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PubMed1996

Exploring approaches to the administration of a long-term care facility: The application of a community planning and development process.

This article outlines the approaches taken to the management of two long-term care facilities by the County of Huron in southwestern Ontario in 1994. Lay-offs, a move to new facilities, loss of local political confidence, changes in key administrative personnel and low staff morale prompted the county to ask an interim administrative team to develop and implement an appropriate response. The article explains how community development and planning principles and techniques were applied to the management of the homes to achieve an overall improvement in communication, staff morale and attitude. These approaches may prove helpful to other administrations facing major change.

Aged↗
PubMedDate not supplied

Guidelines for strategic information planning.

Developing a strategic information plan is an essential step for companies that want to realize the advantages of today's information technology. This article discusses ways to avoid the pitfalls that frequently occur during stages of information planning.

Computer Systems↗
PubMed2001

Biologically effective uniform dose (D) for specification, report and comparison of dose response relations and treatment plans.

Developments in radiation therapy planning have improved the information about the three-dimensional dose distribution in the patient. Isodose graphs, dose volume histograms and most recently radiobiological models can be used to evaluate the dose distribution delivered to the irradiated organs and volumes of interest. The concept of a biologically effective uniform dose (D) assumes that any two dose distributions are equivalent if they cause the same probability for tumour control or normal tissue complication. In the present paper the D concept both for tumours and normal tissues is presented, making use of the fact that probabilities averaged over both dose distribution and organ radiosensitivity are more relevant to the clinical outcome than the expected number of surviving clonogens or functional subunits. D can be calculated in complex target volumes or organs at risk either from the 3D dose matrix or from the corresponding dose volume histograms of the dose plan. The value of the D concept is demonstrated by applying it to two treatment plans of a cervix cancer. Comparison is made of the D concept with the effective dose (Deff ) and equivalent uniform dose (EUD) that have been suggested in the past. The value of the concept for complex targets and fractionation schedules is also pointed out.

Dose Fractionation, Radiation↗
PubMed2006

Gene regulatory networks and the evolution of animal body plans.

Development of the animal body plan is controlled by large gene regulatory networks (GRNs), and hence evolution of body plans must depend upon change in the architecture of developmental GRNs. However, these networks are composed of diverse components that evolve at different rates and in different ways. Because of the hierarchical organization of developmental GRNs, some kinds of change affect terminal properties of the body plan such as occur in speciation, whereas others affect major aspects of body plan morphology. A notable feature of the paleontological record of animal evolution is the establishment by the Early "Cambrian of virtually all phylum-level body plans. We identify a class of GRN component, the kernels" of the network, which, because of their developmental role and their particular internal structure, are most impervious to change. Conservation of phyletic body plans may have been due to the retention since pre-Cambrian time of GRN kernels, which underlie development of major body parts.

Adaptation, Biological↗
PubMed2003

Development of a sampling plan in winter wheat that estimates cereal aphid parasitism levels and predicts population suppression.

From 1998 to 2001, the relationship between the proportion of tillers with >0 mummified aphids (Ptm) and the proportion of cereal aphids parasitized (Pp) was estimated on 57 occasions in fields of hard red winter wheat located in central and western Oklahoma. Both original (57 fields) and validation data (34 fields; 2001-2002) revealed weak relationships between Ptm and Pp, however, when Ptm > 0.1, Pp always exceeded the recommended parasitism natural enemy threshold of 0.2. Based on the relationship between Ptm and Pp, upper (Ptm1) and lower (Ptm0) decision threshold proportions were set at 0.1 and 0.02, respectively. We monitored cereal aphid populations in 16-25 winter wheat fields over time, and based on the upper and lower decision threshold proportions (Ptm1 = 0.1, Ptm0 = 0.02), predicted whether aphid intensities (# per tiller) would increase above or be maintained below selected economic thresholds (3, 9, and 15 aphids per tiller). Results of this validation study revealed that aphid intensity exceeded an economic threshold in only one field when predicted to remain below Ptm > 0.1, but aphid intensity reached a maximum of only four aphids per tiller. The sampling plan developed during this study allowed us to quickly classify Ptm, and independent of initial cereal aphid intensities, very accurately predict suppression of populations by parasitoids. Sequential sampling stop lines based on sequential probability ratio tests for classifying proportions were calculated for Ptm1 = 0.1 and Ptm0 = 0.02. A minimum of 26 tiller samples are required to classify Ptm as above 0.1 or below 0.02. Based on the results of this study, we believe that simultaneous use of aphid and parasitoid sampling plans will be efficient and useful tools for consultants and producers in the southern plains and decrease the number of unnecessary insecticide applications.

Animals↗
PubMed1987

The future of medicine. A scenario analysis. Council on Long Range Planning and Development.

The Council on Long Range Planning and Development has undertaken an analysis of the future of medicine. The purpose in undertaking this study was to examine how the changing environment might effect the AMA and to identify measures the AMA could take to ensure its success in the future. The study involved developing three scenarios that covered a broad range of possibilities for the future. Analysis of these scenarios indicated that the AMA could face some significant environmental threats in the future. In the opinion of the Council, a variety of factors could combine to erode the AMA's membership market share and reduce cooperation among Federation organizations. Consequently, the AMA will have to develop an active response to environmental change to success and thrive in the future. The Council analyzed how the AMA might best respond to environmental change. The AMA could intensify its efforts to guide the course of environmental change. Such efforts would be worth undertaking, but they do not represent a complete solution. Therefore, the AMA must change itself to succeed in the future. The Council analyzed a number of alternative models of the AMA, each representing changes in product mix and/or organizational structure. None of these models provide a solution to environmental change. Rather, the solution lies primarily in program and activity changes. The Council identified specific suggestions for changes in the AMA's activities, organizational structure, and finances. If these suggestions are implemented, they will help the AMA succeed in the emerging environment. After completing its study of the future of medicine, the Council concluded that the need for the AMA will persist in the future. The market for the Association's products and services will remain strong. By taking steps today, the AMA can position itself to benefit from the emerging environment and, thereby, ensure that the Association has a positive future.

American Medical Association↗
PubMed2003

A literature review of the public health roles of health visitors and school nurses.

This paper describes a two-stage review relating to the family-centred public health role of health visitors and the child-centred public health role of school nurses. During the first stage, literature was searched using CINAHL and Medline databases and two models were used to frame the literature analysis. The findings of this analysis were, however, disappointing. Although many policy documents advocate development of the family-centred public health role of health visitors and the child-centred public health role of school nurses, there was no overwhelming evidence of reports of these approaches in health visiting and school nursing practice. The second stage of the review comprised a content analysis of West Midlands community trusts' strategic development plans. Seventeen plans were analysed. Of these, only two were 'formal' plans, the remainder being fragmented documentation related to plans for the development of health visiting and school nursing services. It may be concluded from the analysis that NHS trusts are beginning to adopt ideas from the rhetoric of national policy documents. Additionally, public health practice initiatives form an integrated part of most of the trust strategic development plans that the researchers examined.

Community Health Nursing↗
PubMed1993

Issues in the consumer choice of health care coverage plans.

Developing and implementing successful marketing strategies for prepaid health care coverage plans is becoming an important issue as managers of these plans struggle to remain competitive in the market place. This paper provides insight into the reasons why consumers make choices among varying types of health care coverage plans. Some suggestions are made to plan managers for incorporating these results into the development of marketing strategies for prepaid health care coverage plans.

Arkansas↗
PubMed1990

Cross-national models of fertility, family planning, and development: testing for reciprocal effects.

Cross-national models of fertility, family planning, and development commonly assume that there are no reciprocal effect between fertility and other variables in the model and that when path models are used, there are no reciprocal or nonrecursive effects among any set of variables in the model. The present study tests for nonrecursiveness using 2-wave panel data, and finds that nonrecursive effects are present among variables commonly used in model of fertility, family planning, and development. In addition, the pattern of relationships found has implications for the explanation of the relationship between mortality and fertility in demographic transition theory.

Birth Rate↗
PubMed2005

Financing and reimbursement of elders' oral health care: lessons from the present, opportunities for the future.

This article describes current financing and reimbursement for elders' oral health care and presents innovative options and opportunities for the future. Current health and dental care financing data from the Centers for Medicare and Medicaid Services and Agency for Health Care Research and Quality are reviewed. Existing and potential reimbursement options for the future are presented. Options for future financing and reimbursement include extending dental insurance into retirement, inclusion of oral health care into existing comprehensive health care plans, developing retiree plans for selected, well-defined (by the sponsor) groups of retirees, pre-paying dental care during employment, development of an Elders Health Insurance Program for the poor and near poor, and developing optional "Part D (for Dental)" plans within the Medicare program. Given the absence of universal oral health insurance, a mix of financing options and reimbursement schema will be required to cover the costs of oral health care and eliminate disparities in oral health access and outcomes for the growing elderly population.

Aged↗
PubMed2002

Systematic review of involving patients in the planning and development of health care.

OBJECTIVE: To examine the effects of involving patients in the planning and development of health care. DATA SOURCES: Published and grey literature. STUDY SELECTION: Systematic search for worldwide reports written in English between January 1966 and October 2000. DATA EXTRACTION: Qualitative review of papers describing the effects of involving patients in the planning and development of health care. RESULTS: Of 42 papers identified, 31 (74%) were case studies. Papers often described changes to services that were attributed to involving patients, including attempts to make services more accessible and producing information leaflets for patients. Changes in the attitudes of organisations to involving patients and positive responses from patients who took part in initiatives were also reported. CONCLUSIONS: Evidence supports the notion that involving patients has contributed to changes in the provision of services across a range of different settings. An evidence base for the effects on use of services, quality of care, satisfaction, or health of patients does not exist.

Attitude to Health↗