Population health management guiding principles to stimulate collaboration and improve pharmaceutical care

NARCIS (Netherlands)

B. Steenkamer (Betty); C.A. Baan (Caroline); K. Putters (Kim); H.A.M. Oers (Hans); H.W. Drewes (Hanneke W.)

2018-01-01

markdownabstractPurpose: A range of strategies to improve pharmaceutical care has been implemented by population health management (PHM) initiatives. However, which strategies generate the desired outcomes is largely unknown. The purpose of this paper is to identify guiding principles underlying

Population health management guiding principles to stimulate collaboration and improve pharmaceutical care

NARCIS (Netherlands)

Steenkamer, B.M.; Baan, C.A.; Putters, Kim; van Oers, J.A.M.; Drewes, Hanneke

2018-01-01

Purpose A range of strategies to improve pharmaceutical care has been implemented by population health management (PHM) initiatives. However, which strategies generate the desired outcomes is largely unknown. The purpose of this paper is to identify guiding principles underlying collaborative

Population health management guiding principles to stimulate collaboration and improve pharmaceutical care.

NARCIS (Netherlands)

Steenkamer, Betty; Baan, Caroline; Putters, Kim; van Oers, Hans; Drewes, Hanneke

2018-01-01

Purpose A range of strategies to improve pharmaceutical care has been implemented by population health management (PHM) initiatives. However, which strategies generate the desired outcomes is largely unknown. The purpose of this paper is to identify guiding principles underlying collaborative

Data Fusion for Enhanced Aircraft Engine Prognostics and Health Management

Science.gov (United States)

Volponi, Al

2005-01-01

Aircraft gas-turbine engine data is available from a variety of sources, including on-board sensor measurements, maintenance histories, and component models. An ultimate goal of Propulsion Health Management (PHM) is to maximize the amount of meaningful information that can be extracted from disparate data sources to obtain comprehensive diagnostic and prognostic knowledge regarding the health of the engine. Data fusion is the integration of data or information from multiple sources for the achievement of improved accuracy and more specific inferences than can be obtained from the use of a single sensor alone. The basic tenet underlying the data/ information fusion concept is to leverage all available information to enhance diagnostic visibility, increase diagnostic reliability and reduce the number of diagnostic false alarms. This report describes a basic PHM data fusion architecture being developed in alignment with the NASA C-17 PHM Flight Test program. The challenge of how to maximize the meaningful information extracted from disparate data sources to obtain enhanced diagnostic and prognostic information regarding the health and condition of the engine is the primary goal of this endeavor. To address this challenge, NASA Glenn Research Center, NASA Dryden Flight Research Center, and Pratt & Whitney have formed a team with several small innovative technology companies to plan and conduct a research project in the area of data fusion, as it applies to PHM. Methodologies being developed and evaluated have been drawn from a wide range of areas including artificial intelligence, pattern recognition, statistical estimation, and fuzzy logic. This report will provide a chronology and summary of the work accomplished under this research contract.

Implementation of Remaining Useful Lifetime Transformer Models in the Fleet-Wide Prognostic and Health Management Suite

International Nuclear Information System (INIS)

Agarwal, Vivek; Lybeck, Nancy J.; Pham, Binh; Rusaw, Richard; Bickford, Randall

2015-01-01

Research and development efforts are required to address aging and reliability concerns of the existing fleet of nuclear power plants. As most plants continue to operate beyond the license life (i.e., towards 60 or 80 years), plant components are more likely to incur age-related degradation mechanisms. To assess and manage the health of aging plant assets across the nuclear industry, the Electric Power Research Institute has developed a web-based Fleet-Wide Prognostic and Health Management (FW-PHM) Suite for diagnosis and prognosis. FW-PHM is a set of web-based diagnostic and prognostic tools and databases, comprised of the Diagnostic Advisor, the Asset Fault Signature Database, the Remaining Useful Life Advisor, and the Remaining Useful Life Database, that serves as an integrated health monitoring architecture. The main focus of this paper is the implementation of prognostic models for generator step-up transformers in the FW-PHM Suite. One prognostic model discussed is based on the functional relationship between degree of polymerization, (the most commonly used metrics to assess the health of the winding insulation in a transformer) and furfural concentration in the insulating oil. The other model is based on thermal-induced degradation of the transformer insulation. By utilizing transformer loading information, established thermal models are used to estimate the hot spot temperature inside the transformer winding. Both models are implemented in the Remaining Useful Life Database of the FW-PHM Suite. The Remaining Useful Life Advisor utilizes the implemented prognostic models to estimate the remaining useful life of the paper winding insulation in the transformer based on actual oil testing and operational data.

A Multiple Model Prediction Algorithm for CNC Machine Wear PHM

Directory of Open Access Journals (Sweden)

Huimin Chen

2011-01-01

Full Text Available The 2010 PHM data challenge focuses on the remaining useful life (RUL estimation for cutters of a high speed CNC milling machine using measurements from dynamometer, accelerometer, and acoustic emission sensors. We present a multiple model approach for wear depth estimation of milling machine cutters using the provided data. The feature selection, initial wear estimation and multiple model fusion components of the proposed algorithm are explained in details and compared with several alternative methods using the training data. The final submission ranked #2 among professional and student participants and the method is applicable to other data driven PHM problems.

Experimental program for physics-of-failure modeling of electrolytic capacitors towards prognostics and health management

International Nuclear Information System (INIS)

Rana, Y.S.; Banerjee, Shantanab; Singh, Tej; Varde, P.V.

2017-01-01

Prognostics and Health Management (PHM) is a method used for predicting reliability of a component or system by assessing its current health and future operating conditions. A physics-of-failure (PoF)-based program on PHM for reliability prediction has been initiated at our institute. As part of the program, we aim at developing PoF-based models for degradation of electronic components and their experimental validation. In this direction, a database on existing PoF models for different electronic components has been prepared. We plan to experimentally determine the model constants and propose suitable methodology for PHM. Electrolytic capacitors are one of the most common passive components which find their applications in devices such as power supplies in aircrafts and printed circuit boards (PCBs) for regulation and protection of a nuclear reactor. Experimental studies have established that electrolytic capacitors degrade under electrical and thermal stress and tend to fail before their anticipated useful life at normal operating conditions. Equivalent series resistance (ESR) and capacitance (C) are the two main parameters used for monitoring health of such capacitors. In this paper, we present an experimental program for thermal and electrical overstress studies towards degradation models for electrolytic capacitors. (author)

Research on prognostics and health management of underground pipeline

Science.gov (United States)

Zhang, Guangdi; Yang, Meng; Yang, Fan; Ni, Na

2018-04-01

With the development of the city, the construction of the underground pipeline is more and more complex, which has relation to the safety and normal operation of the city, known as "the lifeline of the city". First of all, this paper introduces the principle of PHM (Prognostics and Health Management) technology, then proposed for fault diagnosis, prognostics and health management in view of underground pipeline, make a diagnosis and prognostics for the faults appearing in the operation of the underground pipeline, and then make a health assessment of the whole underground pipe network in order to ensure the operation of the pipeline safely. Finally, summarize and prospect the future research direction.

Population Health Management for Older Adults

Science.gov (United States)

Tkatch, Rifky; Musich, Shirley; MacLeod, Stephanie; Alsgaard, Kathleen; Hawkins, Kevin; Yeh, Charlotte S.

2016-01-01

Background: The older adult population is expanding, living longer, with multiple chronic conditions. Understanding and managing their needs over time is an integral part of defining successful aging. Population health is used to describe the measurement and health outcomes of a population. Objectives: To define population health as applied to older adults, summarize lessons learned from current research, and identify potential interventions designed to promote successful aging and improved health for this population. Method: Online search engines were utilized to identify research on population health and health interventions for older adults. Results: Population health management (PHM) is one strategy to promote the health and well-being of target populations. Interventions promoting health across a continuum tend to be disease, risk, or health behavior specific rather than encompassing a global concept of health. Conclusion: Many existing interventions for older adults are simply research based with limited generalizability; as such, further work in this area is warranted. PMID:28680938

Requirements Flowdown for Prognostics and Health Management

Science.gov (United States)

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

2012-01-01

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

A self-cognizant dynamic system approach for prognostics and health management

Science.gov (United States)

Bai, Guangxing; Wang, Pingfeng; Hu, Chao

2015-03-01

Prognostics and health management (PHM) is an emerging engineering discipline that diagnoses and predicts how and when a system will degrade its performance and lose its partial or whole functionality. Due to the complexity and invisibility of rules and states of most dynamic systems, developing an effective approach to track evolving system states becomes a major challenge. This paper presents a new self-cognizant dynamic system (SCDS) approach that incorporates artificial intelligence into dynamic system modeling for PHM. A feed-forward neural network (FFNN) is selected to approximate a complex system response which is challenging task in general due to inaccessible system physics. The trained FFNN model is then embedded into a dual extended Kalman filter algorithm to track down system dynamics. A recursive computation technique used to update the FFNN model using online measurements is also derived. To validate the proposed SCDS approach, a battery dynamic system is considered as an experimental application. After modeling the battery system by a FFNN model and a state-space model, the state-of-charge (SoC) and state-of-health (SoH) are estimated by updating the FFNN model using the proposed approach. Experimental results suggest that the proposed approach improves the efficiency and accuracy for battery health management.

Key Design Considerations When Calculating Cost Savings for Population Health Management Programs in an Observational Setting.

Science.gov (United States)

Murphy, Shannon M E; Hough, Douglas E; Sylvia, Martha L; Dunbar, Linda J; Frick, Kevin D

2018-02-08

To illustrate the impact of key quasi-experimental design elements on cost savings measurement for population health management (PHM) programs. Population health management program records and Medicaid claims and enrollment data from December 2011 through March 2016. The study uses a difference-in-difference design to compare changes in cost and utilization outcomes between program participants and propensity score-matched nonparticipants. Comparisons of measured savings are made based on (1) stable versus dynamic population enrollment and (2) all eligible versus enrolled-only participant definitions. Options for the operationalization of time are also discussed. Individual-level Medicaid administrative and claims data and PHM program records are used to match study groups on baseline risk factors and assess changes in costs and utilization. Savings estimates are statistically similar but smaller in magnitude when eliminating variability based on duration of population enrollment and when evaluating program impact on the entire target population. Measurement in calendar time, when possible, simplifies interpretability. Program evaluation design elements, including population stability and participant definitions, can influence the estimated magnitude of program savings for the payer and should be considered carefully. Time specifications can also affect interpretability and usefulness. © Health Research and Educational Trust.

Stress testing on silicon carbide electronic devices for prognostics and health management.

Energy Technology Data Exchange (ETDEWEB)

Kaplar, Robert James; Brock, Reinhard C.; Marinella, Matthew; King, Michael Patrick; Smith, Mark A.; Atcitty, Stanley

2011-01-01

Power conversion systems for energy storage and other distributed energy resource applications are among the drivers of the important role that power electronics plays in providing reliable electricity. Wide band gap semiconductors such as silicon carbide (SiC) and gallium nitride (GaN) will help increase the performance and efficiency of power electronic equipment while condition monitoring (CM) and prognostics and health management (PHM) will increase the operational availability of the equipment and thereby make it more cost effective. Voltage and/or temperature stress testing were performed on a number of SiC devices in order to accelerate failure modes and to identify measureable shifts in electrical characteristics which may provide early indication of those failures. Those shifts can be interpreted and modeled to provide prognostic signatures for use in CM and/or PHM. Such experiments will also lead to a deeper understanding of basic device physics and the degradation mechanisms behind failure.

A module for psycho-social assessment of personal health monitoring.

Science.gov (United States)

Muehlan, Holger; Rhode, Dieter; Schmidt, Silke

2013-01-01

This contribution to an interdisciplinary methodology on Personal Health Monitoring (PHM) aims at developing a psycho-social module for health technology assessment on PHM applications. It covers important aspects that should be taken into account for conducting a health technology assessment from a psycho-social perspective. As it could be used in addition to other tools within the PHM-Ethics approach to health technology assessment it is considered as a module of the interdisciplinary methodology. As a prerequisite, we provide a conceptual framework on psycho-social issues of PHM applications. From that framework we delineate an integrated module for psycho-social health technology assessment for PHM applications, consisting of a map highlighting selective psycho-social issues that may appear when applying a PHM system. This psycho-social tool is at least twofold in its intention as a sole HTA tool on the one hand and as an integral part of the interdisciplinary PHM methodology on the other hand. It provides a quick overview on potential benefits and risks from the user's point of view.

Cassava pest and disease management: An overview | Herren ...

African Journals Online (AJOL)

African Crop Science Journal ... Host-plant resistance and biological control are the cornerstones of crop protection measures against biotic ... Sustainable plant health management (PHM) that considers the crop plant as a component of an ...

Prognostics and health management of engineering systems an introduction

CERN Document Server

Kim, Nam-Ho; Choi, Joo-Ho

2017-01-01

This book introduces the methods for predicting the future behavior of a system’s health and the remaining useful life to determine an appropriate maintenance schedule. The authors introduce the history, industrial applications, algorithms, and benefits and challenges of PHM (Prognostics and Health Management) to help readers understand this highly interdisciplinary engineering approach that incorporates sensing technologies, physics of failure, machine learning, modern statistics, and reliability engineering. It is ideal for beginners because it introduces various prognostics algorithms and explains their attributes, pros and cons in terms of model definition, model parameter estimation, and ability to handle noise and bias in data, allowing readers to select the appropriate methods for their fields of application. Among the many topics discussed in-depth are: • Prognostics tutorials using least-squares • Bayesian inference and parameter estimation • Physics-based prognostics algorithms including non...

Autonomous health management for PMSM rail vehicles through demagnetization monitoring and prognosis control.

Science.gov (United States)

Niu, Gang; Jiang, Junjie; Youn, Byeng D; Pecht, Michael

2018-01-01

Autonomous vehicles are playing an increasingly importance in support of a wide variety of critical events. This paper presents a novel autonomous health management scheme on rail vehicles driven by permanent magnet synchronous motors (PMSMs). Firstly, the PMSMs are modeled based on first principle to deduce the initial profile of pneumatic braking (p-braking) force, then which is utilized for real-time demagnetization monitoring and degradation prognosis through similarity-based theory and generate prognosis-enhanced p-braking force strategy for final optimal control. A case study is conducted to demonstrate the feasibility and benefit of using the real-time prognostics and health management (PHM) information in vehicle 'drive-brake' control automatically. The results show that accurate demagnetization monitoring, degradation prognosis, and real-time capability for control optimization can be obtained, which can effectively relieve brake shoe wear. Copyright © 2018 ISA. Published by Elsevier Ltd. All rights reserved.

Using PHM to measure equipment usable life on the Air Force's next generation reusable space booster

Science.gov (United States)

Blasdel, A.

The U.S. Air Force procures many launch vehicles and launch vehicle services to place their satellites at their desired location in space. The equipment on-board these satellite and launch vehicle often suffer from premature failures that result in the total loss of the satellite or a shortened mission life sometimes requiring the purchase of a replacement satellite and launch vehicle. The Air Force uses its EELV to launch its high priority satellites. Due to a rise in the cost of purchasing a launch using the Air Force's EELV from 72M in 1997 to as high as 475M per launch today, the Air Force is working to replace the EELV with a reusable space booster (RSB). The RSB will be similar in design and operations to the recently cancelled NASA reusable space booster known as the Space Shuttle. If the Air Force uses the same process that procures the EELV and other launch vehicles and satellites, the RSB will also suffer from premature equipment failures thus putting the payloads at a similar high risk of mission failure. The RSB is expected to lower each launch cost by 50% compared to the EELV. The development of the RSB offers the Air Force an opportunity to use a new reliability paradigm that includes a prognostic and health management program and a condition-based maintenance program. These both require using intelligent, decision making self-prognostic equipment The prognostic and health management program and its condition-based maintenance program allows increases in RSB equipment usable life, lower logistics and maintenance costs, while increasing safety and mission assurance. The PHM removes many decisions from personnel that, in the past resulted in catastrophic failures and loss of life. Adding intelligent, decision-making self-prognostic equipment to the RSB will further decrease launch costs while decreasing risk and increasing safety and mission assurance.

Research on key technology of prognostic and health management for autonomous underwater vehicle

Science.gov (United States)

Zhou, Zhi

2017-12-01

Autonomous Underwater Vehicles (AUVs) are non-cable and autonomous motional underwater robotics. With a wide range of activities, it can reach thousands of kilometers. Because it has the advantages of wide range, good maneuverability, safety and intellectualization, it becomes an important tool for various underwater tasks. How to improve diagnosis accuracy of the AUVs electrical system faults, and how to repair AUVs by the information are the focus of navy in the world. In turn, ensuring safe and reliable operation of the system has very important significance to improve AUVs sailing performance. To solve these problems, in the paper the prognostic and health management(PHM) technology is researched and used to AUV, and the overall framework and key technology are proposed, such as data acquisition, feature extraction, fault diagnosis, failure prediction and so on.

Population health management guiding principles to stimulate collaboration and improve pharmaceutical care.

Science.gov (United States)

Steenkamer, Betty; Baan, Caroline; Putters, Kim; van Oers, Hans; Drewes, Hanneke

2018-04-09

Purpose A range of strategies to improve pharmaceutical care has been implemented by population health management (PHM) initiatives. However, which strategies generate the desired outcomes is largely unknown. The purpose of this paper is to identify guiding principles underlying collaborative strategies to improve pharmaceutical care and the contextual factors and mechanisms through which these principles operate. Design/methodology/approach The evaluation was informed by a realist methodology examining the links between PHM strategies, their outcomes and the contexts and mechanisms by which these strategies operate. Guiding principles were identified by grouping context-specific strategies with specific outcomes. Findings In total, ten guiding principles were identified: create agreement and commitment based on a long-term vision; foster cooperation and representation at the board level; use layered governance structures; create awareness at all levels; enable interpersonal links at all levels; create learning environments; organize shared responsibility; adjust financial strategies to market contexts; organize mutual gains; and align regional agreements with national policies and regulations. Contextual factors such as shared savings influenced the effectiveness of the guiding principles. Mechanisms by which these guiding principles operate were, for instance, fostering trust and creating a shared sense of the problem. Practical implications The guiding principles highlight how collaboration can be stimulated to improve pharmaceutical care while taking into account local constraints and possibilities. The interdependency of these principles necessitates effectuating them together in order to realize the best possible improvements and outcomes. Originality/value This is the first study using a realist approach to understand the guiding principles underlying collaboration to improve pharmaceutical care.

An Overview of the NASA Aviation Safety Program Propulsion Health Monitoring Element

Science.gov (United States)

Simon, Donald L.

2000-01-01

The NASA Aviation Safety Program (AvSP) has been initiated with aggressive goals to reduce the civil aviation accident rate, To meet these goals, several technology investment areas have been identified including a sub-element in propulsion health monitoring (PHM). Specific AvSP PHM objectives are to develop and validate propulsion system health monitoring technologies designed to prevent engine malfunctions from occurring in flight, and to mitigate detrimental effects in the event an in-flight malfunction does occur. A review of available propulsion system safety information was conducted to help prioritize PHM areas to focus on under the AvSP. It is noted that when a propulsion malfunction is involved in an aviation accident or incident, it is often a contributing factor rather than the sole cause for the event. Challenging aspects of the development and implementation of PHM technology such as cost, weight, robustness, and reliability are discussed. Specific technology plans are overviewed including vibration diagnostics, model-based controls and diagnostics, advanced instrumentation, and general aviation propulsion system health monitoring technology. Propulsion system health monitoring, in addition to engine design, inspection, maintenance, and pilot training and awareness, is intrinsic to enhancing aviation propulsion system safety.

Performance Health Monitoring of Large-Scale Systems

Energy Technology Data Exchange (ETDEWEB)

Rajamony, Ram [IBM Research, Austin, TX (United States)

2014-11-20

This report details the progress made on the ASCR funded project Performance Health Monitoring for Large Scale Systems. A large-­scale application may not achieve its full performance potential due to degraded performance of even a single subsystem. Detecting performance faults, isolating them, and taking remedial action is critical for the scale of systems on the horizon. PHM aims to develop techniques and tools that can be used to identify and mitigate such performance problems. We accomplish this through two main aspects. The PHM framework encompasses diagnostics, system monitoring, fault isolation, and performance evaluation capabilities that indicates when a performance fault has been detected, either due to an anomaly present in the system itself or due to contention for shared resources between concurrently executing jobs. Software components called the PHM Control system then build upon the capabilities provided by the PHM framework to mitigate degradation caused by performance problems.

Psycho-social aspects of personal health monitoring: a descriptive literature review.

Science.gov (United States)

Muehlan, Holger; Schmidt, Silke

2013-01-01

We aimed at providing a short review on already published studies addressing psycho-social issues of personal health monitoring (PHM). Both core questions addressed within this review are: What is the impact of PHM on intended psycho-social and health-related outcomes? And which psycho-social issues affected by or related to PHM have already been investigated? This descriptive review based on a literature search using various databases (Psycinfo, Psyndex, Pubmed, SSCI). Resulting 428 abstracts were coded regarding their psycho-social content. Inspection of results was carried out along the relevance of the papers regarding psycho-social issues. Research in PHM focuses on telemonitoring and smart home applications: Tele-monitoring studies are directed to outcome-related questions, smart home studies to feasibility issues. Despite of technological matters, comparability of both systems in psycho-social issues is lacking. Tele-monitoring has been proven for impact on patient groups with chronic diseases, yet smart home still lacks evidence in health-related and psycho-social matters. Smart home applications have been investigated with respect to attitudes, perceptions and concerns of end-users, telemonitoring regarding acceptance and adherence.

Prognostic Health Monitoring System: Component Selection Based on Risk Criteria and Economic Benefit Assessment

International Nuclear Information System (INIS)

Pham, Binh T.; Agarwal, Vivek; Lybeck, Nancy J.; Tawfik, Magdy S.

2012-01-01

Prognostic health monitoring (PHM) is a proactive approach to monitor the ability of structures, systems, and components (SSCs) to withstand structural, thermal, and chemical loadings over the SSCs planned service lifespan. The current efforts to extend the operational license lifetime of the aging fleet of U.S. nuclear power plants from 40 to 60 years and beyond can benefit from a systematic application of PHM technology. Implementing a PHM system would strengthen the safety of nuclear power plants, reduce plant outage time, and reduce operation and maintenance costs. However, a nuclear power plant has thousands of SSCs, so implementing a PHM system that covers all SSCs requires careful planning and prioritization. This paper therefore focuses on a component selection that is based on the analysis of a component's failure probability, risk, and cost. Ultimately, the decision on component selection depends on the overall economical benefits arising from safety and operational considerations associated with implementing the PHM system. (author)

Interaction of PHM, PHI and 24-glutamine PHI with human VIP receptors from colonic epithelium: comparison with rat intestinal receptors

International Nuclear Information System (INIS)

Laburthe, M.; Couvineau, A.; Rouyer-Fessard, C.; Moroder, L.

1985-01-01

PHM, the human counterpart of porcine Peptide Histidine Isoleucine amide (PHI), is shown to be a VIP agonist with low potency on human VIP receptors located in colonic epithelial cell membranes. Its potency is identical to that of PHI but by 3 orders of magnitude lower than that of VIP itself in inhibiting 125 I-VIP binding and in stimulating adenylate cyclase activity. This contrasts markedly with the behavior of PHI on rat VIP receptors located in intestinal epithelial cell membranes where PHI is a potent agonist with a potency that is 1/5 that of VIP. In another connection, the authors show that 24-glutamine PHI has the same affinity as 24-glutamic acid PHI (the natural peptide) for rat or human VIP receptors. These results indicate that while PHI may exert some physiological function through its interaction with VIP receptors in rodents, its human counterpart PHM is a very poor agonist of VIP in human. Furthermore, they show that the drastic change in position 24 of PHI (neutral versus acid residue) does not affect the activity of PHI, at least on VIP receptors. 21 references, 1 figure

A Systems Engineering Approach to Electro-Mechanical Actuator Diagnostic and Prognostic Development

Data.gov (United States)

National Aeronautics and Space Administration — The authors have formulated a Comprehensive Systems Engineering approach to Electro-Mechanical Actuator (EMA) Prognostics and Health Management (PHM) system...

Uncertainty Management for Diagnostics and Prognostics of Batteries using Bayesian Techniques

Science.gov (United States)

Saha, Bhaskar; Goebel, kai

2007-01-01

Uncertainty management has always been the key hurdle faced by diagnostics and prognostics algorithms. A Bayesian treatment of this problem provides an elegant and theoretically sound approach to the modern Condition- Based Maintenance (CBM)/Prognostic Health Management (PHM) paradigm. The application of the Bayesian techniques to regression and classification in the form of Relevance Vector Machine (RVM), and to state estimation as in Particle Filters (PF), provides a powerful tool to integrate the diagnosis and prognosis of battery health. The RVM, which is a Bayesian treatment of the Support Vector Machine (SVM), is used for model identification, while the PF framework uses the learnt model, statistical estimates of noise and anticipated operational conditions to provide estimates of remaining useful life (RUL) in the form of a probability density function (PDF). This type of prognostics generates a significant value addition to the management of any operation involving electrical systems.

An Approach to Prognostic Decision Making in the Aerospace Domain

Data.gov (United States)

National Aeronautics and Space Administration — The field of Prognostic Health Management (PHM) has been undergoing rapid growth in recent years, with development of increasingly sophisticated techniques for...

Diagnosis-Driven Prognosis for Decision Making, Phase I

Data.gov (United States)

National Aeronautics and Space Administration — One cannot build a system-level Prognosis and Health Management (PHM) solution by cobbling together a bunch of existing prognostic techniques; it will have a very...

Distributed Prognostics and Health Management with a Wireless Network Architecture

Science.gov (United States)

Goebel, Kai; Saha, Sankalita; Sha, Bhaskar

2013-01-01

A heterogeneous set of system components monitored by a varied suite of sensors and a particle-filtering (PF) framework, with the power and the flexibility to adapt to the different diagnostic and prognostic needs, has been developed. Both the diagnostic and prognostic tasks are formulated as a particle-filtering problem in order to explicitly represent and manage uncertainties in state estimation and remaining life estimation. Current state-of-the-art prognostic health management (PHM) systems are mostly centralized in nature, where all the processing is reliant on a single processor. This can lead to a loss in functionality in case of a crash of the central processor or monitor. Furthermore, with increases in the volume of sensor data as well as the complexity of algorithms, traditional centralized systems become for a number of reasons somewhat ungainly for successful deployment, and efficient distributed architectures can be more beneficial. The distributed health management architecture is comprised of a network of smart sensor devices. These devices monitor the health of various subsystems or modules. They perform diagnostics operations and trigger prognostics operations based on user-defined thresholds and rules. The sensor devices, called computing elements (CEs), consist of a sensor, or set of sensors, and a communication device (i.e., a wireless transceiver beside an embedded processing element). The CE runs in either a diagnostic or prognostic operating mode. The diagnostic mode is the default mode where a CE monitors a given subsystem or component through a low-weight diagnostic algorithm. If a CE detects a critical condition during monitoring, it raises a flag. Depending on availability of resources, a networked local cluster of CEs is formed that then carries out prognostics and fault mitigation by efficient distribution of the tasks. It should be noted that the CEs are expected not to suspend their previous tasks in the prognostic mode. When the

Using Field Data for Energy Efficiency Based on Maintenance and Operational Optimisation. A Step towards PHM in Process Plants

Directory of Open Access Journals (Sweden)

Micaela Demichela

2018-03-01

Full Text Available Energy saving is an important issue for any industrial sector; in particular, for the process industry, it can help to minimize both energy costs and environmental impact. Maintenance optimization and operational procedures can offer margins to increase energy efficiency in process plants, even if they are seldom explicitly taken into account in the predictive models guiding the energy saving policies. To ensure that the plant achieves the desired performance, maintenance operations and maintenance results should be monitored, and the connection between the inputs and the outcomes of the maintenance process, in terms of total contribution to manufacturing performance, should be explicit. In this study, a model for the energy efficiency analysis was developed, based on cost and benefits balance. It is aimed at supporting the decision making in terms of technical and operational solutions for energy efficiency, through the optimization of maintenance interventions and operational procedures. A case study is here described: the effects on energy efficiency of technical and operational optimization measures for bituminous materials production process equipment. The idea of the Conservation Supply Curve (CSC was used to capture both the cost effectiveness of the measures and the energy efficiency effectiveness. The optimization was thus based on the energy consumption data registered on-site: data collection and modelling of the relevant data were used as a base to implement a prognostic and health management (PHM policy in the company. Based on the results from the analysis, efficiency measures for the industrial case study were proposed, also in relation to maintenance optimization and operating procedures. In the end, the impacts of the implementation of energy saving measures on the performance of the system, in terms of technical and economic feasibility, were demonstrated. The results showed that maintenance optimization could help in reaching

Selecting Suitable Candidates for Predictive Maintenance

NARCIS (Netherlands)

Tiddens, Wieger Willem; Braaksma, Anne Johannes Jan; Tinga, Tiedo

2018-01-01

Predictive maintenance (PdM) or Prognostics and Health Management (PHM) assists in better predicting the future state of physical assets and making timely and better-informed maintenance decisions. Many companies nowadays ambition the implementation of such an advanced maintenance policy. However,

An integrated framework for online diagnostic and prognostic health monitoring using a multistate deterioration process

International Nuclear Information System (INIS)

Moghaddass, Ramin; Zuo, Ming J.

2014-01-01

Efficient asset management is of paramount importance, particularly for systems with costly downtime and failure. As in energy and capital-intensive industries, the economic loss of downtime and failure is huge, the need for a low-cost and integrated health monitoring system has increased significantly over the years. Timely detection of faults and failures through an efficient prognostics and health management (PHM) framework can lead to appropriate maintenance actions to be scheduled proactively to avoid catastrophic failures and minimize the overall maintenance cost of the systems. This paper aims at practical challenges of online diagnostics and prognostics of mechanical systems under unobservable degradation. First, the elements of a multistate degradation structure are reviewed and then a model selection framework is introduced. Important dynamic performance measures are introduced, which can be used for online diagnostics and prognostics. The effectiveness of the result of this paper is demonstrated with a case study on the health monitoring of turbofan engines

Lifecycle Prognostics Architecture for Selected High-Cost Active Components

Energy Technology Data Exchange (ETDEWEB)

N. Lybeck; B. Pham; M. Tawfik; J. B. Coble; R. M. Meyer; P. Ramuhalli; L. J. Bond

2011-08-01

There are an extensive body of knowledge and some commercial products available for calculating prognostics, remaining useful life, and damage index parameters. The application of these technologies within the nuclear power community is still in its infancy. Online monitoring and condition-based maintenance is seeing increasing acceptance and deployment, and these activities provide the technological bases for expanding to add predictive/prognostics capabilities. In looking to deploy prognostics there are three key aspects of systems that are presented and discussed: (1) component/system/structure selection, (2) prognostic algorithms, and (3) prognostics architectures. Criteria are presented for component selection: feasibility, failure probability, consequences of failure, and benefits of the prognostics and health management (PHM) system. The basis and methods commonly used for prognostics algorithms are reviewed and summarized. Criteria for evaluating PHM architectures are presented: open, modular architecture; platform independence; graphical user interface for system development and/or results viewing; web enabled tools; scalability; and standards compatibility. Thirteen software products were identified and discussed in the context of being potentially useful for deployment in a PHM program applied to systems in a nuclear power plant (NPP). These products were evaluated by using information available from company websites, product brochures, fact sheets, scholarly publications, and direct communication with vendors. The thirteen products were classified into four groups of software: (1) research tools, (2) PHM system development tools, (3) deployable architectures, and (4) peripheral tools. Eight software tools fell into the deployable architectures category. Of those eight, only two employ all six modules of a full PHM system. Five systems did not offer prognostic estimates, and one system employed the full health monitoring suite but lacked operations and

Lifecycle Prognostics Architecture for Selected High-Cost Active Components

International Nuclear Information System (INIS)

Lybeck, N.; Pham, B.; Tawfik, M.; Coble, J.B.; Meyer, R.M.; Ramuhalli, P.; Bond, L.J.

2011-01-01

There are an extensive body of knowledge and some commercial products available for calculating prognostics, remaining useful life, and damage index parameters. The application of these technologies within the nuclear power community is still in its infancy. Online monitoring and condition-based maintenance is seeing increasing acceptance and deployment, and these activities provide the technological bases for expanding to add predictive/prognostics capabilities. In looking to deploy prognostics there are three key aspects of systems that are presented and discussed: (1) component/system/structure selection, (2) prognostic algorithms, and (3) prognostics architectures. Criteria are presented for component selection: feasibility, failure probability, consequences of failure, and benefits of the prognostics and health management (PHM) system. The basis and methods commonly used for prognostics algorithms are reviewed and summarized. Criteria for evaluating PHM architectures are presented: open, modular architecture; platform independence; graphical user interface for system development and/or results viewing; web enabled tools; scalability; and standards compatibility. Thirteen software products were identified and discussed in the context of being potentially useful for deployment in a PHM program applied to systems in a nuclear power plant (NPP). These products were evaluated by using information available from company websites, product brochures, fact sheets, scholarly publications, and direct communication with vendors. The thirteen products were classified into four groups of software: (1) research tools, (2) PHM system development tools, (3) deployable architectures, and (4) peripheral tools. Eight software tools fell into the deployable architectures category. Of those eight, only two employ all six modules of a full PHM system. Five systems did not offer prognostic estimates, and one system employed the full health monitoring suite but lacked operations and

Diagnostic and Prognostic Models for Generator Step-Up Transformers

Energy Technology Data Exchange (ETDEWEB)

Vivek Agarwal; Nancy J. Lybeck; Binh T. Pham

2014-09-01

In 2014, the online monitoring (OLM) of active components project under the Light Water Reactor Sustainability program at Idaho National Laboratory (INL) focused on diagnostic and prognostic capabilities for generator step-up transformers. INL worked with subject matter experts from the Electric Power Research Institute (EPRI) to augment and revise the GSU fault signatures previously implemented in the Electric Power Research Institute’s (EPRI’s) Fleet-Wide Prognostic and Health Management (FW-PHM) Suite software. Two prognostic models were identified and implemented for GSUs in the FW-PHM Suite software. INL and EPRI demonstrated the use of prognostic capabilities for GSUs. The complete set of fault signatures developed for GSUs in the Asset Fault Signature Database of the FW-PHM Suite for GSUs is presented in this report. Two prognostic models are described for paper insulation: the Chendong model for degree of polymerization, and an IEEE model that uses a loading profile to calculates life consumption based on hot spot winding temperatures. Both models are life consumption models, which are examples of type II prognostic models. Use of the models in the FW-PHM Suite was successfully demonstrated at the 2014 August Utility Working Group Meeting, Idaho Falls, Idaho, to representatives from different utilities, EPRI, and the Halden Research Project.

Online Monitoring of Induction Motors

Energy Technology Data Exchange (ETDEWEB)

McJunkin, Timothy R. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Agarwal, Vivek [Idaho National Lab. (INL), Idaho Falls, ID (United States); Lybeck, Nancy Jean [Idaho National Lab. (INL), Idaho Falls, ID (United States)

2016-01-01

The online monitoring of active components project, under the Advanced Instrumentation, Information, and Control Technologies Pathway of the Light Water Reactor Sustainability Program, researched diagnostic and prognostic models for alternating current induction motors (IM). Idaho National Laboratory (INL) worked with the Electric Power Research Institute (EPRI) to augment and revise the fault signatures previously implemented in the Asset Fault Signature Database of EPRI’s Fleet Wide Prognostic and Health Management (FW PHM) Suite software. Induction Motor diagnostic models were researched using the experimental data collected by Idaho State University. Prognostic models were explored in the set of literature and through a limited experiment with 40HP to seek the Remaining Useful Life Database of the FW PHM Suite.

Pediatric hospital medicine: a strategic planning roundtable to chart the future.

Science.gov (United States)

Rauch, Daniel A; Lye, Patricia S; Carlson, Douglas; Daru, Jennifer A; Narang, Steve; Srivastava, Rajendu; Melzer, Sanford; Conway, Patrick H

2012-04-01

Given the growing field of Pediatric Hospital Medicine (PHM) and the need to define strategic direction, the Society of Hospital Medicine, the American Academy of Pediatrics, and the Academic Pediatric Association sponsored a roundtable to discuss the future of the field. Twenty-one leaders were invited plus a facilitator utilizing established health care strategic planning methods. A "vision statement" was developed. Specific initiatives in 4 domains (clinical practice, quality of care, research, and workforce) were identified that would advance PHM with a plan to complete each initiative. Review of the current issues demonstrated gaps between the current state of affairs and the full vision of the potential impact of PHM. Clinical initiatives were to develop an educational plan supporting the PHM Core Competencies and a clinical practice monitoring dashboard template. Quality initiatives included an environmental assessment of PHM participation on key committees, societies, and agencies to ensure appropriate PHM representation. Three QI collaboratives are underway. A Research Leadership Task Force was created and the Pediatric Research in Inpatient Settings (PRIS) network was refocused, defining a strategic framework for PRIS, and developing a funding strategy. Workforce initiatives were to develop a descriptive statement that can be used by any PHM physician, a communications tool describing "value added" of PHM; and a tool to assess career satisfaction among PHM physicians. We believe the Roundtable was successful in describing the current state of PHM and laying a course for the near future. Copyright © 2011 Society of Hospital Medicine.

A Physics-Based Modeling Framework for Prognostic Studies

Science.gov (United States)

Kulkarni, Chetan S.

2014-01-01

Prognostics and Health Management (PHM) methodologies have emerged as one of the key enablers for achieving efficient system level maintenance as part of a busy operations schedule, and lowering overall life cycle costs. PHM is also emerging as a high-priority issue in critical applications, where the focus is on conducting fundamental research in the field of integrated systems health management. The term diagnostics relates to the ability to detect and isolate faults or failures in a system. Prognostics on the other hand is the process of predicting health condition and remaining useful life based on current state, previous conditions and future operating conditions. PHM methods combine sensing, data collection, interpretation of environmental, operational, and performance related parameters to indicate systems health under its actual application conditions. The development of prognostics methodologies for the electronics field has become more important as more electrical systems are being used to replace traditional systems in several applications in the aeronautics, maritime, and automotive fields. The development of prognostics methods for electronics presents several challenges due to the great variety of components used in a system, a continuous development of new electronics technologies, and a general lack of understanding of how electronics fail. Similarly with electric unmanned aerial vehicles, electrichybrid cars, and commercial passenger aircraft, we are witnessing a drastic increase in the usage of batteries to power vehicles. However, for battery-powered vehicles to operate at maximum efficiency and reliability, it becomes crucial to both monitor battery health and performance and to predict end of discharge (EOD) and end of useful life (EOL) events. We develop an electrochemistry-based model of Li-ion batteries that capture the significant electrochemical processes, are computationally efficient, capture the effects of aging, and are of suitable

First report of Maconellicoccus hirsutus (Green, 1908) (Hemiptera: Coccoidea: Pseudococcidae) and the associated parasitoid Anagyrus kamali Moursi, 1948 (Hymenoptera: Encyrtidae), in Brazil.

Science.gov (United States)

Marsaro Júnior, A L; Peronti, A L B G; Penteado-Dias, A M; Morais, E G F; Pereira, P R V S

2013-05-01

The pink hibiscus mealybug (PHM), Maconellicoccus hirsutus (Green) (Hemiptera: Pseudococcidae) and the associated hymenopterous parasitoid, Anagyrus kamali Moursi, 1948 (Hymenoptera: Encyrtidae), are reported for the first time in Brazil. Specimens of the PHM were collected on nine hosts plants, Annona muricata L. (Anonnaceae), Glycine max (L.) Merr. (Fabaceae), Centrolobium paraensis Tul. (Fabaceae), Inga edulis Mart. (Fabaceae), Hibiscus rosa-sinensis L. (Malvaceae), Psidium guajava L. (Myrtaceae), Averrhoa carambola L. (Oxalidaceae), Citrus sinensis (L.) Osbeck (Rutaceae) and Solanum lycopersicum L. (Solanaceae), in four municipalities in the north-northeast of the state of Roraima. The plants C. paraensis, I. edulis and C. sinensis are recorded for the first time as a hosts for PHM. Characteristic injuries observed on the host plants infested by PHM and suggestions for its management are presented.

The present status and future growth of maintenance in US manufacturing: results from a pilot survey.

Science.gov (United States)

Jin, Xiaoning; Siegel, David; Weiss, Brian A; Gamel, Ellen; Wang, Wei; Lee, Jay; Ni, Jun

A research study was conducted (1) to examine the practices employed by US manufacturers to achieve productivity goals and (2) to understand what level of intelligent maintenance technologies and strategies are being incorporated into these practices. This study found that the effectiveness and choice of maintenance strategy were strongly correlated to the size of the manufacturing enterprise; there were large differences in adoption of advanced maintenance practices and diagnostics and prognostics technologies between small and medium-sized enterprises (SMEs). Despite their greater adoption of maintenance practices and technologies, large manufacturing organizations have had only modest success with respect to diagnostics and prognostics and preventive maintenance projects. The varying degrees of success with respect to preventative maintenance programs highlight the opportunity for larger manufacturers to improve their maintenance practices and use of advanced prognostics and health management (PHM) technology. The future outlook for manufacturing PHM technology among the manufacturing organizations considered in this study was overwhelmingly positive; many manufacturing organizations have current and planned projects in this area. Given the current modest state of implementation and positive outlook for this technology, gaps, future trends, and roadmaps for manufacturing PHM and maintenance strategy are presented.

Present Status and Future Growth of Advanced Maintenance Technology and Strategy in US Manufacturing.

Science.gov (United States)

Jin, Xiaoning; Weiss, Brian A; Siegel, David; Lee, Jay

2016-01-01

The goals of this paper are to 1) examine the current practices of diagnostics, prognostics, and maintenance employed by United States (U.S.) manufacturers to achieve productivity and quality targets and 2) to understand the present level of maintenance technologies and strategies that are being incorporated into these practices. A study is performed to contrast the impact of various industry-specific factors on the effectiveness and profitability of the implementation of prognostics and health management technologies, and maintenance strategies using both surveys and case studies on a sample of U.S. manufacturing firms ranging from small to mid-sized enterprises (SMEs) to large-sized manufacturing enterprises in various industries. The results obtained provide important insights on the different impacts of specific factors on the successful adoption of these technologies between SMEs and large manufacturing enterprises. The varying degrees of success with respect to current maintenance programs highlight the opportunity for larger manufacturers to improve maintenance practices and consider the use of advanced prognostics and health management (PHM) technology. This paper also provides the existing gaps, barriers, future trends, and roadmaps for manufacturing PHM technology and maintenance strategy.

Local-Level Prognostics Health Management Systems Framework for Passive AdvSMR Components. Interim Report

Energy Technology Data Exchange (ETDEWEB)

Ramuhalli, Pradeep [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Roy, Surajit [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Hirt, Evelyn H. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Pardini, Allan F. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Jones, Anthony M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Deibler, John E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States; Pitman, Stan G. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States; Tucker, Joseph C. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States; Prowant, Matthew S. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States; Suter, Jonathan D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States

2014-09-12

This report describes research results to date in support of the integration and demonstration of diagnostics technologies for prototypical AdvSMR passive components (to establish condition indices for monitoring) with model-based prognostics methods. The focus of the PHM methodology and algorithm development in this study is at the localized scale. Multiple localized measurements of material condition (using advanced nondestructive measurement methods), along with available measurements of the stressor environment, enhance the performance of localized diagnostics and prognostics of passive AdvSMR components and systems.

Iodinated derivatives of vasoactive intestinal peptide (VIP), PHI and PHM: purification, chemical characterization and biological activity

International Nuclear Information System (INIS)

McMaster, D.; Suzuki, Y.; Rorstad, O.; Lederis, K.

1987-01-01

The iodination of vasoactive intestinal peptide (VIP) was studied, using a variety of enzymatic and chemical iodination methods. Reversed phase high performance liquid chromatography (HPLC) was used to purify the reaction products. The lactoperoxidase-glucose oxidase method gave excellent results in terms of reproducibility, iodine incorporation, and yield of the non-oxidized products [Tyr(I)10]VIP and [Tyr(I)22]VIP, and was used to prepare both 125 I and 127 I labelled derivatives. In both cases, direct application to HPLC and a single column system were used. Although the oxidized peptides [Tyr(I)10,Met(O)17]VIP and [Tyr(I)22,Met(O)17]VIP could be generated to varying degrees directly by iodination of VIP, these were most conveniently prepared by iodination of [Met(O)17]VIP. Iodinated derivatives of the homologous peptides PHI and PHM were likewise prepared by rapid, one-step HPLC procedures. The site and degree of iodination were determined by HPLC peptide mapping of tryptic digests and amino acid analyses, and in the case of [Tyr(I)10]VIP also by sequencing. The vasorelaxant activities of the iodinated peptides in bovine cerebral artery preparations did not differ significantly from those of the corresponding noniodinated peptides, with the exception of [Tyr(I)10,Met(O)17]VIP and [Tyr(I)22,Met(O)17]VIP which, unlike [Met(O)17]VIP itself, had slightly lower potency than VIP

A framework with nonlinear system model and nonparametric noise for gas turbine degradation state estimation

International Nuclear Information System (INIS)

Hanachi, Houman; Liu, Jie; Banerjee, Avisekh; Chen, Ying

2015-01-01

Modern health management approaches for gas turbine engines (GTEs) aim to precisely estimate the health state of the GTE components to optimize maintenance decisions with respect to both economy and safety. In this research, we propose an advanced framework to identify the most likely degradation state of the turbine section in a GTE for prognostics and health management (PHM) applications. A novel nonlinear thermodynamic model is used to predict the performance parameters of the GTE given the measurements. The ratio between real efficiency of the GTE and simulated efficiency in the newly installed condition is defined as the health indicator and provided at each sequence. The symptom of nonrecoverable degradations in the turbine section, i.e. loss of turbine efficiency, is assumed to be the internal degradation state. A regularized auxiliary particle filter (RAPF) is developed to sequentially estimate the internal degradation state in nonuniform time sequences upon receiving sets of new measurements. The effectiveness of the technique is examined using the operating data over an entire time-between-overhaul cycle of a simple-cycle industrial GTE. The results clearly show the trend of degradation in the turbine section and the occasional fluctuations, which are well supported by the service history of the GTE. The research also suggests the efficacy of the proposed technique to monitor the health state of the turbine section of a GTE by implementing model-based PHM without the need for additional instrumentation. (paper)

Health Applications for Corporate Health Management.

Science.gov (United States)

Steigner, Guido; Doarn, Charles R; Schütte, Michael; Matusiewicz, David; Thielscher, Christian

2017-05-01

Many corporate organizations around the world are looking at new ways to improve the health and well-being of their employees. Many have begun to use m-health approaches and unique applications (apps) to provide assistance. In Germany, both m-health and occupational health management (OHM) are growing quickly. Therefore, we hypothesized that the combination-apps usage in OHM-is growing as well. We studied the usage of health apps in large corporations for health management of employed individuals. To understand the environment in Germany, a two-part study was conducted. First, an extensive literature search was done and second, interviews were conducted with 12 of the 20 biggest companies' health management representatives. Using key search terms, 5,445 peer-reviewed journal articles traced with German databases and on PubMed were reviewed. Interestingly and somewhat surprising to the authors, none of them covered our specific topic. Interviews were conducted with 60% of the companies indicated. Only 3 out of 12 companies use apps. Four companies are piloting apps. With one exception, apps cover well-known areas such as food coaching, physical motion, smoking cessation, stress prevention, and other health-related subjects. One app used sensors in work clothing to prevent unhealthy motion. With a few exceptions, there has been no evaluation of the utility and utilization of apps. Current app usage in corporate health management in Germany is surprisingly low. Apps need to be better evaluated. Main obstacles-which could be resolved in the future-are legal restrictions (especially on data security), the lack of company-owned smart phones, misfit of apps and corporate health strategy, a lack of app evaluation, and high app prices.

Pediatric hospitalists and medical education.

Science.gov (United States)

Ottolini, Mary C

2014-07-01

Pediatric hospital medicine (PHM) is moving toward becoming an American Board of Pediatrics (ABP) subspecialty, roughly a decade after its formal inception in 2003. Education has played a central role as the field has evolved. Hospitalists are needed to educate trainees, medical students, residents, fellows, and nurse practitioner and physician assistant students in inpatient pediatric practice. Continuous professional development is needed for hospitalists currently in practice to augment clinical skills, such as providing sedation and placing peripherally inserted central catheter lines, and nonclinical skills in areas such as quality improvement methodology, hospital administration, and health service research. To address the educational needs of the current and future state of PHM, additional training is now needed beyond residency training. Fellowship training will be essential to continue to advance the field of PHM as well as to petition the ABP for specialty accreditation. Training in using adult educational theory, curriculum, and assessment design are critical for pediatric hospitalists choosing to advance their careers as clinician-educators. Several venues are available for gaining advanced knowledge and skill as an educator. PHM clinician-educators are advancing the field of pediatric education as well as their own academic careers by virtue of the scholarly approach they have taken to designing and implementing curricula for unique PHM teaching situations. PHM educators are changing the educational paradigm to address challenges to traditional education strategies posed by duty hour restrictions and the increasing drive to shorten the duration of the hospitalization. By embracing learning with technology, such as simulation and e-learning with mobile devices, PHM educators can address these challenges as well as respond to learning preferences of millennial learners. The future for PHM education is bright. Copyright 2014, SLACK Incorporated.

Conceptualizing ORGANIZATIONAL HEALTH - Public health management and leadership perspectives

OpenAIRE

Orvik, Arne

2016-01-01

The thesis introduces a new conceptual model of organizational health and discusses its implications for public health management and leadership. It is developed with reference to organizational theories and ideologies, including New Public Management, the use of which has coincided with increasing workplace health problems in health care organizations. The model is based on empirical research and theories in the fields of public health, health care organization and management, and institutio...

Operations management in health care.

Science.gov (United States)

Henderson, M D

1995-01-01

Health care operations encompass the totality of those health care functions that allow those who practice health care delivery to do so. As the health care industry undergoes dramatic reform, so will the jobs of those who manage health care delivery systems. Although health care operations managers play one of the most vital and substantial roles in the new delivery system, the criteria for their success (or failure) are being defined now. Yet, the new and vital role of the operations manager has been stunted in its development, which is primarily because of old and outdated antipathy between hospital administrators and physicians. This article defines the skills and characteristics of today's health care operations managers.

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

Science.gov (United States)

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

2009-01-01

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

Health care engineering management.

Science.gov (United States)

Jarzembski, W B

1980-01-01

Today, health care engineering management is merely a concept of dreamers, with most engineering decisions in health care being made by nonengineers. It is the purpose of this paper to present a rationale for an integrated hospital engineering group, and to acquaint the clinical engineer with some of the salient features of management concepts. Included are general management concepts, organization, personnel management, and hospital engineering systems.

A Model-Driven Framework to Develop Personalized Health Monitoring

Directory of Open Access Journals (Sweden)

Algimantas Venčkauskas

2016-07-01

Full Text Available Both distributed healthcare systems and the Internet of Things (IoT are currently hot topics. The latter is a new computing paradigm to enable advanced capabilities in engineering various applications, including those for healthcare. For such systems, the core social requirement is the privacy/security of the patient information along with the technical requirements (e.g., energy consumption and capabilities for adaptability and personalization. Typically, the functionality of the systems is predefined by the patient’s data collected using sensor networks along with medical instrumentation; then, the data is transferred through the Internet for treatment and decision-making. Therefore, systems creation is indeed challenging. In this paper, we propose a model-driven framework to develop the IoT-based prototype and its reference architecture for personalized health monitoring (PHM applications. The framework contains a multi-layered structure with feature-based modeling and feature model transformations at the top and the application software generation at the bottom. We have validated the framework using available tools and developed an experimental PHM to test some aspects of the functionality of the reference architecture in real time. The main contribution of the paper is the development of the model-driven computational framework with emphasis on the synergistic effect of security and energy issues.

Improve Gear Fault Diagnosis and Severity Indexes Determinations via Time Synchronous Average

Directory of Open Access Journals (Sweden)

Mohamed El Morsy

2016-11-01

Full Text Available In order to reduce operation and maintenance costs, prognostics and health management (PHM of the geared system is needed to improve effective gearbox fault detection tools.  PHM system allows less costly maintenance because it can inform operators of needed repairs before a fault causes collateral damage happens to the gearbox. In this article, time synchronous average (TSA technique and complex continuous wavelet analysis enhancement are used as gear fault detection approach. In the first step, extract the periodic waveform from the noisy measured signal is considered as The main value of Time synchronous averaging (TSA for gearbox signals analyses, where it allows the vibration signature of the gear under analysis to be separated from other gears and noise sources in the gearbox that are not synchronous with faulty gear. In the second step, the complex wavelet analysis is used in case of multi-faults in same gear. The signal phased-locked with the angular position of a shaft within the system is done. The main aims for this research is to improve the gear fault diagnosis and severity index determinations based on TSA  of measured signal for investigated passenger vehicle gearbox under different operation conditions. In addition to, correct the variations in shaft speed such that the spreading of spectral energy into an adjacent gear mesh bin helps in detecting the gear fault position (faulted tooth or teeth and improve the Root Mean Square (RMS, Kurtosis, and Peak Pulse as the sensitivity of severity indexes for maintenance, prognostics and health management (PHM purposes. The open loop test stand is equipped with two dynamometers and investigated vehicle gearbox of mid-size passenger car; the total power is taken-off from one side only. Reference Number: www.asrongo.org/doi:4.2016.1.1.6

Perceived core competency achievements of fellowship and non-fellowship-trained early career pediatric hospitalists.

Science.gov (United States)

Librizzi, Jamie; Winer, Jeffrey C; Banach, Laurie; Davis, Aisha

2015-06-01

The pediatric hospital medicine (PHM) core competencies were established in 2010 to identify the specific knowledge base and skill set needed to provide the highest quality of care for hospitalized children. The objectives of this study were to examine the perceived core competency achievements of fellowship-trained and non-fellowship-trained early career pediatric hospitalists and identify perceived gaps in our current training models. An anonymous Web-based survey was distributed in November 2013. Hospitalists within 5 years of their residency graduation reported their perceived competency in select PHM core competencies. χ(2) and multiprobit regression analyses were utilized. One hundred ninety-seven hospitalists completed the survey and were included; 147 were non-fellowship-trained and 50 were PHM fellowship graduates or current PHM fellows. Both groups reported feeling less than competent in sedation and aspects of business practice. Non-fellowship-trained hospitalists also reported mean scores in the less than competent range in intravenous access/phlebotomy, technology-dependent emergencies, performing Plan-Do-Study-Act process and root cause analysis, defining basic statistical terms, and identifying research resources. Non-fellowship-trained hospitalists reported mean competency scores greater than fellowship-trained hospitalists in pain management, newborn care, and transitions in care. Early career pediatric hospitalists report deficits in several of the PHM core competencies, which should be considered when designing PHM-specific training in the future. Fellowship-trained hospitalists report higher levels of perceived competency in many core areas. © 2015 Society of Hospital Medicine.

Conceptualizing ORGANIZATIONAL HEALTH - Public health management and leadership perspectives

DEFF Research Database (Denmark)

Orvik, Arne

The thesis introduces a new conceptual model of organizational health and discusses its implications for public health management and leadership. It is developed with reference to organizational theories and ideologies, including New Public Management, the use of which has coincided with increasing...... as the disintegration of such values. Possible implications for public health management and leadership include four different forms. The application of the conceptual model can potentially draw attention to value conflicts and help to clarify contradictory, institutional logics. It can also potentially support health...... workplace health problems in health care organizations. The model is based on empirical research and theories in the fields of public health, health care organization and management, and institutional theory. It includes five dimensions and defines organizational health in terms of how an organization...

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

Science.gov (United States)

Willacy, Erika; Bratton, Shelly

2015-09-30

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

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

Science.gov (United States)

Mouyos, William; Wangu, Srimal

1998-01-01

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

Assessment of time management attitudes among health managers.

Science.gov (United States)

Sarp, Nilgun; Yarpuzlu, Aysegul Akbay; Mostame, Fariba

2005-01-01

These days, working people are finding it difficult to manage their time, get more done at work, and find some balance in their work and personal lives. Successful time management is often suggested to be a product of organizing skills, however, what works for one person may not work for others. Context current competence assessment formats for physicians, health professionals, and managers during their training years reliably test core knowledge and basic skills. However, they may underemphasize some important domains of professional medical practice. Thus, in addition to assessments of basic skills, new formats that assess clinical reasoning, expert judgment, management of ambiguity, professionalism, time management, learning strategies, and teamwork to promise a multidimensional assessment while maintaining adequate reliability and validity in classic health education and health care institutional settings are needed to be worked on. It should be kept in mind that institutional support, reflection, and mentoring must accompany the development of assessment programs. This study was designed to describe the main factors that consume time, effective hours of work, time management opportunities, and attitudes and behaviors of health professionals and managers on time management concept through assessment by the assessment tool Time Management Inquiry Form (TMIQ-F). The study was conducted at the State Hospital, Social Security Hospital, and University Hospital at Kirikkale, Turkey between October 1999 and January 2000, including 143 subjects defined as medical managers and medical specialists. According to the results, a manager should give priority to the concept of planning, which may be counted among the efficient time management techniques, and educate him/herself on time management.

Occupational health management: an audit tool.

Science.gov (United States)

Shelmerdine, L; Williams, N

2003-03-01

Organizations must manage occupational health risks in the workplace and the UK Health & Safety Executive (HSE) has published guidance on successful health and safety management. This paper describes a method of using the published guidance to audit the management of occupational health and safety, first at an organizational level and, secondly, to audit an occupational health service provider's role in the management of health risks. The paper outlines the legal framework in the UK for health risk management and describes the development and use of a tool for qualitative auditing of the efficiency, effectiveness and reliability of occupational health service provision within an organization. The audit tool is presented as a question set and the paper concludes with discussion of the strengths and weaknesses of using this tool, and recommendations on its use.

Stress Managment and Health Promotion

Directory of Open Access Journals (Sweden)

Asghar Dadkhah

2004-09-01

Full Text Available Health promotion approach is utilized to address the prevention, management and early intervention for stress management and also to promote positive mental and psychological health. Stress affects everyone and must be managed effectively to reduce its chronic and deleterious effects this study consists of two sections: in first section the principals of health promotion in different human existence levels, prevention of disease related to stress, the effect of stress on human well-being, and stress management were discussed. In second section the role of rehabilitation specialists (Medical technologist, nurses, occupational therapists, physiotherapists, respiratory therapists, and social workers in stress management were counted.

New public management in Iran's health complex: a management framework for primary health care system.

Science.gov (United States)

Tabrizi, Jafar Sadegh; HaghGoshayie, Elaheh; Doshmangir, Leila; Yousefi, Mahmood

2018-05-01

New public management (NPM) was developed as a management reform to improve the efficiency and effectiveness in public organizations, especially in health sector. Using the features of private sector management, the managers of health organizations may try to implement the elements of NPM with the hope to improve the performance of their systems.AimsOur aim in the present study was to identify the elements and infrastructures suitable for implementing NPM in the Iranian health complex. In this qualitative study with conventional content analysis approach, we tried to explore the NPM elements and infrastructures in Iranian public health sector. A series of semi-structured interviews (n=48) were conducted in 2016 with a managers in public and private health complex. Three focus group discussions with nine faculty members were also conducted. A data collection form was used to collect the demographic characteristics and perspectives of the participants.FindingsFrom the perspective of managers, managerialism, decentralization, using market mechanism, performance management, customer orientation and performance budgeting were the main elements of NPM in the Iranian context. The most important infrastructures for implementing this reform were as follows: education and training, information technology, the proper use of human resources, decision support systems, top management commitment, organizational culture, flexibility of rules, rehabilitating of the aging infrastructures, and expanding the coverage of services. The NPM was generally identified to be an effective replacement for the traditional administration method. These reforms may be helpful in strengthening the public health complex and the management capacity, as well. NPM also seems to be useful in interacting the public health sector with the private sector in terms of personnel and resources, performance, reward structure, and methods of doing business.

Impact of Health Behaviors and Health Management on Employment After SCI: Psychological Health and Health Management.

Science.gov (United States)

Reed, Karla S; Meade, Michelle A; Krause, James S

2016-01-01

Objective: The purpose of this study was to examine the relationship between employment and psychological health and health management as described by individuals with spinal cord injury (SCI) who were employed at least once following injury. Methods: A qualitative approach used 6 focus groups at 2 sites with 44 participants who were at least 10 years post SCI. All had been employed at some point since injury. Heterogeneous and homogeneous groups were delineated based on specific characteristics, such as education, gender, or race. Group sessions followed a semi-structured interview format with questions about personal, environmental, and policy related factors influencing employment following SCI. All group sessions were recorded, transcribed, and coded into conceptual categories to identify topics, themes, and patterns. Inferences were drawn about their meaning. NVivo 10 software using the constant comparative method was used for data analysis. Results: Narratives discussed the relationship between employment and psychological and emotional health and health management. Four themes were identified: (1) adjustment and dealing with emotional reactions, (2) gaining self-confidence, (3) preventing burnout, and (4) attitudes and perspectives. Most themes reflected issues that varied based on severity of injury as well as stage of employment. Conclusions: Individuals with SCI who are successful in working following injury must determine how to perform the behaviors necessary to manage their health and prevent emotional or physical complications. The emotional consequences of SCI must be recognized and addressed and specific behaviors enacted in order to optimize employment outcomes.

Technical Needs for Prototypic Prognostic Technique Demonstration for Advanced Small Modular Reactor Passive Components

Energy Technology Data Exchange (ETDEWEB)

Meyer, Ryan M.; Coble, Jamie B.; Hirt, Evelyn H.; Ramuhalli, Pradeep; Mitchell, Mark R.; Wootan, David W.; Berglin, Eric J.; Bond, Leonard J.; Henager, Charles H.

2013-05-17

This report identifies a number of requirements for prognostics health management of passive systems in AdvSMRs, documents technical gaps in establishing a prototypical prognostic methodology for this purpose, and describes a preliminary research plan for addressing these technical gaps. AdvSMRs span multiple concepts; therefore a technology- and design-neutral approach is taken, with the focus being on characteristics that are likely to be common to all or several AdvSMR concepts. An evaluation of available literature is used to identify proposed concepts for AdvSMRs along with likely operational characteristics. Available operating experience of advanced reactors is used in identifying passive components that may be subject to degradation, materials likely to be used for these components, and potential modes of degradation of these components. This information helps in assessing measurement needs for PHM systems, as well as defining functional requirements of PHM systems. An assessment of current state-of-the-art approaches to measurements, sensors and instrumentation, diagnostics and prognostics is also documented. This state-of-the-art evaluation, combined with the requirements, may be used to identify technical gaps and research needs in the development, evaluation, and deployment of PHM systems for AdvSMRs. A preliminary research plan to address high-priority research needs for the deployment of PHM systems to AdvSMRs is described, with the objective being the demonstration of prototypic prognostics technology for passive components in AdvSMRs. Greater efficiency in achieving this objective can be gained through judicious selection of materials and degradation modes that are relevant to proposed AdvSMR concepts, and for which significant knowledge already exists. These selections were made based on multiple constraints including the analysis performed in this document, ready access to laboratory-scale facilities for materials testing and measurement, and

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

Science.gov (United States)

Thompson, Jon M

2010-01-01

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

Crisis management teams in health organisations.

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Canyon, Deon V

2012-01-01

Crisis management teams (CMT) are necessary to ensure adequate and appropriate crisis management planning and response to unforeseen, adverse events. This study investigated the existence of CMTs, the membership of CMTs, and the degree of training received by CMTs in Australian health and allied health organisations. This cross-sectional study draws on data provided by executive decision makers in a broad selection of health and allied health organisations. Crisis management teams were found in 44.2 per cent of the health-related organisations surveyed, which is ten per cent lower than the figure for business organisations. Membership of these CMTs was not ideal and did not conform to standard CMT membership profiles. Similarly, the extent of crisis management training in health-related organisations is 20 per cent lower than the figure for business organisations. If organisations do not become pro-active in their crisis management practices, the onus is on government to improve the situation through regulation and the provision of more physical, monetary and skill resources to ensure that the health services of Australia are sufficiently prepared to respond to adverse events.

Medication therapy disease management: Geisinger's approach to population health management.

Science.gov (United States)

Jones, Laney K; Greskovic, Gerard; Grassi, Dante M; Graham, Jove; Sun, Haiyan; Gionfriddo, Michael R; Murray, Michael F; Manickam, Kandamurugu; Nathanson, Douglas C; Wright, Eric A; Evans, Michael A

2017-09-15

Pharmacists' involvement in a population health initiative focused on chronic disease management is described. Geisinger Health System has cultivated a culture of innovation in population health management, as highlighted by its ambulatory care pharmacy program, the Medication Therapy Disease Management (MTDM) program. Initiated in 1996, the MTDM program leverages pharmacists' pharmacotherapy expertise to optimize care and improve outcomes. MTDM program pharmacists are trained and credentialed to manage over 16 conditions, including atrial fibrillation (AF) and multiple sclerosis (MS). Over a 15-year period, Geisinger Health Plan (GHP)-insured patients with AF whose warfarin therapy was managed by the MTDM program had, on average, 18% fewer emergency department (ED) visits and 18% fewer hospitalizations per year than GHP enrollees with AF who did not receive MTDM services, with 23% lower annual total care costs. Over a 2-year period, GHP-insured patients with MS whose pharmacotherapy was managed by pharmacists averaged 28% fewer annual ED visits than non-pharmacist-managed patients; however, the mean annual total care cost was 21% higher among MTDM clinic patients. The Geisinger MTDM program has evolved over 20 years from a single pharmacist-run anticoagulation clinic into a large program focused on managing the health of an ever-growing population. Initial challenges in integrating pharmacists into the Geisinger patient care framework as clinical experts were overcome by demonstrating the MTDM program's positive impact on patient outcomes. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Health infrastructural challenges to health management information ...

African Journals Online (AJOL)

Aim: This study aims to assess health management information systems at the ... workers' ability to practice and use the health data generated at their Primary Health ... Only 2 (5.7%) of the health centres surveyed were capable of operating the ... The government at all levels should ensure collective effort and political will to ...

Managing Health Information System | Campbell | Nigerian ...

African Journals Online (AJOL)

The effective planning, management monitoring and evaluation of health services, health resources and indeed the health system requires a wealth of health information, with its simultaneous effective and efficient management. It is an instrument used to help policy-making, decision making and day to day actions in the ...

Reengineering health care materials management.

Science.gov (United States)

Connor, L R

1998-01-01

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

Disaster Management: Mental Health Perspective.

Science.gov (United States)

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

2015-01-01

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

Health care operations management

NARCIS (Netherlands)

Carter, M.W.; Hans, Elias W.; Kolisch, R.

2012-01-01

Health care operations management has become a major topic for health care service providers and society. Operations research already has and further will make considerable contributions for the effective and efficient delivery of health care services. This special issue collects seven carefully

Molecular cloning of a peptidylglycine alpha-hydroxylating monooxygenase from sea anemones

DEFF Research Database (Denmark)

Hauser, F; Williamson, M; Grimmelikhuijzen, C J

1997-01-01

conserved regions of PHM, we have now cloned a PHM from the sea anemone Calliactis parasitica showing 42% amino acid sequence identity with rat PHM. Among the conserved (identical) amino acid residues are five histidine and one methionine residue, which bind two Cu2+ atoms that are essential for PHM...... activity. No cDNA coding for PAL could be identified, suggesting that sea anemone PAL is coded for by a gene that is different from the sea anemone PHM gene, a situation similar to the one found in insects. This is the first report on the molecular cloning of a cnidarian PHM. Udgivelsesdato: 1997-Dec-18...

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

Directory of Open Access Journals (Sweden)

Elizabeth H. Bradley

2015-07-01

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

An XML-based framework for personalized health management.

Science.gov (United States)

Lee, Hiye-Ja; Park, Seung-Hun; Jeong, Byeong-Soo

2006-01-01

This paper proposes a framework for personalized health management. In this framework, XML technology is used for representing and managing the health information and knowledge. Major components of the framework are Health Management Prescription (HMP) Expert System and Health Information Repository. The HMP Expert System generates a HMP efficiently by using XML-based templates. Health Information Repository provides integrated health information and knowledge for personalized health management by using XML and relational database together.

Future preparation of occupational health nurse managers.

Science.gov (United States)

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

1991-03-01

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

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

Science.gov (United States)

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

2008-01-01

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

Public health financial management competencies.

Science.gov (United States)

Honoré, Peggy A; Costich, Julia F

2009-01-01

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

The Oral Health Care Manager in a Patient-Centered Health Facility.

Science.gov (United States)

Theile, Cheryl Westphal; Strauss, Shiela M; Northridge, Mary Evelyn; Birenz, Shirley

2016-06-01

The dental hygienist team member has an opportunity to coordinate care within an interprofessional practice as an oral health care manager. Although dental hygienists are currently practicing within interprofessional teams in settings such as pediatric offices, hospitals, nursing homes, schools, and federally qualified health centers, they often still assume traditional responsibilities rather than practicing to the full extent of their training and licenses. This article explains the opportunity for the dental hygiene professional to embrace patient-centered care as an oral health care manager who can facilitate integration of oral and primary care in a variety of health care settings. Based on an innovative model of collaboration between a college of dentistry and a college of nursing, an idea emerged among several faculty members for a new management method for realizing continuity and coordination of comprehensive patient care. Involved faculty members began working on the development of an approach to interprofessional practice with the dental hygienist serving as an oral health care manager who would address both oral health care and a patient's related primary care issues through appropriate referrals and follow-up. This approach is explained in this article, along with the results of several pilot studies that begin to evaluate the feasibility of a dental hygienist as an oral health care manager. A health care provider with management skills and leadership qualities is required to coordinate the interprofessional provision of comprehensive health care. The dental hygienist has the opportunity to lead closer integration of oral and primary care as an oral health care manager, by coordinating the team of providers needed to implement comprehensive, patient-centered care. Copyright © 2016 Elsevier Inc. All rights reserved.

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

Science.gov (United States)

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

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

Medical Waste Management in Community Health Centers.

Science.gov (United States)

Tabrizi, Jafar Sadegh; Rezapour, Ramin; Saadati, Mohammad; Seifi, Samira; Amini, Behnam; Varmazyar, Farahnaz

2018-02-01

Non-standard management of medical waste leads to irreparable side effects. This issue is of double importance in health care centers in a city which are the most extensive system for providing Primary Health Care (PHC) across Iran cities. This study investigated the medical waste management standards observation in Tabriz community health care centers, northwestern Iran. In this triangulated cross-sectional study (qualitative-quantitative), data collecting tool was a valid checklist of waste management process developed based on Iranian medical waste management standards. The data were collected in 2015 through process observation and interviews with the health center's staff. The average rate of waste management standards observance in Tabriz community health centers, Tabriz, Iran was 29.8%. This case was 22.8% in dimension of management and training, 27.3% in separating and collecting, 31.2% in transport and temporary storage, and 42.9% in sterilization and disposal. Lack of principal separation of wastes, inappropriate collecting and disposal cycle of waste and disregarding safety tips (fertilizer device performance monitoring, microbial cultures and so on) were among the observed defects in health care centers supported by quantitative data. Medical waste management was not in a desirable situation in Tabriz community health centers. The expansion of community health centers in different regions and non-observance of standards could predispose to incidence the risks resulted from medical wastes. So it is necessary to adopt appropriate policies to promote waste management situation.

Intelligent Integrated System Health Management

Science.gov (United States)

Figueroa, Fernando

2012-01-01

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

A Weighted Deep Representation Learning Model for Imbalanced Fault Diagnosis in Cyber-Physical Systems

Science.gov (United States)

Guo, Yang; Lin, Wenfang; Yu, Shuyang; Ji, Yang

2018-01-01

Predictive maintenance plays an important role in modern Cyber-Physical Systems (CPSs) and data-driven methods have been a worthwhile direction for Prognostics Health Management (PHM). However, two main challenges have significant influences on the traditional fault diagnostic models: one is that extracting hand-crafted features from multi-dimensional sensors with internal dependencies depends too much on expertise knowledge; the other is that imbalance pervasively exists among faulty and normal samples. As deep learning models have proved to be good methods for automatic feature extraction, the objective of this paper is to study an optimized deep learning model for imbalanced fault diagnosis for CPSs. Thus, this paper proposes a weighted Long Recurrent Convolutional LSTM model with sampling policy (wLRCL-D) to deal with these challenges. The model consists of 2-layer CNNs, 2-layer inner LSTMs and 2-Layer outer LSTMs, with under-sampling policy and weighted cost-sensitive loss function. Experiments are conducted on PHM 2015 challenge datasets, and the results show that wLRCL-D outperforms other baseline methods. PMID:29621131

A Weighted Deep Representation Learning Model for Imbalanced Fault Diagnosis in Cyber-Physical Systems

Directory of Open Access Journals (Sweden)

Zhenyu Wu

2018-04-01

Full Text Available Predictive maintenance plays an important role in modern Cyber-Physical Systems (CPSs and data-driven methods have been a worthwhile direction for Prognostics Health Management (PHM. However, two main challenges have significant influences on the traditional fault diagnostic models: one is that extracting hand-crafted features from multi-dimensional sensors with internal dependencies depends too much on expertise knowledge; the other is that imbalance pervasively exists among faulty and normal samples. As deep learning models have proved to be good methods for automatic feature extraction, the objective of this paper is to study an optimized deep learning model for imbalanced fault diagnosis for CPSs. Thus, this paper proposes a weighted Long Recurrent Convolutional LSTM model with sampling policy (wLRCL-D to deal with these challenges. The model consists of 2-layer CNNs, 2-layer inner LSTMs and 2-Layer outer LSTMs, with under-sampling policy and weighted cost-sensitive loss function. Experiments are conducted on PHM 2015 challenge datasets, and the results show that wLRCL-D outperforms other baseline methods.

Impact of homogenization of pasteurized human milk on gastric digestion in the preterm infant: A randomized controlled trial.

Science.gov (United States)

de Oliveira, Samira C; Bellanger, Amandine; Ménard, Olivia; Pladys, Patrick; Le Gouar, Yann; Henry, Gwénaële; Dirson, Emelyne; Rousseau, Florence; Carrière, Frédéric; Dupont, Didier; Bourlieu, Claire; Deglaire, Amélie

2017-08-01

It has been suggested that homogenization of Holder-pasteurized human milk (PHM) could improve fat absorption and weight gain in preterm infants, but the impact on the PHM digestive kinetics has never been studied. Our objective was to determine the impact of PHM homogenization on gastric digestion in preterm infants. In a randomized controlled trial, eight hospitalized tube-fed preterm infants were their own control to compare the gastric digestion of PHM and of homogenized PHM (PHHM). PHM was obtained from donors and, for half of it, was homogenized by ultrasonication. Over a six-day sequence, gastric aspirates were collected twice a day, before and 35, 60 or 90 min after the start of PHM or PHHM ingestion. The impact of homogenization on PHM digestive kinetics and disintegration was tested using a general linear mixed model. Results were expressed as means ± SD. Homogenization leaded to a six-fold increase in the specific surface (P Homogenization increased the gastric lipolysis level (P Homogenization enhanced the proteolysis of serum albumin (P Homogenization of PHM increased the gastric lipolysis level. This could be a potential strategy to improve fat absorption, and thus growth and development in infants fed with PHM; however, its gastrointestinal tolerance needs to be investigated further. This trial was registered at clinicaltrials.gov as NCT02112331. Copyright © 2017 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

Analysis of Workplace Health Education Performed by Occupational Health Managers in Korea

Directory of Open Access Journals (Sweden)

Yeon-Ha Kim, RN, PhD

2016-09-01

Conclusions: “Analysis and planning” skill is priority training area for healthcare professionals and occupational health managers who managed nonmanufacturing industry. It is necessary to develop a training curriculum for occupational health managers that include improving analysis of worksites and plans for a health education program.

Leadership and management in mental health nursing.

Science.gov (United States)

Blegen, Nina Elisabeth; Severinsson, Elisabeth

2011-05-01

Mental health nurses are agents of change, and their leadership, management role and characteristics exist at many levels in health care. Previous research presents a picture of mental health nurses as subordinate and passive recipients of the leader's influence and regard leadership and management as distinct from the nurses' practical work. The aim was to provide a synthesis of the studies conducted and to discuss the relationship between nursing leadership and nursing management in the context of mental health nursing. A literature search was conducted using EBSCO-host, Academic Search Premier, Science Direct, CINAHL and PubMed for the period January 1995-July 2010. Leadership and management in the context of mental health nursing are human activities that imply entering into mutual relationships. Mental health nurses' leadership, management and transformational leadership are positively related in terms of effectiveness and nurses' skills. It is important to consider mental health nurses' management as a form of leadership similar to or as a natural consequence of transformational leadership (TL) and that ethical concerns must be constantly prioritized throughout every level of the organization. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.

Development and validation of health service management competencies.

Science.gov (United States)

Liang, Zhanming; Howard, Peter F; Leggat, Sandra; Bartram, Timothy

2018-04-09

Purpose The importance of managerial competencies in monitoring and improving the performance of organisational leaders and managers is well accepted. Different processes have been used to identify and develop competency frameworks or models for healthcare managers around the world to meet different contextual needs. The purpose of the paper is to introduce a validated process in management competency identification and development applied in Australia - a process leading to a management competency framework with associated behavioural items that can be used to measure core management competencies of health service managers. Design/methodology/approach The management competency framework development study incorporated both qualitative and quantitative methods, implemented in four stages, including job description analysis, focus group discussions and online surveys. Findings The study confirmed that the four-stage process could identify management competencies and the framework developed is considered reliable and valid for developing a management competency assessment tool that can measure management competence amongst managers in health organisations. In addition, supervisors of health service managers could use the framework to distinguish perceived superior and average performers among managers in health organisations. Practical implications Developing the core competencies of health service managers is important for management performance improvement and talent management. The six core management competencies identified can be used to guide the design professional development activities for health service managers. Originality/value The validated management competency identification and development process can be applied in other countries and different industrial contexts to identify core management competency requirements.

Characteristics of effective health care managers.

Science.gov (United States)

Johnson, Sherryl W

2005-01-01

This article provides an overview of traditional and contemporary management theories. Concerns, characteristics, and skills of effective managers are also presented. Further, a self-assessment (survey) of 7 highly effective health care managers in a South Georgia community was conducted to determine their ratings on 6 management indices. The assessment or Scale of Transformational Leadership uses a Likert-type scale to allow for the evaluation of managers. The scale contains 6 management elements for assessment: attention, meaning, trust, self, vision, and feeling. Individual ratings and group summary skills rating are presented. Findings revealed the order of managerial importance of the elements as follows (from highest to lowest): Management of Trust, Management of Attention, Management of Self, Management of Feeling, Management of Meaning, and Management of Risk. As a second tier, the final ratings are corroborated by health care management interns.

Managed consumerism in health care.

Science.gov (United States)

Robinson, James C

2005-01-01

The future of market-oriented health policy and practice lies in "managed consumerism," a blend of the patient-centric focus of consumer-driven health care and the provider-centric focus of managed competition. The optimal locus of incentives will vary among health services according to the nature of the illness, the clinical technology, and the extent of discretion in utilization. A competitive market will manifest a variety of comprehensive and limited benefit designs, broad and narrow contractual networks, and single-and multispecialty provider organizations.

The Thai-Australian Health Alliance: developing health management capacity and sustainability for primary health care services.

Science.gov (United States)

Briggs, D S; Tejativaddhana, P; Cruickshank, M; Fraser, J; Campbell, S

2010-11-01

There have been recent calls for a renewed worldwide focus on primary health care. The Thai-Australian Health Alliance addresses this call by developing health care management capability in primary health care professionals in rural Thailand. This paper describes the history and current activities of the Thai-Australian Health Alliance and its approaches to developing health care management capacity for primary care services through international collaborations in research, education and training over a sustained time period. The Alliance's approach is described herein as a distributed network of practices with access to shared knowledge through collaboration. Its research and education approaches involve action research, multi-methods projects, and evaluative studies in the context of workshops and field studies. WHO principles underpin this approach, with countries sharing practical experiences and outcomes, encouraging leadership and management resource networks, creating clearing houses/knowledge centres, and harmonising and aligning partners with their country's health systems. Various evaluations of the Alliance's activities have demonstrated that a capacity building approach that aligns researchers, educators and health practitioners in comparative and reflective activities can be effective in transferring knowledge and skills among a collaboration's partners. Project participants, including primary health care practitioners, health policy makers and academics embraced the need to acquire management skills to sustain primary care units. Participants believe that the approaches described herein were crucial to developing the management skills needed of health care professionals for rural and remote primary health care. The implementation of this initiative was challenged by pre-existing low opinions of the importance of the management role in health care, but with time the Alliance's activities highlighted for all the importance of health care management

Applying e-health to case management.

Science.gov (United States)

Adams, J M

2000-01-01

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

A guide to performance management for the Health Information Manager.

Science.gov (United States)

Leggat, Sandra G

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

Concept Development for Software Health Management

Science.gov (United States)

Riecks, Jung; Storm, Walter; Hollingsworth, Mark

2011-01-01

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

Gamification and geospatial health management

Science.gov (United States)

Wortley, David

2014-06-01

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

Gamification and geospatial health management

International Nuclear Information System (INIS)

Wortley, David

2014-01-01

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

Assessment of implementation of the health management ...

African Journals Online (AJOL)

Background Despite Malawi's introduction of a health management information system (HMIS) in 1999, the country's health sector still lacks accurate, reliable, complete, consistent and timely health data to inform effective planning and resource management. Methods A cross-sectional survey was conducted wherein ...

Dual-Use Aspects of System Health Management

Science.gov (United States)

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

1994-01-01

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

Quality management in Irish health care.

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Ennis, K; Harrington, D

1999-01-01

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

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

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

2014-04-01

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

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

Science.gov (United States)

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

2015-11-01

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

Women as managers in the health services

Directory of Open Access Journals (Sweden)

Jocelyne Kane Berman

1989-09-01

Full Text Available Despite their numerical superiority women do not occupy positions o f power and authority in the health services generally. This is perceived as being due to a variety of factors which prevent women from realising their ful l potential as managers. In other parts of the world, as well as in South Africa, middle class white males have dominated health services, since medicine became a form al science, usurping the traditional role of women healers. Some research indicates that women are inclined to practice “feminine " management styles. It is suggested that the femine I masculine dichotomy is artificial and that qualities which ensure effective management should not be regarded as genderlinked. Leaders in the health services should strive for interdisciplinary, mixed-gender education and training at all levels. Identification and development of management potential in women health-care professionals, role-modelling and sponsor-mentor relationships should be encouraged to allow women to acquire the full range of management skills and to achieve positions of power and authority in the health services.

Crisis Management in the Health Sector: Qualities and characteristics of health crisis managers

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Manwlidou Zacharoula

2009-01-01

Full Text Available The rapidly evolving nature of today’s health systems and the need to adapt to modern demands,require that these systems are staffed with skilled health crisis managers. Based on that scenario, crisis managerswith good knowledge and training, adequate experience, as well as virtues of excellent organizational skills,operational planning, mental power and social sensitivity, can play a key role in dealing successfully with crisesin the health sector.

Ethically sound technology? Guidelines for interactive ethical assessment of personal health monitoring.

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Palm, Elin; Nordgren, Anders; Verweij, Marcel; Collste, Göran

2013-01-01

Novel care-technologies possess a transformational potential. Future care and support may be provided via monitoring technologies such as smart devices, sensors, actors (robots) and Information and Communication Technologies. Such technologies enable care provision outside traditional care institutions, for instance in the homes of patients. Health monitoring may become "personalized" i.e. tailored to the needs of individual care recipients' but may also alter relations between care providers and care recipents, shape and form the care environment and influence values central to health-care. Starting out from a social constructivist theory of technology, an interactive ethical assessment-model is offered. The suggested model supplements a traditional analysis based on normative ethical theory (top-down approach) with interviews including relevant stakeholders (a bottom-up approach). This method has been piloted by small-scale interviews encircling stakeholder perspectives on three emerging technologies: (1) Careousel, a smart medicine-management device, (2) Robot Giraff, an interactive and mobile communication-device and (3) I-Care, a care-software that combines alarm and register system. By incorporating stakeholder perspectives into the analysis, the interactive ethical assessment model provides a richer understanding of the impact of PHM-technologies on ethical values than a traditional top-down model. If the assessment is conducted before the technology has reached the market - preferably in close interaction with developers and users - ethically sound technologies may be obtained.

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

Science.gov (United States)

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

2009-07-28

Shortage of human resources is a major problem facing Malawi, where more than 50% of the population lives in rural areas. Most of the district health services are provided by clinical health officers specially trained to provide services that would normally be provided by fully qualified doctors or specialists. As this cadre and the cadre of enrolled nurses are the mainstay of the Malawian health service at the district level, it is important that they are supported and motivated to deliver a good standard of service to the population. This study explores how these cadres are managed and motivated and the impact this has on their performance. A quantitative survey measured health workers' job satisfaction, perceptions of the work environment and sense of justice in the workplace, and was reported elsewhere. It emerged that health workers were particularly dissatisfied with what they perceived as unfair access to continuous education and career advancement opportunities, as well as inadequate supervision. These issues and their contribution to demotivation, from the perspective of both management and health workers, were further explored by means of qualitative techniques.Focus group discussions were held with health workers, and key-informant interviews were conducted with members of district health management teams and human resource officers in the Ministry of Health. The focus groups used convenience sampling that included all the different cadres of health workers available and willing to participate on the day the research team visited the health facility. The interviews targeted district health management teams in three districts and the human resources personnel in the Ministry of Health, also sampling those who were available and agreed to participate. The results showed that health workers consider continuous education and career progression strategies to be inadequate. Standard human resource management practices such as performance appraisal and the

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

Directory of Open Access Journals (Sweden)

MacLachlan Malcolm

2009-07-01

Full Text Available Abstract Background Shortage of human resources is a major problem facing Malawi, where more than 50% of the population lives in rural areas. Most of the district health services are provided by clinical health officers specially trained to provide services that would normally be provided by fully qualified doctors or specialists. As this cadre and the cadre of enrolled nurses are the mainstay of the Malawian health service at the district level, it is important that they are supported and motivated to deliver a good standard of service to the population. This study explores how these cadres are managed and motivated and the impact this has on their performance. Methods A quantitative survey measured health workers' job satisfaction, perceptions of the work environment and sense of justice in the workplace, and was reported elsewhere. It emerged that health workers were particularly dissatisfied with what they perceived as unfair access to continuous education and career advancement opportunities, as well as inadequate supervision. These issues and their contribution to demotivation, from the perspective of both management and health workers, were further explored by means of qualitative techniques. Focus group discussions were held with health workers, and key-informant interviews were conducted with members of district health management teams and human resource officers in the Ministry of Health. The focus groups used convenience sampling that included all the different cadres of health workers available and willing to participate on the day the research team visited the health facility. The interviews targeted district health management teams in three districts and the human resources personnel in the Ministry of Health, also sampling those who were available and agreed to participate. Results The results showed that health workers consider continuous education and career progression strategies to be inadequate. Standard human resource

Health care units and human resources management trends.

Science.gov (United States)

André, Adriana Maria; Ciampone, Maria Helena Trench; Santelle, Odete

2013-02-01

To identify factors producing new trends in basic health care unit management and changes in management models. This was a prospective study with ten health care unit managers and ten specialists in the field of Health in São Paulo, Southeastern Brazil, in 2010. The Delphi methodology was adopted. There were four stages of data collection, three quantitative and the fourth qualitative. The first three rounds dealt with changing trends in management models, manager profiles and required competencies, and the Mann-Whitney test was used in the analysis. The fourth round took the form of a panel of those involved, using thematic analysis. The main factors which are driving change in basic health care units were identified, as were changes in management models. There was consensus that this process is influenced by the difficulties in managing teams and by politics. The managers were found to be up-to-date with trends in the wider context, with the arrival of social health organizations, but they are not yet anticipating these within the institutions. Not only the content, but the professional development aspect of training courses in this area should be reviewed. Selection and recruitment, training and assessment of these professionals should be guided by these competencies aligned to the health service mission, vision, values and management models.

Health care waste management practice in a hospital.

Science.gov (United States)

Paudel, R; Pradhan, B

2010-10-01

Health-care waste is a by-product of health care. Its poor management exposes health-care workers, waste handlers and the community to infections, toxic effects and injuries including damage of the environment. It also creates opportunities for the collection of disposable medical equipment, its re-sale and potential re-use without sterilization, which causes an important burden of disease worldwide. The purpose of this study was to find out health care waste management practice in hospital. A cross-sectional study was conducted in Narayani Sub-Regional Hospital, Birgunj from May to October 2006 using both qualitative and quantitative methods. Study population was four different departments of the hospital (Medical/Paediatric, Surgical/Ortho, Gynae/Obstetric and Emergency), Medical Superintendent, In-charges of four different departments and all sweepers. Data was collected using interview, group discussion, observation and measurement by weight and volume. Total health-care waste generated was 128.4 kg per day while 0.8 kg per patient per day. The composition of health care waste was found to be 96.8 kg (75.4%) general waste, 24.1 kg (8.8%) hazardous waste and 7.5 kg (5.8%) sharps per day by weight. Health staffs and sweepers were not practicing the waste segregation. Occupational health and safety was not given due attention. Majority of the sweepers were unaware of waste management and need of safety measures to protect their own health. Health care waste management practice in the hospital was unsatisfactory because of the lack of waste management plan and carelessness of patients, visitors and staffs. Therefore the hospital should develop the waste management plan and strictly follow the National Health Care Waste Management Guideline.

ASSESSMENT OF LOGISTICS MANAGEMENT IN GHANA HEALTH SERVICE

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john frimpong manso

2013-08-01

Full Text Available Ghana Public Health Sector runs a three-tier system of managing health commodities. Suppliers, the Central Medical Store, The Regional Medical Store, Service Delivery Points and the transportation system form the supply chain.  Ghana Health Service logistics system is centralized and the health care delivery system is decentralized. Logistics management in the health system is crucial. This is because there are instances where medicines and health commodities are not available at the Central Medical Stores and the Regional Medical Stores. Consequently, there is no commodity security at the service delivery points. Upon this backdrop the study seeks to assess the logistics management system in order to bring efficiency in the system. The study adopts a multi-case study approach to assess the practices of logistics management, the causes of inadequacy of logistics and the strengths and weaknesses in Ghana Health Service logistics system.  Two categories of participants that is, the key players of health logistics management and end-users were involved in the study.  Four variables; finance for procurement of health commodities, evenly distribution of health commodities, effective supervision and constant monitoring and evaluation were found crucial in effective and efficient logistics management. Moreover, it was found that poor procurement planning and budgeting, lack of financial resources for procurement, poor quantification and forecasting, delay in procurement process and order processing, and delay in receiving insurance claims are some of the causes of inadequacy of logistics in the health systems. It is recommended that Ghana Health Service logistics or supply system must receive constant monitoring and evaluation. Further, Ghana Health Service must ensure that there is effective top-down supervision in the system to bring up efficiency. Again, Ghana Health Service and Ministry of Health must ensure enough funds are secured from the

Health promotion in Swedish schools: school managers' views.

Science.gov (United States)

Persson, Louise; Haraldsson, Katarina

2017-04-01

Schools are recognized worldwide as settings for health promotion, and leadership has a bearing on schools' ability to be health promoting. School managers have a great influence on what is prioritized in school, which in turn affects students' school performance and health. There is lack of research into school managers' views on health promotion, and what they consider to be central to health promotion. The aim was therefore to examine school managers' views about what health promotion in schools include. An explorative design, qualitative content analysis, was performed. In-depth interviews were conducted with all 13 school managers of a middle-sized municipality in central Sweden. The analysis had both manifest and latent content and three categories: 'Organization and Collaboration', 'Optimize the arena' and 'Strengthen the individual', and 10 subcategories emerged. The theme, 'Opportunities for learning and a good life', describes the latent content of these categories. Taking into account the views of school managers are important because these views help form a more complete picture of how school managers work with health promotion and what is needed to enhance health promotion to improve students' opportunities for learning and a good life. The Ottawa Charter for Health promotion is thereby transformed into practice. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Innovation in health service management: Adoption of project management offices to support major health care transformation.

Science.gov (United States)

Lavoie-Tremblay, Mélanie; Aubry, Monique; Cyr, Guylaine; Richer, Marie-Claire; Fortin-Verreault, Jean-François; Fortin, Claude; Marchionni, Caroline

2017-11-01

To explore the characteristics that influence project management offices acceptance and adoption in healthcare sector. The creation of project management offices has been suggested as a promising avenue to promote successful organisational change and facilitate evidence-based practice. However, little is known about the characteristics that promote their initial adoption and acceptance in health care sector. This knowledge is important in the context where many organisations are considering implementing project management offices with nurse managers as leaders. A descriptive multiple case study design was used. The unit of analysis was the project management offices. The study was conducted in three university-affiliated teaching hospitals in 2013-14 (Canada). Individual interviews (n = 34) were conducted with senior managers. Results reveal that project management offices dedicated to project and change management constitute an innovation and an added value that addresses tangible needs in the field. Project management offices are an innovation highly compatible with health care managers and their approach has parallels to the process of clinical problem solving and reasoning well-known to adopters. This knowledge is important in a context where many nurses hold various roles in project management offices, such as Director, project manager, clinical expert and knowledge broker. © 2017 John Wiley & Sons Ltd.

Factors Affecting Usage of a Personal Health Record (PHR) to Manage Health

Science.gov (United States)

Taha, Jessica; Czaja, Sara J.; Sharit, Joseph; Morrow, Daniel G.

2018-01-01

As the health care industry shifts into the digital age, patients are increasingly being provided with access to electronic personal health records (PHRs) that are tethered to their provider-maintained electronic health records. This unprecedented access to personal health information can enable patients to more effectively manage their health, but little is actually known about patients’ ability to successfully use a PHR to perform health management tasks or the individual factors that influence task performance. This study evaluated the ability of 56 middle-aged adults (40–59 years) and 51 older adults (60–85 years) to use a simulated PHR to perform 15 common health management tasks encompassing medication management, review/interpretation of lab/test results, and health maintenance activities. Results indicated that participants in both age groups experienced significant difficulties in using the PHR to complete routine health management tasks. Data also showed that older adults, particularly those with lower numeracy and technology experience, encountered greater problems using the system. Furthermore, data revealed that the cognitive abilities predicting one’s task performance varied according to the complexity of the task. Results from this study identify important factors to consider in the design of PHRs so that they meet the needs of middle-aged and older adults. As deployment of PHRs is on the rise, knowledge of the individual factors that impact effective PHR use is critical to preventing an increase in health care disparities between those who are able to use a PHR and those who are not. PMID:24364414

Participative management in health care services

Directory of Open Access Journals (Sweden)

M. Muller

1995-03-01

Full Text Available The need and demand for the highest-quality management of all health care delivery activities requires a participative management approach. The purpose with this article is to explore the process of participative management, to generate and describe a model for such management, focusing mainly on the process of participative management, and to formulate guidelines for operationalisation of the procedure. An exploratory, descriptive and theory-generating research design is pursued. After a brief literature review, inductive reasoning is mainly employed to identify and define central concepts, followed by the formulation of a few applicable statements and guidelines. Participative management is viewed as a process of that constitutes the elements of dynamic interactive decision-making and problem-solving, shared governance, empowerment, organisational transformation, and dynamic communication within the health care organisation. The scientific method of assessment, planning, implementation and evaluation is utilised throughout the process of participative management.

Managing health and safety risks: Implications for tailoring health and safety management system practices.

Science.gov (United States)

Willmer, D R; Haas, E J

2016-01-01

As national and international health and safety management system (HSMS) standards are voluntarily accepted or regulated into practice, organizations are making an effort to modify and integrate strategic elements of a connected management system into their daily risk management practices. In high-risk industries such as mining, that effort takes on added importance. The mining industry has long recognized the importance of a more integrated approach to recognizing and responding to site-specific risks, encouraging the adoption of a risk-based management framework. Recently, the U.S. National Mining Association led the development of an industry-specific HSMS built on the strategic frameworks of ANSI: Z10, OHSAS 18001, The American Chemistry Council's Responsible Care, and ILO-OSH 2001. All of these standards provide strategic guidance and focus on how to incorporate a plan-do-check-act cycle into the identification, management and evaluation of worksite risks. This paper details an exploratory study into whether practices associated with executing a risk-based management framework are visible through the actions of an organization's site-level management of health and safety risks. The results of this study show ways that site-level leaders manage day-to-day risk at their operations that can be characterized according to practices associated with a risk-based management framework. Having tangible operational examples of day-to-day risk management can serve as a starting point for evaluating field-level risk assessment efforts and their alignment to overall company efforts at effective risk mitigation through a HSMS or other processes.

Care management actions in the Family Health Strategy

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Marcelo Costa Fernandes

2015-11-01

Full Text Available Objective: to identify, from nurses’ speeches, the actions that enable care management in the Family Health Strategy.Methods: descriptive study with a qualitative approach conducted with 32 nurses of primary care. It was used a semistructuredinterview as the data collection technique. The methodological process of the collective subject discourse wasused to organize the data Results: from the nurses’ speeches one identified the categories: complementary relationshipbetween care and management; meeting with community health agents, a care management strategy in nurses’ work;health education activities such as a care management action and a health information system as an essential tool forcare Conclusion: it was possible to observe that nurses understood the importance of coordination and complementaritybetween the activities of the working process of care and management.

Collective work: a challenge for health management.

Science.gov (United States)

Scherer, Magda Duarte Dos Anjos; Pires, Denise; Schwartz, Yves

2009-08-01

Based on ergology and work process theorization, the study aims to contribute to reflections on health collective work, emphasizing its specificity and difficulties in building and managing groups of workers. It deals with work as a human activity that dialectically comprises the application of a prescribed protocol and a unique and historical perspective. Health work involves a relationship among individuals who act in the drama of using themselves and manage their own work; it is influenced by the history of health professions and macro-political determinations. In conclusion, this health work complexity needs to be considered in the process of management of professional teams/groups of workers, in a way that actions can interact and enable the implementation of a new health care project in the perspective of comprehensiveness.

A New Acoustic Emission Sensor Based Gear Fault Detection Approach

Directory of Open Access Journals (Sweden)

Junda Zhu

2013-01-01

Full Text Available In order to reduce wind energy costs, prognostics and health management (PHM of wind turbine is needed to ensure the reliability and availability of wind turbines. A gearbox is an important component of a wind turbine. Therefore, developing effective gearbox fault detection tools is important to the PHM of wind turbine. In this paper, a new acoustic emission (AE sensor based gear fault detection approach is presented. This approach combines a heterodyne based frequency reduction technique with time synchronous average (TSA and spectrum kurtosis (SK to process AE sensor signals and extract features as condition indictors for gear fault detection. Heterodyne technique commonly used in communication is first employed to preprocess the AE signals before sampling. By heterodyning, the AE signal frequency is down shifted from several hundred kHz to below 50 kHz. This reduced AE signal sampling rate is comparable to that of vibration signals. The presented approach is validated using seeded gear tooth crack fault tests on a notational split torque gearbox. The approach presented in this paper is physics based and the validation results have showed that it could effectively detect the gear faults.

Caseload management, work-related stress and case manager self-efficacy among Victorian mental health case managers.

Science.gov (United States)

King, Robert

2009-05-01

In Australia and comparable countries, case management has become the dominant process by which public mental health services provide outpatient clinical services to people with severe mental illness. There is recognition that caseload size impacts on service provision and that management of caseloads is an important dimension of overall service management. There has been little empirical investigation, however, of caseload and its management. The present study was undertaken in the context of an industrial agreement in Victoria, Australia that required services to introduce standardized approaches to caseload management. The aims of the present study were therefore to (i) investigate caseload size and approaches to caseload management in Victoria's mental health services; and (ii) determine whether caseload size and/or approach to caseload management is associated with work-related stress or case manager self-efficacy among community mental health professionals employed in Victoria's mental health services. A total of 188 case managers responded to an online cross-sectional survey with both purpose-developed items investigating methods of case allocation and caseload monitoring, and standard measures of work-related stress and case manager personal efficacy. The mean caseload size was 20 per full-time case manager. Both work-related stress scores and case manager personal efficacy scores were broadly comparable with those reported in previous studies. Higher caseloads were associated with higher levels of work-related stress and lower levels of case manager personal efficacy. Active monitoring of caseload was associated with lower scores for work-related stress and higher scores for case manager personal efficacy, regardless of size of caseload. Although caseloads were most frequently monitored by the case manager, there was evidence that monitoring by a supervisor was more beneficial than self-monitoring. Routine monitoring of caseload, especially by a workplace

Integrated Health Management Definitions

Data.gov (United States)

National Aeronautics and Space Administration — The Joint Army Navy NASA Air Force Modeling and Simulation Subcommittee's Integrated Health Management panel was started about 6 years ago to help foster...

Air pollution - health and management

Energy Technology Data Exchange (ETDEWEB)

Klug, W; Runca, E; Suess, M J [eds.

1984-01-01

The proceedings of a joint workshop of the World Health Organization and the International Institute for Applied Systems Analysis are presented. The workshop was to review the interaction between man's industrial and urban activities and the environment, and the relationship between ambient air quality and human health, and to examine the effectiveness of proper management on the control and abatement of air pollution. The discussion topics included atmospheric processes and respective modelling, air pollution impact on human health, effects of air pollutants on aquatic and terrestrial ecosystems, air pollution episode cycles and management of control. A selected list of 11ASA and WHO/EURO publications related to air pollution is included. Separate abstracts were prepared for 15 papers in this book.

[The role of management in health care].

Science.gov (United States)

Güntert, Bernhard J

2007-01-01

The situation in the health care sector is affected by a shortage of public funds on the one hand and, on the other hand, by rapid developments in medicine and nursing with an enormous expansion of both diagnostic and therapeutic possibilities. This and the aging population are generating a steadily increasing demand for health care services. The result is an increased cost consciousness in society calling for more professional management in health care organizations. However, the traditional administration of health care organizations, which is closely aligned with health professionals and production processes, was not able to cope with these dynamics or did so only unsatisfactorily. An improved management would surely lead to an optimization of health care delivery processes and a more effective use of resources. The question, however, is whether the effectiveness of the total system can be improved and whether patients' and society's needs can actually be met by classical management approaches.

Service Line Management: A New Paradigm in Health Care System

Directory of Open Access Journals (Sweden)

Rafat Rezapour Nasrabad

2016-12-01

Full Text Available Health care organizations are required to implement modern management practices and approaches due to the importance of improving quality and increasing efficiency of health care services. Service line management of healthcare services is one of the new approaches that managers of health sectors are interested in. The “service line” approach will organize the management of inpatient and outpatient in clinical services focusing on patient diagnostic clusters. Services specific in each patient diagnostic cluster will be offered by a multidisciplinary team including nurses, physicians, and so no. Accordingly, the present study aims to evaluate the features, process and benefits of service line management approach in the provision of health services. In this descriptive study, internal and external scientific database have been reviewed and the necessary data have been extracted from the latest research projects and related scientific documents. The results showed that the new management approach is based on a paradigm shift from traditional health care system management to healthcare service line management with a focus on managers’ competencies. Four specific manager’s competencies in this new management model are: conceptual, collaborative, interpersonal, and leadership competencies. Theses competencies should be developed in health system managers so as to lead to organizational excellency and improvement of health service quality. The health sector managers should strengthen these four key competencies and act on them. Then they will become effective leaders and managers in the health system.

Integrated Building Health Management

Data.gov (United States)

National Aeronautics and Space Administration — Abstract: Building health management is an important part in running an efficient and cost-effective building. Many problems in a building’s system can go undetected...

Software for Intelligent System Health Management (ISHM)

Science.gov (United States)

Trevino, Luis C.

2004-01-01

The slide presentation is a briefing in four areas: overview of health management paradigms; overview of the ARC-Houston Software Engineering Technology Workshop held on April 20-22, 2004; identified technologies relevant to technical themes of intelligent system health management; and the author's thoughts on these topics.

Ambiguity among Managers in Small-Scale Enterprises: How to Handle Business and Workplace Health Management

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Stig Vinberg

2017-11-01

Full Text Available Despite extensive research on health in working life, few studies focus on this issue from the perspective of managers in small-scale enterprises (SSEs. To gain deeper knowledge of managers’ perceptions and strategies for dealing with workplace health management, 13 Norwegian and Swedish SSE managers were interviewed after participating in a workplace health development project. The methodical approach was based on Grounded Theory with a constructivist orientation. The main theme that emerged was ‘ambiguity in workplace health management and maintaining the business’, which was related to the categories ‘internal workplace settings’, ‘workplace surroundings’, and ‘leadership strategies’. The managers experienced ambiguity due to internal and external demands. These requirements were linked to the core challenges in dealing with multitasking leadership, financial decision-making, labour legislation, staff development and maintaining business. However, the managers developed new skills and competence and thereby a more reflexive approach and readiness to create a health-promoting workplace from being part of a development project. The implications are that managers in SSEs need to exchange experiences and discuss workplace health issues with other managers in networks. It is also important that occupational health services and social and welfare organizations use tailor-made models and strategies for supporting SSEs.

Managing workplace health promotion in municipal organizations: The perspective of senior managers.

Science.gov (United States)

Larsson, Robert; Åkerlind, Ingemar; Sandmark, Hélène

2015-01-01

Previous research indicates that companies manage workplace health in various ways, but more in-depth empirical knowledge of how workplace health promotion (WHP) is managed in public sector organizations is needed. The aim of this study was to explore how WHP is managed and incorporated into the general management system in two large Swedish municipal organizations. A qualitative descriptive approach was used. Fourteen senior managers were purposefully selected and interviewed using semi-structured interviews. Documents were used as supplementary data. All data were analysed using qualitative content analysis. The management of WHP was described as a set of components that together contribute to the organization's capacity for WHP. The informants described WHP as dominated by fitness programmes and as following a problem-solving cycle, in which the annual employee survey emerged as an important managerial tool. Achieving feasible WHP measures and appropriate follow-ups were described as challenges. The provision of leadership competence for WHP and use of supportive resources were described as additional components. The WHP management approach needs to be broadened to include work environment and organizational factors. Further integration with occupational health and safety and the general management system in the organizations is also needed.

Applications of Health Management Using Android and RFID

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Young-Long Chen

2012-07-01

Full Text Available Health management has become increasingly important in personal health care in modern life. The system we have designed provides a method to help facilitate health management through an associated smart phone with Radio Frequency Identification (RFID, which is a new type of application. This system consists of medical knowledge and health management. In the application of medical knowledge, we use the human model as well as the operation of RFID to obtain medical knowledge concerning human organs. The two main functions of the health management system are medication reminders and drug identification. The feature of medication reminders allows users to set the time for taking medication so that patients do not miss taking their medication. The feature of drug identification allows the operators to identify the drugs and can let the users know who needs to take drugs. In addition, we have designed a web page that allows users to understand their health status.

Managing the Social Determinants of Health: Part I: Fundamental Knowledge for Professional Case Management.

Science.gov (United States)

Fink-Samnick, Ellen

PRIMARY PRACTICE SETTING(S):: Applicable to health and behavioral health settings, wherever case management is practiced. The SDH pose major challenges to the health care workforce in terms of effective resource provision, health and behavioral health treatment planning plus adherence, and overall coordination of care. Obstacles and variances to needed interventions easily lead to less than optimal outcomes for case managers and their health care organizations. Possessing sound knowledge and clear understanding of each SDH, the historical perspectives, main theories, and integral dynamics, as well as creative resource solutions, all support a higher level of intentional and effective professional case management practice. Those persons and communities impacted most by the SDH comprise every case management practice setting. These clients can be among the most vulnerable and disenfranchised members of society, which can easily engender biases on the part of the interprofessional workforce. They are also among the costliest to care for with 50% of costs for only 5% of the population. Critical attention to knowledge about managing the SDH leverages and informs case management practice, evolves more effective programming, and enhances operational outcomes across practice settings.

Knowledge Management System in Health & Social Care: Review on 20 Practiced Knowledge Management

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Muhammad Saiful Ridhwan

2014-02-01

Full Text Available The importance of managing medical information has become very critical in the healthcare delivery system. Medical information nowadays are optimized towards serving different areas such as; diagnosing of diseases, planning and administration, treatment and monitoring of patient outcomes, services and costs. This article provides a review into various Health and Social Care systems which encompasses the Knowledge Management value. For analysis, more than 30 systems that are related to Health and Social Care were gathered via Internet research, only 20 of these systems were finally selected based on recent system development and popularity of the system.Keywords: Health Care, Knowledge, Knowledge Management, Social Care, systemdoi:10.12695/ajtm.2013.6.2.4 How to cite this article:Ridhwan, M.S., and Oyefolahan, I.O. (2013. Knowledge Management System in Health & Social Care: Review on 20 Practiced Knowledge Management. The Asian Journal of Technology Management 6 (2: 92-101. Print ISSN: 1978-6956; Online ISSN: 2089-791X. doi:10.12695/ajtm.2013.6.2.4

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

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

2016-02-01

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

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

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Lynch, Tim; Cox, Paul

2006-01-01

The British Columbia Ministry of Health's Framework for Core Functions in Public Health was the catalyst that inspired this review of best practices in health emergency management. The fieldwork was conducted in the fall of 2005 between hurricane Katrina and the South Asia earthquake. These tragedies, shown on 24/7 television news channels, provided an eyewitness account of disaster management, or lack of it, in our global village world. It is not enough to just have best practices in place. There has to be a governance structure that can be held accountable. This review of best practices lists actions in support of an emergency preparedness culture at the management, executive, and corporate/governance levels of the organization. The methodology adopted a future quality management approach of the emergency management process to identify the corresponding performance indictors that correlated with practices or sets of practices. Identifying best practice performance indictors needed to conduct a future quality management audit is described as reverse quality management. Best practices cannot be assessed as stand-alone criteria; they are influenced by organizational culture. The defining of best practices was influenced by doubt about defining a practice it is hoped will never be performed, medical staff involvement, leadership, and an appreciation of the resources required and how they need to be managed. Best practice benchmarks are seen as being related more to "measures" of performance defined locally and agreed on by 2 or more parties rather than to achieving industrial standards. Relating practices to performance indicators and then to benchmarks resulted in the development of a Health Emergency Management Best Practices Matrix that lists specific practice in the different phases of emergency management.

Effective public health management: The Nigerian experience | Abe ...

African Journals Online (AJOL)

Public health management in Nigeria is the process of mobilizing and deploying resources for the provision of effective public health services. To ensure an effective public health, population based strategies would need to be put in place and this would require proper management to yield desired results. This paper ...

Software for Intelligent System Health Management

Science.gov (United States)

Trevino, Luis C.

2004-01-01

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

Knowledge management in health: a systematic literature review.

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

2012-01-01

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

Toward a Conceptual Knowledge Management Framework in Health

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Lau, Francis

2004-01-01

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

Managing for soil health can suppress pests

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Amanda Hodson

2016-08-01

Full Text Available A “healthy” soil can be thought of as one that functions well, both agronomically and ecologically, and one in which soil biodiversity and crop management work in synergy to suppress pests and diseases. UC researchers have pioneered many ways of managing soil biology for pest management, including strategies such as soil solarization, steam treatment and anaerobic soil disinfestation, as well as improvements on traditional methods, such as reducing tillage, amending soil with organic materials, and cover cropping. As managing for soil health becomes more of an explicit focus due to restrictions on the use of soil fumigants, integrated soil health tests will be needed that are validated for use in California. Other research needs include breeding crops for disease resistance and pest suppressive microbial communities as well as knowledge of how beneficial organisms influence plant health.

Health system strengthening and hypertension management in China.

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Huang, Kehui; Song, Yu Ting; He, Yong Huan; Feng, Xing Lin

2016-01-01

Non-communicable diseases are the leading causes of global burden of diseases, and hypertension is one of the most important risk factors. Hypertension prevalence doubled in China in the past decade and affects more than 300 million Chinese people. In the review we systematically searched peer-reviewed publications that link health system level factors with hypertension management in China and provide the current knowledge on how to improve a country's health system to manage the hypertension epidemic. A framework was developed to guide the review. The database of PubMed, CNKI were systematically searched from inception to April 13, 2016. Two authors independently screened the searched results for inclusion, conducted data extraction and appraised the quality of studies. Key findings were described according to the framework. Five hundred seventy-two publications were identified, where 11 articles were left according to the inclusion and exclusion criteria. The study periods range from 2010 to 2015. All about 11 researches linked health system factors to the outcome of hypertension management. And the outcomes were just focused on the awareness, treatment and control of hypertension but not hypertension incidence. One study is about the role of health system governance, investigating the performance of different organized community health care centers; three studies were about health financing comparing differences in insurance coverage; three studies were about health information practicing the hypertension guidelines of China or the WHO, and the rest three about mechanisms of health service delivery. No researches were identified about physical resources for health and human resources for health. Hypertension prevalence has been rising rapidly in China and the management of hypertension in China is a detection problem rather than treatment problem. Limited evidence shows the positive effect of health system factors on hypertension management and joint efforts

NETWORKS OF HEALTH CARE: A CHALLENGE TO SUS MANAGEMENT

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Camila Dubow

2013-09-01

Full Text Available The article proposes a critical reflection, based on national law, scholarly, scientific, on the current development of Networks of Health Care, as a strategy for strengthening the Single Health System (SUS. Are weighted inefficiency of traditional ways of organizing care and management, the challenge of Network Health Care for comprehensive care and management mechanisms used in this process. The work provides subsidies for the care practices and health management are reflected, pointing strategies that result in disruptions of paradigms through a refocusing of attention in existing models. For networks of health care can be consolidated, is fundamental to political sensitivity of health managers with a commitment to build a new model of care, through the struggle to consolidate the SUS and the realization of the principles of universality, comprehensiveness and equity.

Health-related behaviour among managers of Slovenian hospitals and institutes of public health

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Jerneja Farkas

2015-12-01

Full Text Available Aim: Behavioural risk factors have a significant impact on health. We aimed to assess health-related behaviour, health status, and use of healthcare services among managers of Slovenian hospitals and institutes of public health. Methods: This was a cross-sectional study which included management (directors, scientific directors, directors’ deputies of Slovenian hospitals and institutes of public health (63 respondents; 57% women; overall mean age: 51±7 years; response rate: 74%. Data were obtained using an anonymous self-administered questionnaire. Results: About 35% of respondents were directors. More than half of the respondents were overweight or obese (52%, the majority were not sufficiently physically active (59% and overloaded with stress (87%. Hypercholesterolemia (36%, spinal disease (17%, and arterial hypertension (16% were most common chronic diseases. Whilst only few participants visited their general practitioner due their health complaints, blood pressure (76%, cholesterol (51%, and glucose (54% were measured within last year in most of the respondents. Conclusion: Our findings point to a high prevalence of overweight and obesity as well as workplace-related stress among Slovenian public health managers. Therefore, effective preventive strategies should be focused on stress management along with promotion of healthy behavioural patterns.

Health Technologies for the Improvement of Chronic Disease Management

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Nikitovic, M; Brener, S

2013-01-01

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

Public health response to striking solid waste management.

Science.gov (United States)

Murti, Michelle; Ayre, Reg; Shapiro, Howard; de Burger, Ron

2011-10-01

In 2009, the City of Toronto, Ontario, Canada, experienced a six-week labor disruption involving 24,000 city workers that included solid waste and public health employees. In an attempt to control illegal dumping and to manage garbage storage across the city during this period, 24 temporary garbage storage sites were established by the city (mostly in local parks) for residents to dispose of their household waste. No other municipality in North America has attempted to operate this many temporary sites for this long a period. Management and nonunion staff from Healthy Environments in Toronto Public Health performed daily inspections, responded to community questions, issued public health orders, and worked closely with Solid Waste Management and the Ministry of the Environment to actively manage the public health concerns associated with these sites. This intensive oversight mitigated public health risks to the community and facilitated an effective, safe solution to the temporary garbage storage problem.

Functioning of primary health care in opinion of managers of primary health care units.

Science.gov (United States)

Bojar, I; Wdowiak, L; Kwiatosz-Muc, M

2006-01-01

The aim of the research is to get to know opinions of primary health care managers concerning working of primary health care and concerning quality of medical services offered by family doctors out-patient clinics. The research among managers of primary health care units took place in all out-patient clinics in Lublin province. Research instrument was survey questionnaire of authors own construction. Results were statistically analyzed. From 460 surveys sent, 108 questionnaires were accepted to analysis. Majority of managers of out-patient clinics of primary health care is satisfied with the way and the quality of work of employed staff. In opinion of 71.3% of managers access to family doctor services is very good. Availability of primary health care services is better estimated by managers of not public units. The occupied local provide comfortable work for the staff in opinion of 78.5% of surveyed managers of out-patient clinics. Managers estimate the level of their services as very good (37.96%) and good (37.96%) comparing to other such a subjects present in the market. Internal program of improving quality is run in 22% of out-patient clinics, which were investigated. Managers of primary health care units assess the quality of their services as good and very good. They estimate positively the comfort and politeness in serving patients as well as technical status of equipment and the lodging. They assess availability of their services as very good. Large group of managers of family doctors practices recognizes neighborhood practices as a competitors.

Place, leisure, and well-being

Science.gov (United States)

Daniel R. Williams; Michael E. Patterson

2008-01-01

The Population Health Model (PHM) (Hamilton and Bhatti 1996) brings much needed attention to the critical role of environmental and community variables in the promotion of physical and mental health. However, it appears to neglect two facets integral to what is otherwise a rich contextual approach to health promotion. One facet, place, is the binding theme of this book...

Integrated Management System Incorporating Quality Management and Management of Environment, Health and Occupational Safety

International Nuclear Information System (INIS)

Manchev, B.; Nenkova, B.; Tomov, E.

2012-01-01

Risk Engineering Ltd is a Bulgarian private company founded in 1990 to provide engineering and consulting services applicable to each and every field of the energy sector. Since its establishment Risk Engineering Ltd develops, implement and apply a System for quality assurance, certified for the first time by BVQI (now Bureau Veritas Certification) in 1999 for conformity with the standard ISO 9001:1994. Later on, in connection with the revision of the standards of ISO 9000 series and introduction of the standard ISO 9001:2000 a Quality Management System in conformity with the standard ISO 9001:2000 was developed, introduced and certified. At present, Risk Engineering Ltd has got developed, documented, introduced and certified by Lloyd's Register Quality Assurance (LRQA) Quality Management System in compliance with ISO 9001:2008 on the process approach basis. On this basis and including the requirements of the ISO 14001:2004 (regarding the environment) and OHSAS 18001:2007 (regarding the health and occupational safety), Risk Engineering Ltd has developed and introduced Integrated Management System aim at achieving and demonstrating good results regarding protection of the environment, health and occupational safety. The processes under control by the Integrated Management System and applicable at the company are divided in two general types: A) Management processes: Strategic management and Management of the human resources. B) Processes describing the main activities: design/development process; project management; management of industrial projects and technical infrastructure project; construction, installation, repair and operation of power industry facilities; commercial activities and marketing; investigation of energy efficiency of industrial systems and certification of buildings regarding energy efficiency; consulting activity in the field of industry and energy as well as consultant in accordance with the Law of the Spatial Planning; management of the

The eHealth Behavior Management Model: a stage-based approach to behavior change and management.

Science.gov (United States)

Bensley, Robert J; Mercer, Nelda; Brusk, John J; Underhile, Ric; Rivas, Jason; Anderson, Judith; Kelleher, Deanne; Lupella, Melissa; de Jager, André C

2004-10-01

Although the Internet has become an important avenue for disseminating health information, theory-driven strategies for aiding individuals in changing or managing health behaviors are lacking. The eHealth Behavior Management Model combines the Transtheoretical Model, the behavioral intent aspect of the Theory of Planned Behavior, and persuasive communication to assist individuals in negotiating the Web toward stage-specific information. It is here - at the point of stage-specific information - that behavioral intent in moving toward more active stages of change occurs. The eHealth Behavior Management Model is applied in three demonstration projects that focus on behavior management issues: parent-child nutrition education among participants in the U.S. Department of Agriculture Special Supplemental Nutrition Program for Women, Infants and Children; asthma management among university staff and students; and human immunodeficiency virus prevention among South African women. Preliminary results have found the eHealth Behavior Management Model to be promising as a model for Internet-based behavior change programming. Further application and evaluation among other behavior and disease management issues are needed.

Managing risk: clinical decision-making in mental health services.

Science.gov (United States)

Muir-Cochrane, Eimear; Gerace, Adam; Mosel, Krista; O'Kane, Debra; Barkway, Patricia; Curren, David; Oster, Candice

2011-01-01

Risk assessment and management is a major component of contemporary mental health practice. Risk assessment in health care exists within contemporary perspectives of management and risk aversive practices in health care. This has led to much discussion about the best approach to assessing possible risks posed by people with mental health problems. In addition, researchers and commentators have expressed concern that clinical practice is being dominated by managerial models of risk management at the expense of meeting the patient's health and social care needs. The purpose of the present study is to investigate the risk assessment practices of a multidisciplinary mental health service. Findings indicate that mental health professionals draw on both managerial and therapeutic approaches to risk management, integrating these approaches into their clinical practice. Rather than being dominated by managerial concerns regarding risk, the participants demonstrate professional autonomy and concern for the needs of their clients.

Simulation modeling for the health care manager.

Science.gov (United States)

Kennedy, Michael H

2009-01-01

This article addresses the use of simulation software to solve administrative problems faced by health care managers. Spreadsheet add-ins, process simulation software, and discrete event simulation software are available at a range of costs and complexity. All use the Monte Carlo method to realistically integrate probability distributions into models of the health care environment. Problems typically addressed by health care simulation modeling are facility planning, resource allocation, staffing, patient flow and wait time, routing and transportation, supply chain management, and process improvement.

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

Science.gov (United States)

Wong-Rieger, Durhane; Rieger, Francis P

2013-02-01

To effectively manage diabetes mellitus, patients must adhere to treatment recommendations and healthy lifestyle behaviors, but research shows many patients do not do this. Education is effective when combined with self-management support but peer-support programs do not lead to lasting changes. Health coaching, or professional support, can be highly effective if it focuses on developing self-efficacy and skills such as goal-setting, problem-solving and managing cognitive and emotional barriers. This overview discusses the benefits of patient self-management for chronic conditions such as diabetes, core competencies for health coaching, theoretical bases and principles of health coaching interventions, delivery methods and the evidence that health coaching works for diabetes self-management. Copyright © 2013 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Permanent education and co-management: experience of a health managing group

Directory of Open Access Journals (Sweden)

Diogo Faria Corrêa da Costa

2015-08-01

Full Text Available This paper presents the experience lived by a group of workers of the Regional Center for Action on Health of the 4th. Regional Health State Department of Health of Rio Grande do Sul in Santa Maria. The paper presents an experience of reorganization of the work process in order to tackle the historical fragmentation of activities in the field of health management, and trigger a learning process for institutional support to carry thirty-two municipalities in the area of administrative scope of this coordinating body . To do so, it relies upon the co-management strategies and continuing health education as tools to trigger processes of change and inventing other ways of designing and conducting health work. With this experience, we can dislodge established places, inventing new forms of teamwork and interdisciplinary manner in order to strengthen this group of workers and their practices.

Degradations analysis and aging modeling for health assessment and prognostics of PEMFC

International Nuclear Information System (INIS)

Jouin, Marine; Gouriveau, Rafael; Hissel, Daniel; Péra, Marie-Cécile; Zerhouni, Noureddine

2016-01-01

Applying prognostics to Proton Exchange Membrane Fuel Cell (PEMFC) stacks is a good solution to help taking actions extending their lifetime. However, it requires a great understanding of the degradation mechanisms and failures occurring within the stack. This task is not simple when applied to a PEMFC due to the different levels (stack - cells - components), the different scales and the multiple causes that lead to degradation. To overcome this problem, this work proposes a methodology dedicated to the setting of a framework and a modeling of the aging for prognostics. This methodology is based on a deep literature review and degradation analyses of PEMFC stacks. This analysis allows defining a proper vocabulary dedicated to PEMFC's prognostics and health management and a clear limited framework to perform prognostics. Then the degradations review is used to select critical components within the stack, and to define their critical failure mechanisms thanks the proposal of new fault trees. The impact of these critical components and mechanisms on the power loss during aging is included to the model for prognostics. This model is finally validated on four datasets with different mission profiles both for health assessment and prognostics. - Highlights: • A proper framework to perform PHM, particularly prognostics, of PEMFC is proposed. • A degradation analysis is performed. • A completely new model of PEMFC degradation is proposed. • SOH estimation is performed with very high coefficients of determination.

Radioactive waste management of health services

International Nuclear Information System (INIS)

Silva, Eliane Magalhaes Pereira da; Miaw, Sophia Teh Whei

2001-01-01

In health care establishment, radioactive waste is generated from the use of radioactive materials in medical applications such as diagnosis, therapy and research. Disused sealed sources are also considered as waste. To get the license to operate from Comissao Nacional de Energia Nuclear - CNEN, the installation has to present a Radiation Protection Plan, in which the Waste Management Programme should be included. The Waste Management Programme should contain detailed description on methodologies and information on technical and administrative control of generated waste. This paper presents the basic guidelines for the implementation of a safe waste management by health care establishments, taking into account the regulations from CNEN and recommendations from the International Atomic Energy Agency - IAEA. (author)

[Organization of health services and tuberculosis care management].

Science.gov (United States)

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

2012-07-01

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

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

Science.gov (United States)

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

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

Developing management capacity building package to district health manager in northwest of Iran: A sequential mixed method study.

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Tabrizi, Jafar Sadegh; Gholipour, Kamal; Farahbakhsh, Mostafa; Jahanbin, Hasan; Karamuz, Majid

2016-11-01

To assess districts health managers educational needs and develop management training programmes. This mixed-method study was carried out between August 2014 and August 2015 in Tabriz, Iran. Four focus group discussion sessions and three semi-structured face-to-face interviews were conducted among district health managers and experts of a health centre. Besides, 52 questionnaires were completed to weigh and finalise management education module and courses. Interviews and focus group discussions were tape-recorded, transcribed and analysed using content analysis method. Data was analysed using SPSS17. There were 52 participants, of whom 40(78.8%) were men and 12(21.2%) were women. All of the subjects (100%) took part in the quantitative phase, while 25(48.08%) participated in the qualitative phase. In the qualitative section, 11(44%) participants were heads of unit/departments in provincial health centre and 14(56%) were district health managers. In the quantitative phase, 30(57.7%) participants were district health managers and 8(28.8%) were heads of units/departments. Moreover, 33(63.4%) participants had medical education. The job experience of 3(5.8%) participants in the current position was below five years. Districts health management training programme consisted of 10modules with 53 educational topics. The normalised score out of a total of 100 for rules and ethics was 75.51, health information management 71.19, management and leadership 69.27, district management 68.08, human resources and organisational creativity 67.58,quality improvement 66.6, health resources management 62.37, planning and evaluation 61.87, research in health system 59.15, and community participation was 53.15. Considering district health managers' qualification in health and medicine, they had not been trained in basic management. Almost all the management and leadership courses were prioritised as most necessary.

Social Exclusion Index-for Health Surveys (SEI-HS): a prospective nationwide study to extend and validate a multidimensional social exclusion questionnaire.

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van Bergen, Addi P L; Hoff, Stella J M; Schreurs, Hanneke; van Loon, Annelies; van Hemert, Albert M

2017-03-14

Social exclusion (SE) refers to the inability of certain groups or individuals to fully participate in society. SE is associated with socioeconomic inequalities in health, and its measurement in routine public health monitoring is considered key to designing effective health policies. In an earlier retrospective analysis we demonstrated that in all four major Dutch cities, SE could largely be measured with existing local public health monitoring data. The current prospective study is aimed at constructing and validating an extended national measure for SE that optimally employs available items. In 2012, a stratified general population sample of 258,928 Dutch adults completed a version of the Netherlands Public Health Monitor (PHM) questionnaire in which 9 items were added covering aspects of SE that were found to be missing in our previous research. Items were derived from the SCP social exclusion index, a well-constructed 15-item instrument developed by the Netherlands Institute for Social Research (SCP). The dataset was randomly divided into a development sample (N =129,464) and a validation sample (N = 129,464). Canonical correlation analysis was conducted in the development sample. The psychometric properties were studied and compared with those of the original SCP index. All analyses were then replicated in the validation sample. The analysis yielded a four dimensional index, the Social Exclusion Index for Health Surveys (SEI-HS), containing 8 SCP items and 9 PHM items. The four dimensions: "lack of social participation", "material deprivation", "lack of normative integration" and "inadequate access to basic social rights", were each measured with 3 to 6 items. The SEI-HS showed adequate internal consistency for both the general index and for two of four dimension scales. The internal structure and construct validity of the SEI-HS were satisfactory and similar to the original SCP index. Replication of the SEI-HS in the validation sample confirmed its

Knowledge Management in Health Technology SMEs.

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Huusko, Juhamatti; Kuusisto-Niemi, Sirpa; Saranto, Kaija

2017-01-01

The purpose of this study was to examine knowledge management's (KM) role in small and medium-sized (SMEs) health technology enterprises, which employ fewer than 250 employees. In this study, KM is understood as the ability to achieve competitive advantage by utilizing management knowledge and making it profitable. The health technology enterprises use modern technology to resolve health-related issues. The research data was acquired from Finnish health technology SMEs. The questionnaire was sent to 140 enterprises, generating 25 responses, or a 17.9% response rate. According to the results, health technology enterprises have not adopted KM concepts, nor do they have the necessary resources to do so. SMEs' KM use is informal: information is transferred informally through human interaction, rather than through information systems. In the SMEs, KM is not perceived as important, although it is seen as associated with the enterprise's financial performance through the potential in making the knowledge profitable.

Data Analysis of Occupational Health and Safety Management and Total Quality Management Systems

Directory of Open Access Journals (Sweden)

Ahmet Yakut

2013-01-01

Full Text Available In our study, Total Quality Management, Occupational Health and Safety on the effects of the construction industry, building sites of Istanbul evaluated with the results of the survey of 25 firms. For Occupational Health and Safety program, walked healthy, active employees in her role increased and will increase the importance of education. Due to non-implementation of the OHS system in our country enough, work-related accidents and deaths and injuries resulting from these accidents is very high. Firms as a result of the analysis, an effective health and safety management system needs to be able to fulfill their responsibilities. This system is designated as OHSAS 18001 Occupational Health and Safety Management System and the construction industry can be regarded as the imperatives.

Real-Time Rocket/Vehicle System Integrated Health Management Laboratory For Development and Testing of Health Monitoring/Management Systems

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Aguilar, R.

2006-01-01

Pratt & Whitney Rocketdyne has developed a real-time engine/vehicle system integrated health management laboratory, or testbed, for developing and testing health management system concepts. This laboratory simulates components of an integrated system such as the rocket engine, rocket engine controller, vehicle or test controller, as well as a health management computer on separate general purpose computers. These general purpose computers can be replaced with more realistic components such as actual electronic controllers and valve actuators for hardware-in-the-loop simulation. Various engine configurations and propellant combinations are available. Fault or failure insertion capability on-the-fly using direct memory insertion from a user console is used to test system detection and response. The laboratory is currently capable of simulating the flow-path of a single rocket engine but work is underway to include structural and multiengine simulation capability as well as a dedicated data acquisition system. The ultimate goal is to simulate as accurately and realistically as possible the environment in which the health management system will operate including noise, dynamic response of the engine/engine controller, sensor time delays, and asynchronous operation of the various components. The rationale for the laboratory is also discussed including limited alternatives for demonstrating the effectiveness and safety of a flight system.

Health and radiation protection management

International Nuclear Information System (INIS)

Huhn, A.; Vargas, M.; Lorenzetti, J.; Lança, L.

2017-01-01

Quality management and continuous improvement systems are becoming part of daily health services, including radiodiagnostic services, which are designed to meet the needs of users, operating in an environment where the differential is due to the competence and quality of the services provided. The objective of this study is to show the scope of the management of health services, especially radiodiagnosis and radiological protection. Method: Exploratory and descriptive study, based on a review of the literature on the subject. Results: Radiodiagnosis has demonstrated the need for efficient management, especially because ionizing radiation is present in this environment and it is imperative that the professionals working in this area are aware of the need to perform adequate radiological protection for themselves and for users. Conclusion: Universal access to information has changed the attitude of the user and the user has become more demanding in his choices, wanting to understand, express, interact and choose the best quality service in view of the various options available in the market

Effects of Integrated Health Management Intervention on Overweight and Obesity

Directory of Open Access Journals (Sweden)

Yiting Yang

2017-01-01

Full Text Available Overweight or obese adults aged 20~55 years and living in Beijing more than one year were randomly divided into different management groups. A one-year integrated health management intervention was applied in the health management groups. The physical indicators and metabolic indicators changed after one-year intervention on the overweight and obese adults. The annual reduction of the physical indicators was significant in all groups (p<0.05 except the weight loss in the placebo + general management group. The health management and the dietary supplement have statistically significant (p<0.001, p<0.001 effects on the annual reduction of these indicators and interactive effect between them was found on some of these indicators such as bodyweight, body mass index (BMI, body fat ratio (BFR, and hipline (p<0.05. The dietary supplement + health management group had the best annual reduction effects for the indicators among the groups. Integrated health management interventions including both dietary supplements intervention and health management could improve metabolic indicators in overweight and obese adults together with the physical indicators, suggesting the intermediated role of metabolic indictors in controlling obesity.

Participative management in health care services.

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Muller, M

1995-03-01

The need and demand for the highest-quality management of all health care delivery activities requires a participative management approach. The purpose with this article is to explore the process of participative management, to generate and describe a model for such management, focusing mainly on the process of participative management, and to formulate guidelines for operationalization of the procedure. An exploratory, descriptive and theory-generating research design is pursued. After a brief literature review, inductive reasoning is mainly employed to identify and define central concepts, followed by the formulation of a few applicable statements and guidelines. Participative management is viewed as a process of that constitutes the elements of dynamic interactive decision-making and problem-solving, shared governance, empowerment, organisational transformation, and dynamic communication within the health care organisation. The scientific method of assessment, planning, implementation and evaluation is utilised throughout the process of participative management. A continuum of interactive decision-making and problem-solving is described, the different role-players involved, as well as the levels of interactive decision-making and problem-solving. The most appropriate decision-making strategy should be employed in pro-active and reactive decision-making. Applicable principles and assumptions in each element of participative management is described. It is recommended that this proposed model for participative management be refined by means of a literature control, interactive dialogue with experts and a model case description or participative management, to ensure the trustworthiness of this research.

[The Utilization of Health-Related Applications in Chronic Disease Self-Management].

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Kao, Chi-Wen; Chuang, Hui-Wan; Chen, Ting-Yu

2017-08-01

The dramatic increase in smartphone usage has spurred the development of many health-related mobile applications (apps). On the other hand, population aging and the associated rise in the incidence of chronic disease is increasing the demand for long-term care. Effective chronic disease self-management has been shown to help patients improve their health condition. Numerous smartphone applications currently support patient self-management of chronic disease, facilitating health management and health promotion. The purpose of the present article was to introduce the definition, contents, and types of health-related apps; to discuss the effectiveness of self-management health-related apps in promoting chronic disease management; and to assess and evaluate these apps. We hope that the present article helps give to healthcare professionals and patients who are willing to manage their diseases a general understanding of health-related apps and their potential to facilitate the self-management of chronic diseases.

Analysis of the new health management based on health internet of things and cloud computing

Science.gov (United States)

Liu, Shaogang

2018-05-01

With the development and application of Internet of things and cloud technology in the medical field, it provides a higher level of exploration space for human health management. By analyzing the Internet of things technology and cloud technology, this paper studies a new form of health management system which conforms to the current social and technical level, and explores its system architecture, system characteristics and application. The new health management platform for networking and cloud can achieve the real-time monitoring and prediction of human health through a variety of sensors and wireless networks based on information and can be transmitted to the monitoring system, and then through the software analysis model, and gives the targeted prevention and treatment measures, to achieve real-time, intelligent health management.

Rural health service managers' perspectives on preparing rural health services for climate change.

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Purcell, Rachael; McGirr, Joe

2018-02-01

To determine health service managers' (HSMs) recommendations on strengthening the health service response to climate change. Self-administered survey in paper or electronic format. Rural south-west of New South Wales. Health service managers working in rural remote metropolitan areas 3-7. Proportion of respondents identifying preferred strategies for preparation of rural health services for climate change. There were 43 participants (53% response rate). Most respondents agreed that there is scepticism regarding climate change among health professionals (70%, n = 30) and community members (72%, n = 31). Over 90% thought that climate change would impact the health of rural populations in the future with regard to heat-related illnesses, mental health, skin cancer and water security. Health professionals and government were identified as having key leadership roles on climate change and health in rural communities. Over 90% of the respondents believed that staff and community in local health districts (LHDs) should be educated about the health impacts of climate change. Public health education facilitated by State or Federal Government was the preferred method of educating community members, and education facilitated by the LHD was the preferred method for educating health professionals. Health service managers hold important health leadership roles within rural communities and their health services. The study highlights the scepticism towards climate change among health professionals and community members in rural Australia. It identifies the important role of rural health services in education and advocacy on the health impacts of climate change and identifies recommended methods of public health education for community members and health professionals. © 2017 National Rural Health Alliance Inc.

Management of health in the construction and assembly of land pipelines

Energy Technology Data Exchange (ETDEWEB)

Richa, Newton M.M.; Ruella, Nildemar C [PETROBRAS, Rio de Janeiro, RJ (Brazil)

2009-07-01

The objectives of this study are: describe the main aspects of a health management experience in a work of construction and assembly of land pipeline, highlighting the positive impacts on safety and productivity; demonstrate that the general objective of the health function is to provide technical support to companies, information and services for leaders, managers, supervisors, workers and families in the management of multiple interfaces of health, especially the health-work interface; and demonstrate that the appropriate management of health may contribute significantly to the overall management of undertakings. (author)

Mental Health Professionals' Suicide Risk Assessment and Management Practices.

Science.gov (United States)

Roush, Jared F; Brown, Sarah L; Jahn, Danielle R; Mitchell, Sean M; Taylor, Nathanael J; Quinnett, Paul; Ries, Richard

2018-01-01

Approximately 20% of suicide decedents have had contact with a mental health professional within 1 month prior to their death, and the majority of mental health professionals have treated suicidal individuals. Despite limited evidence-based training, mental health professionals make important clinical decisions related to suicide risk assessment and management. The current study aimed to determine the frequency of suicide risk assessment and management practices and the association between fear of suicide-related outcomes or comfort working with suicidal individuals and adequacy of suicide risk management decisions among mental health professionals. Mental health professionals completed self-report assessments of fear, comfort, and suicide risk assessment and management practices. Approximately one third of mental health professionals did not ask every patient about current or previous suicidal thoughts or behaviors. Further, comfort, but not fear, was positively associated with greater odds of conducting evidence-based suicide risk assessments at first appointments and adequacy of suicide risk management practices with patients reporting suicide ideation and a recent suicide attempt. The study utilized a cross-sectional design and self-report questionnaires. Although the majority of mental health professionals report using evidenced-based practices, there appears to be variability in utilization of evidence-based practices.

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

Science.gov (United States)

Hannan, Terry J

2015-01-01

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

Traditional vs. Contemporary Management Control Practices for Developing Public Health Policies.

Science.gov (United States)

Naranjo-Gil, David; Sánchez-Expósito, María Jesús; Gómez-Ruiz, Laura

2016-07-14

Public health policies must address multiple goals and complex community health needs. Recently, management control practices have emerged to provide a broader type of information for evaluating the effectiveness of healthcare policies, and relate activities and processes to multiple strategic outcomes. This study compares the effect of traditional and contemporary management control practices on the achievement of public health policies. It is also analyzed how two different uses of such practices (enabling vs. coercive) facilitate the achievement of public health policies. Relationships are explored using data collected from managers from public health agencies and public hospitals in Spain. The findings show that contemporary management control practices are more suitable than traditional practices to achieve public health policies. Furthermore, results show that public health policies are better achieved when managers use management control practices in an enabling way rather than in a coercive way.

Disability management: the application of preventive measures, health promotion and case management in Italy.

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La Torre, G; De Giusti, M; Mannocci, A; De Waure, C; Agostinelli, A; Schena, S; Capelli, G; Ricciardi, W; Boccia, A; Damiani, G; von Pinoci, M; Fanton, C; Federico, B

2009-03-01

Disability Management can be defined as a practice to improve workers' health and to reduce the impact and costs of disability. The aim of the study was to estimate the diffusion of DM in Italian companies. A survey was conducted using a questionnaire, the Worksite Disability Management Audit. The questionnaire was structured into five parts addressing the following domains: 1) characteristics of the company; 2) health promotion activities; 3) preventive measures; 4) case management; 5) disability management. We selected public and private companies and collected information by direct interview. Twenty companies entered the survey. Twelve Companies (60%) indicated that health promotion programs and sensibilisation campaigns are usually carried out. The presence of an individual who provided workplace safety indications and materials was stated by 19 companies (95%). Periodical medical examinations are carried out by 19 companies (95%); 16 (80%) have an evaluation process for ergonomics concerns. Risk assessment and analysis are performed by all companies and the security procedures and policies are updated at least once in a year in 40% of cases. Health status monitoring of injured workers is performed in eight (40%) of the companies, while Disability Management is present as a whole in only three companies. This survey highlights that Disability Management is not undertaken in most companies and that, where applied, there is still confusion and disorganization about ways to promote health and manage workers' illness and disability. Hence, there is still the need to promote an all-inclusive evaluation and management of workers' safety, illness and disabilities.

Corporate social responsibility and the future health care manager.

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Collins, Sandra K

2010-01-01

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

Health and Stress Management and Mental-health Disability Claims.

Science.gov (United States)

Marchand, Alain; Haines, Victor Y; Harvey, Steve; Dextras-Gauthier, Julie; Durand, Pierre

2016-12-01

This study examines the associations between health and stress management (HSM) practices and mental-health disability claims. Data from the Salveo study was collected during 2009-2012 within 60 workplaces nested in 37 companies located in Canada (Quebec) and insured by a large insurance company. In each company, 1 h interviews were conducted with human resources managers in order to obtain data on 63 HSM practices. Companies and workplaces were sorted into the low-claims and high-claims groups according to the median rate of the population of the insurer's corporate clients. Logistic regression adjusted for design effect and multidimensional scaling was used to analyse the data. After controlling for company size and economic sector, task design, demands control, gratifications, physical activity and work-family balance were associated with low mental-health disability claims rates. Further analyses revealed three company profiles that were qualified as laissez-faire, integrated and partially integrated approaches to HSM. Of the three, the integrated profile was associated with low mental-health disability claims rates. The results of this study provide evidence-based guidance for a better control of mental-health disability claims. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Management of Health Information in Malawi: Role of Technology

Directory of Open Access Journals (Sweden)

Patrick Albert Chikumba

2017-01-01

Full Text Available This paper is an extended version of the conference paper presented at IST Africa Week Conference 2016 and it discusses in detail the existing technology gaps using DHIS2 (District Health Information System 2.0 as an example, and how Geographic Information System (GIS and mobile application, as specific examples of technology, can enhance health management information system (HMIS in Malawi. The paper focuses on management of health information. When organisation information is made available, it is expected that the decision-makers use it objectively making rational decisions. This can be achieved by how the information is organized, integrated and presented probably through technology. Along with the increase in strengthening HMIS, questions of how to support the management of information at various organizational levels arise. Research on technologies in health management in developing countries has been on single technologies. Therefore, in this paper, the interest is on multiple technologies and how they support each other to enhance health information management. It has been observed that when it comes to health information management, HMIS employs a mix of paper-based and technology-based practices. Taking into account the infrastructure in Malawi, as in many developing countries, this is probably the most feasible approach. Hence, discussions of existing technology gaps include both paper-based and technology-based practices and how to better support health information management practices through this mixed use of media. The case study confirms that technology plays a role in strengthening HMIS. However, this should be supported by enhancing a culture of information management. It has been noted that DHIS2 is the main information system but it requires the enhancement through inclusions of other technologies. The DHIS2 alone cannot do everything.

Work-related stress management between workplace and occupational health care.

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Kinnunen-Amoroso, Maritta; Liira, Juha

2016-06-13

Work-related stress has been evaluated as one of the most important health risks in Europe. Prevention of work related stress and interventions to reduce risk factors for stress in the workplace are conducted together by the enterprise and occupational health services. The aim of the study was to examine the experiences of Finnish occupational physicians on the stress management with enterprises. From the Finnish Association of Occupational Health Physicians membership list 207 physicians responded to self-administered anonymous questionnaire. The data were analysed using SPSS 17.0. The client enterprises contacted occupational health services frequently about work-related stress. Collaboration between occupational health and enterprises was strongest in companies' own occupational health services and generally with most experienced physicians. Occupational health services and enterprises shared responsibility for managing work-related stress. Professional experience and close contact with organisation management favours successful stress management between occupational health and enterprises.

Environmental health research in Japan - management of environmental risks

Energy Technology Data Exchange (ETDEWEB)

Nakamura, Masahisa [Lake Biwa Research Institute (Japan)

1997-12-31

Briefly discussed the topics on emerging environmental health risks, their assessment and management, with special emphasis on groundwater management , environmental contamination, source protection, new drinking water and ambient water quality standards; and sophistication in instrumentation in environmental quality measurements, hazards and risk assessment and control, technology development in environmental health risk management.

Environmental health research in Japan - management of environmental risks

International Nuclear Information System (INIS)

Masahisa Nakamura

1996-01-01

Briefly discussed the topics on emerging environmental health risks, their assessment and management, with special emphasis on groundwater management , environmental contamination, source protection, new drinking water and ambient water quality standards; and sophistication in instrumentation in environmental quality measurements, hazards and risk assessment and control, technology development in environmental health risk management

An evaluation of the Well at Dell health management program: health risk change and financial return on investment.

Science.gov (United States)

Musich, Shirley; McCalister, Tre'; Wang, Sara; Hawkins, Kevin

2015-01-01

To investigate the effectiveness of the Well at Dell comprehensive health management program in delivering health care and productivity cost savings relative to program investment (i.e., return on investment). A quasi-experimental design was used to quantify the financial impact of the program and nonexperimental pre-post design to evaluate change in health risks. Ongoing worksite health management program implemented across multiple U.S. locations. Subjects were 24,651 employees with continuous medical enrollment in 2010-2011 who were eligible for 2011 health management programming. Incentive-driven, outcomes-based multicomponent corporate health management program including health risk appraisal (HRA)/wellness, lifestyle management, and disease management coaching programs. Medical, pharmacy, and short-term disability pre/post expenditure trends adjusted for demographics, health status, and baseline costs. Self-reported health risks from repeat HRA completers. Analysis: Propensity score-weighted and multivariate regression-adjusted comparison of baseline to post trends in health care expenditures and productivity costs for program participants and nonparticipants (i.e., difference in difference) relative to programmatic investment. The Well at Dell program achieved an overall return on investment of 2.48 in 2011. Most of the savings were realized from the HRA/wellness component of the program. Cost savings were supported with high participation and significant health risk improvement. An incentive-driven, well-managed comprehensive corporate health management program can continue to achieve significant health improvement while promoting health care and productivity cost savings in an employee population.

A survey of the health needs of hospital staff: implications for health care managers.

Science.gov (United States)

Jinks, Annette M; Lawson, Valerie; Daniels, Ruth

2003-09-01

Developing strategies to address the health needs of the National Health Services (NHS) workforce are of concern to many health care managers. Focal to the development of such strategies are of being in receipt of baseline information about employees expressed health needs and concerns. This article addresses obtaining such baseline information and presents the findings of a health needs survey of acute hospital staff in a trust in North Wales. The total population of trust employees were surveyed (n = 2300) and a 44% (n = 1021) response rate was achieved. A number of positive findings are given. Included are that the majority of those surveyed stated that their current health status is good, are motivated to improve their health further, do not smoke and their alcohol consumption is within recommended levels. There appears, however, to be a number of areas where trust managers can help its staff improve their health. Included are trust initiatives that focus on weight control and taking more exercise. In addition, there appears to be a reported lack of knowledge and positive health behaviour amongst the male respondents surveyed that would imply the trust needs to be more effective in promoting well man type issues. Finally there appears to be a general lack of pride in working for the trust and a pervasive feeling that the trust does not care about its employees that needs to be addressed. It is concluded that the findings of this survey have implications for management practices in the trust where the survey was conducted and also wider applicability to the management of health care professionals. For example, addressing work-related psychological and physical problems of employees are of importance to all health care managers. This is especially so when considering recruitment and retention issues.

ISWHM: Tools and Techniques for Software and System Health Management

Science.gov (United States)

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

2010-01-01

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

Leadership and management training as a catalyst to health system strengthening in low-income settings: Evidence from implementation of the Zambia Management and Leadership course for district health managers in Zambia.

Science.gov (United States)

Mutale, Wilbroad; Vardoy-Mutale, Anne-Thora; Kachemba, Arthur; Mukendi, Roman; Clarke, Kupela; Mulenga, Dennis

2017-01-01

Research has shown that the modes of leadership and management may influence health outcomes. However, majority of health leaders and managers in many low-income countries are promoted on account of clinical expertise. It has been recognised that these new managers are often ill-prepared for managing complex health systems. In response to this challenge, the Zambian Ministry of Health (MoH) has developed the Governance and Management Capacity Building (GMCB) Strategic Plan (2012-2016), whose overarching goal is to improve health sector governance and create an environment that is result-oriented, accountable and transparent. This led to the introduction of a new in-service leadership and management course, which has come to be known as the Zambia Management and Leadership Academy (ZMLA). This paper presents the results of an impact evaluation of the ZMLA programme conducted in 2014. This was a cross-sectional mixed method study. The study targeted health workers, stakeholders and course implementers. ZMLA trainees were targeted to gain perspectives on the extent to which the programme affected levels of self-confidence resulting from knowledge gained. Perspectives were sought from both ZMLA and non ZMLA trainees to measure changes in the work environment. Stakeholder perspectives were collected from trainers and key informants involved in providing ZMLA training. On average, knowledge levels increased by 38% after each workshop. A comparison of the average self-rated scores from 444 management and leadership survey responses before ZMLA and after ZMLA training showed a significant increase in the proportion of participants that felt adequately trained to undertake management and leadership, from 63% (before) to 99% (after) in phase 1 and 43% (before) to 98% (after) in the phase II cohort. The calculated before and after percentage change for work environment themes ranged from 5.8% to 13.4%. Majority of respondents perceived improvements in the workplace

Leadership and management training as a catalyst to health system strengthening in low-income settings: Evidence from implementation of the Zambia Management and Leadership course for district health managers in Zambia.

Directory of Open Access Journals (Sweden)

Wilbroad Mutale

Full Text Available Research has shown that the modes of leadership and management may influence health outcomes. However, majority of health leaders and managers in many low-income countries are promoted on account of clinical expertise. It has been recognised that these new managers are often ill-prepared for managing complex health systems. In response to this challenge, the Zambian Ministry of Health (MoH has developed the Governance and Management Capacity Building (GMCB Strategic Plan (2012-2016, whose overarching goal is to improve health sector governance and create an environment that is result-oriented, accountable and transparent. This led to the introduction of a new in-service leadership and management course, which has come to be known as the Zambia Management and Leadership Academy (ZMLA. This paper presents the results of an impact evaluation of the ZMLA programme conducted in 2014.This was a cross-sectional mixed method study. The study targeted health workers, stakeholders and course implementers. ZMLA trainees were targeted to gain perspectives on the extent to which the programme affected levels of self-confidence resulting from knowledge gained. Perspectives were sought from both ZMLA and non ZMLA trainees to measure changes in the work environment. Stakeholder perspectives were collected from trainers and key informants involved in providing ZMLA training.On average, knowledge levels increased by 38% after each workshop. A comparison of the average self-rated scores from 444 management and leadership survey responses before ZMLA and after ZMLA training showed a significant increase in the proportion of participants that felt adequately trained to undertake management and leadership, from 63% (before to 99% (after in phase 1 and 43% (before to 98% (after in the phase II cohort. The calculated before and after percentage change for work environment themes ranged from 5.8% to 13.4%. Majority of respondents perceived improvements in the workplace

Software Health Management with Bayesian Networks

Science.gov (United States)

Mengshoel, Ole; Schumann, JOhann

2011-01-01

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

Financial Management: Implementation of the Data Quality Management Control Program for the Military Health System (D-2002-141)

National Research Council Canada - National Science Library

2002-01-01

DoD health care managers should read this report. Military health care data is used for a variety of critical purposes, including managing patient care, determining the optimal health care system, and for financial management...

Managing Agricultural Biodiversity for Nutrition, Health, Livelihoods ...

International Development Research Centre (IDRC) Digital Library (Canada)

Managing Agricultural Biodiversity for Nutrition, Health, Livelihoods and ... on local ecosystems and human resources can provide sustainable solutions to ... and health among the rural and urban poor through increased dietary diversity.

Familiarity with modern health management trends by West African ...

African Journals Online (AJOL)

Familiarity with modern health management trends by West African Surgeons. ... of the West African College of Surgeons, which was held in Calabar, Nigeria, from ... We recommend for a well-focussed short time duration health management ...

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

Directory of Open Access Journals (Sweden)

Singh Satyavir

2010-11-01

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

Integrated environment, safety, and health management system description

International Nuclear Information System (INIS)

Zoghbi, J. G.

2000-01-01

The Integrated Environment, Safety, and Health Management System Description that is presented in this document describes the approach and management systems used to address integrated safety management within the Richland Environmental Restoration Project

Organizational and methodological aspects for contemporary health and safety management system

Directory of Open Access Journals (Sweden)

Sugak Evgeny

2017-01-01

Full Text Available Industrial injuries and work-related disorders considerable lowering we are facing in developed countries may be due to switching to a new health and safety management system entitled “Occupational Safety and Health Management System”. The Russian Federation has prepared certain regulatory documents prescribing some suggestions regarding implementing the contemporary system for industrial injuries prevention based upon the methods for professional risks management. However, despite the efforts made by the Russian Government, reformation of the health and safety management system at various companies is being performed rather slowly that may be as well owing to poor competence of managers and specialists regarding contemporary labor safety model content, methodical and organizational novations in the sphere of occupational safety and health management.. The article refers to a number of principal issues distinguishing the new health and safety management system from conventional approach.

Safe management of waste from health-care activities

International Nuclear Information System (INIS)

Pruess, A.; Giroult, E.; Rushbrook, P.

1999-01-01

The waste produced in the course of health-care activities, from contaminated needles to radioactive isotopes, carries a greater potential for causing infection and injury than any other type of waste, and inadequate or inappropriate management is likely to have serious public health consequences and deleterious effects on the environment. This handbook - the result of extensive international consultation and collaboration - provides comprehensive guidance on safe, efficient, and environmentally sound methods for the handling and disposal of health-care wastes. The various categories of waste are clearly defined and the particular hazards that each poses are described. Considerable prominence is given to the careful planning that is essential for the success of waste management; workable means of minimizing waste production are outlined and the role of reuse and recycling of waste is discussed. Most of the text, however, is devoted to the collection, segregation, storage, transport, and disposal of wastes. Details of containers for each category of waste, labelling of waste packages, and storage conditions are provided, and the various technologies for treatment of waste and disposal of final residues are discussed at length. Advice is given on occupational safety for all personnel involved with waste handling, and a separate chapter is devoted to the closely related topic of hospital hygiene and infection control. The handbook pays particular attention to basic processes and technologies that are not only safe but also affordable, sustainable, and culturally appropriate. For health-care settings in which resources are severely limited there is a separate chapter on minimal programmes; this summarizes all the simplest and least costly techniques that can be employed for the safe management of health-care wastes. The guide is aimed at public health managers and policy-makers, hospital managers, environmental health professionals, and all administrators with an

Perception of leadership among health managers working in tertiary level hospitals.

Science.gov (United States)

Shahzad, Saadia; Zareen, Humaira

2012-01-01

Rapid growth of medical knowledge has created major changes in technology which in turn has created greater demand of the client for better health services, and health sector is constantly under pressure of great internal and external demands. Quality of services, largely depend on to what extent managers are well versed with the concept of evidence based management, team and group approach in achieving organizational objectives. Making an effective health system, addressing the double burden of diseases coupled with resource crunch in developing countries is a big challenge for policy makers and health managers. Comprehensive concepts and application knowledge of leadership is very important for health managers in the present day in order to get best output that satisfies all the stake holders. Present anthropological study was done to assess the perception and knowledge of leadership among the health managers working in tertiary level hospitals. This qualitative study was conducted in two public sector tertiary level hospitals of Lahore chosen randomly out of a total of seven such hospitals in the same city. Convenient sampling technique was used. Observation and in- depth interviews were conducted for data collection. Open ended questionnaire on the lines of MLQ was used. One main domain of leadership was developed and categorisation of the themes was done in the two evolved categories of transformational and transactional leadership. In the domain of leadership 10 of the health managers showed positive themes for transactional leadership, 6 showed positive themes for transformational leadership, and still 1 health manager showed overall negative response for the concept of leadership; he was totally in favour of dictatorship. Health managers with degrees in management/administration had better concept about the key idea of leadership and its variables. Female health managers were more inclined towards transformational leadership behaviour.

Public health laboratory quality management in a developing country.

Science.gov (United States)

Wangkahat, Khwanjai; Nookhai, Somboon; Pobkeeree, Vallerut

2012-01-01

The article aims to give an overview of the system of public health laboratory quality management in Thailand and to produce a strengths, weaknesses, opportunities and threats (SWOT) analysis that is relevant to public health laboratories in the country. The systems for managing laboratory quality that are currently employed were described in the first component. The second component was a SWOT analysis, which used the opinions of laboratory professionals to identify any areas that could be improved to meet quality management systems. Various quality management systems were identified and the number of laboratories that met both international and national quality management requirements was different. The SWOT analysis found the opportunities and strengths factors offered the best chance to improve laboratory quality management in the country. The results are based on observations and brainstorming with medical laboratory professionals who can assist laboratories in accomplishing quality management. The factors derived from the analysis can help improve laboratory quality management in the country. This paper provides viewpoints and evidence-based approaches for the development of best possible practice of services in public health laboratories.

Participatory management in today's health care setting

International Nuclear Information System (INIS)

Burnham, B.A.

1987-01-01

As the health care revolution progresses, so must the management styles of today's leaders. The authors must ask ourselves if we are managing tomorrow's work force or the work force of the past. Participatory management may better meet the needs of today's work force. This paper identifies the reasons participatory management is a more effective management style, the methods used to implement a participatory management program, its benefits (such as higher productivity and more efficient, effective implementation and acceptance of change), and the difficulties experienced

Meeting global health challenges through operational research and management science.

Science.gov (United States)

Royston, Geoff

2011-09-01

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

Disability management: corporate medical department management of employee health and productivity.

Science.gov (United States)

Burton, W N; Conti, D J

2000-10-01

This study describes a proactive in-house program for managing short-term disability (STD) in the workforce of a very large banking system. The goals of this program were to (1) minimize the personal and economic impacts of STD by early intervention, (2) validate the extent and duration of STD, and (3) coordinate medical services and provide guidance to managers that would facilitate an early return to work. This program was made possible by the installation of a comprehensive database, called Occupational Medicine and Nursing Information System. This database mainly includes employees' claims for inpatient and outpatient health services, disability and workers' compensation benefits, wellness program participation, medical examinations and laboratory tests, use of prescription drugs, and results of Health Risk Appraisals. As a result of these efforts, STD event duration declined after this STD management program was implemented in locations heretofore outside the system, and by providing full pay for part-time work after STD, within the system as well. Of note, the average number of STD days per employee showed substantial variation by health plan, including the fact that it was higher (3.9 STD days/employee) for health maintenance organization participants than for indemnity plan members (2.7 STD days/employee).

Integrating environment health and safety management at Petro-Canada

International Nuclear Information System (INIS)

Raymond, G.

1993-01-01

Petro-Canada has developed a tool to integrate, measure, and improve its management systems of environment, health, and safety (EH ampersand S). This tool, called the Total Loss Management System, is described in the areas of general management issues, policies and procedures, evaluations, organization, stewardship, issue management, and performance measures. Petro-Canada's policies on occupational health and safety are consistent with its environmental policy, being structured in the same way. An integrated audit system is used to cover health, safety, industrial hygiene, reliability, environment, and risk management. EH ampersand S matters are integrated at the corporate level in a separate department. Regional divisions review EH ampersand S performance every month, incidents are discussed, and preventive measures are taken as necessary. Regional performances are combined every quarter for ultimate presentation to the Petro-Canada board. New or emerging issues that may affect divisions are assigned an issue sponsor, a member of divisional management who makes sure the issue receives the resources necessary to study and define its impact. Examples of issues include soil contamination, process hazard management, and benzene exposure limits. Performance measures flow from the corporate environment and occupational health and safety policies, and come in two types: those that measure activities to improve performance and those that measure the outcome of the activities

Public health emergencies and the public health/managed care challenge.

Science.gov (United States)

Rosenbaum, Sara; Skivington, Skip; Praeger, Sandra

2002-01-01

The relationship between insurance and public health is an enduring topic in public health policy and practice. Insurers share certain attributes with public health. But public health agencies operate in relation to the entire community that they are empowered by public law to serve and without regard to the insurance status of community residents; on the other hand, insurers (whether managed care or otherwise) are risk-bearing entities whose obligations are contractually defined and limited to enrolled members and sponsors. Public insurers such as Medicare and Medicaid operate under similar constraints. The fundamental characteristics that distinguish managed care-style insurance and public health become particularly evident during periods of public health emergency, when a public health agency's basic obligations to act with speed and flexibility may come face to face with the constraints on available financing that are inherent in the structure of insurance. Because more than 70% of all personal health care in the United States is financed through insurance, public health agencies effectively depend on insurers to finance necessary care and provide essential patient-level data to the public health system. Critical issues of state and federal policy arise in the context of the public health/insurance relations during public health emergencies. These issues focus on coverage and the power to make coverage decisions, as well as the power to define service networks and classify certain data as exempt from public reporting. The extent to which a formal regulatory approach may become necessary is significantly affected by the extent to which private entities themselves respond to the problem with active efforts to redesign their services and operations to include capabilities and accountability in the realm of public health emergency response.

Leadership and management training as a catalyst to health system strengthening in low-income settings: Evidence from implementation of the Zambia Management and Leadership course for district health managers in Zambia

Science.gov (United States)

Mutale, Wilbroad; Vardoy-Mutale, Anne-Thora; Kachemba, Arthur; Mukendi, Roman; Clarke, Kupela; Mulenga, Dennis

2017-01-01

Background Research has shown that the modes of leadership and management may influence health outcomes. However, majority of health leaders and managers in many low-income countries are promoted on account of clinical expertise. It has been recognised that these new managers are often ill-prepared for managing complex health systems. In response to this challenge, the Zambian Ministry of Health (MoH) has developed the Governance and Management Capacity Building (GMCB) Strategic Plan (2012–2016), whose overarching goal is to improve health sector governance and create an environment that is result-oriented, accountable and transparent. This led to the introduction of a new in-service leadership and management course, which has come to be known as the Zambia Management and Leadership Academy (ZMLA). This paper presents the results of an impact evaluation of the ZMLA programme conducted in 2014. Methods This was a cross-sectional mixed method study. The study targeted health workers, stakeholders and course implementers. ZMLA trainees were targeted to gain perspectives on the extent to which the programme affected levels of self-confidence resulting from knowledge gained. Perspectives were sought from both ZMLA and non ZMLA trainees to measure changes in the work environment. Stakeholder perspectives were collected from trainers and key informants involved in providing ZMLA training. Results On average, knowledge levels increased by 38% after each workshop. A comparison of the average self-rated scores from 444 management and leadership survey responses before ZMLA and after ZMLA training showed a significant increase in the proportion of participants that felt adequately trained to undertake management and leadership, from 63% (before) to 99% (after) in phase 1 and 43% (before) to 98% (after) in the phase II cohort. The calculated before and after percentage change for work environment themes ranged from 5.8% to 13.4%. Majority of respondents perceived

Risk management frameworks for human health and environmental risks.

Science.gov (United States)

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

2003-01-01

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

Self-Management Skills in Chronic Disease Management: What Role Does Health Literacy Have?

Science.gov (United States)

Mackey, Laura M; Doody, Catherine; Werner, Erik L; Fullen, Brona

2016-08-01

Self-management-based interventions can lead to improved health outcomes in people with chronic diseases, and multiple patient characteristics are associated with the development of self-management behaviors. Low health literacy (HL) has been implicated in poorer self-management behaviors and increased costs to health services. However, the mechanisms behind this relationship remain unclear. Therefore, the aim of the current review is to assess the association between HL and patient characteristics related to self-management behaviors (i.e., disease-related knowledge, beliefs, and self-efficacy). The review comprised 3 phases: 1) database searches, 2) eligibility screening, and 3) study quality assessment and strength of evidence. Inclusion criteria specified that a valid HL screening tool was used, that at least one self-management behavior was assessed, and that patients had a chronic condition. An initial search generated a total of 712 articles, of which 31 studies fulfilled the eligibility criteria. A consistent association was found between low HL and poorer disease-related knowledge in respiratory diseases, diabetes, and multiple disease categories. A significant association between low HL and poorer self-efficacy was reported in cardiovascular diseases, diabetes, human immunodeficiency virus, and multiple disease categories. HL was significantly associated with poorer beliefs in respiratory, musculoskeletal, and cardiovascular diseases. The findings from the current review suggest that low HL may affect behaviors necessary for the development of self-management skills. Given that self-management strategies are core components for effective treatment of a range of chronic diseases, low HL poses a considerable health concern. Further research is needed to understand the mediating influence of HL on disease-related knowledge, self-efficacy, and beliefs. From this, HL-sensitive, self-management interventions ought to be devised and implemented. © The Author

Creating and managing a paperless health information management department.

Science.gov (United States)

Greene, Zelda B

2002-08-01

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

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

Science.gov (United States)

Marinescu, Luiza G

2007-02-01

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

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

Science.gov (United States)

Davidson, H. Clint, Jr.

2004-01-01

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

Consumer Health Informatics: Promoting Patient Self-care Management of Illnesses and Health.

Science.gov (United States)

Jung, Minsoo

Consumer health informatics (CHI) is propelling important changes for medical providers and the lives of patients through information and communications technology. Independently, medical consumers seek, collect, and use health information for decision making. However, when constructing a CHI-based medical platform, high technology must be applied in a fully understandable and usable format for both health care providers and consumers. This study examines the present status of CHI and its effect on medical consumers. For the development of CHI, we discuss the need for tailored health communications and capacity building with chronic patients at the medical center. First, empowerment is a key characteristic needed for medical consumer health care management. However, promoting patient self-care management of illnesses and health is necessary to create conjugation where cooperation with medical service providers is possible. Also, establishing a health care delivery system that will support cooperation is necessary. Second, tailored health communications can uniquely construct the health information of patients, which prevents unnecessary or excessive information from leading patients to confused and inappropriate decisions. Ultimately, through the present environment of health communication, the innovation of a consumer health care information system has become the tide of the times and the positive effect of improved health can be expected.

Managing equality and cultural diversity in the health workforce.

Science.gov (United States)

Hunt, Beverley

2007-12-01

This article offers practical strategies to managers and others for supporting overseas trained nurses and managing cultural diversity in the health workforce. Widespread nursing shortages have led managers to recruit nurses from overseas, mainly from developing countries. This paper draws on evidence from the Researching Equal Opportunities for Internationally Recruited Nurses and Other Health Professionals study reported elsewhere in this issue, which indicates that overseas trained nurses encountered widespread discriminatory practices including an overuse of complaints and grievances against them. The researchers also found that the overseas trained nurses responded to their experiences by using various personal strategies to resist or re-negotiate and overcome such discriminatory practices. A research workshop was held in June 2005 at the midpoint of the Researching Equal Opportunities for Internationally Recruited Nurses and Other Health Professionals study. Twenty-five participants attended the workshop. They were the Researching Equal Opportunities for Internationally Recruited Nurses and Other Health Professionals study researchers, advisory group members, including the author of this paper and other researchers in the field of migration. The overall aim of the workshop was to share emerging research data from the Researching Equal Opportunities for Internationally Recruited Nurses and Other Health Professionals and related studies. The final session of the workshop on which this paper is based, was facilitated by the author, with the specific aim of asking the participants to discuss and determine the challenges to managers when managing a culturally diverse workforce. The discussion yielded four main themes collated by the author from which a framework of strategies to facilitate equality and cultural diversity management of the healthcare workers may be developed. The four themes are: assumptions and expectations; education and training to include

The interplay of management accounting research and NPM health initiatives

DEFF Research Database (Denmark)

Malmmose, Margit

This paper investigates the development of management accounting research in the context of New Public Management (NPM) initiatives in health care. Drawing on concepts from diffusion theory and earlier literature reviews, the paper examines the interplay between management accounting research...... and health care reforms in relation to country of origin, development, theoretical approach, research method and topic. The study thus establishes a different focus; namely the interrelationship between the development of management accounting research and practical socio-political NPM innovations. The study...... shows that management accounting techniques are increasingly adopted in governmental health reforms and diffused across nations, themes and initiatives through time with the result that wider social practices become more and more integrated in management accounting research themes...

[Management committees in health services: an empirical study].

Science.gov (United States)

Cecilio, Luiz Carlos de Oliveira

2010-03-01

The aim of the article, based on field data collected from a continuing education program for primary health clinic administrators, was to analyze the functioning of a health service management strategy called "management committees". Different meanings and operational modalities emerged in the committees. Various antimonies appeared in the way the committees operate (autonomy versus heteronomy, reproduction of "instituted" versus "instituting" processes, and communicative versus instrumental reasoning), thus reflecting the level of complexity in this management mechanism. Healthcare provision per se by the clinics only appeared occasionally on the committees' agenda, which mainly focused on administrative issues. The article suggests that further research is needed on the coordinator's involvement in the field of forces constituting the management committee, besides developing pedagogical strategies to support the clinic coordinators and health teams in building the committees. The primary data were submitted to an epistemological discussion anchored in the idea of double hermeneutics, multiple validation of research results, and the relationship between theory and practice.

Integrated System Health Management Development Toolkit

Science.gov (United States)

Figueroa, Jorge; Smith, Harvey; Morris, Jon

2009-01-01

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

Holistic self-management education and support: a proposed public health model for improving women's health in Zimbabwe.

Science.gov (United States)

Kanchense, Jane Handina Murigwa

2006-08-01

The primary health care model of public health has been implemented in many countries around the globe since the Declaration of Alma Ata in 1978, without pilot testing the primary health care model. Therefore, many public health researchers have sought methods of improving primary health care by creating evidence-based models. Many of these researchers recognize the role of behavioral models in public health. These offshoots of primary health care include the ecological, care, central human capabilities, and the SPECIES models. Holistic self-management education and support is a capacity-building philosophy that ensures active involvement of consumers of health care in the planning and implementation and evaluation of health care services. It helps consumers of health care to achieve the desired improved quality of health and life in managing and sustaining their health at the grassroots level. The care model addresses disease management ideals of the in the original primary health care model. The SPECIES model addresses those aspects of the primary health care model that include the cultural and social factors, as well as individual health education and support in the original primary health care model. The ecological model offers an improvement of the socioeconomic ideal in the original primary health care model. Improving the health of individuals will prevent illness, thereby reducing health care costs and lessening the current strain on an overburdened health care system in Zimbabwe. Holistic self-management education and support links health care delivery systems with social processes. It is a best practices model that could better serve Zimbabwean girls and women by contributing positively to the national challenges in health care, thereby meeting the Zimbabwean primary health care and safe motherhood goals. It is here recommended that holistic self-management education and support must be pilot tested before being adopted as the most appropriate model for

A SUSTAINABLE HEALTH CARE SYSTEM REQUIRES MANAGEMENT TRANSFORMATION

Directory of Open Access Journals (Sweden)

Kanellopoulos Dimitros

2011-12-01

Full Text Available In order to be the health care system sustainable , management transformations must be based on very precise diagnostic analysis that includes complete and current information. It is necessary to implement an information system that collects information in real time, that watches the parameters that significantly influence the sustainability of the system. Such an information system should point out a radiography(a scan of the system at some time under following aspects:: 1. An overview of system; 2 An overview of the economic situation; 3 A technical presentation ;4. A legal overview; 5. A social overview ; 6. A management overview .Based on these Xrays of the health system, it outlines a series of conclusions and recommendations together with a SWOT analysis that highlights the potential internal (strengths and weaknesses and external potential (opportunities and threats. Based on this analysis and recommendations, the management is going to redesign the system in order to be adapted to the changing environmental requirements. Management transformation is recommended to be by following steps. :1. The development of a new management system that would make a positive change in the health care system 2. Implementation of the new management system 3. Assessment of the changes

Managing health care organizations in an age of rapid change.

Science.gov (United States)

Benjamin, S; al-Alaiwat, S

1998-03-01

Health care managers find their work increasingly difficult, due in part to rapid environmental change that plagues organizational life. Management practices and attitudes that may have been appropriate in previous eras are ineffective today. A study was conducted among managers in the Ministry of Health, State of Bahrain, seeking information about current trends in the macro or external environment that affect the Ministry of Health, as well as internal environmental pressures that may be similar or different. This article provides a clear picture of the context in which managers perform their work and offers recommendations for coping with change in dynamic, complex organizations.

Health Services management. Health Service use of ionising radiations

International Nuclear Information System (INIS)

1989-12-01

This circular consolidates and updates advice on the statutory and management responsibilities of Health Authorities in relation to the use of ionising radiations (including radioactive substances) on premises controlled by them and/or by persons employed by them (author)

Expectations and needs of patients with a chronic disease toward self-management and eHealth for self-management purposes.

Science.gov (United States)

Huygens, Martine W J; Vermeulen, Joan; Swinkels, Ilse C S; Friele, Roland D; van Schayck, Onno C P; de Witte, Luc P

2016-07-08

Self-management is considered as an essential component of chronic care by primary care professionals. eHealth is expected to play an important role in supporting patients in their self-management. For effective implementation of eHealth it is important to investigate patients' expectations and needs regarding self-management and eHealth. The objectives of this study are to investigate expectations and needs of people with a chronic condition regarding self-management and eHealth for self-management purposes, their willingness to use eHealth, and possible differences between patient groups regarding these topics. Five focus groups with people with diabetes (n = 14), COPD (n = 9), and a cardiovascular condition (n = 7) were conducted in this qualitative research. Separate focus groups were organized based on patients' chronic condition. The following themes were discussed: 1) the impact of the chronic disease on patients' daily life; 2) their opinions and needs regarding self-management; and 3) their expectations and needs regarding, and willingness to use, eHealth for self-management purposes. A conventional content analysis approach was used for coding. Patient groups seem to differ in expectations and needs regarding self-management and eHealth for self-management purposes. People with diabetes reported most needs and benefits regarding self-management and were most willing to use eHealth, followed by the COPD group. People with a cardiovascular condition mentioned having fewer needs for self-management support, because their disease had little impact on their life. In all patient groups it was reported that the patient, not the care professional, should choose whether or not to use eHealth. Moreover, participants reported that eHealth should not replace, but complement personal care. Many participants reported expecting feelings of anxiety by doing measurement themselves and uncertainty about follow-up of deviant data of measurements. In addition

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

Science.gov (United States)

Monroe, C Douglas; Chin, Karen Y

2013-05-01

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

Managing diversity in the health care workplace.

Science.gov (United States)

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

1999-03-01

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

Rural mental health workforce difficulties: a management perspective.

Science.gov (United States)

Moore, T; Sutton, K; Maybery, D

2010-01-01

The recruitment, retention and training of mental health workers is of major concern in rural Australia, and the Gippsland region of Victoria is no exception. Previous studies have identified a number of common factors in these workforce difficulties, including rurality, difficulties of access to professional development and training, and professional and personal isolation. However, those previous studies have often focused on medicine and been based on the perspectives of practitioners, and have almost ignored the perspectives of managers of rural mental health services. The study reported in this article sought to contribute to the development of a more sustainable and effective regional mental health workforce by complementing earlier insights with those of leading administrators, managers and senior clinicians in the field. The study took a qualitative approach. It conducted semi-structured in-person interviews with 24 managers of health/mental-health services and senior administrators and clinicians working in organisations of varying sizes in the public and private sectors. Thematic content analysis of the transcribed interviews identified core difficulties these managers experienced in the recruitment, retention and training of employees. The study found that some of the issues commonly resulting in difficulties in recruiting, retaining and developing a trained workforce in rural areas, such as rurality (implying personal and professional isolation, distances to deliver service and small organisations) and a general shortage of trained personnel, are significant in Gippsland. Through its focus on the perspectives of leaders in the management of rural mental health services, however, the study found other key issues that contribute to workforce difficulties. Many, including the unattractive nature of mental health work, the fragmented administration of the mental health system, short-term and tied funding, and shortcomings in training are external to

Positively charged polymers modulate the fate of human mesenchymal stromal cells via ephrinB2/EphB4 signaling

Directory of Open Access Journals (Sweden)

Ilenia De Luca

2016-09-01

Full Text Available Understanding the mechanisms by which mesenchymal stromal cells (MSCs interact with the physical properties (e.g. topography, charge, ζ-potential, and contact angle of polymeric surfaces is essential to design new biomaterials capable of regulating stem cell behavior. The present study investigated the ability of two polymers (pHM1 and pHM3 with different positive surface charge densities to modulate the differentiation of MSCs into osteoblast-like phenotype via cell-cell ephrinB2/EphB4 signaling. Although pHM1 promoted the phosphorylation of EphB4, leading to cell differentiation, pHM3, characterized by a high positive surface charge density, had no significant effect on EphB4 activation or MSCs differentiation. When the MSCs were cultured on pHM1 in the presence of a forward signaling blocking peptide, the osteoblast differentiation was compromised. Our results demonstrated that the ephrinB2/EphB4 interaction was required for MSCs differentiation into an osteoblast-like phenotype and that the presence of a high positive surface charge density altered this interaction.

Intelligent Vehicle Health Management

Science.gov (United States)

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

2005-01-01

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

Health promotion and disease prevention: a look at demand management programs.

Science.gov (United States)

Fronstin, P

1996-09-01

This Issue Brief describes employers' efforts to contain health expenditures through demand management programs. These programs are designed to reduce utilization by focusing on disease prevention and health promotion. Demand management includes work site health promotion, wellness programs, and access management. Work site health promotion is a comprehensive approach to improving health and includes awareness, health education, behavioral change, and organizational health initiatives. Wellness programs usually include stress management, smoking cessation, weight management, back care, health screenings, nutrition education, work place safety, prenatal and well baby care, CPR and first aid classes, and employee assistance programs (EAPs). These programs are often viewed positively by workers and can have long-term benefits for employers above and beyond health care cost containment. Demand management can benefit employers by increasing productivity, employee retention, and employee morale and by reducing turnover, absenteeism, future medical claims, and ultimately expenditures on health care. Even though a growing number of employers are offering wellness programs, only 37 percent of full-time workers employed in medium and large private establishments were eligible for wellness programs by 1993. However, a recent survey found that 88 percent of major employers have introduced some form of health promotion, disease prevention, or early intervention initiative to encourage healthy lifestyles among their salaried employees. Distinctions must be drawn between short- and long-term strategies. Demand management can be thought of as a short-term strategy when the focus of the program is on creating more appropriate and efficient health care utilization. Disease prevention is characterized by longer-term health improvement objectives. Whether the purpose is to reduce utilization in the short term or in the long term, the ultimate goal remains the same: to reduce health

Implementing a routine health management information system in ...

African Journals Online (AJOL)

South Sudan has recently acquired statehood. Planning and management of the health care system, based on evidence, requires a constant flow of information from health services. The Division of Monitoring and Evaluation (M&E) of the Ministry of Health developed the framework for the health sector of the country in 2008.

Managing interoperability and complexity in health systems.

Science.gov (United States)

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

2015-01-01

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

Health literacy of commercial industry managers: an exploratory qualitative study in Germany.

Science.gov (United States)

Fiedler, Silja; Pförtner, Timo-Kolja; Nitzsche, Anika; McKee, Lorna; Pfaff, Holger

2017-09-05

Managers have been neglected in health literacy research. There still is little known about the health-literacy status and needs of commercial industry managers. This article reduces the existing knowledge gap by presenting findings of an exploratory qualitative study. We conducted 23 separate semi-structured interviews of managers from all management levels (low, middle and top) and experts in the field of health management and/or personnel management. The qualitative interviews were analysed according to Mayring's content analytic approach using MAXQDA. The findings indicate that managers do have considerable information levels about existing health topics and relevant problems but have difficulties of discernment as to which sources of information can be activated or accessed in a timely fashion due to work and information overload. Even those who devise strategies often fail in implementing health-literate behavior. Experts and managers had fairly consistent views on the importance of health literacy among managers. Most agreed that mental health was neglected and that company conditions were important in influencing the ability to act in a way that promoted health literacy. The findings also show that strengthening of managerial self-perception, self-regulation and self-control, raising awareness and ability to take personal responsibility for one's own health, developing skills in handling large amounts of information and fostering open and trusting communication are all essential. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Practicing management and leadership: creating the information network for public health officials.

Science.gov (United States)

Baker, Edward L; Porter, Janet

2005-01-01

The Management Moment" is a regular column within the Journal of Public Health Management and Practice. Janet Porter, PhD, and Edward Baker, MD, MPH, MSc, are serving as The Management Moment Editors. Dr Porter is Associate Dean for Executive Education, The North Carolina Institute for Public Health, School of Public Health, at the University of North Carolina at Chapel Hill, and Dr Baker is Director of The North Carolina Institute for Public Health, School of Public Health, at the University of North Carolina at Chapel Hill. This column provides commentary and guidance on timely management issues commonly encountered in public health practice.

Is "disease management" the answer to our problems? No! Population health management and (disease) prevention require "management of overall well-being"

OpenAIRE

Cramm, Jane; Nieboer, Anna

2016-01-01

textabstractBackground: Disease management programs based on the chronic care model have achieved successful and long-term improvement in the quality of chronic care delivery and patients' health behaviors and physical quality of life. However, such programs have not been able to maintain or improve broader self-management abilities or social well-being, which decline over time in chronically ill patients. Disease management efforts, population health management initiatives and innovative pri...

Impact of human milk pasteurization on the kinetics of peptide release during in vitro dynamic term newborn digestion.

Science.gov (United States)

Deglaire, Amélie; De Oliveira, Samira C; Jardin, Julien; Briard-Bion, Valérie; Emily, Mathieu; Ménard, Olivia; Bourlieu, Claire; Dupont, Didier

2016-07-01

Holder pasteurization (62.5°C, 30 min) ensures sanitary quality of donor's human milk but also denatures beneficial proteins. Understanding whether this further impacts the kinetics of peptide release during gastrointestinal digestion of human milk was the aim of the present paper. Mature raw (RHM) or pasteurized (PHM) human milk were digested (RHM, n = 2; PHM, n = 3) by an in vitro dynamic system (term stage). Label-free quantitative peptidomics was performed on milk and digesta (ten time points). Ascending hierarchical clustering was conducted on "Pasteurization × Digestion time" interaction coefficients. Preproteolysis occurred in human milk (159 unique peptides; RHM: 91, PHM: 151), mostly on β-casein (88% of the endogenous peptides). The predicted cleavage number increased with pasteurization, potentially through plasmin activation (plasmin cleavages: RHM, 53; PHM, 76). During digestion, eight clusters resumed 1054 peptides from RHM and PHM, originating for 49% of them from β-casein. For seven clusters (57% of peptides), the kinetics of peptide release differed between RHM and PHM. The parent protein was significantly linked to the clustering (p-value = 1.4 E-09), with β-casein and lactoferrin associated to clusters in an opposite manner. Pasteurization impacted selectively gastric and intestinal kinetics of peptide release in term newborns, which may have further nutritional consequences. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

A review of health leadership and management capacity in the Solomon Islands.

Science.gov (United States)

Asante, Augustine; Roberts, Graham; Hall, John

2012-04-01

ACCESS AND UTILISATION OF HEALTH CARE: The armed conflict that engulfed the Solomon Islands between 1998 and 2003 significantly disrupted the provision of health care especially in rural and remote areas. There is one doctor for 3,300 people and approximately 13 nurses and midwives for 10,000 people. Despite limitations 87% of people seek health care when sick. FINANCING THE HEALTH SYSTEM: The SIG placed a series of reservations on ministerial goods and services budgets that effectively the budget by 33%, severely impacting provincial budgets and resulting in acquired debts. Shortfalls have been addressed by allocating Health Sector Support Program funds to the provinces to allow services to continue, a strategy that will likely recur, but by which donor support replaces government provision Provincial health accountants have received training in MYOB in 2009 but acquittal systems require higher level accounting skills for reports to be submitted on time to permit the release of subsequent funding tranches. HUMAN RESOURCES FOR HEALTH: The shortage of doctors and specialists is a key challenge. As at December 2010, there were a total of 2,728 health workers in the public sector in Solomon Islands. Staff costs consume on average 55% of provincial health grants Filled Public Service Division staff establishments and budgetary reservations have reduced the ability to meet the salary and wage costs of new graduates. Solomon Islands is currently negotiating to assist Vanuatu in filling its nursing staff vacancies with its surplus The return of 75 Cuban trained medical officers from 2013 presents the management challenge of accessing budget provisions for so many new positions and in funding the infrastructure needed to house, equip and maintain them in service. HEALTH MANAGEMENT STRUCTURE: Provincial health managers are operationally responsive to local needs, managerially responsible to provincial governments, while being concerned with adherence to central MHMS policy

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

Directory of Open Access Journals (Sweden)

Dobbins Maureen

2010-08-01

Full Text Available Abstract Background The ultimate goal of knowledge translation and exchange (KTE activities is to facilitate incorporation of research knowledge into program and policy development decision making. Evidence-informed decision making involves translation of the best available evidence from a systematically collected, appraised, and analyzed body of knowledge. Knowledge management (KM is emerging as a key factor contributing to the realization of evidence-informed public health decision making. The goal of health-evidence.ca is to promote evidence-informed public health decision making through facilitation of decision maker access to, retrieval, and use of the best available synthesized research evidence evaluating the effectiveness of public health interventions. Methods The systematic reviews that populate health evidence.ca are identified through an extensive search (1985-present of 7 electronic databases: MEDLINE, EMBASE, CINAHL, PsycINFO, Sociological Abstracts, BIOSIS, and SportDiscus; handsearching of over 20 journals; and reference list searches of all relevant reviews. Reviews are assessed for relevance and quality by two independent reviewers. Commonly-used public health terms are used to assign key words to each review, and project staff members compose short summaries highlighting results and implications for policy and practice. Results As of June 2010, there are 1913 reviews in the health-evidence.ca registry in 21 public health and health promotion topic areas. Of these, 78% have been assessed as being of strong or moderate methodological quality. Health-evidence.ca receives approximately 35,000 visits per year, 20,596 of which are unique visitors, representing approximately 100 visits per day. Just under half of all visitors return to the site, with the average user spending six minutes and visiting seven pages per visit. Public health nurses, program managers, health promotion workers, researchers, and program coordinators are

Social Support for Diabetes Self-Management via eHealth Interventions.

Science.gov (United States)

Vorderstrasse, Allison; Lewinski, Allison; Melkus, Gail D'Eramo; Johnson, Constance

2016-07-01

eHealth interventions have been increasingly used to provide social support for self-management of type 2 diabetes. In this review, we discuss social support interventions, types of support provided, sources or providers of support, outcomes of the support interventions (clinical, behavioral, psychosocial), and logistical and clinical considerations for support interventions using eHealth technologies. Many types of eHealth interventions demonstrated improvements in self-management behaviors, psychosocial outcomes, and clinical measures, particularly HbA1c. Important factors to consider in clinical application of eHealth support interventions include participant preferences, usability of eHealth technology, and availability of personnel to orient or assist participants. Overall, eHealth is a promising adjunct to clinical care as it addresses the need for ongoing support in chronic disease management.

The Case for Software Health Management

Data.gov (United States)

National Aeronautics and Space Administration — Software Health Management (SWHM) is a new field that is concerned with the development of tools and technologies to enable automated detection, diagnosis,...

An Application of Business Process Management to Health Care Facilities.

Science.gov (United States)

Hassan, Mohsen M D

The purpose of this article is to help health care facility managers and personnel identify significant elements of their facilities to address, and steps and actions to follow, when applying business process management to them. The ABPMP (Association of Business Process Management Professionals) life-cycle model of business process management is adopted, and steps from Lean, business process reengineering, and Six Sigma, and actions from operations management are presented to implement it. Managers of health care facilities can find in business process management a more comprehensive approach to improving their facilities than Lean, Six Sigma, business process reengineering, and ad hoc approaches that does not conflict with them because many of their elements can be included under its umbrella. Furthermore, the suggested application of business process management can guide and relieve them from selecting among these approaches, as well as provide them with specific steps and actions that they can follow. This article fills a gap in the literature by presenting a much needed comprehensive application of business process management to health care facilities that has specific steps and actions for implementation.

Using systems science for population health management in primary care.

Science.gov (United States)

Li, Yan; Kong, Nan; Lawley, Mark A; Pagán, José A

2014-10-01

Population health management is becoming increasingly important to organizations managing and providing primary care services given ongoing changes in health care delivery and payment systems. The objective of this study is to show how systems science methodologies could be incorporated into population health management to compare different interventions and improve health outcomes. The New York Academy of Medicine Cardiovascular Health Simulation model (an agent-based model) and data from the Behavioral Risk Factor Surveillance System were used to evaluate a lifestyle program that could be implemented in primary care practice settings. The program targeted Medicare-age adults and focused on improving diet and exercise and reducing weight. The simulation results suggest that there would be significant reductions projected in the proportion of the Medicare-age population with diabetes after the implementation of the proposed lifestyle program for a relatively long term (3 and 5 years). Similar results were found for the subpopulations with high cholesterol, but the proposed intervention would not have a significant effect in the proportion of the population with hypertension over a time period of Systems science methodologies can be useful to compare the health outcomes of different interventions. These tools can become an important component of population health management because they can help managers and other decision makers evaluate alternative programs in primary care settings. © The Author(s) 2014.

Integrated Structural Health Management, Phase I

Data.gov (United States)

National Aeronautics and Space Administration — Cornerstone Research Group Inc. (CRG) proposes to advance the state of the art in composite health management through refinement of an existing technology developed...

[Survey among livestock practices on herd health management and an Internet-based animal health portal in Switzerland].

Science.gov (United States)

von Tavel, L; Buri, S; Witschi, U; Kirchhofer, M

2009-12-01

The importance of herd health management in Switzerland, its implementation by veterinarians as well as their willingness to collaborate within an Internet portal have been assessed by a questionnaire. The portal is meant to serve the genetic evaluation, the veterinary herd health management and the obligation to record treatments; it should be at disposal for all users in form of a central database. For the survey, questionnaires were sent to 784 veterinarians (mixed and livestock practices) in Switzerland. Amongst them, 217 (27.7 %) questionnaires could be evaluated. 125 veterinarians already offer a herd health management service and 147 veterinarians are inclined to collaborate in a central registration of animal health data. In this context, they are interested in an efficient veterinary herd health management program, which will allow direct exchange of data with farmers via an Internet portal. However, they fear a lack of interest of their customers and express some concern regarding data protection. The portal providers must therefore consider the needs of all potential users in order to succeed in this project. At this condition, the veterinarians are prepared to spread herd health management amongst the breeders by means of the animal health portal.

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

Science.gov (United States)

Torres, Carlos A.

2011-01-01

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

An intelligent content discovery technique for health portal content management.

Science.gov (United States)

De Silva, Daswin; Burstein, Frada

2014-04-23

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

The effect of community-based health management on the health of the elderly: a randomized controlled trial from China

Directory of Open Access Journals (Sweden)

Chao Jianqian

2012-12-01

Full Text Available Abstract Background An aging population poses significant challenges to health care in China. Health management has been implemented to reduce the costs of care, raise health service utilization, increase health knowledge and improve quality of life. Several studies have tried to verify the effectiveness of health management in achieving these goals worldwide. However, there have been insufficient randomized control trials (RCTs to draw reliable conclusions. The few small-scale studies conducted in China include mostly the general population rather than the elderly. Our study is designed to evaluate the impact of community-based health management on the health of the elderly through an RCT in Nanjing, China. Methods Two thousand four hundred participants, aged 60 or older and who gave informed consent, were randomly allocated 1:1 into management and control groups, the randomization schedule was concealed from community health service center staff until allocation. Community-based health management was applied in the former while the latter was only given usual care. After 18 months, three categories of variables (subjective grading health indices, objective health indices and health service utilization were measured based on a questionnaire, clinical monitoring and diagnostic measurements. Differences between the two groups were assessed before and after the intervention and analyzed with t-test, χ2-test, and multiple regression analysis. Results Compared with the control group, the management group demonstrated improvement on the following variables (P Conclusion Community-based health management improved both subjective grading health indices, objective health indices and decreased the number of outpatient clinic visits, demonstrating effectiveness in improving elderly health. Trial registration ChiCTR-OCH-11001716

FAILSAFE Health Management for Embedded Systems

Science.gov (United States)

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

2010-01-01

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

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

Science.gov (United States)

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

2012-06-01

Adoption of health information technology (HIT) is a key effort in improving care delivery, reducing costs of health care, and improving the quality of health care. Evidence from electronic health record (EHR) use suggests that HIT will play a significant role in transforming primary care practices and chronic disease management. This article shows that EHRs and HIT can be used effectively to manage chronic diseases, that HIT can facilitate communication and reduce efforts related to transitions in care, and that HIT can improve patient safety by increasing the information available to providers and patients, improving disease management and safety. Copyright © 2012 Elsevier Inc. All rights reserved.

Aligning smoke management with ecological and public health goals

Science.gov (United States)

Jonathan W. Long; Leland W. Tarnay; Malcolm P. North

2017-01-01

Past and current forest management affects wildland fire smoke impacts on downwind human populations. However, mismatches between the scale of benefits and risks make it difficult to proactively manage wildland fires to promote both ecological and public health. Building on recent literature and advances in modeling smoke and health effects, we outline a framework to...

Management of mutual health organizations in Ghana.

NARCIS (Netherlands)

Baltussen, R.M.P.M.; Bruce, E.; Rhodes, G.; Narh-Bana, S.A.; Agyepong, I.

2006-01-01

OBJECTIVE: Mutual Health Organizations (MHO) emerged in Ghana in the mid-1990s. The organizational structure and financial management of private and public MHO hold important lessons for the development of national health insurance in Ghana, but there is little evidence to date on their features.

Managing terminology assets in Electronic Health Records.

Science.gov (United States)

Abrams, Kelly; Schneider, Sue; Scichilone, Rita

2009-01-01

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

[Quality management is associated with high quality services in health care].

Science.gov (United States)

Nielsen, Tenna Hassert; Riis, Allan; Mainz, Jan; Jensen, Anne-Louise Degn

2013-12-09

In these years, quality management has been the focus in order to meet high quality services for the patients in Danish health care. This article provides information on quality management and quality improvement and it evaluates its effectiveness in achieving better organizational structures, processes and results in Danish health-care organizations. Our findings generally support that quality management is associated with high quality services in health care.

Managing complaints in health and social care.

Science.gov (United States)

Holmes-Bonney, Kathy

2010-04-01

An important aspect of allowing patients to take control of their health care is the introduction of new procedures for dealing with complaints. This article examines the concepts that underpin the new Department of Health regulations on complaints management and what they will mean for health and social care professionals. It also explains why these regulations focus on restorative justice rather than blame when adverse events occur.

HMIS and decision-making in Zambia: re-thinking information solutions for district health management in decentralized health systems.

Science.gov (United States)

Mutemwa, Richard I

2006-01-01

At the onset of health system decentralization as a primary health care strategy, which constituted a key feature of health sector reforms across the developing world, efficient and effective health management information systems (HMIS) were widely acknowledged and adopted as a critical element of district health management strengthening programmes. The focal concern was about the performance and long-term sustainability of decentralized district health systems. The underlying logic was that effective and efficient HMIS would provide district health managers with the information required to make effective strategic decisions that are the vehicle for district performance and sustainability in these decentralized health systems. However, this argument is rooted in normative management and decision theory without significant unequivocal empirical corroboration. Indeed, extensive empirical evidence continues to indicate that managers' decision-making behaviour and the existence of other forms of information outside the HMIS, within the organizational environment, suggest a far more tenuous relationship between the presence of organizational management information systems (such as HMIS) and effective strategic decision-making. This qualitative comparative case-study conducted in two districts of Zambia focused on investigating the presence and behaviour of five formally identified, different information forms, including that from HMIS, in the strategic decision-making process. The aim was to determine the validity of current arguments for HMIS, and establish implications for current HMIS policies. Evidence from the eight strategic decision-making processes traced in the study confirmed the existence of different forms of information in the organizational environment, including that provided by the conventional HMIS. These information forms attach themselves to various organizational management processes and key aspects of organizational routine. The study results point

Organizational Structure and Management in Romanian Health System

OpenAIRE

Boldureanu Daniel; Boldureanu Gabriela

2010-01-01

The health system in Romania in a continuous transformation from a centralized system (type Semashko) exists before 1989 year to one based on social health insurance (type Bismark). This paper examines the management and the organizational structure of the health system in Romania, and the relations between them in the context of the Health Reform Law.

Management system of organizational and economic changes in health services

Directory of Open Access Journals (Sweden)

Natalya Vasilyevna Krivenko

2013-03-01

Full Text Available In the article, the definitions of the concept organizational and economic changes in institution problems of changes in public health service, the purpose and issues of the management system of organizational and economic changes in the field are considered. The combined strategy of development and innovative changes in management is offered. The need of resource-saving technologies implementation is shown. Expediency of use of marketing tools in a management system of organizational and economic changes is considered the mechanism of improvement of planning and pricing in public health service is offered. The author’s model of management of organizational and economic changes in health services supporting achievement of medical, social, economic efficiency in Yekaterinburg's trauma care is presented. Strategy of traumatism prevention is determined on the basis of interdepartmental approach and territorial segmentation of health care market

Effect of Occupational Health and Safety Management System on Work-Related Accident Rate and Differences of Occupational Health and Safety Management System Awareness between Managers in South Korea's Construction Industry

OpenAIRE

Yoon, Seok J.; Lin, Hsing K.; Chen, Gang; Yi, Shinjea; Choi, Jeawook; Rui, Zhenhua

2013-01-01

Background: The study was conducted to investigate the current status of the occupational health and safety management system (OHSMS) in the construction industry and the effect of OHSMS on accident rates. Differences of awareness levels on safety issues among site general managers and occupational health and safety (OHS) managers are identified through surveys. Methods: The accident rates for the OHSMS-certified construction companies from 2006 to 2011, when the construction OHSMS became ...

What we do | Page 42 | IDRC - International Development Research ...

International Development Research Centre (IDRC) Digital Library (Canada)

Although many developing countries are working on appropriate mechanisms for financing adaptation to combat climate-related problems, there is a great ... Movement (PHM) to assess, learn, and improve on its programming, as well as identify lessons to inform broader civil society engagement in achieving Health for All ...

Self-management support and training for patients with chronic and complex conditions improves health-related behaviour and health outcomes.

Science.gov (United States)

Harvey, Peter W; Petkov, John N; Misan, Gary; Fuller, Jeffrey; Battersby, Malcolm W; Cayetano, Teofilo N; Warren, Kate; Holmes, Paul

2008-05-01

The Sharing Health Care SA chronic disease self-management (CDSM) project in rural South Australia was designed to assist patients with chronic and complex conditions (diabetes, cardiovascular disease and arthritis) to learn how to participate more effectively in the management of their condition and to improve their self-management skills. Participants with chronic and complex conditions were recruited into the Sharing Health Care SA program and offered a range of education and support options (including a 6-week peer-led chronic disease self-management program) as part of the Enhanced Primary Care care planning process. Patient self-reported data were collected at baseline and subsequent 6-month intervals using the Partners in Health (PIH) scale to assess self-management skill and ability for 175 patients across four data collection points. Health providers also scored patient knowledge and self-management skills using the same scale over the same intervals. Patients also completed a modified Stanford 2000 Health Survey for the same time intervals to assess service utilisation and health-related lifestyle factors. Results show that both mean patient self-reported PIH scores and mean health provider PIH scores for patients improved significantly over time, indicating that patients demonstrated improved understanding of their condition and improved their ability to manage and deal with their symptoms. These results suggest that involvement in peer-led self-management education programs has a positive effect on patient self-management skill, confidence and health-related behaviour.

Management continuity in local health networks

Directory of Open Access Journals (Sweden)

Mylaine Breton

2012-04-01

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

Experience of hypertensive patients with self-management of health care.

Science.gov (United States)

Balduino, Anice de Fátima Ahmad; Mantovani, Maria de Fátima; Lacerda, Maria Ribeiro; Marin, Maria José Sanches; Wal, Marilene Loewen

2016-11-01

The aim of this study was to interpret how hypertensive patients experience health care self-management. Hypertension is one of the most prevalent chronic diseases worldwide. The involvement of individuals in the management of their health care to treat this disease is fundamental, with aid and advice from healthcare professionals, especially nurses, so that hypertensive patients can effectively self-manage their health care. Qualitative study. Hypertensive patients were recruited using theoretical sampling. The study sample consisted of 28 hypertensive patients aged 18-59 years who were registered in the e-Health programme of the Ministry of Health. Data were collected and analyzed between September 2012-October 2014 using a semi-structured interview based on the methodological framework of the constructivist grounded theory. The participants' statements depicted an outline of their experience with the disease: the beginning of the illness; understanding the disease process; incorporating behaviour for self-management of the disease; experiencing attitudes and actions in the control and treatment of the disease; and being treated in the public healthcare system. A central phenomenon emerged, namely hypertensive patients' experience of self-management of health care. This phenomenon has paths, actions and interactions. When patients discover that they have the disease and become aware of the disease process, they assume the identity of being hypertensive and become proactive in their health care and in living with their families and in communities. © 2016 John Wiley & Sons Ltd.

Using matrix organization to manage health care delivery organizations.

Science.gov (United States)

Allcorn, S

1990-01-01

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

Health physics information management

International Nuclear Information System (INIS)

Schauss, R.D.

1982-01-01

The records that men have kept over the centuries have made the civilizations of man possible. Recorded history shows that our progress is closely correlated to man's ability to communicate recorded facts to others, and to effectively use knowledge gained by others. During the past few decades our ability to store and use information, and to reach larger audiences has grown dramatically. The advent of computers is discussed and their evolution to the state-of-the-art is described. Data bases, batch and on-line processing, centralized and distributed processing as well as other computer jargon are generally explained and examples are given as they apply specifically to health physics programs. It is proposed that systems designed to manage information cannot be adapted to health physics problems without extensive involvement of the HP who must use the computerized program. Specific problems which arise during the development of a computerized health physics program are explained

Conflict management styles in the health professions.

Science.gov (United States)

Sportsman, Susan; Hamilton, Patti

2007-01-01

The purpose of the study was to determine prevalent conflict management styles chosen by students in nursing and to contrast these styles with those chosen by students in allied health professions. The associations among the level of professional health care education and the style chosen were also determined. A convenience sample of 126 students in a comprehensive university completed the Thomas-Kilmann Conflict Mode Instrument (TKI), which requires respondents to choose behaviors most characteristic of their response to conflict and classifies these behaviors as one of five styles. There was no significant difference between the prevalent conflict management styles chosen by graduate and undergraduate nursing students and those in allied health. Some of the students were already licensed in their discipline; others had not yet taken a licensing exam. Licensure and educational level were not associated with choice of styles. Women and men had similar preferences. The prevalent style for nursing students was compromise, followed by avoidance. In contrast, avoidance, followed by compromise and accommodation, was the prevalent style for allied health students. When compared to the TKI norms, slightly more than one half of all participants chose two or more conflict management styles, commonly avoidance and accommodation at the 75th percentile or above. Only 9.8% of the participants chose collaboration at that level. Implications for nurse educators, researchers, and administrators are discussed.

Vibration Analysis and Time Series Prediction for Wind Turbine Gearbox Prognostics

Directory of Open Access Journals (Sweden)

Hossam A. Gabbar

2013-01-01

Full Text Available Premature failure of a gearbox in a wind turbine poses a high risk of increasing the operational and maintenance costs and decreasing the profit margins. Prognostics and health management (PHM techniques are widely used to access the current health condition of the gearbox and project it in future to predict premature failures. This paper proposes such techniques for predicting gearbox health condition index extracted from the vibration signals emanating from the gearbox. The progression of the monitoring index is predicted using two different prediction techniques, adaptive neuro-fuzzy inference system (ANFIS and nonlinear autoregressive model with exogenous inputs (NARX. The proposed prediction techniques are evaluated through sun-spot data-set and applied on vibration based health related monitoring index calculated through psychoacoustic phenomenon. A comparison is given for their prediction accuracy. The results are helpful in understanding the relationship of machine conditions, the corresponding indicating features, the level of damage/degradation, and their progression.

Investigation of health care waste management in Binzhou District, China

International Nuclear Information System (INIS)

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

2010-01-01

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

Fundamental Technology Development for Gas-Turbine Engine Health Management

Science.gov (United States)

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

2007-01-01

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

Integrated Systems Health Management for Intelligent Systems

Science.gov (United States)

Figueroa, Fernando; Melcher, Kevin

2011-01-01

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

Health and Safety Management for Small-scale Methane Fermentation Facilities

Science.gov (United States)

Yamaoka, Masaru; Yuyama, Yoshito; Nakamura, Masato; Oritate, Fumiko

In this study, we considered health and safety management for small-scale methane fermentation facilities that treat 2-5 ton of biomass daily based on several years operation experience with an approximate capacity of 5 t·d-1. We also took account of existing knowledge, related laws and regulations. There are no qualifications or licenses required for management and operation of small-scale methane fermentation facilities, even though rural sewerage facilities with a relative similar function are required to obtain a legitimate license. Therefore, there are wide variations in health and safety consciousness of the operators of small-scale methane fermentation facilities. The industrial safety and health laws are not applied to the operation of small-scale methane fermentation facilities. However, in order to safely operate a small-scale methane fermentation facility, the occupational safety and health management system that the law recommends should be applied. The aims of this paper are to clarify the risk factors in small-scale methane fermentation facilities and encourage planning, design and operation of facilities based on health and safety management.

The transfer of a health insurance/managed care business.

Science.gov (United States)

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

2007-01-01

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

Co-Leadership - A Management Solution for Integrated Health and Social Care.

Science.gov (United States)

Klinga, Charlotte; Hansson, Johan; Hasson, Henna; Sachs, Magna Andreen

2016-05-23

Co-leadership has been identified as one approach to meet the managerial challenges of integrated services, but research on the topic is limited. In the present study, co-leadership, practised by pairs of managers - each manager representing one of the two principal organizations in integrated health and social care services - was explored. To investigate co-leadership in integrated health and social care, identify essential preconditions in fulfilling the management assignment, its operationalization and impact on provision of sustainable integration of health and social care. Interviews with eight managers exercising co-leadership were analysed using directed content analysis. Respondent validation was conducted through additional interviews with the same managers. Key contextual preconditions were an organization-wide model supporting co-leadership and co-location of services. Perception of the management role as a collective activity, continuous communication and lack of prestige were essential personal and interpersonal preconditions. In daily practice, office sharing, being able to give and take and support each other contributed to provision of sustainable integration of health and social care. Co-leadership promoted robust management by providing broader competence, continuous learning and joint responsibility for services. Integrated health and social care services should consider employing co-leadership as a managerial solution to achieve sustainability.

Workaholism and mental health problems among municipal middle managers in Norway.

Science.gov (United States)

Midje, Hilde H; Nafstad, Ingunn T; Syse, Jonn; Torp, Steffen

2014-10-01

To provide empirical knowledge about the antecedents and outcomes of workaholism among municipal middle managers within the framework of the job demands-resources model. We used a self-administered questionnaire to collect cross-sectional data (n = 118) on job demands, job resources, work engagement, workaholism, and mental health problems. Workaholism correlated positively with both work engagement and mental health problems. Job demands affected workaholism and mental health problems more strongly than did job resources. The results indicate that workaholism does not mediate the effects of certain work characteristics on mental health problems, but rather that workaholics create excessive job demands that harm their health. Preventing workaholism should be a central concern of municipal stakeholders because workaholic behavior among middle managers may harm organizational performance and employee health and middle managers' own health.

[The basis of modern technologies in management of health care system].

Science.gov (United States)

Nemytin, Iu V

2014-12-01

For the development of national heaIth care it is required to implement modern and effective methods and forms of governance. It is necessary to clearly identify transition to process management followed by an introduction of quality management care. It is necessary to create a complete version of the three-level health care system based on the integration into the system "Clinic - Hospital - Rehabilitation", which will ensure resource conservation in general throughout the industry. The most important task is purposeful comprehensive management training for health care--statesmen who have the potential ability to manage. The leader must possess all forms of management and apply them on a scientific basis. Standards and other tools of health management should constantly improve. Standards should be a teaching tool and help to improve the quality and effectiveness of treatment processes, the transition to the single-channel financing--the most advanced form of payment for the medical assistance. This type of financing requires managers to new management approaches, knowledge of business economics. One of the breakthrough objectives is the creation of a new type of health care organizations, which as lead locomotives for a rest.

Does Management Really Matter? And If so, to Who?: Comment on "Management Matters: A Leverage Point for Health Systems Strengthening in Global Health".

Science.gov (United States)

Dovlo, Delanyo

2015-12-03

The editorial is commendable and I agree with many of the points raised. Management is an important aspect of health system strengthening which is often overlooked. In order to build the capacity of management, we need to consider other factors such as, the environment within which managers work, their numbers, support systems and distribution. Effective leadership is an issue which cannot be overemphasized as part of management capacity in resource deprived settings as difficult settings require leadership skills in order to achieve managerial success. A primary issue of importance highlighted in the editorial is country ownership of management effectiveness initiatives, which may be very difficult when the health sector is dependent on support and funding from donors and influential partners, who drive change often without a good understanding of the context. How partners finance health programmes is another dilemma as it can distract from locally determined priorities. Further research should help us to understand better what works and under different settings. © 2016 by Kerman University of Medical Sciences.

Factors affecting medical waste management in lowlevel health ...

African Journals Online (AJOL)

African Journal of Environmental Science and Technology ... evaluation of medical waste management systems was conducted in the low-level health ... In Ilala, 70% of the health facilities burn wastes in poorly designed incinerators, open pit ...

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

Science.gov (United States)

Mshelia, C; Huss, R; Mirzoev, T; Elsey, H; Baine, S O; Aikins, M; Kamuzora, P; Bosch-Capblanch, X; Raven, J; Wyss, K; Green, A; Martineau, T

2013-08-30

The single biggest barrier for countries in sub-Saharan Africa (SSA) to scale up the necessary health services for addressing the three health-related Millennium Development Goals and achieving Universal Health Coverage is the lack of an adequate and well-performing health workforce. This deficit needs to be addressed both by training more new health personnel and by improving the performance of the existing and future health workforce. However, efforts have mostly been focused on training new staff and less on improving the performance of the existing health workforce. The purpose of this paper is to disseminate the protocol for the PERFORM project and reflect on the key challenges encountered during the development of this methodology and how they are being overcome. The overall aim of the PERFORM project is to identify ways of strengthening district management in order to address health workforce inadequacies by improving health workforce performance in SSA. The study will take place in three districts each in Ghana, Tanzania and Uganda using an action research approach. With the support of the country research teams, the district health management teams (DHMTs) will lead on planning, implementation, observation, reflection and redefinition of the activities in the study. Taking into account the national and local human resource (HR) and health systems (HS) policies and practices already in place, 'bundles' of HR/HS strategies that are feasible within the context and affordable within the districts' budget will be developed by the DHMTs to strengthen priority areas of health workforce performance. A comparative analysis of the findings from the three districts in each country will add new knowledge on the effects of these HR/HS bundles on DHMT management and workforce performance and the impact of an action research approach on improving the effectiveness of the DHMTs in implementing these interventions. Different challenges were faced during the development of

Online Monitoring of Large Centrifugal Pumps in Nuclear Power Plants

Energy Technology Data Exchange (ETDEWEB)

Emmanuel, Efenji A.; Faragalla, Mohamed M.; Awwal, Arigi M.; Lee, Yong-kwan [KEPCO International Nuclear Graduate School, Ulsan (Korea, Republic of)

2016-10-15

Online Monitoring detects and diagnoses incipient faults, performs predictive maintenance, and can estimate the Remaining Useful Life (RUL) of Active and Passive Components before they fail. In an effort towards assisting Utility Partners to be proactive in the management of their Assets, the Electric Power Research Institute (EPRI) collaborated with the Idaho National Laboratory (INL) to develop a Fleet-Wide Prognostic and Health Monitoring (FW-PHM) Software Suite. The FW-PHM is a web based diagnostic tools and databases designed for use in commercial NPP. The AFS development process as designed by EPRI can be adapted to Large Centrifugal Pumps (LCP) in Nuclear Power Plants (NPP). For the purpose of this endeavor, the set of LCP considered are Safety Class-Motor Driven-Vertical Centrifugal Pumps for primary flow which includes Safety Injection, Containment Spray, and Residual Heat Removal. Fault Signatures of the LCP for OLM has been developed following the INCOSE V-model systems development approach. The fault types, fault features, and their detection methods and effectiveness for the LCP were established by diligently following the guidelines recommended by EPRI. An optimization of the FS for OLM has been suggested for implementation. As a way of extending this work, a Cost-Benefit Analysis between OLM and the conventional Periodic Maintenance for the LCP in NPP is proposed.

Online Monitoring of Large Centrifugal Pumps in Nuclear Power Plants

International Nuclear Information System (INIS)

Emmanuel, Efenji A.; Faragalla, Mohamed M.; Awwal, Arigi M.; Lee, Yong-kwan

2016-01-01

Online Monitoring detects and diagnoses incipient faults, performs predictive maintenance, and can estimate the Remaining Useful Life (RUL) of Active and Passive Components before they fail. In an effort towards assisting Utility Partners to be proactive in the management of their Assets, the Electric Power Research Institute (EPRI) collaborated with the Idaho National Laboratory (INL) to develop a Fleet-Wide Prognostic and Health Monitoring (FW-PHM) Software Suite. The FW-PHM is a web based diagnostic tools and databases designed for use in commercial NPP. The AFS development process as designed by EPRI can be adapted to Large Centrifugal Pumps (LCP) in Nuclear Power Plants (NPP). For the purpose of this endeavor, the set of LCP considered are Safety Class-Motor Driven-Vertical Centrifugal Pumps for primary flow which includes Safety Injection, Containment Spray, and Residual Heat Removal. Fault Signatures of the LCP for OLM has been developed following the INCOSE V-model systems development approach. The fault types, fault features, and their detection methods and effectiveness for the LCP were established by diligently following the guidelines recommended by EPRI. An optimization of the FS for OLM has been suggested for implementation. As a way of extending this work, a Cost-Benefit Analysis between OLM and the conventional Periodic Maintenance for the LCP in NPP is proposed

Online Monitoring Technical Basis and Analysis Framework for Large Power Transformers; Interim Report for FY 2012

Energy Technology Data Exchange (ETDEWEB)

Nancy J. Lybeck; Vivek Agarwal; Binh T. Pham; Heather D. Medema; Kirk Fitzgerald

2012-09-01

The Light Water Reactor Sustainability program at Idaho National Laboratory (INL) is actively conducting research to develop and demonstrate online monitoring (OLM) capabilities for active components in existing Nuclear Power Plants. A pilot project is currently underway to apply OLM to Generator Step-Up Transformers (GSUs) and Emergency Diesel Generators (EDGs). INL and the Electric Power Research Institute (EPRI) are working jointly to implement the pilot project. The EPRI Fleet-Wide Prognostic and Health Management (FW-PHM) Software Suite will be used to implement monitoring in conjunction with utility partners: the Shearon Harris Nuclear Generating Station (owned by Duke Energy for GSUs, and Braidwood Generating Station (owned by Exelon Corporation) for EDGs. This report presents monitoring techniques, fault signatures, and diagnostic and prognostic models for GSUs. GSUs are main transformers that are directly connected to generators, stepping up the voltage from the generator output voltage to the highest transmission voltages for supplying electricity to the transmission grid. Technical experts from Shearon Harris are assisting INL and EPRI in identifying critical faults and defining fault signatures associated with each fault. The resulting diagnostic models will be implemented in the FW-PHM Software Suite and tested using data from Shearon-Harris. Parallel research on EDGs is being conducted, and will be reported in an interim report during the first quarter of fiscal year 2013.

Health education and caregivers' management of Malaria among ...

African Journals Online (AJOL)

Health education and caregivers' management of Malaria among under fives in Ede North L.G.A., Osun State of Nigeria. ... about the dose and regimen of chloroquine drug and (e) had a better attitude towards the management of malaria.

[Health management system in outpatient follow-up of kidney transplantation patients].

Science.gov (United States)

Zhang, Hong; Xie, Jinliang; Yao, Hui; Liu, Ling; Tan, Jianwen; Geng, Chunmi

2014-07-01

To develop a health management system for outpatient follow-up of kidney transplant patients. Access 2010 database software was used to establish the health management system for kidney transplantation patients in Windows XP operating system. Database management and post-operation follow-up of the kidney transplantation patients were realized through 6 function modules including data input, data query, data printing, questionnaire survey, data export, and follow-up management. The system worked stably and reliably, and the data input was easy and fast. The query, the counting and printing were convenient. Health management system for patients after kidney transplantation not only reduces the work pressure of the follow-up staff, but also improves the efficiency of outpatient follow-up.

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

Science.gov (United States)

Kobza, Joanna; Syrkiewicz-Świtała, Magdalena

2014-01-01

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

Time based management in health care system: The chosen aspects

Directory of Open Access Journals (Sweden)

Joanna Kobza

2014-08-01

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

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

Science.gov (United States)

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

2016-08-01

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

eHealth for inflammatory bowel disease self-management - the patient perspective.

Science.gov (United States)

Con, Danny; Jackson, Belinda; Gray, Kathleen; De Cruz, Peter

2017-09-01

Electronic health (eHealth) solutions may help address the growing pressure on IBD outpatient services as they encompass a component of self-management. However, information regarding patients' attitudes towards the use of eHealth solutions in IBD is lacking. The aim of this study was to evaluate eHealth technology use and explore the perspectives of IBD patients on what constitutes the ideal eHealth solution to facilitate self-management. A mixed methods qualitative and quantitative analysis of the outcomes of a discussion forum and an online survey conducted at a tertiary hospital in Melbourne, Australia between November 2015 and January 2016 was undertaken. Eighteen IBD patients and parents participated in the discussion forum. IBD patients expressed interest in eHealth tools that are convenient and improve access to care, communication, disease monitoring and adherence. Eighty six patients with IBD responded to the online survey. A majority of patients owned a mobile phone (98.8%), had access to the internet (97.7%), and felt confident entering data onto a phone or computer (73.3%). Most patients (98.8%) were willing to use at least one form of information and communication technology to help manage their IBD. Smartphone apps and internet websites were the two most preferred technologies to facilitate IBD self-management. This study demonstrates the willifngness of patients to engage with eHealth as a potential solution to facilitate IBD self-management. Future development and testing of eHealth solutions should be informed by all major stakeholders including patients to maximise their uptake and efficacy to facilitate IBD self-management.

Managing information technology human resources in health care.

Science.gov (United States)

Mahesh, Sathiadev; Crow, Stephen M

2012-01-01

The health care sector has seen a major increase in the use of information technology (IT). The increasing permeation of IT into the enterprise has resulted in many non-IT employees acquiring IT-related skills and becoming an essential part of the IT-enabled enterprise. Health care IT employees work in a continually changing environment dealing with new specializations that are often unfamiliar to other personnel. The widespread use of outsourcing and offshoring in IT has introduced a third layer of complexity in the traditional hierarchy and its approach to managing human resources. This article studies 3 major issues in managing these human resources in an IT-enabled health care enterprise and recommends solutions to the problem.

The Impact of Health Behaviors and Health Management on Employment After SCI: Physical Health and Functioning.

Science.gov (United States)

Meade, Michelle A; Reed, Karla S; Krause, James S

2016-01-01

Background : Research has shown that employment following spinal cord injury (SCI) is related to health and functioning, with physical health and functioning after SCI frequently identified as a primary barrier to employment. Objective: To examine the relationship between employment and behaviors associated with the management of physical health and functioning as described by individuals with SCI who have been employed post injury. Methods: A qualitative approach using 6 focus groups at 2 sites included 44 participants with SCI who had worked at some time post injury. Heterogeneous and homogeneous groups were created based on specific characteristics, such as education, gender, or race. A semi-structured interview format asked questions about personal, environmental, and policy-related factors influencing employment after SCI. Groups were recorded, transcribed, and entered into NVivo before coding by 2 reviewers. Results: Within the area of behaviors and management of physical health and functioning, 4 overlapping themes were identified: (1) relearning your own body and what it can do; (2) general health and wellness behaviors; (3) communication, education, and advocacy; and (4) secondary conditions and aging. Specific themes articulate the many types of behaviors individuals must master and their impact on return to work as well as on finding, maintaining, and deciding to leave employment. Conclusions: Individuals with SCI who are successfully employed after injury must learn how to perform necessary behaviors to manage health and function in a work environment. The decision to leave employment often appears to be associated with secondary complications and other conditions that occur as persons with SCI age.

Vasoactive intestinal polypeptide and peptide histidine methionine. Presence in human follicular fluid and effects on DNA synthesis and steroid secretion in cultured human granulosa/lutein cells

DEFF Research Database (Denmark)

Gräs, S; Ovesen, P; Andersen, A N

1994-01-01

Vasoactive intestinal polypeptide (VIP) and peptide histidine methionine (PHM) originate from the same precursor molecule, prepro VIP. In the present study we examined the concentrations of VIP and PHM in human follicular fluid and their effects on cultured human granulosa/lutein cells. Follicular....../l, respectively. VIP at a concentration of 10 nmol/l caused a significant increase in [3H]thymidine incorporation, and at 1000 nmol/l a significant increase in oestradiol secretion was observed. VIP had no effect on progesterone secretion. PHM at the concentrations tested did not influence any of the activities...

Health services management modalities in the Brazilian Unified National Health System: a narrative review of research production in Public Health (2005-2016).

Science.gov (United States)

Ravioli, Antonio Franco; Soárez, Patrícia Coelho De; Scheffer, Mário César

2018-01-01

The current study aimed to systematically analyze trends and priorities in the theoretical and conceptual approaches and empirical studies on specific health services management modalities in the Brazilian Unified National Health System. A narrative review of the literature identified, in 33 publications, the location and nature of services, management models, methodological procedures, and study outcomes. The research deals mainly with the models' conceptual and legal characteristics and management practices, in addition to addressing contracts, procurement, human resources, financing, and control mechanisms. In conclusion, the literature is limited and concentrated in the State of São Paulo, showing little theoretical diversity and methodological weaknesses, while it is nonconclusive as to the superiority of one management model over another. New evaluation studies are needed that are capable of comparing different models and assessing their performance and their effects on the quality of health services' provision, the population's health, and the health system's organization.

Research on Occupational Safety, Health Management and Risk Control Technology in Coal Mines.

Science.gov (United States)

Zhou, Lu-Jie; Cao, Qing-Gui; Yu, Kai; Wang, Lin-Lin; Wang, Hai-Bin

2018-04-26

This paper studies the occupational safety and health management methods as well as risk control technology associated with the coal mining industry, including daily management of occupational safety and health, identification and assessment of risks, early warning and dynamic monitoring of risks, etc.; also, a B/S mode software (Geting Coal Mine, Jining, Shandong, China), i.e., Coal Mine Occupational Safety and Health Management and Risk Control System, is developed to attain the aforementioned objectives, namely promoting the coal mine occupational safety and health management based on early warning and dynamic monitoring of risks. Furthermore, the practical effectiveness and the associated pattern for applying this software package to coal mining is analyzed. The study indicates that the presently developed coal mine occupational safety and health management and risk control technology and the associated software can support the occupational safety and health management efforts in coal mines in a standardized and effective manner. It can also control the accident risks scientifically and effectively; its effective implementation can further improve the coal mine occupational safety and health management mechanism, and further enhance the risk management approaches. Besides, its implementation indicates that the occupational safety and health management and risk control technology has been established based on a benign cycle involving dynamic feedback and scientific development, which can provide a reliable assurance to the safe operation of coal mines.

[The hospital perspective: disease management and integrated health care].

Science.gov (United States)

Schrappe, Matthias

2003-06-01

Disease Management is a transsectoral, population-based form of health care, which addresses groups of patients with particular clinical entities and risk factors. It refers both to an evidence-based knowledge base and corresponding guidelines, evaluates outcome as a continuous quality improvement process and usually includes active participation of patients. In Germany, the implementation of disease management is associated with financial transactions for risk adjustment between health care assurances [para. 137 f, Book V of Social Code (SGB V)] and represents the second kind of transsectoral care, besides a program designed as integrated health care according to para. 140 a ff f of Book V of Social Code. While in the USA and other countries disease management programs are made available by several institutions involved in health care, in Germany these programs are offered by health care insurers. Assessment of disease management from the hospital perspective will have to consider three questions: How large is the risk to compensate inadequate quality in outpatient care? Are there synergies in internal organisational development? Can the risk of inadequate funding of the global "integrated" budget be tolerated? Transsectoral quality assurance by valid performance indicators and implementation of a quality improvement process are essential. Internal organisational changes can be supported, particularly in the case of DRG introduction. The economic risk and financial output depends on the kind of disease being focussed by the disease management program. In assessing the underlying scientific evidence of their cost effectiveness, societal costs will have to be precisely differentiated from hospital-associated costs.

Health management in past disasters in Iran: A qualitative study

Directory of Open Access Journals (Sweden)

Maryam Nakhaei

2014-06-01

Background: Disaster management is relied on prediction of problems and providing necessary preparations in right time and place. In this study researchers intended to explore passed experiences of health disaster management. Method: This study conducted using qualitative content analysis methods. Participants were selected purposefully and data were collected through interviews, observation, and other documents. Results: Transcribed data from 18interviews, field notes and other documents were analyzed. In data analysis reactive management was emerged as main theme. It was included some categories such as ‘exposure shock’, ‘non deliberative relief’, ‘lack of comprehensive health disaster plan’, ‘lack of preparedness’, and ‘poor coordination in health service delivery’ and contextual factors. Discussion: The results clarified deep perception of participants’ experiences about health management in disasters. The professionals' and non-professionals' emotion-based reactions and behaviors, if accompanied with deficiencies in planning and preparedness, can lead to ineffective services, and aggravates the damages.

Excel 2016 for health services management statistics a guide to solving problems

CERN Document Server

Quirk, Thomas J

2016-01-01

This book shows the capabilities of Microsoft Excel in teaching health services management statistics effectively. Similar to the previously published Excel 2013 for Health Services Management Statistics, this book is a step-by-step exercise-driven guide for students and practitioners who need to master Excel to solve practical health service management problems. If understanding statistics isn’t your strongest suit, you are not especially mathematically-inclined, or if you are wary of computers, this is the right book for you. Excel, a widely available computer program for students and managers, is also an effective teaching and learning tool for quantitative analyses in health service courses. Its powerful computational ability and graphical functions make learning statistics much easier than in years past. However, Excel 2016 for Health Services Management Statistics: A Guide to Solving Practical Problems is the first book to capitalize on these improvements by teaching students and managers how to apply...

YouTube Enhanced Case Teaching in Health Management and Policy

Directory of Open Access Journals (Sweden)

Jeremy C. Green

2018-03-01

Discussion: YouTube videos can be a valuable source of content to supplement existing case teaching materials in health management and policy. More research is needed to distinguish the effects of YouTube videos from other case teaching materials and flipped format aspects of course design. The general method of YouTube enhanced case teaching might be expanded beyond health management and policy to other topics in health professions education.

[Structure of Relationships Formed by Occupational Health Nurses for Co-operating with Managers to Support Workers with Mental Health Concerns].

Science.gov (United States)

Hatanaka, Junko; Takasaki, Masako; Hatanaka, Michiyo

2018-05-31

Occupational health staff and managers play important roles in supporting workers with mental health concerns and mutual co-operation among them is a necessary element. However, when co-operating with other professionals, several problems arise that often make such co-operation a challenge. Effective mutual actions are needed to promote such co-operation, and relationships must be formed for this purpose. Therefore, in this study, we aimed to clarify how occupational health nurses form relationships for facilitating co-operation with managers to provide support to workers with mental health concerns. Data were collected using semi-structured interviews with 11 occupational health nurses who provide individualized mental health support and who have at least 5 years of experience as occupational health nurses. Analysis of the recorded interviews was performed using a qualitative statistical method (KJ method). Six elements that constitute the formation of relationships were identified. When occupational health nurses form relationships for facilitating co-operation with a manager to provide support to workers, they "form relationships through strategic communication" with them and when co-operation is required, they form a relationship by "acting in a manner that suits the manager," such as his/her character and the situation. To support this relationship, occupational health nurses "provide mental support to the manager" by listening to his/her anxiety or real intention about supporting the subordinate with mental health concerns and provide relief while understanding their burdens during the co-operation. Occupational health nurses even "provide support to the manager in their activities," which assessed the situation at the workplace as the specialist and advised the manager to understand how to concern to the subordinate specifically. In addition, they "indirectly support the manager" which included coordinating with the concerned persons so as to not excessively

Managed competition versus industrial purchasing of health care among the Fortune 500.

Science.gov (United States)

Maxwell, James; Temin, Peter

2002-02-01

The theory of managed competition has found favor with many health policy analysts and academic economists alike. Three characteristics--consumer choice, defined contribution, and dissemination of information--signal managed competition strategy. By requiring private employers to provide their employees with a choice of health carriers, a fixed-dollar strategy (defined contribution), and quality information to make appropriate choices among carriers, managed competition offers to remedy imperfections in both the consumer and provider sides of the market for health insurance. In an extensive survey of health care purchasing practices among Fortune 500 companies we found that major companies are not using the managed competition approach to health care purchasing. Instead, most of the companies surveyed are purchasing health care in the same way as they do other inputs to production--a pattern we call industrial purchasing.

A study for safety and health management problem of semiconductor industry in Taiwan.

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Chao, Chin-Jung; Wang, Hui-Ming; Feng, Wen-Yang; Tseng, Feng-Yi

2008-12-01

The main purpose of this study is to discuss and explore the safety and health management in semiconductor industry. The researcher practically investigates and interviews the input, process and output of the safety and health management of semiconductor industry by using the questionnaires and the interview method which is developed according to the framework of the OHSAS 18001. The result shows that there are six important factors for the safety and health management in Taiwan semiconductor industry. 1. The company should make employee clearly understand the safety and health laws and standards. 2. The company should make the safety and health management policy known to the public. 3. The company should put emphasis on the pursuance of the safety and health management laws. 4. The company should prevent the accidents. 5. The safety and health message should be communicated sufficiently. 6. The company should consider safety and health norm completely.

Evaluating Performance of Safety Management and Occupational Health Using Total Quality Safety Management Model (TQSM

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E Mohammadfam

2015-11-01

Full Text Available Introduction: All organizations, whether public or private, necessitate performance evaluation systems in regard with growth, stability, and development in the competitive fields. One of the existing models for performance evaluation of occupational health and safety management is Total Quality Safety Management model (TQSM. Therefore, the present study aimed to evaluate performance of safety management and occupational health utilizing TQSM model. Methods: In this descriptive-analytic study, the population consisted of 16 individuals, including managers, supervisors, and members of technical protection and work health committee. Then the participants were asked to respond to TQSM questionnaire before and after the implementation of Occupational Health & Safety Advisory Services 18001 (OHSAS18001. Ultimately, the level of each program as well as the TQSM status were determined before and after the implementation of OHSAS18001. Results: The study results showed that the scores obtained by the company before OHSAS 18001’s implementation, was 43.7 out of 312. After implementing OHSAS 18001 in the company and receiving the related certificate, the total score of safety program that company could obtain was 127.12 out of 312 demonstrating a rise of 83.42 scores (26.8%. The paired t-test revealed that mean difference of TQSM scores before and after OHSAS 18001 implementation was proved to be significant (p> 0.05. Conclusion: The study findings demonstrated that TQSM can be regarded as an appropriate model in order to monitor the performance of safety management system and occupational health, since it possesses the ability to quantitatively evaluate the system performance.

Case manager satisfaction in public health.

Science.gov (United States)

Schutt, Russell K; Fawcett, Jacqueline; Gall, Gail B; Harrow, Brooke; Woodford, Mary Lou

2010-01-01

The purpose of this study was to examine correlates of case managers' satisfaction with their work, services, and service network and to identify connections to service performance and service costs. A decentralized public health program that exemplifies the trend toward more diverse clients and networked services. A mixed method design with 34 case managers. As hypothesized, the case managers' experiences with clients and the service network, and their service effectiveness, were associated with their satisfaction with their jobs and the services they provide. Satisfaction was also positively associated with more timely service delivery. These associations were explained in part by case managers' education and training. Case managers can achieve high levels of job and service satisfaction in outreach programs serving a diverse client population in a decentralized service network. Case managers' job and service satisfaction improves with reduced service problems and service delays and when case managers can devise work-arounds for persistent service problems. Using advanced practice nurses (APN) and providing more on-the-job training may increase case manager satisfaction with their jobs and the services they provide. Special efforts may be needed to prevent a decline in job satisfaction with years of experience.

Guidelines for Management Information Systems in Canadian Health Care Facilities

Science.gov (United States)

Thompson, Larry E.

1987-01-01

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

Consumer choice of social health insurance in managed competition.

NARCIS (Netherlands)

Kerssens, J.J.; Groenewegen, P.P.

2003-01-01

Objective: To promote managed competition in Dutch health insurance, the insured are now able to change health insurers. They can choose a health insurer with a low flat-rate premium, the best supplementary insurance and/or the best service. As we do not know why people prefer one health insurer to

Clinical features of brain metastases in breast cancer: an implication for hippocampal-sparing whole-brain radiation therapy

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Wu S

2016-12-01

Full Text Available San-Gang Wu,1,* Jia-Yuan Sun,2,* Qin Tong,3 Feng-Yan Li,2 Zhen-Yu He2 1Department of Radiation Oncology, Xiamen Cancer Hospital, The First Affiliated Hospital of Xiamen University, Xiamen, 2Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, 3Department of Radiation Oncology, The First Affiliated Hospital of University of South China, Hengyang, People’s Republic of China *These authors contributed equally to this work Objective: The objectives of this study were to describe the distribution of brain metastases (BM in breast cancer patients and investigate the risk factors for perihippocampal metastases (PHM. Patients and methods: Retrospective analysis of the clinicopathological characteristics and patterns of BM was performed. Associations between clinicopathological characteristics and PHM (the hippocampus plus 5 mm margin were evaluated using logistic regression analyses. Results: A total of 1,356 brain metastatic lesions were identified in 192 patients. Patients with 1–3 BM, 4–9 BM, and ≥10 BM accounted for 63.0%, 18.8%, and 18.2%, respectively. There were only 7 (3.6% patients with hippocampal metastases (HM and 14 (7.3% patients with PHM. On logistic regression, the number of BM was an independent risk factor for PHM. Patients with ≥10 BM had a significantly higher risk of PHM compared with those with <10 BM. Breast cancer subtype (BCS was not associated with PHM. The number of BM was significantly correlated with various BCSs. Patients with hormone receptor (HR+/human epidermal growth factor receptor 2 (HER2+, HR-/HER2+, and HR-/HER2- subtypes had a higher probability of ≥10 BM, relative to patients with an HR+/HER2- subtype. Conclusion: Our study suggests that a low incidence of PHM may be acceptable to perform hippocampal-sparing whole-brain radiation therapy for breast cancer patients

Vasoactive intestinal polypeptide and peptide histidine methionine. Presence in human follicular fluid and effects on DNA synthesis and steroid secretion in cultured human granulosa/lutein cells

DEFF Research Database (Denmark)

Gräs, S; Ovesen, Per Glud; Andersen, A N

1994-01-01

Vasoactive intestinal polypeptide (VIP) and peptide histidine methionine (PHM) originate from the same precursor molecule, prepro VIP. In the present study we examined the concentrations of VIP and PHM in human follicular fluid and their effects on cultured human granulosa/lutein cells. Follicula...

Supporting self-management of chronic health conditions: common approaches.

Science.gov (United States)

Lawn, Sharon; Schoo, Adrian

2010-08-01

The aims of this paper are to provide a description of the principles of chronic condition self-management, common approaches to support currently used in Australian health services, and benefits and challenges associated with using these approaches. We examined literature in this field in Australia and drew also from our own practice experience of implementing these approaches and providing education and training to primary health care professionals and organizations in the field. Using common examples of programs, advantages and disadvantages of peer-led groups (Stanford Courses), care planning (The Flinders Program), a brief primary care approach (the 5As), motivational interviewing and health coaching are explored. There are a number of common approaches used to enhance self-management. No one approach is superior to other approaches; in fact, they are often complimentary. The nature and context for patients' contact with services, and patients' specific needs and preferences are what must be considered when deciding on the most appropriate support mode to effectively engage patients and promote self-management. Choice of approach will also be determined by organizational factors and service structures. Whatever self-management support approaches used, of importance is how health services work together to provide support. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

What would it take? Stakeholders' views and preferences for implementing a health care manager program in community mental health clinics under health care reform.

Science.gov (United States)

Cabassa, Leopoldo J; Gomes, Arminda P; Lewis-Fernández, Roberto

2015-02-01

Health care manager interventions can improve the physical health of people with serious mental illness (SMI). In this study, we used concepts from the theory of diffusion of innovations, the consolidated framework for implementation research and a taxonomy of implementation strategies to examine stakeholders' recommendations for implementing a health care manager intervention in public mental health clinics serving Hispanics with SMI. A purposive sample of 20 stakeholders was recruited from mental health agencies, primary care clinics, and consumer advocacy organizations. We presented participants a vignette describing a health care manager intervention and used semistructured qualitative interviews to examine their views and recommendations for implementing this program. Interviews were recorded, professionally transcribed, and content analyzed. We found that a blend of implementation strategies that demonstrates local relative advantage, addresses cost concerns, and enhances compatibility to organizations and the client population is critical for moving health care manager interventions into practice. © The Author(s) 2014.

Herd health and production management in dairy practice.

NARCIS (Netherlands)

Brand, A.; Noordhuizen, J.P.T.M.; Schukken, Y.H.

1996-01-01

This text aims to teach students, practitioners and farm advisors how to give management support to the dairy farmer in order to optimize the health, productivity and welfare of his herd. The book covers management practices and farm conditions which have both positive and negative influences on

Integrated medication management in mHealth applications.

Science.gov (United States)

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

2014-01-01

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

Ground Operations Autonomous Control and Integrated Health Management

Science.gov (United States)

Daniels, James

2014-01-01

The Ground Operations Autonomous Control and Integrated Health Management plays a key role for future ground operations at NASA. The software that is integrated into this system is called G2 2011 Gensym. The purpose of this report is to describe the Ground Operations Autonomous Control and Integrated Health Management with the use of the G2 Gensym software and the G2 NASA toolkit for Integrated System Health Management (ISHM) which is a Computer Software Configuration Item (CSCI). The decision rationale for the use of the G2 platform is to develop a modular capability for ISHM and AC. Toolkit modules include knowledge bases that are generic and can be applied in any application domain module. That way, there's a maximization of reusability, maintainability, and systematic evolution, portability, and scalability. Engine modules are generic, while application modules represent the domain model of a specific application. Furthermore, the NASA toolkit, developed since 2006 (a set of modules), makes it possible to create application domain models quickly, using pre-defined objects that include sensors and components libraries for typical fluid, electrical, and mechanical systems.

Integrating authorities and disciplines into the preparedness-planning process: a study of mental health, public health, and emergency management.

Science.gov (United States)

Robertson, Madeline; Pfefferbaum, Betty; Codispoti, Catherine R; Montgomery, Juliann M

2007-01-01

The process of integrating all necessary authorities and disciplines into an organized preparedness plan is complex, and the inclusion of disaster mental health poses specific challenges. The goals of this project were (1) to identify whether state mental health preparedness was included in state public health and emergency management preparedness plans, (2) to document barriers to entry and strategies reportedly used by state authorities in efforts to incorporate reasonable mental health preparedness into existing public health and emergency management preparedness planning, (3) to employ a theory for organizational change to organize and synthesize this information, and (4) to stimulate further discussion and research supporting coordinated preparedness efforts at the state level, particularly those inclusive of mental health. To accomplish these goals we (1) counted the number of state public health preparedness and emergency management plans that either included, mentioned, or omitted a mental health preparedness plan; (2) interviewed key officials from nine representative states for their reports on strategies used in seeking greater inclusion of mental health preparedness in public health and emergency management preparedness planning; and (3) synthesized these results to contribute to the national dialogue on coordinating disaster preparedness, particularly with respect to mental health preparedness. We found that 15 out of 29 publicly available public health preparedness plans (52 percent) included mental health preparedness, and eight of 43 publicly available emergency management plans (18 percent) incorporated mental health. Interviewees reported numerous barriers and strategies, which we cataloged according to a well-accepted eight-step plan for transforming organizations.

Regional governance: strategies and disputes in health region management

Directory of Open Access Journals (Sweden)

Adriano Maia dos Santos

2014-08-01

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

Excel 2013 for health services management statistics a guide to solving practical problems

CERN Document Server

Quirk, Thomas J

2016-01-01

This book shows the capabilities of Microsoft Excel to teach health services management statistics effectively. Similar to the previously published Excel 2010 for Health Services Management Statistics, this book is a step-by-step exercise-driven guide for students and practitioners who need to master Excel to solve practical health services management problems. If understanding statistics isn’t your strongest suit, you are not especially mathematically-inclined, or if you are wary of computers, this is the right book for you. Excel, a widely available computer program for students and managers, is also an effective teaching and learning tool for quantitative analyses in health services management courses. Its powerful computational ability and graphical functions make learning statistics much easier than in years past. However, Excel 2013 for Health Services Management Statistics: A Guide to Solving Practical Problems is the first book to capitalize on these improvements by teaching students and managers ho...

Health care provider knowledge and routine management of pre-eclampsia in Pakistan.

Science.gov (United States)

Sheikh, Sana; Qureshi, Rahat Najam; Khowaja, Asif Raza; Salam, Rehana; Vidler, Marianne; Sawchuck, Diane; von Dadelszen, Peter; Zaidi, Shujat; Bhutta, Zulfiqar

2016-09-30

Maternal mortality ratio is 276 per 100,000 live births in Pakistan. Eclampsia is responsible for one in every ten maternal deaths despite the fact that management of this disease is inexpensive and has been available for decades. Many studies have shown that health care providers in low and middle-income countries have limited training to manage patients with eclampsia. Hence, we aimed to explore the knowledge of different cadres of health care providers regarding aetiology, diagnosis and treatment of pre-eclampsia and eclampsia and current management practices. We conducted a mixed method study in the districts of Hyderabad and Matiari in Sindh province, Pakistan. Focus group discussions and interviews were conducted with community health care providers, which included Lady Health Workers and their supervisors; traditional birth attendants and facility care providers. In total seven focus groups and 26 interviews were conducted. NVivo 10 was used for analysis and emerging themes and sub-themes were drawn. All participants were providing care for pregnant women for more than a decade except one traditional birth attendant and two doctors. The most common cause of pre-eclampsia mentioned by community health care providers was stress of daily life: the burden of care giving, physical workload, short birth spacing and financial constraints. All health care provider groups except traditional birth attendants correctly identified the signs, symptoms, and complications of pre-eclampsia and eclampsia and were referring such women to tertiary health facilities. Only doctors were aware that magnesium sulphate is recommended for eclampsia management and prevention; however, they expressed fears regarding its use at first and secondary level health facilities. This study found several gaps in knowledge regarding aetiology, diagnosis and treatment of pre-eclampsia among health care providers in Sindh. Findings suggest that lesser knowledge regarding management of pre

Monitoring of internal pH gradients within multi-layer tablets by optical methods and EPR imaging.

Science.gov (United States)

Eisenächer, Friederike; Schädlich, Andreas; Mäder, Karsten

2011-09-30

The high variability of gastrointestinal pH is a general challenge regarding constant release from oral drug delivery systems, especially for ionisable drugs. These drugs often show a pH-dependent solubility and therewith associated intra- and inter-individual variability of emerging drug plasma levels. Several strategies have been investigated with the intention to influence the microenvironmental pH (pH(M)) within solid formulations and therefore achieve pH-independent release profiles. Because of the heterogeneity of solid systems, a precise prediction of the occurring pH(M) is rather difficult. It is therefore important to monitor the pH(M) within the formulations to achieve requested release as well as to minimise pH-dependent degradation processes of the active compound. The purpose of the current study was the analysis of pH(M) gradients within 2- and 3-layer tablets during hydration using 3 different techniques for comparison intensions, in particular a pH indicator dye, fluorescence imaging and EPR imaging. The influence of the presence or absence of pH modifying substances and of an additional lipophilic inter layer on the pH(M) was investigated as well as the variation of matrix forming excipient and buffer pH. The influence of the pH(M) on drug release was analysed as well. In addition, benchtop MRI was accomplished to gain a deeper insight on the hydration and erosion behaviour of 2- and 3-layer tablets. Copyright © 2010 Elsevier B.V. All rights reserved.

The Evolution of Public Health Emergency Management as a Field of Practice.

Science.gov (United States)

Rose, Dale A; Murthy, Shivani; Brooks, Jennifer; Bryant, Jeffrey

2017-09-01

The health impacts of recent global infectious disease outbreaks and other disasters have demonstrated the importance of strengthening public health systems to better protect communities from naturally occurring and human-caused threats. Public health emergency management (PHEM) is an emergent field of practice that draws on specific sets of knowledge, techniques, and organizing principles necessary for the effective management of complex health events. We highlight how the nascent field of PHEM has evolved in recent years. We explore this development by first examining multiple sites of intersection between the fields of public health and emergency management. We then analyze 2 of the principal pillars on which PHEM was built: organizational and programmatic (i.e., industry) standards and the incident management system. This is followed by a sketch of the key domains, or functional areas, of PHEM and their application to the emergency management cycle. We conclude with some observations about PHEM in a global context and discuss how the field might continue to evolve.

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

Science.gov (United States)

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

2006-03-01

The nature of veterinary work in dairy health management in Europe has changed over the past years and will change even more dramatically in the near future. The consumers and the media show increasing concern about animal welfare, safety of products of animal origin and traceability of animal products. Farmers in Europe have to produce under strict, often expensive and laborious regulations, while still commercially competing with farmers outside the EU and not subject to the same rules. Veterinarians should adapt their knowledge and skills to the new challenges and developments of the dairy sector. Dairy farmers nowadays ask for support in areas that go beyond clinical activities: environmental protection, welfare, nutrition, grassland management, economics and business management. Bovine practitioners should be able to advise in many different areas and subjects--that is the challenge to our profession. Veterinary education with regards to cattle health management should start with individual animal clinical work, which constitutes the basis of herd health advisory programmes. The bovine practitioner should then look beyond that and regard the herd as the unit. Each diseased cow or group of cows should be detected early enough to avoid financial losses or such losses should be prevented altogether by detecting and managing risk factors contributing to disease occurrence. Herd health and production management programmes represent the first level to optimise dairy farm performance. Expansions to that should further be considered, comprising both animal health and welfare issues, as well as food safety and public health issues. The latter could be addressed by quality risk management programmes following the HACCP-principles. Cattle veterinarians should follow recent developments and invest in new skills and knowledge in order to maintain their usefulness to the modern dairy farmer. Finally we are convinced that the cattle practitioner should evolve into this

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

Science.gov (United States)

Davies, G

1990-07-01

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

Effect of Occupational Health and Safety Management System on Work-Related Accident Rate and Differences of Occupational Health and Safety Management System Awareness between Managers in South Korea's Construction Industry.

Science.gov (United States)

Yoon, Seok J; Lin, Hsing K; Chen, Gang; Yi, Shinjea; Choi, Jeawook; Rui, Zhenhua

2013-12-01

The study was conducted to investigate the current status of the occupational health and safety management system (OHSMS) in the construction industry and the effect of OHSMS on accident rates. Differences of awareness levels on safety issues among site general managers and occupational health and safety (OHS) managers are identified through surveys. The accident rates for the OHSMS-certified construction companies from 2006 to 2011, when the construction OHSMS became widely available, were analyzed to understand the effect of OHSMS on the work-related injury rates in the construction industry. The Korea Occupational Safety and Health Agency 18001 is the certification to these companies performing OHSMS in South Korea. The questionnaire was created to analyze the differences of OHSMS awareness between site general managers and OHS managers of construction companies. The implementation of OHSMS among the top 100 construction companies in South Korea shows that the accident rate decreased by 67% and the fatal accident rate decreased by 10.3% during the period from 2006 to 2011. The survey in this study shows different OHSMS awareness levels between site general managers and OHS managers. The differences were motivation for developing OHSMS, external support needed for implementing OHSMS, problems and effectiveness of implementing OHSMS. Both work-related accident and fatal accident rates were found to be significantly reduced by implementing OHSMS in this study. The differences of OHSMS awareness between site general managers and OHS managers were identified through a survey. The effect of these differences on safety and other benefits warrants further research with proper data collection.

Performance scorecard for occupational safety and health management systems

Directory of Open Access Journals (Sweden)

Hernâni Veloso Neto

2012-06-01

Full Text Available The pro-active and systematic search for best performances should be the two assumptions of any management system, so safety and health management in organizations must also be guided by these same precepts. However, the scientific production evidences that the performance evaluation processes in safety and health continue to be guided, in their essence, by intermittency, reactivity and negativity, which are not consistent with the assumptions referenced above. Therefore, it is essential that health and safety at work management systems (HSW MS are structured from an active and positive viewpoint, focusing on continuous improvement. This implies considering performance evaluation processes that incorporate, on the one hand, monitoring, measuring and verification procedures, and on the other hand, structured matrixes of results that capture the key factors of success, by mobilizing both reactive and proactive indicators. One of the instruments that can fulfill these precepts of health and safety performance evaluation is the SafetyCard, a performance scorecard for HSW MS that we developed and will seek to outline and demonstrate over this paper.

A new complementary approach for oral health and diabetes management

DEFF Research Database (Denmark)

Cinar, Ayse Basak; Freeman, Ruth; Schou, Lone

2018-01-01

BACKGROUND: Health coaching (HC) is based on 'partnering with clients in a thought-provoking and creative process that inspires them to maximise their personal and professional potential' to adopt healthy lifestyles through 'building awareness and empowerment'. This study's objective is to assess......, for the first time to our knowledge, the effectiveness of HC compared with health education (HE) using clinical and subjective measures among type 2 diabetes (DM2) patients in Turkey and Denmark. METHODS: This stratified random prospective study selected type 2 diabetes patients in Turkey (n = 186) (TR) (2010...... management and health outcomes. There is a need for common health promotion strategies with behavioural interventions such as health coaching for the management of type 2 diabetes that focus on multidisciplinary approaches including oral health....

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

Science.gov (United States)

Caplan, Mary Ager

2014-05-01

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

Management of clandestine drug laboratories: need for evidence-based environmental health policies.

Science.gov (United States)

Al-Obaidi, Tamara A; Fletcher, Stephanie M

2014-01-01

Clandestine drug laboratories (CDLs) have been emerging and increasing as a public health problem in Australia, with methamphetamine being the dominant illegally manufactured drug. However, management and remediation of contaminated properties are still limited in terms of regulation and direction, especially in relation to public and environmental health practice. Therefore, this review provides an update on the hazards and health effects associated with CDLs, with a specific look at the management of these labs from an Australian perspective. Particularly, the paper attempts to describe the policy landscape for management of CDLs, and identifies current gaps and how further research may be utilised to advance understanding and management of CDLs and inform public health policies. The paper highlights a significant lack of evidence-based policies and guidelines to guide regulatory authority including environmental health officers in Australia. Only recently, the national Clandestine Drug Laboratory Guidelines were developed to assist relevant authority and specialists manage and carry out investigations and remediation of contaminated sites. However, only three states have developed state-based guidelines, some of which are inadequate to meet environmental health requirements. The review recommends well-needed inter-sectoral collaborations and further research to provide an evidence base for the development of robust policies and standard operating procedures for safe and effective environmental health management and remediation of CDLs.

Mobile Health (mHealth) Technology for the Management of Hypertension and Hyperlipidemia: Slow Start but Loads of Potential.

Science.gov (United States)

Rehman, Hasan; Kamal, Ayeesha K; Morris, Pamela B; Sayani, Saleem; Merchant, Anwar T; Virani, Salim S

2017-03-01

Hypertension and hyperlipidemia represent two major risk factors for atherosclerotic cardiovascular disease. Mobile health or mHealth is defined as the use of mobile phone and wireless technologies to support the achievement of health objectives. Management of hypertension, and to some extent hyperlipidemia, has often employed mHealth interventions given lower cost and greater patient engagement compared to traditional methods. These interventions include the use of text messaging, wireless devices, and mobile phone applications. This review considers recent studies evaluating the effectiveness of mHealth interventions in the management of hypertension and hyperlipidemia. Numerous studies have evaluated the role of mHealth interventions in the management of hypertension, while very few have evaluated their role in hyperlipidemia. Text messaging has been used most frequently. However, the trend is shifting towards the use of mobile phone applications and wireless devices. Interventions in developing countries have been modified for greater applicability to local settings. mHealth interventions were found to be frequently effective. However, studies comparing the relative efficacy of various mHealth strategies are scarce. Long-term cardiovascular outcomes data and analyses relating to cost effectiveness are also lacking. mHealth interventions may be effective in improving hypertension management. More studies are needed to evaluate the role of mHealth strategies in hyperlipidemia management, particularly in identifying high-risk individuals and improving medication adherence. Studies assessing the long-term impact of these interventions, comparing different interventions and analyzing their relative cost effectiveness, are also needed. Following recently published guidelines on reporting results of mHealth interventions will provide a more meaningful context for interpreting these promising early studies.

Health management of radiation workers

International Nuclear Information System (INIS)

Kunugita, Naoki; Igari, Kazuyuki

2013-01-01

People in Japan have expressed great anxiety about possible radiation and radioactivity after the accident at the Fukushima Daiichi Nuclear Power Plant of Tokyo Electric Power Company's (TEPCO), due to the great earthquake and tsunami in eastern Japan on 11 March 2011. A large number of workers were engaged in response and recovery operations, and they were possibly exposed to high doses of radiation as compared to the general population. In the accident at the Chernobyl Nuclear Power Plant in 1986, high doses of radiation to 134 plant staff and emergency personnel resulted in acute radiation syndrome (ARS), which proved fatal for 28 of them. In the Fukushima accident, six workers were exposed to more than 250 mSv of radiation during the initial response phase, but no one showed ARS. It is necessary to continue registration of radiation doses for all workers who were exposed to radiation to facilitate suitable healthcare management in the future. In addition to radiation exposure, a group of workers were also exposed to other health hazards. Frequent occurrence of heat disorders has been a concern for the workers wearing protective clothing with poor ventilation. A comprehensive program to prevent heat illness was implemented by TEPCO under the guidance of the Ministry of Health, Labour, and Welfare. It is important to provide effective systems not only for prevention of radiation exposure but also for general management of other health risks including heat disorders and infection. (author)

Public and private roles in plant health management

NARCIS (Netherlands)

Oude Lansink, A.G.J.M.

2011-01-01

World-wide, government institutions play an important role in the management of plant health. This paper develops a conceptual framework in which suppliers and demanders jointly determine the optimal level of plant health in a hypothetical market. Next this paper argues that this market falls short

Integrating complementary and alternative medicine into mainstream healthcare services: the perspectives of health service managers.

Science.gov (United States)

Singer, Judy; Adams, Jon

2014-05-22

Complementary and alternative medicine (CAM) is increasingly included within mainstream integrative healthcare (IHC) services. Health service managers are key stakeholders central to ensuring effective integrative health care services. Yet, little research has specifically investigated the role or perspective of health service managers with regards to integrative health care services under their management. In response, this paper reports findings from an exploratory study focusing exclusively on the perspectives of health service managers of integrative health care services in Australia regarding the role of CAM within their service and the health service managers rational for incorporating CAM into clinical care. Health service managers from seven services were recruited using purposive and snowball sampling. Semi-structured interviews were conducted with the health service managers. The services addressed trauma and chronic conditions and comprised: five community-based programs including drug and alcohol rehabilitation, refugee mental health and women's health; and two hospital-based specialist services. The CAM practices included in the services investigated included acupuncture, naturopathy, Western herbal medicine and massage. Findings reveal that the health service managers in this study understand CAM to enhance the holistic capacity of their service by: filling therapeutic gaps in existing healthcare practices; by treating the whole person; and by increasing healthcare choices. Health service managers also identified CAM as addressing therapeutic gaps through the provision of a mind-body approach in psychological trauma and in chronic disease management treatment. Health service managers describe the addition of CAM in their service as enabling patients who would otherwise not be able to afford CAM to gain access to these treatments thereby increasing healthcare choices. Some health service managers expressly align the notion of treating the whole person

Toward a national health risk management approach in Australia.

Science.gov (United States)

O'Donnell, Carol

2002-01-01

There has been increasing international consensus about the importance of competition for achieving national growth and community well-being. The Australian government accordingly has introduced policies to promote such competition. Major legislative review and many public inquiries have assisted implementation of national competition policy and the development of national goals and standards related to international agreements to promote health and sustainable development. Since the 1980s, Australia has had legislation that requires the identification and control of health risks arising at work. The management structures necessary for coordinated delivery of national programs designed for effective identification and control of health risks arising in communities to achieve national health and development goals are still being developed, however. Major difficulties related to this development are discussed. National health development programs should be approached primarily through establishment of regional partnerships between bodies responsible for managing community health, local government, and employment placement, in consultation with other relevant organizations and the community. Related research and evaluation programs are required.

Management of pharmaceutical services in the Brazilian primary health care.

Science.gov (United States)

Gerlack, Letícia Farias; Karnikowski, Margô Gomes de Oliveira; Areda, Camila Alves; Galato, Dayani; Oliveira, Aline Gomes de; Álvares, Juliana; Leite, Silvana Nair; Costa, Ediná Alves; Guibu, Ione Aquemi; Soeiro, Orlando Mario; Costa, Karen Sarmento; Guerra, Augusto Afonso; Acurcio, Francisco de Assis

2017-11-13

To identify limiting factors in the management of pharmaceutical services in the primary health care provided by the Brazilian Unified Health System (SUS). This study was based on the data from the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos no Brasil (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines), and it was conducted by interviews with professionals responsible for pharmaceutical services in Brazilian cities, in 2015. To identify the management limiting factors, we considered the organizational, operational, and sustainability indicators of the management. For the analyses, we included the weights and structure of analysis plan for complex samples. The results were expressed by frequencies and measures of central tendency with 95% confidence interval, considering the Brazilian geographic regions. We identified the following limiting factors: lack of pharmaceutical services in the Municipal Health Secretariat organization chart (24%) and in the health plan (18%); lack of participation of managers in the Health Board and the absence of reference to this topic in the agenda of meetings (58.4%); lack of financial autonomy (61.5%) and lack of knowledge on the available values (81.7%); lack of adoption of operational procedures (about 50%) for selection, scheduling, and acquisition; and the fact that most professionals evaluate the organization of pharmaceutical services as good and great (58.8%), despite the worrisome indicators. Pharmaceutical services management is currently supported by a legal and political framework that should guide and contribute to improve the pharmaceutical services in the Brazilian Unified Health System primary health care. However, there is a mismatch between the goals established by these guidelines and what is actually happening.

Pesticides and public health: integrated methods of mosquito management.

OpenAIRE

Rose, R. I.

2001-01-01

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

Evaluation of two communication strategies to improve udder health management.

Science.gov (United States)

Jansen, J; Renes, R J; Lam, T J G M

2010-02-01

Worldwide, programs to improve udder health are implemented using communication tools and methods that inform and persuade dairy farmers. This study evaluated 2 communication strategies used in a mastitis control program in the Netherlands. To improve farmers' udder health management, tools such as instruction cards, treatment plans, checklists and software were developed following an argument-based comprehensive "central route." These tools were used during on-farm study group meetings for farmers organized by veterinarians and also during individual veterinarian-farmer interactions. The second strategy aimed at adopting a single management practice to increase the use of milking gloves during milking. This approach followed a straightforward "peripheral" route that used implicit persuasion techniques. Results of an online survey of 374 Dutch dairy farmers showed that most farmers were able and willing to use the educational management tools to increase udder health on their farms. They evaluated the tools positively regardless of the mastitis problems on their farms. This seems to indicate that the central route of communication is most effective when farmers are motivated to work on udder health in general. Results of repeated random telephone surveys before, during, and after the campaign on the use of milking gloves showed that the use of gloves increased from 20.9 to 42.0% of the respondents. Respondents' opinions about milking gloves also changed favorably, indicating that a relatively short peripheral campaign on a single action can have a sustained effect on farmers' behavior. Both communication strategies seem to be potentially successful in disseminating knowledge to a specific target group of farmers and in changing that group's behavior. However, to reach as many farmers as possible, the strategies should be combined. When optimizing these strategies, both the farmers' motivation to work on udder health and the aim of the campaign should be considered

Battery Health Management System for Electric UAVs

Data.gov (United States)

National Aeronautics and Space Administration — In summary, this paper lays out a novel battery health management technique for application onboard an electric UAV. This technique is also applicable to other...

Validation of a survey tool for use in cross-cultural studies

Directory of Open Access Journals (Sweden)

Costa FA

2008-09-01

Full Text Available There is a need for tools to measure the information patients need in order for healthcare professionals in general, and particularly pharmacists, to communicate effectively and play an active part in the way patients manage their medicines. Previous research has developed and validated constructs to measure patients’ desires for information and their perceptions of how useful their medicines are. It is important to develop these tools for use in different settings and countries so that best practice is shared and is based on the best available evidence. Objectives: this project sought to validate of a survey tool measuring the “Extent of Information Desired” (EID, the “Perceived Utility of Medicines” (PUM, and the “Anxiety about Illness” (AI that had been previously translated for use with Portuguese patients. Methods: The scales were validated in a patient sample of 596: construct validity was explored in Factor analysis (PCA and internal consistency analysed using Cronbach’s alpha. Criterion validity was explored correlating scores to the AI scale and patients’ perceived health status. Discriminatory power was assessed using ANOVA. Temporal stability was explored in a sub-sample of patients who responded at two time points, using a T-test to compare their mean scores. Results: Construct validity results indicated the need to remove 1 item from the Perceived Harm of Medicines (PHM and Perceived Benefit of Medicines (PBM for use in a Portuguese sample and the abandon of the tolerance scale. The internal consistency was high for the EID, PBM and AI scales (alpha>0.600 and acceptable for the PHM scale (alpha=0.536. All scales, except the EID, were consistent over time (p>0.05; p<0.01. All the scales tested showed good discriminatory power. The comparison of the AI scale with the SF-36 indicated good criterion validity (p<0.05.Conclusion: The translated tool was valid and reliable in Portuguese patients- excluding the Tolerance

Non-Destructive Analysis of Degradation Mechanisms in Cycle-Aged Graphite/LiCoO2 Batteries

Directory of Open Access Journals (Sweden)

Liqiang Zhang

2014-09-01

Full Text Available Non-destructive analysis of degradation mechanisms can be very beneficial for the prognostics and health management (PHM study of lithium-ion batteries. In this paper, a type of graphite/LiCoO2 battery was cycle aged at high ambient temperature, then 25 parameters of the multi-physics model were identified. Nine key parameters degraded with the cycle life, and they were treated as indicators of battery degradation. Accordingly, the degradation mechanism was discussed by using the multi-physics model and key parameters, and the reasons for capacity fade and the internal resistance increase were analyzed in detail. All evidence indicates that the formation reaction of the solid electrolyte interface (SEI film is the main cause of battery degradation at high ambient temperature.

Improving Chronic Disease Self-Management by Older Home Health Patients through Community Health Coaching

Directory of Open Access Journals (Sweden)

Cheryl Dye

2018-04-01

Full Text Available The purpose of the study was to pilot test a model to reduce hospital readmissions and emergency department use of rural, older adults with chronic diseases discharged from home health services (HHS through the use of volunteers. The study’s priority population consistently experiences poorer health outcomes than their urban counterparts due in part to lower socioeconomic status, reduced access to health services, and incidence of chronic diseases. When they are hospitalized for complications due to poorly managed chronic diseases, they are frequently readmitted for the same conditions. This pilot study examines the use of volunteer community members who were trained as Health Coaches to mentor discharged HHS patients in following the self-care plan developed by their HHS RN; improving chronic disease self-management behaviors; reducing risk of falls, pneumonia, and flu; and accessing community resources. Program participants increased their ability to monitor and track their chronic health conditions, make positive lifestyle changes, and reduce incidents of falls, pneumonia and flu. Although differences in the ED and hospital admission rates after discharge from HHS between the treatment and comparison group (matched for gender, age, and chronic condition were not statistically significant, the treatment group’s rate was less than the comparison group thus suggesting a promising impact of the HC program (90 day: 263 comparison vs. 129 treatment; p = 0.65; 180 day 666.67 vs. 290.32; p = 0.19. The community health coach model offers a potential approach for improving the ability of discharged older home health patients to manage chronic conditions and ultimately reduce emergent care.

Integrating cost information with health management support system: an enhanced methodology to assess health care quality drivers.

Science.gov (United States)

Kohli, R; Tan, J K; Piontek, F A; Ziege, D E; Groot, H

1999-08-01

Changes in health care delivery, reimbursement schemes, and organizational structure have required health organizations to manage the costs of providing patient care while maintaining high levels of clinical and patient satisfaction outcomes. Today, cost information, clinical outcomes, and patient satisfaction results must become more fully integrated if strategic competitiveness and benefits are to be realized in health management decision making, especially in multi-entity organizational settings. Unfortunately, traditional administrative and financial systems are not well equipped to cater to such information needs. This article presents a framework for the acquisition, generation, analysis, and reporting of cost information with clinical outcomes and patient satisfaction in the context of evolving health management and decision-support system technology. More specifically, the article focuses on an enhanced costing methodology for determining and producing improved, integrated cost-outcomes information. Implementation issues and areas for future research in cost-information management and decision-support domains are also discussed.

Partnerships in Health Systems: Social Organization as limits and possibilities in the Family Health Strategy Management.

Science.gov (United States)

Silva, Vanessa Costa E; Barbosa, Pedro Ribeiro; Hortale, Virgínia Alonso

2016-05-01

This is a case study in the municipality of Rio de Janeiro about management in the Family Health Strategy based on the Social Organizations model. The aims were to characterize and analyze aspects of the governance system adopted by the Rio de Janeiro Municipal Health Department and identify limits and possibilities of this model as a management option in Brazil's Unified Health System. A qualitative study was performed based on a literature review, document analysisand interviews with key informants. This management model facilitated the expansion of access to primary healthcare through the Family Health Strategy in Rio - where the population covered increased from 7.2% of the population in 2008 to 45.5% in 2015. The results showthat some practices in the contractual logic need to be improved, including negotiation and accountability with autonomywith the service suppliers. Evaluation and control has focus on processes, not results, and there has not been an increase in transparency and social control. The system of performance incentives has been reported as inducing improvements in the work process of the health teams. It is concluded that the regulatory capacity of the municipal management would need to be improved. On the other hand, there is an important and significant process of learning in progress.

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

Science.gov (United States)

Guo, Kristina L

2002-03-01

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

The role of records management professionals in the national health ...

African Journals Online (AJOL)

The introduction of information communication technologies (ICTs) in the health sector has brought about electronic health (eHealth) which uses computing, networking and communications technologies to improve health delivery. However, the inclusion of records management and archival concerns during system design ...

Financial aspects of veterinary herd health management programmes

NARCIS (Netherlands)

Ifende, V.I.; Derks, M.; Hooijer, G.A.; Hogeveen, H.

2014-01-01

Veterinary herd health management (VHHM) programmes are meant to support herd health and farmers’ income (Brand and Guard 1996). They were introduced in the Netherlands in the 1970s (Sol and Renkema 1984) and at present many veterinarians provide them to farmers. VHHM comprises a basic structure of

Future health physics prospects in high-level nuclear waste management

International Nuclear Information System (INIS)

Waite, D.A.; Mayberry, J.J.

1986-01-01

The objective of this presentation is to provide an overview of health physics activities anticipated to be required at a high-level nuclear waste repository and to project the numbers of health physics personnel expected to be required to carry out these activities. Health physics personnel receiving consideration in the projections include the health physics manager, shift supervisors, area supervisors, health physicists, and technologists. Phases of the repository addressed are construction, operation, retrieval, and decommissioning. Specific topics discussed in the process of developing the projections are: (a) the basic features of a geologic repository, (b) the staffing requirements of such a repository, (c) health physics involvement in repository operations, and (d) the anticipated schedule for operation of repositories in the United States. A quantitative assessment of future health physics prospects in high-level nuclear waste management is included

Disabling health care? Medicaid managed care and people with disabilities in America

DEFF Research Database (Denmark)

Hiranandani, Vanmala Sunder

2011-01-01

Medicaid, America's largest government-funded health insurance program, plays a pivotal role in providing health services to eight million adults with disabilities. Since the mid-1990s, many Medicaid programs have aggressively introduced managed care, which reconfigures service delivery using...... business principles. Most states have insufficient experience in developing managed care plans for Medicaid beneficiaries with disabilities. Middle-aged adults with physical disabilities present their own constellation of health care issues that is not readily appreciated in health and social services....... The purpose of the study was to understand their experiences in accessing physical health care services and to ascertain the effects of managed care on their health and well-being. This study found beneficiaries encounter numerous barriers in accessing preventative, treatment, and acute care services. Overall...

Management of health system reform: a view of changes within New Zealand.

Science.gov (United States)

Ritchie, D

1998-08-01

This paper reports on the context and process of health system reform in New Zealand. The study is based on interviews conducted with 31 managers from three Crown Health Enterprises (publicly funded hospital-based health care organizations). A number of countries with publicly funded health services (e.g., UK, Australia and New Zealand) have sought to shift from the traditional 'passive' health management style (using transactional management skills to balance historically-based expenditure budgets) to 'active' transformational leadership styles that reflect a stronger 'private sector' orientation (requiring active management of resources--including a return on 'capital' investment, identification of costs and returns on 'product lines', 'marketing' a 'product mix', reducing non-core activities and overhead costs, and a closer relationship with 'shareholders', suppliers and customers/clients). Evidence of activities and processes associated with transformational leadership are identified. Success of the New Zealand health reforms will be determined by the approach the new managers adopt to improve their organization's performance. Transformational leadership has been frequently linked to the successful implementation of significant organizational change in other settings (Kurz et al., 1988; Dunphy and Stace, 1990) but it is too early to assess whether this is applicable in a health care context.

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

Science.gov (United States)

Martin, Corby K; Gilmore, L Anne; Apolzan, John W; Myers, Candice A; Thomas, Diana M; Redman, Leanne M

2016-03-16

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

The strategic planning of health management information systems.

Science.gov (United States)

Smith, J

1995-01-01

This paper discusses the roles and functions of strategic planning of information systems in health services. It selects four specialised methodologies of strategic planning for analysis with respect to their applicability in the health field. It then examines the utilisation of information planning in case studies of three health organisations (two State departments of health and community services and one acute care institution). Issues arising from the analysis concern the planning process, the use to which plans are put, and implications for management.

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

Science.gov (United States)

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

2009-03-05

The Ministry of Health and Medical Education in the Islamic Republic of Iran has undertaken a reform of its health system, in which-lower level managers are given new roles and responsibilities in a decentralized system. To support these efforts, a United Kingdom-based university was contracted by the World Health Organization to design a series of courses for health managers and trainers. This process was also intended to develop the capacity of the National Public Health Management Centre in Tabriz, Iran, to enable it to organize relevant short courses in health management on a continuing basis. A total of seven short training courses were implemented, three in the United Kingdom and four in Tabriz, with 35 participants. A detailed evaluation of the courses was undertaken to guide future development of the training programmes. The Kirkpatrick framework for evaluation of training was used to measure participants' reactions, learning, application to the job, and to a lesser extent, organizational impact. Particular emphasis was put on application of learning to the participants' job. A structured questionnaire was administered to 23 participants, out of 35, between one and 13 months after they had attended the courses. Respondents, like the training course participants, were predominantly from provincial universities, with both health system and academic responsibilities. Interviews with key informants and ex-trainees provided supplemental information, especially on organizational impact. Participants' preferred interactive methods for learning about health planning and management. They found the course content to be relevant, but with an overemphasis on theory compared to practical, locally-specific information. In terms of application of learning to their jobs, participants found specific information and skills to be most useful, such as health systems research and group work/problem solving. The least useful areas were those that dealt with training and

Training evaluation: a case study of training Iranian health managers

Directory of Open Access Journals (Sweden)

Butcher Christopher

2009-03-01

Full Text Available Abstract Background The Ministry of Health and Medical Education in the Islamic Republic of Iran has undertaken a reform of its health system, in which-lower level managers are given new roles and responsibilities in a decentralized system. To support these efforts, a United Kingdom-based university was contracted by the World Health Organization to design a series of courses for health managers and trainers. This process was also intended to develop the capacity of the National Public Health Management Centre in Tabriz, Iran, to enable it to organize relevant short courses in health management on a continuing basis. A total of seven short training courses were implemented, three in the United Kingdom and four in Tabriz, with 35 participants. A detailed evaluation of the courses was undertaken to guide future development of the training programmes. Methods The Kirkpatrick framework for evaluation of training was used to measure participants' reactions, learning, application to the job, and to a lesser extent, organizational impact. Particular emphasis was put on application of learning to the participants' job. A structured questionnaire was administered to 23 participants, out of 35, between one and 13 months after they had attended the courses. Respondents, like the training course participants, were predominantly from provincial universities, with both health system and academic responsibilities. Interviews with key informants and ex-trainees provided supplemental information, especially on organizational impact. Results Participants' preferred interactive methods for learning about health planning and management. They found the course content to be relevant, but with an overemphasis on theory compared to practical, locally-specific information. In terms of application of learning to their jobs, participants found specific information and skills to be most useful, such as health systems research and group work/problem solving. The least

Management of occupational health risks in small-animal veterinary practices.

Science.gov (United States)

D'Souza, Eva; Barraclough, Richard; Fishwick, David; Curran, Andrew

2009-08-01

Small-animal work is a major element of veterinary practice in the UK and may be hazardous, with high levels of work-related injuries and ill-health reported in Australia and USA. There are no studies addressing the management of occupational health risks arising from small-animal work in the UK. To investigate the sources of health and safety information used and how health and safety and 12 specific occupational health risks are managed by practices. A cross-sectional postal survey of all small-animal veterinary practices in Hampshire. A response was mandatory as this was a Health & Safety Executive (HSE) inspection activity. A total of 118 (100%) practices responded of which 93 were eligible for inclusion. Of these, 99 and 86%, respectively, were aware of the Royal College of Veterinary Surgeons (RCVS) practice standards and had British Small Animal Veterinary Association (BSAVA) staff members, while only 51% had previous contact with HSE (publications, advice and visit). Ninety per cent had health and safety policies, but only 31% had trained responsible staff in health and safety. Specific health hazards such as occupational allergens and computer use were relatively overlooked both by practices and the RCVS/BSAVA guidance available in 2002. Failings in active health risk management systems could be due to a lack of training to ensure competence in those with responsibilities. Practices rely on guidance produced by their professional bodies. Current RCVS guidance, available since 2005, has remedied some previous omissions, but further improvements are recommended.

Is "disease management" the answer to our problems? No! Population health management and (disease) prevention require "management of overall well-being".

Science.gov (United States)

Cramm, Jane Murray; Nieboer, Anna Petra

2016-09-21

Disease management programs based on the chronic care model have achieved successful and long-term improvement in the quality of chronic care delivery and patients' health behaviors and physical quality of life. However, such programs have not been able to maintain or improve broader self-management abilities or social well-being, which decline over time in chronically ill patients. Disease management efforts, population health management initiatives and innovative primary care solutions are still mainly focused on clinical and functional outcomes and health behaviors (e.g., smoking cessation, exercise, and diet) failing to address individuals' overall quality of life and well-being. Individuals' ability to achieve well-being can be assessed with great specificity through the application of social production function (SPF) theory. This theory asserts that people produce their own well-being by trying to optimize the achievement of instrumental goals (stimulation, comfort, status, behavioral confirmation, affection) that provide the means to achieve the larger, universal goals of physical and social well-being. A shift in focus from the management of physical function, disease limitations, and lifestyle behaviors alone to an approach that fosters self-management abilities such as self-efficacy and resource investment as well as overall quality of life, is urgently needed. Disease management interventions should be aimed at adequately addressing all difficulties chronically ill patients face in life, such as the effects of pain and fatigue on the ability to maintain a job and social life and to participate in activities promoting physical and social well-being. Patients' ability to maintain engagement in stimulating work and social activities with the people who are important to them may be even more important than aspects of disease self-management such as blood pressure or glycemic control. Interventions should aim to make chronically ill patients capable of

Development of a standardized job description for healthcare managers of metabolic syndrome management programs in Korean community health centers.

Science.gov (United States)

Lee, Youngjin; Choo, Jina; Cho, Jeonghyun; Kim, So-Nam; Lee, Hye-Eun; Yoon, Seok-Jun; Seomun, GyeongAe

2014-03-01

This study aimed to develop a job description for healthcare managers of metabolic syndrome management programs using task analysis. Exploratory research was performed by using the Developing a Curriculum method, the Intervention Wheel model, and focus group discussions. Subsequently, we conducted a survey of 215 healthcare workers from 25 community health centers to verify that the job description we created was accurate. We defined the role of healthcare managers. Next, we elucidated the tasks of healthcare managers and performed needs analysis to examine the frequency, importance, and difficulty of each of their duties. Finally, we verified that our job description was accurate. Based on the 8 duties, 30 tasks, and 44 task elements assigned to healthcare managers, we found that the healthcare managers functioned both as team coordinators responsible for providing multidisciplinary health services and nurse specialists providing health promotion services. In terms of importance and difficulty of tasks performed by the healthcare managers, which were measured using a determinant coefficient, the highest-ranked task was planning social marketing (15.4), while the lowest-ranked task was managing human resources (9.9). A job description for healthcare managers may provide basic data essential for the development of a job training program for healthcare managers working in community health promotion programs. Copyright © 2014. Published by Elsevier B.V.

Consumer choice of social health insurance in managed competition

NARCIS (Netherlands)

Kerssens, Jan J.; Groenewegen, Peter P.

2003-01-01

Objective To promote managed competition in Dutch health insurance, the insured are now able to change heaith insurers. They can choose a health insurer with a low flat-rate premium, the best supplementary insurance and/or the best service. As we do not know why people prefer one health insurer to

Adoption of online health management tools among healthy older adults: An exploratory study.

Science.gov (United States)

Zettel-Watson, Laura; Tsukerman, Dmitry

2016-06-01

As the population ages and chronic diseases abound, overburdened healthcare systems will increasingly require individuals to manage their own health. Online health management tools, quickly increasing in popularity, have the potential to diminish or even replace in-person contact with health professionals, but overall efficacy and usage trends are unknown. The current study explored perceptions and usage patterns among users of online health management tools, and identified barriers and barrier-breakers among non-users. An online survey was completed by 169 computer users (aged 50+). Analyses revealed that a sizable minority (37%) of participants use online health management tools and most users (89%) are satisfied with these tools, but a limited range of tools are being used and usage occurs in relatively limited domains. Improved awareness and education for online health management tools could enhance people's abilities to remain at home as they age, reducing the financial burden on formal assistance programs. © The Author(s) 2014.

Mapping Health Needs to Support Health System Management in Poland

Science.gov (United States)

Holecki, Tomasz; Romaniuk, Piotr; Woźniak-Holecka, Joanna; Szromek, Adam R.; Syrkiewicz-Świtała, Magdalena

2018-01-01

In Poland, following the example of other EU countries, the first maps of health needs prepared by the Ministry of Health were presented in 2016. The maps constitute a foundation for rational decision-making in the management of health care resources, being potentially useful for all actors in health system. This refers in particular to the institutions responsible for distribution of funds and contracting health service, but also for decision-makers, who determine the scope of funds to be utilized in the health system, or the structure of benefits provided to patients. Service providers are also addressees of the maps, to give them a basis for planning future activities. The article presents a structured assessment of the current state of affairs, based on recent experience and sets out likely directions for the development of health needs in mapping in Poland in the future. We discuss the criticism addressed toward maps by representatives of various groups acting in health care. It includes the lack of recognition of some of the key health needs, or wrong emphases, where much more attention is paid to the recognition of current resources in the health system, instead of making prognoses regarding the future developments of health needs. Nonetheless, we find that this instrument is potentially of high usability, in case of elimination of the existing weaknesses. PMID:29662876

Health and poverty: health management by the woman

Directory of Open Access Journals (Sweden)

Alvarez Maria de la Luz

1992-01-01

Full Text Available The goal this follow-up study was to relate the mother's marital satisfaction to family health status in a low SES. The random sample was made up of 30 families with children under 7 years old: 15 considered as sick (Group A and 15 as healthy (Group B. Both group had similar demographic characteristics (age of father and mother, persons per family group and age of children and SES. Results showed that mothers were those mainly in charge of their family groups. Mothers of Group A were significantly less understanding and more dissatisfied than those of Group B ( p < .05 and p < .01. Mothers of Group A had significantly more arguments with their partners than those of Group B (p < .006. Health care was learned less from the child's own mother in group A than in B (p < .05. Health was considered by mothers of Group A as something that "must be taken care of" more than by those of Group B (p < .01. The behaviours of mothers in choosing one of the health systems was similar in both groups. Dissatisfied mothers were associated more with sick family members during the 6 month follow-up. It is suggested that the satisfaction of the mother is a factor that needs further investigation because health is managed by mothers is the large majority of families.

Health and poverty: health management by the woman

Directory of Open Access Journals (Sweden)

Maria de la Luz Alvarez

1992-04-01

Full Text Available The goal this follow-up study was to relate the mother's marital satisfaction to family health status in a low SES. The random sample was made up of 30 families with children under 7 years old: 15 considered as sick (Group A and 15 as healthy (Group B. Both group had similar demographic characteristics (age of father and mother, persons per family group and age of children and SES. Results showed that mothers were those mainly in charge of their family groups. Mothers of Group A were significantly less understanding and more dissatisfied than those of Group B ( p < .05 and p < .01. Mothers of Group A had significantly more arguments with their partners than those of Group B (p < .006. Health care was learned less from the child's own mother in group A than in B (p < .05. Health was considered by mothers of Group A as something that "must be taken care of" more than by those of Group B (p < .01. The behaviours of mothers in choosing one of the health systems was similar in both groups. Dissatisfied mothers were associated more with sick family members during the 6 month follow-up. It is suggested that the satisfaction of the mother is a factor that needs further investigation because health is managed by mothers is the large majority of families.