One of the obstacles that arises in the generalization of Sturm's oscillation theorem to the case of general linear Hamiltonian systems is the need to associate a sign with each crossing point, ...necessitating a signed count rather than a direct count of such points. It's known, however, that this difficulty does not arise for all system/boundary-condition combinations, and so it can be overcome in some cases by exchanging one boundary condition for another while also keeping track of any ancillary counts that accompany the exchange. The primary tool for making such an exchange is Hörmander's index, and in this analysis we develop a straightforward method for computing Hörmander's index, and employ our method to formulate oscillation-type theorems for linear Hamiltonian systems on both bounded and unbounded intervals.
US benefit-cost analysis requires revision Howard, Peter H; Sarinsky, Max; Bauer, Michael ...
Science (American Association for the Advancement of Science),
05/2023, Letnik:
380, Številka:
6647
Journal Article
Purpose
The purpose of this paper is to report on the validation of a management competency assessment tool for health services managers (HSM), which resulted from the development and validation of ...the framework, addressed by a previous paper.
Design/methodology/approach
The management competency assessment tool (MCAP Tool) was validated using assessment data from a sample of 117 senior and middle managers working in two public hospitals and five community services in Victoria, Australia. The assessments were conducted between January 2013 and September 2014.
Findings
Both validity and reliability of the MCAP Tool were demonstrated.
Practical implications
The MCAP Tool has the potential to assist in the measurement of the competencies of HSM. Further research is required to determine if the framework and tool are applicable to HSM in other settings.
Originality/value
This is the first published study outlining the validity and reliability of an assessment tool to measure the management competencies of Australian health service managers.
Working with a general class of linear Hamiltonian systems specified on
R
, we develop a framework for relating the Maslov index to the number of eigenvalues the systems have on intervals of the form
...
λ
1
,
λ
2
)
and
(
-
∞
,
λ
2
)
. We verify that our framework can be implemented for Sturm–Liouville systems, fourth-order potential systems, and a family of systems nonlinear in the spectral parameter. The analysis is primarily motivated by applications to the analysis of spectral stability for nonlinear waves, and aspects of such analyses are emphasized.
Observational studies have identified surgical factors that are associated with a reduced risk of mortality after joint replacement. It is not clear whether these are causal or reflect patient ...selection. Data on the first primary hip (n = 424,156) and knee replacements (n = 469,989) performed for osteoarthritis in the National Joint Registry were analysed. Flexible parametric survival modelling was used to determine if risk factors for mortality in the perioperative period persisted. To explore selection bias, standardised mortality ratios were calculated for all-cause, respiratory and smoking related cancer mortality using population rates. Selection was apparent for hip resurfacing, combined spinal and general anaesthetic and unicondylar knee implants; reduced mortality was observed for many years for both all and other causes of mortality with a waning effect. Mechanical thromboprophylaxis was also suggestive of selection although patients receiving aspirin had sustained reduced mortality, possibly due to to a cardioprotective effect. Posterior approach for hips was ambiguous with a possible causal component. Spinal anaesthesia was suggestive of a causal effect. We are reliant on observational data when it is not feasible to undertake randomised trials. Our approach of looking at long term mortality risks for perioperative interventions provides further insights to differentiate causal interventions from selection. We recommend the use of aspirin chemothromboprophylaxis, the posterior approach and spinal anaesthetic in total hip replacement due to the apparent causal effect on reduced mortality.
Objective Ensuring sufficient qualified and experienced managers is difficult for public sector healthcare organisations in Australia, with a limited labour market and competition with the private ...sector for talented staff. Although both competency-based management and talent management have received empirical support in association with individual and organisational performance, there have been few studies exploring these concepts in the public healthcare sector. This study addresses this gap by exploring the perceived differences in demonstration of core competencies between average and higher-performing managers in public sector healthcare organisations. Methods Mixed methods were used to define and measure a set of competencies for health service managers. In addition, supervisors of managers were asked to identify the differences in competence between the average and high-performing managers reporting to them. Results Supervisors could clearly distinguish between average and higher-performing managers and identified related competencies. Conclusions The consistent pattern of competence among community health and hospital public sector managers demonstrated by this study could be used to develop a strategic approach to talent management for the public healthcare sector in Australia. What is known about this topic? Although there are validated competency frameworks for health service managers, they are rarely used in practice in Australia. What does this paper add? This paper illustrates the perceived differences in competencies between top and average health services managers using a validated framework. What are the implications for practitioners? The public health sector could work together to provide a more effective and efficient approach to talent management for public hospitals and community health services.
We examined the population dynamics of Salmonella enterica serovar Typhimurium during seasonal salmonellosis epidemics in New South Wales, Australia, during 2009-2016. Of 15,626 isolates, 5%-20% ...consisted of novel genotypes. Seasons with salmonellosis epidemics were associated with a reduction in novel genotypes in the preceding winter and spring.
Competent managers are essential to the productivity of organisations and the sustainability of health systems. Effective workforce development strategies sensitive to the current competency ...development needs of health service managers (HSMs) are required.
To conduct a 360° assessment of the competence of Australian HSMs to identify managerial competence levels, and training and development needs.
Assessment of 93 middle-level HSMs from two public hospitals (n = 25) and five community health services (CHS) (n = 68), using the Managerial Competency Assessment Partnership (MCAP) framework and tool, conducted between 2012 and 2014 in Victoria, Australia.
Mean competency scores from both self- and combined colleagues' assessments indicated competence (scores greater than five but less than six) without guidance, but many HSMs have not had extensive experience. Around 12% of HSMs were unable to demonstrate the competency of 'evidence-informed decision-making' and 4% of HSMs were unable to demonstrate the competency of 'enabling and managing change'.
The assessments confirmed managerial competence for the majority of middle-level HSMs from hospitals and CHS in Victoria, but found competency gaps. In addition, the assessment confirmed managerial strengths and weaknesses varied across management groups from different organisations. These findings suggest that the development of strategies to strengthen the health service management workforce should be multifaceted.
A focus on competency in performance evaluation and development using the MCAP framework and tool not only provides insights into performance of HSMs, but also has the potential to provide an organisation strategic advantage through succession planning and advancing managers' competence via learning needs analysis and targeted professional development. Linking competencies of HSMs to organisational objectives and strategies provides optimal use of the human resource capacity, improving the organisation's productivity and sustainability.
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