Health Management Approach Research Articles

Value of Pharmacy Students Performing Population Management Activity Interventions as an Advanced Pharmacy Practice Experience

Objective. To assess the value of an advanced pharmacy practice experience in which students engaged in population health management (PHM) activities for a managed care setting. Methods. Students were provided with a list of patients, trained on the requirements for each PHM activity and completed them independently. The students reviewed the electronic record for each patient on their list to identify those who were non-adherent to dual antiplatelet therapy (DAPT) within one year of coronary stent placement, non-adherent to beta blockers (BB) within six months post-acute myocardial infarction, or with renal dysfunction and requiring dose adjustment of lipid-lowering therapy. Students coded each intervention based on predefined categories such as patient education, medication discontinuation, or medication reconciliation, and then if necessary were reviewed with the pharmacy preceptor. The primary investigator determined the intervention to be either actionable or non-actionable. The primary outcome was the proportion and type of interventions made by each student. The secondary outcome was clinical pharmacist time offset. A retrospective, data-only pilot study was conducted to determine the outcomes from the program over four years. Results. Forty-six students made 3,774 interventions over the study period, 37% of which were categorized as actionable. The most common actionable interventions were providing patient education (52%), verifying prescription adherence (23%), and medication therapy adjustment (10.5%). Over the study period, an estimated 765.6 hours of clinical pharmacist time was offset, or approximately 191.4 hours per academic year. Conclusion. This study demonstrated that a population health management approach can be used successfully within an APPE. This approach can result in offset pharmacist time for precepting organizations, while offering meaningful clinical interventions for patients and learning opportunities for students.

An evidence-based approach to health and safety management in megaprojects

With regard to the technical challenge on health and safety in megaprojects, this article puts forward a new evidence-based health and safety analysis (EHSA) approach in megaprojects. The purpose of the article is to initiate a conceptual EHSA framework to support evidence-based learning in practice-oriented research into large-scale complex health and safety management in megaprojects. The EHSA approach aims to find an innovative way to facilitate the collection of data and information from accumulated professional knowledge about accidents and failures as well as good practices and innovations, to derive useful lessons to inform improved practice in health and safety management in megaprojects. Through a scenario-based case study, this article will demonstrate how EHSA approach can effectively support health and safety management in megaprojects. It is expected that this article can make a good contribution to the body of knowledge by providing the new EHSA approach and a practice-oriented experimental case study on the use of EHSA approach for health and safety management in construction projects so as to inform future practice and research at strategic and tactic level.

Intensive Cardiac Rehabilitation: an Underutilized Resource.

To review evidence-based lifestyle modification strategies for secondary prevention and explore how they are incorporated in traditional cardiac rehabilitation (CR) and intensive cardiac rehabilitation (ICR) programs. While physical activity is an important element of cardiac rehabilitation, more recent studies support a variety of methods, including stress management and plant-based diets, to reduce cardiovascular risk factors. Patients who participate in traditional CR programs demonstrate clinical improvement, which are significantly greater in intensive CR (ICR). Yet, there is still a disparity in numbers between those who are eligible and those who ultimately enroll. Research into non-surgical and non-pharmacological health management approaches continues to validate the effectiveness of multidisciplinary intensive CR programs, but there is an increasing need to connect patients with these opportunities.

A Novel Machine Learning Method Based Approach for Li-Ion Battery Prognostic and Health Management

Safety accidents caused by Lithium-ion (Li-ion) batteries are numerous in recent years. Therefore, more and more attention has been drawn to the Remaining Useful Life (RUL) prediction and health status monitoring for Li-ion batteries. This paper proposes a deep learning method that combines the Forgetting Online Sequential Extreme Learning Machine (FOS-ELM) with the Hybrid Grey Wolf Optimizer (HGWO) algorithm and attention mechanism for the Prognostic and Health Management (PHM) of Li-ion battery. First, we use the Variational Mode Decomposition (VMD) to denoise the raw data before the training. Then the key parameters optimization of the FOS-ELM model based on the HGWO algorithm is introduced. Finally, we apply the attention mechanism to further improve the accuracy of the algorithm. Compared with traditional neural network methods, the method proposed in this paper has higher efficiency and accuracy.

An Unsupervised Reconstruction-Based Fault Detection Algorithm for Maritime Components

In recent years, the reliability and safety requirements of ship systems have increased drastically. This has prompted a paradigm shift toward the development of prognostics and health management (PHM) approaches for these systems’ critical maritime components. In light of harsh environmental conditions with varying operational loads, and a lack of fault labels in the maritime industry generally, any PHM solution for maritime components should include independent and intelligent fault detection algorithms that can report faults automatically. In this paper, we propose an unsupervised reconstruction-based fault detection algorithm for maritime components. The advantages of the proposed algorithm are verified on five different data sets of real operational run-to-failure data provided by a highly regarded industrial company. Each data set is subject to a fault at an unknown time step. In addition, different magnitudes of random white Gaussian noise are applied to each data set in order to create several real-life situations. The results suggest that the algorithm is highly suitable to be included as part of a pure data-driven diagnostics approach in future end-to-end PHM system solutions.

What Drives Young Vietnamese to Use Mobile Health Innovations? Implications for Health Communication and Behavioral Interventions.

BackgroundMobile phone use in Vietnam has become increasingly popular in recent years, with youth (people aged 15-24 years) being one of the groups with the heaviest use. Health-related apps on mobile phones (mobile health [mHealth] apps) appear to be a feasible approach for disease and health management, especially for self-management. However, there has been a scarcity of research on mobile phone usage for health care among youth and adolescents.ObjectiveThis study aims to identify the patterns of usage of mobile phone apps and the preferences for functionalities of mobile phone-based health-related apps among Vietnamese youth.MethodsAn online cross-sectional study was conducted in Vietnam in August to October 2015. Web-based respondent-driven sampling technique was adopted to recruit participants. The online questionnaire was developed and distributed using Google Forms. Chi square and Mann-Whitney tests were used to investigate the difference in attitude and preference for mobile phone apps between the two genders.ResultsAmong 356 youths (age from 15 to 25 years) sampled, low prevalence was found of using mHealth apps such as beauty counseling (6.5%, 23/356), nutrition counseling (7.9%, 28/356), disease prevention (9.8%, 35/356), and disease treatment (7.6%, 27/356). The majority of users found the app(s) they used to be useful (72.7%, 48/356) and reported satisfaction with these apps (61.9%, 39/356). No significant differences were found between the genders in their perception of the usefulness of apps and their satisfaction with mobile health apps. Most of the participants (68.2%, 238/356) preferred apps which are conceptualized and designed to run on a mobile phone compared to Web-based apps, and 50% (176/356) preferred visual materials. Approximately 53.9% (188/356) reported that it was integral for the mobile phone apps to have a sharing/social network functionality. Participants with a higher perceived stress score and EuroQol-5 Dimensions (EQ-5D) index were significantly less likely to use mHealth apps.ConclusionsThis study found a low proportion using mHealth-related mobile phone apps, but a high level of receptiveness and satisfaction among Vietnamese youth. Acceptance level and preferences toward mHealth apps as well as specifically preferred functionalities discovered in this study are essential not only in conceptualizing and developing appropriate mobile phone interventions targeting youth and adolescents, but also in the application of technically advanced solutions in disease prevention and health management.

New approach integrating the health, safety, and environment systems for the maintenance function in industries

Health, safety, and environment risk assessment, based on company quality, health, safety, and environment commitments, constitutes a precondition in the definition of the strategy to be adopted by the maintenance service. The imperfections of the knowledge; the disputes over opinions among decision-makers; and the absence of health, safety, and environment equipment risk assessment integrated models hinder the assessment of risk acceptability. In this article, we propose a health, safety, and environment risk management approach for the equipment maintenance. This approach expands the scope of action relative to the overall equipment risk-level assessment. It is based, on one hand, on fuzzy logic and, on the other hand, on two methods of decision-making support: the method of converting verbal judgments into numerical values and the pair comparison of decision criteria. This approach allows the maintenance service to implement a health, safety, and environment risk control policy for the most critical equipment. Therefore, it allows to improve the staff and product safety and to protect the environment in accordance with the strategic objectives.

Seroprevalence of brucellosis in Mississippi shelter dogs

Canine brucellosis is an emerging disease and compatible with a One Health management approach. Previous research has found higher prevalence of Brucella canis in stray dog populations than in owned animals, and shelter dogs may represent a zoonotic risk to pet owners. Dogs may also contract other Brucella spp., including Brucella suis, which is carried by some feral swine in the United States and poses a public health risk.Diagnostic tests for Brucella spp. are imperfect. Misclassification of disease status can result in serious repercussions for canine and human health including the unnecessary euthanasia of false positive dogs or failure to identify and remove false negative dogs from susceptible populations. Correct interpretation of any diagnostic test requires knowledge of the pre-test probability of disease in the population, therefore the objective of this cross-sectional study was to estimate the seroprevalence of B. canis and B. suis in Mississippi shelter dogs to guide evidence-based diagnostic testing and inform policy recommendations.Banked serum samples from 571 dogs collected in 2016–2017 as a representative sample of the Mississippi shelter dog population were tested for B. canis using a rapid slide agglutination test (RSAT) and for B. suis using a buffered acidified plate agglutination test. No dogs were seropositive for B. suis antibodies. Twenty-eight dogs (4.9%) were seropositive for B. canis antibodies on the RSAT, with 13 dogs (2.3%) remaining positive when retested with the addition of 2-mercaptoethanol to increase specificity. Test prevalence by shelter ranged from 0 to 8.6%. True prevalence was estimated using stochastic modeling to account for test performance and clustering of dogs by shelter. Approximately 65% of modeled shelters did not have seropositive dogs. For shelters where B. canis was present, the mean modeled seroprevalence was 17.8%.This cross-sectional study reveals important information regarding the distribution of B. canis seroprevalence in Mississippi shelter dogs. Current diagnostic tests lack the sensitivity needed to correctly identify individual infected dogs, but population testing may provide a reasonable estimate of disease. Eradication or control measures may be most efficiently allocated to shelters where canine brucellosis has been identified to effectively minimize transmission among dogs and to humans.

Expansion of Coproduction in Health Care as a Population Health Management Approach.

Expansion of Coproduction in Health Care as a Population Health Management Approach.

The role of small-holder seed supply in commercial mariculture in South-east Asia

Countries in South-east Asia are significant producers of aquacultured products and production is increasing. Seedstock for mariculture are provided from both wild capture (‘capture-based aquaculture’) and hatchery rearing (‘full-cycle aquaculture’). Collection of Palinurid lobster pueruli and juveniles is currently the sole source of seedstock for aquaculture. Other mariculture commodities, such as milkfish (Chanos chanos) and groupers (Family Serranidae, Sub-family Epinephelinae) are supported by a combination of wild-caught and hatchery-reared seedstock. Mariculture in South-east Asia is typified by low levels of vertical integration, and a high proportion of ‘small-scale’ hatcheries. In Indonesia, small-scale hatcheries are clustered in two main areas: Buleleng Regency in northern Bali and Situbondo in East Java, with small-scale hatcheries comprising 95% and 88% of hatcheries in each area respectively. Fingerling production from these hatcheries is considerable, with 7.3 million grouper and 2.5 billion milkfish fingerlings exported from Bali in 2016. Although several studies have quantitatively evaluated the benefits of small-scale hatcheries to local communities, scant attention has been paid to their regional impact. As an example, much of the global production of around 1 million tonnes per annum of milkfish is supported by fingerling production by small-scale hatcheries in Bali. Despite this acknowledged success, disease remains an ongoing problem for small-scale hatcheries with operators of grouper hatcheries in Bali categorising mortality and financial losses as ‘medium’ to ‘high’. A survey of small-scale hatcheries showed that biosecurity is poor and fish health management approaches are based on previous experience. Factors impacting these approaches include purchaser focus on price at the expense of quality, and limited numbers of hatchery staff with any formal aquaculture training. The impact of disease outbreaks remains a weakness for small-scale hatcheries, and consequently a weakness for the mariculture industries dependent on these as a seedstock source.

Temporal Gait Measures Associated With Overground and Treadmill Walking in Rett Syndrome.

Rett syndrome is a severe neurodevelopmental disorder leading to intellectual impairment and global developmental delays, including difficulty or inability to walk. Assessing differences in temporal parameters and associated variability between overground and treadmill walking is important if gait training is to be incorporated into intervention protocols. Fourteen female patients with Rett syndrome (mean age 10.4 years ± SD 5.1) were evaluated during overground and treadmill walking. Stride, stance, swing, and double support times, and the variance of these measures, were obtained. Wilcoxon signed-rank tests were used to assess for potential differences between overground and treadmill measures. Treadmill gait resulted in decreases in swing and double support times. When normalized to stride time, treadmill gait displayed an increase in stance time with decreases in swing and double support times. Excepting stance time, treadmill gait resulted in decreased variability, indicating a more regularized gait while walking on the treadmill. These results suggest that treadmill walking can be beneficial for ambulatory patients with Rett syndrome and could be incorporated into a therapeutic protocol designed to maintain the maximum degree of mobility and overall general health as part of a comprehensive health management approach.

Proton exchange membrane fuel cell remaining useful life prognostics considering degradation recovery phenomena

This work explores the challenges of handling the recovery phenomena in the degradation behavior of the proton exchange membrane fuel cells, from the perspective of the prognostics. An adaptive prognostics and health management approach with additional knowledge, such as the electrochemical impedance spectroscopy, from the state of health characterization, is applied on two fuel cell stacks under both stationary and quasi-dynamic operating regimes. Some improvements in the prognostic performance are obtained in the view of the remaining useful life predictions by comparing with a classical particle filtering–based prognostic approach.

Health and Safety at Work: Labour Security as a Primary Challenge for Human Security

The matter of accidents at work and occupational diseases falls within the aims of various EU and international rules. This is part of a more general interest of the International community, as well as of the European Union’s legislator and judge, for safety and health in the workplace. At this regard, the present paper aims at analyzing the capacity for the implementation and development of an occupational safety and health management approach at the international and European Union’s level. The analysis is conducted through the examination of the international and European legal framework governing the matter, as well as through the investigation of the most recent and relevant case law on accidents at work and occupational diseases. From this research an effort emerges, at the European and international level, to ensure safety and health standards. However, such efforts are inadequate with respect to a constantly changing labor market, characterized by less and less stable employment relationships, new working patterns and an ageing workforce. Neither are all the people concerned by those changes adequately covered by the existing health, safety and insurance legislation, as well as the increasing number of temporary workers and workers with atypical contracts.

REKOMENDASI MODEL PENINGKATAN KEPATUHAN PENGELOLAAN KESEHATAN PASIEN GAGAL GINJAL TERMINAL DI RSUD dr. H. MOH. ANWAR SUMENEP

Management of patients with end stage renal disease include physical therapy of the underlying disease, treatment of comorbid conditions, replace the renal function by renal replacement therapy. Compliance of health management on end stage renal diseases patients is required. Compliance consists of cognitive and psychomotor components. Cognitively, patient compliance involves understanding and ability to recall the information on medical advice. Compliance in hemodialysis patients affected by patient factors, health care systems and personel factor/provider.
 This study was observational design explanative aims to describe and analyzed the factors that affect the health management of compliance in patients with end stage renal disease. The population in this research was all patients with end stage renal disease who undergoing hemodialysis in the hemodialysis unit RSUD dr. H. Moh. Anwar Sumenep. Sampling technique used purposive sampling and obtained a sample of 32 patients in this study. Collecting data usedquestionnaires and was analyzed using partial least square (PLS). Measurement of inner model used to measure hypothesis with t statistic value > 1,96.
 The result showed that the t statistic value of patients factor was 1,989, health care system was 1,747 and provider factor was 2,933. The statistical result showed that factors of patient and personel factor/provider affected health management compliance.
 Improved health management compliance was required in patients with end stage renal disease, especially of patient factors required an understanding of the physical and psychological problems and patient motivation to comply. Enhanced compliance with health management approach based psychoeducation based on King interaction system will improve patient compliance of patients with end stage renal disease undergoing hemodialysis.

A similarity based prognostics approach for real time health management of electronics using impedance analysis and SVM regression

In electronic assemblies, interconnects provide connections between electrical components both mechanically and electrically. During their use conditions, interconnects encounter multiple stress conditions such as temperature extremes, corrosion, and vibration. When these stress conditions are applied repeatedly, interconnects may lose their functionality, and the assemblies may eventually fail during the operation. As the consequence of electronics failure becomes critical, the need for reliable interconnects will grow.This paper demonstrates a prognostic approach for predicting remaining lifetime of solder joints in real-time. During stress testing, impedance has been reported to respond to early stages of solder joint degradation in the form of non-linear increases. These early responses were trended using support vector machine and compared with real-time impedance measurements for solder joint remaining life prediction. To evaluate the prediction performance, the impedance of a degrading solder joint was collected during mechanical fatigue testing, and the proposed approach was applied in real-time. During fatigue testing, the proposed approach successfully predicted solder joint failures over multiple trials. These results imply this prognostic approach can be an effective means for real-time health management of electronics and can be applied to systems whose performance variable demonstrates gradual changes prior to their end of life.

Health Care Experiences of Korean Women Divers (Jeju Haenyeos).

Jeju haenyeos who enter the sea without equipment to collect seafood while holding their breath have a unique culture; however, studies of their health are limited. This study, using an ethnographic approach, explores how Jeju haenyeos have managed and maintained their health. Snowball sampling yielded 15 participants between July and October 2016. We collected data through participant observation and in-depth interviews and conducted Spradley's research sequence. The main theme of the health-management approach of these women was "a life of listening to the body and mind, controlling greed, and adjusting work for safe diving." However, Jeju haenyeos used preventive drugs and excessive doses of other drugs and lacked an understanding of the ways diverse drugs potentially interact. These findings suggest that community nurses should be cautious and should attempt to educate these patients.

A new complementary approach for oral health and diabetes management: health coaching

Health coaching (HC) is based on 'partnering with clients in a thought-provoking and creative process that inspires them to maximise their personal and professional potential' to adopt healthy lifestyles through 'building awareness and empowerment'. This study's objective is to assess, for the first time to our knowledge, the effectiveness of HC compared with health education (HE) using clinical and subjective measures among type 2 diabetes (DM2) patients in Turkey and Denmark. This stratified random prospective study selected type 2 diabetes patients in Turkey (n = 186) (TR) (2010-2012) and in Denmark (n = 116) (DK) (2012-2014). Participants were assigned to HC or HE groups. Selected outcomes were HbA1c, periodontal treatment need index (CPI), health behaviours and anthropometric measures. The study duration was 12 months (6 months initiation-maintenance, 6 months follow-up). At baseline, there were no statistically significant differences between the HC and HE groups. Post-intervention, a reduction of HbA1c in the HC groups was observed (TR: 0.8%; DK: 0.4%, P < 0.01) but not in the HE groups. The HC patients had a higher reduction in CPI than the HE group (P < 0.01). Principal component analysis showed that HbA1c, CPI and 'behaviour change' compose one cluster in the HCTR and HETR groups. Three clusters were formed for the HCDK; respectively HbA1c and CPI, lean mass and body fat percentage, 'behaviour change'. The results indicate that HC has a greater impact on DM management and health outcomes. There is a need for common health promotion strategies with behavioural interventions such as health coaching for the management of type 2 diabetes that focus on multidisciplinary approaches including oral health.

Supporting general practice to make timely decisions for better health care: a population health approach.

Primary Health Networks (PHNs) are tasked to enhance the efficiency and effectiveness of general practice. Gold Coast Primary Health Network (GCPHN) has been collecting de-identified aggregated clinical data from general practices and reporting back on areas for improvement on data coding and some clinical metrics, such as blood pressure not being recorded. However, aggregated data cannot be used to intervene at the individual patient level, and because of the collection-to-reporting time-lag, the data cannot help facilitate immediate action in the general practice. GCPHN developed a practice-based population health management approach based on mapping data from general practices to international coding classification systems, and applying evidenced-based algorithms and tools. General practices are provided with a health profile of their entire patient population, from the healthiest to the most complex comorbid patients. The information is conveyed as alerts and reports on areas including medication quality and safety, possible gaps in care and high-risk patients. The information is received based on the practice's preferences; this can be at the time of data entry, the following day or as specified. Strong clinical governance has ensured GCPHN's approach and methodologies are evidenced-based and appropriate. The consistent application of clinical governance within general practices is also needed to ensure the approach is sustainable and improves clinical outcomes.

INSURANCE AGAINST ACCIDENTS AT WORK AND OCCUPATIONAL DISEASES: THE EU REGULATION AND CASE LAW

The matter of accidents at work and occupational diseases, as the subject of insurance protection, falls within the aims of various EU rules. This is part of a more general interest of the European Union’s legislator and judges for safety and health in the workplace. In this regard, the present paper aims at analyzing the capacity for the implementation and development of an occupational safety and health management approach in the European Union. The analysis is conducted through the examination of the European legal framework governing the matter, as well as the most recent and relevant case law of the Court of Justice of the European Union on insurance and compensation of damages for accidents at work and occupational diseases. From this research an effort emerges, at the European level, to ensure safety and health standards. However, such efforts are inadequate with respect to a constantly changing labour market, characterized by less and less stable employment relationships, new working patterns and an ageing workforce. Nor are all the people concerned by those changes adequately covered by the existing health, safety and insurance legislation, as well as the increasing number of temporary workers and workers with atypical contracts.

The Views of Health Workforce Managers on the Implementation of Workload Indicators of Staffing Need (WISN) Method in Primary Healthcare Settings in South Africa

Background: Several African countries, including South Africa, are using the Workload Indicators of Staffing Need (WISN) method, as the preferred health workforce planning and management approach. Ineffective implementation of this method can however mean that health outcomes are not improved.Objectives: This study explored the views of health workforce managers regarding potential barriers and enablers to implementation of the WISN method in South African primary healthcare (PHC) settings.Method: This study adopted a qualitative approach and Grounded Theory research design. Following ethics clearance, a total of fourteen participants, PHC nurse managers and WISN coordinators were purposefully selected to participate in the study. Data were collected through focus group interviews and document analysis. Open, axial and selective coding was conducted to analyse data, including the use of Nvivo data analysis software to assist with the analysis.Findings: Participants in this study highlighted a number of conditions necessary for the successful implementation of the WISN method. These included political will and leadership, provision of necessary support to enable implementation process, collaborative and consultative approach by stakeholders, clear, efficient and consistent communication, resources availability, continued support in implementing WISN and stability in leadership and staff in PHC settings.Conclusions: The study concludes that successful WISN implementation requires addressing implementation barriers, such as unavailability of financial and human resources, and enhancing enablers, such as normative guides implementation guideline, technical capacity and availability of continuous support to implementers. This study’s results can be used to enhance WISN implementation and health systems strengthening.