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PubMedDate not supplied

[Local planning: the speech of basic health care center manager].

As planning is understood as a management tool, this article offers an argument through the speech framework of Basic Health Care Center Managers in the city of Curitiba-PR, by means of the Collective Subject Speech Methodology on local planning aspects. Its purpose is to bring local managers to a reflection concerning their styles, practices and experiences, as well as to collaborate with central level leading teams towards building their planning processes in an upward, participatory, communicative and strategic way. Considerations of the speeches built from central ideas are presented: planning methodology; inter-sectoriality; territorial basis; team and community participation; training, autonomy and particular profile of local managers; the manager's agenda; and institutional culture.

Administrative Personnel↗
PubMed2006

Evaluating the impact of a disease management program for chronic complex conditions at two large northeast health plans using a control group methodology.

The objective of this study was to observe trends in payer expenditures for plan members with one of 14 chronic, complex conditions comparing one group with a disease management program specific to their condition (the intervention group) and the other with no specific disease management program (the control group) for these conditions. The authors used payer claims and membership data to identify members eligible for the program in a 12-month baseline year (October 2001 to September 2002) and a subsequent 12-month program year (October 2002 to September 2003). Two payers were analyzed: one health plan with members primarily in New Jersey (AmeriHealth New Jersey [AHNJ]), where the disease management program was offered, and one affiliated large plan with members primarily in the metro Philadelphia area, where the program was not offered. The claims payment policy for both plans is identical. Intervention and control groups were analyzed for equivalence. The analysis was conducted in both groups over identical time periods. The intervention group showed statistically significant (p < 0.01) differences in total paid claims trend and expenditures when compared to the control group. Intervention group members showed a reduction in expenditures of -8%, while control group members showed an increase of +10% over identical time periods. Subsequent analyses controlling for outliers and product lines served to confirm the overall results. The disease management program is likely responsible for the observed difference between the intervention and control group results. A well-designed, targeted disease management program offered by a motivated, supportive health plan can play an important role in cost improvement strategies for members with complex, chronic conditions.

Case-Control Studies↗
PubMed2006

Conservation planning for ecosystem services.

Despite increasing attention to the human dimension of conservation projects, a rigorous, systematic methodology for planning for ecosystem services has not been developed. This is in part because flows of ecosystem services remain poorly characterized at local-to-regional scales, and their protection has not generally been made a priority. We used a spatially explicit conservation planning framework to explore the trade-offs and opportunities for aligning conservation goals for biodiversity with six ecosystem services (carbon storage, flood control, forage production, outdoor recreation, crop pollination, and water provision) in the Central Coast ecoregion of California, United States. We found weak positive and some weak negative associations between the priority areas for biodiversity conservation and the flows of the six ecosystem services across the ecoregion. Excluding the two agriculture-focused services-crop pollination and forage production-eliminates all negative correlations. We compared the degree to which four contrasting conservation network designs protect biodiversity and the flow of the six services. We found that biodiversity conservation protects substantial collateral flows of services. Targeting ecosystem services directly can meet the multiple ecosystem services and biodiversity goals more efficiently but cannot substitute for targeted biodiversity protection (biodiversity losses of 44% relative to targeting biodiversity alone). Strategically targeting only biodiversity plus the four positively associated services offers much promise (relative biodiversity losses of 7%). Here we present an initial analytical framework for integrating biodiversity and ecosystem services in conservation planning and illustrate its application. We found that although there are important potential trade-offs between conservation for biodiversity and for ecosystem services, a systematic planning framework offers scope for identifying valuable synergies.

Biodiversity↗
PubMed1990

Functional health development model: a tool for planning.

This paper describes a functional model (gross style) taking available information about the health sector e.g. indicators of health status, types of service utilization, source allocations and placing these quantities into a systematic framework as a tool for planning for health services in a developing area. The major advantages of functional models over trial-and-error for planning have been presented. The functional model described could contribute to the sorting out of desirable from less desirable policy alternatives for a specific population. The output from the model is useful for matching resources to program development, taking into consideration costs and effectiveness.

Computer Simulation↗
PubMed1985

Brainstorming: an application for programme planning in family welfare planning.

There have been many participatory devices developed and applied for programme planning in a variety of fields by the social scientists in the recent past, of which brainstorming is one. This device has been widely used in interpretive structural modelling to higher education programme planning, programme planning for housing in urban development, etc. Following these studies, application of brainstorming to develop a preliminary operational value system as a structural model for programme planning in Family planning was attempted. The products of a sequence of three sessions of approximately 5 hours each generated 39 needs, 28 alterables, and 22 constraints, all of which were used to set Family Planning objectives /34/. The objectives thus derived were used in building an intent structure to understand their priorities in plan formulation and eventual implementation.

Communication↗
PubMed1992

A receiver operating characteristic (ROC) curve analysis of a model of mental health services use by Puerto Rican poor.

In this study, the contribution of four distinct domains of the Help Seeking-Decision Making model to predicting the use of mental health services is examined. Using a proposed methodology the authors assess the relevance of this model and its domains to mental services planning. The methodology combines logistic regression analysis and receiver operating characteristic (ROC) curves. Logistic regression analysis allows us to examine the individual variables of the model and generate predictions about use. ROC curves allow us to compare and interpret the relative contribution of a predisposing domain, a physical and mental health domain, an enabling-restrictive domain, and an organizational domain in correctly classifying users and nonusers of mental health services. The physical and mental health domain yielded a Somer's D-statistic of 0.7, which corresponds to an 85% correct classification of randomly selected pairs of users and nonusers. The study findings suggest that comparing ROC curves helps to describe and interpret the domains of the model that are relevant for making predictions about who will or will not use mental health services during a 1-year period.

Adolescent↗
PubMed2002

Ethical issues in the clinical application of fMRI: factors affecting the validity and interpretation of activations.

The ability of functional magnetic resonance imaging (fMRI) to localize activations in a single patient, along with the safety and widespread availability of this methodology, has lead to an increasing use of fMRI for clinical purposes such as pre-surgical planning. As methodology continues to improve and more experience with fMRI in the clinical setting is acquired, clinical functional neuroimaging will likely have an increasing influence over patient care. Therefore, ethical use of fMRI, as with other medical techniques, requires understanding the factors impacting the interpretation of the methodology. Issues affecting the validity and interpretation of clinical functional neuroimaging, including effects of altered hemodynamic response function, head motion, and structural changes in the brain, are reviewed. The distinction between correlated and necessary activation in a clinical context is discussed. Different types of statistical errors in fMRI analysis are described, along with their consequences to the patient. Finally, for the future of clinical fMRI development, the need for normative patient data, as well as standardized tasks, scan protocols, and data analyses, is discussed.

Bioethics↗
PubMedDate not supplied

A review of systematic and quantifiable methods of estimating the needs of a community for alcohol treatment services.

The purpose of this paper was to review a variety of systematic and quantifiable methodologies for planning and evaluating the provision of alcohol treatment services for communities. These methods include: (a) developing and evaluating indicators of alcohol-related harm in and across defined geographic areas, to assess the relative need for services; (b) demand-oriented techniques that involve the prediction of future demand for services based on the previous utilisation of treatment facilities; (c) comprehensive systems approaches to planning services; and (d) the estimation of the prevalence of individuals who need or would benefit from an intervention for their alcohol problem. In practice, service planners may incorporate a combination of approaches that could be compared and contrasted to assess the convergent validity of results. These methodologies can also be used to provide information for planning and evaluating prevention/health promotion and early intervention initiatives.

Alcoholism↗
PubMedDate not supplied

HIPAA and disaster research: preparing to conduct research.

The Health Insurance Portability and Accountability Act (HIPAA), enacted in 1996 and implemented in 2003, continues to have a profound impact on the ability to carry out research. Many disaster research methodologies are not affected by the HIPAA Privacy Rule and are likely to be appropriate for waivers because of the nature of disaster research. Still other types of studies may require special considerations that researchers must be aware of when planning research methodologies.

Confidentiality↗
PubMed1994

How to unlock the benefits of MRP (materiel requirements planning) II and Just-in-Time.

Manufacturing companies need to use the best and most applicable parts of MRP II and JIT to run their businesses effectively. MRP II provides the methodology to plan and control the total resources of the company and focuses on the processes that add value to their customers' products. It is the cornerstone of total quality management, as it reduces the variability and costly activities in the communication and subsequent execution of the required steps from customer order to shipment. JIT focuses on simplifying the total business operation and execution of business processes. MRP II and JIT are the foundations for successful manufacturing businesses.

Commerce↗
PubMed2004

[Medical registries. Benefits and limitations].

Traditionally, registers are understood as tools of epidemiological research. Recently, medical registers have encountered new tasks in quality management and research on medical care. When registers are complete and representative for a target population, they complement the epidemiological and clinical studies that usually focus on specific endpoints using selected study populations. In this process, registers can benefit substantially from the established methodology of planned studies, for instance by application of survey sampling techniques. In order to fulfil the steadily rising expectations, registers have to meet increased methodological standards. Organization and data management should be orientated towards the standards that are meanwhile generally accepted for randomized controlled trials. The evaluation has to go beyond simple descriptive statistics towards complex statistical model building in order to cope with the unavoidable problem of internal validity of comparisons within registers. If registers fulfil these requirements, they are valuable sources of information (that cannot be replaced by other tools) on the spread of risk factors and diseases and on the distribution and usefulness of preventive measures and therapies; general proof of their efficacy should be provided by randomized clinical trials.

Biomedical Research↗
PubMed1975

Septorhinoplasty.

Pathologic, physiologic, and esthetic problems are considered in the patient desiring and needing septorhinoplasty. Usually there is a one stage operation. Unusual circumstances of age, or severe traumatic residuals, may occasionally be better corrected by a two stage operation. Occasional revision of a planned one stage operation is sometimes necessary. The variety of nasal deformities of congenital, developmental, and traumatic origin is multitudinous. Expertise in septorhinoplasty necessitates a methodology and planning of the surgery to bring the nose and face into good esthetic definition as well as satisfactory functional usefulness. Such techniques are described.

Female↗
PubMed1987

Managing the hospital's portfolio of information systems.

Information systems are becoming of such strategic importance that planning for them must not be left to weak selection processes that executives are tempted to avoid diplomatically because of the difficulty and the internal friction that determined management might cause. Presented here is a methodology for planning the evolution of information systems.

Capital Expenditures↗
PubMed2005

Optimizing drug delivery systems using systematic "design of experiments." Part I: fundamental aspects.

Design of an impeccable drug delivery product normally encompasses multiple objectives. For decades, this task has been attempted through trial and error, supplemented with the previous experience, knowledge, and wisdom of the formulator. Optimization of a pharmaceutical formulation or process using this traditional approach involves changing one variable at a time. Using this methodology, the solution of a specific problematic formulation characteristic can certainly be achieved, but attainment of the true optimal composition is never guaranteed. And for improvement in one characteristic, one has to trade off for degeneration in another. This customary approach of developing a drug product or process has been proved to be not only uneconomical in terms of time, money, and effort, but also unfavorable to fix errors, unpredictable, and at times even unsuccessful. On the other hand, the modern formulation optimization approaches, employing systematic Design of Experiments (DoE), are extensively practiced in the development of diverse kinds of drug delivery devices to improve such irregularities. Such systematic approaches are far more advantageous, because they require fewer experiments to achieve an optimum formulation, make problem tracing and rectification quite easier, reveal drug/polymer interactions, simulate the product performance, and comprehend the process to assist in better formulation development and subsequent scale-up. Optimization techniques using DoE represent effective and cost-effective analytical tools to yield the "best solution" to a particular "problem." Through quantification of drug delivery systems, these approaches provide a depth of understanding as well as an ability to explore and defend ranges for formulation factors, where experimentation is completed before optimization is attempted. The key elements of a DoE optimization methodology encompass planning the study objectives, screening of influential variables, experimental designs, postulation of mathematical models for various chosen response characteristics, fitting experimental data into these model(s), mapping and generating graphic outcomes, and design validation using model-based response surface methodology. The broad topic of DoE optimization methodology is covered in two parts. Part I of the review attempts to provide thought-through and thorough information on diverse DoE aspects organized in a seven-step sequence. Besides dealing with basic DoE terminology for the novice, the article covers the niceties of several important experimental designs, mathematical models, and optimum search techniques using numeric and graphical methods, with special emphasis on computer-based approaches, artificial neural networks, and judicious selection of designs and models.

Drug Delivery Systems↗