Facets of the Evolving Healthcare Management Model

2022 ◽  
pp. 303-321
Author(s):  
Anastasius S. Moumtzoglou

The pandemic represents an opportunity to reimagine future healthcare and rethink healthcare management unbound by preconceived notions based on the following three main drivers that emerged during the pandemic. These include transformed business models, new care delivery models disrupted by ubiquitous data and technology, intelligent spaces, and digitally-enabled hospitality. In this context, it is imperative to reexamine all facets of healthcare management, considering that applying linear models to healthcare management has improved our understanding of their system structure and function. However, such models often fall short of explaining experimental results or predicting future abnormalities in complex nonlinear systems. Nonlinear models may better explain how the individual components collectively act and interact to produce a dynamic system in constant flux. They also assist in filling in some of the results which linear models do not adequately explain. Finally, chaos theory might provide new insights into standard as well as abnormal behavior within systems.

Author(s):  
Anastasius S. Moumtzoglou

The application of linear models to human systems and healthcare management and quality has improved our understanding of their system structure and function. However, such models often fall short of explaining experimental results or predicting future abnormalities in complex nonlinear systems which help in dissecting and analyzing individual system components. Nonlinear models may better explain how the individual components collectively act and interact to produce a dynamic system in constant flux. They also assist in filling in some of the results that are not adequately explained by linear models. In this context, we should consider the integration of linear and non-linear theories in healthcare quality and management, drawing the initial conditions of chaotic behavior from the standardization of the linear theory, and distinguishing between desirable and undesirable variation relegating statistical process control only to issues of high certainty regarding the outcome.


2005 ◽  
Vol 133 (9) ◽  
pp. 2552-2564 ◽  
Author(s):  
N. Andrew Crook ◽  
Donna F. Tucker

Abstract The flow past heated topography is examined with both linear and nonlinear models. It is first shown that the forcing of an obstacle with horizontally homogenous surface heating can be approximated by the forcing of an obstacle with surface heating isolated over the obstacle. The small-amplitude flow past an obstacle with isolated heating is then examined with a linear model. Under the linear approximation, the flow response to heated topography is simply the addition of the separate responses to thermal and orographic forcing. These separate responses are first considered individually and then the combined response is examined. Nondimensional parameters are developed that measure the relative importance of thermal and orographic forcing. Nonaxisymmetric forcing is then considered by examining the flow along and across a heated elliptically shaped obstacle. It is shown that the low-level lifting is maximized when the flow is along the major axis of the obstacle. The linear solutions are then tested in a nonlinear anelastic model. The response to a heat source and orography are first examined separately. Good agreement is found between nonlinear and linear models for the individual responses to thermal and orographic forcing. The case of uniformly heated flow past an obstacle is then examined. In these simulations, the thermal response is isolated by subtracting the orographic-only response from the full thermal–orographic response. The numerical simulations are able to capture the main features of the thermal response. Finally, numerical simulations of the flow along and across an elliptically shaped heated obstacle are examined, where it is verified that the lifting is maximized when the flow is along the major axis of the obstacle. These results are extended in Part II of this study to examine the moist convective response to flow over both idealized terrain and the complex terrain of the Rocky Mountains of the United States.


Moreana ◽  
2012 ◽  
Vol 49 (Number 187- (1-2) ◽  
pp. 207-226
Author(s):  
Marie-Claire Phélippeau

This study examines the notions of pleasure, individual liberty and consensus in Thomas More’s Utopia. The paradox inherent in Utopia, written before the Reformation, is especially visible in the affirmation of religious toleration coexisting with the need for a strict supervision of the citizens. The dream of an ideal republic is based on a Pauline vision of man which defines the individual mainly as a sinner. Consequently, it is the duty of the republic’s rulers to guide the citizens and establish a consensus. This study tries to determine the part left to the individual’s free will and examines the nature and function of the structures that are supposed to ensure the happiness of each one and of the whole community. The notion of moral hierarchy is asserted as the linchpin of the Utopian social construction.


2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Gerhard Johan Klopper ◽  
Oladele Vincent Adeniyi ◽  
Kate Stephenson

Abstract Background The larynx has multiple composite functions which include phonation, airway protection, and sensory control of respiration. Stenosis of the larynx and trachea were first recorded by O’Dwyer in 1885 and by Colles in 1886, respectively. Initially, the aetiology of laryngotracheal stenosis was predominantly infective. Currently, the leading cause is iatrogenic injury to the laryngotracheal complex secondary to prolonged ventilation in an intensive care unit. Main body Laryngotracheal stenosis is a complex and diverse disease. It poses a major challenge to the surgeon and can present as an airway emergency. Management typically demands the combined involvement of various disciplines including otorhinolaryngology, cardiothoracic surgery, anaesthesiology, interventional pulmonology, and radiology. Both the disease and its management can impact upon respiration, voice, and swallowing. The incidence of iatrogenic laryngotracheal stenosis has reflected the evolution of airway and intensive care whilst airway surgery has advanced concurrently over the past century. Correction of laryngotracheal stenosis requires expansion of the airway lumen; this is achieved by either endoscopic or open surgery. We review the relevant basic science, aetiopathogenesis, diagnosis, management, and treatment outcomes of LTS. Conclusion The choice of surgical procedure in the management of laryngotracheal stenosis is often dictated by the individual anatomy and function of the larynx and trachea, together with patient factors and available facilities. Regardless of how the surgeon chooses to approach these lesions, prevention of iatrogenic laryngotracheal damage remains of primary importance.


Author(s):  
Yan Wang ◽  
Feng Hao ◽  
Yunxia Liu

Population change and environmental degradation have become two of the most pressing issues for sustainable development in the contemporary world, while the effect of population aging on pro-environmental behavior remains controversial. In this paper, we examine the effects of individual and population aging on pro-environmental behavior through multilevel analyses of cross-national data from 31 countries. Hierarchical linear models with random intercepts are employed to analyze the data. The findings reveal a positive relationship between aging and pro-environmental behavior. At the individual level, older people are more likely to participate in environmental behavior (b = 0.052, p < 0.001), and at the national level, living in a country with a greater share of older persons encourages individuals to behave sustainably (b = 0.023, p < 0.01). We also found that the elderly are more environmentally active in an aging society. The findings imply that the longevity of human beings may offer opportunities for the improvement of the natural environment.


2021 ◽  
pp. 109442812199190
Author(s):  
Mikko Rönkkö ◽  
Eero Aalto ◽  
Henni Tenhunen ◽  
Miguel I. Aguirre-Urreta

Transforming variables before analysis or applying a transformation as a part of a generalized linear model are common practices in organizational research. Several methodological articles addressing the topic, either directly or indirectly, have been published in the recent past. In this article, we point out a few misconceptions about transformations and propose a set of eight simple guidelines for addressing them. Our main argument is that transformations should not be chosen based on the nature or distribution of the individual variables but based on the functional form of the relationship between two or more variables that is expected from theory or discovered empirically. Building on a systematic review of six leading management journals, we point to several ways the specification and interpretation of nonlinear models can be improved.


Author(s):  
Vladimir Shcherbakov ◽  
Galina Silkina

The customer-oriented approach is actively developing within the global trend of the modern industrial revolution that is Industry 4.0. The focus on customer interests has led to cooperation and integration in supply chains, improving their efficiency and increasing transparency, awareness, and trust. However, an issue emerging in this scenario is that conventional supply chain management (SCM) procedures are unable to identify the potential proposal for a particular user. Modern businesses need to build integrated supply chains, which require well-developed infrastructure and easily available complementary services, relying on logistics as a networking technology. Supply chains of this generation grow from traditional individual desynchronized economic relations (linear models with some feedback and the simplest network configurations) to scalable, adaptable, harmonized partner networks. The logistics potential allows additional income by reducing the total costs of participants in the network, thus increasing the competitiveness of companies; this can be implemented based on new models of interaction in the current digital environment through, firstly, system integration. Our goal consists of identifying the essential characteristics of system integration and substantiating the methods for its implementation in the digital economy. The study is based on the analysis of global best practices, considering the reports from leading consulting companies and competent analytical agencies. We have confirmed that the role of a virtual system integrator of supply chains belongs to logistics platforms; the effects of a transition to platform business models are discussed in detail.


1974 ◽  
Vol 186 (1083) ◽  
pp. 99-120 ◽  

Tissue was obtained from the testes of three men, two in the age range 72-75 years (subjects A and B) and one aged 25 years (subject C). Parts of the testes were dissected to obtain samples of interstitium and tubules. The individual components and whole tissue were each incubated with equimolar concentrations of [7 α - 3 H]pregnenolone and [4- 14 C]progesterone in Krebs-Ringer bicarbonate buffer pH 7.4, at 35 °C with the addition of glucose but without cofactors. Some incubations were carried out with the substrates [4- 14 C]androstenedione and [7 α - 3 H]testosterone. The media were extracted both at various time intervals throughout the incubation for a kinetic study of the metabolic activity and after a fixed interval of time at the end of the incubations. In some incubations with whole tissue both media and tissue were extracted. Both the tubules and interstitium displayed steroid metabolic activity. Qualitatively they yielded the same range of metabolites, one series leading to the formation of testosterone (∆ 5 pathway) and the other to a variety of C 21 compounds as represented by 5 α -pregnan-3 β -ol-20-one. With similar amounts of tissue there was little difference in the yields of the main products formed by the tubules as compared with those formed by the interstitium; in incubations with [4- 14 C]androstenedione the rate of conversion to [ 14 C ]testosterone by the tubules greatly exceeded that due to the interstitium. Marked differences were found in the pattern of steroid metabolism by whole tissue as compared to the general pattern presented by the corresponding tubules and interstitium. It is concluded that the seminiferous tubules and interstitium of the human testis are both capable of steroid metabolism and hence that whole tissue incubations alone are of limited value and could give rise to misleading data. Some clinical aspects of the results are briefly discussed.


2005 ◽  
Vol 16 (4) ◽  
pp. 1606-1616 ◽  
Author(s):  
David Michaelson ◽  
Wasif Ali ◽  
Vi K. Chiu ◽  
Martin Bergo ◽  
Joseph Silletti ◽  
...  

The CAAX motif at the C terminus of most monomeric GTPases is required for membrane targeting because it signals for a series of three posttranslational modifications that include isoprenylation, endoproteolytic release of the C-terminal– AAX amino acids, and carboxyl methylation of the newly exposed isoprenylcysteine. The individual contributions of these modifications to protein trafficking and function are unknown. To address this issue, we performed a series of experiments with mouse embryonic fibroblasts (MEFs) lacking Rce1 (responsible for removal of the –AAX sequence) or Icmt (responsible for carboxyl methylation of the isoprenylcysteine). In MEFs lacking Rce1 or Icmt, farnesylated Ras proteins were mislocalized. In contrast, the intracellular localizations of geranylgeranylated Rho GTPases were not perturbed. Consistent with the latter finding, RhoGDI binding and actin remodeling were normal in Rce1- and Icmt-deficient cells. Swapping geranylgeranylation for farnesylation on Ras proteins or vice versa on Rho proteins reversed the differential sensitivities to Rce1 and Icmt deficiency. These results suggest that postprenylation CAAX processing is required for proper localization of farnesylated Ras but not geranygeranylated Rho proteins.


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