

    Directory of Open Access Journals (Sweden)

    Angharad Marks

    2014-07-01

    Full Text Available With the introduction of the National Kidney Foundation Kidney Disease Outcomes Quality Initiative chronic kidney disease (CKD guidelines, CKD has been identified as common, particularly in the elderly. The outcomes for those with CKD can be poor: mortality, initiation of renal replacement therapy, and progressive deterioration in kidney function, with its associated complications. In young people with CKD, the risk of poor outcome is high and the social cost substantial, but the actual number of patients affected is relatively small. In the elderly, the risk of poor outcome is substantially lower, but due to the high prevalence of CKD the actual number of poor outcomes attributable to CKD is higher. Predicting which patients are at greatest risk, and being able to tailor care appropriately, has significant potential benefits. Risk prediction models in CKD are being developed and show promise but thus far have limitations. In this review we describe the pathway for developing and evaluating risk prediction tools, and consider what models we have for CKD prediction and where next.

  11. Relationship marketing of health care plans: retaining corporate customers in a competitive environment.

    Science.gov (United States)

    Choong, P

    2000-01-01

    Corporate employers have become major purchasers of health care. They are gatekeepers who decide whether to retain or drop an insurance company from the choice set offered to employees as well as whether to include new insurers into this choice set. If marketers of health maintenance organizations are to maintain their market share in this competitive environment, they need to understand issues considered important to corporate employers. This paper identifies the key drivers of satisfaction among corporate employers and shows the impact these key drivers have on overall satisfaction. More importantly, it demonstrates both theoretically and empirically that the impact of performance attributes on satisfaction is asymmetrical. Positive performances of attributes are shown to have smaller impacts on satisfaction than negative performances. The theoretical underpinnings of these phenomena are shown to lie in prospect theory. Finally, quantitative indicators are computed to aid managerial decision-making. Marketing managers of health insurance companies will optimize returns on their investment by understanding this asymmetric effect and eliminate existing deficiencies. PMID:11183659

  12. Future global manpower shortages in nuclear industries with special reference to india including remedial measures

    International Nuclear Information System (INIS)

    Full text: The Radiation Protection Program of the Environmental Protection Agencies of countries employ scientists, engineers, statisticians, economists, lawyers, policy analysts, and public affairs professionals amongst others. These professionals aim to protect workers, the general public, and the environment from harmful radiation exposures and to provide the technical basis for radiation protection policies and regulations. Professionals include Health physicists, Bio statistician, Radio chemist, Radio ecologist, Radio biologist etc. With a large proportion of the population of the nuclear workforce of many countries now approaching retirement age, existing power plants of these countries will be hard pressed to find enough qualified professionals to support their operations. The potential shortage of skilled manpower not only affects utilities, but also impacts the entire nuclear infrastructure, including national laboratories, federal and state agencies, nuclear technology vendors and manufacturing companies, nuclear construction companies, and university nuclear engineering departments. Manpower requirements exist in the nuclear power industry, universities and research establishments, hospitals, government departments, general industry e.g. radiography, transport, instrumentation etc., specialist contractors, agencies and consultancies serving radiation protection. India is no exception. India has the world's 12 th largest economy. Assuming India's average growth rate p.a. of more than 5%, total GDP by 2050 will increase substantially which will require proportionate increase of manpower for all industries. Also chance of brain drain is very high from developing countries e.g. from India to developed countries because of much higher pay and better lifestyle as there will be shortage of manpower in developed countries as explained above. With population growth to be stabilized in future in India, the working age population may not increase in the year 2030

  13. Moving toward a United States strategic plan in primary care informatics: a White Paper of the Primary Care Informatics Working Group, American Medical Informatics Association

    Directory of Open Access Journals (Sweden)

    David Little

    2003-06-01

    Full Text Available The Primary Care Informatics Working Group (PCIWG of the American Medical Informatics Association (AMIA has identified the absence of a national strategy for primary care informatics. Under PCIWG leadership, major national and international societies have come together to create the National Alliance for Primary Care Informatics (NAPCI, to promote a connection between the informatics community and the organisations that support primary care. The PCIWG clinical practice subcommittee has recognised the necessity of a global needs assessment, and proposed work in point-of-care technology, clinical vocabularies, and ambulatory electronic medical record development. Educational needs include a consensus statement on informatics competencies, recommendations for curriculum and teaching methods, and methodologies to evaluate their effectiveness. The research subcommittee seeks to define a primary care informatics research agenda, and to support and disseminate informatics research throughout the primary care community. The AMIA board of directors has enthusiastically endorsed the conceptual basis for this White Paper.

  14. The Emerging Microbe Project: Developing Clinical Care Plans Based on Pathogen Identification and Clinical Case Studies

    Directory of Open Access Journals (Sweden)

    Lauren A. O'Donnell

    2015-08-01

    Full Text Available For many students in the health sciences, including doctor of pharmacy (PharmD students, basic and clinical sciences often appear detached from each other. In the infectious disease field, PharmD students additionally struggle with mastering the diversity of microorganisms and the corresponding therapies. The objective of this study was to design an interdisciplinary project that integrates fundamental microbiology with clinical research and decision-making skills. The Emerging Microbe Project guided students through the identification of a microorganism via genetic sequence analysis. The unknown microbe provided the basis for a patient case that asked the student to design a therapeutic treatment strategy for an infected patient. Outside of lecture, students had two weeks to identify the pathogen using nucleotide sequences, compose a microbiology report on the pathogen, and recommend an appropriate therapeutic treatment plan for the corresponding clinical case. We hypothesized that the students would develop a better understanding of the interplay between basic microbiology and infectious disease clinical practice, and that they would gain confidence and skill in independently selecting appropriate antimicrobial therapies for a new disease state. The exercise was conducted with PharmD students in their second professional year of pharmacy school in a required infectious disease course. Here, we demonstrate that the Emerging Microbe Project significantly improved student learning through two assessment strategies (assignment grades and exam questions, and increased student confidence in clinical infectious disease practice. This exercise could be modified for other health sciences students or undergraduates depending upon the level of clinical focus required of the course.

  15. The Emerging Microbe Project: Developing Clinical Care Plans Based on Pathogen Identification and Clinical Case Studies.

    Science.gov (United States)

    O'Donnell, Lauren A; Perry, Michael W; Doup, Dane't R

    2015-12-01

    For many students in the health sciences, including doctor of pharmacy (PharmD) students, basic and clinical sciences often appear detached from each other. In the infectious disease field, PharmD students additionally struggle with mastering the diversity of microorganisms and the corresponding therapies. The objective of this study was to design an interdisciplinary project that integrates fundamental microbiology with clinical research and decision-making skills. The Emerging Microbe Project guided students through the identification of a microorganism via genetic sequence analysis. The unknown microbe provided the basis for a patient case that asked the student to design a therapeutic treatment strategy for an infected patient. Outside of lecture, students had two weeks to identify the pathogen using nucleotide sequences, compose a microbiology report on the pathogen, and recommend an appropriate therapeutic treatment plan for the corresponding clinical case. We hypothesized that the students would develop a better understanding of the interplay between basic microbiology and infectious disease clinical practice, and that they would gain confidence and skill in independently selecting appropriate antimicrobial therapies for a new disease state. The exercise was conducted with PharmD students in their second professional year of pharmacy school in a required infectious disease course. Here, we demonstrate that the Emerging Microbe Project significantly improved student learning through two assessment strategies (assignment grades and exam questions), and increased student confidence in clinical infectious disease practice. This exercise could be modified for other health sciences students or undergraduates depending upon the level of clinical focus required of the course. PMID:26753029

  16. The Feasibility of Establishing Highway Safety Manpower Development and Research Centers at University-Level Institutions. Final Report, Volume I: Study Report.

    Science.gov (United States)

    Chorness, Maury H.; And Others

    To examine the feasibility of establishing Highway Safety Manpower Development and Research (HSMDR) Centers at university-level institutions which would produce three types of manpower--safety specialists, safety professionals, and research manpower, previous National Highway Safety Bureau research studies and approximately 50 federally funded…

  17. Care Staff Intentions to Support Adults with an Intellectual Disability to Engage in Physical Activity: An Application of the Theory of Planned Behaviour

    Science.gov (United States)

    Martin, Emma; McKenzie, Karen; Newman, Emily; Bowden, Keith; Morris, Paul Graham

    2011-01-01

    Researchers suggest that people with an intellectual disability (ID) undertake less physical activity than the general population and many rely, to some extent, on others to help them to access activities. The Theory of Planned Behaviour (TPB) model was previously found to significantly predict the intention of care staff to facilitate a healthy…

  18. R&D manpower and technological performance : The impact of demographic and task-related diversity

    NARCIS (Netherlands)

    Faems, D.L.M.; Subramaniam, A.

    2013-01-01

    We assess the impact of R&D manpower diversity on firms' technological performance. Relying on insights from two theoretical perspectives on team diversity (i.e. social categorization perspective and information decision-making perspective), we hypothesize that both demographic and task-related sour

  19. Industrial Special Wastes Generated in Iowa and Manpower Characteristics of Employee Handlers, Volume I.

    Science.gov (United States)

    Pierce, David R.

    This document, Vol. I in a set, presents information obtained from a survey of industry in Iowa to determine the use and quantities, distribution, and treatment and disposal practices of hazardous waste generators. Additionally, it tabulated the number and manpower characteristics of employees who are in daily contact with such hazardous…

  20. Evaluation of Availability of Financial Resources and Manpower Development in Selected Monotechnics in Nigeria

    Science.gov (United States)

    Potokri, Onoriode Collins

    2014-01-01

    This research investigates manpower development and availability of financial resources in Nigerian monotechnic education. Monotechnics are single-subject institutions of higher learning that offer specialized programmes. A quantitative research design located within the positivist paradigm was adopted. A sample of 200 students and 80 members of…

  1. National Workplace Literacy Program (NWLP) at Chinatown Manpower Project, Inc. Final Performance Report.

    Science.gov (United States)

    Tse, Ivy Au

    The Chinatown Manpower Project continued as the education partner in a Workplace Literacy Program (WLP) for the Chinese garment workers in New York City. Local 23-25, Union of Needletrades, Industrial and Textile Employees, was the union partner; the Greater Blouse, Skirt & Undergarment Association, Inc., and the Continental Garment Manufacturers…

  2. The Educational Production Function: Implications for Educational Manpower Policy. Institute of Public Employment Monograph No. 4.

    Science.gov (United States)

    Heim, John; Perl, Lewis

    This monograph summarizes and evaluates "educational production function analyses"--studies of the relation between inputs and outputs in an education system--in order to aid in educational manpower policy making. In addition, data from New York state school districts and from a large national sample of high school students is subjected to…

  3. Colloquy and workshops: regional implications of the engineering manpower requirements of the National Energy Program

    Energy Technology Data Exchange (ETDEWEB)

    Segool, H. D. [ed.

    1979-05-01

    The crucial interrelationships of engineering manpower, technological innovation, productivity and capital re-formaton were keynoted. Near-term, a study has indicated a much larger New England energy demand-reduction/economic/market potential, with a probably larger engineering manpower requirement, for energy-conservation measures characterized by technological innovation and cost-effective capital services than for alternative energy-supply measures. Federal, regional, and state energy program responsibilities described a wide-ranging panorama of activities among many possible energy options which conveyed much endeavor without identifiable engineering manpower demand coefficients. Similarly, engineering manpower assessment data was described as uneven and unfocused to the energy program at the national level, disaggregated data as non-existent at the regional/state levels, although some qualitative inferences were drawn. A separate abstract was prepared for each of the 16 individual presentations for the DOE Energy Data Base (EDB); 14 of these were selected for Energy Abstracts for Policy Analysis (EAPA) and 2 for Energy Research Abstracts (ERA).

  4. Manpower Policies for Residents of Lower-Income Rural and Semi-Rural Counties.

    Science.gov (United States)

    Edwards, Clark

    Around 1,000 rural and semi-rural counties are suffering from decreased demand for farm labor and the lack of new nonfarm jobs, resulting in underemployment, low income, frustration, and out-migration. Manpower policies dealing with the economic opportunity of residents of rural, nonfarm areas often overlook two important aspects of the problem:…

  5. Advance Care Planning in Dementia: Do Family Carers Know the Treatment Preferences of People with Early Dementia?

    Science.gov (United States)

    King, Michael; Jones, Louise; Vickestaff, Victoria; Sampson, Elizabeth L.

    2016-01-01

    = -0.52; CPR, k = -0.07; PABAK = -0.45; tube feeding; k = 0.20; PABAK = -0.22). However, both PWD and carers showed marked uncertainty about their preferences for end of life treatment choices. Relationship quality, carer distress and burden had no influence on agreement. Conclusions This study is the first to have used the LSPQ with PWD in the UK to consider treatment options in hypothetical illness scenarios. Key finding are that family carers had a low to moderate agreement with PWD on preferences for end of life treatment. This underscores how planning for care at the end of life is beset with uncertainty, even when the carer and PWD perceive the care-giving/receiving relationship is good. Families affected by dementia may benefit from early and ongoing practical and emotional support to prepare for potential changes and aid decision making in the context of the realities of care towards the end of life. PMID:27410259

  6. The role of nuclear power in the development of industry and manpower

    International Nuclear Information System (INIS)

    Advanced countries have indigenously developed nuclear power technology on the basis of already well established industry and manpower. However, analysis shows that the nuclear developing countries develop these domestic industries and manpower by embarking on nuclear power projects. The paper emphasizes the importance of nuclear power for the development of industry and manpower, citing the experience gained in the Republic of Korea as an example. In the Republic of Korea, there are now six PWRs (two of 600 MW(e) and four of 950 MW(e)) and one PHWR (600 MW(e)) in operation that account for over one-half of the total electricity generated. Two PWRs (950 MW(e)) are under construction, while two more PWRs (950 MW(e)) are in the design stage. Three 600 MW(e) NPPs were constructed on a turnkey basis in the early 1970s, while 950 MW(e) projects were implemented on a non-turnkey basis in the late 1970s, through which domestic participation has much increased, mainly in the fields of architect engineering and equipment manufacturing. Construction technologies for heavy components and sophisticated welding technologies learned via these projects have much contributed to an improvement of the technology of the construction and shipbuilding industries. In particular, quality assurance and quality control concepts from nuclear power projects improved the quality level of domestic industries. However, it has been realized that software technologies including nuclear steam supply system designs are hard to acquire without indigenous research and development efforts. In this respect, measures for integration of the nuclear industry and manpower have been recently taken so as to create close links between the research institutes and the related nuclear industry, and to maintain critical manpower in each of the designated fields, through which self-reliance in nuclear power technology can be effectively achieved. (author). 2 refs, 3 tabs

  7. Stochastic Model to Determine the Expected Time to Recruitment with Three Sources of Depletion of Manpower under Correlated Interarrival Times

    Directory of Open Access Journals (Sweden)

    R. Elangovan

    2014-02-01

    Full Text Available It is a common phenomenon that some personnel leave an organization after completing a certain period of services to that organization voluntarily or involuntarily due to death, retirement or termination. It usually happen that whenever the policy decisions regarding promotion and target of work or sales to be achieved are revised, then, there will be exit of personnel, which in other words called the attrition or wastage. In any organization like marketing, industrial, software, the depletion of manpower due to policy decisions is quite common. This results in manpower attrition and then recruitment becomes necessary. Frequent recruitment is not advisable due to the cost of the same. Hence recruitment is postponed till a point called the breakdown point of total depletion beyond which the normal activities cannot be continued due to shortage of manpower. This level of allowable manpower attrition is called threshold. In this paper a Stochastic model to determine expected time to recruitment with three sources of depletion of manpower attrition under correlated interarrival times has been derived. It provides the optimal solution because; it takes into consideration the cost of frequent recruitments, depletion of manpower and the cost of shortage of manpower. The Stochastic model discussed in the paper is not only applicable to industry as a whole but also in a wider context of other applicable areas.

  8. Discussing dying in the diaspora: attitudes towards advance care planning among first generation Dutch and Italian migrants in rural Australia.

    Science.gov (United States)

    Sinclair, Craig; Smith, Jessica; Toussaint, Yann; Auret, Kirsten

    2014-01-01

    Western cultural practices and values have largely shaped advance care planning (ACP) policies across the world. Low uptake of ACP among ethnic minority groups in Western countries has been interpreted with reference to cultural differences. This paper adopts a life-history approach to explore attitudes towards ACP among older, first-generation Dutch-Australian and Italian-Australian migrants. Thirty people participated in extended ethnographic interviews (N = 17) and group discussions (N = 13) during 2012. Transcripts were thematically analyzed and interpreted using a Foucauldian perspective on knowledge and power. Migration experiences, ongoing contact with the native country and participation in migrant community support networks influenced attitudes towards ACP. Dutch participants framed ACP discussions with reference to euthanasia, and adopted a more individualist approach to medical decision-making. Italian participants often spoke of familial roles and emphasized a family-based decision making style. The importance of migrant identity has been neglected in previous discussions of cultural factors influencing ACP uptake among ethnic minority groups. The unique migration experience should be considered alongside culturally appropriate approaches to decision-making, in order to ensure equitable access to ACP among migrant groups. PMID:24560228

  9. Internal and External Labor Markets: An Analysis of Manpower Utilization.

    Science.gov (United States)

    Schiller, Bradley R.

    The report covers two major topic areas, each of which is treated in a separate paper: (1) the extent of variation in individual workers' relative earnings, and (2) the impact of private pension plans on firm attachment. The first study looks at changes in relative earnings and evaluates them in the framework of alternative labor market models. It…

  10. Assessment of the Required Manpower for Shiraz University of Medical Sciences hospitals based on Ministry of Health and Medical Education Method, 2012

    Directory of Open Access Journals (Sweden)

    Zahra Kavosi

    2015-01-01

    Full Text Available Introduction: New organization’s success depends on the efficient use of human resources In this study, we aimed to estimate the staffing needs in hospitals of Shiraz University of Medical Sciences (SUMS according to model proposed by the Ministry of Health and Medical Education in 2012. Method: This is a cross-sectional definitive study conducted in three general and six specialized SUMS hospitals. The research tool used was a checklist that determines the number of nurses, paraclinic and service employees and finally the decrease and increase of human resources in the departments of the hospitals regarding Iranian Ministry of Health (MOH issues. The data were collected and analyzed using SPSS software to determine the differences between the current situation in accordance to MOH issues. Results: Results showed that of the nine teaching hospitals of SUMs in 2012, Namazi hospital had 288 redundant staff and Khalili hospital had a shortage of manpower in 8 places . We observeda deficiency in human resources in all the studied hospitals. Also, the distribution of human resources among most of the hospital departments was not conform with MOH issues. Conclusion: Various models have been proposed for estimating human resources of hospitals. Because of better ergometer and time to estimate the correct manpower, the model introduced by the Department of Health is suitable for planning to increase the efficiency and effectiveness of the hospitals.

  11. [Parte III. Ethical and juridical aspects in end-stage chronic organ failures. A position paper on a shared care planning].

    Science.gov (United States)

    Barbisan, Camillo; Casonato, Carlo; Palermo Fabris, Elisabetta; Piccinni, Mariassunta; Zatti, Paolo

    2014-01-01

    The specific target of an experts panel was to assess in terms of law and ethics the compliance of a new specific decision making algorithm described in the position paper proposed by the Gruppo di Lavoro Insufficienze Croniche d'Organo, with the main goal of the position paper consisting in the shared care planning process. The following specific aspects were assessed by the experts: a) the impact on case law and statute law of a new clinical pathway shared by scientific societies in light of good clinical practice and scientific evidence; b) the relevance of all tools useful to identify the appropriateness of care pathways, recognizing responsibilities and decision-making skills related to the end of life choices made by all stakeholders involved (healthcare professionals, patients and their beloved ones); c) the consistency of the healthcare professionals duties proposed in the position paper with the Italian legal order; d) the opportunity to take into account the role of all healthcare providers involved in care relationship; e) the consistency of the definition of patient rights at the end of life as proposed in the position paper with the Italian legal order and the relevance in this context of simultaneous palliative care; f) the relevance of shared care planning and its consistency with the proposed operative tools; g) the relevance of the conscientious objection issue and the compliance of management tools proposed in the position paper with the results of ethical and legal considerations; h) considerations about available resources allocation. PMID:24553594

  12. Quasi-experimental trial of diabetes Self-Management Automated and Real-Time Telephonic Support (SMARTSteps in a Medicaid managed care plan: study protocol

    Directory of Open Access Journals (Sweden)

    Ratanawongsa Neda

    2012-01-01

    Full Text Available Abstract Background Health information technology can enhance self-management and quality of life for patients with chronic disease and overcome healthcare barriers for patients with limited English proficiency. After a randomized controlled trial of a multilingual automated telephone self-management support program (ATSM improved patient-centered dimensions of diabetes care in safety net clinics, we collaborated with a nonprofit Medicaid managed care plan to translate research into practice, offering ATSM as a covered benefit and augmenting ATSM to promote medication activation. This paper describes the protocol of the Self-Management Automated and Real-Time Telephonic Support Project (SMARTSteps. Methods/Design This controlled quasi-experimental trial used a wait-list variant of a stepped wedge design to enroll 362 adult health plan members with diabetes who speak English, Cantonese, or Spanish and receive care at 4 publicly-funded clinics. Through language-stratified randomization, participants were assigned to four intervention statuses: SMARTSteps-ONLY, SMARTSteps-PLUS, or wait-list for either intervention. In addition to usual primary care, intervention participants received 27 weekly calls in their preferred language with rotating queries and response-triggered education about self-care, medication adherence, safety concerns, psychological issues, and preventive services. Health coaches from the health plan called patients with out-of-range responses for collaborative goal setting and action planning. SMARTSteps-PLUS also included health coach calls to promote medication activation, adherence and intensification, if triggered by ATSM-reported non-adherence, refill non-adherence from pharmacy claims, or suboptimal cardiometabolic indicators. Wait-list patients crossed-over to SMARTSteps-ONLY or -PLUS at 6 months. For participants who agreed to structured telephone interviews at baseline and 6 months (n = 252, primary outcomes will be

  13. Long-Range Educational Policy Planning and the Demand for Educated Manpower in Times of Uncertainty.

    Science.gov (United States)

    Bakke, E. K.

    1984-01-01

    There is no good method of regulating the educational system based on specific, numerical measurements of labor requirements, and it will be important to integrate uncertainty into future forecasts. Adjustments in demand and supply of educated labor in Norway require a decentralized authority structure providing incentives for institutions and the…

  14. A littoral combat ship manpower analysis using the fleet response training plan

    OpenAIRE

    Williams-Robinson, Mckinnya Juanique.

    2007-01-01

    The Littoral Combat Ship, in its final steps toward employment, is an entirely new breed of U.S. Navy warship. USS Freedom (LCS 1), scheduled to be commissioned in May 2007, introduces an advanced technological platform. It includes but is not limited to several new optimal manning and training concepts such as SHIPTRAIN and SMARTSHIP introduced by the U.S. Navy. The Littoral Combat Ship Wholeness Concept of Operations requires a crew to certify in 15 mission areas using its core crew and ...

  15. Planning manual for energy resource development on Indian lands. Volume III. Manpower and training

    Energy Technology Data Exchange (ETDEWEB)

    1978-03-01

    This volume addresses ways to bridge the gap between existing tribal skill levels and the skill levels required for higher-paying jobs in energy resource development projects. It addresses opportunities for technical, skilled, and semiskilled employment as well as professional positions, because it is important to have tribal participation at all levels of an operation. Section II, ''Energy-Related Employment Opportunities,'' covers three areas: (1) identification of energy-resource occupations; (2) description of these occupations; and (3) identification of skill requirements by type of occupation. Section III, ''Description of Training Programs,'' also covers three areas: (a) concept of a training-program model; (b) description of various training methods; and (c) an assessment of the cost of training, utilizing different programs. Section IV concentrates on development of a training program for target occupations, skills, and populations. Again this section covers three areas: (i) overview of the development of a skills training program; (ii) identification of target occupations, skills, and populations; and (iii) energy careers for younger tribal members.

  16. The Impacts of well Planned Recruitment and Selection Process on Corporate Performance in Nigerian Banking Industry (A Case Study of First Bank Plc 2004-2011)

    OpenAIRE

    Adeniyi Mudashiru Mustapha; O.A. Ilesanmi; M. Aremu

    2013-01-01

    A sound recruitment programme logically follows a well drawn-up manpower plan. In fact, the quality of the present manpower plan as indeed of every present decision of the organization depends upon the quality of recruitment policies and practices. This paper examines recruitment and selection process. It identifies a typical source by separating recruitment into internal and external and discussed the advantages of each method. The analytical tools used in this study were regression analysis...

  17. New land, new town, new health care system: primary care based health care planning in a modern, industrialized society; a case-study evaluating the health care demonstration project in the new Dutch town of Almere.

    OpenAIRE

    Sixma, H.J.M.

    1997-01-01

    Het NIVEL evalueerde het Experiment Almeerse Gezondheidszorg (EAG). Dit experiment was bedoeld om de gezondheidszorg efficiënter en goedkoper te maken door middel van een strikte planning waarin voorrang werd gegeven aan de eerstelijns gezondheidszorg. Begin jaren zeventig wilde de overheid de gezondheidszorg herstructureren omdat die teveel kostte en inefficiënt werkte. Er werd een experiment opgezet in de nieuwe stad Almere. Het EAG had als doel meer zorg van de tweede lijn (ziekenhuis, spe...

  18. Health care marketing: the theory of planned behavior applied to patients' choise between private and public providers in the portuguese health care system.

    OpenAIRE

    Ferreira, Filipa Monteiro

    2011-01-01

    Dissertation submitted in partial fulfillment of the requirements for degree of Master in Statistics and Information Management. Purpose - The Portuguese health care system has been evolving throughout the last 35 years with two relevant facts: the public sector has progressed with improvement in all relevant OECD indicators; the private sector has been widened and reinforced. In this framework, it is important to understand how patient’s intention and behavior are built, so health care...

  19. A randomised controlled trial on the efficacy of advance care planning on the quality of end-of-life care and communication in patients with COPD: the research protocol

    OpenAIRE

    Houben, Carmen H M; Spruit, Martijn A.; Wouters, Emiel F.M.; Janssen, Daisy J A

    2014-01-01

    Introduction Recent research shows that advance care planning (ACP) for patients with chronic obstructive pulmonary disease (COPD) is uncommon and poorly carried out. The aim of the present study was to explore whether and to what extent structured ACP by a trained nurse, in collaboration with the chest physician, can improve outcomes in Dutch patients with COPD and their family. Methods and analysis A multicentre cluster randomised controlled trial in patients with COPD who are recently disc...

  20. Developing a strategic marketing plan for physical and occupational therapy services: a collaborative project between a critical access hospital and a graduate program in health care management.

    Science.gov (United States)

    Kash, Bita A; Deshmukh, A A

    2013-01-01

    The purpose of this study was to develop a marketing plan for the Physical and Occupational Therapy (PT/OT) department at a Critical Access Hospital (CAH). We took the approach of understanding and analyzing the rural community and health care environment, problems faced by the PT/OT department, and developing a strategic marketing plan to resolve those problems. We used hospital admissions data, public and physician surveys, a SWOT analysis, and tools to evaluate alternative strategies. Lack of awareness and negative perception were key issues. Recommended strategies included building relationships with physicians, partnering with the school district, and enhancing the wellness program. PMID:23924224

  1. Care staff intentions to support adults with a learning disability to engage in physical activity: an application of the theory of planned behaviour

    OpenAIRE

    Martin, Emma Lavinia

    2010-01-01

    Background: This study investigates whether the Theory of Planned Behaviour is a viable model to predict the intentions of care staff to support adults with a learning disability to take part in physical activity. Previous research has suggested that people with a learning disability take part in less physical activity than those without disabilities. Research also shows that people with a learning disability have additional health needs when compared to the general population. Some condition...

  2. Effectiveness of Standardized Nursing Care Plans in Health Outcomes in Patients with Type 2 Diabetes Mellitus: A Two-Year Prospective Follow-Up Study

    OpenAIRE

    Cárdenas-Valladolid, Juan; Salinero-Fort, Miguel A; Gómez-Campelo, Paloma; de Burgos-Lunar, Carmen; Abánades-Herranz, Juan C.; Arnal-Selfa, Rosa; Andrés, Ana López-

    2012-01-01

    Background Implementation of a standardized language in Nursing Care Plans (SNCP) allows for increased efficiency in nursing data management. However, the potential relationship with patientś health outcomes remains uncertain. The aim of this study was to evaluate the effectiveness of SNCP implementation, based on North American Nursing Diagnosis Association (NANDA) and Nursing Interventions Classification (NIC), in the improvement of metabolic, weight, and blood pressure control of Type 2 Di...

  3. A complex regional intervention to implement advance care planning in one town's nursing homes: Protocol of a controlled inter-regional study

    OpenAIRE

    Briggs Linda; Hammes Bernard J; Rixen Stephan; Mellert Christine; Rothärmel Sonja; in der Schmitten Jürgen; Wegscheider Karl; Marckmann Georg

    2011-01-01

    Abstract Background Advance Care Planning (ACP) is an emerging strategy to ensure that well-reflected, meaningful and clearly documented treatment preferences are available and respected when critical decisions about life-sustaining treatment need to be made for patients unable to consent. In Germany, recent legislation confirms that advance directives (AD) have to be followed if they apply to the medical situation, but implementation of ACP has not yet been described. Methods/Design In a lon...

  4. A Rational Approach to Estimating the Surgical Demand Elasticity Needed to Guide Manpower Reallocation during Contagious Outbreaks

    OpenAIRE

    Hsiao-Mei Tsao; Ying-Chou Sun; Der-Ming Liou

    2015-01-01

    Background Emerging infectious diseases continue to pose serious threats to global public health. So far, however, few published study has addressed the need for manpower reallocation needed in hospitals when such a serious contagious outbreak occurs. Aim To quantify the demand elasticity of the major surgery types in order to guide future manpower reallocation during contagious outbreaks. Materials and Methods Based on a nationwide research database in Taiwan, we extracted the monthly volume...

  5. Study on the availability of physical infrastructure and manpower facilities in sub-centers of Chittoor district of Andhra Pradesh

    OpenAIRE

    N Bayapa Reddy; G Ravi Prabhu; Sai, T.S.R.

    2012-01-01

    The sub-centers (SCs) are under constant criticism for their inability to deliver quality services due to the nonavailability of adequate infrastructure, manpower and supply of drugs.A cross-sectional study was conducted in Chittoor District of Andhra Pradesh to assess the availability of physical infrastructure and manpower in the SCs. A total of 34 SCs were selected by multistage and stratified random sampling technique. The data was statistically analyzed by using Microsoft Excel. The defi...

  6. Contribution of Kenyan University Undergraduate Fashion and Apparel Design Programs towards the Manpower Development for the Kenyan Apparel Industry

    OpenAIRE

    Rael Chepchumba Maiyo; Susan Abong’o; David R. Tuigon’g

    2013-01-01

    Worldwide, the contribution of university fashion design training programs towards the manpower development for the fashion and apparel (FA) industry cannot be underestimated. The objective of this paper is to identify the contribution of Kenyan University undergraduate fashion and apparel design programs (UUGFADPs) towards manpower development for Kenyan FA industry. Descriptive survey was used to collect data at Kenyatta, Maseno, Egerton, University of Eldoret (UoE), University of Eastern A...

  7. The impact of technological change on military manpower in the 21st century

    OpenAIRE

    Guthrie, Neale D.

    1990-01-01

    Approved for public release; distribution is unlimited. This thesis analyzed the impact of technological change on military manpower in the future. The scope of the study was very broad in an attempt to capture the wide range of social, economic, organizational and psychological affects that technological change is expected to bring. The review of the literature was divided into four sections; general, discipline-specific, civilian sector forecasts, and military forecasts. The general sect...

  8. Development of a big data application architecture for Navy Manpower, Personnel, Training, and Education

    OpenAIRE

    Caindoy, Khristian C.; Moazzami, Armin; Santos, Anthony M.

    2016-01-01

    Approved for public release; distribution is unlimited Navy Manpower, Personnel, Training, and Education (MPTE) decision makers require improved access to the information obtained from the vast amounts of data contained in a number of disparate databases/data stores in order to make informed decisions and understand second- and third-order effects of those decisions. Toward this end, the research effort of this thesis was two-fold. First, this thesis examined and proposed an end-to-end app...

  9. Effective Technological Delivery in Nigerian Polytechnics:Need for Academic Manpower Development Policy

    OpenAIRE

    J. K. Adeyemi; E. E. Uko-Aviomoh

    2004-01-01

    Technical education, especially as provided in the Nigerian polytechnics, leads to the acquisition of practical and applied skills as well as basic scientific knowledge. The production function of the polytechnics in terms of producing quality middle-level manpower through effective teaching delivery depends largely on the quantity and quality of teachers available. However, teacher adequacy is a function of many factors, which include funding, student enrollment overtime, and staff turnover....

  10. Manpower requirements in the nuclear power industry, 1982-1991

    International Nuclear Information System (INIS)

    The objective of this study is to project occupational employment needs, created by growth and employee turnover, for the nuclear power industry over the next decade. Employment data for 1981 were collected in a survey conducted by the Institute of Nuclear Power Operations of its 60 member utilities. The data were analyzed statistically to identify factors that account for variations in power plant staffing and the number of off-site nuclear support personnel employed by a utility. Total employment in the nuclear power industry is predicted to increase from 54,400 in 1981 to 73,600 in 1991. Nuclear generating capacity will increase from 58 to 124 gigawatts, based on the midline forecast of the Energy Information Administration. The projections assume that current regulations will remain in effect and no new plans for additional generating facilities will be initiated

  11. Clinician Adoption Patterns and Patient Outcome Results in Use of Evidence-Based Nursing Plans of Care

    OpenAIRE

    Kim, Tae Youn; Lang, Norma M.; Berg, Karen; Weaver, Charlotte; Murphy, Judy; Ela, Sue

    2007-01-01

    Delivery of safe, effective and appropriate health care is an imperative facing health care organizations globally. While many initiatives have been launched in a number of countries to address this need from a medical perspective, a similar focus for generating evidence-based nursing knowledge has been missing [1]. This paper reports on a collaborative evidence-based practice (EBP) research initiative that adds nursing knowledge into computerized care protocols. Here, a brief overview of the...

  12. Meeting the manpower challenge in the transfer of nuclear power to developing countries

    International Nuclear Information System (INIS)

    One of the constraints to meeting projections of nuclear power's share of energy needs in the United States has been the various manpower problems, ranging from idling of construction manpower because of disruptions in the flow of materials and construction scheduling to the comptetition between various segments of the nuclear industry, government, and educational institutions for the available supply of experienced nuclear-oriented engineering personnel. Similar problems have been encountered in other countries which are presently partially dependent upon nuclear power for energy, and the competition for qualified personnel has become international in scope with considerable migrating of engineers among these nations. The global needs for staffing personnel of nuclear power plants and fuel cycle facilities to 1990 indicate continued stress on the international technical manpower supply. When considering the manpower and training necessary for the execution of a country's first nuclear project, the burden imposed on the purchaser's organization needs to be clearly understood. The work load and the responsibilities that cannot be transferred to other organizations is usually underestimated. In assessing the magnitude of the workload, four important points should be emphasized: (1) The responsibility for the ultimate success or failure of the nuclear project must be borne by the purchaser's organization. Contractors can assume responsibility for the performance of specific tasks but not for the entire project; (2) Even in a turnkey contact, the prime contractor normally will not assume financial responsibility for the performance of the local subcontractors, whose performance must be monitored and controlled by the purchaser's organization; (3) Many areas of a nuclear project involving domestic bureaucracy, politics, regulations, etc., can be dealt with effectively only by nationals. Examples of such areas are customs clearances and import licenses, visas, housing

  13. Health-care district management information system plan: Review of operations analysis activities during calendar year 1975 and plan for continued research and analysis activities

    Science.gov (United States)

    Nielson, G. J.; Stevenson, W. G.

    1976-01-01

    Operations research activities developed to identify the information required to manage both the efficiency and effectiveness of the Veterans Administration (VA) health services as these services relate to individual patient care are reported. The clinical concerns and management functions that determine this information requirement are discussed conceptually. Investigations of existing VA data for useful management information are recorded, and a diagnostic index is provided. The age-specific characteristics of diseases and lengths of stay are explored, and recommendations for future analysis activities are articulated. The effect of the introduction of new technology to health care is also discussed.

  14. Workforce education and manpower development: a road map for Singapore

    Science.gov (United States)

    Lim, Tuan-Kay

    2002-05-01

    In recognition of the rapid growth potential of the world market in optics and photonics Singapore is determined to establish itself as an optics hub. Indeed, Singapore's strong industry base in electronics, electrical devices, and semiconductors will complement well the multidisciplinary characteristics of optics and photonics, and will serve as an excellent foundation to develop more optical applications. In addition, Singapore's excellent infrastructure and appropriate industry mix, coupled with its close proximity to the emerging Asian markets would also give it an advantage for undertaking R&D and incubation of new technologies. However, a critical factor for realizing the rapid growth of the optics industry is the adequate and steady supply of qualified personnel at all levels. In this paper, a plan for developing a comprehensive, integrated education and training system is proposed. It is pointed out that the development and implementation of such a system requires the collaboration and dedication of the whole optics and photonics community in Singapore, as well as the support of a global network of optics clusters. In particular, the important roles of the Singapore Centre of Photonics Excellence (SCOPE) and the Photonics Association, Singapore) [PA(S)] is emphasized.

  15. Comparison of forward planning with automated inverse planning for three-dimensional conformal radiotherapy of non-small cell lung cancer without IMRT.

    Science.gov (United States)

    Mendes, Ruheena; Lavrenkov, Konstantin; Bedford, James L; Henrys, Anthony; Ashley, Sue; Brada, Michael

    2006-03-01

    The forward and inverse treatment plans of 10 patients with lung cancer were compared in terms of PTV coverage, sparing of normal lung and time required to generate a plan. The inverse planning produced as good treatment plans as an experienced dosimetrist with considerable reduction in staff time. When translated to other complex sites, inverse non-IMRT planning may have considerable impact on manpower requirements. PMID:16564591

  16. Comparison of forward planning with automated inverse planning for three-dimensional conformal radiotherapy of non-small cell lung cancer without IMRT

    International Nuclear Information System (INIS)

    The forward and inverse treatment plans of 10 patients with lung cancer were compared in terms of PTV coverage, sparing of normal lung and time required to generate a plan. The inverse planning produced as good treatment plans as an experienced dosimetrist with considerable reduction in staff time. When translated to other complex sites, inverse non-IMRT planning may have considerable impact on manpower requirements

  17. Administrative simplification: adoption of operating rules for eligibility for a health plan and health care claim status transactions. Interim final rule with comment period.

    Science.gov (United States)

    2011-07-01

    Section 1104 of the Administrative Simplification provisions of the Patient Protection and Affordable Care Act (hereafter referred to as the Affordable Care Act) establishes new requirements for administrative transactions that will improve the utility of the existing HIPAA transactions and reduce administrative costs. Specifically, in section 1104(b)(2) of the Affordable Care Act, Congress required the adoption of operating rules for the health care industry and directed the Secretary of Health and Human Services to "adopt a single set of operating rules for each transaction * * * with the goal of creating as much uniformity in the implementation of the electronic standards as possible." This interim final rule with comment period adopts operating rules for two Health Insurance Portability and Accountability Act of 1996 (HIPAA) transactions: eligibility for a health plan and health care claim status. This rule also defines the term "operating rules" and explains the role of operating rules in relation to the adopted transaction standards. In general, transaction standards adopted under HIPAA enable electronic data interchange through a common interchange structure, thus minimizing the industry's reliance on multiple formats. Operating rules, in turn, attempt to define the rights and responsibilities of all parties, security requirements, transmission formats, response times, liabilities, exception processing, error resolution and more, in order to facilitate successful interoperability between data systems of different entities. PMID:21739765

  18. Evaluation of the Factors Concerning the Unexpected Pregnancy of Women who Applied to the Mother and Child Care and Family Planning Center of Van Province

    Directory of Open Access Journals (Sweden)

    Sebahat Gucuk

    2012-02-01

    Full Text Available Introduction: The purpose of this study is to evaluate the experiences of unexpected pregnancy and the related factors of the women who have applied to our center. Material and Method: The study was planned as a descriptive study which enrolled women in the age range of 15-49 on the basis of volunteerism who have applied to the Mother and Child Care and Family Planning Center of Van Province. The participants were administered a survey in which certain situations were questioned, such as age, educational background, age at first labor, income status, number of living children, miscarriage status, unexpected pregnancy status, the presence of trying to undergo an abortion with alternative methods, and the state of receiving consultancy service on pre- and post-pregnancy family planning. Results: The more increased the educational level of 399 women enrolled in the study, the more significant reduction in unexpected pregnancies was detected (P=0.001. When the educational background and the use of alternative methods to have an abortion were compared, the illiterate women were found to use alternative methods (37.6% at a significantly high ratio (p=0.0001. The average of children number of women with at least one unexpected pregnancy was significantly high (p=0.0001. While the ratio of receiving consultancy on post-pregnancy family planning from health care personnel of the women with unexpected pregnancy was 79.5%, a ratio of 97.9% was detected for the women with planned pregnancy which was significantly different (p=0.0001. Conclusion: The health care personnel may reduce the unexpected pregnancies by training women on family planning in a simple, understandable way and by trying to increase health literacy by taking the dominant social rules in our region into consideration. We consider that the primary healthcare will be more effective and result oriented through newly applied Family Practice in our region. Key Words: Unexpected pregnancy

  19. 42 CFR 484.18 - Condition of participation: Acceptance of patients, plan of care, and medical supervision.

    Science.gov (United States)

    2010-10-01

    ... potential, functional limitations, activities permitted, nutritional requirements, medications and... to the original plan. Orders for therapy services include the specific procedures and modalities...

  20. Higher quality and lower cost with innovative cooling technology. Careful planning of cold rooms and refrigerator rooms; Qualitaets- und Kostenvorteile durch innovative Kuehltechnik. Kuehl- und TK-Raeume vorausschauend planen

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    2007-03-15

    Hygienic specifications for gastronomy, catering services and industrial kitchens are very rigid. Cooling is an important element, not least as a result of trends like 'cook and chill'. Problems can be avoided by careful planning. (orig.)

  1. Coordination and Human Resource Planning in the Hawaii Visitor Industry.

    Science.gov (United States)

    Hawaii State Commission on Manpower and Full Employment, Honolulu.

    This report was undertaken in response to a request by the Sixth Legislature, which expressed its concern with the lack of coordination and overall human resource planning in the visitor industry and that the findings of the January 6-7, 1970 Travel Industry Congress had not been fully implemented. The State Commission on Manpower and Full…

  2. Knowledge and opinions about dental human health resources planning in Mexico.

    Science.gov (United States)

    Maupome, G; Borges, A; Diez-de-Bonilla, J

    1998-02-01

    Dental human health resource planning (DHHRP), or manpower planning in Mexico has been plagued by fundamental contradictions. In spite of having trained a great many dentists in the past two decades, the dental health status of the population has not significantly improved. Concurrently, the relative scarcity of patients in relation to the number of practising dentists seems to be more marked, a critical issue since most dental care is delivered under private schemes. In the present investigation, 196 practising dentists in Mexico City were interviewed to establish their knowledge and opinions about DHHRP, and their views about the introduction of innovative alternatives in transforming, evaluating and planning human health resources. Concerns were: a need to examine and re-define the aims, skill content and marketability of professional training in professional practice; a lack of consensus as to how this is to be achieved; and a degree of awareness that professional practice has a limited scope in meeting the challenge of providing adequate care because of maldistribution of dentists and of limited financial resources of patients. PMID:9779080

  3. Joint Commissioning Plan of the Health and Social Care Board and the Public Health Agency: 2010-2011

    OpenAIRE

    Public Health Agency

    2010-01-01

    Legislation enacted on 1 April 2009 created a new Commissioning system with the establishment of a region-wide Health and Social Care Board, including 5 Local Commissioning Groups (LCGs), and a Public Health Agency. In line with Departmental direction and guidance the objectives of the new commissioning arrangementswere to:- Approach the future delivery of Health and Social Care from a region-wide perspective focused on outcomes.- Ensure local sensitivity through the creation of five Local Co...

  4. Responsibilities to Plan for Ancillary Care Pose Ethical Challenges for Nutrition Research in the Community Setting12

    OpenAIRE

    Merritt, Maria W.; Taylor, Holly A.

    2012-01-01

    Investigators who conduct nutrition research in the community setting, particularly among underserved populations, face the ethical question of whether and how to respond to participants’ unmet health needs. The research ethics literature conceptualizes this question as one of ancillary care (AC): what is the nature and extent of researchers’ ethical responsibilities, if any, to provide or facilitate health care that research participants need but that is not necessary to ensure the safety or...

  5. Health Utility Scores for People With Type 2 Diabetes in U.S. Managed Care Health Plans

    OpenAIRE

    Zhang, Ping; Brown, Morton B.; Bilik, Dori; Ackermann, Ronald T.; Li, Rui; Herman, William H.

    2012-01-01

    OBJECTIVE To estimate the health utility scores associated with type 2 diabetes, its treatments, complications, and comorbidities. RESEARCH DESIGN AND METHODS We analyzed health-related quality-of-life data, collected at baseline during Translating Research Into Action for Diabetes, a multicenter, prospective, observational study of diabetes care in managed care, for 7,327 individuals with type 2 diabetes. We measured quality-of-life using the EuroQol (EQ)-5D, a standardized instrument for wh...

  6. River Protection Double-Shell Tank Waste Retrieval Authorization Basis Amendment Task Plan

    International Nuclear Information System (INIS)

    This task plan is a documented agreement between Nuclear Safety and Licensing and Retrieval Engineering. The purpose of this task plan is to identify the scope of work, tasks and deliverables, responsibilities, manpower, and schedules associated with an authorization basis amendment as a result of the Waste Feed Delivery Program, Project W-211, Project W-521, and Project W-522

  7. Soil pollution in day-care centers and playgrounds in Norway: national action plan for mapping and remediation.

    Science.gov (United States)

    Ottesen, Rolf Tore; Alexander, Jan; Langedal, Marianne; Haugland, Toril; Høygaard, Erik

    2008-12-01

    Systematic geochemical mapping based on sampling and analysis of surface soils (0-2 cm) has been carried out in several Norwegian cities. The soils in the oldest parts of the cities are contaminated with metals (especially Pb) and polycyclic aromatic hydrocarbons (PAH). Due to the fact that children are often in contact with surface soil, it was realized that special focus had to be directed towards soils in day-care centers and playgrounds. The first mapping and remedy program was initiated in Trondheim in 1996. Here, the importance of copper-chromium-arsenic (CCA)-pressure-impregnated wood in playing equipment as a pollution source for soils was documented, and a process was started with the aim to ban this product. Soils from day-care centers in the inner city of Bergen were polluted to a degree that required remediation in 45% out of 87 centers, mainly due to high concentrations of Pb and benzo(a)pyrene. In Oslo, 38% of 700 day-care centers needed remediation due to soil pollution by Pb, BaP, Cd, Hg, Ni and PCB. Removal of CCA-impregnated wood was necessary in more than half of the day-care centers The Norwegian parliament has decided to investigate all outdoor playing areas in day-care centers, playgrounds and schoolyards in Norway, starting in 2007 with day-care centers in the ten largest cities and five most important industrial areas. The Norwegian Institute of Public Health has developed quality criteria for soils in day-care centers and playgrounds for As, Cd, Cr(6+), Hg, Ni, Pb, zinc, PAH(sum16), benzo(a)pyrene, and PCB(sum7). The Geological Survey of Norway has developed guidance for mapping of soil pollution (sampling, chemical analysis and reporting) in day-care centers. Especially the sampling strategy has been developed in the period 1996-2007, and the preferred sampling strategy is to collect at least 10 samples of surface soil (0-2 cm) from (1) "original soil" on the site, (2) artificial man-made "hills", and (3) soils used for growing vegetables

  8. Family planning barriers in marginal contexts in Mexico City, Federal District: vision of the health care provider

    OpenAIRE

    Marcela Agudelo B

    2009-01-01

    Objective: To approach the barriers to providing services of family planning in marginal areas of Iztapalapa and Tlalpan in the Federal District of Mexico City, from the perspective of health providers. Methodology: Qualitative exploration involved through focus groups with healthcare providers, both public and private, further topics such as socio-environmental, unmet needs in sexual and reproductive health (including family planning), relations gender, among others. Results:We found that ...

  9. Predictors of dentists’ behaviours in delivering prevention in primary dental care in England: using the theory of planned behaviour

    OpenAIRE

    Yusuf, Huda; Kolliakou, Anna; Ntouva, Antiopi; Murphy, Marie; Newton, Tim; Tsakos, Georgios; Richard G. Watt

    2016-01-01

    BACKGROUND: To explore the factors predicting preventive behaviours among NHS dentists in Camden, Islington and Haringey in London, using constructs from the Theory of Planned Behaviour.METHODS: A cross-sectional survey of NHS dentists working in North Central London was conducted. A self-completed questionnaire based on the theoretical framework of the Theory of Planned Behaviour was developed. It assessed dentists' attitudes, current preventive activities, subjective norms and perceived beh...

  10. Clinician Adoption Patterns and Patient Outcome Results in Use of Evidence-Based Nursing Plans of Care

    Science.gov (United States)

    Kim, Tae Youn; Lang, Norma M.; Berg, Karen; Weaver, Charlotte; Murphy, Judy; Ela, Sue

    2007-01-01

    Delivery of safe, effective and appropriate health care is an imperative facing health care organizations globally. While many initiatives have been launched in a number of countries to address this need from a medical perspective, a similar focus for generating evidence-based nursing knowledge has been missing [1]. This paper reports on a collaborative evidence-based practice (EBP) research initiative that adds nursing knowledge into computerized care protocols. Here, a brief overview of the study’s aims, purpose and methodology is presented as well as results of data analysis and lessons learned. The research team examined nurses’ adoption patterns of EBP recommendations with respect to activity tolerance using four-month patient data collected from a pilot hospital. Study findings indicate a need for more focus on the system design and implementation process with the next rollout phase to promote evidence-based nursing practice. PMID:18693871

  11. Still-Born Autonomy Insurance Plan in Quebec: An Example of a Public Long-Term Care Insurance System in Canada.

    Science.gov (United States)

    Hébert, Réjean

    2016-01-01

    Funding long-term care (LTC) is a challenge under the existing Beveridgean universal healthcare system. The Autonomy Insurance (AI) plan developed in Quebec was an attempt to introduce public LTC insurance into our healthcare system. The AI benefit was based on an assessment of the needs of older people and those with disabilities using a disability scale (SMAF) and case-mix classification system (Iso-SMAF Profiles). Under the plan, the benefit would be used to fund public institutions or purchase services from private organizations. Case managers were responsible for assessments and helping users and their families plan services and decide how to use the AI benefit. Funding AI was based on general tax revenues without capitalized funding, under a separate protected budget program. Projections were made for the additional budget needed to support AI, which would have mitigated the forecast increase in LTC spending due to population aging. All the legal, administrative, funding, training and contractual issues were dealt with, for implementation of the plan in April 2015. Unfortunately, the project was still-born for political reasons, but it demonstrates the feasibility of this essential innovation for Canada. PMID:27230719

  12. The prospective United Kingdom nuclear energy programme up to 2000 AD and the UKAEA's role and manpower requirements

    International Nuclear Information System (INIS)

    This paper begins by surveying the development of the United Kingdom nuclear industry, its organization in both the public and private sectors of the economy, and changes in the numbers employed up to the present day. The possible future nuclear programme and overall manpower needs, and the UKAEA's role and manpower requirements within this programme, are outlined. Manpower problems arising from national shortages of engineers and technicians and reviews of arrangements for their education and training, and also from the pattern of historical development of the UKAEA, are described. UKAEA arrangements for formulating and implementing personnel policies, current policies for recruitment, carrier management and in-service training and their relationship to present and future needs are then discussed. The final section draws attention to UKAEA facilities for the training of staff from other organizations in the United Kingdom and from overseas. (author)

  13. Indian experience in the training of manpower for a nuclear power programme

    International Nuclear Information System (INIS)

    In India manpower training for the nuclear power programme started several years before the introduction of nuclear power plants. Early efforts were concentrated on developing manpower in basic sciences related to nuclear power. The setting up of the Bhabha Atomic Research Centre was an important step in this direction. This enabled the first batch of engineers and scientists to be trained on design and operation in the programmes connected with research reactors and use of isotopes in industry, agriculture and medicine. The next step was to establish a Training School in the Centre where young university graduates could be given courses in their own and interconnected disciplines of nuclear sciences. An interdisciplinary approach with teaching by working scientists and engineers and attachment for short periods to the research laboratories is the framework of this training programme. At present about 3000 graduates from this Training School are involved in various capacities in India's nuclear power programme. With the commissioning of the first power reactors, it became necessary to train engineers, scientists and technicians for the operation and maintenance of such systems on a larger scale. For this purpose, a separate training centre at Rajasthan Atomic Power Project was set up. Models, simulators and courses with emphasis on heavy water reactors were introduced. In addition, a number of craftsmen for servicing equipment have also been trained in power station equipment maintenance. The paper describes the development of this programme in its present form. (author)

  14. Meeting the manpower challenge in the transfer of nuclear power to developing countries

    International Nuclear Information System (INIS)

    The global needs for staffing personnel of nuclear power plants and fuel cycle facilities to 1990 indicate continued stress on the international technical manpower supply. When considering the manpower and training necessary for the execution of a country's first nuclear project, the burden imposed on the purchaser's organization needs to be clearly understood. The work load and the responsibilities that cannot be transferred to other organizations are usually underestimated. In assessing the magnitude of the workload, four important points should be emphasized: (1) The responsibility for the ultimate success or failure of the nucler project must be borne by the purchaser's organization. Contractors can assume responsibility for the performance of specific tasks but not for the entire project. (2) Even in a turnkey contract, the prime contractor normally will not assume financial responsibility for the performance of the local subcontractors. (3) Many areas of a nuclear project involving domestic bureaucracy, politics, regulations, etc., can be dealt with effectively only be nationals. (4) The most serious problems experienced in developing country projects to date have not been the type which require additional personnel with advanced academic training in nuclear science and technology, but rather (a) personnel with practical experience and training in the organizational, contractual, and administrative aspects of large projects, and (b) technicians and skilled craft labour. (author)

  15. 77 FR 72581 - Patient Protection and Affordable Care Act; Establishment of the Multi-State Plan Program for the...

    Science.gov (United States)

    2012-12-05

    ... phase-in period to fully participate in the SHOP. \\37\\ 77 FR at 18401 (March 27, 2012). 3. Authority To... offers coverage over four years, but it must offer MSPs on Exchanges in all States and the District of... U.S. Office of Personnel Management PHS Act Public Health Service Act QHP Qualified Health Plan...

  16. 78 FR 15559 - Patient Protection and Affordable Care Act; Establishment of the Multi-State Plan Program for the...

    Science.gov (United States)

    2013-03-11

    ... December 5, 2012, OPM published proposed regulations (77 FR 72582) establishing the MSPP at part 800 of... that their MSPs do not discriminate based on race, color, national origin, disability, age, sex, gender... Employee Dental and Vision Insurance Program (FEDVIP) dental or vision plan option, respectively,...

  17. Family Planning Knowledge: The Role of Social Networks and Primary Care Providers as Information Sources for African American Women

    Science.gov (United States)

    Blackstock, Oni J.; Mba-Jonas, Adamma; Sacajiu, Galit M.

    2010-01-01

    Disparities in the rates of unintended pregnancy have increased for low-income African American women as compared to other groups due, in part, to declining contraception use. Women obtain family planning information from diverse sources, which may ultimately influence contraceptive decision making. For this qualitative study, we conducted…

  18. Individual Plans for Children in Transition to Pre-School: A Case Study in One Finnish Day-Care Centre

    Science.gov (United States)

    Turunen, Tuija A.

    2012-01-01

    This paper outlines a case study on teachers' and parents' perspectives on children's individual plans in transition from early childhood education to pre-school in Finland. The study was based on the importance of continuity as a part of positive educational transition experiences. The national curricula, educators' interpretations and parents'…

  19. Comprehensive dental health care program at an orphanage in Nellore district of Andhra Pradesh

    OpenAIRE

    Dhanya Muralidharan; Nusrath Fareed; Shanthi, M.

    2012-01-01

    Background: Provision of oral health care in India, especially for the underprivileged is limited due to inadequate finances and manpower. Resources of dental colleges in such a scenario can be utilized to provide prevention oriented oral health care. Aim: To improve the oral health status of children at an institute in Nellore district of Andhra Pradesh, India, through prevention based comprehensive dental health care program (CDHP). Design and Setting: A longitudinal institution bas...

  20. Barriers to shared decision making in mental health care:qualitative study of the Joint Crisis Plan for psychosis

    OpenAIRE

    Farrelly, Simone; Lester, Helen; Rose, Diana; Birchwood, Max; Marshall, Max; Waheed, Waquas; Henderson, R. Claire; Szmukler, George; Thornicroft, Graham

    2016-01-01

    BackgroundDespite increasing calls for shared decision making (SDM), the precise mechanisms for its attainment are unclear. Sharing decisions in mental health care may be especially complex. Fluctuations in service user capacity and significant power differences are particular barriers.Objective and designWe trialled a form of facilitated SDM that aimed to generate patients' treatment preferences in advance of a possible relapse. The ‘Joint Crisis Plan’ (JCP) intervention was trialled in four...

  1. Proceedings of the AMCP Partnership Forum: NCPDP Electronic Prior Authorization Standards-Building a Managed Care Implementation Plan.

    Science.gov (United States)

    2015-07-01

    Today's manual prior authorization (PA) process is often viewed by providers, payers, pharmacists, and patients as cumbersome, costly, and inefficient. The recent approval by the National Council for Prescription Drug Programs of a standard transaction for electronic prior authorization (e-PA) has paved the way for more rapid and efficient processing of PA requests. On April 23, 2014, the Academy of Managed Care Pharmacy (AMCP) convened a meeting of key stakeholders to explore how to support the process of implementing the new standard transactions for e-PA and to recommend activities and programs that AMCP can promote to speed the adoption of e-PA. This Partnership Forum included individuals from managed care organizations, the pharmaceutical industry, pharmacy benefit managers, electronic prescription hubs or networks, and health information technology vendors. The speakers and panelists recommended that AMCP should develop measurable goals for staged and full implementation of e-PA. To accomplish this, it was recommended that AMCP work to collaborate with organizations representing these stakeholders. Additionally, it was recommended that AMCP develop managed care e-PA implementation and e-PA criteria guides, as well as an e-PA scorecard. PMID:26108378

  2. [Part II. Scientific evidence in end-stage chronic organ failure. A position paper on shared care planning].

    Science.gov (United States)

    Gristina, Giuseppe R; Orsi, Luciano; Carlucci, Annalisa; Causarano, Ignazio R; Formica, Marco; Romanò, Massimo

    2014-01-01

    The therapeutic options related to chronic organ failure are interconnected to the variability of human biological responses and the personal history and choices of the chronically ill patient on one hand, and with the variable human answers to therapies on the other hand. All these aspects may explain the small number and low quality of studies aimed to define the clinical criteria useful in identifying end-stage chronically ill patients, as highlighted through the 2012-2013 Medline survey performed by the task force. These results prevented the grading of scientific evidence. However, taking into account the evidence based medicine definition, the task force believes the clinical reasoning and the individual experience of clinicians as well as the patients and families preferences cannot be replaced "tout court" with a strict methodological research. Accordingly, the working method selected by the task force members was to draw up a set of clinical parameters based on the available scientific literature, submitting it to a peer review process carried out by an expert panel. This paper discusses a set of clinical parameters included in the clinical decision-making algorithm and shared by nine medical societies. For each chronic organ failure these clinical parameters should be intended not as a rigid cutoff system to make a choice between two selected care options (intensive vs palliative), rather as the starting point for a joint and careful consideration regarding the opportunity to adopt the clinical decision-making algorithm care proposed in Part I. PMID:24553593

  3. Integration of family planning with national health services. Integration de la planification familiale aux services nationaux de sante.

    Science.gov (United States)

    Mandara, N

    1984-09-01

    After independence in the 1960s, most African government inherited health structures that were curative oriented, costly, and directed toward the urban population. Primary health care, oriented toward prevention, promotion, improvement of the environment, cure, and rehabilitation, has since been adopteed as a better approach to health in Africa. This approach aims to integrate health care with thee activities of other seectors and places relicance on available community resources. An unexpected change has been the transformation of social and political attitudes toward family planning as a basic human right, a concomitant to heealth, and an integral part of socioeconomic development. Family planning is gradually being integrated into the maternal and child health services of all countries in Sub-Saharan Africa. In some cases, the government has assumed service delivery responsibilities previously carried out by family planning associations, thereby changing the association's role to that of education and motivation. Other countries have faced duplication of services and wastage of resources as a result of integration. There is a need for an overall evaluation of the integrated family planning-maternal and child heath services to determine future priorities and strategies. Problems so far encountered have included coverage, acceptability, accessibility, quality and continuity of care, data collection, and limited resources. However, cost factors, the shortage of trained manpower, the lack of facilities, and prevailing cultural and religious attitudes suggest the advisibility of integrated rather than vertical health programs in Africa. For both planning and administrative purposes, it is necessary to have a central Maternal and Child Health-Family Planning unit within the Ministry of Health as well as regional and district units. PMID:12266426

  4. Critical care during epidemics

    OpenAIRE

    Rubinson, Lewis; O'Toole, Tara

    2005-01-01

    We recommend several actions that could improve hospitals' abilities to deliver critical care during epidemics involving large numbers of victims. In the absence of careful pre-event planning, demand for critical care services may quickly exceed available intensive care unit (ICU) staff, beds and equipment, leaving the bulk of the infected populace without benefit of potentially lifesaving critical care. The toll of death may be inversely proportional to the ability to augment critical care c...

  5. Universal Access to HIV prevention, treatment and care: assessing the inclusion of human rights in international and national strategic plans

    OpenAIRE

    Gruskin, Sofia; Tarantola, Daniel

    2008-01-01

    Rhetorical acknowledgment of the value of human rights for the AIDS response continues, yet practical application of human rights principles to national efforts appears to be increasingly deficient. We assess the ways in which international and national strategic plans and other core documents take into account the commitments made by countries to uphold human rights in their efforts towards achieving Universal Access. Key documents from the Joint United Nations Programme on HIV and AIDS (UNA...

  6. Family planning barriers in marginal contexts in Mexico City, Federal District: vision of the health care provider

    Directory of Open Access Journals (Sweden)

    Marcela Agudelo B

    2009-08-01

    Full Text Available Objective: To approach the barriers to providing services of family planning in marginal areas of Iztapalapa and Tlalpan in the Federal District of Mexico City, from the perspective of health providers. Methodology: Qualitative exploration involved through focus groups with healthcare providers, both public and private, further topics such as socio-environmental, unmet needs in sexual and reproductive health (including family planning, relations gender, among others. Results:We found that among the main obstacles to access to family planning services are misinformation, culture and population beliefs, the inadequate training of health professionals in related areas, the shortage methods o f contraception, the deficiency infrastructure and resources. The barriers perceived by providers are coming from the people, and seldom alluded to the barriers arising from service of their own profession and/or personal convictions. Conclusion: Although the study focused on a specific social environment, this could reflect a reality in other contexts with similar characteristics, so this work constitutes a contribution to both practical and methodological analysis of the phenomenon.

  7. Using Integer Programming for Airport Service Planning in Staff Scheduling

    OpenAIRE

    Ip, W. H.; Nick Chung; George Ho

    2010-01-01

    Reliability and safety in flight is extremely necessary and that depend on the adoption of proper maintenance system. Therefore, it is essential for aircraft maintenance companies to perform the manpower scheduling efficiently. One of the objectives of this paper is to provide an Integer Programming approach to determine the optimal solutions to aircraft maintenance planning and scheduling and hence the planning and scheduling processes can become more efficient and effective. Another objecti...

  8. Savannah River Site environmental implementation plan

    International Nuclear Information System (INIS)

    Formal sitewide environmental planning at the Savannah River Site (SRS) began in 1986 with the development and adoption of the Strategic Environmental Plan. The Strategic Environmental Plan describes the philosophy, policy, and overall program direction of environmental programs for the operation of the SRS. The Strategic Environmental Plan provided the basis for development of the Environmental Implementation Plan (EIP). The EIP is the detailed, comprehensive environmental master plan for operating contractor organizations at the SRS. The EIP provides a process to ensure that all environmental requirements and obligations are being met by setting specific measurable goals and objectives and strategies for implementation. The plan is the basis for justification of site manpower and funding requests for environmental projects and programs over a five-year planning period

  9. Savannah River Site Environmental Implementation Plan

    Energy Technology Data Exchange (ETDEWEB)

    1989-08-01

    Formal sitewide environmental planning at the . Savannah River Site (SRS) began in 1986 with the development and adoption of the Strategic Environmental Plan. The Strategic Environmental Plan describes the philosophy, policy, and overall program direction of environmental programs for the operation of the SRS. The Strategic Environmental Plan (Volume 2) provided the basis for development of the Environmental Implementation Plan (EIP). The EIP is the detailed, comprehensive environmental master plan for operating contractor organizations at the SRS. The EIP provides a process to ensure that all environmental requirements and obligations are being met by setting specific measurable goals and objectives and strategies for implementation. The plan is the basis for justification of site manpower and funding requests for environmental projects and programs over a five-year planning period.

  10. Savannah River Site Environmental Implementation Plan

    International Nuclear Information System (INIS)

    Formal sitewide environmental planning at the . Savannah River Site (SRS) began in 1986 with the development and adoption of the Strategic Environmental Plan. The Strategic Environmental Plan describes the philosophy, policy, and overall program direction of environmental programs for the operation of the SRS. The Strategic Environmental Plan (Volume 2) provided the basis for development of the Environmental Implementation Plan (EIP). The EIP is the detailed, comprehensive environmental master plan for operating contractor organizations at the SRS. The EIP provides a process to ensure that all environmental requirements and obligations are being met by setting specific measurable goals and objectives and strategies for implementation. The plan is the basis for justification of site manpower and funding requests for environmental projects and programs over a five-year planning period

  11. PERSONNEL PLANNING. A COMPARATIVE OUTLOOK

    Directory of Open Access Journals (Sweden)

    Catalin Constantin SAMOILA

    2015-10-01

    Full Text Available From a very wide perspective, planning has raised lots of issues over time. Management and business theory struggle to teach what planning is, and why it is so dramatically important, in a manner which seemingly quotes Antoine de Saint-Exupery -“A goal without a plan is just a wish”, or sets up awareness through Benjamin Franklin’s famous words -“By failing to prepare, you are preparing to fail” [1]. However, some voices are circumspect or balance between the usefulness of plans and planning: “… plans are useless, but planning is indispensable” [2], while others, sporadically but decisively, criticize the entire organizational planning process, presenting it as a total failure [3]. Sometimes the ‘cons’ are right, meaning that real life might bring more surprise than ever expected. Even so, organizations benefit from planning by trying at least to ‘see’ one step forward, and to avoid total uncertainty or critical situations, if not to improve. The military ones are not exempt. Military planning has become the organic environment for such organizations since Napoleonic wars, or even longer ago. This present attempt does not intend to deeply analyze the antagonist advocacies over planning, but to bring under comparison, in a brief manner, the business-shaped theoretical approach of planning, against the real concerns of the Romanian military system in terms of manpower planning.

  12. Immigration and Emigration of Professional and Skilled Manpower During the Post-War Period. Special Study No. 1.

    Science.gov (United States)

    Parai, Louis

    The impact of immigration and emigration on Canada's stock of professional and skilled manpower was analyzed for the period 1946-1963. Although the number of immigrants is recorded by Canadian authorities there is no complete record of emigration from Canada; however, a reasonably reliable picture was obtained from emigration data of other…

  13. A Study of Career Ladders and Manpower Development for Non-Management Personnel in the Food Service Industry.

    Science.gov (United States)

    State Univ. of New York, Ithaca. School of Hotel Administration at Cornell Univ.

    Because of its failure to provide career ladders for non-management employees, the food service industry is facing increasingly severe manpower shortages and labor turnover. Unnecessary requirements bar entry workers from many jobs, and training opportunities leave much to be desired. This report identifies the problem areas and develops a model…

  14. Gender Wage Gaps by College Major in Taiwan: Empirical Evidence from the 1997-2003 Manpower Utilization Survey

    Science.gov (United States)

    Lin, Eric S.

    2010-01-01

    In this article, we examine the effect of incorporating the fields of study on the explained and unexplained components of the standard Oaxaca decomposition for the gender wage gaps in Taiwan using 1997-2003 Manpower Utilization Survey data. Using several existing and lately developed measures, we inspect the gender wage gap by college major to…

  15. 75 FR 41522 - Hewlett Packard, Technical Support Call Center, Including On-Site Leased Workers From Manpower...

    Science.gov (United States)

    2010-07-16

    ... Employment and Training Administration Hewlett Packard, Technical Support Call Center, Including On-Site... workers of Hewlett Packard, Technical Support Call Center, including on-site leased workers from Manpower, Volt, and Adecco, Boise, Idaho. The notice was published in the Federal Register March 12, 2010 (75...

  16. Careful treatment planning enables safe ablation of liver tumors adjacent to major blood vessels by percutaneous irreversible electroporation (IRE)

    International Nuclear Information System (INIS)

    Irreversible electroporation (IRE) is a tissue ablation method, which relies on the phenomenon of electroporation. When cells are exposed to a sufficiently electric field, the plasma membrane is disrupted and cells undergo an apoptotic or necrotic cell death. Although heating effects are known IRE is considered as non-thermal ablation technique and is currently applied to treat tumors in locations where thermal ablation techniques are contraindicated. The manufacturer of the only commercially available pulse generator for IRE recommends a voltage-to-distance ratio of 1500 to 1700 V/cm for treating tumors in the liver. However, major blood vessels can influence the electric field distribution. We present a method for treatment planning of IRE which takes the influence of blood vessels on the electric field into account; this is illustrated on a treatment of 48-year-old patient with a metastasis near the remaining hepatic vein after a right side hemi-hepatectomy. Output of the numerical treatment planning method shows that a 19.9 cm3 irreversible electroporation lesion was generated and the whole tumor was covered with at least 900 V/cm. This compares well with the volume of the hypodense lesion seen in contrast enhanced CT images taken after the IRE treatment. A significant temperature raise occurs near the electrodes. However, the hepatic vein remains open after the treatment without evidence of tumor recurrence after 6 months. Treatment planning using accurate computer models was recognized as important for electrochemotherapy and irreversible electroporation. An important finding of this study was, that the surface of the electrodes heat up significantly. Therefore the clinical user should generally avoid placing the electrodes less than 4 mm away from risk structures when following recommendations of the manufacturer

  17. Measuring nursing essential contributions to quality patient care outcomes.

    Science.gov (United States)

    Wolgast, Kelly A; Taylor, Katherine; Garcia, Dawn; Watkins, Miko

    2011-01-01

    Workload Management System for Nursing (WMSN) is a core Army Medical Department business system that has provided near real-time, comprehensive nursing workload and manpower data for decision making at all levels for over 25 years. The Army Manpower Requirements and Documentation Agency populates data from WMSN into the Manpower Staffing Standards System (Inpatient module within Automated Staffing Assessment Model). The current system, Workload Management System for Nursing Internet (WMSNi), is an interim solution that requires additional functionalities for modernization and integration at the enterprise level. The expanding missions and approved requirements for WMSNi support strategic initiatives on the Army Medical Command balanced scorecard and require continued sustainment for multiple personnel and manpower business processes for both inpatient and outpatient nursing care. This system is currently being leveraged by the TRICARE Management Activity as an interim multiservice solution, and is being used at 24 Army medical treatment facilities. The evidenced-based information provided to Army decision makers through the methods used in the WMSNi will be essential across the Army Medical Command throughout the system's life cycle. PMID:22124876

  18. Increasing efficacy of primary care-based counseling for diabetes prevention: Rationale and design of the ADAPT (Avoiding Diabetes Thru Action Plan Targeting trial

    Directory of Open Access Journals (Sweden)

    Mann Devin M

    2012-01-01

    Full Text Available Abstract Background Studies have shown that lifestyle behavior changes are most effective to prevent onset of diabetes in high-risk patients. Primary care providers are charged with encouraging behavior change among their patients at risk for diabetes, yet the practice environment and training in primary care often do not support effective provider counseling. The goal of this study is to develop an electronic health record-embedded tool to facilitate shared patient-provider goal setting to promote behavioral change and prevent diabetes. Methods The ADAPT (Avoiding Diabetes Thru Action Plan Targeting trial leverages an innovative system that integrates evidence-based interventions for behavioral change with already-existing technology to enhance primary care providers' effectiveness to counsel about lifestyle behavior changes. Using principles of behavior change theory, the multidisciplinary design team utilized in-depth interviews and in vivo usability testing to produce a prototype diabetes prevention counseling system embedded in the electronic health record. Results The core element of the tool is a streamlined, shared goal-setting module within the electronic health record system. The team then conducted a series of innovative, "near-live" usability testing simulations to refine the tool and enhance workflow integration. The system also incorporates a pre-encounter survey to elicit patients' behavior-change goals to help tailor patient-provider goal setting during the clinical encounter and to encourage shared decision making. Lastly, the patients interact with a website that collects their longitudinal behavior data and allows them to visualize their progress over time and compare their progress with other study members. The finalized ADAPT system is now being piloted in a small randomized control trial of providers using the system with prediabetes patients over a six-month period. Conclusions The ADAPT system combines the influential

  19. The diverse impact of advance care planning: a long-term follow-up study on patients' and relatives' experiences

    DEFF Research Database (Denmark)

    Andreassen, Pernille; Neergaard, Mette Asbjørn; Brogaard, Trine;

    2015-01-01

    : A qualitative follow-up interview study. Interviews were recorded, transcribed and analysed using thematic synthesis. SETTING/PARTICIPANTS: 3 patients with a life-limiting disease (lung or heart disease), affiliated with a major Danish hospital, and 7 relatives were interviewed 1 year after participating...... in an ACP discussion. RESULTS: The experiences were diverse. Some patients and relatives felt 'relieved', 'more secure' and more in control due to ACP. To some, ACP had led to open communication rather than 'beating around the bush', and to spending more quality time together. However, others perceived ACP...... issues being 'tucked away'. CONCLUSIONS: The study reveals great diversity in patient and relative experiences of ACP. The study challenges previous research which mainly emphasises ACP as a valuable tool to optimise EOL care. This study stresses the importance of awareness of the highly individual...

  20. Using the collaborative intervention planning framework to adapt a health-care manager intervention to a new population and provider group to improve the health of people with serious mental illness

    OpenAIRE

    Cabassa, Leopoldo J.; Gomes, Arminda P.; Meyreles, Quisqueya; Capitelli, Lucia; Younge, Richard; Dragatsi, Dianna; Alvarez, Juana; Manrique, Yamira; Lewis-Fernández, Roberto

    2014-01-01

    Background Health-care manager interventions improve the physical health of people with serious mental illness (SMI) and could be widely implemented in public mental health clinics. Local adaptations and customization may be needed to increase the reach of these interventions in the public mental health system and across different racial and ethnic communities. In this study, we describe how we used the collaborative intervention planning framework to customize an existing health-care manager...

  1. A clinical method for physicians in palliative care: the four points of agreement vital to a consultation; context, issues, story, plan.

    Science.gov (United States)

    Noble, Bill; George, Rob; Vedder, Rachel

    2014-09-01

    In palliative care, where interactions cross clinical, pathological, psychological, social and spiritual considerations, it may be useful to take a minimal approach and avoid an overcomplicated or formulaic structure for the consultation. We will concern ourselves with points in the encounter where doctor and patient with or without family or carers need to be in agreement. Whether a consultation is based on a structured interview, a cue-based assessment or a narrative approach, the points of agreement or concordance need to cover four key areas; missing any of these has grave consequences for the clinical relationship. Without concordance, patients may be right to conclude that you don't know why you're all there (context), you don't know what's the matter (issues), you don't know what's going on (story) or you don't know what you're doing (plan). These four elements may serve also as a guide to the quality and effectiveness of an encounter among a doctor, patient and carers. We consider how this clinical method might integrate the nosological practices of doctors in palliative care services better, and we argue that finding concordance is likely to establish a better doctor-patient relationship at a human and professional level through empathy and trust rather than just a technical exchange. PMID:24644197

  2. Health-related quality of life before planned admission to intensive care: memory over three and six months

    Directory of Open Access Journals (Sweden)

    Tadini Laura

    2010-09-01

    Full Text Available Abstract Background The validity of Health-Related Quality of Life (HRQOL recalled by ICU admitted patients have not been published. The aim of this study was to compare the baseline HRQOL measured before surgery and ICU admission with that recalled at 3 and 6 months in a population of patients with planned ICU admission after surgery. Methods This prospective study was performed in three Italian centres on patients who had undergone General, Orthopaedic or Urologic surgery. All adult patients with planned ICU admission between October 2007 and July 2008 were considered for enrolment. At hospital admission, the Mini Mental Status Examination and EuroQoL (EQ questionnaire (referring to the last two weeks were administered to the patients who consented. Three and six months after ICU admission, the researchers administered by phone the EQ questionnaire and Post-Traumatic Stress Syndrome 14 questions Inventory, asking the patients to rate their HRQOL before surgery and ICU admission. Past medical history demographic and clinical ICU-related variables were collected. Statistical analysis Chi-square test and non parametric statistics were used to compare groups of patients. The EQ-5D was transformed in the time trade-off (TTO to obtain a continuous variable, subsequently analysed using the Intraclass Correlation Coefficient (ICC. Results Of the 104 patients assessed at baseline and discharged from the hospital, 93 had the EQ administered at 3 months, and 89 at 6 months. The ICC for TTO recalled at 3 months vs pre-ICU TTO was 0.851, and that for TTO recalled at 6 months vs pre-ICU TTO was 0.833. The ICC for the EQ-VAS recalled at 3 months vs pre-ICU EQ-VAS was 0.648, and that for the EQ-VAS recalled at 6 months vs pre-ICU EQ-VAS was 0.580. Forty-two (45% patients assessed at 3 months gave the same score in all EQ-5D items as at baseline. They underwent mainly orthopaedic surgery (p 0.011, and perceived the severity of their illness as lower (p 0

  3. Using the theory of planned behaviour as a process evaluation tool in randomised trials of knowledge translation strategies: A case study from UK primary care

    Directory of Open Access Journals (Sweden)

    Grimshaw Jeremy M

    2010-09-01

    Full Text Available Abstract Background Randomised trials of knowledge translation strategies for professional behaviour change can provide robust estimates of effectiveness, but offer little insight into the causal mechanisms by which any change is produced. To illustrate the applicability of causal methods within randomised trials, we undertook a theory-based process evaluation study within an implementation trial to explore whether the cognitions of primary care doctors' predicted their test requesting behaviours and, secondly, whether the trial results were mediated by the theoretical constructs. Methods The process evaluation comprised a cross-sectional questionnaire survey of a random 50% sample of the randomised groups of primary care practices in Grampian (NHS Grampian, UK, who took part in a trial of the effect of enhanced feedback and brief educational reminders on test requesting behaviour. The process evaluation was based upon the Theory of Planned Behaviour and focussed on three of the test requesting behaviours that were targeted in the trial -- ferritin, follicle stimulating hormone (FSH, and Helicobacter Pylori serology (HPS. Results The questionnaire was completed by 131 primary care doctors (56% from 42 (98% of the sampled practices. Behavioural intention, attitude, and subjective norm were highly correlated for all the tests. There was no evidence that perceived behavioural control was correlated with any of the other measures. Simple linear regression analysis of the rate of test requests on minimum behavioural intentions had R2 of 11.1%, 12.5%, and 0.1% for ferritin, FSH, and HPS requesting, respectively. Mediational analysis showed that the trial results for ferritin and FSH were partially mediated (between 23% and 78% mediation through intentions. The HPS trial result was not mediated through intention. Conclusions This study demonstrated that a theory-based process evaluation can provide useful information on causal mechanisms that aid not

  4. Using the theory of planned behaviour as a process evaluation tool in randomised trials of knowledge translation strategies: A case study from UK primary care

    Science.gov (United States)

    2010-01-01

    Background Randomised trials of knowledge translation strategies for professional behaviour change can provide robust estimates of effectiveness, but offer little insight into the causal mechanisms by which any change is produced. To illustrate the applicability of causal methods within randomised trials, we undertook a theory-based process evaluation study within an implementation trial to explore whether the cognitions of primary care doctors' predicted their test requesting behaviours and, secondly, whether the trial results were mediated by the theoretical constructs. Methods The process evaluation comprised a cross-sectional questionnaire survey of a random 50% sample of the randomised groups of primary care practices in Grampian (NHS Grampian), UK, who took part in a trial of the effect of enhanced feedback and brief educational reminders on test requesting behaviour. The process evaluation was based upon the Theory of Planned Behaviour and focussed on three of the test requesting behaviours that were targeted in the trial -- ferritin, follicle stimulating hormone (FSH), and Helicobacter Pylori serology (HPS). Results The questionnaire was completed by 131 primary care doctors (56%) from 42 (98%) of the sampled practices. Behavioural intention, attitude, and subjective norm were highly correlated for all the tests. There was no evidence that perceived behavioural control was correlated with any of the other measures. Simple linear regression analysis of the rate of test requests on minimum behavioural intentions had R2 of 11.1%, 12.5%, and 0.1% for ferritin, FSH, and HPS requesting, respectively. Mediational analysis showed that the trial results for ferritin and FSH were partially mediated (between 23% and 78% mediation) through intentions. The HPS trial result was not mediated through intention. Conclusions This study demonstrated that a theory-based process evaluation can provide useful information on causal mechanisms that aid not only interpretation of

  5. Distribución de recursos del Plan de Atención Básico con criterio de equidad, Bogotá 2002 Resource distribution for the Basic Care Plan with equity approach, Bogotá 2002

    Directory of Open Access Journals (Sweden)

    Juan Fernado Ospina Giraldo

    2003-10-01

    Full Text Available OBJETIVO: Aplicar una técnica que oriente la distribución de recursos financieros del Plan de Atención Básico para acciones colectivas, según las condiciones de salud diferenciales. MÉTODOS: Se parte de la estimación previa de un índice global de salud mediante análisis de componentes principales, que jerarquiza las localidades de Bogotá, Colombia, en grupos según su estado de salud: "peor" estado, "intermedio" y "mejor" que los anteriores. Se aplica una técnica de mínimos cuadrados que minimice la diferencia entre el índice global de salud observado y un índice esperado con la inversión de tales recursos. RESULTADOS: Se obtiene la distribución de los recursos del Plan de Atención Básico para las veinte Localidades, destinando una cifra superior a la mediana Distrital en las Localidades con "peor" estado de salud. Además, se identifican las Localidades con déficit para el cubrimiento universal de la población de acuerdo con la destinación per cápita de dichos recursos. CONCLUSIÓN: La técnica utilizada pone en evidencia la diferencia en las condiciones de salud entre las localidades con "peor" estado de salud, con respecto a las localidades con "mejor" estado, a pesar de la incremento en la asignación del Plan de Atención Básico, indicando la necesidad de inversión social a nivel intersectorial en dichas localidades.OBJECTIVE: To apply a technique that will guide financial resources distribution for the Basic Care Plan for carrying out collective actions according to different health conditions. METHODS: A prior estimation of a global health index was performed by means of the analysis of major components prioritizing areas of Bogotá according to their health condition: "poor", "intermediate," and "good". A square minimum technique was applied to minimize difference between observed and expected global health index after resource investment. RESULTS: Resource distribution for the Basic Care Plan was achieved for

  6. Hospitals - MEDICAL_CARE_FACILITIES_MHMP_IN: Medical Care Facilities in Indiana, derived from Essential Facilities Data of the Multi-Hazard Mitigation Planning Data (The Polis Center, Point Shapefile)

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — MEDICAL_CARE_FACILITIES_MHMP_IN.SHP is a point shapefile that shows medical care facilities in Indiana. MEDICAL_CARE_FACILITIES_MHMP_IN.SHP was derived from the...

  7. Care plan for HIV+ patients in specialized Aids centers inBrazil: Pharmacotherapeutic form and pilot study

    Directory of Open Access Journals (Sweden)

    Henry Pablo Lopes Campos e Reis

    2014-03-01

    The objective of this study is to describe a pharmacotherapy form model to monitor patients’ pharmacotherapeutic follow-up (PF on antiretroviral therapy in a specialized center of Ceará, Brazil. Description comprises its structure up to application. The preparation and application of the PF registration model were carried out by means of a focal group. The following steps were used for the draft: 1. Review of the literature; 2. Diagnosis of place where pharmaceutical care was undertaken; 3. Choice of the PF method; 4. Selection of clinical indicators; 5. Evaluation by a committee of experts; 6. Development of a standard functional procedure with timetable and evaluation frequency of the tool’s different sections or blocks. 7. Pilot study for evaluation of the form with 25 patients. PF form featured six sections comprising patient’s personal data, pharmaceutical anamnesis and records of adherence evaluation, etc. The description and format of the sections are presented in current essay. Further, 322 issues related to antiretroviral drugs were reported during form filling. The multi-section PF form seemed appropriate and applicable for the report of issues related to antiretroviral drugs in HIV positive patients. It was also a helpful guide for pharmaceutical interventions by a multiprofessional team in specialized healthcare settings.

  8. Health Informatics, Sustainable Health Care Development and Malnutrition in India

    OpenAIRE

    RS Balgir

    2011-01-01

    Health informatics aims at studying the principal computer applications related to technology in developing human health care and solving the existing problems to facilitate efficient management. It helps in decision making process, hospital administration and system management and in catering the needs of clients/patients and doctors. However, the inadequacy of skilled manpower, resources and economy are the major hurdles to exploit the full potential of the technology and medical health fac...

  9. A complex regional intervention to implement advance care planning in one town's nursing homes: Protocol of a controlled inter-regional study

    Directory of Open Access Journals (Sweden)

    Briggs Linda

    2011-01-01

    Full Text Available Abstract Background Advance Care Planning (ACP is an emerging strategy to ensure that well-reflected, meaningful and clearly documented treatment preferences are available and respected when critical decisions about life-sustaining treatment need to be made for patients unable to consent. In Germany, recent legislation confirms that advance directives (AD have to be followed if they apply to the medical situation, but implementation of ACP has not yet been described. Methods/Design In a longitudinal controlled study, we compare 1 intervention region (4 nursing homes [n/hs], altogether 421 residents with 2 control regions (10 n/hs, altogether 985 residents. Inclusion went from 01.02.09 to 30.06.09, observation lasted until 30.06.10. Primary endpoint is the prevalence of ADs at follow-up, 17 (12 months after the first (last possible inclusion. Secondary endpoints compare relevance and validity of ADs, process quality, the rate of life-sustaining interventions and, in deceased residents, location of death and intensity of treatment before death. The regional multifaceted intervention on the basis of the US program Respecting Choices® comprises training of n/h staff as facilitators, training of General Practitioners, education of hospital and ambulance staff, and development of eligible tools, including Physician Orders for Life-Sustaining Treatment in case of Emergency (POLST-E. Participation data: Of 1406 residents reported to live in the 14 n/hs plus an estimated turnover of 176 residents until the last possible inclusion date, 645 (41% were willing to participate. Response rates were 38% in the intervention region and 42% in the control region. Non-responder analysis shows an equal distribution of sex and age but a bias towards dependency on nursing care in the responder group. Outcome analysis of this study will become available in the course of 2011. Discussion Implementing an ACP program for the n/hs and related health care providers of a

  10. Program plan for US Department of Energy support for nuclear engineering education

    International Nuclear Information System (INIS)

    This document describes the plan developed to address the growing concern for the continued deterioration of nuclear engineering education in the United States and its ability to meet the manpower demands for this Nation's work force requiring nuclear related talent in the foreseeable future

  11. Survey of dental manpower resource in Beijing%北京市口腔执业医师人力资源现状分析

    Institute of Scientific and Technical Information of China (English)

    张紫云; 赵丽颖; 孙正

    2014-01-01

    目的:分析2012年北京市口腔医疗机构及口腔医师人力资源现状,为相关部门合理配置口腔卫生人力资源,优化口腔医疗服务体系提供参考。方法获取2012年在北京医师协会注册的口腔执业医师及助理执业医师数据,采用Excel 2007软件录入数据,进行统计分析。结果2012年在北京医师协会注册的口腔执业医师及口腔助理执业医师共5059人,46.52%的口腔医师在政府办医疗机构执业,口腔医师与人口比为1∶4061。67.9%的口腔医师在东城区、西城区、海淀区和朝阳区执业。结论北京市口腔医师人力资源年龄结构较合理,口腔医师人数、职称及学历结构存在区县分布不均衡现象。%Objective To analyze the situation of oral medical institutions and dental manpower resources in 2012 in Beijing and to provide reference for optimization of oral medical service and the rational allocation of oral health human resources. Methods The data of the practicing dentists and assistant dentists registered at Beijing Medical Association in 2012 were obtained,input in the via Excel 2007 software and analyzed. Results There were 5059 practicing dentists and assistant dentists registered at Beijing Medical Association in 2012. 46. 52% of the dentists were employed in the state-owned non-profit oral care institutions. On average, the ratio of dentists to the population was 1∶4061. 67. 9% of the dentists working in Dong Cheng District, Xi Cheng District, Hai Dian District and Chao Yang District. Conclusion In Beijing, the age structure of dental manpower resources was reasonable,but the title,number and degree structure of the dentists in district distribution was imbalanced.

  12. Patient beliefs about medicines and quality of life after a clinical medication review and follow-up by a pharmaceutical care plan: A study in elderly polypharmacy patients with a cardiovascular disorder

    NARCIS (Netherlands)

    Geurts, Marlies M.E.; Stewart, Roy E.; Brouwers, Jacobus R.B.J.; de Graeff, Pieter A.; de Gier, Johan J.

    2015-01-01

    Objective: To determine the effect of a clinical medication review, followed up by a pharmaceutical care plan, on the beliefs about medicines and quality of life (QoL) of older patients with polypharmacy and a cardiovascular disorder. Methods: Patients were randomly assigned to an intervention or co

  13. The impact of the global budget system on dynamics of dental manpower and utilization of dental services

    Science.gov (United States)

    Huang, Laura Yueh-Guey; Huang, Boyen

    2016-01-01

    Background: This study aimed to investigate dentists’ supply and practice patterns following the implementation of the global budget system in Taiwan. Materials and Methods: Data of reimbursement claims, municipal socioeconomic status and dental manpower were collected from the National Health Insurance administration, the Ministry of Internal Affair, and the Ministry of Health and Welfare, respectively. A multivariate linear regression method was used for data analysis. Results: A municipality that reported a higher percentage of tertiary educated population (t = 3.718, P dental manpower in Taiwan. A relationship between HHI and dentists’ move-out rate has been found. The relationship between municipal socioeconomic status and the density of dentists has also been confirmed. In addition, reduced utilization of amalgam restorations was accompanied by increased utilization of tooth-colored material restorations. Further investigations are indicated. PMID:27076827

  14. An operational manpower analysis of the RQ-8 Fire Scout Vertical Take-Off Unmanned Aerial Vehicle (VTUAV)

    OpenAIRE

    Stracker, Matthew C.

    2007-01-01

    In August of 2001 the Secretary of the Navy announced the Navy would expand the work and experimentation in unmanned vehicle systems. After the events of September 11 this was accelerated with the increased urgency to combat terrorism and asymmetric threats. The U.S. Navy is currently undergoing testing and evaluation of the Fire Scout Vertical Take-Off Unmanned Aerial Vehicle (VTUAV) and its integration into the fleet. An in depth analysis of the Fire Scout's manpower requirements is necessa...

  15. The impact of the global budget system on dynamics of dental manpower and utilization of dental services

    Directory of Open Access Journals (Sweden)

    Laura Yueh-Guey Huang

    2016-01-01

    Conclusion: This study has demonstrated a stabilizing effect of the global budget system on dynamics of dental manpower in Taiwan. A relationship between HHI and dentists′ move-out rate has been found. The relationship between municipal socioeconomic status and the density of dentists has also been confirmed. In addition, reduced utilization of amalgam restorations was accompanied by increased utilization of tooth-colored material restorations. Further investigations are indicated.

  16. Feedback GAP: study protocol for a cluster-randomized trial of goal setting and action plans to increase the effectiveness of audit and feedback interventions in primary care

    Directory of Open Access Journals (Sweden)

    Francis Jill

    2010-12-01

    Full Text Available Abstract Background Audit and feedback to physicians is commonly used alone or as part of multifaceted interventions. While it can play an important role in quality improvement, the optimal design of audit and feedback is unknown. This study explores how feedback can be improved to increase acceptability and usability in primary care. The trial seeks to determine whether a theory-informed worksheet appended to feedback reports can help family physicians improve quality of care for their patients with diabetes and/or ischemic heart disease. Methods Two-arm cluster trial was conducted with participating primary care practices allocated using minimization to simple feedback or enhanced feedback group. The simple feedback group receives performance feedback reports every six months for two years regarding the proportion of their patients with diabetes and/or ischemic heart disease who are meeting quality targets. The enhanced feedback group receives these same reports as well as a theory-informed worksheet designed to facilitate goal setting and action plan development in response to the feedback reports. Participants are family physicians from across Ontario who use electronic medical records; data for rostered patients are used to produce the feedback reports and for analysis. Outcomes The primary disease outcomes are the blood pressure (BP, and low-density lipoprotein cholesterol (LDL levels. The primary process measure is a composite score indicating the number of recommended activities (e.g., tests and prescriptions conducted by the family physicians for their patients with diabetes and/or ischemic heart disease within the appropriate timeframe. Secondary outcomes are the proportion of patients whose results meet targets for glucose, LDL, and BP as well as the percent of patients receiving relevant prescriptions. A qualitative process evaluation using semi-structured interviews will explore perceived barriers to behaviour change in response to

  17. Factors Enhancing Manpower Efficiency from the Viewpoint of Clinical and Non-clinical Faculty Members at Guilan University of Medical Sciences in 2011

    Directory of Open Access Journals (Sweden)

    Fardin Mehrabian

    2012-11-01

    Full Text Available Introduction: There are various factors that affect manpower efficiency. Identification of the most important and influential factors on efficiency is quite essential. Analysis of factors affecting manpower efficiency from the viewpoint of clinical and non-clinical faculty members at Guilan University of Medical Sciences in 2011.Methods: This descriptive, analytical, cross-sectional study was performed in October and November in 2011. The study sample consisted of 186 faculty members, including 128 clinical and 58 non-clinical. Instruments used to collect library data were questionnaire and field studies. Exploratory factor analysis with Varimax rotation was utilized to determine the factors influencing manpower efficiency as well as loading level of each of the variables. Results: Among clinical faculty members, 70.66% of changes in manpower efficiency, and among non-clinical faculty members, 79.57% of changes in manpower efficiency were explained by 9 and 8 factors, respectivelyConclusion: Staff empowerment and organizational culture were recognized as the most important factors enhancing manpower efficiency from the viewpoint of clinical and non-clinical faculty members, respectively.

  18. Education in palliative care.

    Science.gov (United States)

    Weissman, David E; Blust, Linda

    2005-02-01

    Palliative care education includes the domains of pain and nonpain symptom management, communications skills, ethics and law, psychosocial care, and health systems. Defining key attitudes, knowledge, and skill objectives, and matching these to appropriate learning formats, is essential in educational planning. Abundant educational resource material is available to support classroom and experiential palliative care training. PMID:15639043

  19. Study on the availability of physical infrastructure and manpower facilities in sub-centers of Chittoor district of Andhra Pradesh

    Directory of Open Access Journals (Sweden)

    N Bayapa Reddy

    2012-01-01

    Full Text Available The sub-centers (SCs are under constant criticism for their inability to deliver quality services due to the nonavailability of adequate infrastructure, manpower and supply of drugs.A cross-sectional study was conducted in Chittoor District of Andhra Pradesh to assess the availability of physical infrastructure and manpower in the SCs. A total of 34 SCs were selected by multistage and stratified random sampling technique. The data was statistically analyzed by using Microsoft Excel. The deficiency in the availability of health workers male and female were found to be 67.7% and 27.5%, respectively. The residential facility for health workers was available only in 26.4% SCs. Only 20.6% of SCs had stethoscope and B.P apparatus. The physical infrastructure and manpower availability at the SCs needs considerable improvement as per the Indian Public Health Standard (IPHS. Facilities to conduct the normal delivery and 24-hours emergency referral services need to be addressed at the earliest.

  20. A novel method for constructing a WIFI positioning system with efficient manpower.

    Science.gov (United States)

    Du, Yuanfeng; Yang, Dongkai; Xiu, Chundi

    2015-01-01

    With the rapid development of WIFI technology, WIFI-based indoor positioning technology has been widely studied for location-based services. To solve the problems related to the signal strength database adopted in the widely used fingerprint positioning technology, we first introduce a new system framework in this paper, which includes a modified AP firmware and some cheap self-made WIFI sensor anchors. The periodically scanned reports regarding the neighboring APs and sensor anchors are sent to the positioning server and serve as the calibration points. Besides the calculation of correlations between the target points and the neighboring calibration points, we take full advantage of the important but easily overlooked feature that the signal attenuation model varies in different regions in the regression algorithm to get more accurate results. Thus, a novel method called RSSI Geography Weighted Regression (RGWR) is proposed to solve the fingerprint database construction problem. The average error of all the calibration points' self-localization results will help to make the final decision of whether the database is the latest or has to be updated automatically. The effects of anchors on system performance are further researched to conclude that the anchors should be deployed at the locations that stand for the features of RSSI distributions. The proposed system is convenient for the establishment of practical positioning system and extensive experiments have been performed to validate that the proposed method is robust and manpower efficient. PMID:25868078

  1. Final report for LDRD project 11-0783 : directed robots for increased military manpower effectiveness.

    Energy Technology Data Exchange (ETDEWEB)

    Rohrer, Brandon Robinson; Rothganger, Fredrick H.; Wagner, John S.; Xavier, Patrick Gordon; Morrow, James Dan

    2011-09-01

    The purpose of this LDRD is to develop technology allowing warfighters to provide high-level commands to their unmanned assets, freeing them to command a group of them or commit the bulk of their attention elsewhere. To this end, a brain-emulating cognition and control architecture (BECCA) was developed, incorporating novel and uniquely capable feature creation and reinforcement learning algorithms. BECCA was demonstrated on both a mobile manipulator platform and on a seven degree of freedom serial link robot arm. Existing military ground robots are almost universally teleoperated and occupy the complete attention of an operator. They may remove a soldier from harm's way, but they do not necessarily reduce manpower requirements. Current research efforts to solve the problem of autonomous operation in an unstructured, dynamic environment fall short of the desired performance. In order to increase the effectiveness of unmanned vehicle (UV) operators, we proposed to develop robots that can be 'directed' rather than remote-controlled. They are instructed and trained by human operators, rather than driven. The technical approach is modeled closely on psychological and neuroscientific models of human learning. Two Sandia-developed models are utilized in this effort: the Sandia Cognitive Framework (SCF), a cognitive psychology-based model of human processes, and BECCA, a psychophysical-based model of learning, motor control, and conceptualization. Together, these models span the functional space from perceptuo-motor abilities, to high-level motivational and attentional processes.

  2. Appendix IV: Training of manpower for commissioning projects TAPP-3 and 4 - A case study (India)

    International Nuclear Information System (INIS)

    Nuclear Power Corporation of India Limited (NPCIL), wholly owned by the Indian Government, is responsible for the design, construction, commissioning and operation of nuclear power plants (NPPs) in India. NPCIL owns sixteen operating power plants. NPCIL is currently building six NPP units. The Atomic Energy Regulatory Board (AERB) is the independent regulatory body for NPPs in India. NPCIL understands that training and development of manpower is vital to its success and has an integrated approach for training of its personnel. It is important to first explain the NPCIL organization for a new project before discussing training programmes for project staff in the commissioning organization. Project construction groups of NPCIL undertake construction and installation through departmental agencies, equipment suppliers and contractors. The quality surveillance of plant construction is the responsibility of the QA group at the plant site, with periodic audits by NPCIL Headquarters. The field-engineering organization on site is responsible for overseeing the fulfillment of design intent during construction and commissioning stages in areas engineered by the design group of NPCIL. Similar functions for the conventional area rest with the resident engineers of consultants stationed at the project site. A typical overall organization chart for a new NPP project is given

  3. A Novel Method for Constructing a WIFI Positioning System with Efficient Manpower

    Directory of Open Access Journals (Sweden)

    Yuanfeng Du

    2015-04-01

    Full Text Available With the rapid development of WIFI technology, WIFI-based indoor positioning technology has been widely studied for location-based services. To solve the problems related to the signal strength database adopted in the widely used fingerprint positioning technology, we first introduce a new system framework in this paper, which includes a modified AP firmware and some cheap self-made WIFI sensor anchors. The periodically scanned reports regarding the neighboring APs and sensor anchors are sent to the positioning server and serve as the calibration points. Besides the calculation of correlations between the target points and the neighboring calibration points, we take full advantage of the important but easily overlooked feature that the signal attenuation model varies in different regions in the regression algorithm to get more accurate results. Thus, a novel method called RSSI Geography Weighted Regression (RGWR is proposed to solve the fingerprint database construction problem. The average error of all the calibration points’ self-localization results will help to make the final decision of whether the database is the latest or has to be updated automatically. The effects of anchors on system performance are further researched to conclude that the anchors should be deployed at the locations that stand for the features of RSSI distributions. The proposed system is convenient for the establishment of practical positioning system and extensive experiments have been performed to validate that the proposed method is robust and manpower efficient.

  4. Report on the Canadian Association of Occupational Therapists' manpower survey: 1981.

    Science.gov (United States)

    Filuk, S; Opzoomer, A

    1984-12-01

    The following report outlines the findings of the CAOT Task Force established in 1980 to undertake a national manpower survey. With the assistance of Statistics Canada a survey was designed and through CAOT, it was distributed in the Fall of 1981. Although a completed methodology and tabulation were sent to the CAOT Executive in March 1982, an analysis was not completed until November 1982. This report is to inform all participants of the findings, implications and future considerations. The objectives, methodology and problems encountered are described. Unfortunately, most of the objectives were not met. The task of developing an effective survey tool and the process of collecting meaningful data was far greater than anticipated. Such a massive project, which entails money and time, requires professional assistance to reduce ambiguities in the survey forms and computerization to correlate the information. Much of the information received could not be used nor correlated; however, the results do give a brief description of the profile of an occupational therapist to build on in the future. In addition, the experience gained will facilitate future survey development and distribution. PMID:10269309

  5. Effective Technological Delivery in Nigerian Polytechnics:Need for Academic Manpower Development Policy

    Directory of Open Access Journals (Sweden)

    J. K. Adeyemi

    2004-06-01

    Full Text Available Technical education, especially as provided in the Nigerian polytechnics, leads to the acquisition of practical and applied skills as well as basic scientific knowledge. The production function of the polytechnics in terms of producing quality middle-level manpower through effective teaching delivery depends largely on the quantity and quality of teachers available. However, teacher adequacy is a function of many factors, which include funding, student enrollment overtime, and staff turnover. This article, however, revealed a mismatch between enrollment and available teachers, with huge staff shortfall over the years when the student enrollment was matched with the available teachers, using the ideal teacher-student ratios. Student and teacher projections were carried out based on five-percent annual increase and average teacher-student ratio of 1:12, so as to meet the vision 2010 target year set by the Nigerian government for total development. The projection showed that the polytechnics would require a large additional number of teachers. An all-inclusive funding approach for the polytechnics was recommended so as to increase their financial status, which would allow for improved facilities, workshops, equipment and also improved conditions of service of teachers. We believe that if this was done, more teachers would be attracted from across the world, those who left would return, and new and younger ones will be encouraged to join the teaching force. Such development would to a great extent meet and sustain the anticipated growth for the target year.

  6. Progressive Care of Obese Patients.

    Science.gov (United States)

    Dambaugh, Lori A; Ecklund, Margaret M

    2016-08-01

    Obese patients have complex needs that complicate their care during hospitalization. These patients often have comorbid conditions, including hypertension, heart failure, obstructive sleep apnea, pressure ulcers, and difficulty with mobility. Obese patients may be well served in the progressive care setting because they may require more intensive nursing care than can be delivered in a general care unit. Progressive care nurses have core competencies that enable them to safely and effectively care for obese patients. A plan of care with interdisciplinary collaboration illustrates the integrative care for obese progressive care patients. (Critical Care Nurse 2016; 36[4]:58-63). PMID:27481802

  7. On the road to value co-creation in health care: the role of consumers in defining the destination, planning the journey and sharing the drive.

    Science.gov (United States)

    Janamian, Tina; Crossland, Lisa; Wells, Leanne

    2016-04-18

    The role of consumers is now extending beyond being passive health care recipients and even active participants in their own care to involvement in innovation and value co-creation in health care - from being "users and choosers" to becoming "makers and shapers" of services. For active dialogue to occur in co-creation, consumers must become equal partners with health care organisations and providers, with the focus on areas of interest to all parties. The use of value co-creation in health care involves embedding the approach across the whole health care system - from the microsystem level to the mesosystem and the entire macrosystem. PMID:27078786

  8. Defining the role of University of Kentucky HealthCare in its medical market--how strategic planning creates the intersection of good public policy and good business practices.

    Science.gov (United States)

    Karpf, Michael; Lofgren, Richard; Bricker, Timothy; Claypool, Joseph O; Zembrodt, Jim; Perman, Jay; Higdon, Courtney M

    2009-02-01

    In response both to national pressures to reduce costs and improve health care access and outcomes and to local pressures to become a top-20 public research university, the University of Kentucky moved toward an integrated clinical enterprise, UK HealthCare, to create a common vision, shared goals, and an effective decision-making process. The leadership formed the vision and then embarked on a comprehensive and coordinated planning process that addressed financial, clinical, academic, and operational issues. The authors describe in depth the strategic planning process and specifically the definition of UK HealthCare's role in its medical marketplace. They began a rigorous process to assess and develop goals for the clinical programs and followed the progress of these programs through meetings driven by data and attended by the organization's senior leadership. They describe their approach to working with rural and community hospitals throughout central, eastern, and southern Kentucky to support the health care infrastructure of the state. They review the early successes of their strategic approach and describe the lessons they learned. The clinical successes have led to academic gains. The experience of UK HealthCare suggests that good business practices and good public policy are synergistic. PMID:19174658

  9. Civil emergency planning in Canada.

    Science.gov (United States)

    Wallace, J F

    1967-01-28

    THE NATIONAL OBJECTIVES OF CIVILIAN EMERGENCY PLANNING ARE: (1) protection and preservation of life and property; (2) maintenance of governmental structure; and (3) conservation of resources. The Canada Emergency Measures Organization (E.M.O.) has been developed to accomplish these objectives. E.M.O. co-ordinates other departments and agencies of federal government and its organization is reflected within provincial and municipal governments.Present E.M.O. accomplishments include: an attack warning system; an emergency broadcasting system; emergency government facilities; 400 emergency measure organizations across Canada; plans to implement general readiness; a medical stockpile; and "shadow agencies" for control of housing, food and manpower.PRESENT UNDERTAKINGS INCLUDE: a national survey of fallout shelters; the equipping of the radiation defence (RADEF); the pre-positioning of the items of the medical stockpile; and the training at the Canadian Emergency Measures College at Arnprior. PMID:6015737

  10. Injection Safety and Practices following Needle Stick Injuries An Occupational Risk to Health Care Providers In Gujarat

    Directory of Open Access Journals (Sweden)

    Harsh D Shah, Bonny H Shah, Hiren R Solanki, Vijay R Agarwal, Priyank A Parmar , Kiran M Narkhede

    2015-01-01

    Full Text Available "Background: An occupational exposure to blood can result from percutaneous (needle stick or other sharps injury and mucocutaneous injury (splash of blood or other body fluids into the eyes, nose or mouth, or blood contact with non-intact skin. Beside transmission of infectious diseases, it indirectly affects health care delivery services especially in developing countries where demand is high in compare with manpower resources. Materials and method: The study was a cross sectional conducted among health care workers from a district of Gujarat. During the study, only one injection per health worker was taken into the consideration for better analysis. Results: Out of 251, 147 (58.56% had needle stick injury in last one year and majority health workers were nursing staff. It was found that there was significant association who had NSIs previously before one year and injuries within last year and injuries occurred while giving the injections (48%. Only 32% of HCWs had done reporting about their NSIs to the concern authority and 20% followed the protocols of post exposure prophylaxis guidelines. Conclusion: Under reporting and lack of sensitivity on needles tick injuries had layered up during the study along with safe injection practices. Close monitoring on injection practices, surveillance on NSIs by quality assurance committee and structured communication plan should be in place to avoid health worker at risk and hazard of needle stick injuries."

  11. Treatment of a Frail Older Patient with Diffuse Large B-Cell Lymphoma on Maintenance Dialysis: Attenuated Immunochemotherapy and Adapted Care Plan

    Directory of Open Access Journals (Sweden)

    Luciola de Barros Pontes

    2013-04-01

    Full Text Available Purpose of the Study: Diffuse large B-cell lymphoma (DLBCL is the most common lymphoid malignancy worldwide. Its incidence increases with age and about 40% of cases occur in patients over 70 years. Herein, we describe a case of a frail elderly patient with renal insufficiency and DLBCL treated with R-mini-CHOP. Case Report: A 77-year-old man on maintenance hemodialysis started experiencing persistent fatigue. He was diagnosed with a large mass on the left lobe of the lung. Biopsy demonstrated a DLBCL, CD20 positive. The patient was assigned clinical stage IIBX, with a high age-adjusted international prognosis index. A proper geriatric assessment revealed a frail patient. Thus, an adapted chemotherapy regimen was proposed which consisted of R-mini-CHOP every 21 days, with a reduction of 10% in the doses of doxorubicin and cyclophosphamide. During the treatment, the patient went through regular dialysis sessions, 3 times per week, with an extra session performed 12 h after each chemotherapy administration. The patient experienced no adverse events or grade 3/4 toxicities. After 6 cycles of R-mini-CHOP, the patient achieved unconfirmed complete remission, and consolidation radiotherapy was performed. At the last follow-up, he was still in unconfirmed complete remission, with a progression-free survival of 11.3 months. Conclusions: R-mini-CHOP represented a reasonable treatment option for this patient with renal failure. The oncogeriatric approach led to a successful management of this frail patient, highlighting that an adapted plan of care is a key issue to improve the outcomes of elderly cancer patients.

  12. Savannah River Site Environmental Implementation Plan. Volume 2, Protection programs

    Energy Technology Data Exchange (ETDEWEB)

    1989-08-01

    Formal sitewide environmental planning at the . Savannah River Site (SRS) began in 1986 with the development and adoption of the Strategic Environmental Plan. The Strategic Environmental Plan describes the philosophy, policy, and overall program direction of environmental programs for the operation of the SRS. The Strategic Environmental Plan (Volume 2) provided the basis for development of the Environmental Implementation Plan (EIP). The EIP is the detailed, comprehensive environmental master plan for operating contractor organizations at the SRS. The EIP provides a process to ensure that all environmental requirements and obligations are being met by setting specific measurable goals and objectives and strategies for implementation. The plan is the basis for justification of site manpower and funding requests for environmental projects and programs over a five-year planning period.

  13. Is it safe? Talking to teens with HIV/AIDS about death and dying: a 3-month evaluation of Family Centered Advance Care (FACE) planning – anxiety, depression, quality of life

    OpenAIRE

    Lyon, Maureen E.; Garvie, Patricia A.; Briggs, Linda; He, Jianping; Malow, Robert; D’Angelo, Lawrence J; McCarter, Robert

    2010-01-01

    Purpose To determine the safety of engaging HIV-positive (HIV+) adolescents in a Family Centered Advance Care (FACE) planning intervention. Patients and methods We conducted a 2-armed, randomized controlled clinical trial in 2 hospital-based outpatient clinics from 2006–2008 with HIV+ adolescents and their surrogates (n = 76). Three 60–90 minutes sessions were conducted weekly. FACE intervention groups received: Lyon FCACP Survey©, the Respecting Choices® interview, and completion of The Five...

  14. Understanding health insurance plans

    Science.gov (United States)

    Most insurance companies offer different types of health plans. And when you are comparing plans, it can sometimes seem ... Depending on how you get your health insurance, you may have a ... (HMOs). These plans offer a network of health care providers ...

  15. Space Station Mission Planning Study (MPS) development study. Volume 3: Software development plan

    Science.gov (United States)

    Klus, W. L.

    1987-01-01

    A software development plan is presented for the definition, design, and implementation of the Space Station (SS) Payload Mission Planning System (MPS). This plan is an evolving document and must be updated periodically as the SS design and operations concepts as well as the SS MPS concept evolve. The major segments of this plan are as follows: an overview of the SS MPS and a description of its required capabilities including the computer programs identified as configurable items with an explanation of the place and function of each within the system; an overview of the project plan and a detailed description of each development project activity breaking each into lower level tasks where applicable; identification of the resources required and recommendations for the manner in which they should be utilized including recommended schedules and estimated manpower requirements; and a description of the practices, standards, and techniques recommended for the SS MPS Software (SW) development.

  16. Contribution of Kenyan University Undergraduate Fashion and Apparel Design Programs towards the Manpower Development for the Kenyan Apparel Industry

    Directory of Open Access Journals (Sweden)

    Rael Chepchumba Maiyo

    2013-04-01

    Full Text Available Worldwide, the contribution of university fashion design training programs towards the manpower development for the fashion and apparel (FA industry cannot be underestimated. The objective of this paper is to identify the contribution of Kenyan University undergraduate fashion and apparel design programs (UUGFADPs towards manpower development for Kenyan FA industry. Descriptive survey was used to collect data at Kenyatta, Maseno, Egerton, University of Eldoret (UoE, University of Eastern Africa-Baraton (UEAB and fashion and apparel design (FAD firms in Nairobi, Nakuru, Mombasa, Athi River, Eldoret and Kisumu. The target population was Kenyan university departments offering UUGFADPs as well as their graduates. Purposive and snowball sampling were employed to select 208 respondents. Data collection methods were questionnaires, in-depth oral interviews, and document analysis. Qualitative data were coded according to patterns and themes and presented descriptively. Quantitative data was analyzed and summarized using descriptive statistics then presented in tables. Findings indicate that Kenyan UUGFADPs contributed to FA industry through research, training for various roles, job creation and community development. this paper recommends that for the UUGFADPs to give maximum contribution to the apparel industry, the FAD departments and FA industry should establish strong university-industry linkages and that the Kenyan government, through the relevant ministries should support the FA industry by job creation and identification.

  17. Health Care Waste Management

    OpenAIRE

    World Bank

    2003-01-01

    Health care waste management (HCWM) is a process to help ensure proper hospital hygiene and safety of health care workers and communities. It includes planning and procurement, construction, staff training and behavior, proper use of tools, machines and pharmaceuticals, proper disposal methods inside and outside the hospital, and evaluation. Its many dimensions require a broader focus than ...

  18. Northern settlement family-style: labor planning and population policy in Noril'sk.

    Science.gov (United States)

    Bond, A R

    1985-01-01

    This paper reviews labor planning and population policies in Noril'sk, a mining and metallurgical settlement in northern Siberia. When the settlement was established in 1935, planners were lacking in ideas about how to recruit workers to staff the mines and smelters and how to retain the labor force once it was in place. From 1935-79, planners followed a forced labor policy dependent upon the labor of prisoners. However, this solution was not adequate for meeting the manpower needs of an economy undergoing rapid technological sophistication. Northern wage increments were introduced after 1945 to recruit skilled workers from other regions. These increments built up over a 4-year period to a maximum of 80% of base pay. A special cost of living bonus was also awarded. Although these inducements facilitated labor recruitment, labor retention remained a major problem. Surveys indicated that workers would prefer improvements in housing and social services to further wage increases. Thus, policy was directed at the housing shortages, poor medical care, and inadequate child care facilities in Noril'sk. Such improvements facilitated labor retention but also contributed to overpopulation. The population doubled between 1956-80, exceeding 180,000 in the latter year. In the early 1980s, selective measures toward population control were implemented to ensure maintenance of living standards (e.g., encouragement of older workers to leave the area upon retirement, more careful screening of recruits). The goal is to stabilize city size at around 250,000. The Noril'sk case illustrates that quality of life investments can alleviate labor retention problems even in the harshest physical environments. Recent policies have advocated productivity-enriching technologies that do not require increments in the labor force. PMID:12267496

  19. Planning and Implementing Cooperative Education.

    Science.gov (United States)

    Brown, Sylvia J.

    1978-01-01

    Implementing cooperative education requires careful planning, institutional support, and competent staffing. Suggestions for planning, setting objectives, recruiting students, job development, student counseling and placement, liaison with other colleges offices, and institutionalization are described. (Author/LBH)

  20. Planning Ahead: Advanced Heart Failure

    Science.gov (United States)

    ... Pressure High Blood Pressure Tools & Resources Stroke More Planning Ahead: Advanced Heart Failure Updated:Jul 7,2016 ... making your preferences known is called advance care planning. It allows you to speak for yourself, even ...

  1. An Approach for Safe Medication Assistance in Nursing Homes: A Workshop to Identify Problems of and Plan Measures for Care Workers.

    Science.gov (United States)

    Park, Hyerim; Miki, Akiko; Satoh, Hiroki; Maki, Hideyuki; Asai, Kohei; Konishi, Yukari; Sawada, Yasufumi

    2016-01-01

    We conducted a workshop that aimed to clarify problems with care workers supporting medication use in nursing homes, to propose measures for solving these problems, and to raise awareness of these problems among care workers. Eighteen care workers from different fee-based elderly nursing homes were enrolled in the workshop, and divided into four groups. The participants in these groups identified the issues based on their experiences regarding medication-related incidents, and discussed related problems and viable measures using the KJ method. The issues identified by each group were "dropping a medication", "wrong resident", "refusal to take medication", and "confusion". To resolve these problems, the participants recommended: "conducting study sessions or testing of manuals and medication knowledge", "strengthening monitoring systems", "enhancing information sharing", etc. The involvement of pharmacists was hardly mentioned, despite the workshop being designed for "medication assistance". A post-workshop questionnaire revealed that 88.9% of the participants acknowledged an increased awareness of safe assistance in the use of medication. A follow-up questionnaire, distributed approximately seven months after the workshop, revealed that 82.4% of participants applied the experience and knowledge they learned at the workshop to their work. The workshop seemed to raise awareness and lead to preventive measures for safe medication assistance. Communication between care workers and other health care professionals, such as pharmacists, is important to designing and implementing safe medical care in nursing homes. PMID:27252069

  2. Hygiene guideline for the planning, installation, and operation of ventilation and air-conditioning systems in health-care settings – Guideline of the German Society for Hospital Hygiene (DGKH

    Directory of Open Access Journals (Sweden)

    Külpmann, Rüdiger

    2016-02-01

    Full Text Available Since the publication of the first “Hospital Hygiene Guideline for the implementation and operation of air conditioning systems (HVAC systems in hospitals” ( in 2002, it was necessary due to the increase in knowledge, new regulations, improved air-conditioning systems and advanced test methods to revise the guideline. Based on the description of the basic features of ventilation concepts, its hygienic test and the usage-based requirements for ventilation, the DGKH section “Ventilation and air conditioning technology” attempts to provide answers for the major air quality issues in the planning, design and the hygienically safe operation of HVAC systems in rooms of health care.

  3. Health Plan Employer Data and Information Set (HEDIS(R)) Criteria to Determine the Quality of Asthma Care in Children: What Are the Limitations?

    OpenAIRE

    Farber, Harold J.; Michael Schatz

    2007-01-01

    The Health Plan Employer Data and Information Set (HEDIS(R)) of the National Committee for Quality Assurance is a set of standardized performance measures, the goal of which is to enable purchasers and consumers to evaluate the quality of different health plans. The HEDIS(R) `Use of Appropriate Medications for People with Asthma' measure assesses the presence of an asthma controller medication dispensing in patients who meet healthcare utilization criteria that suggest persistent asthma. The ...

  4. Information Sharing for Care Coordination

    OpenAIRE

    Amir, Ofra; Grosz, Barbara J.; Stern, Roni; Sanders, Lee M.

    2013-01-01

    Teamwork and care coordination are of increasing importance to health care delivery and patient safety and health. This paper describes our initial work on developing agents that are able to make intelligent information sharing decisions to support a diverse, evolving team of care providers in constructing and maintaining a shared plan that operates in uncertain environments and over a long time horizon.

  5. Nuclear physics program plan

    International Nuclear Information System (INIS)

    The nuclear physics program objectives, resources, applications and implications of scientific opportunities are presented. The scope of projected research is discussed in conjunction with accelerator facilities and manpower. 25 figs., 2 tabs

  6. Is it safe? Talking to teens with HIV/AIDS about death and dying: a 3-month evaluation of Family Centered Advance Care (FACE planning – anxiety, depression, quality of life

    Directory of Open Access Journals (Sweden)

    Maureen E Lyon

    2010-02-01

    Full Text Available Maureen E Lyon1, Patricia A Garvie2, Linda Briggs3, Jianping He4, Robert Malow5, Lawrence J D’Angelo1, Robert McCarter41Children’s National Medical Center and George Washington School of Medicine and Health Sciences, Washington, District of Columbia; 2St Jude Children’s Research Hospital, Memphis, Tennessee; 3Gundersen Lutheran Medical Foundation, Inc., Madison, Wisconsin; 4Children’s Research Institute, Washington, District of Columbia; 5Florida International University, Miami, FloridaPurpose: To determine the safety of engaging HIV-positive (HIV+ adolescents in a Family Centered Advance Care (FACE planning intervention.Patients and methods: We conducted a 2-armed, randomized controlled clinical trial in 2 hospital-based outpatient clinics from 2006–2008 with HIV+ adolescents and their surrogates (n = 76. Three 60–90 minutes sessions were conducted weekly. FACE intervention groups received: Lyon FCACP Survey©, the Respecting Choices® interview, and completion of The Five Wishes©. The Healthy Living Control (HLC received: Developmental History, Healthy Tips, Future Planning (vocational, school or vocational rehabilitation. Three-month post-intervention outcomes were: completion of advance directive (Five Wishes©; psychological adjustment (Beck Depression, Anxiety Inventories; quality of life (PedsQL™; and HIV symptoms (General Health Self-Assessment.Results: Adolescents had a mean age, 16 years; 40% male; 92% African-American; 68% with perinatally acquired HIV, 29% had AIDS diagnosis. FACE participants completed advance directives more than controls, using time matched comparison (P < 0.001. Neither anxiety, nor depression, increased at clinically or statistically significant levels post-intervention. FACE adolescents maintained quality of life. FACE families perceived their adolescents as worsening in their school (P = 0.018 and emotional (P = 0.029 quality of life at 3 months, compared with controls.Conclusions: Participating

  7. The Impacts of well Planned Recruitment and Selection Process on Corporate Performance in Nigerian Banking Industry (A Case Study of First Bank Plc 2004-2011

    Directory of Open Access Journals (Sweden)

    Adeniyi Mudashiru Mustapha

    2013-09-01

    Full Text Available A sound recruitment programme logically follows a well drawn-up manpower plan. In fact, the quality of the present manpower plan as indeed of every present decision of the organization depends upon the quality of recruitment policies and practices. This paper examines recruitment and selection process. It identifies a typical source by separating recruitment into internal and external and discussed the advantages of each method. The analytical tools used in this study were regression analysis and analysis of variance (ANOVA to determine the relationship between a well planned recruitment and selection process on corporate performance. Findings revealed that there is a significant relationship between recruitment and selection based on merit and organizational performance; that effective recruitment and selection is a key to organizational commitment; that a well planned recruitment and selection contributes to organizational performance. The paper concludes by drawing the danger potends by poor recruitment and selection as poor recruitment could lead to selection of poor applicants.

  8. Why nursing care is missed?

    OpenAIRE

    Wiwanitkit V

    2014-01-01

    Nursing care is an important part for success of clinical therapeutics and diagnosis. The problem of nursing care can be seen elsewhere. An important consideration is on missed nursing care. The common elements of missed nursing care usually lie on these scopes: “ambulation, turning, delayed or missed feedings, patient teaching, discharge planning, emotional support, hygiene, intake and output documentation, and surveillance.”

  9. Injection Safety and Practices following Needle Stick Injuries An Occupational Risk to Health Care Providers In Gujarat

    OpenAIRE

    Harsh D Shah, Bonny H Shah, Hiren R Solanki, Vijay R Agarwal, Priyank A Parmar , Kiran M Narkhede

    2015-01-01

    "Background: An occupational exposure to blood can result from percutaneous (needle stick or other sharps injury) and mucocutaneous injury (splash of blood or other body fluids into the eyes, nose or mouth), or blood contact with non-intact skin. Beside transmission of infectious diseases, it indirectly affects health care delivery services especially in developing countries where demand is high in compare with manpower resources. Materials and method: The study was a cross sectional...

  10. [Developing the core competencies of long-term care professionals].

    Science.gov (United States)

    Chen, Huey-Tzy; Lee, Kuang-Ting

    2012-12-01

    Longer average life expectancies and an ageing society have made long-term care an urgent and important issue in Taiwan. Although the implementation of Long-Term Care Ten-year Project four years ago has begun showing success in terms of assessing Taiwan's needs in terms of long-term care services and resources, there has been little forward progress in terms of training, recruiting and maintaining more competent professionals in the long-term care sector. This paper explores the current state of long-term care competency in Taiwan and educational strategies in place to improve the competency of long-term care professionals. Results indicate that the term geriatric competency embraces sub-competencies in direct care, communication, assessment, teamwork, cultural sensitivities and career care competencies. The term long-term care competency embraces the sub-competencies of supervision, management, information technology, resource management, and organizational skill. As a main contributor to effective long-term care, the nursing profession must employ effective strategies to develop competency-based education. Also, the profession must have an adequate supply of competent manpower to effectively respond to Taiwan's aging society. PMID:23212250

  11. Childbearing in a Time of ART: Birth Rates, Childbearing Desires and Family Planning in a Rural HIV Treatment and Care Programme in South Africa

    OpenAIRE

    Benton, L. M.

    2015-01-01

    Mixed methods investigate the association between HIV, ART and fertility following scale-up of HIV treatment and care in South Africa. Two longitudinal analyses of surveillance data from the Africa Centre for Health and Population Studies compare factors associated with live birth by HIV and ART exposure. Semi-structured interviews with women enrolled on ART and healthcare providers explore perceptions of childbearing and contraceptive use. A quantitative study reports on one open cohort anal...

  12. Evaluation of a general practitioner-led urgent care centre in an urban setting: description of service model and plan of analysis

    OpenAIRE

    Gnani, Shamini; Ramzan, Farzan; Ladbrooke, Tim; Millington, Hugh; Islam, Saiful; Car, Josip; Majeed, Azeem

    2013-01-01

    Estimates of patients attending with conditions deemed non-urgent or inappropriate for accident and emergency services vary widely, from 6 to 80%. Previous research suggests that general practitioners (GPs) working in emergency departments can reduce referral rates, diagnostic testing, the proportion of patients who become emergency hospital admissions, and inappropriate attendances. However, little of this previous research is recent and new models of care for GPs working in emergency depart...

  13. Using the theory of planned behaviour as a process evaluation tool in randomised trials of knowledge translation strategies: A case study from UK primary care

    OpenAIRE

    Grimshaw Jeremy M; Croal Bernard L; Thomas Ruth E; Ramsay Craig R; Eccles Martin P

    2010-01-01

    Abstract Background Randomised trials of knowledge translation strategies for professional behaviour change can provide robust estimates of effectiveness, but offer little insight into the causal mechanisms by which any change is produced. To illustrate the applicability of causal methods within randomised trials, we undertook a theory-based process evaluation study within an implementation trial to explore whether the cognitions of primary care doctors' predicted their test requesting behavi...

  14. Improving maternity care in the Dominican Republic: a pilot study of a community-based participatory research action plan by an international healthcare team.

    Science.gov (United States)

    Foster, Jennifer; Gossett, Sarah; Burgos, Rosa; Cáceres, Ramona; Tejada, Carmen; Dominguez García, Luis; Ambrosio Rosario, Angel; Almonte, Asela; Perez, Lydia J

    2015-05-01

    This article is a report of the process and results of a feasibility pilot study to improve the quality of maternity care in a sample of 31 women and their newborns delivering in a public, tertiary hospital in the Dominican Republic. The pilot study was the first "action step" taken as a result of a formative, community-based participatory research (CBPR) study conducted between 2008 and 2010 by an interdisciplinary, international partnership of U.S. academic researchers, Dominican medical/nursing personnel, and Dominican community health workers. Health personnel and community health workers separately identified indicators most important to measure quality of antepartum maternity care: laboratory and diagnostic studies and respectful, interpersonal communication. At the midpoint and the completion of data collection, the CBPR team evaluated the change in quality indicators to assess improvement in care. The pilot study supports the idea that joint engagement of community health workers, health personnel, and academic researchers with data creation and patient monitoring is motivating for all to continue to improve services in the cultural context of the Dominican Republic. PMID:24793488

  15. Impact of Education Based on Theory of Planned Behavior: An Investigation into Hypertension-Preventive Self-care Behaviors in Iranian Girl Adolescent

    OpenAIRE

    Shabnam POOREH; Zahra HOSSEINI-NODEH

    2015-01-01

    Background: Since risk factors of hypertension are formed during adolescent period and regarding that attitudes change occurs more easily in these ages, the present paper aimed to evaluate the impact of education based on the theory of planned behavior in hypertension prevention behaviors in female adolescent students.Methods: In this quasi-experimental study, 160 girls of 12-16 yr old (80 in each case and control group), who had not been educated in prevention of hypertension over the recent...

  16. The design and application of the personalized nursing care plan sheet for critically ill patients in the emergency intensive care unit%急诊重症监护病房个性化危重患者护理计划单的设计与应用效果研究

    Institute of Scientific and Technical Information of China (English)

    杨剑; 张其红; 刘艳萍

    2015-01-01

    Objective To investigate the effect of the personalized nursing care plan sheet for critically ill patients in the emergency intensive care unit. Methods The personalized nursing care plan sheet including general, personalized nursing issues and related measures was designed according to the standard from the nursing department. A group of 116 critically ill patients were divided into the observational group (58 patients) and control group (58 patients) from January 2012 to September 2014. The personalized nursing care plan sheet were applied for record and hand over in the observational group, while the unified problem statement nursing care plan sheet were used in the control group. The indicators of nursing quality were observed in the two groups and the nurses′satisfaction with the nursing care plan sheets was compared. Results The nursing quality in the observational group was higher than it in the control group with the lower incidence of failure rate in fundamental nursing, professional nursing, plan sheet, disease treatment and adverse event (32.76% vs. 62.07%,37.93% vs. 67.24%,29.31% vs. 68.97%, 20.69% vs. 53.45%, 10.34% vs. 72.41%, the χ2 values were 2.98, 2.98, 4.09, 3.46 and 6.60 respctively, P<0.05). The nurses′satisfaction with the personalized nursing care plan sheet was also higher than the unified problem statement nursing care plan sheet (P<0.05). Conclusion The incidence of nursing defects could be reduced by avoiding the incomplete nursing assessment and omitted nursing plan.%目的:探讨个性化危重患者护理计划单在急诊重症监护病房的应用效果。方法根据护理部相关标准设计个性化危重患者护理计划单,内容包括共性及个性化护理问题和护理措施;将2012年1月至2014年9月在我科住院的急诊危重患者116例,按随机数字表法分为观察组和对照组各58例,护士分别采用个性化危重患者护理计划单和医院统一的陈述问题式危重患者护理

  17. Applying human capital management to model manpower readiness a conceptual framework

    OpenAIRE

    Ngin, Pert Chin.

    2005-01-01

    The United States Navy is currently going through a human capital transformation in order to better meet the security challenges of the 21st century. A key component of the plan is the job analysis process, conducted using the SkillsNET methodology, to define job requirements in terms of knowledge, skills, abilities, and tools, in contrast to the current approach of relying on the rating badge and a naval enlisted code associated with the billet. The objective of this thesis is to develop a ...

  18. Teamwork for eye care

    Directory of Open Access Journals (Sweden)

    M Babar Qureshi

    2014-04-01

    Full Text Available Human resource development (HRD – the development of the people who deliver health care – has been identified as one of the key pillars of eye health delivery. HRD is one of the essential building blocks of the World Health Organization (WHO Global Action Plan: ‘Towards universal eye health’. The importance of HRD is also recognised beyond eye care, as can be seen in the WHO Health Systems approach.

  19. Teamwork for eye care

    OpenAIRE

    M Babar Qureshi

    2014-01-01

    Human resource development (HRD) – the development of the people who deliver health care – has been identified as one of the key pillars of eye health delivery. HRD is one of the essential building blocks of the World Health Organization (WHO) Global Action Plan: ‘Towards universal eye health’. The importance of HRD is also recognised beyond eye care, as can be seen in the WHO Health Systems approach.

  20. Manpower development for nuclear power programme. China. Project findings and recommendations

    International Nuclear Information System (INIS)

    The United Nations Development Program (UNDP) project was conceived in April 1985, implementation was started on preliminary authorization by summer 1986, and it was approved and signed in early 1987. The duration was originally planned for three years with a UNDP input of US$ 1,657.500 (including Government cost sharing of US$ 280,000). The project is now essentially completed with a few items still pending, though committed as firmly planned, and the current cost estimate is US$ 1,707.617. The objective of the project was to assist in establishing long-term training programmes in two training centres in the People's Republic of China (Qinshan and Suzhou) and strengthen the training capabilities at these centres. The two centres are intended to provide specialized comprehensive training in basic and applied nuclear power engineering disciplines as well as in construction, operation and maintenance of nuclear power plants to technical personnel assigned to the nuclear power plants in the People's Republic of China

  1. 病房护理人力管理系统的开发及应用%Development of Computer System for Nursing Manpower Management

    Institute of Scientific and Technical Information of China (English)

    李红; 张琼瑶; 王小芳; 张秀仪

    2001-01-01

    In order to raise the nursing management level and working efficiency, on the basis of in-patient computer management system and nursing manpower resource utilization index estimation system, nursing manpower management computer system was developed in July 1999. The system had dynamic functions, including nurses' allocation management module, arrangement and checking work attendance, technical file management, manpower resource utilization estimation, etc.. The system was implemented one year in 30 work stations of 19 wards and provided reliable, systemic and rapid data of manpower resource utilization estimation for varied levels of administrators.%为了提高护理科学化管理水平与工作效率,在住院病人计算机管理系统和护理人力资源利用指标评价体系的基础上,于1999年7月开发了病房护理人力管理计算机系统。系统给予动态的功能,包括与工作量相适应的护理人员编配管理模块、排班与考勤、技术档案管理、人力资源利用状况评价等。在本院19个病区的30个工作站实施1年,为各级管理者提供了可靠、系统、快捷的人力资源利用评估资料,使管理者的工作重点转向护理质量的不断改进方面。

  2. Momentum: "Developing Masterful Marketing Plans."

    Science.gov (United States)

    Meservey, Lynne D.

    1988-01-01

    Describes how directors can plan and develop a written marketing plan which can increase enrollment at child care centers. Components of successful marketing plans include parent retention; program merchandising; staff and director training; sales promotions; networking; and enrichment programs/fundraising. (NH)

  3. The development of nuclear power and nuclear manpower training in China

    International Nuclear Information System (INIS)

    There are two nuclear power plants (NPP) in operation in China. The Qinshan NPP was the first that was constructed by China's own efforts and went into operation on 1991. The Daya Bay NPP was constructed using foreign funds, technology and went into operation on 1994. Four nuclear power projects with 8 units were initiated during the State Ninth Five-years Plan. The 8 units are expected for commercial operation between 2002 and 2005. China is preparing for the Tenth Five-Year Plan, in which China will develop the nuclear power at a moderate pace. The 13 universities and colleges were offering nuclear science educations. The students from these universities and college can meet the needs of nuclear institutes and enterprises. China National Nuclear Corporation (CNNC) owns the Graduated School of Nuclear Industry and the Nuclear Industry Administrative Cadre College, which will turn into the nuclear training center in future. Besides, CNNC also owns 4 institutions awarding Doctorate and 9 institutes awarding Master Degree. Many programs for education and training carried out by CNNC are presented, such as direct education supported by CNNC's finances, on job training, education for the second bachelor degree, training for senior economic professionals, research course for senior professionals, short time training course and training for license. China trained nuclear personnel by international cooperation with other countries both through multilateral and bilateral cooperation programs. CNNC has established scientific and economic ties with over 40 countries. CNNC has held diversified training for nuclear industry professionals with our own efforts and with the support from the State for many years. Today, the rapid development of nuclear industry needs more professionals. We must make greater efforts to enhance human resources development. Nuclear Safety is very important for nuclear energy development. Nuclear safety is closely related to each person who works in

  4. Hygiene guideline for the planning, installation, and operation of ventilation and air-conditioning systems in health-care settings - Guideline of the German Society for Hospital Hygiene (DGKH).

    Science.gov (United States)

    Külpmann, Rüdiger; Christiansen, Bärbel; Kramer, Axel; Lüderitz, Peter; Pitten, Frank-Albert; Wille, Frank; Zastrow, Klaus-Dieter; Lemm, Friederike; Sommer, Regina; Halabi, Milo

    2016-01-01

    Since the publication of the first "Hospital Hygiene Guideline for the implementation and operation of air conditioning systems (HVAC systems) in hospitals" (http://www.krankenhaushygiene.de/informationen/fachinformationen/leitlinien/12) in 2002, it was necessary due to the increase in knowledge, new regulations, improved air-conditioning systems and advanced test methods to revise the guideline. Based on the description of the basic features of ventilation concepts, its hygienic test and the usage-based requirements for ventilation, the DGKH section "Ventilation and air conditioning technology" attempts to provide answers for the major air quality issues in the planning, design and the hygienically safe operation of HVAC systems in rooms of health care. PMID:26958457

  5. Trajectories of health care service utilization and differences in patient characteristics among adults with specific chronic pain: analysis of health plan member claims

    Directory of Open Access Journals (Sweden)

    Ruetsch C

    2013-02-01

    Full Text Available Charles Ruetsch,1 Joseph Tkacz,1 Peter G Kardel,1 Andrew Howe,2 Helen Pai,2 Bennett Levitan31Health Analytics, LLC, Columbia, Maryland, 2Janssen Research & Development, Raritan, New Jersey, 3Janssen Research & Development, Titusville, New Jersey, USAIntroduction: The lack of consistency surrounding the diagnosis of chronic non-cancer pain, treatment approaches, and patient management suggests the need for further research to better characterize the chronic non-cancer pain population.Objective: The purpose of this study was to identify distinct trajectories of health care service utilization of chronic non-cancer pain patients and describe the characteristic differences between trajectory groups.Patients and methods: This study utilized the MarketScan claims databases. A total of 71,392 patients diagnosed with either low back pain or osteoarthritis between 2006 and 2009 served as the study sample. Each subject's claims data were divided into three time periods around an initial diagnosis date: pre-period, post-Year 1, and post-Year 2. Subjects were categorized as either high (H or low (L cost at each post period, resulting in the creation of four trajectory groups based on the post-Year 1 and 2 cost pattern: H-H, H-L, L-H, and L-L. Multivariate statistical tests were used to predict and discriminate between trajectory group memberships.Results: The H-H, L-H, and H-L groups each utilized significantly greater pre-period high-cost venue services, post-Year 1 outpatient services, and post-Year 1 opioids compared to the L-L group (P <0.001. Additionally, the H-H and L-H groups displayed elevated Charlson comorbidity index scores compared with the L-L group (P <0.001, with each showing increased odds of having both opioid dependence and cardiovascular disease diagnoses (P <0.01.Conclusion: This study identified patient characteristics among chronic pain patients that discriminated between different levels of post-index high-cost venue service

  6. Prenatal Care

    Science.gov (United States)

    ... am thinking about getting pregnant. How can I take care of myself? You should start taking care of ... What should I do — or not do — to take care of myself and my unborn baby? Follow these ...

  7. Self Care

    Science.gov (United States)

    ... Care Connections Experiences Research Learning Evaluation Print Email Self Care If you are living with a chronic ... help you cope can make a real difference. Self-care techniques are things you can do for ...

  8. Effect of ranking criteria on development goals in capital and manpower-limited oil and gas organizations

    International Nuclear Information System (INIS)

    This paper summarizes a study to determine the effect of financial ranking criteria on development goals of oil and gas organizations. Economic analysis and ranking was applied to one hundred projects representing oil and gas investment opportunities available to an organization. Each project's after tax cash flows were subjected to four financial analysis methods for ranking. The four analysis methods used were net present value to investment ratio (NPVI), internal rate of return (IRR), payback period and profit to investment ratio (P/I). After ranking, the projects were totaled according to a particular organizational objective. Totaling of projects by ranking would continue until a limiting resource to the organization was exhausted. This study demonstrates the insensitivity of financial analysis methods for ranking whether the organization is limited by capital or manpower. It concludes that the only requirement for a ranking criterion to properly allocate resources is that the criterion quantifies the organizational goal to some degree. Decision makers charged with selecting the most attractive growth portfolio of investment opportunities will do well with any profit measuring criterion for ranking

  9. Manpower Development to Support Indian Graduate Training School Program of BARC and its Incorporation in University System

    International Nuclear Information System (INIS)

    Conclusions: • Nuclear technology is multidisciplinary, knowledge intensive, and its education and training are constrained by unusual measures demanded by the concerns about radiation and nuclear safety, physical protection of nuclear materials and facilities, and safeguards to prevent diversion of nuclear material. • This requires vast faculty resources as also extraordinary and expensive infrastructure for conducting nuclear education making the task of human resource development in nuclear science and technology a challenging one. • The human resource for the nuclear energy programme in India so far has therefore been developed in-house in the DAE. • However, large requirement of manpower to take forward the growing nuclear energy programme in the country can be met only by extending concurrently the reach of the human resource development activity in nuclear science and technology. • The DAE is therefore supporting the university system in India, and integrating the existing training program with the university system. • It may be emphasized that nuclear education, being a means of preservation and transmission of explicit knowledge, is just one component of nuclear knowledge management (NKM). • The NKM also involves creation of mechanisms to preserve and transmit implicit and tacit knowledge

  10. Gestational diabetes - self-care

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000598.htm Gestational diabetes - self-care To use the sharing features on ... insulin therapy (shots). What Are the Risks of Gestational Diabetes? Women who follow their treatment plan and keep ...

  11. Medicaid Managed Care Enrollment Report

    Data.gov (United States)

    U.S. Department of Health & Human Services — This report is composed annually and profiles enrollment statistics on Medicaid managed care programs on a plan-specific level. This report also provides...

  12. The role of emergency medicine physicians in trauma care in North America: evolution of a specialty

    Directory of Open Access Journals (Sweden)

    Grossman Michael D

    2009-08-01

    Full Text Available Abstract The role of Emergency Medicine Physicians (EMP in the care of trauma patients in North America has evolved since the advent of the specialty in the late 1980's. The evolution of this role in the context of the overall demands of the specialty and accreditation requirements of North American trauma centers will be discussed. Limited available data published in the literature examining the role of EMP's in trauma care will be reviewed with respect to its implications for an expanded role for EMPs in trauma care. Two training models currently in the early stages of development have been proposed to address needs for increased manpower in trauma and the critical care of trauma patients. The available information regarding these models will be reviewed along with the implications for improving the care of trauma patients in both Europe and North America.

  13. [Primary care in France].

    Science.gov (United States)

    Sánchez-Sagrado, T

    2016-01-01

    The poor planning of health care professionals in Spain has led to an exodus of doctors leaving the country. France is one of the chosen countries for Spanish doctors to develop their professional career. The French health care system belongs to the Bismarck model. In this model, health care system is financed jointly by workers and employers through payroll deduction. The right to health care is linked to the job, and provision of services is done by sickness-funds controlled by the Government. Primary care in France is quite different from Spanish primary care. General practitioners are independent workers who have the right to set up a practice anywhere in France. This lack of regulation has generated a great problem of "medical desertification" with problems of health care access and inequalities in health. French doctors do not want to work in rural areas or outside cities because "they are not value for money". Medical salary is linked to professional activity. The role of doctors is to give punctual care. Team work team does not exist, and coordination between primary and secondary care is lacking. Access to diagnostic tests, hospitals and specialists is unlimited. Duplicity of services, adverse events and inefficiencies are the norm. Patients can freely choose their doctor, and they have a co-payment for visits and hospital care settings. Two years training is required to become a general practitioner. After that, continuing medical education is compulsory, but it is not regulated. Although the French medical Health System was named by the WHO in 2000 as the best health care system in the world, is it not that good. While primary care in Spain has room for improvement, there is a long way for France to be like Spain. PMID:26304179

  14. Special Needs: Planning for Adulthood (Videos)

    Medline Plus

    Full Text Available ... Your Baby's Growth Cerebral Palsy: Caring for Your Child All About Food Allergies Special Needs: Planning for ... for Health Insurance Finding Respite Care for Your Child With Special Needs Special Education: Getting Support for ...

  15. Special Needs: Planning for Adulthood (Videos)

    Medline Plus

    Full Text Available ... For Kids For Parents MORE ON THIS TOPIC Financial Planning for Kids With Special Needs Finding Your Way in the Health Care System Giving Teens a Voice in Health Care Decisions ...

  16. Improving palliative care.

    LENUS (Irish Health Repository)

    Moran, Sue

    2009-05-01

    Any service improvement project requires planning, action and evaluation. Using a recognised quality improvement framework can offer a structured approach to implementing and assessing changes to patient care. This article describes how use of the Deming Cycle has helped to identify nurses\\' learning needs.

  17. Integrating Care Across Disciplines.

    Science.gov (United States)

    Blachman, Nina L; Blaum, Caroline S

    2016-05-01

    Interdisciplinary care teams are important in managing older patients. Geriatric patients with cardiovascular problems represent a unique paradigm for interdisciplinary teams, and patients benefit from the assistance of physicians, nurses, social workers, pharmacists, and therapists collaborating on treatment plans. Teams work on the inpatient and outpatient sides and at patients' homes to maximize function and prevent readmissions to the hospital. PMID:27113153

  18. Hair transplantation: Standard guidelines of care

    Directory of Open Access Journals (Sweden)

    Patwardhan Narendra

    2008-03-01

    Full Text Available Hair transplantation is a surgical method of hair restoration. Physician qualification : The physician performing hair transplantation should have completed post graduation training in dermatology; he should have adequate background training in dermatosurgery at a centre that provides education training in cutaneous surgery. In addition, he should obtain specific hair transplantation training or experience at the surgical table(hands on under the supervision of an appropriately trained and experienced hair transplant surgeon. In addition to the surgical technique, training should include instruction in local anesthesia and emergency resuscitation and care. Facility : Hair transplantation can be performed safely in an outpatient day case dermatosurgical facility. The day case theatre should be equipped with facilities for monitoring and handling emergencies. A plan for handling emergencies should be in place and all nursing staff should be familiar with the emergency plan. It is preferable, but not mandatory to have a standby anesthetist. Indication for hair transplantation is pattern hair loss in males and also in females. In female pattern hair loss, investigations to rule out any underlying cause for hair loss such as anemia and thyroid deficiency should be carried out. Hair transplantation can also be performed in selected cases of scarring alopecia, eyebrows and eye lashes, by experienced surgeons. Preoperative counseling and informed consent :Detailed consent form listing details about the procedure and possible complications should be signed by the patient. The consent form should specifically state the limitations of the procedure and if more procedures are needed for proper results, it should be clearly mentioned. Patient should be provided with adequate opportunity to seek information through brochures, computer presentations, and personal discussions. Need for concomitant medical therapy should be emphasized. Patients should understand

  19. Telemedicine in diabetes foot care delivery: health care professionals’ experience

    OpenAIRE

    Kolltveit, Beate-Christin Hope; Gjengedal, Eva; Graue, Marit; Iversen, Marjolein. M.; Thorne, Sally; Kirkevold, Marit

    2016-01-01

    Background Introducing new technology in health care is inevitably a challenge. More knowledge is needed to better plan future telemedicine interventions. Our aim was therefore to explore health care professionals’ experience in the initial phase of introducing telemedicine technology in caring for people with diabetic foot ulcers. Methods Our methodological strategy was Interpretive Description. Data were collected between 2014 and 2015 using focus groups (n = 10). Participants from home-bas...

  20. Lessons Learned while Implementing an HIV/AIDs Care and Treatment Program in Rural Mozambique

    Directory of Open Access Journals (Sweden)

    Troy D. Moon

    2010-04-01

    Full Text Available Mozambique has severe resource constraints, yet with international partnerships, the nation has placed over 145,000 HIV- infected persons on antiretroviral therapies (ART through May 2009. HIV clinical services are provided at .215 clinical venues in all 11 of Mozambique’s provinces. Friends in Global Health (FGH, affiliated with Vanderbilt University in the United States (US, is a locally licensed non-governmental organization (NGO working exclusively in small city and rural venues in Zambézia Province whose population reaches approximately 4 million persons. Our approach to clinical capacity building is based on: 1 technical assistance to national health system facilities to implement ART clinical services at the district level, 2 human capacity development, and 3 health system strengthening. Challenges in this setting are daunting, including: 1 human resource constraints, 2 infrastructure limitations, 3 centralized care for large populations spread out over large distances, 4 continued high social stigma related to HIV, 5 limited livelihood options in rural areas and 6 limited educational opportunities in rural areas. Sustainability in rural Mozambique will depend on transitioning services from emergency foreign partners to local authorities and continued funding. It will also require “wrap-around” programs that help build economic capacity with agricultural, educational, and commercial initiatives. Sustainability is undermined by serious health manpower and infrastructure limitations. Recent U.S. government pronouncements suggest that the U.S. President’s Emergency Plan for AIDS Relief will support concurrent community and business development. FGH, with its Mozambican government counterparts, see the evolution of an emergency response to a sustainable chronic disease management program as an essential and logical step. We have presented six key challenges that are essential to address in rural Mozambique

  1. Integral multidisciplinary rehabilitation treatment planning

    OpenAIRE

    Braaksma, A.; Kortbeek, Nikky; Post, Gerhard; Nollet, Frans

    2012-01-01

    This paper presents a methodology to plan treatments for rehabilitation outpatients. These patients require a series of treatments by therapists from various disciplines. In current practice, when treatments are planned, a lack of coordination between the different disciplines, along with a failure to plan the entire treatment plan at once, often occurs. This situation jeopardizes both the quality of care and the logistical performance. The multidisciplinary nature of the rehabilitation proce...

  2. [The Development of Long-Term Care Policies and the Impact on Nursing].

    Science.gov (United States)

    Wu, Shiao-Chi; Tsai, Yin-Yin; Yeh, Shin-Ting

    2015-10-01

    The government must reform and enhance current medical and long-term care services in order to respond effectively to societal ageing and labor shortage trends and to ensure sustainable operations. The post-acute care system should be reoriented on the home and community instead of the hospital. The Long Term Care Service Act integrates long-term care services that were previously dispersed amongst different departments, sets up a long-term care development fund, and improves the quality and allocation of long-term care services. Moreover, the Long Term Care Insurance Act will implement a bundle payment system to assist disabled families. The integration of automation and information technology will make long-term care more efficient. Although nurses are more skilled at elderly care and counseling than other community care professionals, nurses generally lack training in business management. Home and community-based services thus require better-trained manpower, opportunities to set care agents, and opportunities to offer flexible caring jobs. Therefore, nurses should strengthen their capabilities in post-acute care, business management, cooperation, and coordination. PMID:26507622

  3. Study on Maintenance Personnel Development Plan For The Exported APR1400 Commissioning

    International Nuclear Information System (INIS)

    This paper indicates ways to develop maintenance personnel for the exported APR1400 commissioning. The exported APR1400 has not been experienced ay maintenance yet, and requirements for maintenance personnel have not been clarified yet. Based on sound maintenance experience, KEPCO Plant Service and Engineering Company (KEPCO KPS) has studied on maintenance training and career requirement to establish a development plan of the maintenance personnel for the exported nuclear power plant. By defining manpower and training requirement, and mobilization plan, we expect to secure reliability of the exported APR1400

  4. How Knowledge Mapping is Being Used to Integrate Plans for Safe and Reliable Operations

    International Nuclear Information System (INIS)

    Conclusions: • Intelligent decisions on prioritising and planning knowledge resources depends on knowing what you need to know and when you need to know it; • A systematic identification of knowledge needs is facilitated by the use of sophisticated knowledge mapping tools; • Knowledge maps can be used for a wide range of applications, from national nuclear manpower planning through to record retention schedules; • Collaboration on a single knowledge map can ensure consistency and efficiency in the activities of different departments and agencies

  5. Critical Care of Pet Birds.

    Science.gov (United States)

    Jenkins, Jeffrey Rowe

    2016-05-01

    Successful care of the critical pet bird patient is dependent on preparation and planning and begins with the veterinarian and hospital staff. An understanding of avian physiology and pathophysiology is key. Physical preparation of the hospital or clinic includes proper equipment and understanding of the procedures necessary to provide therapeutic and supportive care to the avian patient. An overview of patient intake and assessment, intensive care environment, and fluid therapy is included. PMID:27131161

  6. DATA AND STATISTICS REQUIRED FOR HEATH PLANNINGS

    Directory of Open Access Journals (Sweden)

    GR Pezeshkian

    1971-07-01

    Full Text Available Collecting and analyzing health related data and statistics are parts of health planning and in cases that lack sufficient data, the planning section is responsible for gathering the required information, by specific methods or carrying out research programs. In correct health planning, data collection and use of statistics and information, is not considered necessary in a large scale, but only required for as long as they have no objection with the aim of the planning and can be used in specific regional conditions. Since, planning is carried out with the health needs of a given population; the first step in data collection is related to the population. The second important group of data collection and vital statistics is related to the status of the epidemics, vital statistics, important and major health problems, environmental health, nutrition and expectancy, for diagnosing the community health. The third group of data collection and statistics are related to the health sources, manpower and the way the related institutions are active and managed. Finally, collecting helpful data, in the limits of possibilities in the health budget and expenses.

  7. Three-dimensional radiation treatment planning system based on STARDENT super graphic workstation

    International Nuclear Information System (INIS)

    In this paper we have demonstrated our 3D treatment planning system developed on a commercial workstation. The system has been in routine use for planning stereotactic brain implants for the last 2 years. Also we have demonstrated a few cases of the application of our 3D planning system for external beams. In future, several patient with specific clinical indication will be designated for planning, using this system. However, in its current state, the system is not ready to replace 2D planning with 3D planning. This is partly due to the inadequacy of the system, but mostly related to the lack of manpower, commitment and inadequacy of proper technology in the treatment machines in our department. (author). 6 refs., 14 figs

  8. Spatial planning

    OpenAIRE

    Dimitrov, Nikola; Koteski, Cane

    2016-01-01

    The professional book ,, Space planning "processed chapters on: space, concept and definition of space, space as a system, spatial economics, economic essence of space, space planning, social determinants of spatial planning, spatial planning as a process, factors development and elements in spatial planning, methodology, components and content of spatial planning stages and types of preparation of spatial planning, spatial planning and industrialization, industrialization, urbanization and s...

  9. Using Integer Programming for Airport Service Planning in Staff Scheduling

    Directory of Open Access Journals (Sweden)

    W.H. Ip

    2010-09-01

    Full Text Available Reliability and safety in flight is extremely necessary and that depend on the adoption of proper maintenance system. Therefore, it is essential for aircraft maintenance companies to perform the manpower scheduling efficiently. One of the objectives of this paper is to provide an Integer Programming approach to determine the optimal solutions to aircraft maintenance planning and scheduling and hence the planning and scheduling processes can become more efficient and effective. Another objective is to develop a set of computational schedules for maintenance manpower to cover all scheduled flights. In this paper, a sequential methodology consisting of 3 stages is proposed. They are initial maintenance demand schedule, the maintenance pairing and the maintenance group(s assignment. Since scheduling would split up into different stages, different mathematical techniques have been adopted to cater for their own problem characteristics. Microsoft Excel would be used. Results from the first stage and second stage would be inputted into integer programming model using Microsoft Excel Solver to find the optimal solution. Also, Microsoft Excel VBA is used for devising a scheduling system in order to reduce the manual process and provide a user friendly interface. For the results, all can be obtained optimal solution and the computation time is reasonable and acceptable. Besides, the comparison of the peak time and non-peak time is discussed.

  10. The SPHERE Study. Secondary prevention of heart disease in general practice: protocol of a randomised controlled trial of tailored practice and patient care plans with parallel qualitative, economic and policy analyses. [ISRCTN24081411].

    LENUS (Irish Health Repository)

    Murphy, Andrew W

    2005-07-29

    BACKGROUND: The aim of the SPHERE study is to design, implement and evaluate tailored practice and personal care plans to improve the process of care and objective clinical outcomes for patients with established coronary heart disease (CHD) in general practice across two different health systems on the island of Ireland. CHD is a common cause of death and a significant cause of morbidity in Ireland. Secondary prevention has been recommended as a key strategy for reducing levels of CHD mortality and general practice has been highlighted as an ideal setting for secondary prevention initiatives. Current indications suggest that there is considerable room for improvement in the provision of secondary prevention for patients with established heart disease on the island of Ireland. The review literature recommends structured programmes with continued support and follow-up of patients; the provision of training, tailored to practice needs of access to evidence of effectiveness of secondary prevention; structured recall programmes that also take account of individual practice needs; and patient-centred consultations accompanied by attention to disease management guidelines. METHODS: SPHERE is a cluster randomised controlled trial, with practice-level randomisation to intervention and control groups, recruiting 960 patients from 48 practices in three study centres (Belfast, Dublin and Galway). Primary outcomes are blood pressure, total cholesterol, physical and mental health status (SF-12) and hospital re-admissions. The intervention takes place over two years and data is collected at baseline, one-year and two-year follow-up. Data is obtained from medical charts, consultations with practitioners, and patient postal questionnaires. The SPHERE intervention involves the implementation of a structured systematic programme of care for patients with CHD attending general practice. It is a multi-faceted intervention that has been developed to respond to barriers and solutions to

  11. Assembly plans for ITER

    International Nuclear Information System (INIS)

    The assembly of ITER represents an extrapolation of a factor of two or more in size over existing large tokamaks. An assembly plan has been developed based on the ITER Outline Design. This plan was reviewed by technical experts and critical issues were identified. Alternate designs are being developed to address the most serious concerns and to minimize cost and assembly schedule. Because ITER has many characteristics of a full-scale nuclear reactor its assembly has challenges not faced previously by the fusion community. Careful assembly planning and well-designed tooling are required to insure success in the assembly of ITER

  12. Coordinating Care for Children with Special Health Care Needs

    OpenAIRE

    Stephanie Peterson; Shanna Shulman; Henry Ireys

    2007-01-01

    This brief, the fourth in a series on critical issues involved in caring for children with special health care needs, notes that nearly three-quarters of parents who need professional care coordination services for their child say they do not get enough help—if they get any at all. Moreover, one-third of those who do get help are not fully satisfied with the quality of services they receive. Although many health plans coordinate care for their adult members with chronic conditions and disab...

  13. Hair Care

    Science.gov (United States)

    ... Body Looking and feeling your best Hair care Hair care Short, long, curly, straight, up, down. Hair options can seem endless! Not all of what makes your hair look good comes from the outside, though. Good ...

  14. Tracheostomy care

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000076.htm Tracheostomy care To use the sharing features on this ... through your nose and mouth. Caring for Your Tracheostomy Once the hole in your neck is not ...

  15. Planning the operation.

    Science.gov (United States)

    Kiely, Edward M; Spitz, Lewis

    2015-10-01

    The management of conjoined twins falls into three distinct groups-non-operative, emergency separation and elective separation. Planning meetings involving all the personnel who will be required during the operation are held. The radiological findings are presented and the anaesthetic, nursing and intensive care requirements are highlighted. PMID:26382260

  16. Study on the acceptance, complications and continuation rate of post-partum family planning using the post placental intrauterine contraceptive device among women delivering at a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Rajya Lakshmi Bai Gujju

    2015-04-01

    Full Text Available Background: Post placental intrauterine contraceptive device use in India showed that most women were satisfied with their choice of immediate insertion of an IUCD and the rates of complications were relatively low. The large proportion of women accepting the method to limit future childbearing indicates the important place post placental IUCD hold. This study was done to evaluate the acceptance of intrauterine contraceptive device as an immediate family planning method following delivery. The complications associated with it were identified and continuation rates were assessed. Methods: Women admitted for delivery in a tertiary care hospital were included in the study. Only women who fulfilled the medical eligibility criteria were included in the study. Results: A total of 4209 women were counseled of which 780 (18.5% women accepted the method, 3429 declined. Out of the 780 cases, 764 came for follow up, and 16 were lost to follow up, spontaneous expulsion was seen in 2 (0.2% cases, removal was done on request in 1 case and continuation was seen in 761 (97.56% women. Conclusions: The Post placental intrauterine contraceptive device is safe to insert immediately after delivery. It has good acceptance with minimal expulsion and very high continuation rates. [Int J Reprod Contracept Obstet Gynecol 2015; 4(2.000: 388-391

  17. Planejamento da assistência de enfermagem: proposta de um software-protótipo Planificación del cuidado de enfermería: propuesta de un software-prototipo Nursing care planning: proposal for a software prototype

    Directory of Open Access Journals (Sweden)

    Dircelene Jussara Sperandio

    2005-12-01

    hospital nurses plan nursing care, and carry out nursing interventions and all documentation in a computerized way. The methodology is based on the life cycle of system development, particularly the prototype concept, involving two phases: definition and development. The definition phase began with the planning stage, followed by the definition and analysis of requirements for the construction, and culminated with the specification of the software requirements. The development phase translated the group of requirements into a computerized model, structured in 10 modules, regarding the nursing care system process. The performance of this innovative resource in the different stages of the nursing care system process will be analyzed in future studies.

  18. Planning Lessons

    Institute of Scientific and Technical Information of China (English)

    Linda Jensen

    2007-01-01

    @@ Jensen's "Lesson Planning"article serves aS a guide fOr novice teachers who need to create formalized lesson plans.The article covers why,when,and how teachers plan lessons,as well aS basic lesson plan principles and a lesson plan template.

  19. Nuclear manpower training

    International Nuclear Information System (INIS)

    This report describes the annual results of training courses. the scope and contents are as follows: 1. Regional and interregional training courses 2. Training courses assisted by foreign experts 3. Training courses for nuclear industry personnel 4. Training courses for internal staff-members 5. Training courses under the law. This Nuclear Training Center executed the open-door training courses for 2,400 engineers/scientists from the regulatory body, nuclear industries, research institutes and other related organizations by means of offering 51 training courses during the fiscal year 1996. (author). 23 refs

  20. Nuclear Manpower Training

    Energy Technology Data Exchange (ETDEWEB)

    Min, B. J.; Han, K. W.; Lee, H. Y. and others

    2006-01-15

    Through the project on nuclear human resources development in 2005, the Nuclear Training Center of KAERI has provided 67 nuclear education and training courses for 3,658 persons from the domestic nuclear related organizations such as Government Agencies, nuclear industries, R and D institutes, universities, and public as well as from IAEA Member States. In addition, 6 students (MS and Ph D.) have taken nuclear technology related courses offered by UST-KAERI. The project has developed 8 programs and 12 courses. They includes programs for IAEA training, bilateral education and training, and in-house training as well as courses dealing with maintenance of nuclear power plants and management of electricity generation, thermal-hydraulics nuclear hydrogen, nuclear safeguards, radiation emergency preparedness and etc. National and international cooperation has been promoted. For ANENT, test operation, data loading and revision of the web-portal have been undertaken. Also the web-portal operation system has been established. For FNCA, NTC has cooperated for the establishment of a model of human resource development and the exchange of information/materials. With WNU, the NTC has made an effort for hosting 2007 WNU Summer Institute. The infrastructure for nuclear education and training has been strengthened. Basic directions for providing the customers with better service, This includes showing kindness to the customer, renovation of the interior of training facilities, and upgrading of web-based management system for learning and using facilities of NTC. Other efforts have resulted in the publication of 25 course materials (10 for international courses and 15 for national courses), and the improvement of education and training equipment. The International Nuclear Training and Education Center (INTEC), which was opened in 2002, has hosted 296 international and domestic events in 2005.