Program plan recognition for year 2000 tools

There are many commercial tools that address various aspects of the Year 2000 problem. None of these tools, however, make any documented use of plan-based techniques for automated concept recovery. This implies a general perception that plan-based techniques is not useful for this problem. This paper argues that this perception is incorrect and these techniques are in fact mature enough to make a significant contribution. In particular, we show representative code fragments illustrating ``Year 2000'' problems, discuss the problems inherent in recognizing the higher level concepts these fragments implement using pattern-based and rule-based techniques, demonstrate that they can be represented in a programming plan framework, and present some initial experimental evidence that suggests that current algorithms can locate these plans in linear time. Finally, we discuss several ways to integrate plan-based techniques with existing Year 2000 tools

Will the Patient-Centered Medical Home Transform the Delivery of Health Care?

Explores various definitions of the medical home model, its components, rationale, effect on primary care, issues for implementation such as costs and payment methods, evidence of effectiveness, and healthcare reform provisions promoting it

Advancing Patient Safety in the U.S. Department of Veterans Affairs

As part of a systemwide transformation, the VA formed its National Center for Patient Safety to foster an organizational culture of safety within its nationwide network of hospitals and outpatient clinics. A recent medical team training program designed to improve communication among operating room staff was associated with a reduction in surgical mortality and improvements in quality of care, on-time surgery starts, and staff morale. The program is now being expanded to other clinical units, along with a patient engagement program that prevents errors by facilitating communication relating to patients' daily care plans. A recognition program stimulated facilities to conduct timelier and higher-quality root-cause analyses of reported safety events to identify stronger actions for preventing their recurrence. Other initiatives have reduced rates of health care -- associated infections, patient mortality, and post-operative complications. Success factors include leadership accountability for performance and organizational support for testing, expanding, and adopting improvements

Implementation of food waste composting in Malaysia

As urbanisation continues to occurring, waste management is becoming one of the major environmental problems around the world, including Malaysia. The generation of Municipal Solid Waste (MSW) in Malaysia has increased more than 91% over the past decades. Based on waste composition, food waste was indicated as the main waste component. Thus, recycling of food waste through composting had emerged as a potentially viable means that local governments can reduce the waste volume that is entering the landfills. Furthermore, MSW management in Malaysia can be considered as relatively poor and disorganized. The most preferred of MSW disposal method is through landfill due to various factors. This article elaborates on composting that gives benefits to Malaysian. This paper also exposes strategy to implement the composting in Malaysia by focusing on Food Waste Management Development Plan for the Industry, Commercial and Institution Sector. The current methods of food waste composting that are applied in Malaysia are also discussed in this paper. Finally, this paper reveals the challenges towards food waste composting in Malaysia

An interprofessional nurse-led mental health promotion intervention for older home care clients with depressive symptoms.

BackgroundDepressive symptoms in older home care clients are common but poorly recognized and treated, resulting in adverse health outcomes, premature institutionalization, and costly use of health services. The objectives of this study were to examine the feasibility and acceptability of a new six-month interprofessional (IP) nurse-led mental health promotion intervention, and to explore its effects on reducing depressive symptoms in older home care clients (≥ 70 years) using personal support services.MethodsA prospective one-group pre-test/post-test study design was used. The intervention was a six-month evidence-based depression care management strategy led by a registered nurse that used an IP approach. Of 142 eligible consenting participants, 98 (69%) completed the six-month and 87 (61%) completed the one-year follow-up. Outcomes included depressive symptoms, anxiety, health-related quality of life (HRQoL), and the costs of use of all types of health services at baseline and six-month and one-year follow-up. An interpretive descriptive design was used to explore clients', nurses', and personal support workers' perceptions about the intervention's appropriateness, benefits, and barriers and facilitators to implementation.ResultsOf the 142 participants, 56% had clinically significant depressive symptoms, with 38% having moderate to severe symptoms. The intervention was feasible and acceptable to older home care clients with depressive symptoms. It was effective in reducing depressive symptoms and improving HRQoL at six-month follow-up, with small additional improvements six months after the intervention. The intervention also reduced anxiety at one year follow-up. Significant reductions were observed in the use of hospitalization, ambulance services, and emergency room visits over the study period.ConclusionsOur findings provide initial evidence for the feasibility, acceptability, and sustained effects of the nurse-led mental health promotion intervention in improving client outcomes, reducing use of expensive health services, and improving clinical practice behaviours of home care providers. Future research should evaluate its efficacy using a randomized clinical trial design, in different settings, with an adequate sample of older home care recipients with depressive symptoms.Trial registrationClinicaltrials.gov identifier: NCT01407926

Organizing for Higher Performance: Case Studies of Organized Delivery Systems

Offers lessons learned from healthcare delivery systems promoting the attributes of an ideal model as defined by the Fund: information continuity, care coordination and transitions, system accountability, teamwork, continuous innovation, and easy access