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PubMed2002

A preliminary comparative study of two treatment planning systems developed for boron neutron capture therapy: MacNCTPlan and SERA.

Two treatment planning systems have been specifically developed for BNCT: MacNCTPlan by the Harvard-MIT group and the SERA system developed by the INEEL/Montana State University group. In order to compare the dose components computed by the treatment planning systems, and therefore the clinical results available, it is important to first compare the basic features of the codes. This study investigated the effect of the reconstruction techniques and the form of the cross-section libraries used by the two treatment planning systems on the thermal neutron fluence distributions. Six mono-directional neutron sources of 0.0253 eV, 1 keV, 5 keV, 10 keV, 100 keV, and 1 MeV were directed onto simple geometric phantoms filled with water. The general-purpose Monte Carlo radiation transport code MCNP was used as a reference tool in this study. For the examples studied, it is found that the methods used for geometry representation (in MacNCTPlan) and for cross-section representation (in SERA) were found to impact directly on the accuracy of the calculated results.

Boron Neutron Capture Therapy↗
PubMed2002

Developing a strategic plan for school health services in Massachusetts.

School health service programs underwent rapid changes to meet the health needs of today's students. These needs stem largely from: a) increased number of students with special health care needs attending school, b) increased stress and time pressure on families, c) rapid restructuring of the health care system serving children, and d) recognition that schools provide opportunities to identify students with health risks. This paper describes seven components of a statewide Massachusetts plan to develop school health services by: a) setting standards, b) reviewing and revising statutes and regulations, c) promoting credentialing of school health personnel, d) providing continuing education on subjects pertinent to school health, e) exploring reimbursement systems and new funding sources, including funds from the tobacco settlement, f) exploring new models of care, and g) implementing data systems. The plan focuses on developing school nurse-managed school health services within a public health model.

Credentialing↗
PubMedDate not supplied

Developing family planning nurse practitioner protocols.

This article focuses on the process of development of protocols for family planning nurse practitioners. A rationale for the use of protocols, a definition of the types and examples, and the pros and cons of practice with protocols are presented. A how-to description for the development process follows, including methods and a suggested tool for critique and evaluation. The aim of the article is to assist nurse practitioners in developing protocols for their practice.

Evaluation Studies as Topic↗
PubMed1995

Public health crises of cities in developing countries.

During the decade and a half after Alma Ata hundreds of projects were started in developing countries to implement the principles of PHC and start community based health care programs in the rural areas of developing countries. Until the past five years urban health was not seen as a special health problem. Population pressure in the rural areas has created shortages of land, food and employment opportunities. These forces have generated major population movements to the urban centres. The population movements have encouraged unprecedented expansion of urban centres. This sudden concentration of large populations in small geographical areas has resulted in the urban health crises of the developing world. The poor who live in the slum areas have no access to adequate health services, they experience frequent epidemics of communicable diseases like cholera, they live within a heavily polluted environment, and their children have very poor health because they are not immunized and are malnourished. The paper agrees with approaches which have been championed by development agencies to address the urban health crises. These approaches propose the reorientation of urban health systems to include adoption of PHC for urban health programs, intersectoral collaboration and extra budgetary support. The paper argues for further strengthening of the reorientation approach by adjusting the development planning model. It is proposed that the urban plan be integrated into the national development plan so that emerging urban health crises can receive special attention in resource allocation.

Adult↗
PubMed1978

Planning and developing a prehospital mobile intensive care system in an urban setting.

A suggested model for the development of an urban based prehospital emergency care system is described. Factors considered in the planning and development include: 1) demand for services, projected and actual; 2) analysis of costs; 3) design and maintenance of the delivery system; and 4) establishment of the evaluation mechanisms. Over one year's experience and 1,144 mobile intensive care unit (MICU) calls in a densely populated urban setting with over 500,000 persons are reported. During the peak 8-hour period, predetermined dispatch categories were employed to activate one MICU operating in conjunction with three conventional ambulances. This partial conversion imparted MICU capability to the entire system at an 11 per cent increase in the ambulance budget. MICU calls averaged 4.5 per 8-hour peak shift and took 45 minutes each.

Ambulances↗
PubMed1983

Health systems agency and state health planning and development agency reviews; certificate of need programs--PHS. Notice of proposed rulemaking.

The Assistant Secretary for Health, with the approval of the Secretary of Health and Human Services, proposes to amend the regulations governing certificates of need reviews by State health planning and development agencies (State Agencies) and health systems agencies (HSAs). The proposed amendments would accomplish two tasks: (1) Implement amendments to the Public Health Service Act made by the Health Programs Extension Act of 1980 (Pub. L. 96-538) and the Omnibus Budget Reconciliation Act of 1981 (Pub. L. 97-35) and (2) reduce Federal regulatory burdens. Under the provisions of Title XV of the Public Health Service Act, the planning agencies are required to administer certificate of need programs consistent with the Secretary's regulations, under which they review and determine the need for proposed capital expenditures, institutional health services and major medical equipment. These regulations set forth proposed changes to the requirements for satisfactory certificate of need programs. Interested persons are invited to submit written comments and recommendations concerning these proposed rules as well as suggestions for alternative methods of implementing any of the provisions of the amendments that affect the requirements for certificate of need programs.

Health Planning Organizations↗
PubMed1983

Grant application cycles; health systems agency grants and state health planning and development agency grants--HRSA.

This Notice is issued in accordance with Executive Order 12372, Intergovernmental Review of Federal Programs as implemented by HHS in 45 CFR Part 100. The scheduled application due dates and funding dates for health systems agencies (HSAs) and State Health Planning and Development Agencies (SHPDAs) are provided below to assist States and other entities within a State in determining the comment period as required under 45 CFR Part 100.

Health Planning Organizations↗
PubMed1989

The future of adult cardiology. Council on Long Range Planning and Development in cooperation with the American College of Cardiology.

During the past several years, the American Medical Association's Council on Long Range Planning and Development has identified trends in the environment of medicine that are likely to affect physicians, their practices, and the provision of medical care in the future. In the course of its environmental analysis studies, the Council has recognized that each medical specialty is uniquely subject to anticipated changes in the environment of medicine. As part of an ongoing series of analyses prepared by the Council, this report focuses on environmental trends that are likely to influence the practice of adult cardiology. The report outlines the current state of cardiology, the forces for change in the environment, and the implications regarding the changes.

Cardiology↗
PubMed1987

The future of pediatrics. Implications of the changing environment of medicine. Council on Long Range Planning and Development in cooperation with the American Academy of Pediatrics.

We present the results of an environmental analysis by the American Medical Association Council on Long Range Planning and Development to determine the key factors that are likely to affect the pediatric specialty in the future. Three factors were identified that are particularly salient to future pediatric practice: demographic trends, decisions by third-party payers, and public attitudes toward services for children. Less than half as many children per pediatrician is predicted for the year 2000 compared with 1970. Pediatricians are likely to face future constraints on reimbursement, particularly for cognitive services and for providing care to the growing number of children in poverty. One moderating effect may be laws enacted at the state or federal level mandating basic insurance coverage for child health supervision services. The public interest in children's services will influence future access to pediatric care for children and the compensation that pediatricians receive for children in poverty. In light of these issues, organized medicine may seek means to adjust to and also to shape the environment in which pediatric practice is to occur in the future.

American Medical Association↗
PubMed2005

Hybrid coronary artery revascularization: logistics and program development.

Planning hybrid coronary artery revascularization--a combination of cardiac surgery with percutaneous procedures--requires, at first sight, a very complex logistical setup. Technical and equipment related details should be defined as early as possible in order to have time for training of all OR personnel involved. The most challenging aspect in OR-located hybrid coronary revascularization remains a very close cooperation of cardiac surgeons and interventional cardiologists. This teamwork does include indication findings and subsequent referral of multivessel coronary artery disease patients to hybrid procedures, as well as high individual flexibility of interventionalists and surgeons. The major prerequisite for this cooperation is a mutual acceptance of different revascularization approaches and the intent to combine their most striking advantages. Intraoperative graft angiography during coronary artery bypass grafting (CABG) procedures is one important step toward simultaneous hybrid coronary revascularization procedures. We describe our experience with on table angiography using a mobile C-arm for intraoperative imaging. This fluoroscopy system can in selected cases be used for simultaneous hybrid procedures.

Adult↗
PubMedDate not supplied

[Significance of urban climatologic expert assessment for urban planning and development].

Aspects of urban climatology relevant to urban planning are given in respect of quality of the atmosphere and urban climate modification. This paper deals with the spatial evaluation of emission and incidence of air pollution, local conditions of air flow and diffusion, climatic effects of different surface types and conditions of urban ventilation.

Air Movements↗
PubMedDate not supplied

[Population policy in Thailand].

Population policy may be defined differently by students of demography but it is generally defined as measures aiming at influencing demographic processes--fertility, mortality, and migration--through public and private programs. Population policy may also be classified into different types: direct and indirect policies; population influencing and population responsive policies; explicit and implicit policies; and domestic and international policies. For Thailand, earlier population policies tended to be policies aimed at increasing the size of population through pronatalist and public health measures. However, findings of various studies in the early 1960s indicated that the rate of population growth in Thailand since the end of World War II had been as high as 3% per annum. These had led the government to eventually issue the first national population policy statement "supporting family planning through a voluntary system..." in March 1970. The first 5-year family planning program was included in the health plan of the Third National Economic and Social Development Plan (1972-1976). From the Fourth National Economic and Social Development Plan (1977-1981) onwards, population policies were made more comprehensive to cover all dimensions of population: population growth; quality of population; and population distribution and human settlements. Since population policy is an integral component of overall economic and social policies, conflicts between objectives of sectoral policies have to be minimized as much as possible. Future options of the population policies were briefly discussed.

Asia↗
PubMed1989

The future of general internal medicine. Council on Long Range Planning and Development in Cooperation with the American College of Physicians, the American Society of Internal Medicine, and the Society of General Internal Medicine.

The American Medical Association Council on Long Range Planning and Development has been publishing a series of reports that assess trends in the environment of medicine and their impact on physicians and health care provision. The Council believes that each specialty in medicine has unique characteristics and will respond differently to changes in the health care arena. This report, developed in cooperation with the American College of Physicians, the American Society of Internal Medicine, and the Society of General Internal Medicine, provides an overview and environmental analysis of the specialty of general internal medicine. The Council first reviews socioeconomic data pertinent to general internal medicine. This is followed by a review of key issues pertinent to internists that relate to such topics as graduate medical education, reimbursement, scope of practice, manpower, and competition. In the conclusions, the Council suggests activities for the medical profession to pursue in response to the identified environmental trends.

Adult↗