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At least 145 records · Page 8Linked to original sources
PubMed1997

The development of sport-specific planning, rehearsal, and updating of plans during defensive youth baseball game performance.

The development of planning, rehearsal, and updating of defensive baseball plans was investigated in this study. Thirty-two male shortstops (seven 8-year-olds, eight 10-year-olds, nine 12-year-olds, and eight high school youths) were trained to perform a concurrent talk-aloud procedure before a pitch was thrown to the opposing batter. Participants completed a 40-item baseball knowledge test. Players' ages were highly correlated with their baseball knowledge (omega 2 = .88). Any subsequent age differences reflect differences in players' knowledge. Shortstops ages 12 years or younger frequently did not produce: (a) advanced defensive plans, (b) active rehearsal of plans, or (c) updating of defensive plans. When the young players did produce these strategies, the quality was generally poor; High school shortstops produced all these sport-specific strategies with advanced quality. The younger players' production and quality deficits in sport-specific strategy use may be related to their lack of a highly developed knowledge representation and the types of practice and game experiences they have had playing baseball.

Adolescent↗
PubMed1979

Mental health services: utilization by low income enrollees in a prepaid group practice plan and in an independent practice plan.

Mental health services were included in a comprehensive package of benefits available to low income enrollees in a prepaid group practice plan (PGP) and in an independent practice plan (IPP) under the Seattle Prepaid Health Care Project. There were no out-of-pocket costs for enrollees. Utilization of services was studied for four years under conditions that might simulate universal entitlement. The analyses indicated that females used substantially more mental health services than males and that enrollees aged 20-44 used more services than those in other age groups. The prepaid group practice generally experienced higher utilization than the prepaid independent plan. Significant racial differences were evident with whites using more services than blacks and black males using strikingly few services. The prepaid independent plan was oriented toward physician providers and emphasized individual psychotherapy while the prepaid group practice employed a diversity of practitioners and therapeutic modalities. The data indicated that the per cent of enrollees using any mental health services was twice as great in the PGP as in the IPP. However, once access to the provider system was achieved, the number of services utilized was greater in the PGP. Inpatient services were also examined. A significantly higher proportion of IPP enrollees were admitted for inpatient care as compared to PGP enrollees. Finally, the cost of mental health services was less than ten per cent of total health service costs in both plans.

Adolescent↗
PubMed1983

Out-of-plan use and disenrollment: outgrowths of dissatisfaction with a prepaid group plan.

Two opposing theories have been suggested to describe the relationships among member dissatisfaction with a prepaid group practice (PGP), the choice to go outside for care normally covered by the plan, and disenrollment from the PGP: 1) out-of-plan use--a consequence of dissatisfaction, precedes disenrollment and 2) dissatisfaction produces two independent effects--out-of-plan use and disenrollment. Preliminary results are reported on an evaluation of these relationships based on a sample of 1823 families at the Medical Care Group of St. Louis. Dissatisfaction is found to be the most important predictor of both out-of-plan use and disenrollment. However, no direct relationship exists between the latter two variables. This result lends support for the model, which specifies that PGP members respond differently to dissatisfaction with the plan; some go outside the PGP for their care while others simply disenroll.

Consumer Behavior↗
PubMed2003

The Program Plan Index: an evaluation tool for assessing the quality of adolescent pregnancy prevention program plans.

To assess process, impacts, and outcomes among 45 distinct county teen pregnancy prevention initiatives, several standardized data collection procedures, instruments, and protocols were developed including the Program Plan Index (PPI). The PPI was developed to determine if program plans met legislative requirements and were consistent with best practices in public health program planning and teen pregnancy prevention. Analysis of proposals from 45 counties revealed that 12 county plans were evaluated as deficient, 14 as low, 14 as acceptable, 4 as good, and 1 as excellent. Explanations for overall performance included the following: criteria used to develop the PPI based on an in-depth understanding of best practices, variations in the criteria for county request for proposals, lack of prevention expertise at the local level, and minimal time for grantees to draw down funds. Statewide efforts to improve funded community-based teen pregnancy prevention planning, implementation, and empowerment evaluation efforts are ongoing.

Adolescent↗
PubMed2005

Using policy simulation to predict drug plan expenditure when planning reimbursement changes.

BACKGROUND: Drug plan decision makers need accurate financial impact projections before the implementation of new drug policy initiatives. Tools for such projections need to have small margins of error and be based on methodology that is easy to communicate to stakeholders. Ad hoc methods typically used for financial impact projections by health plans are inadequate. OBJECTIVE: To present a flexible tool for projecting the financial impact of drug policy changes based on historical dispensing data and simulation, and explore its validity using a recent example of a complex drug policy change in British Columbia, Canada. METHODS: A policy simulator (SAS) program using a Web browser interface) was used to produce 3-year forecasts of expenditure (for the drug plan and for individual families) along with the number of patients who would pay more or less for their drugs (stratified by age and income level) for various proposed drug policies starting in 2003. Drug expenditure under each policy was simulated based on projections from prescription claim records of the British Columbia PharmaNet database of community pharmacy prescriptions from 1 January 2001 to 31 December 2001. The simulator selected a random 1% sample of British Columbia families (175,000 families) in the database. Once the new drug policy was selected and implemented, the accuracy of the predictions were tested by comparing the actual PharmaCare expenditure for the period 1 May 2003 to 31 March 2004 after implementation of the new drug policy with the final simulation made for this policy in February 2003, 2 months before the policy was implemented. RESULTS: The policy simulation tool produced hundreds of variations for decision makers in the months before the final policy rules were decided upon. When compared with actual drug expenditure after policy implementation, it was found that the tool had predicted spending with <1% error for the first 11 months after introduction of the policy. As well as producing accurate expenditure forecasts for the insurer, the tool was able to predict how family out-of-pocket expenditure would be affected. CONCLUSIONS: The simulator aided drug policy planning and communication. The tool provided rapid and accurate results that were communicated easily to decision makers. Such policy simulation can be applied to a wide range of health plans and policy changes.

Aged↗
PubMed2002

Outcomes of planned home births versus planned hospital births after regulation of midwifery in British Columbia.

BACKGROUND: The choice to give birth at home with a regulated midwife in attendance became available to expectant women in British Columbia in 1998. The purpose of this study was to evaluate the safety of home birth by comparing perinatal outcomes for planned home births attended by regulated midwives with those for planned hospital births. METHODS: We compared the outcomes of 862 planned home births attended by midwives with those of planned hospital births attended by either midwives (n = 571) or physicians (n = 743). Comparison subjects who were similar in their obstetric risk status were selected from hospitals in which the midwives who were conducting the home births had hospital privileges. Our study population included all home births that occurred between Jan. 1, 1998, and Dec. 31, 1999. RESULTS: Women who gave birth at home attended by a midwife had fewer procedures during labour compared with women who gave birth in hospital attended by a physician. After adjustment for maternal age, lone parent status, income quintile, use of any versus no substances and parity, women in the home birth group were less likely to have epidural analgesia (odds ratio 0.20, 95% confidence interval [CI] 0.14-0.27), be induced, have their labours augmented with oxytocin or prostaglandins, or have an episiotomy. Comparison of home births with hospital births attended by a midwife showed very similar and equally significant differences. The adjusted odds ratio for cesarean section in the home birth group compared with physician-attended hospital births was 0.3 (95% CI 0.22-0.43). Rates of perinatal mortality, 5-minute Apgar scores, meconium aspiration syndrome or need for transfer to a different hospital for specialized newborn care were very similar for the home birth group and for births in hospital attended by a physician. The adjusted odds ratio for Apgar scores lower than 7 at 5 minutes in the home birth group compared with physician-attended hospital births was 0.84 (95% CI 0.32-2.19). INTERPRETATION: There was no increased maternal or neonatal risk associated with planned home birth under the care of a regulated midwife. The rates of some adverse outcomes were too low for us to draw statistical comparisons, and ongoing evaluation of home birth is warranted.

Adolescent↗
PubMed2005

Electronic asthma action plan database: asthma action plan development using Microsoft Access.

We created a user-friendly database for use with asthma management consistent with the national guidelines for asthma. A database was designed by using Microsoft Access for the creation of asthma action plans that can be shared between providers caring for patients with asthma. This database and the use of "form entry" improved documentation of asthma action plans, which are increasingly being used to assess appropriateness of care. We currently have 400 asthma action plans in the database. These action plans can be queried to document compliance with accepted best practices. Asthma action plans can be created and stored in an Access database that is both user-friendly and that can be networked to provide more consistent asthma care.

Asthma↗
PubMed2005

Government plans and farmers intentions: a study on forest land use planning in Vietnam.

In 1998, the Vietnamese National Assembly approved a Five Million Hectare Reforestation Program, (5MHRP) 1998-2010. It would increase forest cover by some 45%, use barren hills, produce wood, and generate socioeconomic development. It would, however, also put demands on Vietnamese planning. Experiences from a former development project and two case studies from a commune and village are used as a basis for analyzing the planning system. The study describes the objectives and strategies of government and farmers in one commune and one village and analyzes how planning data influence scenarios on future development. Official planning data do not reflect reality but are derived through negotiations. In the commune and village studied, it would be difficult for the 5MHRP to materialize, as most of the forest land, officially not yet used, is actually used for food production. The approach and method used by the study offers alternatives to current planning practices.

Agriculture↗
PubMedDate not supplied

[Teaching of pediatrics within the plan of studies for general medicine (plan A-36)].

In this article the author exposes some of the bases about the instruction program of General Integral Medicine (plan A-36); also, he compares the teaching aspects of pediatrics of this plan and the traditional plan, both carried out at the medical School of the National Autonomous University of Mexico. The author points out the best distribution of the pediatric aspects through the medical curriculum, which results in more effective teaching hours, besides, the application of the most current pedagogic and didactic technics in Plan A-36. Also the pediatric clinical practice is performed in more appropriate places and the relation between practice and theory shows more adequate equilibrium than the traditional plan.

Education, Medical↗
PubMedDate not supplied

[Planning and instrumental rationality: an analysis of theoretical production in strategic health planning in the 1990s in Brazil].

This article analyzes recent theoretical production in Brazil on strategic health planning, focusing on instrumental logic. The approach centers on authors who have emphasized theoretical and methodological aspects of strategic planning. Emphasis is on the need to develop a new instrumentality capable of answering dilemmatic questions faced in health issues (professional health workers' efficacy/personal achievement) in order to recover the teleological planning action. The author provides a proposal that considers planning a modulator for the incorporation of technology by health institutions.

Brazil↗
PubMed1991

Planning to plan: the process of success for the future.

Taking the confusion out of the planning process is a challenge for hospital administrators who, in the 1990s, will be called on to reevaluate strategies for both the institution and individual clinical areas. Identifying a planning process that fits the hospital and its management style is as important as producing the plan itself. In the following article, the author discusses the factors and players that must be considered in the planning process.

Hospital Planning↗
PubMed1994

Strategic planning or muddling through? The relevance of the strategic planning process to the hospital sector.

We review some of the main themes in the literature about managerial strategy and strategic planning. Attention is paid to the limitations of strategic planning in the government sector generally and the public hospital system particularly. The alternative to strategic planning--to adapt a stance that is more pragmatic, incrementalist and iterative--is considered. A case study of a teaching hospital's approach to strategy over the last two years is used to provide an empirical complement to the literature analysis. We conclude that the rational planning approach has advantages over the adaptive, iterative approach through the information that it provides to hospital management about the strengths and weaknesses of the organisation.

Australia↗
PubMed1998

Sex ratio associated with timing of insemination and length of the follicular phase in planned and unplanned pregnancies during use of natural family planning.

This was a multicentred, prospective study of pregnancies among women using natural family planning. The women maintained natural family planning charts of the conception cycle, recording acts of intercourse and signs of ovulation (cervical mucus changes, including peak day and basal body temperature). Charts were used to assess the most probable day of insemination relative to the day of ovulation and length of the follicular phase of the cycle. The sex ratio (males per 100 females) for 947 singleton births was 101.5, not significantly different from the expected value of 105. The sex ratio did not vary consistently or significantly with the estimated timing of insemination relative to the day of ovulation, with the estimated length of the follicular phase or with the planned or unplanned status of the pregnancy. Although these findings may be affected by imprecision of the data, the study suggests that manipulation of the timing of insemination during the cycle cannot be used to affect the sex of offspring.

Family Planning Services↗
PubMed1990

Planning for primary health care: the case of the Sierra Leone National Action Plan.

The National Action Plan for Primary Health Care, a planning document of the Sierra Leonean Ministry of Health for the restructuring of the country's rural health services, is analyzed in its social, economic, and historical context. It appears to be an attempt of the national government to gain control over the highly devolved health care delivery system, but the state has neither the political will nor the power to achieve this goal. The utility of the document is therefore in doubt, which raises two important questions: Whose interests does this plan serve, and at whose cost?

Health Planning↗
PubMed2001

Needs-based planning: evaluation of a level-of-care planning model.

With the closure of a number of provincial psychiatric hospitals planned, the Ministry of Health of Ontario has commissioned a series of planning projects to identify alternative placements for current hospital patients. The goal is to match need to care in the least restrictive setting. A systematic, clinically driven planning process was implemented that involved three steps: development of a continuum of levels of care representing increasingly intensive and more restrictive supports, development of criteria and decision rules for placement, and comprehensive needs assessment of current patients using the Colorado Client Assessment Record. Results showed that only 10% of current inpatients need to remain in the hospital, and over 60% could live independently in the community with appropriate supports. Evidence supports concurrent validity of the planning model, but further work is needed to assess whether recommended levels of care effectively meet consumer needs in the least restrictive setting.

Aged↗
PubMed1997

Inverse radiotherapy planning for a concave-convex PTV in cervical and upper mediastinal regions. Simulation of radiotherapy using an Alderson-RANDO phantom. Planning target volume.

AIM: Three-dimensional inverse treatment planning with modulated beams was applied for dosimetric optimization of a lengthy (22 cm) and complex (concave-convex) shaped planning target volume (PTV) in the cervical and upper mediastinal regions. MATERIAL AND METHOD: The planning was done for 9 coplanar beams spaced evenly at 40 intervals. Properties of 15 MV photons from a linear accelerator were simulated. The optimization of the fluence modulation profiles for each beam was based on a definition of the desired/permitted relative dose levels in the PTV and organs at risk, and a definition of the strengths of the constraints to achieve these objectives. RESULTS: An adequate dose delivery to the PTV and protection of the spinal cord are completely achievable. The dose delivered to the lungs is clinically acceptable with respect to the risk of radiation-induced pneumonitis. For reasons of physics, no further decrease in the radiation burden on the lungs can be attained with X-rays without compromising the PTV coverage. The radiation burden on some critical part of normal tissues was effectively reduced by application of a dummy organ at risk. CONCLUSION: The inverse planning is an effective method for conformal radiotherapy of large tumors as well. However, the power of the technique is insufficient when the tolerance dose of the neighbouring normal tissue is too low and its volume effect is high. Although requiring further operator interactions, introduction of dummy organs at risk may be of help in reducing the radiation burden on normal tissues.

Body Burden↗
PubMed1984

Pitfalls in planning: contrasting perspectives on mental health and corporate planning.

Planning is a management activity that has been linked to high quality services, organizational growth, and in austere times, to organizational survival. The present study was undertaken to identify the critical barriers that inhibit or derail effective planning. It was predicted that human service and corporate managers would generally agree about the most and least important planning pitfalls in their systems. Discrepancies would be related to differences in the structural characteristics of organizations in the two sectors. Rankings made by 57 senior mental health administrators of the most and least important pitfalls in planning were contrasted with those of 159 corporate executives. Substantial agreement between the two groups of executives was found.

Analysis of Variance↗
PubMed1991

State-of-the-art of external photon beam radiation treatment planning. Photon Treatment Planning Collaborative Working Group.

A virtual revolution in computer capability has occurred in the last few years, largely based on rapidly decreasing costs and increasing reliability of digital memory and mass-storage capability. These developments have now made it possible to consider the application of both computer and display technologies to a much broader range of problems in radiation therapy, including planning of treatment, dose computation, and treatment verification. Several methods of three-dimensional dose computations in heterogeneous media capable of 3% accuracy are likely to be available, but significant work still remains, particularly for high energy x-rays where electron transport, and possibly pair production, need to be considered. Innovative display and planning techniques, as well as plan evaluation schemes, are emerging and show great promise for the future. No doubt these advances will lead to substantially improved treatment planning systems in the next few years. However, it must be emphasized that for many of these applications a tremendous software and hardware development effort is required.

Computer Graphics↗