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Biomedical subjects

D A Singh

Publications and source records attributed to D A Singh.

7 recordsLinked to original sources
PubMed2000

Predicting turnover and retention in nursing home administrators: management and policy implications.

Administrator turnover and its impact on the quality of patient care are important concerns in the nursing home industry. This study evaluates a model to determine which factors, attitudes, and personal characteristics can predict tenure. Responses to a survey from 290 nursing home administrators (NHAs) who furnished data on their previous positions were analyzed using logistic regression methods. The extracted model correlates tenure with the administrator's past patterns of stability, community attachment, organizational commitment, and facility performance. The model is particularly effective (85% accuracy) in flagging NHAs who are likely to depart within their first 3 years of employment. Implications of these findings for recruitment, retention, and licensure policy are discussed.

Attitude of Health Personnel↗
PubMed1998

Retention of administrators in nursing homes: what can management do?

Annual turnover among nursing home administrators may be 40% or higher. To investigate the factors that could lead to greater administrator retention, responses to a survey (53% response rate) were analyzed using factor analysis and multiple regression models. Results show that higher retention is observed when administrators are allowed to function independently, are involved in decision making, are treated fairly, and are given reasonable goals to achieve. Organizations must hire administrators whose values match theirs. Multifacility chain organizations and for-profit facilities appear to have a greater need to embrace organizational principles that lead to greater job satisfaction.

Factor Analysis, Statistical↗
PubMed1998

Physician practice characteristics and satisfaction: a rural-urban comparison of medical directors at U.S. Community and Migrant Health Centers.

For this study, the association between physician practice characteristics and satisfaction of medical directors at rural and urban Community and Migrant Health Centers (C/MHCs) was investigated. Data for this study came from a 1996 cross-sectional survey of C/MHCs' medical directors. A total of 411 centers (68.3 percent) responded to the survey, including 240 rural (67.4 percent) and 171 urban (68.7 percent) C/MHCs. Factor analysis was used to synthesize physician practice characteristics related to overall satisfaction. The resulting factors were entered as new variables in a predictive logistic regression model of overall satisfaction. Growing up in an inner-city community was significantly associated with practicing in an urban center; whereas, growing up in a rural or frontier community was more likely to result in practicing in a rural center. The majority of medical directors (82.3 percent) were either somewhat satisfied or very satisfied with their work. Satisfaction with work was most significantly associated with overall level of satisfaction, followed by satisfaction with administration, peers and patients. Recruitment efforts are more likely to succeed when they target individuals with prior exposure to underserved areas. Improving the working conditions and interactions with administrators would help sustain the high level of satisfaction experienced by medical directors at C/MHCs.

Community Health Centers↗
PubMed1997

How well trained are nursing home administrators?

Nursing home administrators represent wide variations in academic training. General education levels do not seem to affect administrative preparation in key domains of practice--specific academic fields of study are more relevant. Hence, sole emphasis on higher educational requirements for licensure appears to be a misdirected strategy for improving quality of care and enhancing management efficiencies in nursing homes. Educational paradigms studied have strengths and weakness in furnishing various job skills. These results are helpful in defining strategic actions for addressing both current deficiencies and future training needs. A specialized long-term care model that incorporates appropriate clinical and business skills is recommended. The roles of continuing education and executive educational offerings also need streamlining. These initiatives would require a joint effort from policymakers, academicians, and practitioners.

Educational Status↗
PubMed1996

A comparison of academic curricula in the MPH and MHA-type degrees in health administration at the accredited schools of public health.

Based on a survey of the departments of health services administration in accredited schools of public health, this study presents (1) a profile of the M.P.H. and M.H.A. (and similar) programs concentrating in health administration, and (2) a comparison of the M.P.H. and M.H.A. degrees. All 27 schools currently accredited by the Council on Education for Public Health (CEPH) are represented in this research. The curriculum from each school was broken down and classified into eight components: (1) epidemiology, (2) statistics, (3) accounting/finance, (4) management theory, (5) management application, (6) public health policy, (7) electives, and (8) other. That the M.H.A. programs compared to the M.P.H. programs, have higher course requirements to furnish skills in business management and quantitative/analytical areas is the main hypothesis tested. Statistically significant differences were found in seven of the eight curriculum components for M.P.H. and M.H.A. degrees. Overall, the M.H.A. degree was found to be more rigorous in applied management and analytical courses. Implications and recommendations are discussed.

Accreditation↗
PubMed1988

18th Sir Hans Krebs lecture. Knowledge-based protein modelling and design.

A systematic technique for protein modelling that is applicable to the design of drugs, peptide vaccines and novel proteins is described. Our approach is knowledge-based, depending on the structures of homologous or analogous proteins and more generally on a relational data base of protein three-dimensional structures. The procedure simultaneously aligns the known tertiary structures, selects fragments from the structurally conserved regions on the basis of sequence homology, aligns these with the 'average structure' or 'framework', builds on the loops selected from homologous proteins or a wider database, substitutes sidechains and energy minimises the resultant model. Applications to modelling an homologous structure, tissue plasminogen activator on the basis of another serine proteinase, and to modelling an analogous protein, HIV viral proteinase on the basis of aspartic proteinases, are described. The converse problem of ab initio design is also addressed: this involves the selection of an amino acid sequence to give a particular tertiary structure, in this case a symmetrical domain of two Greek-key motifs.

Base Sequence↗