[Advanced training in the development of human resources. Contributions to a strategic planning methodology for human resources in health].
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Efficient organization of the workflow in a reference laboratory is essential to timely resolution of serological problems. This study investigated the usefulness of network planning methods to streamline workflow in a blood center reference laboratory. The investigation of a patient serological problem which included a positive direct antiglobulin test was chosen for analysis. Individual steps in the resolution process were identified. All possible logical sequences of these steps were investigated to determine which steps were along the 'critical path', the sequence of steps which is rate-limiting. By implementing new procedures for these steps, faster resolution of a problem should result. The Program Evaluation Review Technique predicted that altering procedures to shorten 3 steps (autoadsorption, antibody identification panel at 37 degrees C and screening for antigen-negative units) would result in a decrease in the time required to complete a patient problem by 29%. Time-motion studies documented a 35% improvement in problem resolution time with the new procedures (p greater than 0.05). Utilization of the network planning techniques in an immunohematological laboratory may allow for more efficient and expedient operation.
This article summarizes a new methodology recently developed by the Rand Corporation which permits health planners to assess the impact of the local health care system on the health status of the population. The methodology, in algorithm form, should assist health planners in developing objectives and actions related to the occurrence of selected health status indicators and should be amenable to health care interventions. Emphasis has been placed on developing a simplified, approximate analysis that health planners will find both feasible and effective. No detailed mathematic analyses are called for. The data required are, in most instances, readily obtainable. The algorithm is a methodology by which HSAs can investigate determinants of health status, identify breakdowns in the health care system, and specify needed improvements in the system. The goal of these algorithms is to assist HSAs to obtain valid and sufficiently detailed data that will provide a basis for monitoring breakdowns in the health care system and to improve planning decisions aimed at preventing such breakdowns. This should, in turn, affect population health status in the planning area.
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Diabetic foot is considered one of the most threatening and disabling complications for a diabetic patient: lesions of the extremities can become so severe that the person may risk the amputation of the toe, foot or leg. Methodology of planning and implementation of an educational intervention for the prevention of the diabetic foot is presented in its various steps: from the identification of priorities and contents to the problems and difficulties encountered in the implementation of the program.
The existing usage of information technology for information systems in hospitals draws attention to the fact that: (a) health care units which operate sophisticated numerical instrumentation to support medical activities rarely employ computers for the management of their operations and (b) despite the availability of affordable information technologies (microcomputers, networks, etc.), few hospitals include such elements as health care unit management in the development of their information systems portfolio. Is this paradoxical situation a result of the planning methodologies or of factors affecting their use? Or can it be attributed to the failure of present planning methodologies to incorporate the diversity of computerization approaches of the various stakeholders involved? If this is the case, untapped potential computerization possibilities exist that could lead to the development of hospital services and increased organizational efficiency.
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In developing countries in general, malnutrition has been widely reported as a major public health problem. Most of morbidity and mortality in these countries especially in the under fives are attributed to nutritional deficiencies at least in part. However, documentation of malnutritional problems in these countries is inadequate for monitoring, planning and coordination of control programmes. The data that is collected in few instances where this is accomplished is insufficient for a meaningful analysis. This paper suggests some simple epidemiological techniques which could be routinely employed using the existing health personnel to monitor and document temporal trends and types of data required for useful understanding of the problem.
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Structured group interaction, through an emphasis on pre-group structuring, didactic presentations, experiential learning, and evaluation, provides a flexible approach to achieving a variety of goals while compensating for many of the problem characteristics of an aged institutionalized population. Structured groups are characterized by adherence to a rigorous intervention planning methodology, with a high degree of pre-planned group structure, explicit behaviorally stated performance goals, and a concern for transferring group behavior to everyday settings. After a consideration of literature support and some of the limitations and hazards involved in the approach, it is concluded that structured groups represent a useful tool for the applied gerontologist.
Using a planning methodology and a structured design technique for analyzing data and data flow, information requirements can be derived to produce a strategic plan for a management information system. Such a long-range plan classifies information groups and assigns them priorities according to the goals of the organization. The approach emphasizes user involvement.
A treatment planning methodology was developed to investigate the invariant kernel form of conformal therapy proposed by Brahme. Three-dimensional dose distributions were calculated by convolving a rotationally symmetric, invariant kernel with weighting distributions. Fourier transform convolution techniques implemented on an array processor were used to achieve high calculation speeds, thereby allowing iterative techniques in the spatial and frequency domains for computing dose distributions that asymptotically approach a desired dose distribution. To use rotationally symmetric kernels, the generality of the solution is traded for a fast, deterministic, inverse planning approach. The limitations imposed on the dose distributions by this loss of generality are characterized and tentative conclusions are drawn about the potentials and limits of clinical application of this form of the methodology. Further developments of the concept are suggested.
Procedures proposed to present a methodology for planning relevant health education curriculum included having students write out questions they felt their peers had about health in the specific content areas of community health, consumer health, diseases, drugs, alcohol, and tobacco, ecology, family life, nutrition, mental health, personal health and safety and first aid. A sample survey was presented where 80 junior high school students wrote a total of 981 questions and 74 senior high school students wrote 786 questions. Implications for the health education curriculum would be as follows: (1) Curriculum can be made relevant if the specific content covered is directly related to problems of daily living: (2) Provide needed cognitive information to meet real or potential problems of students; and (3) Provide guidance for the health educator in planning the kind and the amount of emphasis within the total health education program.
The authors issued some recommendations for assessment of new radiopharmaceuticals (RP) at the stage of clinical trials. The most decisive thing is to determine the clinico-diagnostic efficacy of a radiopharmaceutical and its safety. Direct extrapolation of the results of experimental investigation of biodistribution of labeled compounds on man was shown to be fraught with serious errors. Differences in RP pharmacokinetics necessitate a planned, methodologically correct and clinically substantiated study of a RP in selected groups of patients taking into account the functional purpose of a drug. The assessment of RP quality is based upon a study of functional suitableness resulting from pharmacokinetic data and the determination of optimum methodological conditions and safety of a new RP, including the calculation of radiation a patient is exposed to during a diagnostic procedure. The stages of clinical trials are given in detail, their unification is aimed at raising their quality and improved clinical assessment of a RP.
This study describes women accused of setting fires in the City of New York who were evaluated between 1980 and 1983 at the Forensic Psychiatry Clinic for the New York Criminal and Supreme Courts. Consideration is given to their age, ethnicity, history of prior mental illness, abuse of controlled substances, economic status, family background, education, and employment. Their methodology, planning, and targeting for their firesetting behavior, as well as reported motivations for engaging in arson, are also considered.
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