Health Management - Science topic

There are 2 methods but step method is the best.  Here is you tube that will assist you...

This question is now closed.

Yes, management support or lack thereof is well documented in the literature, There needs to be "buy-in" from not only management, but also employees. In your business case, which defines the problem, you should lay out the evidence, including any potential monetary loses because of poor quality. 

Thank you all for your answers! Will look into them.

Best regards,

Carlos

Hi Merve - the attached few articles may assist. They relate to nursing - but the principles are 'generic' in terms of workplace health promotion and the workplace as a health-promoting setting.

Good luck with your project,

Dean

Espero te sean útiles

Hello ...

I hope you are useful

The point of triangulation is to compare the results of different studies, so each study should be complete in its own terms. If all three of your interviews are qualitative, then the classic recommendation is to achieve saturation in order to have faith in your results, and you would need to do that in each sub-population.

Dear Dr. Diego M.E.,

See this file may be useful for you.

 Dear Soumitra, thanks for your answer, I suspect my question touched an important topic for you, and I would like to get in a dialogue with you. Could you help me process your comment by writing me in 3-5 key sentences what is your answer to my question? 

Best regards,

Benedek

I'm a supporter of plant-based diets, but Campbell's "China Study" is full of methodological errors and therfore of low scientific value. Take a look at this: http://rawfoodsos.com/the-china-study/

However, there are some evidences that link dairy products with breast and prostata cancer:

1) Qin LQ, Xu JY, Wang PY, Kaneko T, Hoshi K, Sato A. Milk consumption is a risk factor for prostate cancer: meta-analysis of case-control studies. Nutr Cancer. 2009;48(1):22–27

2) Dong JY, Zhang L, He K, Qin LQ. Dairy consumption and risk of breast cancer: a meta-analysis of prospective cohort studies. Breast Cancer Res Treat. 2011;127(1):23–31

Dear Blazenka.

Please, search by Luis Fernando Onuchic or Ita Pfeferman Heilberg in Research gate.

Best regards,

Renato Ferraz

Problem with Yap Ab on kidney lysates. Available from: https://www.researchgate.net/post/Problem_with_Yap_Ab_on_kidney_lysates#592c6c3b615e27b096485d68 [accessed May 29, 2017].

Dear Frieda Mah

You are very lucky; you can choose your favorite job.

For me I am too weak to change anything, I have to earn my life, so I have to fit the world I live.

Liu

Dear Dr. Oglesby,

                            It appears to us from some of our researches jointly and severally that the unit of measurement or medical incidence (Mallick (1998), Mallick, Hamburger, Mallick (2017)) in any public health research has to be population which will define the causality necessary for any "applied genetic or genomics" determined population health biostatistics or String Theoretic analysis of public health management or population health management. You can take a look at some of our research on www.researchgate.net/Soumitra K. Mallick if you wish to.

Soumitra K Mallick

for Soumitra K Mallick, Nick Hamburger, Sandipan Mallick

My dear Academic Friends, I'm working on "architectural design" area, I don't know anything about any researching of engineering area.

Dear Daniel,

Thank you for sharing the special issue on the Population Health Management, a research area of my interest. What is the impact factor of this journal and how open it is to research on public health not directly focusing pharmaceutical topics?

Great！I will be help you maybe

While Prognostics Health Management is an established discipline in engineering, I don't see its application on human being in near future. I would be happy if you explain your intention further. Of course it can be very well applied to the equipment's used in hospitals

Strict regulations and their implementation.

I'm sorry, but I have trouble with a question like this; and you then might wonder why I'm posting an "answer" at all. The reason is that I think, Anthony Nkwankwo, that if you want useful help from the ResearchGate community, you might have said something like the following: "I would like to develop a research topic in the area of administrative management of non-medical staff in government owned health institutions. Here are three possibilities I've considered:............... What do you think would be the pros and cons of these that should lead me to prioritize one of these?" Or something like that.

Dear Amar,

Here are 6 evidence-based ways to lose belly fat.

1. Don’t Eat Sugar… and Avoid Sugar-Sweetened Beverages Like The Plague

Added sugar is extremely unhealthy.

Studies show that it has uniquely harmful effects on metabolic health.

Sugar is half glucose, half fructose… and fructose can only be metabolized by the liver in any significant amount.

When you eat a lot of refined sugar, the liver gets flooded with fructose, and is forced to turn it all into fat.

Numerous studies have shown that excess sugar, mostly due to the large amounts offructose, can lead to increased accumulation of fat in the belly.

Some believe that this is the primary mechanism behind sugar’s harmful effects on health… it increases belly fat and liver fat, which leads to insulin resistance and a host of metabolic problems.

Liquid sugar is even worse in this regard. Liquid calories don’t get “registered” by the brain in the same way as solid calories, so when you drink sugar-sweetened beverages, you end up eating more total calories.

Studies show that sugar-sweetened beverages are linked to a 60% increased risk of obesity in children… per each daily serving.

Make a decision to minimize the amount of sugar in your diet, and considercompletely eliminating sugary drinks.

This includes sugar-sweetened beverages, fruit juices, various sports drinks, as well as coffees and teas with sugar added to them.

Keep in mind that none of this applies to whole fruit, which are extremely healthy and have plenty of fiber that mitigates the negative effects of fructose.

The amount of fructose you get from fruit is negligible compared to what you get from a diet high in refined sugar.

Btw… if you want to cut back on refined sugar, then you must start reading labels. Even foods marketed as health foods can contain huge amounts of sugar.

Bottom Line: Excess sugar consumption may be the primary driver of belly fat accumulation, especially sugary beverages like soft drinks and fruit juices.

Protein is the most important macronutrient when it comes to losing weight.

It has been shown to reduce cravings by 60%, boost metabolism by 80-100 calories per day and help you eat up to 441 fewer calories per day.

If weight loss is your goal, then adding protein to your diet is perhaps the single most effective change you can do.

Not only will it help you lose… it can also help you avoid re-gaining weight if you ever decide to abandon your weight loss efforts.

There is also some evidence that protein is particularly effective against belly fat.

One study showed that the amount and quality of protein consumed was inversely related to fat in the belly. That is, people who ate more and better protein had much less belly fat.

Another study in Denmark showed that protein, especially animal protein, was linked to significantly reduced risk of belly fat gain over a period of 5 years.

This study also showed that refined carbs and vegetable oils were linked to increased amounts of belly fat, but fruits and vegetables linked to reduced amounts.

Many of the studies showing protein to be effective had protein at 25-30% of calories. That’s what you should aim for.

So… make an effort to increase your intake of unprocessed eggs, fish, seafood,meats, poultry and dairy products. These are the best protein sources in the diet.

If you struggle with getting enough protein in your diet, then a quality protein supplement (like whey protein) is a healthy and convenient way to boost your total intake.

If you’re a vegetarian, check out this article on how to increase your protein intake.

Bonus tip: Consider cooking your foods in coconut oil… some studies have shownthat 30 mL (about 2 tablespoons) of coconut oil per day reduces belly fat slightly.

Bottom Line: Eating enough protein is a very effective way to lose weight. Some studies suggest that protein is particularly effective against belly fat accumulation.

Carb restriction is a very effective way to lose fat.

This is supported by numerous studies… when people cut carbs, their appetite goes down and they lose weight.

 Over 20 randomized controlled trials have now shown that low-carb diets lead to 2-3 times more weight loss than low-fat diets.

This is true even when the low-carb groups are allowed to eat as much as they want, while the low-fat groups are calorie restricted and hungry.

Low-carb diets also lead to quick reductions in water weight, which gives people near instant results… a major difference on the scale is often seen within a few days.

There are also studies comparing low-carb and low-fat diets, showing that low-carb diets specifically target the fat in the belly, and around the organs and liver.

What this means is that a particularly high proportion of the fat lost on a low-carb dietis the dangerous and disease promoting abdominal fat.

Just avoiding the refined carbs (white breads, pastas, etc) should be sufficient, especially if you keep your protein high.

However… if you need to lose weight fast, then consider dropping your carbs down to 50 grams per day. This will put your body into ketosis, killing your appetite and making your body start burning primarily fats for fuel.

Of course, low-carb diets have many other health benefits besides just weight loss. They can have life-saving effects in type 2 diabetics, for example.

Bottom Line: Studies have shown that low-carb diets are particularly effective at getting rid of the fat in the belly area, around the organs and in the liver.

Dietary fiber is mostly indigestible plant matter.

It is often claimed that eating plenty of fiber can help with weight loss.

This is true… but it’s important to keep in mind that not all fiber is created equal.

It seems to be mostly the viscous fibers that can have an effect on your weight.

These are fibers that bind water and form a thick gel that “sits” in the gut.

This gel can dramatically slow the movement of food through your stomach and small bowel, and slow down the digestion and absorption of nutrients. The end result is a prolonged feeling of fullness and reduced appetite.

One review study found that an additional 14 grams of fiber per day were linked to a 10% decrease in calorie intake and weight loss of 2 kg (4.5 lbs) over 4 months.

In one 5-year study, eating 10 grams of soluble fiber per day was linked to a 3.7% reduction in the amount of fat in the abdominal cavity, but it had no effect on the amount of fat under the skin.

What this implies, is that soluble fiber may be particularly effective at reducing the harmful belly fat.

The best way to get more fiber is to eat a lot of plant foods like vegetables and fruit. Legumes are also a good source, as well as some cereals like oats.

Then you could also try taking a fiber supplement like glucomannan. This is one of the most viscous dietary fibers in existence, and has been shown to cause weight loss in many studies.

Bottom Line: There is some evidence that soluble dietary fiber may lead to reduced amounts of belly fat, which should cause major improvements in metabolic health.

Exercise is important for various reasons.

It is among the best things you can do if you want to live a long, healthy life and avoid disease.

Getting into all of the amazing health benefits of exercise is beyond the scope of this article, but exercise does appears to be effective at reducing belly fat.

However… keep in mind that I’m not talking about abdominal exercises here. Spot reduction (losing fat in one spot) is not possible, and doing endless amounts of crunches will not make you lose fat from the belly.

In one study, 6 weeks of training just the abdominal muscles had no measurable effect on waist circumference or the amount of fat in the abdominal cavity.

That being said, other types of exercise can be very effective.

Aerobic exercise (like walking, running, swimming, etc) has been shown to cause major reductions in belly fat in numerous studies.

Another study found that exercise completely prevented people from re-gaining abdominal fat after weight loss, implying that exercise is particularly important during weight maintenance.

Exercise also leads to reduced inflammation, blood sugar levels and all the other metabolic abnormalities that are associated with central obesity.

Bottom Line: Exercise can be very effective if you are trying to lose belly fat. Exercise also has a number of other health benefits.

What you eat is important. Pretty much everyone knows this.

However… surprisingly, most people actuallydon’t have a clue what they are really eating.

People think they’re eating “high protein,” “low-carb” or whatever… but tend to drastically over- or underestimate.

I think that for anyone who truly wants to optimize their diet, tracking things for a while is absolutely essential.

It doesn’t mean you need to weigh and measure everything for the rest of your life, but doing it every now and then for a few days in a row can help you realize where you need to make changes.

If you want to boost your protein intake to 25-30% of calories, as recommended above, just eating more protein rich foods won’t cut it. You need to actually measure and fine tune in order to reach that goal.

Hoping this will be helpful,

Rafik

Worker participation is also considered as a major shift. Worker can assist in the formation and implementation of the OSH management plan, enhance commitment etc.

This is the EU-OSHA guide:

Hafiz, I don't understand your question. Could you kindly elaborate as to the basis for your question? It is too vague.

At this time, I do not believe we can isolate one element at a time...it diverts focus, energy, and resources. There is a fundamental lack of health literacy at the participant level. In the US especially at this time, it is critical to engage one community at a time, enlisting the participation of all stakeholders including participants, and the specific health drivers affecting that community. The tools, human capital, and technology exist to facilitate this transformation towards more preventive and chronic condition management through healthy lifestyle behavior change, however. It begins with education, consistently, and continually from all stakeholders all the time. There is no one pill or widget that will satisfy all the requirements. Identify the needs of your community and for population health management's sake, identify the elements that both practitioners and participants will recognize and participate within for successful impact and ultimately outcome. Respectfully, Ken

Sorry, I forgot: As a second idea I would search with the key word "Management of Hospital Mergers" in Google Scholar. Your will find there a bonanza as well.

I am not an expert in healthcare only an interested researcher in understanding and solving problems in this critical area.  My expertise lies in something called “theory of constraints (TOC)”.  While it sounds horribly complex TOC is quite simple and easily applied.  In TOC we use the five focusing steps to continually improve a system‘s ability to produce goal units (in your case treated patients).  The five focusing steps are one of three processes on ongoing improvement (buffer management, frequently used in healthcare, and the change question sequence are the other two processes.). These five focusing steps are:

1. IDENTIFY the system's constraint(s).

2. Decide how to EXPLOIT the system's constraint(s).

3. SUBORDINATE everything else to the above decision.

4. ELEVATE the system's constraint(s).

5. WARNING!!!! If in the previous steps a constraint has been broken, go back to step 1, but do not allow INERTIA to cause a system's constraint.

I recently coauthored (Cox, Robinson, Maxwell; Sept/Oct 2014) an article in the Journal of Family Practice Management illustrating the application of these steps to an 11-provider practice.  I recommend this article if you want to see how to apply this focusing process in healthcare.  It is a quite simple example; just common sense. 

In your case the market (the patients coming into the emergency room) is the constraint most of the time.  Normally you are able to treat incoming patients in a standard manner.  BUT then you occasionally have overloads where you use up the protective capacity of the emergency department and a backup of untreated patients occurs.  Some of this backup occurs because there is no place to offload treated patients immediately so that the provider can move to the next untreated patient.  This situation might be caused by the hospital’s focusing on minimizing staffing in hospital wards to save money.   The TOC solution would be to add a space buffer behind the constraint (between the emergency department and the specialized wards (the UK system calls this department an assessment ward, a holding area as such).  Treated patients are released to this space buffer where trained staff (maybe some removed from the specialized wards) manage patient care until the treated patients are transferred to the wards.  This approach allows emergency department providers to focus on incoming patients instead of managing already treated patients until they can be transferred to wards thus increase the capacity of the emergency room. In academic terms this space buffer aggregates the statistical fluctuations of the various wards thus having less deviations (reduced standard deviation at the assessment ward than at the sum of the specialized wards).  

Several presentations of the TOC basic concepts and applications of the concepts in various industries are available on the TOCICO (Theory of Constraints International Certification Organization) website for free viewing.  See specifically the healthcare portal web link listed below:

There are seven videos available on this link for free viewing.  An annotated bibliography of healthcare presentations is available on this link also.  

Another related link to TOC in healthcare is provided by Alex Knight (also describes his work on the TOC link above) .  Alex has been implementing TOC in emergency rooms, hospitals and the healthcare supply chain for two decades.  He has been able to move hospitals as measured by responsiveness from the bottom of 500 hospitals to the top 10 in a matter of a few months.  He recently authored a novel (Pride and Joy) describing the application of TOC in hospitals (Similar to Eli Goldratt’s The Goal did in manufacturing in the 1980’s). Alex’s consulting organization provides significant educational materials on TOC in healthcare.  This link below is to articles on applying TOC in healthcare.  On the left of this page below are links to case studies (mostly hospitals) and testimonials.

More generally TOC is a management philosophy that focuses attention on the constraint (the leverage point) in any system and how to increase system throughput.  It is not a cost-cutting approach and provides better responsiveness and healthcare.    

I hope this is helpful.  Jim

From the hospital organization point of view you can divide the elective patients from the emergency/urgent patients assigning to these a certain number of beds (about 10% of the total hospital beds).

If hospital space constrain doesn't permit so, check the LoS and the BOR (and benchmark them) to see if is a inefficiency or a structural problem. Tthe last one can't be solve easly, the first is a EBM/GL approach problem.

This will depend on the country and in countries like the US will depend on what insurance one has. So you would need very specific information to look up the answer for one person.

We have developed a program that can 1. assess, 2. Provide an intervention 3. reassess and 4. report. We have recently published on the same.

That is good experience. For  diagnosis, xray lateral view nasopharynx, or better CT scan both coronal and axial is sufficient. Also endoscopic examination, is very helpful in preoperative diagnosis. To treat : endoscopic endonasal surgery is the gold standered for both choanal and nasopharyngeal adenoids, may be assisted with palatal retraction a d digital palpation to cobfirm complete removal.

Its depends on what goal do you want to achieve.

If you are up to managing operational of bio lab then you can attend operational management as it typical of bio graduate.

If you want to know how to handle and assess team of people than you can go to human resources management.

If you want to know how to market product go to marketing management.

If you want to have knowledge in strategic planning go to strategic management.

It go back to your interest and what do you want to have or achieve.

Definitely David, research about impact is always important, and there are also many variations within practice, in both countries. It would be great to read about the protocol for what you will evaluate and why...

sharon

1. I am not convinced that "accurately" and "estimate" should be used in the same sentence.

2. No, I haven't seen any new formulas for this particular problem, but it is an issue similar to predicting plasma concentrations of drugs when using exponential-based algorithms in syringe pumps. It relates to the ratio of fat to total body weight. There have been a number of ways of dealing with this that are accessible to internet search.

However, it boils down to how "accurate" you want your "estimate" to be. Bearing in mind that your lab blood Hb can be as much as 10 to 15% inaccurate, there doesn't seem to be a lot of point in obsessing about more accurate estimates of blood volume.

If you're stuck in a rural clinic and you can only measure height and weight, and the latter is going to give you a misleading answer, you're really only left with height.

What you are sort of saying is that blood volume does not relate to weight when the body weight is outside the "ideal" range of body weight, which varies with height. What you need to use to calculate blood volume outside this range is not the patient's actual weight, but what it should be.

Just roughly eyeballing the ideal body weight charts based on the Quetelet  formula, and extracting the weight ranges associated with "normal" BMIs in the range of 18.5 to 25 (heights 1.5 to 2 m) also gives you an average weight within that range.  Using these average weights with the Nadler formula gives you the average blood volume for each height. Linear regression on the data (R² 0.9996) gives you an approximate relationship of (6100 x body height in metres) - 5500. 

Applying the process to the outer ranges of normality for weight suggests that using the average weight for each height will be =/- 15% accurate for the range.

Is that an "accurate" enough "estimate" for you?. 

for general risk management you can check this one http://www.crosstalkonline.org/storage/issue-archives/2005/200502/200502-0-Issue.pdf

Neumann (2007) studied the problem from a different facet. . For instance, the problem is also about safety and continuity of human activities. I am not very sure that work of Neumann can be helpful for you. But anyway, you can find this author work at

may be it is helpful for you.

Hi Rajakumar,

I think 1st you have to check low yield and high yield soil parameters, such as pH,N,P,K, microbial flora (pathogenic and beneficial ).

accordingly improve that parameters in low yield plots,

so it may help to manage health of soil and fertility.

It gets even worse...how do you feel confident that patients responding as 'satisfied' in a survey are actually 'satisfied' in the common garden variety sense of the term? In the mid-1990's, several key publications reviewed the major methodological challenges of patient satisfaction surveys:

Carr-Hill, R. A. (1992). The measurement of patient satisfaction. Journal of Public Health, 14(3), 236-249.

Williams, B. (1994). Patient satisfaction: a valid concept? Social Science & Medicine, 38(4), 509-516.

Sitzia, J., & Wood, N. (1997). Patient satisfaction: a review of issues and concepts. Social Science & Medicine, 45(12), 1829-1843.

When you look at the problems with measuring patient satisfaction, it is no wonder we get 'puzzling' results, never mind the truth that others have pointed out between technical definitions of 'quality care' and patient understandings.

one of the symptoms of shock (traumatic stress?) in humans is "...cool, clammy skin..." , which indicates that the phenomenon certainly exists.

Each organissation develops their own clinical guidelines. Depending on your research you should target each country and the national organisation in charge of developing the guidelines. For Spain you can find the information on this website: :http://portal.guiasalud.es/web/guest/guias-practica-clinica. they collect all the different clinical guidelines developed by the different regional governments (17 in Spain), so usually if they exist you can find them on this website, if not I;m afraid that you should contact each autonomous community  one by one.

You could contact Guia Salud (through the website)and ask if they keep track of old guidelines.

For European Countries having different regional health governments (Germany, Italy) you will probably face the same problems of non-centralised information.

For UK, they use the guidelines of NECP , ATP III, as mentioned ,through the NIH you can find them easily on their website, the one I found is from 2002 and I also  found an 2004 update in an interesting  article: http://www.nhlbi.nih.gov/files/docs/guidelines/atp3upd04.pdf    ,page 237

It could be a matter of pointing to the right research, and emphisising the need for patient-centred models of care. This is an excerpt from a report written by our firm, MAAP:

COMPLIMENTARY AND ALTERNATIVE MEDICINE: Children's Memorial Hospital in Chicago, Mayo Clinic, Duke University Medical Center, and the University of California, San Francisco and all the top 18 ‘honour roll’ hospitals in the US News Best American Hospitals list offer optional and additional complimentary and alternative medicine of some sort now including acupuncture, massage, reiki, yoga and other therapies (Moisse 2011). The driver for these services is primarily consumer demand, but as models of care progress toward better patient–centredness, consumer demands only get more salient. Therapists are most often nurses, but may also be specialist therapists or physicians (Cotton, Luberto et al. 2013).

Although many health professionals still think of such approaches as some kind of voodoo, an increasing number recognise their importance on the basis of real evidence. A recent study in US and Canadian paediatric hospitals showed that more than half the children (n=519, av age 10 yrs) who received alternative therapies reported very significant reductions in pain (average reductions of 34%), more than 75% showed very significant responses (-70%) in observed pain measurements (children are frequently too young to be able to express themselves fluently). Most of the children being treated were suffering from pain associated with cancer or cystic fibrosis (Cotton, Luberto et al. 2013).

Recommendations: • Provide specialisation and space (where required) for complimentary and alternative therapies. • Encourage a hospital culture that accepts the ethnic, personal and cultural needs and choices of patients.

reference: Smith, Mungo, Golembiewski, Jan, & Hyunh, Alison. (2013). Westmead Health Precinct: An International Review of Optimal Sizing of Children’s & Acute Hospitals. Report prepared for: NSW Health Infrastructure. Sydney. 

citations: 

Cotton, S., Luberto, C. M., Bogenschutz, L. H., Pelley, T. J., & Dusek, J. (2013). Integrative Care Therapies and Pain in Hospitalized Children and Adolescents: A Retrospective Database Review. J Altern Complement Med. doi: 10.1089/acm.2013.0306

Moisse, Katie. (2011). U.S. News and World Report Ranks Nation's Children's Hospitals. ABC News.

Interesting questation.

Hello!

it depends on the content of the tool that you have selected. Basically the tool is made considering the target population. If the illiterate population has to be included, a picture based tool could be useful. The numbers of hours of sleep one had had could be marked in the specified box or space denoting the 

Health management - as any profession encompassing multiple disciplines and integrating technology, people and physical space - is not only complicated but fraught with occasions to be exposed to various legal liabilities. Successful health managers need the ability to manage health risk well. They must anticipate the most likely health problems and protect the clients'  interests in such a way that their health (plus status) can be guaranteed and safe (confidential), yet productive for business purposes. The Health managers must therefore know the major legal rules of risk avoidance, including knowledge of possible legal obstacles.Legal Concepts for health Managers inform them of their legal responsibilities and help them avoid unnecessary exposure to liability. I hope this will guide you further.

Dear Natasa,

For building concepts the paper, published in American Marketing Association in 1985, may help you, http://www.jstor.org/stable/1251430?seq=1#page_scan_tab_contents

http://blog.verint.com/service-quality-gap-model.

Note that the work is not related to health care management. Nonetheless, you can go over the article to gain some ideas.

Unfortunately, I dont find any articles that narrate SQG model including health cards system.

I recommend you to follow the below article dealing with `Measurement of traveler expectations versus service gaps — The case of general aviation services in Aruba` .  You can implement the same in healthcare logistics.

Hope this helps you to look forward.

Regards,

Syed

There are many available article on health management and opinion of health professessional, for example are the attached documents

Health systems across the European Union  are managed in very different

ways. This report focuses on the role of local and regional authoritieswithin these systems in terms of power and responsibility, from the issuing of

legislation to policy development, implementation and funding.

The big difference is the focus of the education. The health management students focus on the management of health systems and health organisations which is fundamentally different from medical professions whose focus is on treatment/care of patients and/or research. Medical professions are often highly specialized in one or a few closely related fields. Health management professionals are broader trained.

I think the confusion comes from the fact that both groups are highly educated. If you compare it to other industries, the difference becomes much more clear: the management of big construction companies are often trained managers in the field of general management or finance. Very few CFO's in construction companies are craftsmen like carpenters.