A implementação do programa Gestão nota 10 no sistema municipal de educação em Mossoró/RN (2005 a 2009)

This research work is focused to show the changes in educational administration from the agreements between the Mossoró / RN and the Ayrton Senna Institute IAS, for education provision. Nowadays, the partnership policy is a constitutive element of the reform of the Brazilian State, which dropped its action on social policies and to strengthen its regulatory role, encouraging private participation in planning, preparation and implementation of public policies, new printing setting the political-social. In this context, the 10 Note Management Programme, developed by the IAS, is part of the neoliberal logic of modernization of public school systems, focusing on results and developing strategies for control and regulation of schools work and its efficiency, effectiveness and greater productivity. The 10 Note focuses on two dimensions: the management of learning and teaching in networking, in a managerial perspective to overcome the culture of failure (expressed as age-grade, dropout and repetition rates in) and implantation of culture of success (as measured in the improvement of the indices). To understanding the process, we have delimited as the object of study, the process of implementing them mentioned program in the city, which its objective is to analyze implications for the school community from the perspective of democratic management, adopting the dimensions of autonomy and participation in institutional processes as a criterion of analysis. From a methodological point of view, the survey was conducted from a literature review and documentary about educational policy developed in the country since the 1990´s, seeking to understand, in a dialectical perspective, the political dimensions of teaching, training and performance of the subjects involved in the school work. Besides the empirical observation, it was also used semi-structured interviews with a methodological tool for gathering information and opinions about the partnership and the implementation of the 10 Note Management Program in the county. The interviewee participants were ex-former education managers, coordinators, school managers, secretaries and teachers. Regarding the dimensions inside the analysis (autonomy and participation), the research led to the conclusion: that GEED, under the guidance of IAS promoted regulation of school autonomy, set up the selection process for exercising the office of school administration and system awards to schools, pupils and teachers, subject to results, there is mismatch between the managerial logic and the democratic management principles, that the ideological discourse of modernization of municipal management coexists with traditional practices, centralizing patronage, which ignores the democratic participation in the school decisions processes, the goals of the partnership were partially achieved, since that the city has improved over the approval and dropouts, although the approval of the Education Municipal Plan of the rules institutional (administrative, financial and educational) and the creation of the Councils observed that the school community participation is still limited, not being characterized as a coordinated intervention, capable of promoting the transformation and improvement its quality in the county. In the same way, the orientation of networking is a limit to the autonomy of schools, given the external definition of goals and strategies to be adopted, along with pressure exerted through the accountability of each school community for their achievements

Heart failure disease management program experience in 4,545 heart failure admissions to a community hospital

Background Disease management programs (DMPs) are developed to address the high morbi-mortality and costs of congestive heart failure (CHF). Most studies have focused on intensive programs in academic centers. Washington County Hospital (WCH) in Hagerstown, MD, the primary reference to a semirural county, established a CHF DMP in 2001 with standardized documentation of screening and participation. Linkage to electronic records and state vital statistics enabled examination of the CHF population including individuals participating and those ineligible for the program. Methods All WCH inpatients with CHF International Classification of Diseases, Ninth Revision code in any position of the hospital list discharged alive. Results Of 4,545 consecutive CHF admissions, only 10% enrolled and of those only 52.2% made a call. Enrollment in the program was related to: age (OR 0.64 per decade older, 95% CI 0.58-0.70), CHF as the main reason for admission (OR 3.58, 95% CI 2.4-4.8), previous admission for CHF (OR 1.14, 95% CI 1.09-1.2), and shorter hospital stay (OR 0.94 per day longer, 95% CI 0.87-0.99). Among DMP participants mortality rates were lowest in the first month (80/1000 person-years) and increased subsequently. The opposite mortality trend occurred in nonenrolled groups with mortality in the first month of 814 per 1000 person-years in refusers and even higher in ineligible (1569/1000 person-years). This difference remained significant after adjustment. Re-admission rates were lower among participants who called consistently (adjusted incidence rate ratio 0.62, 95% CI 0.52-0.77). Conclusion Only a small and highly select group participated in a low-intensity DMP for CHF in a community-based hospital. Design of DMPs should incorporate these strong selective factors to maximize program impact. (Am Heart J 2009; 15 8:459-66.)

Mise en place d'un programme de prévention et de prise en charge du diabète en Suisse: le point de vue des patients et des professionnels de la santé [Implementation of a diabetes disease management program in Switzerland: patients' and healthcare professionals' point of view].

BACKGROUND: A reorganization of healthcare systems is required to meet the challenge of the increasing prevalence of chronic diseases, e.g. diabetes. In North-America and Europe, several countries have thus developed national or regional chronic disease management programs. In Switzerland, such initiatives have only emerged recently. In 2010, the canton of Vaud set up the "Diabetes Cantonal Program", within the framework of which we conducted a study designed to ascertain the opinions of both diabetic patients and healthcare professionals on the elements that could be integrated into this program, the barriers and facilitators to its development, and the incentives that could motivate these actors to participate. METHODS: We organized eight focus-groups: one with diabetic patients and one with healthcare professionals in the four sanitary areas of the canton of Vaud. The discussions were recorded, transcribed and submitted to a thematic content analysis. RESULTS: Patients and healthcare professionals were rather in favour of the implementation of a cantonal program, although patients were more cautious concerning its necessity. All participants envisioned a set of elements that could be integrated to this program. They also considered that the program could be developed more easily if it were adapted to patients' and professionals' needs and if it used existing structures and professionals. The difficulty to motivate both patients and professionals to participate was mentioned as a barrier to the development of this program however. Quality or financial incentives could therefore be created to overcome this potential problem. CONCLUSION: The identification of the elements to consider, barriers, facilitators and incentives to participate to a chronic disease management program, obtained by exploring the opinions of patients and healthcare professionals, should favour its further development and implementation.

Predictors of Weight Loss Maintenance following an Insurance-Sponsored Weight Management Program

Intentional weight loss among overweight and obese adults (body mass index ≥ 25 kg/m2) is associated with numerous health benefits, but weight loss maintenance (WLM) following participation in weight management programming has proven to be elusive. Many individuals attempting to lose weight join formal programs, especially women, but these programs vary widely in focus, as do postprogram weight regain results. We surveyed 2,106 former participants in a community-based, insurance-sponsored weight management program in the United States to identify the pre, during, and post-intervention behavioral and psychosocial factors that lead to successful WLM. Of 835 survey respondents (39.6% response rate), 450 met criteria for inclusion in this study. Logistic regression analyses suggest that interventionists should assess and discuss weight loss and behavior change perceptions early in a program. However, in developing maintenance plans later in a program, attention should shift to behaviors, such as weekly weighing, limiting snacking in the evening, limiting portion sizes, and being physically active every day.

Managing the Brisbane River and Moreton Bay: an integrated research/management program to reduce impacts on an Australian estuary

The Brisbane River and Moreton Bay Study, an interdisciplinary study of Moreton Bay and its major tributaries, was initiated to address water quality issues which link sewage and diffuse loading with environmental degradation. Runoff and deposition of fine-grained sediments into Moreton Bay, followed by resuspension, have been linked with increased turbidity and significant loss of seagrass habitat. Sewage-derived nutrient enrichment, particularly nitrogen (N), has been linked to algal blooms by sewage plume maps. Blooms of a marine cyanobacterium, Lyngbya majuscula, in Moreton Bay have resulted in significant impacts on human health (e.g., contact dermatitis) and ecological health (e.g., seagrass loss), and the availability of dissolved iron from acid sulfate soil runoff has been hypothesised. The impacts of catchment activities resulting in runoff of sediments, nutrients and dissolved iron on the health of the Moreton Bay waterways are addressed. The Study, established by 6 local councils in association with two state departments in 1994, forms a regional component of a national and state program to achieve ecologically sustainable use of the waterways by protecting and enhancing their health, while maintaining economic and social development. The Study framework illustrates a unique integrated approach to water quality management whereby scientific research, community participation and the strategy development were done in parallel with each other. This collaborative effort resulted in a water quality management strategy which focuses on the integration of socioeconomic and ecological values of the waterways. This work has led to significant cost savings in infrastructure by providing a clear focus on initiatives towards achieving healthy waterways. The Study's Stage 2 initiatives form the basis for this paper.

Case Management Program for the Frail Elderly, June 2005

The Case Management Program for the Frail Elderly (CMPFE) is a coordinated comprehensive system that strives to provide Iowa’s frail elderly clients with the opportunity to make their own choices regarding long-term care and to receive services in the home and community setting.

Case Management Program For Frail Elders Manual, August 2008

The purpose of this manual is to guide operation of the Case Management Program for Frail Elders. After Background, Program Administration, Definitions, Consumer Eligibility, and Program Standards, the order follows the flow of a consumer entering the pro-gram from referral through ongoing case activities. The manual is written assuming the reader is the Case Manager. The effective date will appear in the bottom left hand corner of each page. This manual will be updated as needed via Iowa Aging Program Instructions (IAPI). This manual is used in conjunction with the Department of Human Services’ manuals which provide more detail about policies and procedures within the Medicaid elderly waiver program.

Medicaid Value Management Program SFY 2008 Report Executive Summary, 2007

In SFY 2007 the Medicaid Value Management program was developed under the direction of the Iowa Medicaid Director to establish a more comprehensive approach for improving the quality and value of medical services to Iowa Medicaid members. Medical services Unit provided the leadership for the program development and implementation.

Medicaid Value Management Program SFY 2008 Report Executive Summary, 2007

In June, 2007, the Commonwealth Fund released a report entitled, “Aiming Higher: Results from a State Scorecard on Health System Performance.” The report ranked states’ health care performance based upon four areas: access, quality, potentially avoidable use of hospitals and costs of care, and healthy lives. Iowa was ranked second overall and was the only state to rank in the top 25 percent on each of the four measures.1 Coupling the HEDIS measures and CAHPS survey results with the Commonwealth report outcomes provides additional information for determining how the state performs with regard to the health care system, in general, and the Medicaid program specifically. For the past five years the results of eight outcome measures encompassing children and adults, and preventive, chronic and acute care have been reported by the University of Iowa Public Policy Center (PPC). The PPC is the independent evaluator for the Medicaid managed care programs and assists the state in an effort to understand the process of care within the Medicaid program. Seven of the eight measures are recommended by the Centers for Medicare and Medicaid, while the eighth, annual dental visit, is used in recognition of the challenges found in providing dental care to Medicaid‐enrolled children and adults.

2013 Iowa DOT Engineering Intern Development and Management Program, 13-464, 2013

The Institute for Transportation (InTrans) at Iowa State University (ISU) developed an internship mentoring program in collaboration with the Iowa Department of Transportation (DOT) to provide additional mentorship to both student interns and Iowa DOT intern managers. For the summer 2013 Iowa DOT Engineering Intern Development and Management Program, this report summarizes the following: * Mentoring activities conducted by ISU; * Results of the different intern program success assessments that were conducted; * Experiences, lessons learned, and recommendations; * Program benefits that were realized.

Evaluation of a Mobile Rut Depth Device for the Pavement Management Program, HR-248, 1984

With inflation, there is no longer a completely adequate budget for highway construction and maintenance. Restricted budgets have generated development and implementation of pavement management programs. A need for management guidelines generated National Cooperative Highway Research Program Synthesis of Highway Practice 84, "Evaluation Criteria and Priority Setting for State Highway Programs". Traffic volumes and present conditions are two major factors in determining the priority of a proposed highway improvement. The Iowa DOT, Highway Division, Office of Materials has been conducting pavement condition inventory surveys on a three-year frequency since 1969 as input for pavement management. Development of substantial wheel rutting on paved roadways results in a potential hazard to highway safety. During periods of rain, these water-filled ruts may cause hydroplaning and loss of vehicle control. It is, therefore, imparitive that Iowa roadways be continually monitored for rut depths and further that this data be used in a pavement management program to determine priorities for rehabilitation or resurfacing.

Asset Management Program Enhancement Plan: Baseline Assessment Phases I and II, 2015

This project resulted in the development of a framework for making asset management decisions on low-volume bridges. The research focused on low-volume bridges located in the agricultural counties of Iowa because recent research has shown that these counties have the greatest percentage of structurally deficient bridges in the nation. Many of the same counties also have the highest crop yields in the state, creating a situation where detours caused by deficient bridges on farm-to-market roads increase the cost to transport the crops. Thus, the research proposed the use of social return on investment (SROI), a tool used by international institutions such as the World Bank, as an asset management metric to gauge to the socioeconomic impact of structurally deficient bridges on the state in an effort to provide quantified justification to fund improvements on low-volume assets such as these rural bridges. The study found that combining SROI with current asset management metrics like average daily traffic (ADT) made it possible to prioritize the bridges in such a way that the limited resources available are allocated in a manner that promotes a more equitable distribution and that directly benefits the user, in this case Iowa farmers. The result is a system that more closely aligns itself with the spirit of MAP-21, in that infrastructure investments are used to facilitate economic growth for Iowa’s agricultural economy.