Industrial changes and its significance for the occupational therapist.
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Occupational Therapy↗
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An empirical examination of shift strategies in the service industry: how hospitals adapt to industry change.
Research on the ability of firms to select different strategies in an effort to shift their strategic position has focused almost entirely on the mature manufacturing industries. In this paper, we propose that the relationship of strategy selection in manufacturing extends to the service industry, and test this proposition in one very visible faction of the service industry, health care. The results of this study show that health care organizations use both operational and strategic shift strategies to adjust to new environmental conditions.
Analysis of Variance↗
We'd manage to care more if industry changed its name.
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Managed Care Programs↗
Some factors influencing the duration of morbidity in industry. Changing patterns of morbidity.
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England↗
[N-hexane-induced polyneuropathy in the shoe and leather goods industry. Changes in the clinico-epidemiologic picture in the face of partial primary prevention measures].
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Air Pollutants, Occupational↗
Profitability: comparing hospital results with other industries.
Changes in healthcare economics now permit more meaningful financial comparisons between hospitals and other industries. A study focusing on return on equity and other financial ratios highlighted critical changes needed to improve the fiscal health of hospitals. These suggestions include increasing net prices on existing product lines, entering new markets, using short-term debt to relieve long-term debt burdens, and expanding uses of operating leases.
Financial Audit↗
The drug lag revisited: comparison by therapeutic area of patterns of drugs marketed in the United States and Great Britain from 1972 through 1976.
This study describes rates and patterns of new drug introductions in the U.S. and Britain from January, 1972, through December, 1976, updating an earlier study that described the patterns over the previous decade. This comparative international approach enables overall effects of different regulatory, industrial, and other types of changes in drug research and development in the two countries to be evaluated. Numerical differences persisted. In the 1972 to 1976 period, 82 new drugs appeared for the first time in either country. Only 29% of these became mutually available in both countries, 2.4 times as many becoming available first in Britain as in the U.S. Of the 71% that became exclusively available, 2.6 times as many became available in Britain as in the U.S. More important than numerical data are clinical implications of differences between the countries. The largest differences have narrowed since the previous study, but important categories in which the U.S. still lagged behind Britain in December, 1976, included cardiovascular drugs, peptic ulcer drugs, and central nervous system drugs--including therapies for depression, epilepsy, and migraine. Several factors contributed to the narrowing of U.S.--British therapeutic differences, including more realistic regulatory practices and higher quality clinical studies in the U.S., more conservative practices in Britain, attention drawn by previous studies to anachronisms in the U.S., and industrial changes such as more efficient penetration of the U.S. market by foreign firms. It is difficult to determine the relative contribution of each of these factors to the narrowing of the international difference.
Analgesics↗
Some comments on the occurrence of multiple sclerosis in the Faroe Islands.
Some factors which might be related to the marked increase in multiple sclerosis in the Faroe Islands in mid-century were studied. Of these, only the occupation by British troops in World War II was found to be significant. A vague relationship with industrial changes earlier in the century was also found. These findings are discussed with caution with respect to the close association between population on the one hand and all features tested as well as multiple sclerosis on the other.
Denmark↗
Integrating knowledge-based technology into computer aided ventilation systems.
A knowledge-based decision support system for respirator treatment, the KUSIVAR system, has been designed in cooperation between hospital, university and industry. Changes in patient data from respirator and monitoring equipment trigger a computer program that generates advice to the staff concerning e.g. therapy modes and respirator settings using expert systems and process control technology. A prototype has been built on an advanced development workstation, the Unisys Explorer, using the software Knowledge Engineering Environment (KEE). The clinical version is implemented on an Intel 80396-based microcomputer connected on-line via a data-acquisition processor to the respirator. The decision support software is implemented as a module under the Microsoft Windows multitasking environment and communicates with modules for data acquisition, database handling and data presentation by means of message passing using the Windows Dynamic Data Exchange protocol. The modules present coherent user interfaces by conforming to Microsoft Windows standards. The knowledge base is being extensively validated by an expert group in the ICU and the system will be evaluated through animal experiments and clinical studies.
Computer Systems↗
Potential dilemma: the methods of meeting automotive exhaust emission standards of the clean air act of 1970.
This review attempts to provide an overview of the interconnected industrial changes associated with compliance with the exhaust emission standards of the Clean Air Act of 1970. To understand the complex nature of air pollution problems, Federal legislation, and compliance with this legislation requires an understanding of automotive technology, petroleum refining, atmospheric chemistry and physics, economics, and public health. The endeavors of all of these different areas impinge to a greater or lesser extent on the final response to the Clean Air Act which is designed to safeguard public health. This overview begins by examining gasoline refinery practice and gasoline composition. Included in this discussion are average values for trace contaminants in gasoline, and an explanation of the function of the many gasoline additives. Next, exhaust emissions are characterized, average values of exhaust components given, and a summary of important atmospheric air pollution reactions presented. Emission control devices and sulfate emissions from these devices are described. This is followed by a complete discussion of methyl cyclopentadienyl manganese tricarbonyl, a substitute antiknock for tetraethyllead. In the event TEL is legally banned from gasoline, or removed because it poisons the catalytic muffler surface, this manganese antiknock is the most efficaous replacement. In this discussion, the adverse health effects caused by exposure to manganese oxide particulates, the possible exhaust emission products from this additive, are examined in detail. The review concludes with comments on automotive engine and gasoline composition redesign as an approach to automotive air pollution.
Air Pollutants↗
Social and environmental factors in lung cancer mortality in post-war Poland.
Poland and other Eastern European countries have undergone heavy industrial development with marked increases in air pollution and occupational exposure in the nearly 50 years since World War II. These countries have also experienced substantial increases in chronic disease mortality in the past three decades. While it is tempting to assume a direct association between these phenomena, more detailed analyses are called for. Poland offers a potentially rich opportunity for comparing geographical patterns of disease incidence and of industrial change. In this paper we 1) elucidate the prospects for attributing lung cancer mortality to industrial emissions in Poland, using an ecological approach based on the hitherto unaddressed geographic differences, and accounting for regional differences in cigarette consumption; 2) propose explanatory hypotheses for the observed geographic heterogeneity of lung cancer; 3) begin systematic testing of the widely accepted but not well-scrutinized notion that pollution in Poland is a major contributor to declining life expectancy. Regions with the highest fraction of cancer that cannot be explained by smoking appear to be highly urbanized, have high population exposure to occupational carcinogens, experience the highest rates of alcoholism and crime, and are associated with the post- World War II population resettlement. Although the analysis does not rule out pollution as a significant contributor to lung cancer mortality, it indicates that other factors such as occupational exposures and various social factors are of at least comparable importance.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Health insurance and outcomes: comprehensive assessment of health system outputs.
Outcomes analysis in health care has historically meant the examination of clinical results of inpatient hospitalization. In response to climbing health care and health insurance costs, the organization of health care providers, the location of service delivery and reimbursement mechanisms have changed. As the health care industry changes, so too must the definition of outcomes. This article presents a conceptual framework for the analysis of health outcomes as health industry outputs, with an emphasis on the ways in which such outputs are being assessed and improved.
Financial Audit↗
Nursing home reform: five years later.
In 1987 Congress enacted landmark legislation designed to overhaul federal oversight of the U.S. nursing home industry. Changes included creation of a "bill of rights" for residents, a new outcome-oriented inspection system, and new staffing requirements. Five years later, despite delays in the issuance of necessary regulations, portions of the law have succeeded in improving the quality of life of the estimated 1.5 million elderly and disabled American confined to a nursing home.
Aged↗
Special report. Managers jumping into new healthcare models to survive hospital industry downsizing.
The rise of managed care and risk-sharing reimbursement have hospitals shedding personnel and banding together with other providers to protect margins in the face of plummeting occupancy rates. Those forces are taking their toll on the middle levels of hospitals' administrative structures. For many hospital managers, integration and reform promise uncertainty and unemployment. How can hospitals cushion the painful blow to mid-level management? And where do managers look when restructuring leaves them out of a job? Early communication and strong support structures are crucial to easing an organization through a difficult downsizing, one hospital found. For downsizing's management casualties, industry changes are creating opportunities outside the traditional hospital management structure, executive employment experts say.
Communication↗
Hospital-physician relations: the recruitment perspective.
One of the biggest problems in the health care industry today is the supply and demand of physicians. As health care organizations scramble to recruit physicians for vital positions, they find themselves in a highly competitive and exhausting battle. As the health care industry changes, so do the needs and desires of physicians, especially young physicians. The heart and soul of a good recruitment program must include understanding who physicians are and what motivates them, selecting the right candidate, and most importantly, retaining them once you have gone to the time, expense, and heartache of recruiting them. Understanding how integrated systems can deal with these factors in the most effective and efficient way is key to surviving and thriving in an era of health care reform.
Economics, Medical↗
Home health care: occupational health issues.
1. Although much work has been done to identify occupational risks to health care workers in institutions, little has been done to describe such risks in the growing home care industry. Changes in the nature of home care suggest the risks may be equivalent, with additional risks from the variable environment of the home. 2. Directors of home care agencies in Northern California were surveyed with respect to the nature of home care, workers, characteristics of occupational programs, and common illnesses and injuries. Musculoskeletal injuries were the most common occupational injuries reported. 3. Despite legislation and accreditation standards, occupational programs in home care agencies are incomplete. Further work is needed to determine the relationship between the presence of occupational health programs and home health care outcomes.
California↗
[The beginning of psychology as a profession in Argentinian universities].
Two characteristics of professional psychology in Argentine are interesting for historians. On the one hand, the omission of the large past of scientific psychology that began at the end of last century. On the other, the omission of the most recently beginning of professional psychology on '50. In this paper, we point out some political features of the process of psychology's professionalization around those latter years. The main subject of this paper, are the studies of psychology at Tucuman and Cuyo universities, on '40 and '50. In those years, the social and industrial changes in the country, leads to new problems of adaptation to job and to environment. Those subjects and the old problems of psychological aspects in school, pave the way for the new needs of psychological profession in all the country.
Argentina↗
Re-emergence of malaria in India.
Malaria was nearly eradicated from India in the early 1960s but the disease has re-emerged as a major public health problem. Early set backs in malaria eradication coincided with DDT shortages. Later in the 1960s and 1970s malaria resurgence was the result of technical, financial and operational problems. In the late 1960s malaria cases in urban areas started to multiply, and upsurge of malaria was widespread. As a result in 1976, 6.45 million cases were recorded by the National Malaria Eradication Programme (NMEP), highest since resurgence. The implementation of urban malaria scheme (UMS) in 1971-72 and the modified plan of operation (MPO) in 1977 improved the malaria situation for 5-6 yr. Malaria cases were reduced to about 2 million. The impact was mainly on vivax malaria. Easy availability of drugs under the MPO prevented deaths due to malaria and reduced morbidity, a peculiar feature of malaria during the resurgence. The Plasmodium falciparum containment programme (PfCP) launched in 1977 to contain the spread of falciparum malaria reduced falciparum malaria in the areas where the containment programme was operated but its general spread could not be contained. P. falciparum showed a steady upward trend during the 1970s and thereafter. Rising trend of malaria was facilitated by developments in various sectors to improve the national economy under successive 5 year plans. Malaria at one time a rural disease, diversified under the pressure of developments into various ecotypes. These ecotypes have been identified as forest malaria, urban malaria, rural malaria, industrial malaria, border malaria and migration malaria; the latter cutting across boundaries of various epidemiological types. Further, malaria in the 1990s has returned with new features not witnessed during the pre-eradication days. These are the vector resistance to insecticide(s); pronounced exophilic vector behaviour; extensive vector breeding grounds created principally by the water resource development projects, urbanization and industrialization; change in parasite formula in favour of P. falciparum; resistance in P. falciparum to chloroquine and other anti-malarial drugs; and human resistance to chemical control of vectors. Malaria control has become a complex enterprise, and its management requires decentralization and approaches based on local transmission involving multi-sectoral action and community participation.
Disease Outbreaks↗