953 resultados para MANAGEMENT OF HEALTH SERVICES


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This research shows that, to function effectively in a changing environment that includes the convergence of online learning and e-business, managers in the vocational education and training sector need an increasingly sophisticated conceptual framework and set of business skills that appropriately draw on contemporary business management theory and practice.

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This thesis explores the fault tolerance issues of web services computing and proposes a model for reliability of transaction-oriented web services applications.

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The Australian Government's current health reform agenda provides a timely opportunity to highlight the contribution of health psychology interventions in the prevention and management of chronic diseases associated with lifestyle risk factors. The World Health Organisation (2009) has identified the main risk factors responsible for deaths internationally as high blood pressure (responsible for 13% of deaths), tobacco use (9%), high blood sugar (6%), physical inactivity (6%), overweight and obesity (5%), high cholesterol (5%), unsafe sex (4%) and alcohol use (4%). A number of these factors also increase the risk of major chronic diseases - cardiovascular disease, diabetes and cancers. There is now a substantial evidence base for the effectiveness of health improvement interventions based on psychological theory, research and practice and hence they deserve a high level of recognition within systems for funding health. This article presents a summary of a systematic review of the evidence for the effectiveness of health psychology interventions in the prevention and treatment of chronic diseases associated with lifestyle risk factors.

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This thesis investigated the use of mindfulness as an intervention for children with ADHD. Findings indicate significant improvements in attentional, behavioural, and affective deficit symptoms following participation in a mindfulness-based intervention, demonstrating that mindfulness may be a worthwhile alternative or adjunct to ADHD treatment.

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Cloud computing is offering utility-oriented IT services to users worldwide. Based on a pay-as-you-go model, it enables hosting of pervasive applications from consumer, scientific, and business domains. However, data centers hosting Cloud applications consume huge amounts of energy, contributing to high operational costs and carbon footprints to the environment. Therefore, we need Green Cloud computing solutions that can not only save energy for the environment but also reduce operational costs. This paper presents vision, challenges, and architectural elements for energy-efficient management of Cloud computing environments. We focus on the development of dynamic resource provisioning and allocation algorithms that consider the synergy between various data center infrastructures (i.e., the hardware, power units, cooling and software), and holistically work to boost data center energy efficiency and performance. In particular, this paper proposes (a) architectural principles for energy-efficient management of Clouds; (b) energy-efficient resource allocation policies and scheduling algorithms considering quality-of-service expectations, and devices power usage characteristics; and (c) a novel software technology for energy-efficient management of Clouds. We have validated our approach by conducting a set of rigorous performance evaluation study using the CloudSim toolkit. The results demonstrate that Cloud computing model has immense potential as it offers significant performance gains as regards to response time and cost saving under dynamic workload scenarios.

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Aim. To identify life transitions likely to impact diabetes self-care among young adults with Type 1 diabetes and their coping strategies during transition events.
Background. Relationships among psychosocial stress, adjustment, coping and metabolic control affect clinical outcomes and mental health. Life transitions represent major change and are associated with stress that temporarily affects individuals’ problem-solving, coping abilities and blood glucose levels.
Design. A qualitative interpretive inquiry.
Method. Semi-structured interviews were conducted with 20 young adults with Type 1 diabetes and a constant comparative analysis method. Data and analysis was managed using QSR NVIVO 7 software.
Results. Participants identified two significant transition groups: life development associated with adolescence, going through the education system, entering new relationships, motherhood and the workforce and relocating. Diabetes-related transitions included being diagnosed, developing diabetes complications, commencing insulin pump treatment and going on diabetes camps. Participants managed transitions using ‘strategic thinking and planning’ with strategies of ‘self-negotiation to minimise risks’; ‘managing diabetes using previous experiences’; ‘connecting with others with diabetes’; ‘actively seeing information to ‘patch’ knowledge gaps’; and ‘putting diabetes into perspective’.
Conclusions. Several strategies are used to manage diabetes during transitions. Thinking and planning strategically was integral to glycaemic control and managing transitions. The impact of transitions on diabetes needs to be explored in larger and longitudinal studies to identify concrete strategies that assist diabetes care during life transitions.
Relevance to clinical practice. It is important for health professionals to understand the emotional, social and cognitive factors operating during transitions to assist young adults with Type 1 diabetes to achieve good health outcomes by prioritising goals and plan flexible, timely, individualised and collaborative treatment.

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Background: Despite the large volume of research dedicated to understanding chronic low back pain (CLBP), patient outcomes remain modest while healthcare costs continue to rise, creating a major public health burden. Health literacy - the ability to seek, understand and utilise health information - has been identified as an important factor in the course of other chronic conditions and may be important in the aetiology of CLBP. Many of the currently available health literacy measurement tools are limited since they measure narrow aspects of health literacy. The Health Literacy Measurement Scale (HeLMS) was developed recently to measure broader elements of health literacy. The aim of this study was to measure broad elements of health literacy among individuals with CLBP and without LBP using the HeLMS.
Methods: Thirty-six community-dwelling adults with CLBP and 44 with no history of LBP responded to the HeLMS. Individuals were recruited as part of a larger community-based spinal health study in Western Australia. Scores for the eight domains of the HeLMS as well as individual item responses were compared between the groups.
Results: HeLMS scores were similar between individuals with and without CLBP for seven of the eight health literacy domains (p > 0.05). However, compared to individuals with no history of LBP, those with CLBP had a significantly lower score in the domain ‘Patient attitudes towards their health’ (mean difference [95% CI]: 0.46 [0.11- 0.82]) and significantly lower scores for each of the individual items within this domain (p < 0.05). Moderate effect sizes ranged from d = 0.47-0.65.
Conclusions: Although no differences were identified in HeLMS scores between the groups for seven of the health literacy domains, adults with CLBP reported greater difficulty in engaging in general positive health behaviours. This aspect of health literacy suggests that self-management support initiatives may benefit individuals with CLBP.

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Issue addressed: Climate changes and environmental degradation caused by anthropogenic activities are having an irrefutable impact on human health. The critical role played by health promotion in addressing environmental challenges has a history in seminal charters − such as the Ottawa Charter for Health Promotion − that explicitly link human well-being with the natural environment. The lack of documented practice in this field prompted an investigation of health promotion practice that addresses climate change issues within health care settings.

Methods: This qualitative study involved five case studies of Victorian health care agencies that explicitly identified climate change as a priority. Individual and group interviews with ten health promotion funded practitioners as well as document analysis techniques were used to explore diverse practices across these rural, regional and urban health care agencies.

Results: Health promotion practice in these agencies was oriented toward: active and sustainable transport; healthy and sustainable food supply; mental health and community resilience; engaging vulnerable population groups such as women; and organisational development.

Conclusion: Despite differences in approach, target population and context, the core finding was that health promotion strategies, competencies and frameworks were transferable to action on climate change in these health care settings.

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It has been demonstrated that charge depletion (CD) energy management strategies are more efficient choices for energy management of plug-in hybrid electric vehicles (PHEVs). The knowledge of drive cycle as a priori can improve the performance of CD energy management in PHEVs. However, there are many noise factors which affect both drivetrain power demand and vehicle performance even in identical drive cycles. In this research, the effect of each noise factor is investigated by introducing the concept of power cycle instead of drive cycle for a journey. Based on the nature of the noise factors, a practical solution for developing a power-cycle library is introduced. Investigating the predicted power cycle, an energy management strategy is developed which considers the influence of temperature noise factor on engine performance. The effect of different environmental and geographic conditions, driver behavior, aging of battery and other components are considered. Simulation results for a modelled series PHEV similar to GM Volt show that the suggested energy management strategy based on the driver power cycle library improves both vehicle fuel economy and battery health by reducing battery load and temperature.

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Over time, the definition of prevention has expanded so that its meaning in the context of health services is now unclear. As risk factors are increasingly considered to be the equivalent of “diseases” for purposes of intervention, the concept of prevention has lost all practical meaning. This paper reviews the inconsistencies in its utility, and suggests principles that it should follow in the future: a population orientation with explicit consideration of attributable risk, the setting of priorities based on reduction in illness and avoidance of adverse effects, and the imperative to reduce inequities in health.

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The report shows that Australians generally have good health and are privileged to have a range of health care services available to them. There are stark exceptions to this that can be confronting—even if well-known already—notably the generally much poorer health status of Indigenous Australians.

Health care service provider and funding arrangements are both increasingly complex and increasingly costly to both individuals and taxpayers. A continuing challenge is how to balance both the complementary and competitive perspectives of government and non-government agencies, professional groups, and small businesses. Overall, national expenditure on health was 9.7% of GDP in 2003–04; and average health expenditure per person has grown by an average 3.8% each year between 1997–98 to 2002–03. Expenditure on aids and appliances, health research and pharmaceuticals contributed more to this growth than other areas.

While the ageing of the population is having a significant impact on the number and type of health care services delivered, high quality services for children continue to be a priority. Australia’s health 2006 has a special chapter focusing on children and their health. The chapter highlights the fact that while our children are generally very healthy, there are concerns that their ongoing health could be affected by more and more of them becoming overweight or obese. Levels of diabetes are now rising among our children and it is a continuing concern that asthma and mental health problems affect so many of them.

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Australia's Health is the most comprehensive and authoritative source of national information on health in Australia. Australia's Health is published mid-year in even-numbered years and provides national statistics and related information that form a record of health status, service provision and expenditure in Australia.

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It is paramount to provide seamless and ubiquitous access to rich contents available online to interested users via a wide range of devices with varied characteristics. Recently, a service-oriented content adaptation scheme has emerged to address this content-device mismatch problem. In this scheme, content adaptation functions are provided as services by third-party providers. Clients pay for the consumed services and thus demand service quality. As such, negotiating for the QoS offers, assuring negotiated QoS levels and accuracy of adapted content version are essential. Any non-compliance should be handled and reported in real time. These issues elevate the management of service level agreement (SLA) as an important problem. This chapter presents prior work, important challenges, and a framework for managing SLA for service-oriented content adaptation platform.

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Introduction: Clinical depression is highly prevalent yet underdetected and poorly managed within palliative care settings.

Objectives: This qualitative study explored the identification, monitoring, and management of symptoms of depression in patients receiving palliative care from 2 juxtaposed perspectives that are of care providers and care recipients' family members. Examining the barriers that restrict professional carers detecting and managing depression in their patients was a central focus of the study.

Methods: Focus groups were held with 18 professional carers, including 8 holding managerial positions, across 2 palliative care services, 1 regional and 1 metropolitan, which provided both inpatient and community-based care. Individual interviews were conducted with 10 family members of patients who had received or were receiving palliative care through these services.

Results: Thematic analysis of these data identified that both professional carers and family members perceived that depression is a wide-spread concern for patients receiving palliative care; however, numerous barriers were identified that affect professional carers’ ability to identify depression. These included knowledge and training deficits, low self-efficacy, prioritization of physical concerns and time constraints, patient/family characteristics, and system/process issues. These themes (and related subthemes) are discussed in this article.

Conclusions: Specialized training in depression is recommended for professional carers in order to improve their depression-related knowledge, detection skills, and self-efficacy. The ultimate goal of such training is to increase the rate of recognition of depression that in turn will lead to appropriate treatment for depressed patients.